A Meta-analysis Of The Correlation Between Alopecia Areata And Thyroid Disease And Related Indicators

Objective:To evaluate the correlation between alopecia areata and thyroid disease and its related indexes,and to guide clinical diagnosis and treatment.Methods:Using the search strategy of combining subject words with free words,the Chinese national knowledge network,weipu network,China biomedical database,wanfang database,PubMed and SCIE were searched,and the search scope was all the published literatures in both Chinese and English on the correlation between alopecia areata and thyroid disease and related indicators from April 1989 to April 2019.To establish criteria for literature inclusion:(1)the study involves alopecia areata and thyroid function,thyroid autoantibodies and diseases,the research method is case-control study,searching all Chinese and English literatures with unlimited race and nationality and limited range from April 1989 to April 2019;(2)the diagnostic criteria are in line with the clinical diagnosis of alopecia areata formulated by Olsen et al.In 2004;(3)the study is in line with the above diagnosis Standard patients with alopecia areata were compared with those with no history of alopecia areata;(4)the literature provided the original data or could be converted to the ratio and 95% confidence interval.To establish the criteria of literature exclusion:(1)case report or review,repeated published literature;(2)incomplete literature information or data.According to the inclusion and exclusion criteria,two researchers independently screened the literature,and extracted and entered the relevant data after the quality evaluation.R software was used for meta-analysis.Heterogeneity test was carried out for the included studies.The corresponding effect model was selected to analyze the correlation between alopecia areata and thyroid disease and its related indicators.Results:A total of 18 documents,5 in Chinese and 13 in English were included.There were 268713 people in alopecia areata group and 1345687 people in control group.The diseases and indexes related to alopecia areata were: thyroperoxidase antibody 4.39(2.75,7.01),thyroglobulin antibody 2.82(1.45,5.47),Graves disease 1.53(1.43,1.63),Hashimoto thyroiditis 1.21(1.13,1.29),T4 increased by 2.92(1.15,7.43).The diseases and indexes unrelated to alopecia areata were: TSH increased,T3 increased,hyperthyroidism,hypothyroidism;the studies of the decrease of ths,T3 decreased,T4 decreased were only included in one case,without meta analysis.Conclusion:1.Alopecia areata is related to thyroglobulin antibody,thyroperoxidase antibody,toxic diffuse goiter,Hashimoto thyroiditis and T4 increase.2.TSH,T3,hyperthyroidism and hypothyroidism were not related to alopecia areata.3.The patients with alopecia areata are at higher risk of autoimmune thyroid disease.It is of clinical significance to detect the antibodies of thyroglobulin and thyroid peroxidase.