Exp Clin Endocrinol Diabetes 2012; 120(02): 80-83
DOI: 10.1055/s-0031-1285910
Article
© J. A. Barth Verlag in George Thieme Verlag KG Stuttgart · New York

The Association of Cigarette Smoking with Serum TSH Concentration and Thyroperoxidase Antibody

L. Mehran
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
,
A. Amouzgar
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
,
H. Delshad
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
,
F. Azizi
1   Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran
› Author Affiliations
Further Information

Publication History

received21 April 2011
first decision28 June 2011

accepted 29 July 2011

Publication Date:
13 September 2011 (online)

Abstract

Background:

Although several studies have found an association between tobacco smoking and thyroid disorders such as Graves’ disease, Graves’ ophtalmopathy, goiter and thyroid multi nodularity, the effect of smoking on thyroid function is controversial.

Aim:

The aim of this study was to evaluate the association between smoking and serum TSH concentration and the presence of thyroperoxidase antibody (TPO Ab) in Tehranian adults.

Subjects and Methods:

In this cross sectional community based survey, 1 581 randomly selected subjects with no history of thyroid disorders were studied within the framework of Tehran Lipid and Glucose Study. Serum TSH and TPOAb were measured in a fasting serum sample. Weight and height were measured and BMI was calculated. Smokers were classified into ever and never smokers based on the declaration of participants.

Results:

Mean Ln TSH values in the ever smoker (0.36±0.82) was significantly lower than the never smoker (0.6±0.82) group (p<0.001) even after adjustment for age and BMI. The odds ratio for hypothyroidism (TSH>5.8) was 0.4 in the ever smoker group compared to the never one (odds ratio 0.4, 95% CI=0.2–0.8). The frequency of positive TPOAb in never smokers was significantly higher than ever smokers (%13.5 vs. % 6.7, p<0.001).

Conclusion:

The results suggest that smoking is associated with decreased serum TSH concentrations, lower risk of hypothyroidism and possibly with a lower frequency of thyroid auto immunity.

 
  • References

  • 1 Asvold BO, Bjøro T, Nilsen TI et al. Tobacco smoking and thyroid function: a population-based study. Arch Intern Med 2007; 167: 1428-1432
  • 2 Azizi F, Rahmani M, Emami H et al. Cardiovascular risk factors in an Iranian urban population: Tehran lipid and glucose study (phase 1). Soz Praventivmed 2002; 47: 408-426
  • 3 Bartalena L, Martino E, Marcocci C et al. More on smoking habits and Graves’ ophthalmopathy. J Endocrinol Invest 1989; 12: 733-737
  • 4 Belin RM, Astor BC, Powe NR et al. Smoke exposure is associated with a lower prevalence of serum thyroid autoantibodies and thyrotropin concentration elevation and a higher prevalence of mild thyrotropin concentration suppression in the third National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2004; 89: 6077-6086
  • 5 Cho NH, Choi HS, Kim KW et al. Interaction between cigarette smoking and iodine intake and their impact on thyroid function. Clin Endocrinol (Oxf) 2010; 73: 264-270
  • 6 Christensen SB, Ericsson UB, Janzon L et al. Influence of cigarette smoking on goiter formation, thyroglobulin, and thyroid hormone levels in women. J Clin Endocrinol Metab 1984; 58: 615-618
  • 7 Delshad H, Mehran L, Tohidi M et al. The incidence of thyroid function abnormalities and natural course of subclinical thyroid disorders, Tehran, I. R. Iran. J Endo Invest 2011; in press
  • 8 Effraimidis G, Tijssen JG, Wiersinga WM. Discontinuation of smoking increases the risk for developing thyroid peroxidase antibodies and/or thyroglobulin antibodies: a prospective study. J Clin Endocrinol Metab 2009; 94: 1324-1328
  • 9 Ericsson UB, Lindgärde F. Effects of cigarette smoking on thyroid function and the prevalence of goitre, thyrotoxicosis and autoimmune thyroiditis. J Intern Med 1991; 229: 67-71
  • 10 Foss OP, Lund-Larsen PG. Serum thiocyanate and smoking: interpretation of serum thiocyanate levels observed in a large health study. Scand J Clin Lab Invest 1986; 46: 245-251
  • 11 Fukayama H, Nasu M, Murakami S et al. Examination of antithyroid effects of smoking products in cultured thyroid follicles: only thiocyanate is a potent antithyroid agent. Acta Endocrinol (Copenh) 1992; 127: 520-525
  • 12 Hak AE, Pols HA, Visser TJ et al. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study. Ann Intern Med 2000; 132: 270-278
  • 13 Harrison B. Influence of cigarette smoking on disease outcome in rheumatoid arthritis. Curr Opin Rheumatol 2002; 14: 93-97
  • 14 Hersey P, Prendergast D, Edwards A. Effects of cigarette smoking on the immune system. Med J Aust 1983; 2: 425-429
  • 15 Jeremy J, Mikhailidis D. Vascular and platelet eicosanoids, smoking and atherosclerosis. Adv Exp Med Biol 1990; 273: 135-146
  • 16 Jorde R, Sundsfjord J. Serum TSH levels in smokers and non-smokers. The 5th Tromsø study. Exp Clin Endocrinol Diabetes 2006; 114: 343-347
  • 17 Kapoor D, Jones TH. Smoking and hormones in health and endocrine disorders. Eur J Endocrinol 2005; 152: 491-499
  • 18 Karakaya A, Tunçel N, Alptuna G et al. Influence of cigarette smoking on thyroid hormone levels. Hum Toxicol 1987; 6: 507-509
  • 19 Knudsen N, Bülow I, Laurberg P et al. High occurrence of thyroid multinodularity and low occurrence of subclinical hypothyroidism among tobacco smokers in a large population study. J Endocrinol 2002; 175: 571-576
  • 20 Müller B, Zulewski H, Huber P et al. Impaired action of thyroid hormone associated with smoking in women with hypothyroidism. N Engl J Med 1995; 333: 964-969
  • 21 Nystrom E, Bengtsson C, Lapidus L et al. Smoking: a risk factor for hypothyroidism. J Endocrinol Invest 1993; 129-131
  • 22 Pedersen IB, Laurberg P, Knudsen N et al. Smoking is negatively associated with the presence of thyroglobulin autoantibody and to a lesser degree with thyroid peroxidase autoantibody in serum: a population study. Eur J Endocrinol 2008; 158: 367-373
  • 23 Pontikides N, Krassas GE. Influence of cigarette smoking on thyroid function, goiter formation and autoimmune thyroid disorders. Hormones (Athens) 2002; 1: 91-98
  • 24 Prummel MF, Wiersinga WM. Smoking and risk of Graves’ disease. JAMA 1993; 269: 479-482
  • 25 Sepkovic DW, Haley NJ, Wynder EL. Thyroid activity in cigarette smokers. Arch Intern Med 1984; 144: 501-503
  • 26 Strieder TG, Prummel MF, Tijssen JG et al. Risk factors for and prevalence of thyroid disorders in a cross-sectional study among healthy female relatives of patients with autoimmune thyroid disease. Clin Endocrinol (Oxf) 2003; 59: 396-401
  • 27 Tonacchera M, Pinchera A, Dimida A et al. Relative potencies and additivity of perchlorate, thiocyanate, nitrate, and iodide on the inhibition of radioactive iodide uptake by the human sodium iodide symporter. Thyroid 2004; 14: 1012-1019
  • 28 Utiger RD. Cigarette smoking and the thyroid. N Engl J Med 1995; 333: 1001-1002
  • 29 Vejbjerg P, Knudsen N, Perrild H et al. The impact of smoking on thyroid volume and function in relation to a shift towards iodine sufficiency. Eur J Epidemiol 2008; 23: 423-429
  • 30 Vestergaard P. Smoking and thyroid disorders – a meta-analysis. Eur J Endocrinol 2002; 146: 153-161
  • 31 Vestergaard P, Rejnmark L, Weeke J et al. Smoking as a risk factor for Graves’ disease, toxic nodular goiter, and autoimmune hypothyroidism. Thyroid 2002; 12: 69-75