The Journal of Clinical Endocrinology & Metabolism, 2021, Vol. 106, No. 3, e1179–e1190 doi:10.1210/clinem/dgaa927 Clinical Research Article ISSN Print 0021-972X ISSN Online 1945-7197 Printed in USA https://academic.oup.com/jcem e1179 © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Clinical Research Article MorbiNet Study: Hypothyroidism Comorbidity Networks in the Adult General Population Ferran Moratalla-Navarro, 1,2,3,4 Victor Moreno, 1,2,3,4 Flora López-Simarro, 5 and Alba Aguado 6 1 Oncology Data Analytics Program, Catalan Institute of Oncology (ICO), 08908 Barcelona, Spain; 2 ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), 08908 Barcelona, Spain; 3 CIBER of Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain; 4 Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Campus Bellvitge, 08907 Barcelona, Spain; 5 ABS Urban Martorell, Catalan Institute of Health, 08760 Martorell, Spain; and 6 CAP Sagrada Familia, Consorci Sanitari Integral, 08025 Barcelona, Spain ORCiD numbers: 0000-0001-7858-5713 (F. Moratalla-Navarro); 0000-0002-2818-5487 (V. Moreno); 0000-0001-9382-7506 (F. López-Simarro); 0000-0002-5816-2243 (A. Aguado). Abbreviations: ICPC-2, International Classification of Primary Care, 2nd edition; LASSO, least absolute shrinkage and selection operator; OR, odds ratio; SIDIAP, Information System for Research Development in Primary Care; T3, triiodothyronine; TSH, thyrotropin (thyroid-stimulating hormone). Received: 29 September 2020; Editorial Decision: 8 December 2020; First Published Online: 14 December 2020; Corrected and Typeset: 11 January 2021. Abstract Purpose: Multimorbidity impacts quality of life. We constructed hypothyroidism comorbidity networks to identify positive and negative associations with other prevalent diseases. Methods: We analyzed data of 285 342 patients with hypothyroidism from 3 135 948 adults with multimorbidity in a population-based study in Catalonia, Spain, (period: 2006- 2017). We constructed hypothyroidism comorbidity networks using logistic regression models, adjusted by age and sex, and for men and women separately. We considered relevant associations those with odds ratios (OR) >1.2 or <0.8 and P value < 1e-5 to identify coexistence greater (or smaller) than the expected by the prevalence of diseases. Multivariate models considering comorbidities were used to further adjust OR values. Results: The conditions associated included larynx cancer (adjusted OR: 2.48), congenital anomalies (2.26), thyroid cancer (2.13), hyperthyroidism (1.66), vitamin B12/ folate defciency anemia (1.57), and goiter (1.56). The network restricted to men had more connections (mental, cardiovascular, and neurological) and stronger associations with thyroid cancer (7.26 vs 2.55), congenital anomalies (5.11 vs 2.13), hyperthyroidism (4.46 vs 1.69), larynx cancer (3.55 vs 1.67), and goiter (3.94 vs 1.64). After adjustment for comorbidities, OR values were more similar in men and women. The strongest negative associations after adjusting for comorbidities were with HIV/AIDS (OR: 0.71) and tobacco abuse (0.77). Downloaded from https://academic.oup.com/jcem/article/106/3/e1179/6034202 by guest on 28 January 2024