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1.
Thyroid ; 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34806437

RESUMO

BACKGROUND: Despite the implementation of the universal salt iodization (USI) program for correction of iodine deficiency in China for about 20 years, the actual iodine nutrition status of Chinese residents and the prevalence of iodine deficiency and iodine excess are issues that need to be addressed. This nationally representative cross-sectional study was conducted across all 31 provinces of mainland China to gather extensive data on iodine nutrition status and the influential factors. METHODS: This study included 78,470 participants, aged 18 years or older, who were interviewed and asked to answer a questionnaire. Urine iodine concentration (UIC) was measured by the inductively coupled plasma mass spectrometry method, and goiter was examined by thyroid ultrasonography. In addition, sixty 9 -11 years old school-children in each province were randomly selected to evaluate the UIC and thyroid ultrasonography. The iodine nutrition status was determined according to the WHO guidelines. RESULTS: The iodized salt coverage was 95.37%. The median urine iodine (MUI) was 177.89 µg/L (interquartile range [IQR], 117.89-263.90 µg/L) and goiter prevalence was 1.17% (95% CI, 0.95-1.43%) in the adult population. The MUI was 199.75 µg/L (IQR, 128.41-303.37 µg/L) in school-age children, and goiter prevalence was 3.50% (95% CI, 2.93-4.13%). The percentage of individuals with UIC < 50 µg/L was 3.43%, less than 20%. Analysis indicated that sex, age, geographic factors, BMI, smoking habits influence the iodine nutrition level. CONCLUSION: The mandatory USI program has successfully eliminated iodine deficiency disorders, and the findings indicate that the iodine nutrition level in the general population is within the safe range.

2.
Endocrinol Metab (Seoul) ; 36(4): 778-789, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34372624

RESUMO

BACKGROUND: Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. METHODS: Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. RESULTS: The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. CONCLUSION: The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.

3.
Front Endocrinol (Lausanne) ; 12: 651534, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34122333

RESUMO

Background: Universal salt iodization (USI) was implemented in mainland China in 1996. The prevalence of hyperthyroidism and its risk factors now require examination. Methods: Data were acquired from a nationwide Thyroid, Iodine, and Diabetes Epidemiological survey (TIDE 2015-2017) of 78,470 subjects from 31 provinces. Iodine status, and thyroid hormones and antibodies were measured. Results: After two decades of USI, the prevalence of overt hyperthyroidism (OH), Graves' disease (GD), severe subclinical hyperthyroidism (severe SCH), and mild subclinical hyperthyroidism (mild SCH) in mainland China was 0.78%, 0.53%, 0.22%, and 0.22%, respectively. OH and GD prevalence were higher in women than in men (OH: 1.16% vs. 0.64%, P<0.001; GD: 0.65% vs. 0.37%, P<0.001).Prevalence was significantly decreased after 60 years-of-age compared with 30-39 years-of-age (OH:0.61% vs. 0.81%, P<0.001; GD: 0.38% vs. 0.57%, P<0.001).Excessive iodine(EI) and deficient iodine(DI) were both related to increased prevalence of OH (odds ratio [OR] 2.09, 95% confidence interval [CI] 1.68-2.59; OR1.35, 95%CI 1.07-1.72, respectively); however, only deficient iodine was associated with increased prevalence of GD (OR1.67, 95%CI 1.30-2.15). Increased thyroid peroxidase antibody and thyroglobulin antibody levels were significantly associated with prevalence of OH and GD, but not severe SCH and mild SCH. Although hyperthyroidism was more prevalent in women, the association disappeared after adjusting for other factors such as antibody levels. Conclusion: OH and GD prevalences in mainland China are stable after two decades of USI. Iodine deficiency, elevated thyroid antibody levels, and middle age are the main risk factors for OH and GD. The severe SCH population, rather than the mild SCH population, shows similar characteristics to the OH population.

4.
Thyroid ; 31(4): 563-571, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33138723

RESUMO

Background: Malnutrition in early life may permanently change the structure and function of the body, which lead to a number of diseases in adulthood. The effect of famine exposure during the early life on thyroid function and disorders remains unclear. This study investigated the association between exposure to the Great Chinese Famine (1959-1961) in early life and thyroid function and disorders in adulthood. Methods: Nine thousand eight hundred eighty-one subjects with appropriate birth dates derived from the Thyroid disorders, Iodine status, and Diabetes Epidemiological survey were included. Thyroid function and disorders were defined by the test results of blood sample and ultrasonography of all participants. Associations between famine exposure in early life and thyroid function and disorders in adulthood were assessed with binary logistic regression and linear regression. Results: Participants exposed to the Great Chinese Famine during the fetal stage was associated with a higher thyrotropin (TSH) level in adulthood (ß = 0.024; p = 0.038), compared with the nonexposed participants. The association was significant among rural participants (ß = 0.039; p = 0.02) but not in urban participants (ß = 0.005; p = 0.77). Fetal-exposed group did not show a higher risk of thyroid disorders than the age-matched balanced control group, including overt hyperthyroidism, subclinical hyperthyroidism, overt hypothyroidism, subclinical hypothyroidism, autoimmune thyroiditis, and thyroid nodules (p > 0.05). Conclusions: Famine exposure during the fetal stage was associated with a higher TSH level in adulthood. The fetal stage could be the critical period for programming the pituitary-thyroid axis.

5.
Thyroid ; 30(12): 1810-1819, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32762331

RESUMO

Background: Subclinical hypothyroidism is diagnosed based on serum thyrotropin (TSH) reference intervals, which in turn are affected by many factors. Methods: Data were acquired from a Chinese nationally representative cross-sectional study of 78,470 participants (TIDE study). The total study population were participants from the TIDE program, and the reference population was a subset of the total population defined by the National Academy of Clinical Biochemistry (NACB) guidelines. Serum concentrations of thyroid hormones, TSH, thyroid antibodies, and urine iodine concentration (UIC) were measured. Results: The geometric mean serum TSH (2.5th-97.5th) for the reference population (defined by the NACB) and total population was 2.28 mIU/L (0.74-7.04 mIU/L) and 2.34 mIU/L (0.61-8.33 mIU/L), respectively. In the reference population, increase in UIC was significantly associated with increase in the 50th and 97.5th centiles and decrease in the 2.5th centile of TSH. The median TSH was significantly higher in women than in men (2.41 mIU/L vs. 2.16 mIU/L, p-value <0.001). Increased age was significantly associated with an increased TSH, 97.5th centile. For each 10-year increase in the population age, the TSH 97.5th centile increased by 0.534 mIU/L. The prevalence of subclinical hypothyroidism diagnosed according to the assay-recommended interval (Roche 0.27-4.2 mIU/L) and NACB standard interval in the TIDE study (0.74-7.04 mIU/L) differed significantly (Roche 13.61% vs. TIDE 3.00%, p < 0.05). However, there was no significant difference in future cardiovascular disease, reflected by the Framingham risk score, between the 0.27-4.2 and 4.2-7.04 mIU/L TSH groups. Conclusions: Serum TSH concentration significantly increased with increase in iodine intake. Thus, iodine intake must be considered in establishing TSH reference intervals. To avoid overdiagnosis and overtreatment of subclinical hypothyroidism, different areas should use individual serum TSH reference intervals.

6.
Thyroid ; 30(11): 1656-1665, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32586221

RESUMO

Background: Iodine intake is associated with thyroid autoimmunity. In this study, we evaluated the changes in thyroid autoimmunity after 20 years of universal salt iodization (USI) in China. Methods: A total of 78,470 subjects (18 years or older) from 31 provincial regions of mainland China participated in the study. Serum thyroid peroxidase antibody (TPOAb), thyroglobulin antibody (TgAb), TSH receptor antibody, thyrotropin (TSH), and urinary iodine concentration (UIC) were measured. Results: Positive TPOAb and TgAb were detected in 10.19% [CI 9.80-10.59] and 9.70% [CI 9.28-10.13] of the subjects, respectively. The prevalence of positive isolated TPOAb (i-TPOAb), positive isolated TgAb (i-TgAb), and double positive TPOAb and TgAb (d-Ab) was 4.52%, 4.16%, and 5.94%, respectively. The prevalence of thyroid antibody positivity was the highest in the iodine-deficient (UIC <100 µg/L) groups. The prevalence of i-TPOAb was inversely associated with more than adequate iodine intake (MAI) and excessive iodine intake (EI); the odds ratio (OR) was 0.89 [CI 0.81-0.98] for MAI and 0.90 [CI 0.81-0.99] for EI. We observed that i-TgAb, like i-TPOAb, was a high-risk factor for subnormal TSH levels (OR = 3.64 [CI 2.62-5.05]) and elevated TSH levels (OR = 1.62 [CI 1.49-1.77]). The prevalence of thyroid antibody positivity varied among five ethnic groups. Conclusions: After two decades of USI, the prevalence of thyroid antibody positivity has remained low. MAI and EI had an inverse relationship with TPOAb positivity, which reveals that UIC between 100 and 299 µg/L is optimal and safe for thyroid autoimmunity. These conclusions need to be confirmed in a follow-up study because this study was a cross-sectional study.

7.
Artigo em Inglês | MEDLINE | ID: mdl-32256451

RESUMO

Purpose: The expressions of antibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb) are very common in the sera of patients with autoimmune thyroid diseases (AITD). The relationship between thyroid autoantibodies and the occurrence of glucose and lipid metabolic disorders remains unclear. This study was performed to investigate the correlation between the presence of serum TPOAb/TgAb and those metabolic disorders in euthyroid general population. Methods: The data of this study were derived from the Thyroid Disease, Iodine status, and Diabetes National epidemiological (TIDE) survey from all 31 provinces of mainland China. A total of 17,964 euthyroid subjects including 5,802 males (4,000 with TPOAb-TgAb- and 1,802 with TPOAb+/TgAb+) and 12,162 females (8,000 with TPOAb-TgAb- and 4,162 with TPOAb+/TgAb+) were enrolled in this study. The blood glucose and lipid levels were compared between individuals with TPOAb-TgAb- and those with TPOAb+TgAb-, TPOAb-TgAb+, TPOAb+TgAb+. Results: Both fasting blood glucose (FBG) concentration and the proportion of individuals with impaired FBG (IFG) showed the decreased trends in TPOAb-TgAb+ males as compared with TPOAb-TgAb- men. There were significantly lower FBG and higher HDL-C levels as well as tendencies toward decreased incidences of IGT and hypertriglyceridemia in TPOAb-TgAb+ females when compared with TPOAb-TgAb- women. Binary logistic regression analysis further showed that serum TgAb single positivity in males was an independent protective factor for IFG with an OR of 0.691 (95% CI, 0.503-0.949). For females, serum TgAb single positivity was an independent protective factor for hypertriglyceridemia with an OR of 0.859 (95% CI, 0.748-0.987). Trend test showed that with the increase of serum TgAb level, there were significant decreases in the prevalence of IFG among the men with TSH ≤ 2.5 mIU/L and that of hypertriglyceridemia in the women, especially among non-obese females. Conclusion: Serum TgAb single positivity may imply a reduced risk of IFG in euthyroid men and that of hypertriglyceridemia in euthyroid women. The mechanisms for the independent protective roles of TgAb await further investigation.


Assuntos
Autoanticorpos/sangue , Transtornos do Metabolismo de Glucose/epidemiologia , Transtornos do Metabolismo dos Lipídeos/epidemiologia , Tireoglobulina/imunologia , Adulto , Autoanticorpos/análise , Autoantígenos/imunologia , China/epidemiologia , Feminino , Transtornos do Metabolismo de Glucose/sangue , Humanos , Incidência , Iodeto Peroxidase/imunologia , Iodo/análise , Iodo/sangue , Proteínas de Ligação ao Ferro/imunologia , Transtornos do Metabolismo dos Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Estudos Soroepidemiológicos , Inquéritos e Questionários , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/epidemiologia , Glândula Tireoide/fisiologia
8.
BMJ ; 369: m997, 2020 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-32345662

RESUMO

OBJECTIVE: To assess the prevalence of diabetes and its risk factors. DESIGN: Population based, cross sectional study. SETTING: 31 provinces in mainland China with nationally representative cross sectional data from 2015 to 2017. PARTICIPANTS: 75 880 participants aged 18 and older-a nationally representative sample of the mainland Chinese population. MAIN OUTCOME MEASURES: Prevalence of diabetes among adults living in China, and the prevalence by sex, regions, and ethnic groups, estimated by the 2018 American Diabetes Association (ADA) and the World Health Organization diagnostic criteria. Demographic characteristics, lifestyle, and history of disease were recorded by participants on a questionnaire. Anthropometric and clinical assessments were made of serum concentrations of fasting plasma glucose (one measurement), two hour plasma glucose, and glycated haemoglobin (HbA1c). RESULTS: The weighted prevalence of total diabetes (n=9772), self-reported diabetes (n=4464), newly diagnosed diabetes (n=5308), and prediabetes (n=27 230) diagnosed by the ADA criteria were 12.8% (95% confidence interval 12.0% to 13.6%), 6.0% (5.4% to 6.7%), 6.8% (6.1% to 7.4%), and 35.2% (33.5% to 37.0%), respectively, among adults living in China. The weighted prevalence of total diabetes was higher among adults aged 50 and older and among men. The prevalence of total diabetes in 31 provinces ranged from 6.2% in Guizhou to 19.9% in Inner Mongolia. Han ethnicity had the highest prevalence of diabetes (12.8%) and Hui ethnicity had the lowest (6.3%) among five investigated ethnicities. The weighted prevalence of total diabetes (n=8385) using the WHO criteria was 11.2% (95% confidence interval 10.5% to 11.9%). CONCLUSION: The prevalence of diabetes has increased slightly from 2007 to 2017 among adults living in China. The findings indicate that diabetes is an important public health problem in China.


Assuntos
Diabetes Mellitus/epidemiologia , Intolerância à Glucose/epidemiologia , Estado Pré-Diabético/epidemiologia , Adolescente , Adulto , Idoso , Glicemia/metabolismo , China/epidemiologia , Estudos Transversais , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/metabolismo , Jejum , Feminino , Intolerância à Glucose/diagnóstico , Intolerância à Glucose/metabolismo , Teste de Tolerância a Glucose , Hemoglobina A Glicada/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/diagnóstico , Estado Pré-Diabético/metabolismo , Prevalência , Sociedades Médicas , Organização Mundial da Saúde , Adulto Jovem
9.
Endocr Pract ; 2020 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-32339031

RESUMO

OBJECTIVES: Studies have shown that metabolic abnormalities influence the immune system. Because the prevalence of metabolic and autoimmune thyroid diseases has increased synchronously, the correlation between them was worth exploring. The study objective was to investigate the relationship between metabolic disorders and thyroid autoantibodies in euthyroid subjects. METHODS: Data were obtained from a TIDE project survey of 55,891 subjects from 31 provinces in China. The body mass index(BMI), waist circumference(WC), blood pressure(BP), TPOAb, TgAb, TSH, UIC, blood glucose, lipid profile, uric acid(UA) levels were evaluated. FT4 and FT3 levels were measured in patients with abnormal serum TSH levels. RESULTS: In males, the BMI, WC, SBP, DBP, and OGTT2hPG of the TPOAb/TgAb-positive groups were significantly higher than those of the TPOAb/TgAb-negative groups. In females, the BMI, WC, SBP, DBP, TC, and LDL-C in the TPOAb/TgAb-positive groups were significantly increased compared to those in the TPOAb/TgAb-negative groups. Multivariate analysis showed that, in males, the OR of positive TgAb in the abdominal obesity group was 1.175 (95% CI 1.016-1.359, P for difference= 0.03), and the OR of positive TPOAb in the hyperuricemia group was 1.195 (95% CI 1.041-1.372, P for difference = 0.011). In females, the OR of positive TgAb was 1.19 (95% Cl 1.068-1.326, P for difference= 0.002) in the high LDL-C group. CONCLUSIONS: Obesity, high LDL-C and hyperuricemia were positively correlated with the prevalence of positive thyroid autoantibodies in euthyroid subjects in a gender-dependent manner. Summary This cross-sectional survey showed that metabolic disorders are associated with increased positive thyroid autoantibody levels in euthyroid subjects in a gender-dependent manner.

10.
Thyroid ; 30(7): 1053-1065, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32188373

RESUMO

Background: Iodine is important in both thyroid function and human metabolism. Studies have explored the effect of iodine on metabolic disorders through thyroid function. This study aimed to investigate the relationship between iodine status and metabolic disorders, such as metabolic syndrome (MetS), hypertension, impaired glucose metabolism, central obesity, and dyslipidemia. Methods: A total of 51,795 subjects aged ≥18 years from the TIDE (Thyroid Disorders, Iodine Status and Diabetes, a national epidemiological cross-sectional study) program were included. The prevalence of metabolic disorders and its related diseases was calculated based on the level of urinary iodine concentrations (UICs) using the chi-square method. To further explore whether the prevalence was associated with UIC, quadratic and UIC-stratified logistic regression models were used. Results: The prevalence of metabolic disorders as a function of UIC was found to be U-shaped with a lower prevalence of 76.0% at an UIC of 300-499 µg/L. Participants with an UIC of 300-499 µg/L showed an association with metabolic disorders (odds ratio [OR] = 0.857, 95% confidence interval [CI 0.796-0.922]) and hypertension (OR = 0.873 [CI 0.814-0.936]). An UIC of 300-799 µg/L was found to be associated with the occurrence of MetS and impaired glucose tolerance. An UIC of 500-799 µg/L was associated with the occurrence of prediabetes (OR = 0.883 [CI 0.797-0.978]). An UIC of ≥300 µg/L was associated with the occurrence of hypertriglyceridemia, hypercholesterolemia, and high levels of low-density lipoprotein cholesterol. Furthermore, an UIC of <100 µg/L showed an association with hypertension (OR = 1.097 [CI 1.035-1.162]) and hypercholesterolemia (OR = 1.178 [CI 1.117-1.242]). Conclusions: The association between UICs in adults and metabolic disorders and its related diseases is U-shaped. The association between UIC and metabolic disorders disappears in cases of iodine deficiency (<100 µg/L) or excess (≥500 µg/L).


Assuntos
Iodo/urina , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/urina , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/metabolismo , China/epidemiologia , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/sangue , Dislipidemias/epidemiologia , Dislipidemias/urina , Feminino , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/urina , Masculino , Doenças Metabólicas/sangue , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/urina , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Adulto Jovem
11.
Thyroid ; 30(4): 568-579, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32075540

RESUMO

Background: Mandatory universal salt iodization (USI) has been implemented in China for 20 years. Although iodine deficiency disorders are effectively controlled, the risk of excess iodine have been debated. Methods: A nationally representative cross-sectional study with 78,470 enrolled participants, aged 18 years or older, from all 31 provincial regions of mainland China was performed. The participants were given a questionnaire and underwent B-mode ultrasonography of the thyroid. Serum concentrations of thyroid hormones, thyroid antibodies, and urine iodine concentration (UIC) were measured. Results: The median UIC of the adult population was 177.89 µg/L. The weighted prevalence of thyroid disorders in adults were as follows: 0.78% of overt hyperthyroidism, 0.44% of subclinical hyperthyroidism, 0.53% of Graves' disease, 1.02% of overt hypothyroidism, 12.93% of subclinical hypothyroidism, 14.19% of positive thyroid antibodies, 10.19% of positive thyroid peroxidase antibodies, 9.70% of positive thyroglobulin antibodies, 1.17% of goiter, and 20.43% of thyroid nodules. Iodine excess was only associated with higher odds of overt hyperthyroidism and subclinical hypothyroidism, while iodine deficiency was significantly associated with higher odds of most thyroid disorders. In addition, increased iodine intake was significantly associated with elevated serum thyrotropin levels but was inversely associated with thyroid antibodies and thyroid nodules. Conclusions: The long-term mandatory USI program with timely adjustments is successful in preventing iodine deficiency disorders, and it appears to be safe. The benefits outweigh the risks in a population with a stable median iodine intake level of up to 300 µg/L.


Assuntos
Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Iodo/deficiência , Cloreto de Sódio na Dieta/administração & dosagem , Glândula Tireoide/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Hipertireoidismo/diagnóstico por imagem , Hipertireoidismo/prevenção & controle , Hipotireoidismo/diagnóstico por imagem , Hipotireoidismo/prevenção & controle , Iodo/administração & dosagem , Iodo/efeitos adversos , Masculino , Pessoa de Meia-Idade , Prevalência , Cloreto de Sódio na Dieta/efeitos adversos , Ultrassonografia , Adulto Jovem
12.
Eur J Nutr ; 59(8): 3659-3668, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32078063

RESUMO

BACKGROUND AND AIMS: Iodine is one of the most important trace elements in the human body. It is not only the main component of thyroid hormones but also has extrathyroid biological functions. To date, there have been no large-scale epidemiological studies on the relationship between hyperuricemia and iodine intake, although both are closely related to health. A population-based epidemiological survey in China offers such an opportunity. METHODS: This population-based cross-sectional study recruited 75,653 adults aged ≥ 18 years from 2015 to 2017 with a randomized, multistage, stratified sampling strategy. Serum uric acid levels and urinary iodine concentrations (UICs) were measured. RESULTS: Stratified by UIC, the prevalence of hyperuricemia was 17.8%, 18.8%, 16.0% and 13.7% in the UIC < 100, 100-199, 200-299, and ≥ 300 µg/L groups, respectively; the prevalence of gout was 4.0%, 3.4%, 2.4% and 1.7%, respectively. The prevalence of gout decreased significantly as the UIC increased. The prevalence of hyperuricemia and gout were markedly higher in postmenopausal females than in the premenopausal population (hyperuricemia: 15.9% vs. 8.3%, X2 = 520.072, p < 0.001; gout: 3.6% vs. 1.3%, X2 = 219.889, p < 0.001), and the prevalence decreased as the UIC increased. Subjects in the more than adequate and excessive iodine groups had lower likelihoods of having hyperuricemia [aOR = 0.81 (95% CI 0.77-0.85), aOR = 0.68 (95% CI 0.64-0.72)] and lower odds of having gout than subjects in the adequate iodine (AI) group [aOR = 0.77 (95% CI 0.68-0.86), aOR = 0.59 (95% CI 0.51-0.68)]. CONCLUSIONS: UIC was inversely associated with the occurrence of hyperuricemia and gout. More in-depth research and prospective studies are needed to explore the molecular mechanisms and confirm the observed association.


Assuntos
Gota , Hiperuricemia , Iodo , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Gota/epidemiologia , Humanos , Hiperuricemia/epidemiologia , Prevalência , Estudos Prospectivos , Ácido Úrico
13.
Endocr Pract ; 26(8): 869-882, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33471678

RESUMO

OBJECTIVE: Studies have shown that metabolic abnormalities influence the immune system. Because the prevalence of metabolic and autoimmune thyroid diseases has increased synchronously, the correlation between them was worth exploring. The study objective was to investigate the relationship between metabolic disorders and thyroid auto-antibodies in euthyroid subjects. METHODS: Data were obtained from the Thyroid Diseases and Diabetes Mellitus project survey of 55,891 subjects from 31 provinces in China. The body mass index (BMI), waist circumference (WC), blood pressure, thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibodies (TgAbs), thyroid-stimulating hormone (TSH), urinary iodine concentration, blood glucose, lipid profile, and uric acid levels were evaluated. Free thyroxine and free triiodothyronine levels were measured in patients with abnormal serum TSH levels. RESULTS: In males, the BMI, WC, systolic blood pressure (SBP), diastolic blood pressure (DBP), and 2-hour post-glucose oral glucose tolerance test results of the TPOAb-/TgAb-positive group were significantly higher than those of the TPOAb-/TgAb-negative group. In females, the BMI, WC, SBP, DBP, total cholesterol, and low-density-lipoprotein cholesterol (LDL-C) in the TPOAb-/TgAb-positive group were significantly increased compared to the TPOAb-/TgAb-negative group. Multivariate analysis showed that in males, the odds ratio (OR) of positive TgAbs in the abdominal obesity group was 1.175 (95% confidence interval [CI], 1.016 to 1.359; P = .03), and the OR of positive TPOAbs in the hyperuricemia group was 1.195 (95% CI, 1.041 to 1.372; P = .011). In females, the OR of positive TgAbs was 1.19 (95% CI, 1.068 to 1.326; P = .002) in the high LDL-C group. CONCLUSION: Obesity, high LDL-C, and hyperuricemia were positively correlated with the prevalence of positive thyroid autoantibodies in euthyroid subjects in a gender-dependent manner. This cross-sectional survey showed that metabolic disorders are associated with increased positive thyroid autoantibody levels in euthyroid subjects in a gender-dependent manner. ABBREVIATIONS: AIT = autoimmune thyroiditis; BMI = body mass index; CI = confidence interval; DBP = diastolic blood pressure; FPG = fasting plasma glucose; FT3 = free triiodothyronine; FT4 = free thyroxine; HbA1c = glycated hemoglobin; HDL-C = high-density-lipoprotein cholesterol; LDL-C = low-density-lipoprotein cholesterol; OGTT2hPG = oral glucose tolerance test 2-hours post-glucose; OR = odds ratio; SBP = systolic blood pressure; TC = total cholesterol; TG = triglycerides; TgAb = thyroglobulin antibody; TPOAb = thyroid peroxidase antibody; TSH = thyroid-stimulating hormone; UA = uric acid; WC = waist circumference.


Assuntos
Doenças Metabólicas , Tireotropina , Autoanticorpos , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Doenças Metabólicas/epidemiologia , Testes de Função Tireóidea
14.
Exp Ther Med ; 14(3): 2671-2676, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28947919

RESUMO

The aim of the present study was to investigate the protective effect of the glucagon-like peptide-1 receptor agonist exendin-4 on the interleukin (IL)-1ß-induced impairment of glucose-stimulated insulin secretion (GSIS) in ß-TC-6 cells. ß-TC-6 cells were pretreated with various concentrations of IL-1ß (0.15, 1.5 or 15 ng/ml) and exendin-4 (0.1 or 1 mM). Exendin-4 was administered to ß-TC-6 cells prior to, during and following pretreatment. Cells were stimulated with various concentrations of glucose (0, 1.38, 5.5 and 11.1 mM), and insulin was measured via radioimmunoassay of the supernatant; furthermore, western blot analysis was used to detect phosphorylated extracellular receptor kinase (ERK)1/2. The insulin levels (151.08±14.34 µIU/ml) and ERK1/2 phosphorylation in ß-TC-6 cells peaked in response to 1.38 mM glucose stimulation compared with 0, 5.5 and 11.1 mM glucose stimulation. IL-1ß inhibited GSIS in a dose-dependent manner: Insulin levels were 83.76±1.16 µIU/ml when 0.15 ng/ml IL-1ß was added under GSIS, 59.46±3.20 µIU/ml when 1.5 ng/ml IL-1ß was added under GSIS, and 56.98±1.19 µIU/ml when 15 ng/ml IL-1ß was added under GSIS. Exendin-4 exerted a protective effect against IL-1ß-induced GSIS inhibition in a dose-dependent manner. The greatest protective effect was observed when exendin-4 was added prior to IL-1ß pretreatment, which was statistically significant (P<0.05). These findings suggested that exendin-4 was able to reverse the IL-1ß-induced inhibition of ERK1/2 phosphorylation and serves a protective role by impairing GSIS induced by IL-1ß in ß-TC-6 cells. This mechanism may be associated with the recovery of ERK1/2 activation.

15.
Kaohsiung J Med Sci ; 33(5): 224-228, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28433068

RESUMO

Glucose-stimulated insulin secretion (GSIS) is one of the important physiological characteristics of islet ß cells, and extracellular-regulated protein kinase 1/2 (ERK1/2) is an important member of the mitogen-activated protein kinase family that regulates this process. The inflammatory cytokine interleukin (IL)-1ß can inhibit the insulin secretion of pancreatic ß cells, but the exact mechanism is unclear. This study was designed to investigate the inhibitory effect of IL-1ß on GSIS in ßTC-6 cells and its relation with the ERK1/2 signal transduction pathway. ß-TC6 cells were cultured and stimulated with 0mM, 1.38mM, or 5.5mM glucose. In addition, GSIS in ß-TC6 cells was blocked by IL-1ß at concentrations of 0.15 ng/mL, 1.5 ng/mL, and 15 ng/mL. After glucose stimulation and IL-1ß intervention, the insulin level in the cell supernatant was detected by radioimmunoassay, and the phosphorylation level of ERK1/2 was detected by western blotting assay. The insulin level in the 1.38mM glucose group was 108.52 ± 5.94 uIU/mL, which was significantly higher than the 0mM and 5.5mM glucose groups (p < 0.05). Compared with the 0mM glucose group, the level of ERK1/2 phosphorylation was increased in the 1.38mM and 5.5mM glucose groups. After intervention by 0.15 ng/mL, 1.5 ng/mL, and 15 ng/mL IL-1ß, the level of ERK1/2 phosphorylation induced by 1.38mM glucose stimulation decreased in a dose-dependent manner, and the insulin level correspondingly decreased. IL-1ß can inhibit GSIS in ßTC-6 cells, which is related to its inhibition of the phosphorylation of ERK1/2.


Assuntos
Glucose/farmacologia , Insulina/metabolismo , Interleucina-1beta/farmacologia , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Animais , Linhagem Celular , Secreção de Insulina , Camundongos , Fosforilação/efeitos dos fármacos , Radioimunoensaio , Transdução de Sinais/efeitos dos fármacos
16.
Mol Med Rep ; 13(5): 4451-4, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27035884

RESUMO

The present study aimed to investigate the role of the extracellular signal-regulated kinase (ERK)1/2 signal transduction pathway in glucose­stimulated insulin secretion in ß­TC6 mouse pancreatic cells. Insulin production by ß­TC6 cells was stimulated with various concentrations of glucose, which was dose-dependently inhibited by mitogen­activated protein kinase inhibitor PD98059, as indicated by a radioimmunoassay. Furthermore, glucose stimulation enhanced the phosphorylation of ERK1/2, which was dose-dependently inhibited by PD98059, as indicated by western blot analysis. These results indicated that the activation of the ERK1/2 signal transduction pathway may have an important role in glucose­stimulated insulin secretion in ß­TC6 cells.


Assuntos
Glucose/farmacologia , Insulina/metabolismo , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Pâncreas/metabolismo , Animais , Linhagem Celular , Flavonoides/farmacologia , Secreção de Insulina , Sistema de Sinalização das MAP Quinases/fisiologia , Camundongos , Proteína Quinase 3 Ativada por Mitógeno/antagonistas & inibidores , Pâncreas/citologia , Fosforilação/efeitos dos fármacos , Fosforilação/fisiologia
17.
J Clin Endocrinol Metab ; 100(6): 2449-55, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25825944

RESUMO

CONTEXT: Gonadotropin therapy using a human chorionic gonadotropin (hCG) and FSH preparation is an effective regimen in inducing masculinization and spermatogenesis in men with idiopathic hypogonadotropic hypogonadism (IHH). However, the high cost of medication and frequent injections affect compliance. OBJECTIVE: The aim of this study was to determine the efficacy of sequential use of highly purified urinary FSH (uFSH)/hCG in men with IHH. DESIGN AND SETTING: A randomized, open-label, prospective, controlled noninferiority trial with an 18-month follow-up was conducted in 9 tertiary hospitals. PATIENTS AND INTERVENTION: A total of 67 Chinese men with IHH were randomly allocated into group A receiving continual uFSH (75 U, 3 times a week) and hCG (2000 U, twice a week) injection and group B receiving sequential uFSH (75 U, 3 times a week every other 3 months) and hCG (2000 U, twice a week) injection. MAIN OUTCOME MEASURE: The primary outcome was the proportion of subjects with a sperm concentration of ≥ 1.0 × 10(6)/mL during the 18 months. The efficacy between groups A and B was compared for noninferiority. RESULTS: Of the patients, 17/33 (51.5%) receiving continual uFSH/hCG and 19/34 (55.9%) receiving sequential uFSH/hCG achieved sperm concentrations of ≥ 1.0 × 10(6)/mL. The efficacy in the sequential uFSH/hCG group was not inferior to that in the continual uFSH/hCG group (noninferiority, P = .008) by intention-to-treat analysis. CONCLUSIONS: The efficacy of the sequential uFSH/hCG regimen is not inferior to that of the continual uFSH/hCG regimen in inducing spermatogenesis and masculinization of patients with IHH.


Assuntos
Gonadotropina Coriônica/administração & dosagem , Hipogonadismo/tratamento farmacológico , Urofolitropina/administração & dosagem , Adolescente , Adulto , Gonadotropina Coriônica/isolamento & purificação , Gonadotropina Coriônica/urina , Esquema de Medicação , Quimioterapia Combinada , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Contagem de Espermatozoides , Espermatogênese/efeitos dos fármacos , Testículo/efeitos dos fármacos , Urofolitropina/isolamento & purificação , Adulto Jovem
18.
Zhonghua Yi Xue Za Zhi ; 89(16): 1117-21, 2009 Apr 28.
Artigo em Chinês | MEDLINE | ID: mdl-19595144

RESUMO

OBJECTIVE: To investigate insulin secretion function and insulin resistance in Chinese newly diagnosed type 2 diabetes (obese and non-obese patients) in order to provide evidence for clinical treatment. METHODS: 408 newly diagnosed type 2 diabetes and 40 normal controls were recruited. Height, weight were measured, insulin and glucose of 0 min, 30 min, 60 min, 120 min during oral glucose tolerance test were examined. The patients with fasting glucose level greater than 8.3mmol/L were treatment with Gliclazide for 1 - 3 months. After normalization of the plasma glucose levels for more than 2 weeks, and withdraw this medication for 48 hours, then OGTT were repeated to assess IR and IS. RESULTS: The patients were divided into four groups based on fasting plasma glucose (DM1: FPG < 6.9mmol/L; DM2: 6.9 mmol/L < or = FPG < 8.3 mmol/L; DM3: 8.3 mmol/L < or = FPG < 9.7 mmol/L; DM4: FPG > or = 9.7 mmol/L). Every groups were further stratified to subgroups by cut point of BMI = 24 kg/m(2). Their insulin sensitivity and insulin secretion function compared between subgroups. (1) True insulin level in BMI > or = 24 (FPG < 6.9 mmol/L) subgroups were higher than control's (3.5 +/- 0.5 vs 3.2 +/- 0.6 natural logarithm) (P < 0.05). (2) In BMI > or = 24 subgroups, their insulin sensitivity were even worse than BMI < 24 groups', but their insulin secretion function were better at the same FPG level. (3) After intervention, the change of insulin sensitivity in BMI < 24 group was better than BMI > or = 24 group's (-4.7 +/- 0.9 vs -5.5 +/- 1.4 natural logarithm) (P < 0.05); but the change of insulin secretion function in BMI < 24 group was worse. CONCLUSION: (1) In newly diagnostic type 2 diabetes, insulin sensitivity and insulin secretion function were decreased with the increase of FPG, but they were different between obese and non-obese group. (2) Insulin secretion function was recovered better in obese group when eliminated glucose toxicity.


Assuntos
Índice de Massa Corporal , Diabetes Mellitus Tipo 2/diagnóstico , Resistência à Insulina , Insulina/metabolismo , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatologia , Feminino , Teste de Tolerância a Glucose , Humanos , Secreção de Insulina , Masculino , Pessoa de Meia-Idade , Adulto Jovem
19.
Zhonghua Fu Chan Ke Za Zhi ; 39(9): 586-90, 2004 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-15498183

RESUMO

OBJECTIVE: To investigate the effects of metformin and clomiphene on infertility caused by polycystic ovary syndrome (PCOS) with insulin-resistance (IR) and to observe the effects of metformin on PCOS with pseudoacanthosis nigricans (AN) and IR. METHODS: Seventy infertility patients caused by PCOS with IR were randomly divided into three groups : patients in group Aa (n = 20) took metformin 500 mg only, three times daily for 3 months; patients in group Ab (n = 20) took clomiphene 50 mg only, once daily from the 5th day of menstrual cycle or withdrawal bleeding for 5 days and 3 cycles, and patients in group Ac (n = 30) were treated by metformin and clomiphene for 3 cycles, with the same dosages as groups Aa and Ab. Thirty patients who suffered from PCOS with AN and IR were served as group B, They took metformin only, the same as group Aa. The following indexes were measured before and after three months or cycles of treatment in all the patients: body height, weight, waistline, hipline, body mass index (BMI), waist hip ratio (WHR), fasting insulin (FINS), fasting blood-glucose (FBG), total cholesterol (TC), triglyceride (TG), and sex hormones [follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL), estradiol (E(2)), progestin (P), testosterone (T)]. RESULTS: The pregnant rate was 15% (group Aa), 20% (group Ab), and 57% (group Ac) respectively. It was significantly higher in group Ac than in groups Aa and Ab, (P < 0.01), while there was no significant difference between the latter two groups (P > 0.05). In group Ac the pretreatment levels of FINS, BMI, T, TG, and TC were (49.7 +/- 6.4) mU/L, 29.4 +/- 2.2, (6.4 +/- 2.2) nmol/L, (4.1 +/- 1.0) mmol/L, (6.3 +/- 0.5) mmol/L, and posttreatment levels were (27.7 +/- 1.8) mU/L, 23.6 +/- 5.2, (3.8 +/- 2.0) nmol/L, (2.2 +/- 0.7) mmol/L, (4.6 +/- 0.5) mmol/L. In group Aa pretreatment levels of FINS, BMI, T, TG, and TC were (50.0 +/- 8.2) mU/L, 28.7 +/- 1.2, (6.4 +/- 2.0) nmol/L, (4.3 +/- 1.2) mmol/L, (6.6 +/- 0.3) mmol/L, and posttreatment levels were (29.9 +/- 8.2) mU/L, 22.4 +/- 9.3, (4.3 +/- 0.9) nmol/L, (2.3 +/- 0.3) mmol/L, (4.8 +/- 0.6) mmol/L. In group B pretreatment levels of FINS, BMI, T, TG, and TC were (51.0 +/- 8.1) mU/L, 29.8 +/- 3.1, (6.3 +/- 3.5) nmol/L, (4.5 +/- 1.2) mmol/L, (6.8 +/- 0.2) mmol/L, and posttreatment levels were (28.5 +/- 2.8) mU/L, 23.4 +/- 6.1, (3.0 +/- 0.9) nmol/L, (2.3 +/- 0.9) mmol/L, (5.0 +/- 0.6) mmol/L. In groups Ac, Aa and B, the IR condition was obviously improved and posttreatment serum levels of T, TG, TC, FINS and BMI were significantly lower than those of pretreatment (all P < 0.01). In group Ab pretreatment levels of FINS, BMI, T, TG, and TC were (48.8 +/- 7.4) mU/L, 27.3 +/- 2.8, (6.0 +/- 2.0) nmol/L, (3.9 +/- 1.4) mmol/L, (6.4 +/- 0.6) mmol/L, and posttreatment levels were (42.9 +/- 7.0) mU/L, 27.5 +/- 3.1, (4.0 +/- 2.4) nmol/L, (3.9 +/- 0.3) mmol/L, (5.9 +/- 0.3) mmol/L, (all P > 0.05). Among patients in group B, 90% (27/30) menstrual condition and ovulation function were improved and AN was reduced in different degree after three months' treatment. CONCLUSION: Metformin can increase the sensitivity of PCOS to clomiphene and improve ovulation function of clomiphene. Metformin plus clomiphene is an effective way of treating infertility caused by PCOS with IR.


Assuntos
Resistência à Insulina , Ovulação/efeitos dos fármacos , Síndrome do Ovário Policístico/tratamento farmacológico , Adulto , Índice de Massa Corporal , Clomifeno/administração & dosagem , Quimioterapia Combinada , Feminino , Humanos , Metformina/administração & dosagem , Gravidez , Resultado do Tratamento
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