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A P, Kothari R, S Y, Mittal G, Gheewala S, Bokariya P, Palande A, S DM, Tamrakar S, Vemparala SS. Examining Body Fat Percentage, Galvanic Skin Response, and Muscle Grip Strength in Female Hypothyroid Patients. Cureus 2023; 15:e42023. [PMID: 37593312 PMCID: PMC10431213 DOI: 10.7759/cureus.42023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/19/2023] Open
Abstract
Background The thyroid gland is an indispensable organ exerting control over the activity of multiple organ systems including the autonomic nervous system. This study attempted to monitor the variations in autonomic function parameters such as galvanic skin response (GSR) and muscle grip strength (HGS) in conjunction with changes in body fat percentage (BFP). Methodology This case-control study was conducted among 40 female hypothyroid patients as cases and 40 age-matched female healthy volunteers as controls. Anthropometric data were collected using standard techniques. GSR and HGS were measured using Equivital Sensory Electronic Module and Grip Force Transducer, respectively. Data extraction and analysis were done using the LabChart software. Results The mean age of the 40 female hypothyroid patients was 30.14 ± 5.91 years, whereas the mean age of the female controls was 29.37 ± 6.59 years. The waist circumference of cases was 85.81 ± 10.39 cm while that of controls was 80.90 ± 11.18 cm. The BFP of cases was 35.38% ± 6.74% while that of controls was 31.72% ± 5.63%. The GSR amplitude showed a significant difference between hypothyroid and healthy volunteers with values of 1.34 ± 1.14 μS and 2.40 ± 1.86 μS, respectively. The HGS indices showed no significant difference between the two groups. A statistically negative correlation was noted between BFP and GSR amplitude (-0.32), whereas a positive correlation was noted between BFP and mean handgrip strength (0.31) in hypothyroid patients. Conclusions The changes in BFP and autonomic function through GSR and HGS were evaluated in female hypothyroid patients with respect to healthy females. The interrelationship between anthropometry and autonomic function was also explored in this study. The findings of this study can augment prognosis in patients and ensure timely corrective treatment for improving quality of life.
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Affiliation(s)
- Prashanth A
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
- Research, Rotaract Club of Indian Medicos, Mumbai, IND
| | - Ruchi Kothari
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
- Research, Rotaract Club of Indian Medicos, Mumbai, IND
| | - Yogesh S
- Internal Medicine, Madras Medical College and Hospital, Rajiv Gandhi Government General Hospital, Chennai, IND
| | - Gaurav Mittal
- Physiology, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
- Research, Rotaract Club of Indian Medicos, Mumbai, IND
| | - Shabbir Gheewala
- Anatomy, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Pradeep Bokariya
- Anatomy, Mahatma Gandhi Institute of Medical Sciences, Wardha, IND
| | - Amisha Palande
- Physiology, Terna Medical College, Mumbai, IND
- Research, Rotaract Club of Indian Medicos, Mumbai, IND
| | - Devupriya M S
- Research, Rotaract Club of Indian Medicos, Mumbai, IND
| | | | - Sai Shanmukh Vemparala
- Physiology, Andhra Medical College, Visakhapatnam, IND
- Physiology, Great Eastern Medical School and Hospital, Visakhapatnam, IND
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Almas SP, Werneck FZ, Coelho EF, Teixeira PFS, Vaisman M. Endurance training improves heart rate on-kinetics in women with subclinical hypothyroidism: a preliminary study. J Endocrinol Invest 2023; 46:51-57. [PMID: 35918630 DOI: 10.1007/s40618-022-01882-8] [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: 01/18/2022] [Accepted: 07/25/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The aim of the study was to evaluate the effect of endurance training on heart rate (HR) on-kinetics in patients with subclinical hypothyroidism (SH). METHODS Eighteen women were randomly assigned to trained group (TG) or control group (CG). Both groups performed three tests at 50 W in a cycle ergometer for 6 min. HR kinetics was obtained during the tests and the mean response time (MRT), which is equivalent to the time taken to reach 63% of the HR at steady state, was extracted. The TG was then submitted to 12 weeks of endurance training (50 min, 3x/week, intensity between 70 and 85% of the maximum HR predicted for the age). Statistical analysis was performed by the mixed analysis of variance. RESULTS At baseline, TG and CG were similar for TSH (7.7 ± 3.1 vs. 6.9 ± 3.3 mUI/L, p = 0.602, respectively) and FT4 (12.31 ± 1.51 vs. 12.20 ± 1.89 pmol/L, p = 0.889, respectively). After adjustment for body mass index and age, interactions between moment (baseline or after 12 weeks) and group (trained or control) were only significant for MRT (TG: 39.6 ± 10 to 28.9 ± 8.4 s, CG: 53.6 ± 20.3 to 55 ± 19.7 s, p = 0.001) and physical activity level (CG: 7.3 ± 0.7 to 8 ± 0.9, CG: 6.8 ± 0.8 in both moments, p = 0.005). CONCLUSION The preliminary results suggest that 12 weeks of endurance training improve HR on-kinetics and physical activity level in SH.
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Affiliation(s)
- S P Almas
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
| | - F Z Werneck
- Escola de Educação Física, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - E F Coelho
- Escola de Educação Física, Universidade Federal de Ouro Preto (UFOP), Ouro Preto, Minas Gerais, Brazil
| | - P F S Teixeira
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - M Vaisman
- Faculdade de Medicina, Universidade Federal Do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Guan B, Luo J, Huang X, Tian F, Sun S, Ma Y, Yu Y, Liu R, Cao J, Fan L. Association between thyroid hormone levels and frailty in the community-dwelling oldest-old: a cross-sectional study. Chin Med J (Engl) 2022; 135:1962-1968. [PMID: 36378137 PMCID: PMC9746773 DOI: 10.1097/cm9.0000000000002208] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Changes in thyroid hormone levels are commonly recognized characters among the elderly, which were reported to potentially influence incident frailty. Therefore, we examined the cross-sectional associations of thyroid hormones (THs) with frailty as well as the five components characterizing frailty (fatigue, resistance, ambulation, number of illnesses, and loss of weight) among the oldest-old. METHODS Four hundred and eighty-seven community-dwelling oldest-old from a local community in Haidian District, Beijing, participated in our recruitment campaign between April 2019 and May 2020. The primary outcomes were a definitive diagnosis of frailty according to the FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight) and a positive score for each frailty subdomain. Demographic information (age, sex, marital status, and educational status), comorbidities, and details on the participants' lifestyles were recorded. Serum THs including free triiodothyronin (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4) and thyroid stimulating hormone (TSH) levels were also measured at the beginning of our study. Logistic regressions were conducted to screen for potential risk factors for frailty and its subdomains. RESULTS Among the total 487 subjects at enrollment, 60 (12.23%) of them were diagnosed with subclinical hypothyroidism and 110 (22.59%) of the total population scored positive for frailty. Logistic regression analyses adjusted for all potential confounders, showed that frailty was significantly associated with the serum TSH concentration (odds ratio [OR]: 1.06), fT3 concentration (OR: 0.54), and subclinical hypothyroidism score (OR: 2.18). The association between fT4 and frailty was absent in our observational study. The fT3/fT4 ratio characterizing peripheral hormone conversion was also tested to be correlated with frailty. CONCLUSION Subclinical hypothyroidism, higher TSH level, lower fT3 level, and decreased fT3/fT4 ratio were all associated with frailty assessed by the FRAIL scale among the community-dwelling oldest-old, suggesting a relevant role of thyroid function in aging. Future longitudinal studies are warranted to determine the casual relationship between thyroid dysfunction and frailty in the oldest-old.
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Affiliation(s)
- Bo Guan
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Jiakun Luo
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Xin Huang
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Fan Tian
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Shasha Sun
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Yufei Ma
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Yan Yu
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Ruihan Liu
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
- Medical School of People's Liberation Army General Hospital, Beijing 100089, China
| | - Jian Cao
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
| | - Li Fan
- Geriatric Cardiology Department of the Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army General Hospital, Beijing 100089, China
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Charoenngam N, Rittiphairoj T, Ponvilawan B, Prasongdee K. Thyroid Dysfunction and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2022; 13:863281. [PMID: 35600588 PMCID: PMC9114488 DOI: 10.3389/fendo.2022.863281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Studies have suggested that patients with thyroid dysfunction may have an increased risk of developing Parkinson's disease (PD). However, the results from existing studies are inconsistent. Therefore, we aimed to investigate the association of hypothyroidism and hyperthyroidism with risk of PD using the method of systematic review and meta-analysis. METHODS Potentially eligible studies were identified from Medline and EMBASE databases from inception to December 2021 using search strategy that comprised of terms for "Thyroid" and "Parkinson's Disease". Eligible cohort study must consist of one cohort of patients with hypothyroidism/hyperthyroidism and another cohort of individuals without hypothyroidism/hyperthyroidism. Then, the study must report effect estimates with 95% confidence intervals (95% CIs) comparing incident PD between the groups. Eligible case-control studies must include cases with PD and controls without PD. Then, the study must explore their history of hypothyroidism/hyperthyroidism. Odds ratio (OR) with 95% CIs of the association between presence of hypothyroidism/hyperthyroidism and PD must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method. RESULTS A total of 3,147 articles were identified. After two rounds of independent review by three investigators, 3 cohort studies and 6 case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed an increased likelihood of PD in both patients with hypothyroidism (pooled OR 1.56; 95%CI, 1.38 - 1.77; with moderate heterogeneity, I2 66.9%) and patients with hyperthyroidism (pooled OR 1.57; 95%CI, 1.40 - 1.77; with insignificant heterogeneity, I2 0.0%). Funnel plots for both meta-analyses were fairly symmetric, which did not indicate presence of publication bias. CONCLUSION This systematic review and meta-analysis found a significant association of both hypothyroidism and hyperthyroidism with an increased risk of PD.
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Affiliation(s)
- Nipith Charoenngam
- Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- *Correspondence: Nipith Charoenngam,
| | | | - Ben Ponvilawan
- Department of Pharmacology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Klaorat Prasongdee
- Department of Medicine, MetroWest Medical Center, Framingham, MA, United States
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Gallo D, Mortara L, Veronesi G, Cattaneo SAM, Genoni A, Gallazzi M, Peruzzo C, Lasalvia P, Moretto P, Bruno A, Passi A, Pini A, Nauti A, Lavizzari MA, Marinò M, Lanzolla G, Tanda ML, Bartalena L, Piantanida E. Add-On Effect of Selenium and Vitamin D Combined Supplementation in Early Control of Graves' Disease Hyperthyroidism During Methimazole Treatment. Front Endocrinol (Lausanne) 2022; 13:886451. [PMID: 35784564 PMCID: PMC9240752 DOI: 10.3389/fendo.2022.886451] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 05/03/2022] [Indexed: 01/14/2023] Open
Abstract
Prompt and stable control of hyperthyroidism is fundamental to avoid the detrimental effects of thyroid hormone excess, and antithyroid drugs, mainly methimazole (MMI), represent the first-line treatment for Graves' disease (GD) hyperthyroidism. Decreased serum concentrations of selenium (Se) and calcifediol (25(OH)D, VitD) have been reported in newly diagnosed GD patients in observational studies. Low Se levels might exacerbate oxidative stress by compromising the antioxidant machinery's response to reactive oxygen species, and low VitD levels might hamper the anti-inflammatory immune response. We performed a randomized controlled clinical trial (EudraCT 2017-00505011) to investigate whether Se and cholecalciferol (VitD) addition to MMI is associated with a prompter control of hyperthyroidism. Forty-two consecutive patients with newly-onset GD and marginal/insufficient Se and VitD levels were randomly assigned to treatment with either MMI monotherapy or MMI combined with Se and VitD. Se treatment was withdrawn after 180 days, while the other treatments were continued. Combination therapy resulted in a significantly greater reduction in serum FT4 concentration at 45 days (-37.9 pg/ml, CI 95%, -43.7 to -32.2 pg/ml) and 180 days (-36.5 pg/ml, CI 95%, -42 to -30.9 pg/ml) compared to MMI monotherapy (respectively: -25.7 pg/ml, CI 95%, -31.6 to -19.7 pg/ml and -22.9 pg/ml, CI 95%, -28 to -17.3 pg/ml, p 0.002). Data at 270 days confirmed this trend (-37.8 pg/ml, CI 95%, -43.6 to -32.1 pg/ml vs -24.4 pg/ml, CI 95%, -30.3 to -18.4 pg/ml). The quality of life (QoL) score was investigated by the validated "Thyroid-related Patient-Reported Outcome" questionnaire (ThyPRO). ThyPRO composite score showed a greater improvement in the intervention group at 45 days (-14.6, CI 95%, -18.8 to -10.4), 180 (-9, CI 95%, -13.9 to -4.2) and 270 days (-14.3, CI 95%, -19.5 to -9.1) compared to MMI group (respectively, -5.2, CI 95%, -9.5 to -1; -5.4, CI 95%, -10.6 to -0.2 and -3.5, CI 95%, -9 to -2.1, p 0-6 months and 6-9 months <0.05). Our results suggest that reaching optimal Se and VitD levels increases the early efficacy of MMI treatment when Se and VitD levels are suboptimal.
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Affiliation(s)
- Daniela Gallo
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, Azienda Socio Sanitaria Territoriale (ASST) dei Sette Laghi, Varese, Italy
- *Correspondence: Eliana Piantanida, ; Daniela Gallo,
| | - Lorenzo Mortara
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Simona AM Cattaneo
- Immuno-hematology and Transfusion Medicine, ASST dei Sette Laghi, Varese, Italy
| | - Angelo Genoni
- Laboratory of Microbiology, Department of Biotechnology and Life Science, University of Insubria, Varese, Italy
| | - Matteo Gallazzi
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Carlo Peruzzo
- Occupational, Preventive and Toxicology Unit, ASST Sette Laghi, Varese, Italy
| | - Paolo Lasalvia
- Research Center in Epidemiology and Preventive Medicine (EPIMED), University of Insubria, Varese, Italy
| | - Paola Moretto
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Antonino Bruno
- Immunology and General Pathology Laboratory, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
- Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) MultiMedica, Milan, Italy
| | - Alberto Passi
- Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Laboratory of Clinical Chemical Analysis, ASST dei Sette Laghi, Varese, Italy
| | - Andrea Pini
- Laboratory of Clinical Chemical Analysis, ASST dei Sette Laghi, Varese, Italy
| | - Andrea Nauti
- Laboratory of Clinical Chemical Analysis, ASST dei Sette Laghi, Varese, Italy
| | | | - Michele Marinò
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Giulia Lanzolla
- Department of Clinical and Experimental Medicine, Endocrinology Unit II, University of Pisa and University Hospital of Pisa, Pisa, Italy
| | - Maria Laura Tanda
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, Azienda Socio Sanitaria Territoriale (ASST) dei Sette Laghi, Varese, Italy
| | - Luigi Bartalena
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, Azienda Socio Sanitaria Territoriale (ASST) dei Sette Laghi, Varese, Italy
| | - Eliana Piantanida
- Endocrine Unit, Department of Medicine and Surgery, University of Insubria, Azienda Socio Sanitaria Territoriale (ASST) dei Sette Laghi, Varese, Italy
- *Correspondence: Eliana Piantanida, ; Daniela Gallo,
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Chen Z, Zhang Q, Peng N, Hu Y, Li H, He X, Liu R, Xu S, Zhang M, Shi L. Association of serum irisin concentration with thyroid autoantibody positivity and subclinical hypothyroidism. J Int Med Res 2021; 49:3000605211018422. [PMID: 34038203 PMCID: PMC8161903 DOI: 10.1177/03000605211018422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/26/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study evaluated the association of serum irisin level with thyroid autoantibody (TAA) positivity and subclinical hypothyroidism (SH). METHODS In this cross-sectional study, 334 participants were assigned to one of the following four age- and sex-matched groups: TAA plus SH (84 patients), isolated TAA (83 patients), isolated SH (83 patients), or healthy controls (84 individuals). Irisin and creatine kinase (CK) were measured in serum samples. RESULTS Patients with TAA plus SH, isolated TAA, and isolated SH had higher irisin levels compared with the controls. There was a significant increase in the irisin level in the TAA plus SH group compared with the control group. Among all participants, the irisin levels were positively associated with thyroglobulin and thyroid peroxidase antibody titers and high-density lipoprotein cholesterol levels, but negatively associated with waist circumference, glycated hemoglobin levels, and fasting plasma glucose levels. The irisin level was not associated with the thyroid-stimulating hormone, free thyroxine, or CK levels. Irisin levels were independently associated with TAA, with or without SH, but they were not associated with SH alone. CONCLUSIONS Irisin level may help to predict the risk of developing TAA with or without SH.
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Affiliation(s)
- Zhengyi Chen
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Endocrinology and Metabolism, Guiqian International General Hospital, Guiyang, China
| | - Nianchun Peng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Ying Hu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Hong Li
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Xi He
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Endocrinology and Metabolism, Guizhou Provincial People’s Hospital, Guiyang, China
| | - Ruoyi Liu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shujing Xu
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Miao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Lixin Shi
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guiyang, China
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An X, Ogawa-Wong A, Carmody C, Ambrosio R, Cicatiello AG, Luongo C, Salvatore D, Handy DE, Larsen PR, Wajner SM, Dentice M, Zavacki AM. A Type 2 Deiodinase-Dependent Increase in Vegfa Mediates Myoblast-Endothelial Cell Crosstalk During Skeletal Muscle Regeneration. Thyroid 2021; 31:115-127. [PMID: 32787533 PMCID: PMC7840309 DOI: 10.1089/thy.2020.0291] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: The type 2 deiodinase (DIO2) converts thyroxine to 3,3',5-triiodothyronine (T3), modulating intracellular T3. An increase in DIO2 within muscle stem cells during skeletal muscle regeneration leads to T3-dependent potentiation of differentiation. The muscle stem cell niche comprises numerous cell types, which coordinate the regeneration process. For example, muscle stem cells provide secretory signals stimulating endothelial cell-mediated vascular repair, and, in turn, endothelial cells promote muscle stem differentiation. We hypothesized that Dio2 loss in muscle stem cells directly impairs muscle stem cell-endothelial cell communication, leading to downstream disruption of endothelial cell function. Methods: We assessed the production of proangiogenic factors in differentiated C2C12 cells and in a C2C12 cell line without Dio2 (D2KO C2C12) by real-time quantitative-polymerase chain reaction and enzyme-linked immunosorbent assay. Conditioned medium (CM) was collected daily in parallel to evaluate its effects on human umbilical vein endothelial cell (HUVEC) proliferation, migration and chemotaxis, and vascular network formation. The effects of T3-treatment on vascular endothelial growth factor (Vegfa) mRNA expression in C2C12 cells and mouse muscle were assessed. Chromatin immunoprecipitation (ChIP) identified thyroid hormone receptor (TR) binding to the Vegfa gene. Using mice with a targeted disruption of Dio2 (D2KO mice), we determined endothelial cell number by immunohistochemistry/flow cytometry and evaluated related gene expression in both uninjured and injured skeletal muscle. Results: In differentiated D2KO C2C12 cells, Vegfa expression was 46% of wildtype (WT) C2C12 cells, while secreted VEGF was 45%. D2KO C2C12 CM exhibited significantly less proangiogenic effects on HUVECs. In vitro and in vivo T3 treatment of C2C12 cells and WT mice, and ChIP using antibodies against TRα, indicated that Vegfa is a direct genomic T3 target. In uninjured D2KO soleus muscle, Vegfa expression was decreased by 28% compared with WT mice, while endothelial cell numbers were decreased by 48%. Seven days after skeletal muscle injury, D2KO mice had 36% fewer endothelial cells, coinciding with an 83% decrease in Vegfa expression in fluorescence-activated cell sorting purified muscle stem cells. Conclusion:Dio2 loss in the muscle stem cell impairs muscle stem cell-endothelial cell crosstalk via changes in the T3-responsive gene Vegfa, leading to downstream impairment of endothelial cell function both in vitro and in vivo.
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Affiliation(s)
- Xingxing An
- Key Laboratory of Transplant Engineering and Immunology, Department of Endocrinology, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Ashley Ogawa-Wong
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Colleen Carmody
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | | | - Cristina Luongo
- Department of Public Health, University of Naples “Federico II,” Naples, Italy
| | - Domenico Salvatore
- Department of Public Health, University of Naples “Federico II,” Naples, Italy
- CEINGE-Biotecnologie Avanzate Scarl, Naples, Italy
| | - Diane E. Handy
- Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - P. Reed Larsen
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Simone Magagnin Wajner
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Endocrine Division, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Monica Dentice
- Department of Clinical Medicine and Surgery and University of Naples “Federico II,” Naples, Italy
| | - Ann Marie Zavacki
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Abstract
Sarcopenia describes low muscle mass and strength associated with ageing, whilst reduced physical performance indicates the severity of the condition. It can happen independently of other medical conditions and can be a key feature of the frailty phenotype. Frailty is a syndrome of increased vulnerability to incomplete resolution of homeostasis, following a stressor event. Researchers have described the implications of hypothalamic pituitary dysregulation in the pathogenesis of both entities. This review summarizes the recent evidence in this area as well as other endocrine factors such as insulin resistance and vitamin D status and outlines current research priorities. We conducted searches to PubMed and Embase databases for articles, reviews and studies reporting new data on the interaction between hormones of the endocrine system and frailty and/ or sarcopenia in the last 5 years. Interventional studies, cohort studies, case-control studies and animal studies were included. Clinical trials register was also searched to identify ongoing relevant studies. Studies have given us insights into the complex relationships between factors such as anabolic hormones, glucocorticoids and vitamin D on muscle strength and performance and their involvement in ageing phenotypes. However, robust randomized controlled trials are needed to consolidate existing evidence in humans and inform clinical practice. Current evidence supports hormone replacement in patients with confirmed deficiencies, to optimize health and prevent complications. Hormone replacement has limited use for age-related conditions. Current interest is focused on muscle/bone/fat interactions and health outcomes in "sarcopenic obesity." A life-course approach to improving 'health-span' is advocated. Lifestyle factors such as nutrition and physical activity have important interactions with body composition, physical function and metabolic outcomes. Large-scale clinical trials will determine the efficacy and long-term safety of hormone supplementation in the management of sarcopenia and frailty.
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Affiliation(s)
- Vicky Kamwa
- Musculoskeletal Endocrinology Research Group, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK - .,Academic Metabolic Bone Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK - .,Institute of Inflammation and Ageing, The University of Birmingham, Birmingham, UK -
| | - Carly Welch
- Institute of Inflammation and Ageing, The University of Birmingham, Birmingham, UK
| | - Zaki K Hassan-Smith
- Musculoskeletal Endocrinology Research Group, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK.,Academic Metabolic Bone Unit, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
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9
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Baranowska-Bik A, Bik W. The Association of Obesity with Autoimmune Thyroiditis and Thyroid Function-Possible Mechanisms of Bilateral Interaction. Int J Endocrinol 2020; 2020:8894792. [PMID: 33381173 PMCID: PMC7755496 DOI: 10.1155/2020/8894792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/28/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022] Open
Abstract
A growing number of patients suffer from autoimmune diseases, including autoimmune thyroid disease. There has simultaneously been a significant increase in the prevalence of obesity worldwide. It is still an open question whether adiposity can directly influence activation of inflammatory processes affecting the thyroid in genetically predisposed individuals. Adipokines, biologically active substances derived from the adipocytes, belong to a heterogenic group of compounds involved in numerous physiological functions, including the maintenance of metabolism, hormonal balance, and immune response. Notably, the presence of obesity worsens the course of selected autoimmune diseases and impairs response to treatment. Moreover, the excess of body fat may result in the progression of autoimmune diseases. Nutritional status, body weight, and energy expenditure may influence thyroid hormone secretion. Interestingly, thyroid hormones might influence the activity of adipose tissue as metabolic alterations related to fat tissue are observed under pathological conditions in which there are deficits or overproduction of thyroid hormones. Functioning TSH receptors are expressed on adipocytes. Thermogenesis may presumably be stimulated by TSH binding to its receptor on brown adipocytes. There could be a bilateral interaction between the thyroid and adipose. Obesity may influence the onset and course of autoimmune disease.
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Affiliation(s)
- Agnieszka Baranowska-Bik
- Department of Endocrinology, Centre of Postgraduate Medical Education, Ceglowska 80, Warsaw 01-809, Poland
| | - Wojciech Bik
- Department of Neuroendocrinology, Centre of Postgraduate Medical Education, Marymoncka 99/103, Warsaw 01-813, Poland
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10
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Gu Y, Meng G, Wu H, Zhang Q, Liu L, Bao X, Wang Y, Zhang S, Sun S, Wang X, Zhou M, Jia Q, Song K, Niu K. Thyroid Function as a Predictor of Handgrip Strength Among Middle-Aged and Older Euthyroid Adults: The TCLSIH Cohort Study. J Am Med Dir Assoc 2019; 20:1236-1241. [DOI: 10.1016/j.jamda.2019.06.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/31/2019] [Accepted: 06/17/2019] [Indexed: 12/15/2022]
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11
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Tanriverdi A, Ozcan Kahraman B, Ozsoy I, Bayraktar F, Ozgen Saydam B, Acar S, Ozpelit E, Akdeniz B, Savci S. Physical activity in women with subclinical hypothyroidism. J Endocrinol Invest 2019; 42:779-785. [PMID: 30456624 DOI: 10.1007/s40618-018-0981-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 11/11/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Physical activity is associated with many health-related benefits. However, there is a shift towards inactive lifestyles around the world. Subclinical hypothyroidism (SCH) may have adverse effects similar to hypothyroidism. The presence of symptoms and reduced physical performance in SCH may contribute to an inactive lifestyle. Therefore, the present study aimed to compare physical activity levels (PALs) between women with subclinical hypothyroidism and healthy controls. METHODS Thirty-two women with newly diagnosed SCH and 28 healthy women were enrolled in this cross-sectional study. Arterial stiffness was evaluated by pulse wave velocity (PWV). Neuromuscular symptoms were questioned. Participants wore a physical activity monitor (SenseWear® Armband) for 4 consecutive days. Handgrip and quadriceps muscle strength were assessed by dynamometer. Functional exercise capacity was assessed by 6-minute walk test (6MWT). RESULTS There was no significant difference in sociodemographic variables between the groups. PWV was significantly higher in the SCH group (P = 0.006). Physical activity duration and number of steps were significantly lower in the SCH group (P < 0.05). There was significant difference in neuromuscular symptoms, handgrip and quadriceps muscle strength, and 6MWT distance between the groups (P < 0.05). CONCLUSIONS This study demonstrates that women with SCH had lower PALs compared to healthy controls. Women with SCH should participate in exercise programs to increase physical activity and muscle strength to achieve adequate PALs.
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Affiliation(s)
- A Tanriverdi
- Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey.
| | - B Ozcan Kahraman
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - I Ozsoy
- School of Physical Therapy and Rehabilitation, Ahi Evran University, Kirsehir, Turkey
| | - F Bayraktar
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - B Ozgen Saydam
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - S Acar
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
| | - E Ozpelit
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - B Akdeniz
- Department of Cardiology, Faculty of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - S Savci
- School of Physical Therapy and Rehabilitation, Dokuz Eylül University, Izmir, Turkey
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12
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Uc ZA, Gorar S, Mizrak S, Gullu S. Irisin levels increase after treatment in patients with newly diagnosed Hashimoto thyroiditis. J Endocrinol Invest 2019; 42:175-181. [PMID: 29777516 DOI: 10.1007/s40618-018-0899-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/08/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE Irisin is a newly identified myokine secreted by skeletal muscle and has significant effects on body metabolism. Thyroidal functional state has a profound influence on the metabolism of human body. Therefore, the aim of this study was to investigate the possible changes in serum irisin concentrations before and after treatment in hypothyroid subjects. METHODS The study included 26 patients with overt hypothyroidism due to Hashimoto thyroiditis and 19 healthy subjects. Baseline serum thyroid function tests and presence of thyroid autoantibodies and levels of creatine kinase (CK) and irisin were measured in both groups. All measurements in the hypothyroid group were repeated after euthyroidism was achieved. RESULTS Serum irisin levels were significantly lower in the hypothyroid groups than the control group (p < 0.001). Negative correlation between irisin and thyroid stimulating hormone and CK levels (r = - 0.623, p < 0.001 and r = - 0.389, p = 0.008, respectively) and a positive correlation between irisin and free thyroxine (fT4) levels (r = 0.570, p < 0.001) was found. Serum CK levels decreased significantly after treatment (p < 0.001). Serum irisin levels significantly increased (from 57.4 to 99.8 U/L, p < 0.001) when the hypothyroid patients were treated to achieve euthyroidism. CONCLUSIONS To the best of our knowledge, this is the first study providing insight that low serum irisin levels significantly increased following treatment to euthyroid state in overt hypothyroid patients with Hashimoto thyroiditis. Larger scale studies are needed to confirm these results and to ensure irisin as a possible biomarker of Hashimoto's thyroiditis.
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Affiliation(s)
- Z A Uc
- Department of Endocrinology, Usak University School of Medicine, Usak, Turkey.
| | - S Gorar
- Department of Endocrinology, Antalya Training and Research Hospital, Antalya, Turkey
| | - S Mizrak
- Department of Biochemistry, Usak University School of Medicine, Usak, Turkey
| | - S Gullu
- Department of Endocrinology, Ankara University School of Medicine, Ankara, Turkey
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13
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Centanni M, Benvenga S, Sachmechi I. Diagnosis and management of treatment-refractory hypothyroidism: an expert consensus report. J Endocrinol Invest 2017; 40:1289-1301. [PMID: 28695483 PMCID: PMC5680379 DOI: 10.1007/s40618-017-0706-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/01/2017] [Indexed: 12/17/2022]
Abstract
There is a frequently encountered subset of hypothyroid patients who are refractory to standard thyroid hormone replacement treatment and require unexpectedly high doses of levothyroxine. In addition to clinical situations where hypothyroid patients are non-compliant, or where there is the possibility of excipient-induced disease exacerbation (gluten/celiac disease), therapeutic failure may be due to impaired absorption of the administered drug. The common approach to managing patients with unusual thyroxine needs is to escalate the dose of levothyroxine until targeted TSH levels are achieved. This approach can increase the risk for prolonged exposure to supratherapeutic doses of levothyroxine, which increase the chances of adverse outcomes. Repeated adjustments of levothyroxine can also escalate the costs of treatment, as frequent office visits and laboratory tests are required to determine and maintain the desired dose. Clinicians should take a systematic approach to managing patients whom they suspect of having treatment-refractory hypothyroidism. This may include searching for, and adjusting, occult medical conditions and/or other factors that may affect the absorption of levothyroxine, before up-titrating the dose of traditional levothyroxine therapy. Depending on the underlying pathology, another approach that may be considered is to try alternative formulations of levothyroxine that are less susceptible to intolerance issues related to excipients, or, in some cases, to malabsorption. The early discovery of these factors via a thoughtful patient work-up may avoid unnecessary thyroid medication adjustments and their consequences for both patients and clinicians.
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Affiliation(s)
- M. Centanni
- Section of Endocrinology, Department of Medico-surgical Services and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - S. Benvenga
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, A.O.U. Policlinico G Martino, Messina, Italy
| | - I. Sachmechi
- Division of Endocrinology, Queens Hospital Center, Icahn School of Medicine, Jamaica, NY USA
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