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Godbole NP, Koester M, Marcus EN. Hypothyroidism in Adult Women: The Utility of Targeted vs Universal Thyroid Screening. Int J Womens Health 2023; 15:1515-1522. [PMID: 37840554 PMCID: PMC10572379 DOI: 10.2147/ijwh.s397129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023] Open
Abstract
Hypothyroidism is a common disease that is more prevalent in female populations. The purpose of this paper is to discuss the evidence, risks, and benefits of screening asymptomatic women for hypothyroidism. There is lack of evidence to support clinical management of asymptomatic individuals with an elevated TSH and normal serum thyroxine levels. Patients with subclinical hypothyroidism, especially the elderly, are at risk of overtreatment. Given these considerations, the majority of US and UK professional organizations do not support universal screening. Many do offer caveats for special groups, including pregnant people, who may need screening if there are clinical symptoms or family history of autoimmune disease. In conclusion, targeted screening may be best recommended based on risk factors, symptoms, and clinical suspicion, rather than at a universal level.
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Affiliation(s)
- Neha P Godbole
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Erin N Marcus
- Department of Internal Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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2
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Transient high thyroid stimulating hormone and hypothyroidism incidence during follow up of subclinical hypothyroidism. Endocr Regul 2021; 55:204-214. [PMID: 34879182 DOI: 10.2478/enr-2021-0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives. Given the high prevalence of subclinical hypothyroidism (SCH), defined as high thyroid stimulating hormone (TSH) and normal free thyroxine (FT4), and uncertainty on treatment, one of the major challenges in clinical practice is whether to initiate the treatment for SCH or to keep the patients under surveillance. There is no published study that has identified predictors of short-term changes in thyroid status amongst patients with mild elevation of TSH (4.5-10 mIU/L). Subjects and Results. A cohort study was conducted on patients with SCH detected through a general population screening program, who were followed for six months. This project identified factors predicting progression to hypothyroid status, persistent SCH and transient cases. A total of 656 participants joined the study (431 controls and 225 were patients with SCH). A part of participants (12.2%) developed biochemical hypothyroidism during the follow-up, while 73.8% of the subjects became euthyroid and the remained ones (13.4%) stayed in the SCH status. The incidence of overt hypothyroidism for participants with TSH above 6.9 mIU/L was 36.7%, with incidence of 42.3% for females. Anti-thyroid peroxidase antibodies (TPO) positivity is an important predictor of development of hypothyroidism; however, it could be also positive due to transient thyroiditis. Conclusions. It can be concluded that females with TSH above 6.9 mIU/L, particularly those with free triiodothyronine (FT3) and FT4 in the lower half of the reference range, are more likely to develop biochemical hypothyroidism. Therefore, it is recommended to give them a trial of levothyroxine replacement. It is also recommended to repeat TSH after six months for male subjects and participants with baseline TSH equal or less than 6.9 mIU/L.
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Liu ZM, Zhang D, Li G, Ho SC, Chen YM, Ma J, Huang Q, Li S, Ling WH. The 6-month effect of whole soy and purified isoflavones daidzein on thyroid function-A double-blind, randomized, placebo controlled trial among Chinese equol-producing postmenopausal women. Phytother Res 2021; 35:5838-5846. [PMID: 34494323 DOI: 10.1002/ptr.7244] [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: 05/14/2020] [Revised: 07/24/2021] [Accepted: 08/02/2021] [Indexed: 11/11/2022]
Abstract
The aim of this study was to examine the effect of whole soy and purified daidzein on markers of thyroid function in Chinese postmenopausal women who were equol-producers. Total 270 eligible women were randomized to either one of the three isocaloric supplements: 40 g soy flour (whole soy group), 40 g low-fat milk powder +63 mg daidzein (daidzein group) or 40 g low-fat milk powder (placebo) daily for 6 months. Serum thyroid markers were tested at baseline and 6 months for thyroid stimulating hormone, free triiodothyronine, reverse triiodothyronine and free thyroxine (FT4). There was no significant difference in the 6-month changes of thyroid markers among the three groups. Subgroup analysis among women with lowered thyroid function suggested a modest decrease of FT4. This randomized controlled trial among Chinese equol-producing postmenopausal women indicates the consumption of whole soy and purified daidzein at the provided dosages are safe and have no detrimental effect on thyroid function.
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Affiliation(s)
- Zhao-Min Liu
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Di Zhang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Guoyi Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Suzanne C Ho
- Department of Epidemiology, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu-Ming Chen
- Department of Biostatistics and Epidemiology, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Jing Ma
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Qi Huang
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Shuyi Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
| | - Wen-Hua Ling
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University (North Campus), Guangzhou, China
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Jalalvand F, Rezaei A, Badehnoosh B, Yaseri M, Qorbani M, Emaminia F, Shabani M. The Effects of Elaeagnus angustifolia L. on the Thyroid-Stimulating Hormone, Dehydroepiandrosterone-Sulfate, Prolactin and Cortisol Levels in Post-Menopausal Women: A Double-Blind, Randomized, and Placebo-Controlled Study. Front Pharmacol 2021; 12:654459. [PMID: 34305584 PMCID: PMC8293672 DOI: 10.3389/fphar.2021.654459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Menopause is the last menstrual period associated with a decline in ovarian steroid secretion and follicular loss. Hormone profile changes during menopause include a decrease in the production of estrogen, dehydroepiandrosterone (DHEA), and prolactin (PRL), and an increase in thyroid-stimulating hormone (TSH) and cortisol. Herbal medicines are considered as alternatives to hormone therapy. The studies on postmenopausal women have shown that Elaeagnus angustifolia L. (called "Senjed" in Persian) has some efficacy in improving sex hormone and lipid profiles, joint pain, and cardiovascular function, as the decrease in luteinizing hormone, low-density lipoprotein, and heart rate was significant. The aim of the present study was to evaluate the effects of E. angustifolia on TSH, DHEA-S, PRL, and cortisol levels and their ratios in postmenopausal women. It is assumed that the eventual effects of hormones on the brain and other tissues are determined by the balance between interdependent hormones. In the present randomized double-blinded placebo-controlled trial (https://en.irct.ir/search/result?query=IRCT20170227032795N4), fifty-eight postmenopausal women were randomly assigned to one of two medicinal herb (15 g of the whole E. angustifolia fruit powder) and placebo (7.5 g isomalt + 7.5 g cornstarch) groups. After 10 weeks of the treatment, the serum levels of TSH, DHEA-S, PRL, cortisol hormones, and their ratios were measured. The increase in the TSH, and cortisol levels, and cortisol/DHEA-S ratio and the decrease in prolactin and DHEA-S and the PRL/TSH, PRL/cortisol, and DHEA-S/TSH ratios after E. angustifolia consumption were significant only based on within-group but not on the between-group analysis. Based on between-group analyses, the changes in the hormone profile were not significant in the placebo group. According to Iranian tradition and folklore, E. angustifolia fruit is a symbol of female fertility. Therefore, its consumption is highly recommended to maintain health in the elderly, especially women. However, the observed outcomes about the effect of E. angustifolia on menopause were not completely in line with the Iranian folklore. E. angustifolia consumption did not significantly affect the hormone profile and ratios at the end of the ten-week trial, possibly due to the small sample size, short time, and the fact that our participants were postmenopausal women.
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Affiliation(s)
| | - Arezou Rezaei
- School of Biology, Damghan University, Damghan, Iran.,Institute of Biological Sciences, Damghan University, Damghan, Iran
| | - Bita Badehnoosh
- Department of Gynecology and Obstetrics, Faculty of Medical Science, Alborz University of Medical Science, Karaj, Iran.,Dietary supplement and Probiotic Research Center, Alborz University of Medical Science, Karaj, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran.,Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ren B, Wan S, Liu L, Qu M, Wu H, Shen H. Distributions of serum thyroid-stimulating hormone in 2020 thyroid disease-free adults from areas with different iodine levels: a cross-sectional survey in China. J Endocrinol Invest 2021; 44:1001-1010. [PMID: 32816248 DOI: 10.1007/s40618-020-01395-2] [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: 04/25/2020] [Accepted: 08/13/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE The aim of the present study was to describe the distributions of serum thyroid- stimulating hormone (TSH) levels in thyroid disease-free adults from areas with different iodine levels in China. Meanwhile, we aimed to evaluate the influence of age and gender on the distribution of TSH, assess the relationship between concentrations of TSH and free thyroxine (FT4), and analyze the factors that may affect TSH levels. METHODS 2020 adults were included from April 2016 to June 2019. Urinary iodine concentration, serum iodine concentration, serum TSH, FT4, free triiodothyronine, thyroid peroxidase antibodies and thyroglobulin antibodies were measured, and thyroid ultrasonography was performed. RESULTS The median of TSH in iodine-fortification areas (IFA), iodine-adequate areas (IAA), iodine-excessive areas (IEA) were 2.32, 2.11 and 2.34 mIU/L, respectively. Serum TSH concentrations were significantly higher in IFA and IEA than that in IAA (p = 0.005 and < 0.0001). The TSH values of most adults were distributed within the range of 1.01-3.00 mIU/L with the same trend in three groups. In our study, TSH levels did not change with age, and the TSH level of females was higher than that of males (p < 0.0001). There was a negative correlation between FT4 and TSH in IAA (r = - 0.160, p < 0.0001) and IEA (r = - 0.177, p < 0.0001), but there was no correlation between FT4 and TSH in IFA (r = - 0.046, p = 0.370). BMI, smoking status, education levels, and marital status were associated with TSH. CONCLUSION Our study provides a basis for establishing the reference intervals of TSH in different iodine level areas.
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Affiliation(s)
- B Ren
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - S Wan
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - L Liu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - M Qu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Wu
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
| | - H Shen
- Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China.
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Jian C, Xu Y, Ma X, Shen Y, Wang Y, Bao Y. Correlations between neck circumference and serum thyroid hormones levels in postmenopausal women with euthyroid and subclinical hypothyroidism. Clin Exp Pharmacol Physiol 2020; 48:471-477. [PMID: 33350509 DOI: 10.1111/1440-1681.13454] [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] [Received: 08/15/2020] [Accepted: 12/04/2020] [Indexed: 11/29/2022]
Abstract
Middle-aged and elderly women are at a higher risk of subclinical hypothyroidism (SHypo). Menopause is an important period of metabolic change in women and thyroid hormones are closely related to metabolic status. Neck circumference (NC) is a simple anthropometric index that reflects upper body fat accumulation. Therefore, this study aimed to explore the relationship between NC and thyroid hormones in postmenopausal women. A total of 1050 postmenopausal women were enrolled from Shanghai Zhabei communities (888 euthyroid subjects and 162 SHypo patients). Anthropometric parameters, including NC, were measured. The measurements of serum thyroid hormones were performed by electrochemical luminescence immunoassay. The results showed NC was positively correlated with thyroid-stimulating hormone (TSH) (r = .064, P = .039). TSH and the proportion of SHypo patients increased significantly in those with elevated NC (both P < .05). In logistic regression analysis, the risk of SHypo increased by 46.4% in those with elevated NC (OR = 1.464 [1.035-2.071], P = .031). After adjusting for metabolic confounding factors, the positive association disappeared (P = .112). Multiple linear regression analysis showed there were no significant correlations between NC and TSH in either univariate or multivariate model in the total population (both P > .05). And in the subgroup analysis of euthyroid and SHypo individuals, NC was also not related to TSH (all P > .05). In conclusion, there was no independent association between NC, a simple anthropometric index for upper body fat accumulation, and serum TSH levels in Chinese euthyroid and SHypo postmenopausal women.
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Affiliation(s)
- Chaohui Jian
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
| | - Yiting Xu
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
| | - Xiaojing Ma
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
| | - Yun Shen
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
| | - Yufei Wang
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
| | - Yuqian Bao
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Clinical Center for Diabetes, Shanghai Key Clinical Center for Metabolic Disease, Shanghai Diabetes Institute, Shanghai, China
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8
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Sun LM, Liang JA, Lin CL, Lin MC, Chang NJ, Kao CH. Cancer risk in patients with osteoporosis: a population-based cohort study. Curr Med Res Opin 2017; 33:733-739. [PMID: 28044464 DOI: 10.1080/03007995.2017.1278681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Osteoporosis has been associated with cancer development. We conducted a nationwide population-based cohort study in Taiwan to evaluate this possible association of osteoporosis with subsequent cancer development. METHODS A total of 35,979 patients diagnosed with osteoporosis between 2000 and 2010 identified from the National Health Insurance Research Database comprised the osteoporosis cohort, and each patient was randomly frequency matched with one individual from the general population (without osteoporosis) based on age, sex, and year of osteoporosis diagnosis to form the non-osteoporosis (control) cohort. Cox proportional hazard regression analysis was used to calculate adjusted hazard ratios and 95% confidence intervals and determine the effect of osteoporosis on cancer risk. RESULTS Patients with osteoporosis showed a significantly higher risk of developing liver and thyroid cancers and lower risk of colorectal cancer than did individuals without osteoporosis. Male patients with osteoporosis had a significantly increased risk for liver cancer, whereas female patients with osteoporosis had a significantly increased risk for thyroid cancer, but a significantly decreased risk for overall and colorectal cancers. In addition, more significant findings were observed when age ≤64 years or the follow-up duration was ≤5 years; however, a significantly lower risk for colorectal cancer was observed when follow-up duration was >5 years. Study limits including lack of data for some health-related behaviors, inclusion criteria of osteoporosis and potential selection bias have been discussed. CONCLUSION Patients with osteoporosis showed a higher risk for liver and thyroid cancers and a lower risk for colorectal cancer than did control individuals. Stratified analyses by sex, age, and follow-up duration showed various patterns in different cancers.
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Affiliation(s)
- Li-Min Sun
- a Department of Radiation Oncology , Zuoying Branch of Kaohsiung Armed Forces General Hospital , Kaohsiung , Taiwan
| | - Ji-An Liang
- b Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University , Taichung , Taiwan
- c Department of Radiation Oncology , China Medical University Hospital , Taichung , Taiwan
| | - Cheng-Li Lin
- d Management Office for Health Data, China Medical University Hospital , Taichung , Taiwan
- e College of Medicine, China Medical University , Taichung , Taiwan
| | - Ming-Chia Lin
- f Department of Nuclear Medicine , I-Shou University and EDa Hospital , Kaohsiung , Taiwan
| | - Nai-Jen Chang
- g Department of Pathology , Zuoying Branch of Kaohsiung Armed Forces General Hospital , Kaohsiung , Taiwan
| | - Chia-Hung Kao
- b Graduate Institute of Clinical Medical Science, School of Medicine, College of Medicine, China Medical University , Taichung , Taiwan
- h Department of Nuclear Medicine and PET Center , China Medical University Hospital , Taichung , Taiwan
- i Department of Bioinformatics and Medical Engineering , Asia University , Taichung , Taiwan
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Oh M, Ahn J, Lee T, Jang G, Park C, Yoon Y. Drug voyager: a computational platform for exploring unintended drug action. BMC Bioinformatics 2017; 18:131. [PMID: 28241745 PMCID: PMC5329936 DOI: 10.1186/s12859-017-1558-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 02/22/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The dominant paradigm in understanding drug action focuses on the intended therapeutic effects and frequent adverse reactions. However, this approach may limit opportunities to grasp unintended drug actions, which can open up channels to repurpose existing drugs and identify rare adverse drug reactions. Advances in systems biology can be exploited to comprehensively understand pharmacodynamic actions, although proper frameworks to represent drug actions are still lacking. RESULTS We suggest a novel platform to construct a drug-specific pathway in which a molecular-level mechanism of action is formulated based on pharmacologic, pharmacogenomic, transcriptomic, and phenotypic data related to drug response ( http://databio.gachon.ac.kr/tools/ ). In this platform, an adoption of three conceptual levels imitating drug perturbation allows these pathways to be realistically rendered in comparison to those of other models. Furthermore, we propose a new method that exploits functional features of the drug-specific pathways to predict new indications as well as adverse reactions. For therapeutic uses, our predictions significantly overlapped with clinical trials and an up-to-date drug-disease association database. Also, our method outperforms existing methods with regard to classification of active compounds for cancers. For adverse reactions, our predictions were significantly enriched in an independent database derived from the Food and Drug Administration (FDA) Adverse Event Reporting System and meaningfully cover an Adverse Reaction Database provided by Health Canada. Lastly, we discuss several predictions for both therapeutic indications and side-effects through the published literature. CONCLUSIONS Our study addresses how we can computationally represent drug-signaling pathways to understand unintended drug actions and to facilitate drug discovery and screening.
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Affiliation(s)
- Min Oh
- Department of Computer Science, Virginia Tech, Blacksburg, VA, USA
| | - Jaegyoon Ahn
- Department of Computer Science & Engineering, Incheon National University, Incheon, South Korea
| | - Taekeon Lee
- Department of Computer Engineering, Gachon University, Seongnam, South Korea
| | - Giup Jang
- Department of Computer Engineering, Gachon University, Seongnam, South Korea
| | - Chihyun Park
- Biomedical HPC Technology Research Center, Korean Institute of Science and Technology Information, Daejeon, South Korea
| | - Youngmi Yoon
- Department of Computer Engineering, Gachon University, Seongnam, South Korea. .,Postal Address: Gachon University, 339Ho, Woongji B.D., 1324 Seongnam-daero, Seongnam-si, 13120, South Korea.
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Zevenbergen C, Korevaar TIM, Schuette A, Peeters RP, Medici M, Visser TJ, Schomburg L, Visser WE. Association of antiepileptic drug usage, trace elements and thyroid hormone status. Eur J Endocrinol 2016; 174:425-32. [PMID: 26701870 DOI: 10.1530/eje-15-1081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 12/23/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Levels of thyroid hormone (TH) and trace elements (copper (Cu) and selenium (Se)) are important for development and function of the brain. Anti-epileptic drugs (AEDs) can influence serum TH and trace element levels. As the relationship between AEDs, THs, and trace elements has not yet been studied directly, we explored these interactions. METHOD In total 898 participants, from the Thyroid Origin of Psychomotor Retardation study designed to investigate thyroid parameters in subjects with intellectual disability (ID), had data available on serum Se, Cu, thyroid stimulating hormone (TSH), free thyroxine (FT4), tri-iodothyronine (T3), reverse T3, T4, and thyroxine-binding globulin (TBG); 401 subjects were on AED treatment. Differences in trace elements according to medication usage was investigated using ANOVA, and associations between trace elements and thyroid parameters were analysed using (non-) linear regression models. RESULTS Study participants were not deficient in any of the trace elements analyzed. AED (carbamazepine, valproate and phenytoin) usage was negatively associated with serum Se and showed compound-specific associations with Cu levels. After correction for drug usage, Se was positively associated with TSH levels, negatively associated with FT4 levels, and positively with T3 levels. Cu was positively associated with T4, T3, and rT3, which was largely dependent on TBG levels. CONCLUSION The subjects with ID did not display profound deficiencies in trace element levels. AEDs were associated with serum Se and Cu levels, while serum Se and Cu were also associated with thyroid parameters. Further studies on the underlying mechanisms and potential clinical importance are warranted.
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Affiliation(s)
- Chantal Zevenbergen
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Tim I M Korevaar
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Andrea Schuette
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Robin P Peeters
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Marco Medici
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Theo J Visser
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - Lutz Schomburg
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
| | - W Edward Visser
- Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany Department of Internal MedicineRotterdam Thyroid CenterErasmus Medical Center, Wytemaweg 80, 3015 CN Rotterdam, The NetherlandsInstitut für Experimentelle EndokrinologieCharité-Universitätsmedizin Berlin, Augustenburger Platz 1, D-13353 Berlin, Germany
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Meng L, Rijntjes E, Swarts H, Bunschoten A, van der Stelt I, Keijer J, Teerds K. Dietary-Induced Chronic Hypothyroidism Negatively Affects Rat Follicular Development and Ovulation Rate and Is Associated with Oxidative Stress. Biol Reprod 2016; 94:90. [PMID: 26962119 DOI: 10.1095/biolreprod.115.136515] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/04/2016] [Indexed: 11/01/2022] Open
Abstract
The long-term effects of chronic hypothyroidism on ovarian follicular development in adulthood are not well known. Using a rat model of chronic diet-induced hypothyroidism initiated in the fetal period, we investigated the effects of prolonged reduced plasma thyroid hormone concentrations on the ovarian follicular reserve and ovulation rate in prepubertal (12-day-old) and adult (64-day-old and 120-day-old) rats. Besides, antioxidant gene expression, mitochondrial density and the occurrence of oxidative stress were analyzed. Our results show that continuous hypothyroidism results in lower preantral and antral follicle numbers in adulthood, accompanied by a higher percentage of atretic follicles, when compared to euthyroid age-matched controls. Not surprisingly, ovulation rate was lower in the hypothyroid rats. At the age of 120 days, the mRNA and protein content of superoxide dismutase 1 (SOD1) were significantly increased while catalase (CAT) mRNA and protein content was significantly decreased, suggesting a disturbed antioxidant defense capacity of ovarian cells in the hypothyroid animals. This was supported by a significant reduction in the expression of peroxiredoxin 3 ( ITALIC! Prdx3), thioredoxin reductase 1 ( ITALIC! Txnrd1), and uncoupling protein 2 ( ITALIC! Ucp2) and a downward trend in glutathione peroxidase 3 ( ITALIC! Gpx3) and glutathione S-transferase mu 2 ( ITALIC! Gstm2) expression. These changes in gene expression were likely responsible for the increased immunostaining of the oxidative stress marker 4-hydroxynonenal. Together these results suggest that chronic hypothyroidism initiated in the fetal/neonatal period results in a decreased ovulation rate associated with a disturbance of the antioxidant defense system in the ovary.
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Affiliation(s)
- Li Meng
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Eddy Rijntjes
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands Institut für Experimentelle Endokrinologie, Charité Universitäts-Medizin Berlin, Berlin, Germany
| | - Hans Swarts
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Annelies Bunschoten
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Inge van der Stelt
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Jaap Keijer
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
| | - Katja Teerds
- Human and Animal Physiology, Wageningen University, Wageningen, The Netherlands
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Lee HM, Joo BS, Lee CH, Kim HY, Ock JH, Lee YS. Effect of Glucagon-like Peptide-1 on the Differentiation of Adipose-derived Stem Cells into Osteoblasts and Adipocytes. J Menopausal Med 2015; 21:93-103. [PMID: 26357647 PMCID: PMC4561747 DOI: 10.6118/jmm.2015.21.2.93] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 05/13/2015] [Accepted: 05/31/2015] [Indexed: 11/27/2022] Open
Abstract
Objectives Glucagon-like peptide-1 (GLP-1) is an intestinally secreted hormone and it plays an important role in the regulation of glucose homeostasis. However, the possible role of GLP-1 in the differentiation of adipose-derived stem cells (ADSCs) remains unknown. Therefore this study investigated the effect of GLP-1 on the differentiation of ADSCs into osteoblasts and adipocytes. Methods ADSCs were isolated from human adipose tissues of the abdomens, cultured and characterized by flow cytometry and multi-lineage potential assay. ADSCs were induced in osteogenic and adipogenic media treated with two different doses (10 and 100 nM) of GLP-1, and then the effect of GLP-1 on differentiation of ADSCs into osteoblast and adipocyte was examined. The signaling pathway involved in these processes was also examined. Results Isolated human ADSCs expressed mesenchymal stem cell (MSC) specific markers as well as GLP-1 receptor (GLP-1R) proteins. They also showed multiple-lineage potential of MSC. GLP-1 was upregulated the activity and mRNA expression of osteoblast-specific marker, alkaline phosphatase and the mineralization of calcium. In contrast, GLP-1 significantly suppressed the expression of adipocyte-specific markers, peroxisome proliferator-activated receptor gamma (PPAR-γ), lipoprotein lipase (LPL) and adipocyte protein 2 (AP2). This decreased expression of adipocyte specific markers caused by GLP-1 was significantly reversed by the treatment of extracellular signal-regulated kinase (ERK) inhibitor, PD98059 (P < 0.05). Conclusion This result demonstrates that GLP-1 stimulates osteoblast differentiation in ADSCs, whereas it inhibits adipocyte differentiation. The ERK signaling pathway seems to be involved in these differentiation processes mediated by GLP-1.
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Affiliation(s)
- Hye Min Lee
- Department of Molecular Biology, Natural Science College, Pusan National University, Busan, Korea
| | - Bo Sun Joo
- Research Center for Anti-Aging Technology Development, Pusan National University, Busan, Korea
| | - Chang Hoon Lee
- Research Center for Anti-Aging Technology Development, Pusan National University, Busan, Korea
| | - Heung Yeol Kim
- Department of Obstetrics and Gynecology, Kosin University Hospital, Busan, Korea
| | - Ji Hoon Ock
- Department of Obstetrics and Gynecology, Busan Adventist Hospital, Busan, Korea
| | - Young Seok Lee
- Department of Pediatric Cardiology, Dona-A University Hospital, Busan, Korea
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Yin W, Maguire SM, Pham B, Garcia AN, Dang NV, Liang J, Wolfe A, Hofmann HA, Gore AC. Testing the Critical Window Hypothesis of Timing and Duration of Estradiol Treatment on Hypothalamic Gene Networks in Reproductively Mature and Aging Female Rats. Endocrinology 2015; 156:2918-33. [PMID: 26018250 PMCID: PMC4511137 DOI: 10.1210/en.2015-1032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
At menopause, the dramatic loss of ovarian estradiol (E2) necessitates the adaptation of estrogen-sensitive neurons in the hypothalamus to an estrogen-depleted environment. We developed a rat model to test the "critical window" hypothesis of the effects of timing and duration of E2 treatment after deprivation on the hypothalamic neuronal gene network in the arcuate nucleus and the medial preoptic area. Rats at 2 ages (reproductively mature or aging) were ovariectomized and given E2 or vehicle replacement regimes of differing timing and duration. Using a 48-gene quantitative low-density PCR array and weighted gene coexpression network analysis, we identified gene modules differentially regulated by age, timing, and duration of E2 treatment. Of particular interest, E2 status differentially affected suites of genes in the hypothalamus involved in energy balance, circadian rhythms, and reproduction. In fact, E2 status was the dominant factor in determining gene modules and hormone levels; age, timing, and duration had more subtle effects. Our results highlight the plasticity of hypothalamic neuroendocrine systems during reproductive aging and its surprising ability to adapt to diverse E2 replacement regimes.
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Affiliation(s)
- Weiling Yin
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Sean M Maguire
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Brian Pham
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Alexandra N Garcia
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Nguyen-Vy Dang
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Jingya Liang
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Andrew Wolfe
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Hans A Hofmann
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
| | - Andrea C Gore
- Division of Pharmacology and Toxicology (W.Y., B.P., N.-V.D., J.L., A.C.G.), Departments of Integrative Biology (S.M.M., H.A.H.) and Psychology (A.N.G., A.C.G.), and Institute for Neuroscience (H.A.H., A.C.G.), The University of Texas at Austin, Austin, Texas 78712; and Johns Hopkins University School of Medicine (A.W.), Baltimore, Maryland 21287
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Wang K, Yang Y, Wu Y, Chen J, Zhang D, Liu C. The association of menstrual and reproductive factors with thyroid nodules in Chinese women older than 40 years of age. Endocrine 2015; 48:603-14. [PMID: 25012252 DOI: 10.1007/s12020-014-0342-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
Abstract
The purpose of the study was to explore the association of menstrual and reproductive factors with thyroid nodules in Chinese women older than 40 years of age. A questionnaire was completed by 6,571 women aged 40 years or older in a community-based epidemiological investigation of thyroid nodules conducted from June to November 2011 in Nanjing City. Thyroid nodules were measured by ultrasound. The Thyroid Imaging Reporting and Data System score was used to differentiate between benign and possibly malignant nodules. Menopausal age (>55 vs. <50 years: RR = 1.17, 95 % CI 1.00-1.34) and number of reproductive years (>40 vs. <35 years: RR = 1.12, 95 % CI 1.01-1.24) increased the risk of thyroid nodules, but were not associated with suspected malignant nodules. Women who experienced more pregnancies (≥5 vs. ≤1: RR = 2.09, 95 % CI 1.79-2.40) and abortions (≥3 vs. 0: RR = 1.61, 95 % CI 1.41-1.81) were prone to development of thyroid nodules, and more likely to form suspected malignant nodules (pregnancies, RR = 3.59, 95 % CI 1.60-7.20; abortions, RR = 2.36, 95 % CI 1.31-4.06). Furthermore, higher risks of thyroid nodules (RR = 1.36, 95 % CI 1.14-1.59) and suspected malignant nodules (RR = 2.80, 95 % CI 1.08-6.53) were observed in women who had undergone artificial compared with natural abortion. Periods of elevated estrogen and progesterone levels in women, such as pregnancy, were the key occasions for occurrence of both benign and suspiciously malignant thyroid nodules, while longer lifetime length of exposure to female sex hormones might promote the growth of thyroid nodules.
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Affiliation(s)
- Kun Wang
- Department of Endocrinology, The First Clinical College, Nanjing University of Chinese Medicine, Jiangsu Province Hospital on Integration of Chinese and Western Medicine, 138 Xianlin Dadao Road, Nanjing, 210023, China
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Awad HA, Alrefaie ZA. An evidence for the transcriptional regulation of iodothyronine deiodinase 2 by progesterone in ovarectomized rats. J Physiol Biochem 2014; 70:331-9. [PMID: 24362948 DOI: 10.1007/s13105-013-0307-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
Abstract
Recent literature lacks studies on the effects of progesterone withdrawal on peripheral conversion of thyroxin (T4) into triiodothyronine (T3) by iodothyronine deiodinase 2 (D2) in different body tissues. The present study aimed to assess the possible relation of progesterone to T4, T3, and D2 in ovarectomized rats. Thirty female Wistar rats were included into a sham-operated control group and an ovarectomized group. Four months following the surgical procedures, measurements of estradiol, progesterone, free T4, free T3, and thyroid-stimulating hormone (TSH) were done. Also, estradiol/progesterone and T4/T3 ratios were calculated. Tissue homogenates from the kidney, liver, brain, thyroid, mandible, and femur were used to assess expression of D2 mRNA. The estradiol/progesterone ratio showed a significant increase in ovarectomized rats. T4 showed a significant increase in contrast to T3 which showed a highly significant decrease following ovariectomy. The T4/T3 ratio was significantly increased in ovarectomized rats. In addition, D2 expression was significantly attenuated in all tissue homogenates of the ovarectomized group. The present work showed a significant positive correlation between T4 and T3 in the sham-operated control rats, which was abolished in ovarectomized rats. A negative significant correlation between progesterone and T4 was revealed in ovarectomized rats. There was also a significant positive correlation between progesterone and D2 expression in the ovarectomized group. The results of the present study hypothesize that progesterone withdrawal may underlie the decrement in D2 expression, with consequent reduction in the peripheral conversion of T4 into T3 leading to a hypothyroid state.
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Affiliation(s)
- Hossam A Awad
- Physiology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Vincent M, Yogiraj K. A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction. Int J Trichology 2013; 5:57-60. [PMID: 23960405 PMCID: PMC3746235 DOI: 10.4103/0974-7753.114701] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Maya Vincent
- Department of Dermatology, Dr. K. Yogiraj Centre for Dermatology and Cosmetology, Pattom, Trivandrum, Kerala, India
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Polovina S, Popovic V, Duntas L, Milic N, Micic D. Frax score calculations in postmenopausal women with subclinical hypothyroidism. Hormones (Athens) 2013; 12:439-48. [PMID: 24121385 DOI: 10.1007/bf03401309] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of our study was to evaluate the relationship between the elevated TSH and fracture risk in postmenopausal women with subclinical hypothyroidism for evaluation of individuals with a high risk for osteoporotic fractures. DESIGN FRAX score calculation (10-year estimated risk for bone fracture) and measurement of bone markers (osteocalcin and beta cross-laps) were performed in 82 postmenopausal women with newly discovered subclinical hypothyroidism (mean age 59.17±7.07, mean BMI 27.89±3.46kg/m2, menopause onset in 48.05±4.09 years of age) and 51 matched controls (mean age 59.69±5.72, mean BMI 27.68±4.66kg/m2, menopause onset in 48.53±4.58 years of age) with normal thyroid function. RESULTS The main FRAX score was significantly higher in the group with subclinical hypothyroidism than in the controls (6.50±4.58 vs. 4.35±1.56; p=0.001). Hip FRAX score was significantly higher in the group with subclinical hypothyroidism (1.11±1.94 vs. 0.50±0.46; p=0.030). There was no significant difference in bone markers: osteocalcin (23.99±12.63 vs. 21.79±5.34 ng/mL; p=0.484) and beta cross-laps (365.76±184.84 vs. 306.88±110.73 pg/mL; p=0.21) between the two groups. CONCLUSIONS Postmenopausal patients with subclinical hypothyroidism, in particular of autoimmune origin, have higher FRAX scores and a thus greater risk for low-trauma hip fracture than euthyroid postmenopausal women. Our results point to the need to monitor postmenopausal patients with subclinical hypothyroidism for avoidance of fractures.
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Affiliation(s)
- Snezana Polovina
- Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Boeloni JN, de M. Ocarino N, Silva JF, Corrêa CR, Bertollo CM, Hell RC, de M. Pereira M, Goes AM, Serakides R. Osteogenic differentiation of bone marrow mesenchymal stem cells of ovariectomized and non-ovariectomized female rats with thyroid dysfunction. Pathol Res Pract 2013; 209:44-51. [DOI: 10.1016/j.prp.2012.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 09/02/2012] [Accepted: 10/02/2012] [Indexed: 10/27/2022]
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Gustafsson RJ, Ahrné S, Jeppsson B, Benoni C, Olsson C, Stjernquist M, Ohlsson B. The Lactobacillus flora in vagina and rectum of fertile and postmenopausal healthy Swedish women. BMC WOMENS HEALTH 2011; 11:17. [PMID: 21609500 PMCID: PMC3118184 DOI: 10.1186/1472-6874-11-17] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 05/25/2011] [Indexed: 01/05/2023]
Abstract
Background Lactobacillus species are the most often found inhabitants of vaginal ecosystem of fertile women. In postmenopausal women with low oestrogen levels, Lactobacillus flora is diminishing or absent. However, no studies have been performed to investigate the correlation between oestrogen levels and the lactobacilli in the gut. The aim of the present study was to investigate the relation in healthy women between vaginal and rectal microbial flora as well as possible variations with hormone levels. Methods Vaginal and rectal smears were taken from 20 healthy fertile women, average 40 years (range 28-49 years), in two different phases of the menstrual cycle, and from 20 postmenopausal women, average 60 years (range 52-85 years). Serum sex hormone levels were analyzed. Bacteria from the smears isolated on Rogosa Agar were grouped by Randomly Amplified Polymorphic DNA and identified by multiplex PCR and partial 16S rRNA gene sequencing. Results Lactobacillus crispatus was more often found in the vaginal flora of fertile women than in that of postmenopausal (p = 0.036). Fifteen of 20 fertile women had lactobacilli in their rectal smears compared to 10 postmenopausal women (p = 0.071). There was no correlation between the number of bacteria in vagina and rectum, or between the number of bacteria and hormonal levels. Neither could any association between the presence of rectal lactobacilli and hormonal levels be found. Conclusion Lactobacillus crispatus was more prevalent in the vaginal flora of fertile women, whereas the Lactobacillus flora of rectum did not correlate to the vaginal flora nor to hormonal levels.
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Affiliation(s)
- Rita J Gustafsson
- Department of Clinical Sciences, Skåne University Hospital, Malmö, Lund University, Lund, Sweden.
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Hot flushes in prostatic cancer patients during androgen-deprivation therapy with monthly dose of degarelix or leuprolide. Prostate Cancer Prostatic Dis 2011; 14:184-90. [PMID: 21445092 DOI: 10.1038/pcan.2011.11] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of the study was to compare the onset, incidence and frequency/intensity of hot flushes during androgen-deprivation therapy with a gonadotropin-releasing hormone antagonist (GnRH) blocker versus an agonist using data from a randomized Phase 3 clinical trial. In total, 610 prostate cancer patients received monthly degarelix (s.c., 240/80 mg, n=207, or 240/160 mg, n=202) or leuprolide (i.m., 7.5 mg, n=201) for 12 months. Data on hot flushes was collected as self-reported adverse events and in a subgroup of 254 patients with electronic diaries. The onset of hot flushes was faster on degarelix versus leuprolide, and was accompanied by higher median hot flush scores during the first 3 months. However, there were no significant differences in overall incidence rates and median hot flush scores over the entire 12 months. After the third month, incidence rates dropped below 6%, whereas prevalence rates remained constant in all the three treatment arms. In multivariate analysis, body weight and heart rate at baseline were independent predictors of hot flushes (P<0.05). Except for a more rapid onset with the GnRH antagonist, there were no major differences in the overall pattern of hot flushes between treatment options. Weight control may help to minimize the incidence of hot flushes.
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Rijntjes E, Swarts HJM, Anand-Ivell R, Teerds KJ. Prenatal induced chronic dietary hypothyroidism delays but does not block adult-type Leydig cell development. Am J Physiol Endocrinol Metab 2009; 296:E305-14. [PMID: 19033542 DOI: 10.1152/ajpendo.90750.2008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Transient hypothyroidism induced by propyl-2-thiouracyl blocks postpartum Leydig cell development. In the present study, the effects of chronic hypothyroidism on the formation of this adult-type Leydig cell population were investigated, using a more physiological approach. Before mating, dams were put on a diet consisting of an iodide-poor feed supplemented with a low dose of perchlorate and, with their offspring, were kept on this diet until death. In the pups at day 12 postpartum, plasma thyroid-stimulating hormone levels were increased by 20-fold, whereas thyroxine and free tri-iodothyronine levels were severely depressed, confirming a hypothyroid condition. Adult-type progenitor Leydig cell formation and proliferation were reduced by 40-60% on days 16 and 28 postpartum. This was followed by increased Leydig cell proliferation at later ages, suggesting a possible slower developmental onset of the adult-type Leydig cell population under hypothyroid conditions. Testosterone levels were increased 2- to 10-fold in the hypothyroid animals between days 21 and 42 postpartum compared with the age-matched controls. Combined with the decreased presence of 5alpha-reductase, this implicates a lower production capacity of 5alpha-reduced androgens. In 84-day-old rats, after correction for body weight-to-testis weight ratio, plasma insulin-like factor-3 levels were 35% lower in the hypothyroid animals, suggestive of a reduced Leydig cell population. This is confirmed by a 37% reduction in the Sertoli cell-to-Leydig cell ratio in hypothyroid rats. In conclusion, we show that dietary-induced hypothyroidism delays but, unlike propyl-2-thiouracyl, does not block the development of the adult-type Leydig cell population.
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Affiliation(s)
- Eddy Rijntjes
- Dept. of Animal Sciences, Human & Animal Physiology Group, Wageningen Univ., Marijkeweg 40, 6709 PG Wageningen, The Netherlands
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