Hung-Sheng Huang1,2, Keng-Wei Lee3, Chung-Han Ho4,5, Chien-Chin Hsu1,6, Shih-Bin Su2,7,8, Jhi-Joung Wang4, Hung-Jung Lin9,10,11, Chien-Cheng Huang12,13,14,15,16. 1. Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan. 2. Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan. 3. Division of Cardiovascular Diseases, Department of Internal Medicine, Chi-Mei Medical Center, Chiali, Tainan, Taiwan. 4. Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan. 5. Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan. 6. Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan. 7. Department of Leisure, Recreation, and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan. 8. Department of Medical Research, Chi Mei Medical Center, Liouying, Tainan, Taiwan. 9. Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan. hjlin52@gmail.com. 10. Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan. hjlin52@gmail.com. 11. Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan. hjlin52@gmail.com. 12. Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan. chienchenghuang@yahoo.com.tw. 13. Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan. chienchenghuang@yahoo.com.tw. 14. Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan. chienchenghuang@yahoo.com.tw. 15. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan. chienchenghuang@yahoo.com.tw. 16. Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan. chienchenghuang@yahoo.com.tw.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors: Michelle Leemans; Stephan Couderq; Barbara Demeneix; Jean-Baptiste Fini Journal: Front Endocrinol (Lausanne) Date: 2019-12-09 Impact factor: 5.555