Endocrinology · Medical Literature
Autoimmune thyroiditis and comorbid autoimmune diseases: global research landscape and future directions.
Abstract
Autoimmune thyroiditis (AIT) patients frequently present with coexisting autoimmune diseases (ADs), adding complexity to management and outcomes. Although this field has been extensively explored, there is a paucity of bibliometric analyses capable of clarifying worldwide research trajectories, identifying major hotspots, and outlining prospective directions. This study extracted data from PubMed, Web of Science Core Collection, and Scopus, analyzing 2,201 publications published between 1980 and 2024. Data visualization was performed using VOSviewer, CiteSpace, and the bibliometrix R package. The analysis encompassed 95 countries, 2,561 institutions, and 10,355 authors, with publications across 769 sources. The United States led in the number of published articles, while the University of Pisa emerged as the most productive institution. The Journal of Clinical Endocrinology & Metabolism had the highest volume of publications and citations in this field. Alessandro Antonelli was identified as the most prolific author, with the highest number of co-cited authors. Keyword analysis identified five primary areas of research: immune dysregulation and inflammation mechanisms, comorbidity phenomena and shared pathological foundations, immune disturbances in infections and pregnancy, genetic susceptibility and genetic mechanisms, and biomarkers and cancer risk. Key future research areas include further exploration of precision medicine & multi-omics, microbiota's role in immune regulation, genetic factors and polymorphisms, the relationship between comorbidities and systemic ADs, and biomarkers with causal inference. This study provides a comprehensive analysis of the literature on AD and AIT, offering insights into global research trends and current hotspots, while suggesting future directions for further investigation.
Clinical relevance
Autoimmune thyroiditis (AIT) frequently co-occurs with other autoimmune diseases (ADs), compounding diagnostic complexity and clinical management for endocrinologists and internists. This bibliometric analysis synthesizes 44 years of global literature (1980–2024) across 2,201 publications, providing a uniquely comprehensive map of research trajectories that individual studies cannot offer. Clinicians managing AIT patients should be aware of the breadth and direction of comorbid autoimmune research to anticipate emerging evidence in precision medicine, multi-omics, and microbiome-immune interactions.
Key findings
1. The analysis encompassed 2,201 publications from 95 countries, 2,561 institutions, and 10,355 authors across 769 journal sources, reflecting a substantial and globally distributed research base. 2. The United States led in total publication output, while the University of Pisa was the most productive single institution; Alessandro Antonelli was identified as the most prolific and most co-cited author in the field. 3. The Journal of Clinical Endocrinology & Metabolism recorded the highest volume of publications and citations, establishing it as the field's primary dissemination venue. 4. Keyword co-occurrence analysis delineated five core research clusters: (a) immune dysregulation and inflammation mechanisms, (b) comorbidity phenomena and shared pathological foundations, (c) immune disturbances in infections and pregnancy, (d) genetic susceptibility and polymorphisms, and (e) biomarkers and cancer risk. 5. Bibliometric mapping identified precision medicine and multi-omics, gut microbiota's role in immune regulation, and causal inference via biomarkers as the highest-priority emerging research frontiers. 6. NOTE — No primary quantitative effect sizes, confidence intervals, p-values, or NNT/NNH were reported in this abstract, as is expected for a bibliometric/scientometric study rather than a clinical trial or meta-analysis; findings are descriptive and trend-based.
Practice implications
Clinicians managing AIT should systematically screen for comorbid autoimmune conditions (e.g., rheumatoid arthritis, type 1 diabetes, systemic lupus erythematosus) given the well-documented shared immunopathological foundations highlighted across this body of literature, particularly in patients with refractory or atypical presentations. Emerging evidence trajectories in genetic polymorphisms and multi-omics suggest that future patient stratification for AIT-associated AD risk may shift toward molecularly informed, precision medicine frameworks, warranting clinician familiarity with these evolving tools. The identified research gap around gut microbiota and immune regulation in AIT also signals that dietary and microbiome-targeted interventions may become clinically actionable in the near term, and practitioners should monitor high-impact endocrinology journals — particularly the Journal of Clinical Endocrinology & Metabolism — for practice-changing evidence in these areas.