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Horm Metab Res 2020; 52(09): 625-638
DOI: 10.1055/a-1199-2633
Review

Association Between Plasma Homocysteine Levels and Subclinical Hypothyroidism in Adult Subjects: A Meta-Analysis

Shou-Fa Zhang‡
1   Department of Internal Medicine, Shanghai Hudong Hospital, Shanghai, China
,
Li-Zhi Li‡
2   Department of Endocrinology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
,
Wei Zhang  ‡
3   Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
,
Jin-Rong Guo
4   Department of Pharmacy, Hekou District Hospital of Traditional Chinese Medicine, Dongying, China
,
Fang-Fang Liu
5   QiLu Children’s Hospital of Shandong University, Jinan, China
,
Kai Ma
5   QiLu Children’s Hospital of Shandong University, Jinan, China
,
Shao-Hua Chen
3   Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China
,
Ya-Qing Zhang
6   Medical College of Northwest Minzu University, Lanzhou, China
› Author Affiliations Funding Information This study was supported by the Natural Science Foundation under Grant No. ZR2009CQ023 and Medical Science Development Plan of Shandong Province under Grant No. 2009QZ025.
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Abstract

Increased plasma homocysteine (Hcy) levels have been widely documented in patients with overt hypothyroidism; however, the significance of Hcy level changes in patients with subclinical hypothyroidism (SCH) remains controversial. The aim of this meta-analysis was to determine the Hcy status in patients with SCH compared with euthyroid subjects. We searched PubMed, Embase, and Cochrane Library databases prior to December 2019 to identify eligible studies and assessed the quality of selected studies using the Newcastle-Ottawa Quality Assessment Scale. Publication bias was evaluated by Begg’s test and Egger’s test. Meta-regression analysis was conducted to investigate the source of heterogeneity. A likely source of heterogeneity was the year of the study. All statistical analyses were performed with RevMan 5.3 and Stata 12.0 software. Our meta-analysis of twelve observational studies with 684 patients showed that those with SCH aged between 18 and 65 years old were associated with a slightly increased plasma Hcy level compared with euthyroid controls. The pooled result of the weighted mean difference (WMD) of increased tHcy levels was 1.16 μmol/l (95% CI: 0.51, 1.82; p=0.0005). The Hcy level in patients with SCH aged between 18 and 65 years old is significantly increased compared to euthyroid controls.

Key words

Subclinical hypothyroidism - hyperhomocysteinemia - cardiovascular disease - meta-analysis


Publication History

Received: 08 May 2020

Accepted: 04 June 2020

Article published online:
06 July 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

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