wEight chanGes, caRdio-mEtabolic risks and morTality in patients with hyperthyroidism (EGRET): a protocol for a CPRD–HES linked cohort study
| Autor: | Kristien Boelaert, G. Neil Thomas, Krishnarajah Nirantharakumar, Barbara Torlinska, Keith R. Abrams, Philip Saunders, Samuel Finnikin, Julia R Priestley, Jonathan Hazlehurst |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
RM
medicine.medical_specialty Population Hyperthyroidism Cohort Studies Iodine Radioisotopes symbols.namesake Weight loss Epidemiology medicine Humans thyroid disease Poisson regression education cardiac epidemiology education.field_of_study Health Survey for England business.industry Proportional hazards model Weight change General Medicine United Kingdom Stroke Diabetes and Endocrinology Emergency medicine symbols Medicine epidemiology medicine.symptom business RA RC Cohort study |
| Zdroj: | BMJ Open, Vol 11, Iss 10 (2021) BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | IntroductionHyperthyroidism is a common condition affecting up to 3% of the UK population. Treatment improves symptoms and reduces the risk of atrial fibrillation and stroke that contribute to increased mortality. The most common symptom is weight loss, which is reversed during treatment. However, the weight regain may be excessive, contributing to increased risk of obesity. Current treatment options include antithyroid drugs, radioiodine and thyroidectomy. Whether there are differences in either weight change or the long-term cardiometabolic risk between the three treatments is unclear.Methods and analysisThe study will establish the natural history of weight change in hyperthyroidism, investigate the risk of obesity and risks of cardiometabolic conditions and death relative to the treatment. The data on patients diagnosed with hyperthyroidism between 1 January 1996 and 31 December 2015 will come from Clinical Practice Research Datalink linked to Hospital Episode Statistics and Office of National Statistics Death Registry. The weight changes will be modelled using a flexible joint modelling, accounting for mortality. Obesity prevalence in the general population will be sourced from Health Survey for England and compared with the post-treatment prevalence of obesity in patients with hyperthyroidism. The incidence and time-to-event of major adverse cardiovascular events, other cardiometabolic outcomes and mortality will be compared between the treatments using the inverse propensity weighting model. Incidence rate ratios of outcomes will be modelled with Poisson regression. Time to event will be analysed using Cox proportional hazards model. A competing risks approach will be adopted to estimate comparative incidences to allow for the impact of mortality.Ethics and disseminationThe study will bring new knowledge on the risk of developing obesity, cardiometabolic morbidity and mortality following treatment for hyperthyroidism to inform clinical practice and public health policies. The results will be disseminated via open-access peer-reviewed publications and directly to the patients and public groups (Independent Scientific Advisory Committee protocol approval #20_000185). |
| Databáze: | OpenAIRE |
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