Prevalence and Characteristics of Self-Reported Hypothyroidism and its Association with Non-Organ Specific Manifestations in US Sarcoidosis Patients: A Nationwide Registry Study

Abstract

Little is known about the prevalence, clinical characteristics and impact of hypothyroidism in patients with sarcoidosis. We aimed to determine the prevalence and clinical features of hypothyroidism and its relation to organ involvement and other clinical manifestations in patients with sarcoidosis.

We conducted a national registry-based study investigating 3835 respondents to the Sarcoidosis Advanced Registry for Cures Questionnaire between June 2014 and August 2019. This registry is based on a self-reported, web-based questionnaire that provides data related to demographics, diagnostics, sarcoidosis manifestations and treatment. We compared sarcoidosis patients with and without self-reported hypothyroidism. We used multivariable logistic regression and adjusted for potential confounders to determine the association of hypothyroidism with non-organ specific manifestations.

Fourteen-percent of the sarcoidosis patients self-reported hypothyroidism and were generally middle-aged white women. Hypothyroid patients had more comorbid conditions and were more likely to have multi-organ sarcoidosis involvement, especially with cutaneous, ocular, joints, liver and lacrimal glands involvement. Self-reported hypothyroidism was associated with depression (adjusted odds ratio (aOR)=1.3; 95% confidence interval (CI): 1.01–1.6), anti-depressants use (aOR=1.3; CI: 1.1–1.7), obesity (aOR=1.7; CI:1.4–2.1), sleep apnea (aOR=1.7; CI:1.3–2.2), chronic fatigue syndrome (aOR=1.5; CI:1.2–2) and was borderline associated with fibromyalgia (aOR=1.3; CI:1–1.8). Physical impairment was more common in patients with hypothyroidism.

Hypothyroidism is a frequent comorbidity in sarcoidosis patients that might be a potentially reversible contributor to fatigue, depression and physical impairment in this population. We recommend considering routine screening for hypothyroidism in sarcoidosis patients especially in those with multi-organ sarcoidosis, fatigue and depression.