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1.
Mymensingh Med J ; 29(1): 156-161, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915352

RESUMO

Sub clinical hypothyroidism (SCH) is common in clinical practice. Autoimmunity is thought to be the most important cause of SCH. In this cross-sectional study, we investigated 120 SCH patients and 100 healthy controls attending the Endocrinology Outpatient Department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June 2014 to April 2015 for anti-thyroid antibodies (anti-TPO and anti-Tg). Measurement of serum TSH, FT4, anti-TPO, and anti-Tg antibodies were done by using the chemiluminescent sequential immunometric assay. SCH patients had a higher mean age; the frequencies of female subjects, those having family history of thyroid disease or other autoimmune diseases, and goiter were higher in SCH group than in the control group. Forty-five percent (45%) of SCH patients were positive for anti-thyroid antibodies (23.3% for both anti-TPO and anti-Tg, 16.7% for only anti-TPO, and 5% positive for only anti-Tg) in comparison to only 10% anti-thyroid antibody positive controls (none for both antibodies, 8% for only anti-TPO, and 2% positive for only anti-Tg). The SCH subjects in the lower age group, females and with a TSH >10µIU/mL had the higher frequency of thyroid autoimmunity. Female gender, high socioeconomic condition, the presence of other autoimmune diseases, the presence of goiter and TSH >10µIU/mL were associated with higher odds of anti-thyroid antibody positivity in the SCH group, though none were statistically significant. The frequency of anti-thyroid antibody was higher in SCH and was more prevalent among the females, younger patients and those having a goiter, other autoimmune diseases, and TSH >10µIU/mL.


Assuntos
Anticorpos/sangue , Autoanticorpos/sangue , Hipotireoidismo/diagnóstico , Hipotireoidismo/imunologia , Adulto , Autoantígenos , Bangladesh/epidemiologia , Biomarcadores/sangue , Estudos Transversais , Feminino , Humanos , Hipotireoidismo/epidemiologia , Iodeto Peroxidase , Proteínas de Ligação ao Ferro , Prevalência , Tireoglobulina/sangue , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
2.
Eur J Endocrinol ; 182(1): G1-G32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31855556

RESUMO

Obesity is an emerging condition, with a prevalence of ~20%. Although the simple measurement of BMI is likely a simplistic approach to obesity, BMI is easily calculated, and there are currently no data showing that more sophisticated methods are more useful to guide the endocrine work-up in obesity. An increased BMI leads to a number of hormonal changes. Additionally, concomitant hormonal diseases can be present in obesity and have to be properly diagnosed - which in turn might be more difficult due to alterations caused by body fatness itself. The present European Society of Endocrinology Clinical Guideline on the Endocrine Work-up in Obesity acknowledges the increased prevalence of many endocrine conditions in obesity. It is recommended to test all patients with obesity for thyroid function, given the high prevalence of hypothyroidism in obesity. For hypercortisolism, male hypogonadism and female gonadal dysfunction, hormonal testing is only recommended if case of clinical suspicion of an underlying endocrine disorder. The guideline underlines that weight loss in obesity should be emphasized as key to restoration of hormonal imbalances and that treatment and that the effect of treating endocrine disorders on weight loss is only modest.


Assuntos
Índice de Massa Corporal , Hipotireoidismo/diagnóstico , Obesidade/diagnóstico , Comorbidade , Endocrinologia , Humanos , Hipotireoidismo/epidemiologia , Obesidade/epidemiologia , Prevalência , Testes de Função Tireóidea
3.
Acta Odontol Latinoam ; 32(2): 71-74, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664296

RESUMO

Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease of unknown etiology. OLP has recently been linked to thyroid disease, mainly hypothyroidism. The aim of this study was to determine the prevalence of thyroid disease in Colombian patients with OLP. A total of860 clinical records of patients attending the clinics of oral medicine and oral and maxillofacial surgery at IPS CES Sabaneta, Colombia, between 2010 and 2016 were reviewed. Fourteen patients (1.6%) had a diagnosis of OLP. The prevalence of hypothyroidism in patients with OLP was 35.7%, compared to 3.95% in the entire study population (OR 15.92, 95% CI: 5.63-50.09, P = 0.0001). Patients with concomitant hypothyroidism and OLP presented with less severe oral lesions compared to those without thyroid disease. This study supports the notion that patients with OLP should be screened for thyroid disease.


Assuntos
Hipotireoidismo/epidemiologia , Líquen Plano Bucal/epidemiologia , Idoso , Colômbia/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência
4.
Isr Med Assoc J ; 21(10): 692-695, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31599513

RESUMO

BACKGROUND: Data suggest that subclinical hypothyroidism (SCH) is associated with progression of chronic renal disease; however, no study to date has assessed the possible relation between SCH and acute deterioration of renal function. OBJECTIVES: To investigate the possible relation between SCH and acute kidney injury (AKI) in a large cohort of patients with ST-elevation myocardial infarction (STEMI) treated with primary coronary intervention (PCI). METHODS: We evaluated thyroid stimulating hormone (TSH) and free T4 levels of 1591 STEMI patients with no known history of hypothyroidism or thyroid replacement treatment who were admitted to the coronary care unit (October 2007-August 2017). The presence of SCH was defined as TSH levels ≥ 5 mU/ml in the presence of normal free T4 levels. Patients were assessed for development of AKI ( 0.3 mg/dl increase in serum creatinine, according to the KDIGO criteria). RESULTS: The presence of SCH was demonstrated in 68/1593 (4.2%) STEMI patients. Patients presenting with SCH had more AKI complications during the course of STEMI (20.6% vs. 9.6 %; P = 0.003) and had significantly higher serum creatinine change throughout hospitalization (0.19 mg/dl vs. 0.08 mg/dl, P = 0.04). No significant difference was present in groups regarding baseline renal function and the amount of contrast volume delivered during coronary angiography. In multivariate logistic regression model, SCH was independently associated with AKI (odds ratio = 2.19, 95% confidence interval 1.05-4.54, P =0.04). CONCLUSIONS: Among STEMI patients treated with PCI, the presence of SCH is common and may serve as a significant marker for AKI.


Assuntos
Lesão Renal Aguda/epidemiologia , Hipotireoidismo/epidemiologia , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/epidemiologia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Lesão Renal Aguda/fisiopatologia , Estudos de Coortes , Comorbidade , Feminino , Humanos , Hipotireoidismo/fisiopatologia , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-31540358

RESUMO

BACKGROUND: Environmental agents interfere with thyroid function at multiple levels. This study was to investigate the association between pollutant concentrations and the primary hypothyroidism (PH) occurrence odds in residents living in the Capuava Petrochemical Complex (CPC) influence area. METHODS: This area was evaluated with the combination of the AERMOD dispersion model with the Weather Research Forecast (WRF) meteorological model (2016). The concentration of atmospheric pollutants were analyzed in 2017 using meteorological data on the period from 2005 to 2009, correlating this data with the research done in 2003 to 2005. A home-based questionnaire was applied to evaluate 2004 residents, of both sexes, aged from 8 to 72 years, based on their proximity to the industrial areas; were select residents with PH. RESULTS: Volatile organic compounds (VOCs), carbon monoxide (CO), and nitrogen dioxide (NO2) concentrations presented the highest correlations between the PH odds and pollutant concentrations. CONCLUSION: Air pollution associated with the presence of the CPC is an important environmental factor contributing to the development of PH in the nearby population. As the first study showing this association in Brazil, research should be continued to better understand the mechanisms and to find ways to compensate for or remedy to avoid health impacts in future populations.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Poluição do Ar/efeitos adversos , Exposição Ambiental , Hipotireoidismo/epidemiologia , Adolescente , Adulto , Idoso , Brasil/epidemiologia , Criança , Feminino , Humanos , Hipotireoidismo/induzido quimicamente , Incidência , Indústrias , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Prevalência , Medição de Risco , Adulto Jovem
6.
BMC Infect Dis ; 19(1): 826, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533667

RESUMO

BACKGROUND: The association between Toxoplasma gondii infection and thyroid disease has been poorly studied. Therefore, we sought to determine the association between T. gondii seropositivity and thyroid dysfunction. METHODS: We performed an age- and gender-matched case-control study of 176 patients suffering from hypothyroidism (n = 161) or hyperthyroidism (n = 15) and 528 control subjects without these diseases in a public hospital in Durango City, Mexico. Anti-Toxoplasma IgG antibodies were determined in sera from cases and controls using a commercially available enzyme-linked immunoassay. RESULTS: Anti-T. gondii IgG antibodies were found in 11 (6.3%) of 176 patients suffering from thyroid dysfunction and in 48 (9.1%) of 528 control subjects (OR = 0.66; 95% CI: 0.33-1.31; P = 0.23). Stratification by two groups of age (50 years and younger, and 51 year and older) showed that the youngest group of patients with thyroid dysfunction had a significantly lower seroprevalence of T. gondii infection than its age- and gender-matched control group (1/83: 1.2% vs 23/257: 8.6%; OR = 0.12; 95% CI: 0.01-0.93; P = 0.01). This stratification also showed that the youngest group of patients with hypothyroidism had a significantly lower seroprevalence of T. gondii infection than its age- and gender matched control group (0/75: 0% vs 21/233: 9.0%; P = 0.003). CONCLUSIONS: Our results suggest that thyroid dysfunction is not associated with seropositivity to T. gondii in general; however, in young (50 years or less) patients, a negative association between infection and thyroid dysfunction and hypothyroidism was found. Further research to confirm this negative association is needed.


Assuntos
Hipotireoidismo/diagnóstico , Toxoplasmose/diagnóstico , Adulto , Anticorpos Antiprotozoários/sangue , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Hospitais Públicos , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Imunoglobulina G/sangue , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Toxoplasmose/complicações , Toxoplasmose/epidemiologia
7.
DNA Cell Biol ; 38(11): 1249-1256, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31553233

RESUMO

Transmembrane protein 39A (TMEM39A) gene polymorphisms have been related to various autoimmune diseases, but the relationship between TMEM39A polymorphisms and autoimmune thyroid disease (AITD) remains unknown. This study was aimed at investigating whether the polymorphisms of the TMEM39A were associated with AITD in the Chinese Han population. A case-control study was performed in a total of 906 AITD patients and 744 healthy controls. Four single nucleotide polymorphisms, including rs1132200, rs12492609, rs2282175, and rs7629750, in TMEM39A were examined by polymerase chain reaction-ligase detection reaction. We found that the allele T of rs12492609 in TMEM39A was associated with AITD and Hashimoto's thyroiditis (HT) (p = 0.023; p = 0.028 respectively). Compared with controls, the frequency of haplotype CCA in AITD patients was higher than that in controls (p = 0.036), but the frequency of haplotype CTA in AITD and HT patients was lower than that in controls (p = 0.046; p = 0.047 respectively). In addition, the frequency of allele A at rs7629750 in AITD patients with onset age ≤18 years old was higher than that in AITD patients with onset age ≥19 (p = 0.046). Further, there was an obvious difference in the genotype distributions of rs12492609 and rs7629750 between HT patients with hypothyroidism and those without hypothyroidism (p = 0.034 and p = 0.023, respectively). Our study first reveals that the polymorphisms of the TMEM39A gene are associated with the susceptibility to AITD, especially for early-onset AITD and HT with hypothyroidism.


Assuntos
Proteínas de Membrana/genética , Polimorfismo de Nucleotídeo Único , Tireoidite Autoimune/genética , Adolescente , Adulto , Idade de Início , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/epidemiologia , Feminino , Frequência do Gene , Predisposição Genética para Doença , Doença de Hashimoto/epidemiologia , Doença de Hashimoto/genética , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/genética , Desequilíbrio de Ligação , Masculino , Pessoa de Meia-Idade , Tireoidite Autoimune/epidemiologia , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-31540048

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide and its incidence is definitely increasing. NAFLD is a metabolic disease with extensive multi-organ involvement, whose extra-hepatic manifestations include type 2 diabetes mellitus, cardiovascular disease, obstructive sleep apnea, chronic kidney disease, osteoporosis, and polycystic ovarian syndrome. Recently, further evidence has given attention to pathological correlations not strictly related to metabolic disease, also incorporating in this broad spectrum of systemic involvement hypothyroidism, psoriasis, male sexual dysfunction, periodontitis, and urolithiasis. The most common cause of mortality in NAFLD is represented by cardiovascular disease, followed by liver-related complications. Therefore, clinicians should learn to screen and initiate treatment for these extra-hepatic manifestations, in order to provide appropriate multidisciplinary assessments and rigorous surveillance. This review evaluates the current evidence regarding extra-hepatic associations of NAFLD, focusing on the pathogenic hypothesis and the clinical implications.


Assuntos
Síndrome Metabólica/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Osteoporose/epidemiologia , Periodontite/epidemiologia , Síndrome do Ovário Policístico/epidemiologia , Psoríase/epidemiologia , Insuficiência Renal Crônica/epidemiologia , Disfunções Sexuais Fisiológicas/epidemiologia , Apneia Obstrutiva do Sono/epidemiologia , Urolitíase/epidemiologia
9.
Tuberk Toraks ; 67(2): 131-135, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31414644

RESUMO

Chronic obstructive pulmonary disease (COPD) has many systemic effects influencing morbidity and mortality of the disease. Thyroid diseases which are more common in COPD patients than who do not have COPD are underestimated despite important clinical consequences. Similar to general population, thyroid dysfunctions are more common in females than males among COPD patients. Both hypothyroidism and hyperthyroidism may be associated to COPD. As well as systemic inflammation hypoxia, age, glucocorticoid use and smoking are some of the effective factors on developing thyroid dysfunction in COPD patients. In this article thyroid dysfunctions that are underrecognized comorbidities of COPD patients, their mechanisms of action and clinical outcomes were reviewed.


Assuntos
Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Comorbidade , Feminino , Humanos , Hipertireoidismo/epidemiologia , Hipertireoidismo/fisiopatologia , Hipotireoidismo/epidemiologia , Hipotireoidismo/fisiopatologia , Inflamação , Masculino , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Fumar , Doenças da Glândula Tireoide/fisiopatologia
10.
Acta Med Indones ; 51(2): 179-188, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31383835

RESUMO

BACKGROUND: hypothyroidism is a common concomitant disease of non-alcoholic fatty liver disease (NAFLD). Previous studies regarding the relationship between subclinical hypothyroidism and NAFLD showed conflicting results, ranging from a strong association to not significant one. This case report aimed to investigate the risk of developing NAFLD in subclinical hypothyroidism patients. METHODS: literature searching used ScienceDirect, PubMed, ProQuest, and Scopus. Filtering process of titles and abstracts by using inclusion and exclusion criteria yielded 4 eligible articles (1 systematic review, 1 prospective cohort, 1 retrospective cohort, and 1 case-control study) for answering the clinical question. Critical appraisal was conducted by using worksheets from Centre for Evidence-Based Medicine, University of Oxford. RESULTS: the systematic review was considered invalid due to its less comprehensive search for relevant studies, inappropriate article selection to find a causal relationship between diseases, and statistical heterogeneity. The retrospective cohort was decided unimportant because it possessed a relative risk of 0.85 (95% confidence interval [CI], 0.72--1.00) which the upper limit of its CI included 1.00. The rest were valid and had important risk relative and odds ratio (1.27 [95% CI, 1.09--1.47], 3.41 [95% CI, 1.16--9.98]; respectively). The number needed to harm (5-17) indicated the clinically meaningful harm of the exposure since only a few patients with subclinical hypothyroidism is needed to obtain one additional NAFLD incidence. Those two articles were also suitable to be applied in our case. CONCLUSION: patients with subclinical hypothyroidism, compared to euthyroid patients, are at higher risk of developing NAFLD.


Assuntos
Hipotireoidismo/diagnóstico , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Feminino , Humanos , Hipotireoidismo/epidemiologia , Incidência , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Medição de Risco , Fatores de Risco
11.
BMC Endocr Disord ; 19(1): 84, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31382952

RESUMO

BACKGROUND: In patients with diabetes mellitus, the urinary microalbumin-to-urine creatinine ratio (UACR) can not only predict the occurrence of diabetic nephropathy but also can be a risk factor for cardiovascular disease and renal function damage. Current studies on subclinical hypothyroidism (SCH) and UACR are mainly cross-sectional studies, and the results suggest that SCH is an independent risk factor for UACR. To further explore the longitudinal effect of SCH on UACR, we carried out this study. METHODS: This was a retrospective cohort study including 46 patients with type 2 diabetes mellitus and SCH in the Department of Endocrinology, The Affiliated Huai'an Hospital of Xuzhou Medical University from January 2013 to April 2018. At the same time, 96 patients with type 2 diabetes mellitus and euthyroid were chosen according to 1:2 approximately matched with age, sex and duration of diabetes mellitus. Univariate analysis, stratified analysis, and multiple linear regression analysis were used to investigate the effect of SCH on ΔUACR(ΔUACR = UACR after 1 year - baseline UACR) in patients with type 2 diabetes mellitus. RESULTS: There was no significant difference between the baseline UACR, (p > 0.05). However, the ΔUACR was significantly higher in SCH group than euthyroid group, as shown by univariate analysis, stratified analysis and multiple linear regression analysis (ß:-1.071, 95% CI: - 1.713--0.428), and the difference was statistically significant (all p < 0.05). CONCLUSION: SCH is associated with an increased UACR in type 2 diabetes mellitus patients. It is necessary to screen for thyroid function in type 2 diabetes mellitus and increase the follow-up frequency of UACR in patients with SCH.


Assuntos
Albuminúria/etiologia , Biomarcadores/análise , Creatinina/urina , Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/etiologia , Hipotireoidismo/complicações , Adolescente , Adulto , Idoso , Albuminúria/diagnóstico , China/epidemiologia , Nefropatias Diabéticas/diagnóstico , Feminino , Seguimentos , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/patologia , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
12.
Nutrients ; 11(7)2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31323889

RESUMO

The inhabitants of Lazio, similarly to those of other Italian regions, have been historically exposed to the detrimental effects of an inadequate intake of iodine. The latter is a micronutrient essential for the biosynthesis of thyroid hormones (TH). Iodine deficiency is responsible for a number of adverse effects on human health known as iodine deficiency disorders (IDD), the most common of which worldwide are goiter and hypothyroidism. In order to reduce IDD, a national salt iodination program was started in Italy in 2005. In this article we reviewed the available data regarding iodine intake in the Lazio population before and after the introduction of the national salt iodination program, in order to evaluate its efficacy and the eventual problem(s) limiting its success. On the whole, the information acquired indicates that, following the introduction of the program, the dietary iodine intake in the Lazio population is improved. There is, however, still much work ahead to ameliorate the iodine prophylaxis in this region. In fact, although a generally adequate iodine intake in school-age children has been observed, there are still areas where a mild iodine insufficiency is present. Moreover, two independent epidemiological surveys on pregnant women evidenced a low urinary iodine concentration with respect to the reference range conceived by the World Health Organization. These findings demonstrate the need for greater attention to the iodine prophylaxis by health care providers (i.e., obstetricians, gynecologists, pediatricians, etc.), and the implementation of effective advertising campaigns aimed at increasing the knowledge and awareness of the favorable effects of iodine supplementation on population health.


Assuntos
Iodo/deficiência , Iodo/urina , Estado Nutricional , Cloreto de Sódio na Dieta/administração & dosagem , Adolescente , Criança , Feminino , Bócio/epidemiologia , Humanos , Hipotireoidismo/epidemiologia , Hipotireoidismo/prevenção & controle , Iodo/administração & dosagem , Itália/epidemiologia , Masculino , Programas Nacionais de Saúde , Gravidez
13.
Cancer Causes Control ; 30(9): 931-941, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31280456

RESUMO

PURPOSE: Improving the understanding of co-existing chronic diseases prior to and after the diagnosis of cancer may help to facilitate therapeutic decision making in clinical practice. This study aims to examine patterns of comorbidities in Canadian women with breast cancer. METHODS: We conducted a retrospective cohort study using provincial linked administrative health datasets from British Columbia, Canada, between 2000 and 2013. Women diagnosed with breast cancer between 2005 and 2009 were identified. The index date was defined as the date of diagnosis of breast cancer. Subsets of the breast cancer cohort were identified based on the absence of individual type of comorbidity of interest within 5 years prior to breast cancer diagnosis. For each subset, cases were then individually matched by year of birth at 1:2 ratios with controls without a history of cancer and the individual type of comorbidity of interest within 5 years prior to the assigned index year, matching with the year of breast cancer diagnosis of the corresponding case. Baseline comorbidities were measured over a 1-year period prior to the index date using two comorbidity indices, Rx-Risk-V and Aggregated Diagnosis Groups (ADG). Cox regression model was used to assess the development of seven specific comorbidities after the index date between women with breast cancer and non-cancer women. RESULTS: The most prevalent baseline comorbidity in the breast cancer cohort measured using the Rx-Risk-V model was cardiovascular conditions (39.0%), followed by pain/pain-inflammation (34.8%). The most prevalent category measured using the ADG model was major signs or symptoms (71.8%), followed by stable chronic medical conditions (52.2%). The risks of developing ischemic heart disease, heart failure, depression, diabetes, osteoporosis, and hypothyroidism were higher in women with breast cancer compared to women without cancer, with the hazard ratios ranging from 1.09 (95 CI% 1.03-1.16) for ischemic heart disease to 2.10 (95% CI 1.99-2.21) for osteoporosis in the model adjusted for baseline comorbidity measured using Rx-Risk-V score. CONCLUSION: Women with breast cancer had a higher risk of developing new comorbidities than women without cancer. Development of coordinated care models to manage multiple chronic diseases among breast cancer patients is warranted.


Assuntos
Neoplasias da Mama/epidemiologia , Adulto , Idoso , Colúmbia Britânica/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipotireoidismo/epidemiologia , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Prevalência , Estudos Retrospectivos
14.
Clin Exp Rheumatol ; 37(5): 791-796, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31172923

RESUMO

OBJECTIVES: Systemic lupus erythematosus is associated with an increased risk of developing an endocrine disease. These endocrinopathies can closely mimic SLE symptoms ranging from fatigue to renal involvement but the treatment is often very different. METHODS: A careful review of the PubMed and MEsH databases linking endocrine disease to SLE was performed. A retrospective analysis of the 708 SLE patient cohort at University College London Hospital (UCLH) has been completed. They have been followed for at least one year from 1978 to 2017. In our study, we report how often these endocrine diseases are identified in lupus patients compared to the general population and whether these patients with both diseases had a poorer prognosis. We have attempted to establish if the endocrine diseases develop before or after the lupus diagnosis. RESULTS: The literature search produced some conflicting results. 708 SLE patients were included in our study. We found 67 endocrine diseases in 55 different patients of our cohort. The most common endocrinopathy was hypothyroidism (5.22%) followed by type 2 diabetes mellitus (1.41%) and hyperthyroidism (1.41%). Other endocrine disorders also identified were type 1 diabetes mellitus (0.42%) and hyperparathyroidism (0.70%). In terms of mortality, lupus patients with concomitant endocrine disease had similar outcomes compared to those without endocrine disease (16.36% died vs. 15.16%). In general terms, these endocrine diseases were developed after the lupus diagnosis. We found that the 21.8% of our SLE plus endocrinopathy patients also have an increased risk of developing a second endocrine disease. CONCLUSIONS: We report concomitant endocrine disease in 7.76 % of our 708 SLE cohort followed, for almost 40 years, at UCLH. These patients have increased liability to develop a second endocrine disease, but overall there is no difference in terms of mortality between SLE patients with or without an endocrinopathy. It is important to capture endocrine diseases in SLE as the symptoms they cause may mimic SLE features, but require quite distinct treatment.


Assuntos
Doenças do Sistema Endócrino/epidemiologia , Lúpus Eritematoso Sistêmico , Comorbidade , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Londres , Lúpus Eritematoso Sistêmico/epidemiologia , Estudos Retrospectivos
15.
Int J Mol Sci ; 20(11)2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31212642

RESUMO

Secondary nonalcoholic fatty liver disease (NAFLD) defines those complex pathophysiological and clinical consequences that ensue when the liver becomes an ectopic site of lipid storage owing to reasons other than its mutual association with the metabolic syndrome. Disorders affecting gonadal hormones, thyroid hormones, or growth hormones (GH) may cause secondary forms of NAFLD, which exhibit specific pathophysiologic features and, in theory, the possibility to receive an effective treatment. Here, we critically discuss epidemiological and pathophysiological features, as well as principles of diagnosis and management of some common endocrine diseases, such as polycystic ovary syndrome (PCOS), hypothyroidism, hypogonadism, and GH deficiency. Collectively, these forms of NAFLD secondary to specific endocrine derangements may be envisaged as a naturally occurring disease model of NAFLD in humans. Improved understanding of such endocrine secondary forms of NAFLD promises to disclose novel clinical associations and innovative therapeutic approaches, which may potentially be applied also to selected cases of primary NAFLD.


Assuntos
Doenças do Sistema Endócrino/epidemiologia , Doenças do Sistema Endócrino/patologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Animais , Doenças do Sistema Endócrino/metabolismo , Feminino , Humanos , Hipogonadismo/epidemiologia , Hipogonadismo/metabolismo , Hipogonadismo/patologia , Hipotireoidismo/epidemiologia , Hipotireoidismo/metabolismo , Hipotireoidismo/patologia , Masculino , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/patologia , Síndrome do Ovário Policístico/epidemiologia , Síndrome do Ovário Policístico/metabolismo , Síndrome do Ovário Policístico/patologia
16.
Horm Metab Res ; 51(6): 347-352, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31207655

RESUMO

Various cut-offs have been proposed for thyroid peroxidase antibodies (TPOAb) positivity. Considering that the long-term trend of TPOAb levels and its positivity incidence is not clearly understood, we conducted the current study to determine the longitudinal variations of TPOAb in a population-based cohort study. We followed 5783 individuals of Tehran Thyroid cohort Study (TTS) for 10 years (4 phases). After exclusions, data of 3493 euthyroid participants remained for analyses. The baseline prevalence rates of TPOAb positivity were 19.8, 17, and 11.4% and the annual incidence rates (95% CI) of TPOAb positivity were 8.53 (8.29-8.77), 7.59 (7.37-7.80) and 6.79 (6.60-6.98) per 1000 persons for the 3 proposed cut-offs of 14.77, 18.38, and 40 U/l; respectively. Although a slightly increasing trend was observed for TPOAb levels (p=0.001) and its conventional positivity (TPOAb>40U/l), the recently proposed cut-offs of 14.77 and 18.38 U/l showed constant TPOAb positivity over 10 years. The time trends of the TPOAb levels among younger participants were significantly different from older participants (time×age effect p=0.004), with the former having an increasing trend and the latter, a relatively decreasing trend. Although the prevalence of TPOAb positivity was significantly (p<0.001) higher among women as compared to men, the longitudinal changes of TPOAb were similar in men and women. TPOAb positivity along with TSH values between 2.5 and 5.0 mU/l or free T4 values between 0.93 and 1.7 ng/dl exerted a significantly increased risk of subclinical or overt hypothyroidism. In an iodine sufficient population, an increasing trend in TPOAb levels was observed in line with the increasing incidence of subclinical and overt hypothyroidism.


Assuntos
Autoanticorpos/sangue , Hipertireoidismo/diagnóstico , Hipertireoidismo/epidemiologia , Hipotireoidismo/diagnóstico , Hipotireoidismo/epidemiologia , Iodeto Peroxidase/imunologia , Glândula Tireoide/imunologia , Adulto , Autoanticorpos/imunologia , Estudos de Casos e Controles , Feminino , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/imunologia , Hipotireoidismo/sangue , Hipotireoidismo/imunologia , Incidência , Irã (Geográfico)/epidemiologia , Masculino , Prognóstico , Estudos Prospectivos , Testes de Função Tireóidea
17.
PLoS One ; 14(5): e0216389, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31095584

RESUMO

CONTEXT: While the role of overt hypothyroidism in lipid disorders is clear, the association between dyslipidemia and subclinical thyroid diseases remains unclarified. OBJECTIVE: To examine lipid trends based on thyroid function over a 10-year period. DESIGN: This is a prospective population based cohort study. SETTING: General community. PARTICIPANTS: 2383 euthyroid participants, as well as those with subclinical thyroid diseases, in all residents of district 13 of Tehran were examined. Subjects who were on levothyroxine, anti-hyperthyroid drugs, and glucocorticoids, those with a history of thyroid surgery or RAI and pregnant women were excluded. MAIN OUTCOME MEASURES: Lipid trends in Model 1 were adjusted for age and follow up duration, and in Model 2 gender-specific multivariate adjustments were performed for thyroid status, diabetes mellitus, smoking status, education, BMI, lipid lowering medications, age and follow up duration by using generalized estimating equations. RESULTS: In every four years of assessments, there were significant decreases in levels of all lipid parameters (all Ps <0.001) except for HDL-C, in which a decrescendo-crescendo trend was observed. The results did not change after adjusting for thyroid status, consumption of lipid lowering drugs during the follow-up period, or other variables. There were significant decreases in the prevalence of hypercholesterolemia and hypertriglyceridemia (all Ps <0.001) during the follow-up period. CONCLUSION: During a 10 year follow-up, decrescendo trends were observed in levels of total cholesterol, triglycerides, which were not be accounted for by the consumption of lipid lowering drugs and thyroid status.


Assuntos
Dislipidemias , Hipotireoidismo , Lipídeos/sangue , Testes de Função Tireóidea , Tiroxina/administração & dosagem , Adulto , Dislipidemias/sangue , Dislipidemias/tratamento farmacológico , Dislipidemias/epidemiologia , Feminino , Seguimentos , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/epidemiologia , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
18.
Medicine (Baltimore) ; 98(20): e15631, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096476

RESUMO

Thyroid function may alter carbohydrate metabolism via influence of insulin, which may in terms of derangement of thyroid function and insulin function result in the development of type 2 diabetes mellitus (T2D). We investigated the association of thyroid disorders with T2D by a cohort study of the Taiwan nationwide health insurance database.A sub-dataset of the National Health Insurance Research Database (NHIRD) was used in this study. The thyroid disease (both hyper- and hypo-thyroidism) group was chosen from patients older than 18 years and newly diagnosed between 2000 and 2012. The control group consisted of randomly selected patients who never been diagnosed with thyroid disease and 4-fold size frequency matched with the thyroid disease group. The event of this cohort was T2D (ICD-9-CM 250.x1, 250.x2). Primary analysis was performed by comparing the thyroid disease group to the control group and the second analysis was performed by comparing the hyperthyroidism subgroup, hypothyroidism subgroup, and control group.The occurrence of T2D in the thyroid disease group was higher than the control group with hazard ratio (HR) of 1.23 [95% confidence interval (CI) = 1.16-1.31]. Both hyperthyroidism and hypothyroidism were significantly higher than control. Significantly higher HR was also seen in female patients, age category of 18 to 39-year-old (y/o) and 40 to 64 y/o subgroups. Higher occurrence of T2D was also seen in thyroid disease patients without comorbidity than in the control group with HR of 1.47 (95% CI = 1.34-1.60). The highest HR was found in the half-year follow-up.There was a relatively high risk of T2D development in patients with thyroid dysfunctions, especially in the period of 0.5 to 1 year after presentation of thyroid dysfunctions. The results suggest performing blood sugar tests in patients with thyroid diseases for early detection and treatment of T2D.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Estudos de Coortes , Comorbidade , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , Obesidade/epidemiologia , Modelos de Riscos Proporcionais , Fatores de Risco , Fatores Sexuais , Taiwan/epidemiologia , Testes de Função Tireóidea , Adulto Jovem
19.
BMC Res Notes ; 12(1): 294, 2019 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-31133065

RESUMO

OBJECTIVES: Deficiency as well as excess dietary iodine is associated with several thyroid disorders including Grave's disease and goitre. Previously, cross sectional studies conducted among school children in Nepal showed high prevalence of iodine deficiency. In contrast, recently, few studies have revealed emerging trends of excess urinary iodine concentration in children. This paper, reports excess urinary iodine excretion and thyroid dysfunction among school age children from eastern Nepal. RESULTS: It was a community based cross sectional study in which we measured urinary iodine excretion levels among school age children at baseline and after educational program. The educational program consisted of audio-visual and pamphlets on thyroid health. We also screened them for thyroid function status by physical examination and measuring serum thyroid hormones. Our results show that 34.4% of the children had excess urinary iodine concentration above the WHO recommended levels. Overall, 3.2% of the children were identified to have thyroid dysfunction. Urinary iodine concentration was significantly different between types of salt used and between salt iodine content categories.


Assuntos
Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Iodo/urina , Cloreto de Sódio na Dieta/efeitos adversos , Criança , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertireoidismo/induzido quimicamente , Hipertireoidismo/metabolismo , Hipertireoidismo/fisiopatologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/metabolismo , Hipotireoidismo/fisiopatologia , Iodo/administração & dosagem , Iodo/efeitos adversos , Masculino , Nepal/epidemiologia , Estado Nutricional/fisiologia , Cloreto de Sódio na Dieta/administração & dosagem , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Tireotropina/sangue , Tiroxina/sangue
20.
J Dermatol ; 46(7): 557-563, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31090237

RESUMO

The present study (B-1201 clinical trial) was conducted as a multicenter, open-label, single-arm phase II study to evaluate the long-term safety, tolerability and efficacy of bexarotene. This study enrolled 10 Japanese adults aged more than 20 years with cutaneous T-cell lymphoma (CTCL) who completed the 24-week study period of the B-1101 trial. The objective response rate (ORR) was 53.8% (95% confidence interval, 25.1-80.8). In the early stage (IB), the ORR was 60% (3/5 cases). In the advanced stage (IIB and IIIA), the ORR was 57.1% (4/7 cases). The median time to response was 58 days (range, 27-168). The median treatment duration was 380 days (range, 33-1674). The median duration of response (DOR) could not be reached during the study period. The longest DOR reached 1618 days at the end of the B-1201 trial. Nine patients (56.3%) in the full analysis set (FAS) population experienced dose reduction of bexarotene. Common drug-related adverse events in the FAS population included hypothyroidism (93.8%), hypertriglyceridemia (81.3%), hypercholesterolemia (81.3%), leukopenia (68.8%) and neutropenia (56.3%). Dose-limiting toxicity (DLT) was present in five (38.5%) of the 13 patients in the 300 mg/m2 cohort. Of the five patients, four developed grade 3 neutropenia and one developed grade 4 hypertriglyceridemia. All DLT cases recovered after the discontinuation of bexarotene. None of the five patients discontinued this trial because of DLT. The B-1201 trial shows the long-term safety of oral bexarotene for Japanese patients with CTCL, despite frequent dose reduction.


Assuntos
Antineoplásicos/administração & dosagem , Bexaroteno/administração & dosagem , Linfoma Anaplásico Cutâneo Primário de Células Grandes/tratamento farmacológico , Micose Fungoide/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Adulto , Antineoplásicos/efeitos adversos , Bexaroteno/efeitos adversos , Relação Dose-Resposta a Droga , Feminino , Seguimentos , Humanos , Hipercolesterolemia/induzido quimicamente , Hipercolesterolemia/epidemiologia , Hipertrigliceridemia/induzido quimicamente , Hipertrigliceridemia/epidemiologia , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/epidemiologia , Japão , Leucopenia/induzido quimicamente , Leucopenia/epidemiologia , Linfoma Anaplásico Cutâneo Primário de Células Grandes/patologia , Masculino , Micose Fungoide/patologia , Estadiamento de Neoplasias , Neutropenia/induzido quimicamente , Neutropenia/epidemiologia , Neoplasias Cutâneas/patologia , Fatores de Tempo , Adulto Jovem
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