{
  "abstract": "Background: In our previous study, the absence of thyroid cysts was identified as an indicator of thyroid functional strain associated with thyroid peroxidase antibody (TPO-Ab) positivity. In individuals under this continuous functional load, higher levels of thyroid-stimulating hormone are required to maintain serum thyroid hormone concentrations within the normal range, potentially leading to subclinical hypothyroidism (SCH).\n\nHowever, no study has examined whether the association between TPO-Ab positivity and SCH differs according to thyroid cyst status.\n\nMethod: We conducted a cross-sectional study of 1432 euthyroid Japanese participants whose free triiodothyronine (T3) and free thyroxine levels were within normal ranges. Thyroid cysts were defined as cystic lesions with a maximum diameter ≥ 2.0 mm and no solid components.\n\nResults: Among the study population, 964 participants had no thyroid cysts, 267 were TPO-Ab positive, and 80 had SCH. A significant positive association between TPO-Ab positivity and SCH was observed only in participants without thyroid cysts. After adjustment for potential confounders—including sex, age, free T3, body mass index, atherosclerosis, and hypertension—the adjusted odds ratios (95% confidence intervals) were 0.27 (0.04, 2.02) and 2.10 (1.17, 3.77) for participants with and without thyroid cysts, respectively.\n\nConclusion: Among participants without thyroid cysts, TPO-Ab positivity was significantly associated with SCH, whereas no significant association was observed among those with thyroid cysts likely due to the small sample size. Reflecting a significant interaction between these factors, thyroid cyst status may modulate the association between TPO-Ab positivity and SCH, although further large-scale investigation is warranted.",
  "abstract_shown": true,
  "affiliations": [
    "Department of General Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8501 Japan",
    "Epidemiology Section, Division of Public Health, Osaka Institute of Public Health, Osaka, 537-0025 Japan",
    "Department of Community Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523 Japan",
    "Department of Health Society and Statistics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, 852-8523 Japan",
    "Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523 Japan",
    "Nagasaki University Health Center, Nagasaki, 852-8521 Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Yuji Shimizu",
      "orcid": "0000-0002-3381-9288"
    },
    {
      "affs": [
        1
      ],
      "name": "Nagisa Sasaki"
    },
    {
      "affs": [
        1
      ],
      "name": "Asuka Oyama",
      "orcid": "0000-0002-6584-5958"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuko Noguchi"
    },
    {
      "affs": [
        3
      ],
      "name": "Mutsumi Matsuu-Matsuyama"
    },
    {
      "affs": [
        0
      ],
      "name": "Koichiro Hamada",
      "orcid": "0000-0002-4669-5501"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Shin-Ya Kawashiri",
      "orcid": "0000-0002-2606-995X"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Hirotomo Yamanashi",
      "orcid": "0000-0002-8655-4519"
    },
    {
      "affs": [
        0,
        5
      ],
      "name": "Seiko Nakamichi"
    },
    {
      "affs": [
        2,
        4
      ],
      "name": "Yasuhiro Nagata",
      "orcid": "0000-0003-1353-7272"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Takahiro Maeda"
    },
    {
      "affs": [
        3,
        4
      ],
      "name": "Naomi Hayashida"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/abbtj2ga5kyqa.bib",
  "cited_by": 0,
  "doi": "10.1186/s40101-026-00443-9",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13737909/",
  "id": "abbtj2ga5kyqa",
  "issns": [
    "1880-6791",
    "1880-6805"
  ],
  "landing_url": "https://doi.org/10.1186/s40101-026-00443-9",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2712|Thyroid Disorders and Treatments"
    ]
  ],
  "openalex": "W7201872581",
  "pdf_url": null,
  "pmcid": "PMC13737909",
  "pmid": "42983566",
  "published": "2026-08-08",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/abbtj2ga5kyqa.ris",
  "sources": [
    {
      "first_seen": "2026-11-09T12:23:00Z",
      "native_id": "PMC13737909",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s40101-026-00443-9"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2712|Thyroid Disorders and Treatments",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "The potential modulating role of thyroid cysts on the association between anti–thyroid peroxidase antibodies and subclinical hypothyroidism",
  "title_text": "The potential modulating role of thyroid cysts on the association between anti–thyroid peroxidase antibodies and subclinical hypothyroidism",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T12:23:00Z",
  "url": "https://research.draconitic.com/paper/abbtj2ga5kyqa",
  "venue": "Journal of Physiological Anthropology",
  "versions": []
}