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Liu J, Song R, Pan R, Yi W, Jin X, Song J, Cheng J, Zhang X, Su H. Extreme temperatures, PM 2.5 and trajectories of impaired thyroid hormone sensitivity: A longitudinal study of patients with schizophrenia. ENVIRONMENT INTERNATIONAL 2024; 191:108961. [PMID: 39173235 DOI: 10.1016/j.envint.2024.108961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 08/14/2024] [Accepted: 08/14/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND The climate change scenario has witnessed an increase in extreme temperature events (ETEs), including heat waves and cold spells, and a heightened occurrence of compounding with fine particulate matter (PM2.5). However, the impact of this phenomenon on the sensitivity to thyroid hormones (THs) in humans is unclear, especially in a group as specific as schizophrenia. METHODS A longitudinal study was constructed using longitudinal measurements of thyroid function in schizophrenia in the Anhui Mental Health Center. The latent growth mixture model was applied to assess the optimal trajectory of change in impaired THs sensitivity. We then used logistic regression to explore associations between heat waves, cold spells, and PM2.5 with impaired THs sensitivity trajectories in the total population and different gender and age subgroups. Furthermore, the effect of the frequency, intensity, and duration of ETEs in the above associations was explored, as well as an assessment of the interaction between ETEs and PM2.5. RESULTS Among 931 participants, we identified two classifications of trajectories of impaired THs sensitivity: "Low-stable" (n = 836, 89.80 %) and "Rise-slight down" (n = 95, 10.20 %). Logistic regression showed significant associations between each additional day of heat waves (≥3 days with temperature thresholds above the 95th percentile) and cold spells (≥3 days with temperature thresholds below the 5th percentile) and "Rise-slight down" trajectory, with odds ratios (95 % confidence intervals) of 1.06 (1.02, 1.10) and 1.19 (1.14, 1.24), respectively, and the strength of this association increased with the intensity and duration of ETEs. Subgroup analyses indicated that the association was more pronounced in males and the age group above 40 years. Furthermore, PM2.5 was found to interact with heat waves, with high concentrations exacerbating the effects of heat waves. CONCLUSIONS Our findings suggest that mitigating both ETEs and PM2.5 exposures may bring health co-benefits in preventing thyroid impairment in schizophrenia.
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Affiliation(s)
- Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China
| | - Xulai Zhang
- Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China.
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Center for Big Data and Population Health of IHM, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China; Anhui Mental Health Center (Affiliated Psychological Hospital of Anhui Medical University), Hefei, Anhui, China.
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Manocchio F, Bravo FI, Helfer G, Muguerza B. Cherries with Different Geographical Origins Regulate Neuroprotection in a Photoperiod-Dependent Manner in F344 Rats. Antioxidants (Basel) 2024; 13:72. [PMID: 38247496 PMCID: PMC10812723 DOI: 10.3390/antiox13010072] [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: 11/29/2023] [Revised: 12/24/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
The photoperiod is the main environmental cue that drives seasonal adaptive responses in reproduction, behavior, and metabolism in seasonal animals. Increasing evidence suggests that (poly)phenols contained in fruits can also modulate seasonal rhythms. (Poly)phenol-rich diets are associated with an improvement in cognitive function and neuroprotection due to their anti-inflammatory and antioxidative properties. However, it is unknown whether cherries affect neuroprotection in a photoperiod-dependent manner. To test this, F344 rats were exposed to L6 (6 h light/day), L12 (12 h light/day) and L18 (18 h light/day) photoperiods and fed a standard chow diet supplemented with either a control, lyophilized cherry 1 or cherry 2 with distinctive phenolic hallmarks. Physiological parameters (body weight, eating pattern index (EPI), testosterone, T4/T3) and hypothalamic key genes (Dio2, Dio3, Raldh1 and Ghrh) were strongly regulated by the photoperiod and/or fruit consumption. Importantly, we show for the first time that neurotrophs (Bdnf, Sod1 and Gpx1) in the hippocampus are also regulated by the photoperiod. Furthermore, the consumption of cherry 2, which was richer in total flavonols, but not cherry 1, which was richer in total anthocyanins and flavanols, enhanced neuroprotection in the hippocampus. Our results show that the seasonal consumption of cherry with a specific phenolic composition plays an important role in the hippocampal activation of neuroprotection in a photoperiod-dependent manner.
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Affiliation(s)
- Francesca Manocchio
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, C Marcel·lí Domingo s/n, 43007 Tarragona, Spain; (F.M.); (B.M.)
- Nutrigenomics Research Group, Institut d’Investigació Sanitària Pere Virgili, C/Marcel·lí Domingo s/n, 43007 Tarragona, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Francisca Isabel Bravo
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, C Marcel·lí Domingo s/n, 43007 Tarragona, Spain; (F.M.); (B.M.)
- Nutrigenomics Research Group, Institut d’Investigació Sanitària Pere Virgili, C/Marcel·lí Domingo s/n, 43007 Tarragona, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Universitat Rovira i Virgili, 43007 Tarragona, Spain
| | - Gisela Helfer
- School of Chemistry and Biosciences, University of Bradford, Richmond Road, Bradford BD7 1DP, UK
| | - Begoña Muguerza
- Nutrigenomics Research Group, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, C Marcel·lí Domingo s/n, 43007 Tarragona, Spain; (F.M.); (B.M.)
- Nutrigenomics Research Group, Institut d’Investigació Sanitària Pere Virgili, C/Marcel·lí Domingo s/n, 43007 Tarragona, Spain
- Center of Environmental, Food and Toxicological Technology (TecnATox), Universitat Rovira i Virgili, 43007 Tarragona, Spain
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Nikanorova AA, Barashkov NA, Pshennikova VG, Teryutin FM, Nakhodkin SS, Solovyev AV, Romanov GP, Burtseva TE, Fedorova SA. A Systematic Review and Meta-Analysis of Free Triiodothyronine (FT3) Levels in Humans Depending on Seasonal Air Temperature Changes: Is the Variation in FT3 Levels Related to Nonshivering Thermogenesis? Int J Mol Sci 2023; 24:14052. [PMID: 37762355 PMCID: PMC10531421 DOI: 10.3390/ijms241814052] [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: 08/22/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Thyroid hormones play a crucial role in regulating normal development, growth, and metabolic function. However, the controversy surrounding seasonal changes in free triiodothyronine (FT3) levels remains unresolved. Therefore, the aim of this study was to conduct a systematic review and meta-analysis of variations in FT3 levels in relation to seasonal air temperatures in the context of current knowledge about its role in nonshivering thermogenesis. Ten eligible articles with a total of 336,755 participants were included in the meta-analysis. The studies were categorized into two groups based on the air temperature: "Cold winter", where the winter temperature fell below 0 °C, and "Warm winter", where the winter temperature was above 0 °C. The analysis revealed that in cold regions, FT3 levels decreased in winter compared to summer (I2 = 57%, p < 0.001), whereas in warm regions, FT3 levels increased during winter (I2 = 28%, p < 0.001). These findings suggest that seasonal variations in FT3 levels are likely to be influenced by the winter temperature. Considering the important role of the FT3 in the nonshivering thermogenesis process, we assume that this observed pattern is probably related to the differences in use of thyroid hormones in the brown adipose tissue during adaptive thermogenesis, which may depend on intensity of cold exposure.
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Affiliation(s)
- Alena A. Nikanorova
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
| | - Nikolay A. Barashkov
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
| | - Vera G. Pshennikova
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
| | - Fedor M. Teryutin
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
| | - Sergey S. Nakhodkin
- M.K. Ammosov North-Eastern Federal University, Kulakovskogo 46, 677013 Yakutsk, Russia; (S.S.N.); (A.V.S.); (G.P.R.)
| | - Aisen V. Solovyev
- M.K. Ammosov North-Eastern Federal University, Kulakovskogo 46, 677013 Yakutsk, Russia; (S.S.N.); (A.V.S.); (G.P.R.)
| | - Georgii P. Romanov
- M.K. Ammosov North-Eastern Federal University, Kulakovskogo 46, 677013 Yakutsk, Russia; (S.S.N.); (A.V.S.); (G.P.R.)
| | - Tatiana E. Burtseva
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
- M.K. Ammosov North-Eastern Federal University, Kulakovskogo 46, 677013 Yakutsk, Russia; (S.S.N.); (A.V.S.); (G.P.R.)
| | - Sardana A. Fedorova
- Yakut Science Centre of Complex Medical Problems, Yaroslavskogo 6/3, 677000 Yakutsk, Russia; (A.A.N.); (V.G.P.); (F.M.T.); (T.E.B.); (S.A.F.)
- M.K. Ammosov North-Eastern Federal University, Kulakovskogo 46, 677013 Yakutsk, Russia; (S.S.N.); (A.V.S.); (G.P.R.)
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Muse VP, Aguayo-Orozco A, Balaganeshan SB, Brunak S. Population-wide analysis of hospital laboratory tests to assess seasonal variation and temporal reference interval modification. PATTERNS (NEW YORK, N.Y.) 2023; 4:100778. [PMID: 37602220 PMCID: PMC10435957 DOI: 10.1016/j.patter.2023.100778] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/24/2023] [Accepted: 05/26/2023] [Indexed: 08/22/2023]
Abstract
We identified mortality-, age-, and sex-associated differences in relation to reference intervals (RIs) for laboratory tests in population-wide data from nearly 2 million hospital patients in Denmark and comprising more than 300 million measurements. A low-parameter mathematical wave-based modification method was developed to adjust for dietary and environment influences during the year. The resulting mathematical fit allowed for improved association rates between re-classified abnormal laboratory tests, patient diagnoses, and mortality. The study highlights the need for seasonally modified RIs and presents an approach that has the potential to reduce over- and underdiagnosis, affecting both physician-patient interactions and electronic health record research as a whole.
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Affiliation(s)
- Victorine P. Muse
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Alejandro Aguayo-Orozco
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Sedrah B. Balaganeshan
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Søren Brunak
- Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2200 Copenhagen, Denmark
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5
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Fröhlich E, Wahl R. Pars Distalis and Pars Tuberalis Thyroid-Stimulating Hormones and Their Roles in Macro-Thyroid-Stimulating Hormone Formation. Int J Mol Sci 2023; 24:11699. [PMID: 37511458 PMCID: PMC10380753 DOI: 10.3390/ijms241411699] [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: 06/17/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Thyroid-stimulating hormone (TSH) and thyroid hormone levels are standard parameters in blood analysis. However, the immunoassays employed may lead to false-positive or false-negative results when the sample contains certain materials that interfere with the assay. Macro-TSH, a complex of TSH with immunoglobulin or albumin, may cause apparently increased TSH concentrations. TSH is produced in the pars tuberalis (PT) of the pituitary gland and by thyrotrophs of the pars distalis (PD). It was found that variable glycosylation can render the molecule more strongly bound to antibodies or albumin in the blood, leading to the hypothesis that macro-TSH consists mainly of PT-TSH. Although less known than PD-TSH, PT-TSH plays an important role in the central regulation of thyroid metabolism. The present review summarizes the physiological function of human PT-TSH and its role in macro-TSH formation. The prevalence of macro-hyperthyrotropinemia, the structure of PT-TSH and macro-TSH, problems in the measurement of TSH, and the action of PT-TSH in animals with seasonal breeding are discussed. Despite the absence of a specific function of macro-TSH in the organism, the identification of macro-TSH is important for avoiding unnecessary treatment based on a falsified readout of increased TSH concentrations as numerous individual case reports describe.
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Affiliation(s)
- Eleonore Fröhlich
- Center for Medical Research, Medical University of Graz, 8010 Graz, Austria
| | - Richard Wahl
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, 72076 Tübingen, Germany
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Croce L, Chytiris S, Coperchini F, Ferraro G, Minelli L, Navarra A, Magri F, Chiovato L, Trimboli P, Rotondi M. Unexplained Hyperthyrotropinemia: A Biochemical and Clinical Challenge. J Clin Med 2023; 12:jcm12082934. [PMID: 37109270 PMCID: PMC10146086 DOI: 10.3390/jcm12082934] [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: 02/22/2023] [Revised: 03/31/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND A raised serum TSH in the absence of a clear etiology, or "unexplained hyperthyrotropinemia" (UH), can be challenging for clinicians. The aim of the present study was to evaluate potential strategies aimed at a clinical and biochemical characterization of UH patients. METHODS We compared 36 patients with UH with a control group of 14 patients with chronic autoimmune thyroiditis (CAT) and subclinical hypothyroidism. The two groups were compared in terms of the following: (i) the rate of normalization of TSH after repeating with another assay; (ii) the rate of normalization of TSH over time with the same assay; (iii) the reduction in TSH after precipitation with polyethilenglycole (PEG); and (iv) free thyroxine (FT4) levels. RESULTS Similar TSH levels were observed in UH [5.65 (5.21-6.37)] and CAT [5.62 (5.17-8.50)] (p = 0.489). TSH measurement with another assay method showed a normal TSH value in 41.9% of UH vs. 46.1% of CAT patients (p = 0.797). After repeating the TSH measurement in time with the same assay method, an increased TSH value was confirmed in all cases, in both groups (0% in the UH group vs. 0% in the CAT group, p = 1.000). TSH recovery after PEG precipitation was similar in the two groups (% precipitable post-PEG: 68.75 ± 3.14 in UH vs. 68.67 ± 7.18 in CAT, p = 0.960). FT4 levels were similar in the two groups (FT4 1.02 ± 0.20 ng/dl in UH vs. 1.00 ± 0.20 ng/dl in CAT, p = 0.789). CONCLUSIONS The results do not support the concept that laboratory interferences are more frequent in UH patients, suggesting that patients with UH should be managed in the same way as patients with CAT until proven otherwise.
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Affiliation(s)
- Laura Croce
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Spyridon Chytiris
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Francesca Coperchini
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Giovanni Ferraro
- Laboratory Service, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Linda Minelli
- Unit of Internal Medicine, Medical-Oncologic Department, ASST Lodi, 26900 Lodi, Italy
| | - Antonella Navarra
- Laboratory Service, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Flavia Magri
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Luca Chiovato
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
| | - Pierpaolo Trimboli
- Clinic for Endocrinology and Diabetology, Lugano Regional Hospital, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
| | - Mario Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy
- Unit of Endocrinology, Laboratory for Endocrine Disruptors, Istituti Clinici Scientifici Maugeri IRCCS, 27100 Pavia, Italy
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Yamada S, Horiguchi K, Akuzawa M, Sakamaki K, Shimomura Y, Kobayashi I, Andou Y, Yamada M. Seasonal variation in thyroid function in over 7,000 healthy subjects in an iodine-sufficient area and literature review. J Endocr Soc 2022; 6:bvac054. [PMID: 35528829 PMCID: PMC9070835 DOI: 10.1210/jendso/bvac054] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Indexed: 12/05/2022] Open
Abstract
Context Seasonal variation in thyroid function, especially serum free triiodothyronine (FT3) and free thyroxine (FT4) levels, in healthy subjects remains unclear. Methods We examined thyroid function, including serum FT3 and FT4 levels, in healthy Japanese subjects using data of more than 7,000 health check-up participants and applied the analysis of means with transformed ranks (ANOMTR) to compare each month. In addition, we reviewed reports published in the last 2 decades. Results The median serum thyrotropin (TSH) level was the highest in January (1.61 mIU/L), and the lowest in May (1.16 mIU/L). ANOMTR revealed that serum TSH levels are high in winter and low in summer. Conversely, the median serum FT3 level was higher in July than in other months, and the ANOMTR plot demonstrated serum FT3 levels to be significantly higher in summer and lower in winter. In contrast, serum FT4 levels were more consistent throughout the year, but statistically, those in February and March, October, and November were higher than those in other months. ANOMTR revealed variations in serum FT4 levels to be small through the year but biphasic. Conclusions Taken together with previous reports, our study demonstrated seasonal changes in the serum TSH levels to be high in winter in the northern hemisphere; however, the serum FT3 differed among countries, and those of Japanese, an iodine-sufficient country, were high in summer. In contrast, FT4 levels were more consistent. These changes should be taken into account to precisely evaluate thyroid function.
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Affiliation(s)
- Sayaka Yamada
- Gunma University Graduate School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Maebashi, Gunma, Japan
| | - Kazuhiko Horiguchi
- Gunma University Graduate School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Maebashi, Gunma, Japan
| | | | | | | | | | | | - Masanobu Yamada
- Gunma University Graduate School of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Maebashi, Gunma, Japan
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Beltran-Frutos E, Casarini L, Santi D, Brigante G. Seasonal reproduction and gonadal function: A focus on humans starting from animal studies. Biol Reprod 2021; 106:47-57. [PMID: 34718419 DOI: 10.1093/biolre/ioab199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Photoperiod impacts reproduction in many species of mammals. Mating occurs at specific seasons to achieve reproductive advantages, such as optimization of offspring survival. Light is the main regulator of these changes during the photoperiod. Seasonally breeding mammals detect and transduce light signals through extraocular photoreceptor, regulating downstream melatonin-dependent peripheral circadian events. In rodents, hormonal reduction and gonadal atrophy occur quickly, and consensually with short-day periods. It remains unclear whether photoperiod influences human reproduction. Seasonal fluctuations of sex hormones have been described in humans, although they seem to not imply adaptative seasonal pattern in human gonads. This review discusses current knowledge about seasonal changes in the gonadal function of vertebrates, including humans. The photoperiod-dependent regulation of hypothalamic-pituitary-gonadal axis, as well as morphological and functional changes of the gonads are evaluated herein. Endocrine and morphological variations of reproductive functions, in response to photoperiod, are of interest as they may reflect the nature of past population selection for adaptative mechanisms that occurred during evolution.
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Affiliation(s)
- Ester Beltran-Frutos
- Department of Cell Biology and Histology, Aging Institute, IMIB-Arrixaca. School of Medicine, Regional Campus of International Excellence "Campus Mare Nostrum", University of Murcia, 30100 Murcia. Spain
| | - Livio Casarini
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Center for Genomic Research, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Giulia Brigante
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.,Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
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The effect of season of birth on brain epigenome-wide DNA methylation of older adults. J Dev Orig Health Dis 2021; 13:367-377. [PMID: 34308828 DOI: 10.1017/s2040174421000453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Perinatal light exposure predisposes towards health and behaviour in adulthood. Season of birth is associated with psychiatric, allergic, cardiovascular and metabolic problems. It has been proposed that early-life environmental light disrupts the development of biological rhythms which, in turn, influence later-life health. However, the mechanisms linking perinatal seasonal light to later-life biological rhythm and health in humans are unknown. In this study, we investigated the association between season of birth and epigenome-wide DNA methylation of two postmortem human brain regions (16 hypothalamus, 14 temporal cortex). We did not find statistically significant differences at the whole epigenome level, either because we lacked statistical power or that no association exists. However, when we examined 24 CpG sites that had the highest significance or differential methylation, we identified regions which may be associated with circadian rhythm entrainment, cholinergic neurotransmission and neural development. Amongst methylation of the core clock genes, we identified that hypothalamus Neuronal PAS Domain Protein 2 (NPAS2) gene has hypermethylated regions in long photoperiod-born individuals. In addition, we found nominal associations between season of birth and genes linked to chronotype and narcolepsy. Season of birth-related brain DNA methylation profile was different than a previously reported blood methylation profile, suggesting a tissue-specific mechanism of perinatal light programming. Overall, we are the first to analyse the relationship between season of birth and human brain DNA methylation. Further studies with larger sample sizes are required to confirm an imprinting effect of perinatal light on the circadian clock.
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Abstract
We provide a dataset of millions of hormone tests from medical records that shows seasonality with a winter−spring peak in hormones for reproduction, growth, metabolism, and stress adaptation. Together with a long history of studies on a winter−spring peak in human function and growth, the hormone seasonality indicates that, like other animals, humans may have a physiological peak season for basic biological functions. We further use the specific seasonal phases of the hormones to suggest a model for a circannual clock in humans and animals that can keep track of the seasons, similar in spirit to the circadian clock that keeps track of time of day. Hormones control the major biological functions of stress response, growth, metabolism, and reproduction. In animals, these hormones show pronounced seasonality, with different set-points for different seasons. In humans, the seasonality of these hormones remains unclear, due to a lack of datasets large enough to discern common patterns and cover all hormones. Here, we analyze an Israeli health record on 46 million person-years, including millions of hormone blood tests. We find clear seasonal patterns: The effector hormones peak in winter−spring, whereas most of their upstream regulating pituitary hormones peak only months later, in summer. This delay of months is unexpected because known delays in the hormone circuits last hours. We explain the precise delays and amplitudes by proposing and testing a mechanism for the circannual clock: The gland masses grow with a timescale of months due to trophic effects of the hormones, generating a feedback circuit with a natural frequency of about a year that can entrain to the seasons. Thus, humans may show coordinated seasonal set-points with a winter−spring peak in the growth, stress, metabolism, and reproduction axes.
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11
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Zeng Y, He H, Wang X, Zhang M, An Z. Climate and air pollution exposure are associated with thyroid function parameters: a retrospective cross-sectional study. J Endocrinol Invest 2021; 44:1515-1523. [PMID: 33159683 DOI: 10.1007/s40618-020-01461-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/26/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES There are still controversies about the impact of climatic and environmental factors on thyroid function parameters in healthy populations. We investigated the relationships between climate, air pollution exposure, and thyroid function fluctuations. METHODS We retrospectively reviewed 327,913 individuals attending routine health checks from December 2013 to December 2018. We analyzed the associations between thyroid function and climatic factors using Spearman's correlation analysis. We explored the relationships between thyroid function and air pollution exposure using multiple linear regression analysis, after adjusting for age, sex, season, and outdoor temperature. We also performed subgroup analyses by age and sex and sensitivity analyses of different anti-thyroid peroxidase antibody status. RESULTS Thyroid-stimulating hormone (TSH) and free triiodothyronine (FT3) were negatively associated with outdoor temperature (r = - 0.66, P < 0.001; r = - 0.55, P < 0.001), while free thyroxine (FT4) and FT4/FT3 were positively associated with temperature (r = 0.35, P < 0.001; r = 0.79, P < 0.001). An increase of 10 μg/m3 in fine particulate matter ≤ 2.5 μm (PM2.5) was associated with a decrease of 0.12 pmol/L in FT4 and an increase of 0.07 pmol/L in FT3 (both P < 0.01). FT4/FT3 was significantly negatively associated with PM2.5 (coefficient: - 0.06, P < 0.01). These results remained robust in hierarchical analyses and sensitivity analyses. CONCLUSIONS Thyroid function parameters are associated with climate and air pollution exposure. These factors may influence variations in thyroid function. Our results also highlight the importance of public health interventions to reduce air pollution.
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Affiliation(s)
- Y Zeng
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China
| | - H He
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China
| | - X Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China
| | - M Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China.
| | - Z An
- Department of Endocrine and Metabolism, West China Hospital, Sichuan University, No. 37, Guoxue Lane, Chengdu, China.
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12
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Spaggiari G, Setti M, Tagliavini S, Roli L, De Santis MC, Trenti T, Rochira V, Santi D. The hypothalamic-pituitary-adrenal and -thyroid axes activation lasting one year after an earthquake swarm: results from a big data analysis. J Endocrinol Invest 2021; 44:1501-1513. [PMID: 33123965 DOI: 10.1007/s40618-020-01457-5] [Citation(s) in RCA: 3] [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: 07/29/2020] [Accepted: 10/20/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To cope physical and/or psychological threats, the human body activates multiple processes, mediated by a close interconnection among brain, endocrine and inflammatory systems. The aim of the study was to assess the hypothalamic-pituitary-adrenal (HPA) and hypothalamic-pituitary-thyroid (HPT) axes involvement after an acute stressful event (Emilia Romagna earthquake swarm) with a big data approach. METHODS A retrospective, observational trial was performed, collecting all biochemical examinations regarding HPA and HPT axes performed in the same laboratory the year before and the year after the earthquake swarm (20-29 May 2012). RESULTS Comparing 2576 pre-earthquake to 3021 post-earthquake measurements, a cortisol serum level increase was observed (p < 0.001). Similar increase was evident for urinary free cortisol (p = 0.016), but not for adrenocorticotropic hormone (p = 0.222). The biochemical hypercortisolism incidence increased from 7.6 to 10.3% after earthquakes (p = 0.001). Comparing 68,456 pre-earthquake to 116,521 post-earthquake measurements, a reduction in thyroid-stimulating hormone (TSH) levels was evident (p = 0.018), together with an increase in free triiodothyronine and free thyroxine levels (p < 0.001 and p < 0.001). Moreover, a significant increase in altered TSH after earthquakes was registered considering the epicenter-nearest measurements (p < 0.001). No clinically relevant alterations were observed considering thyroid-specific autoantibodies. CONCLUSION A long-term HPA axis activation in the inhabitants of the earthquake-affected areas was highlighted for the first time. Moreover, an increased incidence of biochemical hypercortisolism emerged after earthquakes. We confirmed a recruitment of HPT axis after stressful events, together with increased incidence of altered TSH in the. Our big data study allowed to increase knowledge about the connection between external stressors and endocrine regulation.
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Affiliation(s)
- G Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - M Setti
- Service of Clinical Engineering, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - S Tagliavini
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - L Roli
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - M C De Santis
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - T Trenti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
| | - V Rochira
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy.
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, via Campi 287, 41125, Modena, Italy.
| | - D Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, via Giardini 1355, 41126, Modena, Italy
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, via Campi 287, 41125, Modena, Italy
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13
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La Marca A, Spaggiari G, Domenici D, Grassi R, Casonati A, Baraldi E, Trenti T, Simoni M, Santi D. Elevated levels of nitrous dioxide are associated with lower AMH levels: a real-world analysis. Hum Reprod 2021; 35:2589-2597. [PMID: 32951044 DOI: 10.1093/humrep/deaa214] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/17/2020] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION Are there any associations between environmental pollutants and ovarian reserve, expressed by anti-Mullerian hormone (AMH) serum levels? SUMMARY ANSWER In this first real-world approach to demonstrate the relationship between air pollutants and serum AMH levels, adverse associations were observed for nitrogen dioxide (NO2) but not with particulate matter. WHAT IS KNOWN ALREADY In recent years, air pollution has emerged as a potential disrupter to the homeostasis of physiological hormones, possibly affecting human reproduction. Although the influence of age and smoking on AMH levels is largely accepted, the relationship between AMH and the environment has not currently been established. STUDY DESIGN, SIZE, DURATION A longitudinal, observational, retrospective, real-world study was carried out, including all AMH measurements performed in a single laboratory from January 2007 to October 2017. PARTICIPANTS/MATERIALS, SETTING, METHODS Serum AMH data were connected to patients' age and residential address, to include air pollution data after geo-localisation. The air pollution considered daily particulate matter (PM) and NO2 values. MAIN RESULTS AND THE ROLE OF CHANCE A total of 1463 AMH measurements were collected (mean 1.94 ng/ml, median 0.90 ng/ml). AMH was inversely related to patients' age in women older than 25 years (adjusted R-squared 0.120, P < 0.001), but not in those younger than 25 years (adjusted R-squared 0.068, P = 0.055). AMH levels were inversely related to environmental pollutants, such as PM10 (Rho = -0.088, P = 0.001), PM2.5 (Rho = -0.062, P = 0.021) and NO2 (Rho = -0.111, P < 0.001). After subdividing the dataset into quartiles for PM10 and PM2.5, the influence of age on AMH serum levels was found to be a stronger influence than that exerted by PM (P = 0.833 and P = 0.370, respectively). On the contrary, considering NO2 quartiles, higher AMH levels were observed in third quartile compared to fourth quartile, even after adjustment for age (P = 0.028), indicating a stronger influence of NO2 exposure on AMH serum levels. Considering an AMH cut-off of 0.3 ng/ml, a significant higher frequency of women with severe ovarian reserve reduction in the fourth quartile was shown only for NO2 (P = 0.010). LIMITATIONS, REASONS FOR CAUTION Several limitations should be underlined, such as the lack of information about work and life habits of each patient and the retrospective nature of the analysis performed on real-world data. WIDER IMPLICATIONS OF THE FINDINGS Although the genetic component is highly predictive for defining the ovarian reserve at birth, potentially modifiable environmental factors could influence the rate of decline in AMH and ovarian reserve during adulthood. STUDY FUNDINGCOMPETING INTEREST(S) Authors have neither funding nor competing interests to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Antonio La Marca
- Mother-Infant Department, University of Modena and Reggio Emilia, Modena, Italy
| | - Giorgia Spaggiari
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy
| | - Daniela Domenici
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Enrica Baraldi
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Anatomy Pathology, Azienda USL of Modena, Modena, Italy
| | - Manuela Simoni
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Daniele Santi
- Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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14
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A prospective, observational clinical trial on the impact of COVID-19-related national lockdown on thyroid hormone in young males. Sci Rep 2021; 11:7075. [PMID: 33782499 PMCID: PMC8007755 DOI: 10.1038/s41598-021-86670-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 03/17/2021] [Indexed: 11/08/2022] Open
Abstract
Trying to manage the dramatic coronavirus disease 2019 (COVID-19) infection spread, many countries imposed national lockdown, radically changing the routinely life of humans worldwide. We hypothesized that both the pandemic per se and the consequent socio-psychological sequelae could constitute stressors for Italian population, potentially affecting the endocrine system. This study was designed to describe the effect of lockdown-related stress on the hypothalamic-pituitary-thyroid (HPT) axis in a cohort of young men. A prospective, observational clinical trial was carried out, including patients attending the male infertility outpatient clinic before and after the national lockdown for COVID-19 pandemic. The study provided a baseline visit performed before and a follow-up visit after the lockdown in 2020. During the follow-up visit, hormonal measurements, lifestyle habits and work management were recorded. Thirty-one male subjects were enrolled (mean age: 31.6 ± 6.0 years). TSH significantly decreased after lockdown (p = 0.015), whereas no significant changes were observed in the testosterone, luteinising hormone, follicle-stimulating hormone, estradiol and prolactin serum levels. No patient showed TSH serum levels above or below reference ranges, neither before nor after lockdown. Interestingly, TSH variation after lockdown was dependent on the working habit change during lockdown (p = 0.042). We described for the first time a TSH reduction after a stressful event in a prospective way, evaluating the HPT axis in the same population, before and after the national lockdown. This result reinforces the possible interconnection between psychological consequences of a stressful event and the endocrine regulation.
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15
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Kuzmenko NV, Tsyrlin VA, Pliss MG, Galagudza MM. Seasonal variations in levels of human thyroid-stimulating hormone and thyroid hormones: a meta-analysis. Chronobiol Int 2021; 38:301-317. [PMID: 33535823 DOI: 10.1080/07420528.2020.1865394] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Seasonal dynamics in biological functions of mammals is regulated by melatonin-mediated circannual fluctuations in the secretion of thyroid-stimulating hormone (TSH) and thyroid hormones. Most anatomical and molecular structures responsive to photoperiod and melatonin secretion changes and the associated receptors are preserved in modern humans. This work aimed to determine the seasonal dynamics of TSH and thyroid hormone levels (total triiodothyronine (T3), free triiodothyronine (FT3), thyroxine (T4), free thyroxine (FT4) and to investigate the dependence of these variations on gender, age and amplitude of meteorological fluctuations. A meta-analysis of 13 panel and 7 cross-sectional studies was performed using Review Manager 5.3 (Cochrane Library). We found that circulating TSH levels were higher in winter than in other seasons, and FT4 levels were higher in autumn than in winter. T4 level had no pronounced seasonal dynamics. The level of circulating T3 was significantly higher in winter than in summer and FT3 levels were lower in summer than in autumn and spring. In addition, analysis of TSH seasonal dynamics (winter vs summer) accounting for gender differences showed pronounced increases in TSH levels during winter in women, but not in men; and also significant increases in FT4 levels during summer in men, but not in women. Seasonal dynamics of FT3 and T4 did not depend on gender. Seasonal dynamics of TSH did not change with respect to age. We also found that the extent of the seasonal dynamics of TSH is influenced by the extent of the annual dynamics of the partial density of oxygen in the air, as well as the magnitude of the annual dynamic of meteorological factors that determine it (atmospheric pressure and relative humidity).
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Affiliation(s)
- N V Kuzmenko
- Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre, St. Petersburg, Russia.,Laboratory of Byophysics of Blood Circulation, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - V A Tsyrlin
- Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre, St. Petersburg, Russia
| | - M G Pliss
- Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre, St. Petersburg, Russia.,Laboratory of Byophysics of Blood Circulation, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - M M Galagudza
- Department for Experimental Physiology and Pharmacology, Almazov National Medical Research Centre, St. Petersburg, Russia
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16
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van der Spoel E, Roelfsema F, van Heemst D. Within-Person Variation in Serum Thyrotropin Concentrations: Main Sources, Potential Underlying Biological Mechanisms, and Clinical Implications. Front Endocrinol (Lausanne) 2021; 12:619568. [PMID: 33716972 PMCID: PMC7945716 DOI: 10.3389/fendo.2021.619568] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/08/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Individuals exhibit fluctuations in the concentration of serum thyroid-stimulating hormone (TSH) over time. The scale of these variations ranges from minutes to hours, and from months to years. The main factors contributing to the observed within-person fluctuations in serum TSH comprise pulsatile secretion, circadian rhythm, seasonality, and ageing. In clinical practice and clinical research however, such within-person biological variation in serum TSH concentrations is often not considered. The aim of this review is to present an overview of the main sources of within-person variation in TSH levels, as well as the potential underlying biological mechanisms, and the clinical implications. SUMMARY In euthyroid individuals, the circadian rhythm, with a nocturnal surge around 02:00-04:00 h and a nadir during daytime has the greatest impact on variations in serum TSH concentrations. Another source of within-person variation in TSH levels is seasonality, with generally higher levels during the cold winter months. Since TSH is secreted in a pulsatile manner, TSH levels also fluctuate over minutes. Furthermore, elevated TSH levels have been observed with ageing. Other factors that affect TSH levels include thyroid peroxidase (TPO)-antibody positivity, BMI, obesity, smoking, critical illness, and many xenobiotics, including environmental pollutants and drugs. Potential underlying biological mechanisms of within-person variation in TSH levels can be safely concluded from the ability of TSH to respond quickly to changes in cues from the internal or external environment in order to maintain homeostasis. Such cues include the biological clock, environmental temperature, and length of day. The observed increase in TSH level with ageing can be explained at a population level and at an organism level. In clinical practice, the season for thyroid testing can influence a patient's test result and it occurs frequently that subclinical hypothyroid patients normalize to euthyroid levels over time without intervention. CONCLUSIONS Serum TSH concentrations vary over time within an individual, which is caused by multiple different internal and external factors. It is important to take the within-person variations in serum TSH concentrations into account when testing a patient in clinical practice, but also in performing clinical research.
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Affiliation(s)
- Evie van der Spoel
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
- *Correspondence: Evie van der Spoel,
| | - Ferdinand Roelfsema
- Section Endocrinology, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
| | - Diana van Heemst
- Section Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Leiden, Netherlands
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17
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Fu J, Zhang G, Xu P, Guo R, Li J, Guan H, Li Y. Seasonal Changes of Thyroid Function Parameters in Women of Reproductive Age Between 2012 and 2018: A Retrospective, Observational, Single-Center Study. Front Endocrinol (Lausanne) 2021; 12:719225. [PMID: 34539571 PMCID: PMC8443767 DOI: 10.3389/fendo.2021.719225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/13/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Thyroid function can be influenced by external stimuli such as light and temperature. However, it is currently unknown whether there is seasonal variation of thyroid function in women of reproductive age. Adequate thyroid function in reproductive-aged women is necessary for optimal fetal-maternal outcomes. Therefore, this study aims to evaluate the seasonal changes in levels of thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4), and TSH index (TSHI) in women of reproductive age. METHODS A large retrospective study was conducted that included women aged 20-49 years who visited our outpatient or checkup center between 2012 and 2018. Thyroid function was measured using the automated immunochemiluminescent assay kit. Subjects with overt thyroid dysfunction, pregnancy, thyroid disease, cancer, and severe infectious or psychological disease were excluded. Seasonal differences of thyroid function were analyzed using the Kruskal-Wallis test or the analysis of means with transformed ranks. Spearman's correlation was performed to evaluate the association between thyroid function parameters and age. A subset of 181 subjects was included in the longitudinal analyses. Differences in thyroid function between summer and winter were analyzed using the Wilcoxon signed-rank test. RESULTS A total of 48,990 women with a median age of 39 years were included. The prevalence of subclinical hypothyroidism was lower in summer but higher in winter (5.6% vs. 7.0%, p < 0.05). The TSH, FT3, and FT4 levels and TSHI reached a peak in winter, while they declined to trough in summer. The TSH concentrations (r = 0.044, p < 0.001) and TSHI (r = 0.025, p < 0.001) were positively correlated with age, whereas FT3 (r = -0.073, p < 0.001) and FT4 (r = -0.059, p < 0.001) were negatively correlated with age. The associations of thyroid parameters with age were similar between subjects with positive thyroid peroxidase antibody (TPOAb) and those with negative TPOAb. In the matched longitudinal analysis of 181 subjects, no differences were detected in the thyroid parameters between summer and winter. CONCLUSIONS This retrospective single-center study showed that thyroid hormone levels and central sensitivity to thyroid hormones are influenced by age and seasonal fluctuations among women of reproductive age, while their impact on reproductive health remains to be elucidated in future studies.
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Affiliation(s)
- Jinrong Fu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Endocrinology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guofeng Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Pei Xu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Rui Guo
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jiarong Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haixia Guan
- Department of Endocrinology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- *Correspondence: Haixia Guan, ; Yushu Li,
| | - Yushu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Haixia Guan, ; Yushu Li,
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18
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Wang D, Yu S, Zou Y, Li H, Cheng X, Qiu L, Xu T. Data mining: Seasonal fluctuations and associations between thyroid stimulating hormone and lipid profiles. Clin Chim Acta 2020; 506:122-128. [PMID: 32165124 DOI: 10.1016/j.cca.2020.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 02/22/2020] [Accepted: 03/06/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Thyroid stimulating hormone (TSH) is associated with lipid metabolism. In this study, we aimed to evaluate seasonal variations and the association between TSH and lipid profiles based on clinical big data. METHOD This observational, retrospective big data study enrolled a total of 20,192 individuals who visited Peking Union Medical College Hospital for routine health check-ups from 2014 to 2018. Demographic, medical history, common biochemical analytes, and thyroid related test data were obtained. A Kruskal-wallis analysis was used to compare the differences in total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) by TSH quartiles. Spearman correlation analysis was used to evaluate the association between TSH and lipid profiles as well as temperature. RESULTS TC and LDL did not vary significantly with TSH concentration; however, TG and HDL-C did. TSH concentration showed weak positive correlation with serum TC, TG, and HDL-C but not with LDL-C. Serum TC concentration was positively correlated with TG and LDL-C. TG was positively correlated with LDL-C but negatively correlated with HDL-C. HDL-C was negatively correlated with LDL-C. TSH and lipid profiles showed seasonal fluctuations. Monthly median TSH, TC, and LDL-C peaked in winter and dropped to a minimum in summer. The correlation coefficient (r) between the average monthly temperature and TSH, TC, TG, HDL-C, and LDL-C was -0.424 (p = 0.001), -0.539 (p < 0.001), -0.020 (p = 0.880), -0.199 (p = 0.127), and -0.442 (p < 0.001), respectively. CONCLUSION Seasonal variation was observed in both TSH and lipids. Apart from the seasonal variation of TC and LDL-C, our results also have clinical interpretation. It suggested that it may not reflect the real status of lipids during and immediately after the Spring festival. Thus, in order to diagnosis of hypercholesterolemia, re-testing was needed later to provide the precision diagnostic, monitoring and treatment.
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Affiliation(s)
- Danchen Wang
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Songlin Yu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Yutong Zou
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Honglei Li
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Xinqi Cheng
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China
| | - Ling Qiu
- Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
| | - Tengda Xu
- Department of Health Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, China.
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19
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Castellana M, Castellana C, Giovanella L, Trimboli P. Prevalence of gastrointestinal disorders having an impact on tablet levothyroxine absorption: should this formulation still be considered as the first-line therapy? Endocrine 2020; 67:281-290. [PMID: 31953721 DOI: 10.1007/s12020-019-02185-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 12/31/2019] [Indexed: 02/06/2023]
Abstract
PURPOSE In patients with hypothyroidism, levothyroxine (LT4) is the treatment of choice, and tablets are the most commonly prescribed formulation. Despite multiple scenarios being reported in the literature with impaired tablet absorption and likely missed TSH targets, it is yet unclear what the implications are for clinical practice and the role of liquid solution (LS) and soft gel (SG) formulations. We have thus conducted a narrative review evaluating the prevalence within the general population of gastrointestinal disorders impacting tablet LT4 absorption. METHODS PubMed and Google Scholar were searched until December 2019 for systematic reviews and meta-analyses on the topic. If they could not be retrieved, other types of manuscripts were searched. RESULTS Lactose malabsorption and Helicobacter pylori infection represented the most common disorders, with a global prevalence of 68% and 48%, respectively. The prevalence of other conditions, including autoimmune gastritis, bariatric surgery, celiac disease, gastroparesis, giardiasis, liver cirrhosis, or ulcerative colitis, was lower than 20%. Data at regional and country levels were found to be heterogeneous, but at least one in five patients was diagnosed with one disorder. CONCLUSIONS The worldwide prevalence of gastrointestinal disorders associated with tablet LT4 malabsorption, including lactose malabsorption and Helicobacter pylori infection, is high. Interactions with drugs or food can further increase this risk. Considering that all studies investigating the impact of switching patients from tablet to LS or SG found an improved thyroid balance, the latter formulations should be considered as first-line therapy for managing hypothyroidism.
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Affiliation(s)
- Marco Castellana
- National Institute of Gastroenterology "S. De Bellis", Castellana Grotte, Bari, Italy
| | | | - Luca Giovanella
- Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - Pierpaolo Trimboli
- Clinic for Nuclear Medicine and Competence Center for Thyroid Diseases, Imaging Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
- Scienze Biomediche, Università della Svizzera Italiana (USI), Lugano, Switzerland.
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