Autoimmune thyroid disease and inflammatory diseases: association with subclinical Atherosclerosis and general and cardiovascular mortality in ELSA-Brasil

• Grant number: 21/06798-0
• Support Opportunities: Scholarships in Brazil - Post-Doctoral
• Start date: August 01, 2021
• End date: April 28, 2026
• Field of knowledge: Health Sciences - Collective Health - Epidemiology
• Principal Investigator: Isabela Judith Martins Bensenor
• Grantee: Vandrize Meneghini
• Host Institution: Hospital Universitário (HU). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated research grant: 19/23734-6 - Chronic inflammatory diseases and all-cause, cardiovascular and mortality related to other causes: association with risk factors, subclinical Atherosclerosis and fatal and non-fatal events in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), AP.TEM
• Associated scholarship(s): 24/06985-3 - Biomarkers of autoimmune inflammatory diseases, thyroid function and psychological health of the participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), BE.EP.PD

Abstract

The main objective of the Longitudinal Study of Adult Health (ELSA-Brasil) is to understand the incidence of Cardiovascular Diseases (CVD) and Diabetes, and the associated risk and protection factors. Although the study includes all classical risk factors for CVD, it also studies the less explored non-classical risk factors in the literature. Among the non-classical risk factors for CVD, the thyroid function was included in a previous thematic project. The new thematic project will study the relationship between chronic inflammatory diseases, thyroid function and cardiovascular disease. The main objective of this postdoctoral project is to evaluate the effect of changes in thyroid function on inflammatory diseases and its influence in the determination of subclinical Atherosclerosis, measured by calcium score (CAC) and carotid intima-media thickness, and fatal and non-fatal cardiovascular events, in addition to all-cause mortality. Other objectives are: 1. evaluate the association of thyroid disease and inflammatory diseases in the long-term survival of patients with inflammatory diseases and thyroid dysfunction; 2. describe the association of thyroid function changes in each of the inflammatory diseases in the project: Rheumatoid Arthritis, disseminated Lupus Erythematosus, Sjögren's Syndrome, Celiac Disease, Vasculitis and Psoriasis; 3. assess the incidence of changes in thyroid function in patients diagnosed with each of the inflammatory diseases, using baseline (2008-2010), 4-year (2012-2014) and 9-year (2017-2019) follow-up data; 4. assess the incidence of inflammatory disease in participants with positive antithyroid peroxidase antibodies and with subclinical thyroid disease at baseline to follow-up. Participants at high risk for inflammatory diseases will be identified using data from questionnaires, annual calls to investigate hospitalizations and cardiovascular events, and the use of medications for the specific treatment of each inflammatory disease and thyroid function data obtained from the waves 1, 2, and 3. The study randomly selected a sample of 1500 participants that are representative of the total study participants (N=15105). This will allow for lower costs associated with greater analysis power. To achieve these goals, the study will use a case-cohort design (in which the comparison group will be chosen from the random sample of the cohort that saved the most biological samples at baseline precisely because of greater future use); and nested case-control design, in which age- and sex-matched controls will be chosen from participants without inflammatory or thyroid disease depending on what is most effective for each analysis. In addition, cross-sectional analyzes may be used for specific purposes. The results will be presented in the form of Poisson regressions in the case of exposures evaluated in data collection waves where the interval between measurements is very similar or by the Cox proportional hazards model when dealing with cardiovascular events or all-cause and cardiovascular mortality. Relative Risk (RR) will be presented without adjustment, adjusted for sociodemographic factors and multivariate adjustment by confounding factors. Survival analysis with Kaplan-Meier curves compared by the log-rank test will be used, in addition with the application of machine learning models in order to identify sociodemographic and clinical variables that are predictive of the prognosis of participants with inflammatory diseases and thyroid dysfunction. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

TEBAR, W. R.; SANTOS, I. S.; MENEGHINI, V.; BITTENCOURT, M. S.; LOTUFO, P. A.; BENSENOR, I. M.. Eight-year change in carotid intima-media thickness and associated risk factors in adults with and without psoriasis - the ELSA-Brasil cohort study. Brazilian Journal of Medical and Biological Research, v. 56, n. 1, p. 11-pg., 2023-01-01. (19/23734-6, 21/04416-3, 21/06798-0)

MENEGHINI, VANDRIZE; TEBAR, WILLIAM RODRIGUES; SANTOS, ITAMAR SOUZA; JANOVSKY, CAROLINA CASTRO PORTO SILVA; DE ALMEIDA-PITITTO, BIANCA; BIRCK, MARINA GABRIELA; LOTUFO, PAULO ANDRADE; GOULART, ALESSANDRA CARVALHO; SGARBI, JOSE AUGUSTO; TEIXEIRA, PATRICIA DE FATIMA DOS SANTOS; et al. Potential Determinants of Thyroid Peroxidase Antibodies and Mortality Risk: Results From the ELSA-Brasil Study. JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, v. 109, n. 2, p. 13-pg., 2024-01-18. (19/23734-6, 21/04416-3, 21/06798-0)

TEBAR, WILLIAM R.; SANTOS, ITAMAR DE S.; MENEGHINI, VANDRIZE; BITTENCOURT, MARCIO SOMMER; LOTUFO, PAULO A.; BENSENOR, ISABELA M.. Carotid intima-media thickness in adults with and without psoriasis - a nested case-control study from baseline data of ELSA-Brasil cohort. INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, v. 39, n. 8, p. 9-pg., 2023-06-08. (19/23734-6, 21/04416-3, 21/06798-0)