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Soylu H, Ersoy R, Keske PB, Tunçay ME, Ateş C, Çakır B, Yalçın B. The diurnal change of thyroid-stimulating hormone and the effect of this change on thyroid functions in patients with chronic kidney disease. Endocrine 2023; 82:580-585. [PMID: 37490264 DOI: 10.1007/s12020-023-03446-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 07/01/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Thyroid-stimulating hormone (TSH) has a pulsatile and circadian rhythm in healthy individuals. We aimed to evaluate the diurnal changes of free thyroid hormones and serum TSH levels in patients with end-stage renal failure (ESRF) whose thyroidal functions are at normal ranges. METHODS Thirty hemodialysis patients with chronic renal failure and without a known thyroidal disease who are over 18 and 35 healthy individuals were included. The serum TSH, free T3, and free T4 levels were examined among the patient and control group which were taken at 8:00 a.m., 4:00 p.m., and 0:00 a.m. RESULTS Twenty-two (73.3%) patients were male, and the mean age of the patient group was 64 (sd = 14.45 years). Seventeen (48.6%) of the control group were female, and the mean age was 31.9 (sd = 6.4 years). Serum free T3 levels, measured at three different time points (8:00 a.m., 4:00 p.m., and 0:00 a.m.), were significantly lower in the patient group than in the control group and serum free T4 levels were measured at three different time points (8:00 am, 4:00 p.m., and 0:00 a.m.) were significantly higher in the patient group than in the control group. Serum TSH levels were higher in the patient group than in the control group at 08:00, and were lower at 24:00 (p < 0.001). The nocturnal increase of serum TSH level under 0.525 suggested diurnal rhythm disruption with 83% sensitivity and 87% specificity. CONCLUSION The nocturnal serum TSH increase is not seen in ESRF patients who did not have a thyroid disease. We think that not observing a nocturnal TSH increase could be an early indication of the sick euthyroid syndrome.
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Affiliation(s)
- Hüseyin Soylu
- Batman Training and Research Hospital, Batman, Turkey.
| | - Reyhan Ersoy
- Ankara Yıldırım Beyazıt University, Medicine Faculty, Ankara, Turkey
| | - Pelin Bal Keske
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Education Research Hospital, Department of Intensive Care, Istanbul, Turkey
| | | | - Can Ateş
- Aksaray University, Medicine Faculty Department of Biostatistics, Aksaray, Turkey
| | - Bekir Çakır
- Ankara Yıldırım Beyazıt University, Medicine Faculty, Ankara, Turkey
| | - Bülent Yalçın
- Ankara Yıldırım Beyazıt University, Medicine Faculty, Ankara, Turkey
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Liu C, Li L, Zeng L, Ahmad S. The Clinical Value of Thyroid Hormone Levels and Correlation with Severity of Liver Cirrhosis. Computational Intelligence and Neuroscience 2022; 2022:1-12. [PMID: 35707192 PMCID: PMC9192234 DOI: 10.1155/2022/5365172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
Background. The aims of this study were to expound the effect of thyroid hormone on the occurrence of liver cirrhosis and the severity classification of liver cirrhosis with meta-analysis. Methods. A comprehensive search of PubMed, EMbase, The Cochrane Library, Web of Science, Google Scholar, CNKI, and WanFang Data databases and reference lists of retrieved articles was performed since the inception of each database until September 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias by RevMan 5.3 software. In continuous variable analysis, the standardized mean difference (SMD) and 95% confidence interval (95% CI) were calculated through a random-effect model. Results. Eighteen case-control studies involving 3336 subjects were included for review. The results of the meta-analysis showed free triiodothyronine (FT3) and free thyroxine (FT4) levels in the liver cirrhosis group were lower than the control group (SMD = −1.29, 95% CI [−1.85, −0.74],
< 0.001), (SMD = −0.61, 95% CI [−0.96, −0.26],
< 0.001), thyroid-stimulating hormone (TSH) levels in liver cirrhosis group were higher than the control group (SMD = 0.34, 95%CI [0.06, 0.63],
< 0.001) and that FT3 levels in Child-Pugh A VS B and Child-Pugh B VS C group were higher than the control group (SMD = 1.08, 95%CI [0.80, 1.37],
= 0.008), (SMD = 0.68, 95%CI [0.38, 0.98],
< 0.001). Conclusions. Cirrhosis has decreased FT3 and FT4 levels and increased TSH levels. FT3 levels correlate negatively with the Child-Pugh score, and it is a measure of the severity of liver cirrhosis dysfunction. FT3 serum levels of thyroid hormones are a prognostic marker in liver cirrhosis.
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Li MF, Ke JF, Li S, Wang JW, Zhu ZH, Li JB. Serum free triiodothyronine is inversely associated with diabetic peripheral neuropathy but not with carotid atherosclerotic lesions in euthyroid patients with type 2 diabetes. Diabetol Metab Syndr 2021; 13:142. [PMID: 34863289 PMCID: PMC8645151 DOI: 10.1186/s13098-021-00760-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The associations between serum free triiodothyronine (FT3) and diabetic peripheral neuropatprohy (DPN)/carotid atherosclerotic lesions in euthyroid patients with type 2 diabetes are still unclear. The purpose of our study was to explore the relations of FT3 to DPN and carotid atherosclerotic lesions in Chinese type 2 diabetes inpatients with euthyroid function. METHODS 2477 euthyroid inpatients with type 2 diabetes were recruited and they were stratified into quartiles by FT3 levels in this cross-sectional study. Peripheral neuropathy was assessed by neurological symptoms and signs as well as nerve conduction velocity tests. Carotid atherosclerotic lesions, including carotid intima-media thickness, plaque and stenosis, were evaluated by Doppler ultrasound. RESULTS The prevalence of DPN in type 2 diabetic patients exhibited the significant decrease across the FT3 quartiles (23.5%, 20.9%, 18.8%, and 11.2%, respectively, p < 0.001). Multiple logistical regression analysis also revealed that FT3 quartiles were significantly and inversely associated with DPN. Compared with the subjects in the highest FT3 quartile, the adjusted odds ratios (95% confidence interval) of DPN from the first to third FT3 quartile were successively 2.338 (1.407-3.884), 1.903 (1.134-3.194) and 1.598 (0.960-1.125). The patients with DPN had significantly higher prevalence of carotid atherosclerotic lesions compared with non-DPN patients. However, no statistical association was observed between FT3 quartiles and carotid atherosclerotic lesions after adjusting for confounder factors. CONCLUSIONS Lower FT3 within the normal range was independently associated with DPN, but not with carotid atherosclerotic lesions in Chinese euthyroid inpatients with type 2 diabetes.
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Affiliation(s)
- Mei-Fang Li
- Department of Emergency, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiang-Feng Ke
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Shuai Li
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China
| | - Jun-Wei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Zhi-Hui Zhu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Shanghai Institute for Diabetes, Shanghai Key Laboratory of Diabetes, Shanghai, China
| | - Jing-Bo Li
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, China.
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Alam MA, Quamri MA, Sofi G, Ansari S. Update of hypothyroidism and its management in Unani medicine. J Basic Clin Physiol Pharmacol 2020; 32:1-10. [PMID: 32776903 DOI: 10.1515/jbcpp-2020-0121] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/22/2020] [Indexed: 06/11/2023]
Abstract
Hypothyroidism is a clinical syndrome caused by thyroid hormone deficiency due to reduced production, deranged distribution, or lack of effects of thyroid hormone. The prevalence of hypothyroidism in developed countries is around 4-5%, whereas it is about 11% in India, only 2% in the UK, and 4·6% in the USA. It is more common in women than in men. Hypothyroidism has multiple etiologies and manifestations. The most common clinical manifestations are weight gain, loss of hair, cold intolerance, lethargy, constipation, dry skin, and change in voice. The signs and symptoms of hypothyroidism differ with age, gender, severity of condition, and some other factors. The diagnosis is based on clinical history, physical examination and serum level of FT3, FT4, and thyroid-stimulating hormone, imaging studies, procedures, and histological findings. The treatment of choice for hypothyroidism is levothyroxine, however; in this review article, we have discussed the epidemiology, etiology, clinical sign and symptoms, diagnosis, complications, and management of hypothyroidism in modern medicine and a comparative treatment by the Unani system of medicine (USM). In the USM, the main emphasis of the principle of treatment (Usool-e-Ilaj) is to correct the abnormal constitution (Su-e-Mizaj) and alter the six prerequisites for existence (Asbab-e-Sitta Zarooriya) to restore normal health. It is a packaged treatment, that is, different components of treatment are given as a package form which includes different drugs, dosages form, and regimens.
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Affiliation(s)
- Md Anzar Alam
- Department of Moalajat, National Institute of Unani Medicine, Bangalore, India
| | | | - Ghulamuddin Sofi
- Department of Ilmul Advia, National Institute of Unani Medicine, Bangalore, India
| | - Shabnam Ansari
- Department of Biotechnology, Natural Sciences, Jamia Millia Islamia, Central University, New Delhi, India
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Xue J, Feng R, Fu H, Jiang Q, Jiang H, Lu J, Liu H, Wang J, Niu T, Wang X, Xie Y, Wang H, Xu L, Liu K, Huang X, Zhang X. Combined prednisone and levothyroxine improve treatment of severe thrombocytopenia in hepatitis B with compensatory cirrhosis accompanied by subclinical and overt hypothyroidism. Sci China Life Sci 2018. [PMID: 29524121 DOI: 10.1007/s11427-017-9250-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The aim of the present study was to investigate the relationship between hypothyroidism and thrombocytopenia in hepatitis B-related compensatory liver cirrhosis and to determine whether treatment with levothyroxine and prednisone is superior in a multicenter, open-label, observational study in China. In total, 125 consecutive hepatitis B-related compensated liver cirrhosis patients with severe thrombocytopenia accompanied by hypothyroidism were included. The patients were divided into four groups according to treatment strategy: a control group (n=29), a prednisone group (n=25), a levothyroxine group (n=32) and a prednisone plus levothyroxine group (n=39). Severe thrombocytopenia was more prevalent in hepatitis B-associated compensatory liver cirrhosis patients with hypothyroidism than in euthyroid patients (29.6% vs. 14.7%, P<0.05). Combination treatment with prednisone and levothyroxine decreased the risk of bleeding and improved platelet recovery compared to control treatment and treatment with either prednisone or levothyroxine alone. The platelet count before therapy, serum thyroid stimulating hormone and combination treatment with prednisone and levothyroxine were associated with bleeding events. Therefore, the present study suggests that hypothyroidism is associated with severe thrombocytopenia in hepatitis B-associated compensatory liver cirrhosis. Treatment with prednisone plus levothyroxine may present a novel approach in these patients.
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Affiliation(s)
- Jing Xue
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Ru Feng
- Departments of Hematology, Beijing Hospital, National Center of Gerontology, Beijing, 100005, China
| | - Haixia Fu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Qian Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Hao Jiang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Jing Lu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Hui Liu
- Departments of Hematology, Beijing Hospital, National Center of Gerontology, Beijing, 100005, China
| | - Jingwen Wang
- Department of Hematology, Beijing Tongren Hospital, Beijing, 100730, China
| | - Ting Niu
- Department of Hematology, Sichuan University West China Medical Center, Chengdu, 610041, China
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital, Qingdao, 266003, China
| | - Yandi Xie
- Peking University, People's Hospital, Institute of Hepatic Diseases, Beijing, 100044, China
| | - Hao Wang
- Peking University, People's Hospital, Institute of Hepatic Diseases, Beijing, 100044, China
| | - Lanping Xu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Kaiyan Liu
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China
| | - Xiaojun Huang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China.
| | - Xiaohui Zhang
- Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing, 100044, China.
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Wang K, Wu Y, Yang Y, Chen J, Zhang D, Hu Y, Liu Z, Xu J, Shen Q, Zhang N, Mao X, Liu C. The associations of bedtime, nocturnal, and daytime sleep duration with bone mineral density in pre- and post-menopausal women. Endocrine 2015; 49:538-48. [PMID: 25449993 DOI: 10.1007/s12020-014-0493-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 11/24/2014] [Indexed: 01/03/2023]
Abstract
To explore the association of sleep patterns with bone mineral density (BMD) in pre- and post-menopausal women, we used a questionnaire to evaluate the sleep patterns and performed calcaneal quantitative ultrasound to estimate BMD, in 6,510 women aged 40 years or older, from June to November 2011 in Nanjing City. We found a 1.7-fold risk of osteoporosis in post-menopausalwomen with bedtime of ≥0:00 am (OR = 1.69, 95 % CI 1.39-2.13), compared to those whose bedtime of <0:00 am. post-menopausalwomen with excessive total sleep (>10 h vs. 8-9 h, OR = 1.54, 95 % CI 1.05-2.02) were shown to have a higher risk of osteoporosis, however, this high risk was not detected in those with excessive nocturnal sleep (>10 h vs. 8-9 h, OR = 0.85, 95 % CI 0.62-1.30). By contrast, post-menopausalwomen with inadequate nocturnal sleep (≤7 h vs. 8-9 h, OR = 1.68, 95 % CI 1.32-2.75), excessive daytime sleep (≥180 min vs. 0 min, OR = 1.52, 95 % CI 1.08-2.13), and noontime nap (>60 min vs. 0 min: OR = 1.37, 95 % CI 1.06-1.76) were demonstrated to have higher risk of bone loss. Nevertheless, these associations were not found in premenopausal women. We conclude that delayed bedtime, nocturnal sleep deprivation, excessive daytime sleep, and noontime nap, but not reduced total sleep duration, could promote bone loss in post-menopausalwomen, which might be related to circadian rhythm disturbances. However, they have limited influences to BMD in women who were still in menstruating. Mechanism responsible for the phenomena warrants further investigation.
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Affiliation(s)
- Kun Wang
- Department of Endocrinology, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, 100, Hongshan Road, Nanjing, 210028, China
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