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Mendez DA, Soñanez-Organis JG, Yang X, Vazquez-Anaya G, Nishiyama A, Ortiz RM. Exogenous thyroxine increases cardiac GLUT4 translocation in insulin resistant OLETF rats. Mol Cell Endocrinol 2024; 590:112254. [PMID: 38677465 DOI: 10.1016/j.mce.2024.112254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 04/29/2024]
Abstract
During insulin resistance, the heart undergoes a metabolic shift in which fatty acids (FA) account for roughly about 99% of the ATP production. This metabolic shift is indicative of impaired glucose metabolism. A shift in FA metabolism with impaired glucose tolerance can increase reactive oxygen species (ROS), lipotoxicity, and mitochondrial dysfunction, ultimately leading to cardiomyopathy. Thyroid hormones (TH) may improve the glucose intolerance by increasing glucose reabsorption and metabolism in peripheral tissues, but little is known on its effects on cardiac tissue during insulin resistance. In the present study, insulin resistant Otsuka Long Evans Tokushima Fatty (OLETF) rats were used to assess the effects of exogenous thyroxine (T4) on glucose metabolism in cardiac tissue. Rats were assigned to four groups: (1) lean, Long Evans Tokushima Otsuka (LETO; n=6), (2) LETO + T4 (8 μg/100 g BM/d × 5 wks; n = 7), (3) untreated OLETF (n = 6), and (4) OLETF + T4 (8 μg/100 g BM/d × 5 wks; n = 7). T4 increased GLUT4 gene expression by 85% in OLETF and increased GLUT4 protein translocation to the membrane by 294%. Additionally, T4 increased p-AS160 by 285%, phosphofructokinase-1 (PFK-1) mRNA, the rate limiting step in glycolysis, by 98% and hexokinase II by 64% in OLETF. T4 decreased both CPT2 mRNA and protein expression in OLETF. The results suggest that exogenous T4 has the potential to increase glucose uptake and metabolism while simultaneously reducing fatty acid transport in the heart of insulin resistant rats. Thus, L-thyroxine may have therapeutic value to help correct the impaired substrate metabolism associated with diabetic cardiomyopathy.
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Affiliation(s)
- Dora A Mendez
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA.
| | - José G Soñanez-Organis
- Division of Science and Engineering, Department of Chemical Biological and Agropecuary Sciences, University of Sonora, Navojoa, SON, Mexico
| | - Xue Yang
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
| | - Guillermo Vazquez-Anaya
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
| | - Akira Nishiyama
- Department of Pharmacology, Kagawa University Medical School, Kagawa, Japan
| | - Rudy M Ortiz
- Department of Molecular and Cell Biology, School of Natural Sciences, University of California, Merced, CA, USA
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Moreno KGT, Marques AAM, da Silva GP, Bertoncelo LA, Pessoal LB, Gonçalves LD, Dos Santos AC, Souza RIC, Silva DB, Gasparotto Junior A. Cardioprotective Effects of Aloysia polystachya Essential Oil on a Rat Model with Multiple Cardiovascular Risk Factors. PLANTA MEDICA 2024; 90:708-716. [PMID: 38631368 DOI: 10.1055/a-2294-6922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
Traditional medicine is a frequently utilized method to treat cardiovascular disease and its primary risk factors, including hypertension and dyslipidemia. Aloysia polystachya is a species that is commonly employed to treat various pathological conditions, and it has already been identified as having some cardioprotective effects. This study aimed to investigate the protective effects of the essential oil extracted from the leaves of A. polystachya in a rat model that simulates multiple cardiovascular risk factors. We evaluate the acute toxicity, as well as the cardioprotective effects, by giving different doses of A. polystachya essential oil (1.47 mg/kg, 4.40 mg/kg, and 13.20 mg/kg) over a period of 42 days. The control group was treated with rosuvastatin (5 mg/kg). At the end of the treatments, the renal function, electrocardiography, blood pressure, vascular reactivity, serum biochemical profile, and organ histopathology were evaluated. The main compounds identified in the essential oil of A. polystachya using gas chromatography coupled with mass spectrometry were beta-myrcene (1.08%), limonene (40.13%), and carvone (56.47%). The essential oil of A. polystachya not only lacks acute toxicity but also mitigates the reduction in the excretion of sodium, chloride, and creatinine in urine. Furthermore, it reduces electrocardiographic abnormalities and decreases blood pressure levels. Moreover, this treatment prevents an elevation in markers of inflammation and oxidative stress in the bloodstream. Our findings indicate significant cardioprotective effects of the essential oil of A. polystachya against multiple risk factors for cardiovascular diseases in hypertensive rats.
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Affiliation(s)
- Karyne Garcia Tafarelo Moreno
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Aline Aparecida Macedo Marques
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Gabriela Pereira da Silva
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Luana Ale Bertoncelo
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Luciane Barbosa Pessoal
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Larissa Dantas Gonçalves
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | - Ariany Carvalho Dos Santos
- Laboratory of Histopathology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
| | | | - Denise Brentan Silva
- Laboratory of Natural Products and Mass Spectrometry (LAPNEM), Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Arquimedes Gasparotto Junior
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, MS, Brazil
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Koirala P, Tawfiq RK, Raslau D. 22-Year-Old Man With Seizures. Mayo Clin Proc 2024; 99:661-664. [PMID: 38300207 DOI: 10.1016/j.mayocp.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 07/14/2023] [Accepted: 07/21/2023] [Indexed: 02/02/2024]
Affiliation(s)
- Priscilla Koirala
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - Reema K Tawfiq
- Resident in Internal Medicine, Mayo Clinic School of Graduate Medical Education, Rochester, MN
| | - David Raslau
- Advisor to residents and Consultant in General Internal Medicine, Mayo Clinic, Rochester, MN.
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Zhang Y, Yang J, Gong Y, He S, Wen P, Jiang Y, He J, Zhu B, Li L. In Vitro and In Vivo Supplementation with Curcumin Promotes Hippocampal Neuronal Synapses Development in Rats by Inhibiting GSK-3β and Activating β-catenin. Mol Neurobiol 2024; 61:2390-2410. [PMID: 37875709 DOI: 10.1007/s12035-023-03665-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/18/2023] [Indexed: 10/26/2023]
Abstract
The human fetal thyroid gland is not capable of producing thyroid hormones independently until 20 weeks of gestation, and if maternal thyroid hormone synthesis is inadequate in early pregnancy, fetal brain and nerve development may be affected by maternal hypothyroidism. Curcumin, which is isolated from turmeric (Curcuma longa), has been shown to be effective in repairing neurological disorders and is effective in relieving nerve damage when consumed over a long period of time. In this experiment, we investigated the effect of curcumin supplementation on synaptic development of rat hippocampal neurons. A cell model of oxidative damage and a young rat model of hypothyroidism were constructed, and model cells and rats were treated with triiodothyronine (T3), tetraiodothyronine (T4), and curcumin, respectively. Damage of nerve cells and animal brain tissues was examined, and the effect of curcumin in alleviating the blocked neurodevelopment was investigated. Further modulation of GSK-3β/β-catenin was performed to investigate the mechanism of action of curcumin. Ultimately, we found that T3-, T4-, and curcumin-treated model cells and young rats had increased numbers of synapses and good neurodevelopment. At the same time, we found that curcumin inhibited the production of GSK-3β and Axin to activate β-catenin. The inhibition of β-catenin weakened the therapeutic effect of curcumin, and the differences between the indicators and the model group disappeared. Both cellular and animal experiments supported that curcumin effectively alleviated the oxidative cell damage caused by thyroxine deficiency and activated the synaptogenic ability of nerve synapses by inhibiting GSK-3β and protecting β-catenin activity.
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Affiliation(s)
- Yinhong Zhang
- Faculty of Life Science and Biotechnology, Kunming University of Science and Technology, Kunming, 650500, China
- Department of Medical Genetics, NHC Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
- School of Medicine, Kunming University of Science and Technology, Kunming, 650500, China
| | - Jinghui Yang
- Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Yanling Gong
- School of Medicine, Kunming University of Science and Technology, Kunming, 650500, China
| | - Shan He
- Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Ping Wen
- Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Yan Jiang
- Department of Prevention and Healthcare, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Jing He
- Department of Medical Genetics, NHC Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China
| | - Baosheng Zhu
- Department of Medical Genetics, NHC Key Laboratory of Preconception Health Birth in Western China, Yunnan Provincial Key Laboratory for Birth Defects and Genetic Diseases, Yunnan Provincial Clinical Research Center for Birth Defects and Rare Diseases, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China.
| | - Li Li
- Faculty of Life Science and Biotechnology, Kunming University of Science and Technology, Kunming, 650500, China.
- School of Medicine, Kunming University of Science and Technology, Kunming, 650500, China.
- Department of Pediatrics, The Affiliated Hospital of Kunming University of Science and Technology, The First People's Hospital of Yunnan Province, Kunming, 650032, China.
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Wang L, Zhao G, Sandeep B. A review regarding the article 'systematic review and meta-analysis of levothyroxine effect on blood pressure in patients with subclinical hypothyroidism'. Curr Probl Cardiol 2024; 49:102351. [PMID: 38128632 DOI: 10.1016/j.cpcardiol.2023.102351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023]
Abstract
Subclinical hypothyroidism (SCH) is a biochemical condition defined by elevated serum thyroid stimulating hormone levels in the setting of normal levels of the peripheral thyroid hormones, thyroxine, and triiodothyronine. SCH is becoming increasingly prevalent in recent years especially among the elderly, and its prevalence ranges approximately from 5 to 20% in the general population. Clinical manifestations of SCH range from obvious symptoms to no signs or symptoms, and the most common symptoms of SCH include fatigue, mild depression, muscle weakness, cold intolerance, and weight gain. However, despite the clear biochemical pattern of mild thyroid failure, few patients with SCH have typical hypothyroid symptoms. Patients with SCH have elevated blood pressure, but the effect of levothyroxine (LT4) therapy on blood pressure among those patients is still unclear. Severe SCH or mild SCH with symptoms are generally recommended to be treated with levothyroxine (LT4), which requires monitoring of TSH level over several months and adjusting LT4 dosage accordingly. Oral LT4 administered daily is the treatment of choice for SCH, and the goal of LT4 treatment for SCH is to restore the TSH level within the reference range.
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Affiliation(s)
- Liwei Wang
- Department of General Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China.
| | - Gang Zhao
- Department of General Surgery, Qingbai Jiang District People's Hospital, Graduate School of Jinzhou Medical University, Chengdu, Sichuan 610300, China
| | - Bhushan Sandeep
- Department of Cardio-Thoracic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China
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Darouei B, Amani-Beni R, Abhari AP, Fakhrolmobasheri M, Shafie D, Heidarpour M. Systematic review and meta-analysis of levothyroxine effect on blood pressure in patients with subclinical hypothyroidism. Curr Probl Cardiol 2024; 49:102204. [PMID: 37967804 DOI: 10.1016/j.cpcardiol.2023.102204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/17/2023]
Abstract
This study aims to evaluate the effect of levothyroxine therapy on blood pressure (BP) in patients with subclinical hypothyroidism (SCH). Were searched Six databases, and randomized controlled trials (RCT) and prospective cohort studies evaluating the effect of levothyroxine therapy on BP in patients with SCH were included. 37 articles (9 RCTs and 28 prospective cohorts) were included in this meta-analysis. Pooled analysis of RCT studies was insignificant; however, pooled analysis of 28 prospective cohort studies showed a significant difference before and after the therapy, reducing both systolic blood pressure (SBP) and diastolic blood pressure (DBP) (MD=-4.02 [-6.45, -4.58] and MD=-2.13 [-3.69, -0.56], both P-values<0.05). Levothyroxine therapy can play a role in lowering BP in patients with SCH. However, this effect is more observed in Caucasians, SCH patients with higher initial TSH followed by more remarkable TSH change to normal levels, and SCH patients with hypertension.
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Affiliation(s)
- Bahar Darouei
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Reza Amani-Beni
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Parsa Abhari
- Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Fakhrolmobasheri
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Davood Shafie
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Heidarpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Wang X, Zhang E, Tian Z, Zhao R, Huang K, Gao S, Su S, Xie S, Liu J, Luan Y, Zhang Y, Zhang Z, Yan Y, Yue W, Yin C, Liu R. The association between dyslipidaemia in the first trimester and adverse pregnancy outcomes in pregnant women with subclinical hypothyroidism: a cohort study. Lipids Health Dis 2024; 23:13. [PMID: 38212787 PMCID: PMC10782788 DOI: 10.1186/s12944-023-01998-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/28/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Subclinical hypothyroidism (SCH) is linked to dyslipidaemia and adverse pregnancy outcomes. However, the impact of dyslipidaemia on the outcome of pregnancy in SCH is unclear. METHODS We enrolled 36,256 pregnant women and evaluated their pregnancy outcomes. The following data was gathered during the first trimester (≤ 13+ 6 weeks of gestation): total cholesterol (TC), low-density lipoprotein (LDL-C), triglyceride (TG), high-density lipoprotein (HDL-C), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) concentrations. The reference ranges for lipids were estimated to range from the 5th to the 95th percentile. Logistic regression assessed the relationships between dyslipidaemia and adverse pregnancy outcomes, including abortion, preeclampsia/eclampsia, low birth weight, foetal growth restriction, premature rupture of foetal membranes, gestational hypertension, preterm birth, macrosomia and gestational diabetes mellitus (GDM). Additionally, the best thresholds for predicting adverse pregnancy outcomes based on TSH, FT4, and lipid levels were determined using receiver operating characteristic curves. RESULTS In the first trimester, LDL-C > 3.24 mmol/L, TG > 1.92 mmol/L, HDL-C < 1.06 mmol/L, and TC > 5.39 mmol/L were used to define dyslipidaemia. In this cohort, 952 (3.56%) patients were diagnosed with SCH, and those who had dyslipidaemia in the first trimester had higher incidences of gestational hypertension (6.59% vs. 3.25%), preeclampsia/eclampsia (7.14% vs. 3.12%), GDM (22.53% vs. 13.77%), and low birth weight (4.95% vs. 2.08%) than did those without dyslipidaemia. However, after adjusting for prepregnancy body mass index (pre-BMI), dyslipidaemia was no longer related to these risks. Furthermore, elevated TG dyslipidaemia in SCH patients was connected to an enhanced potential of gestational hypertension (odds ratio [OR]: 2.687, 95% confidence interval [CI]: 1.074 ~ 6.722), and elevated LDL-C dyslipidaemia correlated with increased preeclampsia/eclampsia risk (OR: 3.172, 95% CI: 1.204 ~ 8.355) after accounting for age, smoking status, alcohol use, pre-BMI, and levothyroxine use. Additionally, the combination of TC, TG, LDL-C, pre-BMI, and TSH exhibited enhanced predictive capabilities for gestational hypertension, preeclampsia/eclampsia, and GDM. Values of 0.767, 0.704, and 0.706 were obtained from the area under the curve. CONCLUSIONS Among pregnant women with SCH, dyslipidaemia in early pregnancy was related to elevated risks of adverse pregnancy consequences. The combined consideration of age, pre-BMI, TSH, and lipid levels in the first trimester could be beneficial for monitoring patients and implementing interventions to reduce adverse pregnancy outcomes.
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Affiliation(s)
- Xueran Wang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Enjie Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Zongyuan Tian
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Rong Zhao
- Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Kaikun Huang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Shen Gao
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Shaofei Su
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Shuanghua Xie
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Jianhui Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Yingyi Luan
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Yue Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Zheng Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Yousheng Yan
- Department of Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China
| | - Wentao Yue
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Chenghong Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
| | - Ruixia Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China.
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Gottwald-Hostalek U, Kahaly GJ. Optimizing levothyroxine treatment for subclinical hypothyroidism during pregnancy. Curr Med Res Opin 2024; 40:43-49. [PMID: 37897184 DOI: 10.1080/03007995.2023.2276120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
The onset of pregnancy places additional stress of the thyroid gland, which must produce additional thyroid hormones to support the developing foetus. Hypothyroidism, including subclinical hypothyroidism (SCH), may appear de novo at this time, or existing thyroid disease may become more severe. Accordingly, SCH is a relatively common complication of up to about 3% of pregnancies, with higher rates in some areas. There is strong evidence from systematic reviews and meta-analyses that uncontrolled SCH is associated with an increased risk of adverse pregnancy outcomes, including miscarriage, preeclampsia, and gestational diabetes. The evidence base also suggests that treatment with levothyroxine (LT4), optimized to control thyrotropin (TSH) to within its pregnancy-specific reference ranges reduces these risks. Current management guidelines provide a clear framework of intervention with LT4 in pregnant women with SCH, especially where TSH is high or where thyroperoxidase autoantibodies are present. Sub-optimal adherence to LT4 is common: it is important that patients take their LT4 correctly and that treating physicians and/or healthcare professionals manage these patients according to the latest management guidelines. The titration of LT4 is likely to occur within a range of LT4 daily doses between 25 µg and 75 µg for the majority of this population. LT4 is a narrow therapeutic index drug and small variations in dosage may produce a clinically significant change in thyroid status. Newer formulations of LT4, engineered to provide more precise and consistent dosing, and with a broad range of tablet strengths, may facilitate the precise titration of the LT4 dose for these patients.
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Affiliation(s)
| | - George J Kahaly
- Department of Medicine, Johannes Gutenberg University Medical Center, Mainz, Germany
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9
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Zúñiga D, Balasubramanian S, Mehmood KT, Al-Baldawi S, Zúñiga Salazar G. Hypothyroidism and Cardiovascular Disease: A Review. Cureus 2024; 16:e52512. [PMID: 38370998 PMCID: PMC10874251 DOI: 10.7759/cureus.52512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Hypothyroidism is an endocrine disorder more commonly in older adults. Simultaneously, this population has an increased incidence of cardiovascular risk factors and disease, which remains the leading cause of death worldwide. Thyroid hormones (THs) promote adequate function of the cardiovascular system as they exert their effects through receptors located in the myocardium and the vasculature. In hypothyroidism, this homeostasis is disrupted, which leads to the emergence of pathogenic pathways that accelerate the progression of cardiovascular disease and aggravate its outcomes in these individuals. This article has reviewed existing literature on the relationship between hypothyroidism and cardiovascular disease (CVD). We have explored the pathogenic mechanisms linking both conditions and highlighted the prevalence of cardiovascular risk factors as well as the increased incidence of cardiovascular events in overt and subclinical diseases. Furthermore, indications of hormone replacement therapy in subclinical disease and its efficacy in reducing CVD morbidities in a particular subset of patients have been discussed.
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Affiliation(s)
- Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
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10
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Luo S, Wang XR, Yang LJ, Zou LY. FT4-to-FT3 ratio is a novel prognostic marker in subacute combined spinal cord degeneration patients. Transl Neurosci 2024; 15:20220340. [PMID: 38708097 PMCID: PMC11069125 DOI: 10.1515/tnsci-2022-0340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/31/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
Objectives The FT4-to-FT3 ratio (FFR) variations in patients with subacute combined spinal cord degeneration (SCSD) as a potentially useful prognostic indicator are still unknown. This study aimed to investigate the changes of FFR as a potentially valuable prognostic predictor in patients with SCSD. Methods This study included 144 consecutive SCSD patients who received standard diagnostic and therapeutic procedures between January 2015 and December 2021 and were admitted to the Department of Neurology at the First Affiliated Hospital of Bengbu Medical University. At the time of admission, we gathered data on all patients' demographics, daily routines, previous chronic conditions, medication histories, and other clinical details. For the purpose of measuring FFR, blood samples were specifically taken within 48 h of admission. The degree of neurological impairment of patients was assessed using the functional disability scale at the time of admission. At 6 months following discharge, the Modified Rankin Scale (mRS) was used to evaluate the clinical prognosis. To evaluate the relationship between the FFR and the risks of a poor outcome (mRS > 2), univariate and multivariate logistic regression analysis was utilized. The significance of the FT4/FT3 ratio in predicting the clinical outcomes in SCSD patients 6 months after discharge was assessed using the area under curve-receiver operating characteristic (AUC-ROC). Results About 90 patients (62.5%) of the 144 patients had poor outcomes, while 54 (37.5%) had favorable outcomes. Higher FFR at admission was independently linked to higher odds of a poor outcome, according to a logistic analysis. With an optimized cutoff value of >2.843, the FFR exhibited the maximum accuracy for predicting a poor outcome, according to the AUC‒ROC curve (AUC 0.731, P < 0.001; sensitivity, 77.8%; specificity, 83.3%). FFR was identified as an independent predictor of poor outcomes by multivariate logistic regression (OR, 2.244; 95% CI, 1.74-2.90; P < 0.001). Conclusions We discovered that in patients who had a bad result 6 months after discharge, the FFR had dramatically increased at the time of admission, providing a unique prognostic marker in patients with SCSD.
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Affiliation(s)
- Song Luo
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical University, Bengbu233004, China
| | - Xiao-rui Wang
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical University, Bengbu233004, China
| | - Li-juan Yang
- Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical University, Bengbu233004, China
| | - Liang-yu Zou
- Department of Neurology, Shenzhen People’s Hospital, The Second Clinical Medical University, Jinan University, Shenzhen518020, China
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Duñabeitia I, González-Devesa D, Varela-Martínez S, Diz-Gómez JC, Ayán-Pérez C. Effect of physical exercise in people with hypothyroidism: systematic review and meta-analysis. Scand J Clin Lab Invest 2023; 83:523-532. [PMID: 37999992 DOI: 10.1080/00365513.2023.2286651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/19/2023] [Indexed: 11/26/2023]
Abstract
This study aimed to systematically revise the available evidence on the effects of physical exercise training programmes on people with hypothyroidism. Comparative studies were searched in six electronic databases until April 2023. The Physiotherapy Evidence Database and the Methodological Index for Non-Randomized Studies were used to determine the methodological quality of the randomized controlled trials and comparative studies respectively. A total of 10 studies were found showing a low to moderate methodological quality. Most of them were performed in women with subclinical hypothyroidism. Exercise seemed to be safe, with aerobic and resistance training leading to improvements in outcomes related to physical and mental health. The performed meta-analysis with data from 120 participants indicated that exercise showed a non-significant trend towards reducing thyroid-stimulating hormone levels (Hedges'g -0.96; 95% CI -2.71; 0.79, p = 0.160; I2 = 92%). When the analysis was performed by comparing the experimental, and control groups with data from 180 participants the results remained non-significant (SMD -1.09; CI 95% -2.88; 0.70, p = 0.23; I2 = 95%). Similar findings were obtained when pooling data for FT3 and FT4 levels. Exercise does not have a significant impact on thyroid function, although its practice can lead to secondary outcomes related to physical and mental health.
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Affiliation(s)
- Iratxe Duñabeitia
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, Spain
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
| | - Daniel González-Devesa
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad de León, León, Spain
| | - Silvia Varela-Martínez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
| | - Jose Carlos Diz-Gómez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
| | - Carlos Ayán-Pérez
- RIDEAIDI, Research Network on People with Disability: Exercise, Physical Activity and Inclusive Sport, Consejo Superior de Deportes (CSD), Spain
- Well-Move Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, Vigo, Spain
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12
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Zhang W, Zhu G, Li B, Chen C, Zhu Y. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery. Open Med (Wars) 2023; 18:20230821. [PMID: 38025544 PMCID: PMC10656761 DOI: 10.1515/med-2023-0821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/24/2023] [Accepted: 09/21/2023] [Indexed: 12/01/2023] Open
Abstract
This study aims to analyze the effect of cardiac rehabilitation therapy on cardiac autonomic nervous function in patients with cardiac insufficiency complicated with anxiety depression after cardiac operation to provide a reference for clinical practice. A total of 109 patients subject to cardiac operation in our hospital from January 2020 to March 2023 were enrolled as study subjects, including 50 patients who received conventional rehabilitation therapy (control group) and 69 patients who received cardiac rehabilitation therapy (research group). Before and after treatment, the left ventricular ejection fraction (LVEF) and central venous pressure (CVP) were determined, and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) was measured. Low frequency/high frequency (LF/HF), standard deviation of normal to normal (SDNN), and root mean of successive square differences (RMSSD) were measured by a multi-lead ECG system. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), Activity of daily living (ADL), and Barthel Index (BI) were applied for corresponding investigations, as well as the 6-min walk test (6MWT). After treatment, the research group showed higher LVEF, CVP, LF/HF, SDNN, and RMSSD, and lower NT-proBNP, SAS, and SDS than the control group (P < 0.05). Significantly elevated ADL score, BI, and 6MWT and reduced PSQI were observed in both groups after treatment, with more remarkable changes in the research group (P < 0.05). In conclusion, cardiac rehabilitation therapy effectively improved the cardiac function of patients with cardiac insufficiency complicated with anxiety and depression after the cardiac operation and alleviated their negative emotions.
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Affiliation(s)
- Wenyu Zhang
- Department of Cardiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Guangjian Zhu
- Department of Cardiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Beibei Li
- Department of Cardiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Chen Chen
- Department of Cardiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yingzhi Zhu
- Department of Cardiology, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu, 210029, China
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13
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Li C, Rui Q, Dong X, Ning S, Zhou J, Wu H, Jiang C, Cui Y, Liu J, Jiang J, Qin L. Human amnion-derived mesenchymal stem cells improve subclinical hypothyroidism by immunocompetence mediating apoptosis inhibition on thyroid cells in aged mice. Cell Tissue Res 2023; 394:309-323. [PMID: 37572164 PMCID: PMC10638193 DOI: 10.1007/s00441-023-03822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/27/2023] [Indexed: 08/14/2023]
Abstract
Subclinical hypothyroidism (SCH) affects 10% of the global population, which is most prevalent in women and the elderly. However, it remains debatable whether the elderly with subclinical hypothyroidism needs thyroxine supplement. Human amnion-derived mesenchymal stem cells (hAMSCs) could play important roles in autoimmune diseases, suggesting that hAMSC be a candidate to regulate the thyroid function of female age-related subclinical hypothyroidism. Herein, we established the model of SCH in the aged female mice. This study was designed to investigate whether human amnion-derived mesenchymal stem cells (hAMSC) could effect on immune regulation, apoptosis inhibition of thyroid cells, thyroid function, blood lipid levels, and heart function. In addition, qualified hAMSCs were intravenously injected into aged female SCH mice via the tail vein on day 0 and day 10. The levels of thyroid hormone and blood lipids as well as cardiac function, serum immunological indexes, and apoptosis of thyroid cells were then analyzed on day 5, 10, 15, and 20; meanwhile, the quantity of Th1, Th2, Th17, and Treg immune cells in peripheral blood was evaluated before and on day 20 post-injection. Our study demonstrated that after hAMSC transplantation, the thyroid functions, blood lipid levels, and heart function indexes of age-related SCH (AR-SCH) mice were significantly improved. Consistent with this, Th1 and Treg cells increased significantly, while Th2 and Th17 cells decreased in peripheral blood. Apoptosis was also suppressed in the thyroid cells. In summary, hAMSC delivery can potentially be a safe and effective therapy for treating SCH in the elderly, improving related complications by immunomodulatory and apoptosis inhibition.
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Affiliation(s)
- Chuyu Li
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Qiang Rui
- Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210000, China
| | - Xiaohan Dong
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Song Ning
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Jing Zhou
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Huimin Wu
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Chunyan Jiang
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Yugui Cui
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Jiayin Liu
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China
| | - Jun Jiang
- Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.
| | - Lianju Qin
- State Key Laboratory of Reproductive Medicine, Center of Clinical Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, 210029, China.
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14
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Zhao S, Zhang B, Han Y, Guan J, Fang W, Zhang H, Wang A. Increased 10-year cardiovascular disease risk in depressed patients with coexisting subclinical hypothyroidism. Front Psychiatry 2023; 14:1185782. [PMID: 37469355 PMCID: PMC10352495 DOI: 10.3389/fpsyt.2023.1185782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/29/2023] [Indexed: 07/21/2023] Open
Abstract
Purpose The prevalence of depressive disorder (DD) and subclinical hypothyroidism (SH) was almost twofold higher in women compared with men, both of which are confirmed to be related to cardiovascular disease (CVD) risk. The current study aimed to identify the prevalence of CVD risk factors and evaluate the 10-year CVD risk in female depressed patients with and without comorbid SH. Methods We recruited 1744 female inpatients with a diagnosis of DD. Venous blood samples were taken from all patients for lipid and thyroid hormones. Framingham Risk Score (FRS) was used to estimate the 10-year CVD risk. Results Female depressed patients with SH had increased BMI, higher Hamilton Anxiety Scale (HAMA) scores, higher LDL-C, TC, UA, and a higher 10-year CVD risk than euthyroid DD groups. Serum TSH levels and HAMA scores were critical predictive variables for 10-year CVD risk in female depressed patients with comorbid SH. Conclusion Our study suggests that female depressed patients with SH have a high 10-year CVD risk. Serum TSH levels and HAMA scores may be helpful to predict cardiovascular risk in female patients with SH. The increased CVD risk in female depressed patients with comorbid SH requires more attention from researchers and clinicians.
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Affiliation(s)
- Shuai Zhao
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Boyu Zhang
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Yuqin Han
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Jianjun Guan
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Wenmei Fang
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Hongqin Zhang
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
| | - Anzhen Wang
- Department of Psychiatry, The Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Hefei Fourth People’s Hospital, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Anhui Clinical Research Center for Mental Disorders, Hefei, China
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15
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Dalila N, Frikke-Schmidt R, Nordestgaard BG, Tybjærg-Hansen A. Plasma TSH and cardiovascular disease in the general population: A Mendelian randomization study of 105,224 individuals. Atherosclerosis 2023; 376:26-33. [PMID: 37263031 DOI: 10.1016/j.atherosclerosis.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND AND AIMS The association between thyroid stimulating hormone (TSH) and cardiovascular disease has mainly been determined using clinical categories of disease. We tested the hypothesis that TSH on a continuous scale is associated with risk of atrial fibrillation (AF), myocardial infarction (MI), stroke, heart failure (HF), aortic valve stenosis (AVS), and major adverse cardiovascular events (MACE) and whether these associations are likely to be causal. METHODS We first tested whether plasma TSH on a continuous scale was observationally associated with incident cardiovascular events in a prospective cohort study of 105,224 individuals from the Copenhagen General Population Study followed for a median 7 years. Next, we tested whether a genetic risk score weighted on TSH was associated with cardiovascular endpoints. Finally, using Mendelian randomization, we tested whether the observed associations were likely to be causal. RESULTS Using restricted cubic splines, lower concentrations of TSH relative to the population median (=1.53 mIU/L) were associated with higher risk of AF, MI, stroke, HF, AVS, and MACE. Comparing individuals with TSH ≤5th percentile (≤0.54 mIU/L) versus >50th percentile (>1.53 mIU/L), hazard ratios (HRs) ranged from 1.12 (1.00-1.26) for stroke to 1.27 (1.11-1.46) for HF. Genetic risk estimates per standard deviation decrease in TSH were 1.28 (1.08-1.52) for AF, 1.35 (1.06-1.71) for MI, 1.06 (0.89-1.26) for stroke, 1.19 (0.94-1.52) for HF, 1.53 (1.03-2.26) for AVS, and 1.09 (0.97-1.23) for MACE. CONCLUSIONS In 105,224 individuals from the general population low plasma TSH was observationally and genetically associated with increased risk of AF, MI, and AVS suggesting that these observations may reflect causal pathways.
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Affiliation(s)
- Nawar Dalila
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Børge G Nordestgaard
- The Copenhagen General Population Study, Denmark; Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tybjærg-Hansen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Denmark; The Copenhagen General Population Study, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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16
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Zhao G, Wang Z, Ji J, Cui R. Effect of coffee consumption on thyroid function: NHANES 2007-2012 and Mendelian randomization. Front Endocrinol (Lausanne) 2023; 14:1188547. [PMID: 37351106 PMCID: PMC10282749 DOI: 10.3389/fendo.2023.1188547] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 05/23/2023] [Indexed: 06/24/2023] Open
Abstract
Background Coffee is one of the most consumed beverages worldwide, but the effects on the thyroid are unknown. This study aims to examine the association between coffee and thyroid function. Methods Participant data (≥ 20 years, n = 6578) for the observational study were obtained from NHANES 2007-2012. Analysis was performed using weighted linear regression models and multiple logistic regression models. Genetic datasets for Hyperthyroidism and Hypothyroidism were obtained from the IEU database and contained 462,933 European samples. Mendelian randomization (MR) was used for the analysis, inverse variance weighting (IVW) was the main method of analysis. Results In the model adjusted for other covariates, participants who drank 2-4 cups of coffee per day had significantly lower TSH concentrations compared to non-coffee drinkers (b=-0.23, 95% CI: -0.30, -0.16), but no statistically significant changes in TT4, FT4, TT3 and FT3. In addition, participants who drank <2 cups of coffee per day showed a low risk of developing subclinical hypothyroidism. (OR=0.60, 95% CI: 0.41, 0.88) Observational studies and MR studies have demonstrated both that coffee consumption has no effect on the risk of hyperthyroidism and hypothyroidism. Conclusions Our study showed that drinking <2 cups of coffee per day reduced the risk of subclinical hypothyroidism and drinking 2-4 cups of coffee reduced serum TSH concentrations. In addition, coffee consumption was not associated with the risk of hyperthyroidism and hypothyroidism.
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Affiliation(s)
- Guoxu Zhao
- Mudanjiang Medical University, Mudanjiang, China
| | - Zhao Wang
- Chungnam National University School of Medicine, Daejeon Gwangyeoksi, Republic of Korea
| | - Jinli Ji
- Mudanjiang Medical University, Mudanjiang, China
| | - Rongjun Cui
- Mudanjiang Medical University, Mudanjiang, China
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17
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Wang B, Zhang J, Zhang D, Lu C, Liu H, Gao Q, Niu T, Yin M, Cui S. Casein Kinase 1α as a Novel Factor Affects Thyrotropin Synthesis via PKC/ERK/CREB Signaling. Int J Mol Sci 2023; 24:7034. [PMID: 37108197 PMCID: PMC10138882 DOI: 10.3390/ijms24087034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Abstract
Casein kinase 1α (CK1α) is present in multiple cellular organelles and plays various roles in regulating neuroendocrine metabolism. Herein, we investigated the underlying function and mechanisms of CK1α-regulated thyrotropin (thyroid-stimulating hormone (TSH)) synthesis in a murine model. Immunohistochemistry and immunofluorescence staining were performed to detect CK1α expression in murine pituitary tissue and its localization to specific cell types. Tshb mRNA expression in anterior pituitary was detected using real-time and radioimmunoassay techniques after CK1α activity was promoted and inhibited in vivo and in vitro. Relationships among TRH/L-T4, CK1α, and TSH were analyzed with TRH and L-T4 treatment, as well as thyroidectomy, in vivo. In mice, CK1α was expressed at higher levels in the pituitary gland tissue than in the thyroid, adrenal gland, or liver. However, inhibiting endogenous CK1α activity in the anterior pituitary and primary pituitary cells significantly increased TSH expression and attenuated the inhibitory effect of L-T4 on TSH. In contrast, CK1α activation weakened TSH stimulation by thyrotropin-releasing hormone (TRH) by suppressing protein kinase C (PKC)/extracellular signal-regulated kinase (ERK)/cAMP response element binding (CREB) signaling. CK1α, as a negative regulator, mediates TRH and L-T4 upstream signaling by targeting PKC, thus affecting TSH expression and downregulating ERK1/2 phosphorylation and CREB transcriptional activity.
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Affiliation(s)
- Bingjie Wang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Jinglin Zhang
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety, The Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
| | - Di Zhang
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
| | - Chenyang Lu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Hui Liu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Qiao Gao
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
| | - Tongjuan Niu
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Mengqing Yin
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
| | - Sheng Cui
- College of Veterinary Medicine, Yangzhou University, Yangzhou 225009, China; (B.W.)
- Institute of Reproduction and Metabolism, Yangzhou University, Yangzhou 225009, China
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
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18
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Muacevic A, Adler JR. Relationship Between Subclinical Hypothyroidism and the Risk of Cardiovascular Complications. Cureus 2023; 15:e33708. [PMID: 36788909 PMCID: PMC9922092 DOI: 10.7759/cureus.33708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/12/2023] [Indexed: 01/13/2023] Open
Abstract
Subclinical hypothyroidism is characterized by raised thyroid-stimulating hormone levels in the presence of normal free thyroxine levels. When free thyroxine levels are normal and subclinical hypothyroidism is present, thyroid-stimulating hormone levels are elevated. The impact of subclinical hypothyroidism on the cardiovascular system has recently garnered attention because it is known that thyroid hormones impact the heart and its vasculature. There is compelling evidence linking subclinical hypothyroidism to increased cardiac risks, including changes in blood pressure and cholesterol. It is unclear whether subclinical hypothyroidism is associated with a higher risk of cardiovascular illnesses. In addition to discussing the advantages of levothyroxine therapy in delaying the onset of cardiovascular complications, this review makes the connection between subclinical hypothyroidism patients and the risk of cardiovascular complications-related death.
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Abstract
Subclinical thyroid dysfunction is defined by serum thyroid-stimulating hormone (TSH) levels either greater or less than the reference range with normal thyroxine (T4) concentrations, and consists of subclinical hypothyroidism (SCH) and subclinical hyperthyroidism (SCHyper). For the proper diagnosis of SCH, it is most important to be able to correctly evaluate the serum TSH levels, which have numerous unique characteristics. We also need to be versed in TSH harmonization, which was recently launched world-wide. In this review, we will attempt to determine the best clinical approaches to the treatment of subclinical thyroid dysfunction based on recent guidelines published from several countries and novel findings of several recent large-scale clinical studies.
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Affiliation(s)
- Koshi Hashimoto
- Department of Diabetes, Endocrinology, and Hematology, Dokkyo Medical University Saitama Medical Center, Saitama 343-8555, Japan
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20
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Moreno KGT, Marques AAM, da Silva GP, Lourençone BR, Fortini CS, Leite PRT, dos Santos AC, Souza RIC, da Siva LI, Gasparotto Junior A. A New Approach for the Development of Multiple Cardiovascular Risk Factors in Two Rat Models of Hypertension. Pharmaceuticals (Basel) 2022; 15:ph15070853. [PMID: 35890152 PMCID: PMC9318210 DOI: 10.3390/ph15070853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 01/21/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death among non-communicable diseases. There is a lack of valid animal models that mimic associations among multiple cardiovascular risk factors in humans. The present study developed an animal model that uses multiple cardiovascular risk factors—namely, hypertension, hypothyroidism, and a high-fat diet (HFD). Two models of hypertension were used: renovascular hypertension (two-kidney, one clip [2K1C]) and spontaneously hypertensive rats (SHRs). The naive group was composed of normotensive rats. Twelve weeks after surgery to induce renovascular hypertension, rats in the 2K1C and SHR groups underwent thyroidectomy. The HFD was then implemented for 6 weeks. Renal function, serum redox status, biochemical CVD markers, electrocardiographic profile, blood pressure, mesenteric vascular bed reactivity, histopathology, and morphometry were investigated. Both experimental models induced dyslipidemia, renal function impairment, and hepatic steatosis, accompanied by higher levels of different inflammatory markers and serum oxidative stress. These alterations contributed to end-organ damage in all hypertensive rats. Our findings corroborate a viable alternative model that involves multiple cardiovascular risk factors and resembles conditions that are seen in humans. Both models mimicked CVD, but our data show that SHRs exhibit more significant pathophysiological changes.
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Affiliation(s)
- Karyne Garcia Tafarelo Moreno
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Aline Aparecida Macedo Marques
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Gabriela Pereira da Silva
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Bethânia Rosa Lourençone
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Clara Soligo Fortini
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Patrícia Regina Terço Leite
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
| | - Ariany Carvalho dos Santos
- Laboratory of Histopathology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (A.C.d.S.); (R.I.C.S.)
| | - Roosevelt Isaías Carvalho Souza
- Laboratory of Histopathology, Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (A.C.d.S.); (R.I.C.S.)
| | - Leila Isabel da Siva
- Post-Graduate Program in Biotechnology Applied to Agriculture, Paranaense University, Umuarama 87502-210, Brazil;
| | - Arquimedes Gasparotto Junior
- Laboratory of Cardiovascular Pharmacology (LaFAC), Faculty of Health Sciences, Federal University of Grande Dourados, Dourados 79825-070, Brazil; (K.G.T.M.); (A.A.M.M.); (G.P.d.S.); (B.R.L.); (C.S.F.); (P.R.T.L.)
- Correspondence: ; Tel.: +55-(67)-3410-2333; Fax: +55-(67)-3410-2321
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21
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Salvio G, Ciarloni A, Cutini M, delli Muti N, Finocchi F, Perrone M, Rossi S, Balercia G. Metabolic Syndrome and Male Fertility: Beyond Heart Consequences of a Complex Cardiometabolic Endocrinopathy. Int J Mol Sci 2022; 23:ijms23105497. [PMID: 35628307 PMCID: PMC9143238 DOI: 10.3390/ijms23105497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 05/02/2022] [Accepted: 05/13/2022] [Indexed: 12/06/2022] Open
Abstract
Metabolic syndrome (MetS) is a highly prevalent condition among adult males, affecting up to 41% of men in Europe. It is characterized by the association of obesity, hypertension, and atherogenic dyslipidemia, which lead to premature morbidity and mortality due to cardiovascular disease (CVD). Male infertility is another common condition which accounts for about 50% of cases of couple infertility worldwide. Interestingly, male infertility and MetS shares several risk factors (e.g., smoking, ageing, physical inactivity, and excessive alcohol consumption), leading to reactive oxygen species (ROS) production and increased oxidative stress (OS), and resulting in endothelial dysfunction and altered semen quality. Thus, the present narrative review aims to discuss the pathophysiological mechanisms which link male infertility and MetS and to investigate the latest available evidence on the reproductive consequences of MetS.
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22
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Pereira DN, Silveira LFG, Guimarães MMM, Polanczyk CA, Nunes AGS, Costa ASDM, Farace BL, Cimini CCR, Carvalho CAD, Ponce D, Roesch EW, Manenti ERF, Lucas FB, Rodrigues FD, Anschau F, Aranha FG, Bartolazzi F, Vietta GG, Nascimento GF, Duani H, Vianna HR, Guimarães HC, Costa JHSM, Batista JDL, Alvarenga JCD, Chatkin JM, Morais JDPD, Machado-Rugolo J, Ruschel KB, Pinheiro LS, Menezes LSM, Couto LSF, Kopittke L, Castro LCD, Nasi LA, Cabral MADS, Floriani MA, Souza MD, Carneiro M, Bicalho MAC, Godoy MFD, Nogueira MCA, Guimarães Júnior MH, Sampaio NDCS, Oliveira NRD, Assaf PL, Finger RG, Campos RX, Menezes RM, Francisco SC, Alvarenga SP, Guimarães SMM, Araújo SF, Oliveira TF, Diniz THO, Ramires YC, Cenci EPDA, Oliveira TCD, Schwarzbold AV, Ziegelmann PK, Pozza R, Carvalho CS, Pires MC, Marcolino MS. Hypothyroidism does not lead to worse prognosis in COVID-19: findings from the Brazilian COVID-19 registry. Int J Infect Dis 2022; 116:319-327. [PMID: 35065257 PMCID: PMC8769529 DOI: 10.1016/j.ijid.2022.01.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background It is not clear whether previous thyroid diseases influence the course and outcomes of COVID-19. Methods The study is a part of a multicentric cohort of patients with confirmed COVID-19 diagnosis from 37 hospitals. Matching for age, sex, number of comorbidities, and hospital was performed for the paired analysis. Results Of 7,762 patients with COVID-19, 526 had previously diagnosed hypothyroidism and 526 were matched controls. The median age was 70 years, and 68.3% were females. The prevalence of comorbidities was similar, except for coronary and chronic kidney diseases that were higher in the hypothyroidism group (p=0.015 and p=0.001). D-dimer levels were lower in patients with hypothyroid (p=0.037). In-hospital management was similar, but hospital length-of-stay (p=0.029) and mechanical ventilation requirement (p=0.006) were lower for patients with hypothyroidism. There was a trend of lower in-hospital mortality in patients with hypothyroidism (22.1% vs 27.0%; p=0.062). Conclusion Patients with hypothyroidism had a lower requirement of mechanical ventilation and showed a trend of lower in-hospital mortality. Therefore, hypothyroidism does not seem to be associated with a worse prognosis.
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Affiliation(s)
- Daniella Nunes Pereira
- Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena, 190, Belo Horizonte, Brazil.
| | - Leticia Ferreira Gontijo Silveira
- Endocrinology Unit, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil.
| | - Milena Maria Moreira Guimarães
- Endocrinology Unit, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil.
| | - Carísi Anne Polanczyk
- Internal Medicine Department. Universidade Federal do Rio Grande do Sul. Coordinator of the Institute for Health Technology Assessment (IATS/CNPq). Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507, Porto Alegre, Brazil.
| | | | | | - Barbara Lopes Farace
- Hospital Risoleta Tolentino Neves. Rua das Gabirobas, 01, Belo Horizonte, Brazil.
| | | | | | - Daniela Ponce
- Hospital das Clínicas da Faculdade de Medicina de Botucatu. Botucatu, Brazil.
| | - Eliane Würdig Roesch
- Hospital de Clínicas de Porto Alegre. Av. Ramiro Barcellos, 2350, Porto Alegre, Brazil.
| | | | | | - Fernanda d'Athayde Rodrigues
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul. Av. Ramiro Barcellos, 2350, Porto Alegre, Brazil.
| | - Fernando Anschau
- Graduation Program on Evaluation and Production of Technologies for the Brazilian National Health System, Hospital Nossa Senhora da Conceição and Hospital Cristo Redentor. Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | | | | | | | | | - Helena Duani
- Internal Medicine Department. University Hospital, Universidade Federal de Minas Gerais. Av. Prof Alfredo Balena, 110, Belo Horizonte, Brazil.
| | | | | | | | | | | | - José Miguel Chatkin
- Pneumology Department, Medical School, Universidade Católica do Rio Grande do Sul (RGS), Porto Alegre, Brazil. Hospital São Lucas PUCRS, Porto Alegre, Brazil.
| | | | | | - Karen Brasil Ruschel
- Hospital Mãe de Deus, Hospital Universitário de Canoas, Universidade Federal do Rio Grande do Sul e Instituto de Avaliação de Tecnologia em Saúde (IATS/CNPQ), Porto Alegre, Brasil.
| | - Lílian Santos Pinheiro
- Universidade Federal dos Vales do Jequitinhonha e Mucuri. R. Cruzeiro, 1, Teófilo Otoni, Brazil.
| | | | | | - Luciane Kopittke
- Hospital Nossa Senhora da Conceição. Av. Francisco Trein, 326, Porto Alegre, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | - Pedro Ledic Assaf
- Hospital Metropolitano Doutor Célio de Castro. Rua Dona Luiza, 311, Belo Horizonte, Brazil.
| | | | - Roberta Xavier Campos
- Hospital Julia Kubitschek. Avenida Professor Alfredo Balena 190, Belo Horizonte, Brazil.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Magda Carvalho Pires
- Department of Statistics, Universidade Federal de Minas Gerais. Av. Presidente Antônio Carlos, 6627, ICEx, sala 4071, Belo Horizonte, Brazil.
| | - Milena Soriano Marcolino
- Department of Internal Medicine, Medical School; and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena 190 sala 246, Belo Horizonte, Brazil; Institute for Health Technology Assessment (IATS/ CNPq). Rua Ramiro Barcelos, 2359. Prédio 21 | Sala 507, Porto Alegre, Brazil.
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23
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Yao X, Wang Y, Wang L, Cao M, Chen A, Zhang X. Expression patterns of serum MicroRNAs related to endothelial dysfunction in patients with subclinical hypothyroidism. Front Endocrinol (Lausanne) 2022; 13:981622. [PMID: 36147570 PMCID: PMC9485940 DOI: 10.3389/fendo.2022.981622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/15/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Increasing evidence has shown that elevated Thyroid stimulating hormone (TSH) levels are positively correlated with atherosclerosis (ATH) in patients with subclinical hypothyroidism (SCH). Some researchers found that the dysfunction of Endothelial Cells (ECs) in SCH plays an important role in the pathogenesis of ATH in SCH, but the association remains controversial. OBJECTIVES To determine the expression profiles of serum microRNAs critical to the function of Endothelial cells (ECs) may help reanalyze the possible mechanism underlying ATH in SCH and the association between ATH and SCH. METHODS We used qRT-PCR to perform microRNA profiling and analysis in normal control subjects (NC), patients with SCH alone (SCH), patients with SCH and ATH (SCH+ATH), and patients with ATH without SCH (ATH). RESULTS Both miR-221-3p and miR-222-3p showed a decreasing expression trend between the SCH and SCH+ATH groups. In addition, miR-126-3p and miR-150-5p showed a stepwise decrease from the NC to SCH groups and then to the SCH+ATH or ATH group. miR-21-5p was unregulated in the SCH, SCH+ATH, and ATH groups. Furthermore, elevated levels of miR-21-5p in SCH+ATH group were higher than SCH and ATH group. No differences were found in the levels of miR-150, miR-126, miR-221 and miR-222 between the ATH and the SCH+ATH subjects. CONCLUSIONS miR-21-5p may be involved in the atherosclerosis process in patients with SCH (SCH and SCH+ATH groups). miR-150-5p may be sensitive risk markers for predicting endothelial dysfunction in patients with ATH (ATH and SCH+ATH groups).
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Affiliation(s)
- Xuelin Yao
- Shandong Academy of Medical Sciences, Shandong First Medical University, Taian, China
| | - Ying Wang
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Li Wang
- Department of Pharmacy, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Mingfeng Cao
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Aifang Chen
- Ultrasound Department, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Aifang Chen, ; Xinhuan Zhang,
| | - Xinhuan Zhang
- Department of Endocrinology, the Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Aifang Chen, ; Xinhuan Zhang,
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24
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Abstract
Hypothyroidism is a common condition with a prevalence that varies according to local dietary iodine availability, gender and age. The symptoms of hypothyroidism are generally nonspecific, with considerable overlap with other conditions and with the consequences for the health of advancing age. These symptoms are not useful for diagnosing hypothyroidism and a thyroid function test is required for a firm clinical diagnosis. Lack of knowledge and understanding of hypothyroidism, and a tendency for many people to attribute the symptoms of hypothyroidism to other causes have led to substantial unawareness and often late diagnosis of hypothyroidism. Large observational studies and meta-analyses have shown that about 4-7% of community-derived populations in the USA and Europe have undiagnosed hypothyroidism. About four cases in five of these are subclinical hypothyroidism, with the remainder being overt hypothyroidism. The prevalence of undiagnosed hypothyroidism is higher in older subjects, in women, and some ethnic groups, consistent with diagnosed disease. More research is needed to quantify the clinical burden of undiagnosed hypothyroidism around the world, with educational efforts aimed at the public and healthcare professionals aimed at identifying and managing these individuals.
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Zhu S, Pang Y, Xu J, Chen X, Zhang C, Wu B, Gao J. Endocrine Regulation on Bone by Thyroid. Front Endocrinol (Lausanne) 2022; 13:873820. [PMID: 35464058 PMCID: PMC9020229 DOI: 10.3389/fendo.2022.873820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND As an endocrine organ, the thyroid acts on the entire body by secreting a series of hormones, and bone is one of the main target organs of the thyroid. SUMMARY This review highlights the roles of thyroid hormones and thyroid diseases in bone homeostasis. CONCLUSION Thyroid hormones play significant roles in the growth and development of bone, and imbalance of thyroid hormones can impair bone homeostasis.
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Affiliation(s)
- Siyuan Zhu
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yidan Pang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Jun Xu
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiaoyi Chen
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Changqing Zhang
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Junjie Gao, ; Bo Wu, ; Changqing Zhang,
| | - Bo Wu
- Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Junjie Gao, ; Bo Wu, ; Changqing Zhang,
| | - Junjie Gao
- Department of Orthopaedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
- *Correspondence: Junjie Gao, ; Bo Wu, ; Changqing Zhang,
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26
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Abstract
Subclinical thyroid disease is frequently encountered in clinic practice. Although overt thyroid dysfunction has been associated with adverse clinical outcomes, uncertainty remains about the implications of subclinical thyroid disease. Available data suggest that subclinical hypothyroidism may be associated with increased risk of cardiovascular disease and death. Despite this finding, treatment with thyroid hormone has not been consistently demonstrated to reduce cardiovascular risk. Subclinical hyperthyroidism has been associated with increased risk of atrial fibrillation and osteoporosis, but the association with cardiovascular disease and death is uncertain. The decision to treat depends on the degree of thyroid-stimulating hormone suppression and underlying comorbidities.
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Affiliation(s)
- Josh M Evron
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of North Carolina, Burnett-Womack, CB 7172, Chapel Hill, NC 27599, USA
| | - Maria Papaleontiou
- Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Bldg. 16, Rm 453S, Ann Arbor, MI 48109, USA.
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