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Is Thyroid Dysfunction Associated with Unruptured Intracranial Aneurysms? A Population-Based, Nested Case-Control

Hyeree Park1,2,3, Sun Wook Cho4, Sung Ho Lee5

  • 1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Thyroid : Official Journal of the American Thyroid Association
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Summary

Hypothyroidism increases intracranial aneurysm risk, while hyperthyroidism may reduce it. Thyroid hormone replacement therapy might offer protection against aneurysm development.

Keywords:
hyperthyroidismhypothyroidismintracranial aneurysmsthyroid hormone

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Area of Science:

  • Endocrinology
  • Neurology
  • Epidemiology

Background:

  • Intracranial aneurysms (IAs) have limited known risk factors.
  • Thyroid diseases are common and may influence vascular health.

Purpose of the Study:

  • To investigate the association between thyroid diseases and intracranial aneurysms using real-world data.
  • To explore the potential protective role of thyroid hormones in IA development.

Main Methods:

  • Nested case-control study using nationwide Korean health insurance data (2002-2019).
  • 5,335 unruptured IA cases matched with 80,025 controls (1:15 ratio).
  • Multivariable conditional logistic regression analyzed associations between thyroid disease history and IA risk.

Main Results:

  • Hypothyroidism was linked to increased unruptured IA risk (aOR: 1.46).
  • Hyperthyroidism was associated with reduced unruptured IA risk (aOR: 0.71).
  • Long-term thyroid hormone use (>5 years) in hypothyroid patients showed a reduced IA risk (aOR: 0.69).
  • Associations were significant in females but not males.

Conclusions:

  • Hypothyroidism is a risk factor for unruptured IAs; hyperthyroidism may be protective.
  • Thyroid hormones might play a role in preventing IA development.
  • Further research is needed to confirm causality and elucidate biological mechanisms.