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A Cohort Historical Analysis of the Relationship between Thyroid Hormone Malady and Alpha-Human Herpesvirus Activation.

Hsia SH, Hsia S V - J Steroids Horm Sci (2014)

Bottom Line: Using 2×2 contingency table analyses and Statistical Analysis Software (SAS), an Odds Ratio (OR) of 2.83 was observed for the total population of 21 years old and above with a chi-square of 61.55 and p < 0.001, confirming that a severe significant difference was found between these two cohorts.This result suggested that patients with αHHV diagnosis have higher chances to have TH disorders.These results indicated that TH dysfunction may have implication in αHHV pathogenesis and females exhibited much higher probability to suffer αHHV reactivation due to TH disruption.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Division of Pediatric Critical Care Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang-Gung University, Kweishan, Taiwan.

ABSTRACT

Background: A number of physiological factors have been suggested to participate in the alpha- Human Herpesvirus (αHHV) reactivation, such as hormonal aberration. Thyroid hormone (TH) was shown to play a suppressive role in Herpes Simplex Virus Type-1 (HSV-1) gene expression and replication in cell culture and animal models. We hypothesize that reactivation of αHHV in humans may be due to, at least in part, by TH status.

Methods: Prior to implementing a full-scale population-based prospective inquiry into this hypothesis, a pilot study using a medical claims data base and a case-controlled, retrospective cohort investigation was conducted to develop a hypothetical link between TH complication and αHHV reactivation. Using diagnostic codes for treating thyroid disorders and αHHV infections as proxies for biologic/clinic outcomes, we queried a large, comprehensive hospital data base to construct two patient cohorts: Cohort 1 was comprised of patients receiving TH diagnoses over a twelve-year period, and Cohort 2 was composed of patients not receiving TH diagnoses during this period. Diagnoses of αHHV were recorded for each cohort and the difference in the frequency was examined for statistical significance. Demographic analyses such as age, gender, etc were also performed.

Results: Using 2×2 contingency table analyses and Statistical Analysis Software (SAS), an Odds Ratio (OR) of 2.83 was observed for the total population of 21 years old and above with a chi-square of 61.55 and p < 0.001, confirming that a severe significant difference was found between these two cohorts. This result suggested that patients with αHHV diagnosis have higher chances to have TH disorders. Additional investigation revealed that female were at higher/significant probability to have both TH and αHHV diagnosis, indicating a link of αHHV reactivation to a complex hormonal profile difference between genders. Our observation indicated that female patients of 21 years of age and above exhibited a very high incidence (OR of 3.40, p < 0.001) compared to the male groups (OR of 1.91, p < 0.05), indicating the possibility that hormonal alteration in females maybe transient but robust and can lead to αHHV reactivation more often than the males.

Conclusion: These results indicated that TH dysfunction may have implication in αHHV pathogenesis and females exhibited much higher probability to suffer αHHV reactivation due to TH disruption. Although the results from this pilot study have limitations and require additional controlled clinical examination such as more detailed patient records, lab data, therapeutic outcome, etc, it provides a tool to assess the effects of hormone imbalance on virus reactivation by retrospective analyses using existing large scale data base.

No MeSH data available.


Related in: MedlinePlus

Experimental design of the cohort studies. ICD9 diagnosis codes were collected from 2001–2012 and divided into two groups based on the diagnoses of their TH level. After categorized into two cohorts with or without TH diagnoses, each group was further separated into different units based on their gender and age. To ensure the data validity, confounding factors were cleared.
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Figure 1: Experimental design of the cohort studies. ICD9 diagnosis codes were collected from 2001–2012 and divided into two groups based on the diagnoses of their TH level. After categorized into two cohorts with or without TH diagnoses, each group was further separated into different units based on their gender and age. To ensure the data validity, confounding factors were cleared.

Mentions: The data of patients who were hospitalized within a twelve-year period (2001–2012) were obtained from Chang Gung Memorial Hospital, a large research/teaching comprehensive hospital in Taiwan. The ICD-9 codes for Disorders of Thyroid Gland (240.xx to 246.xx) and αHHV infections (VZV: 053.xx and HSV: 054.xx) were collected and analyzed. Demographic data such as years, genders, age groups, etc were assessed to comprehend the features of this population. Of all the patients receiving examination within this twelve-year period, the following specific diagnosis data were categorized: 1) total number of patients for all diagnoses within the time period; 2) number of patients without diagnoses of αHHV and thyroid dysfunction; 3) number of patients with diagnoses for thyroid dysfunction; 4) number of patients with diagnoses for thyroid malady and no diagnoses of αHHV; 5) number of patients with diagnoses of αHHV; 6) number of patients receiving diagnoses of αHHV without diagnoses for thyroid dysfunction; and 7) number of patients receiving diagnoses of both αHHV AND thyroid disorders. This analysis was also performed on different genders and age groups to compare the effects of putative sex differences. The strategy was summarized in Figure 1.


A Cohort Historical Analysis of the Relationship between Thyroid Hormone Malady and Alpha-Human Herpesvirus Activation.

Hsia SH, Hsia S V - J Steroids Horm Sci (2014)

Experimental design of the cohort studies. ICD9 diagnosis codes were collected from 2001–2012 and divided into two groups based on the diagnoses of their TH level. After categorized into two cohorts with or without TH diagnoses, each group was further separated into different units based on their gender and age. To ensure the data validity, confounding factors were cleared.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4380329&req=5

Figure 1: Experimental design of the cohort studies. ICD9 diagnosis codes were collected from 2001–2012 and divided into two groups based on the diagnoses of their TH level. After categorized into two cohorts with or without TH diagnoses, each group was further separated into different units based on their gender and age. To ensure the data validity, confounding factors were cleared.
Mentions: The data of patients who were hospitalized within a twelve-year period (2001–2012) were obtained from Chang Gung Memorial Hospital, a large research/teaching comprehensive hospital in Taiwan. The ICD-9 codes for Disorders of Thyroid Gland (240.xx to 246.xx) and αHHV infections (VZV: 053.xx and HSV: 054.xx) were collected and analyzed. Demographic data such as years, genders, age groups, etc were assessed to comprehend the features of this population. Of all the patients receiving examination within this twelve-year period, the following specific diagnosis data were categorized: 1) total number of patients for all diagnoses within the time period; 2) number of patients without diagnoses of αHHV and thyroid dysfunction; 3) number of patients with diagnoses for thyroid dysfunction; 4) number of patients with diagnoses for thyroid malady and no diagnoses of αHHV; 5) number of patients with diagnoses of αHHV; 6) number of patients receiving diagnoses of αHHV without diagnoses for thyroid dysfunction; and 7) number of patients receiving diagnoses of both αHHV AND thyroid disorders. This analysis was also performed on different genders and age groups to compare the effects of putative sex differences. The strategy was summarized in Figure 1.

Bottom Line: Using 2×2 contingency table analyses and Statistical Analysis Software (SAS), an Odds Ratio (OR) of 2.83 was observed for the total population of 21 years old and above with a chi-square of 61.55 and p < 0.001, confirming that a severe significant difference was found between these two cohorts.This result suggested that patients with αHHV diagnosis have higher chances to have TH disorders.These results indicated that TH dysfunction may have implication in αHHV pathogenesis and females exhibited much higher probability to suffer αHHV reactivation due to TH disruption.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Division of Pediatric Critical Care Medicine, Chang Gung Memorial Hospital, College of Medicine, Chang-Gung University, Kweishan, Taiwan.

ABSTRACT

Background: A number of physiological factors have been suggested to participate in the alpha- Human Herpesvirus (αHHV) reactivation, such as hormonal aberration. Thyroid hormone (TH) was shown to play a suppressive role in Herpes Simplex Virus Type-1 (HSV-1) gene expression and replication in cell culture and animal models. We hypothesize that reactivation of αHHV in humans may be due to, at least in part, by TH status.

Methods: Prior to implementing a full-scale population-based prospective inquiry into this hypothesis, a pilot study using a medical claims data base and a case-controlled, retrospective cohort investigation was conducted to develop a hypothetical link between TH complication and αHHV reactivation. Using diagnostic codes for treating thyroid disorders and αHHV infections as proxies for biologic/clinic outcomes, we queried a large, comprehensive hospital data base to construct two patient cohorts: Cohort 1 was comprised of patients receiving TH diagnoses over a twelve-year period, and Cohort 2 was composed of patients not receiving TH diagnoses during this period. Diagnoses of αHHV were recorded for each cohort and the difference in the frequency was examined for statistical significance. Demographic analyses such as age, gender, etc were also performed.

Results: Using 2×2 contingency table analyses and Statistical Analysis Software (SAS), an Odds Ratio (OR) of 2.83 was observed for the total population of 21 years old and above with a chi-square of 61.55 and p < 0.001, confirming that a severe significant difference was found between these two cohorts. This result suggested that patients with αHHV diagnosis have higher chances to have TH disorders. Additional investigation revealed that female were at higher/significant probability to have both TH and αHHV diagnosis, indicating a link of αHHV reactivation to a complex hormonal profile difference between genders. Our observation indicated that female patients of 21 years of age and above exhibited a very high incidence (OR of 3.40, p < 0.001) compared to the male groups (OR of 1.91, p < 0.05), indicating the possibility that hormonal alteration in females maybe transient but robust and can lead to αHHV reactivation more often than the males.

Conclusion: These results indicated that TH dysfunction may have implication in αHHV pathogenesis and females exhibited much higher probability to suffer αHHV reactivation due to TH disruption. Although the results from this pilot study have limitations and require additional controlled clinical examination such as more detailed patient records, lab data, therapeutic outcome, etc, it provides a tool to assess the effects of hormone imbalance on virus reactivation by retrospective analyses using existing large scale data base.

No MeSH data available.


Related in: MedlinePlus