Associations of Yersinia Enterocolitica Infection with Autoimmune Thyroid Diseases: A Systematic Review and Meta-Analysis

Abstract

Introduction: Yersinia enterocolitica infection is reportedly associated with the development of autoimmune thyroid diseases (AITD). However, evidence that such infection can lead to AITD is controversial. Thus, this study was aimed to investigate the associations of Y. enterocolitica infection with AITD.

Methods: A meta-analysis was performed using PubMed, Web of Science, Embase and Cochrane library to identify relevant studies. The odds ratios (OR) and associated 95% confidence intervals [CI] were obtained. Data were analyzed by STATA 13.0 (Stata Corporation, College Station, TX, USA).

Results: Of 215 articles identified, 8 studies with a total of 1490 participants met the criteria and were included in the meta-analysis. There was a significant association between Y. enterocolitica positivity and AITD (OR: 4.31 [CI 95%: 1.81-10.07], P-value: 0.00). According to the subgroup analysis, Y. enterocolitica infection statistically increased the risk of Graves' disease (GD) (OR: 6.12, [CI 95%: 3.71-10.10], P-value: 0.00). Likewise, the pooled OR of association between Y. enterocolitica positivity and hashimoto's thyroiditis (HT) was 2.84 (CI 95%: 0.71-11.25, P-value: 0.1).

Conclusion: The current studies suggest that Y. enterocolitica may be associated with the development of AITD. Further study is needed to explore the underlying mechanisms.

Keywords: Graves' disease; Yersinia enterocolitica; autoimmune thyroid diseases; hashimoto's thyroiditis; meta-analysis; thyroid dysfunction.