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Zaitoon H, Shefer G, Segev-Becker A, Eyal O, Lebenthal Y, Brener A. Polyethylene glycol thyroid-stimulating hormone (PEG-TSH) testing in the management of pediatric thyroid dysfunction. Endocrine 2024; 84:524-532. [PMID: 37882906 DOI: 10.1007/s12020-023-03575-5] [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: 06/25/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE The polyethylene glycol (PEG) methodology is used for investigating incongruities in laboratory assays, such as thyroid-stimulating hormone (TSH) measurements. The aim of the study is to investigate the practical application of PEG-TSH testing in cases of discrepancies between elevated TSH and normal free thyroxine (FT4) levels. METHODS A real-life observational study conducted in a tertiary medical center. The hospital's electronic database was queried for TSH tests performed in pediatric patients between 2015 and 2023. Of those, PEG-TSH were identified. Patients' clinical and biochemical characteristics and PEG-TSH-guided management were assessed. RESULTS In total, 2949 TSH tests were performed in 891 children and adolescents for various indications. Among them were 61 (2.1%) PEG-TSH results, mean age 7.1 ± 5.3 years, of 38 patients (4.3%), comprised of 16 with congenital hypothyroidism, 16 with subclinical hypothyroidism, and 6 with Hashimoto thyroiditis. Both the TSH and the PEG-TSH levels of patients with congenital hypothyroidism were higher than those of the other two groups (P = 0.021 and P = 0.009, respectively), with no group differences in FT4 levels. Spearman's correlation analysis revealed a strong association between TSH and PEG-TSH levels: r = 0.871, P < 0.001. In nearly one-half of the cases, clinical decisions made by clinicians (decreasing the dose or not initiating L-thyroxine treatment) were affected by the PEG-TSH results. CONCLUSION Our findings support PEG-TSH testing for determining appropriate TSH levels and avoid unnecessary thyroid hormone treatment among children and adolescents. We propose the suitability of managing their clinical condition based upon age-appropriate clinical parameters and FT4 levels when their PEG-TSH levels are within the normal range.
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Affiliation(s)
- Hussein Zaitoon
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gabi Shefer
- The Endocrine Laboratory, The Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anat Segev-Becker
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ori Eyal
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Lebenthal
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Avivit Brener
- The Institute of Pediatric Endocrinology and Diabetes, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, affiliated to the Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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Bablis P, Day RR, Bablis S, Pollard H. Treatment of Hypothyroidism and Stress Using Neuro-Emotional Technique (NET): A Case Study. Cureus 2024; 16:e58231. [PMID: 38745794 PMCID: PMC11092426 DOI: 10.7759/cureus.58231] [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: 04/14/2024] [Indexed: 05/16/2024] Open
Abstract
Hypothyroidism is generally considered an autoimmune condition, and typical medical management involves taking levothyroxine (synthetic thyroid hormone) for life. This case report details the results of a mind-body intervention (MBI) called the Neuro-Emotional Technique (NET) used to treat a 28-year-old Caucasian female presenting with symptoms and bloodwork markers associated with two years of hypothyroidism and a long history of stress. The patient's medical doctor provided a diagnosis of hypothyroidism after blood tests showed that thyroid-stimulating hormone (TSH) levels were high at 6.87 mIU/L (where the acceptable range is 0.40-3.50 mIU/L) and free T4 (FT4) levels were low at 8.6 pmol/L (where the acceptable range is 9.0-19.0 pmol/L). Psychometric tests were completed at baseline and after 12 weeks of treatment to evaluate changes in mental health and emotional well-being. The Adverse Childhood Experiences Questionnaire (ACE-Q) revealed a high degree of childhood trauma that may have predisposed to the underlying autoimmune thyroid dysfunction. At the conclusion of the treatment period, serum thyroid-stimulating hormone (TSH) and free T4 were within normal ranges and psychometric indicators normalized. We hypothesize that these changes may be due to the stress-reducing mechanism of NET and outline possible mechanisms via the Psycho-Immune-Neuroendocrine (PINE) network. The PINE network model asserts that chronic stress acts as a potential driver of pathophysiology that can lead to one or more medical and mental health conditions. While further studies with larger sample sizes are required to establish whether these results could be extrapolated to a wider population, the results of this case suggest that it may be pertinent to consider co-management of subclinical hypothyroidism with a relatively quick and cost-effective MBI such as NET.
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Affiliation(s)
- Peter Bablis
- Department of Maternal and Child Health and Precision Medicine, University Research Institute, Athens, GRC
- Department of Integrative and Complementary Medicine, Universal Health, Sydney, AUS
| | - Ryan R Day
- Department of Chiropractic, Universal Health, Sydney, AUS
| | - Sophia Bablis
- Department of Psychology, Universal Health, Sydney, AUS
| | - Henry Pollard
- Faculty of Health Sciences, Durban University of Technology, Durban, ZAF
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Arculeo AJ, Heaney-Burcher L. An Integrative/Functional Approach to Congenital Hypothyroidism in Infants. Integr Med (Encinitas) 2024; 23:38-40. [PMID: 38618163 PMCID: PMC11007623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
Congenital hypothyroidism (CHT) is a condition that, if left untreated, has severe consequences. In this case we report the resolution of hypothyroidism in a newborn with nutritional and alternative treatments. In evidence-based medicine, clinical expertise, research, and patient preference are an important triad used to make clinical decisions; in this case the patient's parents preferred to begin with nutritional and alternative treatments.
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Alhowail AH, Aldubayan MA. The Impact of Metformin on the Development of Hypothyroidism and Cardiotoxicity Induced by Cyclophosphamide, Methotrexate, and Fluorouracil in Rats. Pharmaceuticals (Basel) 2023; 16:1312. [PMID: 37765120 PMCID: PMC10535803 DOI: 10.3390/ph16091312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Cyclophosphamide (CYP), methotrexate (MTX), and 5-fluorouracil (5-FU) are extensively utilized in the therapeutic management of various malignancies. It is noteworthy, however, that potential chemotherapy-related complications include the occurrence of hypothyroidism and cardiotoxicity. Metformin (MET) is a pharmacological agent for managing type 2 diabetes. It has been reported to mitigate certain toxic manifestations associated with chemotherapy. This study's primary objective is to investigate MET's protective effects against hypothyroidism and cardiotoxicity induced by CMF treatment. A total of forty male rats were allocated into four distinct groups, each consisting of ten rats per group. These groups were categorized as follows: saline, MET, CMF, and CMF + MET. The experimental group of rats were administered CMF via intraperitoneal injection, receiving two doses of CMF, and fed MET in their daily drinking water, with a 2.5 mg/mL concentration. Blood samples were collected into EDTA tubes for assessment of TSH, free and total (T4 and T3), troponin I, CK, and CK-MB levels utilizing Electrochemiluminescence Immunoassays (ECI). The saline and MET groups did not exhibit significant alterations in thyroid hormones or cardiotoxic biomarkers. In contrast, in the CMF group, there was a notable reduction in T4, FT4, T3, and FT3 levels but no significant changes in TSH levels; however, troponin I, CK, and CK-MB levels were notably elevated. MET co-treatment with CMF did not ameliorate these effects caused by CMF. In conclusion, CMF treatment induced hypothyroidism and cardiotoxicity in rats, but MET co-treatment did not rescue the reduction of thyroid hormones or the elevation of cardiotoxic biomarkers.
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Affiliation(s)
- Ahmad H. Alhowail
- Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia;
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Lindberg FA, Nordenankar K, Forsberg EC, Fredriksson R. SLC38A10 Deficiency in Mice Affects Plasma Levels of Threonine and Histidine in Males but Not in Females: A Preliminary Characterization Study of SLC38A10−/− Mice. Genes (Basel) 2023; 14:genes14040835. [PMID: 37107593 PMCID: PMC10138244 DOI: 10.3390/genes14040835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
Solute carriers belong to the biggest group of transporters in the human genome, but more knowledge is needed to fully understand their function and possible role as therapeutic targets. SLC38A10, a poorly characterized solute carrier, is preliminary characterized here. By using a knockout mouse model, we studied the biological effects of SLC38A10 deficiency in vivo. We performed a transcriptomic analysis of the whole brain and found seven differentially expressed genes in SLC38A10-deficient mice (Gm48159, Nr4a1, Tuba1c, Lrrc56, mt-Tp, Hbb-bt and Snord116/9). By measuring amino acids in plasma, we found lower levels of threonine and histidine in knockout males, whereas no amino acid levels were affected in females, suggesting that SLC38A10−/− might affect sexes differently. Using RT-qPCR, we investigated the effect of SLC38A10 deficiency on mRNA expression of other SLC38 members, Mtor and Rps6kb1 in the brain, liver, lung, muscle, and kidney, but no differences were found. Relative telomere length measurement was also taken, as a marker for cellular age, but no differences were found between the genotypes. We conclude that SLC38A10 might be important for keeping amino acid homeostasis in plasma, at least in males, but no major effects were seen on transcriptomic expression or telomere length in the whole brain.
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Iodine Status in Pregnant Women Having Urinary Fluoride in Contaminated Areas: A Case Study of Phayao Province. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2023; 2023:3677359. [PMID: 36755777 PMCID: PMC9902143 DOI: 10.1155/2023/3677359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 07/22/2022] [Accepted: 01/02/2023] [Indexed: 01/31/2023]
Abstract
Fluoride naturally occurs in the Earth's crust and is widely dispersed in groundwater. The high consumption of fluoride can inhibit iodine metabolism in the human body, especially in the thyroid gland. This study assessed iodine knowledge, iodine consumption behavior, urinary iodine (UI), thyroid stimulating hormone (serum TSH), and free triiodothyronine3 (serum FT3) and examined the connection between fluoride exposure and UI and thyroid function as serum concentrations of TSH and FT3 in pregnant women dwelling in an area of endemic fluorosis. This was a cross-sectional study. The population included 152 pregnant women within the 1st trimester of pregnancy, during which they were provided antenatal care (ANC) in seven public community hospitals in Phayao province, Thailand. The study consisted of two components. First, the study consisted of a questionnaire in which we evaluated the iodine knowledge and iodine consumptive behaviors in subjects. Second, biochemical data were investigated to evaluate thyroid function in the subjects. The gestational age of most subjects was 8-12 weeks. The study population has lived in fluoride-contaminated areas since birth (76.97%). The iodine and iodine consumption levels were moderate (50.00%). Their food iodine consumption was 3-4 days/week, and the top five consumption ranks were iodized salt, cooked pork, eggs, sticky rice, and iodine fish sauce. In terms of biochemical parameters, 63.16% of respondents had UI levels below 150.00 g/L, which is below the normal reference range of 150.00-249.00 g/L. 89.47% of the risk of hypothyroidism was associated with serum TSH levels below 2.50 g/L. In 38.16% of the samples, normal levels of serum FT3 (2.00-4.40 pg/L) were identified in the subjects. In addition, 61.84% of the samples had FT3 concentrations greater than 4.40 pg/L (high intake of iodine). The approved association between positive serum FT3 data and serum TSH was positive (r = 260 and p < 0.05). These studies imply that these elevated levels of TSH and FT3 place pregnant women in their first trimester at risk for hypothyroidism.
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Alonso-Ventura V, Campos-Magallon P, Moreno-Franco B, Calmarza P, Calvo-Gracia F, Lou-Bonafonte JM, de Diego-Garcia P, Casasnovas JA, Marco-Benedi V, Civeira F, Laclaustra M. An elevated parametric thyroid feedback quantile-based index is associated with atrial fibrillation. Front Endocrinol (Lausanne) 2023; 14:1087958. [PMID: 36909333 PMCID: PMC9995977 DOI: 10.3389/fendo.2023.1087958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/09/2023] [Indexed: 02/25/2023] Open
Abstract
INTRODUCTION Atrial fibrillation is associated with hyperthyroidism. Within the euthyroid range, it is also associated with high thyroxine (fT4), but not with thyrotropin (TSH). We aim to describe differences in thyroid regulation, measured by the Parametric Thyroid Feedback Quantile-Based Index (PTFQI), between patients with atrial fibrillation and the general population. MATERIALS AND METHODS Thyroid parameters (PTFQI, TSH, and fT4) of a sample of 84 euthyroid subjects with atrial fibrillation (cases) were compared to a reference sample of euthyroid healthcare patients (controls). We calculated age and sex adjusted ORs for atrial fibrillation across tertiles of these parameters. Also, within cases, we studied thyroid parameters association with clinical characteristics of the atrial fibrillation. RESULTS After adjusting for age and sex, fT4 and PTFQI were higher in subjects with atrial fibrillation when compared to the general sample (p<0.01 and p=0.01, respectively). Atrial fibrillation ORs of the third versus the first PTFQI tertile was 1.88(95%CI 1.07,3.42), and there was a gradient across tertiles (p trend=0.02). Among atrial fibrillation patients, we observed that higher PTFQI was associated with sleep apnea/hypopnea syndrome (OSAS) (p=0.03), higher fT4 was associated with the presence of an arrhythmogenic trigger (p=0.02) and with heart failure (p<0.01), and higher TSH was also associated with OSAS (p<0.01). CONCLUSIONS Euthyroid subjects with atrial fibrillation have an elevation of the pituitary TSH-inhibition threshold, measured by PTFQI, with respect to the general population. Within atrial fibrillation patients, high PTFQI was associated with OSAS, and high fT4 with heart failure. These results hint of the existence of a relationship between thyroid regulation and atrial fibrillation.
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Affiliation(s)
- Vanesa Alonso-Ventura
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | | | - Belen Moreno-Franco
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
| | - Pilar Calmarza
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
| | - Fernando Calvo-Gracia
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Jose Manuel Lou-Bonafonte
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Instituto Agroalimentario de Aragón, CITA-Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición-Instituto de Salud Carlos III (CIBEROBN-ISCIII), Madrid, Spain
| | - Patricia de Diego-Garcia
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Jose Antonio Casasnovas
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
| | - Victoria Marco-Benedi
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
| | - Fernando Civeira
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
| | - Martin Laclaustra
- Hospital Universitario Miguel Servet, Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
- Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares-Instituto de Salud Carlos III (CIBERCV-ISCIII), Madrid, Spain
- *Correspondence: Martin Laclaustra,
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Muacevic A, Adler JR, Shaban M, Matos Noboa C, Trinh T. Pre-workout Induced Demand Ischemia. Cureus 2023; 15:e33694. [PMID: 36793833 PMCID: PMC9925028 DOI: 10.7759/cureus.33694] [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: 01/12/2023] [Indexed: 01/15/2023] Open
Abstract
Pre-workout supplement use has increased in recent years. Multiple side effects and off-labeled substances have been reported. We report a case of a 35-year-old patient who recently started a pre-workout and was found to have sinus tachycardia, elevated troponin, and subclinical hyperthyroidism. The echocardiogram showed normal ejection fraction and no wall motion abnormality. Beta-blockade therapy with propranolol was offered, but she refused, and her symptoms and troponin levels improved after proper hydration within 36 hours. A cautious and accurate assessment of young, fitness-enthusiastic patients experiencing unusual chest pain is essential to identify a reversible cardiac injury and possible off-label substances in over-the-counter supplements.
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Han Y, Yang J, Zhong R, Guo X, Cai M, Lin W. Side effects of long-term oral anti-seizure drugs on thyroid hormones in patients with epilepsy: a systematic review and network meta-analysis. Neurol Sci 2022; 43:5217-5227. [DOI: 10.1007/s10072-022-06120-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/02/2022] [Indexed: 11/08/2022]
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Oki T, Inoue A, Nagatani Y, Oki M, Watanabe Y. Computed tomography imaging findings of nivolumab-induced thyroid dysfunction. J Clin Imaging Sci 2022; 12:22. [PMID: 35673588 PMCID: PMC9168394 DOI: 10.25259/jcis_194_2021] [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: 10/22/2021] [Accepted: 03/15/2022] [Indexed: 11/04/2022] Open
Abstract
The thyroid gland is most frequently involved in immune-related adverse events (irAEs) by nivolumab. We reviewed the thyroid function and thyroid gland volume and volume change ratio between baseline and follow-up CT (volume follow-up/volume baseline) in 24 patients treated with nivolumab for lung cancer and renal cell carcinoma. Among them, four (16.7%) demonstrated nivolumab-induced thyroid dysfunction that shows either hypothyroidism or hyperthyroidism. Three and one cases were treated with nivolumab for lung cancer and renal cell carcinoma, respectively. Two patients with hypothyroidism (cases 1 and 2) showed reduced thyroid volume (volume change ratio: 0.80 and 0.84) on computed tomography (CT) images. Besides, remarkably diminished CT attenuation of the thyroid gland was observed in a patient with hypothyroidism (case 2). One of the two patients with hyperthyroidism showed increased thyroid volume (volume change ratio: 1.32) (case 3), whereas no difference in the thyroid gland volume was observed between the previous and follow-up CT in another patient with hyperthyroidism (case 4). Thyroid volume change ratio >0.1 was observed even in 6 of 20 (30%) patients without thyroid dysfunction. Considering the wide use of nivolumab in cancer treatment, radiologists should be aware that changes in the thyroid volume and attenuation on CT are associated with thyroid dysfunction caused by nivolumab, as well as thyroid volume may change even in patients with normal thyroid function during nivolumab therapy.
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Affiliation(s)
- Tatsuya Oki
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan,
| | - Akitoshi Inoue
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan,
| | - Yukihiro Nagatani
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan,
| | - Maya Oki
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan,
| | - Yoshiyuki Watanabe
- Department of Radiology, Shiga University of Medical Science, Otsu, Shiga, Japan,
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Appunni S, Rubens M, Ramamoorthy V, Saxena A, Tonse R, Veledar E, McGranaghan P. Association between vitamin D deficiency and hypothyroidism: results from the National Health and Nutrition Examination Survey (NHANES) 2007-2012. BMC Endocr Disord 2021; 21:224. [PMID: 34772378 PMCID: PMC8590325 DOI: 10.1186/s12902-021-00897-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 11/05/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE Many smaller studies have previously shown a significant association between thyroid autoantibody induced hypothyroidism and lower serum vitamin D levels. However, these finding have not been confirmed by large-scale studies. In this study, we evaluated the relationship between hypothyroidism and vitamin D levels using a large population-based data. METHODS For this study, we used National Health and Nutrition Examination Survey (NHANES) during the years 2007-2012. We categorized participants into three clinically relevant categories based on vitamin D levels: optimal, intermediate and deficient. Participants were also split into hypothyroid and hyperthyroid. Weighted multivariable logistic regression analyses were used to calculate the odds of being hypothyroid based on vitamin D status. RESULTS A total of 7943 participants were included in this study, of which 614 (7.7%) were having hypothyroidism. Nearly 25.6% of hypothyroid patients had vitamin D deficiency, compared to 20.6% among normal controls. Adjusted logistic regression analyses showed that the odds of developing hypothyroidism were significantly higher among patients with intermediate (adjusted odds ratio [aOR], 1.7, 95% CI: 1.5-1.8) and deficient levels of vitamin D (aOR, 1.6, 95% CI: 1.4-1.9). CONCLUSION Low vitamin D levels are associated with autoimmune hypothyroidism. Healthcare initiatives such as mass vitamin D deficiency screening among at-risk population could significantly decrease the risk for hypothyroidism in the long-term.
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Affiliation(s)
- Sandeep Appunni
- Department of Biochemistry, Government Medical College, Kozhikode, Kerala, India
| | | | | | | | | | - Emir Veledar
- Baptist Health South Florida, Miami, Florida, USA
- Department of Biostatistics, Florida International University, Miami, FL, USA
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Peter McGranaghan
- Miami Cancer Institute, Miami, Florida, USA.
- Baptist Health South Florida, Miami, Florida, USA.
- Department of Internal Medicine and Cardiology, Charité - Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
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Sirivarasai J, Chanprasertyothin S, Kongtip P, Woskie S. Genetic Polymorphisms of Pesticide-Metabolizing Enzymes and Transporters in Agricultural Workers and Thyroid Hormone Levels. Risk Manag Healthc Policy 2021; 14:3435-3451. [PMID: 34434063 PMCID: PMC8380960 DOI: 10.2147/rmhp.s314510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 07/22/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Chronic exposure to pesticides has been associated with thyroid dysfunction owing to their endocrine disruption ability. Genetic variations in genes encoding phase I and II enzymes and phase III transporters are partly responsible for individual responses to chemical pesticides. This study investigated the association between variations in genes involved in pesticide metabolism and altered thyroid hormone concentrations. METHODS We assessed thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) in organic agriculture workers (n = 216) and workers who used chemical pesticides (n = 229). A questionnaire was used to collect sociodemographic, pesticide exposure, and health status data. Blood samples were analyzed for TSH, FT3, and FT4. Genomic DNA was extracted and genotyped using the TaqMan real-time PCR genotyping assay and restriction fragment length polymorphism method for 15 metabolically related genes. RESULTS Significant differences in the TSH (1.58 vs 1.12 µIU/mL) and FT3 (0.34 vs 0.31 ng/dL) concentrations between the chemical and organic worker groups were observed. The frequencies of all single nucleotide polymorphisms were in Hardy-Weinberg equilibrium and were mostly consistent with Asian populations. The findings showed the association between SNPs of enzymes and transporters and TSH, FT3, and FT4. The odd ratio and adjusted odd ratio (with sex, age, smoking status, alcohol consumption and exposure parameters) for subclinical thyroid disease by the variant alleles CYP1A1 rs1048943, CYP2B6 rs2279343, CYP2C19 rs4244285, NAT2 rs1799931, and PON1 rs662 in the chemical workers compared with the organic workers were found (P values < 0.05). CONCLUSION This is the first study to assess gene-environment interactions in Thai agricultural workers by investigating disruptions of the hypothalamic-pituitary-thyroid axis. The investigated SNP profiles revealed several gene-thyroid hormone associations in which even low levels of pesticide exposure could disturb thyroid homeostasis. These findings provide a foundation for planning future studies investigating associations between complex diseases and occupational pesticide exposure.
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Affiliation(s)
- Jintana Sirivarasai
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Suwanee Chanprasertyothin
- Research and Innovation Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Pornpimol Kongtip
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Susan Woskie
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA, USA
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13
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Ramsay N, Carizey R, Popa D. Coronavirus Disease 2019-Induced Thyroiditis. J Emerg Med 2021; 61:420-423. [PMID: 34332823 PMCID: PMC7833333 DOI: 10.1016/j.jemermed.2021.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/08/2021] [Accepted: 01/11/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is a disease that presents with acute respiratory symptoms that are well documented and sequelae that are yet to be fully understood. CASE REPORT We present the case of a 51-year old woman, recently diagnosed with COVID-19, who presented with symptoms including chest pain, palpitations, difficulty swallowing, and anterior neck discomfort. We ultimately diagnosed her with COVID-19-induced thyroiditis and discharged her on propranolol and nonsteroidal anti-inflammatory medication. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Thyroiditis can present with symptoms similar to other etiologies like pulmonary embolism. We discuss the process of evaluating and treating thyroiditis. We further discuss the risk of administering iodinated contrast media that could further exacerbate thyroid dysfunction.
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Affiliation(s)
- Nicolas Ramsay
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Rene Carizey
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
| | - Daniel Popa
- Department of Emergency Medicine, Rush University Medical Center, Chicago, Illinois
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14
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Harjantini U, Retno Dewi YL, Hanim D, Nurwati I. Correlation of dietary iron intake and serum iron with thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels in adult hyperthyroid patients. J Basic Clin Physiol Pharmacol 2021; 32:571-576. [PMID: 34214342 DOI: 10.1515/jbcpp-2020-0483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 03/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES National Baseline Health Research 2013 showed that there were 706,757 (0.4%) hyperthyroid patients in Indonesia. Hyperthyroidism is characterized by abnormal thyroid stimulating immunoglobulin (TSI) which causes low TSH and high FT4 levels. Hyperthyroid patients have a decrease of serum iron levels due to acute phase reactions of hyperthyroidism. This study aimed to analyze the correlation between dietary iron intake and serum iron with TSH and FT4 levels in adult hyperthyroid patients. METHODS This study was conducted in February-July 2020 at the Clinic of Magelang Health Research and Development Center. Sampling of this cross sectional study was based on inclusion criteria in order to obtain 50 adult hyperthyroid patients. Dietary iron intake was collected with 2 × 24 h dietary recall, serum iron was measured with colorimetric analysis, the levels of TSH and FT4 were measured by ELISA. The collected data were analyzed using Spearman correlation and multivariate linear regression with 95% confidence level. RESULTS Deficiencies of dietary iron intake was found in 20 hyperthyroid patients (40%). Low serum iron levels were found in 10 hyperthyroid patients (20%). Spearman correlation analysis showed that dietary iron intake had a negative correlation with TSH (r=-0.294; p<0.05) but did not correlate with FT4 (r=-0.142; p>0.05), while serum iron didn't associated with both TSH (r=0.110; p>0.05) and FT4 (r=0.142; p>0.05). Furthermore, regression analysis showed that dietary iron intake, serum iron, phytate, and thyrozol intake correlate with TSH levels (R square=0.193; p<0.05) and FT4 levels (R square=0.341; p<0.05), but there were no independent association between dietary iron intake and serum iron with TSH and FT4 levels (p>0.05). CONCLUSIONS Intake and serum of iron didn't correlate with TSH and FT4 levels in adult hyperthyroid patients.
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Affiliation(s)
| | - Yulia Lanti Retno Dewi
- Department of Nutrition Science, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
| | - Diffah Hanim
- Department of Nutrition Science, Faculty of Medicine, Sebelas Maret University, Surakarta, Indonesia
| | - Ida Nurwati
- Medical Faculty, Sebelas Maret University, Surakarta, Indonesia
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15
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Mardhiyah D, Komaruddin WN, Jalal FN, Wuryanti S, Bahri S, Qomariah Q, Sosiawan I, Marsiati H, Legiono L, Hanif H, Woskie S, Kongtip P. Comparison of Thyroid Hormone Levels between Women Farmers and Non-Farmers in Banten Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6618. [PMID: 34205433 PMCID: PMC8296419 DOI: 10.3390/ijerph18126618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022]
Abstract
Pesticides are suspected of being endocrine disruptors. This cross-sectional study measured serum samples for levels of thyroid hormones including thyroid stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free T3 (FT3), and free T4 (FT4) among Indonesian female farmers (n = 127) and non-farmers (n = 127). A questionnaire was used to collect information on demographics and risk factors including work characteristics and frequency, and the use of home and agricultural pesticides. Results showed that there were no significant differences in the distribution of the clinical categories of thyroid levels between farmers and non-farmers except for FT3 and T4. However, in multivariable regression controlling for confounders, FT3 and T4 were significantly higher for farmers compared to non-farmers. In addition, 32% of farmers had clinically low iodine levels and 49% of non-farmers had clinically high iodine levels. We conclude that pesticide exposure may not be as important as iodine intake in explaining these findings. We recommend counseling by health workers about the importance of using iodized salt for farmers and counseling about high iodine foods that need to be avoided for non-farmers.
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Affiliation(s)
- Dian Mardhiyah
- Department of Public Health, YARSI University, Jakarta 10510, Indonesia
| | | | - Fasli Nedra Jalal
- Department of Nutrition, YARSI University, Jakarta 10510, Indonesia; (F.N.J.); (S.W.)
| | - Sri Wuryanti
- Department of Nutrition, YARSI University, Jakarta 10510, Indonesia; (F.N.J.); (S.W.)
| | - Syukrini Bahri
- Department of Clinical Pathology, YARSI University, Jakarta 10510, Indonesia;
| | - Qomariah Qomariah
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Insan Sosiawan
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Himmi Marsiati
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Legiono Legiono
- Department of Physiology, YARSI University, Jakarta 10510, Indonesia; (Q.Q.); (I.S.); (H.M.); (L.L.)
| | - Harliansyah Hanif
- Department of Biomedical Science, YARSI University, Jakarta 10510, Indonesia;
| | - Susan Woskie
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA 01854, USA;
| | - Pornpimol Kongtip
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand;
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16
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Mullarkey EM, Iyer A, Ihuoma A. Lessons of the month: A challenging presentation of hypopituitarism secondary to an intracerebral aneurysm. Clin Med (Lond) 2021; 21:e228-e230. [PMID: 33762391 PMCID: PMC8002787 DOI: 10.7861/clinmed.2020-1017] [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] [Indexed: 11/27/2022]
Abstract
A 65-year-old man presented to ambulatory care with a 10-month history of muscle weakness, weight loss, dysphagia and fatigue.Prior to presentation he had been managed in general practice for hypothyroidism with a low T4 level and normal thyroid stimulation hormone (TSH). He was commenced on levothyroxine yet, despite dose titrations, had ongoing symptoms. He had been extensively reviewed by gastroenterology and rheumatology teams.The thyroid function tests (TFTs) pattern prompted a pituitary hormone profile test, which revealed panhypopituitarism with a cortisol of 22 nmol/L. Therefore, hydrocortisone was commenced. A pituitary magnetic resonance imaging (MRI) detected a left internal carotid aneurysm that was confirmed on computed tomography angiography. He successfully underwent embolisation of the aneurysm in the local neurosurgical centre.This case highlights the importance of correctly interpreting TFTs as this patient's initial TFTs indicated central hypothyroidism which should have prompted urgent pituitary hormone screening. The risk of addisonian crisis with commencement of levothyroxine without steroid replacement in secondary hypothyroidism emphasises the importance of TFT interpretation. Internal carotid artery aneurysms are a rare, yet important, cause of hypopituitarism resulting in high mortality and morbidity associated with delayed diagnosis secondary to the pressure effects of the aneurysm or the effects of aneurysmal rupture.
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Affiliation(s)
| | - Ashok Iyer
- University Hospital Lewisham, Lewisham, UK
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17
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Olichwier A, Balatskyi VV, Wolosiewicz M, Ntambi JM, Dobrzyn P. Interplay between Thyroid Hormones and Stearoyl-CoA Desaturase 1 in the Regulation of Lipid Metabolism in the Heart. Int J Mol Sci 2020; 22:ijms22010109. [PMID: 33374300 PMCID: PMC7796080 DOI: 10.3390/ijms22010109] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/17/2020] [Accepted: 12/21/2020] [Indexed: 12/19/2022] Open
Abstract
Stearoyl-CoA desaturase 1 (SCD1), an enzyme that is involved in the biosynthesis of monounsaturated fatty acids, induces the reprogramming of cardiomyocyte metabolism. Thyroid hormones (THs) activate both lipolysis and lipogenesis. Many genes that are involved in lipid metabolism, including Scd1, are regulated by THs. The present study used SCD1 knockout (SCD1−/−) mice to test the hypothesis that THs are important factors that mediate the anti-steatotic effect of SCD1 downregulation in the heart. SCD1 deficiency decreased plasma levels of thyroid-stimulating hormone and thyroxine and the expression of genes that regulate intracellular TH levels (i.e., Slc16a2 and Dio1-3) in cardiomyocytes. Both hypothyroidism and SCD1 deficiency affected genomic and non-genomic TH pathways in the heart. SCD1 deficiency is known to protect mice from genetic- or diet-induced obesity and decrease lipid content in the heart. Interestingly, hypothyroidism increased body adiposity and triglyceride and diacylglycerol levels in the heart in SCD1−/− mice. The accumulation of triglycerides in cardiomyocytes in SCD1−/− hypothyroid mice was caused by the activation of lipogenesis, which likely exceeded the upregulation of lipolysis and fatty acid oxidation. Lipid accumulation was also observed in the heart in wildtype hypothyroid mice compared with wildtype control mice, but this process was related to a reduction of triglyceride lipolysis and fatty acid oxidation. We also found that simultaneous SCD1 and deiodinase inhibition increased triglyceride content in HL-1 cardiomyocytes, and this process was related to the downregulation of lipolysis. Altogether, the present results suggest that THs are an important part of the mechanism of SCD1 in cardiac lipid utilization and may be involved in the upregulation of energetic metabolism that is associated with SCD1 deficiency.
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Affiliation(s)
- Adam Olichwier
- Laboratory of Molecular Medical Biochemistry, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 02-093 Warsaw, Poland; (A.O.); (V.V.B.); (M.W.)
| | - Volodymyr V. Balatskyi
- Laboratory of Molecular Medical Biochemistry, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 02-093 Warsaw, Poland; (A.O.); (V.V.B.); (M.W.)
| | - Marcin Wolosiewicz
- Laboratory of Molecular Medical Biochemistry, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 02-093 Warsaw, Poland; (A.O.); (V.V.B.); (M.W.)
| | - James M. Ntambi
- Department of Biochemistry, University of Wisconsin-Madison, Madison, WI 53706, USA;
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Pawel Dobrzyn
- Laboratory of Molecular Medical Biochemistry, Nencki Institute of Experimental Biology, Polish Academy of Sciences, 02-093 Warsaw, Poland; (A.O.); (V.V.B.); (M.W.)
- Correspondence:
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18
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Leemans M, Couderq S, Demeneix B, Fini JB. Pesticides With Potential Thyroid Hormone-Disrupting Effects: A Review of Recent Data. Front Endocrinol (Lausanne) 2019; 10:743. [PMID: 31920955 PMCID: PMC6915086 DOI: 10.3389/fendo.2019.00743] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/14/2019] [Indexed: 12/26/2022] Open
Abstract
Plant Protection Products, more commonly referred to as pesticides and biocides, are used to control a wide range of yield-reducing pests including insects, fungi, nematodes, and weeds. Concern has been raised that some pesticides may act as endocrine disrupting chemicals (EDCs) with the potential to interfere with the hormone systems of non-target invertebrates and vertebrates, including humans. EDCs act at low doses and particularly vulnerable periods of exposure include pre- and perinatal development. Of critical concern is the number of pesticides with the potential to interfere with the developing nervous system and brain, notably with thyroid hormone signaling. Across vertebrates, thyroid hormone orchestrates metamorphosis, brain development, and metabolism. Pesticide action on thyroid homeostasis can involve interference with TH production and its control, displacement from distributor proteins and liver metabolism. Here we focused on thyroid endpoints for each of the different classes of pesticides reviewing epidemiological and experimental studies carried out both in in vivo and in vitro. We conclude first, that many pesticides were placed on the market with insufficient testing, other than acute or chronic toxicity, and second, that thyroid-specific endpoints for neurodevelopmental effects and mixture assessment are largely absent from regulatory directives.
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Affiliation(s)
- Michelle Leemans
- Muséum National d'Histoire Naturelle, CNRS UMR 7221, Laboratoire Physiologie moléculaire de l'adaptation, Paris, France
| | | | | | - Jean-Baptiste Fini
- Muséum National d'Histoire Naturelle, CNRS UMR 7221, Laboratoire Physiologie moléculaire de l'adaptation, Paris, France
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19
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Anyiam O, Cheung B, Al‐sabbagh S. Subclinical hypothyroidism or central hypothyroidism-The danger of thyroid function misinterpretation. Clin Case Rep 2018; 6:1953-1957. [PMID: 30349705 PMCID: PMC6186879 DOI: 10.1002/ccr3.1694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/23/2018] [Accepted: 05/25/2018] [Indexed: 01/28/2023] Open
Abstract
Correct interpretation of thyroid function tests is critical to providing appropriate care to patients with suspected thyroid disease. It is particularly important to distinguish central hypothyroidism from other types due to the potential of concurrent secondary adrenal insufficiency and thus the need for immediate steroid replacement prior to commencing thyroxine.
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Affiliation(s)
| | - Billy Cheung
- East and North Hertfordshire NHS TrustStevenageHertfordshireUK
- Present address:
Homerton University HospitalLondonUK
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20
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Skalny AV, Klimenko LL, Turna AA, Budanova MN, Baskakov IS, Savostina MS, Mazilina AN, Deyev AI, Skalnaya MG, Tinkov AA. Serum trace elements are interrelated with hormonal imbalance in men with acute ischemic stroke. J Trace Elem Med Biol 2017; 43:142-147. [PMID: 28108058 DOI: 10.1016/j.jtemb.2016.12.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/28/2016] [Accepted: 12/30/2016] [Indexed: 11/22/2022]
Abstract
UNLABELLED The objective of the present study was to assess hormonal and trace element status in men suffering from acute ischemic stroke. METHODS 21 acute ischemic stroke patients and 21 age- and body mass index-matched healthy volunteers were enrolled in the study. Serum trace elements were assessed using inductively coupled plasma mass spectrometry. Serum hormones and brain damage markers were estimated using enzyme-linked immunosorbent assay. RESULTS Ischemic stroke patients are characterized by significantly higher levels of total and free triiodothyronine (T3), anti-thyroid peroxidase antibodies (Anti-TPO-Ab), prolactin, and cortisol, whereas the level of thyroid stimulating hormone (TSH) was decreased. Serum B, Cu, Li, Mn, Ni, Pb, Se, V, and Zn in stroke significantly exceeded the control values, whereas the level of Co and Fe was decreased. Correlation analysis revealed a significant association between serum B and T3, Anti-TPO-Ab, and iodine concentration; serum Li and Sr levels - with circulating TSH, free T3, and Anti-TPO-Ab; and V concentration - with total T3 and I levels. The following positive relationships were also revealed: Co - TSH, Mn - free T3, Zn - free T3. Multiple linear regression demonstrated that Co, I, and Li were directly related to circulating TSH levels, whereas V concentration was negatively interrelated. In turn, only serum Li levels were characterized by a significant direct relationship with free T3 values. CONCLUSION Generally, the obtained data demonstrate that altered serum trace elements are associated with thyroid dysfunction in acute ischemic stroke patients. However, the causal relationship should be estimated.
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Affiliation(s)
- Anatoly V Skalny
- All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR), Grina St., 7, Moscow, 117216, Russia; Orenburg State University, Pobedy Avenue, 13, 460018, Orenburg, Russia; Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; RUDN University, Miklukho-Maklay St., 10/2, Moscow, 117198, Russia.
| | - Lydmila L Klimenko
- Institute of Chemical Physics of N. N. Semenov of the Russian Academy of Sciences, Kosygina St., 4, Moscow, 119991, Russia
| | - Aliya A Turna
- Institute of Professional Development of Federal Medical-Biological Agency of Russia, Volokolamskoe St., 30, 1, Moscow, 123182, Russia
| | - Maria N Budanova
- Institute of Chemical Physics of N. N. Semenov of the Russian Academy of Sciences, Kosygina St., 4, Moscow, 119991, Russia
| | - Ivan S Baskakov
- Institute of Chemical Physics of N. N. Semenov of the Russian Academy of Sciences, Kosygina St., 4, Moscow, 119991, Russia
| | - Marina S Savostina
- Clinical Hospital № 123 Federal Medical-Biological Agency of Russia, Odintsovo, Moscow Region, Russia
| | - Aksana N Mazilina
- Clinical Hospital № 123 Federal Medical-Biological Agency of Russia, Odintsovo, Moscow Region, Russia
| | - Anatoly I Deyev
- Institute of Chemical Physics of N. N. Semenov of the Russian Academy of Sciences, Kosygina St., 4, Moscow, 119991, Russia; N. I. Pirogov Russian National Research Medical University, Ostrovitianov str. 1, Moscow, 117997, Russia
| | | | - Alexey A Tinkov
- Orenburg State University, Pobedy Avenue, 13, 460018, Orenburg, Russia; Yaroslavl State University, Sovetskaya St., 14, Yaroslavl, 150000, Russia; RUDN University, Miklukho-Maklay St., 10/2, Moscow, 117198, Russia; Orenburg State Medical University, Sovetskaya St., 6, Orenburg, 460000, Russia
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