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Shulhai AM, Rotondo R, Petraroli M, Patianna V, Predieri B, Iughetti L, Esposito S, Street ME. The Role of Nutrition on Thyroid Function. Nutrients 2024; 16:2496. [PMID: 39125376 PMCID: PMC11314468 DOI: 10.3390/nu16152496] [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: 07/03/2024] [Revised: 07/26/2024] [Accepted: 07/27/2024] [Indexed: 08/12/2024] Open
Abstract
Thyroid function is closely linked to nutrition through the diet-gut-thyroid axis. This narrative review highlights the influence of nutritional components and micronutrients on thyroid development and function, as well as on the gut microbiota. Micronutrients such as iodine, selenium, iron, zinc, copper, magnesium, vitamin A, and vitamin B12 influence thyroid hormone synthesis and regulation throughout life. Dietary changes can alter the gut microbiota, leading not just to dysbiosis and micronutrient deficiency but also to changes in thyroid function through immunological regulation, nutrient absorption, and epigenetic changes. Nutritional imbalance can lead to thyroid dysfunction and/or disorders, such as hypothyroidism and hyperthyroidism, and possibly contribute to autoimmune thyroid diseases and thyroid cancer, yet controversial issues. Understanding these relationships is important to rationalize a balanced diet rich in essential micronutrients for maintaining thyroid health and preventing thyroid-related diseases. The synthetic comprehensive overview of current knowledge shows the importance of micronutrients and gut microbiota for thyroid function and uncovers potential gaps that require further investigation.
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Affiliation(s)
- Anna-Mariia Shulhai
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (A.-M.S.); (R.R.); (S.E.)
| | - Roberta Rotondo
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (A.-M.S.); (R.R.); (S.E.)
| | - Maddalena Petraroli
- Paediatric Clinic, University Hospital of Parma, 43121 Parma, Italy; (M.P.); (V.P.)
| | - Viviana Patianna
- Paediatric Clinic, University Hospital of Parma, 43121 Parma, Italy; (M.P.); (V.P.)
| | - Barbara Predieri
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (B.P.); (L.I.)
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy; (B.P.); (L.I.)
| | - Susanna Esposito
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (A.-M.S.); (R.R.); (S.E.)
- Paediatric Clinic, University Hospital of Parma, 43121 Parma, Italy; (M.P.); (V.P.)
| | - Maria Elisabeth Street
- Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy; (A.-M.S.); (R.R.); (S.E.)
- Paediatric Clinic, University Hospital of Parma, 43121 Parma, Italy; (M.P.); (V.P.)
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Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S. Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4790. [PMID: 38004184 PMCID: PMC10675576 DOI: 10.3390/nu15224790] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Objective: Iron deficiency (ID) is the most prevalent nutritional deficiency worldwide. Low levels of serum ferritin (SF) could affect the thyroid gland and its functioning. The purpose of this systematic review and meta-analysis is to summarize the main currently available evidence and analyze data on the relationship between ID and thyroid function. Methods: This study included all articles evaluating the relationship between ID and thyroid function. Quality assessment was performed using Cambridge Quality Checklists. The search strategy included the following combination of Medical Subjects Headings terms and keywords: "iron deficiency", "thyroid function", "thyroid disease", "thyroid dysfunction", and "hypothyroidism". A meta-analysis was performed to evaluate whether thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels differed between patients with ID and healthy controls without ID. For statistical comparison between cases and controls, the mean difference (MD) was calculated, and a subgroup analysis of pregnant and non-pregnant women was performed. Cochran's Q testing and heterogeneity indices (I2) were used to assess statistical heterogeneity. Sensitivity analysis and publication bias analyses were also performed, both qualitatively and quantitatively. Finally, a meta-regression analysis was performed to evaluate the correlation between serum TSH or FT4 levels and SF in the study population. Results: Ten cross-sectional studies were identified and reviewed. Patients with ID showed TSH (MD: -0.24 mIU/L; 95% CI -0.41, -0.07; I2 = 100%, p = 0.005), FT4 (MD: -1.18 pmol/L; 95% CI -1.43, -0.94; I2 = 99%, p < 0.000001), and FT3 (MD: -0.22 pmol/L; 95% CI -0.32, -0.12; I2 = 99%, p < 0.00001) levels that were significantly lower. Subgroup analysis confirmed significantly lower TSH, FT4, and FT3 levels in pregnant women. Non-pregnant women showed significantly lower serum FT4 and FT3 levels but no difference in TSH values. Meta-regression analysis showed that serum TSH and FT4 levels were positively correlated with SF levels. Our systematic review of the literature found that ID significantly increases the prevalence of thyroid autoantibody (anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies) positivity both individually and collectively. Conclusion: Studies currently published in the literature indicate a possible relationship between ID, thyroid function, and autoimmunity, especially in some patient groups. Data analysis shows that thyroid hormone levels are lower in patients with ID and, in particular, in pregnant women. Further studies are needed to understand the role played by iron in thyroid metabolism.
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Affiliation(s)
- Vincenzo Garofalo
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
- Cleveland Clinic Foundation, Glickman Urological & Kidney Institute, Cleveland, OH 44195, USA
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
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Wang F, Zhang Y, Yuan Z, Li Y, Liu S, Zeng X, Qiu X, Ye L, Huang D. The association between iron status and thyroid hormone levels during pregnancy. J Trace Elem Med Biol 2022; 74:127047. [PMID: 35930951 DOI: 10.1016/j.jtemb.2022.127047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/07/2022] [Accepted: 07/19/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Iron deficiency may be a risk factor for thyroid disorder; however, the relationship between iron deficiency and thyroid disorder as well as mechanism involved remain unclear. METHODS A hospital-based cross-sectional study was conducted to analyze the correlation between iron status and thyroid hormone levels in pregnant women. A total of 2218 pregnant women were recruited, and iron status and thyroid hormones were measured. Canonical correlation, Lasso regression, and Receiver operator characteristic (ROC) curve analysis were used to determine the association and related factors. RESULTS There were 219 cases with iron deficiency anemia (IDA), 168 cases with iron deficiency (ID), and 1831 subjects with normal iron status. Compared with normal group, free triiodothyronine (FT3) and free thyroxine (FT4) in ID group and IDA group had a significant decreasing trend (P < 0.05), with the lowest levels in IDA group. Thyroid stimulating hormone (TSH) was significantly increased in ID group and IDA group (P < 0.05). Moreover, the proportion of hypothyroidism in both ID group and IDA group was higher than the normal group, meanwhile the proportion of hyperthyroidism was lower in both groups (P < 0.05). Serum ferritin (SF) and hemoglobin (Hb) were positively correlated with FT3 and FT4 but negatively correlated with TSH. Correlation analysis indicated that iron status was associated with thyroid hormone levels (P < 0.05). Lasso regression analysis showed that SF, Hb and other variables could be included in the prediction model of FT4. The variables selected by Lasso model were used for ROC curve analysis, and the prediction accuracy was acceptable (AUC=0.778, P < 0.05). CONCLUSION Our study indicated that there is an association between iron status and thyroid hormone levels in pregnant women, and the level of FT4 may change with iron status. Our findings provide new ideas for regulating the thyroid hormone levels to prevent thyroid dysfunction during pregnancy.
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Affiliation(s)
- Fengyi Wang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Yuanxiao Zhang
- Pingguo Maternal and Child Health Hospital, Baise, Guangxi, China.
| | - Zongxiang Yuan
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Yanning Li
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Shun Liu
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Xiaoyun Zeng
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Xiaoqiang Qiu
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
| | - Li Ye
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, Guangxi, China; Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, China.
| | - Dongping Huang
- School of Public Health, Guangxi Medical University, Nanning, Guangxi, China.
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Zhuo L, Wang Z, Yang Y, Liu Z, Wang S, Song Y. Obstetric and offspring outcomes in isolated maternal hypothyroxinaemia: a systematic review and meta-analysis. J Endocrinol Invest 2022; 46:1087-1101. [PMID: 36422828 DOI: 10.1007/s40618-022-01967-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 11/12/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To examine the association between isolated maternal hypothyroxinaemia (IMH) and adverse obstetric outcomes and offspring outcomes and also investigate the effects of levothyroxine therapy on IMH for the above outcomes. METHODS We systematically searched PubMed, EMBASE, and Cochrane Library, and the reference lists of key reviews were hand searched on June 9, 2021. Two authors independently screened titles/abstracts. Full articles were further assessed if the information suggested that the study met the inclusion/exclusion criteria, and two researchers performed data extraction and risk-of-bias assessment using standardized tables. Summary relative risks or the mean difference between maternal effects and offspring outcomes were calculated by a random-effects model. RESULTS We identified 38 eligible articles (35 cohort studies and two randomized controlled trials [RCT]). Meta-analysis showed that maternal IMH was associated with increased gestational diabetes mellitus, preterm premature rupture of membranes, preterm birth, fetal distress, and macrosomia outcomes in IMH compared to euthyroid women, and the relative risks were 1.42 (1.03-1.96), 1.50 (1.05-2.14), 1.33 (1.15-1.55), 1.75 (1.16-2.65) and 1.62 (1.35-1.94), respectively. IMH was not associated with placenta previa, gestational hypertension, pre-eclampsia, intrauterine growth restriction, and offspring outcomes like birth weight, low birth weight infants, fetal macrosomia, neonatal intensive care, neonatal death, or fetal head circumference. In addition, we did not find an association between IMH and adverse offspring cognitive defects. Due to insufficient data for meta-analysis, it failed to pool the evidence of levothyroxine's therapeutic effect on IMH and their offspring. CONCLUSIONS AND RELEVANCE IMH in pregnancy may relate to a few maternal and offspring outcomes. Moreover, there is currently no sufficient evidence that levothyroxine treatment during pregnancy reduces adverse maternal outcomes and disability in offspring. Further investigation to explore the beneficial effects of levothyroxine therapy is warranted.
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Affiliation(s)
- L Zhuo
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, People's Republic of China
| | - Z Wang
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, People's Republic of China
| | - Y Yang
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, People's Republic of China
| | - Z Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China
| | - S Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China.
| | - Y Song
- Department of Endocrinology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, People's Republic of China.
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Asadi M, Toghdory A, Hatami M, Ghassemi Nejad J. Milk Supplemented with Organic Iron Improves Performance, Blood Hematology, Iron Metabolism Parameters, Biochemical and Immunological Parameters in Suckling Dalagh Lambs. Animals (Basel) 2022; 12:ani12040510. [PMID: 35203218 PMCID: PMC8868252 DOI: 10.3390/ani12040510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/12/2022] [Accepted: 02/15/2022] [Indexed: 01/09/2023] Open
Abstract
This study was conducted to investigate the effect of milk supplemented with organic iron on performance, blood hematology, iron metabolism parameters, biochemical and immunological parameters in suckling lambs. Thirty-six newborn Dalagh lambs were randomly divided into three groups with 12 replications. The control group was fed with milk without organic iron. The other two groups were fed milk supplemented with 25 and 50 mg/d organic iron, respectively. During the experiment, increased daily weight gain and total body weight were observed in the iron-supplemented groups. An increase in the levels of red blood cell, hemoglobin, hematocrit, mean corpuscular hemoglobin, and mean corpuscular concentration in iron supplemented groups was indicated. Consumption of organic iron caused a significant decrease in plasma copper concentration. Total antioxidant status level was lower, but levels of glutathione peroxidase, superoxide dismutase, and catalase were higher in iron supplemented groups. In organic iron supplemented groups, insulin and thyroid hormones levels were significantly increased, and glucose level was significantly decreased. In organic iron supplemented groups, alkaline phosphatase level significantly increased, and aminotransferase level significantly decreased. Overall, the use of organic iron in the milk improved the performance and health in suckling lambs, and since a lower level of supplementation is naturally preferable, supplementation of milk with 25 mg/d organic iron is recommended.
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Affiliation(s)
- Mohammad Asadi
- Department of Animal and Poultry Nutrition, Animal Science Faculty, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan 49189-43464, Iran; (M.A.); (A.T.)
| | - Abdolhakim Toghdory
- Department of Animal and Poultry Nutrition, Animal Science Faculty, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan 49189-43464, Iran; (M.A.); (A.T.)
| | - Maryam Hatami
- Department of Animal Science, Faculty of Agriculture, University of Tabriz, Tabriz 51666-16471, Iran;
| | - Jalil Ghassemi Nejad
- Department of Animal Science and Technology, Konkuk University, Seoul 05029, Korea
- Correspondence: ; Tel.: +82-2-450-3744
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Liu Y, Li G, Guo N, Liu X, Huang S, Du Q. Association Between Maternal Characteristics and the Risk of Isolated Maternal Hypothyroxinemia. Front Endocrinol (Lausanne) 2022; 13:843324. [PMID: 35498400 PMCID: PMC9039333 DOI: 10.3389/fendo.2022.843324] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Accepted: 03/08/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We aimed to determine the association between maternal characteristics and isolated maternal hypothyroxinemia (IMH). METHODS Pregnancies registered at Shanghai First Maternity and Infant Hospital between January 2014 and September 2020 were included in this cross-sectional study. IMH was defined as free thyroxine (FT4) levels below the 10th percentile with TSH within the normal reference range. Multivariate logistic regression models were used to identify potential risk factors for IMH, including demographic information, anthropometric measurements and nutritional status. RESULTS A total of 54586 singleton pregnancies were included, involving 6084 women with IMH and 48502 euthyroid women. Multivariate logistic regression analyses showed that the variables for women with ages ≥35 (adjusted OR = 1.30, 95% CI:1.20-1.40), non-local residence (adjusted OR = 1.16, 95% CI:1.09-1.23), multiparas (adjusted OR = 1.11, 95% CI:1.03-1.21), pre-pregnancy overweight (adjusted OR = 1.37, 95% CI:1.27-1.49) or obesity (adjusted OR = 1.35, 95% CI:1.18-1.54), and iron deficiency (adjusted OR = 1.27, 95% CI:1.20-1.35) were independent risk factors for IMH in the overall study population, which were identical to those in the first trimester subgroup. CONCLUSIONS Maternal characteristics were associated with the onset of IMH. Maternal age, residence of origin, parity, pre-pregnancy body mass index (BMI) and iron status should be comprehensively considered to evaluate the risk of IMH, according to which obstetricians could determine an optimal assessment time for thyroid function.
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Affiliation(s)
- Yang Liu
- Department of Obstetrics, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Guohua Li
- Department of Reproductive Immunology, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Nafei Guo
- Department of Nursing, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaosong Liu
- Department of Obstetrics, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shijia Huang
- Department of Obstetrics, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Qiaoling Du
- Department of Obstetrics, Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Qiaoling Du,
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Alnuwaysir RIS, Hoes MF, van Veldhuisen DJ, van der Meer P, Beverborg NG. Iron Deficiency in Heart Failure: Mechanisms and Pathophysiology. J Clin Med 2021; 11:125. [PMID: 35011874 PMCID: PMC8745653 DOI: 10.3390/jcm11010125] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 12/15/2022] Open
Abstract
Iron is an essential micronutrient for a myriad of physiological processes in the body beyond erythropoiesis. Iron deficiency (ID) is a common comorbidity in patients with heart failure (HF), with a prevalence reaching up to 59% even in non-anaemic patients. ID impairs exercise capacity, reduces the quality of life, increases hospitalisation rate and mortality risk regardless of anaemia. Intravenously correcting ID has emerged as a promising treatment in HF as it has been shown to alleviate symptoms, improve quality of life and exercise capacity and reduce hospitalisations. However, the pathophysiology of ID in HF remains poorly characterised. Recognition of ID in HF triggered more research with the aim to explain how correcting ID improves HF status as well as the underlying causes of ID in the first place. In the past few years, significant progress has been made in understanding iron homeostasis by characterising the role of the iron-regulating hormone hepcidin, the effects of ID on skeletal and cardiac myocytes, kidneys and the immune system. In this review, we summarise the current knowledge and recent advances in the pathophysiology of ID in heart failure, the deleterious systemic and cellular consequences of ID.
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Affiliation(s)
| | | | | | | | - Niels Grote Beverborg
- Department of Cardiology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands; (R.I.S.A.); (M.F.H.); (D.J.v.V.); (P.v.d.M.)
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Moreno-Reyes R, Corvilain B, Daelemans C, Wolff F, Fuentes Peña C, Vandevijvere S. Iron Deficiency Is a Risk Factor for Thyroid Dysfunction During Pregnancy: A Population-Based Study in Belgium. Thyroid 2021; 31:1868-1877. [PMID: 34538131 DOI: 10.1089/thy.2021.0286] [Citation(s) in RCA: 9] [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: 01/01/2023]
Abstract
Background: Iron deficiency affects thyroid hormone synthesis by impairing the activity of the heme-dependent thyroid peroxidase. The prevalence of iron deficiency is elevated particularly in pregnant women. This study aimed to investigate the effects of iron status on thyroid function in a nationally representative sample of mildly iodine-deficient pregnant women. Methods: The study population comprised a sample of pregnant women in Belgium during the first and third trimesters of pregnancy (n = 1241). Women were selected according to a multistage proportional-to-size stratified and clustered sampling design. Urine and blood samples were collected, and a questionnaire was completed face to face with the study nurse. Concentrations of free thyroxine (fT4), total thyroxine (T4), free triiodothyronine, thyrotropin (TSH), thyroglobulin (Tg), thyroid peroxidase antibodies, Tg antibodies, hemoglobin, serum ferritin (SF), soluble transferrin receptor, urinary iodine concentrations (UICs) were measured and body iron stores (BIS) were calculated. Results: Median UICs were 117 and 132 μg/L in the first and third trimesters of pregnancy, respectively (p < 0.05). The frequency of SF <15 μg/L was 6.2% in the first trimester and 39.6% in the third trimester of pregnancy (p < 0.05). UIC was a significant predictor of serum Tg concentrations (p < 0.01) but not of thyroid hormone or TSH concentrations. The frequency of fT4<percentile 10th in the third trimester of pregnancy was 24% and 14% in pregnant women with negative BIS and positive BIS, respectively (p < 0.05). SF and BIS were significant predictors of fT4 and T4 in the first trimester of pregnancy (p < 0.05). Hemoglobin was a significant predictor of fT4 in both trimesters (p < 0.01) and for T4 in the third trimester (p = 0.015). Conclusion: Iron deficiency, but not mild iodine deficiency, is a determinant of serum fT4 and T4 in pregnant women. Correcting iron deficiency may help to maintain optimal thyroid function, in addition to preventing anemia during pregnancy.
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Affiliation(s)
- Rodrigo Moreno-Reyes
- Department of Nuclear Medicine, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB); Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Bernard Corvilain
- Department of Endocrinology and Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB); Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Caroline Daelemans
- Department of Gynecology and Obstetrics, Hôpital Erasme; Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB); Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Fleur Wolff
- Department of Department of Clinical Chemistry, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB); Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Camilo Fuentes Peña
- Department of Nuclear Medicine, Laboratoire Hospitalier Universitaire de Bruxelles (LHUB-ULB); Université Libre de Bruxelles (ULB), Brussels, Belgium
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Associations between the thyroid panel and serum protein concentrations across pregnancy. Sci Rep 2021; 11:15970. [PMID: 34354103 PMCID: PMC8342432 DOI: 10.1038/s41598-021-94358-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 07/01/2021] [Indexed: 02/07/2023] Open
Abstract
Establishing any characteristic associations between the serum parameters of thyroid function and serum proteins in pregnancy may aid in elucidating the role of the thyroid gland in the regulation of pregnancy-specific metabolic processes and in selecting candidate biomarkers for use in their clinical assessment. Concentrations of thyroid stimulating hormone (TSH), free tri-iodothyronine (fT3) and free thyroxine (fT4), six electrophoretically separated protein fractions (albumin, alpha-1-, alpha2-, beta-1-, beta-2- and gamma-globulins), representative proteins—albumin (ALB), transferrin (TRF), alpha-2-macroglobulin (AMG) and ceruloplasmin (CER) were measured in 136 serum samples from 65 women in their consecutive trimesters of pregnancy. The concentrations of TSH, fT4 and fT3 were significantly correlated (p < 0.05) with the concentrations of the albumin, alpha-2- and beta-1 globulin fractions. Significant correlations (p < 0.05) which were positive between fT4 and ALB and negative between fT4 and TRF were established throughout pregnancy. Significant negative correlations (p < 0.05) were demonstrated for fT3 with alpha-2-globulin, AMG and CER. Changes in the serum concentrations of thyroid hormones seen between the trimesters were found to correlate with the concentrations of high-abundance serum proteins. Opposite directions of correlations between fT4 and ALB and fT4 and TRF observed throughout pregnancy may indicate the shared biological role of these parameters in maintaining maternal homeostasis and they suggest their potential use in the clinic as a simple biomarker panel. A negative correlation of fT3 with CER in the second trimester possibly reflects their involvement in the active regulation of metabolic processes.
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Babić Leko M, Gunjača I, Pleić N, Zemunik T. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels. Int J Mol Sci 2021; 22:6521. [PMID: 34204586 PMCID: PMC8234807 DOI: 10.3390/ijms22126521] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 01/09/2023] Open
Abstract
Thyroid hormones are necessary for the normal functioning of physiological systems. Therefore, knowledge of any factor (whether genetic, environmental or intrinsic) that alters the levels of thyroid-stimulating hormone (TSH) and thyroid hormones is crucial. Genetic factors contribute up to 65% of interindividual variations in TSH and thyroid hormone levels, but many environmental factors can also affect thyroid function. This review discusses studies that have analyzed the impact of environmental factors on TSH and thyroid hormone levels in healthy adults. We included lifestyle factors (smoking, alcohol consumption, diet and exercise) and pollutants (chemicals and heavy metals). Many inconsistencies in the results have been observed between studies, making it difficult to draw a general conclusion about how a particular environmental factor influences TSH and thyroid hormone levels. However, lifestyle factors that showed the clearest association with TSH and thyroid hormones were smoking, body mass index (BMI) and iodine (micronutrient taken from the diet). Smoking mainly led to a decrease in TSH levels and an increase in triiodothyronine (T3) and thyroxine (T4) levels, while BMI levels were positively correlated with TSH and free T3 levels. Excess iodine led to an increase in TSH levels and a decrease in thyroid hormone levels. Among the pollutants analyzed, most studies observed a decrease in thyroid hormone levels after exposure to perchlorate. Future studies should continue to analyze the impact of environmental factors on thyroid function as they could contribute to understanding the complex background of gene-environment interactions underlying the pathology of thyroid diseases.
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Affiliation(s)
| | | | | | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia; (M.B.L.); (I.G.); (N.P.)
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Khaleghnia N, Mohri M, Seifi HA. The Effects of Parenteral Iron Administration on Thyroid Hormones, Hematology, Oxidative Stress Characteristics, Performance, and Health in Neonatal Holstein Calves. Biol Trace Elem Res 2021; 199:1823-1832. [PMID: 32683561 DOI: 10.1007/s12011-020-02293-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 07/16/2020] [Indexed: 12/11/2022]
Abstract
The present study investigated the effect of iron supplementation on thyroid hormones concentrations, oxidative stress characteristics, complete blood count (CBC) and serum biochemistry, and performance and health in calves of two groups: test group (n = 17, intramuscular injection of 500 mg iron-dextran on the 2nd day of life) and control group (n = 17, intramuscular injection of normal saline at the same time). Blood samples were taken from all of the calves instantly after birth and at 7, 14, 21, 28, and 90 days of age. Duration of treatment for diseases, body weight, height, and length were measured at each sampling time to evaluate growth and health. The results indicated that age (sampling time) had a significant effect (p ≤ 0.05) on the values of all measured variables except for ferric reducing ability of plasma (FRAP) amount and band neutrophil number. The treatment (group) had no significant effect on the amount of measured variables. Significant interactions between sampling time and group were found for white blood cell count (WBC), adult neutrophil, and bilirubin amounts (p ≤ 0.05). Significant higher amounts of hematocrit (HCT) and hemoglobin (Hb) at day 28 and mean corpuscular volume (MCV) at day 7 were seen in the test group compared with control group. Test group in comparison with control group had significantly lower amount of WBC at day 7; mean corpuscular hemoglobin concentration (MCHC), band neutrophils, and lymphocytes at day 14; and number of platelets at day 28. Growth and total weight gain and mean daily gain had no significant differences between the two groups. The duration of treatment for pneumonia and diarrhea was not significantly different between trial groups. The results show that parenterally administration of iron to newborn calves had no effect on improving erythropoiesis, performance, thyroid metabolism, oxidative/antioxidative situation, and health of dairy calves.
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Affiliation(s)
- Narges Khaleghnia
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Mehrdad Mohri
- Department of Clinical Sciences and Center of Excellence in Ruminant Abortion and Neonatal Mortality, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran.
| | - Hesam A Seifi
- Department of Clinical Sciences and Center of Excellence in Ruminant Abortion and Neonatal Mortality, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
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Barandiarán Aizpurua A, Sanders‐van Wijk S, Brunner‐La Rocca H, Henkens MT, Weerts J, Spanjers MH, Knackstedt C, van Empel VP. Iron deficiency impacts prognosis but less exercise capacity in heart failure with preserved ejection fraction. ESC Heart Fail 2021; 8:1304-1313. [PMID: 33522131 PMCID: PMC8006701 DOI: 10.1002/ehf2.13204] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/12/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS Whether and how iron deficiency (ID) impacts patients with heart failure (HF) with preserved ejection fraction (HFpEF) remain unclear. The aim of our study was to investigate the impact of ID on functional status, exercise capacity, and prognosis in HFpEF. METHODS AND RESULTS The study population consisted of 300 HFpEF patients. ID was defined as serum ferritin <100 μg/L or 100-300 μg/L and transferrin-saturation <20%. Baseline functional status, quality of life (HADS score and EQ 5D index), 6 min walking test, echocardiography, and outcome (all-cause mortality and combined all cause-mortality and HF hospitalization) were evaluated. ID was found in 159 (53%) patients. Patients with ID had a worse prognosis with a higher combined endpoint of all-cause mortality and HF hospitalization after 4 years of follow-up (log rank = 0.008). Pulmonary hypertension, depression, and thyroid disease were more prevalent in the ID group. Multivariable analysis showed that ID was independently associated with body mass index (P = 0.003), pulmonary hypertension (P = 0.008), and thyroid disease (P = 0.01). Although patients with ID had a lower exercise capacity compared with patients without ID (393 m [294-455] vs. 344 m [260-441], P = 0.008), there was no significant correlation after multivariable correction for age, BMI, NT-proBNP, DM, and depression. CONCLUSIONS Heart failure with preserved ejection fraction patients with ID have a worse prognosis and impaired exercise capacity compared with those without ID. However, although a trend was observed, after multivariable correction ID was no longer significantly associated with a reduced exercise capacity. This reflects that impaired exercise capacity in HFpEF is complex and seems multifactorial. Interestingly, pulmonary hypertension was an independent predictor of both ID and exercise capacity.
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Affiliation(s)
- Arantxa Barandiarán Aizpurua
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Sandra Sanders‐van Wijk
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Hans‐Peter Brunner‐La Rocca
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Michiel T.H.M. Henkens
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Jerremy Weerts
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Mireille H.A. Spanjers
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
| | - Christian Knackstedt
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
| | - Vanessa P.M. van Empel
- Department of CardiologyMaastricht University Medical Centre (MUMC+)PO 5800Maastricht6202AZThe Netherlands
- Cardiovascular Research Institute Maastricht (CARIM)Maastricht University Medical Centre (MUMC+)MaastrichtThe Netherlands
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Ramezani Tehrani F, Nazarpour S, Behboudi-Gandevani S. Isolated maternal hypothyroxinemia and adverse pregnancy outcomes: A systematic review. J Gynecol Obstet Hum Reprod 2021; 50:102057. [PMID: 33401029 DOI: 10.1016/j.jogoh.2020.102057] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 02/08/2023]
Abstract
Maternal thyroid hormones are vital for a normal pregnancy and the development of fetus and childhood; inadequate availability of thyroid hormones during pregnancy is associated with adverse pregnancy outcomes. Isolated maternal hypothyroxinemia (IMH) is defined as a low maternal T4 in the absence of TSH elevation. This systematic review aimed to investigate the association between IMH and adverse pregnancy outcomes. PubMed, Scopus and Web of science were searched for retrieving observational studies published up to September 2020, investigating the association of IMH with adverse pregnancy outcomes. From a total of 308 articles, 17 met our eligibility criteria and were used for the purpose of the present study. Definition of IMH varied in different studies. While some studies reported no adverse pregnancy outcomes for IMH, other studies found a positive association between first trimester IMH and feto-maternal outcomes including gestational hypertension, gestational diabetes, preterm delivery, fetal distress, small for gestational age, musculoskeletal malformations, spontaneous abortion, placental abruption and macrosomia. IMH, identified in the second trimester was associated with an increase in the risk of gestational diabetes, and hypertensive disorders of pregnancy in one study. There is no consensus on the adverse effects of IMH on pregnancy outcomes. Further comprehensive cohort studies using one standard definition for IMH, with large sample size and control of important confounders such as iodine status and maternal Thyroid peroxidase antibody (TPOAb) are needed for precise assessment of this association.
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Affiliation(s)
- Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sima Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Midwifery, Varamin - Pishva Branch, Islamic Azad University, Tehran, Iran.
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Dell'Aquila C, Neal AL, Shewry PR. Development of a reproducible method of analysis of iron, zinc and phosphorus in vegetables digests by SEC-ICP-MS. Food Chem 2019; 308:125652. [PMID: 31669949 DOI: 10.1016/j.foodchem.2019.125652] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/10/2019] [Accepted: 10/05/2019] [Indexed: 01/25/2023]
Abstract
Vegetables contain iron, zinc and phosphorus as complexes with phytates limiting their availability from a vegetarian diet, meaning non-haem iron deficiency anaemia and zinc deficiency immune malfunction are a risk. Although these elements have been analysed previously in biological fluids and cereal using LC-ICP-MS, there is no method suitable for analysing iron, zinc and phosphorus simultaneously in vegetables because of their complex matrix. In this study, we analysed iron, zinc and phosphorus in cabbage, broccoli, pepper, spinach, kale and rocket after a simulated gastrointestinal digestion using a newly optimised SEC-ICP-MS method. Ammonium nitrate, as the mobile phase, and a suitable rinsing regime, allowed good reproducibility and maintenance of the equipment. The method showed good reproducibility and can be easily adapted to other vegetables, as required.
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Affiliation(s)
| | - Andrew L Neal
- Rothamsted Research, West Common, Harpenden, Hertfordshire AL5 2JQ, UK
| | - Peter R Shewry
- Rothamsted Research, West Common, Harpenden, Hertfordshire AL5 2JQ, UK
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The relationship between iron deficiency anemia and sexual function and satisfaction among reproductive-aged Iranian women. PLoS One 2018; 13:e0208485. [PMID: 30521614 PMCID: PMC6283628 DOI: 10.1371/journal.pone.0208485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 11/19/2018] [Indexed: 01/23/2023] Open
Abstract
Iron deficiency anemia (IDA) is a common micronutrient deficiency worldwide, and an important health problem especially in women of reproductive age. This study aimed to determine the relationship between IDA and sexual satisfaction and function among reproductive-aged Iranian women. In this study, 129 women (52 with IDA and 77 non-IDA) with age 18–45 in Mahshahr, Iran were recruited. Data was gathered by a demographic questionnaire, Female Sexual Function Index (FSFI) and Larson Sexual Satisfaction Questionnaire. Data were analyzed using an independent t-test, Mann-Whitney test, Chi-square, and correlation coefficient test. The results of this study showed that the means of hemoglobin (Hb), hematocrit (HCT), serum iron and ferritin were significantly lower in the IDA group than those in the non-IDA group (p<0.01). All dimensions of sexual function and satisfaction were significantly lower in women with IDA compared to the healthy women (p<0.001). Also, all blood indices for IDA had a significant relationship with all sexual function components and sexual satisfaction (p = 0.01) except for pain with Hb and ferritin. Health care providers should provide screening, education, and counseling about anemia and sexual function in reproductive age women.
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