Prevalence and Trends of Thyroid Disease Among Adults, 1999-2018

Thyroid hormones in people with chronic obstructive pulmonary disease: A systematic review and meta-analysis

OBJECTIVE

To determine the influence of COPD on thyroid hormone levels.

METHODS

We performed a meta-analysis after conducting a literature search in PubMed, Embase, Web of Science, the Cochrane Library, ScienceDirect, and the Virtual Health Library from database inception to December 31st, 2023. We employed the inverse variance method with a random effects model to calculate the effect estimate as the mean difference (MD) and 95 % confidence interval (CI). We calculated the heterogeneity with the I2 statistic and performed a meta-regression analysis based on age, sex, and smoking status. The PROSPERO registry number was CRD42024492108.

RESULTS

The meta-analysis included 25 studies with 1613 patients with COPD and 1792 controls. The pooled MD (95 %CI) for TSH and total T3 were -0.26 mUI/L (-0.46, -0.07); p = 0.009, and -0.15 pg/mL (-0.29, -0.00); p = 0.04 respectively. There was no difference for free T3 and T4 and for total T4 between patients and controls. Heterogeneity was high in all cases. The patients with acute exacerbation of COPD had lower levels of TSH, free and total T3, pooled MD for TSH -0.58 mIU/L (-0.86, -0.31); p < 0.001, for free T3 -0.80 pg/mL (-1.53, -0.31); p < 0.001 and for total T3 -0.21 ng/mL (-0.33, -0.08); p < 0.001. TSH and total T3 levels were lower in patients with more severe airflow obstruction. The meta-regression analysis showed that the percentage of males and smokers in each study could explain the heterogeneity in T4 values.

CONCLUSIONS

TSH and T3 levels are decreased in patients with COPD, particularly in severe stages and during acute exacerbations.

Trends in atrial fibrillation and flutter mortality associated with disorders of thyroid gland in the United States from 1999 to 2020

Background

Thyroid gland disorders are a known risk factor for atrial fibrillation and flutter (AF/AFL). Despite being a well-established risk factor, most studies have primarily examined prevalence, comorbidities, and treatment patterns with little to no research on mortality trends for this association. Objective: We aimed to analyze the trends in AF/AFL-related mortality in patients with thyroid gland disorders.

Methods

Age-adjusted mortality rates and crude rates per 100,000 population from 1999 to 2020 using the CDC WONDER database. Annual percent changes and their averages were calculated via Joinpoint regression. AF/AFL-related mortality trends in patients with thyroid disorders were compared with those in the general population using pairwise comparison.

Results

In the study period, a total of 7187 AF/AFL-related deaths were observed in individuals diagnosed with thyroid gland disorders. The age-adjusted mortality rates increased throughout the study period. The mortality rates in females remained consistently higher than those in males. Mortality rates did not vary substantially across regions (South: 0.09; Northeast: 0.09; Midwest: 0.10; West: 0.11). Furthermore, the annual percent change in females and South with thyroid disorders differed significantly from the general population. The states with the highest mortality rates were Oregon, Wyoming, and Nebraska. The mortality rates remained higher in nonmetropolitan regions (0.11) than in metropolitan regions (0.09).

Conclusions

AF/AFL-related mortality trends associated with thyroid disorders increased from 1999 to 2020. Policies that target vulnerable populations and regions may be beneficial in mitigating the increasing AF/AFL-related mortality associated with disorders of the thyroid gland.

Preoperative Vocal Characteristics of Female Patients With Thyroid Disorders

PURPOSE

This study aimed to investigate the preoperative voice-related outcomes in female patients with thyroid disorders and reveal the possible clinical factors affecting vocal quality.

METHODS

A prospective case-control study was conducted with a total of 72 participants. The study group (SG) consisted of 24 preoperative female subjects with thyroid disorders (mean ± age, 42.96 ± 13.71 years) and the control group (CG) consisted of 48 normophonic subjects (mean ± age, 42.85 ± 9.61 years). Acoustic [mean F0, jitter, shimmer, harmonics-to-noise ratio (HNR), cepstral peak prominence-smoothed (CPPS)], auditory-perceptual (G parameter of Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale), and maximum phonation time (MPT) outcomes were compared between the groups. Additionally, the study examined the association between vocal outcomes and various clinical factors, including the final diagnosis based on surgical pathology, preoperative ultrasound characteristics (nodule localization, largest nodule size, and thyroid volume), and thyroid specimen weight following postoperative histologic examination.

RESULTS

All acoustic parameters (except for HNR) were significantly deteriorated in the SG than in the CG (P < 0.05). Auditory-perceptual comparisons revealed a significantly higher G score of GRBAS in SG than in CG (P < 0.001). However, no significant differences were obtained between the SG and CG for MPT. There was no association between the voice-related measurements and the clinical factors, including final diagnosis, nodule localization, largest nodule size, thyroid volume, and thyroid specimen weight.

CONCLUSIONS

Female patients with thyroid disorders may have deviated vocal quality before surgery. A comprehensive voice assessment is recommended to identify dysphonia and enhance treatment outcomes in this population.

The Current Understanding of the Molecular Pathogenesis of Papillary Thyroid Cancer

The thyroid is a vital endocrine organ that regulates metabolism, heart rate, respiration, digestion, body temperature, brain development, skin and bone maintenance, and reproduction and fertility. Thyroid cancer (TC) is the most common endocrine malignancy, with an estimate of 44,020 new cases in 2025. Incidence has been increasing, most notably at 4-5% per year in young adults. Papillary thyroid cancer (PTC), the most common TC subtype, accounts for approximately 80% of newly diagnosed TC cases. Furthermore, 2290 deaths are expected from the disease in 2025, with survival at over 98% with treatment. However, as PTC occurs most frequently in young women, recurrences are frequent and the 10-year disease-specific survival rate for advanced PTC is less than 50%. This narrative review aims to describe the current understanding of the thyroid gland, the incidence and subtypes of thyroid cancer, and specifically the diagnosis, prognosis, treatment, and recurrence of PTC. This is supplemented by the role of molecular pathways and biomarkers in PTC.

Phthalates and Non-Phthalate Plasticizers and Thyroid Dysfunction: Current Evidence and Novel Strategies to Reduce Their Spread in Food Industry and Environment

Thyroid hormones (THs) play a crucial role in various biological functions, including metabolism, cell growth, and nervous system development, and any alteration involving the structure of the thyroid gland and TH secretion may result in thyroid disease. Growing evidence suggests that phthalate plasticizers, which are commonly used in a wide range of products (e.g., food packaging materials, children's toys, cosmetics, medical devices), can impact thyroid function, primarily affecting serum levels of THs and TH-related gene expression. Like phthalate compounds, recently introduced alternative plasticizers can leach from their source material into the environment, particularly into foods, although so far only a very limited number of studies have investigated their thyroid toxicity. This review aimed at summarizing the current knowledge on the role of phthalate and non-phthalate plasticizers in thyroid dysfunction and disease, describing the major biological mechanisms underlying this relationship. We will also focus on the food industry as one of the main players for the massive spread of such compounds in the human body, in turn conveyed by edible compounds. Given the increasing worldwide use of plasticizers and the essential role of THs in humans, novel strategies should be envisaged to reduce this burden on the thyroid and, in general, on human health.

Exposome-wide association study of thyroid function using U.S. National Health and Nutrition Examination Survey data

Previous epidemiologic studies examining thyroid function and chemical exposures have typically focused on a single or a limited number of chemical classes, often neglecting the effects of chemical mixtures. This study addressed this gap by exploring the associations between exposure to hundreds of chemicals and thyroid function using an exposome-wide association study (ExWAS) approach and National Health and Nutrition Examination Survey (NHANES) data. We analyzed data from three NHANES cycles (2007-2008, 2009-2010, and 2011-2012), which include measures of thyroid function (free and total triiodothyronine [T3], free and total thyroxine [T4], thyroid-stimulating hormone [TSH]) and chemical biomarker concentrations from 9,082 participants. For adolescents (aged 12-19 years) and adults (aged ≥20 years), we employed multiple regression by accounting for survey weights to identify biomarkers associated with thyroid function test levels and used Bayesian group weighted quantile sum (BGWQS) regression to assess the effects of chemical mixtures on these measurements. After adjusting for multiple comparisons, we found in single exposure scenarios that 44 and 67 biomarkers were associated with at least one thyroid function measure in adolescents and adults, respectively (adjusted p-value <0.05). In scenarios involving mixed chemical exposures, groups such as pesticides, sodium/iodide symporter (NIS) inhibitors, and metals were associated with alterations in thyroid hormones or TSH across both age groups. Volatile organic compounds were specifically linked to lower T4 levels in adolescents, whereas phenols and parabens were associated with lower TSH levels exclusively in adults. Although limited by the cross-sectional data, this study identified chemical biomarkers linked to thyroid function.

Associations between exposure to sodium/iodide symporter inhibitors and markers of thyroid function: A systematic review and meta-analysis

BACKGROUND

Perchlorate, nitrate, and thiocyanate are well-known sodium/iodide symporter (NIS) inhibitors that disturb iodide uptake at the thyroid, affecting thyroid function. However, the associations between NIS inhibitor exposure and thyroid function are not well summarized in humans.

OBJECTIVE

We aimed to summarize associations between NIS inhibitor exposure and thyroid function markers and to identify key information gaps for future studies.

METHODS

From four databases (Embase, Web of Science, PubMed, CINAHL plus) up to May 31, 2024, we systematically searched studies that examined associations between levels of the three NIS inhibitors and thyroid hormones, including free thyroxine (FT4), total thyroxine (TT4), free triiodothyronine (FT3), and total triiodothyronine (TT3) as well as thyroid-stimulating hormone (TSH). We also conducted a random-effects meta-analysis to estimate the pooled effect size of the associations between NIS inhibitor levels and thyroid function marker levels.

RESULTS

Of 2,588 identified studies, we selected 9 studies for full-text review and 4 studies for a meta-analysis. The association between perchlorate and TSH was primarily studied and only three studies considered iodine concentrations. As a result of a meta-analysis, TSH levels were positively associated with levels of combined NIS inhibitors [β: 0.105; 95% confidence interval (CI): 0.046, 0.160] and perchlorate [β = 0.133; 95% CI: 0.056, 0.211]. We found negative trends between NIS inhibitors and FT3 and TT4 and positive but nonsignificant trends between FT3 and perchlorate and between TT4 and thiocyanate.

CONCLUSIONS

Our study provided comprehensive evidence on the association between exposure to NIS inhibitors and thyroid function markers in humans, aligning with the mechanisms observed in in vivo studies.

An unsupervised automatic texture classification method for ultrasound images of thyroid nodules

Objective.Ultrasound is the predominant modality in medical practice for evaluating thyroid nodules. Currently, diagnosis is typically based on textural information. This study aims to develop an automated texture classification approach to aid physicians in interpreting ultrasound images of thyroid nodules. However, there is currently a scarcity of pixel-level labeled datasets for the texture classes of thyroid nodules. The labeling of such datasets relies on professional and experienced doctors, requiring a significant amount of manpower. Therefore, the objective of this study is to develop an unsupervised method for classifying nodule textures.Approach.Firstly, we develop a spatial mapping network to transform the one-dimensional pixel value space into a high-dimensional space to extract comprehensive feature information. Subsequently, we outline the principles of feature selection that are suitable for clustering. Then we propose a pixel-level clustering algorithm with a region growth pattern, and a distance evaluation method for texture sets among different nodules is established.Main results.Our algorithm achieves a pixel-level classification accuracy of 0.931 for the cystic and solid region, 0.870 for the hypoechoic region, 0.959 for the isoechoic region, and 0.961 for the hyperechoic region. The efficacy of our algorithm and its concordance with human observation have been demonstrated. Furthermore, we conduct calculations and visualize the distribution of different textures in benign and malignant nodules.Significance.This method can be used for the automatic generation of pixel-level labels of thyroid nodule texture, aiding in the construction of texture datasets, and offering image analysis information for medical professionals.

An extended PFAS profiling of a Swedish subpopulation and mixture risk assessments using multiple approaches

Per- and polyfluoroalkyl substances (PFAS) have been detected worldwide, from the deep seas to polar regions. A previous review showed that PFAS are risk drivers of the chemical mixture present in human blood. This study focused on establishing the PFAS exposure of a Swedish subpopulation and investigated whether the exposure poses a risk of adverse health effects. Human serum from 60 blood donors in Stockholm, Sweden, was analyzed. A target method including 32 PFAS analytes and over 270 suspect features was used to detect and quantify PFAS. Twenty-six PFAS were quantified, and 7 suspect PFAS features (6 H-PFCAs and PFECHS) were semi-quantified. Nine mixture risk assessment (MRA) strategies were used to assess the risk of health outcomes. Fifteen effect levels were derived and used, along with 15 already established values. The certainty of various derivation techniques was discussed. The MRAs showed that the entire studied population exceeded some of the risk thresholds, with effects including high cholesterol and immune suppression. However, the certainty was lower when deriving these two effect levels. The MRA, using human biomonitoring guidance values (high certainty), concluded that for 63 % of the individuals, a risk for adverse health effects cannot be excluded. This study has demonstrated that there is a reason for concern regarding PFAS exposure in the general population of Sweden. To our knowledge, this is the first time the H-PFCAs have been semi-quantified in human blood using a reference standard.

Thyroid Dysfunction Prevalence and Risk Factors in the Southeastern Part of Bangladesh: A Cross-Sectional Study

Background and Aims

Globally thyroid disorders (TDs) are common health issues including in the Southeast Asian region. The purpose of this study was to ascertain the prevalence of thyroid disorders in the Bangladeshi population, with a particular focus on the frequency, etiology, and comorbidity of various thyroid diseases.

Methods

A cross-sectional research design was conducted in the southeastern part of Bangladesh. Information regarding prior diagnosis and current management of TDs was obtained through a questionnaire.

Results

Of the 300 respondents, 209 were female, and 91 were male. Females were found to be more predominant across all categories of TDs (χ 2 = 17.738, p < 0.05). Furthermore, the older age group (31-45 years) demonstrated a higher frequency of thyroid problems (OR: 1.320). Specifically, hyperthyroidism was identified as the most common thyroid disorder, followed by hypothyroidism, and euthyroidism. Hyperthyroidism was found to be less common in males (18.69%) compared to females (43.06%), while hypothyroidism was more prevalent in males (46.15%) compared to females (27.75%). Multiple logistic regression analysis demonstrates that participants with a family history of TDs have a significantly higher chance (OR: 2.991, CI: 1.480-6.044, p < 0.05) of having hyperthyroidism than those without such a history. Interestingly, the studied population also exhibited higher rates of comorbidities including gastritis, diabetes, and cardiovascular diseases.

Conclusion

According to the study's findings, it is advised to concentrate on educating Bangladeshis about thyroid problems, particularly female population. Moreover, healthcare professionals should check elderly patient's thyroid conditions and consider the possibility that thyroid dysfunction can coexist with other conditions.

Trends of Pathological Findings in Patients with Thyroid Diseases: A Single-center, Retrospective Study

Background

Globally, a rising trend has been observed in the prevalence of thyroid disorders, with many demographic and geographic factors influencing its epidemiology. Nonetheless, some cases often go undetected due to the inconsistent and non-specific nature of the clinical symptoms. Therefore, we aimed to determine the trend and relationship between various pathological findings in thyroid disease patients and their demographic factors to aid clinicians in making a prompt diagnosis and treatment plan.

Methods

A descriptive correlational study was conducted from January 2020 to May 2022 at Jinnah Postgraduate Medical Center, Karachi. We collected data via random sampling from 258 patients suffering from thyroid disorders. We evaluated baseline patient characteristics, along with, thyroid scan and fine needle aspiration cytology (FNAC) reports, and local thyroid gland examination findings.

Results

Out of 258 participants, 192 (74.4%) were females, whereas 66 (25.6%) were males, giving a female: male ratio of 2.9: 1. On local examination, 167 (64.7%) were found to have a solitary nodule, 79 (30.6%) had multinodular goiter. Findings revealed that benign follicular lesions had the highest prevalence (35.3%). Moreover, among the cancerous growth, papillary carcinoma presented the highest cases (12.4%). Of 258 cases, 24 patients had non-surgical interventions, while most (234) had surgical interventions. Total thyroidectomy was the most common procedure opted for by 45.3% (n = 117) of the participants, followed by lobectomy 70 (27.1%), near total thyroidectomy 43 (13.2%), modified radical neck dissection 5 (1.9%).

Conclusion

Our study showed that nearly all thyroid-related pathologies were more prevalent amongst females than males, with the majority having an acute to sub-acute clinical presentation. Multinodular goiter was a prominent finding indicating a greater need for screening tools and access to healthcare facilities, especially in rural areas, to allow future studies to compare provinces accurately.

A novel meta learning based stacked approach for diagnosis of thyroid syndrome

Thyroid syndrome, a complex endocrine disorder, involves the dysregulation of the thyroid gland, impacting vital physiological functions. Common causes include autoimmune disorders, iodine deficiency, and genetic predispositions. The effects of thyroid syndrome extend beyond the thyroid itself, affecting metabolism, energy levels, and overall well-being. Thyroid syndrome is associated with severe cases of thyroid dysfunction, highlighting the potentially life-threatening consequences of untreated or inadequately managed thyroid disorders. This research aims to propose an advanced meta-learning approach for the timely detection of Thyroid syndrome. We used a standard thyroid-balanced dataset containing 7,000 patient records to apply advanced machine-learning methods. We proposed a novel meta-learning model based on a unique stack of K-Neighbors (KN) and Random Forest (RF) models. Then, a meta-learning Logistic Regression (LR) model is built based on the collective experience of stacked models. For the first time, the novel proposed KRL (KN-RF-LR) method is employed for the effective diagnosis of Thyroid syndrome. Extensive research experiments illustrated that the novel proposed KRL outperformed state-of-the-art approaches, achieving an impressive performance accuracy of 98%. We vindicated the performance scores through k-fold cross-validation and enhanced performance using hyperparameter tuning. Our research revolutionized the timely detection of thyroid syndrome, contributing to the enhancement of human life by reducing thyroid mortality rates.

National trends in thyroid disease and COVID-19 pandemic-related factors, 1998-2021: A nationwide representative study in South Korea

Objective

Although thyroid disease is a common condition, there is limited research examining the prevalence of thyroid disease over a long period of time, including both before and during the COVID-19 pandemic. Therefore, we aimed to investigate sociodemographic aspects that might be associated with thyroid disease and how its prevalence has varied during the pandemic.

Methods

We assessed the prevalence of thyroid disease among Korean adults by using data from the Korea National Health and Nutrition Examination Survey from 1998 to 2021. We evaluated weighted prevalence and β-coefficients with 95 % CI for factors such as age, sex, residential area, education level, household income, perceived stress level, weight change, occupation category, and body mass index groups.

Results

From 1998 to 2021, the prevalence of thyroid disease among 159,896 Korean adults (88,120 females [55.1 %]) aged 20 years and older exhibited an overall increasing trend. The weighted prevalence in the general population rose from 1.52 % (95 % CI, 1.41-1.64) in 1998-2005 to 3.84 % (3.30-4.39) in 2021, with a higher likelihood of thyroid disease exposure as age increased. In addition, females, individuals with lower education levels, those with high levels of perceived stress, those who gained weight, and those classified as overweight or obese emerged as vulnerable groups for thyroid disease. For the majority of subgroups, the change amid the effect of the pandemic on prevalence was minimal. However, the aged ≥60 years group showed a greater increase in prevalence during the pandemic than before the pandemic (βdiff: 0.52 [95 % CI, 0.37-0.68]).

Conclusions

A nationwide representative study in South Korea revealed an increasing trend in the prevalence of thyroid disease over 24 years, particularly among the older population. Despite the minimal variation during the pandemic, our findings emphasize the need for targeted thyroid disease policies and further research, especially for specific subgroups such as the older population.

Sex-Based Differences in Thyroid Plasma B Cell Infiltration: Implications for Autoimmune Disease Susceptibility

Thyroid autoimmune diseases, such as Hashimoto thyroiditis and Graves disease, are significantly more prevalent in women than in men, suggesting underlying biological differences in immune system function and regulation between sexes. Plasma B cells are crucial in autoimmunity due to their role in producing antibodies targeting self-antigens, but their presence in the thyroids of women without clinical autoimmune diseases remains largely unexplored. This study investigates the infiltration of plasma B cells in female thyroids specifically excluding those with any clinical signs of autoimmune diseases. Using bulk RNA-seq analysis, we identified significant sex differences in gene expression profiles, particularly in genes associated with plasma B cells. Single-cell RNA-seq and spatial transcriptomic analyses further revealed that the CXCL13-CXCR5 signaling axis plays a pivotal role in recruiting and organizing plasma B cells within the thyroid tissue. These findings suggest that the inherent presence of plasma B cells in the female thyroid, driven by CXCL13, may contribute to the higher risk of developing autoimmune thyroid diseases in women. Our study provides new insights into the immune landscape of the thyroid and underscores the importance of understanding sex-specific differences in immune cell distribution and function.

Analyzing Comorbidity Patterns in Patients With Thyroid Disease Using Large-Scale Electronic Medical Records: Network-Based Retrospective Observational Study

BACKGROUND

Thyroid disease (TD) is a prominent endocrine disorder that raises global health concerns; however, its comorbidity patterns remain unclear.

OBJECTIVE

This study aims to apply a network-based method to comprehensively analyze the comorbidity patterns of TD using large-scale real-world health data.

METHODS

In this retrospective observational study, we extracted the comorbidities of adult patients with TD from both private and public data sets. All comorbidities were identified using ICD-10 (International Classification of Diseases, 10th Revision) codes at the 3-digit level, and those with a prevalence greater than 2% were analyzed. Patients were categorized into several subgroups based on sex, age, and disease type. A phenotypic comorbidity network (PCN) was constructed, where comorbidities served as nodes and their significant correlations were represented as edges, encompassing all patients with TD and various subgroups. The associations and differences in comorbidities within the PCN of each subgroup were analyzed and compared. The PageRank algorithm was used to identify key comorbidities.

RESULTS

The final cohorts included 18,311 and 50,242 patients with TD in the private and public data sets, respectively. Patients with TD demonstrated complex comorbidity patterns, with coexistence relationships differing by sex, age, and type of TD. The number of comorbidities increased with age. The most prevalent TDs were nontoxic goiter, hypothyroidism, hyperthyroidism, and thyroid cancer, while hypertension, diabetes, and lipoprotein metabolism disorders had the highest prevalence and PageRank values among comorbidities. Males and patients with benign TD exhibited a greater number of comorbidities, increased disease diversity, and stronger comorbidity associations compared with females and patients with thyroid cancer.

CONCLUSIONS

Patients with TD exhibited complex comorbidity patterns, particularly with cardiocerebrovascular diseases and diabetes. The associations among comorbidities varied across different TD subgroups. This study aims to enhance the understanding of comorbidity patterns in patients with TD and improve the integrated management of these individuals.

Epidemiologic changes in thyroid disease

PURPOSE OF REVIEW

To analyze the evolving epidemiologic trends in thyroid disease, focusing on risk factors, underlying drivers of these changes, and their implications on clinical practice and research priorities.

RECENT FINDINGS

Thyroid disease remains one of the most prevalent groups of disorders globally, and the shift in its frequency and distribution is multifactorial. The prevalence of hypothyroidism increases with age, although normal thyrotropin ranges appear to be age-dependent, raising concern for potentially inappropriate levothyroxine use. Hyperthyroidism and Graves' disease continue to be predominant in reproductive-age women but exhibit a milder phenotype at diagnosis. Thyroid nodules are increasingly found in asymptomatic patients, likely from more widespread use of neck and chest imaging. Thyroid cancer incidence has risen exponentially over the years, mostly driven by overdiagnosis of low-risk tumors; however, a small rise in incidence of higher risk tumors has been noted. Obesity appears to be a risk factor for thyroid cancer occurrence and more aggressive forms of the disease.

SUMMARY

Understanding epidemiologic trends in thyroid disease is crucial for guiding clinical practice and research efforts, aiming to optimize patient outcomes while preventing unnecessary and potentially harmful interventions.

Association between total body muscle-fat ratio and risk of thyroid disorders: a cross-sectional study

BACKGROUND

Thyroid disorders(TD) poses a significant health threat to Americans due to its high incidence rate. Obesity, a common factor linked to thyroid disorders, has garnered increasing attention. While Body mass index (BMI) is a widely used obesity index, it fails to account for the distribution of muscle and fat in the body. Recently, tMFR has emerged as a crucial obesity index in clinical research, warranting further investigation into its association with TD.

OBJECTIVE

Exploring the association between tMFR and thyroid disorders.

METHOD

A comprehensive survey and data analysis were conducted using the NHANES database to investigate the relationship between tMFR and the risk of TD. This study utilized multiple logistic regression, smooth curve fitting, and subgroup analysis across four periods from 2011 to 2018.

RESULT

A total of 11,912 subjects were included in the study, showing a prevalence of 7.14% for TD. The research indicated that tMFR had an inverse correlation with the risk of TD in a comprehensive model (OR = 0.90, 95% CI 0.82 to 1.00). When tMFR was divided into quartiles (Q1-Q4), individuals in the highest quartile had a 28% lower risk of TD than those in Q1 (OR = 0.72, 95% CI 0.57 to 0.91). Analysis using smoothed curve fitting demonstrated a nonlinear relationship between tMFR and TD risk, with the inflection point for tMFR saturation effect identified as 1.5. Subgroup analysis further confirmed the strong association between tMFR and TD risk. Receiver operating characteristic (ROC) curve analysis indicated that tMFR exhibited superior predictive ability for TD relative to BMI.

CONCLUSION

The study found a negative association between tMFR and the risk of TD; however, additional prospective studies are required to validate these findings.

Impact of methimazole-induced hypothyroidism on postnatal swine

Thyroid hormones regulate metabolic rate, nutrient utilization, growth, and development. Swine are susceptible to thyroid suppression in response to disease or environmental conditions, but the physiological impact of such disruption has not been established. The objective of this study was to evaluate the impact of hypothyroidism induced with the antithyroid medication methimazole (MMI). 10 mg/kg MMI significantly decreased circulating triiodothyronine (T3) for the duration of treatment but had only a transient effect on circulating thyroxine (T4). Thyroid tissue weight was significantly increased by more than 3.5-fold in response to MMI treatment. Histologically, the eosinophilic colloid was largely absent from the thyroid follicle which displayed a disorganized columnar epithelium consistent with goiter. MMI induced hypothyroidism has no effect on growth rate over 28 days. Hepatic expression of genes associated with thyroid metabolism (DIO1, DIO2, and DIO3), lipid utilization (CD36, FASN, and ACACA), apoptosis (TP53, PERP, SIVA1, and SFN) and proliferation (CDK1, CDK2, CDK4, and CDKN1A) were unaffected by treatment. Collectively these results demonstrate that MMI induces mild systemic hypothyroidism and pronounced goiter, indicating a strong homeostatic central regulation within the hypothalamic pituitary thyroid axis. This combined with limited peripheral effects, indicates resilience to hypothyroidism in modern swine.

Hypothyroidism and hyperthyroidism related to gynecologic cancers: a nationwide population-based cohort study

The purpose of this study was to assess the risks of hyperthyroidism and hypothyroidism related to gynecological cancers. Population-based retrospective cohort study. We conducted a cohort study using the Taiwan National Health Insurance Research Database to explore hyperthyroidism and hypothyroidism associated with site-specific gynecologic cancers in women from January 1, 2000 to December 31, 2018. The examined gynecologic cancers included endometrial (EC), uterine corpus cancer (UC), and ovarian cancer (OC). The incidence and hazard ratios were quantified using Cox proportional hazards models. The incidence of developing gynecological (Gyn) cancers in the hyperthyroid and hypothyroid women was 0.29 and 0.44 per 1000 person-years, which was 0.86 fold lower and 1.13 fold higher than that in the comparison cohort (p < 0.001). Compared with patients aged 20-40 years, patients in older age groups had a lower and higher risk of developing Gyn cancers (for hyperthyroid, 40-65 years: adjusted hazard ratio (aHR) = 0.82; > 65 years: aHR = 0.94; for hypothyroid, adjusted hazard ratio (aHR) = 1.26; > 65 years: aHR = 1.38). Compared with the non-hypothyroid women and non-hyperthyroid women beyond 6 years of follow-up, hypothyroid and hyperthyroid women showed decreased risk of Gyn cancers. Medication treatment for hyperthyroid and hypothyroid disease did not showed significant association in subgroup analyses (aHR = 0.99 and 0.80, respectively). Our results show that women with hyperthyroidism have a significantly reduced risk of gynecological cancers, whereas women with hypothyroidism have a slightly increased risk of gynecological cancers suggesting an association between thyroid function level and risk of gynecological cancers.

Prevalence of self-reported thyroid disease among adults with depression

BACKGROUND

Thyroid disorders are a common comorbidity in patients with depression, yet there is limited information available about the clinical epidemiology of thyroid diseases in this specific population. This study aims to describe the prevalence of thyroid disease among US adults with depression from 2007 to 2018.

METHODS

This cross-sectional study used nationally representative data collected through the National Health and Nutrition Examination Survey (NHANES) between January 1, 2007, to December 31, 2018. Age-standardized prevalence of thyroid disease among depressed patients was calculated within 4-year survey periods (2007-2010, 2011-2014, and 2015-2018), and adjusted to the 2000 U.S. standard population.

RESULTS

In our weighed sample, 6.1% of depressed individuals and 4.3% of non-depressed individuals reported thyroid disease between 2007 and 2018 (P < 0.0001). The age-standardized prevalence of thyroid disease in patients with depression increased over time, from 5.4% (95%CI, 4.6%-6.2%) in 2007-2010 to 6.8% (95%CI, 5.8%-8.0%) in 2015-2018 (P for trend = 0.0270). Furthermore, thyroid disease prevalence was highest in non-Hispanic white individuals, increased with age, and tended to be higher in women. Mean depression scores in patients with thyroid disease (9.1; 95%CI, 8.7-9.5) did not significantly different from those without thyroid disease (9.1; 95%CI, 9.0-9.3) (P = 0.96).

CONCLUSION

The age-standardized prevalence of thyroid disease among US adults with depression exhibited a consistent increase from 2007 to 2018, with the highest rate occurring in older, non-Hispanic white individuals, and women.

Innate Immunity in Autoimmune Thyroid Disease during Pregnancy

Autoimmune thyroid disease (AITD) is the most common organ-specific autoimmune disorder clinically presented as Hashimoto thyroiditis (HT) and Graves' disease (GD). The pathogenesis of AITD is caused by an inappropriate immune response related to genetic, non-genetic, and environmental factors. Pregnancy is one of the factors that have a great influence on the function of the thyroid gland because of the increased metabolic demand and the effects of hormones related to pregnancy. During pregnancy, an adaptation of the maternal immune system occurs, especially of the innate immune system engaged in maintaining adaptive immunity in the tolerant state, preventing the rejection of the fetus. Pregnancy-related hormonal changes (estrogen, progesterone, hCG) may modulate the activity of innate immune cells, potentially worsening the course of AITD during pregnancy. This especially applies to NK cells, which are associated with exacerbation of HD and GD. On the other hand, previous thyroid disorders can affect fertility and cause adverse outcomes of pregnancy, such as placental abruption, spontaneous abortion, and premature delivery. Additionally, it can cause fetal growth retardation and may contribute to impaired neuropsychological development of the fetus. Therefore, maintaining the thyroid equilibrium in women of reproductive age and in pregnant women is of the highest importance.