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Alsulami SS, Baig M, Albeladi AH, Alyoubi SB, Alsubaie SA, Albeladi SA, Ghamri KA, Alraiqi AMS, Alyoubi SM, Almutairi WA. Correlation between Subclinical Hypothyroidism and Metabolic Syndrome: A Retrospective Study. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:250-256. [PMID: 37533656 PMCID: PMC10393097 DOI: 10.4103/sjmms.sjmms_225_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 11/06/2022] [Accepted: 05/25/2023] [Indexed: 08/04/2023]
Abstract
Background Several studies worldwide have studied the correlation between subclinical hypothyroidism (SCH), and metabolic syndrome (MetS), but have reported inconsistent findings. Objectives To assess the correlation between SCH and MetS in a population from Saudi Arabia. Methods This retrospective study was conducted at King Abdulaziz University Hospital and analyzed all thyroid function tests conducted between January 1, 2019, to December 31, 2021. A predesigned checklist was used to collect data about patients' characteristics such as age, gender, nationality, TSH, FT4 level, and MetS components. Results A total of 41,519 thyroid function tests were conducted during the study period. From this, 1303 (3.1%) patients were found to have SCH, with the majority being females (74.4%). The prevalence did not differ according to gender but increased to 3.5% among those aged >60 years. MetS components between mildly and markedly elevated TSH were significant for total cholesterol (P < 0.001) and high-density lipoprotein cholesterol (P < 0.05). Male patients with SCH were at a higher risk of developing diabetes (P < 0.001) and hypertension (P < 0.02), than female patients with SCH. After adjusting for age, in the multiple stepwise linear regression analysis, a significant association was found between TSH levels and ALT (odds ratio: 0.77) and SBP (odds ratio: 0.35). Conclusion The study demonstrated that the prevalence of SCH is similar between both genders but increases with age. MetS components were abnormal in patients aged >50 years and in males with SCH. SCH and MetS components were found to be correlated, and thus monitoring these variables in patients with SCH is advisable.
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Affiliation(s)
- Salhah Saleh Alsulami
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Mukhtiar Baig
- Department of Biochemistry, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Atheer Hameed Albeladi
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shahad Bandar Alyoubi
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shahad Alhumaidi Alsubaie
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samah Abdulsalam Albeladi
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Kholoud Alawi Ghamri
- Department of Internal Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
- Department of Internal Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Safa Mobarak Alyoubi
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Wesam Aied Almutairi
- Department of Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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KALAN SARI I, COŞKUNER MA. The relationship between subclinical hypothyroidism and vitamin D. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1124332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: Vitamin D (vitD) is primarily responsible for bone formation and mineralization. However, in recent years, it has been suggested that vitD may play a role as an immune modulator in the development of numerous diseases, including autoimmune diseases. It has been observed that there is an association between chronic autoimmune thyroiditis (AIT) and vitD levels. This study aims to investigate whether there are differences in the levels of 25-hydroxy vitamin D [25(OH)D], calcium, and phosphorus in patients with subclinical hypothyroidism (SCH) due to AIT, in patients with antibody-negative subclinical hypothyroidism (ANSCH), and in healthy control subjects.
Material and Method: Data from 50 newly diagnosed patients with SCH (35 of whom AIT) and 50 euthyroid and antibody-negative healthy controls who presented to the Department of Endocrinology and Internal Medicine at our hospital between 2018 and 2020 were retrospectively reviewed. Calcium, phosphorus, and 25(OH)D levels of patients and controls were compared.
Results: Serum 25(OH)D levels were significantly lower in patients compared to controls (16.2±7.8 ng/ml and 20.4±8.2 ng/ml, respectively; p=0.024). Serum levels of calcium (p=0.081) and phosphorus (p=0.712) did not differ between groups. In a subgroup analysis, patients with AIT had significantly lower 25(OH)D values than controls (p=0.009). Compared to controls, 25(OH)D levels were comparable in the ANSCH group (p=0.096). 25(OH)D level was higher in the AIT group than in the ANSCH group (p=0.01).
Conclusion: Our results show that patients with SCH have lower 25(OH)D levels than healthy controls. However, this difference is significant in patients with AIT. It is recommended to screen for vitD deficiency in patients with SCH due to AIT.
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Zhao Y, Song X, Ding S, Qi W, Zhang Y, Xu Q, Zhao T, Zhang X, Li X, Wu F, Ye L. The associations of urinary DEHP metabolite levels, serum thyroid hormones, and thyroid-related genes among the adolescent students from China: a cross-sectional study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:19081-19097. [PMID: 34708313 DOI: 10.1007/s11356-021-16909-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 10/02/2021] [Indexed: 06/13/2023]
Abstract
Our study aimed to investigate the associations between DEHP exposure and serum thyroid hormone levels in 347 adolescents and young adults. We measured DEHP metabolites including mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), and mono(2-carboxymethyl)hexyl phthalate (MCMHP) in their urine. Total thyroxine (TT4), total triiodothyronine, free triiodothyronine, free thyroxine (FT4), thyroid-stimulating hormone and the mRNA levels of thyroid peroxidase (TPO), thyroglobulin (TG), sodium iodide symporter (NIS), thyroid transcription factor 1 (TTF-1), and paired box gene 8 (PAX-8) in serum were measured. The results of statistical analysis showed that urinary DEHP metabolites were generally negatively associated with TT4 levels in serum. In the males, the FT4 levels showed positive associations with urinary MEHP, MECPP, MCMHP, and ∑DEHP. The mRNA level of TG was significantly positively correlated with the levels of MECPP, MCMHP, and ∑DEHP, while the levels of TTF-1 and PAX-8 mRNA were significantly positively correlated with the levels of DEHP metabolites. Taken together, DEHP may affect the synthesis of TG by altering the normal transcription of TTF-1 and PAX-8, leading to decreased TT4 levels in Chinese adolescents.
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Affiliation(s)
- Yaming Zhao
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Xinyue Song
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Shuang Ding
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Wen Qi
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Yuezhu Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Qi Xu
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Tianyang Zhao
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Xueting Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Xu Li
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Fuju Wu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China.
| | - Lin Ye
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China.
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Zhang X, Qi W, Xu Q, Li X, Zhou L, Ye L. Di(2-ethylhexyl) phthalate (DEHP) and thyroid: biological mechanisms of interference and possible clinical implications. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:1634-1644. [PMID: 34677768 DOI: 10.1007/s11356-021-17027-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 10/10/2021] [Indexed: 05/15/2023]
Abstract
Di(2-ethylhexyl) phthalate (DEHP) is a ubiquitous environmental endocrine disruptor. DEHP can be absorbed into the human body through the air, food, water, and skin. After entering the human body, DEHP is rapidly converted to mono(2-ethylhexyl) phthalate (MEHP) with greater toxicity than DEHP. An increasing number of studies indicates that DEHP or MEHP can damage the thyroid tissue and disrupt the function, but the mechanisms remain unclear. This article reviews the toxicity of DEHP on thyroid structures and functions and summarizes the potential mechanisms to provide evidence for preventing the thyroid-related diseases.
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Affiliation(s)
- Xueting Zhang
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Wen Qi
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Qi Xu
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Xu Li
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Liting Zhou
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China
| | - Lin Ye
- Department of Occupational and Environmental Health, School of Public Health, Jilin University, 1163 Xin Min Street, Changchun, 130021, China.
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Appunni S, Rubens M, Ramamoorthy V, Saxena A, Tonse R, Veledar E, McGranaghan P. Association between vitamin D deficiency and hypothyroidism: results from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. BMC Endocr Disord 2021; 21:224. [PMID: 34772378 PMCID: PMC8590325 DOI: 10.1186/s12902-021-00897-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/05/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Many smaller studies have previously shown a significant association between thyroid autoantibody induced hypothyroidism and lower serum vitamin D levels. However, these finding have not been confirmed by large-scale studies. In this study, we evaluated the relationship between hypothyroidism and vitamin D levels using a large population-based data. METHODS For this study, we used National Health and Nutrition Examination Survey (NHANES) during the years 2007-2012. We categorized participants into three clinically relevant categories based on vitamin D levels: optimal, intermediate and deficient. Participants were also split into hypothyroid and hyperthyroid. Weighted multivariable logistic regression analyses were used to calculate the odds of being hypothyroid based on vitamin D status. RESULTS A total of 7943 participants were included in this study, of which 614 (7.7%) were having hypothyroidism. Nearly 25.6% of hypothyroid patients had vitamin D deficiency, compared to 20.6% among normal controls. Adjusted logistic regression analyses showed that the odds of developing hypothyroidism were significantly higher among patients with intermediate (adjusted odds ratio [aOR], 1.7, 95% CI: 1.5-1.8) and deficient levels of vitamin D (aOR, 1.6, 95% CI: 1.4-1.9). CONCLUSION Low vitamin D levels are associated with autoimmune hypothyroidism. Healthcare initiatives such as mass vitamin D deficiency screening among at-risk population could significantly decrease the risk for hypothyroidism in the long-term.
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Affiliation(s)
- Sandeep Appunni
- Department of Biochemistry, Government Medical College, Kozhikode, Kerala, India
| | | | | | | | | | - Emir Veledar
- Baptist Health South Florida, Miami, Florida, USA
- Department of Biostatistics, Florida International University, Miami, FL, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter McGranaghan
- Miami Cancer Institute, Miami, Florida, USA.
- Baptist Health South Florida, Miami, Florida, USA.
- Department of Internal Medicine and Cardiology, Charité - Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Refaat B, Azzeh F. Factors Associated with Thyroid Disorders and Iodine Adequacy in Pregnant Saudi Women. Biol Trace Elem Res 2021; 199:1715-1728. [PMID: 32710351 DOI: 10.1007/s12011-020-02301-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/21/2020] [Indexed: 10/23/2022]
Abstract
Little is known about iodine adequacy and gestational thyroid disorders (GTDs) in Saudi Arabia. This study measured the rates of GTDs and iodine adequacy in 810 healthy Saudi women. Concentrations of serum thyroid hormones and 24-h urine iodine (24-h UIC), and GTDs were diagnosed according to the American Thyroid Association guidelines. Dietary and socioeconomic data to determine factors associated with GTDs and iodine insufficiency were collected. GTDs were detected in 265 women (32.7%) as follows: subclinical (SCH; 20.2%) and overt (OH; 5.8%) hypothyroidism, isolated hypothyroxinemia (ISH; 4.7%) and hyperthyroidism (2%). The SCH (109.2 μg/L; IQR: 77.2-149.7), OH (95.3 μg/L; IQR: 74.3-130.5) and ISH (107.3 μg/L; IQR: 65.5-133.1) groups had median 24-h UIC below the WHO recommended limit, whereas the euthyroid (191.4 μg/L; IQR: 170.03-219.8) and hyperthyroid (159.5 μg/L; IQR: 152.9-238.3) groups were iodine sufficient. Numbers of pregnancies, less education, not consuming iodized salt and not using iodine supplements increased risk of hypothyroidism and ISH. Contrariwise, interval ≥ 3 years from last pregnancy and higher 24-h UIC decreased odds of hypothyroidism and ISH. Moreover, dairy products and egg consumption were markedly lower in all GTD groups. Dairy products and seafood consumption correlated independently with 24-h UIC of the study participants, whereas consuming yogurt, eggs, redfish and shellfish protected against GTDs. In conclusion, GTDs appear to be prevalent in pregnant Saudi women and the hypothyroid and hypothyroxinemia groups had iodine insufficiency. However, consuming iodized salt, iodine supplements, dairy products, seafoods and eggs may protect against GTDs.
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Affiliation(s)
- Bassem Refaat
- Laboratory Medicine Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box 7607, Makkah, Saudi Arabia
| | - Firas Azzeh
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Al Abdeyah, PO Box 7607, Holy Makkah, Saudi Arabia.
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Kumari B, Kumar B, Gupta D, Ganju N. FMD and CIMT: Surrogate Markers of Atherosclerosis in Subclinical and Overt Hypothyroidism in Sub Himalyan Region. Indian J Endocrinol Metab 2021; 25:220-225. [PMID: 34760677 PMCID: PMC8547403 DOI: 10.4103/ijem.ijem_247_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 08/06/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Hypothyroidism increases the risk of atherosclerosis. Carotid intima-media thickness (CIMT) and flow-mediated dilation (FMD) have been used as a noninvasive method to detect atherosclerosis. But the literature is scarce on patients with subclinical hypothyroidism. Such a study was not done in our region, so we conducted this study at a tertiary care center to compare CIMT and FMD among subclinical and overt hypothyroid patients and to analyze the risk of atherosclerosis. METHODS We evaluated 68 patients aged 18-50 years, with newly diagnosed hypothyroidism. We divided them into overt and subclinical hypothyroidism groups and compared the findings. All analyses were performed by the computerized SPSS 17.0. The results were noted as means ± SD and percentage. Student's t-test was used to compare continuous variables, and the Chi-square test was used to compare differences. RESULTS The total number of patients with dyslipidemia in the subclinical hypothyroidism (SCH) group was 22 (45.83%) and in the overt hypothyroidism (OH) group was 26 (54.16%) with a P- value of 0.009. The mean FMD% in subclinical hypothyroidism patients was 6.9816 ± 3.4224 and in overt hypothyroidism patients was 5.3670 ± 2.7278 (P = 0.03). The mean CIMT was 0.5009 ± 0.0732, CIMT in the SCH group was 0.5082 ± 0.0672 and in the OH group was 0.5305 ± 0.0799 (P = 0.2). CONCLUSION The outcome of this study specifies that hypothyroidism is associated with endothelial dysfunction as established by impaired FMD, and it may be the first marker of atherosclerosis appearing before any structural evidence like CIMT. We can speculate that there is a link between subclinical hypothyroidism and atherosclerosis, and thyroxine replacement in SCH may help to prevent the progression of atherosclerosis.
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Affiliation(s)
- Bandana Kumari
- Department of Medicine, IGMC, Shimla, Himachal Pradesh, India
| | - Bhupender Kumar
- Medicine Department, AIIMS, Bilaspur, Himachal Pradesh, India
| | - Dalip Gupta
- Department of Medicine, IGMC, Shimla, Himachal Pradesh, India
| | - Neeraj Ganju
- Department of Cardiology, IGMC, Shimla, Himachal Pradesh, India
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Aldossari K, Al-Ghamdi S, Al-Zahrani J, Al Jammah A, Alanazi B, Al-Briek A, Alanazi M. Association between subclinical hypothyroidism and metabolic disorders: A retrospective chart review study in an emerging university hospital. J Clin Lab Anal 2019; 33:e22983. [PMID: 31325211 PMCID: PMC6868411 DOI: 10.1002/jcla.22983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/06/2022] Open
Abstract
Background Subclinical hypothyroidism is defined as an increase in serum levels of Thyroid Stimulating Hormone (TSH) above the normal range, without alteration of total T4 concentrations that is reported to have association with various metabolic conditions. The study aimed to investigate any association between subclinical hypothyroidism and metabolic disorders in Al Kharj city. Methods This is a cross‐sectional study that included review of patients’ charts from prince Sattam bin Abdul‐Aziz University, Al Kharj, Saudi Arabia, from August 1 to November 30, 2016. Data were analyzed with SPSS version 21. Descriptive statistics were obtained as frequencies. Pearson chi‐square analysis was used to assess any differences between disease status and study variables. P‐value < 0.05 was considered significant. Results The mean age was 30.65 ± 13.3 with a female predominance. The average BMI was 29.5 ± 7.71; 46 (11.5%) had hypertension, 52 (46.8%) had diabetes, 173 (44%) had anemia, and 192 (56%) had vitamin D deficiency. Due to increased TSH levels, male gender had higher prevalence of subclinical hypothyroidism with P‐value < 0.001 and 0.011, respectively. Conclusion Subclinical hypothyroidism is a significant topic worldwide whose prevalence is rising. In this study, we could not find any significant association between subclinical hypothyroidism and metabolic disorder. Further longitudinal studies with large sample size are needed to study this association.
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Affiliation(s)
- Khaled Aldossari
- Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Sameer Al-Ghamdi
- Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Jamaan Al-Zahrani
- Department of Family Medicine, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Anwar Al Jammah
- Department of Endocrinology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Bader Alanazi
- Undergraduate Medical Student, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Abdulilah Al-Briek
- Undergraduate Medical Student, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohammad Alanazi
- Undergraduate Medical Student, College of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
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