{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:42:29Z","timestamp":1775025749250,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autoimmune thyroiditis (AIT) frequently coexists with other autoimmune diseases, suggesting shared pathophysiological pathways. However, large-scale evidence supporting the relationship between AIT and rheumatoid arthritis (RA), as well as the potential metabolic and endocrine mediators linking the two, remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional analysis was conducted using nationally representative data from NHANES 2007\u20132012 (n = 5,715). Multivariable logistic regression models were used to evaluate associations between AIT and RA. Mediation analyses assessed the potential indirect effects of uric acid and free triiodothyronine (FT3). A cross-sectional risk stratification nomogram for RA status among individuals with AIT was constructed. Model performance was assessed in NHANES and examined for consistency in an independent hospital-based clinical cohort from China (n = 196).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AIT was significantly associated with prevalent RA in the NHANES cohort after multivariable adjustment. Uric acid and FT3 were statistically associated with both AIT and RA in regression analyses. Exploratory mediation analyses suggested that uric acid accounted for a modest proportion of the observed association in NHANES (13.4%), with directionally consistent findings in the external clinical cohort, whereas FT3 demonstrated inconsistent and non-significant mediation across cohorts. The risk stratification model showed good discriminative performance in NHANES (AUC\u00a0=\u00a00.776) and maintained comparable discrimination in the external cohort (AUC\u00a0=\u00a00.724), with acceptable calibration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this cross-sectional study, AIT was associated with prevalent RA, and selected metabolic and endocrine biomarkers were statistically related to this association. Although causal inference is precluded by the study design, these findings suggest the presence of shared metabolic and endocrine contexts underlying thyroid and joint autoimmunity and support further longitudinal investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1764735","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:46:38Z","timestamp":1775018798000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association between autoimmune thyroiditis and rheumatoid arthritis: a cross-sectional risk stratification study"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiang","family":"Ji","sequence":"first","affiliation":[{"name":"Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yina","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shilong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Shao","sequence":"additional","affiliation":[{"name":"School of Medicine, Southwest Jiaotong University","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Wu","sequence":"additional","affiliation":[{"name":"Center of Breast and Thyroid Surgery, Department of General Surgery, The Third People\u2019s Hospital of Chengdu","place":["Chengdu, Sichuan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12395","article-title":"Human autoimmune diseases: a comprehensive update","volume":"278","author":"Wang","year":"2015","journal-title":"J Intern Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2022.102266","article-title":"The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention","volume":"80","author":"Miller","year":"2023","journal-title":"Curr Opin Immunol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102649","article-title":"Hashimoto\u2019s thyroiditis: an update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential Malignant transformation","volume":"19","author":"Ralli","year":"2020","journal-title":"Autoimmun Rev"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp2310178","article-title":"What is rheumatoid arthritis","volume":"390","author":"Gravallese","year":"2024","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1007\/s10067-024-06888-6","article-title":"Autoimmune thyroid disease and rheumatoid arthritis: where the twain meet","volume":"43","author":"Lichtiger","year":"2024","journal-title":"Clin Rheumatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines13030552","article-title":"Polyautoimmunity reflecting immune dysregulation in common variable immunodeficiency","volume":"13","author":"Danieli","year":"2025","journal-title":"Biomedicines"},{"key":"B7","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1186\/s12902-023-01473-5","article-title":"The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity","volume":"23","author":"Yazdanifar","year":"2023","journal-title":"BMC Endocr Disord"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1282890","article-title":"The dysregulation of immune cells induced by uric acid: mechanisms of inflammation associated with hyperuricemia and its complications","volume":"14","author":"Li","year":"2023","journal-title":"Front Immunol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/5831858","article-title":"Association between the systemic immune-inflammation index and thyroid function in U.S. adults","volume":"2023","author":"Hu","year":"2023","journal-title":"Mediators Inflammation"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0561","article-title":"Vitamin E intake and prevalence rates of thyroid dysfunction and autoimmune thyroiditis: a cross-sectional analysis of NHANES data","volume":"34","author":"Liu","year":"2024","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B11","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s13075-023-03018-6","article-title":"The association between systemic immune-inflammation index and rheumatoid arthritis: evidence from NHANES 1999-2018","volume":"25","author":"Liu","year":"2023","journal-title":"Arthritis Res Ther"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23063188","article-title":"Uric acid and oxidative stress-relationship with cardiovascular, metabolic, and renal impairment","volume":"23","author":"Gherghina","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.022","article-title":"Uric acid regulates hepatic steatosis and insulin resistance through the NLRP3 inflammasome-dependent mechanism","volume":"64","author":"Wan","year":"2016","journal-title":"J Hepatol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"106119","DOI":"10.1016\/j.intimp.2019.106119","article-title":"Uric acid increases IL-1\u03b2 secretion and Caspase-1 activation in PBMCs of Beh\u00e7et\u2019s disease patients: the in vitro immunomodulatory effect of xanthine oxidase inhibitor Allopurinol","volume":"80","author":"Chekaoui","year":"2020","journal-title":"Int Immunopharmacol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-024-07271-1","article-title":"Correlation of systemic immune inflammation and serum uric acid with gout: based on NHANES","volume":"44","author":"Yan","year":"2025","journal-title":"Clin Rheumatol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2024.119944","article-title":"Free thyroid hormone: methods and standardization","volume":"565","author":"Ma","year":"2025","journal-title":"Clin Chim Acta Int J Clin Chem"},{"key":"B17","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.yjmcc.2024.04.007","article-title":"Triiodothyronine induces a proinflammatory monocyte\/macrophage profile and impedes cardiac regeneration","volume":"191","author":"Chen","year":"2024","journal-title":"J Mol Cell Cardiol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cbpa.2024.111769","article-title":"The influence of triiodothyronine on the immune response and extracellular matrix remodeling during zebrafish heart regeneration","volume":"299","author":"Long","year":"2025","journal-title":"Comp Biochem Physiol A Mol Integr Physiol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/cphy.c200003","article-title":"The role of thyroid hormone in the innate and adaptive immune response during infection","volume":"10","author":"Rubingh","year":"2020","journal-title":"Compr Physiol"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1764735\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:46:48Z","timestamp":1775018808000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1764735\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":19,"alternative-id":["10.3389\/fendo.2026.1764735"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1764735","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"article-number":"1764735"}}