Volume 32 Issue 1 - January 3, 2020 PDF
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Increased Risk for Hypothyroidism Associated with Carbon Monoxide Poisoning: a Nationwide Population-Based Cohort Study
Chien-Cheng Huang1,2,3, Chung-Han Ho4,5, Yi-Chen Chen4, Chien-Chin Hsu1,6, Hung-Jung Lin1,6,7, Shih-Bin Su8,9, Jhi-Joung Wang4,10, How-Ran Guo2,11,*
1Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.
2Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
3Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
4Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
5Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
6Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
7Department of Emergency Medicine, Taipei Medical University, Taipei, Taiwan.
8Department of Occupational Medicine, Chi Mei Medical Center, Tainan, Taiwan.
9Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
10Allied AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan.
11Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.
 
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Carbon monoxide poisoning (COP) is the common acute gas poisoning across the globe and will lead to hypoxia in organs and tissues in the human body. If the brain and the thyroid gland are damaged due to hypoxia, hypothyroidism might be introduced. However, related epidemiological literature is limited. From Nationwide Poisoning Database in Taiwan, we identified 24,328 patients with COP diagnosed between 1999 to 2012 and selected 72,984 patients without COP who were matched with the COP patients by the index date and age as the reference group. The two groups were followed up to 2013. After adjusting for age, gender, underlying comorbidities (e.g. hypertension, diabetes mellitus, hyperlipidemia, rheumatoid arthritis, or drug abuse, etc.) and income, we found that COP patients had a significantly higher risk for hypothyroidism (adjusted hazard ratio: 3.8) than the reference. COP patients who have diabetes mellitus, hyperlipidemia, or mental illness had particular higher risks for hypothyroidism, and the adjusted hazard ratios were 9.2, 5.2, and 5.5, respectively. In addition, we found that the increased risk was highest in the first month after the patients have been diagnosed with COP, the adjusted hazard ratio reaching nearly 41.0. Furthermore, and the health effect remained a significant impact even after 4 years.


Comparison of the risk for hypothyroidism between patients with and without carbon monoxide poinsoning (COP).

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