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2.
J Assoc Physicians India ; 67(10): 33-36, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571449

RESUMO

Background and Objectives: Thyroid disorders in elderly population are of prime importance as it has emphasis on various metabolic activity and disease states. There is limited data regarding the prevalence of thyroid disorders in elderly from India. This study was an attempt to assess the thyroid function tests in elderly population and to correlate them with clinical symptoms. Methodology: This one year hospital based prospective cross sectional study was done in outpatient Department, Department of General Medicine and Geriatric Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi on a total of 100 elderly patients who presented for regular checkups with clinical suspicion of thyroid disorders from January 2017 to December 2017. The selected patients were investigated for T3, T4, TSH and thyroid antibodies. Results: Majority of the patients were females (67%), the male to female ratio was 1:2.03. The mean age was 67.69±7.21 years. The mean T3 levels were 1.32±0.88 ng/mL, the mean T4 levels were 7.69±4.13 µg/mL and mean TSH levels were 12.31±22.82 mcIU/mL. The mean TPO antibodies were noted as 95.97±211.82 IU/mL. Thyroid abnormalities were diagnosed in 28% of the patients and hypothyroidism was the most common thyroid abnormality noted in 12% of the patients. No association was found between thyroid abnormalities and sex (p=0.349) as well as age (p=0.946). Easy fatiguability (94%) and generalized weakness (93%) were the common clinical complaints and mild pallor was the common clinical sign noted in 26% of the patients followed by dry/coarse skin in 25% of the patients. Thyroid abnormalities were significantly associated with easy fatiguability, generalized weakness, swelling of limb/face, weight gain, constipation and with clinical signs of pallor, dry/coarse skin, hoarseness, ankle jerk and oedema. Family history of thyroid disorders was reported by 47% of the patients and it was significantly associated with of thyroid disorders (p=0.001). Conclusion and Interpretation: There is higher incidence of thyroid abnormalities among elderly population in the study area and overt hypothyroidism is the common thyroid abnormality.


Assuntos
Testes de Função Tireóidea , Tireotropina , Idoso , Estudos Transversais , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
4.
Wiad Lek ; 72(7): 1300-1303, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31398159

RESUMO

OBJECTIVE: Introduction: In the treatment of hypothyroidism substitution therapy with L-thyroxine is used, it is also advisable to use the metabolites with membrane-stabilizing properties that normalize the metabolism in the body, for example, calcitonin, which significantly reduces the depth of the dystrophic phenomena in the myocardium. The aim was to study the patterns of structural changes in the left ventricular myocardial capillaries of rats with congenital hypothyroidism in combinative drug therapy with L-thyroxine and calcitonin. PATIENTS AND METHODS: Materials and methods: 30 white Wistar line rats were used as experimental animals: 10 with treatment and 10 without as well as control - 10 intact Wistar line rats of the same age. Mercazolil was used to inhibit thyroid gland in order to model congenital hypothyroidism. After birth, the rats received L-thyroxine at a dose of 10 µg / kg per os daily, calcitonin at a dose of 1.0 MU / kg per day intramuscularly, then with mother's milk, later by themselves for 100 days. The arterial pressure was measured in all experimental groups during extraction from the experiment by plethysmograph, their left ventricular myocardium was examined under electron microscope and micropinocytotic vesicles in their cells were studied morphometrically. RESULTS: Results: In rats with congenital hypothyroidism, for which L-thyroxin drug in combination with calcitonin was used as a substitution therapy, after pharmacological correction, in general there is no pronounced heteromorphism of the ultrastructure of the left ventricular myocardial blood capillaries, which was characteristic for animals without pharmacological correction. The analysis showed normalization of the content of free thyroxine in blood plasma and blood pressure of rats with congenital hypothyroidism after complex substitution therapy. CONCLUSION: Conclusions: In rats with congenital hypothyroidism, which received L-thyroxine and calcitonin at birth, the myocardium capillaries generally remain intact and have morphological and functional characteristics similar to intact animals, which is the theoretical basis for the need for calcitonin to be used in substitution therapy in hypothyroidism.


Assuntos
Hipotireoidismo Congênito , Animais , Ratos , Ratos Wistar , Testes de Função Tireóidea , Tiroxina
5.
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
6.
Rev Assoc Med Bras (1992) ; 65(6): 755-760, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31340298

RESUMO

INTRODUCTION: Graves' disease (GD) is an autoimmune disorder characterized by hyperthyroidism. Antithyroid drugs (ATDs) are available as therapy. Agranulocytosis is a rare but potentially fatal complication of this therapy. In this study, we report agranulocytosis induced by propylthiouracil (PTU) in a patient with GD and the difficulties of clinical management. CASE: RNBA, male, 30 years old, with GD, treated with propylthiouracil (PTU). He progressed with pharyngotonsillitis. Then, PTU was suspended and antibiotic, filgrastim, propranolol, and prednisone were initiated. Due to the decompensation of hyperthyroidism, lithium carbonate, dexamethasone, and Lugol's solution were introduced. Total thyroidectomy (TT) was performed with satisfactory postoperative progression. DISCUSSION: We describe here the case of a young male patient with GD. For the treatment of hyperthyroidism, thioamides are effective options. Agranulocytosis induced by ATDs is a rare complication defined as the occurrence of a granulocyte count <500/mm3 after the use of ATDs. PTU was suspended, and filgrastim and antibiotics were prescribed. Radioiodine (RAI) or surgery are therapeutic alternatives. Due to problems with ATD use, a total thyroidectomy was proposed. The preoperative preparation was performed with beta-blocker, glucocorticoid, lithium carbonate, and Lugol solution. Cholestyramine is also an option for controlling hyperthyroidism. TT was performed without postoperative complications. CONCLUSION: Thionamide-induced agranulocytosis is a rare complication. With a contraindication to ATDs, RAI and surgery are definitive therapeutic options in GD. Beta-blockers, glucocorticoids, lithium carbonate, iodine, and cholestyramine may be an adjunctive therapy for hyperthyroidism.


Assuntos
Agranulocitose/induzido quimicamente , Antitireóideos/efeitos adversos , Doença de Graves/tratamento farmacológico , Propiltiouracila/efeitos adversos , Adulto , Humanos , Masculino , Doenças Raras , Testes de Função Tireóidea , Tireoidectomia
7.
J Assoc Physicians India ; 67(3): 51-54, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31304707

RESUMO

Aims and Objectives: To evaluate the Thyroid functions in patients with cirrhosis of liver and to assess the severity of liver dysfunction in relation with interpretation of thyroid functions. Material and Methods: The present study was undertaken at Maharana Bhupal Govt. Hospital, attached to R.N.T. Medical College, Udaipur (Raj.). Study included total 50 patients admitted at Maharana Bhupal Govt. Hospital, attached to R.N.T. Medical College Udaipur (Raj.) with clinical, biochemical, and radiological evidence of cirrhosis of liver. All patients were subjected to medical examination as per the fixed Performa. Observations and Conclusion: Prevalence of subclinical hypothyroidism with cirrhosis was 62%. 31 out of 50 patients had subclinical hypothyroidism. The study showed that prevalence of hypothyroidism in cirrhosis patients increases as the severity of cirrhosis increases and findings were statistically significant (p value 0.00).This study found association between serum T3 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of T3 reduces and findings were statistically significant (p value 0.00).All 50 patients of cirrhosis had their serum T4 level within normal limit and it does not change with severity of liver disease. This study found association between serum FT4 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of FT4 fall in low-normal or below normal value and findings were statistically significant (p value 0.00). This study found association between serum FT3 and severity of liver disease. As the severity of cirrhosis increases which is indicated by Child Pugh A to C, serum level of FT3 reduces. All patients of Child Pugh C had low FT3 level and the findings were statistically significant (p value 0.00). This study showed that serum bilirubin, prothombin time, INR, TSH level increases and serum albumin level, T3, FT3, and FT4 level reduces as the severity of cirrhosis increases.According to this study all cirrhotic patients should undergo thyroid function evaluation as these patients are definitely associated with development of hypothyroidism. There is significant inverse correlation between serum level of T3, FT3, and FT4 with severity of cirrhosis. These parameters can be used as markers to indicate the severity of cirrhosis.


Assuntos
Cirrose Hepática/epidemiologia , Hepatopatias , Testes de Função Tireóidea , Criança , Humanos , Testes de Função Hepática
8.
Crit Rev Oncol Hematol ; 141: 23-35, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31202955

RESUMO

Recently, tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICPIs) have emerged as new classes of anticancer therapies. Although generally considered less toxic than cytotoxic chemotherapy, these new drugs can cause significant unanticipated side effects including thyroid dysfunction. This review provides a literature assessment of thyroid dysfunctions induced by TKI and ICPIs. We intend to define for these two classes the frequency of thyroid involvement, the potential mechanisms that result in this toxicity, the clinical-biological impact and the therapeutic management. Detection of thyroid dysfunction requires monitoring of TSH, in combination with free T4 if needed and, depending on the clinical impact and the kinetics of biological abnormalities, starting symptomatic treatment of hyperthyroidism and/or correcting hypothyroidism.


Assuntos
Antineoplásicos Imunológicos/efeitos adversos , Neoplasias/tratamento farmacológico , Inibidores de Proteínas Quinases/efeitos adversos , Proteínas Tirosina Quinases/antagonistas & inibidores , Doenças da Glândula Tireoide/induzido quimicamente , Antineoplásicos Imunológicos/uso terapêutico , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Pontos de Checagem do Ciclo Celular/imunologia , Humanos , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/diagnóstico , Hipotireoidismo/patologia , Hipotireoidismo/terapia , Neoplasias/fisiopatologia , Inibidores de Proteínas Quinases/uso terapêutico , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/patologia , Doenças da Glândula Tireoide/terapia , Testes de Função Tireóidea
9.
Prensa méd. argent ; 105(5): 293-295, jun 2019. tab
Artigo em Inglês | LILACS, BINACIS | ID: biblio-1024573

RESUMO

Introduction: Mole hydatiforme is the most common type of gestational trophoblast disease (GTI) and the aim of this study, is evaluation the frequency of changes in thyroid function test in mole hydatidiform patients. Materials and Methods: In this retrospective study, 63 patients with mole hydatidiform who reffering to gynecolgy ward of Ali ibn Abitaleb Hospital in Zahedan from April 2016 to March 2017, were studied. Information such as age, gravidity and laboratory findings inclluding thyroid function test (TFT) and the presence or absence of clinical sympltoms were recorded in the information forms and analyzed by SPSS software. Results: In this study, 63 patients with mole hydatidiform were studied. The mean age of the patients was 26.6 ± 7.7 years. The most common clinical manifestations of hyperthyroidism in patients with mole hydatidorme was tachycardia (39.7%). There was no relationschip between age and gravidity with the hyperthyroid simptoms and thyroid function test. Conclusion: Overall, the results of this study showed ttat 67% of patients with mole hydatidiform hay reduced TSH and more than 50% of cases hay increased free T3 and T4. There was no relationship between maternal age and gravidity with changes in thyroid functional test (AU)


Assuntos
Humanos , Feminino , Gravidez , Adulto , Testes de Função Tireóidea/tendências , Mola Hidatiforme/diagnóstico , Estudos Transversais , Estudos Retrospectivos , Idade Materna , Doença Trofoblástica Gestacional/diagnóstico
10.
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
11.
Pediatrics ; 143(5)2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31040197

RESUMO

BACKGROUND AND OBJECTIVES: Recent studies show that long-term (LT) antithyroid drugs reduce relapse of hyperthyroidism in patients with Graves' disease. Our objective was to evaluate the effectiveness and safety of LT methimazole treatment and to compare remission rates in Graves' disease patients after LT and short-term (ST) therapy. METHODS: In this randomized, parallel group trial, 66 consecutive patients with untreated juvenile Graves' hyperthyroidism were enrolled. After a median 22 months of methimazole treatment, 56 patients were randomly assigned to either continue low-dose methimazole treatment (n = 24, LT group) or to discontinue treatment (n = 24, ST group). Twenty-four patients in LT group completed 96 to 120 months of methimazole treatment. Patients in both groups were managed for 48 months after discontinuation of treatment. RESULTS: Except for 3 cases of cutaneous reactions, no other adverse events were observed throughout 120 months of methimazole therapy. Serum free thyroxine, triiodothyronine, thyrotropin, and thyrotropin receptor antibody remained normal, and the required daily dosage of methimazole was gradually decreased from 5.17 ± 1.05 mg at 22 months to 3.5 ± 1.3 mg between 96 and 120 months of treatment (P < .001). Hyperthyroidism was cured in 92% and 88% of LT patients and in 46% and 33% of ST patients, 1 and 4 years after methimazole withdrawal, respectively. CONCLUSIONS: LT methimazole treatment of 96 to 120 months is safe and effective for treatment of juvenile Graves' disease. The four-year cure rate of hyperthyroidism with LT methimazole treatment is almost 3 times more than that of ST methimazole treatment.


Assuntos
Antitireóideos/administração & dosagem , Doença de Graves/diagnóstico , Doença de Graves/tratamento farmacológico , Metimazol/administração & dosagem , Adolescente , Esquema de Medicação , Feminino , Doença de Graves/sangue , Humanos , Masculino , Testes de Função Tireóidea/tendências
13.
Endocr Pract ; 25(8): 824-829, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31013164

RESUMO

Objective: To characterize anti-programmed cell death 1 (PD-1)-induced thyroid immune-related adverse events (irAEs) in metastatic melanoma patients treated at our institution and to identify risk factors associated with their development. Methods: We reviewed the files of 154 patients with metastatic melanoma treated with PD-1 inhibitors at a single institution from November 1, 2011, to February 28, 2017. The association of thyroid irAEs within 120 days posttreatment initiation with age, gender, melanoma characteristics, treatment protocol, and baseline thyroid-stimulating hormone (TSH) was examined. Results: Overall, 42.4% developed thyroid dysfunction following treatment, including 20.2% (20/99) subclinical thyroid dysfunction, 13.1% (13/99) overt hypothyroidism, and 9.1% (9/99) overt hyperthyroidism. Of those that developed overt hyperthyroidism, 8 progressed to overt hypothyroidism, consistent with thyroiditis. Age, gender, melanoma characteristics, or treatment protocol did not modify the risk of developing thyroid irAEs. Higher baseline TSH was observed in patients who developed overt hypothyroidism versus hyperthyroidism versus those who remained euthyroid (P = .05). A pretreatment TSH >2.19 mIU/mL was associated with an increased risk of overt thyroid dysfunction (odds ratio, 3.46; 95% confidence interval, 1.2 to 9.8). Conclusion: Thyroid dysfunction following treatment with PD-1 inhibitors is common, and patients with a higher baseline TSH appear to be at increased risk. Such patients may benefit from closer monitoring of their thyroid function following initiation of anti PD-1 agents. Abbreviations: CTLA-4 = cytotoxic T-lymphocyte antigen 4; FT3 = free triiodothyronine; FT4 = free thyroxine; irAE = immune-related adverse event; PD-1 = programmed cell death 1; TFT = thyroid function test; TPO = thyroid peroxidase; TSH = thyroid-stimulating hormone.


Assuntos
Hipotireoidismo , Humanos , Receptor de Morte Celular Programada 1 , Fatores de Risco , Testes de Função Tireóidea , Tireotropina , Tiroxina
14.
Diabetes Res Clin Pract ; 151: 114-119, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30935929

RESUMO

PURPOSE: The objective of this study was to estimate the combined effect of serum ferritin (SF) concentration and free thyroxine (fT4) levels on the risk of gestational diabetes mellitus (GDM). METHODS: Women presented for antenatal care at a tertiary hospital in Shanghai, China were included in this study from December 2012 to March 2014. Women were divided into six groups according to the SF and fT4 level. Multiple logistical regression model was used to estimate odds ratio (OR) among different groups. Relative excess risk of interaction (RERI), the attributable proportion (AP) of the interaction and the synergy index (SI) were applied to evaluate the additive interaction of SF concentration and fT4 level. RESULTS: A total of 6542 qualifying pregnant women were included in this study. We observed that a high SF concentration in early pregnancy was related to an increased risk of GDM (OR = 1.21, 95%CI: 1.02-1.43); while a low fT4 level was not (OR = 1.18, 95%CI: 0.89-1.58). There is no addictive interaction between SF and fT4 level on the presence of GDM. CONCLUSIONS: The study suggests that only high serum ferritin concentration is associated with an increased risk of GDM in early pregnancy. The level of fT4 in early pregnancy might have no effect on the association between high SF and risk of GDM.


Assuntos
Diabetes Gestacional/sangue , Diabetes Gestacional/diagnóstico , Ferritinas/sangue , Testes de Função Tireóidea/métodos , Tiroxina/sangue , Adulto , Diabetes Gestacional/patologia , Feminino , Humanos , Gravidez , Primeiro Trimestre da Gravidez/sangue , Adulto Jovem
15.
Medicine (Baltimore) ; 98(14): e15055, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30946351

RESUMO

In this study, we evaluated the association between thyroid echogenicity on ultrasonography (US) and thyroid function in pediatric and adolescent Hashimoto's thyroiditis (HT) patients.In 86 pediatric and adolescent HT patients, the association between echogenicity and thyroid function and microsomal autoantibody status was evaluated. Among patients with overt hypothyroidism, 89.2% (33/37) showed a US grade of 3 or 4. All of the patients at grade 4 presented with overt hypothyroidism. In contrast, 97.8% (44/49) of the patients with subclinical hypothyroidism or euthyroidism showed grades 1 or 2. Patients with increased thyroid-stimulating hormone titer also tended to have increased US grades (P < .001). In contrast, free thyroxine levels were significantly decreased with increasing US grade (P < .001).In conclusion, patients with higher US grades had decreased thyroid function (P < .001).


Assuntos
Doença de Hashimoto/diagnóstico por imagem , Doença de Hashimoto/fisiopatologia , Glândula Tireoide/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adolescente , Criança , Pré-Escolar , Progressão da Doença , Feminino , Doença de Hashimoto/classificação , Humanos , Masculino , Estudos Retrospectivos , Método Simples-Cego , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue
16.
Endocr Pract ; 25(4): 315-319, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30995430

RESUMO

Objective: Few studies have explored the influence of thyroid status on sex ratio at birth, and conclusions are inconsistent. The aim of this study was to determine if there is an association between serum thyroid-stimulating hormone (TSH) level in first trimester and sex ratio at birth. Methods: The study was a retrospective cohort study performed at a tertiary care center. From March 2014 to February 2017, a total of 4,822 women who had thyroid function testing during the first trimester were included. Study population was divided into five groups according to quintile of TSH level (≤0.60 mIU/L; 0.61 to 1.02 mIU/L; 1.03 to 1.44 mIU/L; 1.45 to 2.13 mIU/L; and ≥2.14 mIU/L). Logistic regression analysis was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) of the percentage of male infants across the quintiles, with the lowest quintile as the reference category. Results: Median level of TSH was 1.27 mIU/L in women who delivered a boy, which was significantly higher than that in women who delivered a girl (1.15 mIU/L). After adjusting for age, gravidity, and parity, multivariate logistic analysis found that women in quintiles 3, 4, and 5 all showed significantly higher ORs for delivering a boy than those in quintile 1. In addition, after adjusting for age, gravidity, and parity, serum TSH was significantly associated with likelihood of having a boy (OR, 1.08; 95% CI, 1.03 to 1.13). Conclusion: Maternal TSH level in the first trimester is positively associated with the probability of delivering a male newborn. Abbreviations: CI = confidence interval; FT3 = free triiodothyronine; FT4 = free thyroxine; OR = odd ratio; SRB = sex ratio at birth; TBG = thyroxin-binding globulin; TSH = thyroid-stimulating hormone.


Assuntos
Testes de Função Tireóidea , Tireotropina/sangue , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Primeiro Trimestre da Gravidez , Estudos Retrospectivos , Razão de Masculinidade , Tiroxina
17.
Lipids Health Dis ; 18(1): 84, 2019 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-30947712

RESUMO

BACKGROUND: Two important regulators for circulating lipid metabolisms are lipoprotein lipase (LPL) and hepatic triglyceride lipase (HTGL). In relation to this, glycosylphosphatidylinositol anchored high-density lipoprotein binding protein 1 (GPIHBP1) has been shown to have a vital role in LPL lipolytic processing. However, the relationships between skeletal muscle mass and lipid metabolism, including LPL, GPIHBP1, and HTGL, remain to be elucidated. Demonstration of these relationships may lead to clarification of the metabolic dysfunctions caused by sarcopenia. In this study, these relationships were investigated in young Japanese men who had no age-related factors; participants included wrestling athletes with abundant skeletal muscle. METHODS: A total of 111 young Japanese men who were not taking medications were enrolled; 70 wrestling athletes and 41 control students were included. The participants' body compositions, serum concentrations of lipoprotein, LPL, GPIHBP1 and HTGL and thyroid function test results were determined under conditions of no extreme dietary restrictions and exercises. RESULTS: Compared with the control participants, wrestling athletes had significantly higher skeletal muscle index (SMI) (p < 0.001), higher serum concentrations of LPL (p < 0.001) and GPIHBP1 (p < 0.001), and lower fat mass index (p = 0.024). Kruskal-Wallis tests with Bonferroni multiple comparison tests showed that serum LPL and GPIHBP1 concentrations were significantly higher in the participants with higher SMI. Spearman's correlation analyses showed that SMI was positively correlated with LPL (ρ = 0.341, p < 0.001) and GPIHBP1 (ρ = 0.309, p = 0.001) concentration. The serum concentrations of LPL and GPIHBP1 were also inversely correlated with serum concentrations of triglyceride (LPL, ρ = - 0.198, p = 0.037; GPIHBP1, ρ = - 0.249, p = 0.008). Serum HTGL concentration was positively correlated with serum concentrations of total cholesterol (ρ = 0.308, p = 0.001), low-density lipoprotein-cholesterol (ρ = 0.336, p < 0.001), and free 3,5,3'-triiodothyronine (ρ = 0.260, p = 0.006), but not with SMI. CONCLUSIONS: The results suggest that increased skeletal muscle mass leads to improvements in energy metabolism by promoting triglyceride-rich lipoprotein hydrolysis through the increase in circulating LPL and GPIHBP1.


Assuntos
Lipase/sangue , Lipase Lipoproteica/sangue , Músculo Esquelético/metabolismo , Doenças Musculares/genética , Receptores de Lipoproteínas/sangue , Adolescente , Adulto , Atletas , LDL-Colesterol/sangue , Metabolismo Energético/genética , Exercício/fisiologia , Feminino , Estudos de Associação Genética , Humanos , Lipase/genética , Metabolismo dos Lipídeos/genética , Lipase Lipoproteica/genética , Fígado/metabolismo , Masculino , Músculo Esquelético/fisiologia , Doenças Musculares/sangue , Doenças Musculares/patologia , Receptores de Lipoproteínas/genética , Testes de Função Tireóidea , Triglicerídeos/sangue , Adulto Jovem
18.
J Pediatr Endocrinol Metab ; 32(4): 341-346, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-30862763

RESUMO

Background The management options for Graves' disease in children are limited and there is controversy regarding optimal treatment. Remission rate with anti-thyroid drug (ATD) treatment in children is said to be lower than in adults. Definitive treatments are effective, but they often result in permanent hypothyroidism. The objective of this study was to investigate the outcome of methimazole treatment, identify significant predictors of a remission and evaluate the adverse effects of methimazole in a pediatric population of GD patients. Methods Medical records of the patients who had been diagnosed with Graves' disease were screened retrospectively. Diagnostic criteria included elevated free thyroxine (fT4) and total triiodothyronine (T3), suppressed thyroid-stimulating hormone (TSH) and either positive thyroid-stimulating immunoglobulin (TSI) or thyroid receptor antibodies (TRABs) or clinical signs suggestive of Graves' disease, for example, exophthalmos. Remission was defined as maintenance of euthyroidism for more than 12 months after discontinuing methimazole treatment. Results Of the 48 patients, provisional remission was achieved in 21 patients. Of the 21 patients, 14 experienced a relapse (66.6%). Remission was achieved in seven (24.1%) of 29 patients who received methimazole treatment for more than 2 years. In patients who achieved long-term remission, the male sex ratio and fT4 levels at diagnosis were significantly lower than the relapsed and non-remission groups, whereas the free triiodothyronine (fT3)/fT4 ratio and duration of methimazole treatment were significantly higher than the relapse group. Conclusions Long-term methimazole treatment in pediatric Graves' disease would be appropriate. High fT4 levels at the time of diagnosis and male sex were associated with a risk of relapse.


Assuntos
Antitireóideos/uso terapêutico , Doença de Graves/tratamento farmacológico , Metimazol/uso terapêutico , Hormônios Tireóideos/sangue , Adolescente , Adulto , Criança , Feminino , Seguimentos , Doença de Graves/sangue , Doença de Graves/patologia , Humanos , Masculino , Prognóstico , Indução de Remissão , Estudos Retrospectivos , Testes de Função Tireóidea , Adulto Jovem
19.
J Trace Elem Med Biol ; 53: 55-61, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30910207

RESUMO

Previous studies on blood cadmium (BCd) and changes in thyroid hormone levels are controversial. We investigated whether thyroid hormone levels and thyroid function status were associated with BCd according to sex in the Korean population. Our study included 1972 participants based on the 2013 Korea National Health and Nutrition Examination Survey (KNHANES) data. Participants whose thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were altered physiologically or medically were excluded. Changes in TSH, fT4, and anti-thyroid peroxidase antibody (TPOAb) in men and women were analyzed by different characteristics: age, body mass index (BMI), smoking status, drinking status, BCd, and urine iodine-to-creatinine ratio (UI/Cre). Thyroid function status was classified as hypothyroidism, euthyroidism, and hyperthyroidism as defined by TSH and fT4 levels. Among the total participants, there was a negative correlation between BCd and fT4 (r=-0.067, p = 0.003). In men (n = 1057), fT4 levels decreased with increasing BCd quartile (p-for-trend = 0.002). After adjustment for age, BMI, smoking status, UI/Cre, and TPOAb, the association between BCd and hypothyroidism was significant in men (odds ratio = 1.813, p = 0.032) but not in women. These results suggest that cadmium accumulation is closely associated with thyroid dysfunction, and there is a difference in metabolic capacity according to sex.


Assuntos
Cádmio/sangue , Caracteres Sexuais , Glândula Tireoide/metabolismo , Glândula Tireoide/fisiopatologia , Hormônios Tireóideos/sangue , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Testes de Função Tireóidea , Hormônios Tireóideos/metabolismo , Adulto Jovem
20.
BMJ ; 364: l805, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30824431

RESUMO

The studyRoberts L, McCahon D, Johnson O, Haque MS, Parle J, Hobbs FR. Stability of thyroid function in older adults: the Birmingham Elderly Thyroid Study. Published on 28 August 2018 Br J Gen Pract 2018;68:e718-26.This study was funded by the National Institute for Health Research School for Primary Care Research (SPCR).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000703/repeat-thyroid-function-tests-for-healthy-older-people-are-not-needed.


Assuntos
Testes de Função Tireóidea , Glândula Tireoide , Idoso , Idoso de 80 Anos ou mais , Humanos , Atenção Primária à Saúde
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