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1.
Medicine (Baltimore) ; 99(18): e19737, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32358346

RESUMO

INTRODUCTION: Hypothyroidism, the most common endocrine disease, comprises a deficiency of thyroid hormone, causing coldness, fatigue, and dysmenorrhea. Here, we report the improvement of hypothyroidism symptoms and thyroid hormone level normalization by using Korean herbal medicine and acupuncture therapy. PATIENT CONCERNS: A 30-year-old woman (Case 1) presented at the clinic with continuous seborrheic dermatitis on the scalp, accompanied by dysmenorrhea. A 55-year-old woman (Case 2) presented with symptoms of coldness of the limbs and fatigue. DIAGNOSIS: Both patients were diagnosed with "Yin deficiency and Yang hyperactivity" and hypothyroidism after serum thyroid function tests. INTERVENTIONS: Both patients received herbal medicine decoction, acupuncture, and electroacupuncture therapy. OUTCOMES: Korean medicine improved the symptoms of hypothyroidism and significantly normalized thyroid-stimulating hormone and free-thyroxine levels. CONCLUSION: These outcomes suggest that Korean medicine may be effective for resolution of hypothyroidism; however, further research is needed to confirm these findings.


Assuntos
Terapia por Acupuntura/métodos , Hipotireoidismo/terapia , Medicina Tradicional Coreana/métodos , Fitoterapia/métodos , Adulto , Terapia Combinada , Feminino , Humanos , Hipotireoidismo/sangue , Pessoa de Meia-Idade , República da Coreia , Hormônios Tireóideos/sangue , Resultado do Tratamento
2.
Medicine (Baltimore) ; 99(11): e19492, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32176089

RESUMO

Despite many studies, the molecular mechanisms of hepatocellular carcinoma (HCC) development remain unclear. Thyroid hormone (TH) levels may vary in many chronic diseases including cirrhosis. The aim of this study was to evaluate TH status in patients with cirrhosis and HCC and to investigate the relationship between THs and HCC development.Five hundred seventy-seven patients with cirrhosis who applied to Demiroglu Bilim University, Faculty of Medicine, Gastroenterology Department between 2004 and 2019 were included the study. Three hundred sixty-seven patients who applied to Internal Medicine Unit for general health check-up were included in the study as healthy control group. Demographic, laboratory, and imaging findings of study groups were retrospectively reviewed and recorded from hospital information system.In the cirrhosis group, 252 patients had HCC (43.67%), and 325 patients had non-HCC cirrhosis (56.33%). Free thyroxine (FT4) levels were higher in the control group than in the cirrhotic group but there was no significant difference (P = .501). Thyroid-stimulating hormone (TSH) and FT4 levels were similar between groups, while free triiodothyronine (FT3) levels were significantly different between HCC group, non-HCC cirrhosis group, and control group (P = .299 for TSH, P = .263 for FT4, P < .001 for FT3). FT3 levels were significantly higher in HCC group than non-HCC cirrhosis group, but significantly lower than control group (P < .05).Our study confirmed the presence of hypothyroidism in cirrhosis patients and clearly demonstrated a strong relationship between FT3 levels and HCC development.


Assuntos
Carcinoma Hepatocelular/complicações , Hipotireoidismo/complicações , Cirrose Hepática , Neoplasias Hepáticas/complicações , Hormônios Tireóideos/sangue , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Carcinoma Hepatocelular/sangue , Estudos de Casos e Controles , Progressão da Doença , Feminino , Humanos , Hipotireoidismo/sangue , Neoplasias Hepáticas/sangue , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Testes de Função Tireóidea
3.
Eur J Endocrinol ; 182(6): 533-538, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32213658

RESUMO

Objective: Familial dysalbuminaemic hyperthyroxinaemia (FDH), most commonly due to an Arginine to Histidine mutation at residue 218 (R218H) in the albumin gene, causes artefactual elevation of free thyroid hormones in euthyroid individuals. We have evaluated the susceptibility of most current free thyroid hormone immunoassay methods used in the United Kingdom, Europe and Far East to interference by R218H FDH. Methods: Different, one- and two-step immunoassay methods were tested, measuring free T4 (FT4) and free T3 (FT3) in 37 individuals with genetically proven R218H FDH. Results: With the exception of Ortho VITROS, FT4 measurements were raised in all assays, with greatest to lowest susceptibility to interference being Beckman ACCESS > Roche ELECSYS > FUJIREBIO Lumipulse > Siemens CENTAUR > Abbott ARCHITECT > Perkin-Elmer DELFIA. Five different assays recorded high FT3 levels, with the Siemens CENTAUR method measuring high FT3 values in up to 30% of cases. However, depending on the assay method, FT4 measurements were unexpectedly normal in some, genetically confirmed, affected relatives of index FDH cases. Conclusions: All FT4 immunoassays evaluated are prone to interference by R218H FDH, with their varying susceptibility not being related to assay architecture but likely due to differing assay conditions or buffer composition. Added susceptibility of many FT3 assays to measurement interference, resulting in high FT4 and FT3 with non-suppressed TSH levels, raises the possibility of R218H FDH being misdiagnosed as resistance to thyroid hormone beta or TSH-secreting pituitary tumour, potentially leading to unnecessary investigation and inappropriate treatment.


Assuntos
Hipertireoxinemia Disalbuminêmica Familiar/sangue , Testes de Função Tireóidea/métodos , Hormônios Tireóideos/sangue , Humanos , Imunoensaio , Tiroxina/sangue , Tri-Iodotironina/sangue
4.
Zhonghua Nei Ke Za Zhi ; 59(2): 129-133, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32074686

RESUMO

Objective: To establish reference intervals (RIs) of thyroid hormone based on data from healthy subjects in laboratory information system (LIS) by indirect methods. Methods: Data were selected from the physical examination center in LIS of the First Hospital of Jilin University from May 2014 to December 2018. The normal distribution of the original data was checked by the Kolmogorov-Smirnov test. Skewed data were transformed into normal distribution using BOX-COX techniques, and outliers were identified by the Turkey method. The continuous percentile curve was established by coefficient of skewness-median-coefficient of variation(LMS) methods. Cut-off value of age was determined by decision trees, and the differences between groups were verified by Z-tests. P(2.5) and P(97.5) in the RIs were analyzed by non-parametric methods. Results: A total of 45 742 subjects were included in the study. There were no differences in the RI for thyroid stimulating hormone (TSH) among age groups or between men and women (Z

Assuntos
Sistemas de Informação em Laboratório Clínico , Doenças da Glândula Tireoide/diagnóstico , Glândula Tireoide/metabolismo , Hormônios Tireóideos/sangue , Tireotropina/sangue , Adulto , Distribuição por Idade , Idoso , Biomarcadores/sangue , Química Clínica/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Distribuição por Sexo , Doenças da Glândula Tireoide/sangue , Testes de Função Tireóidea , Adulto Jovem
6.
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
7.
Heart Fail Clin ; 16(1): 11-21, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735309

RESUMO

"Chronic heart failure (CHF) is a complex syndrome characterized by symptoms and signs supported by different forms of cardiac impairment. The link between multiple hormonal and metabolic derangements and the development of CHF and the beneficial effects seen with hormonal replacement therapy suggest that a reduction of anabolic pathways might contribute to the onset of CHF. Therefore, an imbalance between anabolic and catabolic forces could be responsible for the development of CHF. There are sufficient evidence to support the screening in patients with CHF of hormonal deficiencies and their correction with replacement therapy."


Assuntos
Hormônio do Crescimento/sangue , Insuficiência Cardíaca/metabolismo , Resistência à Insulina , Doenças Metabólicas/etiologia , Testosterona/sangue , Hormônios Tireóideos/sangue , Biomarcadores/sangue , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/tratamento farmacológico , Terapia de Reposição Hormonal/métodos , Humanos , Doenças Metabólicas/tratamento farmacológico , Doenças Metabólicas/metabolismo
8.
Environ Pollut ; 258: 113731, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31874442

RESUMO

The widespread use of neonicotinoids has resulted in large residues in the soil, which has a major impact on the lizards that inhabit the soil. Thyroid hormones play an important role in the growth and development of lizards. In this report, we assessed the disrupting effects of thyroid system on lizards after 28 days of continuous exposure to dinotefuran, thiamethoxam, and imidacloprid, respectively. Neonicotinoid insecticides could seriously affect the concentration of T4 in lizard plasma and the conversion of T4 to T3 in the thyroid gland. Specifically, exposure to dinotefuran affected the intake and utilization of iodine in the thyroid gland, resulting in insufficient thyroid function, which in turn lead to thyroid epithelial hyperplasia and follicular volume enlargement by negative feedback. Exposure to thiamethoxam could activate thyroid function, significantly increasing plasma T3 and T4 concentrations and promoting the binding of T3 and thyroid hormone receptors. Imidacloprid exposure could inhibit the secretion of thyroid hormones, leading to down-regulation of thyroid hormone receptors and related phase II metabolic enzyme genes. This study verified that the continuous exposure of neonicotinoids could affect the lizard thyroid endocrine system. The harm of neonicotinoids to reptiles deserved more attention.


Assuntos
Inseticidas/toxicidade , Lagartos , Neonicotinoides/toxicidade , Glândula Tireoide/efeitos dos fármacos , Animais , Nitrocompostos , Hormônios Tireóideos/sangue
9.
Chemosphere ; 240: 124918, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31563717

RESUMO

Bisphenol A (BPA) is one of the largest amounts of chemicals in daily life and source of polycarbonate plastics, epoxy resins, medical equipment, plastic consumer products. Recent studies reported that the effects of BPA on human health in the thyroid hormone. Therefore, this study aimed to indicate the association between urinary BPA concentration and thyroid function in total triiodothyronine (T3), thyroxine (T4), thyroidal stimulating hormone (TSH) and stratified the population by body mass index (BMI). This study was performed on 6478 adults aged 19 years and older based on the Second Korean National Environmental Health Survey (KoNEHS, 2012-2014). We measured BPA in urine and total T3, T4 and TSH in serum from the 2nd KoNEHS study. The multiple regression analysis was performed to assess the association of urinary BPA concentrations with thyroid hormone after BMI stratification. Urinary BPA associated with thyroid hormone. Especially, BPA is related to T3 (-0.627) in all group, and T4 (-0.060, -0.098) in all group and the group of BMI 25.0kg/m2 or more negatively. When stratified by BPA, T3 and T4 were significantly decreased with the high BPA exposure compared with the low BPA exposure for BMI more than 25.0kg/m2 (adjusted ß = -3.402, 95% CI: 4.942, -1.862, adjusted ß = -0.209, 95% CI: 0.328, -0.090). However, no obvious associations were found between BPA concentration and TSH. The results of urinary BPA decrease with T3 and T4 levels increase in the higher BMI group is a new finding which does not exist in recent studies of Korea.


Assuntos
Compostos Benzidrílicos/urina , Poluentes Ambientais/urina , Fenóis/urina , Glândula Tireoide/fisiologia , Hormônios Tireóideos/sangue , Adulto , Idoso , Compostos Benzidrílicos/toxicidade , Índice de Massa Corporal , Estudos Transversais , Saúde Ambiental , Poluentes Ambientais/toxicidade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Fenóis/toxicidade , República da Coreia , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto Jovem
10.
PLoS One ; 14(12): e0226609, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31877169

RESUMO

Minerals, such as zinc, copper, and iron are reported to play roles in chronic infectious diseases; however, their role in paracoccidioidomycosis (PCM) remains unknown. This study aimed to examine the micronutrient dynamics and their correlation with serum proteins and thyroid hormones in patients with PCM. In 14 patients with PCM and 10 healthy subjects, we evaluated the body mass index (BMI) along with serum levels of hemoglobin, iron, ferritin, zinc, copper, magnesium, albumin, globulin, thyroid stimulating hormone (TSH), thyroxine (free T4), and triiodothyronine (T3). Evaluations were conducted at the first appointment, before treatment, and at the end of the first, second, fourth, and sixth month of PCM treatment. The control group was only evaluated once. We observed that before treatment, patients with PCM, had higher levels of copper and lower level of iron than those of the control group. After one month of treatment, the iron levels increased, whereas the levels of copper after six months of treatment. Reduction in inflammatory activity, indicated by the normalization of C-reactive protein, ferritin, albumin, and globulin levels, was observed during treatment. However, no correlation was observed between the serum levels of minerals and inflammatory activity or thyroid function in this study. In conclusion, our results showed higher serum copper levels in control group compared to those in pretreatment patients; the clinical importance of this observation should be investigated in further studies. After treatment, serum copper levels showed a tendency to decrease. In addition, serum iron levels were decreased at the stage of active disease, and were increased after treatment. Thus, serum iron levels can be used as a better biomarker for treatment control.


Assuntos
Proteínas Sanguíneas/análise , Micronutrientes/sangue , Paracoccidioidomicose/sangue , Hormônios Tireóideos/sangue , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/diagnóstico
11.
Sci Total Environ ; 688: 1172-1183, 2019 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-31726548

RESUMO

Polychlorinated biphenyls (PCBs) and their hydroxylated metabolites (OH-PCBs) might disrupt thyroid function. However, there is no clear evidence of PCB exposure disrupting thyroid hormone (TH) homeostasis in dogs and cats. The present study conducted in vivo experiments to evaluate the effects of a mixture of 12 PCB congeners (CB18, 28, 70, 77, 99, 101, 118, 138, 153, 180, 187 and 202, each congener 0.5 mg/kg BW, i.p. administration) on serum TH levels in male dogs (Canis lupus familiaris) and male cats (Felis silvestris catus). In PCB-exposed dogs, the time courses of higher-chlorinated PCBs and L-thyroxine (T4)-like OH-PCBs (4-OH-CB107 and 4-OH-CB202) concentrations were unchanged or tended to increase, whereas those of lower-chlorinated PCBs and OH-PCBs tended to decrease after 24 h. In PCB-exposed cats, concentrations of PCBs increased until 6 h and then remained unchanged. The levels of lower-chlorinated OH-PCBs including 4'-OH-CB18 increased until 96 h and then decreased. In PCB-exposed dogs, free T4 concentrations were higher than those in the control group at 48 and 96 h after PCB administration and positively correlated with the levels of T4-like OH-PCBs, suggesting competitive binding of T4 and T4-like OH-PCBs to a TH transporter, transthyretin. Serum levels of total T4 and total 3,3',5-triiodo-L-thyronine (T3) in PCB-exposed dogs were lower than in the control group at 24 and 48 h and negatively correlated with PCB concentrations, implying that PCB exposure enhanced TH excretion by increasing TH uptake and TH conjugation enzyme activities in the dog liver. In contrast, no obvious changes in TH levels were observed in PCB-exposed cats. This could be explained by the lower levels of T4-like OH-PCBs and lower hepatic conjugation enzyme activities in cats compared with dogs. Different effects on serum TH levels in PCB-exposed dogs and cats are likely to be attributable to species-specific PCB and TH metabolism.


Assuntos
Poluentes Ambientais/metabolismo , Bifenilos Policlorados/metabolismo , Hormônios Tireóideos/sangue , Animais , Gatos , Cães , Poluentes Ambientais/toxicidade , Feminino , Masculino , Bifenilos Policlorados/toxicidade , Tiroxina/sangue
12.
Niger J Clin Pract ; 22(10): 1349-1355, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31607723

RESUMO

Objective: The objective of the this study is to document the existence of statistically significant differences between parameters of heart rate variability (HRV) and heart rate turbulence (HRT), determined in women with overt hyperthyroidism (hT), compared to controls and to highlight their correlations with the level of thyroid hormones and the incidence of arrhythmias. Methods: We studied the HRV in time and frequency domain, and the HRT in a group of 113 women with overt hT, without other cardiovascular risk factors or comorbidities, admitted to the endocrinology clinic of our hospital, between 2012 and 2016. Depending on the severity and duration of hT and levels of thyroid hormones, the patients were assigned to three groups: mild and moderate forms, severe hT with thyrotoxicosis and persistent cases with a relapse of hT. We performed 24 h Holter monitoring in all patients. Results: HRV parameters in time domain (TD) were significantly depressed in patients comparing to controls. All patients had abnormal, positive values of turbulence onset (TO) with significant statistically differences (P < 0.0001) comparing to controls. Although positive, the values of turbulence slope (TS) decreased according to the severity of hT. Conclusion: Patients with hT had depressed values of HRV parameters in TD, correlated with the severity of the thyroid disease and with the incidence of arrhythmias. All patients presented pathological values of TO. TS values were positive, but lower compared to controls.


Assuntos
Arritmias Cardíacas/diagnóstico , Eletrocardiografia Ambulatorial/métodos , Frequência Cardíaca/fisiologia , Hipertireoidismo/complicações , Hormônios Tireóideos/sangue , Adulto , Arritmias Cardíacas/epidemiologia , Estudos de Casos e Controles , Doença Crônica , Comorbidade , Feminino , Humanos , Hipertireoidismo/epidemiologia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
13.
Exp Suppl ; 111: 55-84, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31588528

RESUMO

Thyroid hormone (TH) action is crucial for the development of several tissues.A number of syndromes are associated with reduced responsiveness to thyroid hormones, expanding the original definition of thyroid hormone resistance, firstly described by Refetoff and collaborators in 1967, which is characterized by elevated circulating levels of T4 and T3 with measurable serum TSH concentrations, as a consequence of mutations of thyroid hormone receptor beta (TRß), recently named as RTHß. More recently, another form of insensitivity to TH has been identified due to mutations in the thyroid hormone receptor alpha (TRα), named RTHα. In this chapter we will focus the discussion on the phenotype of RTHß and RTHα. These diseases share the same pathogenic mechanism caused by dominant negative mutations in TH receptor genes that reduce T3 binding or affect the recruitment of cofactors. As a consequence, thyroid hormone actions are impaired at the tissue level. The phenotypic manifestations of RTHß and RTHα are to some extent correlated with the degree of disruption and the tissue distribution of the TRs being characterized by variable coexistence of hypothyroid or thyrotoxic manifestations in RTHß or by a congenital hypothyroid features in RTHα despite normal TSH and borderline low free T4.


Assuntos
Receptores alfa dos Hormônios Tireóideos/genética , Receptores beta dos Hormônios Tireóideos/genética , Síndrome da Resistência aos Hormônios Tireóideos/genética , Hormônios Tireóideos/sangue , Humanos , Fenótipo
14.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(9): 1134-1138, 2019 Sep 10.
Artigo em Chinês | MEDLINE | ID: mdl-31594160

RESUMO

Objective: To understand the serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), triiodothyronine (T3), and thyroxine (T4) and identify the related influencing factors of thyroid dysfunction in drug users. Methods: From June to August 2018, a face-to-face questionnaire survey was conducted in 788 male drug users in a drug rehabilitation center in Jiangsu province to collect their socio-demographic information. Then, venous blood sample was collected from each participant for the detection of various hematological indicators, such as thyroid hormones. Results: The abnormal rates of T3, T4, FT3, FT4 and TSH were 4.57%, 1.27%, 0.51%, 0.38% and 0.89%, respectively, in the male drug users. HCV infection was an influencing factor for abnormal T3 level in the male drug users (OR=8.52, 95%CI: 2.36-30.74, P=0.001). And serum T3 (P<0.001) and T4 (P=0.048) levels increased with increasing HCV viral load. Conclusions: HCV infection was an influencing factor for the abnormality of serum T3 level in drug users. Therefore, thyroid-related knowledge should be added in the health education for drug users, and the monitoring of thyroid function should be strengthened for drug users infected with HCV.


Assuntos
Usuários de Drogas , Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias/sangue , Hormônios Tireóideos/sangue , China , Humanos , Masculino , Tireotropina , Tiroxina , Tri-Iodotironina
15.
Semin Ophthalmol ; 34(7-8): 533-540, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31646925

RESUMO

Purpose: To evaluate selected systemic findings, especially thyroid functions, in acute central serous chorioretinopathy (CSC) patients.Materials and Methods: In all, 71 consecutive acute CSC patients who fulfilled the inclusion criteria and 70 age-matched healthy control subjects were included in the study. Systemic findings, including serum levels of thyroid hormones, thyroid stimulating hormone (TSH), mean arterial pressure (MAP), pulse rate, serum lipid levels and optical coherence tomography findings, were compared between the groups. Independent samples t-test was used for statistical analysis.Results: The mean ages of the CSC and control groups were 41.06 ± 6.49 and 40.06 ± 7.08 years old, respectively. Retinal thickness, choroidal thickness, TSH levels, pulse rate and MAP were significantly different between CSC patients and healthy control subjects (range of p values: <0.001-0.042). In the logistic regression analysis, MAP, serum triglyceride concentration and central choroidal thickness were positively associated with CSC (range of p values: <0.001-0.035).Conclusion: Acute CSC patients had significantly higher pulse rates and MAP and significantly thicker choroidal thickness than were found in healthy subjects. TSH levels were also significantly higher in CSC patients than in controls. Hence, hypothyroidism might be associated with CSC.


Assuntos
Coriorretinopatia Serosa Central/etiologia , Corioide/patologia , Angiofluoresceinografia/métodos , Hipotireoidismo/complicações , Retina/patologia , Hormônios Tireóideos/sangue , Tomografia de Coerência Óptica/métodos , Doença Aguda , Adulto , Biomarcadores/sangue , Coriorretinopatia Serosa Central/sangue , Coriorretinopatia Serosa Central/diagnóstico , Feminino , Seguimentos , Fundo de Olho , Humanos , Hipotireoidismo/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
World J Pediatr Congenit Heart Surg ; 10(5): 604-615, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31496400

RESUMO

BACKGROUND: Patients with congenital heart disease have higher prevalence of thyroid dysfunction due to embryonic and genetic coexistence. Marked changes in cardiac function occur secondary to alternations in thyroid hormone levels. Cardiac catheterizations or cardiac surgeries with cardiopulmonary bypass can cause abnormalities in the circulating hormones, in the absence of primary thyroid disease. Therefore, monitoring of thyroid function should be routinely performed in children with congenital heart disease. Thyroid hormone supplementation has been postulated as a possible therapeutic option; however, the therapeutic decisions should be made based on individual circumstances, symptoms, and the severity of the thyroid dysfunction. OBJECTIVES: To describe the correlation between congenital heart disease in children and thyroid dysfunction and the debate on monitoring, intervention, and treatment. METHODS: PubMed, Clinical Key, and the Cochrane Library were searched using keywords relevant to congenital heart disease/surgery, cardiopulmonary bypass, thyroid hormones, sick euthyroid syndrome, and cardiac catheterization. Studies were limited to the English language and to children 0 to 18 years old. Studies in adults with important findings were reviewed as well. All clinical studies believed to have relevance were considered. All relevant studies were reviewed, and the most pertinent data were incorporated in this review. CONCLUSION: There is lack of significant evidence concerning treatment for thyroid dysfunction in children with a congenital cardiac diagnosis. Adequately powered studies are needed before a uniform recommendation about treatment can be made.


Assuntos
Síndromes do Eutireóideo Doente/complicações , Cardiopatias Congênitas/complicações , Cardiopatias Congênitas/cirurgia , Glândula Tireoide/fisiopatologia , Adolescente , Amiodarona/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Ponte Cardiopulmonar/efeitos adversos , Criança , Pré-Escolar , Hipotireoidismo Congênito/complicações , Feminino , Coração/fisiopatologia , Humanos , Lactente , Recém-Nascido , Masculino , Hormônios Tireóideos/sangue
17.
Environ Int ; 133(Pt A): 105123, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31521814

RESUMO

BACKGROUND: Bisphenols and triclosan are considered as potential thyroid disruptors. While mild alterations in maternal thyroid function can result in adverse pregnancy and child developmental outcomes, there is still uncertainty whether bisphenols or triclosan can interfere with thyroid function during pregnancy. OBJECTIVES: We aimed to investigate the association of urinary bisphenol A (BPA), bisphenol S (BPS), bisphenol F (BPF) and triclosan with early pregnancy thyroid function. METHODS: This study was embedded in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy study (SELMA), a population-based prospective pregnancy cohort. In total, 1996 participants were included in the current study. Maternal urinary concentrations of three bisphenols and triclosan, collected at median (95% range) 10 (6-14) weeks of pregnancy as well as serum concentrations of thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), total thyroxine (TT4), and total triiodothyronine (TT3) were measured. RESULTS: Higher BPA levels were associated with lower TT4 concentrations (non-monotonic, P = 0.03), a lower FT4/FT3 ratio (ß [SE] -0.02 [0.01], P = 0.03) and a lower TT4/TT3 ratio (ß [SE] -0.73 [0.27], P = 0.008). Higher BPF levels were associated with a higher FT3 (ß [SE] 0.01 [0.007], P = 0.04). There were no associations between other bisphenols or triclosan and absolute TSH, (F)T4 or (F)T3 concentrations. The association of BPA with thyroid function differed with gestational age. The negative association of BPA with FT4/FT3 and TT4/TT3 ratios was only apparent in early but not late gestation (P for interaction: 0.003, 0.008, respectively). CONCLUSION: These human data during pregnancy substantiate experimental findings suggesting that BPA could potentially affect thyroid function and deiodinase activities in early gestation.


Assuntos
Fenóis/urina , Glândula Tireoide/fisiologia , Triclosan/urina , Adulto , Compostos Benzidrílicos/urina , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Gravidez , Estudos Prospectivos , Sulfonas/urina , Suécia , Testes de Função Tireóidea , Hormônios Tireóideos/sangue , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
18.
Drugs Aging ; 36(11): 1007-1014, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31512083

RESUMO

The age-related resistance to thyroid hormones (THs) explains the paucity of symptoms and signs of hyperthyroidism in older adults and may partly explain the myriad of symptoms and signs of hypothyroidism in biochemically euthyroid older people. This review considers the available data on the mechanisms underlying TH resistance with aging and compares these physiologic changes with the changes observed in congenital TH resistance syndromes. Aging is associated with alterations in TH economy along with a host of changes in the responsiveness of various tissues to THs. The age-related resistance to THs can be attributed to decreased TH transport to tissues, decreased nuclear receptor occupancy, decreased activation of thyroxine to triiodothyronine, and alterations in TH responsive gene expression. Although an increase in serum TH levels is expected in syndromes of TH resistance, unchanged serum TH levels in the euthyroid elderly is the result of increased sensitivity to TH negative feedback with increased suppression of thyroid-stimulating hormone, decreased thyroidal sensitivity to thyroid-stimulating hormone, and decreased TH production and secretion. The current clinical evidence suggests that the age-related TH resistance is mostly an adaptive response of the aging organism. It is tempting to speculate that similar changes can occur prematurely in a group of younger people who present with signs and symptoms of hypothyroidism despite normal serum thyroid function tests.


Assuntos
Envelhecimento/metabolismo , Hipertireoidismo/metabolismo , Hipotireoidismo/metabolismo , Hormônios Tireóideos/metabolismo , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/genética , Animais , Humanos , Hipertireoidismo/genética , Hipotireoidismo/genética , Iodeto Peroxidase/genética , Masculino , Receptores dos Hormônios Tireóideos/genética , Hormônios Tireóideos/sangue , Hormônios Tireóideos/genética , Tiroxina/sangue , Tiroxina/genética , Tiroxina/metabolismo , Tri-Iodotironina/sangue , Tri-Iodotironina/genética , Tri-Iodotironina/metabolismo
19.
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
20.
Int J Mol Sci ; 20(15)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31374823

RESUMO

Heart function and its susceptibility to arrhythmias are modulated by thyroid hormones (THs) but the responsiveness of hypertensive individuals to thyroid dysfunction is elusive. We aimed to explore the effect of altered thyroid status on crucial factors affecting synchronized heart function, i.e., connexin-43 (Cx43) and extracellular matrix proteins (ECM), in spontaneously hypertensive rats (SHRs) compared to normotensive Wistar Kyoto rats (WKRs). Basal levels of circulating THs were similar in both strains. Hyperthyroid state (HT) was induced by injection of T3 (0.15 mg/kg b.w. for eight weeks) and hypothyroid state (HY) by the administration of methimazol (0.05% for eight weeks). The possible benefit of omega-3 polyunsaturated fatty acids (Omacor, 200 mg/kg for eight weeks) intake was examined as well. Reduced levels of Cx43 in SHRs were unaffected by alterations in THs, unlike WKRs, in which levels of Cx43 and its phosphorylated form at serine368 were decreased in the HT state and increased in the HY state. This specific Cx43 phosphorylation, attributed to enhanced protein kinase C-epsilon signaling, was also increased in HY SHRs. Altered thyroid status did not show significant differences in markers of ECM or collagen deposition in SHRs. WKRs exhibited a decrease in levels of profibrotic transforming growth factor ß1 and SMAD2/3 in HT and an increase in HY, along with enhanced interstitial collagen. Short-term intake of omega-3 polyunsaturated fatty acids did not affect any targeted proteins significantly. Key findings suggest that myocardial Cx43 and ECM responses to altered thyroid status are blunted in SHRs compared to WKRs. However, enhanced phosphorylation of Cx43 at serine368 in hypothyroid SHRs might be associated with preservation of intercellular coupling and alleviation of the propensity of the heart to malignant arrhythmias.


Assuntos
Conexina 43/metabolismo , Proteínas da Matriz Extracelular/metabolismo , Hipertensão/metabolismo , Miocárdio/metabolismo , Hormônios Tireóideos/metabolismo , Animais , Hipertensão/sangue , Masculino , Ratos Endogâmicos SHR , Ratos Endogâmicos WKY , Hormônios Tireóideos/sangue
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