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Monterrosa-Castro Á, Monterrosa-Blanco A, Sánchez-Zarza S. Possible association between subclinical hypothyroidism and age at menopause in Colombian women. Gynecol Endocrinol 2024; 40:2334798. [PMID: 38590105 DOI: 10.1080/09513590.2024.2334798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/20/2024] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To evaluate the association between subclinical hypothyroidism with early menopause, premature menopause, and last menstrual bleeding before the natural age of menopause. METHODS This was a cross-sectional study conducted in 643 postmenopausal women aged 40-69 years. Groups were formed according to last menstrual episode: ≥45 [Natural age at menopause], 40-44 and [Early menopause], <40 [Premature menopause], and <45 [last menstrual episode before the natural age of menopause]. The Zulewski scale was applied to identify manifestations related to hypothyroidism and subclinical hypothyroidism, diagnosed with a serum TSH > 4.5 µIU/mL plus T4-free between 0.7 and 1.9 ng/dL. RESULTS It was found that 24.4% had the last menstrual episode before the natural age of menopause, 18.6% had early menopause, and 5.7% had premature menopause. Subclinical hypothyroidism was diagnosed in 4.5% of patients. Among women with subclinical hypothyroidism, there was a higher frequency of early menopause, premature menopause, and last menstrual episode before the natural age of menopause, than in women without subclinical hypothyroidism (p < 0.05). Paresthesia (50%) and dry skin (40.7%) were the most reported hypothyroidism-related manifestations. Early menopause, premature menopause, and last menstrual episode before the natural age of menopause were associated with subclinical hypothyroidism, OR: 3.37 [95% CI: 1.40-8.10], OR: 4.31 [95% CI: 1.24-14.97], and OR: 3.57 [95% CI: 1.57-8.10], respectively. CONCLUSIONS The last menstrual episode before the natural age of menopause, early menopause, and premature menopause were significantly associated with a higher chance of subclinical hypothyroidism.
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Affiliation(s)
- Álvaro Monterrosa-Castro
- Grupo de investigación Salud de la Mujer, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Angelica Monterrosa-Blanco
- Grupo de investigación Salud de la Mujer, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
| | - Sandra Sánchez-Zarza
- Grupo de investigación Salud de la Mujer, Facultad de Medicina, Universidad de Cartagena, Cartagena, Colombia
- Instituto de Previsión Social (IPS). Hospital Central, Dr. Emilio Cubas, Facultad de Ciencias de la Salud, Universidad Católica Nuestra Señora de la Asunción', Asunción, Paraguay
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Yang Q, Wang Q, Peng P, Liu T, Zhang X. Association of clinical variables and thyroid-stimulating hormone with psychotic symptoms in patients with first-episode and drug-naïve major depressive disorder with elevated fasting blood glucose: preliminary exploratory study with a large sample. BJPsych Open 2024; 10:e99. [PMID: 38699891 PMCID: PMC11094438 DOI: 10.1192/bjo.2024.53] [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: 07/04/2023] [Revised: 02/26/2024] [Accepted: 03/13/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Psychotic symptoms and elevated fasting blood glucose (FBG) are frequently observed in people with major depressive disorder (MDD), but there is a lack of research into this relationship within this cohort. AIMS This study aimed to preliminarily explore the prevalence of psychotic symptoms and their predictors among patients with MDD and elevated FBG. METHOD This study enrolled 1718 patients with first-episode and drug-naïve (FEDN) MDD. Sociodemographic data and physical and biochemical indicators were collected. Clinical symptoms were assessed with tools such as the Hamilton Rating Scale for Anxiety, Hamilton Rating Scale for Depression (HRSD) and Positive and Negative Syndrome Scale positive subscale. RESULTS The odds ratio for psychotic symptoms in those with MDD and elevated FBG (18.7%) was 2.33 times higher than those with MDD without elevated FBG. Presence of psychotic symptoms was significantly correlated with HRSD score, suicide attempts, and total cholesterol and thyroid-stimulating hormone levels. The combination of HRSD score, suicide attempts and thyroid-stimulating hormone levels among patients with MDD and elevated FBG effectively distinguished between individuals with and without psychotic symptoms, achieving an area under the curve of 0.87. CONCLUSIONS Psychotic symptoms are frequently observed among FEDN MDD patients with elevated FBG, and depressive symptoms, suicide attempts and thyroid-stimulating hormone levels are related to psychotic symptoms in this cohort.
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Affiliation(s)
- Qian Yang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China; and Department of Psychology, Zhongshan City People's Hospital, Zhongshan, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, and National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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3
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Cowper B, Lyle AN, Vesper HW, Van Uytfanghe K, Burns C. Standardisation and harmonisation of thyroid-stimulating hormone measurements: historical, current, and future perspectives. Clin Chem Lab Med 2024; 62:824-829. [PMID: 38295422 DOI: 10.1515/cclm-2023-1332] [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: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Thyroid-stimulating hormone (TSH) is an important clinical marker in the diagnosis and management of thyroid disease. TSH measurements are reported in milli-International Units per Litre (mIU/L), traceable to a World Health Organisation (WHO) reference material. There is a wide variety of commercial immunoassays for TSH measurements available, which have historically been poorly harmonised due to a lack of commutability of the WHO reference materials with patient samples. This led to the recent development of a serum-based reference panel for TSH, traceable to the WHO reference material, available via the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC), aimed at harmonisation of TSH immunoassays. This report describes recent developments in the TSH reference system, including establishment of the 4th WHO International Standard for TSH, and aims to clarify the relationship between the available reference materials and their intended uses. This 4th WHO IS is widely available and defines the unit of TSH activity, therefore its continued existence is of paramount importance, however it continues to show a lack of commutability with patient in many TSH immunoassays. This makes the C-STFT TSH panel, albeit available in restricted numbers, a critical resource to ensure better TSH assay harmonisation.
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Affiliation(s)
- Ben Cowper
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
| | - Alicia N Lyle
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | - Hubert W Vesper
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | | | - Chris Burns
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
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4
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Winter J, Axelsson E, Björkhem-Bergman L, Ihre Lundgren C, Hedman C. Five-Year Follow-Up of Health-Related Quality of Life in Differentiated Thyroid Cancer Patients Treated with Total Thyroidectomy and Radioiodine in Sweden: A Nationwide Prospective Cohort Study. Thyroid 2024. [PMID: 38526369 DOI: 10.1089/thy.2023.0691] [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: 03/26/2024]
Abstract
Background: Despite a good prognosis, survivors of differentiated thyroid cancer (DTC) may have reduced health-related quality of life (HRQOL) many years after treatment, and it is unclear how suppression of thyroid-stimulating hormone (TSH) may contribute to HRQOL. This study investigated changes in HRQOL in the 5 years following DTC treatment, the association between HRQOL and TSH suppression, and how HRQOL compares to the general population. Methods: In this nationwide prospective cohort study, 487 patients with DTC were identified between 2012 and 2017 from all Swedish hospitals treating patients with DTC. Patients treated with total thyroidectomy and planned for radioiodine answered the Swedish version of the Short Form-36 Health Survey (SF-36) and a study specific questionnaire at treatment and after 1, 3, and 5 years. Summary measures for physical and mental QOL were derived from the SF-36, and TSH values were collected from patient records. To study changes in HRQOL over time, linear mixed models were fitted on multiply imputed data, with all patients and measurement points included in the model. Results: In total, 351 patients consented to participate in the study. In the 5 years following DTC treatment, physical QOL did not change significantly with time, while mental QOL improved by on average 0.61 (p < 0.001) per year. TSH levels were not predictive of either physical or mental QOL, or their change over time. At 5 years, there was a significant difference in physical and mental QOL compared with the Swedish general population, but effect sizes were small (Cohen's d = 0.29 and -0.21, respectively). The SF-36 domains general health, vitality, social functioning, and mental health were lower at 5 years compared with the general population (difference 8.7-13.3), and these differences were clinically significant. Conclusions: The mental component of HRQOL improves over time following DTC treatment. HRQOL in patients with DTC is not explained by TSH suppression. Although overall differences in physical and mental HRQOL compared with the general population were small 5 years after treatment, several specific psychosocial HRQOL domains were clinically meaningfully reduced. Psychosocial health issues should be screened for during DTC follow-up.
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Affiliation(s)
- Julia Winter
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Erland Axelsson
- Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Liljeholmen University Primary Health Care Center, Academic Primary Health Care Center, Stockholm, Sweden
| | - Linda Björkhem-Bergman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
- R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
| | - Catharina Ihre Lundgren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Breast, Endocrine Tumours and Sarcoma, Karolinska University Hospital, Stockholm, Sweden
| | - Christel Hedman
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Department of Clinical Sciences, Lund University, Lund, Sweden
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Hadi ZM, Alidrisi HA, Mansour AA. Triiodothyronine/Thyroxine Ratio as a Marker of Clinical Response to Levothyroxine Replacement in Patients With Hypothyroidism. Cureus 2024; 16:e58370. [PMID: 38756268 PMCID: PMC11097253 DOI: 10.7759/cureus.58370] [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: 04/16/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Hypothyroidism is one of the most common endocrine disorders with a simple therapy, that is levothyroxine (LT4). A normal thyroid-stimulating hormone (TSH) measurement is used as a marker of optimal replacement. But, many patients still have symptoms. Triiodothyronine (T3), thyroxine (T4), and their ratio may correlate with clinical improvement. The study aims to assess the T3/T4 ratio as a marker of clinical response in patients with hypothyroidism. Method: A cross-sectional study was conducted from June to November 2022 at Faiha Specialized Diabetes, Endocrine, and Metabolism Center, in Basrah, southern Iraq. We included 48 adult patients with primary hypothyroidism on LT4 treatment only and TSH within the target reference range for at least within the last six months. Each patient was subjected to a questionnaire that was designed to capture hypothyroidism-related complaints in the form of a five-point Likert scale. Biochemical assessments were done with the measurement of TSH, T3, and T4. RESULTS Despite having a normal TSH level, nearly all the patients had persistent and varying severity of clinical complaints of hypothyroidism. Tiredness, hair problems, weight gain, and cold intolerance were the most severely persistent symptoms. Patients with scores of two and more for weight gain, cold intolerance, and skin problems had significantly lower T3/T4 ratios (P = 0.04, 0.002, and 0.02, respectively), while in the remaining clinical symptoms, the T3/T4 ratio did not differ significantly. CONCLUSION A low T3/T4 ratio was significantly associated with resistant symptoms of hypothyroidism and may be used as a marker for treatment efficacy with TSH rather than TSH value alone.
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Affiliation(s)
- Zaid M Hadi
- Medicine, Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah, IRQ
| | - Haider A Alidrisi
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah, IRQ
- Diabetes and Endocrinology, University of Basrah, College of Medicine, Basrah, IRQ
| | - Abbas A Mansour
- Diabetes and Endocrinology, Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah, IRQ
- Diabetes and Endocrinology, University of Basrah, College of Medicine, Basrah, IRQ
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Annison DR, Abedi A, Mansfield M. Hashimoto's Thyroiditis Presenting As Non-specific Low Back Pain: A Case Report on Diagnostic Challenges and Management in Primary Care. Cureus 2024; 16:e58084. [PMID: 38738164 PMCID: PMC11088718 DOI: 10.7759/cureus.58084] [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: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
Non-specific low back pain (NSLBP) may account for 90-95% of cases of low back pain presenting to primary care. Clinicians should remain vigilant however to non-spinal musculoskeletal conditions that may mimic NSLBP and musculoskeletal complaints. We present a case of a 38-year-old female with low back pain, lower limb tightness, groin pain, and leg cramps. Symptoms failed to improve with physiotherapy and subsequent blood tests revealed elevated thyroid-stimulating hormone (TSH), and elevated thyroid peroxidase antibody (TPO). The patient was diagnosed with hypothyroidism secondary to Hashimoto's thyroiditis (HT), an autoimmune endocrine thyroid disorder. Levothyroxine 100 microgram(µg) was prescribed, and clinical symptoms improved within eight weeks. Clinicians may wish to consider thyroid dysfunction when patients with common musculoskeletal complaints, weight gain, and fatigue respond atypically to evidence-based physiotherapy management.
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Affiliation(s)
- David R Annison
- Orthopaedics, Academic Centre for Surgery, South Tees Hospitals NHS Foundation Trust, Middlesbrough, GBR
| | - Afsaneh Abedi
- Physical Medicine and Rehabilitation, Pure Physiotherapy-Greenfield Surgery, Nottingham, GBR
| | - Michael Mansfield
- Physical Medicine and Rehabilitation, School of Sport, Exercise, and Rehabilitation Sciences, University of Birmingham, Birmingham, GBR
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Xiao M, Luo G, Zhang Z, Liu Y, Gong R, Ke J. Correlation Between Thyroid-Related Hormones and Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients with Normal Thyroid Function: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:1481-1490. [PMID: 38562279 PMCID: PMC10982540 DOI: 10.2147/dmso.s455428] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose To investigate the correlation between thyroid-related hormones and diabetic retinopathy (DR) in euthyroid patients with type 2 diabetes mellitus (T2DM). Patients and Methods Patients with T2DM admitted to our hospital between January 2023 and June 2023 were retrospectively analyzed. The patients were divided into DR and non-diabetic retinopathy (NDR) groups according to whether DR occurred. Thyroid function-related hormones (TSH, FT3, and FT4), blood glucose indices (FBG and HbA1c), and blood lipid indices (HDL-C, LDL-C, TC, and TG) of the two groups were analyzed by univariate and multivariate logistic regression to explore the risk factors for DR. Pearson correlation analysis and multiple stepwise regression analysis were used to investigate the correlation of TSH or FT3 with FBG, HbA1c, and TG in DR patients. Results Of the 286 patients with T2DM included in this study, 101 (35.31%) developed DR and 185 (64.69%) did not. High TG, FBG, HbA1c, and TSH and low FT3 levels were independent risk factors for DR in T2DM patients. TSH positively correlated with TG, whereas FT3 negatively correlated with TG and HbA1c in T2DM patients with DR. Conclusion Higher TSH and lower FT3 in T2DM patients with normal thyroid function may affect glucose and lipid metabolism, thereby increasing the risk of DR.
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Affiliation(s)
- Mei Xiao
- Department of Pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
| | - Guangwen Luo
- Department of Pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
| | - Zhaowei Zhang
- Department of Pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
| | - Yanfen Liu
- Department of Endocrinology and Metabolism, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
| | - Rui Gong
- Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
| | - Jianghuan Ke
- Department of Pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China
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Gao Y, Zhan T, Xu Y, Zhu K, Shi Y, Jin L, Meng L. Causal association of TSH with ischemic heart diseases and heart failure: A 2-sample Mendelian randomization study. Medicine (Baltimore) 2024; 103:e37539. [PMID: 38518006 PMCID: PMC10957026 DOI: 10.1097/md.0000000000037539] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 02/16/2024] [Indexed: 03/24/2024] Open
Abstract
Thyroid dysfunction is associated with the risk of cardiovascular disease; however, whether plasma thyroid-stimulating hormone (TSH) levels in subjects with euthyroidism affect the risk of cardiovascular disease remains unclear. This study aimed to investigate the causal association between plasma TSH levels and cardiovascular diseases, particularly ischemic heart disease and heart failure (HF). Summary statistics from the Integrative Epidemiology Unit Open genome-wide association studies Project and FinnGen consortium were used to investigate the causal relationship between plasma TSH levels and the risk of cardiovascular diseases. Two-sample Mendelian randomization analysis using inverse-variance weighting as the primary method was performed. The MR Pleiotropy RESidual Sum and Outlier and leave-one-out methods were used to ensure the robustness of our findings. Genetically determined plasma TSH levels were associated with major coronary heart disease events (OR 1.0557, 95% CI 1.0141-1.0991), all-cause HF (OR 0.9587, 95% CI 0.9231-0.9956), and HF + non-ischemic cardiomyopathy (OR 0.9318, 95% CI 0.8786-0.9882). After the Bonferroni correction, the causation described above disappeared. In the secondary analysis, genetically determined higher TSH levels were associated with a higher risk for unstable angina pectoris (OR 1.0913, 95% CI 1.0350-1.1507), but were associated with a lower risk for HF + overweight (OR 0.9265, 95% CI 0.8821-0.9731). These results were further validated using sensitivity analysis. Our findings show that increased plasma TSH levels in patients with euthyroidism may increase the risk of unstable angina pectoris but reduce the risk of HF in overweight patients. This evidence indicates that plasma TSH levels may need to be carefully controlled in specific patients.
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Affiliation(s)
- Yuan Gao
- Department of Breast and Thyroid Surgery, Shaoxing People’s Hospital, Shaoxing, China
| | - Tianwei Zhan
- Otolaryngology & Head and Neck Center, Cancer Center, Department of Head and Neck Surgery, Zhejiang Provincial People’ s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yingchun Xu
- Department of Breast and Thyroid Surgery, Shaoxing People’s Hospital, Shaoxing, China
| | - Kaijun Zhu
- School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China
| | - Yifei Shi
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Zhejiang Provincial Clinical Research Center for CANCER, Hangzhou, China
- Cancer Center of Zhejiang University, Hangzhou, China
| | - Langping Jin
- Department of Breast and Thyroid Surgery, Shaoxing People’s Hospital, Shaoxing, China
| | - Liwei Meng
- Department of Breast and Thyroid Surgery, Shaoxing People’s Hospital, Shaoxing, China
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Zhao Z, Gao Y, Pei X, Wang W, Wang R, Zhang H. Thyroid function and polycystic ovary syndrome: a Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1364157. [PMID: 38586452 PMCID: PMC10995335 DOI: 10.3389/fendo.2024.1364157] [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: 01/01/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Background Multiple evidence suggests that thyroid function is associated with polycystic ovary syndrome (PCOS), but whether thyroid function is causally related to PCOS is unclear. To investigate whether the association reflect causality, a Mendelian randomization (MR) analysis was conducted. Methods Single nucleotide polymorphisms (SNPs) involved in this study were acquired from The ThyroidOmics Consortium and the IEU Open Genome-wide association study (GWAS) database, respectively. In forward MR analysis, we included normal free thyroxine (FT4, n=49,269), normal thyroid-stimulating hormone (TSH, n=54,288), hypothyroidism (n=53,423) and hyperthyroidism (n=51,823) as exposure. The outcome was defined as PCOS in a sample size of 16,380,318 individuals. The exposure in the reverse MR analyses was chosen as PCOS, while the outcome consisted of the four phenotypes of thyroid function. The inverse-variance weighted (IVW) method was performed as the major analysis, supplemented by sensitivity analyses. Results The occurrence of PCOS was associated with increased risk of hyperthyroidism (IVW, OR=1.08, 95%CI=1.02-1.13, P=0.004). No evidence suggested that other phenotypes of thyroid function were related to PCOS. Conclusions Our findings demonstrate a cause-and-effect connection between PCOS and hyperthyroidism. The study established foundation for further investigation for interaction between thyroid function and PCOS.
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Affiliation(s)
| | | | | | | | | | - Huawei Zhang
- Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
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Wang Z, Wu P, Yang J, Jiang Y, Wang J, Lin C. Serum FT3/FT4, but not TSH is associated with handgrip strength in euthyroid U.S. population: evidence from NHANES. Front Endocrinol (Lausanne) 2024; 15:1323026. [PMID: 38501102 PMCID: PMC10947195 DOI: 10.3389/fendo.2024.1323026] [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: 10/17/2023] [Accepted: 02/13/2024] [Indexed: 03/20/2024] Open
Abstract
Objective Although several studies have examined the relationship between thyroid function and muscle strength, their population primarily derived from Asian areas, and their results were controversial. Thus, this study aimed to explore the association between thyroid function and handgrip strength (HGS) in the U.S. population. Methods A total of 1,067 participants from NHANES were categorized into three different age groups including young (<45 years), middle (45~64 years), and old (≥65 years) age groups. Thyroid function was measured by the competitive binding immune-enzymatic assays, while HGS was examined by a trained evaluator using a dynamometer. The weighted multiple linear regression models were used to examine the association between thyroid function and handgrip strength. The restricted cubic splines were employed to explore the non-linear relationship between these two variables. All statistical analyses were performed using the SPSS version 20.0 and R software. Results After adjustment for potential covariates, FT3/FT4, but not TSH was positively associated with HGS in middle age group (β=0.091, t=2.428, P=0.016). The subgroup analysis by sex revealed that the positive association between FT3/FT4 and HGS was observed in the middle age group for both male and female participants (β=0.163, t=2.121, P=0.035; β=0.157, t=2.180, P=0.031). The RCS analysis showed a statistically significant non-linear association between FT3/FT4 and HGS in overall population (P for non-linear=0.026). After adjustment for covariates, men with low HGS had a significant lower FT3/FT4 than those without low HGS in old age group (P=0.013). There was a significant increase in TSH level for female participants with low HGS in old age group compared to those with normal HGS (P=0.048). Conclusions This study demonstrated FT3/FT4, but not TSH, was positively associated with HGS in middle age group, and the different association was observed in men in middle age group when participants were stratified by sex. Future longitudinal cohort study should be conducted to reveal the causal relationship between thyroid function and muscle strength.
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Affiliation(s)
| | | | | | | | | | - Cheng Lin
- Department of Rehabilitation Medicine, School of Health, Fujian Medical University, Fuzhou, China
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11
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Endo K, Tanaka M, Sato T, Mori K, Hosaka I, Mikami T, Umetsu A, Akiyama Y, Ohnishi H, Hanawa N, Furuhashi M. A high level of thyroid-stimulating hormone is a risk factor for the development of chronic kidney disease in men: a 10-year cohort study. Hypertens Res 2024; 47:663-671. [PMID: 37845396 DOI: 10.1038/s41440-023-01453-1] [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: 05/17/2023] [Revised: 08/27/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Hypothyroidism has been reported to be associated with chronic kidney disease (CKD). However, the impact of thyroid-stimulating hormone (TSH) on new onset of CKD and its gender dependence remain undetermined. We investigated the association of serum TSH level and the development of CKD defined by estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 or positive for urine protein in 28,990 Japanese subjects who received annual health examinations. After excluding subjects with no data for serum TSH, urinalysis and eGFR and those with CKD at baseline, a total of 10,392 subjects (men/women: 6802/3590, mean age: 48 years) were recruited. During a 10-year follow-up, 1185 men (6.7%) and 578 women (2.9%) newly developed CKD. Multivariable Cox proportional hazard models after adjustment of age, body mass index, smoking habit, hypertension, diabetes mellitus, dyslipidemia, ischemic heart disease and eGFR (≥ 90 mL/min/1.73 m2) showed that the hazard ratio (HR) for the development of CKD in the high TSH (> 4.2 mU/L) group was significantly higher than that in the low TSH (≤ 4.2 mU/L) group in men (HR [95% confidence interval]: 1.41 [1.09-1.83]) but not in women (1.08 [0.77-1.51]). There was a significant interaction between sex and the category of TSH level for the development of CKD (p = 0.02). The adjusted HR with a restricted cubic spline increased with a higher level of TSH in men but not in women. In conclusion, a high level of TSH is associated with an increased risk for the development of CKD in men but not in women.
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Affiliation(s)
- Keisuke Endo
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Marenao Tanaka
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Tanaka Medical Clinic, Yoichi, Japan
| | - Tatsuya Sato
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kazuma Mori
- Department of Immunology and Microbiology, National Defense Medical College, Tokorozawa, Japan
| | - Itaru Hosaka
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takuma Mikami
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Araya Umetsu
- Department of Ophthalmology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hirofumi Ohnishi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
- Department of Public Health, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Nagisa Hanawa
- Department of Health Checkup and Promotion, Keijinkai Maruyama Clinic, Sapporo, Japan
| | - Masato Furuhashi
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Zheng P, Raj P, Wu L, Mizutani T, Szabo M, Hanson WA, Barman I. Quantitative Detection of Thyroid-Stimulating Hormone in Patient Samples with a Nanomechanical Single-Antibody Spectro-Immunoassay. Small 2024; 20:e2305110. [PMID: 37752776 PMCID: PMC10922205 DOI: 10.1002/smll.202305110] [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] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/12/2023] [Indexed: 09/28/2023]
Abstract
Functional disorders of the thyroid remain a global challenge and have profound impacts on human health. Serving as the barometer for thyroid function, thyroid-stimulating hormone (TSH) is considered the single most useful test of thyroid function. However, the prevailing TSH immunoassays rely on two types of antibodies in a sandwich format. The requirement of repeated incubation and washing further complicates the issue, making it unable to meet the requirements of the shifting public health landscape that demands rapid, sensitive, and low-cost TSH tests. Herein, a systematic study is performed to investigate the clinical translational potential of a single antibody-based biosensing platform for the TSH test. The biosensing platform leverages Raman spectral variations induced by the interaction between a TSH antigen and a Raman molecule-conjugated TSH antibody. In conjunction with machine learning, it allows TSH concentrations in various patient samples to be predicted with high accuracy and precision, which is robust against substrate-to-substrate, intra-substrate, and day-to-day variations. It is envisioned that the simplicity and generalizability of this single-antibody immunoassay coupled with the demonstrated performance in patient samples pave the way for it to be widely applied in clinical settings for low-cost detection of hormones, other molecular biomarkers, DNA, RNA, and pathogens.
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Affiliation(s)
- Peng Zheng
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Piyush Raj
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Lintong Wu
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Takayuki Mizutani
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - Miklos Szabo
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - William A. Hanson
- Beckman Coulter Diagnostics – Immunoassay Business Unit, 1000 Lake Hazeltine Dr, Chaska, MN 55318
| | - Ishan Barman
- Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, United States
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
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13
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Tu Y, Ji F, Yang J, Rao Q, Wu H, Xie Z, Zhang S, Hou Z, Wu D. Weighted thyroid-stimulating hormone disturbance in prognosis of hepatitis B virus-related acute-on-chronic liver failure. Hepatol Res 2024; 54:151-161. [PMID: 37768830 DOI: 10.1111/hepr.13970] [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: 04/24/2023] [Revised: 09/02/2023] [Accepted: 09/17/2023] [Indexed: 09/30/2023]
Abstract
AIM To weight the prognostic value of thyroid hormones in catastrophic acute-on-chronic liver failure (ACLF). METHODS A retrospective cohort (n = 635) and two prospective cohorts (n = 353, and 198) were enrolled in this study. The performance of a novel developed prognostic score was assessed from aspects of reliability, discrimination, and clinical net benefit. RESULTS Thyroid-stimulating hormone (TSH) was identified to have the most potential as a prognostic predictor for hepatitis B virus-related ACLF among thyroid hormones. The novel score (modified chronic liver failure-organ failure score [mCLIF-OFs]) was developed with weighted TSH and other scored organs in the CLIF-OFs using the retrospective cohort (n = 635). The predicted risk and observed probabilities of death were comparable across the deciles of mCLIF-OFs (Hosmer-Lemeshow χ2 = 4.28, p = 0.83; Brier scaled = 11.9). The C-index of mCLIF-OFs (0.885 [0.883-0.887]) for 30-day mortality was significantly higher than that of the CLIF-OFs, chronic liver failure-sequential organ failure assessment score (CLIF-SOFAs), CLIF-C ACLFs, Model of End-stage Liver Disease (MELD), and Child-Pugh (all p < 0.001). The absolute improvements of prediction error rates of the mCLIF-OFs compared to the above five scores were from 19.0% to 61.1%. After the analysis of probability density function, the mCLIF-OFs showed the least overlapping coefficients (27.9%) among the above prognostic scores. Additionally, the mCLIF-OFs showed greater net benefit than the above five prognostic scores over a wide range of risk threshold of death. Similar results were validated in two prospective ACLF cohorts with HBV and non-HBV etiologies. CONCLUSION Weighted TSH portended the outcome of ACLF patients, which could be treated as a "damaged organ" of the hypothalamic-pituitary-thyroid axis. The novel mCLIF-OFs is a reliable prognostic score with better discrimination power and clinical net benefit than CLIF-OFs, CLIF-SOFAs, CLIF-C ACLFs, MELD, and Child-Pugh.
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Affiliation(s)
- Yasi Tu
- Department of Infectious Diseases, Jiangxi Medical Center for Critical Public Health Events, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Feiyang Ji
- Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China
| | - Jing Yang
- National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qunfang Rao
- Department of Infectious Diseases, Jiangxi Medical Center for Critical Public Health Events, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Haiquan Wu
- Department of Infectious Diseases, Jiangxi Medical Center for Critical Public Health Events, the First Affiliated Hospital, Nanchang University, Nanchang, China
| | - Zhongyang Xie
- National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sainan Zhang
- Department of Infectious Diseases, Shulan Hospital of Hangzhou, Hangzhou, China
| | - Zhouhua Hou
- Department of Infectious Diseases, Xiangya Hospital of Central South University, Changsha, China
| | - Daxian Wu
- Department of Infectious Diseases, Jiangxi Medical Center for Critical Public Health Events, the First Affiliated Hospital, Nanchang University, Nanchang, China
- National Clinical Research Center for Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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14
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Tan SY, Chubb SAP, Flicker L, Almeida OP, Golledge J, Hankey GJ, Yeap BB. Changes in thyroid function and evolution of subclinical thyroid disease in older men. Clin Endocrinol (Oxf) 2024; 100:170-180. [PMID: 38059618 PMCID: PMC10952793 DOI: 10.1111/cen.14997] [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: 08/21/2023] [Revised: 10/22/2023] [Accepted: 11/16/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE Prevalence of subclinical thyroid disease increases with age, but optimal detection and surveillance strategies remain unclear particularly for older men. We aimed to assess thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentrations and their longitudinal changes, to determine the prevalence and incidence of subclinical thyroid dysfunction in older men. DESIGN, PARTICIPANTS AND MEASUREMENTS Longitudinal study of 994 community-dwelling men aged ≥70 years without known or current thyroid disease, with TSH and FT4 concentrations assessed at baseline and follow-up (after 8.7 ± 0.9 years). Factors associated with incident subclinical thyroid dysfunction were examined by logistic regression and receiver operating characteristic analyses. RESULTS At baseline, 85 men (8.6%) had subclinical hypothyroidism and 10 (1.0%) subclinical hyperthyroidism. Among 899 men euthyroid at baseline (mean age 75.0 ± 3.0 years), 713 (79.3%) remained euthyroid, 180 (20.0%) developed subclinical/overt hypothyroidism, and 6 (0.7%) subclinical/overt hyperthyroidism. Change in TSH correlated with baseline TSH (r = .16, p < .05). Change in FT4 correlated inversely with baseline FT4 (r = -0.35, p < .05). Only higher age and baseline TSH predicted progression from euthyroid to subclinical/overt hypothyroidism (fully-adjusted odds ratio [OR] per year=1.09, 95% confidence interval [CI] = 1.02-1.17, p = .006; per 2.7-fold increase in TSH OR = 65.4, CI = 31.9-134, p < .001). Baseline TSH concentration ≥2.34 mIU/L had 76% sensitivity and 77% specificity for predicting development of subclinical/overt hypothyroidism. CONCLUSIONS In older men TSH concentration increased over time, while FT4 concentration showed little change. Subclinical or overt hypothyroidism evolved in one fifth of initially euthyroid men, age and higher baseline TSH predicted this outcome. Increased surveillance for thyroid dysfunction may be justified in older men, especially those with high-normal TSH.
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Affiliation(s)
| | - S. A. Paul Chubb
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- Clinical Biochemistry Department, PathWest Laboratory MedicineFiona Stanley HospitalPerthWAAustralia
| | - Leon Flicker
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- WA Centre for Health & AgeingUniversity of Western AustraliaPerthWAAustralia
| | - Osvaldo P. Almeida
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- WA Centre for Health & AgeingUniversity of Western AustraliaPerthWAAustralia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular DiseaseJames Cook UniversityTownsvilleQLDAustralia
- Department of Vascular and Endovascular SurgeryTownsville HospitalTownsvilleQLDAustralia
| | - Graeme J. Hankey
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- Perron Institute for Neurological and Translational SciencePerthWAAustralia
| | - Bu B. Yeap
- Medical SchoolUniversity of Western AustraliaPerthWAAustralia
- Department of Endocrinology and DiabetesFiona Stanley HospitalPerthWAAustralia
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Huang K, Su S, Wang X, Hu M, Zhao R, Gao S, Zhang E, Liu J, Xie S, Luan Y, Sun Y, Zhang Y, Yue W, Liu R, Yin C. Association Between Maternal Thyroid Function in Early Pregnancy and Gestational Diabetes: A Prospective Cohort Study. J Clin Endocrinol Metab 2024; 109:e780-e787. [PMID: 37647889 PMCID: PMC10795920 DOI: 10.1210/clinem/dgad518] [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: 05/24/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/01/2023]
Abstract
CONTEXT Previous studies on the relationship between thyroid gland function and the development of gestational diabetes mellitus (GDM) have reported different results, leading to the need for a cohort study design with a large sample size. OBJECTIVE We aimed to investigate the relationship between thyroid function in early pregnancy and GDM. METHODS This was a prospective cohort study based on the China Birth Cohort Study (CBCS), from February 2018 to December 2020. The study took place at a tertiary maternal and child health hospital. A total of 36 256 pregnant women were successfully recruited based on the CBCS. The main outcome measure was GDM. RESULTS This study consisted of 26 742 pregnant women who met the inclusion criteria, of whom 3985 (14.90%) were diagnosed with GDM, and the women with GDM were older than their healthy counterparts (33.26 ± 4.01 vs 31.51 ± 3.76 years, P < .001). After removing potential influencing variables, we found that increased thyroid-stimulating hormone (TSH) (adjusted odds ratio [aOR] 1.030, 95% CI 1.007, 1.054, P = .012) and subclinical hypothyroidism (aOR 1.211, 95% CI 1.010, 1.451, P = .039), but not free thyroxine or thyroid peroxidase antibody, were associated with the occurrence of GDM. Further analysis indicated a nonlinear relationship between TSH and GDM (P < .05): when TSH ≤ 1.24 mIU/L, the occurrence of GDM was elevated with increasing TSH, but when TSH > 1.24 mIU/L, this trend was not obvious. CONCLUSION High TSH might be associated with increased risk of GDM.
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Affiliation(s)
- Kaikun Huang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shaofei Su
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Xueran Wang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Minhui Hu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Rong Zhao
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shen Gao
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Enjie Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Jianhui Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shuanghua Xie
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yingyi Luan
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yongqing Sun
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yue Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wentao Yue
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Ruixia Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Chenghong Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
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Ratajczak M, Krzywicka M, Szulińska M, Musiałowska D, Kusy K, Karolkiewicz J. Effects of 12-Week Combined Strength and Endurance Circuit Training Program on Insulin Sensitivity and Retinol-Binding Protein 4 in Women with Insulin-Resistance and Overweight or Mild Obesity: A Randomized Controlled Trial. Diabetes Metab Syndr Obes 2024; 17:93-106. [PMID: 38204866 PMCID: PMC10778163 DOI: 10.2147/dmso.s432954] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Background Circuit training is an exercise mode, that may include both endurance and resistance components. There are premises that a combination of these two modalities brings additional benefits, particularly in improving insulin sensitivity. The retinol-binding protein 4 (RBP4) may inhibit signaling from insulin metabolic pathways in skeletal muscles, thus developing insulin resistance. This study aimed to evaluate whether moderate intensity circuit training combining strength and endurance exercise induces changes in tissue insulin sensitivity, carbohydrate and lipid metabolism, and serum RBP4 levels in insulin-resistant women. Methods In this clinical controlled trial women diagnosed with insulin-resistance were randomly divided into two groups. The training group (T) performed circuit training combining strength (50%-80%1RM) and endurance (50%-75%HRR) exercise on five weight and two cardio machines, for 33 minutes, three times per week, for 3 months. Women from the control non-training group (NT) did not change their previous physical activity. At the beginning of the study and after the intervention period, a one-repetition maximum, body mass, and composition, resting heart rate (HR), blood pressure, glucose, insulin, blood lipids, thyroid-stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), RBP4, and insulin resistance (HOMA-IR) were measured. The results of 27 patients were analyzed using a two-way repeated measures ANOVA. Results Significant differences in the pattern of change over time between the groups for resting HR (p < 0.010) and total lean mass (p < 0.039) were found. No differences in HOMA-IR, and RBP4 were observed post-study compared to pre-study in the T group. A significant correlation between RBP4 and TSH concentration was found. Conclusion Twelve-week circuit training combining strength and endurance exercise has minor effects on HOMA-IR, glucose and lipid metabolism, IGF-1, TSH, and RBP4. Although moderate-intensity circuit training is considered safe, its effectiveness in patients with overweight and mild obesity may be insufficient to reduce insulin resistance. Trial Registration ClinicalTrials.gov: NCT04528693, registered August 23, 2020.
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Affiliation(s)
- Marzena Ratajczak
- Department of Medical Biology, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Monika Krzywicka
- Department of Cardiological and Rheumatological Rehabilitation, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Monika Szulińska
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, 61-701, Poland
| | - Dominika Musiałowska
- Insulin Resistance Foundation – Healthy Diet and Healthy Life, Poznan, 61-379, Poland
| | - Krzysztof Kusy
- Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, 61-871, Poland
| | - Joanna Karolkiewicz
- Department of Food and Nutrition, Poznan University of Physical Education, Poznan, 61-871, Poland
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17
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Hashida Y, Mino Y, Okuno K, Uemasu H, Sakata S, Fujimoto M, Namba N. Thyroid hormone may predict treatment failure in Kawasaki disease. Pediatr Int 2024; 66:e15723. [PMID: 38326932 DOI: 10.1111/ped.15723] [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: 02/23/2023] [Revised: 11/03/2023] [Accepted: 11/08/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND In systemic inflammatory conditions, inflammatory cytokines can cause low thyroid hormone levels. There are no reports discussing the relation between thyroid hormone levels and response to treatment for Kawasaki disease. METHODS We investigated 67 patients who underwent treatment in the acute phase of Kawasaki disease. We divided patients into two groups based on their response to initial intravenous immunoglobulin (IVIG) treatment: the responder group (n = 40), and the non-responder group (n = 27). The serum levels of the thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were compared before and after treatment in all patients, and between responder and non-responder groups. RESULTS The FT3, FT4, and TSH levels were low before the initial treatment and increased significantly after treatment (p < 0.05). The FT3, FT4, and TSH levels before treatment were significantly lower in the non-responder group than in the responder group (p < 0.05). Logistic regression analysis suggested that the addition of pre-treatment FT4 values to Gunma score was useful in predicting treatment failure. CONCLUSIONS Thyroid hormone and TSH levels were lower in the non-responder group than in the responder group in the initial IVIG treatment for Kawasaki disease. This study suggests that Kawasaki disease in the acute phase is associated with low thyroid hormone levels and TSH. It is possible that these hormone levels predict response to the initial IVIG.
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Affiliation(s)
- Yuichiro Hashida
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
- Department of Pediatrics, Tottori Prefectural Kousei Hospital, Kurayoshi, Japan
| | - Yoichi Mino
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Keisuke Okuno
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Hitoshi Uemasu
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Shinji Sakata
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masanobu Fujimoto
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
| | - Noriyuki Namba
- Division of Pediatrics and Perinatology, Department of Multidisciplinary Internal Medicine, School of Medicine, Tottori University Faculty of Medicine, Yonago, Japan
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Ushakov AV. Thyroid ultrasound pattern in primary hypothyroidism is similar to Graves' disease: a report of three cases. J Med Life 2024; 17:116-122. [PMID: 38737666 PMCID: PMC11080503 DOI: 10.25122/jml-2023-0507] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/01/2024] [Indexed: 05/14/2024] Open
Abstract
Ultrasound can identify important characteristics in primary hypothyroidism and diffuse hyperthyroidism (Graves' disease). Therefore, sonologists are actively investigating ultrasound criteria to differentiate between these two conditions. Nevertheless, practice shows the absence of such ultrasonic landmarks. For the first time in the literature, three cases of primary hypothyroidism have demonstrated an ultrasound pattern identical to that of Graves' disease. This pattern includes the presence of goiter, marked total hypoechogenicity of the parenchyma, significantly or moderately increased blood flow intensity ('thyroid inferno'), and elevated peak systolic velocity of the superior thyroid arteries. These signs are less common in hypothyroidism compared to hyperthyroidism. Diagnostic data suggest that the pathogeneses of primary hypothyroidism and Graves' disease share the same mechanisms, leading to similar thyroid ultrasound patterns. One of these shared mechanisms is presumably thyroid overstimulation by the autonomic nervous system, which is adequate to the body's hormonal requirements in hypothyroidism but excessive in hyperthyroidism.
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19
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Demir A, Böber E, Darcan S, Aydın A, Stenman UH, Büyükgebiz A, Hero M. The negative impact of levothyroxine treatment on urinary luteinizing hormone measurements in pediatric patients with thyroid disease. Front Endocrinol (Lausanne) 2023; 14:1236710. [PMID: 38161981 PMCID: PMC10756903 DOI: 10.3389/fendo.2023.1236710] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives Previous studies suggest urinary luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measurements by immunofluorometric assays (IFMA) as noninvasive alternatives to serum assays for puberty assessment. However, these studies excluded patients with other endocrine disorders and those taking medications. Besides, the recent discontinuation of IFMA manufacturing is a concern. We explored the utility of luminometric assays (LIA) for urinary gonadotropins and thyroid-stimulating hormone (TSH) determinations in euthyroid patients with thyroid pathologies. Methods We used LIA and IFMA assays to measure serum and first-morning-voided (FMV) urine LH, FSH, and TSH concentrations in euthyroid patients with various thyroid disorders. Of the 47 euthyroid patients with normal serum TSH (S-TSH) levels, 14 were receiving levothyroxine therapy. Results FMV total urinary LH (U-LH) concentrations correlated significantly with those measured in serum using either LIA (r=0.67, P<.001) or IFMA (r=0.83, P=.003) in patients not receiving levothyroxine treatment; however, no significant correlation could be detected in patients receiving levothyroxine regardless of the assay method (for LIA: r=0.50, P=.08 and IFMA r=0.44, P=.15). Urinary TSH (U-TSH) concentrations correlated poorly with those in serum in both the untreated and the treated groups (r=-0.13, P=.49, and r=-0.45, P=.11, respectively). Conclusion FMV total U-LH determinations by LIA can be used to assess pubertal development in patients with thyroid pathology, provided the euthyroid patient is not on levothyroxine treatment. U-TSH measurements by LIA cannot replace invasive S-TSH measurements at least in patients with normal S-TSH levels. Further research may reveal the utility of U-TSH determinations in patients with elevated S-TSH levels.
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Affiliation(s)
- And Demir
- Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ece Böber
- Department of Pediatrics, Division of Pediatric Endocrinology, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye
| | - Sükran Darcan
- Department of Pediatrics, Division of Pediatric Endocrinology, Ege University Faculty of Medicine, Izmir, Türkiye
| | - Adem Aydın
- Department of Pediatrics, Dokuz Eylül University Faculty of Medicine, Izmir, Türkiye
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry; University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Atilla Büyükgebiz
- Department of Pediatrics, Division of Pediatric Endocrinology, Demiroğlu Bilim University, Istanbul, Türkiye
| | - Matti Hero
- Pediatric Research Center, New Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Li X, Zhang Z, Cai W, Zhou X, Zhang Y, Wu C, Xu X, Wu H. Association Between Serum Ferritin Levels in Early Pregnancy and Thyroid Function and Pregnancy Outcomes in Chinese Population. Int J Womens Health 2023; 15:1951-1957. [PMID: 38106565 PMCID: PMC10723073 DOI: 10.2147/ijwh.s436651] [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] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/22/2023] [Indexed: 12/19/2023] Open
Abstract
Background The relationship of iron deficiency and thyroid hormone has been researched a lot among pregnant or other healthy population. However, invisible iron deficiency, namely shortage of serum ferritin (sFer) level, has been barely investigated among Chinese pregnant women. This study aimed to explore the effects of sFer status on thyroid function and pregnancy outcomes in a population-based upper first-class hospital. Methods A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in this retrospective cohort study. The participants were divided into four groups by quartiles of serum ferritin levels (Q1-4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferritin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across sFer quartiles. Categorical measures were compared by Fisher exact test or chi-square test. Results As the sFer concentration rises, incidence of premature birth (15.8%vs 12.3% vs 9.20% vs 6.20% p = 0.016) as well as threatened miscarriage (14.8% vs 7.2% vs 8.70% vs 6.70% p = 0.021) presented a downward trend. Compared with the other sFer group, subjects of the low sFer group were older, more often to be found to have lower serum γT3 and FT4 levels in early pregnancy but not in middle pregnancy. Conclusion sFer concentration in the first trimester can affect thyroid function. The correction of invisible iron deficiency with inadequate sFer status prior to pregnancy or during early pregnancy is imperative, not only to prevent anemia, but also for maintaining optimum thyroid function and normal fetal development. For clinicians, sFer status of pregnant women should be attached great importance apart from attention to iron level.
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Affiliation(s)
- Xing Li
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Zhuyuan Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Wen Cai
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Xuexin Zhou
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Yan Zhang
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Cailiang Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Xianming Xu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
| | - Hao Wu
- Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of China
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Kikuchi T, Hanaoka S, Nakao T, Nomura Y, Yoshikawa T, Alam MA, Mori H, Hayashi N. Relationship between Thyroid CT Density, Volume, and Future TSH Elevation: A 5-Year Follow-Up Study. Life (Basel) 2023; 13:2303. [PMID: 38137904 PMCID: PMC10744487 DOI: 10.3390/life13122303] [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: 11/06/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
This study aimed to explore the relationship between thyroid-stimulating hormone (TSH) elevation and the baseline computed tomography (CT) density and volume of the thyroid. We examined 86 cases with new-onset hypothyroidism (TSH > 4.5 IU/mL) and 1071 controls from a medical check-up database over 5 years. A deep learning-based thyroid segmentation method was used to assess CT density and volume. Statistical tests and logistic regression were employed to determine differences and odds ratios. Initially, the case group showed a higher CT density (89.8 vs. 81.7 Hounsfield units (HUs)) and smaller volume (13.0 vs. 15.3 mL) than those in the control group. For every +10 HU in CT density and -3 mL in volume, the odds of developing hypothyroidism increased by 1.40 and 1.35, respectively. Over the course of the study, the case group showed a notable CT density reduction (median: -8.9 HU), whereas the control group had a minor decrease (-2.9 HU). Thyroid volume remained relatively stable for both groups. Higher CT density and smaller thyroid volume at baseline are correlated with future TSH elevation. Over time, there was a substantial and minor decrease in CT density in the case and control groups, respectively. Thyroid volumes remained consistent in both cohorts.
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Affiliation(s)
- Tomohiro Kikuchi
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
- Department of Radiology, School of Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Shouhei Hanaoka
- Department of Radiology, The University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Takahiro Nakao
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
| | - Yukihiro Nomura
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
- Center for Frontier Medical Engineering, Chiba University, Chiba 263-8522, Japan
| | - Takeharu Yoshikawa
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
| | - Md Ashraful Alam
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
| | - Harushi Mori
- Department of Radiology, School of Medicine, Jichi Medical University, Tochigi 329-0498, Japan
| | - Naoto Hayashi
- Department of Computational Diagnostic Radiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo 113-8655, Japan (M.A.A.)
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22
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Heo JE, Kim DG, Yoo JW, Lee KS. Metabolic syndrome-related factors as possible targets for lower urinary tract symptoms in Korean males. Aging Male 2023; 26:6-12. [PMID: 36633207 DOI: 10.1080/13685538.2023.2166920] [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: 01/13/2023] Open
Abstract
INTRODUCTION A positive association between benign prostate hyperplasia (BPH)/lower urinary tract symptoms (LUTS) and metabolic syndrome (MetS) was reported in several studies, but studies from Asia often showed conflicting results. MATERIALS AND METHODS Medical records were obtained from a health promotion center database between 2021 and 2022. Men without a history of treatment for LUTS were evaluated using the International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), transrectal ultrasonography. RESULTS Of 1345 individuals, 603 (44.8%) had MetS. Older age, higher IPSS values, higher prevalence rates of BPH and overactive bladder, higher triiodothyronine, and lower testosterone and sex-hormone binding globulin were observed in individuals with MetS than in individuals without MetS. The severity of LUTS significantly increased in the individuals with MetS (p = .002). In individuals with MetS, age, HbA1c, and cerebrovascular disease (CVD) were associated with IPSS. For OABSS, age, HbA1c, thyroid-stimulating hormone (TSH), coronary artery occlusive disease, and CVD were identified as predictors. CONCLUSIONS We confirmed the positive correlation between MetS and BPH/LUTS in Korean. Factors including TSH and atherosclerosis affected LUTS in individuals with MetS. These findings suggested a potential role of thyroid hormones and atherosclerosis in the etiology and treatment of BPH/LUTS in patients with MetS.
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Affiliation(s)
- Ji Eun Heo
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dong Gyun Kim
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jeong Woo Yoo
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kwang Suk Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
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Parakkal SA, Hakeem FA, Madathil H, Alabidi RA, Alfaifi AY, Nemr HS, Al-Ghamdi FH. Pharmacist-Mediated Thyroid-Stimulating Hormone (TSH) Test Guideline Monitoring Program- Outcomes of a Retrospective Study In Patients On Levothyroxine. J Pharm Pract 2023; 36:1336-1342. [PMID: 35835724 DOI: 10.1177/08971900221111139] [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] [Indexed: 11/15/2022]
Abstract
Thirty to sixty percent of individuals taking levothyroxine were either under or overtreated, which leads to organ damage and excess mortality. This study aims to assess the gaps in the "thyroid-stimulating hormone (TSH) test guideline compliance rate" and validate the scope of ambulatory care pharmacist-mediated practice in patients on levothyroxine. At the study site, pharmacists offered patient-centered telephonic counseling to patients on levothyroxine who had been non-compliant with TSH tests for more than a year. A two-month quantitative retrospective analysis of this practice was conducted to assess its impact on TSH lab test adherence and dose modification outcomes. 415 patients met the study's inclusion criteria who received pharmacist counseling with documented intervention. Pharmacists bridged the significant gap in practice by creating new TSH lab requests with counseling in 81.2% (n = 337) of the study population who did not have TSH lab requests prior to the program. The non-compliance rate population dropped from 79.27% (n = 329) to 17.59% (n = 73) in the study population who had been non-compliant with the TSH test for 13 and 24 months. 74.5% (n = 309) were found to have performed their TSH test after the pharmacist's intervention. Among 100, 66% (n = 66) patients with abnormal TSH values consulted their physician for advice, of which 60.6% (n=40) had their levothyroxine dose adjusted (χ2=82.702, P < 0.01. The study suggests that pharmacists can significantly mediate between patients and physicians to enhance TSH test compliance and essential dose adjustment in patients prescribed levothyroxine.
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Affiliation(s)
| | - Faisal Ahmed Hakeem
- Pharmacy Service Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | - Hafees Madathil
- Pharmacy Service Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | | | - Areej Yahya Alfaifi
- Pharmacy Service Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | - Habib Shaker Nemr
- Pharmacy Service Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
| | - Fuad Hamed Al-Ghamdi
- Pharmacy Service Department, Johns Hopkins Aramco Healthcare, Dhahran 34465, Saudi Arabia
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24
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Gu P, Pu B, Ma Y, Yue D, Xin Q, Li H, Liu T, Zheng X, Ouyang C. Appraising the causal relationship between thyroid function and rheumatoid arthritis: a two-sample bidirectional Mendelian randomization study. Front Immunol 2023; 14:1238757. [PMID: 38090574 PMCID: PMC10713877 DOI: 10.3389/fimmu.2023.1238757] [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] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
Background Hypothyroidism and hyperthyroidism are observationally associated with rheumatoid arthritis (RA), but causality is unclear. To evaluate the causal relationship between thyroid function and RA, we conducted a two-Sample bidirectional Mendelian Randomization (MR) study. Methods Single nucleotide polymorphisms associated with six phenotypes were selected from the FinnGen biobank database, The ThyroidOmics Consortium database, and the IEU Open GWAS database. For the forward MR analysis, we selected hypothyroidism (N=213,390), Graves' disease (GD) (N=199,034), other types of hyperthyroidism (N=190,799), free thyroxine (FT4, N=49,269), and thyroid-stimulating hormone (TSH, N=54,288) as the five related thyroid function phenotypes for exposure, with RA (N=58,284) as the outcome. Reverse MR analysis selected RA as the exposure and five phenotypes of thyroid function as the outcome. The Inverse variance weighting (IVW) method was used as the primary analysis method, supplemented by weighted median (WM) and MR-Egger methods. Cochran's Q test, MR-PRESSO, MR-Egger regression methods, and leave-one-out analysis were employed to assess sensitivity and pleiotropy. Results Forward MR evidence indicates that genetic susceptibility to hypothyroidism is associated with an increased risk of RA (ORIvw=1.758, P=7.61×10-5). Reverse MR evidence suggests that genetic susceptibility to RA is associated with an increased risk of hypothyroidism (ORIvw=1.274, P=3.88×10-20), GD (ORIvw=1.269, P=8.15×10-05), and other types of hyperthyroidism (ORIvw=1.141, P=1.80×10-03). There is no evidence to support a forward or reverse causal relationship between genetic susceptibility to RA and FT4, TSH. Conclusion Our results provide genetic evidence supporting bidirectional causal relationships between thyroid function and RA. These findings inform preventive strategies and interventions targeting RA and thyroid dysfunction.
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Affiliation(s)
- Peng Gu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bin Pu
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - YangCheng Ma
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Dan Yue
- College of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan, China
| | - Qiao Xin
- Graduated School, Jiangxi University of Chinese Medicine, Nanchang, Jiangxi, China
| | - HaiShan Li
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Teng Liu
- First School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - XiaoHui Zheng
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - ChongZhi Ouyang
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
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25
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Unlu MT, Aygun N, Caliskan O, Isgor A, Uludag M. The relationship of pre-operative vitamin D and TSH levels with papillary thyroid cancer. North Clin Istanb 2023; 10:697-703. [PMID: 38328719 PMCID: PMC10846581 DOI: 10.14744/nci.2022.09699] [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: 07/21/2022] [Revised: 08/31/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Our goal in this study is to analyze the correlation between papillary thyroid cancer (PTC) with elevated thyroid-stimulating hormone (TSH) levels and deficiency of vitamin D. METHODS Patients who underwent thyroidectomy, also with available vitamin D test results preoperatively, were included in the study. The patients were separated into two different categories as having papillary thyroid carcinoma (Group 1), benign diseases (Group 2). According to the TSH (mUI/mL) level and vitamin D values, patients were categorized into four quarters. RESULTS Preoperatively, TSH level (mean±SDmUI/mL) was higher in Group 1 (2.04±1.55) compared to Group 2 (1.82±1.94) significantly (p=0.029). Preoperatively, vitamin D levels (mean±SD) were higher in Group 1 (15.88±10.88) than in Group 2 (12.94±10.26) significantly (p=0.011). There was no significant difference between Group 1 and Group 2 according to the vitamin D deficiency (65.5%, 72.8%; respectively (p=0.472)). When categorized with reference to pre-operative vitamin D levels, the proportion of patients in Group 2 and Category 1 was higher significantly (p=0.031). CONCLUSION Although the pre-operative TSH level was significantly higher in papillary thyroid carcinoma than benign thyroid diseases, the categorical distributions of the patients according to the TSH value were similar and the TSH values overlapped. Pre-operative mean vitamin D levels were similar in both PTC and benign thyroid disease groups so PTC was not associated with vitamin D deficiency.
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Affiliation(s)
- Mehmet Taner Unlu
- Department of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
| | - Nurcihan Aygun
- Department of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
| | - Ozan Caliskan
- Department of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
| | - Adnan Isgor
- Department of General Surgery, Bahcesehir University Faculty of Medicine, Istanbul, Turkiye
| | - Mehmet Uludag
- Department of General Surgery, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkiye
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Sadegh Fakhari M, Dorreh F, Ahangar Davoodi M, Ghandi Y. Thyroid Function in Children with Cyanotic and Non-Cyanotic Congenital Heart Disease. Turk Arch Pediatr 2023; 58:594-599. [PMID: 37737230 PMCID: PMC10724722 DOI: 10.5152/turkarchpediatr.2023.22277] [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: 12/13/2022] [Accepted: 08/07/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVE Congenital heart disease (CHD) is one of the common diseases of childhood, which is classified into non-cyanotic and cyanotic types. It can affect thyroid function and lead to disruptions in thyroid hormone secretion and hypofunction. This study aimed to evaluate thyroid function in patients younger than 2 years old with cyanotic and non-cyanotic CHD. MATERIALS AND METHODS In our study, 101 patients (female/male: 50/51) were included. The thyroid-stimulating hormone and thyroid hormones such as thyroxine (T4) and triiodothyronine (T3) were measured using the electrochemiluminescence method, and thyroid peroxidase antibodies were measured by an enzyme-linked immunosorbent assay. Subclinical hypothyroidism referred to normal levels of T4, with elevated levels of thyroid-stimulating hormone in the serum. RESULTS The frequency of subclinical hypothyroidism and hypothyroidism in patients with cyanotic CHD was estimated at 27.5% and 10%, respectively, and 1 patient had hyperthyroidism. The majority of cyanotic and non-cyanotic CHD cases were diagnosed with tetralogy of Fallot (30%) and patent ductus arteriosus (32.79%). There were no significant differences between cyanotic and non-cyanotic groups regarding T3, T4, free T3, free T4, and anti-thyroid peroxidase antibody levels (0.389, 0.142, 0.354, 0.248, and 0.333, respectively). CONCLUSION Based on the present findings, subclinical hypothyroidism is a common finding in cyanotic CHD patients during childhood, which is associated with increased levels of oxygen saturation, severity of cyanosis, and age.
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Affiliation(s)
- Mohammad Sadegh Fakhari
- Department of Pediatrics, Amir Kabir Hospital, Arak University of Medical Sciences Faculty of Medicine, Arak, Iran
| | - Fatemeh Dorreh
- Department of Pediatrics, Amir Kabir Hospital, Arak University of Medical Sciences Faculty of Medicine, Arak, Iran
| | - Mohammad Ahangar Davoodi
- Department of Pediatrics, Endocrinology & Metabolism, Amir-Kabir Hospital, Arak University of Medical Sciences Faculty of Medicine, Arak, Iran
| | - Yazdan Ghandi
- Department of Pediatrics, Amir Kabir Hospital, Arak University of Medical Sciences Faculty of Medicine, Arak, Iran
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Sakyi SA, Ameyaw B, Laing EF, Anthony R, Ephraim RKD, Effah A, Kwayie AA, Senu E, Anto EO, Acheampong E, Afranie BO, Amoani B, Opoku S. Thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus patients in Ghana: A comparative cross-sectional study. Endocrinol Diabetes Metab 2023; 6:e447. [PMID: 37621219 PMCID: PMC10638622 DOI: 10.1002/edm2.447] [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: 06/01/2023] [Revised: 08/06/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
INTRODUCTION Thyroid disorders and diabetes mellitus coexist and are prevalent endocrinopathies among adult population. Thyroid dysfunction contributes to metabolic imbalances, increase beta-cell apoptosis and glucose intolerance. There is paucity of data and contradicting findings on how thyroid dysfunction influence glycaemic control. Therefore, we evaluated thyroid dysfunction and glycaemic control among Type 2 diabetes mellitus (T2DM) patients in Ghana. METHODS A comparative cross-sectional study was conducted among 192 T2DM patients from Effia Nkwanta Regional Hospital. Three consecutive monthly fasting plasma glucose (FBG) and glycated haemoglobin (HbA1c) were analysed and the results were classified as, moderate hyperglycaemia (MH) (FBG = 6.1-12.0 mmol/L, HbA1c < 7%), severe hyperglycaemia (SH) (FBG ≥ 12.1 mmol/L, HbA1c > 7%) and good glycaemic controls (GC) (FBG = 4.1-6.0 mmol/L, HbA1c < 7%). Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), body mass index (BMI) and other clinical parameters were measured. Data analysis was done using R language version 4.0.2 and p < .05 was considered statistically significant. RESULTS There were no significant differences in age (years) between patients in the various glycaemic groups (p = .9053). The overall prevalence of thyroid disorders was 7.8% among T2DM patients. The prevalence of thyroid disorders was higher in patients with SH (11.7%) followed by those with MH (7.5%) and then those with GC (5.4%). Serum levels of TSH and FT3/FT4 ratio were significantly lower in T2DM patients with SH compared to those with MH and the GC (p < .0001). However, FT4 was significantly higher in SH patients compared to the good glycaemic controls (p < .01). The first tertiles of TSH [aOR = 10.51, 95% CI (4.04-17.36), p < .0001] and FT3 [aOR = 2.77, 95% CI (1.11-6.92), p = .0290] were significantly and independently associated with increased odds of hyperglycaemia. CONCLUSION The prevalence of thyroid dysfunction is high in T2DM and increases with hyperglycaemia. Reduced TSH and T3 may worsen glycaemic control. Periodic monitoring of thyroid function should be incorporated into management guidelines among T2DM patients in Ghana.
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Affiliation(s)
- Samuel Asamoah Sakyi
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Bright Ameyaw
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- Laboratory DepartmentEffia Nkwanta Regional HospitalWestern RegionGhana
| | - Edwin Ferguson Laing
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Richard Anthony
- Department of Internal MedicineEffia Nkwanta Regional HospitalWestern RegionGhana
| | | | - Alfred Effah
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Afia Agyapomaa Kwayie
- Department of Medical Diagnostics, Faculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Ebenezer Senu
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Enoch Odame Anto
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
| | - Bright Oppong Afranie
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Benjamin Amoani
- Department of Medical Laboratory TechnologyUniversity of Cape CoastCape CoastGhana
| | - Stephen Opoku
- Department of Molecular Medicine, School of Medicine and DentistryKwame Nkrumah University of Science and TechnologyKumasiGhana
- Department of Medical Diagnostics, Faculty of Allied Health SciencesKwame Nkrumah University of Science and TechnologyKumasiGhana
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Tunç Karaman S. Insulin resistance in non-diabetic hypothyroid patients: a critical examination of METS-IR as a diagnostic marker. Curr Med Res Opin 2023:1-7. [PMID: 37831409 DOI: 10.1080/03007995.2023.2270422] [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: 09/11/2023] [Accepted: 10/10/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Insulin resistance (IR) is a significant metabolic disturbance that plays a pivotal role in various health conditions, including hypothyroidism. Homeostatic Model Assessment For Insulin Resistance (HOMA-IR) is widely used for assessing IR. However, alternative indices, such as the Metabolic Score for Insulin Resistance (METS-IR), have been developed for diverse applications. This study aimed to meticulously investigate IR in patients with hypothyroidism and to compare the effectiveness of METS-IR with HOMA-IR. To enrich our analyses, additional metrics, including the Triglyceride Glucose (TyG) Index, the Triglyceride to High-Density Lipoprotein Cholesterol Ratio (TG/HDL-C), and the Quantitative Insulin Sensitivity Check Index (QUICKI) have been incorporated. METHODS This cross-sectional study included 260 non-diabetic adults, 130 with hypothyroidism (case group), and 130 healthy volunteers (control group). Parameters, including Thyroid-Stimulating Hormone (TSH), free thyroxine (T4), fasting blood glucose, HbA1c, insulin levels, and lipid profiles, were measured. IR indices were calculated. RESULTS The groups were matched for age and gender (p = .143; p = .099). The case group demonstrated a notably elevated mean METS-IR of 195.58, in contrast to the control group's mean METS-IR of 131.10 (p = .044). The mean HOMA-IR was significantly higher in the case group than in the control group, with average of 2.00 and 1.81, respectively (p = .027). METS-IR was positively correlated with TyG (r = 0.505, p = .001) and TG/HDL-C (r = 0.844, p = .001). Meanwhile, the relationships between METS-IR, HOMA-IR, and QUICKI were significant at r = 0.194 (p = .027) and r = .210 (p = .016), respectively. METS-IR was significantly higher in patients with overt hypothyroidism (p = .016). CONCLUSION This study emphasizes the efficacy of METS-IR as a diagnostic tool for IR in patients with hypothyroidism, establishing it as a proficient alternative to HOMA-IR. These findings were substantiated by the correlations observed with the TyG, TG/HDL-C, and QUICKI measurements. Variations in METS-IR between individuals with subclinical and overt hypothyroidism accentuate its effectiveness in identifying metabolic abnormalities in hypothyroid conditions.
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Affiliation(s)
- Sibel Tunç Karaman
- Department of Family Medicine, University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Istanbul, Turkey
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Li S, Guo W, Meng Q, Zhu M, Wei H, Ji F, Tan L, Zhang W. The association between thyroid-stimulating hormone and thyroid nodules, goiter and thyroid antibody positivity. Front Endocrinol (Lausanne) 2023; 14:1204552. [PMID: 37850098 PMCID: PMC10577406 DOI: 10.3389/fendo.2023.1204552] [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: 06/19/2023] [Accepted: 09/14/2023] [Indexed: 10/19/2023] Open
Abstract
Background The relationship between normal thyroid-stimulating hormone (TSH) levels and thyroid disease in adults remains controversial. This study aimed to investigate the correlation between serum TSH levels, particularly those falling within the normal range, and thyroid diseases in Chinese adults, including thyroid nodules (TN), goiter (GR), and thyroid antibody positivity. Materials and methods This research was a cross-sectional study conducted in an adult population in Tianjin, China. Thyroid volume (Tvol) and TN were assessed using thyroid ultrasonography. Fasting venous blood and spot urine samples were collected to evaluate thyroid function and iodine status. Results A total of 2460 subjects participated in the survey. The prevalence of thyroid dysfunction was 9.76%, and abnormal TSH levels were found to potentially increase the risk of GR and thyroid antibody positivity in adults. A total of 2220 subjects with TSH within the normal reference range were included in the further study. In these patients, Tvol decreased as TSH levels increased, in both men and women (P < 0.0001). Low TSH levels (0.27-1.41 IU/mL) were identified as a risk factor for TN (odds ratio [OR], 1.46; 95% CI: 1.14-1.87) and GR (OR 5.90, 95% CI 2.27-15.3). Upon stratification by sex and age, the risk of TN was found to be higher in women and elderly individuals (≥60 years old), while the risk of GR was found to be higher in men and younger individuals (<60 years old). High TSH levels (2.55-4.2 IU/mL) were identified as a risk factor for thyroid antibody positivity (OR, 1.53; 95% CI: 1.11-2.10). Men and younger individuals with high TSH levels exhibited a higher risk of thyroid antibody positivity. Conclusion In adults with normal TSH levels, low TSH levels were associated with an increased risk of TN and GR, whereas high TSH levels were associated with thyroid antibody positivity. The research also suggests that adults whose TSH levels at upper or lower limits of the normal range should be reviewed regularly.
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Affiliation(s)
- Shaohan Li
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qi Meng
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Fengying Ji
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- Qingdao Institute of Preventive Medicine, Qingdao, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Tianjin Key Laboratory of Hormones and Development (Ministry of Health), Tianjin, China
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Ursem SR, Boelen A, Hillebrand JJ, den Elzen WPJ, Heijboer AC. How low can we (reliably) go? A method comparison of thyroid-stimulating hormone assays with a focus on low concentrations. Eur Thyroid J 2023; 12:e230123. [PMID: 37552779 PMCID: PMC10503215 DOI: 10.1530/etj-23-0123] [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: 06/21/2023] [Accepted: 08/08/2023] [Indexed: 08/10/2023] Open
Abstract
Objective International guidelines concerning subclinical hyperthyroidism and thyroid cancer advice absolute cut-off values for aiding clinical decisions in the low range of thyroid-stimulating hormone (TSH) concentrations. As TSH assays are known to be poorly standardized in the normal to high range, we performed a TSH assay method comparison focusing on the low range. Methods Sixty samples, selected to cover a wide range of TSH concentrations (<0.01 to 120 mIU/L) with oversampling in the lower range (<0.4 mIU/L), were used for the method comparison between three TSH immunoassays (Cobas, Alinity and Atellica). In addition, 20 samples were used to assess the coefficient of variation from duplicate measurements in these three methods. Results The TSH immunoassays showed standardization differences with a bias of 7-16% for the total range and 1-14% for the low range. This could lead to a different classification of 1.5% of all measured TSH concentrations <0.40 mIU/L measured in our laboratory over the last 6 months, regarding the clinically important cut-off value of TSH = 0.1 mIU/L. As the imprecision of the immunoassays varied from 1.6-5.5%, this could lead to a similar reclassification as the bias between immunoassays. Conclusions We established the standardization differences of frequently used TSH assays for the total and low concentration ranges. Based on the proportional bias and the imprecision, this effect seems to have limited clinical consequences for the low TSH concentration range. Nevertheless, as guidelines mention absolute TSH values to guide clinical decision-making, caution must be applied when interpreting values close to these cut-offs.
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Affiliation(s)
- Stan R Ursem
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Anita Boelen
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development, Amsterdam, The Netherlands
| | - Jacquelien J Hillebrand
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
| | - Wendy P J den Elzen
- Department of Laboratory Medicine, Laboratory Specialized Diagnostics & Research, Amsterdam UMC location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
- Amsterdam Public Health, Amsterdam, The Netherlands
| | - Annemieke C Heijboer
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location University of Amsterdam, Meibergdreef, Amsterdam, The Netherlands
- Amsterdam Gastroenterology, Endocrinology & Metabolism, Amsterdam, The Netherlands
- Amsterdam Reproduction & Development, Amsterdam, The Netherlands
- Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan, Amsterdam, The Netherlands
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31
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Al-Hakami HA, Altayyeb JF, Alsharif SM, Alshareef MA, Awad BI, Al-Garni M. Preoperative Thyroid-Stimulating Hormone Levels and Risk of Thyroid Cancer in Post-thyroidectomy Patients for Thyroid Nodules: A Study From a Tertiary Hospital in Western Saudi Arabia. Cureus 2023; 15:e47622. [PMID: 38022328 PMCID: PMC10667624 DOI: 10.7759/cureus.47622] [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: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Although serum thyroid-stimulating hormone (TSH) is one of the basic investigations to assess thyroid nodules, its role in thyroid oncogenesis remains unclear. Previous literature has conflicting findings regarding TSH levels and the prediction of malignancy. This study aims to investigate the association between TSH levels and the risk of malignancy and advanced staging in patients who underwent thyroidectomy for nodular thyroid disease. Additionally, it aims to assess if higher TSH correlates with malignancy in Bethesda staging III, IV, and V. Methodology This retrospective cohort study was conducted among participants who underwent near-total/total thyroidectomy or hemithyroidectomy at King Abdulaziz Medical City between 2016 and 2021. Results A total of 378 cases were included, and 50.3% of the cases had malignant nodules in the surgical histopathology findings. The median TSH levels were higher in malignant nodules compared to benign ones (1.64 mIU/L versus 1.49 mIU/L; p < 0.001). Additionally, higher TSH levels were not associated with advanced staging or malignancy in patients with Bethesda stage III-V. Conclusions Higher TSH levels are associated with an increased risk of malignancy in patients with nodular thyroid disease. Using TSH levels as an adjunctive tool for identifying high-risk patients with thyroid nodules would aid in management planning.
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Affiliation(s)
- Hadi Afandi Al-Hakami
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard Health Affairs, Jeddah, SAU
| | - Jamelah F Altayyeb
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Salwan M Alsharif
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Mohammad A Alshareef
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Baraa I Awad
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard Health Affairs, Jeddah, SAU
| | - Mohammed Al-Garni
- Otolaryngology - Head and Neck Surgery, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Ministry of the National Guard Health Affairs, Jeddah, SAU
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Yang L, Sato M, Saito-Abe M, Miyaji Y, Sato C, Nishizato M, Kumasaka N, Mezawa H, Yamamoto-Hanada K, Ohya Y. Congenital hypothyroidism and thyroid function in a Japanese birth cohort: data from The Japan Environment and Children's Study. Clin Pediatr Endocrinol 2023; 32:213-220. [PMID: 37842138 PMCID: PMC10568570 DOI: 10.1297/cpe.2022-0068] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
The most common hormonal and metabolic disease in early childhood is congenital hypothyroidism (CH). This study aimed to describe CH in large-scale birth cohort data and summarize the results of serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels in 2-yr-old children. Data were obtained from the Japan Environment and Children's Study (JECS), and we identified 171 children with CH detected in newborn screenings or medical records (170.5 per 100,000 population). Infants with CH are at higher risk of developing congenital diseases than those without CH. Of 171 children with CH, 20 (11.7%) were diagnosed with congenital heart defects, 33 (19.3%) had chromosomal or other congenital abnormalities, and 23 (13.5%) had Down syndrome. At the age of 2 yr old, the median and 95% reference range values for TSH and fT4 were 2.13 (0.78-5.52) μIU/mL and 1.2 (1.0-1.5) ng/dL, respectively. Moreover, boys had slightly higher TSH and fT4 levels than did girls. Data on the distribution of TSH and fT4 in 2-yr-old children should be useful for decreasing the misclassification of thyroid disorders in the pediatric population. Trial-off treatment and re-evaluation of thyroid function are needed to classify permanent congenital hypothyroidism and transient congenital hypothyroidism after 3 yr of age.
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Affiliation(s)
- Limin Yang
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Miori Sato
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Mayako Saito-Abe
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yumiko Miyaji
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Chikako Sato
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Minaho Nishizato
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Natsuhiko Kumasaka
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hidetoshi Mezawa
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Kiwako Yamamoto-Hanada
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Medical Support Center for the Japan Environment and Children's Study, National Research Institute for Child Health and Development, Tokyo, Japan
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Ittermann T, von Rheinbaben S, Markus MRP, Dörr M, Steveling A, Nauck M, Teumer A, Gollasch M, Spira D, König M, Demuth I, Steinhagen-Thiessen E, Völzke H, Stracke S. High Thyroid-Stimulating Hormone and Low Free Triiodothyronine Levels Are Associated with Chronic Kidney Disease in Three Population-Based Studies from Germany. J Clin Med 2023; 12:5763. [PMID: 37685830 PMCID: PMC10489120 DOI: 10.3390/jcm12175763] [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: 08/04/2023] [Revised: 08/28/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
High serum thyroid-stimulating hormone (TSH) levels have previously been associated with a low estimated glomerular filtration rate (eGFR), but studies associating thyroid hormone levels with albuminuria revealed inconsistent results. We used cross-sectional data from 7933 individuals aged 20 to 93 years of the Berlin Aging Study II and the Study of Health in Pomerania to associate serum TSH, fT3, and fT4 levels with eGFR and albuminuria. In multivariable analyses adjusted for confounding, we found inverse non-linear associations of serum TSH levels with eGFR, while serum fT3 levels showed a positive association with eGFR. High as well as low serum fT4 levels were associated with a lower eGFR. Age but not sex modified the association between thyroid hormone levels and eGFR. The inverse associations between serum TSH levels and eGFR were strongest in the youngest age groups, while the positive associations between serum fT3 levels and eGFR were strongest in older individuals. No significant associations between thyroid hormone levels and albuminuria were found. Our results indicate that hypothyroidism might be associated with a reduced kidney function. Thyroid function might be more tightly related to the eGFR than to albuminuria in the general population.
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Affiliation(s)
- Till Ittermann
- Institute for Community Medicine—SHIP Clinical-Epidemiological Research, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Sabrina von Rheinbaben
- Department of Medicine A—Gastroenterology, Nephrology, Endocrinology and Rheumatology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.v.R.); (A.S.); (S.S.)
| | - Marcello R. P. Markus
- Department of Internal Medicine B—Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, 17475 Greifswald, Germany; (M.R.P.M.); (M.D.)
| | - Marcus Dörr
- Department of Internal Medicine B—Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, University Medicine Greifswald, 17475 Greifswald, Germany; (M.R.P.M.); (M.D.)
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, 17475 Greifswald, Germany; (M.N.); (A.T.)
| | - Antje Steveling
- Department of Medicine A—Gastroenterology, Nephrology, Endocrinology and Rheumatology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.v.R.); (A.S.); (S.S.)
| | - Matthias Nauck
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, 17475 Greifswald, Germany; (M.N.); (A.T.)
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Alexander Teumer
- DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, 17475 Greifswald, Germany; (M.N.); (A.T.)
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Maik Gollasch
- Department of Internal Medicine and Geriatrics, University Medicine Greifswald, 17475 Greifswald, Germany; (M.G.); (M.K.)
| | - Dominik Spira
- Department of Endocrinology and Metabolism, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (D.S.); (I.D.); (E.S.-T.)
| | - Maximilian König
- Department of Internal Medicine and Geriatrics, University Medicine Greifswald, 17475 Greifswald, Germany; (M.G.); (M.K.)
| | - Ilja Demuth
- Department of Endocrinology and Metabolism, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (D.S.); (I.D.); (E.S.-T.)
- BCRT—Berlin Institute of Health Center for Regenerative Therapies, Charité—Universitätsmedizin Berlin, 13353 Berlin, Germany
| | - Elisabeth Steinhagen-Thiessen
- Department of Endocrinology and Metabolism, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany; (D.S.); (I.D.); (E.S.-T.)
| | - Henry Völzke
- Institute for Community Medicine—SHIP Clinical-Epidemiological Research, University Medicine Greifswald, 17475 Greifswald, Germany;
| | - Sylvia Stracke
- Department of Medicine A—Gastroenterology, Nephrology, Endocrinology and Rheumatology, University Medicine Greifswald, 17475 Greifswald, Germany; (S.v.R.); (A.S.); (S.S.)
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Turan H, Aşkın Turan S, Butun Z, Kayapınar M. The Prevalence, Severity, and Predictive Factors of Restless Legs Syndrome in Pregnancy. Cureus 2023; 15:e44884. [PMID: 37692184 PMCID: PMC10485731 DOI: 10.7759/cureus.44884] [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: 09/08/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVES The current study aimed to search the prevalence and severity of restless legs syndrome (RLS) in pregnancy according to the three trimesters and predictive factors of RLS in pregnancy based on validated diagnostic tools and a thorough literature review. METHODS The cross-sectional descriptive study included 500 pregnant women without comorbidities who were interviewed face-to-face. Age, height, weight, week of pregnancy, smoking, alcohol, caffeine use, regular exercise, and lab test results from the last visit were all included in the data. Only women satisfying the RLS diagnostic criteria were given the Restless Legs Syndrome Rating Scale. RESULTS The prevalence of RLS was found to be 29.2% with the highest rate in the third trimester (64.4%). In all trimesters, low ferritin (first trimester: p = 0.004; second trimester: p < 0.001; third trimester: p < 0.001), folic acid (first trimester: p = 0.001; second trimester: p < 0.001; third trimester: p < 0.001), vitamin B12 (first trimester: p = 0.003; second trimester: p < 0.001; third trimester: p < 0.001), and hemoglobin (first trimester: p < 0.001; second trimester: p < 0.001; third trimester: p < 0.001) levels were associated with RLS. In the second and third trimesters, low magnesium (p < 0.001 and p < 0.001, respectively) and high creatinine (p = 0.027 and p < 0.001, respectively) levels were associated with RLS. Higher thyroid-stimulating hormone and free T4 levels were associated with RLS in the third trimester but not in the first and second trimesters (median: 2.4 vs. 2.1, p < 0.001; median: 1.5 vs. 1.2, p < 0.001). In the multivariate regression analysis, age (p = 0.034, OR: 1.060, 95% CI: 1.005-1.119), present BMI (p < 0.001, OR: 1.8884, 95% CI: 1.597-2.222), BMI before conception (p < 0.001, OR: 0.607, 95% CI: 0.513-0.718), gravida (p < 0.001, OR: 2.172, 95% CI: 1.547-3.049), low ferritin level (p < 0.001, OR: 6.396, 95% CI: 0.00744-0.010405), low vitamin B12 (p < 0.001, OR: 10.347, 95% CI: 0.00120-0.00176), low folate (p < 0.001, OR: 5.841, 95% CI: 0.00616-0.01240), RLS history before conception (p = 0.013, OR: 4.963, 95% CI: 1.402-17.57), and RLS family history (p < 0.001, OR: 7.914, 95% CI: 0.18760-0.31151) were found to be predictive factors for RLS in pregnancy. CONCLUSION More attention is needed to RLS during pregnancy to prevent or treat this syndrome.
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Affiliation(s)
- Hasan Turan
- Obstetrics and Gynecology, University of Health Sciences, Mersin City Hospital, Mersin, TUR
| | - Suna Aşkın Turan
- Neurology/Pain Management, University of Health Sciences, Mersin City Hospital, Mersin, TUR
| | - Zafer Butun
- Obstetrics and Gynecology/Maternal Fetal Medicine, University of Health Sciences, Eskişehir City Hospital, Eskişehir, TUR
| | - Masum Kayapınar
- Obstetrics and Gynecology/Maternal Fetal Medicine, University of Health Sciences, Mersin City Hospital, Mersin, TUR
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Prieto JM, Carney PC, Smith SM, Miller ML, Rishniw M, Randolph JF, Salerno VJ, Lamb SV, Place NJ, Farace G, Peterson S, Peterson ME. Biological variation of serum thyrotropin and thyroid hormones concentrations determined at 8-week intervals for 1 year in clinically healthy cats. Vet Clin Pathol 2023; 52:493-502. [PMID: 37528445 DOI: 10.1111/vcp.13251] [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: 09/28/2022] [Revised: 02/04/2023] [Accepted: 02/23/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Cats commonly develop thyroid disease but little is known about the long-term biological variability of serum thyroid hormone and thyrotropin (thyroid-stimulating hormone; TSH) concentrations. OBJECTIVES We aimed to determine the long-term biological variation of thyroid hormones and TSH in clinically healthy cats. METHODS A prospective, observational study was carried out. Serum samples for analysis of total thyroxine (T4, by radioimmunoassay [RIA] and homogenous enzyme immunoassay [EIA]), triiodothyronine (T3 ), free T4 (by dialysis), and TSH were obtained every 8 weeks for 1 year from 15 healthy cats, then frozen until single-batch analysis. Coefficients of variation (CV) within individual cats (CV I ) and among individual cats (CV G ), as well as the variation between duplicates (ie, analytical variation [CV A ]) were determined with restricted maximum likelihood estimation. The indices of individuality (IoI) and reference change values (RCVs) for each hormone were calculated. RESULTS Some thyroid hormones showed similar (total T4 by EIA) or greater (TSH) interindividual relative to intraindividual variation resulting in intermediate to high IoI, consistent with previous studies evaluating the biological variation of these hormones weekly for 5-6 weeks. By contrast, total T4 (by RIA) and free T4 had a low IoI. Total T3 had a high ratio ofCV A toCV I ; therefore, interindividual variation could not be distinguished from analytical variation. No seasonal variability in the hormones could be demonstrated. CONCLUSIONS Clinicians might improve the diagnosis of feline thyroid disease by establishing baseline concentrations for analytes with intermediate-high IoI (total T4, TSH) for individual cats and applying RCVs to subsequent measurements.
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Affiliation(s)
- Jennifer M Prieto
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Patrick C Carney
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Stephanie M Smith
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Meredith L Miller
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Mark Rishniw
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - John F Randolph
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
| | - Valerie J Salerno
- Population Medicine & Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Steve V Lamb
- Population Medicine & Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | - Ned J Place
- Population Medicine & Diagnostic Sciences, Cornell University, Ithaca, New York, USA
| | | | | | - Mark E Peterson
- Departments of Clinical Sciences, Cornell University, Ithaca, New York, USA
- Animal Endocrine Clinic, New York, New York, USA
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Zheng H, Wang Q, Chen F. Correlation between serum beta-human chorionic gonadotropin levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum. CHINESE J PHYSIOL 2023; 66:359-364. [PMID: 37929347 DOI: 10.4103/cjop.cjop-d-23-00045] [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] [Indexed: 11/07/2023] Open
Abstract
As previously demonstrated, serum beta-human chorionic gonadotropin (β-hCG) is linked to identifying early gestational abnormalities. This research was aimed at investigating the correlation between serum β-hCG levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum (HG). Ninety-one pregnant women with HG were selected as the study group and divided into early pregnancy (EP), mid-pregnancy (MP), and late pregnancy (LP) groups according to their gestational weeks, while 84 normal pregnant women were selected as the control group. Venous blood was collected from pregnant women in both groups and serum β-hCG levels were measured by chemiluminescent immunoassay. The levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid-stimulating hormone receptor antibody (TRAb), and thyroglobulin antibody (TgAb) were tested by chemiluminescent microparticle immunoassay. Visual analog scale (VAS) scores were utilized to assess the degree of HG. Pearson analysis was implemented to measure the correlations between serum β-hCG levels and serum FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and the correlations between β-hCG, FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and gestation period. The receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic values of thyroid hormones, thyroid-related antibodies, and β-hCG levels for HG. Versus those in the control group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores were higher and TSH levels were lower in the study group. Versus those in the EP group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women in the MP and LP groups were decreased, and TSH levels were increased. Serum β-hCG levels of pregnant women with HG were positively correlated with FT3, FT4, TPOAb, TRAb, TgAb, and VAS scores and negatively correlated with TSH levels. Serum β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women with HG had a negative correlation with the gestation period, while TSH levels had a positive correlation with the gestation period. The ROC curve analysis showed that β-hCG and thyroid function-related indicators were of high clinical values in the diagnosis of HG. Collectively, our article suggests that serum β-hCG expression of pregnant women with HG is abnormally elevated and closely related to the degree of HG and hyperthyroidism. In addition, β-hCG and thyroid function-related indicators have certain diagnostic efficacy for HG.
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Affiliation(s)
- Haiyan Zheng
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Qian Wang
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Feng Chen
- Department of Traditional Chinese Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Ju N, Hou L, Song H, Qiu Z, Wang Y, Sun Z, Luo Q, Shen C. TSH ≥30 mU/L may not be necessary for successful 131I remnant ablation in patients with differentiated thyroid cancer. Eur Thyroid J 2023; 12:e220219. [PMID: 37022724 PMCID: PMC10305696 DOI: 10.1530/etj-22-0219] [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: 02/10/2023] [Accepted: 04/06/2023] [Indexed: 04/07/2023] Open
Abstract
Purpose To determine whether thyroid-stimulating hormone level ≥ 30 mU/L is necessary for radioiodine (131I) remnant ablation (RRA) in patients with differentiated thyroid cancer (DTC), as well as its influencing factors and predictors. Methods A total of 487 DTC patients were retrospectively enrolled in this study. They were divided into two groups (TSH < 30 and ≥ 30 mU/L) and further divided into eight subgroups (0-<30, 30-<40, 40-<50, 50-<60, 60-<70, 70-<80, 80-<90, and 90-<100 mU/L). The simultaneous serum lipid level, successful rate of RRA and its influencing factors in different groups were analyzed. The receiver operating characteristic curves derived from pre-ablative thyroglobulin (pre-Tg) and pre-Tg/TSH ratio were compared for RRA success prediction performance. Results There was no statistical difference in success rates of RRA between the two groups (P = 0.247) and eight subgroups (P = 0.685). Levels of total cholesterol (P < 0.001), triglyceride (P = 0.006), high-density lipoprotein cholesterol (P = 0.024), low-density lipoprotein cholesterol (P = 0.001), apolipoprotein B (P < 0.001), and apolipoprotein E (P = 0.002) were significantly higher while apoA/apoB ratio (P = 0.024) was significantly lower at TSH ≥ 30 mU/L group. Pre-Tg level, gender, and N stage were influencing factors for RRA. The area under the curve of pre-Tg level and pre-Tg/TSH ratio was 0.7611 (P < 0.0001) and 0.7340 (P < 0.0001) for all enrolled patients and 0.7310 (P = 0.0145) and 0.6524 (P = 0.1068) for TSH < 30 mU/L, respectively. Conclusion TSH ≥ 30 mU/L may not be necessary for the success of RRA. Patients with higher serum TSH levels prior to RRA will suffer from severer hyperlipidemia. Pre-Tg level could be used as a predictor for the success of RRA, especially when TSH < 30 mU/L.
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Affiliation(s)
- Nianting Ju
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Liying Hou
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongjun Song
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhongling Qiu
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Wang
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenkui Sun
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Quanyong Luo
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chentian Shen
- Department of Nuclear Medicine, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Klett D, Pellissier L, Lomet D, Derouin-Tochon F, Robert V, Nguyen TMD, Duittoz A, Reiter E, Locatelli Y, Dupont J, Dardente H, Jean-Alphonse F, Combarnous Y. Highly-Sensitive In Vitro Bioassays for FSH, TSH, PTH, Kp, and OT in Addition to LH in Mouse Leydig Tumor Cell. Int J Mol Sci 2023; 24:12047. [PMID: 37569429 PMCID: PMC10419024 DOI: 10.3390/ijms241512047] [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: 06/06/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
We demonstrate here that highly sensitive in vitro bioassays for FSH, TSH, and PTH can be set up in mouse Leydig Tumor Cells (mLTC), in addition to the normal LH/CG bioassay, after they were transfected with expression vectors encoding the corresponding Gs Protein-Coupled Receptors (GsPCR), such as FSHR, TSHR, or PTHR. Although the β2 adrenergic receptor is also a GsPCR, its expression in mLTC led to a significant but very low cAMP response compared to those observed with FSH, TSH, or PTH. Similarly, after transfection of the GiPCR MT1 melatonin receptor, we did not observe any inhibitory effect by melatonin of the LH or hCG stimulation. Interestingly, after transfection of mLTC with the human kisspeptin receptor (hKpR), which is a GqPCR, we observed a dose-dependent synergy of 10-12-10-7 M kisspeptin variants with a fixed concentration of 0.3 nM LH or hCG. Without any exogenous receptor transfection, a 2 h preincubation with OT or AVP led to a dose-dependent cAMP response to a fixed dose of LH or hCG. Therefore, highly sensitive in vitro bioassays for various hormones and other GPCR ligands can be set up in mLTC to measure circulating concentrations in only 3-10 µL of blood or other body fluids. Nevertheless, the development of an LHRKO mLTC cell line will be mandatory to obtain strict specificity for these bioassays to eliminate potential cross-reaction with LH or CG.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Yves Combarnous
- INRAe, CNRS, UMR “Physiologie de la Reproduction & des Comportements”, Tours University, Inria, 37380 Nouzilly, France; (D.K.); (L.P.); (D.L.); (T.M.D.N.); (A.D.); (E.R.); (Y.L.); (J.D.); (H.D.); (F.J.-A.)
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Fröhlich E, Wahl R. Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation. Int J Mol Sci 2023; 24:11699. [PMID: 37511458 PMCID: PMC10380753 DOI: 10.3390/ijms241411699] [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: 06/17/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Thyroid-stimulating hormone (TSH) and thyroid hormone levels are standard parameters in blood analysis. However, the immunoassays employed may lead to false-positive or false-negative results when the sample contains certain materials that interfere with the assay. Macro-TSH, a complex of TSH with immunoglobulin or albumin, may cause apparently increased TSH concentrations. TSH is produced in the pars tuberalis (PT) of the pituitary gland and by thyrotrophs of the pars distalis (PD). It was found that variable glycosylation can render the molecule more strongly bound to antibodies or albumin in the blood, leading to the hypothesis that macro-TSH consists mainly of PT-TSH. Although less known than PD-TSH, PT-TSH plays an important role in the central regulation of thyroid metabolism. The present review summarizes the physiological function of human PT-TSH and its role in macro-TSH formation. The prevalence of macro-hyperthyrotropinemia, the structure of PT-TSH and macro-TSH, problems in the measurement of TSH, and the action of PT-TSH in animals with seasonal breeding are discussed. Despite the absence of a specific function of macro-TSH in the organism, the identification of macro-TSH is important for avoiding unnecessary treatment based on a falsified readout of increased TSH concentrations as numerous individual case reports describe.
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Affiliation(s)
- Eleonore Fröhlich
- Center for Medical Research, Medical University of Graz, 8010 Graz, Austria
| | - Richard Wahl
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, 72076 Tübingen, Germany
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de Lange P, Cioffi F, Senese R, Chiellini G. Editorial: Thyroid hormone and metabolites: central versus peripheral effects, volume II. Front Endocrinol (Lausanne) 2023; 14:1241233. [PMID: 37538789 PMCID: PMC10394093 DOI: 10.3389/fendo.2023.1241233] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Affiliation(s)
- Pieter de Lange
- Dipartimento di Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche, Università della Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Federica Cioffi
- Dipartimento di Scienze e Tecnologie, Università del Sannio, Benevento, Italy
| | - Rosalba Senese
- Dipartimento di Scienze e Tecnologie Ambientali, Biologiche e Farmaceutiche, Università della Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Grazia Chiellini
- Dipartimento di Patologia Chirurgica, Medica, Molecolare e dell’Area Critica, Università di Pisa, Pisa, Italy
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Zavros A, Andreou E, Aphamis G, Bogdanis GC, Sakkas GK, Roupa Z, Giannaki CD. The Effects of Zinc and Selenium Co-Supplementation on Resting Metabolic Rate, Thyroid Function, Physical Fitness, and Functional Capacity in Overweight and Obese People under a Hypocaloric Diet: A Randomized, Double-Blind, and Placebo-Controlled Trial. Nutrients 2023; 15:3133. [PMID: 37513551 PMCID: PMC10386647 DOI: 10.3390/nu15143133] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 06/19/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Evidence of the effectiveness of zinc (Zn) and selenium (Se) on resting metabolic rate (RMR) and physical function parameters in people with overweight and obesity is scarce, while the effects of zinc and selenium on thyroid function and body composition are still a topic of debate and controversy. The aim of this randomized, double-blind, and placebo-controlled trial was to examine the effects of a hypocaloric diet and Se-Zn co-supplementation on RMR, thyroid function, body composition, physical fitness, and functional capacity in overweight or obese individuals. Twenty-eight overweight-obese participants (mean BMI: 29.4 ± 4.7) were randomly allocated (1:1) to the supplementation group (n = 14, 31.1 ± 5.5 yrs, 9 females) and the placebo group (n = 14, 32.1 ± 4.8 yrs, 6 females). The participants received Zn (25 mg of zinc gluconate/day) and Se (200 mcg of L-selenomethionine/day) or placebo tablets containing starch for eight weeks. The participants of both groups followed a hypocaloric diet during the intervention. RMR, thyroid function, body composition, cardiorespiratory fitness (VO2max), and functional capacity (sit-to-stand tests, timed up-and-go test, and handgrip strength) were assessed before and after the intervention. A significant interaction was found between supplementation and time on RMR (p = 0.045), with the intervention group's RMR increasing from 1923 ± 440 to 2364 ± 410 kcal/day. On the other hand, no interaction between supplementation and time on the thyroid function was found (p > 0.05). Regarding the effects of Zn/Se co-administration on Se levels, a significant interaction between supplementation and time on Se levels was detected (p = 0.004). Specifically, the intervention group's Se serum levels were increased from 83.04 ± 13.59 to 119.40 ± 23.93 μg/L. However, Zn serum levels did not change over time (90.61 ± 23.23 to 89.58 ± 10.61 umol/L). Even though all body composition outcomes improved in the intervention group more than placebo at the second measurement, no supplement × time interaction was detected on body composition (p > 0.05). Cardiorespiratory fitness did not change over the intervention. Yet, a main effect of time was found for some functional capacity tests, with both groups improving similarly over the eight-week intervention period (p < 0.05). In contrast, a supplement x group interaction was found in the performance of the timed up-and-go test (TUG) (p = 0.010), with the supplementation group improving more. In conclusion, an eight-week intervention with Zn/Se co-supplementation combined with a hypocaloric diet increased the RMR, TUG performance, and Se levels in overweight and obese people. However, thyroid function, Zn levels, body composition, and the remaining outcomes of exercise performance remained unchanged.
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Affiliation(s)
- Antonis Zavros
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - George Aphamis
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
| | - Gregory C Bogdanis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 10679 Athens, Greece
| | - Giorgos K Sakkas
- Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece
| | - Zoe Roupa
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Christoforos D Giannaki
- Department of Life Sciences, University of Nicosia, Nicosia 2417, Cyprus
- Research Centre for Exercise and Nutrition (RECEN), Nicosia 2417, Cyprus
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Lejman-Larysz K, Golara A, Baranowska M, Kozłowski M, Guzik P, Szydłowska I, Nawrocka-Rutkowska J, Sowińska-Przepiera E, Cymbaluk-Płoska A, Brodowska A. Influence of Vitamin D on the Incidence of Metabolic Syndrome and Hormonal Balance in Patients with Polycystic Ovary Syndrome. Nutrients 2023; 15:2952. [PMID: 37447279 DOI: 10.3390/nu15132952] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 05/16/2023] [Revised: 06/21/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder that affects 8-13% of women of reproductive age. It is one of the most common causes of infertility and is associated with hyperandrogenism in the form of hirsutism and acne, non-ovulatory cycles, and characteristic ovarian morphology. The available research on serum vitamin D deficiency in patients with PCOS and the appropriateness of vitamin D supplementation in this group of women is inconclusive, so we decided to investigate the influence of vitamin D on the incidence of metabolic syndrome and hormonal balance in patients with polycystic ovary syndrome. The study comprised 120 women aged between 18 and 42 years, who were divided into two groups: a group with diagnosed polycystic ovary syndrome (PCOS) and a group of regularly menstruating women without features of androgenisation, in whom polycystic ovary syndrome was excluded. Each patient underwent a history and physical examination, including a gynecological examination, anthropometric measurements were taken, including height, weight, waist, and hip circumference, and blood pressure was measured using the Korotkow method. In the female patients, the following parameters were also determined from the blood: follicle-stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, TSH, ft4, prolactin (PRL), total testosterone, DHEASO4, 17-hydroxyprogesterone (17-OHP), sex-hormone-binding globulin (SHBG), androstendione, 25(OH) vitamin D3 metabolite. The majority of the patients with polycystic ovary syndrome were found to have deficient or suboptimal serum vitamin D levels, and the effects of vitamin D on the SHBG levels and free-androgen indices in these patients was examined. The effects of vitamin D on the incidence of metabolic syndrome and BMI, waist-to-hip ratio, waist circumference, and blood pressure in patients with polycystic ovary syndrome were also found.
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Affiliation(s)
- Katarzyna Lejman-Larysz
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Anna Golara
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Marta Baranowska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Mateusz Kozłowski
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Paweł Guzik
- Clinical Department of Gynecology and Obstetrics, City Hospital, 35-241 Rzeszów, Poland
| | - Iwona Szydłowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Jolanta Nawrocka-Rutkowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Elżbieta Sowińska-Przepiera
- Department of Endocrinology, Metabolic and Internal Diseases, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University in Szczecin, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Agnieszka Brodowska
- Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
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Meirelles-Cardoso TBBC, Slhessarenko N, Fontes CJF. Reference intervals for serum TSH concentrations of healthy children from the Central Region of Brazil. Arch Endocrinol Metab 2023; 67:e220499. [PMID: 37364157 PMCID: PMC10660994 DOI: 10.20945/2359-4292-2022-0499] [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: 12/12/2022] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
Objective The objective of this study was to determine the serum thyroid-stimulating hormone (TSH) concentration reference intervals (RIs) of healthy children aged 1 to 10 years of both sexes, living in the Central Region of Brazil. Subjects and methods 1,735 children [869 (50.1%) female; 866 (49.9%) male] enrolled in the morning shift of 47 pre- and 83 public elementary schools in the municipality of Cuiabá, Mato Grosso, were studied by gathering anthropometric and social data and their medical history. A blood sample was collected from each child to determine the TSH concentration using the electrochemiluminescence method on a Cobas® 6000 modular analyzer (Analyzer series, Roche Diagnostics). Results The RIs were determined using the 2.5 and 97.5 percentile and the mean ± 2 standard deviations methods. After identifying the homoscedastic groups by age and sex, outliers higher or lower than three standard deviations were excluded. The distribution of serum TSH concentrations showed no significant age or sex differences. Based on the percentile method, TSH RI ranged from 0.93 to 5.86 μIU/mL. Based on the mean ± 2 standard deviations, TSH RI ranged from 0.30 to 5.29 μIU/mL. Conclusion The normal serum TSH concentration of the Brazilian children evaluated in this study differ from those of populations from other countries. Other regional population studies may validate the RIs found in this study and enable its safer use in pediatric clinical practice.
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Affiliation(s)
- Tula Beatriz Brandão Caldas Meirelles-Cardoso
- Hospital Universitário Júlio Müller, Universidade Federal de Mato Grosso, Departamento de Clínica Médica, Cuiabá, MT, Brasil,
- Universidade de Cuiabá, Faculdade de Medicina, Cuiabá, MT, Brasil
| | - Natasha Slhessarenko
- Faculdade de Medicina, Universidade Federal de Mato Grosso, Departamento de Pediatria, Cuiabá, MT, Brasil
- Alta Excelência Diagnóstica (DASA), São Paulo, SP, Brasil
| | - Cor Jesus Fernandes Fontes
- Hospital Universitário Júlio Müller, Universidade Federal de Mato Grosso, Departamento de Clínica Médica, Cuiabá, MT, Brasil
- Centro Universitário de Várzea Grande (UNIVAG), Várzea Grande, MT, Brasil
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Meneghini V, Tebar WR, Souza Santos I, Silva Janovsky CCP, de Almeida-Pititto B, Lotufo PA, Goulart AC, Bensenor IM. Association between psoriasis and thyroid function: results from the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil). Arch Endocrinol Metab 2023; 67:e000640. [PMID: 37364143 PMCID: PMC10661003 DOI: 10.20945/2359-3997000000640] [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: 05/04/2022] [Accepted: 02/10/2023] [Indexed: 06/28/2023]
Abstract
Objective To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis.
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Affiliation(s)
- Vandrize Meneghini
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil,
| | - William R Tebar
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Itamar Souza Santos
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil
- Departamento de Medicina Interna, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | | | - Paulo A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil
- Departamento de Medicina Interna, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Alessandra C Goulart
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Isabela M Bensenor
- Centro de Pesquisa Clínica e Epidemiológica, Universidade de São Paulo, São Paulo, SP, Brasil
- Departamento de Medicina Interna, Universidade de São Paulo, São Paulo, SP, Brasil
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Gu Y, Song Z, Li Q, Wang J, Song Y, Meng G, Wu H, Zhang S, Wang X, Zhang J, Lu X, Liu Q, Huang T, Yang J, Niu K. Association of Thyroid-Stimulating Hormone With All-Cause Mortality: A 2-Sample Mendelian Randomization Study. J Clin Endocrinol Metab 2023; 108:e396-e403. [PMID: 36658102 DOI: 10.1210/clinem/dgad025] [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: 08/13/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/21/2023]
Abstract
CONTEXT Thyroid-stimulating hormone (TSH), as the most sensitive and specific marker of thyroid status, is associated with multiple health outcomes, including mortality. However, whether TSH levels are causally associated with the risk of mortality remains unclear. OBJECTIVE This study aims to investigate the causal association between TSH levels and all-cause mortality using Mendelian randomization (MR) analyses. METHODS MR analyses using single-nucleotide polymorphisms (SNPs) associated with TSH levels (P < 5 × 10-8) as instruments. Mortality data were obtained from the UK Biobank, including 384 344 participants who were recruited from 22 assessment centers across the UK taken between 2006 and 2010. Cox proportional hazards regression was used to estimate the association of the TSH genetic risk score (GRS) with all-cause and cause-specific mortality. RESULTS 15 557 individuals died during a median of 9.00 years of follow-up in the UK Biobank. A total of 70 SNPs were included in the MR analysis. The main MR analyses showed that 1 SD increase in TSH was associated with a decreased risk of all-cause mortality (OR 0.972, 95% CI 0.948-0.996), which may be largely attributed to respiratory disease mortality (OR 0.881, 95% CI 0.805-0.963). The multivariable hazard ratios (HRs) (95% CI) of all-cause mortality across 3 TSH GRS categories were 1.00 (reference), 0.976 (0.940-1.014), and 0.947 (0.911-0.985), respectively (P for trend < .01). Moreover, except digestive diseases mortality, genetically predicted TSH levels were negatively associated with mortality from CVD, cancer, noncancer diseases causes, and dementia, although not statistically significant. CONCLUSION Higher TSH levels were causally associated with lower risk of all-cause mortality, which may be largely attributed to respiratory disease mortality.
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Affiliation(s)
- Yeqing Gu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Zimin Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100817, China
| | - Qingkui Li
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Jinhan Wang
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Yanqi Song
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Hongmei Wu
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Shunming Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Juanjuan Zhang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xinran Lu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Qiang Liu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
| | - Tao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing 100817, China
| | - Jian Yang
- School of Life Sciences, Westlake University, Hangzhou 310024, China
- Westlake Laboratory of Life Sciences and Biomedicine, Westlake University, Hangzhou 310024, China
| | - Kaijun Niu
- Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300192, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
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Uto K, Bando H, Fukuoka H, Yamamoto M, Ogasahara A, Ono S, Oyabu C, Sato I, Imanishi T, Saegusa J, Ogawa W, Yano Y. Instability of harmonized thyroid-stimulating hormone immunoassays in clinical practice. Clin Endocrinol (Oxf) 2023. [PMID: 37278108 DOI: 10.1111/cen.14938] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/01/2023] [Accepted: 05/27/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Thyroid-stimulating hormone (TSH) harmonization is effective in minimizing differences between the results of immunoassays in healthy subjects. However, the effectiveness of TSH harmonization in clinical practice has not been investigated. The aim of this study was to evaluate the instability of TSH harmonization in clinical practice. METHODS We compared the reactivities of four harmonized TSH immunoassays using combined difference plots of 431 patients. We selected patients with statistically significant deviations in TSH levels and analyzed their thyroid hormone levels and clinical characteristics. RESULTS The combined difference plots showed that one harmonized TSH immunoassay exhibited markedly different reactivity even after TSH harmonization compared with the other three immunoassays. Among 109 patients with mild-to-moderate elevation of TSH levels, we selected 15 patients with statistically significant deviations in TSH levels according to the difference plots of three harmonized TSH immunoassays, excluding one immunoassay that showed different reactivity. The thyroid hormone levels of three patients were misclassified as hypothyroidism or normal due to deviating TSH levels. In terms of clinical characteristics, these patients were in poor nutritional status and general condition, possibly due to their severe illness (e.g., advanced metastatic cancer). CONCLUSION We have confirmed that TSH harmonization in clinical practice is relatively stable. However, some patients showed deviating TSH levels in the harmonized TSH immunoassays, indicating the need for caution, particularly in poorly nourished patients. This finding suggests the presence of factors that contribute to the instability of TSH harmonization in such cases. Further investigation is warranted to validate these results.
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Affiliation(s)
- Kenichi Uto
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Hironori Bando
- Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe, Japan
| | - Hidenori Fukuoka
- Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe, Japan
| | - Masaaki Yamamoto
- Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe, Japan
| | - Ayako Ogasahara
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Shoko Ono
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Chinami Oyabu
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Itsuko Sato
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Takamitsu Imanishi
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
| | - Jun Saegusa
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiko Yano
- Department of Clinical Laboratory, Kobe University Hospital, Kobe, Japan
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Doğru AG, Rehders M, Brix K. Investigations on Primary Cilia of Nthy-ori 3-1 Cells upon Cysteine Cathepsin Inhibition or Thyrotropin Stimulation. Int J Mol Sci 2023; 24:ijms24119292. [PMID: 37298246 DOI: 10.3390/ijms24119292] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/19/2023] [Accepted: 05/23/2023] [Indexed: 06/12/2023] Open
Abstract
In the thyroid gland, cysteine cathepsins are secreted upon thyrotropin stimulation for thyroglobulin processing, and they are present at the primary cilia of thyroid epithelial cells. Treatment with protease inhibitors resulted in the loss of cilia from rodent thyrocytes and caused redistribution of the thyroid co-regulating G protein-coupled receptor Taar1 to the endoplasmic reticulum. These findings suggest that ciliary cysteine cathepsins are important to maintain sensory and signaling properties for the proper regulation and homeostasis of thyroid follicles. Therefore, it is important to better understand how cilia structure and frequencies are maintained in human thyroid epithelial cells. Hence, we aimed to investigate the potential role of cysteine cathepsins for the maintenance of primary cilia in the normal human Nthy-ori 3-1 thyroid cell line. This was approached by determining cilia lengths and frequencies in cysteine peptidase inhibition conditions in Nthy-ori 3-1 cell cultures. Cilia lengths were shortened upon 5 h of cysteine peptidase inhibition with cell-impermeable E64. Likewise, cilia lengths and frequencies were decreased upon additional overnight treatment with the cysteine peptidase-targeting, activity-based probe DCG-04. The results suggest that cysteine cathepsin activity is required for the maintenance of the cellular protrusions not only in rodents, but also in human thyrocytes. Hence, thyrotropin stimulation was used to simulate physiological conditions that eventually lead to cathepsin-mediated thyroglobulin proteolysis, which is initiated in the thyroid follicle lumen. Immunoblotting revealed that thyrotropin stimulation conditions result in the secretion of little procathepsin L and some pro- and mature cathepsin S but no cathepsin B from the human Nthy-ori 3-1 cells. Unexpectedly, however, 24 h incubation periods with thyrotropin shortened the cilia although higher amounts of cysteine cathepsins were present in the conditioned media. These data point to the necessity of further studies to delineate which of the cysteine cathepsins plays the most prominent role in cilia shortening and/or elongation. Collectively, the results of our study provide corroboration for the hypothesis of thyroid autoregulation by local mechanisms that our group previously proposed.
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Affiliation(s)
- Alara Gaye Doğru
- School of Science, Constructor University, Campus Ring 1, D-28759 Bremen, Germany
| | - Maren Rehders
- School of Science, Constructor University, Campus Ring 1, D-28759 Bremen, Germany
| | - Klaudia Brix
- School of Science, Constructor University, Campus Ring 1, D-28759 Bremen, Germany
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48
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Zhang Y, Wang HL, Zhou CQ, He DH, Wu F, Li HC, Xie QR, Luo Y, Kong LR. Intraday Changes and Clinical Applications of Thyroid Function Biomarkers in Healthy Subjects. Lab Med 2023; 54:282-286. [PMID: 36222001 DOI: 10.1093/labmed/lmac105] [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] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE We evaluated the intraday changes of thyroid function biomarkers in healthy subjects to help clinicians diagnose thyroid diseases in appropriate timing. METHODS Blood samples were collected from 31 subjects at 0:00, 4:00, 8:00, 12:00, 16:00 and 20:00 on the sampling day and analyzed for thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4). The intraday concentration changes were analyzed using Friedman's 2-way analysis of variance by ranks. RESULTS The concentrations of TSH, T3, T4, FT3, and FT4 in males were significantly higher than those in females (P < .01). The obvious peak circadian rhythm of TSH was observed at 0:00 AM with gradual decline thereafter, whereas other biomarkers showed no rhythmic changes. CONCLUSION Sex differences should be considered in interpreting thyroid function tests. It is important to select the sampling time according to the clinician's diagnostic needs, especially at night when TSH secretion peaks.
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Affiliation(s)
- Yan Zhang
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Hua-Li Wang
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Chao-Qiong Zhou
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Da-Hai He
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Feng Wu
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Hong-Chuan Li
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Qian-Rong Xie
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Yu Luo
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
| | - Li-Rui Kong
- Department of Clinical Laboratory, Traditional Chinese Medicine Hospital of the Pidu District, Chengdu, China
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Wang B, Zhang J, Zhang D, Lu C, Liu H, Gao Q, Niu T, Yin M, Cui S. Casein Kinase 1α as a Novel Factor Affects Thyrotropin Synthesis via PKC/ERK/CREB Signaling. Int J Mol Sci 2023; 24:7034. [PMID: 37108197 PMCID: PMC10138882 DOI: 10.3390/ijms24087034] [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] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Casein kinase 1α (CK1α) is present in multiple cellular organelles and plays various roles in regulating neuroendocrine metabolism. Herein, we investigated the underlying function and mechanisms of CK1α-regulated thyrotropin (thyroid-stimulating hormone (TSH)) synthesis in a murine model. Immunohistochemistry and immunofluorescence staining were performed to detect CK1α expression in murine pituitary tissue and its localization to specific cell types. Tshb mRNA expression in anterior pituitary was detected using real-time and radioimmunoassay techniques after CK1α activity was promoted and inhibited in vivo and in vitro. Relationships among TRH/L-T4, CK1α, and TSH were analyzed with TRH and L-T4 treatment, as well as thyroidectomy, in vivo. In mice, CK1α was expressed at higher levels in the pituitary gland tissue than in the thyroid, adrenal gland, or liver. However, inhibiting endogenous CK1α activity in the anterior pituitary and primary pituitary cells significantly increased TSH expression and attenuated the inhibitory effect of L-T4 on TSH. In contrast, CK1α activation weakened TSH stimulation by thyrotropin-releasing hormone (TRH) by suppressing protein kinase C (PKC)/extracellular signal-regulated kinase (ERK)/cAMP response element binding (CREB) signaling. CK1α, as a negative regulator, mediates TRH and L-T4 upstream signaling by targeting PKC, thus affecting TSH expression and downregulating ERK1/2 phosphorylation and CREB transcriptional activity.
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Affiliation(s)
- Bingjie Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Jinglin Zhang
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
| | - Di Zhang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
| | - Chenyang Lu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Hui Liu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Qiao Gao
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
| | - Tongjuan Niu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Mengqing Yin
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Sheng Cui
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
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Li W, He Q, Zhang H, Shu S, Wang L, Wu Y, Yuan Z, Zhou J. Thyroid-stimulating hormone within the normal reference range has a U-shaped association with the severity of coronary artery disease in nondiabetic patients but is diluted in diabetic patients. J Investig Med 2023; 71:350-360. [PMID: 36680358 DOI: 10.1177/10815589221149187] [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] [Indexed: 01/22/2023]
Abstract
Too high or too low thyroid-stimulating hormone (TSH) has been associated with the progress and prognosis of coronary artery disease (CAD). However, whether TSH within its normal reference range plays a role in the severity of CAD remains unclear. In this observational study, we explored the potential relationship of hypersensitive TSH (hs-TSH) with the severity of CAD in euthyroid patients with or without diabetes mellitus. A total of 7357 CAD patients with euthyroidism were enrolled in this study. Of those, 1997 had diabetes mellitus. The severity of CAD was evaluated through the presence of myocardial infarction (MI) and the severity of coronary lesions, which was calculated using the Gensini score (GS). Logistic regression models treating hs-TSH as a categorical variable and restricted cubic spline analyses treating it as a continuous variable were used to evaluate the associations of hs-TSH with the severity of CAD. The propensity score matching method was used to further validate the differences between diabetic and nondiabetic patients. CAD patients with diabetes mellitus had lower levels of hs-TSH (1.6 (0.97-2.53) vs 1.67 (1.00-2.64)) in serum compared with CAD patients without diabetes mellitus. Meanwhile, hs-TSH was independently related to the severity of CAD. In CAD patients with vs without diabetes mellitus, the U-shaped relationship between hs-TSH and MI was more prominent in patients without diabetes mellitus, and the significant U-shaped association between higher GS and hs-TSH remained only in nondiabetes. Therefore, hs-TSH within the normal reference range has a U-shaped association with the severity of CAD in nondiabetic patients, which is markedly diluted in diabetic patients.
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Affiliation(s)
- Wenyuan Li
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qingyuan He
- Department of Endocrinology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Haoxuan Zhang
- Department of Bioengineering, Southwest Jiaotong University, Chengdu, Sichuan, China
- Department of Biological Science, Georgia State University, Atlanta, GA, USA
| | - Shan Shu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lijun Wang
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Wu
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zuyi Yuan
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, Shaanxi, China
| | - Juan Zhou
- Department of Cardiovascular Medicine, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
- Key Laboratory of Molecular Cardiology of Shannxi Province, Xi'an, Shaanxi, China
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