The association of multiple sclerosis with thyroid disease: A meta-analysis

Abstract

Background: Multiple Sclerosis (MS) is an autoimmune disease with T-cell-mediated inflammation showing different clinical and pathological phenotypes. The relationship between MS and thyroid diseases has been debated, with varying research outcomes. This meta-analysis aims to clarify the association between different thyroid diseases and MS.Methods: Databases PubMed, Google Scholar, ScienceDirect, and Web of Science were searched electronically for the studies investigating the association of thyroid disorders in MS. Studies were selected based on the eligibility criteria and meta-analysis was performed on Review Manager Version 5.4 using a random-effects model. Sub-group analyses were performed based on the clinical subtypes of thyroid disorders and forest plots were generated to interpret the findings. Publication bias was assessed using Egger's and Begg's tests and interpreted into funnel plots. Sensitivity analysis was performed to investigate the effect of the exclusion of each study on the pooled odds ratio. Results: Inclusive of thirteen studies comprising 13,012 MS cases and 56,850 controls, our analysis unveiled notable findings. pwMS displayed a significantly elevated prevalence of both hypothyroidism (Odds Ratio OR: 2.29, 95 % Confidence Interval CI: 1.16-4.49, pvalue: 0.02, I2 = 27 %) and autoimmune thyroid disorder (OR: 1.70, 95 % CI: 1.02-2.85, pvalue: 0.04, I2 = 79 %). The collective prevalence of all thyroid diseases among pwMS was markedly higher (OR: 1.60, 95 % CI: 1.20-2.11, p-value: 0.001, I2 = 61 %). Furthermore, gender-specific analyses revealed that females with MS experienced a significantly increased prevalence of thyroid disorders compared to their male counterparts. (pooled odds ratio 2.38,95 % CI 1.11-5.10, p-value: 0.03, I2 = 28 %) Conclusion: This comprehensive meta-analysis establishes a significant association between thyroid diseases and MS, substantiating the increased risk of thyroid disorders in pwMS. Moreover, the gender-based analysis im-plicates a potentially significant interaction between gender and the observed association. These findings collectively contribute to a better understanding of the complex interplay between MS and thyroid diseases, offering crucial insights for both clinical management and future research endeavors.