{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T18:19:19Z","timestamp":1785176359198,"version":"3.55.0"},"reference-count":51,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T00:00:00Z","timestamp":1613520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research foundation of Korea","doi-asserted-by":"publisher","award":["NRF-2018-R1D1A1A02085328 and 2020R1A2C4002594"],"award-info":[{"award-number":["NRF-2018-R1D1A1A02085328 and 2020R1A2C4002594"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: This study investigated relationship between multiple thyroid disorders and benign paroxysmal positional vertigo (BPPV), adjusting for levothyroxine medication. Methods: The Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 were used. A total of 19,071 patients with BPPV were matched with 76,284 participants of a control group in a ratio of 1:4 for age, sex, income, and region of residence. The previous histories of thyroid disorders such as goiter, hypothyroidism, thyroiditis, hyperthyroidism, and autoimmune thyroiditis were investigated in both the BPPV and control groups. The odds ratios (ORs) for BPPV in thyroid diseases were calculated using conditional logistic regression analyses. Results: The histories of goiter (5.5% vs. 4.1%), hypothyroidism (4.7% vs. 3.7%), thyroiditis (2.1% vs. 1.6%), and hyperthyroidism (3.1% vs. 2.5%) were higher in the BPPV group than in the control group (all p &lt; 0.001). Goiter, hypothyroidism, thyroiditis, and hyperthyroidism were associated with BPPV (adjusted OR = 1.28 (95% CI = 1.17\u20131.39) for goiter, 1.23 (95% CI = 1.10\u20131.37) for hypothyroidism, 1.13 (95% CI = 1.02\u20131.26) for hyperthyroidism, each p &lt; 0.05). Conclusions: BPPV was associated with thyroid disorders such as goiter, hypothyroidism, thyroiditis, and hyperthyroidism.<\/jats:p>","DOI":"10.3390\/diagnostics11020329","type":"journal-article","created":{"date-parts":[[2021,2,17]],"date-time":"2021-02-17T21:35:42Z","timestamp":1613597742000},"page":"329","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Analyses of the Relation between BPPV and Thyroid Diseases: A Nested Case-Control Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1655-9549","authenticated-orcid":false,"given":"Hyo Geun","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology-Head &amp; Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea"},{"name":"Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-1999","authenticated-orcid":false,"given":"Young Shin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6513-7011","authenticated-orcid":false,"given":"Jee Hye","family":"Wee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head &amp; Neck Surgery, Hallym University College of Medicine, Anyang 14068, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0629-9299","authenticated-orcid":false,"given":"Chanyang","family":"Min","sequence":"additional","affiliation":[{"name":"Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Korea"},{"name":"Graduate School of Public Health, Seoul National University, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2511-5536","authenticated-orcid":false,"given":"Dae Myoung","family":"Yoo","sequence":"additional","affiliation":[{"name":"Graduate School of Public Health, Seoul National University, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-4930","authenticated-orcid":false,"given":"So Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology-Head &amp; Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3035","DOI":"10.1172\/JCI60047","article-title":"Mechanisms of thyroid hormone action","volume":"122","author":"Brent","year":"2012","journal-title":"J. Clin. Investig."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1530\/EJE-16-0559","article-title":"Prevalence, incidence and associated comorbidities of treated hypothyroidism: An update from a European population","volume":"176","author":"Giorda","year":"2017","journal-title":"Eur. J. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1089\/105072502761016458","article-title":"Epidemiology and prevention of clinical and subclinical hypothyroidism","volume":"12","author":"Vanderpump","year":"2002","journal-title":"Thyroid"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"479","DOI":"10.23736\/S0393-3660.19.04176-7","article-title":"A historical excursus of diagnostic methods for Hashimoto thyroiditis and Graves\u2019 disease","volume":"179","author":"Trovato","year":"2020","journal-title":"Gazz. Med. Ital. Arch. Sci. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/cen.12060","article-title":"Incidence rate and clinical features of hyperthyroidism in a long-term iodine sufficient area of Sweden (Gothenburg) 2003\u20132005","volume":"78","author":"Jansson","year":"2013","journal-title":"Clin. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1210\/er.2018-00163","article-title":"Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders","volume":"40","author":"Biondi","year":"2019","journal-title":"Endocr. Rev."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Wolffenbuttel, B.H.R., Wouters, H.J.C.M., Slagter, S.N., Van Waateringe, R.P., Kobold, A.C.M., Van Vliet-Ostaptchouk, J.V., Links, T.P., and Van Der Klauw, M.M. (2017). Thyroid function and metabolic syndrome in the population-based LifeLines cohort study. BMC Endocr. Disord., 17.","DOI":"10.1186\/s12902-017-0215-1"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/nrcardio.2016.174","article-title":"Thyroid hormones and cardiovascular disease","volume":"14","author":"Jabbar","year":"2017","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1590\/2359-3997000000292","article-title":"Mechanisms involved in hearing disorders of thyroid ontogeny: A literature review","volume":"61","author":"Andrade","year":"2017","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"863","DOI":"10.4158\/EP161635.RA","article-title":"Hashimoto Thyroiditis and Vestibular Dysfunction","volume":"23","author":"Chiarella","year":"2017","journal-title":"Endocr. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1111\/cen.12471","article-title":"Vestibular disorders in euthyroid patients with Hashimoto\u2019s thyroiditis: Role of thyroid autoimmunity","volume":"81","author":"Chiarella","year":"2014","journal-title":"Clin. Endocrinol."},{"key":"ref_13","first-page":"710","article-title":"Epidemiology of benign paroxysmal positional vertigo: A population based study","volume":"78","author":"Radtke","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3233\/VES-150553","article-title":"Benign paroxysmal positional vertigo: Diagnostic criteria","volume":"25","author":"Bertholon","year":"2015","journal-title":"J. Vestib. Res."},{"key":"ref_15","first-page":"373","article-title":"Current view of the mechanism of benign paroxysmal positioning vertigo: Cupulolithiasis or canalolithiasis?","volume":"3","author":"Brandt","year":"1993","journal-title":"J. Vestib. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1177\/0003489418771988","article-title":"Treatment of Patients with Benign Paroxysmal Positional Vertigo and Severe Immobility Using the Particle Repositioning Chair: A Retrospective Cohort Study","volume":"127","author":"Luryi","year":"2018","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1136\/practneurol-2018-002117","article-title":"Post-traumatic benign paroxysmal positional vertigo","volume":"19","author":"Mumford","year":"2019","journal-title":"Pract. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/709469","article-title":"Inner ear disease and benign paroxysmal positional vertigo: A critical review of incidence, clinical characteristics, and management","volume":"2011","author":"Riga","year":"2011","journal-title":"Int. J. Otolaryngol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1089\/thy.2009.0319","article-title":"The association between benign paroxysmal positional vertigo and autoimmune chronic thyroiditis is not related to thyroid status","volume":"20","author":"Papi","year":"2010","journal-title":"Thyroid"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1111\/j.1365-2265.2008.03311.x","article-title":"Association between benign paroxysmal positional vertigo and autoimmune chronic thyroiditis","volume":"70","author":"Papi","year":"2009","journal-title":"Clin. Endocrinol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"754","DOI":"10.3109\/00016489.2015.1021932","article-title":"The relationship between benign paroxysmal positional vertigo and thyroid autoimmunity","volume":"135","author":"Sari","year":"2015","journal-title":"Acta Otolaryngol."},{"key":"ref_22","first-page":"16","article-title":"Vertigo and metabolic disorders","volume":"17","author":"Santos","year":"2012","journal-title":"Int. Tinnitus J."},{"key":"ref_23","first-page":"128","article-title":"Metabolic disorders of the vestibular system","volume":"112","author":"Rybak","year":"1995","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e026936","DOI":"10.1136\/bmjopen-2018-026936","article-title":"Risk of benign paroxysmal positional vertigo in patients with depressive disorders: A nationwide population-based cohort study","volume":"9","author":"Hsu","year":"2019","journal-title":"BMJ Open"},{"key":"ref_25","first-page":"76","article-title":"Can Hashimoto\u2019s thyroiditis cause vertigo? [Czy choroba Hashimoto moze byc przyczyna zawrotow glowy?]","volume":"70","author":"Lisowska","year":"2020","journal-title":"Endokrynol. Pol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"412","DOI":"10.21053\/ceo.2018.01774","article-title":"Tobacco Smoking and Alcohol Consumption Are Related to Benign Parotid Tumor: A Nested Case-Control Study Using a National Health Screening Cohort","volume":"12","author":"Kim","year":"2019","journal-title":"Clin. Exp. Otorhinolaryngol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s00405-018-5230-y","article-title":"Osteoporosis increases the risk of benign paroxysmal positional vertigo: A nested case-control study using a national sample cohort","volume":"276","author":"Choi","year":"2019","journal-title":"Eur. Arch. Oto Rhino Laryngol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"18224","DOI":"10.1038\/s41598-020-75404-y","article-title":"Association between Meniere\u2019s disease and thyroid diseases: A nested case-control study","volume":"10","author":"Kim","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1016\/j.jaip.2019.10.043","article-title":"Bidirectional Association Between GERD and Asthma: Two Longitudinal Follow-Up Studies Using a National Sample Cohort","volume":"8","author":"Kim","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_30","unstructured":"World Health Organization. Regional Office for the Western Pacific (2000). The Asia-Pacific Perespective: Redefining Obesity and its Treatment, Health Communications Australia."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am. J. Epidemiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"Quan","year":"2005","journal-title":"Med. Care"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1054\/mehy.1999.0905","article-title":"A relationship between autoimmune thyroiditis and benign paroxysmal positional vertigo?","volume":"54","author":"Modugno","year":"2000","journal-title":"Med. Hypotheses"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1609","DOI":"10.1007\/s00405-020-05855-6","article-title":"Is drug consumption correlated with benign paroxysmal positional vertigo (BPPV) recurrence?","volume":"277","author":"Picciotti","year":"2020","journal-title":"Eur. Arch. Oto Rhino Laryngol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1146\/annurev-pathol-012513-104713","article-title":"Mechanisms of autoimmune thyroid diseases: From genetics to epigenetics","volume":"9","author":"Tomer","year":"2014","journal-title":"Annu. Rev. Pathol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"M315","DOI":"10.1093\/gerona\/57.5.M315","article-title":"Hypothyroidism in patients older than 55 years: An analysis of the etiology and assessment of the effectiveness of therapy","volume":"57","author":"Diez","year":"2002","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/000348947508400215","article-title":"Positional nystagmus in association with macroglobulinemia","volume":"84","author":"Keim","year":"1975","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2018\/5072582","article-title":"Update on Vertigo in Autoimmune Disorders, from Diagnosis to Treatment","volume":"2018","author":"Girasoli","year":"2018","journal-title":"J. Immunol. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.mehy.2007.04.032","article-title":"Enlarged vestibular aqueduct (EVA) related with recurrent benign paroxysmal positional vertigo (BPPV)","volume":"70","author":"Manzari","year":"2008","journal-title":"Med. Hypotheses"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.beem.2017.04.011","article-title":"Pendred syndrome","volume":"31","author":"Wemeau","year":"2017","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1007\/s00405-004-0884-z","article-title":"Long-term follow-up in patients with Pendred syndrome: Vestibular, auditory and other phenotypes","volume":"262","author":"Sugiura","year":"2005","journal-title":"Eur. Arch. Oto Rhino Laryngol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.3109\/00016489.2012.662714","article-title":"Enlarged vestibular aqueduct may precipitate benign paroxysmal positional vertigo in children","volume":"132","author":"Song","year":"2012","journal-title":"Acta Otolaryngol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1016\/j.imbio.2010.09.015","article-title":"SLC26A4 expression among autoimmune thyroid tissues","volume":"216","author":"Rebuffat","year":"2011","journal-title":"Immunobiology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1089\/105072501316973073","article-title":"Sodium iodide symporter and pendrin expression in human thyroid tissues","volume":"11","author":"Mian","year":"2001","journal-title":"Thyroid"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1007\/s00405-014-3172-6","article-title":"High stimulus rate brainstem auditory evoked potential in benign paroxysmal positional vertigo","volume":"272","author":"He","year":"2015","journal-title":"Eur. Arch. Oto Rhino Laryngol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1097\/00005537-200408000-00020","article-title":"Giant cell arteritis: A new association with benign paroxysmal positional vertigo","volume":"114","author":"Llorca","year":"2004","journal-title":"Laryngoscope"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5935\/0946-5448.20170007","article-title":"Management of Benign Paroxysmal Positional Vertigo: A Comparative Study between Epleys Manouvre and Betahistine","volume":"21","author":"Kaur","year":"2017","journal-title":"Int. Tinnitus J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1177\/0003489419892285","article-title":"The Impact of Betahistine versus Dimenhydrinate in the Resolution of Residual Dizziness in Patients with Benign Paroxysmal Positional Vertigo: A Randomized Clinical Trial","volume":"129","author":"Jalali","year":"2020","journal-title":"Ann. Otol Rhinol Laryngol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Murdin, L., Hussain, K., and Schilder, A.G. (2016). Betahistine for symptoms of vertigo. Cochrane Database Syst. Rev., CD010696.","DOI":"10.1002\/14651858.CD010696.pub2"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1007\/s13577-020-00341-x","article-title":"Thyroid-related hormones as potential markers of hypoxia\/ischemia","volume":"33","author":"Tani","year":"2020","journal-title":"Hum. Cell"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1007\/s12020-019-02050-4","article-title":"Novel uses of thyroid hormones in cardiovascular conditions","volume":"66","author":"Razvi","year":"2019","journal-title":"Endocrine"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/2\/329\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:25:14Z","timestamp":1760160314000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/11\/2\/329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,17]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["diagnostics11020329"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics11020329","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,17]]}}}