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1.
Anticancer Res ; 40(11): 6417-6428, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33109580

RESUMO

BACKGROUND/AIM: Silencing mediator of retinoid and thyroid receptors (SMRT) is a nuclear corepressor in thyroid and estrogen hormones pathways. The aim was to evaluate SMRT expression in relation to thyroid hormone levels and prognostic markers in breast cancer (BC). PATIENTS AND METHODS: Serum and tumor tissues were obtained from 36 patients with benign breast disease (BBD) and 79 BC patients. SMRT expression was determined by immunohistochemistry. Free-triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured in serum. RESULTS: Higher FT4, lower FT3/FT4 ratio and higher expression of SMRT were found in BC compared to BBD (for all p<0.001). In BC, increased SMRT expression was associated with lower FT3 (p=0.028), higher tumor grade (p=0.031), increased KI67 proliferation index (p=0.015), higher risk of recurrence (p=0.014) and shorter disease-free survival (p=0.006). In multivariate analysis, SMRT overexpression and below-median levels of TSH were independent prognostic factors in BC. CONCLUSION: Elevated FT4 and decreased FT3/FT4 in BC patients suggest a role for thyroid hormones in malignant transformation. SMRT tumor overexpression is associated with lower FT3 levels, tumor proliferative activity and an aggressive clinical course.


Assuntos
Neoplasias da Mama/sangue , Correpressor 2 de Receptor Nuclear/genética , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Intervalo Livre de Doença , Feminino , Regulação Neoplásica da Expressão Gênica/genética , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/patologia , Correpressor 2 de Receptor Nuclear/sangue , Prognóstico , Glândula Tireoide/metabolismo , Glândula Tireoide/patologia , Hormônios Tireóideos/sangue , Hormônios Tireóideos/genética
2.
Medicine (Baltimore) ; 99(43): e22898, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33120839

RESUMO

Elevated serum creatine kinase (CK) concentration was reported in some Graves disease patients during the treatment with oral antithyroid drugs (ATD). The pathogenesis of this abnormal biochemical value was considered to be related to the therapeutic drug. However, the relevant epidemiological investigation was absent.Overall, 416 patients with Graves disease treated with oral ATDs were recruited from December 2017 to October 2019. Clinical characteristics such as the patient's medical history and therapeutic regimen were collected. Serum CK concentration and thyroid function were measured. Statistical analysis was adopted to clarify the relationship between serum CK level and these clinical parameters.Elevation of serum CK concentration was emerged in 13.5% patients who were treated with oral ATDs. The proportion was significantly higher among men than among women (19.5% vs 10.8%). There was no correlation between increased serum CK concentration and age. More than 60% of serum CK elevations occurred within 6 months after taking oral ATDs. Free triiodothyronine and free thyroxine are negatively correlated with serum CK concentration. The correlation coefficients are respectively -0.222 (P < .05) and -0.234 (P < .05). There is positive correlation between thyroid stimulating hormone and serum CK concentration. The correlation coefficient is 0.405 (P < .05). There was no statistical correlation between drug dosage and increased serum CK level.Increased serum CK level is a common adverse reaction of oral ATDs. It generally develops early after starting treatment. The cause of this adverse reaction is not clear. It is speculated that elevation of serum CK level is related to the fluctuation of thyroid function.


Assuntos
Antitireóideos/efeitos adversos , Antitireóideos/uso terapêutico , Creatina Quinase/sangue , Doença de Graves/tratamento farmacológico , Administração Oral , Adolescente , Adulto , Idoso , Antitireóideos/administração & dosagem , Estudos de Casos e Controles , Criança , China/epidemiologia , Creatina Quinase/efeitos dos fármacos , Estudos Transversais , Feminino , Doença de Graves/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Testes de Função Tireóidea/métodos , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto Jovem
3.
PLoS One ; 15(9): e0239579, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970739

RESUMO

The clinical manifestations of thyroid diseases in elderly patients are often atypical. This study aimed to establish reference intervals for thyroid function in the elderly in order to help diagnose thyroid diseases in this population. A total of 5345 healthy individuals were examined and divided into three groups according to their age: 4297 individuals aged < 65 years (19-64), 719 individuals aged between 65 and 79 years, and 329 individuals aged between 80 and 100 years. Levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody, and thyroglobulin antibody were measured in these subjects by using a fully automated analyzer. The following free triiodothyronine, free thyroxine, and thyroid-stimulating hormone reference intervals were obtained from each age group: For individuals aged < 65 years (19-64 years), FT3, FT4, and TSH were 3.40-6.44, 10.26-19.25 pmol/L and 0.50-4.81 µIU/mL, respectively. For individuals aged between 65 and 79 years, FT3, FT4 and TSH ranged between 3.01-5.91, 10.04-19.76 pmol/L, and 0.54-5.51 µIU/mL, respectively. For individuals aged between 80 and 100 years, FT3, FT4, and TSH varied between 2.82-5.57, 9.79-21.22 pmol/L, 0.31-6.28 µIU/mL respectively. FT3 concentration was lower and the concentrations of FT4 and TSH were higher in individuals aged ≥ 65 years than in those aged <65 years (P<0.0001; P = 0.0039; P<0.0001, respectively). In conclusion, establishment of a reference interval would allow clinicians to diagnose diseases more accurately and easily.


Assuntos
Tireotropina/análise , Tiroxina/análise , Tri-Iodotironina/análise , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático/genética , Bioensaio , China/epidemiologia , Grupos Étnicos/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Doenças da Glândula Tireoide , Testes de Função Tireóidea/métodos , Hormônios Tireóideos , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
4.
Croat Med J ; 61(3): 230-238, 2020 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-32643339

RESUMO

AIM: To analyze the association of thyroid function and hormone levels with metabolic syndrome (MetS) and its components. METHODS: This cross-sectional population-based study involved 2183 Croatian individuals with no history of thyroid disease, hypertension, diabetes, and hyperlipidemia. MetS was diagnosed according to the National Cholesterol Education Program's Adult Treatment Panel III criteria. RESULTS: We found no association between thyroid function groups and the prevalence of MetS and its components. Clinically hypothyroid participants showed significantly higher triceps skinfold measurements than subclinically hypothyroid and euthyroid participants. Furthermore, clinically hypothyroid participants had higher abdominal skinfold thickness than subclinically hypothyroid participants. Otherwise, suprailiac and abdominal skinfold measurements were higher in the subclinically and clinically hyperthyroid group of participants compared with euthyroid and subclinically hypothyroid participants. A strong positive association of thyroid-stimulating hormone (TSH) and strong negative association of free triiodothyronine (fT3) and free thyroxine (fT4) levels with HOMA-IR and cholesterol levels were found. Furthermore, the fT4 level also showed a strong negative association with HDL and triceps skinfold thickness. CONCLUSIONS: This study supports the standing that TSH, fT3, and fT4 levels are important variables to determine the association of thyroid function with MetS.


Assuntos
Síndrome Metabólica/sangue , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , Autoantígenos/imunologia , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Medições Luminescentes , Masculino , Pessoa de Meia-Idade , Tireoglobulina/imunologia , Hormônios Tireóideos/sangue , Adulto Jovem
5.
Am J Med Sci ; 360(2): 192-195, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32540147

RESUMO

Dermato-neuro syndrome is a potentially fatal neurological complication of scleromyxedema consisting of fever, seizures, and coma. This is an overlooked scleromyxedema case of a 62-year-old female patient from 2-years ago. She was admitted to our ICU because of high fever, colloid speech, muscle ache, and nausea. Molecular methods in the cerebrospinal fluid for neurotropic viruses ruled out acute infectious encephalitis. Her thyroid hormones were within normal values while the serum protein electrophoresis confirmed the monoclonal gammopathy of immunoglobulin G lambda (IgG(λ)), known for the last 2 years. The subsequent bone-marrow biopsy excluded the development of multiple myeloma. The patient fulfilled fundamental diagnostic criteria of scleromyxedema (monoclonal gammopathy, normal thyroid function and the appearance of marked sclerosis and induration of the skin papules on the face, neck, extremities, and skin creases) presenting as dermato-neuro syndrome, which was histologically confirmed. She demonstrated a remarkable improvement after intravenous immunoglobulin treatment during the first 24 hours. Mimics of non-infectious acute encephalitis should include the clinical diagnosis of scleromyxedema, especially when patients present in the emergency department with acute fever, coma, and skin lesions of diffuse sclerodermoid and papular type.


Assuntos
Encefalopatia Aguda Febril/etiologia , Erros de Diagnóstico , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Gamopatia Monoclonal de Significância Indeterminada/complicações , Escleromixedema/complicações , Encefalopatia Aguda Febril/diagnóstico , Encefalopatia Aguda Febril/terapia , Biópsia , Eletroforese das Proteínas Sanguíneas , Encéfalo/diagnóstico por imagem , Coma/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Imunoglobulina G , Encefalite Infecciosa/diagnóstico , Unidades de Terapia Intensiva , Pessoa de Meia-Idade , Gamopatia Monoclonal de Significância Indeterminada/sangue , Escleromixedema/diagnóstico , Escleromixedema/patologia , Escleromixedema/terapia , Convulsões/etiologia , Pele/patologia , Tireotropina/sangue , Tiroxina/sangue , Tomografia Computadorizada por Raios X , Tri-Iodotironina/sangue
6.
J Clin Endocrinol Metab ; 105(7)2020 07 01.
Artigo em Inglês | MEDLINE | ID: covidwho-327293

RESUMO

CONTEXT: Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak. OBJECTIVES: The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection. METHODS: We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2-positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days. RESULTS: At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days. CONCLUSIONS: We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Prednisona/uso terapêutico , Tireoidite Subaguda/diagnóstico , Adolescente , Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Feminino , Humanos , Itália , Contagem de Leucócitos , Orofaringe/virologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Glândula Tireoide/diagnóstico por imagem , Tireoidite Subaguda/sangue , Tireoidite Subaguda/tratamento farmacológico , Tireoidite Subaguda/virologia , Tiroxina/sangue , Resultado do Tratamento , Tri-Iodotironina/sangue , Ultrassonografia
7.
PLoS One ; 15(5): e0233336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32433694

RESUMO

The factors that determine Serum Thyrotropin (TSH) levels have been examined through different methods, using different covariates. However, the use of machine learning methods has so far not been studied in population databases like NHANES (National Health and Nutritional Examination Survey) to predict TSH. In this study, we performed a comparative analysis of different machine learning methods like Linear regression, Random forest, Support vector machine, multilayer perceptron and stacking regression to predict TSH and classify individuals with normal, low and high TSH levels. We considered Free T4, Anti-TPO antibodies, T3, Body Mass Index (BMI), Age and Ethnicity as the predictor variables. A total of 9818 subjects were included in this comparative analysis. We used coefficient of determination (r2) value to compare the results for predicting the TSH and show that the Random Forest, Gradient Boosting and Stacking Regression perform equally well in predicting TSH and achieve the highest r2 value = 0.13, with mean absolute error of 0.78. Moreover, we found that Anti-TPO is the most important feature in predicting TSH followed by Age, BMI, T3 and Free-T4 for the regression analysis. While classifying TSH into normal, high or low levels, our comparative analysis also shows that Random forest performs the best in the classification study, performed with individuals with normal, high and low levels of TSH. We found the following Areas Under Curve (AUC); for low TSH, AUC = 0.61, normal TSH, AUC = 0.61 and elevated TSH AUC = 0.69. Additionally, we found that Anti-TPO was the most important feature in classifying TSH. In this study, we suggest that artificial intelligence and machine learning methods might offer an insight into the complex hypothalamic-pituitary -thyroid axis and may be an invaluable tool that guides us in making appropriate therapeutic decisions (thyroid hormone dosing) for the individual patient.


Assuntos
Inteligência Artificial , Tireotropina/sangue , Fatores Etários , Índice de Massa Corporal , Grupos Étnicos/estatística & dados numéricos , Feminino , Humanos , Aprendizado de Máquina , Masculino , Estudos Retrospectivos , Tiroxina/sangue , Tri-Iodotironina/sangue
8.
J Clin Endocrinol Metab ; 105(7)2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32436948

RESUMO

CONTEXT: Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak. OBJECTIVES: The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection. METHODS: We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2-positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days. RESULTS: At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days. CONCLUSIONS: We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Prednisona/uso terapêutico , Tireoidite Subaguda/diagnóstico , Adolescente , Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Feminino , Humanos , Itália , Contagem de Leucócitos , Orofaringe/virologia , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Glândula Tireoide/diagnóstico por imagem , Tireoidite Subaguda/sangue , Tireoidite Subaguda/tratamento farmacológico , Tireoidite Subaguda/virologia , Tiroxina/sangue , Resultado do Tratamento , Tri-Iodotironina/sangue , Ultrassonografia
9.
PLoS One ; 15(4): e0231622, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298352

RESUMO

OBJECTIVES: Nonthyroidal illness syndrome (NTIS), also known as low triiodothyronine (T3) syndrome, frequently affects patients with systemic lupus erythematosus (SLE) and may affect lipid metabolism. Dyslipidemia is highly prevalent and associated with the long-term prognosis of SLE. The aim of the present study was to explore the clinical significance of NTIS on disease activity and dyslipidemia in patients with SLE. METHODS: Clinical and laboratory data were collected retrospectively from 223 patients with SLE. The correlation between free triiodothyronine (FT3), SLE disease activity, and lipid profiles were estimated. The correlation coefficient (r) was calculated using a Pearson's regression model. Univariate and multivariate logistic regression analyses were performed to identify the risk factors for dyslipidemia in SLE. RESULTS: Serum FT3 levels were negatively correlated with the levels of 24 h urine protein (UP), blood urea nitrogen (BUN), creatinine (Cr) and SLE disease activity index (SLEDAI) (all p < 0.001) in NTIS patients but not in euthyroid patients. ApoB/ApoA1 was significantly correlated with SLEDAI (p < 0.01) in NTIS patients and CRP (p < 0.001) and ESR (p < 0.01) in euthyroid patients. A multivariate analysis revealed that only FT3 exhibited an independent negative association with dyslipidemia (P = 0.01; OR = 0.48; 95% CI 0.27-0.85). CONCLUSION: NTIS frequently occurs in patients with SLE. Low FT3 is associated with disease activity in SLE patients complicated with NTIS. Low FT3 is an independent risk factor for dyslipidemia in patients with SLE.


Assuntos
Dislipidemias/complicações , Síndromes do Eutireóideo Doente/complicações , Lúpus Eritematoso Sistêmico/complicações , Adulto , Apolipoproteína A-I/sangue , Apolipoproteínas B/sangue , Dislipidemias/sangue , Síndromes do Eutireóideo Doente/sangue , Feminino , Humanos , Lipídeos/sangue , Lúpus Eritematoso Sistêmico/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tri-Iodotironina/sangue , Adulto Jovem
10.
Anticancer Res ; 40(4): 2323-2329, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234933

RESUMO

BACKGROUND/AIM: The aim of this study was to determine the association between total triiodothyronine (T3), free fraction of thyroxin (FT4), and thyrotropin (TSH) levels with prostate cancer histopathological features. PATIENTS AND METHODS: Blood samples from 140 patients with prostate cancer were analyzed preoperatively and stratified according to postoperative histopathological differentiation. The first group (N=62) included patients with prostate cancer Grade Groups (GG) 1-2, while the second group (N=63) included patients with prostate cancer GG 3-5. RESULTS: T3 levels were significantly higher in patients with prostate cancer GG 3-5 (p=0.047). There was no significant difference in the FT4 and TSH levels between the two groups (p=0.680 and 0.801, respectively). T3 levels were positively correlated with tumor percentage involvement (TPI) (p=0.002), and pT stage (p=0.047) on definitive pathology. CONCLUSION: Higher T3 levels are associated with several indicators of prostate cancer histopathological aggressiveness.


Assuntos
Neoplasias da Próstata/cirurgia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Período Pré-Operatório , Estudos Prospectivos , Antígeno Prostático Específico/sangue , Prostatectomia/métodos , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia
11.
JAAPA ; 33(5): 21-26, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32282411

RESUMO

Subclinical hypothyroidism affects 4.3% of the US population. Despite this prevalence, whether to treat or to observe patients with subclinical hypothyroidism remains controversial. Guidelines for overt hypothyroidism strongly favor treatment for symptomatic benefits, but the same benefits of levothyroxine treatment have not been proven for patients with subclinical hypothyroidism-most likely due to the asymptomatic nature of the condition. Additionally, a connection between subclinical hypothyroidism and cardiovascular complications has not been definitively established, although the evidence favors a relationship. This article describes the background, presentation, and diagnostics of subclinical hypothyroidism, treatment, and potential cardiovascular complications, so clinicians can decide if initiating treatment is best for their patients with subclinical hypothyroidism.


Assuntos
Hipotireoidismo/diagnóstico , Hipotireoidismo/tratamento farmacológico , Idoso , Doenças Assintomáticas , Autoantígenos/sangue , Biomarcadores/sangue , Doenças Cardiovasculares/etiologia , Diagnóstico Diferencial , Feminino , Humanos , Hipotireoidismo/etiologia , Iodeto Peroxidase/sangue , Proteínas de Ligação ao Ferro/sangue , Lipídeos , Fatores de Risco , Tireoidite Autoimune/complicações , Tireotropina/sangue , Tiroxina/uso terapêutico , Tri-Iodotironina/sangue
12.
Hum Cell ; 33(3): 545-558, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32146707

RESUMO

This study aimed to investigate the usefulness of the thyroid-related hormones as markers of acute systemic hypoxia/ischemia to identify deaths caused by asphyxiation due to neck compression in human autopsy cases. The following deaths from pathophysiological conditions were examined: mechanical asphyxia and acute/subacute blunt head injury; acute/subacute non-head blunt injury; sharp instrument injury as the hemorrhagic shock condition; drowning as alveolar injury; burn; and death due to cardiac dysfunction. Blood samples were collected from the left and right cardiac chambers and iliac veins, and serum triiodothyronine (T3), thyroxine (T4), thyroglobulin (Tg), and thyroid-stimulating hormone (TSH) levels were measured using electrochemiluminescence immunoassays. Two types of thyroid cell lines were used to confirm independent thyroid function under the condition of hypoxia (3% O2). The human thyroid carcinoma cell line (HOTHC) cell line derived from human anaplastic thyroid carcinoma and the UD-PTC (sample of the second resection papillary thyroid carcinoma) cell line derived from human thyroid papillary adenoma, which forms Tg retention follicles, were used to examine the secretion levels of T3, T4, and Tg hormones. The results showed a strong correlation between T3 and T4 levels in all blood sampling sites, while the TSH and Tg levels were not correlated with the other markers. Serum T3 and T4 levels were higher in cases of mechanical asphyxia and acute/subacute blunt head injury, representing hypoxic and ischemic conditions of the brain as compared to those in other causes of death. In the thyroid gland cell line, T4, T3, and Tg levels were stimulated after exposure to hypoxia for 10-30 min. These findings suggest that systemic advanced hypoxia/ischemia may cause a rapid and TSH-independent release of T3 and T4 thyroid hormones in autopsy cases. These findings demonstrate that increased thyroid-related hormone (T3 and T4) levels in the pathophysiological field may indicate systemic hypoxia/ischemia.


Assuntos
Asfixia/diagnóstico , Hipóxia/diagnóstico , Isquemia/diagnóstico , Tireoglobulina/sangue , Tireotropina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Autopsia , Biomarcadores/sangue , Feminino , Traumatismos Cranianos Fechados , Humanos , Masculino , Pessoa de Meia-Idade , Tiroxina
13.
Medicine (Baltimore) ; 99(9): e19232, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118725

RESUMO

The aim of the study was to systematically characterize the interference of biotin on thyroid function tests and biotin washout periods.Ten healthy adults were recruited with administration of 5 and 10 mg/d biotin for 7 days. Analyte concentrations of thyroid function tests were measured at baseline prior to starting biotin and from 2 hours to 2 days after withdrawal of 5 and 10 mg/d biotin. The outcomes were compared the baseline with the several points after taking biotin at Roche cobas e602, Beckman UniCel DxI 800, and Abbott Architect 2000 immunoassay platforms, respectively.Ingesting 5 or 10 mg/d of biotin for 7 days could produce positive or negative interference among the thyroid function tests at Roche cobas e602 and Beckman UniCel DxI 800 systems, but no interference on Abbott Architect 2000. Interference duration of 5 mg/d biotin for Roche cobas e602 and Beckman UniCel DxI 800 of thyroid function tests lasted for 8 hours, while 10 mg/d biotin interfered with Roche cobas e602 or Beckman UniCel DxI 800 for 1 day or 2 days.This study provides valuable guidance on biotin washout periods at doses common in over-the-counter supplements necessary to avoid false assay results.Trial registration: ChiCTR1800020472.


Assuntos
Biotina/farmacologia , Testes de Função Tireóidea/normas , Complexo Vitamínico B/farmacologia , Administração Oral , Adulto , Biotina/administração & dosagem , Feminino , Voluntários Saudáveis , Humanos , Masculino , Tiroxina/sangue , Tiroxina/efeitos dos fármacos , Tri-Iodotironina/sangue , Tri-Iodotironina/efeitos dos fármacos , Complexo Vitamínico B/administração & dosagem , Adulto Jovem
14.
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
15.
Arch Endocrinol Metab ; 64(1): 66-70, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32187261

RESUMO

Objective Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments. Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 ± 0.45 m/s and 1.95 ± 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 ± 5.65 kPa (p = 0.005) and 12.24 ± 6.17 kPa (p = 0.02), respectively]. Conclusion Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder. Arch Endocrinol Metab. 2020;64(1):66-70.


Assuntos
Autoanticorpos/imunologia , Autoimunidade/imunologia , Febre Familiar do Mediterrâneo/imunologia , Febre Familiar do Mediterrâneo/fisiopatologia , Glândula Tireoide/imunologia , Adulto , Autoanticorpos/sangue , Estudos de Casos e Controles , Febre Familiar do Mediterrâneo/diagnóstico por imagem , Feminino , Humanos , Iodeto Peroxidase/sangue , Iodeto Peroxidase/imunologia , Masculino , Tireotropina/sangue , Tireotropina/imunologia , Tri-Iodotironina/sangue , Tri-Iodotironina/imunologia , Ultrassonografia Doppler
16.
J Therm Biol ; 88: 102517, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32125994

RESUMO

Initial brooding temperature is critical for post-hatch growth of broiler chickens. A study was conducted to investigate the early age thermal manipulation (EATM) on the performance and physiological responses broiler chickens under hot humid tropical climate. A total of 260 unsexed day-old Arbor-acre broiler chicks were assigned to five thermal treatments of brooding temperature regimens having 4 replicates of thirteen birds each. The heat treatments were: initial brooding temperature of 35 °C for the first 2 days, and then decreased subsequently, gradually to 22 °C at 21 d of age (CT), initial temperature of 35 °C, sustained for the first 4 days and then decreased gradually (conventionally) (FD), initial temperature of 35 °C for the first 7 days (SD), the birds in CT, but the brooding temperature was raised to 35 °C again for another 3 days from day 7 (SD3), initial brooding temperature of 35 °C for the first 10 days (TD). Data were collected on daily feed intake and weekly body weights. Blood samples were collected from 8 birds per treatment weekly for the determination of plasma uric acid, triglycerides, triiodothyronine (T3) and creatinine kinase. Data obtained were laid out in a Completely Randomized Design (CRD). Results showed that the final weights of the birds in FD were higher (P < 0.05) than those of the other treatments at the finisher phase. Feed intake of the birds in FD was higher than those of SD3 and TD. FCR of broiler chickens in CT, SD, SD3 and TD was higher than that of FD. The rectal temperature, plasma MDA and blood glucose of the thermally challenged birds in FD was generally better (P < 0.05) than those of the other treatments. It was concluded that EATM can be used to improve performance and also protect broiler chickens from acute heat stress at market age.


Assuntos
Galinhas/fisiologia , Temperatura Alta , Animais , Glicemia/análise , Temperatura Corporal , Peso Corporal , Galinhas/sangue , Creatinina/análise , Umidade , Malondialdeído/sangue , Triglicerídeos/sangue , Tri-Iodotironina/sangue , Clima Tropical , Ácido Úrico/sangue
17.
Environ Health Prev Med ; 25(1): 7, 2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32085700

RESUMO

BACKGROUND: Anti-thyroid peroxidase antibody (TPO-Ab) has been shown to cause autoimmune thyroiditis by inducing a deleterious influence on thyroid hormone synthesis. Further, thyroglobulin, which has an important role in thyroid hormone synthesis, is reported to be high in the fluid from thyroid cysts. Therefore, TPO-Ab could be associated with the presence of thyroid cyst, partly by affecting the activity of thyroid hormone synthesis. METHODS: To investigate the association between TPO-Ab and thyroid cysts, we conducted a cross-sectional study of 1432 Japanese with normal thyroid function [i.e., normal range of free triiodothyronine (free T3) and free thyroxine (free T4)] between the ages of 40 and 74 years, who participated in an annual health check-up. RESULTS: In men, the statistical power did not reach a statistical significance value. Additionally, subjects with TPO-Ab showed lower odds ratios (ORs) of thyroid cysts than those without TPO-Ab. In women, subjects with TPO-Ab showed significantly lower ORs of thyroid cysts than those without TPO-Ab. The fully adjusted ORs were 0.68 (0.40, 1.18) for men and 0.40 (0.27, 0.60) for women. When evaluating the association between logarithmic values of TPO-Ab titer and thyroid cysts in both men and women, a notable inverse correlation was observed. The fully adjusted ORs were 0.68 (0.50, 0.92) for men and 0.68 (0.57, 0.81) for women. CONCLUSION: TPO-Ab titer revealed to be inversely associated with thyroid cysts among Japanese with normal thyroid function. The presence of a thyroid cyst could indicate a lower risk of having TPO-Ab among the general population with normal thyroid function.


Assuntos
Autoanticorpos/sangue , Cistos/epidemiologia , Doenças da Glândula Tireoide/epidemiologia , Tiroxina/sangue , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Tri-Iodotironina/sangue
19.
Medicine (Baltimore) ; 99(7): e19106, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32049820

RESUMO

We sought to investigate the effect of total triiodothyronine (TT3) reduction in the follow-up of patients with idiopathic membranous nephropathy (IMN). A total of 121 patients were enrolled and classified into a low TT3 group or a normal group. Clinical indicators were compared between the groups, and changes in estimated glomerular filtration rate (eGFR), albumin (ALB), thyroid-stimulating hormone, serum creatinine, total protein, total cholesterol (TC), triglyceride (TG), and low-density lipoprotein cholesterol (LDL-C) during follow-up were analysed. In the analysis by TT3 level, ALB was significantly lower in the low TT3 group (P < .05), while TC, TG, LDL-C, fibrinogen, and renal pathological staging were significantly higher in the low TT3 group (P < .05). Analysis of variance for repeated measurement during follow-up showed that there were no significant differences in eGFR and ALB between the groups. TC, TG, and LDL-C levels were significantly higher in the low TT3 group (P < .05). Approximately 37% of patients with IMN showed a decrease in TT3, which was accompanied by significantly decreased ALB level, higher pathological stage, and increased serum lipid level compared with patients having a normal TT3 level. The management of TT3, and appropriate intervention, may therefore help to prevent the kidney damage progress in patients with IMN.


Assuntos
Glomerulonefrite Membranosa/sangue , Tri-Iodotironina/sangue , Adulto , Análise de Variância , Estudos de Casos e Controles , LDL-Colesterol/sangue , Progressão da Doença , Feminino , Seguimentos , Taxa de Filtração Glomerular , Glomerulonefrite Membranosa/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Albumina Sérica/metabolismo
20.
Arch. endocrinol. metab. (Online) ; 64(1): 52-58, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1088768

RESUMO

ABSTRACT Objective This study aimed to present the impact of age and gender on thyroid hormone levels in a large Chinese population with sufficient iodine intake. Subjects and methods A total of 83643 individuals were included and were stratified by age and gender. The median, 2.5th and 97.5th of thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and FT3/FT4 ratio were calculated for both genders for every decade from 18 to over 80 years. TSH, FT3, FT4, FT3/FT4 distribution in each age group was evaluated for females and males using smoothing splines in the generalized additive models (GAM). TSH concentrations were compared in the different age groups in gender. Results In the over 80s age group, the TSH level (median: 2.57 mIU/L, 2.5th-97.5th: 0.86-7.56 mIU/L) was significantly higher than other age groups, irrespective to gender (P<0.001). Females had a higher TSH value than males in all age groups (P<0.001). Results of the smoothing curves showed that TSH increased with age, FT3 concentration was higher in males than in females and the tendency of the FT3/FT4 ratio was basically similar to that of FT3. TSH concentration in the 50s age group (median 2.48 mIU/L for females versus 2.00 mIU/L for males) was significantly higher than that in the 30s age group (median 2.18 mIU/L for females versus median 1.85 mIU/L for males). Conclusions In accord with increasing TSH values during aging, females and older adults have lower FT3 values and lower FT3/FT4 ratios, while the FT4 values remain stable.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Tiroxina/sangue , Tri-Iodotironina/sangue , Tireotropina/sangue , Fatores Sexuais , Fatores Etários , Valores de Referência , Testes de Função Tireóidea , Estudos Retrospectivos , Grupo com Ancestrais do Continente Asiático
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