مقاله انگلیسی رایگان در مورد ارتباط میان اختلال اضطراب، افسردگی و اختلال دو قطبی با تیروئیدیت هاشیموتو – الزویر 2024

Abstract

Background
Anxiety disorder, depression, and bipolar disorder are common psychiatric disorders, and their association with autoimmune thyroiditis (AIT) has been of great interest. This study aimed to investigate the potential causal relationship between these psychiatric disorders and AIT.

Methods
We used publicly available summary statistics from large-scale genome-wide association studies to select, quality control and cluster genetic variant loci associated with anxiety disorder, depression, bipolar disorder and AIT as instrumental variables (IVs). The Mendelian randomization (MR) study mainly used inverse variance weighting (IVW) combined with MR-egger regression and weighted median estimation (WME) to estimate bidirectional causality between mental disorders and AIT. In addition, we conducted heterogeneity and multivariate tests to verify the validity of IVW.

Results
Two-sample bidirectional MR analysis revealed a positive causal link between depression and AIT. The forward MR analysis of IVW (OR 1.614, 95 % CI 1.104–2.358, P = 0.013) and WME (OR 2.314, 95 % CI 1.315–4.074, P = 0.004) demonstrated thatdepression potentially elevate the risk of AIT development, while, our investigation did not uncover a causal relationship between anxiety disorder, bipolar disorder and AIT. The results of reverse MR analysis showed that there was no significant causal relationship between AIT and anxiety disorder, depression, and bipolar disorder (P > 0.05).

Conclusions
The results of the forward MR analysis suggest a positive association between depression, and AIT risk, while indicating no support for a causal link between anxiety disorder or bipolar disorder and AIT risk based on the current data. Subsequent studies will be essential for elucidating the biological mechanisms and potential confounders underlying these associations.

Introduction

Autoimmune thyroiditis (AIT) stands as the most prevalent autoimmune endocrine disorder (Ruggeri et al., 2018), affecting an estimated 3–5 % of the general population (McLeod and Cooper, 2012). Predominantly afflicting women, its incidence escalates with advancing age (McLeod et al., 2014; Hollowell et al., 2002), soaring up to 20 % among elderly women (Surks et al., 2004). Furthermore, it serves as the primary cause of hypothyroidism. In the initial stages, AIT usually manifests with common hypothyroidism symptoms, such as mood disturbances, anxiety, or depression (van Zuuren et al., 2013), while, AIT can also precipitate hyperthyroidism.

Anxiety disorder, depression, and bipolar disorder are prevalent mental disorders with genetic and clinical overlap, suggesting that they may share common etiologic mechanisms (Tondo et al., 2017; Trede et al., 2005; Anttila et al., 2018). Research indicates a shared pattern of abnormal regional intrinsic brain activity in depression and bipolar disorder, particularly implicating the insula, medial prefrontal cortex, and cerebellum (Gong et al., 2020). The lifetime prevalence of anxiety disorder among individuals with bipolar disorder is estimated to be at least 40 %, even exceeding 50 % (Seon et al., 2021; Kessler et al., 1997; Vieta et al., 2001). Recent evidence suggests that the comorbidity of anxiety disorder with bipolar disorder is as high as that of monophasic depression (Preti et al., 2016).

Conclusion

We conducted the first bidirectional Mendelian randomization study of anxiety disorder, depression, bipolar disorder and autoimmune thyroiditis. Depression increases the risk of AIT, while no causal relationship has been found between anxiety disorders, bipolar disorder and AIT. Psychiatric disorders lead to AIT mainly through the expression of related genes affecting the levels of T and B lymphocytes or through the hypothalamic-pituitary-thyroid axis affecting the feedback regulation mechanism to induce thyroid dysfunction. We look forward to more clinical and experimental research data to validate the relationship between psychiatric disorders and AIT. In the meantime, we need to focus on more updated and larger data sets to explore whether there is a causal relationship between other psychiatric disorders and AIT.