Effects of thyroid hormone and depression on common components of central obesity

Thyroid scintigraphy: establishing a clinically useful normal range for 99mTc pertechnetate uptake

PURPOSE

This study aims to establish a normal range for the thyroid uptake derived from 99mTc pertechnetate scans. In particular, variations of uptake with TSH stimulation and other factors such as urinary iodine concentration are taken into account and compared with the calculation of a raw uptake value.

METHODS

Clinical multicentric (center A, B and C) prospective study on 125 consecutive healthy patients undergoing thyroid scans for thyroid nodules. Normal functional thyroid status was assured by normal TSH, normal thyroid size, no thyroid antibodies and no symptoms of thyroid functional disorders. Calculations of raw Tc-uptake (uptake) and modified uptake values regarding current TSH value (uptakeTSH1), urinary iodine concentration (uptakeTSH1&uic), gland volume, age, smoking status, weight and tissue thickness ventral to the thyroid were performed.

RESULTS

There is a positive correlation of thyroid uptake with TSH allowing for the calculation of a normalized uptake value (uptakeTSH1). The normal range for uptakeTSH1 compares favourable to that for raw uptake in that it yields a clear distinction from thyroid functional disorders. The additional normalization for urinary iodine concentration (uptakeTSH1&uic) may even improve the distinctive power whereas further normalizations such as for gland volume, age and others are not warranted by this study. The 95% CI of uptakeTSH1 for sites A, A&B, and A&B&C were 0.21%-2.06%, 0.22%-2.38% and 0.24%-2.40%.

CONCLUSION

A normal range for the thyroid uptake can be established with respect to the current TSH stimulation. This normalization (uptakeTSH1) overcomes the drawback of raw uptake by yielding a clinically useful parameter with obviously high distinctive power against functional thyroid disorders.

A review of complex hormone regulation in thyroid cancer: novel insights beyond the hypothalamus-pituitary-thyroid axis

Like the ovaries and prostate, the thyroid exhibits characteristic hormone secretion and regulation. Thyroid cancer (TC), especially differentiated thyroid carcinoma, has typical sex-specific and age-specific hormone-driven clinical features. Previous research has primarily focused on the effects of thyroid stimulating hormone, thyroid hormones, and estrogens on the onset and progression of TC, while the roles of growth hormone (GH), androgens, and glucocorticoids have largely been overlooked. Similarly, few studies have investigated the interactions between hormones and hormone systems. In fact, numerous studies of patients with acromegaly have shown that serum levels of GH and insulin-like growth factor-1 (IGF-1) may be associated with the onset and progression of TC, although the influences of age, sex, and other risk factors, such as obesity and stress, remain unclear. Sex hormones, the GH/IGF axis, and glucocorticoids are likely involved in the onset and progression of TC by regulating the tumor microenvironment and metabolism. The aim of this review was to clarify the roles of hormones and hormone systems in TC, especially papillary thyroid carcinoma, as references for further investigations.

Sex-dependent impact of obesity on aggressiveness of papillary thyroid cancer

PURPOSE

To investigate the impact of body mass index (BMI) on the aggressiveness of papillary thyroid cancer (PTC).

METHODS

A total of 1720 PTC patients with total thyroidectomy or lobectomy, from January 2017 to April 2020, were retrospectively evaluated. Based on BMI, they were divided into two groups, as follows: control (CON, < 24 kg/m2) and overweight and obesity (OB, ≥ 24 kg/m2), each sex being analyzed separately.

RESULTS

In the whole cohort, the OB group had significantly higher rates of extrathyroidal extension (21.5 vs. 16.8%, p = 0.013), multifocality (43.2 vs. 37.7%, p = 0.018), and BRAF-V600E mutation (82.9 vs. 79.3%, p = 0.015) than the CON group. In males, the OB group had increased rates of tumor size over 1cm (54.4 vs. 42.7%, p = 0.008), extrathyroidal extension (24.9 vs. 12.4%, p = 0.001), and multifocality (42.7 vs. 33.5%, p = 0.038). The OB group had significantly higher adjusted odds ratios (ORs) of 1.63 (1.14-2.33, p = 0.008), 2.12 (1.26-3.57, p = 0.005), and 1.56 (1.07-2.29, p = 0.022) for tumor size over 1cm, extrathyroidal extension, and multifocality compared with CON. Additionally, overweight and obesity were analyzed alone and the rates of extrathyroidal extension (30/100, 30.0%, p = 0.001) and tumor size over 1cm (65/100, 65.0%, p = 0.001) were significantly higher in the obesity group than in the overweight and CON groups. The obesity group had robust higher adjusted ORs of 2.51(1.50-4.20, p < 0.001), 2.93 (1.50-5.73, p = 0.002) and 1.89 (1.11-3.22, p = 0.020) for tumor size over 1cm, extrathyroidal extension, and multifocality compared with CON.

CONCLUSIONS

Overweight and obesity were predominant independent risk factors for PTC aggressiveness in males. These data indicated that the therapeutic treatment should be based on risk stratification by BMI in males.

Influence of Metabolic Dysregulation in the Management of Depressive Disorder-Narrative Review

Depressive disorders are heterogeneous in nature, and their global reach makes them the cause of suffering for a million individuals worldwide. Standard treatment does not work for one in three people, and side effects can significantly reduce the quality of life. A multidisciplinary approach allows for a broader insight into the nature of the disease, given its complex etiology. One of its elements is the hypothesis of inflammation, which also accompanies obesity-related disease. Obesity and depression interact, causing many researchers to develop new non-pharmacological treatment methods for both diseases. One suggestion is physical exercises that have great potential to be used in clinical practice. They can exert changes on the central nervous system and thus modulate mood. Another is diet, which concentrates on active molecules that also affect the central nervous system (CNS). There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice. There is an urgent need to create appropriate criteria and recommendations that systematize existing knowledge and allow it to be used in practice.

Accumulative prediction values of serum thyroid stimulating hormone and visceral adipose tissue for metabolic syndrome in postmenopausal women: A 10-year follow-up study of Chinese population

AIMS

We aim to explore the cumulative predictive value of elevated serum thyroid stimulating hormone (TSH) and visceral fat area (VFA) for metabolic syndrome (MS) development in postmenopausal women.

METHODS

A total of 1006 postmenopausal females were enrolled in a 10-year prospective longitudinal study from 2011 to 2021 in the community of Banknote Printing Company of Chengdu. The sociodemographic information collection and anthropometric measurements were made by a professional nurse. Fasting blood samples were drawn for chemical analysis of fasting plasma glucose, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and TSH. Magnetic resonance imaging was performed to measure VFA. All the participants were categorized into four groups according to median VFA and serum level of TSH.

RESULTS

A total of 793 postmenopausal females without MS underwent a 10-year follow-up study grouping by TSH and VFA: Group 1 (TSH level <4.2 μIU/mL, and VFA < 70 cm2 ), Group 2 (TSH level ≥4.2 μIU/mL, and VFA < 70 cm2 ), Group 3 (TSH level <4.2 μIU/mL, and VFA ≥70 cm2 ) and Group 4 (TSH level ≥4.2 μIU/mL, and VFA ≥70 cm2 ). During the 10-year follow-up, MS was newly developed in 326 (41.1%) subjects. The incidence of MS was 29.8% (n = 53), 35.2% (n = 63), 41% (n = 87), and 55% (n = 123) from Group 1 to Group 4 (Group 4 vs other groups, p < .001). Cox regression analysis for MS prediction demonstrated that both TSH (Model 3, hazard ratio [HR] = 1.07 [95% confidence interval, 1.05-1.09]) and VFA (Model 4, HR = 1.02 [95% confidence interval, 1.01-1.08]) were not only independent predictors of MS but also involved some interaction between each other (p for interaction = .021).

CONCLUSION

Our findings suggested that mutual interaction between higher TSH and VFA contributed to the development of MS. Further studies are needed to clarify these contributions.

Palmitoylation of PKCδ by ZDHHC5 in hypothalamic microglia presents as a therapeutic target for fatty liver disease

The hypothalamus plays a fundamental role in controlling lipid metabolism through neuroendocrine signals. However, there are currently no available drug targets in the hypothalamus that can effectively improve human lipid metabolism. In this study, we found that the antimalarial drug artemether (ART) significantly improved lipid metabolism by specifically inhibiting microglial activation in the hypothalamus of high-fat diet-induced mice. Mechanically, ART protects the thyrotropin-releasing hormone (TRH) neurons surrounding microglial cells from inflammatory damage and promotes the release of TRH into the peripheral circulation. As a result, TRH stimulates the synthesis of thyroid hormone (TH), leading to a significant improvement in hepatic lipid disorders. Subsequently, we employed a biotin-labeled ART chemical probe to identify the direct cellular target in microglial cells as protein kinase Cδ (PKCδ). Importantly, ART directly targeted PKCδ to inhibit its palmitoylation modification by blocking the binding of zinc finger DHHC-type palmitoyltransferase 5 (ZDHHC5), which resulted in the inhibition of downstream neuroinflammation signaling. In vivo, hypothalamic microglia-specific PKCδ knockdown markedly impaired ART-dependent neuroendocrine regulation and lipid metabolism improvement in mice. Furthermore, single-cell transcriptomics analysis in human brain tissues revealed that the level of PKCδ in microglia positively correlated with individuals who had hyperlipemia, thereby highlighting a clinical translational value. Collectively, these data suggest that the palmitoylation of microglial PKCδ in the hypothalamus plays a role in modulating peripheral lipid metabolism through hypothalamus-liver communication, and provides a promising therapeutic target for fatty liver diseases.

Testicular fat deposition attenuates reproductive performance via decreased follicle-stimulating hormone level and sperm meiosis and testosterone synthesis in mouse

OBJECTIVE

Testicular fat deposition has been reported to affect animal reproduction. However, the underlying mechanism remains poorly understood. The present study explored whether sperm meiosis and testosterone synthesis contribute to mouse testicular fat depositioninduced reproductive performance.

METHODS

High fat diet (HFD)-induced obesity CD1 mice (DIO) were used as a testicular fat deposition model. The serum hormone test was performed by agent kit. The quality of sperm was assessed using a Sperm Class Analyzer. Testicular tissue morphology was analyzed by histochemical methods. The expression of spermatocyte marker molecules was monitored by an immuno-fluorescence microscope during meiosis. Analysis of the synthesis of testosterone was performed by real-time polymerase chain reaction and reagent kit.

RESULTS

It was found that there was a significant increase in body weight among DIO mice, however, the food intake showed no difference compared to control mice fed a normal diet (CTR). The number of offspring in DIO mice decreased, but there was no significant difference from the CTR group. The levels of follicle-stimulating hormone were lower in DIO mice and their luteinizing hormone levels were similar. The results showed a remarkable decrease in sperm density and motility among DIO mice. We also found that fat accumulation affected the meiosis process, mainly reflected in the cross-exchange of homologous chromosomes. In addition, overweight increased fat deposition in the testis and reduced the expression of testosterone synthesis-related enzymes, thereby affecting the synthesis and secretion of testosterone by testicular Leydig cells.

CONCLUSION

Fat accumulation in the testes causes testicular cell dysfunction, which affects testosterone hormone synthesis and ultimately affects sperm formation.

Overweight or Obesity Rate and Risk Factors in First-Episode and Drug-Naïve Patients with Major Depressive Disorder with Comorbid Abnormal Lipid Metabolism: A Large-Scale Cross-Sectional Study

Overweight and obesity are frequent symptoms in patients with major depressive disorder (MDD) and abnormal lipid metabolism (ALM). There are no studies on the rate, risk factors, and underlying mechanisms of overweight/obesity in Chinese patients with MDD with comorbid ALM. The purpose of this study was to examine the rate of overweight/obesity and the associated risk factors among Chinese patients with MDD first-episode and drug-naïve (FEDN) with comorbid ALM. This study was a cross-sectional research work. A total of 1718 patients were enrolled. Their clinical and laboratory data were obtained. All participants were assessed with the 17-item Hamilton Depression Rating Scale (HAMD), the Hamilton Anxiety Rating Scale (HAMA), and the Positive and Negative Syndrome Scale (PANSS) positive subscale. The plasma total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triacylglycerols (TG), blood glucose concentrations, thyroid peroxidase antibody (A-TPO), thyoglubulin antibody (A-TG), thyroid-stimulating hormone (TSH), free thyoxine (FT4) and free triiodothyronine (FT3), and blood glucose concentrations were measured. ALM was identified as elevations in the plasma lipid values in this study. Of all the included subjects, the rate of ALM was 81.1%. The rate of obesity and overweight was 3.94% and 57.21%, respectively. Logistic regression analysis showed that TSH was the independent risk factor for overweight or obesity in MDD patients (adjusted OR = 1.158, 95%CI = 1.081-1.24, p < 0.001). The risk of developing overweight or obesity in MDD with ALM with comorbid TSH abnormalities was 2.176 times higher than those without TSH abnormalities (p < 0.001). Further linear regression showed TSH level (B = 0.1, t = 3.376, p = 0.001) and systolic blood pressure (B = 0.015, t = 2.351, p = 0.019) were risk factors for a higher body mass index (BMI). Our results demonstrate that being overweight is very frequent among patients with FEDN MDD with comorbid ALM but not obesity. TSH was the risk factor for overweight and obesity in MDD patients with comorbid ALM.

Correlation between serum thyroid stimulating hormone level and glycolipid metabolism in patients with polycystic ovary syndrome

To investigate the correlation between serum thyroid-stimulating hormone (TSH) levels and glycolipid metabolism in patients with polycystic ovary syndrome (PCOS). From January 2021 to November 2022, 105 patients with PCOS were selected for this retrospective study. All patients were administered drug-induced ovulation treatment and were divided into 2 groups according to ovulation status. There were 67 and 38 patients in the ovulation and non-ovulation groups, respectively. Venous blood (5 mL) was collected on the day after admission from the non-ovulation group and on the day of physical examination from the ovulation group. Several indicators were measured, including TSH, fasting plasma glucose (FPG), glycosylated hemoglobin, total cholesterol (TC), high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglyceride (TG), albumin (ALB), prealbumin (PA), and transferrin (TF). Weight, BMI, waistline, and hipline in the non-ovulation group were significantly higher than those in the ovulation group (P < .05). There were no significant differences in glycosylated hemoglobin, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels between the non-ovulation and ovulation groups (P > .05). Compared with the ovulation group, the levels of TSH, FPG, TC, and TG in the non-ovulation group were significantly higher (P < .05). Serum ALB, PA, and TF the non-ovulation group were significantly higher than those in the ovulation group (P < .05). Correlation analysis showed that TSH was negatively correlated with weight, BMI, waistline, hipline, waist-hip ratio, FPG, ALB, PA, and TF in the non-ovulation group (P < .05) and had no significant correlation with TC and TG (P > .05). Our findings demonstrate TSH levels may be associated with weight, BMI, waistline, hipline, waist-hip ratio, FPG, ALB, PA, and TF in patients with PCOS.

Exploring the Heart-Mind Connection: Unraveling the Shared Pathways between Depression and Cardiovascular Diseases

Civilization diseases are defined as non-communicable diseases that affect a large part of the population. Examples of such diseases are depression and cardiovascular disease. Importantly, the World Health Organization warns against an increase in both of these. This narrative review aims to summarize the available information on measurable risk factors for CVD and depression based on the existing literature. The paper reviews the epidemiology and main risk factors for the coexistence of depression and cardiovascular disease. The authors emphasize that there is evidence of a link between depression and cardiovascular disease. Here, we highlight common risk factors for depression and cardiovascular disease, including obesity, diabetes, and physical inactivity, as well as the importance of the prevention and treatment of CVD in preventing depression and other mental disorders. Conversely, effective treatment of CVD can also help prevent depression and improve mental health outcomes. It seems advisable to introduce screening tests for depression in patients treated for cardiac reasons. Importantly, in patients treated for mood disorders, it is worth controlling CVD risk factors, for example, by checking blood pressure and pulse during routine visits. It is also worth paying attention to the mental condition of patients with CVD. This study underlines the importance of interdisciplinary co-operation.

Anthropometric Indices With Insulin Resistance in Obese Patients: A Literature Review

The hormone insulin is responsible for regulating the metabolism of proteins, carbs, and lipids by promoting the absorption of molecules such as glucose from the bloodstream into fat, the liver, and skeletal muscle cells. Insulin resistance (IR) is considered to be a physiological response to obesity that inhibits fat from accumulating and supports weight stabilization. People with IR gain less weight than those with insulin sensitivity, and therefore IR individuals have a three-fold increased likelihood of losing more weight when compared with insulin-sensitive individuals. A person's health is jeopardized by obesity, which is defined as excessive or unusual storage of fat in adipose tissue. Early identification using different anthropometric measuring parameters and proper and suitable therapy is essential as the incidence of obesity cases is increasing as a result of sedentary lifestyles, bad eating habits, a lack of physical exercise, and a lack of knowledge among young adults. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, following which based on inclusion and exclusion criteria, eight articles were considered for the review. The analysis showed that all the parameters are easily accessible and hence can be used in daily practices. Due to being readily available, body mass index (BMI) and waist circumference (WC) constituted the most often employed anthropometric measures in everyday practices. In addition, variances in the values of the variables were seen due to differences in gender.

Thyroid dysfunction in young, first-episode and drug-naïve patients with major depressive disorder: prevalence and associated clinical factors

Objective

The incidence of thyroid dysfunction (TD) and major depressive disorder (MDD) is increasing year by year in the general population. However, the prevalence and correlates of TD in first-episode drug-naive (FEDN) MDD patients have not been explored. This study sought to fill this gap and examine the association between TD and MDD.

Methods

We recruited 1,289 FEDN MDD patients aged 18 ~ 45 years. A total of 1,289 FEDN MDD outpatients were recruited. Demographical and suicide data were collected for each patient, and lipid profiles, thyroid function, and fasting blood glucose (FBG) levels were measured. The Hamilton Depression Scale 17 (HAMD-17) was assessed for depression.

Results

The prevalence of TD in young FEDN MDD patients was 64.86%. Compared with those without TD, patients with TD had longer duration of illness, greater HAMD score, higher BMI, TG, TC, and LDL-C levels, and higher suicide attempt rates, but lower HDL-C and FBG levels. Further logistic regression indicated that duration of illness, HAMD score, TC, HDL-C, BMI, and FBG levels were significantly associated with TD.

Limitations

No causal relationship can be drawn due to the cross-sectional design.

Conclusion

TD is common in young FEDN MDD patients. So clinicians should monitor thyroid function in patients with MDD.

Gut microbiota short-chain fatty acids and their impact on the host thyroid function and diseases

Thyroid disorders are clinically characterized by alterations of L-3,5,3',5'-tetraiodothyronine (T4), L-3,5,3'-triiodothyronine (T3), and/or thyroid-stimulating hormone (TSH) levels in the blood. The most frequent thyroid disorders are hypothyroidism, hyperthyroidism, and hypothyroxinemia. These conditions affect cell differentiation, function, and metabolism. It has been reported that 40% of the world's population suffers from some type of thyroid disorder and that several factors increase susceptibility to these diseases. Among them are iodine intake, environmental contamination, smoking, certain drugs, and genetic factors. Recently, the intestinal microbiota, composed of more than trillions of microbes, has emerged as a critical player in human health, and dysbiosis has been linked to thyroid diseases. The intestinal microbiota can affect host physiology by producing metabolites derived from dietary fiber, such as short-chain fatty acids (SCFAs). SCFAs have local actions in the intestine and can affect the central nervous system and immune system. Modulation of SCFAs-producing bacteria has also been connected to metabolic diseases, such as obesity and diabetes. In this review, we discuss how alterations in the production of SCFAs due to dysbiosis in patients could be related to thyroid disorders. The studies reviewed here may be of significant interest to endocrinology researchers and medical practitioners.

Hypothyroidism and non-alcoholic fatty liver disease: A coincidence or a causal relationship?

Non-alcoholic fatty liver disease (NAFLD) is a global problem. It may be caused by metabolic and hormonal disorders, including hypothyroidism. However, non-thyroid causes of NAFLD in people with hypothyroidism, including improper eating behavior and low physical activity, should be acknowledged. This study aimed to present the current literature on whether the development of NAFLD is related to hypothyroidism or a typical consequence of an unhealthy lifestyle in people with hypothyroidism. The results of previous studies do not allow for an unequivocal determination of the pathogenetic relationship between hypothyroidism and NAFLD. Important non-thyroid-initiating factors include providing too many calories in relation to requirements, consuming excessive amounts of monosaccharides and saturated fats, being overweight, and maintaining low physical activity levels. The recommended nutritional model for both hypothyroidism and NAFLD may be the Mediterranean diet, which is rich in fruits and vegetables, polyunsaturated fatty acids, and vitamin E.

Prevalence of overweight and obesity in patients with major depressive disorder with anxiety: Mediating role of thyroid hormones and metabolic parameters

BACKGROUNDS

Anxiety is a common comorbidity in major depressive disorder (MDD); however, its role in overweight and obesity in MDD patients remains unclear. We examined the relationship between severe anxiety and overweight and obesity, as well as the mediating role of thyroid hormones and metabolic parameters in MDD patients.

METHODS

This cross-sectional study recruited 1718 first-episode drug-naïve MDD outpatients. All participants were rated on the Hamilton Depression Rating Scale for depression and Hamilton Anxiety Rating Scale for anxiety and measured in thyroid hormones and metabolic parameters.

RESULTS

A total of 218 (12.7 %) individuals had severe anxiety. The prevalence of overweight and obesity in patients with severe anxiety was 62.8 % and 5.5 %, respectively. Severe anxiety symptoms were related to overweight (Odds Ratio [OR]: 1.47, 95 % CI: 1.08, 2.00) and obesity (OR: 2.10, 95 % CI: 1.07, 4.15). The association between severe anxiety and overweight was mainly attenuated by thyroid hormones (40.4 %), blood pressure (31.9 %), and plasma glucose (19.1 %). For obesity, the association with severe anxiety was mainly attenuated by thyroid hormones (48.2 %), blood pressure (39.1 %), and total cholesterol (28.2 %).

LIMITATIONS

Due to the cross-sectional design, no causal relationship could be derived.

CONCLUSIONS

Thyroid hormones and metabolic parameters can explain the risk of overweight and obesity associated with severe anxiety in MDD patients. These findings add to the knowledge of the pathological pathway of overweight and obesity in severe anxiety comorbid MDD.

Could Vaspin Be a Potential Diagnostic Marker in Endometrial Cancer?

Obesity and being overweight are risk factors for many types of cancer, including endometrial cancer. Adipose tissue is thought to be an endocrine organ that produces various hormones, including one known as vaspin. Insulin resistance, metabolic syndrome and type 2 diabetes are all associated with higher vaspin levels. A total of 127 patients divided into study (endometrial cancer) and control groups (non-cancerous) participated in this research. Serum vaspin levels were measured for all patients. The analysis was performed while taking into account grading and staging. In order to assess the usefulness of the tested protein as a new diagnostic marker, we used the plotting of a curve (ROC) and the calculation of the AUC curve to characterize the sensitivity and specificity of the parameters tested. We concluded that there were significantly lower vaspin levels in patients with endometrial cancer compared to patients with benign endometrial lesions. Vaspin may be a useful diagnostic marker in separating benign lesions from endometrial cancer.

The causal effects of thyroid function and lipids on cholelithiasis: A Mendelian randomization analysis

OBJECTIVE

To investigate the relationship between function of thyroid, lipids, and cholelithiasis and to identify whether lipids mediate the causal relationship between function of thyroid and cholelithiasis.

METHODS

A Mendelian randomization (MR) study of two samples was performed to determine the association of thyroid function with cholelithiasis. A two-step MR was also performed to identify whether lipid metabolism traits mediate the effects of thyroid function on cholelithiasis. A method of inverse variance weighted (IVW), weighted median method, maximum likelihood, MR-Egger, MR-robust adjusted profile score (MR-RAPS) method, and MR pleiotropy residual sum and outlier test (MR-PRESSO) methods were utilized to obtain MR estimates.

RESULTS

The IVW method revealed that FT4 levels were correlated with an elevated risk of cholelithiasis (OR: 1.149, 95% CI: 1.082-1.283, P = 0.014). Apolipoprotein B (OR: 1.255, 95% CI: 1.027-1.535, P = 0.027) and low-density lipoprotein cholesterol (LDL-C) (OR: 1.354, 95% CI: 1.060-1.731, P = 0.016) were also correlated with an elevated risk of cholelithiasis. The IVW method demonstrated that FT4 levels were correlated with the elevated risk of apolipoprotein B (OR: 1.087, 95% CI: 1.019-1.159, P = 0.015) and LDL-C (OR: 1.084, 95% CI: 1.018-1.153, P = 0.012). Thyroid function and the risk of cholelithiasis are mediated by LDL-C and apolipoprotein B. LDL-C and apolipoprotein B had 17.4% and 13.5% of the mediatory effects, respectively.

CONCLUSIONS

We demonstrated that FT4, LDL-C, and apolipoprotein B had significant causal effects on cholelithiasis, with evidence that LDL-C and apolipoprotein B mediated the effects of FT4 on cholelithiasis risk. Patients with high FT4 levels should be given special attention because they may delay or limit the long-term impact on cholelithiasis risk.

Evaluation of Tissue Expression of Vaspin and Serum Vaspin Concentration as a Prognostic and Risk Factor in Endometrial Cancer

Adipose tissue is a multifunctional endocrine organ. One of the biologically active substances is vaspin, which is part of the serpin family. The purpose of the following study is to determine the possibility of using vaspin as a prognostic and risk factor in endometrial cancer. The study included 127 patients with abnormal uterine bleeding. To determine the value of adipokine, the study used Kaplan-Meier curves to estimate patients survival. Univariate and multivariate analyses were performed simultaneously using the Cox regression model. Tissue expression of vaspin was assessed in patients from the study group (endometrial cancer) and the control group (non-cancerous). We found that higher levels of vaspin are found in obese people, with lower staging (FIGO I and II), lower grading (G1), no LVSI metastases and no lymph node metastases. Higher serum vaspin levels are an independent protective factor for endometrial cancer. We concluded that endometrial cancer patients with serum vaspin concentrations above the median have longer DFS compared to patients with concentrations below the median. Considering multivariate analysis, vaspin concentrations above the median are independent favourable prognostic factors for endometrial cancer. Tissue expression of vaspin cannot be a histological marker to distinguish between cancer and non-cancerous lesions and between different grading levels.

Causal Association of Thyroid Signaling with C-Reactive Protein: A Bidirectional Mendelian Randomization

Methods

Based on the latest genome-wide association study summary data, bidirectional two-sample Mendelian randomization (MR) was employed to detect the causal relationship and effect direction between TSH, fT4, and CRP. Furthermore, in view of obesity being an important risk factor of CVD, obesity trait waist-hip ratio (WHR) and body mass index (BMI) were treated as the research objects in MR analyses for exploring the causal effects of TSH and fT4 on them, respectively.

Results

Genetically increased CRP was associated with increased TSH (β = -0.02, P = 0.011) and with increased fT4 (β = 0.043, P = 0.001), respectively, but there was no evidence that TSH or fT4 could affect CRP. In further analyses, genetically increased TSH was associated with decreased WHR (β = -0.02, P = 3.99e - 4). Genetically increased WHR was associated with decreased fT4 (β = -0.081, P = 0.002). Genetically increased BMI was associated with increased TSH (β = 0.03, P = 0.028) and with decreased fT4 (β = -0.078, P = 1.05e - 4). Causal associations of WHR and BMI with thyroid signaling were not supported by weighted median analysis in sensitivity analyses.

Conclusion

TSH and fT4 were increased due to the higher genetically predicted CRP. WHR was decreased due to the higher genetically predicted TSH. These findings will provide reference for the prevention and treatment of inflammation and metabolic syndrome.

Depression and obesity among females, are sex specificities considered?

This study aimed to systematically review the relationship of obesity-depression in the female sex. We carried out a systematic search (PubMed, MEDLINE, Embase) to quantify the articles (controlled trials and randomized controlled trials) regarding obesity and depression on a female population or a mixed sample. Successively, we established whether the sex specificities were studied by the authors and if they reported on collecting data regarding factors that may contribute to the evolution of obesity and depression and that could be responsible for the greater susceptibility of females to those conditions. After applying the inclusion and exclusion criteria, we found a total of 20 articles with a female sample and 54 articles with a mixed sample. More than half of all articles (51.35%, n = 38) evaluated the relationship between depression and obesity, but only 20 (27.03%) evaluated this relationship among females; still, 80% of those (n = 16) presented supporting results. However, few articles considered confounding factors related to female hormones (12.16%, n = 9) and none of the articles focused on factors responsible for the binomial obesity-depression in the female sex. The resulting articles also supported that depression (and related impairments) influencing obesity (and related impairments) is a two-way road. This systematic review supports the concurrency of obesity-depression in females but also shows how sex specificities are ultimately under-investigated. Female sex specificity is not being actively considered when studying the binomial obesity-depression, even within a female sample. Future studies should focus on trying to understand how the female sex and normal hormonal variations influence these conditions.

Independent associations of thyroid-related hormones with hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults

PURPOSE

The aim of the study is to explore the independent association of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) with hepatic steatosis and insulin resistance.

METHODS

A cross-sectional study of 88 overweight/obese adults who underwent anthropometric measurements [BMI, waist circumference (WC) and waist-to-height ratio (WHtR)], hepatic steatosis assessment (FibroScan) and thyroid-related hormones tests was conducted from 2018 to 2020 in Xiamen, China.

RESULTS

Subjects with increasing tertiles of FT3 showed significantly higher levels of controlled attenuation parameter (CAP) ((295.4 ± 44.1, 290.1 ± 68.2 and 331.7 ± 43.6 (dB/m) for tertile 1-3, respectively, p = 0.007) and fatty liver index (FLI) score (47.7 (33.9-60.8), 61.5 (45.1-88.9) and 90.5 (84.5-94.8), respectively, p < 0.001). FT3 significantly and positively correlated with obesity index (BMI, WC, and WHtR), homeostatic model assessment of insulin resistance (HOMA-IR) and hepatic steatosis (CAP and FLI). Multivariable linear regression analyses with adjustment for potential confounding factors showed FT3 was independently associated with BMI (regression coefficient (β (95%CI): 0.024 (0.004-0.043), p = 0.020), HOMA-IR (β (95%CI): 0.091 (0.007-0.174), p = 0.034), CAP (β (95%CI): 25.45 (2.59-48.31), p = 0.030) and FLI (β (95%CI): 0.121 (0.049-0.194), p = 0.001). Neither FT4 nor TSH was significantly associated with any indicators of obesity, insulin resistance or hepatic steatosis.

CONCLUSIONS

Increased FT3, but not FT4 or TSH, was independently associated with higher risks of hepatic steatosis and insulin resistance in euthyroid overweight/obese Chinese adults. Trial registration Registration is not applicable for our study.

The Influence of Oxidative Stress on Thyroid Diseases

Thyroid diseases, including neoplasms, autoimmune diseases and thyroid dysfunctions, are becoming a serious social problem with rapidly increasing prevalence. The latter is increasingly linked to oxidative stress. There are many methods for determining the biomarkers of oxidative stress, making it possible to evaluate the oxidative profile in patients with thyroid diseases compared to the healthy population. This opens up a new perspective for investigating the role of elevated parameters of oxidative stress and damage in people with thyroid diseases, especially of neoplastic nature. An imbalance between oxidants and antioxidants is observed at different stages and in different types of thyroid diseases. The organ, which is part of the endocrine system, uses free radicals (reactive oxygen species, ROS) to produce hormones. Thyroid cells release enzymes that catalyse ROS generation; therefore, a key role is played by the internal defence system and non-enzymatic antioxidants that counteract excess ROS not utilised to produce thyroid hormones, acting as a buffer to neutralise free radicals and ensure whole-body homeostasis. An excess of free radicals causes structural cell damage, undermining genomic stability. Looking at the negative effects of ROS accumulation, oxidative stress appears to be implicated in both the initiation and progression of carcinogenesis. The aim of this review is to investigate the oxidation background of thyroid diseases and to summarise the links between redox imbalance and thyroid dysfunction and disease.

Prevalence and risk factors of overweight and obesity in Chinese patients with first-episode drug-naïve major depressive disorder

BACKGROUNDS

Obesity and overweight are common in patients with major depressive disorder (MDD); the results are inconsistent due to confounding variables involved in studies. Furthermore, no well-designed study has been published to investigate the prevalence, risk factors and underlying mechanisms of obesity/overweight in Chinese MDD patients. This study aimed to investigate the prevalence of obesity/overweight and related risk factors in first-episode, drug-naïve (FEDN) patients with MDD in China.

METHODS

A total of 1718 patients were recruited. Their clinical and anthropometric data, thyroid function and biochemical parameters were collected. All patients were evaluated on the 17-item Hamilton Rating Scale for Depression, 14-item Hamilton Anxiety Rating Scale and the Positive and Negative Syndrome Scale.

RESULTS

The prevalence of obesity and overweight was 3.73% and 56.00%, respectively. Multivariable logistic regression analysis showed that TSH was the only independent risk factor for weight gain in MDD patents. The fitting curve of the relationship between TSH and BMI formed an inverted U-shaped parabola. The ordinal logit mode showed that when TSH<=2.68 was set as a reference, the odd rates of weight increased with the increase of TSH, and the highest rate was 3.929 (95%CI: 2.879-5.361, P<0.0001).

LIMITATION

Causality cannot be drawn due to cross-sectional design.

CONCLUSION

Our results suggest that overweight is very common among patients with FEDN MDD rather than obesity. TSH is a promising predictor and potential biomarker of high weight in MDD patients, and there is an inverted U-shaped parabolic relationship between TSH and BMI.

Contribution of Glycation and Oxidative Stress to Thyroid Gland Pathology-A Pilot Study

The patho-mechanism of changes in the thyroid gland, including carcinogenesis, is a complex process, which involves oxidative stress. The goal of our investigation was to verify the extent of stress in the thyroid gland related to glycation. The study samples were comprised of blood sera, thyroid, and adipose tissue sections probed from 37 patients diagnosed with thyroid cancers and goiter. Using immuno-enzymatic and fluorometric assays we analyzed the content of advanced glycation end-products (AGEs), pentosidine, receptors for advanced glycation end-products (RAGE), scavenger receptor class (SR)-A, SR-B, glutathione, malondialdehyde and nitric oxide synthase. In addition to classic AGEs, a recent study detected the melibiose-derived glycation (MAGE) product. We demonstrated the presence of AGEs, MAGE and their receptors of the RAGE and SR-A. In addition, in the control samples of thyroid glands SR-B groups were detected as well as of pathological groups without noticeable tendency to antigen concentration in the area of carcinogenesis. Fluorescent AGEs correlate positively with glutathione, which supports the assumption that glycation stress leads to augmentation of oxidative stress and increase of the intensity of antioxidant mechanisms.

Depression, Metabolic Syndrome, Serum TSH, and Vitamin D Concentrations in Rural and Urban Postmenopausal Women

Background and objectives: Depression is a serious problem affecting people worldwide, however it more commonly concerns women. Depression reduces the quality of life and, in many cases, leads to suicide. Numerous new biological factors have been demonstrated to have an impact on the pathogenesis of depression, including vitamin D, thyroid hormones, as well as factors related to heart disease. The aim of the study was to assess the impact of serum thyroid stimulating hormone (TSH) and vitamin D concentrations as well as metabolic syndrome on the severity of depression in Polish postmenopausal women from urban and rural areas. Materials and Methods: The study was conducted in 2018–2019 in the Lublin region, Poland, and comprised 396 postmenopausal women (239 living in rural areas and 157 living in urban areas). Metabolic syndrome criteria according to the International Diabetes Federation and Beck Depression Inventory were used, and laboratory blood tests were performed. Results: A significantly higher percentage of the examined rural residents had moderate or severe depression in comparison to the urban ones (p = 0.049). The examined women from rural areas had a significantly higher serum vitamin D concentration in comparison to the urban ones (p < 0.001). The rural residents more commonly had below-normal levels of serum TSH and less commonly had normal levels in comparison to the urban residents. Metabolic syndrome was found in 70% of the rural residents, and that number was significantly lower in the urban ones (22%, p < 0.001). Conclusions: The severity of depression in postmenopausal Polish women was correlated negatively with the serum TSH concentration in women from rural areas. The severity of depression was increased in urban postmenopausal women with hypertension. No correlation of the depression severity with the serum vitamin D concentration or other criteria of metabolic syndrome was found.