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Ye J, Huang Z, Liang C, Yun Z, Huang L, Liu Y, Luo Z. Thyroid dysfunction and risk of different types of dementia: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e39394. [PMID: 39183422 PMCID: PMC11346895 DOI: 10.1097/md.0000000000039394] [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: 10/10/2023] [Revised: 04/13/2024] [Accepted: 08/01/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND The impact of thyroid function on the risk of various types of dementia, including Alzheimer's disease (AD) and vascular dementia (VD), remains unclear. This meta-analysis investigates the association between thyroid dysfunction and the risk of these dementia types, aiming to inform strategies for dementia prevention. METHODS A comprehensive search was conducted in PubMed, Embase, and the Cochrane Library for studies published up to February 2023, focusing on the risk of thyroid dysfunction in dementia. We excluded duplicates, studies without full text, those with incomplete data, animal studies, case reports, and reviews. Data analysis was performed using STATA 15.1 software. RESULTS Our analysis indicated that overt hyperthyroidism significantly increases the risk of all studied dementia types (OR = 1.18, 95% CI: 1.04-1.35). In contrast, overt hypothyroidism was associated with a decreased risk of AD (OR = 0.73, 95% CI: 0.55-0.98) and VD (OR = 0.71, 95% CI: 0.62-0.82). Subclinical hyperthyroidism also showed a significant association with an increased risk of any dementia (OR = 1.26, 95% CI: 1.09-1.46) and specifically VD (OR = 6.70; 95% CI: 1.38-32.58). CONCLUSION This study suggests that overt hypothyroidism may reduce the risk of dementia, including AD and VD, whereas overt and subclinical hyperthyroidism are linked to an increased risk. These findings highlight the importance of monitoring thyroid function as a preventative measure against dementia.
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Affiliation(s)
- Jianbo Ye
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhenxing Huang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Chunfeng Liang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zhang Yun
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Lili Huang
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Yuping Liu
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
| | - Zuojie Luo
- Department of Endocrinology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China
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Hu X, Zhang L, Zhang M, Mi W, Sun Y, Wang Y, Zou H, Liu C, Xu S. Correlation of subclinical hypothyroidism with sarcopenia and its components in the Chinese older adults. Endocrine 2024; 84:1030-1039. [PMID: 38151629 DOI: 10.1007/s12020-023-03654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/09/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To identify the correlation of thyroid function and subclinical hypothyroidism (SCH) with sarcopenia and its components in the older Chinese adults. METHODS Older adults were recruited and divided into SCH group and non-SCH group. Free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured by electrochemiluminescence. Appendicular skeletal muscle mass (ASM) was measured, and skeletal muscle index (SMI) was further calculated. Grip strength was measured. Physical performance was graded by the Short Physical Performance Battery (SPPB) scores of the gait speed test, chair stand test and balance test. RESULTS Of the 240 older adults included, 48 (20.00%) presented with SCH. The prevalence of sarcopenia in SCH group was higher than that in non-SCH group (33.33% v.s. 18.75%). Grip strength was significantly lower in patients with SCH than those without sarcopenia. In terms of physical performance, 6-meter gait speed and SPPB score were lower in subjects with SCH than those without SCH, while 5 sit-to-stand movements was longer score in subjects with SCH than those without SCH. SCH was significantly correlated with sarcopenia, while FT3, FT4, and TSH levels were not. SCH was significantly correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3 level was positively correlated with grip strength and SMI. TSH level was negatively correlated with grip strength, 6-meter gait speed, and SPPB score, but positively correlated with the time of 5 sit-to-stand movements. CONCLUSION SCH is a risk factor for sarcopenia in the older adults and correlated with low muscle strength and low muscle mass, but not with low physical performance. FT3, FT4 and TSH levels are associated with sarcopenia components, but not with sarcopenia.
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Affiliation(s)
- Xin Hu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Lina Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Mengjie Zhang
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Weinuo Mi
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Yu Sun
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Yan Wang
- Department of Geriatrics, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China.
| | - Huiling Zou
- Department of Endocrinology, The Affiliated Suqian Hospital of Xuzhou Medical University, Suqian, China
| | - Chao Liu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
- Key Laboratory of TCM Syndrome and Treatment of Yingbing (Thyroid Disease) of State Administration of Traditional Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China
| | - Shuhang Xu
- Endocrine and Diabetes Center, The Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.
- Endocrine and Diabetes Center, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
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Liang R, Fan L, Lai X, Shi D, Wang H, Shi W, Liu W, Yu L, Song J, Wang B. Air pollution exposure, accelerated biological aging, and increased thyroid dysfunction risk: Evidence from a nationwide prospective study. ENVIRONMENT INTERNATIONAL 2024; 188:108773. [PMID: 38810493 DOI: 10.1016/j.envint.2024.108773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/30/2024] [Accepted: 05/23/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Long-term air pollution exposure is a major health concern, yet its associations with thyroid dysfunction (hyperthyroidism and hypothyroidism) and biological aging remain unclear. We aimed to determine the association of long-term air pollution exposure with thyroid dysfunction and to investigate the potential roles of biological aging. METHODS A prospective cohort study was conducted on 432,340 participants with available data on air pollutants including particulate matter (PM2.5, PM10, and PM2.5-10), nitrogen dioxide (NO2), and nitric oxide (NO) from the UK Biobank. An air pollution score was calculated using principal component analysis to reflect joint exposure to these pollutants. Biological aging was assessed using the Klemera-Doubal method biological age and the phenotypic age algorithms. The associations of individual and joint air pollutants with thyroid dysfunction were estimated using the Cox proportional hazards regression model. The roles of biological aging were explored using interaction and mediation analyses. RESULTS During a median follow-up of 12.41 years, 1,721 (0.40 %) and 9,296 (2.15 %) participants developed hyperthyroidism and hypothyroidism, respectively. All air pollutants were observed to be significantly associated with an increased risk of incident hypothyroidism, while PM2.5, PM10, and NO2 were observed to be significantly associated with an increased risk of incident hyperthyroidism. The hazard ratios (HRs) for hyperthyroidism and hypothyroidism were 1.15 (95 % confidence interval: 1.00-1.32) and 1.15 (1.08-1.22) for individuals in the highest quartile compared with those in the lowest quartile of air pollution score, respectively. Additionally, we noticed that individuals with higher pollutant levels and biologically older generally had a higher risk of incident thyroid dysfunction. Moreover, accelerated biological aging partially mediated 1.9 %-9.4 % of air pollution-associated thyroid dysfunction. CONCLUSIONS Despite the possible underestimation of incident thyroid dysfunction, long-term air pollution exposure may increase the risk of incident thyroid dysfunction, particularly in biologically older participants, with biological aging potentially involved in the mechanisms.
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Affiliation(s)
- Ruyi Liang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lieyang Fan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Xuefeng Lai
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Da Shi
- Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta T6G 2P5, Canada
| | - Hao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Wendi Shi
- Lucy Cavendish College, University of Cambridge, Cambridge CB3 0BU, UK
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Linling Yu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Jiahao Song
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Bin Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Song L, Zhou H, Yang Q, He N, Fu F, Li W, Duan G, Wu D, Hao S, Wang J, Liu J. Association between the oxidative balance score and thyroid function: Results from the NHANES 2007-2012 and Mendelian randomization study. PLoS One 2024; 19:e0298860. [PMID: 38498431 PMCID: PMC10947682 DOI: 10.1371/journal.pone.0298860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Oxidative stress is a significant contributor to the development of various diseases, and the oxidative balance score (OBS) is a valuable tool for assessing the impact of dietary and lifestyle factors on oxidative stress in humans. Nevertheless, the precise relationship between OBS and thyroid function in adults remains elusive. METHODS This cross-sectional study comprised 6222 adult participants drawn from the National Health and Nutrition Examination Survey (NHANES) conducted from 2007 to 2012. Employing weighted multivariable linear regression modeling, the study estimated the connection between OBS quartiles and thyroid functions. The causal relationship between OBS components and thyroid function was analyzed by Mendelian randomization (MR). RESULTS We found a significant negative correlation between OBS and free thyroxine (FT4) and total thyroxine (TT4). Univariate and multivariate MR Analyses showed a causal relationship between BMI and FT4. Copper, smoking, and riboflavin showed a causal relationship with FT4 after moderation. CONCLUSION We found that a lifestyle high in antioxidant exposure reduced FT4 and TT4 levels in the population. We suggest that BMI, Copper, and Riboflavin are important factors in the regulation of FT4 levels.
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Affiliation(s)
- Liying Song
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Haonan Zhou
- Department of Vascular Surgery, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences and Tongji Shanxi Hospital, Tongji Medical College of HUST, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Qian Yang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Ningyu He
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Feifan Fu
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Weichao Li
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Guosheng Duan
- Radiotherapy Department, Shanxi Provincial Peoples Hospital: Fifth Hospital of Shanxi Medical University, Taiyuan, China
| | - Di Wu
- Fifth School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Shuai Hao
- School of Basic Medicine, Shanxi Medical University, Taiyuan, China
| | - Jiaxing Wang
- School of Management, Shanxi Medical University, Taiyuan, China
| | - Jing Liu
- Department of Thyroid Surgery, First Hospital of Shanxi Medical University, Taiyuan, China
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Ohadi H, Khalili P, Abasnezhad Kasrineh F, Esmaeili OS, Esmaeili Ranjbar F, Manshoori A, Hajizadeh MR, Jalali Z. Umbilical cord blood thyroid hormones are inversely related to telomere length and mitochondrial DNA copy number. Sci Rep 2024; 14:3164. [PMID: 38326475 PMCID: PMC10850477 DOI: 10.1038/s41598-024-53628-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 02/02/2024] [Indexed: 02/09/2024] Open
Abstract
Hypothyroidism has been linked to reduced mortality rate and increased lifespan and health span. Telomere shortening, enhanced oxidative stress, and reduced cellular mitochondrial content are important hallmarks of aging shown to be related to age-associated diseases. It was proposed that the status of these markers in early life can be predictive of lifespan and the predisposition to certain age-associated disease in adulthood. Animal studies indicated that prenatal injection of thyroid hormones affects postnatal telomere length. Here, we sought to determine whether thyroid hormones TSH and fT4 are related to the telomere length, mitochondrial DNA copy number (mtDNAcn), and oxidative stress resistance marker GPX in the cord blood of newborns. In this study, we analyzed 70 mothers (18-42 years) and neonate dyads born in 2022 at the Nik Nafs maternity Hospital in Rafsanjan. The relative telomere length (RTL) and mtDNAcn were measured in the genomic DNA of cord blood leukocytes using real-time PCR. GPX enzyme activity was measured in the serum using colorimetric assays. In this study the correlation between these markers and the cord blood TSH and fT4 hormones were assessed using regression models. We found a reverse relationship between TSH levels and RTL in the cord blood of neonates. Additionally, our results displayed increased TSH levels associated with enhanced GPX activity. Regarding the mitochondrial DNA copy number, we found an indirect relationship between fT4 level and mtDNAcn only in male newborns. Future analyses of various oxidative stress markers, mitochondrial biogenesis status, telomerase activity, and the level of DNA damage are warranted to demonstrate the underlying mechanism of our observations.
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Affiliation(s)
- Homa Ohadi
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Parvin Khalili
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Abasnezhad Kasrineh
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Ozra Sadat Esmaeili
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Faeze Esmaeili Ranjbar
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Azita Manshoori
- Department of Gynecology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Mohammad Reza Hajizadeh
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Molecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Zahra Jalali
- Department of Clinical Biochemistry, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
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Apostolou K, Paunovic I, Frountzas M, Zivaljevic V, Tausanovic K, Karanikas M, Koutelidakis I, Schizas D. Posthemithyroidectomy Hypothyroidism: Updated Meta-Analysis of Risk Factors and Rates of Remission. J Surg Res 2024; 293:102-120. [PMID: 37734294 DOI: 10.1016/j.jss.2023.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/09/2023] [Accepted: 08/23/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION The aim of this study was to determine the incidence and risk factors for hypothyroidism, both clinical and subclinical, following hemithyroidectomy in preoperatively euthyroid patients, as well as hypothyroidism remission and its time of remission. MATERIALS AND METHODS A search was performed in Medline (via PubMed), Web of Science, and the Cochrane Library using the keywords "hemithyroidectomy + postoperative + hypothyroidism" and "hemithyroidectomy + hormone supplementation". RESULTS Fifty-four studies with a total of 9,999 patients were included. After a mean follow-up interval of 48.2 mo, the pooled hypothyroidism rate was 29%. The subclinical hypothyroidism rate was 79% of patients with hypothyroidism (18 studies). Moreover, a meta-analysis of 12 studies indicated a pooled hypothyroidism remission rate after hemithyroidectomy of 42% (95% CI: 24%-60%). Older patient age (MD = -2.54, 95% CI = -3.99, -1.10, P = 0.0006), female gender (OR = 0.69, 95% CI = 0.58, 0.82, P < 0.0001), higher preoperative thyroid-stimulating hormone levels (MD = -0,81, 95% CI = -0.96, -0.66, P < 0.00001), pathological preoperative anti-thyroid peroxidase antibodies (OR = 0.37, 95% CI = 0.24, 0.57, P < 0.00001) and anti-thyroglobulin antibodies (OR = 0.52, 95% CI = 0.36, 0.75, P = 00,005), and right-sided hemithyroidectomy (OR = 0.54, 95% CI = 0.43, 0.68, P < 0.00001) were associated with postoperative hypothyroidism development. In metaregression analysis, Asia presented a significantly higher hypothyroidism rate after hemithyroidectomy (34.6%, 95% CI = 29.3%-9.9%), compared to Europe (22.9%, 95% CI = 16.2%-29.5%, P = 0.037) and Canada (1.8%, 95% CI = -22.6%-26.2%, P = 0.013). CONCLUSIONS Hypothyroidism is a frequent and significant postoperative sequela of hemithyroidectomy, necessitating individualization of treatment strategy based on the underlying disease as well as the estimated risk of hypothyroidism and its risk factors.
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Affiliation(s)
- Konstantinos Apostolou
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece.
| | - Ivan Paunovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Maximos Frountzas
- 1st Department of Propaedeutic Surgery, Medical School University of Athens, "Hippocratio" General Hospital, Athens, Greece
| | - Vladan Zivaljevic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Tausanovic
- Centre for Endocrine Surgery, Clinical Centre of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Michael Karanikas
- 1st University Surgical Department, University Hospital of Alexandropoulis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Koutelidakis
- Second Department of Surgery, Aristotle University of Thessaloniki, G. Gennimatas General Hospital, Thessaloniki, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Mirahmad M, Mansour A, Moodi M, Safkhani E, Haghpanah V, Asili P, Fakhrzadeh H, Payab M, Ebrahimpur M, Khorashadi M, Khodabakhshi H, Esmaeili AA, Sharifzadeh G, Zarban A, Sharifi F, Sajjadi-Jazi SM. Prevalence of thyroid dysfunction among Iranian older adults: a cross-sectional study. Sci Rep 2023; 13:21651. [PMID: 38066216 PMCID: PMC10709612 DOI: 10.1038/s41598-023-49085-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
There is limited data on the prevalence of thyroid dysfunction in the older population. This study aimed to determine the prevalence of thyroid dysfunction among a sample of Iranian older adults. A cross-sectional analysis of older adults who aged 60 years and over was conducted. A total of 363 subjects were randomly selected from Birjand longitudinal aging study (BLAS) cohort study. Serum thyroid-stimulating hormone (TSH) level, total thyroxine (T4) and total triiodothyronine (T3) were measured by the enzyme-linked immunosorbent assay (ELISA). Based on thyroid function tests and history of taking medicines used to treat thyroid disorders, participants were classified into the following groups: euthyroid, overt/subclinical hypothyroidism, and overt/subclinical hyperthyroidism. Subsequently, the crude and World Health Organization (WHO) age-standardized prevalence were estimated for different thyroid function categories. A total of 171 men and 192 women, aged 60-94 years, were randomly selected. The crude prevalence of total hypothyroidism was 22.31% (subclinical [18.46%], overt [3.86%]), and that of hyperthyroidism was 1.66% (subclinical [1.38%], overt [0.28%]). The crude prevalence of total thyroid dysfunction was, therefore, 23.97%. A female preponderance was noticed in both total (P-value = 0.035) and overt (P-value = 0.035) hypothyroidism. An increasing trend with age was noticed in the prevalence of total hypothyroidism (P-value = 0.049). Age-standardized prevalence of total hypothyroidism and hyperthyroidism was 26.63% (95% confidence interval [CI] 20.58-33.69%) and 1.11% (95% CI 0.49-2.51%), respectively. A considerable proportion of our study population demonstrated evidence of thyroid dysfunction, particularly subclinical hypothyroidism. Our findings highlight the importance of further investigation of thyroid disorders among older Iranian adults.
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Affiliation(s)
- Maryam Mirahmad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Asieh Mansour
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Elaheh Safkhani
- Department of Internal Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Haghpanah
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Pooria Asili
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Non-Comunicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Khorashadi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Huriye Khodabakhshi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Akbar Esmaeili
- Department of Psychiatry, School of Medicine Medical Toxicology & Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamreza Sharifzadeh
- Department of Epidemiology and Biostatistics, School of Health, Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Asghar Zarban
- Department of Clinical Biochemistry, School of Medicine, Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Sayed Mahmoud Sajjadi-Jazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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8
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Si H, Chen K, Qin Q, Liu Y, Zhao B. Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction: a prospective cohort study. Chin Med J (Engl) 2023; 136:2044-2049. [PMID: 36729845 PMCID: PMC10476826 DOI: 10.1097/cm9.0000000000002260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND More than 75 million procedures with intravascular iodine-based contrast media (ICM) are performed worldwide every year, and some patients undergoing these procedures do not have normal thyroid function. The long-term effects of ICM in patients with mild thyroid dysfunction (TD) are unclear. METHODS This prospective cohort study was conducted in China. Patients with stable angina pectoris with total triiodothyronine (TT3) reduction, normal thyroid-stimulating hormone, and reverse triiodothyronine (rT3) were enrolled and divided into high-dose (≥100 mL ICM) and low-dose groups (<100 mL ICM). We dynamically investigated the trends in thyroid function, rT3, and thyroid antibodies one year after ICM exposure. RESULTS A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up. Thyroglobulin antibody (TGAB) levels were elevated in 41 (26.6%) patients before ICM exposure, 11 (7.1%) of whom also had elevated thyroid peroxidase antibody levels. Transient subclinical TD occurred 6 months after ICM exposure; 75.5% (34/45) of post-operative TD occurred in the high-dose group. One patient developed severe hypothyroidism with myxedema, requiring drug intervention 1 year after ICM exposure. The level of rT3 showed no statistically significant changes during post-operative follow-up ( P = 0.848). The TGAB level decreased at 6th month ( P < 0.001), but increased at 1 year after ICM exposure ( P = 0.002). CONCLUSIONS Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM. Follow-up of this population at 9-12 months after ICM exposure is warranted.
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Affiliation(s)
- Hailong Si
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
- Department of Cardiovascular Disease, Tianjin Chest Hospital, Tianjin 300051, China
- Tianjin Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin 300051, China
| | - Kangyin Chen
- Department of Cardiology, Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Tianjin Institute of Cardiology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
| | - Qin Qin
- Department of Cardiovascular Disease, Tianjin Chest Hospital, Tianjin 300051, China
- Tianjin Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin 300051, China
| | - Yuanyuan Liu
- Comprehensive Disease Center, Tianjin Chest Hospital, Tianjin 300051, China
| | - Bingrang Zhao
- Department of Cardiovascular Disease, Tianjin Chest Hospital, Tianjin 300051, China
- Tianjin Institute of Cardiovascular Diseases, Tianjin Chest Hospital, Tianjin 300051, China
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Chen J, Wei L, Zhu X, Xu W, Zou Y, Qi X, Fang J, Wang X, Shi X, Sheng Y, Ding G, Ouyang X, Duan Y. TT3, a More Practical Indicator for Evaluating the Relationship Between Sarcopenia and Thyroid Hormone in the Euthyroid Elderly Compared with FT3. Clin Interv Aging 2023; 18:1285-1293. [PMID: 37560750 PMCID: PMC10408719 DOI: 10.2147/cia.s420558] [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: 05/10/2023] [Accepted: 07/22/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND AND AIMS Sarcopenia is a common disease in the elderly, and the thyroid hormone (TH) might participate in the pathogenesis of sarcopenia. However, the results of previous studies were not completely consistent. We performed this study to investigate the association between THs and sarcopenia in a Chinese elderly euthyroid population. SUBJECTS AND METHODS A total of 309 Chinese elderly euthyroid subjects with an average age of 85.19 ± 7.8 years were enrolled. Participants were divided into four groups (non-sarcopenia, possible sarcopenia, sarcopenia and serve sarcopenia) according to the consensus update of AWGS in 2019. Serum levels of TT3, FT3, TT4, FT4, TSH, rT3 and TBG were measured. Muscle mass was measured by multifrequency bioelectrical impedance analysis, hand grip (HG) was represented by spring-type dynamometer, and gait speed (GS) was determined by 6-metre walk test. The FRAIL scale was used to assess frailty. RESULTS Compared to the non-sarcopenia group, the sarcopenia group showed a significant increase in age and FRIAL score, while FT3 and TT3 levels decreased significantly. Partial correlation analysis (adjusted by age, gender and the scores of FRIAL scale) indicated that FT3, TT3 and TSH had significant positive correlations with HG, and there also was a significant positive correlation between TT3 and GS. In addition, after adjusting for age, gender, BMI, ALT, sCr, and score on the FRAIL scale, the multivariate linear regression analysis showed that TT3 was positively associated with muscle strength and negatively associated with sarcopenia risk. CONCLUSION There is an association between the low TT3 level and sarcopenia. Therefore, maintaining higher T3 concentrations within the normal range appears to be beneficial for sarcopenia in the elderly. In addition, due to the fluctuation of FT3, TT3 is a more stable and practical indicator to evaluate the relationship between sarcopenia and thyroid hormone in the elderly euthyroid population.
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Affiliation(s)
- Jihai Chen
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Lijun Wei
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaoxia Zhu
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Wenli Xu
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Yuxin Zou
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xinyu Qi
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Jia Fang
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaodong Wang
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaolan Shi
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
| | - Yunlu Sheng
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Guoxian Ding
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
| | - Xiaojun Ouyang
- Department of Geriatric, Geriatric Hospital of Nanjing Medical University, Nanjing, 210024, People’s Republic of China
| | - Yu Duan
- Department of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, People’s Republic of China
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10
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Xing Y, Xuan F, Wang K, Zhang H. Aging under endocrine hormone regulation. Front Endocrinol (Lausanne) 2023; 14:1223529. [PMID: 37600699 PMCID: PMC10433899 DOI: 10.3389/fendo.2023.1223529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Aging is a biological process in which the environment interacts with the body to cause a progressive decline in effective physiological function. Aging in the human body can lead to a dysfunction of the vital organ systems, resulting in the onset of age-related diseases, such as neurodegenerative and cardiovascular diseases, which can seriously affect an individual's quality of life. The endocrine system acts on specific targets through hormones and related major functional factors in its pathways, which play biological roles in coordinating cellular interactions, metabolism, growth, and aging. Aging is the result of a combination of many pathological, physiological, and psychological processes, among which the endocrine system can achieve a bidirectional effect on the aging process by regulating the hormone levels in the body. In this paper, we explored the mechanisms of growth hormone, thyroid hormone, and estrogen in the aging process to provide a reference for the exploration of endocrine mechanisms related to aging.
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Affiliation(s)
| | | | | | - Huifeng Zhang
- Second Hospital of Hebei Medical University, Shijiazhuang, China
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11
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Cappola AR, Auchus RJ, El-Hajj Fuleihan G, Handelsman DJ, Kalyani RR, McClung M, Stuenkel CA, Thorner MO, Verbalis JG. Hormones and Aging: An Endocrine Society Scientific Statement. J Clin Endocrinol Metab 2023; 108:1835-1874. [PMID: 37326526 DOI: 10.1210/clinem/dgad225] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 06/17/2023]
Abstract
Multiple changes occur across various endocrine systems as an individual ages. The understanding of the factors that cause age-related changes and how they should be managed clinically is evolving. This statement reviews the current state of research in the growth hormone, adrenal, ovarian, testicular, and thyroid axes, as well as in osteoporosis, vitamin D deficiency, type 2 diabetes, and water metabolism, with a specific focus on older individuals. Each section describes the natural history and observational data in older individuals, available therapies, clinical trial data on efficacy and safety in older individuals, key points, and scientific gaps. The goal of this statement is to inform future research that refines prevention and treatment strategies in age-associated endocrine conditions, with the goal of improving the health of older individuals.
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Affiliation(s)
- Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Richard J Auchus
- Departments of Pharmacology and Internal Medicine, Division of Metabolism, Endocrinology, and Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
- Endocrinology and Metabolism Section, Medical Service, LTC Charles S. Kettles Veteran Affairs Medical Center, Ann Arbor, MI 48015, USA
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center for Metabolic Bone Disorders, Division of Endocrinology, Department of Internal Medicine, American University of Beirut, Beirut 1107-2020, Lebanon
| | - David J Handelsman
- ANZAC Research Institute, University of Sydney and Andrology Department, Concord Repatriation General Hospital, Sydney 2139, Australia
| | - Rita R Kalyani
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Michael McClung
- Oregon Osteoporosis Center, Portland, OR 97213, USA
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia
| | - Cynthia A Stuenkel
- Department of Medicine, University of California, San Diego, School of Medicine, La Jolla, CA 92093, USA
| | - Michael O Thorner
- Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, VA 22903, USA
- Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, MA 02115, USA
| | - Joseph G Verbalis
- Division of Endocrinology and Metabolism, Georgetown University Medical Center, Washington, DC 20057, USA
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12
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Kim HS, Jang S, Kim J. Genome-Wide Integrative Transcriptional Profiling Identifies Age-Associated Signatures in Dogs. Genes (Basel) 2023; 14:1131. [PMID: 37372311 DOI: 10.3390/genes14061131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
Mammals experience similar stages of embryonic development, birth, infancy, youth, adolescence, maturity, and senescence. While embryonic developmental processes have been extensively researched, many molecular mechanisms regulating the different life stages after birth, such as aging, remain unresolved. We investigated the conserved and global molecular transitions in transcriptional remodeling with age in dogs of 15 breeds, which revealed that genes underlying hormone level regulation and developmental programs were differentially regulated during aging. Subsequently, we show that the candidate genes associated with tumorigenesis also exhibit age-dependent DNA methylation patterns, which might have contributed to the tumor state through inhibiting the plasticity of cell differentiation processes during aging, and ultimately suggesting the molecular events that link the processes of aging and cancer. These results highlight that the rate of age-related transcriptional remodeling is influenced not only by the lifespan, but also by the timing of critical physiological milestones.
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Affiliation(s)
- Hyun Seung Kim
- Division of Applied Life Science (BK21 Four), Gyeongsang National University, Jinju 52828, Republic of Korea
- Institute of Agriculture and Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Subin Jang
- Division of Applied Life Science (BK21 Four), Gyeongsang National University, Jinju 52828, Republic of Korea
- Institute of Agriculture and Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
| | - Jaemin Kim
- Division of Applied Life Science (BK21 Four), Gyeongsang National University, Jinju 52828, Republic of Korea
- Institute of Agriculture and Life Sciences, Gyeongsang National University, Jinju 52828, Republic of Korea
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13
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Taylor PN, Lansdown A, Witczak J, Khan R, Rees A, Dayan CM, Okosieme O. Age-related variation in thyroid function - a narrative review highlighting important implications for research and clinical practice. Thyroid Res 2023; 16:7. [PMID: 37009883 PMCID: PMC10069079 DOI: 10.1186/s13044-023-00149-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/05/2023] [Indexed: 04/04/2023] Open
Abstract
BACKGROUND Thyroid hormones are key determinants of health and well-being. Normal thyroid function is defined according to the standard 95% confidence interval of the disease-free population. Such standard laboratory reference intervals are widely applied in research and clinical practice, irrespective of age. However, thyroid hormones vary with age and current reference intervals may not be appropriate across all age groups. In this review, we summarize the recent literature on age-related variation in thyroid function and discuss important implications of such variation for research and clinical practice. MAIN TEXT There is now substantial evidence that normal thyroid status changes with age throughout the course of life. Thyroid stimulating hormone (TSH) concentrations are higher at the extremes of life and show a U-shaped longitudinal trend in iodine sufficient Caucasian populations. Free triiodothyronine (FT3) levels fall with age and appear to play a role in pubertal development, during which it shows a strong relationship with fat mass. Furthermore, the aging process exerts differential effects on the health consequences of thyroid hormone variations. Older individuals with declining thyroid function appear to have survival advantages compared to individuals with normal or high-normal thyroid function. In contrast younger or middle-aged individuals with low-normal thyroid function suffer an increased risk of adverse cardiovascular and metabolic outcomes while those with high-normal function have adverse bone outcomes including osteoporosis and fractures. CONCLUSION Thyroid hormone reference intervals have differential effects across age groups. Current reference ranges could potentially lead to inappropriate treatment in older individuals but on the other hand could result in missed opportunities for risk factor modification in the younger and middle-aged groups. Further studies are now needed to determine the validity of age-appropriate reference intervals and to understand the impact of thyroid hormone variations in younger individuals.
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Affiliation(s)
- Peter N Taylor
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK.
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK.
| | - Andrew Lansdown
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Justyna Witczak
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Rahim Khan
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
| | - Aled Rees
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
- Department of Endocrinology, University Hospital of Wales, Cardiff, UK
- Neuroscience and Mental Health Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Colin M Dayan
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
| | - Onyebuchi Okosieme
- Thyroid Research Group Institute of Molecular and Experimental Medicine, C2 link corridor, UHW, Cardiff University School of Medicine, Heath Park, Cardiff, UK
- Diabetes Department, Prince Charles Hospital, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, UK
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14
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Li R, Zhou L, Chen C, Han X, Gao M, Cheng X, Li J. Sensitivity to thyroid hormones is associated with advanced fibrosis in euthyroid patients with non-alcoholic fatty liver disease: A cross-sectional study. Dig Liver Dis 2023; 55:254-261. [PMID: 35853822 DOI: 10.1016/j.dld.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/26/2022] [Accepted: 06/20/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND AIMS The relationship between thyroid hormone sensitivity and the occurrence of advanced hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD) remains unclear. We aimed to explore the association between sensitivity to thyroid hormones and advanced fibrosis (F3-F4) of NAFLD in patients with biopsy-proven euthyroid NAFLD. METHODS In this study, 129 participants with biopsy-proven euthyroid NAFLD were enrolled, all of whom underwent thyroid function tests and liver biopsy. Indicators reflecting the sensitivity to thyroid hormones were also calculated. A logistic regression model was used to evaluate the association between thyroid hormone sensitivity and risk of advanced liver fibrosis. RESULTS Among the 129 participants, 40 (31.0%) had advanced fibrosis. Advanced fibrosis was independently associated with TSH, FT3, FT3/FT4, thyrotroph T4 resistance index (TT4RI), TSH index (TSHI), and thyroid feedback quantile-based index (TFQI) (P<0.05), even after adjusting for sex, age, and metabolic factors. The combination of TFQI with age, waist circumference (WC), triglycerides (TGs), and low-density lipoprotein cholesterol (LDL-C) performed best for advanced fibrosis diagnosis. CONCLUSION In euthyroid NAFLD patients, higher FT3/FT4, TFQI, TT4RI, and TSHI values were strongly associated with an increased incidence of advanced liver fibrosis. The combination of TFQI with age, WC, TGs, and LDL-C can be used as a predictor for advanced fibrosis in patients with NAFLD.
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Affiliation(s)
- Ruifang Li
- School of Medicine, Nankai University, Tianjin, China
| | - Li Zhou
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Chen Chen
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Xu Han
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Min Gao
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Xiaojing Cheng
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital, Tianjin, China
| | - Jia Li
- Department of Gastroenterology and Hepatology, Tianjin Second People's Hospital; School of Medicine, Nankai University, Tianjin, China.
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15
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SARS-CoV-2 infection may enhance the adverse effect of thyroid disturbance on climacteric symptoms. J Diabetes Metab Disord 2022; 21:2005-2006. [PMID: 35909633 PMCID: PMC9309014 DOI: 10.1007/s40200-021-00926-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/21/2021] [Indexed: 11/03/2022]
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16
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Liu CL, Chien MN, Hsu YC, Cheng SP. Transcriptomic Characteristics Associated With Aging in the Thyroid Gland. Front Nutr 2022; 9:859702. [PMID: 35694164 PMCID: PMC9174607 DOI: 10.3389/fnut.2022.859702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/19/2022] [Indexed: 11/17/2022] Open
Abstract
The aging thyroid is associated with a plethora of morphological and functional changes. Limited studies have addressed the gene expression signature in the aging thyroid, except for sporadic reports using data from postmortem samples in the Genotype-Tissue Expression (GTEx) project. In this investigation, we analyzed the RNA sequencing data of 58 samples of normal-appearing counterpart thyroid tissues from The Cancer Genome Atlas. Aging-correlated genes were identified by determining the Spearman rank-order correlation between patient age and gene expression level. Additionally, we performed gene set enrichment analysis and conducted a weighted correlation network analysis. The results were compared with those analyzed using the GTEx data. The over-represented protein class of aging-correlated genes is mainly metabolite interconversion enzymes. Our analyses identified alterations in immune and inflammatory responses, mitochondrial functions, cytoskeletal proteins, as well as amino acid and cytochrome P450 metabolism. There was no significant association between thyroid differentiation and age. Our findings may shed molecular light on thyroid disorders in the geriatric population.
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Affiliation(s)
- Chien-Liang Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Ming-Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Yi-Chiung Hsu
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
- Institute of Biomedical Sciences, Mackay Medical College, New Taipei City, Taiwan
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- *Correspondence: Shih-Ping Cheng
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Dominguez LJ, Barbagallo M. Thyroid disorders. PATHY'S PRINCIPLES AND PRACTICE OF GERIATRIC MEDICINE 2022:1041-1058. [DOI: 10.1002/9781119484288.ch83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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18
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Lv S, Ling L, Shi H, Chen X, Chen S, Zhu S, Lin W, Lv R, Ding G. Application of Muscle Thickness and Quality Measured by Ultrasound in Frailty Assessment in China. Front Med (Lausanne) 2022; 9:859555. [PMID: 35433721 PMCID: PMC9009442 DOI: 10.3389/fmed.2022.859555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/08/2022] [Indexed: 11/17/2022] Open
Abstract
To explore the correlation between Fried Frailty Phenotype (FFP) and the muscle thickness and quality of local muscle, and to provide a reasonable basis for the application of ultrasound measurement in the frailty assessment. A total of 150 people (age ≥ 65 years, 58 women, 92 men) were included from the First Hospital Affiliated to Nanjing Medical University. They were divided into Normal group (40 cases), Prefrailty group (69 cases) and Frailty group (41 cases). The thickness and the quality of local muscle were detected by ultrasound. Participants in the prefrailty group had a higher grayscale value of the vastus lateralis muscle, indicating the deterioration of muscle quality. At the frailty stage, the muscle thickness and quality of the vastus lateralis muscle and the anterior tibialis muscle decreased significantly compared with the normal and the prefrailty group. Pearson's correlation analysis also showed FFP was negatively correlated with muscle thickness and quality of the lower limbs. In multiple regression model, FFP was positively associated with gray value (Vastus lateralis muscle:β =0.457, p < 0.001; Anterior tibialis muscle: β = 0.220, p = 0.037) and inversely associated with muscle thickness (Vastus lateralis muscle:β = −0.973, p = 0.031; Anterior tibialis muscle: β = −4.551, p = 0.004) in the frailty stage. Together, FFP was closely related to muscle thickness and quality, especially vastus lateralis muscle. Moreover, Muscle quality has deteriorated in the prefrailty stage, which is earlier than muscle thickness.
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Affiliation(s)
- Shan Lv
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Ling Ling
- Department of Gerontology, Suzhou Ninth People's Hospital, Suzhou, China
| | - Hui Shi
- NHC Contraceptives Adverse Reaction Surveillance Center, Jiangsu Health Development Research Center, Nanjing, China
| | - Xing Chen
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Shu Chen
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Siping Zhu
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Wei Lin
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
| | - Rong Lv
- Department of Gerontology, Suzhou Ninth People's Hospital, Suzhou, China
- Rong Lv
| | - Guoxian Ding
- Department of Geriatrics, Jiangsu Province Hospital and The First Affiliated Hospital With Nanjing Medical University, Nanjing, China
- *Correspondence: Guoxian Ding
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Wei L, Bai Y, Zhang Y, Yong Z, Zhu B, Zhang Q, Zhao W. Thyroid function and age-related decline in kidney function in older Chinese adults: a cross-sectional study. BMC Geriatr 2022; 22:221. [PMID: 35300615 PMCID: PMC8932124 DOI: 10.1186/s12877-022-02904-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Thyroid function may be a factor affecting kidney function in the general population. Kidney and thyroid function vary with age; therefore, the association between thyroid function and decreased kidney function in older adults may be different from that in younger adults and remains controversial. This study aimed to estimate the association between normal-range thyroid function and age-related decline in kidney function in older Chinese adults. Methods A total of 15,653 adults, of whom 23.2% (N = 3624) were older adults (age≧65 years), were collected at the Health Management Center of the First Affiliated Hospital of Nanjing Medical University from January 2018 to January 2020. Basic demographic information was collected by a physician-administered questionnaire. The estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI formula. Trends in thyroid function with age were shown by means of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) in subgroups every ten years. The association between kidney function and thyroid function was estimated by multiple linear regression using β value and by multivariable logistic regression models using odds ratios (OR) after adjusting for age, gender, body mass index, and serum urine acid. Results In the older population, TSH tended to increase with age and FT3 tended to decrease, whereas FT4 was relatively stable. eGFR decreased significantly with increasing TSH (β = -0.081) and decreasing FT3 (β = 0.083) concentrations. Compared with those in the lowest quartile of FT3 (3.10–4.47 pmol/L), the prevalence of eGFR < 75 ml/min/1.73m2 decreased significantly by 22.0% for those with FT3 of 4.47–4.81 pmol/L, 27.6% for those with FT3 of 4.82–5.20 pmol/L, and 34.9% for those with FT3 of 5.21–6.8 pmol/L in older individuals (P for trend < .001). The OR was 1.315 (P: 0.025) in subjects with high-normal TSH, using low-normal TSH as a reference. The prevalence of reduced kidney function was not significantly associated with FT4 within the reference range. Similar results were found in association between the prevalence of eGFR < 60 ml/min/1.73m2 and thyroid function. Conclusions This study demonstrated a significant association between kidney function and thyroid function, particularly FT3, in the older population. Clinicians may need to pay more attention to the assessment and follow-up of kidney function in older individuals with low-normal FT3 and high-normal TSH. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02904-z.
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Affiliation(s)
- Lu Wei
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China
| | - Yun Bai
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China
| | - Yu Zhang
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China
| | - Zhenzhu Yong
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China
| | - Bei Zhu
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China
| | - Qun Zhang
- Health Management Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weihong Zhao
- Division of Nephrology, Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, No. 300 Guangzhou Road, Jiangsu, 210029, China.
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20
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Biondi B, Cappola AR. Subclinical hypothyroidism in older individuals. Lancet Diabetes Endocrinol 2022; 10:129-141. [PMID: 34953533 DOI: 10.1016/s2213-8587(21)00285-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/30/2021] [Accepted: 10/01/2021] [Indexed: 12/24/2022]
Abstract
Subclinical hypothyroidism, which is defined as a thyroid-stimulating hormone concentration higher than the reference range (generally 4·5 mIU/L or higher) with normal free thyroxine concentrations, is frequently found in older individuals. International guidelines differ in recommendations for management of subclinical hypothyroidism in older individuals. We assessed published data during the past decade on the clinical significance and treatment of subclinical hypothyroidism in individuals aged 65 years and older. Meta-analyses, randomised clinical trials, and cohort studies are discussed in this narrative Review. Studies showed no significantly increased incidence in adverse cardiovascular, musculoskeletal, or cognitive outcomes in individuals aged 65 years or older when serum thyroid-stimulating hormone concentration was 4·5-7·0 mIU/L versus a euthyroid group. Moreover, in older individuals with subclinical hypothyroidism, symptoms of hypothyroidism and cardiac and bone parameters did not improve after levothyroxine treatment. These data suggest that treatment with levothyroxine should be considered for individuals aged 65 years or older with subclinical hypothyroidism when thyroid-stimulating hormone concentration is persistently 7 mIU/L or higher and to not initiate treatment with thyroid-stimulating hormone concentrations of less than 7 mIU/L. Levothyroxine doses should be personalised according to age, comorbidities, and life expectancy.
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Affiliation(s)
- Bernadette Biondi
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
| | - Anne R Cappola
- Division of Endocrinology, Diabetes, and Metabolism, University of Pennsylvania School of Medicine, Philadelphia, PA 19104
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21
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Jongejan RMS, van Velsen EFS, Meima ME, Klein T, van den Berg SAA, Massolt ET, Visser WE, Peeters RP, de Rijke YB. Change in Thyroid Hormone Metabolite Concentrations Across Different Thyroid States. Thyroid 2022; 32:119-127. [PMID: 34806412 DOI: 10.1089/thy.2021.0453] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: In contrast to the thyroid hormones (TH) 3,3',5-triiodothyronine (T3) and thyroxine (T4), current literature on thyroid hormone metabolite concentrations in the hypothyroid and hyperthyroid states is inconclusive. It is unknown how thyroidectomy affects thyroid hormone metabolite concentrations and if levothyroxine (LT4) replacement therapy after thyroidectomy restores thyroid hormone metabolite concentrations in those without a thyroid gland. The treatment of patients with differentiated thyroid cancer (DTC) covers the euthyroid, hypothyroid, and (subclinical) hyperthyroid states and therefore provides a unique model to answer this. Here, we prospectively studied nine TH and its metabolites (THM) across different thyroid states in a cohort of patients treated for DTC. Also, three potentially important determinants for THM concentrations were studied. Methods: We prospectively included patients aged 18 to 80 years who were scheduled for DTC treatment at the Erasmus MC. Peripheral blood samples were obtained before surgery (euthyroid, endogenous TH production), after surgery just before radioactive iodine therapy (hypothyroid), and six months later on LT4 therapy ([subclinically] hyperthyroid, exogenous T4 supplementation). Nine THMs were quantified in serum with an established liquid chromatography/tandem mass spectrometry method. Repeated measurement analysis was used to compare the three different thyroid states with each other for each THM, while linear regression was used to determine the association between THM concentrations and age, sex, and kidney function. Results: In total, 77 patients (mean age 49 years; 65% women) were eligible for the study. 3,5-diiodothyronine and 3,3',5-triiodothyroacetic acids were below the lower limit of detection. Compared with the euthyroid state, all THMs were significantly decreased in the hypothyroid state and significantly increased in the (subclinically) hyperthyroid state, with T3 concentrations remaining within the reference interval. Higher age was associated with higher 3-monoiodothyronine (3-T1) concentrations (p < 0.001). Women had higher L-thyronine concentrations than men (p = 0.003). A better kidney function was associated with lower 3-T1 concentrations (p < 0.001). Conclusions: All THMs decrease after a thyroidectomy and increase under thyrotropin (TSH)-suppressive LT4-therapy, suggesting that formation of thyroid hormone metabolites is dependent on peripheral extrathyroidal metabolism of T4. This is also reflected by T3 concentrations that remained within the reference interval in patients receiving TSH-suppressive LT4-therapy as T3 has some thyroidal origin.
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Affiliation(s)
- Rutchanna M S Jongejan
- Department of Clinical Chemistry, Rotterdam, The Netherlands
- Department of Internal Medicine, Rotterdam, The Netherlands
| | - Evert F S van Velsen
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Marcel E Meima
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Theo Klein
- Department of Clinical Chemistry, Rotterdam, The Netherlands
| | - Sjoerd A A van den Berg
- Department of Clinical Chemistry, Rotterdam, The Netherlands
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Elske T Massolt
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - W Edward Visser
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Yolanda B de Rijke
- Department of Clinical Chemistry, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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22
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Yu L, Li Z, Yang R, Pan G, Cheng Q, He Y, Liu Y, Liu F, Ma M, Yang T, Wang Y, Su J, Zheng Y, Gao S, Xu Q, Li L, Yu C. Impaired Sensitivity to Thyroid Hormones Is Associated With Elevated Blood Glucose in Coronary Heart Disease. Front Endocrinol (Lausanne) 2022; 13:895843. [PMID: 35784545 PMCID: PMC9240192 DOI: 10.3389/fendo.2022.895843] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/28/2022] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Thyroid hormones influence glucose homeostasis through central and peripheral regulation. To date, the association between thyroid hormone sensitivity and elevated blood glucose (EBG) in patients with coronary heart disease (CHD) remains unknown. The purpose of this study was to investigate the association between thyroid hormone sensitivity and risk of EBG in patients with CHD, and to further explore their association in different sexes and ages. METHODS This large multicenter retrospective study included 30,244 patients with CHD (aged 30-80 years) between 1 January 2014 and 30 September 2020. Parameters representing central and peripheral sensitivity to thyroid hormones were calculated. Central sensitivity to thyroid hormones was assessed by calculating the Thyroid Feedback Quantile-based Index (TFQI), Thyroid-stimulating Hormone Index (TSHI), and Thyrotropin Thyroxine Resistance Index (TT4RI), and Parametric Thyroid Feedback Quantile-based Index (PTFQI); peripheral sensitivity to thyroid hormones was evaluated using the ratio of free triiodothyronine (FT3) /free thyroxine (FT4). Taking normal glucose tolerance (NGT) as a reference, logistic regression was used to analyse the relationship between central and peripheral thyroid hormone sensitivity and EBG in patients with CHD. RESULTS Among the 30,244 participants, 15,493 (51.23%) had EBG. The risk of EBG was negatively correlated with TSHI (OR: 0.91; 95%CI: 0.91 to 0.92; P < 0.001), TT4RI (OR: 0.99; 95% CI: 0.99 to 0.99; P<0.001), TFQI (OR: 0.82; 95%CI: 0.80 to 0.84; P <0.001) and PTFQI (OR: 0.76; 95%CI: 0.74 to 0.78; P<0.001). Compared to males and patients aged 60 and below, the OR value for EBG was lower in females and in patients aged over 60 years old. Conversely, EBG risk was positively associated with FT3/FT4 (OR: 1.08; 95% CI: 1.07 to 1.09; P <0.001) and in the sex-categorized subgroups, males had higher OR values than females. CONCLUSIONS This study showed that thyroid hormone sensitivity is significantly associated with EBG in patients with CHD. This association is higher in females than in males, and the association in those aged over 60 years old is higher than that in patients aged 60 years and below.
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Affiliation(s)
- Lu Yu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhu Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Rongrong Yang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Guangwei Pan
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qi Cheng
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuanyuan He
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yijia Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Fanfan Liu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mei Ma
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tong Yang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yang Wang
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jinyu Su
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanchao Zheng
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shan Gao
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiang Xu
- Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Chunquan Yu, ; Lin Li, ; Qiang Xu,
| | - Lin Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Chunquan Yu, ; Lin Li, ; Qiang Xu,
| | - Chunquan Yu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
- *Correspondence: Chunquan Yu, ; Lin Li, ; Qiang Xu,
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Vargese SS, Halonen P, Raitanen J, Forma L, Jylhä M, Aaltonen M. Comorbidities in dementia during the last years of life: a register study of patterns and time differences in Finland. Aging Clin Exp Res 2021; 33:3285-3292. [PMID: 33939125 PMCID: PMC8668841 DOI: 10.1007/s40520-021-01867-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Comorbidities have major implications for the care of people with dementia. AIM To investigate the patterns of comorbidities in dementia in the last five years of life and how these patterns differed between three cohorts. METHODS The study included people who died at age 70 and above in 2001 (n = 13,717), 2007 (n = 34,750) and 2013 (n = 38,087) in Finland. ICD-10 morbidity data for a five-year period prior to death were extracted from national registers. Principal component analysis was employed to identify patterns for several morbidities. The associations of principal component scores with dementia were analysed using binary logistic regression. Linear regression was used to examine changes in the number of morbidities in patterns over time. RESULTS The morbidity patterns identified in the last years of life were (1) cardiometabolic disorders, (2) neurological, (3) cerebrovascular diseases and (4) musculoskeletal, thyroid and psychiatric disorders. Among the patterns, neurological and musculoskeletal, thyroid and psychiatric disorders were associated with dementia. The number of diagnoses in the cerebrovascular pattern increased and those in the musculoskeletal, thyroid and psychiatric pattern decreased over time. DISCUSSION Comorbidity patterns identified in this nationwide register study are largely in line with previous evidence. Time difference in these patterns provide crucial information for service planning. CONCLUSIONS Comorbidities in dementia in the last years of life occur in patterns and change over time. More systematic monitoring and updated clinical guidelines are needed for the care of comorbidities with dementia.
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Affiliation(s)
- Saritha Susan Vargese
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland.
| | - Pauliina Halonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Leena Forma
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Marja Jylhä
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
| | - Mari Aaltonen
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), University of Tampere, Tampere, Finland
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The Type 2 Deiodinase Thr92Ala Polymorphism Is Associated with Higher Body Mass Index and Fasting Glucose Levels: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9914009. [PMID: 34660805 PMCID: PMC8516525 DOI: 10.1155/2021/9914009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/14/2021] [Indexed: 01/11/2023]
Abstract
Background Type 2 deiodinase (Dio2) is a selenoenzyme that is mainly expressed in the endoplasmic reticulum of the central nervous system, brown adipose tissue, and placenta and is responsible for outer ring deiodination of thyroxine (T4) to form biologically active triiodothyronine (T3). The Thr92Ala polymorphism of Dio2 has been found to be a potential risk factor for various diseases beyond the hypothalamus-pituitary-thyroid (HPT) axis. Methods We searched the relevant studies in the PubMed, Embase, and Cochrane Library databases and Google Scholar. A systematic review and meta-analysis of studies on the Thr92Ala polymorphism and metabolic parameters beyond the HPT axis (e.g., BMI, fasting glycemic traits, plasma lipid levels, and hypertension risk) were performed. Results Six eligible studies that analyzed the relationship between the Thr92Ala polymorphism and metabolic parameters beyond the thyroid were identified. All selected studies excluded patients with thyroid dysfunction, and diabetic patients were also excluded when fasting glucose and fasting insulin levels were meta-analyzed. The Thr92Ala polymorphism was found to be a significant risk factor for higher BMI (Std. mean difference 0.31 (0.01, 0.60), p = 0.04) and higher fasting glucose levels (Std. mean difference 1.18 (0.05, 2.31), p = 0.04). However, fasting insulin levels, plasma lipid levels, and hypertension risk showed a nonsignificant association with the Thr92Ala polymorphism. Conclusion Compared with euthyroid noncarriers (Thr/Thr), euthyroid Ala92-Dio2 carriers showed increased BMI levels, and Ala92-Dio2 carriers also had higher fasting plasma glucose levels than matched euthyroid nondiabetic noncarriers.
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25
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Kaur N, Suryanarayanan R. Levothyroxine sodium pentahydrate tablets - formulation considerations. J Pharm Sci 2021; 110:3743-3756. [PMID: 34384799 DOI: 10.1016/j.xphs.2021.08.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 12/16/2022]
Abstract
Even though levothyroxine sodium pentahydrate tablets have been in the market since 1955, there continue to be recalls due to sub potency. We have comprehensively reviewed the factors affecting its stability in solid oral dosage forms. A compilation of marketed formulation compositions enabled the identification of the potential 'problem excipients'. Two excipient properties, hygroscopicity and microenvironmental acidity, appeared to be responsible for inducing drug instability. In drug products, depending on the formulation composition and storage conditions, the pentahydrate can dehydrate to highly reactive levothyroxine sodium monohydrate, or undergo salt disproportionation to the free acid form of the drug. The USP assay method (HPLC based) is insensitive to these different physical forms of the drug. The influence of physical form of levothyroxine on its chemical stability is incompletely understood. The USP has five product-specific dissolution tests reflecting the complexity in its evaluation.
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Affiliation(s)
- Navpreet Kaur
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota-Twin Cities, 9-177 WDH, 308 Harvard Street Southeast, Minneapolis, Minnesota 55455, United States
| | - Raj Suryanarayanan
- Department of Pharmaceutics, College of Pharmacy, University of Minnesota-Twin Cities, 9-177 WDH, 308 Harvard Street Southeast, Minneapolis, Minnesota 55455, United States.
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Sun B, Wang X, McLarnon MED, Ding Y, Liu M, Dai W, Wang G. Higher Prevalence of Non-thyroidal-Illness Syndrome in Elderly Male Patients With Active Helicobacter pylori Infection. Front Med (Lausanne) 2021; 8:682116. [PMID: 34307412 PMCID: PMC8295606 DOI: 10.3389/fmed.2021.682116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/11/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: It is currently unclear whether the Helicobacter pylori (H. pylori) infection leads to associated alterations in thyroid functions and thyroidal illnesses. This study aims to analyse this relationship in an elderly male cohort over a five-year period. Design: A case retrospective study. Methods: A longitudinal study was designed to collect subjects (≥65 years old) receiving both a thyroid examination and H. pylori infection status determined by 13C-urea breath test in 2013 at our unit. Subjects were followed every 1 to 2 years until December 2017 for laboratory results, visits to outpatient clinics/emergency departments etc. Blood tests and thyroid ultrasonography were performed to determine thyroid function and morphology. Results: 356 male subjects with mean age 78.5 ± 9.8 years were included. Active H. pylori infection was positive in 88 subjects (24.7%). Thyroid function tests and ultrasonography showed similar patterns between H. pylori positive and negative groups. Non-thyroidal-illness syndrome (NTIS) was diagnosed in 30/210 (14%) patients who experienced acute illnesses and hospitalization over five-year follow-up. Notably, NTIS demonstrated significantly higher prevalence in the H. pylori positive group compared to the negative group (17.1 vs. 5.6%, P = 0.001). Multivariate analysis showed that when age, APACHE II score and hemoglobin levels were adjusted, H. pylori status still has significant interrelationship with NTIS (OR = 3.497, P = 0.003). Conclusions: There is a positive association between chronic active H. pylori infection and NTIS prevalence in this elderly male cohort. Further studies are needed to elucidate the role of H. pylori infection on NTIS in elderly male patients.
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Affiliation(s)
- Banruo Sun
- Department of Endocrinology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Xuanping Wang
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom
| | | | - Yu Ding
- Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Graduate School of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Wei Dai
- Office of Information Management, Second Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Gangshi Wang
- Department of Gastroenterology, Second Medical Center, Chinese People's Liberation Army General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
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Deng B, Yuan Y, Zhong M, Ren R, Deng W, Duan X. The Relationship Between Metabolic Parameters, Age, and Thyroid Status: A Cross-Sectional Study-Based National Survey of Iodine Nutrition, Thyroid Disease. Risk Manag Healthc Policy 2021; 14:1723-1730. [PMID: 33935526 PMCID: PMC8079349 DOI: 10.2147/rmhp.s306122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/31/2021] [Indexed: 01/07/2023] Open
Abstract
Aim The relationship between thyroid status and metabolic factors was investigated as well as iodine nutrition in the general population and among the elderly population. Methods We performed a cross-sectional survey of 2483 subjects to assess the status of national iodine nutrition and incidence of thyroid disease. The general and elderly populations were divided into normal thyroid function (NTF) and subclinical hypothyroidism (SCH) groups. The anthropometric parameters and biochemical indicators were then analyzed. Results Overall, 327 participants were diagnosed with thyroid diseases, 73 (22.32%) of whom were 65 years or older. For the general population, compared with the NTF group, individuals in the SCH group were older, presented with higher systolic blood pressure, fasting blood glucose, serum cholesterol, and urinary iodine concentration (all p<0.05) but lower blood uric acid (UA) (p<0.05). Linear regression analysis further revealed that age and triglyceride (TG) serum levels positively correlated with serum thyroid-stimulating hormone (TSH) levels. Multiple regression analyses revealed that age, TG, waist circumference (WC), and body mass index were independent predictors for abnormal TSH serum levels. For the elderly population, compared with NTF group, individuals in the SCH group were substantially older (p<0.05) but presented with lower UA (p<0.05). Pearson linear regression analysis revealed a positive correlation between age (p=0.003) as well as TG levels (p<0.001) and serum TSH levels. In contrast, WC (p=0.003) was negatively related to TSH serum levels. Further multiple regression analysis revealed that age, TG, WC and heart rate were independent predictors of blood TSH. Conclusion The large-scale national study of iodine nutrition, thyroid disease has shown a vital relationship between metabolic indicators and serum TSH levels. Age and metabolic diseases increase the likelihood of developing thyroid diseases, both the general population and among the elderly.
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Affiliation(s)
- Bo Deng
- Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, 400014, People's Republic of China
| | - Yi Yuan
- Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, 400014, People's Republic of China
| | - Miao Zhong
- Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, 400014, People's Republic of China
| | - Rui Ren
- Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, 400014, People's Republic of China
| | - Wuquan Deng
- Department of Endocrinology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, 400014, People's Republic of China
| | - Xiaodong Duan
- Department of Rehabilitation, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People's Republic of China
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Mohanty SK, Suchiang K. Triiodothyronine (T3) enhances lifespan and protects against oxidative stress via activation of Klotho in Caenorhabditis elegans. Biogerontology 2021; 22:397-413. [PMID: 33851304 DOI: 10.1007/s10522-021-09923-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
Age predisposes individuals to significant diseases, and the biological processes contributing to aging are currently under intense investigation. Klotho is an anti-aging protein with multifaceted roles and is an essential component of the endocrine fibroblast growth factor. In Caenorhabditis elegans (C. elegans), there are two prospective orthologs of α-Klotho, C50F7.10, and E02H9.5, identified. The two orthologs' products are homologous to the highly conserved KL1 domain of human and mouse Klotho protein. Considering the endocrine system's major involvement in an organism's homeostasis and that thyroid disorders increase with advancing age, the molecular mechanisms underlying its impact on different endocrine components during the aging process remain poorly characterized. In this study, we sought to determine the regulatory role of Triiodothyronine (T3) on homologs genes of klotho and its impact on different parameters of aging in the C. elegans model organism. We showed that T3 could increase the mRNA expressions of the klotho homologous genes in C. elegans. Moreover, T3 could also extend a worm lifespan and modulate oxidative stress resistance and aging biomarkers significantly and positively. Further investigations employing different mutant and transgenic strains reveal that these observed effects are mediated through the EGL-17/EGL-15 pathway via Klotho activation along with the involvement of transcription factor DAF-16. In conclusion, these findings have revealed an unexpected link between T3 and Klotho and how this link can modulate the aging process in C. elegans via activation of klotho. This study will help understand the crosstalk and regulations of different endocrine components and their consequences on the aging process in multiple species.
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Affiliation(s)
- Saswat Kumar Mohanty
- Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, 605 014, India
| | - Kitlangki Suchiang
- Department of Biochemistry and Molecular Biology, Pondicherry University, Pondicherry, 605 014, India.
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Azizi F, Abdi H, Cheraghi L, Amouzegar A. Treatment of Subclinical Hyperthyroidism in the Elderly: Comparison of Radioiodine and Long-Term Methimazole Treatment. Thyroid 2021; 31:545-551. [PMID: 32811342 DOI: 10.1089/thy.2020.0433] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background: This study aimed to compare the effectiveness and safety of radioiodine (RAI) and long-term methimazole (MMI) in the treatment of subclinical hyperthyroidism (SH) in the elderly. Methods: From 306 patients, aged ≥65 years, with SH, 83 patients with thyrotropin <0.1 mU/L entered the study. In this randomized parallel-group trial, 41 and 42 patients were randomized to either RAI or long-term MMI treatment, respectively. Results: In the RAI and MMI groups, 3 and 4 patients were excluded due to side effects, choosing other modes of treatment, and not returning for follow-up; 35 and 36 patients completed 60 months of follow-up, respectively. In the RAI group, 23 (66%) became hypothyroid, and 12 (34%) remained euthyroid 60 months after a fixed dose of 15 mCi RAI. In the MMI group, the starting dose was 10 mg daily and decreased to 4.9 ± 1.0, 4.3 ± 1.0, 4.4 ± 1.4, 4.3 ± 1.8, and 3.7 ± 1.3 mg after 1, 2, 3, 4, and 5 years of continuous MMI treatment, employing titration method. By the end of study, 34 (94%) patients were euthyroid and 2 patients with diffuse goiter developed spontaneous hypothyroidism with MMI treatment. Minor adverse events occurred in both groups in the first four months of treatment. No death or serious side effects were observed during 60 months of follow-up. Conclusions: Both RAI and long-term low-dose MMI therapies are effective and safe for treatment of SH in the elderly.
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Affiliation(s)
- Fereidoun Azizi
- Endocrine Research Center; Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hengameh Abdi
- Endocrine Research Center; Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Leila Cheraghi
- Department of Epidemiology and Biostatistics; Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atieh Amouzegar
- Endocrine Research Center; Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chen J, Lippo L, Labella R, Tan SL, Marsden BD, Dustin ML, Ramasamy SK, Kusumbe AP. Decreased blood vessel density and endothelial cell subset dynamics during ageing of the endocrine system. EMBO J 2021; 40:e105242. [PMID: 33215738 PMCID: PMC7780152 DOI: 10.15252/embj.2020105242] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023] Open
Abstract
Age-associated alterations of the hormone-secreting endocrine system cause organ dysfunction and disease states. However, the cell biology of endocrine tissue ageing remains poorly understood. Here, we perform comparative 3D imaging to understand age-related perturbations of the endothelial cell (EC) compartment in endocrine glands. Datasets of a wide range of markers highlight a decline in capillary and artery numbers, but not of perivascular cells in pancreas, testis and thyroid gland, with age in mice and humans. Further, angiogenesis and β-cell expansion in the pancreas are coupled by a distinct age-dependent subset of ECs. While this EC subpopulation supports pancreatic β cells, it declines during ageing concomitant with increased expression of the gap junction protein Gja1. EC-specific ablation of Gja1 restores β-cell expansion in the aged pancreas. These results provide a proof of concept for understanding age-related vascular changes and imply that therapeutic targeting of blood vessels may restore aged endocrine tissue function. This comprehensive data atlas offers over > 1,000 multicolour volumes for exploration and research in endocrinology, ageing, matrix and vascular biology.
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Affiliation(s)
- Junyu Chen
- Tissue and Tumor Microenvironments GroupThe Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
- Department of ProsthodonticsState Key Laboratory of Oral DiseasesWest China Hospital of StomatologySichuan UniversityChengduChina
| | - Luciana Lippo
- Tissue and Tumor Microenvironments GroupThe Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
| | - Rossella Labella
- Tissue and Tumor Microenvironments GroupThe Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
| | - Sin Lih Tan
- Tissue and Tumor Microenvironments GroupThe Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
| | - Brian D Marsden
- The Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
- Structural Genomics ConsortiumNDMUniversity of OxfordOxfordUK
| | - Michael L Dustin
- The Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
| | - Saravana K Ramasamy
- Institute of Clinical SciencesImperial College LondonLondonUK
- MRC London Institute of Medical SciencesImperial College LondonLondonUK
| | - Anjali P Kusumbe
- Tissue and Tumor Microenvironments GroupThe Kennedy Institute of RheumatologyUniversity of OxfordOxfordUK
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31
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Liu B, Wang Z, Fu J, Guan H, Lyu Z, Wang W. Sensitivity to Thyroid Hormones and Risk of Prediabetes: A Cross-Sectional Study. Front Endocrinol (Lausanne) 2021; 12:657114. [PMID: 34017311 PMCID: PMC8129566 DOI: 10.3389/fendo.2021.657114] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 04/14/2021] [Indexed: 01/12/2023] Open
Abstract
CONTEXT Thyroid hormone influences glucose homeostasis through central and peripheral regulations. To date, the link between sensitivity to thyroid hormones and prediabetes remains unknown. We aimed to investigate the association between thyroid hormones sensitivity and risk of prediabetes in both general and euthyroid populations. METHODS Participants with serum free triiodothyronine (FT3), free thyroxine (FT4), and thyrotropin (TSH) measurements from the health checkup programs of the First Hospital of China Medical University were collected. We measured the parameters representing central and peripheral sensitivities to thyroid hormones (central sensitivity, assessed by calculating Thyroid Feedback Quantile-based Index (TFQI), TSH Index (TSHI), and Thyrotroph Thyroxine Resistance Index (TT4RI); peripheral sensitivity, evaluated by FT3/FT4 ratio). Associations between thyroid hormones sensitivities and risk of prediabetes were assessed with logistic regression. RESULTS A total of 4378 participants (mean age ± SD, 49 ± 11 years) were included, with 1457 (33%) subjects had prediabetes. The risk of prediabetes was negatively associated with levels of TSHI (odds ratio [OR] 0.91; 95% confidence interval [CI], 0.85-0.97), TT4RI (OR 0.91; 95% CI, 0.84-0.99) and Parametric TFQI (PTFQI) (OR 0.89; 95% CI, 0.83-0.95) among all subjects. The association remained significant in euthyroid subjects and euthyroid subjects with negative thyroid autoimmunity. Higher FT3/FT4 ratio was associated with a mild increased risk of prediabetes (95% CI 1.09; 1.02-1.16). Compared with subjects in the lowest quartile of PTFQI, those in the highest quartile had lower risk of prediabetes (0.70; 95% CI, 0.58-0.84). CONCLUSIONS Decreased central sensitivity to thyroid hormones is associated with lower risk of prediabetes. This demonstrates the complex interaction between thyroid system and glucose metabolism. Future studies are warranted to confirm our findings and underlying mechanisms.
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Affiliation(s)
- Bingyang Liu
- Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zixiao Wang
- Department of Physical Examination Center, The First Hospital of China Medical University, Shenyang, China
| | - Jinrong Fu
- Department of Endocrinology and Metabolism, The First Hospital of China Medical University, Shenyang, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zhaohui Lyu
- Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Wei Wang, ; Zhaohui Lyu,
| | - Wei Wang
- Department of Physical Examination Center, The First Hospital of China Medical University, Shenyang, China
- *Correspondence: Wei Wang, ; Zhaohui Lyu,
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Kumari K, Chainy GB, Subudhi U. Prospective role of thyroid disorders in monitoring COVID-19 pandemic. Heliyon 2020; 6:e05712. [PMID: 33344794 PMCID: PMC7733548 DOI: 10.1016/j.heliyon.2020.e05712] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic has affected more than 200 countries and 1.3 million individuals have deceased within eleven months. Intense research on COVID-19 occurrence and prevalence enable us to understand that comorbidities play a crucial role in spread and severity of SARS-CoV-2 infection. Chronic kidney disease, diabetes, respiratory diseases and hypertension are among the various morbidities that are prevalent in symptomatic COVID-19 patients. However, the effect of altered thyroid-driven disorders cannot be ignored. Since thyroid hormone critically coordinate and regulate the major metabolism and biochemical pathways, this review is on the potential role of prevailing thyroid disorders in SARS-CoV-2 infection. Direct link of thyroid hormone with several disorders such as diabetes, vitamin D deficiency, obesity, kidney and liver disorders etc. suggests that the prevailing thyroid conditions may affect SARS-CoV-2 infection. Further, we discuss the oxidative stress-induced aging is associated with the degree of SARS-CoV-2 infection. Importantly, ACE2 protein which facilitates the host-cell entry of SARS-CoV-2 using the spike protein, are highly expressed in individuals with abnormal level of thyroid hormone. Altogether, we report that the malfunction of thyroid hormone synthesis may aggravate SARS-CoV-2 infection and thus monitoring the thyroid hormone may help in understanding the pathogenesis of COVID-19.
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Affiliation(s)
- Kanchan Kumari
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Department of Molecular Biology, Umea University, Sweden
| | - Gagan B.N. Chainy
- Post Graduate Department of Biotechnology, Utkal University, Bhubaneswar 751004, Odisha, India
| | - Umakanta Subudhi
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi 110025, India
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Gauthier BR, Sola‐García A, Cáliz‐Molina MÁ, Lorenzo PI, Cobo‐Vuilleumier N, Capilla‐González V, Martin‐Montalvo A. Thyroid hormones in diabetes, cancer, and aging. Aging Cell 2020; 19:e13260. [PMID: 33048427 PMCID: PMC7681062 DOI: 10.1111/acel.13260] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 07/27/2020] [Accepted: 09/13/2020] [Indexed: 12/18/2022] Open
Abstract
Thyroid function is central in the control of physiological and pathophysiological processes. Studies in animal models and human research have determined that thyroid hormones modulate cellular processes relevant for aging and for the majority of age‐related diseases. While several studies have associated mild reductions on thyroid hormone function with exceptional longevity in animals and humans, alterations in thyroid hormones are serious medical conditions associated with unhealthy aging and premature death. Moreover, both hyperthyroidism and hypothyroidism have been associated with the development of certain types of diabetes and cancers, indicating a great complexity of the molecular mechanisms controlled by thyroid hormones. In this review, we describe the latest findings in thyroid hormone research in the field of aging, diabetes, and cancer, with a special focus on hepatocellular carcinomas. While aging studies indicate that the direct modulation of thyroid hormones is not a viable strategy to promote healthy aging or longevity and the development of thyromimetics is challenging due to inefficacy and potential toxicity, we argue that interventions based on the use of modulators of thyroid hormone function might provide therapeutic benefit in certain types of diabetes and cancers.
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Affiliation(s)
- Benoit R. Gauthier
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
- Biomedical Research Network on Diabetes and Related Metabolic Diseases‐CIBERDEM Instituto de Salud Carlos III Madrid Spain
| | - Alejandro Sola‐García
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
| | - María Ángeles Cáliz‐Molina
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
| | - Petra Isabel Lorenzo
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
| | - Nadia Cobo‐Vuilleumier
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
| | - Vivian Capilla‐González
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
| | - Alejandro Martin‐Montalvo
- Department of Cell Therapy and Regeneration Andalusian Center for Molecular Biology and Regenerative Medicine‐CABIMER Junta de Andalucía‐University of Pablo de Olavide‐University of Seville‐CSIC Seville Spain
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Ge YJ, Xu W, Tan CC, Tan L. Blood-based biomarkers in hypothalamic-pituitary axes for the risk of dementia or cognitive decline: a systematic review and meta-analysis. Aging (Albany NY) 2020; 12:20350-20365. [PMID: 33104518 PMCID: PMC7655197 DOI: 10.18632/aging.103813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022]
Abstract
Blood-based biomarkers are ideal candidates for dementia prediction. This systematic review and meta-analysis aimed to evaluate longitudinal relationships of blood hormones and hormone-binding proteins in hypothalamic-pituitary (HP) axes with dementia or cognitive decline. PubMed, MEDLINE, EMBASE, PsycINFO, and BIOSIS were systematically searched from 1919 to June 2020. Fifteen types of hormones and four types of hormone-binding proteins were measured in 48 prospective studies. Increased risk of dementia or cognitive decline could be predicted by elevated blood concentrations of free-thyroxine (free-T4, RR = 1.06, p = 0.001) and sex hormone-binding globulin (SHBG, RR = 1.10, p = 0.025). Lower thyroid-stimulating hormone (TSH) levels within (RR = 1.28, p < 0.001) and below (RR = 1.27, p = 0.004) the normal range were both risky. Current evidence suggests the alterations of multiple blood molecules in HP axes, especially TSH, free-T4, and SHBG precede the incidence of dementia or cognitive decline. The underpinning etiology remains to be elucidated in the future.
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Affiliation(s)
- Yi-Jun Ge
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Wei Xu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Chen-Chen Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
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Xiu S, Mu Z, Zhao L, Sun L. Low free triiodothyronine levels are associated with risk of frailty in older adults with type 2 diabetes mellitus. Exp Gerontol 2020; 138:111013. [PMID: 32590129 DOI: 10.1016/j.exger.2020.111013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 05/27/2020] [Accepted: 06/17/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES With aging populations around the world, frailty is becoming more prevalent increasing the need to early identify those at risk of frailty. The association between thyroid hormone levels and frailty in subjects with type 2 diabetes mellitus (T2DM) remains unclear. The objective of the study was to evaluate the relationship between thyroid hormone concentrations and frailty in older adults with T2DM. METHODS A total of 240 older adults with T2DM were divided into three groups according to the frailty phenotype criteria: robust group (n = 94), pre-frail (n = 110) and frail group (n = 36). Concentrations of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), 25-hydroxyvitamin D3 [25(OH) D3], highly sensitive C-reactive protein (hs-CRP) and interleukin-6 (IL-6) were determined. Handgrip strength was measured using a Jamar hand dynamometer. Physical function was assessed by gait speed and the timed go and up (TUG) test. Logistic regression analysis was performed to evaluate the association between FT3 and frailty. RESULTS The FT3 level was the lowest among frail people (2.56 ± 0.42 pg/mL), followed by pre-frail participants (2.73 ± 0.38 pg/mL), with the highest among the robust subjects (2.83 ± 0.43 pg/mL). FT3 level was positively correlated with handgrip strength and gait speed (R = 0.313, P < 0.001; R = 0.250, P < 0.001, respectively), while negatively correlated with TUG time (R = -0.276, P < 0.001). After adjusting for age, sex, TSH, 25(OH) D3 and estimate glomerular filtration rate (eGFR), logistic regression showed that low FT3 was significantly associated with an increased risk of frailty (odds ratio (OR): 4.53; 95% confidence interval (CI): 1.89-10.83; P = 0.001). CONCLUSION Low levels of FT3 were associated with an increased risk of frailty in older adults with T2DM. Measuring FT3 might be useful for identifying those at high risk of frailty.
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Affiliation(s)
- Shuangling Xiu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
| | - Zhijing Mu
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Lei Zhao
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Lina Sun
- Department of Endocrinology, Beijing Institute of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Kuś A, Chaker L, Teumer A, Peeters RP, Medici M. The Genetic Basis of Thyroid Function: Novel Findings and New Approaches. J Clin Endocrinol Metab 2020; 105:5818501. [PMID: 32271924 DOI: 10.1210/clinem/dgz225] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 01/06/2020] [Indexed: 12/18/2022]
Abstract
CONTEXT Genetic factors are major determinants of thyroid function. Over the last two decades, multiple genetic variants have been associated with variations in normal range thyroid function tests. Most recently, a large-scale genome-wide association study (GWAS) doubled the number of known variants associated with normal range thyrotropin (TSH) and free thyroxine (FT4) levels. EVIDENCE ACQUISITION This review summarizes the results of genetic association studies on normal range thyroid function and explores how these genetic variants can be used in future studies to improve our understanding of thyroid hormone regulation and disease. EVIDENCE SYNTHESIS Serum TSH and FT4 levels are determined by multiple genetic variants on virtually all levels of the hypothalamus-pituitary-thyroid (HPT) axis. Functional follow-up studies on top of GWAS hits has the potential to discover new key players in thyroid hormone regulation, as exemplified by the identification of the thyroid hormone transporter SLC17A4 and the metabolizing enzyme AADAT. Translational studies may use these genetic variants to investigate causal associations between thyroid function and various outcomes in Mendelian Randomization (MR) studies, to identify individuals with an increased risk of thyroid dysfunction, and to predict the individual HPT axis setpoint. CONCLUSIONS Recent genetic studies have greatly improved our understanding of the genetic basis of thyroid function, and have revealed novel pathways involved in its regulation. In addition, these findings have paved the way for various lines of research that can improve our understanding of thyroid hormone regulation and thyroid diseases, as well as the potential use of these markers in future clinical practice.
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Affiliation(s)
- Aleksander Kuś
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine and Endocrinology, Medical University of Warsaw, Warsaw, Poland
| | - Layal Chaker
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, Greifswald, Germany
| | - Robin P Peeters
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Marco Medici
- Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Center, Nijmegen, The Netherlands
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Ikram MA, Brusselle G, Ghanbari M, Goedegebure A, Ikram MK, Kavousi M, Kieboom BCT, Klaver CCW, de Knegt RJ, Luik AI, Nijsten TEC, Peeters RP, van Rooij FJA, Stricker BH, Uitterlinden AG, Vernooij MW, Voortman T. Objectives, design and main findings until 2020 from the Rotterdam Study. Eur J Epidemiol 2020; 35:483-517. [PMID: 32367290 PMCID: PMC7250962 DOI: 10.1007/s10654-020-00640-5] [Citation(s) in RCA: 304] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/19/2022]
Abstract
The Rotterdam Study is an ongoing prospective cohort study that started in 1990 in the city of Rotterdam, The Netherlands. The study aims to unravel etiology, preclinical course, natural history and potential targets for intervention for chronic diseases in mid-life and late-life. The study focuses on cardiovascular, endocrine, hepatic, neurological, ophthalmic, psychiatric, dermatological, otolaryngological, locomotor, and respiratory diseases. As of 2008, 14,926 subjects aged 45 years or over comprise the Rotterdam Study cohort. Since 2016, the cohort is being expanded by persons aged 40 years and over. The findings of the Rotterdam Study have been presented in over 1700 research articles and reports. This article provides an update on the rationale and design of the study. It also presents a summary of the major findings from the preceding 3 years and outlines developments for the coming period.
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Affiliation(s)
- M Arfan Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Guy Brusselle
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Mohsen Ghanbari
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André Goedegebure
- Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Kamran Ikram
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Maryam Kavousi
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Brenda C T Kieboom
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Caroline C W Klaver
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robert J de Knegt
- Department of Gastroenterology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annemarie I Luik
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Tamar E C Nijsten
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank J A van Rooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - André G Uitterlinden
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
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Giassi K, Piccoli V, da Costa Rodrigues T, Gorga Bandeira de Mello R. Evaluation of evening versus morning levothyroxine intake in elderly (MONIALE). Trials 2019; 20:742. [PMID: 31847914 PMCID: PMC6918562 DOI: 10.1186/s13063-019-3816-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/22/2019] [Indexed: 12/30/2022] Open
Abstract
Background The aging population is associated with increased multimorbidity and polypharmacy. Older adults are at a higher risk of adverse events and reduced therapeutic response. This phenomenon is partially explained by drug interactions and treatment adherence. Most randomized clinical trials have found no significant differences between morning and evening levothyroxine (LT4) administration in young adults, but there is little evidence regarding alternative LT4 regimens in older populations. Thus, the MONIALE trial aims to test an alternative schedule for LT4 administration in older adults. Methods/design This randomized crossover clinical trial will include participants aged 60 years or older with primary hypothyroidism. The trial groups will consist of morning LT4 intake (60 min before breakfast) or evening LT4 intake (60 min after supper). The primary outcome will be variation in serum thyrotropin (TSH) levels after 24 weeks of the LT4 protocol. The secondary outcomes will be the prevalence of drugs that potentially interact with LT4 and hypothyroidism control according to interaction status. The sample size was calculated to detect a minimum mean difference of 1 mUI/L in serum TSH level between the groups with 80% power and a 5% probability of type I error, resulting in 91 patients per group. The project was approved by the Hospital de Clínicas de Porto Alegre Ethics Committee. Discussion Considering the aging population, the increased prevalence of multimorbidity and polypharmacy, as well as potential drug interactions and treatment adherence difficulties, an alternative LT4 protocol could be useful for hypothyroidism treatment in the elderly. Prior studies comparing alternative LT4 administration protocols have mainly included young adult populations and have not addressed potential drug interactions. Trial registration ClinicalTrials.gov, NCT03614988. Registered 30 July 2018.
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Affiliation(s)
- Karina Giassi
- Endocrinology Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vanessa Piccoli
- Internal Medicine and Geriatric Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ticiana da Costa Rodrigues
- Endocrinology Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Endocrine Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, 4° andar, Porto Alegre, RS, CEP 90035-903, Brazil
| | - Renato Gorga Bandeira de Mello
- Endocrinology Program, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil. .,Internal Medicine and Geriatric Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.
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Thyroid function and life expectancy with and without noncommunicable diseases: A population-based study. PLoS Med 2019; 16:e1002957. [PMID: 31652264 PMCID: PMC6814213 DOI: 10.1371/journal.pmed.1002957] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/02/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Variations in thyroid function within reference ranges are associated with increased risk of diseases and death. However, the impact of thyroid function on life expectancy (LE) with and without noncommunicable diseases (NCDs) remains unknown. We therefore aimed to investigate the association of thyroid function with total LE and LE with and without NCD among euthyroid individuals. METHODS AND FINDINGS The study was embedded in the Rotterdam Study, a prospective population-based study carried out in the Netherlands. In total, 7,644 participants without known thyroid disease and with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels within reference ranges were eligible. NCDs were defined as presence of cardiovascular disease, diabetes mellitus type 2, or cancer. We used the demographic tool of multistate life tables to calculate LE estimates at the age of 50 years, using prevalence, incidence rates, and hazard ratios for three transitions (healthy to NCD, healthy to death, and NCD to death). The total LE and LE with and without NCD among TSH and FT4 tertiles were calculated separately in men and women. Analyses were adjusted for sociodemographic and cardiovascular risk factors. The mean (standard deviation) age of the participants was 64.5 (9.7) years, and 52.3% were women. Over a median follow-up of 8 years (interquartile range 2.7-9.9 years), 1,396 incident NCD events and 1,422 deaths occurred. Compared with those in the lowest TSH tertile, men and women in the highest TSH tertile were expected to live 1.5 years (95% confidence interval [CI] 0.8-2.3, p < 0.001) and 1.5 years (CI 0.8-2.2, p < 0.001) longer, respectively, of which 1.4 years (CI 0.5-2.3, p = 0.002) and 1.3 years (CI 0.3-2.1, p = 0.004) with NCD. Compared with those in the lowest FT4 tertile, the difference in LE for men and women in the highest FT4 tertile was -3.7 years (CI -5.1 to -2.2, p < 0.001) and -3.3 years (CI -4.7 to -1.9, p < 0.001), respectively, of which -1.8 years (CI -3.1 to -0.7, p = 0.003) and -2.0 years (CI -3.4 to -0.7, p = 0.003) without NCD. A limitation of the study is the observational design. Thus, the possibility of residual confounding cannot be entirely ruled out. CONCLUSIONS In this study, we found that people with low-normal thyroid function (i.e., highest tertile of TSH and lowest tertile of FT4 reference ranges) are expected to live more years with and without NCD than those with high-normal thyroid function (i.e., lowest tertile of TSH and highest tertile of FT4 reference ranges). These findings provide support for a re-evaluation of the current reference ranges of thyroid function.
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Medici M, Peeters RP, Teumer A, Taylor P. The importance of high-quality mendelian randomisation studies for clinical thyroidology. Lancet Diabetes Endocrinol 2019; 7:665-667. [PMID: 31076377 DOI: 10.1016/s2213-8587(19)30145-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 11/21/2022]
Affiliation(s)
- Marco Medici
- Department of Endocrinology, Radboud University Medical Center, 6525 Nijmegen, Netherlands; Department of Internal Medicine and Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
| | - Robin P Peeters
- Department of Internal Medicine and Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany; German Centre for Cardiovascular Research DZHK), Greifswald, Germany
| | - Peter Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
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Megquier K, Genereux DP, Hekman J, Swofford R, Turner-Maier J, Johnson J, Alonso J, Li X, Morrill K, Anguish LJ, Koltookian M, Logan B, Sharp CR, Ferrer L, Lindblad-Toh K, Meyers-Wallen VN, Hoffman A, Karlsson EK. BarkBase: Epigenomic Annotation of Canine Genomes. Genes (Basel) 2019; 10:E433. [PMID: 31181663 PMCID: PMC6627511 DOI: 10.3390/genes10060433] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 05/29/2019] [Accepted: 06/03/2019] [Indexed: 12/20/2022] Open
Abstract
Dogs are an unparalleled natural model for investigating the genetics of health and disease, particularly for complex diseases like cancer. Comprehensive genomic annotation of regulatory elements active in healthy canine tissues is crucial both for identifying candidate causal variants and for designing functional studies needed to translate genetic associations into disease insight. Currently, canine geneticists rely primarily on annotations of the human or mouse genome that have been remapped to dog, an approach that misses dog-specific features. Here, we describe BarkBase, a canine epigenomic resource available at barkbase.org. BarkBase hosts data for 27 adult tissue types, with biological replicates, and for one sample of up to five tissues sampled at each of four carefully staged embryonic time points. RNA sequencing is complemented with whole genome sequencing and with assay for transposase-accessible chromatin using sequencing (ATAC-seq), which identifies open chromatin regions. By including replicates, we can more confidently discern tissue-specific transcripts and assess differential gene expression between tissues and timepoints. By offering data in easy-to-use file formats, through a visual browser modeled on similar genomic resources for human, BarkBase introduces a powerful new resource to support comparative studies in dogs and humans.
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Affiliation(s)
- Kate Megquier
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Diane P Genereux
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jessica Hekman
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Ross Swofford
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jason Turner-Maier
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jeremy Johnson
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Jacob Alonso
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Xue Li
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Kathleen Morrill
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Lynne J Anguish
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
| | - Michele Koltookian
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
| | - Brittney Logan
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
| | - Claire R Sharp
- School of Veterinary and Life Sciences, College of Veterinary Medicine, Murdoch University, Perth, Murdoch, WA 6150, Australia.
| | - Lluis Ferrer
- Departament de Medicina i Cirurgia Animals Veterinary School, Universitat Autonoma de Barcelona, 08193 Barcelona, Spain.
| | - Kerstin Lindblad-Toh
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Science for Life Laboratory, Department of Medical Biochemistry & Microbiology, Uppsala University, 751 23 Uppsala, Sweden.
| | - Vicki N Meyers-Wallen
- Baker Institute for Animal Health and Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14850, USA.
| | - Andrew Hoffman
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
- Cummings School of Veterinary Medicine, Tufts University, Grafton, MA 01536, USA.
| | - Elinor K Karlsson
- Vertebrate Genomics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA.
- Bioinformatics and Integrative Biology, University of Massachusetts Medical School, Worcester, MA 01655, USA.
- Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA 01655, USA.
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Ren R, Ma Y, Deng F, Li T, Wang H, Wei J, Jiang X, He M, Tian M, Liu D, Chen B, Deng W. Association between serum TSH levels and metabolic components in euthyroid subjects: a nationwide population-based study. Diabetes Metab Syndr Obes 2019; 12:1563-1569. [PMID: 31686877 PMCID: PMC6709806 DOI: 10.2147/dmso.s202769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Whether a relationship exists between various metabolic factors and thyroid-stimulating hormone (TSH) levels in euthyroid persons remains unknown. This study aims to explore the relationship between TSH levels and metabolic factors in euthyroid individuals. METHODS A total of 2,663 subjects were enrolled from a nationwide population-based cross-sectional survey of iodine nutrition, thyroid disease and diabetes in China (2014-2017). Euthyroid individuals were divided into four groups according to quartiles of TSH levels: group A (n=305, 0.3-1.3 mIU/L), group B (n=829, 1.3-2.2 mIU/L), group C (n=673, 2.2-3.2 mIU/L) and group D (n=349, 3.2-4.2 mIU/L). Anthropometric parameters, biochemical indicators and TSH levels were determined. RESULTS A total of 2,156 euthyroid subjects with serum TSH levels within the normal range accounted for 86.8% of the sample. The systolic blood pressure (SBP) in group D was significantly higher than that in the other three groups. Group C displayed significantly lower thyroid peroxidase antibody (TPOAb) levels than the other three groups. Group C also had lower anti-thyroglobulin antibody (TgAb) levels than groups A and D, whereas the TgAb levels in group B were only lower than those in group A. Spearman's or Pearson's linear regression analysis showed that SBP (r=0.054; P=0.013) was positively correlated with TSH, but cholesterol (TC) (r=-0.043, P=0.047) was negatively correlated with TSH. Multiple stepwise regression analysis revealed that SBP, the urinary iodine concentration (UIC), waist circumference (WC), body mass index (BMI), TC, triglycerides (TGs) and low-density lipoprotein cholesterol (LDL-C) were independent predictors of serum TSH levels. CONCLUSION This large population-based study demonstrates a significant interaction between metabolic factors and TSH levels. An adverse weight status, high blood pressure levels, blood lipid metabolism disorder and excessive iodine intake may be early manifestations of thyroid disease in euthyroid subjects.
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Affiliation(s)
- Rui Ren
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Yu Ma
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Fang Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Tao Li
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Hongyan Wang
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Jing Wei
- Department of Endocrinology, General Hospital of Xinjiang Military Region, PLA, Urumqi, People’s Republic of China
| | - Xiaoyan Jiang
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
| | - Min He
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Mingyuan Tian
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dongfang Liu
- Department of Endocrinology, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, People’s Republic of China
| | - Bing Chen
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
| | - Wuquan Deng
- Department of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, Chongqing, People’s Republic of China
- Department of Endocrinology, Southwest Hospital, Army Medical University, Chongqing, People’s Republic of China
- Correspondence: Wuquan DengDepartment of Endocrinology and Nephrology, Chongqing University Central Hospital, Chongqing Emergency Medical Center, No. 1 Jiankang Road, Yuzhong District, Chongqing, People’s Republic of ChinaTel +86 236 369 2185Email
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Dominguez LJ, Barbagallo M. Thyroid Disorders in Old Age. REFERENCE MODULE IN BIOMEDICAL SCIENCES 2019. [DOI: 10.1016/b978-0-12-801238-3.11338-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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