AUTHOR=Zhang Juanjuan , Hai Xinghua , Wang Siyu , Zhu Fan , Gu Yeqing , Meng Ge , Zhang Qing , Liu Li , Wu Hongmei , Zhang Shunming , Zhang Tingjing , Wang Xing , Sun Shaomei , Zhou Ming , Jia Qiyu , Song Kun , Niu Kaijun 

TITLE=Helicobacter pylori infection increase the risk of subclinical hyperthyroidism in middle-aged and elderly women independent of dietary factors: Results from the Tianjin chronic low-grade systemic inflammation and health cohort study in China

JOURNAL=Frontiers in Nutrition

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2023.1002359

DOI=10.3389/fnut.2023.1002359

ISSN=2296-861X

ABSTRACT=<sec><title>Background</title><p>Prospective studies on the association between <italic>Helicobacter pylori</italic> (<italic>H. pylori</italic>) infection and subclinical hyperthyroidism are limited. We, therefore, designed a large-scale cohort study to explore the association between <italic>H. pylori</italic> infection and the risk of subclinical hyperthyroidism in women.</p></sec><sec><title>Methods</title><p>This prospective cohort study investigated 2,713 participants. <italic>H. pylori</italic> infection was diagnosed with the carbon 13 breath test. Subclinical hyperthyroidism was defined as serum thyroid-stimulating hormone levels are low or undetectable but free thyroxine and tri-iodothyronine concentrations are normal. Propensity score matching (PSM) analyses and Cox proportional hazards regression models were used to estimate the association between <italic>H. pylori</italic> infection and subclinical hyperthyroidism.</p></sec><sec><title>Results</title><p>A total of 1,025 PS-matched pairs of <italic>H. pylori</italic> infection women were generated after PSM. During 6 years of follow-up, the incidence rate of subclinical hyperthyroidism was 7.35/1,000 person-years. After adjusting potential confounding factors (including iodine intake in food and three main dietary patterns score), the multivariable hazard ratio (HR; 95% confidence intervals) of subclinical hyperthyroidism by H. pylori infection was 2.49 (1.36, 4.56). Stratified analyses suggested a potential effect modification by age, the multivariable HR (95% confidence intervals) was 2.85 (1.45, 5.61) in participants aged ≥ 40 years and 0.70 (0.08, 6.00) in participants aged &lt; 40 years (P for interaction = 0.048).</p></sec><sec><title>Conclusion</title><p>Our prospective study first indicates that <italic>H. pylori</italic> infection is significantly associated with the risk of subclinical hyperthyroidism independent of dietary factors among Chinese women, especially in middle-aged and older individuals.</p><p><bold>Clinical Trial Registration:</bold><ext-link xlink:href="https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137" ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink">https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137</ext-link>, identifier UMIN000027174.</p></sec>