Abstract
Increased plasma homocysteine (Hcy) levels have been widely documented in
patients with overt hypothyroidism; however, the significance of Hcy level
changes in patients with subclinical hypothyroidism (SCH) remains
controversial. The aim of this meta-analysis was to determine the Hcy status
in patients with SCH compared with euthyroid subjects. We searched
PubMed, Embase, and Cochrane Library databases prior to December 2019 to
identify eligible studies and assessed the quality of selected studies using
the Newcastle-Ottawa Quality Assessment Scale. Publication bias was
evaluated by Begg’s test and Egger’s test. Meta-regression
analysis was conducted to investigate the source of heterogeneity. A likely
source of heterogeneity was the year of the study. All statistical analyses
were performed with RevMan 5.3 and Stata 12.0 software. Our meta-analysis of
twelve observational studies with 684 patients showed that those with SCH
aged between 18 and 65 years old were associated with a slightly increased
plasma Hcy level compared with euthyroid controls. The pooled result of the
weighted mean difference (WMD) of increased tHcy levels was
1.16 μmol/l (95% CI: 0.51, 1.82;
p=0.0005). The Hcy level in patients with SCH aged between 18 and 65
years old is significantly increased compared to euthyroid controls.
Key words
Subclinical hypothyroidism - hyperhomocysteinemia - cardiovascular disease - meta-analysis
