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Alfadda AA, Benabdelkamel H, Fathaddin AA, Alanazi IO, Lauzon N, Chaurand P, Masood A. A matrix-assisted laser desorption/ionization imaging mass spectrometric approach to study weight-related changes within thyroid tissue. JOURNAL OF MASS SPECTROMETRY : JMS 2021; 56:e4671. [PMID: 33169897 DOI: 10.1002/jms.4671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/23/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
Obesity is associated with numerous comorbidities along with abnormalities of the endocrine system, more commonly manifesting as dysfunctions of the thyroid gland such as goiter. Changes in weight, especially an increase, could lead to an increase in the incidence of thyroid dysfunction; however, its pathophysiology remains to be elucidated. In the present study, we aimed to interrogate the changes in the protein distribution and abundance between the lean patients and patients with obesity thyroid tissue sections through utilizing this technique. The FFPE-fixed thyroid tissue blocks from the selected cases and controls were identified and targeted for matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) analysis. Patients in the 30 to 75 years age group and undergoing total thyroidectomy for benign thyroid disease were recruited. Patients with thyroid cancers, autoimmune disorders, and other inflammatory conditions were excluded from the study. The selected patients were divided into two groups according to their BMIs: lean (BMI < 25) and obese (BMI > 35). An initial trial set was used as a pilot study for the optimization of the MALDI IMS protocol that was next applied to the selected thyroid tissues. MALDI IMS data from all the samples were aligned and statistical analysis carried out by k-means and linear discriminant analysis (LDA) classification model using principle component analysis (PCA) results were evaluated between the two groups: controls (lean) and cases (obese). Receiver operator characteristic (ROC) curves were alternatively used to calculate the variability of the identified peptides. The discriminating peptides were also independently identified and related to their corresponding proteins by using liquid chromatography and tandem mass spectrometry (LC-MS/MS) analyses. Eight peptides mainly from thyroglobulin were found to be upregulated whereas 10 others were found to be downregulated in the lean compared to the obese group. Through this technique, we will be able to better understand the relationship between the disease entity and obesity.
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Affiliation(s)
- Assim A Alfadda
- Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh, 11461, Saudi Arabia
- Department of Medicine, College of Medicine, King Saud University, P.O. Box 2925 (38), Riyadh, 11461, Saudi Arabia
| | - Hicham Benabdelkamel
- Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh, 11461, Saudi Arabia
| | - Amany A Fathaddin
- Department of Pathology and Laboratory Medicine, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh, 11461, Saudi Arabia
| | - Ibrahim O Alanazi
- The National Center for Biotechnology, King Abdulaziz City for Science and Technology, P.O. Box 6086, Riyadh, Saudi Arabia
| | - Nidia Lauzon
- Drug Discovery Platform, Research Institute of McGill University Health Centre, 1001 Boulevard Décarie, Montreal, Quebec, H4A 3J1, Canada
| | - Pierre Chaurand
- Department of Chemistry, Université de Montréal, P.O. Box 6128, Succursale Centre-Ville, Montreal, Quebec, H3C 3J7, Canada
| | - Afshan Masood
- Obesity Research Center, College of Medicine, King Saud University, P.O. Box 2925 (98), Riyadh, 11461, Saudi Arabia
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Fitzgerald SP, Bean NG, Falhammar H, Tuke J. Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis. Thyroid 2020; 30:1695-1709. [PMID: 32349628 PMCID: PMC7757573 DOI: 10.1089/thy.2019.0535] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Though the functional states of other endocrine systems are not defined on the basis of levels of controlling hormones, the assessment of thyroid function is based on levels of the controlling hormone thyrotropin (TSH). We, therefore, addressed the question as to whether levels of thyroid hormones [free thyroxine (fT4), total triiodothyronine (TT3)/free triiodothyronine (fT3)], or TSH levels, within and beyond the reference ranges, provide the better guide to the range of clinical parameters associated with thyroid status. Methods: A PubMed/MEDLINE search of studies up to October 2019, examining associations of levels of thyroid hormones and TSH, taken simultaneously in the same individuals, with clinical parameters was performed. We analyzed atrial fibrillation, other cardiac parameters, osteoporosis and fracture, cancer, dementia, frailty, mortality, features of the metabolic syndrome, and pregnancy outcomes. Studies were assessed for quality by using a modified Newcastle-Ottawa score. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. A meta-analysis of the associations was performed to determine the relative likelihood of fT4, TT3/fT3, and TSH levels that are associated with the clinical parameters. Results: We identified 58 suitable articles and a total of 1880 associations. In general, clinical parameters were associated with thyroid hormone levels significantly more often than with TSH levels-the converse was not true for any of the clinical parameters. In the 1880 considered associations, fT4 levels were significantly associated with clinical parameters in 50% of analyses. The respective frequencies for TT3/fT3 and TSH levels were 53% and 23% (p < 0.0001 for both fT4 and TT3/fT3 vs. TSH). The fT4 and TT3/fT3 levels were comparably associated with clinical parameters (p = 0.71). More sophisticated statistical analyses, however, indicated that the associations with TT3/fT3 were not as robust as the associations with fT4. Conclusions: Thyroid hormones levels, and in particular fT4 levels, seem to have stronger associations with clinical parameters than do TSH levels. Associations of clinical parameters with TSH levels can be explained by the strong negative population correlation between thyroid hormones and TSH. Clinical and research components of thyroidology currently based on the measurement of the thyroid state by reference to TSH levels warrant reconsideration.
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Affiliation(s)
- Stephen P. Fitzgerald
- Department of General Medicine and Royal Adelaide Hospital, Adelaide, South Australia
- Department of Endocrinology, Royal Adelaide Hospital, Adelaide, South Australia
- School of Medicine, University of Adelaide, Adelaide, South Australia
| | - Nigel G. Bean
- School of Mathematical Sciences, University of Adelaide, Adelaide, South Australia
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, University of Adelaide, Adelaide, South Australia
| | - Henrik Falhammar
- Department of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Wellbeing and Chronic Preventable Diseases Division, Menzies School of Health Research and Royal Darwin Hospital, Tiwi, Australia
| | - Jono Tuke
- School of Mathematical Sciences, University of Adelaide, Adelaide, South Australia
- ARC Centre of Excellence for Mathematical and Statistical Frontiers, University of Adelaide, Adelaide, South Australia
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Radetti G, Grugni G, Lupi F, Marazzi N, Longhi S, Fanolla A, Sartorio A. The relationship between hyperthyrotropinemia and metabolic and cardiovascular risk factors in a large group of overweight and obese children and adolescents. J Endocrinol Invest 2017; 40:1311-1319. [PMID: 28585021 DOI: 10.1007/s40618-017-0705-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 05/29/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Mild TSH elevations are frequently observed in obese patients, in the absence of any detectable thyroid disease. Our objective is to evaluate the relationship between the raised TSH levels and the biochemical and clinical consequences of obesity. METHODS This is a retrospective cross-sectional study of a large population of obese children and adolescents. We evaluated 833 subjects (340 m, 493 f), aged 14.4 ± 2.5 (range 5.2-18.5) years, height SDS 0.27 ± 1.04 (-3.49-4.35), and BMI SDS 2.94 ± 0.59 (1.60-4.68). Body composition, free T4, TSH, anti-TPO antibodies, anti-TG antibodies, inflammation markers (total WBC and the subtypes, ultrasensitive C-reactive protein), and metabolic parameters [AST, ALT, γGT, ALP, glycaemia, insulin, total cholesterol (TC), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C), triglycerides (TG)] were measured, and oral disposition index (ODI) and cardiovascular risk factors (TC/HDL-C and TG/HDL-C) were calculated. After exclusion of the subjects showing anti-thyroid antibodies, the remaining 779 (325 m, 454 f) were then subdivided into two subgroups according to a TSH value below (group A) or above (group B) 4.5 mU/L. RESULTS Clinical characteristics and hematological markers of patients with and without positive anti-thyroid antibodies were similar, with the exception of higher TSH levels in the latter group. Using analysis of covariance, the subjects of group B had significantly higher values of TC (170.3 ± 28.7 vs 163.3 ± 32.9 mg/dL; p < 0.05), systolic (125.8 ± 13.5 vs 124.5 ± 13.1 mm/Hg), and diastolic blood pressure (79.2 ± 8.0 vs 77.9 ± 8.2 mm/Hg) than subjects of group A. No difference was observed in body composition, ODI, and the cardiovascular risk factors between these two groups. CONCLUSION TSH elevation in overweight and obese children and adolescents, being associated with a higher TC and blood pressure, might negatively influence the cardiac status. Longitudinal studies are requested, however, to confirm this hypothesis and, therefore, to conclude whether a substitutive treatment with l-thyroxine is really needed in these patients.
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Affiliation(s)
- G Radetti
- Marienklinik, via Claudia De Medici 2, 39100, Bolzano, Italy.
| | - G Grugni
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
| | - F Lupi
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - N Marazzi
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
| | - S Longhi
- Department of Pediatrics, Regional Hospital of Bolzano, Bolzano, Italy
| | - A Fanolla
- Department of Biostatistics, Regional Hospital of Bolzano, Bolzano, Italy
| | - A Sartorio
- Experimental Laboratory for Auxo-endocrinological Research and Division of Auxology, Istituto Auxologico Italiano, Research Institute, Milan, Verbania, Italy
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Mosso L, Martínez A, Rojas MP, Latorre G, Margozzini P, Lyng T, Carvajal J, Campusano C, Arteaga E, Boucai L. Early pregnancy thyroid hormone reference ranges in Chilean women: the influence of body mass index. Clin Endocrinol (Oxf) 2016; 85:942-948. [PMID: 27260560 PMCID: PMC5572466 DOI: 10.1111/cen.13127] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 05/19/2016] [Accepted: 06/01/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Thyroid dysfunction and obesity during pregnancy have been associated with negative neonatal and obstetric outcomes. Thyroid hormone reference ranges have not been established for the pregnant Hispanic population. This study defines thyroid hormone reference ranges during early pregnancy in Chilean women and evaluates associations of body mass index (BMI) with thyroid function. DESIGN, PATIENTS, MEASUREMENTS This is a prospective observational study of 720 healthy Chilean women attending their first prenatal consultation at an outpatient clinic. Thyroid function [TSH, Free T4, Total T4 and antithyroid peroxidase antibodies (TPOAb)] and BMI were assessed at 8·8 ± 2·4 weeks of gestational age. RESULTS Median, 2·5th percentile (p2·5), and 97·5th percentile (p97·5) TSH values were higher, while median, p2·5, and p97·5 free T4 values were lower in obese patients compared with normal weight patients. Obesity was associated with a median TSH 16% higher (P = 0·035) and a median free T4 6·5% lower (P < 0·01) than values from patients with normal weight. BMI had a small, but statistically significant effect on TSH (P = 0·04) and free T4 (P < 0·01) when adjusted by maternal age, TPO antibodies, parity, sex of the newborn, gestational age and smoking. In all TPOAb (-) patients, median (p2·5-p.97·5) TSH was 1·96 mIU/l (0·11-5·96 mIU/l) and median (p2·5-p.97·5) free T4 was 14·54 pmol/l (11·1 - 19·02 pmol/l). Applying these reference limits, we found a prevalence of overt and subclinical hypothyroidism of 0·9% and 3·05% respectively. CONCLUSIONS TSH distributes at higher values and free T4 at lower values in obese pregnant women compared to normal weight pregnant women. Thyroid hormone reference ranges derived from Chilean patients with negative TPOAb are different from the fixed internationally proposed reference ranges and may be used in the Hispanic population.
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Affiliation(s)
- Lorena Mosso
- Departments of Endocrinology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Alejandra Martínez
- Departments of Endocrinology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - María Paulina Rojas
- Family Medicine, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Gonzalo Latorre
- Public Health, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Paula Margozzini
- Public Health, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Trinidad Lyng
- Departments of Endocrinology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Jorge Carvajal
- Obstetrics and Gynecology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Claudia Campusano
- Departments of Endocrinology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Eugenio Arteaga
- Departments of Endocrinology, Faculty of Medicine. Pontificia Universidad Catolica de Chile
| | - Laura Boucai
- Department of Medicine, Division of Endocrinology, Memorial Sloan-Kettering Cancer Center, Weill Cornell University
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Mervish NA, Pajak A, Teitelbaum SL, Pinney SM, Windham GC, Kushi LH, Biro FM, Valentin-Blasini L, Blount BC, Wolff MS. Thyroid Antagonists (Perchlorate, Thiocyanate, and Nitrate) and Childhood Growth in a Longitudinal Study of U.S. Girls. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:542-549. [PMID: 26151950 PMCID: PMC4829993 DOI: 10.1289/ehp.1409309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 07/02/2015] [Indexed: 05/29/2023]
Abstract
BACKGROUND Perchlorate, thiocyanate, and nitrate are sodium/iodide symporter (NIS) inhibitors that block iodide uptake into the thyroid, thus affecting thyroid function. Thyroid dysfunction can adversely affect somatic growth and development in children. To our knowledge, no studies have examined effects of NIS inhibitors on body size measures. OBJECTIVE We investigated associations between NIS inhibitors and childhood growth in 940 girls from the Puberty Study of the Breast Cancer and Environment Research Program. METHODS Urine samples collected from girls 6-8 years of age at enrollment (2004-2007) from New York City, greater Cincinnati, Ohio, and the Bay Area in California were analyzed for NIS inhibitors and creatinine (C). The longitudinal association between NIS inhibitors and anthropometric measures [height, waist circumference, and body mass index (BMI)] during at least three visits was examined using mixed effects linear models, adjusted for race and site. RESULTS Compared with girls in the low-exposure group (3.6, 626, and 500 mg/gC, median perchlorate, thiocyanate, and nitrate, respectively) girls with the highest NIS inhibitor exposure (9.6, 2,343, and 955 mg/gC, median perchlorate, thiocyanate, and nitrate, respectively) had slower growth in waist circumference and BMI but not height. Significant differences in the predicted mean waist circumference and BMI between the low- and high-exposure groups were observed beginning at 11 years of age. CONCLUSIONS Higher NIS inhibitor exposure biomarkers were associated with reductions in waist circumference and BMI. These findings underscore the need to assess exposure to NIS inhibitors with respect to their influence on childhood growth. CITATION Mervish NA, Pajak A, Teitelbaum SL, Pinney SM, Windham GC, Kushi LH, Biro FM, Valentin-Blasini L, Blount BC, Wolff MS, for the Breast Cancer and Environment Research Project (BCERP). 2016. Thyroid antagonists (perchlorate, thiocyanate, and nitrate) and childhood growth in a longitudinal study of U.S. girls. Environ Health Perspect 124:542-549; http://dx.doi.org/10.1289/ehp.1409309.
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Affiliation(s)
- Nancy A. Mervish
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashley Pajak
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan L. Teitelbaum
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan M. Pinney
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, Ohio, USA
| | - Gayle C. Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | | | - Frank M. Biro
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Liza Valentin-Blasini
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Benjamin C. Blount
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary S. Wolff
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Abstract
AIM Although obesity and weight gain generally are anticipated to be caused by an imbalance between energy intake and energy expenditure, the significance of thyroid hormones (TH) remains unclear. Examination of mitochondrial function may reflect intracellular thyroid hormone effect and elucidate whether a lower metabolic rate is present. METHODS In a group of 34 obese adolescents (age <16 years and body mass index above the age-related 95th percentile), and an age- and gender-matched group of 32 lean adolescent, thyroid stimulating hormone (TSH) and basal oxygen consumption were measured and mitochondrial function in peripheral blood monocytes was determined by flow cytometry. RESULTS Significant increase in TSH (3.06 +/- 1.56 mU/L vs. 2.33 +/- 0.91 mU/L, p < 0.05) and a decrease in VO2 (129 +/- 16 mL O2/m(2)*min vs. 146 +/- 15 mL O2/m(2)*min, p < 0.05) were observed in obese adolescents compared with lean adolescents. Flow cytometry analysis demonstrated a lower mitochondrial mass (6385 +/- 1962 a.u. vs. 7608 +/- 2328 a.u., p < 0.05) and mitochondrial membrane potential (11426 +/- 3861 a.u. vs. 14017 +/- 5536 a.u., p < 0.05) in obese adolescents compared with lean adolescents. These results are even more pronounced in adolescents with obese mothers. CONCLUSION In obese adolescents, the increased TSH and lowered VO2 propose a lowered basal metabolic rate and the impaired mitochondrial function suggests a decreased thyroid hormone stimulation of mitochondrial energy production. The maternal in-heritage is suggestive of a basal metabolic defect or mitochondrial resistance for TH.
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Affiliation(s)
- L Wilms
- The Mitochondrial Research Unit, Naestved Hospital, Naestved, Denmark.
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Alevizaki M, Saltiki K, Voidonikola P, Mantzou E, Papamichael C, Stamatelopoulos K. Free thyroxine is an independent predictor of subcutaneous fat in euthyroid individuals. Eur J Endocrinol 2009; 161:459-65. [PMID: 19700640 DOI: 10.1530/eje-09-0441] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Thyroid function parameters have been associated with obesity, but associations with the type of adiposity have not been examined. We used ultrasound (US) to assess regional adiposity and investigated associations of thyroid function with parameters of central obesity. DESIGN Cross-sectional study. METHODS A total of 303 apparently healthy individuals (age 42.9+/-8.8, body mass index (BMI) 19.0-43.3, median 26.2 kg/m(2), 181 women) were examined for indices of the metabolic syndrome. BMI, waist and hip circumference, abdominal subcutaneous fat (SF), and preperitoneal fat (PF) layer was estimated. TSH, free thyroxine (fT(4)), triiodothyronine (T(3)), thyroid autoantibodies, insulin, glucose, and lipid levels were measured. Subjects receiving T(4) (9.2%) were excluded. RESULTS SF and SF/PF ratio were inversely correlated with fT(4) levels (r=-0.169, P=0.023, r=-0.193, P=0.009 respectively). In multivariate analysis, fT(4) was a predictor of SF and SF/PF, independently of age, sex, and smoking. SF correlated with TSH levels (r=0.149, P=0.037). PF and SF were positively associated with T(3) levels (r=0.245, P=0.004 and r=0.189, P=0.019 respectively). T(3) levels were positively associated with BMI (r=0.257, P=0.0004), waist perimeter (r=0.324, P<0.0001), and waist-to-hip ratio (WHR; r=0.363, P<0.0001). The T(3)/fT(4) ratio was positively correlated with SF (r=0.182, P=0.028), WHR (r=0.267, P=0.0003), and BMI (r=0.146, P=0.043). CONCLUSIONS Increasing SF accumulation as assessed by US is associated with lower fT(4) and higher TSH levels among euthyroid slightly overweight individuals. These associations indicate that subtle variation in thyroid function may participate in regional adiposity.
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Affiliation(s)
- Maria Alevizaki
- Endocrine Unit, Department of Endocrinology and Metabolism, Evgenidion Hospital, Athens, Greece.
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Radetti G, Kleon W, Buzi F, Crivellaro C, Pappalardo L, di Iorgi N, Maghnie M. Thyroid function and structure are affected in childhood obesity. J Clin Endocrinol Metab 2008; 93:4749-54. [PMID: 18840640 DOI: 10.1210/jc.2008-0823] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVE Alterations in thyroid function are reported in obesity, although no relevant data exist on the thyroid structure of these patients and the frequency of autoimmunity. The aim of our study was to evaluate the involvement of the thyroid gland in a large group of obese children. DESIGN This was a cross-sectional study. METHODS The study was conducted between March 2004 and December 2007 in 186 overweight and obese children. In all subjects, serum free T(3), free T(4), TSH, antithyroid antibodies, and a thyroid ultrasound were assessed. A total ot 40 healthy children matched for age and of normal weight for height served as controls. RESULTS A total of 23 children (12.4%) showed antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto's thyroiditis (group A). Of them, 20 (10.8%) showed antithyroid antibodies and normal ultrasound (group B). A total of 70 subjects (37.6%) showed absent antithyroid antibodies and an ultrasound pattern suggestive of Hashimoto's thyroiditis (group C), and 73 children (39.2%) showed no thyroid antibodies with normal ultrasound (group D). TSH was higher in groups A and C compared with groups B and C, and controls (P < 0.05). Mean free T(4) was lower in group B (P < 0.05) than in controls, whereas free T(3) was higher in group C than in controls (P < 0.05). TSH and body mass index sd scores were significantly correlated in group C (P < 0.001), and TSH was also significantly associated with the degree of thyroid structure alterations (P < 0.05). CONCLUSION Obese children frequently show alterations of thyroid structure and function that are not completely explained by the presence of an autoimmune involvement.
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Affiliation(s)
- Giorgio Radetti
- Department of Pediatrics, Regional Hospital, via L. Boehler 5, 39100 Bolzano, Italy.
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Michalaki MA, Vagenakis AG, Leonardou AS, Argentou MN, Habeos IG, Makri MG, Psyrogiannis AI, Kalfarentzos FE, Kyriazopoulou VE. Thyroid function in humans with morbid obesity. Thyroid 2006; 16:73-8. [PMID: 16487017 DOI: 10.1089/thy.2006.16.73] [Citation(s) in RCA: 181] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Morbidly obese subjects may present with abnormal thyroid function tests but the reported data are scarce. Therefore, we studied the thyroid parameters in 144 morbidly obese patients, 110 females and 34 males, to assess the prevalence of hypothyroidism. Eleven percent (11.8%) carried the diagnosis of hypothyroidism and were undergoing levothyroxine (LT4) replacement therapy, 7.7% had newly diagnosed subclinical hypothyroidism, 0.7% had subclinical hyperthyroidism and 7.7% were euthyroid with positive antibodies (anti-thyroid peroxidase antibodies [TPOAb]). From the 144 subjects, we selected a cohort of 78 euthyroid subjects with negative TPOAb, who did not receive LT4 replacement or suppression therapy (the experimental group) and compared them to 77 normal-weight euthyroid subjects, TPOA-negative, matched for age and gender who served as controls. The experimental group had higher serum levels of triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), and thyrotropin (TSH) compared to the control group. Serum TSH concentration was associated with fasting serum insulin levels and insulin resistance but not with serum leptin levels, body mass index (BMI), fat mass, and lean body mass. In conclusion, in morbidly obese individuals, the prevalence of overt and subclinical hypothyroidism was high (19.5%). The morbidly obese subjects have higher levels of T3, FT3, T4, and TSH, probably the result of the reset of their central thyrostat at higher level.
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Affiliation(s)
- Marina A Michalaki
- Division of Endocrinology, Department of Medicine, University Hospital, Patras, Greece
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Sari R, Balci MK, Altunbas H, Karayalcin U. The effect of body weight and weight loss on thyroid volume and function in obese women. Clin Endocrinol (Oxf) 2003; 59:258-62. [PMID: 12864805 DOI: 10.1046/j.1365-2265.2003.01836.x] [Citation(s) in RCA: 116] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Thyroid volume and thyroid function may vary in obese and nonobese women. It is not known whether weight loss could affect thyroid volume and function in obese subjects. PATIENTS AND METHODS The study population consisted of 98 premenopausal euthyroid obese [body mass index (BMI) = 30 kg/m2] women (mean age 40.5 +/- 11.4 years) and 31 nonobese (BMI < 25 kg/m2) women (mean age 38.6 +/- 12.9 years). Weight, height, BMI, waist circumference, body fat percentage and fat weight of all subjects were measured. Thyroid function and thyroid ultrasonography were performed at baseline and after 6 months of obesity treatment. Subgroup analysis was done according to weight loss. RESULTS Thyroid volume (P = 0.021) and TSH concentration (P = 0.047) were higher; free T3 (P < 0.001) and free T4 concentrations (P = 0.045) were lower in obese women; however, all were still in the normal range. There was a positive correlation between thyroid volume and body weight (r = 0.319, P = 0.002), BMI (r = 0.504, P < 0.001), body fat percentage (r = 0.375, P = 0.001), body fat weight (r = 0.309, P = 0.01) and waist circumference (r = 0.386, P = 0.004). There was a positive correlation between TSH concentration and body weight (r = 0.227, P = 0.042) and body fat weight (r = 0.268, P = 0.038). After 6 months of obesity treatment, thyroid volume (P = 0.008) and TSH concentration (P = 0.006) decreased only in obese women who lost > 10% body weight. There was a positive correlation between the changes of thyroid volume and the change of body weight (r = 0.341, P = 0.009) and the change of body fat weight (r = 0.406, P = 0.013). CONCLUSIONS Our study suggests that thyroid volume and function may vary in obese women in association with body weight and fat mass; > 10% weight loss may affect thyroid volume and function, which however, is clinically insignificant.
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Affiliation(s)
- Ramazan Sari
- Division of Endocrinology and Metabolism, Akdeniz University Medical Faculty, Antalya, Turkey
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Abstract
BACKGROUND: The reference range for thyroid hormones and thyroid stimulating hormone (TSH) is usually established either by using the manufacturer's recommendations or by analyzing blood tests from a serum bank or from the local laboratory staff, assuming that they are healthy and euthyroid. The aim of this study was to examine the significance of clinical euthyroidism and a normal basal oxygen consumption on the reference range for thyroid hormones and TSH. METHODS: A clinical examination, including information on medication, was performed on 31 apparently healthy persons. The following determinations were made for all of the subjects: basal oxygen consumption, serum TSH, serum total T(3), and serum total T(4). T(4) uptake for calculation of FT(4)I was also measured. RESULTS: The clinical examination and determination of VO(2) reduced what initially appeared to be a euthyroid and healthy population by 32%. This also resulted in a narrower reference interval than that suggested by the manufacturer (range) (TSH: 0.35-5.50 mU/l, T(4): 58-140 nmol/l, T(3): 0.9-2.8 nmol/l) or than that established in the initially selected population (TSH=0.76-3.90 mU/l, T(4)=54-168 nmol/l, T(3)=1.27-2.74 nmol/l, FT(4)I=64-123 a.u.). In the finally selected population, this was TSH=0.76-3.90 mU/l, T(4)=59-127 nmol/l, T(3)=1.45-2.74 nmol/l, and FT(4)I=64-120 a.u. CONCLUSION: The method of selecting the population for establishing the reference interval for thyroid hormones and TSH influences the reference ranges. Neglecting to deal with this problem may invalidate screening procedures, especially for subclinical diseases.
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Affiliation(s)
- Jan Kvetny
- Section of Endocrinology, Department of Internal Medicine, Esbjerg County Hospital, DK 6700, Esbjerg, Denmark
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12
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Näslund E, Andersson I, Degerblad M, Kogner P, Kral JG, Rössner S, Hellström PM. Associations of leptin, insulin resistance and thyroid function with long-term weight loss in dieting obese men. J Intern Med 2000; 248:299-308. [PMID: 11086640 DOI: 10.1046/j.1365-2796.2000.00737.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The aim of the present study was to identify predictors of weight loss in obese men participating in a 2-year behaviour modification programme. DESIGN Longitudinal, clinical intervention study of a behaviour modifying weight loss program. SETTING University Hospital, Stockholm, Sweden. SUBJECTS Forty-four obese men (age, 42.7 +/- 1.1 years: BMI, 37.1 +/- 0.6 kg m(-2), mean +/- SEM) followed for 2 years. INTERVENTIONS Behaviour modification weight loss programme. MAIN OUTCOME MEASURES Associations between plasma leptin and thyroid function tests, insulin resistance by homeostatic model assessment (HOMA), dietary recall and anthropometrically determined body composition. RESULTS At baseline, there were significant correlations between plasma leptin and body mass index (BMI), fat-free mass (FFM) and insulin resistance. Median weight loss over 2 years was 4.9 kg (range, -27.2 to +11.9). Baseline serum leptin concentrations adjusted for BMI (leptin/BMI ratio) were significantly correlated with 2-year weight change (r = 0.34, P = 0.04). A subset of seven of the 44 men gained weight over the 2 years. These 'gainers' differed significantly in initial leptin/BMI ratio (0.62 +/- 0.07) compared with the 37 'losers' (0.42 +/- 0.03, P < 0.05). In a multiple regression model, baseline leptin, insulin and age predicted 22% of the variance in weight change with no additional significant contribution from BMI, FFM, waist:hip ratio, thyroid function tests or energy intake. There was a strong correlation between the change in leptin concentrations and the change in insulin resistance from baseline to 2-year follow-up (r = 0.54; P < 0.001). CONCLUSION Baseline plasma leptin concentrations predicted long-term weight loss. Inappropriate leptin secretion or disposal, corrected for BMI, was associated with failure to maintain weight loss in obese men in a behaviour modification weight loss programme.
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Affiliation(s)
- E Näslund
- Division of Surgery, Danderyd Hospital, Sweden.
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13
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Langer P, Balázová E, Vician M, Martino E, Jezová D, Michalíková S, Moravec R. Acute development of low T3 syndrome and changes in pituitary-adrenocortical function after elective cholecystectomy in women: some differences between young and elderly patients. Scand J Clin Lab Invest 1992; 52:215-20. [PMID: 1329184 DOI: 10.3109/00365519209088788] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
From two groups of female patients (young group: 15 patients aged less than 25 years; elderly group: 15 patients aged more than 65 years) who were subjected to cholecystectomy, blood samples were obtained on the day before surgery, on the day of surgery before premedication and after waking up from anaesthesia and also on days 1, 3 and 7 after surgery. In aliquots of sera the levels of TSH, ACTH, thyroxine (T4), triiodothyronine (T3), reverse triiodothyronine (rT3) and cortisol were estimated with the aid of radio-immunoassay (RIA). The differences between the young and elderly subjects were evaluated with the aid of four different statistical tests. Though no changes in the level of T4 were found, the level of T3 was significantly decreased and that of rT3 was significantly increased on Day 1 after surgery. However, the decrease of T3 was expressed more significantly in the young group and, in addition, an increase of rT3 in the same group was found even before premedication. The level of TSH showed a sharp increase at the end of surgery, which was expressed more in the young group. Though no differences between groups were observed in a sharp peak of the ACTH level during surgery, the increase of cortisol level in the elderly group was significantly higher and remained so during the post-operative period.
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Affiliation(s)
- P Langer
- Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, CSFR
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14
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Matzen LE, Andersen BB, Jensen BG, Gjessing HJ, Sindrup SH, Kvetny J. Different short-term effect of protein and carbohydrate intake on TSH, growth hormone (GH), insulin, C-peptide, and glucagon in humans. Scand J Clin Lab Invest 1990; 50:801-5. [PMID: 2293343 DOI: 10.1080/00365519009091076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The effect of isocaloric (500 kcal) protein and carbohydrate ingestion was studied in a crossover study in nine healthy humans. Subjects were studied twice after overnight fasting, with an interval of 3 to 7 days. Blood was collected for 240 min after food ingestion. The initial reaction of growth hormone (GH) and thyroid stimulating hormone (TSH) to protein and carbohydrate was identical, with a reduction in both GH and TSH, and nadir occurring after 45-60 min and 120 min, respectively. During the next 120 min TSH returned to starting level after carbohydrate intake but was still reduced after protein intake (p less than 0.04). After both diets GH increased after the initial decline, the increase was greatest after protein intake and maximum was reached at 180 min (p less than 0.02). It has been reported that the 5'-deiodination of T4 is stimulated by insulin and inhibited by glucagon. The physiological increase in insulin after carbohydrate ingestion (p less than 0.05), and the physiological increase in glucagon after protein ingestion (p less than 0.05) was not associated with any changes in TT4, FT4, TT3, FT3, or rT3 that could indicate changes in the 5'-deiodinase activity.
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Affiliation(s)
- L E Matzen
- Department of Clinical Chemistry, Odense University Hospital, Denmark
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