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Menotti S, Mura C, Raia S, Bergianti L, De Carolis S, Romeo DM, Rota CA, Pontecorvi A. Overt hypothyroidism in pregnancy and language development in offspring: is there an association? J Endocrinol Invest 2024:10.1007/s40618-024-02317-2. [PMID: 38498228 DOI: 10.1007/s40618-024-02317-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/17/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Overt hypothyroidism during pregnancy is linked to various obstetric complications, such as premature birth and fetal death. While some studies have shown that maternal hypothyroidism can impact a child's Intelligence Quotient (IQ) and language development, findings are controversial. The aim of this study was to explore the connection between treated maternal hypothyroidism during pregnancy and offspring neurodevelopment, focusing on learning and language and examining related maternal obstetric complications. METHODS Group 1 included 31 hypothyroid women with elevated thyroid stimulating hormone (TSH) (> 10 mU/L, > 10 µIU/mL) during pregnancy, and Group 2 had 21 euthyroid women with normal TSH levels (0.5-2.5 mU/L, 0.5-2.5 µIU/mL). Children underwent neuropsycological assessments using the Griffiths-II scale. RESULTS Pregnancy outcome showed an average gestational age at delivery of 38.2 weeks for hypothyroid women, compared to 40 weeks for controls, and average birth weight of 2855.6 g versus 3285 g for controls, with hypothyroid women having children with higher intrauterine growth restriction (IUGR) prevalence and more caesarean sections. The 1-min APGAR score was lower for the hypothyroid group's children, at 8.85 versus 9.52. Neuropsychological outcomes showed children of hypothyroid mothers scored lower in neurocognitive development, particularly in the learning and language subscale (subscale C), with a notable correlation between higher maternal TSH levels and lower subscale scores. CONCLUSION Fetuses born to hypothyroid mothers appeared to be at higher risk of IUGR and reduced APGAR score at birth. Neurocognitive development seemed to affect language performance more than the developmental quotient. This alteration appeared to correlate with the severity of hypothyroidism and its duration.
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Affiliation(s)
- S Menotti
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.
| | - C Mura
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - S Raia
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - L Bergianti
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - S De Carolis
- Department of Woman and Child Health, Woman Health Area Fondazione Policlinico Universitario A. Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - D M Romeo
- Pediatric Neurology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Largo A. Gemelli, 00168, Rome, Italy
- Pediatric Neurology Unit, Università Cattolica del Sacro Cuore, 00168, Rome, Italy
| | - C A Rota
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
| | - A Pontecorvi
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Endocrinology and Metabolism, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
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Korkmaz L, Alan C, Topal İ, Tayfur M, Bozkurt AS, Gürsul C, Baştuğ O. Can amniotic fluid protect developing fetal lungs against the harmful effects of oxidative stress? Turk J Med Sci 2023; 53:109-120. [PMID: 36945927 PMCID: PMC10387876 DOI: 10.55730/1300-0144.5564] [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: 04/23/2022] [Accepted: 09/18/2022] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Preterm births cause fetuses to be born without completing the development of their organs. Due to this undesirable situation, it is the pulmonary tissue which has to be most exposed to harmful effects of extrauterine environment. Early disappearance of the prophylactic and constructive effects of amniotic fluid (AF) on developing tissues, such as pulmonary tissue, facilitates the formation of pulmonary morbidities resulting from oxygen. Setting out from this knowledge, we wanted, in addition to assessing the beneficent effects of AF on pulmonary tissue, to study the importance of AF in morbidities of this tissue thought to originate from oxygen. METHODS In this experimental study, while the study group was made up of the fetuses of pregnant rats exposed to hyperbaric oxygen, (hyperoxic pregnant rat fetuses-HPRF), the control group was formed of the fetuses of the rats pregnant in the usual room setting (normoxic pregnant rat fetuses-NPRF). The pulmonary and hepatic tissues taken from the fetuses of these pregnant rats on the 21st day of their pregnancy were compared biochemically and histologically. For biochemical assessment, total glutathione (tGSH), catalase (CAT), malondialdehyde (MDA), tumor necrosis factor-alpha (TNF-α) values and for histopathological assessment, apoptosis, alveolar wall count (AWC), vena centralis count (VCC) were included. RESULTS Statistical significance was found in the pulmonary tissue values of tGSH on behalf of NPRF, and MDA on behalf of HPRF (p < 0.05). In liver tissue, statistical significance was detected in tGSH and CAT values in favor of NPRF and in MDA, and TNF-α values in favor of HPRF (p < 0.05). DISCUSSION : Our study has demonstrated that AF protects the pulmonary tissue from the harmful effects of oxygen in the intrauterine period. In addition, our data have suggested that the pulmonary tissue's being deprived of the useful effects of AF owing to premature birth may be an important trigger in the occurrence of the pulmonary morbidities thought to result from oxygen.
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Affiliation(s)
- Levent Korkmaz
- Division of Neonatology, Department of Pediatrics, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Cumali Alan
- Department of Pediatrics, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - İsmail Topal
- Department of Pediatrics, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Mahir Tayfur
- Department of Pathology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Ali Seydi Bozkurt
- Department of Urology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Cebrail Gürsul
- Department of Physiology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey
| | - Osman Baştuğ
- Division of Neonatology, Department of Pediatrics, Kayseri Training and Research Hospital, Kayseri, Turkey
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Cakina S, Pek E, Ozkavak O, Kocyigit D, Beyazıt F. The role of paraoxonase and myeloperoxidase as oxidative stress markers in pregnant women with hypothyroidism. Gynecol Endocrinol 2022; 38:840-843. [PMID: 35999709 DOI: 10.1080/09513590.2022.2114449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Objective: This study aims to measure paraoxonase 1 (PON 1) and myeloperoxidase (MPO) levels in patients diagnosed with hypothyroidism during pregnancy by spectrophotometric method and to compare the results with healthy controls. Methods: For the study, the blood samples of 45 hypothyroid pregnant patients and 45 healthy control pregnant individuals who were compatible with the patient group in terms of age were taken. PON 1 and MPO levels in both groups were measured using spectrophotometric methods and statistical analysis was performed. Results: Serum PON 1 activity levels were significantly lower in hypothyroid pregnant patients than in the control group (p=.020). The patients group had significantly higher serum MPO concentrations than in control group (p=.020). MPO/PON-1 ratio was higher in pregnant patients with hypothyroidism than in the control group (p=.030). Conclusion: Decreased levels of PON1 with increased levels of MPO in hypothyroid pregnant patients suggest the critical role of oxidative stress in hypothyroidism during pregnancy.
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Affiliation(s)
- Suat Cakina
- Canakkale 18 Mart University, Health Service Vocational College, Canakkale, Turkey
| | - Eren Pek
- Canakkale 18 Mart University, Faculty of Medicine, Department of Obstetrics and Gynecology, Canakkale, Turkey
| | - Onur Ozkavak
- Canakkale 18 Mart University, Faculty of Medicine, Department of Obstetrics and Gynecology, Canakkale, Turkey
| | - Deniz Kocyigit
- Canakkale 18 Mart University, Faculty of Medicine, Department of Obstetrics and Gynecology, Canakkale, Turkey
| | - Fatma Beyazıt
- Canakkale 18 Mart University, Faculty of Medicine, Department of Obstetrics and Gynecology, Canakkale, Turkey
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Li Y, Sun Y, Zhang X, Wang X, Yang P, Guan X, Wang Y, Zhou X, Hu P, Jiang T, Xu Z. Relationship between amniotic fluid metabolic profile with fetal gender, maternal age, and gestational week. BMC Pregnancy Childbirth 2021; 21:638. [PMID: 34537001 PMCID: PMC8449898 DOI: 10.1186/s12884-021-04116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 09/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amniotic fluid (AF) provides vital information on fetal development, which is also valuable in identifying fetal abnormalities during pregnancy. However, the relationship between the metabolic profile of AF in the second trimester of a normal pregnancy with several maternal-fetal parameters remains poorly understood, which therefore limits its application in clinical practice. The aim of this study was to explore the association between the metabolic profile of AF with fetal gender, maternal age, and gestational week using an untargeted metabolomics method. METHODS A total of 114 AF samples were analyzed in this study. Clinical data on fetal gender, maternal age, and gestational week of these samples were collected. Samples were analyzed by gas chromatography/time-of-flight-mass spectrometry (GC-TOF/MS). Principal component analysis(PCA), orthogonal partial least square discrimination analysis(OPLS-DA) or partial least square discrimination analysis (PLS-DA) were conducted to compare metabolic profiles, and differential metabolites were obtained by univariate analysis. RESULTS Both PCA and OPLS-DA demonstrated no significant separation trend between the metabolic profiles of male and female fetuses, and there were only 7 differential metabolites. When the association between the maternal age on AF metabolic profile was explored, both PCA and PLS-DA revealed that the maternal age in the range of 21 to 40 years had no significant effect on the metabolic profile of AF, and only four different metabolites were found. There was no significant difference in the metabolic profiles of AF from fetuses of 17-22 weeks, and 23 differential metabolites were found. CONCLUSIONS In the scope of our study, there was no significant correlation between the AF metabolic profile and the fetal gender, maternal age and gestational week of a small range. Nevertheless, few metabolites appeared differentially expressed.
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Affiliation(s)
- Yahong Li
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Yun Sun
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Xiaojuan Zhang
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Xin Wang
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Peiying Yang
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Xianwei Guan
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Yan Wang
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China
| | - Xiaoyan Zhou
- Department of Obstetrics, The Affiliated Huaian No, 1 People's Hospital of Nanjing Medical University, Huaian, Jiangsu, 223001, P. R. China
| | - Ping Hu
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China.
| | - Tao Jiang
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China.
| | - Zhengfeng Xu
- Center for Genetic Medicine, Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, P. R. China.
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Li J, Cheng J, Li Q. Combined use of thyroid stimulating hormone plus free thyroxine levels and gestational age at birth for the prediction of neonatal hypothyroidism and associated risk factors. Exp Ther Med 2020; 20:219. [PMID: 33193834 DOI: 10.3892/etm.2020.9349] [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: 09/10/2019] [Accepted: 06/10/2020] [Indexed: 11/06/2022] Open
Abstract
The present study aimed to explore the effectiveness of the combined use of thyroid-stimulating hormone (TSH) and free thyroxine [(FT4); TSH+FT4] levels and gestational age at birth to predict neonatal hypothyroidism and to identify the risk factors associated with the disease. The clinical data of 686 neonates with suspected hypothyroidism (TSH >10 mIU/l) who were admitted to The First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed. From these, 70 neonates with confirmed hypothyroidism were assigned to the patient group and another 70 neonates with normal thyroid function to the normal (control) group. Sex, gestational age at birth, Apgar score, birth weight, body length, head circumference and heart rate data were collected. TSH and FT4 levels were measured by electrochemiluminescence immunoassay, and the predictive value of combined use of TSH+FT4 and gestational age at birth on neonatal hypothyroidism was analyzed. The prespecified secondary outcomes were the risk factors for neonatal hypothyroidism determined using univariate and logistic regression analyses. TSH levels were significantly higher, whereas FT4 levels were lower in the patient group at 3 days of age compared with the control group (P<0.05). After 8-week treatment with thyroxine, these levels were not significantly different between the patient and control groups (P<0.05). The combined use of TSH+FT4 levels and gestational age at birth to predict neonatal hypothyroidism demonstrated a significantly improved sensitivity, specificity, accuracy, positive predictive value and negative predictive value (92.86, 97.26, 96.76, 81.25 and 99.07%, respectively) compared with the use of only TSH+FT4 levels (P<0.05). Logistic regression analysis revealed a low gestational age at birth, maternal thyroid dysfunction and low birth weight were risk factors for neonatal hypothyroidism (P<0.05). The combined use of TSH+FT4 levels and gestational age at birth resulted in an improved prediction of neonatal hypothyroidism and contributed to early therapeutic intervention. Thus, special intervention is necessary for pregnant women with thyroid dysfunction to reduce the incidence of neonatal hypothyroidism.
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Affiliation(s)
- Junqi Li
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Jing Cheng
- Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Qiuyue Li
- Department of Obstetrics, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P.R. China
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Al-Khaldi A, Sultan S. The expression of sirtuins, superoxide dismutase, and lipid peroxidation status in peripheral blood from patients with diabetes and hypothyroidism. BMC Endocr Disord 2019; 19:19. [PMID: 30736780 PMCID: PMC6368800 DOI: 10.1186/s12902-019-0350-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 02/04/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sirtuin 1 (SIRT1) and sirtuin 3 (SIRT3) proteins have an important role in counteracting oxidative stress. Although diabetes and hypothyroidism (HT) are both characterized by oxidative stress, the mechanisms are not fully understood. This study investigated the effects of type 1 diabetes (T1D), type 2 diabetes (T2D), and HT on the expression levels of SIRT1, SIRT3, and manganese superoxide dismutase (SOD2). METHODS Gene expression of SIRT1, SIRT3, and SOD2 was measured using real-time PCR. The protein expression of SOD2 and lipid peroxidation (thiobarbituric acid reactive substances) was measured by the TBARS Assay kit and enzyme-linked immunosorbent assay (ELISA) respectively. RESULTS The results showed that the SIRT1 and SIRT3 levels were lower in peripheral blood samples from patients with T1D, T2D, or HT than in healthy individuals. Interestingly, the mRNA and protein expression levels of SOD2 were higher in all three patient groups. Lipid peroxidation was higher in the patients with HT than in the healthy individuals. CONCLUSIONS These results indicate alterations in the expression levels of sirtuins and superoxide dismutase in diabetes and HT, which may be related, at least in part, to the oxidative stress. Identifying such alterations in those patients will pave the way towards the development of drugs to enhance SIRT1 and SIRT3 expression and their activity to prevent the damaging effect of oxidative stress.
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Affiliation(s)
- Abdullah Al-Khaldi
- Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Samar Sultan
- Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia.
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Rostami S, Fathollahpour A, Abdi M, Naderi K. Alteration in Prooxidant-antioxidant Balance Associated with Selenium Concentration in Patients with Congenital Hypothyroidism. J Med Biochem 2018; 37:355-363. [PMID: 30598633 PMCID: PMC6298467 DOI: 10.1515/jomb-2017-0052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 11/20/2017] [Indexed: 12/28/2022] Open
Abstract
Background There is a paucity of studies regarding oxidative balance and selenium (Se) status in congenital hypothyroidism. Recently, more attention has been given to the use of Se supplementation as a new treatment for thyroid disorders. Oxidative stress increases in different thyroid disorders and causes many pathological outcomes. The present study aimed to determine the serum prooxidant-anti - oxidant balance (PAB), Se, thyroid stimulating hormone (TSH) and free thyroxine (FT4) concentration in congenital hypothyroidism (CH) patients and the association of their probable change with hematological indices. Methods Blood samples were collected from 60 healthy and 39 CH subjects. Serum PAB values were measured and Se, TSH, FT4 and hematological indices were determined. Data were analyzed by SPSS version 16 and p value less than 0.05 was considered statistically significant. Results Serum TSH concentration was significantly higher in CH patients group compared to the controls (p value < 0.05); however, FT4 was in the same concentration in patients and controls. Platelet (Plt) and lymphocytes (Lym) counts markedly decreased in all patients and showed a significant direct correlation with serum TSH levels (rs = 0.307, p value = 0.004 and rs = 0.413, p value < 0.0001). Serum PAB and Se had no significant correlation with he - mato logical indices in the studied subjects. Conclusions Although there was no correlation between PAB and also Se with hematologic and biochemical markers in CH patients, changes in these two factors might be considered as a potential risk factor due to the other known effects of high PAB values and low Se concentrations.
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Affiliation(s)
- Shilan Rostami
- Department of Biology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
| | - Asadollah Fathollahpour
- Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad Abdi
- Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.,Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Kejal Naderi
- Food and drugs control laboratory, Vice-chancellery for food and drugs, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Novakovic TR, Dolicanin ZC, Djordjevic NZ. Effects of maternal subclinical hypothyroidism on amniotic fluid cells oxidative status. Reprod Toxicol 2018; 78:97-101. [DOI: 10.1016/j.reprotox.2018.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/19/2018] [Accepted: 04/06/2018] [Indexed: 11/15/2022]
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