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1.
Biomed Environ Sci ; 37(3): 254-265, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38582990

RESUMO

Objective: Studies on the relationship between iodine, vitamin A (VA), and vitamin D (VD) and thyroid function are limited. This study aimed to analyze iodine and thyroid-stimulating hormone (TSH) status and their possible relationships with VA, VD, and other factors in postpartum women. Methods: A total of 1,311 mothers (896 lactating and 415 non-lactating) from Hebei, Zhejiang, and Guangxi provinces were included in this study. The urinary iodine concentration (UIC), TSH, VA, and VD were measured. Results: The median UIC of total and lactating participants were 142.00 µg/L and 139.95 µg/L, respectively. The median TSH, VA, and VD levels in all the participants were 1.89 mIU/L, 0.44 µg/mL, and 24.04 ng/mL, respectively. No differences in the UIC were found between lactating and non-lactating mothers. UIC and TSH levels were significantly different among the three provinces. The rural UIC was higher than the urban UIC. Obese mothers had a higher UIC and a higher prevalence of excessive TSH. Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group. After adjustment, no linear correlation was observed between UIC and VA/VD. No interaction was found between vitamins A/D and UIC on TSH levels. Conclusion: The mothers in the present study had no iodine deficiency. Region, area type, BMI, and VD may be related to the iodine status or TSH levels.


Assuntos
Iodo , Tireotropina , Humanos , Feminino , Estudos Transversais , Lactação , China/epidemiologia , Período Pós-Parto , Estado Nutricional , Vitaminas , Vitamina D , Vitamina A , Colecalciferol
2.
Sci Rep ; 14(1): 7828, 2024 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-38570629

RESUMO

The prevalence of hyperthyroidism and hypothyroidism and associated risk factors are unknown in liver transplant recipients. We aimed to determine the prevalence of hyperthyroidism and hypothyroidism and associated risk factors in liver transplant recipients and to compare it with controls from the general population. As part of the Danish Comorbidity in Liver Transplant Recipients (DACOLT) Study, all Danish liver transplant recipients over the age of 20 were invited for measurements of concentrations of thyrotropin and thyroid hormones. The prevalence of hyperthyroidism and hypothyroidism was compared to age- and sex-matched controls from the Copenhagen General Population Study. Using logistic regression adjusted for age, sex, smoking, and body-mass index, we investigated potential risk factors. We recruited 489 liver transplant recipients and 1808 controls. Among liver transplant recipients, 14 (2.9%) had hyperthyroidism compared with 21 (1.2%) of controls (adjusted odds ratio [aOR] 2.24, 95% confidence interval [CI] 1.05-4.75, P = 0.04), while 42 (5.7%) had hypothyroidism compared with 139 (7.7%) of controls (aOR 0.68, 95% CI 0.43-1.08, P = 0.10). Female sex, and autoimmune hepatitis and primary sclerosing cholangitis as causes of transplantation were associated with hyperthyroidism after adjustments. Age, female sex, and autoimmune liver diseases as cause of transplantation were associated with hypothyroidism after adjustments. DACOLT is registered in ClinicalTrials.gov (NCT04777032).


Assuntos
Hipertireoidismo , Hipotireoidismo , Transplante de Fígado , Humanos , Feminino , Prevalência , Transplante de Fígado/efeitos adversos , Hipotireoidismo/etiologia , Hipotireoidismo/complicações , Hipertireoidismo/epidemiologia , Hipertireoidismo/complicações , Fatores de Risco , Tireotropina
3.
Gynecol Endocrinol ; 40(1): 2333432, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38567465

RESUMO

OBJECTIVE: To evaluate the possible association between thyroid function within the euthyroid range and musculoskeletal parameters as well as body composition in a sample of postmenopausal women. METHODS: This cross-sectional study included 96 postmenopausal women with serum thyroid-stimulating hormone (TSH) within the normal laboratory reference range. Fasting venous blood samples were obtained for biochemical/hormonal assessment. Bone status and body composition were measured using Dual Energy X-ray absorptiometry (DXA). Physical activity was quantified using the International Physical Activity Questionnaire (IPAQ) index. RESULTS: Serum TSH correlated with handgrip strength (HGS, r-coefficient = 0.233, p = .025), and total body bone mineral density (BMD) T-score values (r-coefficient = 0.321, p = .003). HGS measures were associated with BMD (r-coefficient = 0.415, p < .001), with bone mineral content (BMC, r-coefficient = 0.427, p < .001), and lean mass (r-coefficient = 0.326, p = .003). Women with low muscle strength, defined as HGS < 16 kg, had lower TSH levels than women with normal muscle strength (low vs. normal muscle strength, ANCOVA 1.13 ± 0.49 mU/L vs. 1.60 ± 0.83 mU/L, p = 0.024) independently of age, BMD, percentage of body fat or absolute lean mass. Multivariable linear regression analysis showed that HGS values were associated with TSH measurements (ß-coefficient = 0.246, p = .014) and BMD T-score values (ß-coefficient = 0.306, p = .002). All models were adjusted for age, body mass index (BMI), vitamin D, low-density lipoprotein cholesterol, current smoking, physical activity, and homeostasis model assessment of insulin resistance. CONCLUSIONS: In this sample of postmenopausal women, lower serum TSH values, within normal range, were associated with lower muscle strength compared to higher normal TSH values. Further research is needed to elucidate the significance of our preliminary findings.


Assuntos
Pós-Menopausa , Tireotropina , Humanos , Feminino , Valores de Referência , Projetos Piloto , Pós-Menopausa/fisiologia , Força da Mão/fisiologia , Estudos Transversais , Densidade Óssea/fisiologia , Absorciometria de Fóton , Composição Corporal
4.
Mymensingh Med J ; 33(2): 341-349, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38557508

RESUMO

The level of thyroid hormones is often changed in uncontrolled diabetic patients. Screening for Thyroid dysfunction (TD) among patients with Type 2 Diabetes mellitus (T2DM) should be performed considering the increased prevalence of thyroid disorders. This cross-sectional comparative study was conducted in outpatient department of Endocrinology and Medicine, Mymensingh Medical College Hospital, Mymensingh (MMCH) from 1st March 2020 to 30th August 2021. One hundred (100) patients with type 2 diabetes along with 100 (hundred) non-diabetic controls of same age group were enrolled in the study. After taking clinical data, patients were investigated to estimate Fasting plasma glucose (FPG), serum free tri-iodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) level to see thyroid dysfunction. Patients were selected with purposive sampling. Thyroid dysfunction was found to be more in T2DM (15.0%) in comparison with non-diabetic controls (5.0%) and this difference was statistically significant (p=0.018). In both diabetic and non-diabetic groups, subclinical hypothyroidism and hypothyroidism were the most common thyroid dysfunction. Thyroid dysfunction was found more in 40-60 years that suggests the prevalence of thyroid dysfunction are increasing in diabetic patients with advancing age. Thyroid dysfunction was found more among overweight and obese patient in both groups. Mean BMI was found higher among diabetic patient with thyroid dysfunction. Logistic regression showed significant association of Thyroid dysfunction with age >50 years and high FPG level. We found thyroid dysfunction was more prevalent in patients with T2DM than non-diabetics. So, screening for thyroid dysfunction among type 2 diabetic patients by estimating Serum TSH, FT4 level should be performed.


Assuntos
Diabetes Mellitus Tipo 2 , Hipotireoidismo , Doenças da Glândula Tireoide , Humanos , Pessoa de Meia-Idade , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Estudos Transversais , Prevalência , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/epidemiologia , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Hormônios Tireóideos , Tireotropina
5.
Gynecol Endocrinol ; 40(1): 2334798, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38590105

RESUMO

OBJECTIVE: To evaluate the association between subclinical hypothyroidism with early menopause, premature menopause, and last menstrual bleeding before the natural age of menopause. METHODS: This was a cross-sectional study conducted in 643 postmenopausal women aged 40-69 years. Groups were formed according to last menstrual episode: ≥45 [Natural age at menopause], 40-44 and [Early menopause], <40 [Premature menopause], and <45 [last menstrual episode before the natural age of menopause]. The Zulewski scale was applied to identify manifestations related to hypothyroidism and subclinical hypothyroidism, diagnosed with a serum TSH > 4.5 µIU/mL plus T4-free between 0.7 and 1.9 ng/dL. RESULTS: It was found that 24.4% had the last menstrual episode before the natural age of menopause, 18.6% had early menopause, and 5.7% had premature menopause. Subclinical hypothyroidism was diagnosed in 4.5% of patients. Among women with subclinical hypothyroidism, there was a higher frequency of early menopause, premature menopause, and last menstrual episode before the natural age of menopause, than in women without subclinical hypothyroidism (p < 0.05). Paresthesia (50%) and dry skin (40.7%) were the most reported hypothyroidism-related manifestations. Early menopause, premature menopause, and last menstrual episode before the natural age of menopause were associated with subclinical hypothyroidism, OR: 3.37 [95% CI: 1.40-8.10], OR: 4.31 [95% CI: 1.24-14.97], and OR: 3.57 [95% CI: 1.57-8.10], respectively. CONCLUSIONS: The last menstrual episode before the natural age of menopause, early menopause, and premature menopause were significantly associated with a higher chance of subclinical hypothyroidism.


Assuntos
Hipotireoidismo , Menopausa Precoce , Humanos , Feminino , Estudos Transversais , Colômbia/epidemiologia , Tireotropina , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Menopausa
6.
Front Endocrinol (Lausanne) ; 15: 1368088, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38590826

RESUMO

Background: There is no doubt that both Hashimoto thyroiditis and Graves' disease are autoimmune thyroid diseases (AITDs), but the relationship between anti-nuclear antibody (ANA) and AITDs is poorly studied. The association between thyroid autoantibody levels and ANA positivity was evaluated to assess the role of ANA in AITDs. Methods: We conducted an analysis using data from 1,149,893 patients registered at our hospital and 53,021 patients registered in the National Health and Nutrition Examination Survey databases. We focused on patients with data for thyroid peroxidase antibody (TPOAb)/ANA, TPOAb/immunoglobulin G (IgG), thyroid-stimulating hormone (TSH) receptor antibody (TRAb)/ANA, TRAb/IgG, TSH/ANA, or TSH/IgG. Results: ANA positivity rates were 12.88% and 21.22% in TPOAb/ANA and TSH/ANA patients, respectively. In TPOAb/IgG and TSH/IgG data, high IgG levels (≥15 g/L) were detected in 2.23% and 4.06% of patients, respectively. There were significant differences in ANA positivity rates and high IgG proportions among patients with different TPOAb and TSH levels. TPOAb level was correlated with ANA positivity rate and high IgG proportion, and TSH level was correlated with ANA positivity rate. Regression analysis showed positive correlations between TPOAb levels and ANA positivity risk or high IgG risk, TSH levels and high IgG risk, and elevated TSH and ANA positivity risk. Of patients with TRAb/ANA data, 35.99% were ANA-positive, and 13.93% had TRAb levels ≥1.75IU/L; 18.96% of patients with TRAb/IgG data had high IgG levels, and 16.51% had TRAb levels ≥1.75IU/L. ANA positivity rate and high IgG proportion were not significantly different among different TRAb levels. TRAb levels, ANA positivity risk and high IgG risk were not correlated. Conclusion: ANA positivity and high IgG are related to Hashimoto thyroiditis but not Graves' disease, which implies distinct pathophysiological mechanisms underlying the AITDs.


Assuntos
Doença de Graves , Doença de Hashimoto , Humanos , Inquéritos Nutricionais , Autoanticorpos , Doença de Graves/diagnóstico , Receptores da Tireotropina , Imunoglobulina G , Tireotropina
7.
Front Endocrinol (Lausanne) ; 15: 1340415, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38577576

RESUMO

Background: Thyroid stimulating immunoglobulins (TSI) play a central role in the pathogenesis of Graves' orbitopathy (GO), while soluble interleukin-2 receptor (sIL-2R) is a marker for T-cell activity. We investigated TSI and sIL-2R levels in relation to thyroid function, disease activity and severity and response to treatment with intravenous methylprednisolone (IVMP) in patients with GO. Methods: TSI (bridge-based TSI binding assay), sIL-2R, TSH and fT4 levels were measured in biobank serum samples from 111 GO patients (37 male, 74 female; mean age 49.2 years old) and 25 healthy controls (5 male, 20 female; mean age 39.8 years old). Clinical characteristics and response to treatment were retrospectively retrieved from patient files. Results: Higher sIL-2R levels were observed in GO patients compared to controls (p < 0.001). sIL-2R correlated with fT4 (r = 0.26), TSH (r = -0.40) and TSI (r = 0.21). TSI and sIL-2R concentrations were higher in patients with active compared to inactive GO (p < 0.001 and p < 0.05, respectively). Both TSI and sIL-2R correlated with total clinical activity score (CAS; r = 0.33 and r = 0.28, respectively) and with several individual CAS items. Cut-off levels for predicting active GO were 2.62 IU/L for TSI (AUC = 0.71, sensitivity 69%, specificity 69%) and 428 IU/mL for sIL-2R (AUC = 0.64, sensitivity 62%, specificity 62%). In multivariate testing higher TSI (p < 0.01), higher age (p < 0.001) and longer disease duration (p < 0.01) were associated with disease activity. TSI levels were higher in patients with a poor IVMP response (p = 0.048), while sIL-2R levels did not differ between responders and non-responders. TSI cut-off for predicting IVMP response was 19.4 IU/L (AUC = 0.69, sensitivity 50%, specificity 91%). In multivariate analysis TSI was the only independent predictor of response to IVMP (p < 0.05). Conclusions: High TSI levels are associated with active disease (cut-off 2.62 IU/L) and predict poor response to IVMP treatment (cut-off 19.4 IU/L) in GO. While sIL-2R correlates with disease activity, it is also related to thyroid function, making it less useful as an additional biomarker in GO.


Assuntos
Oftalmopatia de Graves , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Imunoglobulinas Estimuladoras da Glândula Tireoide , Oftalmopatia de Graves/tratamento farmacológico , Estudos Retrospectivos , Receptores da Tireotropina , Tireotropina
8.
Front Endocrinol (Lausanne) ; 15: 1301260, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38516415

RESUMO

Ectopic thyroid-stimulating hormone (TSH)-secreting tumors are extremely rare, with only 15 reported cases in the literature. Herein, we described a 60-year-old female patient with thyrotoxicosis and elevated or unsuppressed levels of TSH. Family history and laboratory and genetic tests did not support a diagnosis of resistance to thyroid hormone (RTH). Given the unsuppressed TSH, TSH-secreting tumor was suspected, and magnetic resonance imaging (MRI) of the pituitary gland was performed. Surprisingly, the MRI scans revealed a nodule in the nasopharynx rather than a pituitary tumor in the sella region. Further evaluation using Gallium-68 DOTATATE positron emission tomography/computed tomography (68Ga-DOTATATE PET/CT) demonstrated increased DOTATATE uptake in the nasopharyngeal nodule. Additionally, an octreotide suppression test (OST) revealed an obvious reduction in TSH levels, further supporting the suspicion of the nasopharyngeal mass as the cause of inappropriate TSH secretion. To prepare for surgery, the patient received preoperative administration of octreotide, resulting in the normalization of TSH and thyroid hormone levels. The patient subsequently underwent successful surgical removal of the nasopharyngeal mass. Following the procedure, the patient experienced complete resolution of hyperthyroidism symptoms, with TSH declined and thyroid hormone levels returned to normal. Histochemistry analysis of the tumor revealed positive staining for TSH, growth hormone (GH), prolactin (PRL), luteinizing hormone (LH), and somatostatin receptor 2 (SSTR2). We discussed differential diagnosis of hyperthyroidism due to inappropriate TSH secretion, with a particular emphasis on the importance of 68Ga-DOTATATE PET/CT in combination with OST for identifying ectopic pituitary tumors.


Assuntos
Adenoma , Hipertireoidismo , Neoplasias Hipofisárias , Neoplasias da Glândula Tireoide , Feminino , Humanos , Pessoa de Meia-Idade , Adenoma/patologia , Radioisótopos de Gálio , Hipertireoidismo/etiologia , Octreotida/uso terapêutico , Neoplasias Hipofisárias/patologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Hormônios Tireóideos , Neoplasias da Glândula Tireoide/complicações , Tireotropina
9.
Clin Endocrinol (Oxf) ; 100(5): 477-485, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38462996

RESUMO

OBJECTIVE: Hypothyroidism is a common endocrine condition usually managed with levothyroxine (LT4). However, controversy remains around the use of liothyronine (LT3). We aimed to investigate the practices of Australian endocrinologists when managing patients with hypothyroidism, their use of LT3 + LT4 combination therapy and use of thyroid hormones in euthyroid patients. DESIGN AND PARTICIPANTS: Members of the Endocrine Society of Australia (ESA) were invited to participate in an online questionnaire. MEASUREMENTS: We analysed questionnaires that had complete demographic data. RESULTS: Eighty-seven questionnaires fulfilled the criteria. LT4 was used as first line treatment for hypothyroidism by all respondents. Only 45% reported that their patients were dispensed the brand of LT4 that they recommend. LT3 (alone or in combination) was prescribed by 44% in their clinical practice. Although 49% of respondents would consider LT3 + LT4 in patients with normal TSH who had ongoing symptoms of hypothyroidism, the inability of LT4 to restore normal physiology was ranked the least likely explanation for persistent symptoms and only 32% would consider it for themselves if they were diagnosed with hypothyroidism. The majority (55%), in accordance with evidence, would not prescribe thyroid hormone to euthyroid individuals but 39% would consider use in euthyroid female infertility with high levels of thyroid antibodies and 11% in euthyroid patients with a simple goitre growing over time. LT4 use in pregnancy was variable among members. CONCLUSIONS: Australian endocrinologists mostly follow international guidelines when prescribing thyroid hormone therapy and many prescribe combination LT3 and LT4 therapy, particularly for patients who remain symptomatic on LT4 monotherapy. Prescribing practices are largely similar to other countries who have completed similar questionnaires.


Assuntos
Hipotireoidismo , Gravidez , Humanos , Feminino , Austrália , Hipotireoidismo/tratamento farmacológico , Hormônios Tireóideos/uso terapêutico , Tiroxina/uso terapêutico , Tri-Iodotironina/uso terapêutico , Inquéritos e Questionários , Tireotropina/uso terapêutico
10.
Int J Med Robot ; 20(2): e2624, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38430543

RESUMO

BACKGROUND: The aim of this study was to investigate 8-mm robotic trocar site hernia (TSH) rate over the short and long term, providing aids to manage the related fascial wounds. METHODS: A retrospective analysis of 320 patients undergoing robotic surgery was conducted. The primary outcome was 8-mm TSH rate with a minimum follow-up of 12 months. The secondary outcome was the rate of haematomas and infections related to 8-mm wounds and their association with patient comorbidities and trocar position. RESULTS: One case of TSH was observed (0.31%). There were 15 cases of wound infection (4.68%) and 22 cases of wound haematoma (6.87%). Trocar related complications were significantly associated with patient comorbidities, not with trocar position. CONCLUSIONS: Our results do not justify the 8-mm fascial wound closure. Data concerning the association between trocar-related complications and patient comorbidities strengthen the need to implement the control of metabolic state and correct administration of perioperative therapy in high-risk patients.


Assuntos
Laparoscopia , Procedimentos Cirúrgicos Robóticos , Humanos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Estudos Retrospectivos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Instrumentos Cirúrgicos/efeitos adversos , Tireotropina
11.
Medicine (Baltimore) ; 103(9): e37326, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38428856

RESUMO

BACKGROUND: Hashimoto thyroiditis (HT) is a common autoimmune thyroid disease for which there is no specific treatment. Oral levothyroxine sodium tablets significantly improved thyroid function but did not promote a reduction in thyroid-related antibody concentrations. Acupuncture can improve clinical symptoms and thyroid function in HT patients, reduce serum TPOAb and TGAb levels in HT patients, and improve patients' quality of life. METHODS: We conducted a systematic review and meta-analysis to evaluate the effect of acupuncture versus levothyroxine sodium tablets on Hashimoto thyroiditis. We searched Web of Science, Embase, China National Knowledge Infrastructure, WanFang, VIP, SinoMed and the Cochrane Central Registry of Controlled Trials to identify candidate randomized controlled trials (RCTs). RESULTS: A total of 1020 patients participated in 14 randomized controlled trials. The results of meta-analysis showed that acupuncture regulated TPOAb content (mean difference [MD] = -63.18, 95%CI = -91.73 to -34.62, P < .00001), TGAb content (MD = -68.56, 95%CI = -101.55 to -35.57, P < .00001), serum free triiodothyronine (FT3) content (MD = 0.74, 95%CI = 0.20 to 1.27, P < .00001), serum free thyroxine (FT4) content (MD = 1.10, 95%CI = 0.29 to 1.92, P < .00001), TSH content (MD = -2.16, 95%CI = -3.14 to -1.19, P < .00001) had a significant effect. CONCLUSION: Compared with levothyroxine sodium tablets alone, acupuncture can significantly regulate the contents of TPOAb, TGAb, FT3, FT4 and TSH.


Assuntos
Terapia por Acupuntura , Doença de Hashimoto , Humanos , Doença de Hashimoto/tratamento farmacológico , Tiroxina/uso terapêutico , Hormônios Tireóideos , Tireotropina
12.
Commun Biol ; 7(1): 388, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38553567

RESUMO

In seasonally breeding mammals and birds, the production of the hormones that regulate reproduction (gonadotropins) is controlled by a complex pituitary-brain-pituitary pathway. Indeed, the pituitary thyroid-stimulating hormone (TSH) regulates gonadotropin expression in pituitary gonadotropes, via dio2-expressing tanycytes, hypothalamic Kisspeptin, RFamide-related peptide, and gonadotropin-releasing hormone neurons. However, in fish, how seasonal environmental signals influence gonadotropins remains unclear. In addition, the seasonal regulation of gonadotrope (gonadotropin-producing cell) proliferation in the pituitary is, to the best of our knowledge, not elucidated in any vertebrate group. Here, we show that in the vertebrate model Japanese medaka (Oryzias latipes), a long day seasonally breeding fish, photoperiod (daylength) not only regulates hormone production by the gonadotropes but also their proliferation. We also reveal an intra-pituitary pathway that regulates gonadotrope cell number and hormone production. In this pathway, Tsh regulates gonadotropes via folliculostellate cells within the pituitary. This study suggests the existence of an alternative regulatory mechanism of seasonal gonadotropin production in fish.


Assuntos
Oryzias , Animais , Oryzias/metabolismo , Estações do Ano , Reprodução/fisiologia , Vertebrados/metabolismo , Hormônio Liberador de Gonadotropina/metabolismo , Gonadotropinas/metabolismo , Mamíferos , Tireotropina/metabolismo
13.
Sci Rep ; 14(1): 6583, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38503873

RESUMO

We collected thyroid-related hormone index levels, sleep duration, and other basic characteristics of the population with depression from the NHANES 2009-2012 cycles and evaluated the association of Thyroid-Stimulating Hormone Index (TSHI) with sleep duration in the euthyroid population with depression via different analysis methods. We found that the association between TSHI and sleep duration was only found in patients with depression degree < Moderate (score: 1-14) rather than > Moderate group. Among the populations with degree < Moderate (N = 1918), only 4 indexes (parametric Thyroid Feedback Quantile Index, PTFQI, Thyrotroph Thyroxine Resistance Index, TT4RI, Thyroid-Stimulating Hormone TSH, and TSHI) reflecting the sensitivity to thyroid hormones were related to the sleep duration, with a significant non-linear relationship after adjusting for potential confounders (all P < 0.05). Trend analysis indicated that with the level increase of these 4 indexes, the sleep duration increased (all P for trend < 0.001). Further, we found that TSHI was relatively more important among the 4 indexes. Sum up, sensitivity to thyroid hormones is associated with sleep duration in the euthyroid population with depression degree lower than Moderate. Poor sensitivity referred to a longer sleep duration.


Assuntos
Depressão , Duração do Sono , Humanos , Inquéritos Nutricionais , Hormônios Tireóideos , Tiroxina , Tireotropina
15.
Front Endocrinol (Lausanne) ; 15: 1340204, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38449850

RESUMO

Background: Hypothyroidism is treated with daily levothyroxine (LT4). In recent years, soft gel caps of LT4 (LT4-C) have been commercialized, and their performance has been optimized. Since guidelines recommend dose LT4 according to the tablet preparation efficacy, the present study was undertaken to obtain data about the daily requirement, normalized per body weight, of LT4-C. Methods: Patients undergoing LT4-C after total thyroidectomy and radioiodine treatment for differentiated thyroid carcinoma were selected. There was no specific indication of suppression of TSH (i.e., <0.5 or <0.1 mIU/L). Patients were required to maintain a stable LT4 dose during the study period. Patients with interfering factors were excluded from this study. Results: Thirty patients were enrolled (18 females and 12 males; median age, 50 years; median body weight, 71 kg; median LT4-C dose, 1.71 µg/kg/day). The analysis of patient age did not reveal any differences. The LT4-C dose correlated with free-T4 p = 0.03), but not with TSH (p = 0.42) and free-T3 (p = 0.13). TSH was <1.0 mIU/L in 90% of the cases. The LT4-C dose-TSH response effect was analysed by probit regression model: the probability to achieve TSH <1.0 mIU/l was 99% with a dose of 1.84 (95%CI 1.57-2.12) µg/kg/day, 75% with a dose of 1.38 µg/kg/day (95%CI 1.17-1.59), and 50% with a dose of 1.20 (95%CI 0.96-1.43). At ROC curve analysis, the most accurate cut-off of LT4-C dose to achieve TSH <1.0 mIU/l was 1.53 ug/kg/day with 70% sensitivity and 100% specificity. Conclusions: Athyreotic patients can be initially treated with an LT4-C dose lower than previously stated. Therefore, further prospective studies are warranted.


Assuntos
Hipotireoidismo , Tiroxina , Feminino , Masculino , Humanos , Pessoa de Meia-Idade , Tiroxina/uso terapêutico , Radioisótopos do Iodo/uso terapêutico , Hipotireoidismo/tratamento farmacológico , Peso Corporal , Tireotropina
16.
Medicine (Baltimore) ; 103(10): e37298, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457535

RESUMO

This study aims to investigate the relationship between benign thyroid disease and breast cancer. The clinical study includes a total of 600 participants, divided into 2 groups: the control group (N = 300), which consists of individuals from the checkup population during the same periods, and the experimental group (N = 300), which consists of patients with breast cancer. General data of the participants, including age, tumor diameter, tumor staging, pathological classification, lymph node metastasis, and classification of benign thyroid disease, were collected and analyzed. The levels of TT3, TT4, FT3, FT4, TSH, TPOAb, and TgAb in blood samples from the experimental and control groups were determined using a radioimmune method. The levels of TPOAb, TgAb, and TSH in the experimental group were significantly higher than those in the control group, while the levels of TT3, TT4, FT3, and FT4 in the experimental group were significantly lower. The general data of the participants contributed to the appropriate sample size and allocation. Furthermore, benign thyroid disease contributes to the development of breast cancer by regulating the levels of TT3, TT4, FT3, FT4, TSH, TPOAb, and TgAb.


Assuntos
Neoplasias da Mama , Doenças da Glândula Tireoide , Humanos , Feminino , Hormônios Tireóideos , Tireotropina , Tiroxina , Tri-Iodotironina
17.
Medicine (Baltimore) ; 103(10): e37350, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38457537

RESUMO

Mean corpuscular volume (MCV) is an important indicator used to determine the etiology of anemia and is associated with a variety of diseases. However, the link between thyroid function and MCV has yet to be clarified. This study was thus developed to assess relationships between thyroid function and MCV in a population of adults in the US. Results from the National Health and Nutrition Examination Survey study performed from 2007 to 2012 were used to conduct a cross-sectional analysis. Key thyroid-related variables included in this analysis were thyroid-stimulating hormone, total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), antithyroglobulin, thyroglobulin, and antithyroid peroxidase levels. Generalized linear regression models were employed when estimating associations between MCV quartiles and thyroid parameters in 8104 adults 18 + years of age. In these participants, the weighted mean (SD) MCV was 89.36 (0.16) fL, with thyroid-stimulating hormone levels of 1.86 (0.03) mIU/mL, FT3 levels of 3.20 (0.01) pg/mL, FT4 levels of 0.80 (0.01) ng/dL, TT3 levels of 115.09 (0.64) ng/dL, and TT4 levels of 7.81 (0.04) µg/dL. When analyses were not adjusted, higher MCV values were related to reduced serum levels of FT3, TT3, or TT4. Following adjustment for possible confounding variables, this significant negative correlation between MCV and levels of FT3, TT3, and TT4 remained, and subgroup analysis revealed that this negative correlation was present in the male group and in the age group >50 years, but not in the female group and in the age group less than or equal to 50 years. These results suggest a significant negative correlation between MCV and FT3, TT3, and TT4, and this negative correlation originated more from the male population and those older than 50 years of age. The underlying mechanisms warrant additional investigation.


Assuntos
Glândula Tireoide , Tri-Iodotironina , Adulto , Masculino , Feminino , Humanos , Pessoa de Meia-Idade , Tiroxina , Inquéritos Nutricionais , Estudos Transversais , Índices de Eritrócitos , Hormônios Tireóideos , Tireotropina
18.
J Pediatr Endocrinol Metab ; 37(4): 347-352, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38462926

RESUMO

OBJECTIVES: A connection between thyroid hormones (THs) and diverse metabolic pathways has been reported. We evaluated thyroid function and tissue sensitivity to THs in children and adolescents with T1D in comparison to euthyroid controls. Additionally, we investigate whether a relationship exists between sensitivity indices and metabolic parameters. METHODS: A retrospective analysis was conducted on 80 pediatric patients diagnosed with T1D. Clinical parameters, TSH, FT3, FT4, and the presence of MS were documented. Additionally, indices of peripheral sensitivity (FT3/FT4 ratio) and central sensitivity (TSH index, TSHI; TSH T4 resistance index, TT4RI; TSH T3 resistance index, TT3RI) were assessed. Thirty healthy subjects were considered as controls. RESULTS: The overall prevalence of MS was 7.27 %, with MS identified in 8 out of 80 (10 %) T1D subjects; none of the controls manifested MS (p<0.01). No significant differences were observed in indexes of tissue sensitivity to THs between subjects with or without MS (all p>0.05). Correlations between THs and indexes of THs tissue sensitivity and metabolic parameters in controls and T1D patients were noted. CONCLUSIONS: This study affirms a heightened prevalence of MS in children with T1D compared to controls and underscores the potential role of THs in maintaining metabolic equilibrium.


Assuntos
Diabetes Mellitus Tipo 1 , Síndrome Metabólica , Síndrome da Resistência aos Hormônios Tireóideos , Humanos , Adolescente , Criança , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Diabetes Mellitus Tipo 1/complicações , Tri-Iodotironina , Tiroxina , Estudos Retrospectivos , Tireotropina , Hormônios Tireóideos
19.
Curr Oncol ; 31(3): 1145-1161, 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38534918

RESUMO

BACKGROUND: Two-staged hepatectomy (TSH) including portal vein embolization (PVE) may offer surgical treatment for extensive bilobar colorectal liver metastases (CRLM). This study aimed to investigate the feasibility and outcomes of extended right hepatectomy (ERH) within TSH including PVE for patients with extended CRLM. METHODS: We retrospectively collected data of patients who underwent TSH for extended CRLM between 2015 and 2021 at our institution. Clearance of the left liver lobe (clear-up, CU) associated with PVE was followed by ERH. RESULTS: Minimally invasive (n = 12, 46%, MIH) or open hepatectomy (n = 14, 54%, OH) was performed. Postoperative major morbidity and 90-day mortality were 54% and 0%. Three-year overall survival was 95%. Baseline characteristics, postoperative and long-term outcomes were comparable between MIH and OH. However, hospital stay was significantly shorter after MIH (8 vs. 15 days, p = 0.008). Additionally, the need for intraoperative transfusions tended to be lower in the MIH group (17% vs. 50%, p = 0.110). CONCLUSIONS: ERH following CU and PVE for extended CRLM is feasible and safe in laparoscopic and open approaches. MIH for ERH may result in shorter postoperative hospital stays. Further high-volume, multicenter studies are required to evaluate the potential superiority of MIH.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Humanos , Hepatectomia , Veia Porta/patologia , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/cirurgia , Tireotropina
20.
An Sist Sanit Navar ; 47(1)2024 Mar 11.
Artigo em Espanhol | MEDLINE | ID: mdl-38465415

RESUMO

BACKGROUND: The study aim was to analyze the relationship between functional thyroid pathology and the exposure to work shifts / night shifts, and describe the most prevalent thyroid disorders based on the type of shift. METHODOLOGY: Cross-sectional study performed in the emergency department of a hospital in Almeria (Spain). Relationships between thyroxine and thyrotropin levels (TSH) and work shifts, professional category and history of thyroid pathology were analyzed. RESULTS: The study included 133 workers; 80.5% female, average age was 46.11 years (38 - 65), and 52% were part of the nursing staff; thyroid disorders were more frequent in female participants. Most participants (81.2%) had rotating shifts schedules and 11.3% night shifts (12.1% female and 7.7% male). Thyroid alterations were found in 27% of the participants (usually elevated TSH levels and normal thyroxine levels), particularly in those doing night shifts (61.1%). TSH alterations were more frequent in individuals doing night shifts than in rotating shifts (53.3 vs 13.0%; p<0.001). Individuals working night shifts had mean TSH values in the normal range, although significantly higher than the individuals in the rest of the shifts; thyroxine levels were found to be similar. No thyroid disorders were found in day shift participants. Night shift and a history of thyroid pathology were independent predictors of thyroid disorders. CONCLUSIONS: Night shift schedules and history of thyroid disorders are more frequent in female, both related to the presence of thyroid disorders, indicating the need to include the evaluation of these disorders in health surveillance programs and analyze gender differences.


Assuntos
Recursos Humanos de Enfermagem , Tolerância ao Trabalho Programado , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Glândula Tireoide , Estudos Transversais , Tiroxina , Tireotropina
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