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1.
Chemosphere ; 286(Pt 1): 131605, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34298295

RESUMO

Prenatal exposure to polycyclic aromatic hydrocarbons (PAHs) evokes extensive concerns regarding public health. Monitoring the pregnant women's exposure can be considered a suitable alternative to assess the fetus's exposure. This study aimed to monitor pregnant women's exposure (n = 126) to PAHs using a biomonitoring approach to evaluate effects on anthropometric indices and neonatal thyroid-stimulating hormone (TSH) in Shiraz, Iran. PAHs priority compounds were measured by gas chromatography-mass spectrometry (GC-MS) after separating blood serum and liquid-liquid extraction (LLE) method. Information on anthropometric indices, neonatal TSH levels, and data from the respondents was obtained from medical records and questionnaires. The mean PAHs concentrations ranged from 0.29 to 327.91 ng/g lipid. There was no significant difference between the measured PAHs in maternal serum at the seventh month and pregnancy termination except for ACY (p-Value<0.05). Regression analysis results showed a significant correlation (p-value<0.05) between exposure to passive smoke and total PAHs concentrations. There was no significant relationship between exposure to PAHs and weight, height, head circumference, and Apgar score of newborns. The results showed TSH decreased by 0.99 units as ACE increased per unit (ß = -0.001). This study is the first to evaluate relationships between prenatal exposure to PAHs and effects on newborn health indicators, including TSH levels in a Middle Eastern population. Future studies are suggested to perform detailed assessments of PAHs intake sources, especially in vulnerable populations such as pregnant women and children.


Assuntos
Hidrocarbonetos Policíclicos Aromáticos , Efeitos Tardios da Exposição Pré-Natal , Criança , Monitoramento Ambiental , Feminino , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Recém-Nascido , Hidrocarbonetos Policíclicos Aromáticos/análise , Gravidez , Tireotropina
2.
Environ Pollut ; 292(Pt A): 118362, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34648836

RESUMO

The fetus is prenatally exposed to a mixture of organochlorine pesticides (OCPs), mercury (Hg), docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA) and selenium (Se) through maternal seafood consumption in real-life scenario. Prenatal exposure to these contaminants and nutrients has been suggested to affect thyroid hormone (TH) status in newborns, but the potential relationships between them are unclear and the joint effects of the mixture are seldom analyzed. The aim of the study is to investigate the associations of prenatal exposure to a mixture of OCPs, Hg, DHA, EPA and Se with TH parameters in newborns. 228 mother-infant pairs in Shanghai, China were included. We measured 20 OCPs, total Hg, DHA, EPA and Se in cord blood samples as exposure variables. The total thyroxine (TT4), free thyroxine (FT4), total triiodothyronine (TT3), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels and the FT3/FT4 ratio in cord serum were determined as outcomes. Using linear regression models, generalized additive models and Bayesian kernel machine regression, we found dose-response relationships of the mixture component with outcomes: among the contaminants, p,p'-DDE was the most important positive predictor of TT3, while HCB was predominantly positively associated with FT3 and the FT3/FT4 ratio, indicating different mechanisms underlying these relationships; among the nutrients, EPA was first found to be positively related to the FT3/FT4 ratio. Additionally, we found suggestive evidence of interactions between p,p'-DDE and HCB on both TT3 and FT3, and EPA by HCB interactions for TT3, FT3 and FT3/FT4 ratio. However, the overall effects of the mixture on thyroid hormone parameters were not significant. Our result suggests that prenatal exposure to p,p'-DDE, HCB and EPA as part of a mixture might affect thyroid function of newborns in independent and interactive ways. The potential biological mechanisms merit further investigation.


Assuntos
Mercúrio , Praguicidas , Teorema de Bayes , China , Feminino , Sangue Fetal , Humanos , Recém-Nascido , Nutrientes , Gravidez , Hormônios Tireóideos , Tireotropina , Tiroxina
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(11): 1075-1079, 2021 Nov 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34753537

RESUMO

Congenital hypothyroidism is one of the common diseases causing delayed intelligence development and growth retardation in children. In 2021, the ENDO-European Reference Network updated the practice guidelines for the diagnosis and management of congenital hypothyroidism. The guidelines give a comprehensive and detailed description of the screening, diagnosis, and management of congenital hypothyroidism in neonates. This article gives an interpretation of the guidelines in order to provide a reference for clinicians in China.


Assuntos
Hipotireoidismo Congênito , Criança , China , Hipotireoidismo Congênito/diagnóstico , Consenso , Humanos , Recém-Nascido , Triagem Neonatal , Tireotropina
4.
Anticancer Res ; 41(11): 5713-5721, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732444

RESUMO

BACKGROUND/AIM: Thyroid lobectomy may cause post-lobectomy hypothyroidism. We investigated the difference in levothyroxine (LT4) supplementation and cessation between patients with benign disease and those with papillary thyroid carcinoma (PTC) and found that the rate of LT4 cessation could be decreased after thyroid-stimulating hormone (TSH) suppression in PTC. PATIENTS AND METHODS: We retrospectively reviewed 88 patients with benign tumor and 463 patients with PTC and investigated the risk factors for LT4 supplementation after thyroid lobectomy. RESULTS: During the median follow-up of 73.0 months, 207 (37.6%) patients maintained the euthyroid state, while 344 (62.4%) patients continued LT4 supplementation for LT4 replacement or TSH suppression. In patients with benign tumors, only high pre-TSH level (>1.98 mIU/l) was a significant risk factor (odds ratio [OR]=10.09). However, in patients with PTC, pre-TSH level ≥1.98 mIU/l (OR=3.28), pregnancy planning (OR=2.97), and age ≥42.5 years (OR=1.94) were significant risk factors. Moreover, the most potent risk factor was tumor aggressiveness (OR=4.00), which was found to be more significant than high pre-TSH. The overall rate of LT4 cessation in all patients was 37.6%; however, in the 303 patients who underwent the LT4-Off trial, there was no difference in the rate in the benign tumor, low-risk PTC, and intermediate-risk PTC groups (66.2%, 68.8%, and 70.8%, respectively; p=0.886). CONCLUSION: When post-lobectomy TSH levels were adequate and the risk of recurrence was reduced, LT4 cessation in PTC could be achieved at the same rate as that in benign tumors, regardless of the duration of TSH suppression.


Assuntos
Hipotireoidismo/tratamento farmacológico , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Tiroxina/administração & dosagem , Adulto , Biomarcadores/sangue , Esquema de Medicação , Feminino , Humanos , Hipotireoidismo/sangue , Hipotireoidismo/diagnóstico , Hipotireoidismo/etiologia , Masculino , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Câncer Papilífero da Tireoide/patologia , Neoplasias da Glândula Tireoide/patologia , Tireoidectomia/efeitos adversos , Tireotropina/sangue , Tiroxina/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
5.
BMC Med ; 19(1): 266, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34727949

RESUMO

BACKGROUND: Observational studies suggest interconnections between thyroid status, metabolism, and risk of coronary artery disease (CAD), but causality remains to be proven. The present study aimed to investigate the potential causal relationship between thyroid status and cardiovascular disease and to characterize the metabolomic profile associated with thyroid status. METHODS: Multi-cohort two-sample Mendelian randomization (MR) was performed utilizing genome-wide significant variants as instruments for standardized thyrotropin (TSH) and free thyroxine (fT4) within the reference range. Associations between TSH and fT4 and metabolic profile were investigated in a two-stage manner: associations between TSH and fT4 and the full panel of 161 metabolomic markers were first assessed hypothesis-free, then directional consistency was assessed through Mendelian randomization, another metabolic profile platform, and in individuals with biochemically defined thyroid dysfunction. RESULTS: Circulating TSH was associated with 52/161 metabolomic markers, and fT4 levels were associated with 21/161 metabolomic markers among 9432 euthyroid individuals (median age varied from 23.0 to 75.4 years, 54.5% women). Positive associations between circulating TSH levels and concentrations of very low-density lipoprotein subclasses and components, triglycerides, and triglyceride content of lipoproteins were directionally consistent across the multivariable regression, MR, metabolomic platforms, and for individuals with hypo- and hyperthyroidism. Associations with fT4 levels inversely reflected those observed with TSH. Among 91,810 CAD cases and 656,091 controls of European ancestry, per 1-SD increase of genetically determined TSH concentration risk of CAD increased slightly, but not significantly, with an OR of 1.03 (95% CI 0.99-1.07; p value 0.16), whereas higher genetically determined fT4 levels were not associated with CAD risk (OR 1.00 per SD increase of fT4; 95% CI 0.96-1.04; p value 0.59). CONCLUSIONS: Lower thyroid status leads to an unfavorable lipid profile and a somewhat increased cardiovascular disease risk.


Assuntos
Doenças Cardiovasculares , Tireotropina , Adulto , Idoso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Feminino , Humanos , Lipídeos , Masculino , Análise da Randomização Mendeliana , Pessoa de Meia-Idade , Tiroxina , Adulto Jovem
6.
Acta Biomed ; 92(5): e2021283, 2021 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-34738602

RESUMO

BACKGROUND: Current reference values for thyroid function tests are derived from data from different ethnicities and geographical areas. In this article, we aim to select criteria from the guidelines proposed by the National Academy of Clinical Biochemistry (NACB) and to determine the TSH and T4 reference limits in the iodine-sufficient area of Isfahan, a metropolitan city in Iran. MATERIALS AND METHODS: This study was conducted within the framework of "Isfahan Thyroid Study (ITS)", an ongoing prospective cohort that started in 2006 (n=2523) until 2011 (n=711) and included participants above the age of twenty. We measured TSH, total T4, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb). RESULTS: Recruitment was based on the NACB criteria, 1899 participants were included in 2006(58.5% male) and 377 in 2011(62.3% male). The mean± SD age was 39.66 ±12.71 and 48.96±12.35 years in 2006 and 2011, respectively. The mean± SD for TSH was 2.0±1.19 and 2.11±1.11 mU/L and T4 was 6.67±1.47 and 8.3±2.95 µg /dl in 2006 and 2011, respectively. In 2006, the 2.5th percentile of serum TSH levels was 0.4 mU/L (males: 0.4 mU/L, females: 0.5 mU/L) and the 97.5th percentile of serum TSH was 4.96 mU/L (males: 4.72 mU/L, females: 5. 3 mU/L). In 2011, the 2.5th percentile of serum TSH levels was 0.7 mU/L (males: 0.6 mU/L, females: 0.77 mU/L) and 97.5th percentiles of serum TSH was 4.9 mU/L (males: 5.7 mU/L, females: 5. 57 mU/L). CONCLUSION: This study determined age and sex specific TSH and T4 reference ranges in the Isfahanian population, which could theoretically enable clinicians to classify patients more accurately. (www.actabiomedica.it).


Assuntos
Glândula Tireoide , Tireotropina , Adulto , Estudos de Coortes , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Valores de Referência
7.
BMC Gastroenterol ; 21(1): 431, 2021 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-34794374

RESUMO

PURPOSE: The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance. METHODS: A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China. RESULTS: Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1-3, respectively, p = 0.007) and fatty liver index (FLI) score (47.7 (33.9-60.8), 61.5 (45.1-88.9) and 90.5 (84.5-94.8), respectively, p < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (ß (95%CI): 0.024 (0.004-0.043), p = 0.020), HOMA-IR (ß (95%CI): 0.091 (0.007-0.174), p = 0.034), CAP (ß (95%CI): 25.45 (2.59-48.31), p = 0.030) and FLI (ß (95%CI): 0.121 (0.049-0.194), p = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis. CONCLUSIONS: Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults. Trial registration Registration is not applicable for our study.


Assuntos
Fígado Gorduroso , Resistência à Insulina , Adulto , China , Estudos Transversais , Humanos , Obesidade/complicações , Sobrepeso/complicações , Glândula Tireoide , Hormônios Tireóideos , Tireotropina , Tiroxina , Tri-Iodotironina
8.
An Pediatr (Engl Ed) ; 95(5): 330-335, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34716082

RESUMO

INTRODUCTION: Several studies conclude that small for gestational age (SGA) children have a higher number of comorbidities, as well as a different hormonal profile compared to those with appropriate weight for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Thyroid function in SGA children is still not completely known. OBJECTIVES: To compare the thyroid function of SGA children during the first 2 years of life with that in publications on thyroid function in other groups of infants, such as AGA and premature children, using the same methodology. METHODS: A cohort of 38 SGA children was obtained, in which the thyrotropin (TSH) values in blood were measured at different points in the development of the SGA child. The results were compared with a population of AGA children from Zaragoza and a population of premature children from Barcelona by comparing the means using a 2-tailed test. RESULTS: A statistically significant difference (P < 0.05) was observed between the SGA children in our study and the AGA children older than 6 months, but not between the SGA children of the study and the population of premature infants. CONCLUSIONS: SGA children have higher TSH values compared to AGA children older than 6 months. Therefore, it seems reasonable to establish a screening and a follow-up protocol in those SGA with high risk to develop thyroid dysfunction.


Assuntos
Recém-Nascido Pequeno para a Idade Gestacional , Glândula Tireoide , Criança , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Tireotropina
9.
BMC Med ; 19(1): 257, 2021 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-34670571

RESUMO

BACKGROUND: Diabetes mellitus and thyroid disease are two areas of broad interest in the field of endocrinology and metabolism. Variation of thyroid hormone concentration, even within the normal range, may portend the onset of type 2 diabetes mellitus (T2DM), especially among those with prediabetes. However, current evidence is mixed. METHODS: Prospective studies which assessed diabetes incidence were identified using a database search of MEDLINE and Embase through May 1, 2021. The Sidik-Jonkman random-effects model and cubic spline model were used to evaluate the associations and dose-response relationships between thyroid function/hormone levels and risk of T2DM and cardiovascular disease (CVD) risk among T2DM patients. RESULTS: A total of 12 prospective studies were included. We found that high baseline TSH levels were related to a 17% higher risk of T2DM (RR 1.17, 95% CI 1.01, 1.36; I2=78%, P<0.01), compared with normal TSH levels. Low FT3 (RR 1.40, 95% CI 1.09, 1.80; I2=59%, P=0.03) and low FT4 (RR 1.33, 95% CI 1.04, 1.71; I2=62%, P=0.02) levels were significantly associated with risk of T2DM. The cubic spline model indicated a J-shaped relationship with TSH, but inverted-J-shaped relationships with FT3 and FT4. CVD events and all-cause deaths were prospectively evaluated in four studies, but were not associated with abnormal thyroid function. CONCLUSIONS: Our meta-analysis determined that abnormal thyroid hormone level is associated with an increased risk of T2DM, showing a J-shaped relationship with TSH and inverted-J-shaped relationships with FT3 and FT4. TRIAL REGISTRATION: Registered number in PROSPERO: CRD42021225695 .


Assuntos
Diabetes Mellitus Tipo 2 , Doenças da Glândula Tireoide , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Estudos Observacionais como Assunto , Estudos Prospectivos , Doenças da Glândula Tireoide/epidemiologia , Tireotropina
10.
Pan Afr Med J ; 39: 254, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34707755

RESUMO

A 23-year-old young man presented with a painless neck mass that he noticed slowly growing over the past 4 years. Neck imaging showed an irregular 5 x 5 cm mixed solid and cystic mass in mid neck that looked suspicious but normal looking thyroid and no neck lymphadenopathy. Thyroid uptake scan was within normal also. Fine needle biopsy (FNA) from thyroglossal cyst (TGC) was malignant, Bethesda VI. Multi-disciplinary meeting discussed the case and advised for removal of both the TGC cancer and total thyroidectomy. After patient counseling, he underwent Sistrunk procedure for excision of the TGC mass and total thyroidectomy. histopathological examination revealed a poorly differentiated carcinoma of insular type in TGC with unremarkable thyroid gland. Patient recovery was uneventful. Post-operative multi-disciplinary meeting discussed the histopathology results and advised for post-operative radioactive iodine therapy (RAI) and thyroxine suppression followed by serum thyroid stimulating hormone (TSH) and thyroglobulin (TG). We shall review the diagnostic and management considerations of our case having this rare cancer.


Assuntos
Cisto Tireoglosso/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Tireoidectomia , Biópsia por Agulha Fina , Humanos , Radioisótopos do Iodo/administração & dosagem , Masculino , Cisto Tireoglosso/patologia , Cisto Tireoglosso/cirurgia , Câncer Papilífero da Tireoide/diagnóstico , Câncer Papilífero da Tireoide/patologia , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireotropina/sangue , Adulto Jovem
11.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(2): 266-270, 2021 Feb 06.
Artigo em Chinês | MEDLINE | ID: mdl-34645191

RESUMO

To establish reference intervals for thyroid functional indicators in early (T1), mid-term (T2), and late stage (T3) pregnancy in a population of women in Northwestern China. A cross-sectional study was conducted on 620 pregnant women. Subjects were recruited through a questionnaire where apparently healthy women were selected. Serum thyroid stimulating hormone (TSH3), total triiodothyronine (TT3), total thyroid hormone (TT4), free triiodothyronine (FT3), and free thyroid hormone (FT4) were detected using the Beckman Unicel DXI 800 automatic chemiluminescence analyzer (the third-generation TSH detection reagent for TSH3),and the reference intervals of different gestation periods were established. The results showed that the reference intervals of TSH3 in T1, T2, and T3 were 0.05-4.59, 0.61-6.01, and 0.63-4.78 mIU/L, respectively; TT3 were 1.62-2.97 nmol/L, 1.59-2.95 nmol/L, and 1.45-2.70 nmol/L, respectively; TT4 were 95.49-185.00 nmol/L, 92.70-181.54 nmol/L, and 77.93-155.09 nmol/L, respectively; FT3 were 3.18-5.22 pmol/L, 2.78-4.67 pmol/L, and 2.51-4.18 pmol/L, respectively; and FT4 were 7.72-12.97 pmol/L, 6.90-1.09 pmol/L, and 5.63-9.85 pmol/L, respectively. All thyroid function indexes had statistically significant differences between the three stages of pregnancy (TSH:H=30.879,P<0.01;FT3:H =153.827,P<0.01;FT4:H =229.967,P<0.01;TT3:H =36.484,P<0.01;TT4:H =58.531,P<0.01). 20 independent samples were collected to verify the reference intervals of TSH, FT3, FT4, TT3 and TT4 for three trimesters of pregnancy, and all of them passed.


Assuntos
Glândula Tireoide , Tiroxina , Estudos Transversais , Feminino , Humanos , Gravidez , Valores de Referência , Testes de Função Tireóidea , Tireotropina , Tri-Iodotironina
12.
Scanning ; 2021: 1834556, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34630818

RESUMO

Objective: The aim of this study was to investigate the relationship between different psoriasis types and thyroid dysfunction. Methods: The data of patients diagnosed with psoriasis between January 2013 and October 2018 who underwent thyroid function tests were collected. Free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroid-stimulating hormone (TSH), thyroglobulin antibody (TGAb), and thyroid peroxidase antibody (TPOAb) were measured. The thyroid function of patients with psoriasis vulgaris, pustular psoriasis, erythrodermic psoriasis, and psoriatic arthritis was evaluated, and the differences in hormone levels and antibodies in the pituitary-thyroid axis with psoriasis type were analyzed. Results: The data of a total of 468 patients were analyzed in this study. The proportion of normal hormone levels was higher among vulgaris patients (P < 0.001), while the erythrodermic patients were more likely to have decreased FT3 or FT4 but normal TSH (P < 0.001). FT3 levels were lower in pustular patients (P < 0.05), FT4 levels were lower in erythrodermic patients (P < 0.05), and TSH levels were higher in patients with psoriatic arthritis (P < 0.05). TPOAb levels were higher than normal in all patients, but there was no significant difference in the levels of TPOAb and TGAb among 4 types of the patients. Conclusion: Psoriasis is related to thyroid dysfunction, especially in patients with atypical psoriasis types. The possibility of complications should be considered in erythrodermic patients.


Assuntos
Psoríase , Glândula Tireoide , Humanos , Estudos Retrospectivos , Tireotropina , Tiroxina
13.
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
14.
Med Clin North Am ; 105(6): 1033-1045, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34688413

RESUMO

Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.


Assuntos
Tomada de Decisão Clínica , Doenças da Glândula Tireoide/epidemiologia , Fatores Etários , Fibrilação Atrial/epidemiologia , Doenças Cardiovasculares/epidemiologia , Transtornos Cognitivos/epidemiologia , Comorbidade , Humanos , Hipertireoidismo/epidemiologia , Hipotireoidismo/epidemiologia , Osteoporose/epidemiologia , Fatores de Risco , Doenças da Glândula Tireoide/sangue , Tireotropina/sangue , Tiroxina/sangue
15.
Environ Pollut ; 291: 118238, 2021 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-34600063

RESUMO

Ambient carbon monoxide (CO) and particulate matters (PMs) are two important air pollutants in urban areas with known impacts on fetuses. Hence, this study measured some biochemistry factors of 200 neonates with birth dates from January 19 to October 12, 2020, including the birth weight and height and the serum levels of ALT, AST, ALP, GGT, and TSH. The Support Vector Machine-fitted land-use regression approach was used to predict the spatio-temporal variability of intra-urban PM 2.5 and CO concentrations by month during the pregnancy period of the cases employing 5 variables of Digital Elevation Model (DEM), slope, and distance from Compressed Natural Gas (CNG) stations, Bus Rapid Transit (BRT) stations, and mines and industries. Spearman correlation analysis (p < 0.05) was performed between the neonate indices and mean monthly PM 2.5 and CO concentrations at the exact residential address of maternal cases and their nearby areas in 250, 500, 1000, 1500, and 2000 m-radius buffer rings. All modeling efforts succeeded in predicting CO and PM 2.5 levels with acceptable adjusted r2 values. Northern Isfahan had relatively higher CO and PM 2.5 concentrations due to its adjacency to low-vegetated open lands and its high traffic load as compared to southern areas. The correlation results between the neonate biochemistry indices and mean PM 2.5 and CO concentrations were mostly positive in most buffer rings, especially in the >500 m-radius buffer rings for PM 2.5 and in the 2000 m-radius rings for CO. Although the correlation results of PM 2.5 followed a detectable trend in the buffer rings, the associations between CO and the neonate biochemistry indices differed significantly between the buffer rings. Results showed that increasing mean monthly concentration of CO and PM 2.5 may stimulate further production of liver enzymes while decreasing the birth weight and height.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Monóxido de Carbono/análise , Monitoramento Ambiental , Feminino , Feto , Humanos , Irã (Geográfico) , Fígado/química , Material Particulado/análise , Gravidez , Tireotropina , Urbanização
16.
J Physiol Anthropol ; 40(1): 15, 2021 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-34627373

RESUMO

BACKGROUND: High normal levels of thyroid-stimulating hormone (TSH) have been reported to be associated with chronic kidney disease (CKD) among euthyroid individuals. However, there has been only limited research on the association between TSH and proteinuria, a major risk factor for the progression of renal disease. METHODS: A cross-sectional study of 1595 euthyroid individuals was conducted. All participants were within the normal range for free triiodothyronine (T3), free thyroxine (T4), and TSH. Analyses were stratified by thyroid cyst status to test the hypothesis that the absence of thyroid cysts, an indicator of latent thyroid damage, is associated with declining ability to synthesis thyroid hormone. RESULTS: For participants with thyroid cysts, a significant inverse association between TSH and proteinuria was observed (adjusted odds ratio (95% confidence intervals) of log-transformed TSH for proteinuria 0.40 (0.18, 0.89)). In participants without thyroid cysts, a significant positive association between those two factors was observed (2.06 (1.09, 3.90)). CONCLUSIONS: Among euthyroid individuals in the general population, being in the normal range of TSH was found to have an ambivalent association with proteinuria. Thyroid cyst status could be an effect modifier for those associations.


Assuntos
Proteinúria , Doenças da Glândula Tireoide , Glândula Tireoide/fisiologia , Tireotropina/sangue , Idoso , Estudos Transversais , Cistos/complicações , Cistos/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proteinúria/complicações , Proteinúria/epidemiologia , Doenças da Glândula Tireoide/complicações , Doenças da Glândula Tireoide/epidemiologia , Hormônios Tireóideos/sangue
17.
J Med Case Rep ; 15(1): 473, 2021 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-34560890

RESUMO

BACKGROUND: Resistance to thyroid hormone is a rare autosomal dominant disorder characterized by reduced responsiveness to thyroid hormone and can cause syndrome of inappropriate secretion of thyroid stimulating hormone. Although Graves' disease is a common autoimmune thyroid disorder, the coexistence of these two diseases is extremely rare and makes the diagnosis and treatment complicated, leading to the delayed diagnosis of resistance to thyroid hormone. We describe the case of a Japanese man with resistance to thyroid hormone coexisting with Graves' disease, in which the correct diagnosis of resistance to thyroid hormone was delayed by masking of the signs of syndrome of inappropriate secretion of thyroid stimulating hormone, with final diagnosis 30 years after the initial treatment for Graves' disease. CASE PRESENTATION: A 30-year-old Japanese man presented with diffuse goiter and thyrotoxicosis. Anti-thyroid stimulating hormone receptor antibody was positive. He was diagnosed with Graves' disease. Anti-thyroid medication was chosen as the initial treatment for Graves' disease. However, this treatment failed to normalize the free triiodothyronine, free thyroxine, and thyroid stimulating hormone levels. His thyroid hormone levels indicated syndrome of inappropriate secretion of thyroid stimulating hormone. After cessation of methimazole treatment by remission of Graves' disease, his state of syndrome of inappropriate secretion of thyroid stimulating hormone persisted. Magnetic resonance imaging revealed no pituitary tumor lesions. The results of thyroid stimulating hormone-releasing hormone stimulation test showed a normal response of thyroid stimulating hormone. He was suspected to have resistance to thyroid hormone. Direct sequencing analysis of the thyroid hormone receptor ß gene identified a heterozygous missense mutation, R282S. Coexistence of resistance to thyroid hormone with Graves' disease was confirmed. He has no signs of thyrotoxic symptoms, and is capable in activities of daily living at the present time. CONCLUSION: We described a rare case of resistance to thyroid hormone simultaneously existing with Graves' disease. This case demonstrated that these diseases can coexist, and indicated some of the difficulties in diagnosis of resistance to thyroid hormone with coexisting Graves' disease. The diagnosis of resistance to thyroid hormone did not become apparent until after anti-hyperthyroidism treatment. Although rare, careful follow-up after the initial treatment of Graves' disease is necessary. The coexistence of these two diseases should be considered in patients showing occasional syndrome of inappropriate secretion of thyroid stimulating hormone.


Assuntos
Atividades Cotidianas , Doença de Graves , Adulto , Doença de Graves/complicações , Doença de Graves/diagnóstico , Doença de Graves/tratamento farmacológico , Humanos , Masculino , Metimazol/uso terapêutico , Tireotropina , Tri-Iodotironina
19.
BMJ Case Rep ; 14(9)2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479901

RESUMO

Carbamazepine (CBZ) is a medication used commonly in epilepsy. Decreases in free T4 levels simulating central hypothyroidism have been reported, although the clinical significance is still unclear. We present a 24-year-old man with Bardet-Biedl syndrome (BBS) who was found to have isolated biochemical central hypothyroidism. BBS is a ciliopathy occasionally associated with anterior pituitary dysfunction. While taking CBZ for epilepsy, his TSH was 1.73 mIU/L (reference range: 0.20-4.00 mIU/L) with a low free T4 of 6.6 pmol/L (reference range: 10.0-26.0 pmol/L). Pituitary MRI was normal. Although treated with levothyroxine initially, his apparent biochemical central hypothyroidism was later recognised as secondary to CBZ drug effect. This was confirmed with a normal free T4 of 12.2 pmol/L while he was off CBZ and levothyroxine. Despite the association between CBZ and biochemical central hypothyroidism, nearly all patients remain clinically euthyroid. This effect is reversible and recognition could lead to reductions in unnecessary thyroid replacement therapy if CBZ is discontinued.


Assuntos
Síndrome de Bardet-Biedl , Hipotireoidismo , Preparações Farmacêuticas , Adulto , Carbamazepina/efeitos adversos , Humanos , Hipotireoidismo/induzido quimicamente , Hipotireoidismo/diagnóstico , Masculino , Tireotropina , Adulto Jovem
20.
Gynecol Obstet Invest ; 86(4): 398-407, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34515132

RESUMO

OBJECTIVES: The aim of this study was to analyze the fertility outcome in intracytoplasmic sperm injection (ICSI)-treated women across normal range thyroid-stimulating hormone (TSH) levels. Published results are inconclusive about optimal TSH levels and fertility. DESIGN: This is a retrospective cohort study in 752 ICSI-treated women with predominantly severe male factor subfertility, starting treatment between the first of January 2008 and the first of March 2012 with a follow-up until 2014. Participants/Materials, Setting, Methods: Women aged 22-45 years with TSH 0.3-4.5 mIU/L without thyroid hormone substitution were included in Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands, an iodine-sufficient area. Demographic and baseline characteristics were compared between groups of patients based on TSH, using one-way ANOVA, Kruskal-Wallis ANOVA, and χ2 test. The patient was the unit of analysis: all cumulative cycles per patient were analyzed up to and including the first ongoing pregnancy. The primary outcome was a cumulative live birth rate. Clinical pregnancy rate, pregnancy loss, and ongoing pregnancy rate were secondary outcomes. The χ2 test and logistic regression were used to compare interquartile groups while adjusting for confounders. Logistic regression was used with the natural logarithm of TSH as a continuous predictor. Primary and secondary subfertile women were analyzed separately. RESULTS: Analysis of the total cohort (n = 752) showed no difference in fertility outcomes across the normal TSH range. The cumulative live birth rate for the 4 groups of primary subfertile women (n = 455) was 76% in the upper TSH quartile compared to 56%, 60%, and 59% in the lower TSH quartiles. LIMITATIONS: Levels of thyroxine and presence of thyroid autoimmunity were not measured in this retrospective cohort study. CONCLUSIONS: The observation that a higher live birth rate was found in primary subfertile ICSI-treated women with high but allegedly normal TSH levels contributes to the hypothesis that in certain subfertile women in addition to a male factor, female factors such as subtle hypothyroidism and/or thyroid autoimmunity may play a role in keeping them from conception, which can be overcome by the process of ICSI.


Assuntos
Infertilidade Masculina , Injeções de Esperma Intracitoplásmicas , Feminino , Fertilização In Vitro , Humanos , Nascido Vivo/epidemiologia , Masculino , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Tireotropina
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