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Hellmann A, Turyn J, Zwara A, Korczynska J, Taciak A, Mika A. Alterations in the amino acid profile in patients with papillary thyroid carcinoma with and without Hashimoto's thyroiditis. Front Endocrinol (Lausanne) 2023; 14:1199291. [PMID: 37664829 PMCID: PMC10471980 DOI: 10.3389/fendo.2023.1199291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/07/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose Amino acids (AAs) play important physiological roles in living cells. Some amino acid changes in blood are specific for autoimmune disorders, and some are specific for thyroid cancer. The aims of this study were to profile AA metabolites in the serum of patients with papillary thyroid carcinoma (PTC0) without Hashimoto's thyroiditis (HT) and patients with PTC with HT (PTC1) and predict whether AA metabolites are associated with thyroid disease, thyroid hormone and thyroid autoantibodies. Methods A total of 95 serum samples were collected, including 28 healthy controls (HCs), 28 PTC0 patients and 39 PTC1 patients. Serum samples were analyzed by high-performance liquid chromatography-triple stage quadrupole-mass spectrometry (HPLC-TSQ-MS), and twenty-one amino acids (AAs) were detected. Results The serum concentration of glutamic acid was significantly elevated in PTC1 patients compared with PTC0 patients. Lysine was the second amino acid that differentiated these two groups of PTC patients. In addition, the serum concentrations of glycine, alanine and tyrosine were significantly reduced in both PTC patient groups compared to the HC group. These AAs were also correlated with thyroid hormones and antibodies. Five amino acid markers, namely, glycine, tyrosine, glutamic acid, glutamine and arginine, separated/distinguished PTC0 patients from healthy subjects, and eight AA markers, the same AAs as above without arginine but with alanine, leucine, valine and histidine, separated/distinguished PTC1 patients from healthy subjects based on ROC analysis. Conclusion Compared with the HCs, changes in AAs in PTC0 and PTC1 patients showed similar patterns, suggesting the possibility of a common pathophysiological basis, which confirms preliminary research that PTC is significantly associated with pathologically confirmed HT. We found two AAs, lysine and alanine, that can perform diagnostic functions in distinguishing PTC1 from PTC0.
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Affiliation(s)
- Andrzej Hellmann
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Turyn
- Department of Biochemistry, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Agata Zwara
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
| | - Justyna Korczynska
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
| | - Aleksandra Taciak
- Department of General, Endocrine and Transplant Surgery, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Adriana Mika
- Department of Environmental Analysis, Faculty of Chemistry, University of Gdansk, Gdansk, Poland
- Department of Pharmaceutical Biochemistry, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
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Ruíz-Pacheco MG, Hernández I, Hernández-Estrella G, Basurto L, Vargas-Ortega G, González-Virla B, Molina-Ayala M, Hernández-Martínez AF, Luengas-Mondragón R, Hernández-Allende AA, Mendoza-Zubieta V, Balcázar-Hernández L. Severity of Fatigue and Its Relationship with TSH before and after Levothyroxine Replacement Therapy in Patients with Primary Hypothyroidism. Biomedicines 2023; 11:biomedicines11030811. [PMID: 36979787 PMCID: PMC10045891 DOI: 10.3390/biomedicines11030811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023] Open
Abstract
Background: Fatigue is a common symptom in hypothyroidism; however, the effect of levothyroxine on fatigue has been little studied. The aim of this study was to evaluate the effect of levothyroxine on fatigue in Latino patients with primary hypothyroidism, as well as the association of TSH and free T4 (FT4) with the severity and persistence of fatigue. Methods: A prospective study was performed in 92 patients with primary hypothyroidism. Fatigue severity scale (FSS) scores and clinical and biochemical characteristics before and at 6 months of levothyroxine were evaluated. Results: After 6 months of levothyroxine, a reduction in FSS (53 (47–57) vs. 36 (16–38); p = 0.001) and fatigue frequency (45.7% vs. 26.1%; p = 0.008) was evident. Both before and after 6 months of levothyroxine, there was a positive correlation of the FSS score with TSH and a negative correlation with FT4. Persistent fatigue was associated with a pretreatment FSS score (r = 0.75; p = 0.001) and diabetes (r = 0.40; p = 0.001). An FSS > 34 (RR 3.9 (95% CI 1.43–10.73; p = 0.008)), an FSS > 36 (RR 3.23 (95% CI 1.21–8.6; p = 0.019)), and diabetes (RR 5.7 (95% CI 1.25–9.6; p = 0.024)) before treatment were risk factors for persistent fatigue. Conclusions: Levothyroxine improved fatigue in most patients. Diabetes and an FSS score >34 or >36 before treatment were risk factors for persistent fatigue.
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Affiliation(s)
- María Guadalupe Ruíz-Pacheco
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Irma Hernández
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Guadalupe Hernández-Estrella
- Unidad de Medicina Familiar No. 69, Department of Family Medicine, Instituto Mexicano del Seguro Social, Calle José María Morelos 210-232, Centro, Texcoco 56100, Mexico
| | - Lourdes Basurto
- Endocrine Diseases Research Unit, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Guadalupe Vargas-Ortega
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Baldomero González-Virla
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Mario Molina-Ayala
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Alex Francisco Hernández-Martínez
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | | | | | - Victoria Mendoza-Zubieta
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
| | - Lourdes Balcázar-Hernández
- Centro Médico Nacional Siglo XXI, Department of Endocrinology, Hospital de Especialidades, Instituto Mexicano del Seguro Social, Mexico City 06720, Mexico
- Faculty of Medicine, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
- Correspondence: ; Tel.: +52-5556276900 (ext. 21551)
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Kalra S, Aggarwal S, Khandelwal D. Thyroid Dysfunction and Dysmetabolic Syndrome: The Need for Enhanced Thyrovigilance Strategies. Int J Endocrinol 2021; 2021:9641846. [PMID: 33859689 PMCID: PMC8024090 DOI: 10.1155/2021/9641846] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 02/26/2021] [Accepted: 03/19/2021] [Indexed: 12/25/2022] Open
Abstract
Thyroid dysfunction (TD) is common in metabolic disorders such as diabetes mellitus (DM), cardiovascular disease (CVD), obesity, dyslipidemia, hyperuricemia, kidney and liver dysfunctions, and polycystic ovary syndrome (PCOS). Subclinical hypothyroidism (SHypo) worsens glycemic control in patients with DM, and these patients, especially those with Type-1DM, have higher prevalence of TD. Both TD and DM increase CVD risk. Even minor alteration in thyroid hormone (TH) levels can alter cardiovascular function. While hyperthyroidism increases systolic blood pressure and leads to high-output heart failure, hypothyroidism increases diastolic blood pressure and leads to low-output heart failure. Chronic subclinical hyperthyroidism (SHyper) and SHypo both increase the risk of hypertension, coronary artery disease (CAD) events, CAD deaths, and total deaths. SHyper alters cardiac morphology and function. SHypo causes dyslipidemia and endothelial dysfunction and increases the risk for weight gain and obesity. Overweight and obese patients often have hyperleptinemia, which increases the secretion of thyroid stimulating hormone (TSH) and induces TD. Dyslipidemia associated with TD can increase serum uric acid levels. Hyperuricemia promotes inflammation and may increase the risk for dyslipidemia, atherosclerosis, and CVD. TD increases the risk for developing chronic kidney disease. In nephrotic syndrome, proteinuria is associated with urinary loss of TH leading to TD. Some correlation between TD and severity of liver disease is also seen. TD and PCOS have common risk factors and pathophysiological abnormalities. Hypothyroidism must be excluded before diagnosing PCOS. Current guidelines do not strongly recommend thyroid screening in the presence of all metabolic disorders. However, pragmatic thyrovigilance is required. Clinicians must stay alert to signs and symptoms of TD, maintain high clinical suspicion, and investigate thoroughly. Drug-induced TD should be considered when TH levels do not match clinical findings or when patients are on medications that can alter thyroid function.
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TURNAOĞLU H, ALTAY F, KURAL RAHATLI F, BOZKUŞ Y, TURHAN İYİDİR Ö, HABERAL KM. Acoustic radiation force impulse elastography findings of achilles tendon in patients with hypothyroidism. TURKISH JOURNAL OF INTERNAL MEDICINE 2021. [DOI: 10.46310/tjim.869648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Dutta D, Jindal R, Kumar M, Mehta D, Dhall A, Sharma M. Efficacy and Safety of Once Weekly Thyroxine as Compared to Daily Thyroxine in Managing Primary Hypothyroidism: A Systematic Review and Meta-Analysis. Indian J Endocrinol Metab 2021; 25:76-85. [PMID: 34660234 PMCID: PMC8477739 DOI: 10.4103/ijem.ijem_789_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/11/2021] [Accepted: 07/02/2021] [Indexed: 01/27/2023] Open
Abstract
AIMS No meta-analysis is available which has holistically analyzed efficacy and safety of once weekly thyroxine (OWT) vs. standard daily therapy (SDT) with regards to managing primary hypothyroidism. We undertook this meta-analysis to address this knowledge gap. METHODS Electronic databases were searched for clinical trials involving hypothyroid patients receiving OWT in intervention arm, and SDT in control arm. Primary outcome was to evaluate changes in serum thyroid stimulating hormone. Secondary outcomes were to evaluate alterations in total tetra-iodothyronine (TT4), total tri-iodothyronine (TT3), free T4 (FT4), free T3 (FT4), heart rate (HR), cardiac function, symptomatology, and adverse events. RESULTS From initially screened 159 studies, data from four trials involving 294 patients were analyzed. Patients of OWT had significantly higher thyroid stimulating hormone (TSH) [mean difference (MD) +1.85 mU/L (95% confidence interval, CI: 0.95-2.75); P < 0.01; I 2 = 63%], comparable TT4 [MD -0.87 mcg/dl (95% CI: -2.98-1.24); P = 0.42; I 2 = 65%], and significantly lower TT3 [MD -15.7 ng/dl (95% CI: -29.9-1.51); P = 0.03; I 2 = 90%], following 6-weeks therapy. TT4 [MD 3.05 mcg/dl (95% CI: 1.44-4.66); P < 0.01], and FT4 [MD 0.56 ng/dl (95% CI: 0.04-1.08); P = 0.03; I 2 = 66%] were significantly higher 2 h after thyroxine intake, in people on OWT compared to SDT. TT4 levels were significantly higher 4 h after thyroxine intake in OWT as compared to SDT [MD 0.70 ng/dl (95% CI: 0.52-0.88); P < 0.01]. Following 4-8 h of intake of thyroxine, isovolumetric contraction time [MD 3.62 ms (95% CI: 1.93-5.31); P < 0.01; I 2 = 0%] and aortic ejection time/pre-ejection period ratio [MD 0.01 (95% CI: 0.00-0.02); P = 0.02; I 2 = 0%], were significantly higher in people on OWT as compared to SDT. CONCLUSION OWT is associated with less efficient control of hypothyroidism at 6 weeks and may be associated with supraphysiologic elevation of thyroid hormone levels along with transient echocardiographic changes in some patients following 2-4 h of thyroxine intake.
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Affiliation(s)
- Deep Dutta
- Department of Endocrinology, CEDAR Super-Speciality Clinics, New Delhi, India
| | - Radhika Jindal
- Department of Endocrinology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Manoj Kumar
- Department of Endocrinology, CEDAR Super-Speciality Clinics, Zirakpur, Punjab, India
| | - Divij Mehta
- Department of Gastroenterology, CEDAR Super-Speciality Clinics, New Delhi, India
| | - Anil Dhall
- Department of Cardiology, Janakpuri Superspeciality Hospital, New Delhi, India
| | - Meha Sharma
- Department of Rheumatology, CEDAR Super-Speciality Clinics, New Delhi, India
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Kumari K, Chainy GB, Subudhi U. Prospective role of thyroid disorders in monitoring COVID-19 pandemic. Heliyon 2020; 6:e05712. [PMID: 33344794 PMCID: PMC7733548 DOI: 10.1016/j.heliyon.2020.e05712] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/01/2020] [Accepted: 12/10/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 pandemic has affected more than 200 countries and 1.3 million individuals have deceased within eleven months. Intense research on COVID-19 occurrence and prevalence enable us to understand that comorbidities play a crucial role in spread and severity of SARS-CoV-2 infection. Chronic kidney disease, diabetes, respiratory diseases and hypertension are among the various morbidities that are prevalent in symptomatic COVID-19 patients. However, the effect of altered thyroid-driven disorders cannot be ignored. Since thyroid hormone critically coordinate and regulate the major metabolism and biochemical pathways, this review is on the potential role of prevailing thyroid disorders in SARS-CoV-2 infection. Direct link of thyroid hormone with several disorders such as diabetes, vitamin D deficiency, obesity, kidney and liver disorders etc. suggests that the prevailing thyroid conditions may affect SARS-CoV-2 infection. Further, we discuss the oxidative stress-induced aging is associated with the degree of SARS-CoV-2 infection. Importantly, ACE2 protein which facilitates the host-cell entry of SARS-CoV-2 using the spike protein, are highly expressed in individuals with abnormal level of thyroid hormone. Altogether, we report that the malfunction of thyroid hormone synthesis may aggravate SARS-CoV-2 infection and thus monitoring the thyroid hormone may help in understanding the pathogenesis of COVID-19.
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Affiliation(s)
- Kanchan Kumari
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Department of Molecular Biology, Umea University, Sweden
| | - Gagan B.N. Chainy
- Post Graduate Department of Biotechnology, Utkal University, Bhubaneswar 751004, Odisha, India
| | - Umakanta Subudhi
- CSIR-Institute of Minerals & Materials Technology, Bhubaneswar 751013, Odisha, India
- Academy of Scientific & Innovative Research (AcSIR), New Delhi 110025, India
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Sharma LK, Sharma N, Kulshreshtha BA, Bansal R, Aggarwal A, Dutta D. Carbohydrate-rich Meals Have no Impact on Post-prandial Lipid Parameters in Indians with Subclinical and Overt Primary Hypothyroidism. EUROPEAN ENDOCRINOLOGY 2020; 16:161-166. [PMID: 33117450 DOI: 10.17925/ee.2020.16.2.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 01/06/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND AIMS The impact of altered cholesterol metabolism on post-prandial lipids in Indians with hypothyroidism is not known. This study evaluated the impact of overt primary hypothyroidism (OPH) and subclinical hypothyroidism (ScH) on post-prandial lipids after a standardised, carbohydrate-rich, mixed meal. METHODS Endocrinology outpatients were screened for possible inclusion into the study. Patients >18 years of age with hypothyroidism who were not taking levothyroxine and who did not present with any comorbidities underwent biochemical evaluation following a carbohydrate-rich, mixed meal. Assessments included total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides, lipoprotein-A (Lp-A), apolipoprotein-A1 (apo-A1), apolipoprotein-B (apo-B), insulin and fasting glucose. Assessments were carried out 1 hour, 2 hours and 4 hours after the meal. Patients were compared against healthy matched controls recruited from healthcare professionals in the hospital (asymptomatic and apparently healthy nursing staff, reception staff and ward staff). RESULTS Data from 194 patients (161 with ScH and 33 with OPH) and 40 euthyroid controls were analysed. Anthropometry, body mass index, glycaemia and insulin resistance were comparable among patients with OPH and ScH, and controls. LDL-C and Lp-A were significantly higher in those with OPH, compared with ScH and controls, at baseline, 1 hour, 2 hours and 4 hours after mixed meal consumption (all p<0.05). There was progressive and similar decline in post-prandial TC, LDL-C and Lp-A in all three groups. Triglycerides were similar among the OPH, ScH and control groups, both in fasting and post-prandial state, with a progressive and similar increase in post-prandial triglycerides in all three groups. CONCLUSION This study demonstrated that severity of hypothyroidism had no impact on post-prandial TC, LDL-C and Lp-A. In addition, hypothyroidism had no impact on post-prandial triglycerides. Therefore, we conclude that lipid profile can be reliably estimated in a non-fasting state in individuals with ScH and OPH.
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Affiliation(s)
- Lokesh Kumar Sharma
- Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia (RML) Hospital, New Delhi, India
| | - Neera Sharma
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
| | - Bindu Amarjeet Kulshreshtha
- Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism (CEDAR) Superspecialty Center, Dwarka, New Delhi, India
| | - Rahul Bansal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
| | - Anshita Aggarwal
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Dr RML Hospital, New Delhi, India
| | - Deep Dutta
- Department of Endocrinology, Center for Endocrinology, Diabetes, Arthritis and Rheumatism (CEDAR) Superspecialty Center, Dwarka, New Delhi, India
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