Does iodine fortification affect the risk of atrial fibrillation in incident hyperthyroidism? A national register-based cohort
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Does iodine fortification affect the risk of atrial fibrillation in incident hyperthyroidism? A national register-based cohort. / Møllehave, Line T.; Knudsen, Nils; Prescott, Eva; Pedersen, Inge B.; Ravn-Haren, Gitte; Carlé, Allan; Linneberg, Allan.
I: Clinical Endocrinology, Bind 100, Nr. 5, 2024, s. 502-510.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Does iodine fortification affect the risk of atrial fibrillation in incident hyperthyroidism? A national register-based cohort
AU - Møllehave, Line T.
AU - Knudsen, Nils
AU - Prescott, Eva
AU - Pedersen, Inge B.
AU - Ravn-Haren, Gitte
AU - Carlé, Allan
AU - Linneberg, Allan
N1 - Publisher Copyright: © 2024 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.
PY - 2024
Y1 - 2024
N2 - Objective: Iodine fortification (IF) induces an initial increase followed by a decrease in the incidence of hyperthyroidism in the general population. Within the population of hyperthyroid patients, the sex-, age- and subtype distribution changes after IF. The risk of atrial fibrillation (AF) in hyperthyroid patients may be influenced by these factors. Therefore, we aimed to examine how the association between incident hyperthyroidism and AF was affected by IF increasing the population iodine intake from moderate-mild iodine deficiency to low adequacy. Design, Patients and Measurements: Incident hyperthyroid patients were included at the date of first inpatient or outpatient diagnosis, and AF diagnoses within 3 months before to 6 months after the index date were identified in Danish nationwide registers, 1997–2018. The relative risk (RR) of AF each calendar year (reference: 1997; IF introduced: 2000) was analyzed in Poisson regression models adjusted for age, sex, educational level, geographic region, and comorbidities. Results: Overall, in 62,201 patients with incident hyperthyroidism 7.9% were diagnosed with AF. There was a minor nonsignificantly increased risk of AF during the first years after IF followed by a gradual decrease to RR 0.76 (0.62–0.94) in 2017. There were no statistically significant differences in the development in the risk of AF by sex, age group, or geographic region. Conclusions: Results indicate that IF may reduce the risk of concomitant AF in hyperthyroid patients. If these results are confirmed, IF may not only reduce the population incidence of hyperthyroidism but also reduce the burden of morbidity in the remaining hyperthyroid patients.
AB - Objective: Iodine fortification (IF) induces an initial increase followed by a decrease in the incidence of hyperthyroidism in the general population. Within the population of hyperthyroid patients, the sex-, age- and subtype distribution changes after IF. The risk of atrial fibrillation (AF) in hyperthyroid patients may be influenced by these factors. Therefore, we aimed to examine how the association between incident hyperthyroidism and AF was affected by IF increasing the population iodine intake from moderate-mild iodine deficiency to low adequacy. Design, Patients and Measurements: Incident hyperthyroid patients were included at the date of first inpatient or outpatient diagnosis, and AF diagnoses within 3 months before to 6 months after the index date were identified in Danish nationwide registers, 1997–2018. The relative risk (RR) of AF each calendar year (reference: 1997; IF introduced: 2000) was analyzed in Poisson regression models adjusted for age, sex, educational level, geographic region, and comorbidities. Results: Overall, in 62,201 patients with incident hyperthyroidism 7.9% were diagnosed with AF. There was a minor nonsignificantly increased risk of AF during the first years after IF followed by a gradual decrease to RR 0.76 (0.62–0.94) in 2017. There were no statistically significant differences in the development in the risk of AF by sex, age group, or geographic region. Conclusions: Results indicate that IF may reduce the risk of concomitant AF in hyperthyroid patients. If these results are confirmed, IF may not only reduce the population incidence of hyperthyroidism but also reduce the burden of morbidity in the remaining hyperthyroid patients.
KW - atrial fibrillation
KW - epidemiology
KW - hyperthyroidism
KW - iodine
KW - registries
U2 - 10.1111/cen.15042
DO - 10.1111/cen.15042
M3 - Journal article
C2 - 38433726
AN - SCOPUS:85186887176
VL - 100
SP - 502
EP - 510
JO - Clinical Endocrinology
JF - Clinical Endocrinology
SN - 0300-0664
IS - 5
ER -
ID: 387438779