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1.
Anticancer Res ; 42(1): 253-261, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34969732

RESUMO

BACKGROUND/AIM: Many experimental studies have suggested the importance of thyroid hormones in breast cancer (BC) morphogenesis. The aim of this study was to evaluate the association of thyroid hormone levels in serum of patients with primary BC with morphological presentations of the disease in pathological specimens and prognosis. PATIENTS AND METHODS: We measured the serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), along with serum thymidine kinase 1 activity and examined their relation to pathological features and prognosis of 158 patients with primary BC. RESULTS: We found a significant positive association of serum FT3 level with the presence of carcinoma in situ component (CIS) (p=0.032) and its size (p=0.047), with the presence (p=0.022) and the number of multifocal/multicentric tumors (MMTs) (p=0.002), as well as with increased proliferative activity in terms of serum thymidine kinase 1 (p=0.002). Moreover, we report that each 1.0 unit rise of FT3/FT4 ratio×10 was associated with an odds ratio of 1.77 (95% confidence interval=1.17-3.30, p=0.007), 1.97 (95% confidence interval=1.17-2.67, p=0.010) and 1.56 (95% confidence interval=1.02-2.37, p=0.039) for the detection of patients with CIS, MMTs and lymphovascular invasion, respectively, after adjusting for age. We did not find statistically significant associations of serum TSH level with breast cancer`s parameters. A Cox regression survival analysis identified serum FT3 level >5.95 pmol/l as a risk factor for BC recurrence (relative risk=2.65, p=0.017), a finding that retained significance in a multivariate model (relative risk=2.52, p=0.027). CONCLUSION: The FT3/FT4 ratio is a valuable parameter predicting the presence of CIS, MMTs and lymphovascular invasion in pathological specimens. An elevated serum FT3 level is associated with the presence of CIS, MMTs, increased proliferative activity and poor prognosis.


Assuntos
Neoplasias da Mama/sangue , Carcinoma in Situ/sangue , Recidiva Local de Neoplasia/sangue , Glândula Tireoide/metabolismo , Hormônios Tireóideos/sangue , Adulto , Idoso , Biomarcadores Tumorais/sangue , Neoplasias da Mama/patologia , Carcinoma in Situ/patologia , Proliferação de Células/genética , Feminino , Humanos , Pessoa de Meia-Idade , Invasividade Neoplásica/genética , Invasividade Neoplásica/patologia , Recidiva Local de Neoplasia/patologia , Prognóstico , Timidina Quinase/sangue , Testes de Função Tireóidea , Glândula Tireoide/patologia , Hormônios Tireóideos/genética , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
2.
Nutrients ; 13(12)2021 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-34960089

RESUMO

PURPOSE: Low T3 syndrome is defined by a fall in free triiodothyronine (FT3) in spite of normal serum thyroid-stimulating hormone (TSH) and often normal free thyroxin (FT4). A low FT3/FT4 ratio, a relevant marker for low T3 syndrome, is known as a risk of mortality in hemodialysis (HD) patients, as well as low muscle mass in the general population. Because of the local activation of T4 to FT3 in muscle tissue, we examined the association of FT3/FT4 ratio with serum creatinine, a marker of muscle mass and strength in HD patients to investigate the significance of muscle tissue in the development of low T3 syndrome in HD patients. METHODS: This was a cross-sectional study derived from our prospective cohort study, named DREAM, of Japanese HD patients. After the exclusion of patients with treated and untreated thyroid dysfunction, 332 patients were analyzed in the study. RESULTS: The serum FT4 and TSH of HD patients (n = 332) were 0.9 ± 0.1 ng/dL. and 2.0 ± 0.9 µIU/mL, which were within the respective normal range, while serum FT3 was 2.2 ± 0.3 pg/mL. As many as 101 out of 332 (30.4%) HD patients exhibited a serum FT3 less than the normal lower limit of 2.2 pg/mL. The serum FT3/FT4 ratio correlated significantly positively with serum creatinine, and inversely with serum log CRP and total cholesterol, while it exhibited a tendency towards positive correlation with serum albumin. Multiple regression analysis, which included serum creatinine, albumin, and log CRP, simultaneously, in addition to sex, age, diabetic kidney disease or not, log HD duration, body mass index, systolic blood pressure, and Kt/V, as independent variables, revealed an independent and significant positive association of serum creatinine, but not serum albumin or CRP, with the serum FT3/FT4 ratio. CONCLUSIONS: The present study demonstrated an independent and positive correlation of serum creatinine with the serum FT3/FT4 ratio in HD patients. The lack of association of the serum FT3/FT4 ratio with serum albumin and CRP suggested the presence of a creatinine-specific mechanism to associate with serum FT3/FT4 ratio. Because of the local activation of T4 to T3 at muscle tissue, a lower muscle mass may be causatively associated with low T3 syndrome.


Assuntos
Creatinina/sangue , Diálise Renal , Tiroxina/sangue , Tri-Iodotironina/sangue , Proteína C-Reativa , Estudos de Coortes , Estudos Transversais , Humanos , Albumina Sérica
3.
Med Sci Monit ; 27: e935075, 2021 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-34969944

RESUMO

BACKGROUND Thyroiditis is an important extrahepatic association in chronic hepatitis C virus (HCV) infection. There have been reports of an association between SARS-CoV-2 infection and the onset or re-activation of autoimmune hypothyroidism. Therefore, we performed this prospective observational study of 42 patients with COVID-19 infection and a history of hepatitis C virus infection and thyroid disease with follow-up thyroid function and autoantibody testing. MATERIAL AND METHODS From April 2020 to October 2020, we performed a prospective observational study of patients with cured hepatitis C virus (HCV) infection and documented thyroid disease who became infected with SARS-CoV-2 (confirmed by SARS-CoV-2 RNA detection via reverse-transcription polymerase chain reaction [RT-PCT] from the upper respiratory tract, both nasal and pharyngeal swabs). Evaluation at 1 and 3 months after SARS-CoV-2 infection included serum determination of antithyroid antibodies (anti-thyroglobulin [anti-Tg] and antithyroid peroxidase [ATPO]), thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and evaluation of thyroid medication, with dose adjustment if required. RESULTS One-month follow-up showed that both patients with autoimmune thyroiditis as well as patients without antibodies had increased ATPO levels. Also, levels of TSH, fT3, and fT4 were significantly decreased. At 3-month follow-up, levels of ATPO were decreased in all patient groups and the levels of thyroid hormones increased to normal values. CONCLUSIONS This study supports previous reports of an association between SARS-CoV-2 infection and thyroid dysfunction associated with thyroid autoantibodies. Thyroid function tests may be considered as part of the laboratory work-up in patients with COVID-19.


Assuntos
COVID-19/complicações , Hepatite C/complicações , Hipotireoidismo/etiologia , Adulto , Idoso , COVID-19/virologia , Feminino , Seguimentos , Hepacivirus/patogenicidade , Hepatite C/virologia , Humanos , Hipotireoidismo/fisiopatologia , Hipotireoidismo/virologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RNA Viral , Romênia/epidemiologia , SARS-CoV-2/imunologia , SARS-CoV-2/patogenicidade , Doenças da Glândula Tireoide/fisiopatologia , Testes de Função Tireóidea , Glândula Tireoide/fisiologia , Tireoidite Autoimune/sangue , Tireoidite Autoimune/imunologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
4.
Medicine (Baltimore) ; 100(41): e27490, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34731129

RESUMO

BACKGROUND: Prunella vulgaris (PV), a traditional Chinese medical herb, is considered beneficial for some thyroid diseases. However, the effectiveness is not consistent in different studies. This review compiles the evidence from randomized controlled trials (RCTs) and quantifies the effects of PV preparation on thyroid nodules. METHODS: Eight databases were searched up to April 2021 to identify eligible studies. Only RCTs were included. Meta-analysis of homogeneous studies was performed by RevMan5.3 software. Cochrane risk of bias assessment tool version 2.0 was used to assess the risk of bias of each trial. The research screening, data extraction, and risk of bias assessment were employed by 2 reviewers independently, and disagreement will be decided by a third senior reviewer. The risk ratio (RR), mean difference (MD) and corresponding 95% confidence interval (CI) of each study are summarized. RESULTS: Thirteen RCTs with 1468 patients were included in this study. A meta-analysis showed that the RR of the clinical efficacy of PV combined with levothyroxine sodium tablets was 1.22 (95% CI [1.11, 1.33]). The MD of thyroid nodule diameter was -0.43 (95% CI [-0.63, -0.22]). The MD of free triiodothyronine and free tetraiodothyronine levels was -1.99 (95% CI [-3.14, -0.86]) and -3.20 (95% CI [-5.50, -0.89]), respectively. The RR of the adverse reaction rate was 0.67 (95% CI [0.36, 1.22]), and the RR of the clinical efficacy of PV preparation combined with thyroxin tablets was 1.29 (95% CI [1.03, 1.62]). CONCLUSIONS: PV combined with levothyroxine sodium tablets or thyroxin tablets has more benefits for thyroid nodules, further improving the clinical efficiency, reducing the diameter of nodules and reducing the occurrence of adverse reactions. However, the quality of these studies is uncertain, and higher quality and more RCTs are needed to provide comprehensive evidence-based medical evidence in the future.


Assuntos
Lamiaceae/efeitos adversos , Prunella/efeitos adversos , Nódulo da Glândula Tireoide/tratamento farmacológico , Estudos de Casos e Controles , Composição de Medicamentos/métodos , Quimioterapia Combinada , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Humanos , Iodeto Peroxidase/sangue , Lamiaceae/química , Masculino , Medicina Tradicional Chinesa/métodos , Prunella/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Segurança , Nódulo da Glândula Tireoide/patologia , Tiroxina/administração & dosagem , Tiroxina/uso terapêutico , Resultado do Tratamento , Tri-Iodotironina/sangue
5.
Front Endocrinol (Lausanne) ; 12: 746602, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34659128

RESUMO

Background: Some studies have indicated that interferon (IFN) may be valuable in COVID-19. We aimed to evaluate the impact of short-term IFN on incident thyroid dysfunction and autoimmunity among COVID-19 survivors. Methods: We included consecutive adults without known thyroid disorder admitted to Queen Mary Hospital for COVID-19 from July 2020 to January 2021 who had thyroid function tests (TFTs) and anti-thyroid antibodies measured both on admission and at three months. Results: 226 patients were included (median age 55.0 years; 49.6% men): 135 were IFN-treated. There tended to be more abnormal TFTs upon reassessment in IFN-treated patients (8.1% vs 2.2%, p=0.080). 179 patients (65.4% IFN-treated) had a complete reassessment of anti-thyroid antibodies. There were significant increases in titres of both anti-thyroid peroxidase antibodies (anti-TPO: baseline 29.21 units [IQR: 14.97 - 67.14] vs reassessment 34.30 units [IQR: 18.82 - 94.65], p<0.001) and anti-thyroglobulin antibodies (anti-Tg: baseline 8.23 units [IQR: 5.40 - 18.44] vs reassessment 9.14 units [IQR: 6.83 - 17.17], p=0.001) in the IFN-treated group but not IFN-naïve group. IFN treatment (standardised beta 0.245, p=0.001) was independently associated with changes in anti-TPO titre. Of the 143 patients negative for anti-TPO at baseline, 8 became anti-TPO positive upon reassessment (seven IFN-treated; one IFN-naïve). Incident anti-TPO positivity was more likely to be associated with abnormal TFTs upon reassessment (phi 0.188, p=0.025). Conclusion: IFN for COVID-19 was associated with modest increases in anti-thyroid antibody titres, and a trend of more incident anti-TPO positivity and abnormal TFTs during convalescence. Our findings suggest that clinicians monitor the thyroid function and anti-thyroid antibodies among IFN-treated COVID-19 survivors, and call for further follow-up studies regarding the clinical significance of these changes.


Assuntos
Autoimunidade/efeitos dos fármacos , COVID-19/tratamento farmacológico , COVID-19/imunologia , Interferon beta-1b/efeitos adversos , Interferon beta-1b/uso terapêutico , Doenças da Glândula Tireoide/induzido quimicamente , Testes de Função Tireóidea , Glândula Tireoide/efeitos dos fármacos , Adulto , Anticorpos/análise , Estudos de Coortes , Feminino , Seguimentos , Humanos , Imunoglobulinas Glândula Tireoide-Estimulantes/análise , Masculino , Pessoa de Meia-Idade , Sobreviventes , Doenças da Glândula Tireoide/imunologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
6.
Eur J Endocrinol ; 185(5): 743-753, 2021 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-34524976

RESUMO

Objective: Genetic factors underpin the narrow intraindividual variability of thyroid function, although precise contributions of environmental vs genetic factors remain uncertain. We sought to clarify the heritability of thyroid function traits and thyroid peroxidase antibody (TPOAb) positivity and identify single nucleotide polymorphisms (SNPs) contributing to the trait variance. Methods: Heritability of thyroid-stimulating hormone (TSH), free T4 (fT4), free T3 (fT3) and TPOAb in a cohort of 2854 euthyroid, dizygous and monozygous twins (age range 11.9-16.9 years) from the Brisbane Longitudinal Twin Study (BLTS) was assessed using structural equation modelling. A genome-wide analysis was conducted on 2832 of these individuals across 7 522 526 SNPs as well as gene-based association analyses. Replication analysis of the association results was performed in the Raine Study (n = 1115) followed by meta-analysis to maximise power for discovery. Results: Heritability of thyroid function parameters in the BLTS was 70.8% (95% CI: 66.7-74.9%) for TSH, 67.5% (59.8-75.3%) for fT4, 59.7% (54.4-65.0%) for fT3 and 48.8% (40.6-56.9%) for TPOAb. The genome-wide association study (GWAS) in the discovery cohort identified a novel association between rs2026401 upstream of NCOA3 and TPOAb. GWAS meta-analysis found associations between TPOAb and rs445219, also near NCOA3, and fT3 and rs12687280 near SERPINA7. Gene-based association analysis highlighted SERPINA7 for fT3 and NPAS3 for fT4. Conclusion: Our findings resolve former contention regarding heritability estimates of thyroid function traits and TPOAb positivity. GWAS and gene-based association analysis identified variants accounting for a component of this heritability.


Assuntos
Estudo de Associação Genômica Ampla , Coativador 3 de Receptor Nuclear/genética , Testes de Função Tireóidea , Glândula Tireoide/fisiologia , Globulina de Ligação a Tiroxina/genética , Adolescente , Austrália/epidemiologia , Estudos de Coortes , Feminino , Humanos , Iodeto Peroxidase/análise , Iodeto Peroxidase/imunologia , Estudos Longitudinais , Masculino , Polimorfismo de Nucleotídeo Único , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue , Gêmeos Monozigóticos
7.
Endocrinol Metab (Seoul) ; 36(4): 769-777, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34474515

RESUMO

BACKGROUND: Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients. METHODS: The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones. RESULTS: Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile. CONCLUSION: Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.


Assuntos
COVID-19/sangue , COVID-19/diagnóstico , Tireotropina/sangue , Tri-Iodotironina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , COVID-19/epidemiologia , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , República da Coreia/epidemiologia , Estudos Retrospectivos
8.
Clin Chem Lab Med ; 59(12): 1906-1913, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34380183

RESUMO

OBJECTIVES: There is increasing interest regarding the relationship between serum levels of free triiodothyronine (fT3) and outcomes of COronaVIrus Disease-19 (COVID-19) patients. As several recent reports have described a worse prognosis in patients with low fT3 levels, we performed a meta-analysis to assess the prognostic role of fT3 serum levels in patients with COVID-19 as this information could be clinically relevant for the management of these patients. METHODS: The methodology was registered in the International prospective register of systematic reviews (PROSPERO) database under the protocol number CRD42021260952. A systematic search was carried out on PubMed, Embase, Web of Science, and Scopus from May to June 2021 without time and language restrictions. The literature search strategy was based on the following keywords: (T3 OR fT3 OR triiodothyronine) AND (COVID-19) AND (prognosis OR survival). RESULTS: The literature search identified 163 studies. Seven retrospective studies met the inclusion and exclusion criteria and were included in the meta-analysis. The included studies had a total of 1,183 patients. From the analysis of the included studies, lower fT3 serum levels were consistently observed in intensive care unit (ICU) than in non-ICU patients and in non-survivors than survivors, respectively. CONCLUSIONS: Serum fT3 concentrations are significantly lower in patients with severe COVID-19 than in non-severely ill patients and predict all-cause mortality of patients with severe COVID-19. Accordingly, fT3 may become a simple tool for stratified management of patients with severe COVID-19.


Assuntos
COVID-19/patologia , Tri-Iodotironina/sangue , COVID-19/mortalidade , COVID-19/virologia , Humanos , Unidades de Terapia Intensiva , Razão de Chances , Prognóstico , SARS-CoV-2/isolamento & purificação , Análise de Sobrevida
9.
Sci Rep ; 11(1): 15970, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34354103

RESUMO

Establishing any characteristic associations between the serum parameters of thyroid function and serum proteins in pregnancy may aid in elucidating the role of the thyroid gland in the regulation of pregnancy-specific metabolic processes and in selecting candidate biomarkers for use in their clinical assessment. Concentrations of thyroid stimulating hormone (TSH), free tri-iodothyronine (fT3) and free thyroxine (fT4), six electrophoretically separated protein fractions (albumin, alpha-1-, alpha2-, beta-1-, beta-2- and gamma-globulins), representative proteins-albumin (ALB), transferrin (TRF), alpha-2-macroglobulin (AMG) and ceruloplasmin (CER) were measured in 136 serum samples from 65 women in their consecutive trimesters of pregnancy. The concentrations of TSH, fT4 and fT3 were significantly correlated (p < 0.05) with the concentrations of the albumin, alpha-2- and beta-1 globulin fractions. Significant correlations (p < 0.05) which were positive between fT4 and ALB and negative between fT4 and TRF were established throughout pregnancy. Significant negative correlations (p < 0.05) were demonstrated for fT3 with alpha-2-globulin, AMG and CER. Changes in the serum concentrations of thyroid hormones seen between the trimesters were found to correlate with the concentrations of high-abundance serum proteins. Opposite directions of correlations between fT4 and ALB and fT4 and TRF observed throughout pregnancy may indicate the shared biological role of these parameters in maintaining maternal homeostasis and they suggest their potential use in the clinic as a simple biomarker panel. A negative correlation of fT3 with CER in the second trimester possibly reflects their involvement in the active regulation of metabolic processes.


Assuntos
Gravidez/metabolismo , Testes de Função Tireóidea/métodos , Glândula Tireoide/metabolismo , Adulto , Proteínas Sanguíneas , Feminino , Humanos , Gravidez/fisiologia , Trimestres da Gravidez , Gestantes , Albumina Sérica/análise , Soroglobulinas/análise , Glândula Tireoide/fisiologia , Hormônios Tireóideos/análise , Hormônios Tireóideos/sangue , Tireotropina/análise , Tireotropina/sangue , Tiroxina/análise , Tiroxina/sangue , Tri-Iodotironina/análise , Tri-Iodotironina/sangue
10.
Sci Rep ; 11(1): 15590, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34341406

RESUMO

Few studies have assessed the application and side effects of potassium iodide (KI) iontophoresis. Using a double-blinded randomized controlled trial with a 1:1 parallel-group, we investigated the effect of galvanization and the KI iontophoresis in the throat and larynx on three thyroid parameters. A total of 50 healthy volunteers with normal TSH, FT3, and FT4 levels and lacking focal changes in the thyroid ultrasonography were subjected to 10 electrotherapy treatments. The TSH, FT3, and FT4 levels were determined prior to the 10 electrotherapeutic treatments (T1), 2-weeks after treatment (T2) and 6-months after treatment (T3). At T2 and T3, both groups had normal levels of TSH, FT3, and FT4. Regarding the change of TSH, FT3, and FT4 levels between T1 vs. T2 and T1 vs. T3, no significant differences between the galvanization and iontophoresis groups were found. However, both groups had lower levels of all three hormones at T3. Together, these data indicate that KI iontophoresis does not affect thyroid hormone levels in the short- nor long-term. Additional follow-up studies with larger groups are required to better confirm the safety of galvanization and iontophoresis procedures in the pharynx and larynx.Trial registration ClinicalTrials.gov (NCT04013308; URL: www.clinicaltrials.gov ). Day of first registration 09/07/2019.


Assuntos
Iontoforese , Laringe/fisiologia , Faringe/fisiologia , Iodeto de Potássio/farmacologia , Glândula Tireoide/fisiologia , Índice de Massa Corporal , Terapia por Estimulação Elétrica , Feminino , Humanos , Laringe/efeitos dos fármacos , Masculino , Faringe/efeitos dos fármacos , Glândula Tireoide/efeitos dos fármacos , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
11.
Biochem Med (Zagreb) ; 31(3): 030702, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34393595

RESUMO

Introduction: Evaluation of thyroid function is often requested and therefore defining paediatric reference intervals (RIs) is of vital importance. Currently, there is a distinct lack of paediatric RIs for thyroid function tests in Croatia. Thus, we established RIs for thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) in the Croatian paediatric population. Materials and methods: Reference intervals were calculated from 397 apparently healthy children, aged from 2 days to < 19 years. Serum samples were analysed for thyroid function tests on the Abbott Architect i2000. Age- and sex-specific 95% RIs with 90% confidence intervals were established according to Clinical and Laboratory Standards Institute guidelines. To express the magnitude of sex and age variation, standard deviation ratio (SDR) was calculated using two-level nested ANOVA. The criterion for considering partitioning reference values was set to SDR > 0.3. Results: All thyroid function tests required age partitioning, confirmed by SDR above 0.3. There was no need for sex partitioning, confirmed by SDR below 0.3. Still, FT3 was partitioned due to visually noticeable sex related difference for the oldest group (12 years to < 19 years). Conclusion: This is the first study to establish RIs for thyroid function tests in the Croatian paediatric population. We propose RIs for widely used Abbott platform, thus giving laboratories method- and population-specific paediatric RIs for thyroid function tests that should improve clinical test interpretation.


Assuntos
Análise Química do Sangue/instrumentação , Pediatria/normas , Testes de Função Tireóidea/normas , Adolescente , Análise Química do Sangue/normas , Criança , Pré-Escolar , Serviços de Laboratório Clínico , Croácia/epidemiologia , Feminino , Humanos , Imunoensaio/normas , Lactente , Recém-Nascido , Masculino , Valores de Referência , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
12.
Fish Physiol Biochem ; 47(4): 1313-1327, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34241763

RESUMO

Selenium (Se), an essential component of deiodinases (DIOs), regulates the contents of thyroid hormones and thus improves animal growth. To explore the influences of selenium supplementation on fish growth metabolism, a total of 270 healthy grass carp (Ctenopharyngodon idella) were divided into three groups and feed three graded dietary selenium (0.141, 0.562, and 1.044 mg Se/kg) levels. The results showed that after 60-day feeding, dietary selenium improved the final body weight and specific growth rate (SGR) of grass carp. The hepatic DIO activities in selenium-supplemented groups were higher than those in control group. A significant increase in triiodothyronine (T3), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels was accompanied by a decrease in the contents of thyroxine (T4) and free thyroxine (FT4) in selenium-supplemented groups. The histopathological observation of thyroid suggested that selenium deficiency resulted in hypertrophy of follicular epithelial cells. Moreover, the gene relative expression levels of dio1, dio2, and dio3 showed an increasing trend with the rising concentration of dietary selenium. The transcription levels of HPT axis-related genes (crh, tsh-ß, ttr, tr-s, tpo, nis) and GH/IGF1-related genes (gh, ghr, igf1, igf1r) were significantly upregulated in selenium-supplemented groups. No significant differences in the above indicators were observed between 0.562 and 1.044 mg Se/kg diet group except T3 content and dio1 relative expression ratio. These results indicate that dietary selenium supplementation improves the hepatic DIO activities and thyroid hormone metabolism and regulates the transcription levels of HPT and GH/IGF axis-related genes, which may be responsible for the growth promotion in grass carp.


Assuntos
Carpas , Suplementos Nutricionais , Selênio/farmacologia , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Carpas/sangue , Carpas/crescimento & desenvolvimento , Carpas/metabolismo , Expressão Gênica/efeitos dos fármacos , Hormônio do Crescimento/genética , Hipotálamo , Fator de Crescimento Insulin-Like I/genética , Iodeto Peroxidase/genética , Fígado/efeitos dos fármacos , Fígado/metabolismo , Hipófise , Receptor IGF Tipo 1/genética , Receptores da Somatotropina/genética , Glândula Tireoide/efeitos dos fármacos , Glândula Tireoide/patologia , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
13.
Biomed Res Int ; 2021: 6681491, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34195279

RESUMO

Background: Although hypothyroidism during pregnancy may develop grave outcomes for both mothers and offspring, management of which is still a challenge due to the insufficient understanding of this disease. The close correlation between hypothyroidism and preeclampsia is well documented, suggesting that preeclampsia is a potential risk factor for the development of maternal hypothyroidism. However, the exact role of preeclampsia in gestational hypothyroidism is still obscure. Objective: In this study, we explored the possible mechanisms of the effect of preeclampsia on thyroid function of maternal rats. Methods: Thirty pregnant rats were randomly divided into normal pregnancy control (NOP), preeclampsia (PE), and preeclampsia supplemented with amlodipine besylate (PEAml). NG-Nitro-L-arginine-methyl ester was used to induce preeclamptic symptoms. On gestational day 21, rats were sacrificed, and then, the ultrastructure of the thyroid gland, type 1 iodothyronine deiodinase (Dio1) expression, and serum-free thyroxine (FT4), free triiodothyronine (FT3), and thyroid stimulation hormones (TSH) were assessed. Results: Compared to NOP rats, results of PE rats showed that thyroid follicular cells' ultrastructure was damaged; both hepatic Dio1 mRNA and protein levels were decreased. Interestingly, these changes were ameliorated in PEAml rats. Additionally, FT4, FT3, and TSH levels have no significant differences among groups. Conclusion: These findings indicated that preeclampsia could disrupt synthesis, secretion, and metabolism function of thyroid hormones by damaging thyroid follicular cells and interfering Dio1 expression.


Assuntos
Hipotireoidismo/metabolismo , Iodeto Peroxidase/metabolismo , Fígado/enzimologia , Pré-Eclâmpsia/metabolismo , Glândula Tireoide/ultraestrutura , Hormônios Tireóideos/sangue , Animais , Feminino , Hipotireoidismo/complicações , NG-Nitroarginina Metil Éster/metabolismo , Gravidez , Prenhez , Ratos , Ratos Sprague-Dawley , Fatores de Risco , Tireotropina/sangue , Tiroxina/sangue , Fatores de Tempo , Tri-Iodotironina/sangue
14.
Sci Rep ; 11(1): 13922, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34230513

RESUMO

Our recent studies indicate that thyroid cysts have clinical implications. Thyroid cysts could have a positive effect on the supply of thyroid hormones. Both hyperthyroidism and hypothyroidism cause hypertension. Hypothyroidism, but not hyperthyroidism, is a risk factor for atherosclerosis. Therefore, thyroid cysts could be associated with hypertension, and atherosclerosis might influence the association between thyroid cysts and hypertension. To evaluate the clinical significance of thyroid cysts, a cross-sectional study was conducted with 1801 Japanese aged 40-74 years. Thyroid cysts were significantly positively associated with hypertension in participants without atherosclerosis. However, there was a significant inverse association in those with atherosclerosis. The potential confounding factor adjusted odd ratios and 95% confidence intervals (95% CIs) were 1.49 (95% CI 1.17-1.90) for participants without atherosclerosis and 0.49 (95% CI 0.24-0.98) for those with atherosclerosis. The present study demonstrates that thyroid cysts have clinical implications because thyroid cysts support thyroid hormone activity. Our findings provide sufficient evidence to develop a risk assessment for hypertension for the general population, even though further research is required.


Assuntos
Aterosclerose/complicações , Cistos/complicações , Hipertensão/complicações , Glândula Tireoide/patologia , Adulto , Idoso , Anti-Hipertensivos/uso terapêutico , Aterosclerose/sangue , Aterosclerose/fisiopatologia , Estudos Transversais , Cistos/sangue , Cistos/fisiopatologia , Feminino , Humanos , Hipertensão/sangue , Hipertensão/tratamento farmacológico , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Glândula Tireoide/fisiopatologia , Tri-Iodotironina/sangue
15.
Clin Biochem ; 95: 54-59, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34077759

RESUMO

BACKGROUND: Due to the lack of reference intervals for serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) in preterm neonates during the 5th to 7th day of life, we performed a retrospective study using the chemiluminescence immunoassay system. METHODS: A total of 2040 preterm neonates with a gestational age (GA) of 26-35 weeks in the neonatal intensive care unit from 2014 to 2019 were included. Their serum FT3, FT4 and TSH values were calculated and analyzed to establish reference intervals for preterm neonates stratified by GA. The comparisons of FT3, FT4 and TSH were made by sex (males and females) and gestational age (26-28 weeks; 29-32 weeks; 33-35 weeks). RESULTS: The reference intervals for FT3, FT4 and TSH in preterm neonates with a GA of 26-35 weeks were (1.65~5.21) pmol/L, (8.64~25.41) pmol/L, and (0.406~12.468) mlU/L, respectively. There were significant differences between serum FT3 and FT4 values and GA, while TSH levels were not significantly different (P < 0.01). The serum FT3 values of males were lower than those of females, especially in the 29-32 weeks group. No significant differences in serum values between sexes were found in FT4 or TSH (P > 0.05). CONCLUSION: Reference intervals of thyroid function tests were established to determine the early diagnostic criteria of thyroid diseases for neonates with a GA of 26-35 weeks and to avoid unnecessary retesting and interventions. The reference intervals of FT4 can be used as an indicator to regulate the doses of thyroid hormone supplement in the treatments of congenital hypothyroidism.


Assuntos
Glândula Tireoide/fisiologia , Tireotropina/normas , Tiroxina/normas , Tri-Iodotironina/normas , Feminino , Idade Gestacional , Humanos , Imunoensaio , Recém-Nascido , Recém-Nascido Prematuro , Medições Luminescentes , Masculino , Valores de Referência , Estudos Retrospectivos , Caracteres Sexuais , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/diagnóstico , Testes de Função Tireóidea , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
16.
J Endocrinol Invest ; 44(12): 2735-2739, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34101132

RESUMO

PURPOSE: "Non thyroidal illness syndrome" (NTIS) or "euthyroid sick syndrome" (ESS) is a possible biochemical finding in euthyroid patients with severe diseases. It is characterized by a reduction of serum T3 (fT3), sometimes followed by reduction of serum T4 (fT4). The relationship between thyroid hormones levels and mortality is well known and different studies showed a direct association between NTIS and mortality. The sudden spread of the 2019 novel coronavirus (SARS-CoV 2) infection (COVID-19) and its high mortality become a world healthcare problem. Our aim in this paper was to investigate if patients affected by COVID-19 presented NTIS and the relationship between thyroid function and severity of this infection. METHODS: We evaluated the thyroid function in two different groups of consecutive patients affected by COVID-19 with respect to a control group of euthyroid patients. Group A included patients hospitalized for COVID-19 pneumonia while patients requiring intensive care unit (ICU) for acute respiratory syndrome formed the group B. Group C identified the control group of euthyroid patients. RESULTS: Patients from group A and group B showed a statistically significant reduction in fT3 and TSH compared to group C. In group B, compared to group A, a further statistically significant reduction of fT3 and TSH was found. CONCLUSIONS: COVID-19 in-patients can present NTIS. FT3 and TSH serum levels are lower in patients with more severe symptoms.


Assuntos
COVID-19/complicações , Síndromes do Eutireóideo Doente/complicações , Doenças da Glândula Tireoide/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidados Críticos , Síndromes do Eutireóideo Doente/sangue , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome do Desconforto Respiratório/complicações , Estudos Retrospectivos , Doenças da Glândula Tireoide/sangue , Testes de Função Tireóidea , Glândula Tireoide/fisiopatologia , Tiroxina/sangue , Tri-Iodotironina/sangue
17.
Endocr Res ; 46(4): 170-177, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34014139

RESUMO

Background: Coronavirus disease 2019 (COVID-19) is a severe infectious illness. It has been reported that COVID-19 has an effect on thyroid function. However, the association between thyroid function and prognosis of COVID-19 is still unclear.Methods: This retrospective study included patients with COVID-19 admitted to Tongji Hospital in Wuhan from January 28 to April 4, 2020. Demographic, epidemiological, clinical, laboratory, treatment, and outcome data were collected from patients with laboratory-confirmed COVID-19. Patients without history of thyroid disease who had a thyroid function test at admission were enrolled in the final analysis. Risk factors of in-hospital death were explored using univariable and multivariable Cox regression analyses. Survival differences were assessed with Kaplan-Meier curves and log-rank test.Results: A total of 127 patients were included in this study, with 116 survivors and 11 non-survivors. The serum levels of thyroid stimulating hormone (TSH) [0.8 (0.5-1.7) vs. 1.9 (1.0-3.1) µIU/mL, P = .031] and free triiodothyronine (FT3) [2.9 (2.8-3.1) vs. 4.2 (3.5-4.7) pmol/L, P < .001] were lower in non-survivors than in survivors, and a low FT3 state (defined as FT3 < 3.1 pmol/L) at admission accounted for a higher proportion in non-survivors than in survivors (72.7% vs. 11.2%, P < .001). Univariate Cox regression analysis showed that FT3 level (HR 0.213, 95% CI: 0.101-0.451, P < .001) and the low FT3 state (HR 14.607, 95% CI: 3.873-55.081, P < .001) were negatively and positively associated with the risk of in-hospital death, respectively. Furthermore, multivariate Cox regression analysis revealed that a low FT3 state was associated with an increased risk of in-hospital death after adjusting for confounding factors (HR 13.288, 95% CI: 1.089-162.110, P = .043). Moreover, Kaplan-Meier curves indicated a lower survival probability in COVID-19 patients with a low FT3 status.Conclusion: Serum FT3 level is lower in non-survivors among moderate-to-critical patients with COVID-19, and the low FT3 state is associated with an increased risk of in-hospital mortality of COVID-19.


Assuntos
COVID-19/mortalidade , COVID-19/fisiopatologia , Prognóstico , SARS-CoV-2 , Glândula Tireoide/fisiopatologia , Idoso , COVID-19/epidemiologia , China/epidemiologia , Feminino , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
18.
Am J Med Sci ; 362(3): 303-307, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34023311

RESUMO

Subacute thyroiditis (SAT) is a self-limiting thyroid dysfunction of viral origin. Relatively little is known about its occurrence in SARS CoV-2 infected COVID-19 patients. Herein, we report a case of SAT in a 58-year-old patient that was apparently triggered by infection with SARS CoV-2. Clinical, laboratory and imaging features of the patient are presented. The patient was vitally stable with a slightly tender and warm thyroid gland, which was painful on swallowing. His free thyroxine (FT4) was elevated, thyroid stimulating hormone (TSH) was below normal and free triiodothyronine (FT3) was in the physiological range. Previous thyroid exam conducted as a part of routine annual physical checkup was normal. The patient was put on prednisolone and recovered completely within three weeks.


Assuntos
COVID-19/complicações , Cervicalgia/etiologia , SARS-CoV-2 , Tireoidite Subaguda/etiologia , Anti-Inflamatórios/uso terapêutico , Proteína C-Reativa/análise , COVID-19/sangue , COVID-19/tratamento farmacológico , Glucocorticoides/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/sangue , Cervicalgia/tratamento farmacológico , Prednisolona/uso terapêutico , Tireoidite Subaguda/sangue , Tireoidite Subaguda/tratamento farmacológico , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
19.
Kobe J Med Sci ; 66(4): E153-E158, 2021 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-33994519

RESUMO

Triiodothyronine (T3)-predominant Graves' disease is characterized by increased serum free T3 (FT3) levels after free thyroxine (FT4) levels become normal or even low during antithyroid drug treatment. We encountered a 34-year-old pregnant woman, gravida 5 para 4, who was complicated by T3-predominant Graves' disease. She was diagnosed with Graves' disease at 20 years old, and had received methimazole. Methimazole was changed to potassium iodide to reduce the risk of congenital anomalies during the first trimester. The dose of antithyroid drugs was adjusted based on maternal FT4 levels, so that maternal Graves' disease deteriorated and fetal goitrous hyperthyroidism appeared during the second trimester. Since the fetus presented goiter and tachycardia at 27-28 gestational weeks, doses of methimazole and potassium iodide were increased. A male newborn weighing 2604 g was delivered by a cesarean section at 35 gestational weeks. The newborn was diagnosed with neonatal hyperthyroidism, and received methimazole for six months. He developed normally with normal thyroid function at 1 year old. In pregnancies complicated by T3-predominant Graves' disease, the kinds and doses of antithyroid drugs have to be carefully selected to maintain maternal levels of FT4 as well as FT3 within the normal range, considering trimesters of pregnancy, teratogenicity of medication, and maternal levels of thyroid-stimulating hormone receptor antibody.


Assuntos
Antitireóideos/uso terapêutico , Bócio/congênito , Bócio/tratamento farmacológico , Doença de Graves/tratamento farmacológico , Tiroxina/sangue , Tri-Iodotironina/sangue , Adulto , Feminino , Bócio/diagnóstico por imagem , Doença de Graves/complicações , Doença de Graves/imunologia , Humanos , Recém-Nascido , Masculino , Troca Materno-Fetal , Metimazol/uso terapêutico , Iodeto de Potássio/uso terapêutico , Gravidez , Complicações na Gravidez/diagnóstico por imagem , Complicações na Gravidez/tratamento farmacológico , Gestantes , Resultado do Tratamento , Ultrassonografia Pré-Natal
20.
J Transl Med ; 19(1): 139, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33794925

RESUMO

BACKGROUND: Low T3 syndrome is frequent in patients admitted to intensive care units for critical illness and pneumonia. It has been reported also in patients with COVID-19, Hodgkin disease and chronic lymphocytic leukemia. We analyzed the clinical relevance of Low T3 syndrome in COVID-19 patients and, in particular, in those with associated hematological malignancies. METHODS: Sixty-two consecutive patients, hospitalized during the first wave of SARS-CoV-2 outbreak in Sant'Andrea University Hospital in Rome, were subdivided in 38 patients (Group A), showing low levels of FT3, and in 24 patients (Group B), with normal FT3 serum values. During the acute phase of the disease, we measured serum, radiologic and clinical disease severity markers and scores, in search of possible correlations with FT3 serum values. In addition, in 6 COVID-19 patients, 4 with Low T3 syndrome, including 2 with a hematological malignancy, and 2 with normal FT3 values, we performed, high-dimensional single-cell analysis by mass cytometry, multiplex cytokine assay and gene expression profiling in peripheral blood mononuclear cells (PBMC). RESULTS: Low FT3 serum values were correlated with increased Absolute Neutrophil Count, NLR and dNLR ratios and with reduced total count of CD3+, CD4+ and CD8+ T cells. Low FT3 values correlated also with increased levels of inflammation, tissue damage and coagulation serum markers as well as with SOFA, LIPI and TSS scores. The CyTOF analysis demonstrated reduction of the effector memory and terminal effector subtypes of the CD4+ T lymphocytes. Multiplex cytokine assay indicates that mainly IL-6, IP-10 and MCAF changes are associated with FT3 serum levels, particularly in patients with coexistent hematological malignancies. Gene expression analysis using Nanostring identified four genes differently expressed involved in host immune response, namely CD38, CD79B, IFIT3 and NLRP3. CONCLUSIONS: Our study demonstrates that low FT3 serum levels are associated with severe COVID-19. Our multi-omics approach suggests that T3 is involved in the immune response in COVID-19 and coexistent hematological malignancy and new possible T3 target genes in these patients have been identified.


Assuntos
COVID-19/complicações , Síndromes do Eutireóideo Doente/complicações , Neoplasias Hematológicas , Idoso , Idoso de 80 Anos ou mais , Feminino , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/genética , Humanos , Itália , Leucócitos Mononucleares , Masculino , Pessoa de Meia-Idade , Análise de Célula Única , Tri-Iodotironina/sangue
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