Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.862
Filtrar
1.
Heart Fail Clin ; 16(1): 1-9, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735307

RESUMO

The effects of hyperthyroidism and hypothyroidism on the heart and cardiovascular system are well documented. It has also been shown that various forms of heart disease including but not limited to congenital, hypertensive, ischemic, cardiac surgery, and heart transplantation cause an alteration in thyroid function tests including a decrease in serum liothyronine (T3). This article discusses the basic science and clinical data that support the hypothesis that these changes pose pathophysiologic and potential novel therapeutic challenges.


Assuntos
Insuficiência Cardíaca/complicações , Doenças da Glândula Tireoide/etiologia , Hormônios Tireóideos/sangue , Biomarcadores/sangue , Ecocardiografia , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/diagnóstico , Humanos , Lipoproteínas/sangue , Índice de Gravidade de Doença , Doenças da Glândula Tireoide/sangue
2.
Diabetes Metab Syndr ; 13(4): 2513-2517, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405670

RESUMO

OBJECTIVE: It is usually difficult to clinically identify thyroid abnormalities in diabetics as features of thyroid dysfunction may simulate diabetes symptoms or complications. So, assessing thyroid dysfunction prevalence in patients with type 2 diabetes mellitus (DM) would help better control of DM and its complications. Several studies reported this prevalence, however, some included small sample size or lacked a control group. We aimed to determine thyroid dysfunction prevalence in diabetic patients as well as its relation to glycemic control. METHODS: A cross-sectional study included 200 patients having type 2 DM and 200 apparently healthy controls. Each participant was tested for fasting and 2-h post-prandial blood glucose, glycated haemoglobin (HbA1C), thyroid function tests: thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), free thyroxine (FT4), serum total cholesterol and triglycerides and thyroid antibodies; anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) for hypothyroidism only. RESULTS: There was a significant increase in serum TSH and T3 levels in diabetics when compared with the controls, (P < 0.001, P = 0.001), respectively. Thyroid dysfunction was significantly more prevalent in patients with HbA1c ≥ 8%, (P = 0.0001), and in those having longer diabetes duration, (P < 0.001). CONCLUSION: There was a higher prevalence of thyroid dysfunction among patients with type 2 DM. This dysfunction increased with the rise of HbA1c. This could suggest that poor glycemic control may have a role in the development of thyroid dysfunction in type 2 DM patients. Subclinical hypothyroidism was the most prevalent type of thyroid dysfunction in diabetic patients.


Assuntos
Biomarcadores/sangue , Diabetes Mellitus Tipo 2/complicações , Hemoglobina A Glicada/análise , Doenças da Glândula Tireoide/epidemiologia , Hormônios Tireóideos/sangue , Glicemia/análise , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Índice Glicêmico , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/etiologia , Testes de Função Tireóidea
3.
Orv Hetil ; 160(35): 1376-1379, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31448641

RESUMO

Introduction: Recent experiments and clinical studies indicate the contribution of thyroid hormones to prostate pathology. Aim: In our retrospective analyzis of university patient population, we evaluated the association between thyroid stimulatory hormone (TSH) and prostate specific antigen (PSA). Method: From the Laboratory Information System we retrieved the data of male patients between 40 and 75 years of age who had been subjected to simultaneous TSH and PSA measurements during the last 12 years (n = 7279). The association between logTSH and logPSA levels was tested with multiple regression analysis and adjusted for age. Results: Significant associations between logPSA and logTSH and age (r = 0.297 and 0.472, respectively) were detected. PSA levels were higher in patients with TSH below (n = 405) than in those with TSH within reference range (TSH 0,35-4,95 mU/ml) (n = 6698) (PSA level: 1.118 [0.639-2.338] vs. 0.920 [0.508-1.826] ng/ml, p<0.016). Based on estimates, a 10% decrease in TSH is associated with a 0.42% increase in PSA levels in our population. This corresponds to a 42% increase in PSA levels in the same patient if he would present with 0.2 mU/ml instead of 2.0 mU/ml TSH. Conclusion: The finding that hyperthyreosis might be associated with higher PSA levels indicates that PSA reference ranges would differ in hyperthyreotic and in euthyreotic patients. Probably the PSA clinical decision limits is also recommended to be modified according to the patient's thyroid status. Orv Hetil. 2019; 160(35): 1376-1379.


Assuntos
Antígeno Prostático Específico/sangue , Doenças da Glândula Tireoide/sangue , Glândula Tireoide/fisiologia , Tireotropina/sangue , Adulto , Fatores Etários , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Doenças da Glândula Tireoide/diagnóstico
4.
JAMA ; 322(7): 632-641, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31429897

RESUMO

Importance: Maternal hypothyroidism and hyperthyroidism are risk factors for preterm birth. Milder thyroid function test abnormalities and thyroid autoimmunity are more prevalent, but it remains controversial if these are associated with preterm birth. Objective: To study if maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth. Data Sources and Study Selection: Studies were identified through a search of the Ovid MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and Google Scholar databases from inception to March 18, 2018, and by publishing open invitations in relevant journals. Data sets from published and unpublished prospective cohort studies with data on thyroid function tests (thyrotropin [often referred to as thyroid-stimulating hormone or TSH] and free thyroxine [FT4] concentrations) or thyroid peroxidase (TPO) antibody measurements and gestational age at birth were screened for eligibility by 2 independent reviewers. Studies in which participants received treatment based on abnormal thyroid function tests were excluded. Data Extraction and Synthesis: The primary authors provided individual participant data that were analyzed using mixed-effects models. Main Outcomes and Measures: The primary outcome was preterm birth (<37 weeks' gestational age). Results: From 2526 published reports, 35 cohorts were invited to participate. After the addition of 5 unpublished data sets, a total of 19 cohorts were included. The study population included 47 045 pregnant women (mean age, 29 years; median gestational age at blood sampling, 12.9 weeks), of whom 1234 (3.1%) had subclinical hypothyroidism (increased thyrotropin concentration with normal FT4 concentration), 904 (2.2%) had isolated hypothyroxinemia (decreased FT4 concentration with normal thyrotropin concentration), and 3043 (7.5%) were TPO antibody positive; 2357 (5.0%) had a preterm birth. The risk of preterm birth was higher for women with subclinical hypothyroidism than euthyroid women (6.1% vs 5.0%, respectively; absolute risk difference, 1.4% [95% CI, 0%-3.2%]; odds ratio [OR], 1.29 [95% CI, 1.01-1.64]). Among women with isolated hypothyroxinemia, the risk of preterm birth was 7.1% vs 5.0% in euthyroid women (absolute risk difference, 2.3% [95% CI, 0.6%-4.5%]; OR, 1.46 [95% CI, 1.12-1.90]). In continuous analyses, each 1-SD higher maternal thyrotropin concentration was associated with a higher risk of preterm birth (absolute risk difference, 0.2% [95% CI, 0%-0.4%] per 1 SD; OR, 1.04 [95% CI, 1.00-1.09] per 1 SD). Thyroid peroxidase antibody-positive women had a higher risk of preterm birth vs TPO antibody-negative women (6.6% vs 4.9%, respectively; absolute risk difference, 1.6% [95% CI, 0.7%-2.8%]; OR, 1.33 [95% CI, 1.15-1.56]). Conclusions and Relevance: Among pregnant women without overt thyroid disease, subclinical hypothyroidism, isolated hypothyroxinemia, and TPO antibody positivity were significantly associated with higher risk of preterm birth. These results provide insights toward optimizing clinical decision-making strategies that should consider the potential harms and benefits of screening programs and levothyroxine treatment during pregnancy.


Assuntos
Doenças Autoimunes/diagnóstico , Iodeto Peroxidase/imunologia , Complicações na Gravidez/diagnóstico , Nascimento Prematuro/etiologia , Doenças da Glândula Tireoide/diagnóstico , Testes de Função Tireóidea , Adulto , Autoanticorpos/sangue , Doenças Autoimunes/sangue , Doenças Autoimunes/complicações , Feminino , Idade Gestacional , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/diagnóstico , Recém-Nascido , Gravidez , Complicações na Gravidez/sangue , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/complicações , Tireotropina/sangue , Tiroxina/sangue
5.
BMC Endocr Disord ; 19(1): 83, 2019 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-31362731

RESUMO

BACKGROUND: Thyroid dysfunction is one of the prevalent endocrine disorders. The relationship between lifestyle factors and thyroid dysfunction was not clear and some of the factors seemed paradoxical. METHODS: We conducted this population-based study using data from 5154 She ethnic minority people who had entered into the epidemic survey of diabetes between July 2007 to September 2009. Life style information was collected using a standard questionnaire. Body mass index (BMI), Blood pressure and serum TSH, TPOAb, triglycerides (TG), total cholesterol (TC) and high-density lipoprotein cholesterol (HDL) were collected. RESULTS: The study showed that people who drank, had higher education or suffered from insomnia have lower incidence of hyperthyroidism. On the other hand, smoking, alcohol consumption, exercise, undergoing weight watch and chronic headache were associated with decreased incidence of hypothyroidism. Using multivariable logistic regression analysis, we found that alcohol consumption was associated with decreased probability of hyperthyroidism, hypothyroidism, as well as positive TPOAb. The amounts of cigarettes smoked daily displayed a positive correlation with hyperthyroidism among smokers. Accordingly, smoking seemed to be associated with decreased risk for hypothyroidism and positive TPOAb. Exercise and maintaining a healthy weight might have a beneficial effect on thyroid health. Interestingly, daily staple amount showed an inverse correlation with incidence of positive TPOAb. CONCLUSIONS: Within the Chinese She ethnic minority, we found associations between different lifestyle factors and the incidence of different thyroid diseases. Understanding the nature of these associations requires further investigations.


Assuntos
Grupos Étnicos/estatística & dados numéricos , Estilo de Vida , Grupos Minoritários/estatística & dados numéricos , Doenças da Glândula Tireoide/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , China/epidemiologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Doenças da Glândula Tireoide/sangue , Adulto Jovem
6.
Endokrynol Pol ; 70(3): 271-276, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31290558

RESUMO

Obesity-related changes in the composition of the body interfere with the proper functioning of the thyrotropic axis, leading to its disturbances and changes in the structure of the thyroid gland. Distinguishing what is related to obesity and what constitutes pathological changes is crucial for the proper treatment of patients. In this paper authors present a case of a patient with a diet-induced obesity, whose only abnormalities in thyroid assessment included an elevated level of thyroid stimulating hormone (TSH) and hypoechoic thyroid gland on ultrasound. Based on this clinical situation, we reviewed literature in order to establish rules regarding management of thyroid disorders in obese individuals. The most common obesity-related thyroid abnormality is an isolated increase of TSH, without clinical symptoms of hypothyroidism, defined as hyperthyrotropinaemia. In obese adults, autoimmune thyroid disease is found equally often as in the normal-weight population. Thyroid enlargement, increased risk of nodules, and decreased echogenicity, not related to autoimmunity, is frequent among obese individuals. Weight loss leads to the normalisation of TSH levels and thyroid echogenicity. Excessive weight can influence both the TSH level and ultrasound image of the thyroid gland; however, these findings can be reversed by weight reduction. Therefore, in asymptomatic obese patients elevated TSH should not be treated with thyroid hormone replacement.


Assuntos
Obesidade/terapia , Doenças da Glândula Tireoide/terapia , Cirurgia Bariátrica , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/cirurgia , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/etiologia , Doenças da Glândula Tireoide/cirurgia , Tireotropina/sangue , Perda de Peso
7.
BMC Endocr Disord ; 19(1): 47, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064360

RESUMO

BACKGROUND: Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite alternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions and ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones, thyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age specific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran Thyroid Study (TTS). METHODS: Reproductive age women(n = 775) without any thyroid disease or ovarian dysfunction were selected from the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1, the lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone (TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits. RESULTS: At baseline, there was no statistically significant difference in thyroid hormones between women of the four quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in all quartiles (p < 0.05), whereas TPO Ab increased in Q1 (p = 0.02). Odds ratio of overall TPO Ab positivity in women of Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01). CONCLUSION: Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this antibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of hypothyroidism over time.


Assuntos
Autoimunidade/fisiologia , Infertilidade Feminina/prevenção & controle , Reserva Ovariana/fisiologia , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/imunologia , Hormônios Tireóideos/sangue , Adulto , Biomarcadores/análise , Feminino , Seguimentos , Humanos , Incidência , Infertilidade Feminina/sangue , Irã (Geográfico)/epidemiologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Gravidez , Prognóstico , Doenças da Glândula Tireoide/epidemiologia , Adulto Jovem
8.
Arch Endocrinol Metab ; 63(4): 351-357, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31038589

RESUMO

OBJECTIVE: In this study, we aimed to describe the prevalence and distribution of positive antithyroperoxidase antibodies (TPOAb) according to sex, age strata, and presence of thyroid dysfunction using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). MATERIALS AND METHODS: Thyroid hormone tests were obtained from each study participant at baseline. Levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured using a third-generation immunoenzymatic assay. Antithyroperoxidase antibodies were measured by electrochemiluminescence and were considered to be positive when ≥ 34 IU/mL. RESULTS: The prevalence of TPOAb among 13,503 study participants was 12%. Of participants with positive TPOAb, 69% were women. Almost 60% of the individuals with positive TPOAb were white. The presence of positive TPOAb was associated with the entire spectrum of thyroid diseases among women, but only with overt hyperthyroidism and overt hypothyroidism in men. CONCLUSION: The distribution of positive TPOAb across sex, race, age, and thyroid function in the ELSA-Brasil study is aligned with the worldwide prevalence of positive TPOAb reported in iodine-sufficient areas. In women, the presence of TPOAb was related to the entire spectrum of thyroid dysfunction, while in men, it was only related to the occurrence of overt thyroid disease.


Assuntos
Anticorpos/sangue , Iodeto Peroxidase/sangue , Doenças da Glândula Tireoide/epidemiologia , Adulto , Distribuição por Idade , Idoso , Índice de Massa Corporal , Brasil/epidemiologia , Brasil/etnologia , Estudos Transversais , Grupo com Ancestrais do Continente Europeu/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição por Sexo , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Tiroxina/sangue
10.
J Pediatr Endocrinol Metab ; 32(6): 597-606, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31112508

RESUMO

Background For several decades, transient hypothyroxinemia of prematurity (THOP) has been a topic of debate. The pathophysiology is incompletely understood and consensus on the therapeutic approach is lacking. This study aimed at gaining a better insight into the pathogenesis by studying the trends in thyroid hormone (TH) levels during the first week of life. Methods This single-center prospective observational study analyzed the plasma levels of total thyroxine (T4) and free thyroxine (fT4), total triiodothyronine (T3), thyroid-stimulating hormone (TSH) and T4-binding globulin (TBG) in cord blood and at the end of the first week of life in 120 preterm infants (gestational age [GA] <37 weeks). The change over time was calculated (delta, ∆). The impact of perinatal and subsequently postnatal variables on ∆ was studied by hierarchical multiple regression. The impact of ∆ on the neurodevelopmental outcome at the corrected ages of 9 and 24 months, measured by the Bayley Scales of Infant Development (BSID)-II, was assessed by logistic regression. Results ∆fT4 levels were negatively affected by GA and use of dopamine, whereas only GA was associated with low ∆T3 levels. Negative ∆fT4 levels were present in 75% of the extremely low-for-gestational-age infants, whereas 23.5% had a negative ∆T3 level. There was an increased risk for an abnormal mental developmental score (<85) with decreasing ∆T3 at 9 months, corrected age, but not at 24 months. Conclusions A negative evolution in circulating TH levels is principally an immaturity phenomenon, whereas dopamine can further suppress the hypothalamic-pituitary-thyroid axis. There is at least a temporary negative effect of this evolution on the infants' neurodevelopment.


Assuntos
Biomarcadores/sangue , Doenças do Prematuro/fisiopatologia , Recém-Nascido Prematuro/crescimento & desenvolvimento , Transtornos do Neurodesenvolvimento/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Hormônios Tireóideos/sangue , Bélgica/epidemiologia , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido Prematuro/sangue , Masculino , Transtornos do Neurodesenvolvimento/sangue , Transtornos do Neurodesenvolvimento/diagnóstico , Prognóstico , Estudos Prospectivos , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/diagnóstico , Testes de Função Tireóidea
11.
Kidney Blood Press Res ; 44(2): 170-178, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31013508

RESUMO

CONTEXT: Patients with chronic kidney disease (CKD) usually manifest with disorder of thyroid hormone; however, the correlation is unknown. OBJECTIVE: The study was designed to explore the relationships between CKD and thyroid dysfunction. DESIGN, SETTING, AND PARTICIPANTS: A total number of 905 non-dialysis participants were collected at Nanjing First Hospital from August 2009 to October 2012 according to the case records system. Patients were grouped via the estimated glomerular filtration rate (eGFR) according to the KDIGO guideline. Levels of thyroid hormone and biomarkers in different CKD groups were compared by ANOVA. Prevalence of different thyroid diseases was calculated by χ2 test. RESULTS: We found that FT3 or T3 became more prevalent with increasing eGFR with the lowest level in CKD5 (p < 0.01). No significant differences were found between groups in FT4, T4, or TSH (p > 0.05). Frequency of euthyroid sick syndrome (ESS) in CKD groups was high, especially in CKD stage 5 (69.1%, p < 0.01). eGFR had positive correlation with T3 and FT3 (r = 0.239, p = 0.0001; r = 0.292, p = 0.0001). ESS had correlations with prealbumin, ß2-microglobin, eGFR, and C-reactive protein (r = 0.095, p = 0.004; r = -0.12, p = 0.001; r = 0.091, p = 0.007; r = -0.096, p = 0.008; r = 0.154, p = 0.001). After adjustment for prealbumin, uric acid, HbA1c, age, gender, eGFR, and ß2-microglobin, binary regression revealed that hemoglobin, C-reactive protein, and albumin were independent influence factors of ESS (p = 0.016, r = 1.014; p = 0.023, r = 1.007; p = 0.029, r = 0.996). CONCLUSION: CKD patients have a high morbidity of ESS, mainly low T3 syndrome. Anemia, inflammation, and malnutrition may contribute to ESS in CKD.


Assuntos
Insuficiência Renal Crônica/sangue , Doenças da Glândula Tireoide/sangue , Adulto , Idoso , Biomarcadores/sangue , Síndromes do Eutireóideo Doente/diagnóstico , Feminino , Taxa de Filtração Glomerular , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Insuficiência Renal Crônica/classificação , Hormônios Tireóideos/sangue , Tri-Iodotironina/deficiência
12.
J Pediatr Endocrinol Metab ; 32(4): 355-361, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-30903759

RESUMO

Background Zinc transporter 8 autoantibodies (ZnT8Abs) together with glutamic acid decarboxylase autoantibodies (GADAbs), insulinoma antigen 2 autoantibodies (IA-2Abs) and insulin autoantibodies (IAbs) are markers of type 1 diabetes mellitus (T1DM). We studied the prevalence of ZnT8Ab in children with autoimmune thyroid diseases (AITDs) to assess the association of AITDs and T1DM at the serological level. Methods The study groups consisted of 44 children with Graves' disease (GD), 65 children with Hashimoto's thyroiditis (HT), 199 children with T1DM with or without AITDs and 58 control children. ZnT8Ab, GADAb, IA-2Ab, IAb, 21-hydroxylase autoantibodies (21-OHAbs) and acetylcholine receptor autoantibodies (AChRAbs) were measured. Results ZnT8Abs were found in 4/44 (9.1%) patients with GD, and 4/44 (9.1%) patients with GD were positive for GADAb. Of the 65 HT patients, six (9.2%) were positive for ZnT8Ab, while four (6.2%) were positive for GADAb. In the T1DM group, 128/199 (64%) of the patients were positive for ZnT8Ab, 133/199 (67%) for GADAb and 109/199 (55%) for IA-2Ab. One GD patient and one HT patient were positive for all the four diabetes-associated autoantibodies. Two HT patients were positive for three diabetes autoantibodies. Two GD (4.5%) and five HT (7.7%) patients were positive for 21-OHAb only. None of the patients had AChRAb. In the control group, 2/58 (3.4%) were positive for GADAb and 2/58 (3.4%) were positive for ZnT8Ab. Conclusions Diabetes-associated autoantibodies including ZnT8Ab were found in children and adolescents with GD and HT.


Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/complicações , Biomarcadores/sangue , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/etiologia , Doenças da Glândula Tireoide/complicações , Transportador 8 de Zinco/imunologia , Adolescente , Autoanticorpos/imunologia , Doenças Autoimunes/sangue , Doenças Autoimunes/imunologia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/imunologia
13.
Anal Bioanal Chem ; 411(8): 1659-1670, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30707263

RESUMO

Multielemental analysis of whole blood can provide significant information for the evaluation of nutritional status and diagnosis of certain diseases as well as for the assessment of exposure to potentially toxic metals. However, the quantification of multiple elements in whole blood is not easy partly because of the wide variation in element concentrations (from ng L-1 to g L-1) and the complex matrix. The aim of this work was to develop a fast, sustainable, and reliable analytical method, in combination with low-power TXRF, for multielemental analysis of blood samples. Firstly, a set of experiments were carried out to select the best diluent type and dilution factor using the control material SeronormTM Trace Elements Whole Blood L-1. A critical evaluation of the parameters affecting the sample deposition on the reflector was also carried out including a study of the shape and element distribution of the deposited residue on the reflector by micro X-ray fluorescence spectrometry. Using the best analytical conditions, limits of detection estimated were in the low milligrams per kilogram range and similar to those obtained using more complex sample treatments such as digestion. Accuracy and precision of the results were in most cases acceptable (recoveries 89-102%, RSD 6-8%, n = 5). Only underestimated values were obtained for light elements such as potassium. To prove the applicability of the method, several blood samples from control and thyroid disease patients were analyzed. Despite the fact that more samples need to be analyzed, it seems that Zn and Br contents in some of the patients are significantly higher compared to control samples. Graphical abstract.


Assuntos
Análise Química do Sangue/métodos , Espectrometria por Raios X/métodos , Doenças da Glândula Tireoide/sangue , Adulto , Idoso , Elementos , Humanos , Pessoa de Meia-Idade , Doenças da Glândula Tireoide/diagnóstico , Glândula Tireoide/patologia
14.
Eur J Obstet Gynecol Reprod Biol ; 234: 207-212, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30731333

RESUMO

OBJECTIVE: To study the effects of long-acting gonadotropin-releasing hormone agonist (GnRH-a) on thyroid function in euthyroid patients of in vitro fertilization (IVF)/ intracytoplasmic sperm injection of embryo transfer (ICSI-ET) and to investigate the timing and alteration of thyroid stimulating hormone (TSH) during controlled ovarian stimulation(COS). MATERIALS AND METHODS: Euthyroid patients scheduled for IVF/ICSI were enrolled. Euthyroidism was defined as having no history of hypothyroidism with normal TSH before IVF. Long GnRH-a protocol was chosen as COS protocol. 207 patients were divided into two groups based on basal serum TSH level: group A with 0.35mIU/L<TSH<2.5mIU/L (n = 137) and group B with 2.5mIU/L ≤ TSH<4.5mIU/L (n = 70). Serum TSH was tested on 6 time points: before COS (2-5days in menstrual cycle, before GnRH-a injection), Gn injection day 1, Gn injection day 5, human chorionic gonadotropin (HCG) day, 14 and 28 days after transplantation. The serum TSH, clinical pregnancy and abortion rate were investigated. RESULT: The serum TSH value was significantly (P < 0.05) increased after injection of long-acting GnRH-a in all patients. Both groups had significant (P < 0.05) increases in serum TSH level after long-acting GnRH-a injection. The TSH level was increased in 131(63.3%) patients after GnRH-a injection, of which twenty (9.7%) had subclinical hypothyroidism with TSH level over 4.5 mIU/L. The other 76 (36.7%) patients had decreased TSH. In group A, 79 (57.7%) patients showed an increase of TSH, including three patients (2.2%) with simultaneous rise of TPOAb and four (2.9%) diagnosed of subclinical hypothyroidism with TSH level over 4.5 mIU/L, and the rest fifty-eight (42.3%) patients had decreased TSH with one patient with elevated TPOAb who was diagnosed with subclinical hyperthyroidism. In group B, fifty-two (74.3%) patients showed an increase of TSH, including thirteen (18.6%) patients with elevated TPOAb and sixteen (22.9%) patients diagnosed of subclinical hypothyroidism with TSH level over 4.5 mIU/L, and the rest eighteen (25.7%) patients had decreased TSH with one patient diagnosed with subclinical hyperthyroidism. Group B had a significant higher proportion of patients with elevated serum TSH than group A (P < 0.05). Compared to the baseline level, serum TSH ascended distinctly and reached peak level on HCG day in all patients. Group A and B had similar trends of alteration. Patients in group A had significantly (P<0.05) higher clinical pregnancy rate than in group B. No significant (P>0.05) difference in abortion rate were observed between the two groups. CONCLUSION: GnRH-a can significantly increase serum TSH levels with possible development of subclinical thyroid dysfunction. Infertile patients with serum TSH > 2.5 mIU/L are more susceptible to GnRH-a while patients with basal TSH less than 2.5 mIU/L may get a higher clinical pregnancy rate when receiving IVF/ICSI.


Assuntos
Hormônio Liberador de Gonadotropina/agonistas , Infertilidade Feminina/terapia , Indução da Ovulação/efeitos adversos , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Adulto , Feminino , Fertilização In Vitro , Humanos , Hipotireoidismo/induzido quimicamente , Infertilidade Feminina/etiologia , Indução da Ovulação/métodos , Gravidez , Taxa de Gravidez , Injeções de Esperma Intracitoplásmicas , Doenças da Glândula Tireoide/complicações , Resultado do Tratamento
15.
Gynecol Endocrinol ; 35(4): 276-279, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30721102

RESUMO

In the past two decades, the issue of thyroid dysfunctions during pregnancy and the postpartum period received increasing attention by both endocrinologists and obstetrics/gynecologists (OB/GYNs), the latter often became the first to diagnose an impaired thyroid function in pregnant women. In this setting, a series of different clinical guidelines have been published and reviewed, the latest ones being represented by the 2017 ATA guidelines, which extensively address a wide variety of topics, including iodine supplementation, thyroid autoimmunity, hyper- and hypo-thyroidism, thyroid nodules and cancer, post-partum management, as well as the need for pre-conception screening. Aim of this editorial is to offer a practical guidance to the OB/GYN reader by focusing upon evidence-based changes introduced by the latest guidelines, with particular regard to: (a) prescribing further endocrine testing before referral; (b) providing evidence-based answers to some of the frequently asked questions.


Assuntos
Complicações na Gravidez/diagnóstico , Doenças da Glândula Tireoide/diagnóstico , Feminino , Humanos , Iodo/administração & dosagem , Guias de Prática Clínica como Assunto , Gravidez , Complicações na Gravidez/sangue , Complicações na Gravidez/terapia , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/terapia , Tireotropina/sangue , Oligoelementos/administração & dosagem
16.
Otolaryngol Head Neck Surg ; 160(4): 612-615, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30668264

RESUMO

OBJECTIVE: To quantify how frequently intraoperative parathyroid hormone levels increase during thyroid surgery and to explore a possible relationship between secondary hyperparathyroidism due to vitamin D deficiency and elevation in intraoperative parathyroid hormone. STUDY DESIGN: Case series with chart review. SETTING: Tertiary academic center. SUBJECTS AND METHODS: A total of 428 consecutive patients undergoing completion and total thyroidectomy by the senior author over a 7-year period were included for analysis. All patients had baseline and postexcision intraoperative parathyroid hormone levels as well as vitamin D levels from the same laboratory. Institute of Medicine criteria were employed for vitamin D stratification (>30, normal; 20-29.9, insufficient; <20, deficient) . Other data analyzed include sex, age, neck dissection status, and parathyroid autotransplantation. RESULTS: A total of 118 patients (27.6%) had an intraoperative parathyroid hormone elevation above baseline. Patients with vitamin D deficiency were significantly more likely to experience hormone elevation ( P = .04). When parathyroid hormone rose, it did so by a mean 32.1 pg/mL. Patients with vitamin D deficiency demonstrated significantly larger hormone increases ( P = .03). CONCLUSION: Elevation in intraoperative parathyroid hormone levels above baseline after completion and total thyroidectomy occurs in over one-fourth of cases and is significantly associated with vitamin D deficiency. This study is the first to report this observation. We hypothesize that vitamin D deficiency in these patients may create a subclinical secondary hyperparathyroidism that leads to intraoperative parathyroid hormone elevation when the glands are manipulated. Additional studies will be needed to explore this physiologic mechanism and its clinical significance.


Assuntos
Hiperparatireoidismo Secundário/etiologia , Complicações Intraoperatórias/etiologia , Hormônio Paratireóideo/sangue , Doenças da Glândula Tireoide/cirurgia , Tireoidectomia/efeitos adversos , Deficiência de Vitamina D/complicações , Feminino , Humanos , Hiperparatireoidismo Secundário/diagnóstico , Complicações Intraoperatórias/diagnóstico , Masculino , Monitorização Intraoperatória , Estudos Retrospectivos , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/complicações , Deficiência de Vitamina D/sangue
18.
Semergen ; 45(1): 44-51, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30509849

RESUMO

BACKGROUND: Creatinine is the most widely used renal failure biomarker; however, it has a lot of drawbacks. One of the major drawbacks is the blind range (does not increase until 50% of the kidney deteriorates). On the other hand, cystatin C has gained more attention as a promising biomarker due to several advantages over creatinine. Cystatin C levels are elevated as soon as any mild defect in the kidney occurs. Furthermore, cystatin C is influenced by several non-renal diseases which provide an additional prognostic value for this promising biomarker. OBJECTIVES: 1. Study the effects of age, gender and smoking on cystatin C levels to. 2. Challenge the adoption of glomerular filtration rate equations for healthy population. 3. Compare the values generated from different glomerular filtration rate equations. 4. Evaluate the prognostic value of cystatin C for selected non-renal diseases. METHODS: Using cross sectional analyses, we established the relationship between cystatin C levels and non-renal predictors. The quantification of cystatin C was performed by high performance liquid chromatographic method, while for creatinine by a colorimetric enzymatic method. RESULTS: In the healthy volunteers the levels of cystatin C were slightly higher in men than in women and in individuals older than 50 years old than those under 50 years old and in smokers than non-smokers, however, statistical data confirmed a non-significant relationship with respect to the aforementioned factors. For the recruited patients suffering from (diabetes, hyper- and hypothyroidism and cardiac dysfunctions) a clear increase in cystatin C levels were observed with the exception of hypothyroidism patients in which a decrease in their cystatin C levels were observed. CONCLUSION: Diabetes, thyroid and cardiac dysfunctions have a clear impact on the levels of cystatin C in human blood, whereas age, gender and smoking habit have no effect. Therefore, cystatin C could be considered as a useful biomarker of the aforementioned diseases, in turn, this requires extra precautions including the evaluation of several clinical conditions by physicians should CC is considered as a renal failure biomarker.


Assuntos
Cistatina C/sangue , Diabetes Mellitus/epidemiologia , Cardiopatias/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Fatores Etários , Biomarcadores/sangue , Criança , Estudos Transversais , Diabetes Mellitus/sangue , Feminino , Cardiopatias/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores Sexuais , Fumar/epidemiologia , Doenças da Glândula Tireoide/sangue , Adulto Jovem
19.
Endocrinol Diabetes Nutr ; 66(5): 305-311, 2019 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30455046

RESUMO

OBJECTIVE: To determine the risk of hypothyroidism in pregnant women with autoimmune thyroid disease and thyrotropin (TSH) < 2,5 mIU/l at the beginning of pregnancy. METHODS: Prospective longitudinal study of pregnant women with no personal history of thyroid disease, and with TSH < 2.5 mIU/l in the first trimester. TSH, free thyroxine (FT4), anti peroxidase (TPO) and anti thyroglobulin antibodies were measured in the 3 trimesters of pregnancy. We compared thyroid function throughout pregnancy, and the development of gestational hypothyroidism (TSH >4 mIU/l) among pregnant women with positive thyroid autoimmunity and those with negative autoimmunity. RESULTS: We included 300 pregnant women with mean baseline TSH 1.3 ± 0.6 mIU/l (9th gestational week). Positive thyroid autoinmunity was detected in 17.7% of women (n = 53) at the first trimester. Between the first and the third trimesters, TPO and anti thyroglobulin antibodies titers decreased 76.8% and 80.7% respectively. Thyroid function during pregnancy was similar among the group with positive autoimmunity and the group with negative autoimmunity, and the development of hypothyroidism was 1.9% (1/53) and 2% (5/247) respectively. Pregnant women in whom TSH increased above 4 mIU/l (n = 6), had higher baseline TSH levels compared to those who maintained TSH ≤4 mIU/l during pregnancy (1.8 vs. 1.3 mIU/l; p=.047). CONCLUSION: In our population, women with TSH levels <2.5 mIU/l at the beginning of pregnancy have a minimal risk of developing gestational hypothyroidism regardless of thyroid autoimmunity.


Assuntos
Autoimunidade , Hipotireoidismo/etiologia , Complicações na Gravidez/etiologia , Primeiro Trimestre da Gravidez/sangue , Doenças da Glândula Tireoide/imunologia , Tireotropina/sangue , Adulto , Autoanticorpos/sangue , Autoantígenos/imunologia , Subunidade RIalfa da Proteína Quinase Dependente de AMP Cíclico , Feminino , Seguimentos , Humanos , Hipotireoidismo/imunologia , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Gravidez , Complicações na Gravidez/sangue , Primeiro Trimestre da Gravidez/imunologia , Estudos Prospectivos , Doenças da Glândula Tireoide/sangue , Testes de Função Tireóidea
20.
Mol Cell Biochem ; 451(1-2): 139-144, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29961210

RESUMO

Advanced glycation end products (AGE) and its cell-bound receptor called receptor for AGE (RAGE) are implicated in the pathogenesis of numerous diseases. Soluble receptor for AGE (sRAGE) counteracts the adverse effects of AGE-RAGE interaction by competing with RAGE for binding with AGE. Low levels of serum sRAGE have been proposed as a biomarker for diseases. However, the serum levels of sRAGE in diabetes and end-stage renal disease (ESRD) are elevated. Thus, low levels of sRAGE cannot be a universal biomarker. An elevated ratio of AGE/sRAGE was then proposed as a universal biomarker. However, evidence was not provided for this new biomarker. The objective of this paper is to provide evidence in support of elevated AGE/sRAGE being a universal biomarker. The data for serum levels of AGE, sRAGE, and ratio of AGE/sRAGE were collected from patients with low serum sRAGE [non-ST-elevation myocardial infarction (NSTEMI), hyperthyroidism (HT), thoracic aortic aneurysm (TAA),and hypercholesterolemia (HC)], and with high serum levels of sRAGE [type-2 diabetes (T2D) and ESRD], and control subjects. The serum levels of AGE and ratio of AGE/sRAGE were higher in all types of patients irrespective of low or high serum sRAGE as compared to control subjects. Reasons are provided as to why AGE or sRAGE individually cannot be considered as a universal biomarker. In conclusion, the evidence supports the validity of the high ratio AGE/sRAGE as a universal biomarker/risk marker for diseases.


Assuntos
Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Produtos Finais de Glicação Avançada/sangue , Falência Renal Crônica/diagnóstico , Receptor para Produtos Finais de Glicação Avançada/sangue , Doenças da Glândula Tireoide/diagnóstico , Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Humanos , Falência Renal Crônica/sangue , Prognóstico , Doenças da Glândula Tireoide/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA