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Huang N, Chen L, Yan Z, Zeng L, Wang H, Chi H, Qiao J. Intracytoplasmic Sperm Injection Versus In vitro Fertilization in Infertile Women with Thyroid Autoimmunity. Thyroid 2024. [PMID: 38623805 DOI: 10.1089/thy.2023.0676] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Background: It has been reported that intracytoplasmic sperm injection (ICSI) may be the preferred fertilization method for women with thyroid autoimmunity (TAI) seeking assisted reproduction. We compared the reproductive outcomes of women with TAI who were treated with ICSI compared with in vitro fertilization (IVF). Methods: In this retrospective cohort study, we included women with infertility who were referred to the Reproductive Centre of Peking University Third Hospital for their first IVF/ICSI and embryo transfer (ET) treatment cycle from January 2019 to February 2021. In total, 2171 and 743 women with TAI underwent IVF and ICSI, respectively, while 8702 and 2668 women without TAI underwent IVF and ICSI, respectively. We examined the cumulative live birth rate (primary outcome) from the initiated stimulative cycle as well as the secondary outcomes of fertilization rate, rates of clinical pregnancy, and live birth after the first ET cycle. We compared the reproductive outcomes of women treated with IVF and ICSI according to TAI status. Multivariable logistic regression analyses were performed to adjust for relevant confounders. Results: Women who underwent ICSI had significantly higher fertilization rates than those who underwent IVF (median [interquartile range]: 0.6 [0.5-0.8] in the TAI-positive and IVF group vs. 0.7 [0.5-0.8] in the TAI-positive and ICSI group vs. 0.6 [0.5-0.8] the TAI-negative and IVF group vs. 0.7 [0.5-0.8] in the TAI-negative and ICSI group, p < 0.001). However, the rates of cumulative live births, clinical pregnancies, and live births were significantly lower among women with TAI who underwent ICSI than those who underwent IVF (cumulative live birth: 51.8% vs. 47%, adjusted odds ratio [aOR]: 0.80 [confidence interval, CI: 0.67-0.97]; clinical pregnancy: 43.0% vs. 38.8%, aOR: 0.81 [CI: 0.67-0.97]; live birth: 36.2% vs. 32.4%, aOR: 0.81 [CI: 0.66-0.98]). Conclusion: We observed that the use of ICSI in women with TAI was not associated with better assisted reproductive outcomes compared with IVF. Further prospective clinical trials are needed to confirm our findings.
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Affiliation(s)
- Ning Huang
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Lixue Chen
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Zhiqiang Yan
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China
| | - Haining Wang
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, China
| | - Hongbin Chi
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Jie Qiao
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
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Chen K, Sun W, He L, Dong W, Zhang D, Zhang T, Zhang H. Exploring the bidirectional relationship between metabolic syndrome and thyroid autoimmunity: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1325417. [PMID: 38567309 PMCID: PMC10985172 DOI: 10.3389/fendo.2024.1325417] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Background Observational studies have reported a possible association between metabolic syndrome (MetS) and thyroid autoimmunity. Nevertheless, the relationship between thyroid autoimmunity and MetS remains unclear. The objective of this research was to assess the causal impact of MetS on thyroid autoimmunity through the utilization of Mendelian randomization (MR) methodology. Methods We performed bidirectional MR to elucidate the causal relationship between MetS and their components and thyroid autoimmunity (positivity of TPOAb). Single nucleotide polymorphisms (SNPs) of MetS and its components were obtained from the publicly available genetic variation summary database. The Thyroidomics Consortium conducted a genome-wide association analysis, which provided summary-level data pertaining to thyroid autoimmunity. The study included several statistical methods, including the inverse variance weighting method (IVW), weighted median, simple mode, weight mode, and MR-Egger methods, to assess the causal link. In addition, to ensure the stability of the results, a sensitivity analysis was conducted. Results IVW showed that MetS reduced the risk of developing thyroid autoimmunity (OR = 0.717, 95% CI = 0.584 - 0.88, P = 1.48E-03). The investigation into the causative association between components of MetS and thyroid autoimmune revealed a statistically significant link between triglycerides levels and the presence of thyroid autoimmunity (IVW analysis, OR = 0.603, 95%CI = 0.45 -0.807, P = 6.82E-04). The reverse analysis did not reveal any causal relationship between thyroid autoimmunity and MetS, including its five components. Conclusions We have presented new genetic evidence demonstrating that MetS and its triglyceride components may serve as potential protective factors against thyroid autoimmunity.
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Affiliation(s)
| | | | | | | | | | | | - Hao Zhang
- Department of Thyroid Surgery, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Bouayad A, Benzekri L. Thyroid autoimmunity in relation to HLA-DRB1 and HLA-DQB1 polymorphism in nonsegmental vitiligo: a cross-sectional-study. Am J Transl Res 2024; 16:524-530. [PMID: 38463584 PMCID: PMC10918139] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/28/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVES Nonsegmental vitiligo (NSV) is frequently associated with thyroid autoimmunity (TAI), however, the immunopathogenic mechanisms of such association remain to be investigated. The aims of this work were to estimate the frequency of TAI and to describe the genetic polymorphism in the human leukocyte antigen (HLA)-DRB1 and -DQB1 loci in TAI susceptibility among patients with NSV. PATIENTS AND METHODS In this cross-sectional study, screening for TAI was performed in 97 Moroccan patients with NSV by measuring antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TGAb). HLA-DRB1 and -DQB1 were determined with single specific primer-polymerase chain reaction (PCR-SSP) typing methods. RESULTS TAI was diagnosed in 20 patients with NSV (20.6%). The phenotypic frequency of DQB1*05 (OR = 5.04; P = 0.006; pc = 0.036) was significantly higher in NSV patients with TAI. Genotype DQB1*05/DQB1*06 (OR = 25.33; P = 0.001; pc = 0.003) confer susceptibility to TAI in NSV patients. NSV patients with TAI and early onset vitiligo have an extremely high phenotype frequency of DQB1*05 allele (OR = 14.67; P = 0.001; pc = 0.048) and DQB1*05/DQB1*06 genotype (OR = 26.55; P = 0.01; pc = 0.03). TAI in patients with NSV was (6.2%) associated with onset of clinical thyroid disease based on TSH and free T4. CONCLUSION Our findings suggest that HLA-DQ polymorphisms influence TAI risk in subjects with NSV, although HLA does not completely explain the co-occurrence of these two diseases.
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Affiliation(s)
- Abdellatif Bouayad
- Faculty of Medicine and Pharmacy, Mohammed First UniversityOujda, Morocco
| | - Laila Benzekri
- Department of Dermatology, Faculty of Medicine and Pharmacy, Mohammed V Souissi University, Ibn Sina HospitalRabat, Morocco
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Song JL, Hu JW, Li LR, Xu ZL, Li JJ, Sun SR, Chen C. Association of thyroid autoimmunity with extra-thyroid diseases and the risk of mortality among adults: evidence from the NHANES. Front Endocrinol (Lausanne) 2024; 15:1323994. [PMID: 38405150 PMCID: PMC10884096 DOI: 10.3389/fendo.2024.1323994] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Background Thyroid autoimmunity is one of the most prevalent autoimmune diseases. However, its association with extra-thyroid diseases and mortality risk in the general population remains uncertain. Our study aims to evaluate the association of thyroid autoimmunity with extra-thyroid disease and the risk of mortality. Methods A prospective cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) with participants from 2007-2008, 2009-2010, and 2011-2012, tracking their mortality until 2019. Associations between thyroid autoimmunity, which was defined as having positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb), and extra-thyroid disease including diabetes, hypertension, cardiovascular disease, chronic lung disease, arthritis, cancer and chronic renal disease and the risk of mortality were investigated. Results A total of 7431 participants were included in this study. Positive The prevalence of positive TgAb was 7.54%, and positive TPOAb prevalence was 11.48%. TgAb was significantly associated with diabetes (Model 1: OR=1.64, 95% CI:1.08-2.50; Model 2: OR=1.93, 95% CI: 1.21-3.08) and hypertension (Model 1: OR=0.67, 95% CI: 0.49-0.91; Model 2: OR=0.62, 95% CI: 0.44-0.88). TPOAb was associated with a lower prevalence of chronic lung disease (model 1: OR=0.71, 95% CI: 0.54-0.95; model 2: OR=0.71, 95% CI: 0.53-0.95). No associations were observed between TgAb, TPOAb and other extra-thyroid diseases. Neither TgAb nor TPOAb were associated with all-cause mortality or heart disease mortality. Conclusion TgAb was linked to a higher prevalence of diabetes and a lower prevalence of hypertension, while TPOAb was associated with a decreased prevalence of chronic lung disease. However, neither TgAb nor TPOAb posed a risk for all-cause mortality or heart disease mortality.
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Affiliation(s)
| | | | | | | | | | - Sheng-Rong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chuang Chen
- *Correspondence: Chuang Chen, ; Sheng-Rong Sun,
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Alsuraikh MA, Almalki E, Bazuhair T, Almalki M. Thyroid Disorders in Saudi Patients With Acromegaly: A Tertiary Care Center Experience. Cureus 2024; 16:e53663. [PMID: 38455769 PMCID: PMC10917699 DOI: 10.7759/cureus.53663] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Background Acromegaly is a rare disease that is frequently associated with thyroid diseases. The exact prevalence of goiter and thyroid dysfunction remains uncertain. Objectives This study aims to provide a comprehensive description of the clinical, morphological, and biochemical features of thyroid disorder in Saudi patients with acromegaly and to establish its correlation with the activity and duration of the disease. Methods This retrospective study involved patients who were diagnosed with acromegaly during the period 2006-2023 in an outpatient endocrine clinic at a tertiary hospital. Results A total of 40 patients with acromegaly (27 males and 13 females) were identified and included in the analysis, with a mean age of 46.78 ± 13.76 years and an estimated duration of disease of 8.08 ± 6.43 years. Goiter was diagnosed in 28 patients (70.0%), including multinodular goiter (MNG) (70.0%), solitary thyroid nodules (14.2%), and thyroid cysts (14.2%). Primary hypothyroidism was present at 40.0%. Goiter was not correlated with estimated insulin-like growth factor 1 (IGF-1) levels or disease duration. In 40 patients with nodular goiter, fine needle biopsies were performed in six cases; five nodules were benign, and one nodule was a follicular lesion of unknown significance (Bethesda III). Conclusions The patients with acromegaly have a high prevalence of nodular thyroid disorders and thyroid dysfunction. No cases of thyroid cancer were found in our study. The periodic ultrasonography assessment of the thyroid is needed for evaluating patients with acromegaly.
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Affiliation(s)
- Moayad A Alsuraikh
- Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Riyadh, SAU
| | - Eyad Almalki
- College of Medicine, Shaqra University, Shaqra, SAU
| | - Tuqa Bazuhair
- Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Riyadh, SAU
| | - Mussa Almalki
- Obesity, Endocrine, and Metabolism Center, King Fahad Medical City, Riyadh, SAU
- College of Medicine, Alfaisal University, Riyadh, SAU
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Gurunathan OS, Chellapandian E, Thirunavukkarasu S, Thermalingem S, Eswaradass P. Effect of Steroids on Patients With Fibromyalgia/Chromic Widespread Pain: An Observational Study. Cureus 2024; 16:e53736. [PMID: 38465077 PMCID: PMC10920059 DOI: 10.7759/cureus.53736] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/12/2024] Open
Abstract
OBJECTIVE Fibromyalgia causes widespread chronic pain. Pain management and treating underlying conditions are of utmost importance. Recent studies found an association of thyroid autoimmunity with fibromyalgia. Pain management of patients with anti-thyroid peroxidase antibody (anti-TPO Ab) positive was studied sparsely. To determine the effect of steroid (deflazacort) on pain management using numerical rating scale (NRS) pain score at baseline and at 3-month follow-up. STUDY DESIGN A retrospective observational study was undertaken, recruiting patients diagnosed with fibromyalgia as per 2010 American College of Rheumatology guidelines and treated with the steroid, deflazacort 12 mg. Patients with missing details were excluded. Patients were categorized into negative, positive, and strongly positive anti-TPO Ab groups. Baseline and follow-up (3 months) pain score was compared across the groups. Reduction in pain was considered as a primary outcome variable. RESULTS The study included 128 participants with 98 (76.6%) females and 30 (23.4%) males. The age of the study population was 48±13.29 years. The proportion of hyper, hypo, and euthyroid was 10 (7.81%), 42 (32.81%), and 76 (59.38%), respectively. The proportion of participants with negative, positive, and strongly positive anti-TPO Ab levels was 41 (32.03)%, 50 (39.06%), and 37 (28.91%), respectively. Baseline pain score was 7.3±1.32 and 3-month follow-up was 4.7±2.46. Steroid response was found in 66 (51.6%). Negative and positive anti-TPO Ab had a 1-point reduction in pain score from baseline, p-value <0.001. The strongly positive group had 5 points reduction, p-value<0.05. CONCLUSION Fibromyalgia patients with thyroid autoimmunity responded well to short courses of steroids. Greater pain relief was observed among those who are strongly positive anti-TPO Ab group.
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Unnikrishnan S, Anilakumari VP, Mohammed F. Subclinical hypothyroidism and anti-thyroid peroxidase antibodies in primary open-angle glaucoma: A case-control study. Indian J Ophthalmol 2024; 72:228-231. [PMID: 38099584 PMCID: PMC10941937 DOI: 10.4103/ijo.ijo_603_23] [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] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/27/2023] [Accepted: 08/05/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To evaluate the association among subclinical hypothyroidism, anti-thyroid peroxidase (anti-TPO) antibody, and primary open-angle glaucoma (POAG). STUDY DESIGN Case-control study. METHODS The cases consisted of patients with POAG and controls were age- and sex-matched patients from the general eye clinic with no history of glaucoma. Blood samples were taken from the participants' antecubital veins and sent for measurement of thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and anti-thyroid peroxidase (anti-TPO) antibody. Data was analyzed using the Mann-Whitney U test and the Chi-square test. Odds ratio with 95% confidence interval (CI) was calculated. A two-tailed P value less than 0.05 was considered for statistical significance. RESULTS There were a total of 63 cases and 63 controls. Subclinical hypothyroidism was present in 20.6% of patients in the glaucoma group and 4.8% of patients in the control group ( P < 0.01). The odds of subclinical hypothyroidism in patients with POAG compared to controls was 5.2 (95% CI 1.7-22). Anti-TPO antibody positivity was higher in the glaucoma group (22.2%) than in the control group (14.3%), but this did not reach statistical significance ( P = 0.25). CONCLUSION This study suggests an association between POAG and subclinical hypothyroidism. Further research is needed to establish the cause-and-effect relationship between these two conditions.
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Affiliation(s)
- Suma Unnikrishnan
- Department of Ophthalmology, Government Medical College, Kozhikode, Kerala, India
| | - VP Anilakumari
- Department of Nuclear Medicine, Government Medical College, Kozhikode, Kerala, India
| | - Ferzana Mohammed
- Department of Ophthalmology, Government Medical College, Kozhikode, Kerala, India
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Zhang J, Song Z, Yuan H, Cai ZH. The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study. Front Endocrinol (Lausanne) 2024; 14:1297902. [PMID: 38298186 PMCID: PMC10827934 DOI: 10.3389/fendo.2023.1297902] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/27/2023] [Indexed: 02/02/2024] Open
Abstract
Background The etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions. Methods A retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies. Results The prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients. Conclusion TAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.
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Affiliation(s)
- Jie Zhang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhan Song
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hui Yuan
- Key Laboratory of Digital Technology in Medical Diagnostics of Zhejiang Province, Dian Diagnostics Group Co., Ltd., Hangzhou, Zhejiang, China
| | - Zhu-Hua Cai
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Thamamongood T, Hara S, Akagawa H, Inaji M, Tanaka Y, Nariai T, Maehara T. Synergistic Interaction of Thyroid Autoantibodies and Ring Finger Protein 213 Variant in Moyamoya Disease. Neurol Med Chir (Tokyo) 2024; 64:43-49. [PMID: 38057092 PMCID: PMC10835577 DOI: 10.2176/jns-nmc.2023-0169] [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] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/11/2023] [Indexed: 12/08/2023] Open
Abstract
Recently, thyroid autoantibodies were found to be associated with moyamoya disease (MMD). The ring finger protein 213 (RNF213) p.R4810K variant represents the most important susceptibility genotype of this disease, but its relationship with thyroid autoantibodies remains to be elucidated. Thus, in this study, we aimed to evaluate the clinical relevance of thyroid autoantibodies in each RNF213 genotype in patients with MMD. Included in this study were patients with MMD without a thyroid disease history and in euthyroid status; they were then classified into the mutated or nonmutated based on the RNF213 p.R4810K genotype and positive or negative based on thyroid autoantibody (thyroperoxidase and thyroglobulin) levels. Clinical data of each group were thereafter evaluated. Among the 209 patients, the mutated RNF213 p.R4810K variant and positive thyroid autoantibodies were detected in 155 and 41 patients, respectively. Positive thyroid autoantibodies were found to be more common in the nonmutated patients than in the mutated patients (31.5% vs. 15.5%; P = 0.011). In the mutated patients, as compared to autoantibody-negative patients, autoantibody-positive patients were determined to be more likely to have advanced disease with posterior cerebral artery involvement (54.2% vs. 29.0%; P = 0.017), white matter infarction (58.3% vs. 37.6%; P = 0.046), and a higher modified Rankin Scale at last visit (16.7% vs. 3.1%; P = 0.021). These results suggest that thyroid autoantibodies can act as an immunity inducer in patients with MMD lacking the susceptibility gene RNF213 p.R4810K variant. Moreover, the simultaneous presence of thyroid autoantibodies and the variant seems to aggravate the disease, which indicates synergy between thyroid autoantibodies and the variant.
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Affiliation(s)
- Thiparpa Thamamongood
- Department of Neurosurgery, Tokyo Medical and Dental University
- Tokyo Women's Medical University Institute for Integrated Medical Sciences
| | - Shoko Hara
- Department of Neurosurgery, Tokyo Medical and Dental University
| | - Hiroyuki Akagawa
- Tokyo Women's Medical University Institute for Integrated Medical Sciences
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University
| | - Yoji Tanaka
- Department of Neurosurgery, Tokyo Medical and Dental University
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University
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Donnici A, Mirabelli M, Giuliano S, Misiti R, Tocci V, Greco M, Aiello V, Brunetti FS, Chiefari E, Aversa A, Foti DP, Brunetti A. Coexistence of Hashimoto's Thyroiditis in Differentiated Thyroid Cancer: Post-Operative Monitoring of Anti-Thyroglobulin Antibodies and Assessment of Treatment Response. Diagnostics (Basel) 2024; 14:166. [PMID: 38248043 PMCID: PMC10814696 DOI: 10.3390/diagnostics14020166] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION Differentiated thyroid carcinoma (DTC) is frequently found in conjunction with autoimmune thyroid disorders, particularly Hashimoto's thyroiditis (HT). This study investigates the impact of coexisting HT on the persistence of an indeterminate response to therapy due to positive anti-thyroglobulin antibodies (AbTg), measured via competitive immunoassay, in a consecutive patient series from Calabria, Southern Italy. METHODS This retrospective longitudinal study analyzed 259 consecutive DTC patients managed at the Endocrinology Unit of Renato Dulbecco Hospital (Catanzaro, Italy) up to 2023. Patients with medullary and undifferentiated thyroid carcinoma, partial thyroidectomy, less than six months of post-operative monitoring, or missing clinical data were excluded. Demographic information, histological findings, initial tumor stage, and ATA risk category were collected. The response to therapy was assessed based on ATA guidelines. RESULTS Among the 259 patients, 29% had coexisting HT. Patients with HT exhibited distinct characteristics: a higher proportion of females (87.0% vs. 74.7%), a shorter post-operative monitoring duration (median 3 vs. 5 years), and a higher prevalence of papillary thyroid carcinoma (PTC) (97.4% vs. 86.3%). The tumor size, lymph node involvement, and distant metastasis were similar between the groups, with patients without HT having a higher incidence of extrathyroidal tumor extension. However, the initial TNM stage and ATA risk category did not differ significantly. At the six-month follow-up, HT patients showed a higher rate of indeterminate responses, primarily due to positive AbTg. After 12 months, the response categories aligned, with decreasing AbTg levels in the HT group. After 24 months, most patients with long-term follow-up demonstrated an excellent response to DTC therapy, irrespective of HT coexistence. CONCLUSIONS While HT does not worsen DTC prognosis, it may result in indeterminate responses. AbTg measurements in the peri-operative period should be encouraged to facilitate post-operative monitoring, emphasizing the importance of using standardized assays. Further research in larger populations with extended follow-up is needed to comprehensively understand the HT-DTC relationship.
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Affiliation(s)
- Alessandra Donnici
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
| | - Maria Mirabelli
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Stefania Giuliano
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
| | - Roberta Misiti
- Clinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (M.G.)
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Vera Tocci
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Marta Greco
- Clinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (M.G.)
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Aiello
- Rheumatology Clinic ‘Madonna dello Scoglio’ Cotronei, 88900 Crotone, Italy
| | - Francesco S. Brunetti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Eusebio Chiefari
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Aversa
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Daniela P. Foti
- Clinical Pathology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (M.G.)
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
| | - Antonio Brunetti
- Endocrinology Unit, University Hospital “Renato Dulbecco” of Catanzaro, 88100 Catanzaro, Italy (A.A.)
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, 88100 Catanzaro, Italy
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Mendiratta V, Himadri H, Verma D, Aggarwal M, Yadav J. Is Atopic Dermatitis a Risk Factor for Thyroid Autoimmunity? - A Cross-Sectional Study from a Tertiary Care Center in India. Indian Dermatol Online J 2024; 15:45-48. [PMID: 38283001 PMCID: PMC10810387 DOI: 10.4103/idoj.idoj_48_23] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/20/2023] [Accepted: 04/26/2023] [Indexed: 01/30/2024] Open
Abstract
Background Because of the counter-regulation of Th1 and Th2 cells, Th1-type autoimmune diseases like thyroid autoimmunity and Th2-mediated allergic diseases like atopic dermatitis (AD) should occur in mutually exclusive populations. However, thyroid autoimmunity has been associated with chronic urticaria, and atopy is considered a cause of both AD and urticaria. Objectives To assess the frequency of thyroid autoimmunity in children with AD and to study the correlation between the clinical severity of AD using the SCORing Atopic Dermatitis (SCORAD) score, and biochemical parameters of serum immunoglobulin E (IgE), absolute eosinophil count, and vitamin D levels. Materials and Methods A hospital-based cross-sectional study was conducted, recruiting children (0-18 years) with AD. Patients on drugs affecting thyroid dysfunction and those with sick euthyroid syndrome or an immunodeficiency disorder were excluded. Clinical severity was assessed using SCORAD, and the thyroid profile, anti-thyroid peroxidase antibodies, antinuclear antibody (ANA), absolute eosinophil count, serum IgE, and vitamin D levels were measured. Results Thyroid autoimmunity was diagnosed in 18.9% (10/53) of children. There was a significant correlation between SCORAD and serum IgE (r = 0.432, P = 0.002) and absolute eosinophil count (r = 0.575, P = <0.001). There was a negative correlation between SCORAD and vitamin D levels (r = -0.373, P = 0.006). Conclusions Thyroid autoimmunity may be associated with AD, and a high index of suspicion is essential. Vitamin D also should be supplemented in children with AD as it is frequently found to be low, especially in severe cases. Multi-center case-control studies are required to determine the prevalence of thyroid autoimmunity in children with AD.
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Affiliation(s)
- Vibhu Mendiratta
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Himadri Himadri
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Damini Verma
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Meenakshi Aggarwal
- Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Jyoti Yadav
- Department of Dermatology and STD, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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12
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Chung SM, Chang MC. Cadmium exposure and thyroid hormone disruption: a systematic review and meta-analysis. Rev Environ Health 2023; 0:reveh-2023-0122. [PMID: 38142367 DOI: 10.1515/reveh-2023-0122] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/04/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION This meta-analysis aimed to analyze the effect of cadmium (Cd) exposure on thyroid hormone disruption. CONTENT Databases including PubMed, Embase, Cochrane Library, and Scopus were searched for studies published up to December 14, 2022. Studies evaluating the association between Cd exposure (blood Cd [BCd] or urine Cd [UCd]) and thyroid function (thyroid-stimulating hormone [TSH], free thyroxine [FT4], total triiodothyronine [TT3]) or thyroid autoimmunity (thyroglobulin antibody [TgAb] or thyroperoxidase Ab [TPOAb]) were included. SUMMARY AND OUTLOOK This systematic review included 12 cross-sectional studies. Cd exposure showed a neutral association with TSH (pooled correlation=0.016, 95 % confidence interval [CI]=-0.013 to 0.045, p=0.277), FT4 (pooled correlation=0.028, 95 % CI=-0.005 to 0.061, p=0.098), and thyroid autoimmunity (pooled odds ratio=1.143, 95 % CI=0.820-1.591, p=0.430). However, Cd exposure showed a positive association with TT3 (pooled correlation=0.065, 95 % CI=0.050-0.080, p<0.001), which was consistent with the BCd and UCd subgroup analyses (pooled correlation=0.053 and 0.081, respectively, both p<0.001). Cd exposure was not associated with TSH, FT4, or thyroid autoimmunity but tended to increase with TT3.
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Affiliation(s)
- Seung Min Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu, Republic of Korea
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Graven-Nielsen CS, Vittrup I, Kragh AJ, Lund F, Bliddal S, Kofoed K, Kristensen S, Stensballe A, Nielsen CH, Feldt-Rasmussen U, Cordtz R, Dreyer L. Polyautoimmunity in patients with cutaneous lupus erythematosus: A nationwide sex- and age-matched cohort study from Denmark. JAAD Int 2023; 13:126-133. [PMID: 37808964 PMCID: PMC10550802 DOI: 10.1016/j.jdin.2023.07.018] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2023] [Indexed: 10/10/2023] Open
Abstract
Background Polyautoimmunity is defined as having 2 or more autoimmune diseases. Little is known about polyautoimmunity in patients with cutaneous lupus erythematosus (CLE). Objectives To estimate prevalence and 5-year incidence of non-lupus erythematosus (LE) autoimmune diseases in patients with CLE. Methods Patients with CLE were identified In the Danish National Patient Registry and each patient was age- and sex-matched with 10 general population controls. Outcome information on non-LE autoimmune diseases was obtained by register-linkage between Danish National Patient Registry and the National Prescription Register. The risk ratio (RR) for prevalent non-LE autoimmune disease at time of CLE diagnosis was calculated in modified Poisson regression; and hazard ratios (HRs) for incident non-LE autoimmune disease were estimated in Cox regression analyses. Results Overall, 1674 patients with CLE had a higher prevalence of a non-LE autoimmune disease than the comparators (18.5 vs 7.9%; RR 2.4; 95% CI, 2.1 to 2.6). Correspondingly, the cumulative incidence of a non-LE autoimmune disease during 5 years of follow-up was increased for the patients with CLE: HR 3.5 (95% CI, 3.0 to 4.0). Limitations Risk of detection and misclassification bias, mainly pertaining to the CLE group. Conclusion Patients with CLE had higher prevalence and 5-year cumulative incidence of a non-LE autoimmune disease than the general population.
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Affiliation(s)
| | - Ida.V. Vittrup
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
| | - Anna J. Kragh
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
| | - Fredrik Lund
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Institute of Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | | | - Salome Kristensen
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Denmark
| | - Allan Stensballe
- Department of Health Science and Technology, Aalborg University, Denmark
- Clinical Cancer Research Center, Aalborg University Hospital, Aalborg, Denmark
| | - Claus H. Nielsen
- Institute of Inflammation Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - René Cordtz
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
| | - Lene Dreyer
- Center for Rheumatology Research Aalborg (CERRA), Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Denmark
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14
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Wei SX, Wang L, Liu YB, Fan QL, Fan Y, Qiao K. TPOAb positivity can impact ovarian reserve, embryo quality, and IVF/ICSI outcomes in euthyroid infertile women. Gynecol Endocrinol 2023; 39:2266504. [PMID: 37798837 DOI: 10.1080/09513590.2023.2266504] [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: 05/29/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
The aim of this study was to investigate the effects of positive anti-thyroid peroxidase (TPO) antibodies on fertility, embryo quality, and pregnancy outcomes in women with normal thyroid function. A cross-sectional study of 1223 infertile women who received assisted reproductive technology (ART) treatment for the first time was conducted at our hospital from January 2019 to March 2022. Overall, 263 infertile women were included, comprising 263 cycles and 1813 embryos, and were divided into a positive group and a control group based on TPO antibody levels. The positive group was further divided into two subgroups according to the median antibody titer, and the therapeutic indices and pregnancy outcomes for each group were compared. The results showed that the AMH level in the positive group was significantly lower than that in the control group (2.37 (1.26-3.63) ng/ml vs. 3.54 (1.74-5.41) ng/ml, p < 0.001). The high-quality embryo rate (40.04% vs. 45.49%, p = 0.034) and live birth rate (23.26% vs. 36.16, p = 0.035) of the positive group were lower than those of the control group; the miscarriage rate was higher than that of the control group (37.50% vs. 17.95%, p = 0.035). The live birth rate in the low-titer group was significantly higher than that in the high-titer group (32.56% vs. 13.95%, p = 0.041). Studies have shown that positive anti-thyroid peroxidase antibodies are associated with a decreased ovarian reserve and decreased embryo quality. High titers of anti-thyroid peroxidase antibodies can reduce the live birth rate.
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Affiliation(s)
- Shi-Xi Wei
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Ling Wang
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yu-Bing Liu
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Qiu-Lin Fan
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Yu Fan
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Kun Qiao
- Center for Reproductive Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
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15
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Guo M, Li Q, Liu X, Wang Y, Yang Q, Li R, Zhao Y, Li C, Sheng S, Ma H, Li Z, Gao R. Mapping the path towards novel treatment strategies: a bibliometric analysis of Hashimoto's thyroiditis research from 1990 to 2023. Front Endocrinol (Lausanne) 2023; 14:1277739. [PMID: 38027117 PMCID: PMC10667915 DOI: 10.3389/fendo.2023.1277739] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Hashimoto's thyroiditis (HT), a common form of thyroid autoimmunity, is strongly associated with deteriorating clinical status and impaired quality of life. The escalating global prevalence, coupled with the complexity of disease mechanisms, necessitates a comprehensive, bibliometric analysis to elucidate the trajectory, hotspots, and future trends in HT research. Objective This study aims to illuminate the development, hotspots, and future directions in HT research through systematic analysis of publications, institutions, authors, journals, references, and keywords. Particular emphasis is placed on novel treatment strategies for HT and its complications, highlighting the potential role of genetic profiling and immunomodulatory therapies. Methods We retrieved 8,726 relevant documents from the Web of Science Core Collection database spanning from 1 January 1990 to 7 March 2023. Following the selection of document type, 7,624 articles were included for bibliometric analysis using CiteSpace, VOSviewer, and R software. Results The temporal evolution of HT research is categorized into three distinct phases: exploration (1990-1999), rapid development (1999-2000), and steady growth (2000-present). Notably, the United States, China, Italy, and Japan collectively contributed over half (54.77%) of global publications. Among the top 10 research institutions, four were from Italy (4/10), followed by China (2/10) and the United States (2/10). Recent hotspots, such as the roles of gut microbiota, genetic profiling, and nutritional factors in HT management, the diagnostic dilemmas between HT and Grave's disease, as well as the challenges in managing HT complicated by papillary thyroid carcinoma and type 1 diabetes mellitus, are discussed. Conclusion Although North America and Europe have a considerable academic impact, institutions from emerging countries like China are demonstrating promising potential in HT research. Future studies are anticipated to delve deeper into the differential diagnosis of HT and Grave's disease, the intricate relationship between gut microbiota and HT pathogenesis, clinical management of HT with papillary thyroid carcinoma or type 1 diabetes, and the beneficial effects of dietary modifications and micronutrients supplementation in HT. Furthermore, the advent of genetic profiling and advanced immunotherapies for managing HT offers promising avenues for future research.
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Affiliation(s)
- Manping Guo
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Postdoctoral Research Station, China Academy of Chinese Medical Sciences, Beijing, China
- Postdoctoral Works Station, Yabao Pharmaceutical Group Co., Ltd., Yuncheng, Shanxi, China
| | - Qingna Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, National Medical Products Administration, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Xingfang Liu
- Research Department, Swiss University of Traditional Chinese Medicine, Bad Zurzach, Switzerland
| | - Yiming Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiaoning Yang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, National Medical Products Administration, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Rui Li
- Evidence Based Medicine Center, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, Henan, China
| | - Yang Zhao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, National Medical Products Administration, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Chenfei Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, National Medical Products Administration, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
| | - Song Sheng
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hangkun Ma
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zhenghong Li
- Research Department, Swiss University of Traditional Chinese Medicine, Bad Zurzach, Switzerland
| | - Rui Gao
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Key Laboratory for Clinical Research and Evaluation of Traditional Chinese Medicine, National Medical Products Administration, Beijing, China
- National Clinical Research Center for Chinese Medicine Cardiology, Beijing, China
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Huisman P, Krogh J, Nielsen CH, Nielsen HS, Feldt-Rasmussen U, Bliddal S. Thyroglobulin Antibodies in Women with Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis. Thyroid 2023; 33:1287-1301. [PMID: 37725583 DOI: 10.1089/thy.2023.0292] [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] [Indexed: 09/21/2023]
Abstract
Background: Thyroid autoimmunity is the most prevalent autoimmune disorder among women of reproductive age and has been suggested as a risk factor in recurrent pregnancy loss (RPL)-a condition in which couples suffer several consecutive pregnancy losses, but where a cause can be identified in less than half of the cases. Most studies have focused on thyroid peroxidase antibodies (TPOAbs), not considering the presence of thyroglobulin antibodies (TgAbs). The aim of this study was to systematically assess the prevalence of TgAb positivity in women with RPL, and whether TgAb positivity was associated with the outcome of the next pregnancy. Methods: A systematic literature search of PubMed and Embase (from inception to April 29, 2023) was performed for studies reporting on TgAbs in women with RPL. The primary outcome was TgAb positivity in women with RPL compared with women without RPL, with a secondary outcome of association between TgAb positivity and the outcome of the next pregnancy. Pooled effect estimates were expressed as odds ratios (ORs) with confidence intervals [CI] using a random-effects model. The study was registered with PROSPERO (No. CRD42022310232) and adhered to the PRISMA guidelines. Results: A total of 770 studies were screened, 28 of which could be included reporting data from a total of 6868 women. The prevalence of TgAb positivity in women with RPL ranged from 3.6% to 28% compared with 2.4% to 29% in women without RPL. The OR for TgAb positivity was 1.93 ([CI 1.27-2.92]; I2 = 63%) compared with women without RPL, and for TgAbs and/or TPOAbs 2.66 ([CI 1.75-4.05]; I2 = 69%). Four studies reported on the outcome of the next pregnancy after antibody measurement with highly heterogeneous results (OR for pregnancy loss ranging from 0.99 in one study to 10.0 in the other study, and two studies reported no data eligible for meta-analysis). Consequently, a meta-analysis could not be performed. Conclusions: Women with RPL were significantly more often TgAb-positive than women without RPL. Although there was a lack of studies reporting prospective outcomes, the findings of this study support the significance of awareness about the strong association between RPL and thyroid autoimmunity.
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Affiliation(s)
- Perrine Huisman
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
- Faculty of Medicine, Leiden University, Leiden, The Netherlands
| | - Jesper Krogh
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Claus Henrik Nielsen
- Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Hvidovre and Rigshospitalet, Copenhagen, Denmark
- Institute of Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
- Recurrent Pregnancy Loss Unit, Capital Region, Copenhagen University Hospitals, Hvidovre and Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
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Odeh R, Gharaibeh L, Ibrahim S, Alassaf A. Associated autoimmune thyroid diseases in children and adolescents with type one diabetes in Jordan. J Pediatr Endocrinol Metab 2023; 36:917-924. [PMID: 37656596 DOI: 10.1515/jpem-2023-0322] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/15/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES To investigate the prevalence of thyroid autoimmunity and related thyroid disorders among children and adolescents with type 1 diabetes in Jordan. METHODS In a retrospective study, thyroid stimulating hormone and thyroid hormone (Free T4) levels were measured in 684 children with type 1 diabetes who presented to Jordan University Hospital between January 2012 and February 2021. Anti-thyroid peroxidase (TPOAb) and anti-thyroglobulin (TGAb) antibodies were measured in 526 and 438 subjects with type 1 diabetes, respectively. RESULTS 681 children were included in the study (52.4 % females, average current age 14.3 years, average age at diagnosis 8.0 years, and average diabetes duration 6.2 years). Of the whole group, 18 children (2.6 %) were diagnosed with subclinical hypothyroidism and 31 children (4.4 %) had overt hypothyroidism. Of those who were tested for TPOAb and TGAb, 22.6 and 23.1 % were positive respectively. Predictors for developing hypothyroidism were female sex and positive antibodies to glutamic acid decarboxylase. CONCLUSIONS Screening for associated thyroid autoimmunity in children and adolescents with type one diabetes from Jordan is advised with a special focus on females and those with positive antibodies to glutamic acid decarboxylase.
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Affiliation(s)
- Rasha Odeh
- Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Lobna Gharaibeh
- Pharmacological and Diagnostic Research Center, Faculty of Pharmacy, AI-Ahliyya Amman University, Amman, Jordan
| | - Sarah Ibrahim
- Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan
| | - Abeer Alassaf
- Department of Pediatrics, School of Medicine, University of Jordan, Amman, Jordan
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Wasilewski T, Wasilewska J, Łukaszewicz-Zając M, Mroczko B. Subfertility as Overlapping of Nutritional, Endocrine, Immune, and Cardiometabolic Dysregulations-A Study Focused on Biochemical Endophenotypes of Subfertile Couples. J Clin Med 2023; 12:6094. [PMID: 37763034 PMCID: PMC10531916 DOI: 10.3390/jcm12186094] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 09/01/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
Subfertility is a global health issue, and as many as 30% of cases are attributed to unexplained reasons. A hypercaloric, high-fat diet stimulates the expansion of pro-inflammatory gut microbiota with a consequent rise in circulating lipopolysaccharides. Adverse gut microbiota remodeling can exacerbate insulin resistance, while sex and thyroid hormones may influence the variability in gut microbiota. This cross-sectional study included 150 participants and was designed to determine a biochemical, nutritional-related pattern that may distinguish subfertile from fertile individuals and couples. A panel of 28 biomarkers was assessed. Four biochemical phenotypes of unexplained subfertility were found, including two metabolic and two immune, when assessed using binary logistic regression models. Two phenotypes were distinguished in women: cardio-metabolic with atherogenic dyslipidemia (LowHDL-cholesterol: OR = 10.9; p < 0.05) and autoimmune thyroid disorder (Highanti-thyroid-peroxidase: OR = 5.5; p < 0.05) and two in men: hepato-metabolic with elevated liver injury enzymes (HighHOMA-IR: OR = 6.1; p < 0.05) and immune type-2 response (HighIgE: OR = 6.4; p < 0.05). The chances of a couple's subfertility rose with the number of laboratory components of metabolic syndrome in the couple (OR = 1.7; p < 0.05) and if at least one partner had an elevated total IgE level (>100 kU/L) (OR = 6.5; p < 0.05). This study found that unexplained subfertility may be accompanied by mutually overlapping immune and metabolic dysregulations in individuals and couples. We propose one-time laboratory diagnostics taking into account the lipid profile, insulin resistance, anti-thyroid-peroxidase, and total IgE in both males and females with unexplained subfertility. This may allow for a one-time assessment of targeted medical and nutritional interventions and help optimize patients' health. The gut-organ axes related to subfertility are discussed in the context of the obtained results.
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Affiliation(s)
- Tadeusz Wasilewski
- Centre for Restorative Procreative Medicine, Napromedica, 15-741 Bialystok, Poland;
| | - Jolanta Wasilewska
- Centre for Paediatrics, Allergology, Psychodietetics, and Treatment of Children Diagnosed with Autism, IPM, 15-404 Bialystok, Poland
| | - Marta Łukaszewicz-Zając
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland;
| | - Barbara Mroczko
- Department of Biochemical Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland;
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-269 Bialystok, Poland
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19
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Lanzolla G, Sabini E. Editorial: News in Graves' orbitopathy: patients management and treatments. Front Endocrinol (Lausanne) 2023; 14:1270467. [PMID: 37664861 PMCID: PMC10472934 DOI: 10.3389/fendo.2023.1270467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023] Open
Affiliation(s)
- Giulia Lanzolla
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Pisa, Italy
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Elena Sabini
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
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Abstract
CONTEXT Teprotumumab therapy for thyroid eye disease (TED) patients represents a major step forward. It targets and inhibits the insulin-like growth factor-1 receptor (IGF-1R), and its effectiveness is based on its interconnectedness with the thyrotropin receptor. However, IGF-1R has a ubiquitous expression and several adverse effects have been reported with teprotumumab use. OBJECTIVE Describing these adverse effects for better understanding is the purpose of this review. METHODS We reviewed the oncological studies in which teprotumumab was initially used. Subsequently we reviewed the clinical trials for TED and then the case series and case reports associated with teprotumumab use since it is US Food and Drug Administration approval (January 2020). We focused on common and/or serious adverse effects reported with the use of teprotumumab. RESULTS We described the common occurrence of hyperglycemia (10%-30% incidence), its risk factors and suggested management. Hearing changes are described, a broad spectrum from mild ear pressure to hearing loss (sensorineural mechanism). Risk factors, suggested monitoring, and possible upcoming therapies are reviewed. We also reviewed data on fatigue, muscle spasms, hair loss, weight loss, gastrointestinal disturbances, menstrual changes, and infusion reactions. We noted some discrepancies between adverse effects in oncological studies vs studies focused on TED, and we aimed to explain these differences. CONCLUSION The use of teprotumumab should consider patient's values and preferences in balancing the expected benefit with these potential risks. Future drugs targeting IGF-1R should investigate these adverse effects for a possible class effect. Combination therapies with different agents hopefully will be identified that maximize benefits and minimize risks.
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Affiliation(s)
- Marius N Stan
- Division of Endocrinology, Mayo Clinic Rochester, Rochester, MN 55905, USA
| | - Christine C Krieger
- Laboratory of Endocrinology and Receptor Biology, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892, USA
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21
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Zhang M, Ni W, Zhang L, Fan K, Sun Y, Liu C, Xu S. Age-specific association between thyroid autoimmunity and hypothyroidism in Chinese adults aged over 65 years: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1216308. [PMID: 37564984 PMCID: PMC10410462 DOI: 10.3389/fendo.2023.1216308] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/05/2023] [Indexed: 08/12/2023] Open
Abstract
Background The correlation between thyroid autoimmune (TAI) disease and hypothyroidism in the elderly of different ages remains unclear. This study aimed to investigate the epidemiological characteristics of hypothyroidism, including subclinical hypothyroidism (Shypo) and overt hypothyroidism (Ohypo) in those aged ≥65 years from iodine-adequate areas and reveal the correlation between TAI and hypothyroidism in the elderly of different ages. Methods It was a cross-sectional study involving 2,443 subjects aged ≥65 years from two iodine-adequate areas in China by cluster sampling. They were assigned to the 65-69-, 70-79-, and ≥80-year-old age group. All subjects were surveyed by questionnaires and received physical examinations, laboratory testing, and thyroid ultrasound. Epidemiological characteristics of thyroid diseases in the elderly were compared among the three groups. Risk factors for hypothyroidism were predicted by binary logistic regression analysis. Results The median urinary iodine level was 238.70 (197.00, 273.70) μg/L. Thyroid peroxidase antibody or thyroglobulin antibody positivity (11.87%) and Shypo (9.13%) were common in the elderly. The prevalence of hypothyroidism in the elderly increases with age. TAI was a risk factor for Shypo (OR, 1.94; 95% CI, 1.35, 2.80; p < 0.01) and Ohypo (OR, 7.64; 95% CI, 3.40, 17.19; p < 0.01) in elderly Chinese. There was an age-specific correlation between TAI and hypothyroidism in the elderly. However, a significant correlation was not identified between TAI and hypothyroidism in ≥80-year-old age group (p > 0.05). Conclusion Hypothyroidism, particularly Shypo, is common in the elderly from iodine-adequate areas in China. TAI serves as a risk factor for hypothyroidism in the elderly, with an age-specific correlation with hypothyroidism.
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Affiliation(s)
- Mengjie Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Wenjing Ni
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lina Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Kuanlu Fan
- Department of Endocrinology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yu Sun
- Department of Endocrinology and Metabolism, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chao Liu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Key Laboratory of Traditional Chinese Medicine Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
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22
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Erratum: Effect of SARS-CoV-2 BNT162b2 mRNA vaccine on thyroid autoimmunity: a twelve-month follow-up study. Front Endocrinol (Lausanne) 2023; 14:1257424. [PMID: 37554767 PMCID: PMC10406239 DOI: 10.3389/fendo.2023.1257424] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/12/2023] [Indexed: 08/10/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fendo.2023.1058007.].
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23
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Lee YL, Zaini AA, Idris AN, Abdullah RA, Wong JS, Hong JS, Hussain S, Lim PG, Lim SH, Nor NS, Wu LL, Jalaludin MY. Thyroid autoimmunity and autoimmune thyroid disease in Malaysian girls with Turner syndrome: An understudied population. J Paediatr Child Health 2023; 59:879-884. [PMID: 37066819 DOI: 10.1111/jpc.16405] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/20/2023] [Accepted: 04/06/2023] [Indexed: 04/18/2023]
Abstract
AIMS Knowledge on the spectrum of thyroid disorders amongst Turner syndrome (TS) patients in Southeast Asia is limited. This study aimed to evaluate the prevalence of thyroid autoimmunity, the spectrum of autoimmune thyroid disease and association with age and karyotype amongst Malaysian TS girls. METHODS A cross-sectional study was conducted at 11 paediatric endocrine units in Malaysia. Blood samples for antithyroglobulin antibodies, antithyroid peroxidase antibodies and thyroid function test were obtained. In patients with pre-existing thyroid disease, information on clinical and biochemical thyroid status was obtained from medical records. RESULTS Ninety-seven TS patients with a mean age of 13.4 ± 4.8 years were recruited. Thyroid autoimmunity was found in 43.8% of TS patients. Nineteen per cent of those with thyroid autoimmunity had autoimmune thyroid disease (Hashimoto thyroiditis in 7.3% and hyperthyroidism in 1% of total population). Patients with isochromosome X and patients with 45,X mosaicism or other X chromosomal abnormalities were more prone to have thyroid autoimmunity compared to those with 45,X karyotype (OR 5.09, 95% CI 1.54-16.88, P = 0.008 and OR 3.41, 95% CI 1.32-8.82, P = 0.01 respectively). The prevalence of thyroid autoimmunity increased with age (33.3% for age 0-9.9 years; 46.8% for age 10-19.9 years and 57.1% age for 20-29.9 years) with autoimmune thyroid disease detected in 14.3% during adulthood. CONCLUSION Thyroid autoimmunity was significantly associated with the non 45,X karyotype group, particularly isochromosome X. Annual screening of thyroid function should be carried out upon diagnosis of TS until adulthood with more frequent monitoring recommended in the presence of thyroid autoimmunity.
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Affiliation(s)
- Yee L Lee
- Paediatric Endocrine Unit, Department of Paediatrics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Azriyanti A Zaini
- Paediatric Endocrine Unit, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Arini N Idris
- Paediatric Endocrine Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Raja A Abdullah
- Paediatric Endocrine Unit, Department of Paediatrics, Hospital Pulau Pinang, Pulau Pinang, Malaysia
| | - Jeanne Sl Wong
- Paediatric Endocrine Unit, Department of Paediatrics, Putrajaya Hospital, Putrajaya, Malaysia
- Sunway Specialist Centre, Kota Damansara, Malaysia
| | - Joyce Ss Hong
- Paediatric Endocrine Unit, Department of Paediatrics, Hospital Pakar Kanak-kanak, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Suhaimi Hussain
- Paediatric Endocrine Unit, Department of Paediatrics, Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
| | - Poi G Lim
- Paediatric Endocrine Unit, Department of Paediatrics, Hospital Tunku Azizah, Kuala Lumpur, Malaysia
| | - Song H Lim
- Paediatric Endocrine Unit, Department of Paediatrics, Sabah Women and Children's Hospital, Kota Kinabalu, Malaysia
| | - Noor Sm Nor
- Department of Paediatrics, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Shah Alam, Malaysia
- Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA (UiTM), Shah Alam, Malaysia
| | - Loo L Wu
- Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - Muhammad Y Jalaludin
- Paediatric Endocrine Unit, Department of Paediatrics, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Gontarz-Nowak K, Szklarz M, Szychlińska M, Matuszewski W, Bandurska-Stankiewicz E. A Brief Look at Hashimoto's Disease, Adrenal Incidentalomas, Obesity and Insulin Resistance-Could Endocrine Disruptors Be the Other Side of the Same Coin? Medicina (Kaunas) 2023; 59:1234. [PMID: 37512046 PMCID: PMC10385892 DOI: 10.3390/medicina59071234] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/20/2023] [Accepted: 06/24/2023] [Indexed: 07/30/2023]
Abstract
Hashimoto's disease (HD) is the most common cause of hypothyroidism in developed countries. The exact pathomechanism behind it has not been clearly established; however, an interplay of genetic susceptibility, environmental triggers (including diet) and epigenetic factors seems to be involved. Among the latter, increasingly more attention has been paid to some hormonally active substances, known as endocrine disruptors, which are commonly used worldwide. HD has become a condition widely reported in the media, acting as a culprit for inexplicable weight gain, chronic fatigue or weakness. Nevertheless, the recognition of HD is undeniably increasing and represents a major public health burden. At the same time, improving access to imaging tests has increased the number of incidentally diagnosed adrenal tumors. Above all, the widespread use of chest computed tomography (CT) due to the COVID-19 pandemic has contributed to frequent incidental detection of adrenal lesions. Fortunately, a vast majority of these findings are asymptomatic benign tumors with no excessive hormonal activity, and therefore, they are defined as adrenal incidentalomas (AIs). Interestingly, recent studies have indicated that patients with AIs are more prone to obesity and insulin resistance. Although mutual relationships between the thyroid and the adrenal glands have been studied widely, still, little is known about the possible pathophysiological associations between thyroid autoimmunity and the occurrence of adrenal incidentalomas. This article presents a brief review of the common endocrine disorders with a special focus on the frequently coexisting insulin resistance and/or obesity. Furthermore, in response to the recent growing interest in endocrine disruptors, with their transgenerational epigenetic effects that influence hormonal system function, a concise overview of the topic has also been included.
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Affiliation(s)
- Katarzyna Gontarz-Nowak
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Michał Szklarz
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Magdalena Szychlińska
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Wojciech Matuszewski
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Elżbieta Bandurska-Stankiewicz
- Department of Internal Medicine, Faculty of Medical Sciences, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
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Krysiak R, Kowalcze K, Szkróbka W, Okopień B. Sexual Function and Depressive Symptoms in Young Women with Euthyroid Hashimoto's Thyroiditis Receiving Vitamin D, Selenomethionine and Myo-Inositol: A Pilot Study. Nutrients 2023; 15:2815. [PMID: 37375719 DOI: 10.3390/nu15122815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Thyroid autoimmunity is associated with an increased risk of sexual dysfunction. The aim of this study was to compare sexual functioning and depressive symptoms in women with Hashimoto's thyroiditis receiving different treatments. The study included euthyroid women with autoimmune thyroiditis, untreated or receiving vitamin D, selenomethionine, or myo-inositol. Apart from measuring antibody titers and hormone levels, all participants completed questionnaires evaluating female sexual function (FSFI) and depressive symptoms (BDI-II). In untreated women, the overall FSFI scores and domain scores for desire, arousal, lubrication, and sexual satisfaction were lower than in women receiving vitamin D, selenomethionine, and myo-inositol. In the vitamin D-treated women, the total FSFI scores and scores for desire and arousal were higher than in women receiving the remaining micronutrients. The BDI-II score was lowest in the vitamin D-treated women and highest in the untreated patients with thyroiditis. Vitamin D-treated women were also characterized by lower antibody titers and higher testosterone levels than the women receiving the remaining micronutrients. There were no differences in sexual functioning and depressive symptoms between the selenomethionine- and myo-inositol-treated women. The study results suggest that although all antibody-lowering treatments are associated with better sexual functioning and well-being in young women with euthyroid autoimmune thyroiditis, the greatest benefits are observed in patients receiving vitamin D.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Stefana Batorego 15, 41-902 Bytom, Poland
| | - Witold Szkróbka
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
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Liu Y, He Z, Huang N, Zeng L, Wang Y, Li R, Chi H. Impact of thyroid autoimmunity and vitamin D on in vitro fertilization/intracytoplasmic sperm injection outcomes among women with normal thyroid function. Front Endocrinol (Lausanne) 2023; 14:1098975. [PMID: 37223025 PMCID: PMC10200944 DOI: 10.3389/fendo.2023.1098975] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/12/2023] [Indexed: 05/25/2023] Open
Abstract
This prospective cohort study aimed to determine the impact of thyroid autoimmunity and total 25-hydroxyvitamin D concentration on early pregnancy outcomes in women undergoing in vitro fertilization/intracytoplasmic sperm injection who had intact thyroid function. The study included 1,297 women who underwent in vitro fertilization/intracytoplasmic sperm injection cycles, although only 588 patients received fresh embryo transfer. The study endpoints were clinical pregnancy, ongoing pregnancy, ectopic pregnancy, and early miscarriage rates. Our study found that the total 25-hydroxyvitamin D serum concentrations (P<0.001) and anti-Mullerian hormone levels (P=0.019) were lower among patients in the TAI group (n=518) than among those in the non-TAI group (n=779). Additionally, the study population in each group was divided into three subgroups according to the total vitamin D status based on clinical practice guidelines (deficient, <20 ng/mL; insufficient, 21-29 ng/mL; and sufficient, ≥30 ng/mL), TAI group: sufficient, n=144; insufficient, n=187; and deficient, n=187; non-TAI group: sufficient, n=329; insufficient, n=318, and deficient, n=133. In the TAI group, the number of good-quality embryos decreased in patients with vitamin D deficiency (P=0.007). Logistic regression analysis indicated that aging prevented women from achieving clinical (P=0.024) and ongoing pregnancy (P=0.026). The current findings suggest that patients with TAI had reduced serum vitamin D concentration. Furthermore, in the TAI group, the number of good-quality embryos decreased in patients with vitamin D deficiency. Finally, aging adversely impacted achieving clinical and ongoing pregnancy.
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Affiliation(s)
- Yalong Liu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Zining He
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Ning Huang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Yang Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
| | - Hongbin Chi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, China
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McAninch EA, Desai K, McCowen KC, Orloff LA. Hyperthyroidism Due to Graves Disease After Radiofrequency Ablation. JCEM Case Rep 2023; 1:luad056. [PMID: 37908568 PMCID: PMC10580446 DOI: 10.1210/jcemcr/luad056] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Indexed: 11/02/2023]
Abstract
Management options for benign, autonomously functioning, and malignant thyroid nodules were limited to surgery or targeting by radioactive iodine before the availability of radiofrequency ablation (RFA). Despite being a relatively new technique, RFA may be favored for patients of high surgical risk, and for those who wish to avoid hypothyroidism. Although insurance coverage for the procedure can be a significant barrier, several groups of investigators have shown improved quality of life for RFA compared to surgery, due to the less invasive nature and favorable risk profile. Hyperthyroidism due to transient thyroiditis is a known risk of RFA, secondary to direct trauma and subsequent thyroid hormone release. Here we present a case of an adult with large, symptomatic, multinodular goiter, with no prior history of thyroid autoimmunity, who underwent RFA with successful volume reduction of two nodules, but who developed acute hyperthyroidism due to Graves disease eight weeks after RFA. Larger studies evaluating the risks of RFA should evaluate for incident hyperthyroidism, specifically for Graves disease/thyroid autoimmunity, as this could represent an additional risk of the procedure.
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Affiliation(s)
- Elizabeth A McAninch
- Division of Endocrinology, Gerontology and Metabolism, Stanford University Medical Center, Stanford, CA 94305, USA
| | - Kaniksha Desai
- Division of Endocrinology, Gerontology and Metabolism, Stanford University Medical Center, Stanford, CA 94305, USA
| | - Karen C McCowen
- Division of Endocrinology, University of California San Diego, San Diego, CA 92093, USA
| | - Lisa A Orloff
- Department of Otolaryngology-Head and Neck Surgery, Stanford University Medical Center, Stanford, CA 94305, USA
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28
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Yang X, Qiu S, Jiang W, Huang Z, Shi H, Du S, Sun Y, Zheng B. Impact of thyroid autoimmunity on pregnancy outcomes in euthyroid women following fresh/frozen-thawed embryo transfer. Clin Endocrinol (Oxf) 2023. [PMID: 37096335 DOI: 10.1111/cen.14924] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/18/2023] [Accepted: 04/16/2023] [Indexed: 04/26/2023]
Abstract
OBJECTIVE To investigate whether thyroid autoimmunity (TAI) is associated with assisted reproductive technology (ART) outcomes in euthyroid women undergoing fresh embryo transfer (ET) and frozen-thawed embryo transfer (FET). DESIGN A retrospective cohort study. Pregnancy and neonatal outcome after fresh ET or FET were compared between the positive and negative thyroid autoimmune antibody groups. PATIENTS A total of 5439 euthyroid women who started their ART cycle at our centre between 2015 and 2019 were included. RESULTS The thyroid antibody positive group had a greater mean age than the thyroid antibody negative group (32(29,35) vs. 31(28,34), p < .001). Women with positive thyroid antibody presented with a higher prevalence of diminished ovarian reserve (DOR) (9.1% vs. 7.1%, p = .026) and lower number of oocyte retrieved (9(5,15) vs. 10(6,15), p = .020), but difference was not significant after adjusting for age. The pregnancy rate, live birth rate, pregnancy loss rate, preterm delivery rate and low birthweight rate between the thyroid antibody positive and thyroid antibody negative groups were comparable both in fresh ET cycles and FET cycles. Subanalysis of the treatment outcomes when using a stricter threshold of TSH of 2.5 mIU/L showed no difference to that achieved when using an upper limit of 4.78 mIU/L. CONCLUSIONS The present study reveals that patients with anti-thyroid peroxidase antibodies (TPOAbs) and/or antithyroglobulin antibodies (TgAbs) showed no significant differences in pregnancy outcomes following fresh ET and FET when compared with patients with negative thyroid antibodies.
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Affiliation(s)
- Xiaoyan Yang
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
- Fujian Maternal-Fetal Clinical Medicine Research Center, Fuzhou, Fujian, China
| | - Shumin Qiu
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Wenwen Jiang
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Zhiqing Huang
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Hang Shi
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Shengrong Du
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Yan Sun
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
| | - Beihong Zheng
- Reproductive Medicine Center, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, China
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Asero R, Ferrucci SM, Calzari P, Consonni D, Cugno M. Thyroid Autoimmunity in CSU: A Potential Marker of Omalizumab Response? Int J Mol Sci 2023; 24:ijms24087491. [PMID: 37108654 PMCID: PMC10139159 DOI: 10.3390/ijms24087491] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/16/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023] Open
Abstract
The response of severe chronic spontaneous urticaria (CSU) to omalizumab largely depends on the autoimmune or autoallergic endotype of the disease. Whether thyroid autoimmunity may predict omalizumab response along with total IgE in CSU is still unclear. Three hundred and eighty-five patients (M/F 123/262; mean age 49.5 years; range 12-87 years) with severe CSU were studied. Total IgE levels and thyroid autoimmunity (levels of anti-thyroid peroxidase [TPO] IgG) were measured before omalizumab treatment. Based on the clinical response, patients were divided into early (ER), late (LR), partial (PR) and non (NR) responders to omalizumab. Thyroid autoimmunity was detected in 92/385 (24%) patients. Altogether, 52%, 22%, 16% and 10% of patients were ER, LR, PR and NR to omalizumab, respectively. Response to omalizumab was not associated with thyroid autoimmunity (p = 0.77). Conversely, we found a strongly positive association between IgE levels and omalizumab response (p < 0.0001); this association was largely driven by early response (OR = 5.46; 95% CI: 2.23-13.3). Moreover, the predicted probabilities of early response strongly increased with increasing IgE levels. Thyroid autoimmunity alone cannot be used as a clinical predictor of omalizumab response. Total IgE levels remain the only and most reliable prognostic marker for omalizumab response in patients with severe CSU.
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Affiliation(s)
- Riccardo Asero
- Clinica San Carlo, Ambulatorio di Allergologia, 20037 Paderno Dugnano, 20037 Milan, Italy
| | - Silvia Mariel Ferrucci
- Unit of Dermatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Paolo Calzari
- Postgraduate School of Allergy and Clinical Immunology, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Massimo Cugno
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milan, Italy
- Dipartmento di Medicina Interna, UOC Medicina Generale-Emostasi e Trombosi, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Poppe KG, Frommer L, Hatun B, Autin C, Wolff F, Kahaly GJ. Ovarian Stimulation Does Not Induce Thyrotropin Receptor Autoantibodies in Women with Thyroid Autoimmunity. Eur J Endocrinol 2023; 188:K24-K28. [PMID: 36995895 DOI: 10.1093/ejendo/lvad045] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
Women of subfertile couples with thyroid autoimmunity (TAI) have an increased risk of miscarriage when pregnant after an assisted reproductive technology (ART) treatment. This might amongst others be due to the presence of thyrotropin receptor antibodies (TSH-R-Ab) that can impede the development of the corpus luteum. TSH-R-Ab can be present in women with TAI and/or be induced by the ovarian stimulation procedure (OS) that is performed to initiate the ART. In this prospective pilot study, we determined the presence of both binding and functional TSH-R-Ab (stimulating or blocking) with five different assays before and after OS in ten women (eleven cycles) with TAI of subfertile couples and in one woman without TAI. Mean (SD) age was 38.8 (±3.2) years, median (range) cumulative OS dose 1413 (613-2925) IU/L. Median baseline serum levels of thyrotropin, free thyroxine, and thyro-peroxidase antibodies were 2.33 (2.23-2.61) mIU/L, 16.8 (14.4-18.5) pmol/L and 152 (86-326) kIU/L, respectively. Oestradiol levels increased during OS from 40 (26-56) ng/L to 963 (383-5095) ng/L; p < 0.01. TSH-R-Ab measurements in all subject samples were below the cut-off of the corresponding immunoassay and four bioassays before or after OS.
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Affiliation(s)
- K G Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute 322, 1000 Brussels, Belgium
| | - L Frommer
- Molecular Thyroid Lab, Dept. of Medicine I, Johannes Gutenberg University (JGU) Medical Centre, Mainz 55101, Germany
| | - B Hatun
- Molecular Thyroid Lab, Dept. of Medicine I, Johannes Gutenberg University (JGU) Medical Centre, Mainz 55101, Germany
| | - C Autin
- Departement of Gynaecology and Obstetrics, Centre Hospitalier Universitaire Saint Pierre, Université Libre de Bruxelles (ULB), Rue Haute 322, 1000 Brussels, Belgium
| | - F Wolff
- Department of Clinical Chemistry, LHUB-ULB, Université Libre de Bruxelles (ULB), Rue Haute 322, 1000 Brussels, Belgium
| | - G J Kahaly
- Molecular Thyroid Lab, Dept. of Medicine I, Johannes Gutenberg University (JGU) Medical Centre, Mainz 55101, Germany
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Zhang S, Yang M, Li T, Yang M, Wang W, Chen Y, Ding Y, Liu J, Xu X, Zhang J, Wang Z, Liu J. High level of thyroid peroxidase antibodies as a detrimental risk of pregnancy outcomes in euthyroid women undergoing ART: A meta-analysis. Mol Reprod Dev 2023; 90:218-226. [PMID: 36922915 DOI: 10.1002/mrd.23677] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 12/27/2022] [Accepted: 02/08/2023] [Indexed: 03/18/2023]
Abstract
Thyroid autoimmunity (TAI) triggered by genetic and epigenetic variation occurs mostly in women of reproductive age. TAI is described mainly by positivity of anti-thyroid peroxidase antibody (TPO-Ab) and/or thyroglobulin antibody (TG-Ab). TPO-Ab, but not TG-Ab, was suggested to be associated with pregnancy outcome in euthyroid women undergoing assisted reproductive technology (ART), but their results are conflicting. This meta-analysis was performed to decide whether the presence of TPO-Ab-in a concentration dependent manner-correlates with the success of ART. A systematic literature search was performed in the PubMed, Web of Science, and EMBASE databases for relevant articles published from January 1999 to April 2022, and these studies focused on the effect of TAI on pregnancy outcomes of women who underwent in vitro fertilization, intracytoplasmic sperm injection and intrauterine insemination and met the inclusion criteria: (i) the studies were prospective or retrospective study; (ii) all patients undergoing ART were tested for thyroid-related antibodies; (iii) the assessed ART outcomes included miscarriage rate (MR) or delivery rate (DR). The exclusion criteria were: (i) female congenital uterine malformation, chromosomal diseases and other infectious diseases; (ii) overt hypothyroidism or pre-existing thyroid disease; (iii) thrombus tendency. We divided the included patients into three groups according to the TPO-Ab threshold they defined: (i) TPO-Ab (-), threshold <34 IU/mL; (ii) TPO-Ab-34, threshold >34 IU/mL; (iii) TPO-Ab-100, threshold >100 IU/mL. We then extracted necessary relevant data, including MR and DR. Egger's test was used to evaluate the risk of publication bias. This meta-analysis included a total of 7 literatures involving 7466 patients with TAI (-) and 965 patients with TAI (+) and revealed that there was no significant difference between group TPO-Ab-34 and group TPO-Ab (-) in MR [risk ratio (RR): 0.61 (0.35, 1.08), p = 0.09] and DR [RR: 0.97 (0.83, 1.13), p = 0.69]. By contrast, compared to TPO-Ab (-) group, TPO-Ab-100 patients showed markedly higher MR [RR: 2.12 (1.52, 2.96), p = 0.0046], and lower DR [RR: 0.66 (0.49, 0.88), p < 0.0001] with high degree of statistical significance. This meta-analysis suggests that, for euthyroid patients, high level of TPO-Ab (>100 IU/mL) could adversely influence the pregnancy outcome of ART.
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Affiliation(s)
- Sudan Zhang
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Mingdong Yang
- Department of Rheumatology and Immunology, Shouguang People's Hospital, Shouguang, Shandong, China
| | - Teng Li
- Qingdao Branch of SJTU Bio-X Institutes, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,Department of Toxicology, School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Min Yang
- Department of Internal Medicine, The People's Hospital of Shinan District, Qingdao, Shandong, China
| | - Wei Wang
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yunqing Chen
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Yu Ding
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jianxin Liu
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiaohui Xu
- Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, Shandong, China
| | - Jian Zhang
- Department of Cell Biology, Yale Stem Cell Center, Yale University, New Haven, Connecticut, USA
| | - Zheng Wang
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, Shandong, China
| | - Jiane Liu
- Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.,Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, Shandong, China
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Rao M, Zeng Z, Zhang Q, Su C, Yang Z, Zhao S, Tang L. Thyroid Autoimmunity Is Not Associated with Embryo Quality or Pregnancy Outcomes in Euthyroid Women Undergoing Assisted Reproductive Technology in China. Thyroid 2023; 33:380-388. [PMID: 36571280 DOI: 10.1089/thy.2022.0184] [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] [Indexed: 12/27/2022]
Abstract
Background: Studies have shown that thyroid autoimmunity (TAI) is associated with increased risks of adverse pregnancy outcomes. The aim of this study was to investigate the associations between TAI and embryo quality in euthyroid women undergoing in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI). Methods: This retrospective cohort study included euthyroid infertile women with and without TAI (defined as a serum thyroperoxidase concentration ≥34 IU/mL or a thyroglobulin concentration ≥115.0 IU/mL) who underwent their first complete IVF/ICSI treatment cycles at a tertiary referral center between April 2016 and February 2022. Embryo quality measurements and clinical outcomes were compared between women with (TAI positive) and without TAI (TAI negative). The high-quality cleavage embryo rate and cumulative live birth rate (cLBR) were the primary outcomes. Results: A total of 499 TAI-positive and 2945 TAI-negative women were included in this study, and their mean (standard deviation) ages were 31.6 (4.5) and 30.9 (4.4) years, respectively (p = 0.001). The overall analysis showed no significant differences between TAI-negative and TAI-positive women in the high-quality cleavage embryo rate (n/N: 11,139/22,553 vs. 1971/3820; adjusted rate: 52.8% vs. 53.4%, p = 0.66) and cLBR (1917/2945 vs. 327/499; 53.4% vs. 56.2%, p = 0.31). Moreover, no significant differences were observed between TAI-negative and TAI-positive women in the rates of oocyte retrieval (35,078/51,978 vs. 5853/8628; 69.1% vs. 69.4%; p = 0.65), fertilization (23,067/34,197 vs. 3902/5728; 61.1% vs. 62.2%, p = 0.34), embryo utilization (18,233/22,553 vs. 3156/3820; 80.2% vs. 80.8%, p = 0.61), blastocyst formation (7051/13,721 vs. 1192/2330; 48.5% vs. 48.4%, p = 0.97), and high-quality blastocysts (4819/13,721 vs. 799/2330; 29.9% vs. 29.4%, p = 0.73). Furthermore, no significant differences were observed between TAI-negative and TAI-positive women in the clinical pregnancy rate (1524/2808 vs. 248/482; 46.7% vs. 44.6%, p = 0.40), early pregnancy loss rate (156/1524 vs. 23/248; 13.5% vs. 11.5%, p = 0.44), and LBR (1338/2808 vs. 218/482; 37.4% vs. 36.0%, p = 0.55) of the first transfer cycle. Conclusions: This study demonstrated that TAI in women was not associated with embryo quality or the cLBR following IVF/ICSI. Future large studies are warranted to confirm these findings.
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Affiliation(s)
- Meng Rao
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zhengyan Zeng
- Department of General Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Qiaoling Zhang
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cunmei Su
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zexing Yang
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shuhua Zhao
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li Tang
- Department of Reproduction and Genetics, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Ashrafian H. Goiters in the Renaissance era: Multiple cases of thyroid autoimmunity and iodine deficiency. Best Pract Res Clin Endocrinol Metab 2023; 37:101748. [PMID: 36868952 DOI: 10.1016/j.beem.2023.101748] [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] [Indexed: 02/17/2023]
Abstract
The Renaissance is recognised as an inflection point in history that led to the dissemination of innovation, science, philosophy, and the arts to spearhead a leap for global civilisation. Many of the greatest outputs from the Renaissance were presented in artwork which was able to champion elements of naturalism and realism, and therefore moved away from preconceived ideas. This included the portrayal of anatomy and pathology with an exactitude previously unseen in art. I note novel identification of goiters in multiple paintings of the foremost Renaissance genius artists and their originating artistic schools, those of Verrocchio, Lippi and Ferrara. These can be categorised through the proposed (i) 'da Vinci Sign' after Leonardo da Vinci, where the goitre is artistically presented as a loss or shallowing of the suprasternal notch recess or (ii) the 'Botticelli Sign' after Sandro Botticelli, where there is demonstrable cranio-cervical neck flexion that forward projects the visceral compartment of the neck that includes the thyroid to accentuate a recognisable thyroid enlargement. These are notable in the works of genius artists that include Verrocchio, Lorenzo di Credi, Filippo Lippi, Cosimo Tura and Francesco Cossa. Together, the work of these artistic geniuses add to the corpus of notable endocrine pathology in the Renaissance deriving from endemic iodine deficiency and autoimmunity. They demonstrate this profound extent of pathology within their artistic masterpieces and extend our admiration of the wider experience of Renaissance artists into the current era and beyond.
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Affiliation(s)
- Hutan Ashrafian
- Institute of Global Health Innovation, The Department of Surgery and Cancer, Imperial College London, 10th Floor Queen Elizabeth the Queen Mother (QEQM) Building, St Mary's Hospital, Praed Street, London W2 1NY, UK.
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Kyrilli A, Unuane D, Poppe KG. Thyroid autoimmunity and pregnancy in euthyroid women. Best Pract Res Clin Endocrinol Metab 2023; 37:101632. [PMID: 35256265 DOI: 10.1016/j.beem.2022.101632] [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] [Indexed: 11/20/2022]
Abstract
Women with thyroid autoimmunity (TAI), predominately characterized by increased levels of thyroid peroxidase antibody (TPOAb), are at risk for developing pregnancy related complications. In this review, we discuss the importance of TAI during natal and perinatal stages. Before pregnancy, TAI is associated with higher mean serum TSH levels and certain causes of subfertility. During pregnancy, TAI increases the risk of an insufficient response of the thyroid to an increasing strain induced by pregnancy, and consequently (subclinical) hypothyroidism might develop. Euthyroid women with TAI have a higher rate of maternal and foetal complications, but it seems that causality cannot be pinned down to thyroid dysfunction alone. Almost half of the women known with TAI prior to pregnancy will also develop post-partum thyroiditis (PPT). However, any relation between PPT and post-partum depression remains uncertain. More research is required to explain possible associations between TAI and pregnancy morbidities, and studies should focus on a better understanding of TAI as such. Given the many unanswered questions, at present, it is not recommended to screen all (potentially) pregnant women for the presence of TAI.
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Affiliation(s)
- Aglaia Kyrilli
- Department of Endocrinology, Hôpital Erasme (Université Libre de Bruxelles, ULB), Route de Lennik, 808, 1070, Brussels, Belgium
| | - David Unuane
- Department of Endocrinology, Universitair Ziekenhuis Brussel, UZ Brussel, (Vrije Universiteit Brussel, VUB), Laarbeeklaan, 101, 1090, Brussels, Belgium
| | - Kris G Poppe
- Department of Endocrinology, CHU Saint-Pierre (Université Libre de Bruxelles, ULB), Rue Haute, 322, 1000, Brussels, Belgium.
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Safarian GK, Niauri DA, Kogan IY, Bespalova ON, Dzhemlikhanova LK, Lesik EA, Komarova EM, Krikheli IO, Obedkova KV, Tkachenko NN, Milyutina YP, Gzgzyan AM, Shoenfeld Y. Impact of Antithyroperoxidase Antibodies (Anti-TPO) on Ovarian Reserve and Early Embryo Development in Assisted Reproductive Technology Cycles. Int J Mol Sci 2023; 24. [PMID: 36902134 DOI: 10.3390/ijms24054705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/17/2023] [Accepted: 02/21/2023] [Indexed: 03/05/2023] Open
Abstract
Autoimmune thyroid disease (AITD) is one of the most common endocrinopathies and is more prevalent in women. It becomes evident that the circulating antithyroid antibodies that often follow AITD have effects on many tissues, including ovaries, and therefore that this common morbidity might have an impact on female fertility, the investigation of which is the aim of the present research. Ovarian reserve, ovarian response to stimulation and early embryo development in infertile patients with thyroid autoimmunity were assessed in 45 women with thyroid autoimmunity and 45 age-matched control patients undergoing infertility treatment. It was demonstrated that the presence of anti-thyroid peroxidase antibodies is associated with lower serum anti-Müllerian hormone levels and antral follicle count. Further investigation revealed the higher prevalence of sub-optimal response to ovarian stimulation in TAI-positive women, lower fertilization rate and lower number of high-quality embryos in this group of patients. The cut-off value for follicular fluid anti-thyroid peroxidase antibody affecting the above-mentioned parameters was determined to be 105.0 IU/mL, highlighting the necessity of closer monitoring in couples seeking infertility treatment with ART.
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36
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Asero R. Atopic status and thyroid autoimmunity do not predict omalizumab response in severe CSU patients. Eur Ann Allergy Clin Immunol 2023. [PMID: 36786337 DOI: 10.23822/eurannaci.1764-1489.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Affiliation(s)
- R Asero
- Allergology Clinic, Clinica San Carlo, Paderno Dugnano, Milan, Italy
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37
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Morita S, Takagi T, Inaba H, Furukawa Y, Kishimoto S, Uraki S, Shimo N, Takeshima K, Uraki S, Doi K, Imagawa M, Kokawa M, Konami T, Hara H, Hara Y, Sone E, Furuta H, Nishi M, Doi A, Tamura S, Matsuoka TA. Effect of SARS-CoV-2 BNT162b2 mRNA vaccine on thyroid autoimmunity: A twelve-month follow-up study. Front Endocrinol (Lausanne) 2023; 14:1058007. [PMID: 36777341 PMCID: PMC9911871 DOI: 10.3389/fendo.2023.1058007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives Graves' disease (GD) has been highlighted as a possible adverse effect of the respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine. However, it is unknown if the SARS-CoV-2 vaccine disrupts thyroid autoimmunity. We aimed to present long-term follow-up of thyroid autoimmunity after the SARS-CoV-2 BNT162b2 mRNA vaccine. Methods Serum samples collected from seventy Japanese healthcare workers at baseline, 32 weeks after the second dose (pre-third dose), and 4 weeks after the third dose of the vaccine were analyzed. The time courses of anti-SARS-CoV-2 spike immunoglobulin G (IgG) antibody, thyroid-stimulating hormone receptor antibody (TRAb), and thyroid function were evaluated. Anti-thyroglobulin antibodies (TgAb) and anti-thyroid peroxidase antibodies (TPOAb) were additionally evaluated in thirty-three participants. Results The median age was 50 (IQR, 38-54) years and 69% were female. The median anti-spike IgG antibody titer was 17627 (IQR, 10898-24175) U/mL 4 weeks after the third dose. The mean TRAb was significantly increased from 0.81 (SD, 0.05) IU/L at baseline to 0.97 (SD, 0.30) IU/L 4 weeks after the third dose without functional changes. An increase in TRAb was positively associated with female sex (β = 0.32, P = 0.008) and low basal FT4 (β = -0.29, P = 0.02) and FT3 (β = -0.33, P = 0.004). TgAb was increased by the third dose. Increase in TgAb was associated with history of the thyroid diseases (β = 0.55, P <0.001). Conclusions SARS-CoV-2 BNT162b2 mRNA vaccine can disrupt thyroid autoimmunity. Clinicians should consider the possibility that the SARS-CoV-2 vaccine may disrupt thyroid autoimmunity.
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Affiliation(s)
- Shuhei Morita
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tomoyuki Takagi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hidefumi Inaba
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yasushi Furukawa
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shohei Kishimoto
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinsuke Uraki
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoki Shimo
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ken Takeshima
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Saya Uraki
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Kei Doi
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Mitsuyo Imagawa
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Mika Kokawa
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Tomomi Konami
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hitomi Hara
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Yoshihiro Hara
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Emiko Sone
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hiroto Furuta
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Nishi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Asako Doi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinobu Tamura
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Taka-aki Matsuoka
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
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Medenica S, Garalejić E, Abazović D, Bukumirić Z, Paschou SA, Arsić B, Vujošević S, Međo B, Žarković M. Pregnancy outcomes and newborn characteristics in women with follicular fluid thyroid autoantibodies undergoing assisted reproduction. J Med Biochem 2023; 42:27-33. [PMID: 36819134 PMCID: PMC9920930 DOI: 10.5937/jomb0-35243] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/20/2022] [Indexed: 11/02/2022] Open
Abstract
Background Higher levels of thyroid autoantibodies in follicular fluid (FF) of thyroid autoimmunity (TAI) positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development. Literature highlights that levothyroxine (LT4) treatment may attenuate the risk of adverse pregnancy outcomes. The aim of the study was to estimate the pregnancy and newborn outcomes in women with FF thyroid autoantibodies undergoing assisted reproductive technology (ART). Methods The study population included 24 women with confirmed clinical pregnancy, 8 TAI positive and 16 TAI negative women. LT4 supplementation was applied in 20.8% patients, TAI positive. Results Pregnancy outcomes were: twin pregnancy rate 41.7%, early miscarriage rate 8.3%, late miscarriage rate 4.2%, preterm birth rate 16.7%, term birth rate 70.8%, live birth rate 96.0%. There was significant difference in serum and in FF TgAbs (p< 0.001)between the groups according to TAI, while serum fT3 was lower in the group with TAI (p = 0.047). Serum P4 was higher in LT4 treated group (p = 0.005), with TAI, and newborns in this group had higher birth weight (p = 0.001) and height (p = 0.008). Maternal complications occurred in 23.8% of patients. No congenital malformations in newborns were noted. Conclusions Thyroid autoantibodies present in FF may have an effect on the post-implantation embryo development, but have no effect on further course of pregnancy. The special benefit of LT4 treatment for successful ART outcome was demonstrated for newborn anthropometric parameters.
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Affiliation(s)
- Sanja Medenica
- University of Montenegro, School of Medicine, Clinical Center of Montenegro, Internal Medicine Clinic, Department of Endocrinology, Podgorica, Montenegro
| | - Eliana Garalejić
- Clinic for Gynecology and Obstetrics "Narodni front", In Vitro Fertilisation Department, Belgrade
| | - Džihan Abazović
- Emergency Medicine Center of Montenegro, Podgorica, Montenegro
| | - Zoran Bukumirić
- University of Belgrade, Institute for Medical Statistics and Informatics, Faculty of Medicine, Belgrade
| | - Stavroula A. Paschou
- National and Kapodistrian University of Athens, School of Medicine, Alexandra Hospital, Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Athens, Greece
| | - Biljana Arsić
- Clinic for Gynecology and Obstetrics "Narodni front", In Vitro Fertilisation Department, Belgrade
| | - Snežana Vujošević
- University of Montenegro, School of Medicine, Clinical Center of Montenegro, Internal Medicine Clinic, Department of Endocrinology, Podgorica, Montenegro
| | - Biljana Međo
- University of Belgrade, School of Medicine, Belgrade
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Chen J, Jiao XF, Zhang L, Zhang M, Zeng L, Liu D, Li H, Zou K, Wei Q, Zhang L. The impact of levothyroxine therapy on pregnancy and neonatal outcomes in euthyroid pregnant women with thyroid autoimmunity: A systematic review, meta-analysis and trial sequential analysis. Front Pharmacol 2023; 14:1054935. [PMID: 36937892 PMCID: PMC10018182 DOI: 10.3389/fphar.2023.1054935] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
Background: At present, only one systematic review has investigated the effect of levothyroxine (LT4) in the treatment of euthyroid pregnant women with thyroid autoimmunity, but some problems [such as merging different types of research for meta-analysis, lacking neonatal outcomes, and so on] exist in this study, satisfactory results can not be provided. So, this systematic review was performed to investigate the effect of LT4 in euthyroid pregnant women with thyroid autoimmunity, in the hope of providing more comprehensive evidence for clinical use. Methods: Medline (Ovid), Embase (Ovid), and Cochrane Central Register of Controlled Trials were electronically searched from database inception to March 2022. We included cohort studies and RCTs that evaluated the impact of LT4 therapy on pregnancy and neonatal outcomes in euthyroid pregnant women with thyroid autoimmunity. Meta-analyses of different types of studies were performed separately, and meta-analyses were further performed by only including researches with low and moderate risk of bias. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach to evaluate the quality of evidence, and used TSA to test the sufficiency of the evidence. Results: Finally, 2,901 euthyroid pregnant women with thyroid autoimmunity in six RCTs and five cohort studies were included. In all outcomes, no statistically significant differences were found between LT4 group and control group, including miscarriage [RR = 0.85, 95%CI (0.69,1.05), p = 0.14, I 2 = 1%], preterm birth [RR = 0.80, 95%CI (0.59,1.08), p = 0.14, I2 = 0%], preeclampsia [RR = 0.68, 95%CI (0.12, 3.91), p = 0.66, I 2 = 0%], placenta abruption [Peto' OR = 0.14, 95%CI (0.00, 6.94), p = 0.32, I 2 = 0%], birth weight [MD = -36.00, 95%CI (-170.41, 98.41), p = 0.60, I 2 = 0%], gestational age at delivery [MD = -0.10, 95%CI (-0.61, 0.41), p = 0.70, I 2 = 0%] and neonatal admission [RR = 1.33, 95%CI (0.21, 8.58), p = 0.76, I 2 = 0%]. The results for all outcomes were insufficient and inconclusive as demonstrated by TSA. The GRADE assessments showed that the quality of evidence of 4 outcomes (miscarriage, preterm birth, birth weight and gestational age at delivery) were moderate, and 3 outcomes (preeclampsia, placenta abruption and neonatal admission) were low or very low. Conclusion: For pregnancy and neonatal outcomes in euthyroid pregnant women with thyroid autoimmunity, we did not find benefit of LT4 treatment in this study. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022346745, identifier CRD42022346745.
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Affiliation(s)
- Jingjing Chen
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Xue-Feng Jiao
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Li Zhang
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Miao Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Linan Zeng
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Dan Liu
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Hailong Li
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Kun Zou
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
| | - Qiang Wei
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China
- *Correspondence: Lingli Zhang, ; Qiang Wei,
| | - Lingli Zhang
- Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China
- NMPA Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu, China
- Chinese Evidence-based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Lingli Zhang, ; Qiang Wei,
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Xu Y, Chen H, Ren M, Gao Y, Sun K, Wu H, Ding R, Wang J, Li Z, Liu D, Wang Z, Yan L. Thyroid autoimmunity and adverse pregnancy outcomes: A multiple center retrospective study. Front Endocrinol (Lausanne) 2023; 14:1081851. [PMID: 36923219 PMCID: PMC10008944 DOI: 10.3389/fendo.2023.1081851] [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: 10/27/2022] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The relationship between thyroid autoimmunity (TAI) and adverse pregnancy outcomes is disputable, and their dose-dependent association have not been fully clarified. OBJECTIVE To investigate the association and dose-dependent effect of TAI with multiple maternal and fetal-neonatal complications. METHODS This study is a multi-center retrospective cohort study based on singleton pregnancies of three medical college hospitals from July 2013 to October 2021. The evolution of thyroid function parameters in TAI and not TAI women were described, throughout pregnancy. The prevalences of maternal and fetal-neonatal complications were compared between the TAI and control group. Logistic regression was performed to study the risk effects and dose-dependent effects of thyroid autoantibodies on pregnancy complications, with adjustment of maternal age, BMI, gravidity, TSH concentrations, FT4 concentrations and history of infertility. RESULTS A total of 27408 participants were included in final analysis, with 5342 (19.49%) in the TAI group and 22066 (80.51%) in control group. TSH concentrations was higher in TAI women in baseline and remain higher before the third trimester. Positive thyroid autoantibodies were independently associated with higher risk of pregnancy-induced hypertension (OR: 1.215, 95%CI: 1.026-1.439), gestational diabetes mellitus (OR: 1.088, 95%CI: 1.001-1.183), and neonatal admission to NICU (OR: 1.084, 95%CI: 1.004-1.171). Quantitative analysis showed that increasing TPOAb concentration was correlated with higher probability of pregnancy-induced hypertension, and increasing TGAb concentration was positively correlated with pregnancy-induced hypertension, small for gestational age and NICU admission. Both TPOAb and TGAb concentration were negatively associated with neonatal birthweight. CONCLUSION Thyroid autoimmunity is independently associated with pregnancy-induced hypertension, gestational diabetes mellitus, neonatal lower birthweight and admission to NICU. Dose-dependent association were found between TPOAb and pregnancy-induced hypertension, and between TGAb and pregnancy-induced hypertension, small for gestational age and NICU admission.
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Affiliation(s)
- Yun Xu
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Endocrinology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Chen
- Department of Obstetrics and Gynecology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yu Gao
- Department of Obstetrics and Gynecology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kan Sun
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hongshi Wu
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rui Ding
- Department of Laboratory, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Junhui Wang
- Artificial Intelligence Lab and the Big Data Center, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheqing Li
- Network Information Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dan Liu
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zilian Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Yan, ; Zilian Wang,
| | - Li Yan
- Department of Endocrinology, The Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China
- *Correspondence: Li Yan, ; Zilian Wang,
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Rossini A, Cassibba S, Perticone F, Benatti SV, Venturelli S, Carioli G, Ghirardi A, Rizzi M, Barbui T, Trevisan R, Ippolito S. Increased prevalence of autoimmune thyroid disease after COVID-19: A single-center, prospective study. Front Endocrinol (Lausanne) 2023; 14:1126683. [PMID: 36967795 PMCID: PMC10031076 DOI: 10.3389/fendo.2023.1126683] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 12/18/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
INTRODUCTION Thyroid dysfunctions associated with SARS-CoV-2 acute infection have been extensively described since the beginning of COVID-19 pandemics. Conversely, few data are available on the occurrence of thyroid autoimmunity after COVID-19 resolution. We assessed the prevalence of autoimmune thyroid disease (ATD) and thyroid dysfunctions in COVID-19 survivors three months after hospital admission. DESIGN AND METHODS Single-center, prospective, observational, cohort study performed at ASST Papa Giovanni XXIII Hospital, Bergamo, Italy. 599 COVID-19 survivors were prospectively evaluated for thyroid function and autoimmunity thyroperoxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb). When a positive antibody concentration was detected, thyroid ultrasound was performed. Multiple logistic regression model was used to estimate the association between autoimmunity and demographic characteristics, respiratory support, and comorbidities. Autoimmunity results were compared to a cohort of 498 controls referred to our Institution for non-thyroid diseases before the pandemic onset. A sensitivity analysis comparing 330 COVID-19 patients with 330 age and sex-matched controls was performed. RESULTS Univariate and multivariate analysis found that female sex was positively associated (OR 2.01, SE 0.48, p = 0.003), and type 2 diabetes (T2DM) was negatively associated (OR 0.36, SE 0.16, p = 0.025) with thyroid autoimmunity; hospitalization, ICU admission, respiratory support, or COVID-19 treatment were not associated with thyroid autoimmunity (p > 0.05). TPOAb prevalence was greater in COVID-19 survivors than in controls: 15.7% vs 7.7%, p = 0.002. Ultrasonographic features of thyroiditis were present in 94.9% of the evaluated patients with positive antibodies. TSH was within the normal range in 95% of patients. CONCLUSIONS Autoimmune thyroid disease prevalence in COVID-19 survivors was doubled as compared to age and sex-matched controls, suggesting a role of SARS-CoV-2 in eliciting thyroid autoimmunity.
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Affiliation(s)
- Alessandro Rossini
- Endocrinology and Diabetes Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Sara Cassibba
- Endocrinology and Diabetes Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | | | | | - Serena Venturelli
- Infectious Diseases Unit, Papa Giovanni XXII Hospital, Bergamo, Italy
| | - Greta Carioli
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Arianna Ghirardi
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marco Rizzi
- Infectious Diseases Unit, Papa Giovanni XXII Hospital, Bergamo, Italy
| | - Tiziano Barbui
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Roberto Trevisan
- Endocrinology and Diabetes Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Silvia Ippolito
- Endocrinology and Diabetes Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy
- *Correspondence: Silvia Ippolito,
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Muacevic A, Adler JR, Tonk RS, Gupta SK, Narayan A. Study of Relationship Between Iron Deficiency and Thyroid Function in Pregnant Females. Cureus 2022; 14:e32411. [PMID: 36636539 PMCID: PMC9831750 DOI: 10.7759/cureus.32411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Iron is essential for the normal functioning of thyroid peroxidase and iron deficiency is very commonly encountered during pregnancy. Thyroid disorders and iron deficiency are associated with obstetrical and fetal complications. The aim of the study was to find out the relationship between iron deficiency and thyroid function in pregnant females during first trimester. METHODOLOGY The present cross-sectional observational study was conducted among first trimester pregnant females at the Department of Medicine, Obstetrics and Gynecology, and Biochemistry at Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi. Hundred pregnant women were included in this study. On the basis of serum ferritin value, the study population was divided into two groups namely iron deficient and non-iron deficient. Serum thyroid-stimulating hormone (TSH), FT4, and anti-thyroid peroxidase (TPO) values were then compared between the two groups. RESULTS In the present study, 68% of the females were iron deficient. In the Iron deficient group, serum TSH and anti-TPO levels were significantly higher as compared to that in the non-iron deficient group (35.29% vs. 6.25% and 22.06% vs. 3.13%; p=0.001 and 0.018, respectively). A positive correlation was obtained between FT4 and ferritin with correlation coefficient of 0.907 and p-value of 0.0001. Serum TSH levels and serum anti-TPO levels were inversely correlated with ferritin. Univariate logistic regression analysis revealed that iron deficiency was associated with an increased risk of subclinical hypothyroidism with odds ratio (OR) 8.182 (95% CI: 1.798-37.234, p=0.007) and raised anti-TPO with OR 8.77 (95% CI: 1.105-69.681; p=0.040). CONCLUSIONS Iron deficiency is frequent during the first trimester of pregnancy and is associated with an increased risk of subclinical hypothyroidism and thyroid autoimmunity.
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Orsolini F, Gianetti E, Terrenzio C, Montanelli L, Benelli E, Bagattini B, Fiore E, Tonacchera M. Thyroid Function Rather Than Thyroid Antibodies Affects Pregnancy and Perinatal Outcomes: Results of a Prospective Study. J Clin Endocrinol Metab 2022; 107:e4302-e4310. [PMID: 36054923 DOI: 10.1210/clinem/dgac497] [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: 05/06/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Thyroid autoantibody positivity has been associated with an increased rate of obstetrical complications. OBJECTIVE We aimed to evaluate the role of thyroid autoantibodies in adverse pregnancy outcomes. METHODS This prospective study was conducted in the Endocrinology Unit of Pisa Hospital. A total of 975 pregnant women were studied from 2012 to 2021; 572 (59%) were diagnosed with autoimmune thyroid (AT) diseases; 403 (41%) served as controls. Levothyroxine (LT4) treatment was introduced when TSH was > 2.5 mIU/L in the AT group and when TSH was > 4 mIU/L in the controls. Rates of obstetrical complications in each group were measured. RESULTS Although the frequency of miscarriage in the AT group was greater (4.8%) than in the controls (2.9%), no significant differences were detected (P = 0.181). There were no differences between the 2 groups concerning the other pregnancy complications, and no association with the titer of thyroid antibodies was observed. The frequency of congenital malformations was greater in the AT group than in the controls (P = 0.019), but no correlation with major congenital malformations was detected (P = 0.872). Given that thyroid hormone concentrations were strictly controlled in our population, we documented a tendency (not significant) toward an increase in miscarriage and preterm birth among women with TSH > 4 mIU/L. CONCLUSION If thyroid function is adequately controlled, the presence and titer of thyroid autoantibodies does not negatively influence gestation. Although not significant, suboptimal thyroid hormone status seems to affect pregnancy outcomes more than thyroid autoimmunity.
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Affiliation(s)
- Francesca Orsolini
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Elena Gianetti
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Chiara Terrenzio
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Lucia Montanelli
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Elena Benelli
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Brunella Bagattini
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Emilio Fiore
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
| | - Massimo Tonacchera
- Department of Clinical and Experimental Medicine, Endocrine Unit, University of Pisa, Pisa 56124, Italy
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Krysiak R, Kowalcze K, Okopień B. Gluten-free diet attenuates the impact of exogenous vitamin D on thyroid autoimmunity in young women with autoimmune thyroiditis: a pilot study. Scand J Clin Lab Invest 2022; 82:518-524. [PMID: 36200764 DOI: 10.1080/00365513.2022.2129434] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Although both exogenous vitamin D and a gluten-free diet were found to reduce thyroid antibody titers, no study investigated interactions between gluten intake and vitamin D status in patients with autoimmune thyroid disorders. The aim of the present study was to assess whether the gluten-free diet determines the effect of vitamin D treatment on thyroid autoimmunity and thyroid function in young women with autoimmune (Hashimoto's) thyroiditis. The study compared two groups of euthyroid premenopausal women with this disorder, matched for thyroid antibody titers: 31 women with non-celiac gluten sensitivity complying for at least 12 months with the gluten-free diet and 31 unaffected sisters of women with non-celiac gluten sensitivity remaining without any dietary intervention. Plasma titers of thyroid peroxidase and thyroglobulin antibodies, as well as plasma concentrations of thyrotropin, free thyroid hormones, prolactin, 25-hydroxyvitamin D and high-sensitive C-reactive protein were measured at entry and after a six-month follow-up. Moreover, at both time points, the structure parameters of thyroid homeostasis were assessed. Although exogenous vitamin D decreased titers of thyroid peroxidase and thyroglobulin antibodies and increased 25-hydroxyvitamin D levels in each treatment group, this effect was less pronounced in patients on the gluten-free diet than in patients not following any dietary recommendations. Only in the latter group of patients, vitamin D increased SPINA-GT. Treatment-induced changes in thyroid peroxidase and thyroglobulin antibodies correlated with the impact of treatment on 25-hydroxyvitamin D levels. The obtained results suggest that gluten-free diet may impair beneficial effects of exogenous vitamin D in individuals with Hashimoto's thyroiditis.
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Affiliation(s)
- Robert Krysiak
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
| | - Karolina Kowalcze
- Department of Pediatrics in Bytom, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Bogusław Okopień
- Department of Internal Medicine and Clinical Pharmacology, Medical University of Silesia, Katowice, Poland
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Bellastella G, Scappaticcio L, Caiazzo F, Tomasuolo M, Carotenuto R, Caputo M, Arena S, Caruso P, Maiorino MI, Esposito K. Mediterranean Diet and Thyroid: An Interesting Alliance. Nutrients 2022; 14:nu14194130. [PMID: 36235782 PMCID: PMC9571437 DOI: 10.3390/nu14194130] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/30/2022] Open
Abstract
The Mediterranean diet, recognized as being cultural heritage by UNESCO, is mostly plant-based and includes a high consumption of whole-grain, fruit, and vegetables with a moderate consumption of alcohol during meals. Thus, it provides a small amount of saturated fatty acids and a high quantity of antioxidants and fiber. For this reason, it has been considered to have an important role in preventing cardiovascular diseases, chronic kidney diseases, type 2 diabetes mellitus, and cancer, but its relationship with thyroid function and diseases is still under debate. The aim of this review was to search for the possible correlation between the Mediterranean diet and thyroid function, and to critically evaluate the pathophysiological link between selected food intake and thyroid disorders.
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Affiliation(s)
- Giuseppe Bellastella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-0815665289
| | - Lorenzo Scappaticcio
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Francesco Caiazzo
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Tomasuolo
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Raffaela Carotenuto
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Mariangela Caputo
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Stefania Arena
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Paola Caruso
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Maria Ida Maiorino
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Katherine Esposito
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
- Unit of Endocrinology and Metabolic Diseases, University Hospital, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
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Tricarico L, Di Cesare T, Galli J, Fetoni AR, Paludetti G, Picciotti PM. Benign paroxysmal positional vertigo: is hypothyroidism a risk factor for recurrence? Acta Otorhinolaryngol Ital 2022; 42:465-470. [PMID: 35129542 PMCID: PMC9793138 DOI: 10.14639/0392-100x-n1775] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 09/27/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To investigate the relationship between risk of Benign Paroxysmal Positional Vertigo (BPPV) recurrence and hypothyroidism treated with hormone replacement therapy (HRT). METHODS 797 patients with idiopathic BPPV were divided into two groups: 250 patients with recurrence of BPPV (R-BPPV) and 547 patients without recurrence (NR-BPPV). Regarding patients with thyroid disease on HRT, we collected serum test results of thyroid-stimulating hormone (TSH), free triiodothyronine f-T3, free thyroxine f-T4, thyroglobulin antibodies (TG-Ab) and thyroid peroxidase antibodies (TPO-Ab). RESULTS Hypothyroidism in long-term HRT was found in 61/250 (24.4%) patients of the R-BPPV group vs 79/547 (14.4%) of the NR-BPPV-group (p = 0.0006). Hashimoto thyroiditis (HT) was associated with recurrence (p < 0.0001). A significant correlation was found between recurrence and level of serum TPO-Ab (p = 0.0117) and TG-Ab (p = 0.0025), but not with mean serum TSH, f-T3 and f-T4. CONCLUSIONS We assume that patients with hypothyroidism in HRT have an increased risk of BPPV recurrence, which is particularly strong for patients with HT and positive thyroid antibodies, suggesting an association between autoimmunity and recurrent vertigo.
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Affiliation(s)
- Laura Tricarico
- Correspondence Laura Tricarico Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria; Università Cattolica del Sacro Cuore largo A. Gemelli 1, 00168 Rome, Italy E-mail:
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Yang L, Zhang M, Zhang H, Zheng G, Xu C, Li G. Association of thyroid autoimmunity with the presence and severity of coronary atherosclerosis in patients undergoing coronary angiography. Medicine (Baltimore) 2022; 101:e30881. [PMID: 36181027 PMCID: PMC9524898 DOI: 10.1097/md.0000000000030881] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Studies on the association of thyroid autoimmunity with cardiometabolic risk and coronary artery disease (CAD) have produced conflicting results. This study aimed to investigate the relationship of thyroid autoimmune bodies (thyroid peroxidase antibody [TPOAb] and thyroglobulin antibody [TgAb]) with CAD in euthyroid subjects undergoing coronary angiography. A total of 307 subjects who underwent coronary angiography were included. The severity of coronary atherosclerosis was evaluated by using Gensini score. Serum TSH, total T3, total T4, TPOAb, TgAb, lipid levels et al were measured and compared between the groups with and without CAD. Logistic multivariate regression analysis were performed to assess the associations. Levels of thyroid hormones were comparable between the two groups. The positive percentage of anti-Tg antibodies was higher in non-CAD group (15.22% vs 7.91%, χ2 = 3.95, p = .047) while no significant difference was observed for anti-TPO antibodies (19.57% vs 17.21%, χ2 = 0.243, p = .622). The natural log-transformed Gensini score (ln (Gensini score)) was lower in the TgAb+ group (2.94 ± 1.11 vs 2.41 ± 1.18, P = .015). There was no significant difference for ln (Gensini score) between TPOAb- and TPOAb+ group (2.90 ± 1.14 vs 2.85 ± 1.09, P = .782). Logistical regression analysis revealed that positive TgAb was inversely associated with the presence of CAD (OR: 0.387, 95% CI: 0.157-0.952, p = .039) independent of other risk factors. The results showed that TgAb positivity might be an independent protective factor for CAD.
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Affiliation(s)
- Libo Yang
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
- Liaocheng People’s Hospital, Liaocheng, Shandong Province, P.R. China
- Department of Endocrinology, The Affiliated Taian City Central Hospital of Qingdao University, Taian city, Shandong Province, P.R. China
| | - Mingliang Zhang
- Department of Cardiology, The Affiliated Taian City Central Hospital of Qingdao University, Taian city, Shandong Province, P.R. China
| | - Hui Zhang
- Department of Clinical laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian city, Shandong Province, P.R. China
| | - Guanlin Zheng
- Taishan vocational college of nursing, Taian city, 271000, Shandong Province, P.R. China
| | - Chao Xu
- Department of Endocrinology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, P.R. China
| | - Guangyao Li
- Liaocheng People’s Hospital, Liaocheng, Shandong Province, P.R. China
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Busnelli A, Beltratti C, Cirillo F, Bulfoni A, Lania A, Levi-Setti PE. Impact of Thyroid Autoimmunity on Assisted Reproductive Technology Outcomes and Ovarian Reserve Markers: An Updated Systematic Review and Meta-Analysis. Thyroid 2022; 32:1010-1028. [PMID: 35819278 DOI: 10.1089/thy.2021.0656] [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] [Indexed: 11/13/2022]
Abstract
Background: Thyroid autoimmunity (TAI) has a high prevalence among women of reproductive age. Investigating its possible impact on ovarian function and fertility is, thus, of utmost relevance. The aim of this systematic review and meta-analysis was to elucidate the effect of TAI on both assisted reproductive technology (ART) outcomes and ovarian reserve. Methods: This systematic review and meta-analysis was restricted to two groups of research articles investigating the association between TAI and: (1) autologous ART outcomes (i.e., fertilization rate [FR], implantation rate, clinical pregnancy rate [CPR], miscarriage rate, and live birth rate), (2) markers of ovarian reserve (i.e., anti-Müllerian hormone, basal follicle stimulating hormone, antral follicle count, and number of oocytes retrieved). Studies including women affected by overt hypo/hyperthyroidism were excluded. Relevant studies were identified by a systematic search in PubMed, MEDLINE, ClinicalTrials.gov, Embase, and Scopus, from database inception to May 1, 2022. Results: From a total of 432 identified publications, 22 studies were included in Group 1 and 26 studies in Group 2. The presence of TAI was associated with a higher risk of miscarriage (7606 participants, odds ratio [OR] 1.52, confidence interval [CI 1.14-2.01], p = 0.004, I2 = 53%), lower chance of embryo implantation (7118 participants, OR 0.72, [CI 0.59-0.88], p = 0.001, I2 = 36%), and live birth (11417 participants, OR 0.73, [CI 0.56-0.94], p = 0.02, I2 = 71%). These associations were no longer observed in a subgroup analysis of patients who exclusively underwent intracytoplasmic sperm injection (ICSI). The FR and CPR as well as the mean values of surrogate markers of oocyte quantity appeared not to be affected by TAI. Conclusions: This data synthesis suggest a higher risk of adverse ART outcomes in women with positive TAI. However, the reliability of these findings is hampered by the relatively low quality of the evidence and significant heterogeneity in many of the meta-analyses. The possible protective effect of ICSI is promising but should be confirmed in controlled prospective clinical trials. PROSPERO Registration ID: CRD42021236529.
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Affiliation(s)
- Andrea Busnelli
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy
| | - Carola Beltratti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Federico Cirillo
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy
| | - Alessandro Bulfoni
- Division of Obstetrics and Gynecology, Humanitas S. Pio X Hospital, Rozzano, Italy
| | - Andrea Lania
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Endocrinology, Diabetology and Medical Andrology Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Paolo Emanuele Levi-Setti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Division of Gynecology and Reproductive Medicine, Department of Gynecology, IRCCS Humanitas Research Hospital, Fertility Center, Rozzano, Italy
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Cevher Akdulum MF, Erdem M, Barut G, Demirdag E, İyidir ÖT, Guler I, Erdem A. The relationship between thyroid autoimmunity and poor response to ovarian stimulation in in vitro fertilization women with infertility. Endokrynol Pol 2022; 73:699-705. [PMID: 35971933 DOI: 10.5603/ep.a2022.0061] [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] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Thyroid autoimmunity (TAI) is the most common autoimmune disorder. Patients with TAI are usually euthyroid, and the presence of anti-thyroid peroxidase (anti-TPO) in patients with or without thyroid dysfunction is associated with infertility, recurrent embryo implantation failure, and early pregnancy loss. We aimed to investigate the relationship between low ovarian reserve, pregnancy outcomes, and TAI. MATERIAL AND METHODS This retrospective cohort study was conducted in in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) patients between 2010 and 2018. All patients (n = 1400) for whom thyroid autoantibody testing was requested were detected. A study group was formed from patients with anti-TPO positivity (n = 363). The control group (n = 555) comprised euthyroid anti-TPO negative patients matched to the study group regarding age and body mass index (BMI). RESULTS Mean serum TSH value was 2.35 ± 1.70 mIU/mL in anti-TPO-positive patients and 1.81 ± 1.2 mIU/mL in controls, and the difference was significant (p < 0.05). Total dose of gonadotropins used in ovulation induction in anti-TPO-positive and control patients were 3000 IU and 2700 IU, respectively, and the difference was statistically significant (p < 0.05). The number of metaphase 2 oocytes was significantly lower in the anti-TPO-positive group (p < 0.05). Embryo transfer number and embryo grade were significantly lower in the anti-TPO-positive group (p < 0.01). Poor ovarian response was significantly higher in anti-TPO-positive patients (40%) as compared to anti-TPO-negative controls (30%) (p < 0.01). Clinical pregnancy rate was significantly lower in the anti-TPO-positive group (29.2%), as compared to the antibody-negative group (38.4%) (p < 0.01). CONCLUSIONS There are controversial data regarding the impact of antithyroid antibodies on ovarian reserve and pregnancy outcome after IVF treatment. The results of this study indicate that there was a relationship between TAI and poor ovarian response, and that TAI adversely affects IVF outcomes. Further investigations are required to explore the mechanism behind these effects.
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Affiliation(s)
- Münire Funda Cevher Akdulum
- Department of Obstetrics and Gynaecology, Gazi University Faculty of Medicine, Emniyet Mahallesi, Gazeteci Yazar Muammer Yaşar Bostancı Sokak, Yenimahalle/Ankara, Turkey.
| | - Mehmet Erdem
- Department of Obstetrics and Gynaecology, Gazi University Faculty of Medicine, Emniyet Mahallesi, Gazeteci Yazar Muammer Yaşar Bostancı Sokak, Yenimahalle/Ankara, Turkey
| | - Gunel Barut
- Esenler Obstetrics Gynaecology and Paediatric Hospital Clinic of Obstetrics and Gynaecology, İstanbul, Turkey
| | - Erhan Demirdag
- Department of Obstetrics and Gynaecology, Gazi University Faculty of Medicine, Emniyet Mahallesi, Gazeteci Yazar Muammer Yaşar Bostancı Sokak, Yenimahalle/Ankara, Turkey
| | - Özlem Turhan İyidir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Başkent University, Ankara, Turkey
| | - Ismail Guler
- Department of Obstetrics and Gynaecology, Gazi University Faculty of Medicine, Emniyet Mahallesi, Gazeteci Yazar Muammer Yaşar Bostancı Sokak, Yenimahalle/Ankara, Turkey
| | - Ahmet Erdem
- Department of Obstetrics and Gynaecology, Gazi University Faculty of Medicine, Emniyet Mahallesi, Gazeteci Yazar Muammer Yaşar Bostancı Sokak, Yenimahalle/Ankara, Turkey
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Li L, Li L, Li P. Effects of controlled ovarian stimulation on thyroid function during pregnancy. Biol Reprod 2022; 107:1376-1385. [PMID: 35960990 DOI: 10.1093/biolre/ioac159] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Controlled ovarian stimulation (COS) is a major component of assisted reproductive technologies. Clinically, it has been observed that, some women experience changes in thyrotropin levels following COS, which then bring about subclinical hypothyroidism and may adversely affect conception. Studies have also shown that the specific degree as well as the tendency of changes in thyroid function vary with differences in thyroid function before pregnancy, thyroid autoimmunity, the COS regimen, and the observation time point. However, the associated pathophysiological mechanism of the effects of COS on pregnancy has not yet been fully elucidated. This may be because increased estradiol levels, caused by COS, induce increased levels of thyroxine-binding globulin, resulting in a decrease in free thyroxine (FT4) level and an increase in TSH level. Conversely, it has also been observed that human chorionic gonadotropin (hCG) can act directly on thyroid cells, exerting opposite effects on FT4 and TSH levels. Additionally, the effects of COS on thyroid function may be more pronounced, especially in women with autoimmune thyroid disease or thyroid dysfunction before pregnancy, ultimately leading to subclinical hypothyroidism. Here, we review recent research progress regarding the effects of COS on thyroid function during pregnancy.
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Affiliation(s)
- Lingfei Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Ling Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
| | - Ping Li
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, People's Republic of China
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