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Meta-Analysis
. 2023 Mar 17;102(11):e33301.
doi: 10.1097/MD.0000000000033301.

Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

Yunmeng Wang  1 , Chaowei Ding  2 , Chang Guo  2 , Jingru Wang  1 , Suyun Liu  1
Affiliations
Meta-Analysis

Association between thyroid dysfunction and venous thromboembolism: A systematic review and meta-analysis

Yunmeng Wang et al. Medicine (Baltimore). .

Abstract

Background: Thyroid dysfunction plays an important role in the development of cardiovascular disease. However, its relationship with venous thromboembolism (VTE) remains unclear. We performed a meta-analysis of published cohort and case-control studies to investigate the association between thyroid dysfunction and VTE comprehensively.

Methods: Three reviewers independently searched EMbase, PubMed, China national knowledge infrastructure, and Cochrane Library databases for relevant articles from the time of database establishment to 01 October 2022 and identified all studies on thyroid dysfunction and VTE as studies of interest. Of the 2418 publications retrieved, we identified 10 articles with 15 studies that met our selection criteria. Pooled ORs and 95% confidence intervals were calculated using fixed- or random-effect models.

Results: We pooled 8 studies by a fixed-effect model, which suggested an increased risk of VTE in patients with (subclinical) hyperthyroidism (OR 1.33, 95% CI: 1.29-1.38). In the other 7 studies on patients with (subclinical) hypothyroidism, the risk was similarly increased when pooled by a random-effect model (OR 1.52, 95% CI: 1.23-1.89). After sensitivity analysis and risk of bias analysis, the risk of VTE was still increased in both (subclinical) hyperthyroidism (OR 1.322, 95% CI: 1.278-1.368) and (subclinical) hypothyroidism (OR 1.74, 95% CI: 1.41-2.16).

Conclusion: Patients with thyroid dysfunction have an increased risk of VTE. Therefore, it is recommended to perform thyroid function screening routinely in patients at high risk of VTE.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Flow chart of study selection.
Figure 2.
Figure 2.
Forest plot of (subclinical) hyperthyroidism and risk of VTE for all included studies (fixed effect model). VTE = venous thromboembolism.
Figure 3.
Figure 3.
The sensitivity analysis of (subclinical) hyperthyroidism and risk of VTE for all included studies. VTE = venous thromboembolism.
Figure 4.
Figure 4.
The funnel plot of (subclinical) hyperthyroidism and risk of VTE for all included studies. VTE = venous thromboembolism.
Figure 5.
Figure 5.
Funnel plots following trim-and-fill.
Figure 6.
Figure 6.
Forest plot of (subclinical) hypothyroidism and risk of VTE for all included studies(random effect model). VTE = venous thromboembolism.
Figure 7.
Figure 7.
The sensitivity analysis of (subclinical) hypothyroidism and risk of VTE for all included studies. VTE = venous thromboembolism.
Figure 8.
Figure 8.
The funnel plot of (subclinical) hypothyroidism and risk of VTE for all included studies. VTE = venous thromboembolism.
See this image and copyright information in PMC

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