Helicobacter pylori infection increase the risk of subclinical hyperthyroidism in middle-aged and elderly women independent of dietary factors: Results from the Tianjin chronic low-grade systemic inflammation and health cohort study in China

Juanjuan Zhang; Xinghua Hai; Siyu Wang; Fan Zhu; Yeqing Gu; Ge Meng; Qing Zhang; Li Liu; Hongmei Wu; Shunming Zhang; Tingjing Zhang; Xing Wang; Shaomei Sun; Ming Zhou; Qiyu Jia; Kun Song; Kaijun Niu

doi:10.3389/fnut.2023.1002359

Helicobacter pylori infection increase the risk of subclinical hyperthyroidism in middle-aged and elderly women independent of dietary factors: Results from the Tianjin chronic low-grade systemic inflammation and health cohort study in China

Front Nutr. 2023 Mar 6:10:1002359. doi: 10.3389/fnut.2023.1002359. eCollection 2023.

Authors

Juanjuan Zhang¹, Xinghua Hai^{2

3}, Siyu Wang³, Fan Zhu¹, Yeqing Gu⁴, Ge Meng¹, Qing Zhang⁵, Li Liu⁵, Hongmei Wu¹, Shunming Zhang¹, Tingjing Zhang¹, Xing Wang⁵, Shaomei Sun⁵, Ming Zhou⁵, Qiyu Jia⁵, Kun Song⁵, Kaijun Niu^{1

3

4

5

6

7}

Affiliations

¹ Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
² First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
³ School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
⁴ Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China.
⁵ Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China.
⁶ Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
⁷ Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.

Abstract

Background: Prospective studies on the association between Helicobacter pylori (H. pylori) infection and subclinical hyperthyroidism are limited. We, therefore, designed a large-scale cohort study to explore the association between H. pylori infection and the risk of subclinical hyperthyroidism in women.

Methods: This prospective cohort study investigated 2,713 participants. H. pylori infection was diagnosed with the carbon 13 breath test. Subclinical hyperthyroidism was defined as serum thyroid-stimulating hormone levels are low or undetectable but free thyroxine and tri-iodothyronine concentrations are normal. Propensity score matching (PSM) analyses and Cox proportional hazards regression models were used to estimate the association between H. pylori infection and subclinical hyperthyroidism.

Results: A total of 1,025 PS-matched pairs of H. pylori infection women were generated after PSM. During 6 years of follow-up, the incidence rate of subclinical hyperthyroidism was 7.35/1,000 person-years. After adjusting potential confounding factors (including iodine intake in food and three main dietary patterns score), the multivariable hazard ratio (HR; 95% confidence intervals) of subclinical hyperthyroidism by H. pylori infection was 2.49 (1.36, 4.56). Stratified analyses suggested a potential effect modification by age, the multivariable HR (95% confidence intervals) was 2.85 (1.45, 5.61) in participants aged ≥ 40 years and 0.70 (0.08, 6.00) in participants aged < 40 years (P for interaction = 0.048).

Conclusion: Our prospective study first indicates that H. pylori infection is significantly associated with the risk of subclinical hyperthyroidism independent of dietary factors among Chinese women, especially in middle-aged and older individuals.Clinical Trial Registration:https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137, identifier UMIN000027174.

Keywords: Helicobacter pylori; cohort study; dietary factors; propensity score matching; subclinical hyperthyroidism.