Increased risk for hypothyroidism after anticholinesterase pesticide poisoning: a nationwide population-based study

doi:10.1007/s12020-017-1373-7

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Title:	Increased risk for hypothyroidism after anticholinesterase pesticide poisoning: a nationwide population-based study
Authors:	Huang, Hung-Sheng Lee, Keng-Wei Ho, Chung-Han Hsu, Chien-Chin Su, Shih-Bin Wang, Jhi-Joung Lin, Hung-Jung Huang, Chien-Cheng
Contributors:	Chi Mei Med Ctr, Dept Emergency Med Chi Mei Med Ctr, Dept Occupat Med Chi Mei Med Ctr, Div Cardiovasc Dis, Dept Internal Med Chi Mei Med Ctr, Dept Med Res Chia Nan Univ Pharm & Sci, Dept Hosp & Hlth Care Adm Southern Taiwan Univ Sci & Technol, Dept Biotechnol Southern Taiwan Univ Sci & Technol, Dept Leisure Recreat & Tourism Management Chi Mei Med Ctr, Dept Med Res Taipei Med Univ, Dept Emergency Med Southern Taiwan Univ Sci & Technol, Bachelor Program Senior Serv Natl Cheng Kung Univ, Dept Environm & Occupat Hlth, Coll Med Chi Mei Med Ctr, Dept Geriatr & Gerontol
Keywords:	Anticholinesterase pesticide Hypothyroidism Poisoning
Date:	2017-09
Issue Date:	2018-11-30 15:51:02 (UTC+8)
Publisher:	Springer
Abstract:	Previous animal studies have reported that acute anticholinesterase pesticide (organophosphate and carbamate) poisoning may affect thyroid hormones. However, there is no human study investigating the association between hypothyroidism and anticholinesterase pesticide poisoning, and therefore, we conducted a retrospective nationwide population-based cohort study to delineate this issue. We identified 10,372 anticholinesterase pesticide poisoning subjects and matched 31,116 non-anticholinesterase pesticide poisoning subjects between 2003 and 2012 from the Nationwide Poisoning Database and the Longitudinal Health Insurance Database 2000, respectively, in a 1:3 ratio by index date, age, and sex for this study. We compared the cumulative incidence of hypothyroidism between the two cohorts by following up until 2013. Independent predictors for hypothyroidism were also investigated. In total, 75 (0.72%) anticholinesterase pesticide poisoning subjects and 184 (0.59%) non-anticholinesterase pesticide poisoning subjects were diagnosed with hypothyroidism during the follow-up. Cox proportional hazard regression analysis showed that anticholinesterase pesticide poisoning subjects had higher risk for hypothyroidism than did non-anticholinesterase pesticide poisoning subjects (adjusted hazard ratio: 1.47, 95% confidence interval: 1.11-1.95) after adjusting for age, sex, hypertension, malignancy, liver disease, renal disease, atrial fibrillation or flutter, thyroiditis, goiter, other endocrine disorders, and mental disorder. Stratified analysis showed that anticholinesterase pesticide poisoning subjects had higher risk for hypothyroidism than did non-anticholinesterase pesticide poisoning subjects in terms of the age subgroup of 40-64 years, female sex, past history of goiter, follow-up of < 1 month, and anticholinesterase pesticide poisoning subjects without atropine treatment (incidence rate ratio [IRR]: 1.66, 95% confidence interval: 1.20-2.30). Female sex, malignancy, renal disease, thyroiditis, goiter, mental disorder, and anticholinesterase pesticide poisoning without atropine treatment were independent predictors for hypothyroidism. Anticholinesterase pesticide poisoning is associated with increased risk for hypothyroidism. Early evaluation of thyroid function in anticholinesterase pesticide poisoning subjects is suggested, especially in subjects without atropine treatment, aged 40-64 years, female sex, and past history of goiter.
Relation:	Endocrine, v.57, n.3, pp.436-444
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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