Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis

Justin Oldham, Disha Kumar, Cathryn Lee, Shruti B. Patel, Stephenie Takahashi-Manns, Carley Demchuk, Mary E. Strek, Imre Noth

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

BACKGROUND: A significant minority of patients with idiopathic pulmonary fibrosis (IPF) display features of autoimmunity without meeting the criteria for overt connective tissue disease. A link between IPF and other immune-mediated processes, such as hypothyroidism (HT), has not been reported. In this investigation, we aimed to determine whether HT is associated with IPF and if outcomes differ between patients with IPF with and without HT. METHODS: A retrospective case-control analysis was conducted. Of 311 patients referred to the University of Chicago Interstitial Lung Disease Center with an initial diagnosis of IPF, 196 met the inclusion criteria and were included in the final analysis. Each case was matched 1:1 by age, sex, and race to a control subject with COPD. RESULTS: HT was identified in 16.8% of cases and 7.1% of control subjects (OR, 2.7; 95% CI, 1.31-5.54; P =.01). Among patients with IPF, HT was associated with reduced survival time ( P < .001) and was found to be an independent predictor of mortality in multivariable Cox regression analysis (hazard ratio, 2.12; 95% CI, 1.31-3.43; P = .002). A secondary analysis of two IPF clinical trial datasets supports these findings. CONCLUSIONS: HT is common among patients with IPF, with a higher prevalence than in those with COPD and the general population. The presence of HT also predicts mortality in IPF, a finding that may improve future prognostication models. More research is needed to determine the biologic link between IPF and HT and how the presence of thyroid disease may influence disease progression.

Original languageEnglish (US)
Pages (from-to)692-700
Number of pages9
JournalChest
Volume148
Issue number3
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

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Idiopathic Pulmonary Fibrosis
Thyroid Diseases
Hypothyroidism
Survival
Chronic Obstructive Pulmonary Disease
Connective Tissue Diseases
Mortality
Interstitial Lung Diseases
Autoimmunity
Disease Progression
Regression Analysis
Clinical Trials

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Oldham, J., Kumar, D., Lee, C., Patel, S. B., Takahashi-Manns, S., Demchuk, C., ... Noth, I. (2015). Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis. Chest, 148(3), 692-700. https://doi.org/10.1378/chest.14-2714

Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis. / Oldham, Justin; Kumar, Disha; Lee, Cathryn; Patel, Shruti B.; Takahashi-Manns, Stephenie; Demchuk, Carley; Strek, Mary E.; Noth, Imre.

In: Chest, Vol. 148, No. 3, 01.09.2015, p. 692-700.

Research output: Contribution to journalArticle

Oldham, J, Kumar, D, Lee, C, Patel, SB, Takahashi-Manns, S, Demchuk, C, Strek, ME & Noth, I 2015, 'Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis', Chest, vol. 148, no. 3, pp. 692-700. https://doi.org/10.1378/chest.14-2714
Oldham, Justin ; Kumar, Disha ; Lee, Cathryn ; Patel, Shruti B. ; Takahashi-Manns, Stephenie ; Demchuk, Carley ; Strek, Mary E. ; Noth, Imre. / Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis. In: Chest. 2015 ; Vol. 148, No. 3. pp. 692-700.
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N2 - BACKGROUND: A significant minority of patients with idiopathic pulmonary fibrosis (IPF) display features of autoimmunity without meeting the criteria for overt connective tissue disease. A link between IPF and other immune-mediated processes, such as hypothyroidism (HT), has not been reported. In this investigation, we aimed to determine whether HT is associated with IPF and if outcomes differ between patients with IPF with and without HT. METHODS: A retrospective case-control analysis was conducted. Of 311 patients referred to the University of Chicago Interstitial Lung Disease Center with an initial diagnosis of IPF, 196 met the inclusion criteria and were included in the final analysis. Each case was matched 1:1 by age, sex, and race to a control subject with COPD. RESULTS: HT was identified in 16.8% of cases and 7.1% of control subjects (OR, 2.7; 95% CI, 1.31-5.54; P =.01). Among patients with IPF, HT was associated with reduced survival time ( P < .001) and was found to be an independent predictor of mortality in multivariable Cox regression analysis (hazard ratio, 2.12; 95% CI, 1.31-3.43; P = .002). A secondary analysis of two IPF clinical trial datasets supports these findings. CONCLUSIONS: HT is common among patients with IPF, with a higher prevalence than in those with COPD and the general population. The presence of HT also predicts mortality in IPF, a finding that may improve future prognostication models. More research is needed to determine the biologic link between IPF and HT and how the presence of thyroid disease may influence disease progression.

AB - BACKGROUND: A significant minority of patients with idiopathic pulmonary fibrosis (IPF) display features of autoimmunity without meeting the criteria for overt connective tissue disease. A link between IPF and other immune-mediated processes, such as hypothyroidism (HT), has not been reported. In this investigation, we aimed to determine whether HT is associated with IPF and if outcomes differ between patients with IPF with and without HT. METHODS: A retrospective case-control analysis was conducted. Of 311 patients referred to the University of Chicago Interstitial Lung Disease Center with an initial diagnosis of IPF, 196 met the inclusion criteria and were included in the final analysis. Each case was matched 1:1 by age, sex, and race to a control subject with COPD. RESULTS: HT was identified in 16.8% of cases and 7.1% of control subjects (OR, 2.7; 95% CI, 1.31-5.54; P =.01). Among patients with IPF, HT was associated with reduced survival time ( P < .001) and was found to be an independent predictor of mortality in multivariable Cox regression analysis (hazard ratio, 2.12; 95% CI, 1.31-3.43; P = .002). A secondary analysis of two IPF clinical trial datasets supports these findings. CONCLUSIONS: HT is common among patients with IPF, with a higher prevalence than in those with COPD and the general population. The presence of HT also predicts mortality in IPF, a finding that may improve future prognostication models. More research is needed to determine the biologic link between IPF and HT and how the presence of thyroid disease may influence disease progression.

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