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Pierantoni F, Dionese M, Basso U, Lai E, Cavasin N, Erbetta E, Mattana A, Bimbatti D, Zagonel V, Lonardi S, Maruzzo M. The prognostic Value of Thyroid Hormone Levels in Immunotherapy-Treated Patients With Metastatic Urothelial Carcinoma. Clin Genitourin Cancer 2023; 21:e378-e385. [PMID: 37164813 DOI: 10.1016/j.clgc.2023.04.006] [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: 01/19/2023] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 05/12/2023]
Abstract
INTRODUCTION A low fT3/fT4 ratio has been associated with a poorer prognosis in patients treated for different solid malignancies. However, the prognostic role of baseline thyroid function in patients with metastatic urothelial carcinoma (mUC) has not yet been established. PATIENTS AND METHODS We analyzed 72 consecutive immunotherapy-treated patients with mUC from a single institution. We recorded clinical data, baseline blood test results, and oncological outcomes. We stratified patients into three groups according to the fT3/fT4 ratio value and analyzed differences in progression-free survival (PFS), overall survival (OS), and radiological response in the three groups. We also conducted univariate and multivariate analyses to identify prognostic factors for PFS and OS. RESULTS The median PFS in the low, intermediate, and high fT3/fT4 ratio groups was 2.2, 4.1, and 8.2 months, respectively (P < 0.01). The median OS in the low, intermediate, and high fT3/fT4 groups was 3.6, 10.3, and 19.1 months, respectively (P < .01). The low fT3/fT4 ratio maintained its prognostic role independently of other prognostic factors. Patients with a high fT3/fT4 ratio had an increased radiological response. CONCLUSION Thyroid hormone impairment, as measured by the fT3/fT4 ratio, is a strong prognostic factor in patients treated with immunotherapy for urothelial carcinoma.
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Affiliation(s)
| | - Michele Dionese
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Umberto Basso
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Eleonora Lai
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Nicolò Cavasin
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Elisa Erbetta
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy; Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, Italy
| | - Alvise Mattana
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Davide Bimbatti
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Vittorina Zagonel
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Sara Lonardi
- Oncology Unit 3, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy
| | - Marco Maruzzo
- Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy.
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Sun J, Liu J, Wu TT, Gu ZY, Zhang XW. Sensitivity to thyroid hormone indices are associated with papillary thyroid carcinoma in Chinese patients with thyroid nodules. BMC Endocr Disord 2023; 23:126. [PMID: 37264363 DOI: 10.1186/s12902-023-01381-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The association between thyroid hormone sensitivity and thyroid cancer is unknown, and we aimed to investigate the association between sensitivity to thyroid hormone indices and papillary thyroid carcinoma (PTC) in Chinese patients with thyroid nodules (TNs). METHODS A total of 1,998 patients undergoing thyroid surgery due to TNs from Nanjing Drum Tower Hospital were included in this study. We evaluated central sensitivity to thyroid hormones, such as thyroid stimulating hormone index (TSHI), TSH T4 resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), and parametric thyroid feedback quantile-based Index (PTFQI). Peripheral sensitivity to thyroid hormone was evaluated by FT3 to FT4 ratio. Multivariate logistic regression analysis was performed to evaluate the association between sensitivity to thyroid hormone indices and PTC risk. RESULTS The results showed that central indices of thyroid hormone sensitivity, including TSHI, TT4RI, TFQI, and PTFQI, were positively associated with PTC risk. For each SD increase in TSHI, TT4RI, TFQI, and PTFQI, the odds ratios (OR, 95% CI) of PTC were 1.31 (1.18-1.46), 1.01 (1.01-1.02), 1.94 (1.45-2.60), and 1.82 (1.41-2.34), respectively. On the other hand, the association between peripheral sensitivity to thyroid hormone and PTC was significantly negative. For each SD increase in FT3/FT4 ratio, the OR (95% CI) of PTC was 0.18 (0.03-0.96), and a negative correlation was found between FT3/FT4 ratio and TNM staging of PTC. CONCLUSIONS Sensitivity to thyroid hormone indices could be used as new indicators for predicting PTC in Chinese patients with TNs. Future researches are still needed to confirm our findings.
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Affiliation(s)
- Jie Sun
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Jie Liu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Nanjing, China
| | - Ting-Ting Wu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Zhi-Yuan Gu
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China
| | - Xiao-Wen Zhang
- Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
- Branch of National Clinical Research Centre for Metabolic Diseases, Nanjing, China.
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Caccese M, Desideri I, Padovan M, Bruno F, Cerretti G, Fiorentino A, Denaro L, Chioffi F, Della Puppa A, Maccari M, Cavallin F, Coppola M, Pittaro A, Rudà R, Livi L, Lombardi G. Association between thyroid function and regorafenib efficacy in patients with relapsed wild-type IDH glioblastoma: a large multicenter study. J Neurooncol 2023; 163:377-383. [PMID: 37264256 PMCID: PMC10322943 DOI: 10.1007/s11060-023-04356-w] [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: 04/19/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023]
Abstract
PURPOSE Regorafenib demonstrated encouraging results in recurrent glioblastoma patients. Some studies showed that changes in circulating thyroid hormones (fT3, fT4, fT3/fT4 ratio) can be considered as prognostic factors in patients with various types of tumors. We designed this study to investigate the relationship between baseline thyroid variables and outcome in IDH-wild type GBM patients who were treated with regorafenib. METHODS This multicenter retrospective study included recurrent IDH-wild-type glioblastoma patients treated with regorafenib. Only patients with baseline thyroid function values (TSH, fT3, fT4, fT3/fT4 ratio) available were evaluated. RANO criteria were used to analyze neuroradiological response. Survival curves were estimated using the Kaplan-Meier method. The relationships between baseline thyroid variables (TSH, fT3, fT4, fT3/fT4) and survival (PFS, OS) were investigated with Cox regression models. RESULTS From November 2015 to April 2022, 134 recurrent IDH-wildtype GBM patients were treated with regorafenib and 128 of these had information on baseline thyroid function value. Median follow-up was 8 months (IQR 4.7-14.0). Objective Response Rate was 9% and Disease Control Rate was 40.9%. Median PFS was 2.7 months (95%CI 2.2-3.6) and median OS was 10.0 months (95%CI 7.0-13.0). Lower baseline TSH value in the blood was correlated with a higher rate of disease progression to regorafenib (p = 0.04). Multivariable analyses suggested a non-linear relationship between PFS (p = 0.01) and OS (p = 0.03) with baseline fT3/fT4 ratio. CONCLUSION In recurrent wild-type IDH glioblastoma patients, baseline fT3/fT4 ratio showed a non-linear relationship with survival, with different impacts across the spectrum of fT3/fT4 ratio. Moreover, baseline TSH may be a predictor of regorafenib activity.
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Affiliation(s)
- Mario Caccese
- Department of Oncology, Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy.
| | - Isacco Desideri
- Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marta Padovan
- Department of Oncology, Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Francesco Bruno
- Division of Neuro-Oncology, Department Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Giulia Cerretti
- Department of Oncology, Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Alba Fiorentino
- Department of Medicine, LUM Giuseppe Degennaro University, Casamassima, Bari, Italy
| | - Luca Denaro
- Academic Neurosurgery, Department of Neurosciences DNS, University of Padua, Padua, Italy
| | - Franco Chioffi
- Department of Neurosurgery, Padua University Hospital, Padua, Italy
| | - Alessandro Della Puppa
- Neurosurgical Clinical Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
| | - Marta Maccari
- Department of Oncology, Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Marina Coppola
- Pharmacy, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Alice Pittaro
- Radiology Unit, Department of Imaging and Medical Physics, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | - Roberta Rudà
- Division of Neuro-Oncology, Department Neuroscience, University and City of Health and Science Hospital, Turin, Italy
| | - Lorenzo Livi
- Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology, Careggi Hospital, University of Florence, Florence, Italy
| | - Giuseppe Lombardi
- Department of Oncology, Oncology 1, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
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Insights on the Association between Thyroid Diseases and Colorectal Cancer. J Clin Med 2023; 12:jcm12062234. [PMID: 36983233 PMCID: PMC10056144 DOI: 10.3390/jcm12062234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 02/22/2023] [Accepted: 03/11/2023] [Indexed: 03/15/2023] Open
Abstract
Benign and malignant thyroid diseases (TDs) have been associated with the occurrence of extrathyroidal malignancies (EMs), including colorectal cancers (CRCs). Such associations have generated a major interest, as their characterization may provide useful clues regarding diseases’ etiology and/or progression, with the possible identification of shared congenital and environmental elements. On the other hand, elucidation of the underlying molecular mechanism(s) could lead to an improved and tailored clinical management of these patients and stimulate an increased surveillance of TD patients at higher threat of developing EMs. Here, we will examine the epidemiological, clinical, and molecular findings connecting TD and CRC, with the aim to identify possible molecular mechanism(s) responsible for such diseases’ relationship.
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Lin Y, Wang P, Chen Z, Peng R, Lai S, Li J, Kuang J, Wang L. The correlation between preoperative serum thyroglobulin and pathological features of thyroid follicular carcinoma.. [DOI: 10.21203/rs.3.rs-1965404/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Abstract
Purpose: To explore more meaningful information for making individualized medical decisions for patients with follicular thyroid carcinoma (FTC), we investigated the correlations between pathological features of FTC and preoperative serum markers, including thyroglobulin (Tg), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibodies (TPOAb), thyroid stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and fT3/fT4 ratio.Methods:We retrospectively analyzed 82 patients with FTC. Data collected included demographics (sex and age), pathological features (infiltration extent, tumor stage, presence of multifocal FTC, and presence of concomitant PTC), and preoperative serum markers (Tg, TgAb, TPOAb, TSH, fT3, fT4, and fT3/fT4 ratio). The correlations between preoperative serum markers and pathological features were analyzed.Results:72.0% patients were female. Mean age was 46.4±16.5 years. In univariate analysis, older age (≥55 years) was associated with non-minimally invasive (P=0.016), larger (>T2 category, P=0.006), and multifocal (P=0.034) FTC; elevated preoperative serum Tg level (≥500.00 ng/mL) was associated with non-minimally invasive (P=0.015) and larger (>T2 category, P=0.001) FTC; higher fT3/fT4 ratio (≥0.541) was associated with multifocal FTC (P=0.031). In multivariable analysis, Tg ≥500.00 ng/mL was an independent risk factor for non-minimally invasive FTC [P=0.015, OR=3.289 (1.260-8.583)] and for >T2 category FTC [P=0.001, OR=5.397 (1.963-14.840)]; older age [≥55 years, P=0.045, OR=4.756 (1.037-21.818)] and higher fT3\fT4 ratio [≥0.541, P=0.044, OR=4.626 (1.043-20.525)] was an independent risk factor multifocal FTC, respectively.Conclusions: Preoperative serum Tg was correlated with the local tumor extent and primary tumor diameter of FTC. Further research regarding the utility of preoperative serum Tg in FTC is still needed.
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Affiliation(s)
| | | | - Zhijiang Chen
- Guangdong Academy of Medical Sciences: Guangdong Provincial People's Hospital
| | | | - Shuiqing Lai
- Guangdong Academy of Medical Sciences: Guangdong Provincial People's Hospital
| | | | - Jian Kuang
- Guangdong Academy of Medical Sciences: Guangdong Provincial People's Hospital
| | - Long Wang
- Guangdong Academy of Medical Sciences: Guangdong Provincial People's Hospital
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Deligiorgi MV, Trafalis DT. The continuum of care of anticancer treatment-induced hypothyroidism in patients with solid non thyroid tumors: time for an intimate collaboration between oncologists and endocrinologists. Expert Rev Clin Pharmacol 2022; 15:531-549. [PMID: 35757870 DOI: 10.1080/17512433.2022.2093714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hypothyroidism is a common adverse event of various anticancer treatment modalities, constituting a notable paradigm of the integration of the endocrine perspective into precision oncology. AREAS COVERED The present narrative review provides a comprehensive and updated overview of anticancer treatment-induced hypothyroidism in patients with solid non-thyroid tumors. A study search was conducted on the following electronic databases: PubMed, Google Scholar, Scopus.com, ClinicalTrials.gov, and European Union Clinical Trials Register from 2011 until August 2021. EXPERT OPINION In patients with solid non-thyroid tumors, hypothyroidism is a common adverse event of radiotherapy, high dose interleukin 2 (HD IL-2), interferon alpha (IFN-α), bexarotene, immune checkpoint inhibitors (ICPi), and tyrosine kinase inhibitors (TKIs), while chemotherapy may induce hypothyroidism more often than initially considered. The path forward for the management of anticancer treatment-induced hypothyroidism in patients with solid non-thyroid tumors is an integrated approach grounded on 5 pillars: prevention, vigilance, diagnosis, treatment and monitoring. Current challenges concerning anticancer treatment-induced hypothyroidism await counteraction, namely awareness of the growing list of related anticancer treatments, identification of predictive factors, counteraction of diagnostic pitfalls, tuning of thyroid hormone replacement, and elucidation of its prognostic significance. Close collaboration of oncologists with endocrinologists will provide optimal patient care.
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Affiliation(s)
- Maria V Deligiorgi
- Department of Pharmacology - Clinical Pharmacology Unit, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
| | - Dimitrios T Trafalis
- Department of Pharmacology - Clinical Pharmacology Unit, National and Kapodistrian University of Athens, Faculty of Medicine, Athens, Greece
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7
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KAPLAN İ, CAN C, KÖMEK H, KEPENEK F, SOYLU H, ERDUR E, AGÜLOĞLU N, GÜNDOĞAN C. Is there an association between thyroid function tests and 18F FDG PET/CT parameters in untreated cancer patients? JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1107903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives: We aimed to investigate the association between the extent of disease, 18F FDG PET/CT parameters (SUVmax and the highest SUVmax) and thyroid function tests (TFT) (TSH, FT4, FT3, FT3/FT4 ratio, AntiTG, and AntiTPO) in untreated cancer patients.
Material and Method: One hundred and seventy-nine patients who underwent FDG PET/CT for metabolic characterization and staging in our clinic between May 2020 and November 2020 were included in the study. Patients were divided into two groups as malignant and benign according to histopathology findings. Thyroid function tests were ordered from all patients at the time of PET/CT imaging. The association between the presence of local lymph node metastasis, distant metastases and thyroid function tests as well as the association between PET/CT parameters and thyroid function tests in benign and malignant groups were statistically analyzed.
Results: Thyroid function tests did not exhibit a significant difference between patients with malignant and benign disease (p> 0.05). Univariate logistic regression analysis revealed that age, FT4 value, and the FT3/F4 ratio were significant parameters in predicting distant metastases. These parameters were also significant in predicting mortality. Multivariate logistic regression analysis showed that age was an independent prognostic factor predicting mortality.
Conclusion: Thyroid function tests are not decisive in differentiating malignant and benign lesions. While no statistically significant correlation was observed between thyroid function tests and PET/CT parameters, univariate analyses revealed that especially FT4 and FT3/FT4 ratio were significant in predicting disease extent and mortality in malignant disease. Age was found to be an independent prognostic factor in predicting mortality.
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Affiliation(s)
- İhsan KAPLAN
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Canan CAN
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Halil KÖMEK
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Ferat KEPENEK
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Hikmet SOYLU
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ENDOCRINOLOGY AND METABOLIC DISEASES
| | - Erkan ERDUR
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF INTERNAL MEDICINE, ONCOLOGY
| | - Nurşin AGÜLOĞLU
- UNIVERSITY OF HEALTH SCIENCES, İZMİR DR. SUAT SEREN HEALTH RESEARCH CENTER FOR PULMONOLOGY AND THORACIC SURGERY, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
| | - Cihan GÜNDOĞAN
- UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER, DEPARTMENT OF INTERNAL MEDICINE, DEPARTMENT OF NUCLEAR MEDICINE
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Zhang H, Che W, Shi K, Huang Y, Xu C, Fei M, Fan X, Zhang J, Hu X, Hu F, Qin S, Zhang X, Huang Q, Yu F. FT4/FT3 ratio: A novel biomarker predicts coronary microvascular dysfunction (CMD) in euthyroid INOCA patients. Front Endocrinol (Lausanne) 2022; 13:1021326. [PMID: 36187090 PMCID: PMC9520241 DOI: 10.3389/fendo.2022.1021326] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Ischemia and no obstructive coronary artery disease (INOCA) patients who presented coronary microvascular dysfunction (CMD) demonstrate a poor prognosis, yet the risk factors for CMD remain unclear. Subtle changes in thyroid hormone levels within the normal range, especially the free thyroxine (FT4)/free triiodothyronine (FT3) ratio, have been shown to regulate the cardiovascular system. This prospective study investigated the correlation between FT4/FT3 ratio and CMD in euthyroid patients with INOCA. METHODS This prospective study (www.chictr.org.cn/, ChiCTR2000037112) recruited patients with myocardial ischemia symptoms who underwent both coronary angiography (CAG) and myocardial perfusion imaging (MPI) with dynamic single-photon emission computed tomography (D-SPECT). INOCA was defined as coronary stenosis< 50% and CMD was defined as coronary flow reserve (CFR)<2.5. All patients were excluded from abnormal thyroid function and thyroid disease history. RESULTS Among 71 INOCA patients (15 [21.1%] CMD), FT4 and FT4/FT3 ratio in CMD group were significantly higher and both showed significantly moderate correlation with CFR (r=-0.25, p=0.03; r=-0.34, p=0.003, respectively). The ROC curve revealed that FT4/FT3 ratio had the highest efficacy for predicting CMD with an optimized cutoff value>3.39 (AUC 0.78, p<0.001, sensitivity, 80.0%; specificity, 71.4%). Multivariate logistic regression showed that FT4/FT3 ratio was an independent predictor of CMD (OR 7.62, 95% CI 1.12-51.89, p=0.038, P for trend=0.006). CONCLUSION In euthyroid INOCA patients, increased FT4/FT3 ratio levels are associated with the occurrence of CMD, presenting a novel biomarker for improving the risk stratification.
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Affiliation(s)
- Han Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Wenliang Che
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kuangyu Shi
- Department of Nuclear Medicine, University of Bern, Bern, Switzerland
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Yan Huang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Chong Xu
- Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Mengyu Fei
- Department of Radiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xin Fan
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Jiajia Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Xueping Hu
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Fan Hu
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Shanshan Qin
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Xiaoying Zhang
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Institute of Nuclear Medicine, Tongji University School of Medicine, Shanghai, China
| | - Qingqing Huang
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Qingqing Huang, ; Fei Yu,
| | - Fei Yu
- Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Qingqing Huang, ; Fei Yu,
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