https://doi.org/10.4081/monaldi.2024.2956
Hormonal harmony disrupted: hypothyroidism and diabetes mellitus in interstitial lung disease. An observational study
Submitted: February 13, 2024
Accepted: April 24, 2024
Published: July 23, 2024
Accepted: April 24, 2024
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are chronic respiratory diseases that affect the lungs and airways. ILD encompasses approximately 200 different conditions with known and unknown causes. Various comorbidities, such as cardiovascular, psychological, obstructive sleep apnea, and gastrointestinal disorders, are often associated with them. However, little is known about the relationship and prevalence of hypothyroidism and diabetes mellitus (DM) in ILD and COPD. Therefore, understanding these connections is crucial for proper treatment. This cross-sectional, prospective observational study was conducted at a tertiary care hospital in North India. After obtaining informed consent, we consecutively enrolled 100 patients with ILD and 100 patients with COPD who reported to the Respiratory Medicine Outpatient Department. We collected demographic, clinical, and medical data from the patients and conducted appropriate statistical analysis to determine the prevalence of hypothyroidism and DM in patients with ILD. ILD patients exhibit a significantly higher prevalence of hypothyroidism (24% versus 4%) and DM (24% versus 4%) compared to those with COPD (p<0.05). Additionally, the study showed that ILD patients also had a significantly higher prevalence of self-reported gastroesophageal reflux disease (30%), had a higher body mass index, and consulted a pulmonologist earlier than COPD patients after the onset of symptoms (p<0.05). Therefore, it is important to screen for hypothyroidism and DM in ILD patients due to their high prevalence and potential impact on disease progression and management. Additionally, evidence suggests a bidirectional relationship between these conditions, making it essential to screen patients with hypothyroidism and DM for ILD if there is any suspicion. These screening measures could contribute to the early detection and management of these comorbidities, thereby improving the overall outcome for ILD patients.
GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990- 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020;396:1204-22.
DOI: https://doi.org/10.1016/S0140-6736(20)30925-9
Syamlal GBA, Dodd KE. Medical expenditures attributed to asthma and chronic obstructive pulmonary disease among workers- United States, 2011-2015. MMWR Morb Mortal Wkly Rep 2020;69:809-14.
DOI: https://doi.org/10.15585/mmwr.mm6926a1
Global strategy for the diagnosis, management, and prevention of COPD. Global initiative for chronic obstructive lung disease (GOLD) 2023. Available from: http://goldcopd.org. Accessed on: 30/12/2023.
Ryerson CJ, Arean PA, Berkeley J, et al. Depression is a common and chronic comorbidity in patients with interstitial lung disease. Respirology 2012;17:525-32.
DOI: https://doi.org/10.1111/j.1440-1843.2011.02122.x
Du Bois RM. An earlier and more confident diagnosis of idiopathic pulmonary fibrosis. Eur Respir Rev 2012;21:141-6.
DOI: https://doi.org/10.1183/09059180.00000812
Raghu G, Chen SY, Hou Q, et al. Incidence and prevalence of idiopathic pulmonary fibrosis in US adults 18–64 years old. Eur Respir J 2016;48:179-86.
DOI: https://doi.org/10.1183/13993003.01653-2015
Raghu G, Remy Jardin M, Myers JL, et al. Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 2018;198:e44 68.
DOI: https://doi.org/10.1164/rccm.201807-1255ST
Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013;188:733-48.
DOI: https://doi.org/10.1164/rccm.201308-1483ST
Garber JR, Cobin RH, Gharib H, et al. Clinical practice guidelines for hypothyroidism in adults. Endocr Pract 2012;18:988-1028.
DOI: https://doi.org/10.4158/EP12280.GL
ElSayed NA, Aleppo G, Aroda VR, et al. Classification and diagnosis of diabetes: standards of care in diabetes-2023. Diabetes Care 2023;46:S19-40.
DOI: https://doi.org/10.2337/dc23-S002
Jones R, Junghard O, Dent J, et al. Development of the GERDQ, a tool for the diagnosis and management of gastroesophageal reflux disease in primary care. Aliment Pharmacol Ther 2009;30:1030-8.
DOI: https://doi.org/10.1111/j.1365-2036.2009.04142.x
Nutritional anemias. Report of a WHO Scientific Group. World Health Organization Tech Rep Ser 1968:45:5-37.
Frost A, Badesch D, Gibbs JSR, et al. Diagnosis of pulmonary hypertension. Eur Respir J 2019;53:1801904.
DOI: https://doi.org/10.1183/13993003.01904-2018
Kanis JA. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 1994;4:368-81.
DOI: https://doi.org/10.1007/BF01622200
Snaith RP, Zigmond AS. The hospital anxiety and depression scale. Br Med J 1986;292:344.
DOI: https://doi.org/10.1136/bmj.292.6516.344
Dhooria S, Sehgal IS, Agarwal R, et al. (2022) Incidence, prevalence, and national burden of interstitial lung diseases in India: estimates from two studies of 3089 subjects. PLoS One 17:e0271665.
DOI: https://doi.org/10.1371/journal.pone.0271665
Oldham JM, Kumar D, Lee C, et al. Thyroid disease is prevalent and predicts survival in patients with idiopathic pulmonary fibrosis. Chest 2015;148:692-700.
DOI: https://doi.org/10.1378/chest.14-2714
Rajpoot A, Garg K, Saini V, Gupta N. Psychological morbidity in interstitial lung disease: a study from India. Monaldi Arch Chest Dis 2020;90:1434.
DOI: https://doi.org/10.4081/monaldi.2020.1434
Hill J, Harrison J, Christian D, et al. The prevalence of comorbidity in rheumatoid arthritis: a systematic review and meta-analysis. Br J Community Nurs 2022;27:232-41.
DOI: https://doi.org/10.12968/bjcn.2022.27.5.232
Smith MC, Wrobel JP. Epidemiology and clinical impact of major comorbidities in patients with COPD. Int J Chron Obstruct Pulmon Dis 2014;9:871-88.
DOI: https://doi.org/10.2147/COPD.S49621
Alzghoul BN, Amer FN, Barb D, et al. Prevalence and characteristics of self-reported hypothyroidism and its association with non-organ-specific manifestations in US sarcoidosis patients: a nationwide registry study. ERJ Open Res 2021;7:00754-2020.
DOI: https://doi.org/10.1183/23120541.00754-2020
Suga T, Sugiyama Y, Kitamura S. Clinical study of patients with idiopathic interstitial pneumonia accompanied by diabetes mellitus. Nihon Kyobu Shikkan Gakkai Zasshi 1994;32:1131-5. [Article in Japanese].
George JT, Thow JC, Rodger KA, et al. Reversibility of fibrotic appearance of lungs with thyroxine replacement therapy in patients with severe hypothyroidism. Endocr Pract 2009;15:720-4.
DOI: https://doi.org/10.4158/EP09021.CRR
Bagnato G, Bitto A, Irrera N, et al. Propylthiouracil prevents cutaneous and pulmonary fibrosis in the reactive oxygen species murine model of systemic sclerosis. Arthritis Res Ther 2013;15:R120. Erratum in: Arthritis Res Ther 2014;16:406. Retraction in: Arthritis Res Ther 2022;24:272.
DOI: https://doi.org/10.1186/s13075-022-02973-w
Bruck R, Weiss S, Traister A, et al. Induced hypothyroidism accelerates the regression of liver fibrosis in rats. J Gastroenterol Hepatol 2007;22:2189-94.
DOI: https://doi.org/10.1111/j.1440-1746.2006.04777.x
Herazo-Maya JD, Noth I, Duncan SR, et al. Peripheral blood mononuclear cell gene expression profiles predict poor outcomes in idiopathic pulmonary fibrosis. Sci Transl Med 2013;5:205ra136.
DOI: https://doi.org/10.1126/scitranslmed.3005964
Kim SY, Yoo CG, Lee CT, et al. Incidence and risk factors of steroid-induced diabetes in patients with respiratory disease. J Korean Med Sci 2011;26:264-7.
DOI: https://doi.org/10.3346/jkms.2011.26.2.264
Kopf S, Groener JB, Kender Z, et al. Breathlessness and restrictive lung disease: an important diabetes-related feature in patients with type 2 diabetes. Respiration 2018;96:29-40.
DOI: https://doi.org/10.1159/000488909
Enomoto T, Usuki J, Azuma A, et al. Diabetes mellitus may increase the risk for idiopathic pulmonary fibrosis. Chest 2003;123:2007-11.
DOI: https://doi.org/10.1378/chest.123.6.2007
Margaritopoulos GA, Antoniou KM, Wells AU. Comorbidities in interstitial lung
diseases. Eur Respir Rev 2017;26:160027.
DOI: https://doi.org/10.1183/16000617.0027-2016
Aggarwal D, Palta A, Jindal R, et al. Prevalence and predictors of osteoporosis in patients of interstitial lung disease: An observational study from North India. Indian J Respir Care 2022;11:353-7.
DOI: https://doi.org/10.4103/ijrc.ijrc_86_22
Babakhanlou R, Verstovsek S, Pemmaraju N, Rojas-Hernandez CM. Secondary erythrocytosis. Expert Rev Hematol 2023;16:245-51.
DOI: https://doi.org/10.1080/17474086.2023.2192475
Ethics Approval
This study followed ethical standards set by the institutional and national research committee, as well as the 1964 Helsinki Declaration and its later amendments. Approval was obtained from the Institute’s Ethics Committee of SSJGIMSR Almora, IRB- EC/NEW/INST/2022/1921.How to Cite
Bala, Manju, Akhlesh Rajpoot, Dinesh Chandra Punera, and Suyash Singh Rathore. 2024. “Hormonal Harmony Disrupted: Hypothyroidism and Diabetes Mellitus in Interstitial Lung Disease. An Observational Study”. Monaldi Archives for Chest Disease, July. https://doi.org/10.4081/monaldi.2024.2956.
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