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Osinga JAJ, Liu Y, Männistö T, Vafeiadi M, Tao FB, Vaidya B, Vrijkotte TGM, Mosso L, Bassols J, López-Bermejo A, Boucai L, Aminorroaya A, Feldt-Rasmussen U, Hisada A, Yoshinaga J, Broeren MAC, Itoh S, Kishi R, Ashoor G, Chen L, Veltri F, Lu X, Taylor PN, Brown SJ, Chatzi L, Popova PV, Grineva EN, Ghafoor F, Pirzada A, Kianpour M, Oken E, Suvanto E, Hattersley A, Rebagliato M, Riaño-Galán I, Irizar A, Vrijheid M, Delgado-Saborit JM, Fernández-Somoano A, Santa-Marina L, Boelaert K, Brenta G, Dhillon-Smith R, Dosiou C, Eaton JL, Guan H, Lee SY, Maraka S, Morris-Wiseman LF, Nguyen CT, Shan Z, Guxens M, Pop VJM, Walsh JP, Nicolaides KH, D'Alton ME, Visser WE, Carty DM, Delles C, Nelson SM, Alexander EK, Chaker L, Palomaki GE, Peeters RP, Bliddal S, Huang K, Poppe KG, Pearce EN, Derakhshan A, Korevaar TIM. Risk Factors for Thyroid Dysfunction in Pregnancy: An Individual Participant Data Meta-Analysis. Thyroid 2024. [PMID: 38546971 DOI: 10.1089/thy.2023.0646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background: International guidelines recommend targeted screening to identify gestational thyroid dysfunction. However, currently used risk factors have questionable discriminative ability. We quantified the risk for thyroid function test abnormalities for a subset of risk factors currently used in international guidelines. Methods: We included prospective cohort studies with data on gestational maternal thyroid function and potential risk factors (maternal age, body mass index [BMI], parity, smoking status, pregnancy through in vitro fertilization, twin pregnancy, gestational age, maternal education, and thyroid peroxidase antibody [TPOAb] or thyroglobulin antibody [TgAb] positivity). Exclusion criteria were pre-existing thyroid disease and use of thyroid interfering medication. We analyzed individual participant data using mixed-effects regression models. Primary outcomes were overt and subclinical hypothyroidism and a treatment indication (defined as overt hypothyroidism, subclinical hypothyroidism with thyrotropin >10 mU/L, or subclinical hypothyroidism with TPOAb positivity). Results: The study population comprised 65,559 participants in 25 cohorts. The screening rate in cohorts using risk factors currently recommended (age >30 years, parity ≥2, BMI ≥40) was 58%, with a detection rate for overt and subclinical hypothyroidism of 59%. The absolute risk for overt or subclinical hypothyroidism varied <2% over the full range of age and BMI and for any parity. Receiver operating characteristic curves, fitted using maternal age, BMI, smoking status, parity, and gestational age at blood sampling as explanatory variables, yielded areas under the curve ranging from 0.58 to 0.63 for the primary outcomes. TPOAbs/TgAbs positivity was associated with overt hypothyroidism (approximate risk for antibody negativity 0.1%, isolated TgAb positivity 2.4%, isolated TPOAb positivity 3.8%, combined antibody positivity 7.0%; p < 0.001), subclinical hypothyroidism (risk for antibody negativity 2.2%, isolated TgAb positivity 8.1%, isolated TPOAb positivity 14.2%, combined antibody positivity 20.0%; p < 0.001) and a treatment indication (risk for antibody negativity 0.2%, isolated TgAb positivity 2.2%, isolated TPOAb positivity 3.0%, and combined antibody positivity 5.1%; p < 0.001). Twin pregnancy was associated with a higher risk of overt hyperthyroidism (5.6% vs. 0.7%; p < 0.001). Conclusions: The risk factors assessed in this study had poor predictive ability for detecting thyroid function test abnormalities, questioning their clinical usability for targeted screening. As expected, TPOAb positivity (used as a benchmark) was a relevant risk factor for (subclinical) hypothyroidism. These results provide insights into different risk factors for gestational thyroid dysfunction.
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Affiliation(s)
- Joris A J Osinga
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Yindi Liu
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tuija Männistö
- Northern Finland Laboratory Center Nordlab and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui, China
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, University of Exeter Medical School, Exeter, United Kingdom
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Lorena Mosso
- Departments of Endocrinology, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, Girona, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, Girona, Spain
- Departament de Ciències Mèdiques, Universitat de Girona, Girona, Spain
| | - Laura Boucai
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, New York, USA
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Aya Hisada
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, The Netherlands
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ghalia Ashoor
- Harris Birthright Research Center for Fetal Medicine, King's College Hospital, London, United Kingdom
| | - Liangmiao Chen
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Flora Veltri
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Xuemian Lu
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Polina V Popova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elena N Grineva
- Department of Endocrinology, First Medical University, Saint Petersburg, Russia
| | - Farkhanda Ghafoor
- Department of Research and Innovation, Shalamar Institute of Health Sciences, Lahore, Pakistan
| | | | - Maryam Kianpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Andrew Hattersley
- Department of Molecular Medicine, University of Exeter Medical School, Royal Devon and Exeter Hospital, Exeter, Devon, United Kingdom
| | - Marisa Rebagliato
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Predepartamental Unit of Medicine, Jaume I University, Castelló, Spain
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Isolina Riaño-Galán
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain
- IUOPA-Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
- Servicio de Pediatría, Endocrinología Pediátrica, HUCA, Oviedo, Asturias, Spain
| | - Amaia Irizar
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, San Sebastian, Spain
- Department of Preventive Medicine and Public Health, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Juana Maria Delgado-Saborit
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain
- Department of Medicine, Faculty of Health Sciences, Universitat Jaume I, Castellón de la Plana, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain
- IUOPA-Department of Medicine, University of Oviedo, Oviedo, Asturias, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- Biodonostia Health Research Institute, Group of Environmental Epidemiology and Child Development, San Sebastian, Spain
- Department of Health of the Basque Government, Subdirectorate of Public Health of Gipuzkoa, San Sebastian, Spain
| | - Kristien Boelaert
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Gabriela Brenta
- Department of Internal Medicine, Unidad Asistencial Dr. César Milstein, Buenos Aires, Argentina
| | - Rima Dhillon-Smith
- Tommys National Centre for Miscarriage Research, Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Chrysoula Dosiou
- Division of Endocrinology, Stanford University School of Medicine, Stanford, California, USA
| | - Jennifer L Eaton
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, and Women and Infants Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Haixia Guan
- The First Hospital of China Medical University, Shenyang, China
| | - Sun Y Lee
- Section of Endocrinology, Diabetes, and Nutrition, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Endocrine Section, Medicine Service, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| | - Lilah F Morris-Wiseman
- Division of Endocrine Surgery, Johns Hopkins Department of Surgery, Baltimore, Maryland, USA
| | - Caroline T Nguyen
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Hospital of China Medical University, Shenyang, China
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Kypros H Nicolaides
- Department of Women and Children's Health, Faculty of Life Sciences and Medicine King's College London, London, United Kingdom
| | - Mary E D'Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - W Edward Visser
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - David M Carty
- Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, Glasgow, United Kingdom
- School of Cardiovascular and Metabolic Health, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Christian Delles
- School of Cardiovascular and Metabolic Health, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Scott M Nelson
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women and Infants Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, Scientific Research Center in Preventive Medicine; School of Public Health; Anhui Medical University, Hefei, Anhui, China
| | - Kris G Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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2
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Derakhshan A, Männistö T, Chen L, Osinga JAJ, Ashoor G, Lu X, Bliddal S, Tao FB, Brown SJ, Vaidya B, Hattersley AT, Itoh S, Popova PV, Aminorroaya A, Kishi R, Kianpour M, Vasukova EA, López-Bermejo A, Oken E, Chatzi L, Vafeiadi M, Bramer WM, Bassols J, Lertxundi A, Fernández-Somoano A, Carrasco P, Auvinen J, Huang K, Feldt-Rasmussen U, Grineva EN, Alexander EK, Pearce EN, Chaker L, Walsh JP, Peeters RP, Guxens M, Suvanto E, Nicolaides KH, Korevaar TIM. Association of Gestational Free and Total Triiodothyronine With Gestational Hypertension, Preeclampsia, Preterm Birth, and Birth Weight: An Individual Participant Data Meta-analysis. J Clin Endocrinol Metab 2024; 109:e1290-e1298. [PMID: 37878891 PMCID: PMC10876397 DOI: 10.1210/clinem/dgad631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/22/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
CONTEXT Triiodothyronine (T3) is the bioactive form of thyroid hormone. In contrast to thyroid-stimulating hormone and free thyroxine, we lack knowledge on the association of gestational T3 with adverse obstetric outcomes. OBJECTIVE To investigate the associaiton of gestational free or total T3 (FT3 or TT3) with adverse obstetric outcomes. METHODS We collected individual participant data from prospective cohort studies on gestational FT3 or TT3, adverse obstetric outcomes (preeclampsia, gestational hypertension, preterm birth and very preterm birth, small for gestational age [SGA], and large for gestational age [LGA]), and potential confounders. We used mixed-effects regression models adjusting for potential confounders. RESULTS The final study population comprised 33 118 mother-child pairs of which 27 331 had data on FT3 and 16 164 on TT3. There was a U-shaped association of FT3 with preeclampsia (P = .0069) and a J-shaped association with the risk of gestational hypertension (P = .029). Higher TT3 was associated with a higher risk of gestational hypertension (OR per SD of TT3 1.20, 95% CI 1.08 to 1.33; P = .0007). A lower TT3 but not FT3 was associated with a higher risk of very preterm birth (OR 0.72, 95% CI 0.55 to 0.94; P = .018). TT3 but not FT3 was positively associated with birth weight (mean difference per 1 SD increase in TT3 12.8, 95% CI 6.5 to 19.1 g, P < .0001) but there was no association with SGA or LGA. CONCLUSION This study provides new insights on the association of gestational FT3 and TT3 with major adverse pregnancy outcomes that form the basis for future studies required to elucidate the effects of thyroid function on pregnancy outcomes. Based on the current study, routine FT3 or TT3 measurements for the assessment of thyroid function during pregnancy do not seem to be of added value in the risk assessment for adverse outcomes.
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Affiliation(s)
- Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
| | - Tuija Männistö
- Northern Finland Laboratory Center Nordlab and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu 90570, Finland
| | - Liangmiao Chen
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China
| | - Joris A J Osinga
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
| | - Ghalia Ashoor
- Harris Birthright Research Center for Fetal Medicine, King’s College Hospital, London SE5 9RS, UK
| | - Xuemian Lu
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, China
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen 2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen 1172, Denmark
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui 230032, China
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands 6009, Perth, Western Australia, Australia
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon University Hospital NHS Foundation Trust, University of Exeter Medical School, Exeter EX1 2LU, UK
| | - Andrew T Hattersley
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter EX1 2LU, UK
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Hokkaido 060-0808, Japan
| | - Polina V Popova
- World-Class Research Center for Personalized Medicine and institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 197341, Russia
- Department of Internal Diseases and Endocrinology, St.Petersburg Pavlov State Medical University, Saint Petersburg 197341, Russian Federation
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Hokkaido 060-0808, Japan
| | - Maryam Kianpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan 81745-33871, Iran
| | - Elena A Vasukova
- World-Class Research Center for Personalized Medicine and institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 197341, Russia
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI) & Dr. Josep Trueta Hospital, Girona 17007, Spain
- Departament de Ciències Mèdiques, Universitat de Girona, Girona 17007, Spain
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02215, USA
| | - Leda Chatzi
- Department of Population and Public Health Sciences UoSC, Keck School of Medicine, Los Angeles, CA 90033, USA
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion 700 13, Crete, Greece
| | - Wichor M Bramer
- Medical Library, Erasmus University Medical Centre, GD Rotterdam 3015, The Netherlands
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, Girona 17007, Spain
| | - Aitana Lertxundi
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid 28029, Spain
- Department of Preventive Medicine and Public Health, University of Basque Country, Leioa 48940, Spain
- BIODONOSTIA Health Research Institute, San Sebastian 20014, Spain
| | - Ana Fernández-Somoano
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid 28029, Spain
- Unit of Molecular Cancer Epidemiology, University Institute of Oncology of the Principality of Asturias (IUOPA)–Department of Medicine, University of Oviedo, Oviedo 33006, Asturias, Spain
- Institute of Health Research of the Principality of Asturias (ISPA), Oviedo 33006, Spain
| | - Paula Carrasco
- Epidemiology and Environmental Health Joint Research Unit, FISABIO−Universitat Jaume I−Universitat de València, Valencia 46020, Spain
- Department of Medicine, Universitat Jaume I, Castellón de la Plana 12071, Spain
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital, and Center for Life Course Health Research, University of Oulu, Oulu 90570, Finland
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Anhui 230032, China
- Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, Anhui 230032, China
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen 2100, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, Copenhagen University, Copenhagen 1172, Denmark
| | - Elena N Grineva
- World-Class Research Center for Personalized Medicine and institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 197341, Russia
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA 02215, USA
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands 6009, Perth, Western Australia, Australia
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
| | - Mònica Guxens
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid 28029, Spain
- ISGlobal, Barcelona 08003, Spain
- Pompeu Fabra University, Barcelona 08002, Spain
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, GD Rotterdam 3012, The Netherlands
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, Oulu 90570, Finland
| | - Kypros H Nicolaides
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine King’s College London, London WC2R 2LS, UK
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam 3015 GD, The Netherlands
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3
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Osinga JAJ, Derakhshan A, Feldt-Rasmussen U, Huang K, Vrijkotte TGM, Männistö T, Bassols J, López-Bermejo A, Aminorroaya A, Vafeiadi M, Broeren MAC, Palomaki GE, Ashoor G, Chen L, Lu X, Taylor PN, Tao FB, Brown SJ, Sitoris G, Chatzi L, Vaidya B, Popova PV, Vasukova EA, Kianpour M, Suvanto E, Grineva EN, Hattersley A, Pop VJM, Nelson SM, Walsh JP, Nicolaides KH, D’Alton ME, Poppe KG, Chaker L, Bliddal S, Korevaar TIM. TSH and FT4 Reference Interval Recommendations and Prevalence of Gestational Thyroid Dysfunction: Quantification of Current Diagnostic Approaches. J Clin Endocrinol Metab 2024; 109:868-878. [PMID: 37740543 PMCID: PMC10876390 DOI: 10.1210/clinem/dgad564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/14/2023] [Accepted: 09/21/2023] [Indexed: 09/24/2023]
Abstract
CONTEXT Guidelines recommend use of population- and trimester-specific thyroid-stimulating hormone (TSH) and free thyroxine (FT4) reference intervals (RIs) in pregnancy. Since these are often unavailable, clinicians frequently rely on alternative diagnostic strategies. We sought to quantify the diagnostic consequences of current recommendations. METHODS We included cohorts participating in the Consortium on Thyroid and Pregnancy. Different approaches were used to define RIs: a TSH fixed upper limit of 4.0 mU/L (fixed limit approach), a fixed subtraction from the upper limit for TSH of 0.5 mU/L (subtraction approach) and using nonpregnancy RIs. Outcome measures were sensitivity and false discovery rate (FDR) of women for whom levothyroxine treatment was indicated and those for whom treatment would be considered according to international guidelines. RESULTS The study population comprised 52 496 participants from 18 cohorts. Compared with the use of trimester-specific RIs, alternative approaches had a low sensitivity (0.63-0.82) and high FDR (0.11-0.35) to detect women with a treatment indication or consideration. Sensitivity and FDR to detect a treatment indication in the first trimester were similar between the fixed limit, subtraction, and nonpregnancy approach (0.77-0.11 vs 0.74-0.16 vs 0.60-0.11). The diagnostic performance to detect overt hypothyroidism, isolated hypothyroxinemia, and (sub)clinical hyperthyroidism mainly varied between FT4 RI approaches, while the diagnostic performance to detect subclinical hypothyroidism varied between the applied TSH RI approaches. CONCLUSION Alternative approaches to define RIs for TSH and FT4 in pregnancy result in considerable overdiagnosis and underdiagnosis compared with population- and trimester-specific RIs. Additional strategies need to be explored to optimize identification of thyroid dysfunction during pregnancy.
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Affiliation(s)
- Joris A J Osinga
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and clinical Sciences, Copenhagen University, 1172 Copenhagen, Denmark
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, Scientific Research Center in Preventive Medicine, School of Public Health, Anhui Medical University, 230032 Anhui, China
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, 1081 HV Amsterdam, The Netherlands
| | - Tuija Männistö
- Northern Finland Laboratory Center Nordlab and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, 90570 Oulu, Finland
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, 17007 Girona, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, 17007 Girona, Spain
- Departament de Ciències Mèdiques, Universitat de Girona, 17003 Girona, Spain
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, 81745-33871 Isfahan, Iran
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, 710 03 Crete, Greece
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Hematology, Máxima Medical Centre, 5504 DB Veldhoven, The Netherlands
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital and Alpert Medical School at Brown University, Providence, RI 02903, USA
| | - Ghalia Ashoor
- Harris Birthright Research Center for Fetal Medicine, King’s College Hospital, SE5 9RS London, UK
| | - Liangmiao Chen
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, 325035 Wenzhou, China
| | - Xuemian Lu
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, 325035 Wenzhou, China
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, CF10 3EU Cardiff, UK
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, 230032 Anhui, China
- Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, 230032 Anhui, China
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 6009 Nedlands, Perth, Australia
| | - Georgiana Sitoris
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Brussels, Belgium
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, University of Exeter Medical School, EX1 2LU Exeter, UK
| | - Polina V Popova
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Elena A Vasukova
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Maryam Kianpour
- Departament de Ciències Mèdiques, Universitat de Girona, 17003 Girona, Spain
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, 90570 Oulu, Finland
| | - Elena N Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, 197341 Saint Petersburg, Russia
| | - Andrew Hattersley
- Molecular Medicine, University of Exeter Medical School, Royal Devon & Exeter Hospital, EX3 0AW Exeter, UK
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, 5000 LE Tilburg, The Netherlands
| | - Scott M Nelson
- School of Medicine, University of Glasgow, G12 8QQ Glasgow, UK
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, 6009 Nedlands, Perth, Australia
- Medical School, University of Western Australia, Crawley, WA 6009, Australia
| | - Kypros H Nicolaides
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine King’s College London, SE5 9RS London, UK
| | - Mary E D’Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, NewYork, NY 10032, USA
| | - Kris G Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), 1000 Brussels, Belgium
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, 3000 CA Rotterdam, The Netherlands
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4
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Osinga JAJ, Derakhshan A, Palomaki GE, Ashoor G, Männistö T, Maraka S, Chen L, Bliddal S, Lu X, Taylor PN, Vrijkotte TGM, Tao FB, Brown SJ, Ghafoor F, Poppe K, Veltri F, Chatzi L, Vaidya B, Broeren MAC, Shields BM, Itoh S, Mosso L, Popova PV, Anopova AD, Kishi R, Aminorroaya A, Kianpour M, López-Bermejo A, Oken E, Pirzada A, Vafeiadi M, Bramer WM, Suvanto E, Yoshinaga J, Huang K, Bassols J, Boucai L, Feldt-Rasmussen U, Grineva EN, Pearce EN, Alexander EK, Pop VJM, Nelson SM, Walsh JP, Peeters RP, Chaker L, Nicolaides KH, D’Alton ME, Korevaar TIM. TSH and FT4 Reference Intervals in Pregnancy: A Systematic Review and Individual Participant Data Meta-Analysis. J Clin Endocrinol Metab 2022; 107:2925-2933. [PMID: 35861700 PMCID: PMC9516198 DOI: 10.1210/clinem/dgac425] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Indexed: 12/02/2022]
Abstract
CONTEXT Interpretation of thyroid function tests during pregnancy is limited by the generalizability of reference intervals between cohorts due to inconsistent methodology. OBJECTIVE (1) To provide an overview of published reference intervals for thyrotropin (TSH) and free thyroxine (FT4) in pregnancy, (2) to assess the consequences of common methodological between-study differences by combining raw data from different cohorts. METHODS (1) Ovid MEDLINE, EMBASE, and Web of Science were searched until December 12, 2021. Studies were assessed in duplicate. (2) The individual participant data (IPD) meta-analysis was performed in participating cohorts in the Consortium on Thyroid and Pregnancy. RESULTS (1) Large between-study methodological differences were identified, 11 of 102 included studies were in accordance with current guidelines; (2) 22 cohorts involving 63 198 participants were included in the meta-analysis. Not excluding thyroid peroxidase antibody-positive participants led to a rise in the upper limits of TSH in all cohorts, especially in the first (mean +17.4%; range +1.6 to +30.3%) and second trimester (mean +9.8%; range +0.6 to +32.3%). The use of the 95th percentile led to considerable changes in upper limits, varying from -10.8% to -21.8% for TSH and -1.2% to -13.2% for FT4. All other additional exclusion criteria changed reference interval cut-offs by a maximum of 3.5%. Applying these findings to the 102 studies included in the systematic review, 48 studies could be used in a clinical setting. CONCLUSION We provide an overview of clinically relevant reference intervals for TSH and FT4 in pregnancy. The results of the meta-analysis indicate that future studies can adopt a simplified study setup without additional exclusion criteria.
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Affiliation(s)
- Joris A J Osinga
- Correspondence: Joris Osinga, MD, Erasmus MC, Generation R, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands.
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Glenn E Palomaki
- Department of Pathology and Laboratory Medicine, Women & Infants Hospital and Alpert Medical School at Brown University, Providence, RI 02905, USA
| | - Ghalia Ashoor
- Harris Birthright Research Center for Fetal Medicine, King’s College Hospital, London, UK
| | - Tuija Männistö
- Northern Finland Laboratory Center Nordlab and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN 55902, USA
- Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Liangmiao Chen
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and clinical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Xuemian Lu
- Department of Endocrinology and Rui’an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Tanja G M Vrijkotte
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei, Anhui, China
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Farkhanda Ghafoor
- Department of Research and Innovation, Shalamar Institute of Health Sciences, Lahore, Pakistan
| | - Kris Poppe
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Flora Veltri
- Endocrine Unit, Centre Hospitalier Universitaire Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA 90089, USA
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, University of Exeter Medical School, Exeter, UK
| | - Maarten A C Broeren
- Laboratory of Clinical Chemistry and Haematology, Máxima Medical Centre, Veldhoven, The Netherlands
| | - Beverley M Shields
- Department of Medical Statistics, University of Exeter Medical School, Exeter, UK
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Lorena Mosso
- Departments of Endocrinology, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Polina V Popova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
- Department of Internal Diseases and Endocrinology, St. Petersburg Pavlov State Medical University, Saint Petersburg, Russian Federation
- World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Anna D Anopova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ashraf Aminorroaya
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Kianpour
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, Girona, Spain
- Departament de Ciències Mèdiques, Universitat de Girona, Spain
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Amna Pirzada
- Shifa Institute of Medical Technology, Shifa International Hospital, Islamabad, Pakistan
| | - Marina Vafeiadi
- Department of Social Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Wichor M Bramer
- Medical Library, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Kun Huang
- Department of Maternal, Child and Adolescent Health, Scientific Research Center in Preventive Medicine; School of Public Health; Anhui Medical University, China
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr. Josep Trueta Hospital, Girona, Spain
| | - Laura Boucai
- Department of Medicine, Division of Endocrinology, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, NY 10065, USA
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, and Department of Clinical Medicine, Faculty of Health and clinical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Elena N Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, Massachusetts 02118, USA
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 0211, USA
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Medical School, University of Western Australia, Crawley, Western Australia, Australia
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Kypros H Nicolaides
- Department of Women and Children’s Health, Faculty of Life Sciences and Medicine King’s College London, London, UK
| | - Mary E D’Alton
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York 10032, USA
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands
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5
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Kuritsyna NV, Tsoy UA, Cherebillo VY, Paltsev AA, Ryzhkov AV, Ryazanov PA, Ryzhkov VK, Grineva EN. A Comprehensive Approach to Predicting the Outcomes of Transsphenoidal Endoscopic Adenomectomy in Patients with Cushing’s Disease. J Pers Med 2022; 12:jpm12050798. [PMID: 35629220 PMCID: PMC9144911 DOI: 10.3390/jpm12050798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/03/2022] [Accepted: 05/11/2022] [Indexed: 12/10/2022] Open
Abstract
Persistent and recurrent hypercortisolism after transsphenoidal endoscopic surgery (TSS) is considered to be an urgent issue prompting the search for Cushing’s disease (CD) remission predictors. The goal was to find a combination of predictors that can forecast the remission of CD after TSS. A total of 101 patients with CD who had undergone TSS were included. One year after surgery, CD remission status was evaluated. Preoperative pituitary magnetic resonance imaging (MRI) data, preoperative results of a high-dose dexamethasone suppression test (HDDST) and morning serum cortisol level collected 24 h after TSS (24 h MSeC) were compared in patients with and without remission of hypercortisolism. Remission one year after TSS was confirmed in 63 patients. CD remission predictors one year after TSS were: adenoma size ≥ 3 mm in the absence of invasive growth and the suppression of serum cortisol ≥ 74% in the HDDST, 24 h MSeC ≤ 388 nmol/L. A total of 38 patients had three favorable values of detected predictors; all of them had CD remission one year after TSS. With long-term follow-up, 36 of them remained in remission. Patients who had no one favorable predictor had no remission of hypercortisolism one year after TSS. Our data confirmed the prospects of using a combination of selected predictors to forecast CD remission after TSS.
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6
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Toloza FJK, Derakhshan A, Männistö T, Bliddal S, Popova PV, Carty DM, Chen L, Taylor P, Mosso L, Oken E, Suvanto E, Itoh S, Kishi R, Bassols J, Auvinen J, López-Bermejo A, Brown SJ, Boucai L, Hisada A, Yoshinaga J, Shilova E, Grineva EN, Vrijkotte TGM, Sunyer J, Jiménez-Zabala A, Riaño-Galan I, Lopez-Espinosa MJ, Prokop LJ, Singh Ospina N, Brito JP, Rodriguez-Gutierrez R, Alexander EK, Chaker L, Pearce EN, Peeters RP, Feldt-Rasmussen U, Guxens M, Chatzi L, Delles C, Roeters van Lennep JE, Pop VJM, Lu X, Walsh JP, Nelson SM, Korevaar TIM, Maraka S. Association between maternal thyroid function and risk of gestational hypertension and pre-eclampsia: a systematic review and individual-participant data meta-analysis. Lancet Diabetes Endocrinol 2022; 10:243-252. [PMID: 35255260 PMCID: PMC10314731 DOI: 10.1016/s2213-8587(22)00007-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/24/2021] [Accepted: 01/04/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Adequate maternal thyroid function is important for an uncomplicated pregnancy. Although multiple observational studies have evaluated the association between thyroid dysfunction and hypertensive disorders of pregnancy, the methods and definitions of abnormalities in thyroid function tests were heterogeneous, and the results were conflicting. We aimed to examine the association between abnormalities in thyroid function tests and risk of gestational hypertension and pre-eclampsia. METHODS In this systematic review and meta-analysis of individual-participant data, we searched MEDLINE (Ovid), Embase, Scopus, and the Cochrane Database of Systematic Reviews from date of inception to Dec 27, 2019, for prospective cohort studies with data on maternal concentrations of thyroid-stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase (TPO) antibodies, individually or in combination, as well as on gestational hypertension, pre-eclampsia, or both. We issued open invitations to study authors to participate in the Consortium on Thyroid and Pregnancy and to share the individual-participant data. We excluded participants who had pre-existing thyroid disease or multifetal pregnancy, or were taking medications that affect thyroid function. The primary outcomes were documented gestational hypertension and pre-eclampsia. Individual-participant data were analysed using logistic mixed-effects regression models adjusting for maternal age, BMI, smoking, parity, ethnicity, and gestational age at blood sampling. The study protocol was registered with PROSPERO, CRD42019128585. FINDINGS We identified 1539 published studies, of which 33 cohorts met the inclusion criteria and 19 cohorts were included after the authors agreed to participate. Our study population comprised 46 528 pregnant women, of whom 39 826 (85·6%) women had sufficient data (TSH and FT4 concentrations and TPO antibody status) to be classified according to their thyroid function status. Of these women, 1275 (3·2%) had subclinical hypothyroidism, 933 (2·3%) had isolated hypothyroxinaemia, 619 (1·6%) had subclinical hyperthyroidism, and 337 (0·8%) had overt hyperthyroidism. Compared with euthyroidism, subclinical hypothyroidism was associated with a higher risk of pre-eclampsia (2·1% vs 3·6%; OR 1·53 [95% CI 1·09-2·15]). Subclinical hyperthyroidism, isolated hypothyroxinaemia, or TPO antibody positivity were not associated with gestational hypertension or pre-eclampsia. In continuous analyses, both a higher and a lower TSH concentration were associated with a higher risk of pre-eclampsia (p=0·0001). FT4 concentrations were not associated with the outcomes measured. INTERPRETATION Compared with euthyroidism, subclinical hypothyroidism during pregnancy was associated with a higher risk of pre-eclampsia. There was a U-shaped association of TSH with pre-eclampsia. These results quantify the risks of gestational hypertension or pre-eclampsia in women with thyroid function test abnormalities, adding to the total body of evidence on the risk of adverse maternal and fetal outcomes of thyroid dysfunction during pregnancy. These findings have potential implications for defining the optimal treatment target in women treated with levothyroxine during pregnancy, which needs to be assessed in future interventional studies. FUNDING Arkansas Biosciences Institute and Netherlands Organization for Scientific Research.
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Affiliation(s)
- Freddy J K Toloza
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Medicine, MetroWest Medical Center, Tufts Medical School, Framingham, MA, USA
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Tuija Männistö
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland; Northern Finland Laboratory Center Nordlab, University of Oulu, Oulu, Finland
| | - Sofie Bliddal
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Polina V Popova
- Department of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; World-Class Research Center for Personalized Medicine, Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, Saint Petersburg, Russia
| | - David M Carty
- Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Liangmiao Chen
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Peter Taylor
- Thyroid Research Group, Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Lorena Mosso
- Department of Endocrinology and Centro Traslacional en Endocrinologia, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, USA
| | - Eila Suvanto
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland; Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Laura Boucai
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, NY, USA
| | - Aya Hisada
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Ekaterina Shilova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Gynecology and Endocrinology, DO Ott Research Institute of Obstetrics and Gynecology, Saint Petersburg, Russia
| | - Elena N Grineva
- Department of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia; Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Tanja G M Vrijkotte
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Ana Jiménez-Zabala
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; BIODONOSTIA Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Isolina Riaño-Galan
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; AGC Pediatrics, Hospital Universitario Central de Asturias, Oviedo, Spain; IUOPA-Departamento de Medicina-ISPA, Universidad de Oviedo, Oviedo, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València, Valencia, Spain; Faculty of Nursing and Chiropody, Universitat de València, Valencia, Spain
| | | | - Naykky Singh Ospina
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL, USA
| | - Juan P Brito
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rene Rodriguez-Gutierrez
- Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Division of Endocrinology, Department of Internal Medicine, University Hospital Dr Jose E Gonzalez, Autonomous University of Nuevo León, Monterrey, Mexico; Plataforma INVEST Medicina UANL-KER Unit, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mònica Guxens
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, Netherlands; ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Leda Chatzi
- Department of Population and Public Health Sciences, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | | | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Xuemian Lu
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Medical School, University of Western Australia, Crawley, WA, Australia
| | | | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, University of Arkansas for Medical Sciences, Little Rock, AR, USA; Knowledge and Evaluation Research Unit, Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Central Arkansas Veterans Healthcare System, Little Rock, AR, USA.
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Karonova TL, Chernikova AT, Golovatyuk KA, Bykova ES, Grant WB, Kalinina OV, Grineva EN, Shlyakhto EV. Vitamin D Intake May Reduce SARS-CoV-2 Infection Morbidity in Health Care Workers. Nutrients 2022; 14:nu14030505. [PMID: 35276863 PMCID: PMC8839300 DOI: 10.3390/nu14030505] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
In the last 2 years, observational studies have shown that a low 25-hydroxyvitamin D (25(OH)D) level affected the severity of infection with the novel coronavirus (COVID-19). This study aimed to analyze the potential effect of vitamin D supplementation in reducing SARS-CoV-2 infection morbidity and severity in health care workers. Of 128 health care workers, 91 (consisting of 38 medical doctors (42%), 38 nurses (42%), and 15 medical attendants (16%)) were randomized into two groups receiving vitamin D supplementation. Participants of group I (n = 45) received water-soluble cholecalciferol at a dose of 50,000 IU/week for 2 consecutive weeks, followed by 5000 IU/day for the rest of the study. Participants of group II (n = 46) received water-soluble cholecalciferol at a dose of 2000 IU/day. For both groups, treatment lasted 3 months. Baseline serum 25(OH)D level in health care workers varied from 3.0 to 65.1 ng/mL (median, 17.7 (interquartile range, 12.2; 24.7) ng/mL). Vitamin D deficiency, insufficiency, and normal vitamin D status were diagnosed in 60%, 30%, and 10%, respectively. Only 78 subjects completed the study. Vitamin D supplementation was associated with an increase in serum 25(OH)D level, but only intake of 5000 IU/day was accompanied by normalization of serum 25(OH)D level, which occurred in 53% of cases. Neither vitamin D intake nor vitamin D deficiency/insufficiency were associated with a decrease in SARS-CoV-2 morbidity (odds ratio = 2.27; 95% confidence interval, 0.72 to 7.12). However, subjects receiving high-dose vitamin D had only asymptomatic SARS-CoV-2 in 10 (26%) cases; at the same time, participants who received 2000 IU/day showed twice as many SARS-CoV-2 cases, with mild clinical features in half of them.
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Affiliation(s)
- Tatiana L. Karonova
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
- Correspondence: ; Tel.: +7-921-310-60-41
| | - Alena T. Chernikova
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
| | - Ksenia A. Golovatyuk
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
| | - Ekaterina S. Bykova
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
| | - William B. Grant
- Sunlight, Nutrition, and Health Research Center, San Francisco, CA 94164-1603, USA;
| | - Olga V. Kalinina
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
| | - Elena N. Grineva
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
| | - Evgeny V. Shlyakhto
- Clinical Endocrinology Laboratory, Department of Endocrinology, Almazov National Medical Research Centre, 194021 Saint Petersburg, Russia; (A.T.C.); (K.A.G.); (E.S.B.); (O.V.K.); (E.N.G.); (E.V.S.)
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8
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Yanevskaya LG, Pogosian KA, Semenova AN, Chernikov RA, Buzanakov DM, Belyaeva OD, Grineva EN, Karonova TL. The activity of the renin-angiotensin-aldosterone system before and after parathyroidectomy in patients with primary hyperparathyroidism. Consilium Medicum 2021. [DOI: 10.26442/20751753.2021.12.201235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background. The relationships between renin-angiotensin-aldosterone system (RAAS) and elevated parathyroid hormone levels in primary hyperparathyroidism (PHPT) is being actively discussed. But the way how parathyroid hormone interacts with renin and aldosterone currently is not clear.
Materials and methods. Forty patients aged 18 to 70 years with a confirmed diagnosis of PHPT were involved in the study. All patients were tested for the main parameters of phosphorus-calcium metabolism and the RAAS parameters (plasma renin, plasma aldosterone) before and 2 weeks after parathyroidectomy.
Results. Sixty percent of patients had any cardiovascular disease (CVD) and hypertension was the most common. Patients CVD in comparison with patients without CVD were older (61 and 41 years, respectively; p0.001), had a higher body mass index (28.9 and 21.9 kg/m2, respectively; p0.001) and had a lower aldosterone-to-renin ratio ARR (1.78 and 5.42, respectively; p=0.030). Patients with hypertension were older than patients with normal blood pressure (63 and 41 years, respectively; p0.001), had a higher body mass index (28.1 and 23.5 kg/m2, respectively; p=0.005), a lower ARR (1.46 and 5.82, respectively; p=0.001), as well higher levels of plasma renin (109.2 and 20.3 pg/ml, respectively; p=0.007) and serum total calcium (2.84 and 2.71 mmol/l, respectively; p=0.041). Correlation analysis showed that in patients with PHPT and CVD, the concentration of aldosterone is associated with the level of 24-hour urinary calcium (r=0.829, p=0.042), and in patients with symptomatic PHPT and CVD, the level of aldosterone correlated with the level of ionized calcium (r=-0.812, p=0.05). We found no significant differences between the levels of renin, aldosterone and ARR before and 2 weeks after parathyroidectomy. However, in the postoperative period, there were no differences in the levels of renin and ARR among patients with hypertension and without hypertension.
Conclusion. In our study we found that the levels of plasma renin and serum total calcium were higher in patients with PHPT and hypertension compared to patients with normal blood pressure. Also, we found the associations between plasma aldosterone and levels of ionized calcium and 24-hour urinary calcium. But the relationships between RAAS parameters and parameters of phosphorus-calcium metabolism need further investigations.
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9
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Karonova TL, Andreeva AT, Golovatyuk KA, Bykova ES, Skibo II, Grineva EN, Shlyakhto EV. [SARS-CoV-2 morbidity depending on vitamin D status]. Probl Endokrinol (Mosk) 2021; 67:20-28. [PMID: 34766486 DOI: 10.14341/probl12820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 09/21/2021] [Accepted: 10/06/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND The association between vitamin D deficiency and the severity of COVID-19 is currently being actively discussed around the world. AIM The aim of this study was to assess the prevalence of vitamin D insufficiency and deficiency and compare it with the incidence rates of SARS-CoV-2 in eight Federal Districts of the Russian Federation. MATERIALS AND METHODS We included 304,564 patients (234,716 women; 77,1%) with serum 25(OH)D levels results performed September 2019 through October 2020. RESULTS Only 112,877 people (37.1%) had a normal serum 25(OH)D level, others had a deficiency. Vitamin D insufficiency and deficiency was presented with the same frequency in women and men, and no differences were found depending on the geographical location and age in subjects from 18 to 74 years old. However, subjects over 75 years more often had vitamin D deficiency, while subjects under 18 years had normal levels in over 50% cases. In addition, 21,506 patients were tested for SARS-CoV-2 by PCR with further comparison of results with serum 25(OH)D level. The SARS-CoV-2 positivity rate was detected in 3,193 subjects, negative in 18,313. There were no differences in the morbidity in a vitamin D deficiency and a normal level. Thus, 14.8% subjects had positive PCR rates among vitamin D deficiency patients (4,978 tests), 14.9% when 25(OD)D level was from 20 to 30 ng/ml (7,542 tests), 15.0% among those who had 25(OH)D 30- 50 ng/ml (6,622 tests), and 13.9% when vitamin D was more than 50 ng/ml (4,612 tests). CONCLUSION There was no association between the COVID-19 incidence and vitamin D status in different regions of Russia. Although the nutrient deficiency persists in all regions and is most often diagnosed in people over 75 years old.
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Affiliation(s)
| | | | | | - E S Bykova
- Almazov National Medical Research Centre
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10
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Popova PV, Pustozerov EA, Tkachuk AS, Grineva EN. Improving nutrition for the prevention of gestational diabetes: Current status and perspectives. World J Diabetes 2021; 12:1494-1506. [PMID: 34630902 PMCID: PMC8472503 DOI: 10.4239/wjd.v12.i9.1494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 04/20/2021] [Accepted: 08/16/2021] [Indexed: 02/06/2023] Open
Abstract
Gestational diabetes mellitus (GDM) is a common complication of pregnancy and a serious public health problem. It carries significant risks of short-term and long-term adverse health effects for both mothers and their children. Risk factors, especially modifiable risk factors, must be considered to prevent GDM and its consequences. Observational studies have identified several nutritional and lifestyle factors associated with the risk of GDM. The results of intervention studies examining the effects of diet and lifestyle on the prevention of GDM are contradictory. Differences in the study populations, types and intensity of intervention, time frame of the intervention, and diagnostic criteria for GDM may explain the heterogeneity in the results of intervention studies. This review provides an overview of new diets and other factors that may help prevent GDM. The main results of epidemiological studies assessing the risk factors for GDM, as well as the results and methodological problems of intervention studies on the prevention of GDM and their meta-analyses, are discussed. In addition, the evidence that gene and lifestyle interactions influence the development of GDM, as well as prospects for increasing the effectiveness of interventions designed to prevent GDM, including new data on the possible uses of personalized diet therapy, are highlighted.
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Affiliation(s)
- Polina V Popova
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 194156, Russia
- Department of Faculty Therapy, Saint Petersburg Pavlov State Medical University, Saint Petersburg 197022, Russia
| | - Evgenii A Pustozerov
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 194156, Russia
- Department of Biomedical Engineering, Saint Petersburg State Electrotechnical University, Saint Petersburg 197341, Russia
| | - Aleksandra S Tkachuk
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 194156, Russia
| | - Elena N Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg 194156, Russia
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Popova PV, Klyushina AA, Vasilyeva LB, Tkachuk AS, Vasukova EA, Anopova AD, Pustozerov EA, Gorelova IV, Kravchuk EN, Li O, Pervunina TM, Kostareva AA, Grineva EN. Association of Common Genetic Risk Variants With Gestational Diabetes Mellitus and Their Role in GDM Prediction. Front Endocrinol (Lausanne) 2021; 12:628582. [PMID: 33953693 PMCID: PMC8092356 DOI: 10.3389/fendo.2021.628582] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/23/2021] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE We aimed to explore the associations between common genetic risk variants with gestational diabetes mellitus (GDM) risk in Russian women and to assess their utility in the identification of GDM cases. METHODS We conducted a case-control study including 1,142 pregnant women (688 GDM cases and 454 controls) enrolled at Almazov National Medical Research Centre. The International Association of Diabetes and Pregnancy Study Groups criteria were used to diagnose GDM. A total of 11 single- nucleotide polymorphisms (SNPs), including those in HKDC1 (rs10762264), GCK (rs1799884), MTNR1B (rs10830963 and rs1387153), TCF7L2 (rs7903146 and rs12255372), KCNJ11 (rs5219), IGF2BP2 (rs4402960), IRS1 (rs1801278), FTO (rs9939609), and CDKAL1 (rs7754840) were genotyped using Taqman assays. A logistic regression model was used to calculate odds ratios (ORs) and their confidence intervals (CIs). A simple-count genetic risk score (GRS) was calculated using 6 SNPs. The area under the receiver operating characteristic curve (c-statistic) was calculated for the logistic regression model predicting the risk of GDM using clinical covariates, SNPs that had shown a significant association with GDM in our study, GRS, and their combinations. RESULTS Two variants in MTNR1B (rs1387153 and rs10830963) demonstrated a significant association with an increased risk of GDM. The association remained significant after adjustment for age, pre-gestational BMI, arterial hypertension, GDM in history, impaired glucose tolerance, polycystic ovary syndrome, family history of diabetes, and parity (P = 0.001 and P < 0.001, respectively). After being conditioned by each other, the effect of rs1387153 on GDM predisposition weakened while the effect of rs10830963 remained significant (P = 0.004). The risk of GDM was predicted by clinical variables (c-statistic 0.712, 95 % CI: 0.675 - 0.749), and the accuracy of prediction was modestly improved by adding GRS to the model (0.719, 95 % CI 0.682 - 0.755), and more by adding only rs10830963 (0.729, 95 % CI 0.693 - 0.764). CONCLUSION Among 11 SNPs associated with T2D and/or GDM in other populations, we confirmed significant association with GDM for two variants in MTNR1B in Russian women. However, these variants showed limited value in the identification of GDM cases.
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Affiliation(s)
- Polina V. Popova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- Department of Internal Diseases and Endocrinology, St. Petersburg Pavlov State Medical University, Saint Petersburg, Russia
- *Correspondence: Polina V. Popova,
| | | | | | | | | | - Anna D. Anopova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Evgenii A. Pustozerov
- Almazov National Medical Research Centre, Saint Petersburg, Russia
- Department of Biomedical Engineering, Saint Petersburg State Electrotechnical University, Saint Petersburg, Russia
| | - Inga V. Gorelova
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | - O. Li
- Almazov National Medical Research Centre, Saint Petersburg, Russia
| | | | | | - Elena N. Grineva
- Almazov National Medical Research Centre, Saint Petersburg, Russia
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12
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Tsiberkin AI, Tsoy UA, Cherebillo VY, Polezhaev AV, Kuritsyna NV, Paltsev AA, Alkhazishvili AV, Grineva EN. [Early postoperative measurement of growth hormone level for prognosis of surgical outcomes in acromegaly]. TERAPEVT ARKH 2020; 92:48-53. [PMID: 33346479 DOI: 10.26442/00403660.2020.10.000490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022]
Abstract
AIM To investigate the value of 24 hours post-surgery measurement of growth hormone (GH) level for prognosis of surgical outcomes in acromegaly. MATERIALS AND METHODS A prospective cohort study included 45 patients with newly diagnosed acromegaly. The degree of parasellar extension was measured on the preoperative sellar magnetic resonance imaging according to the Knosps classification. All patients underwent a transsphenoid adenomectomy performed by one neurosurgeon. Basal GH level was measured at 24 hours after surgery. The efficacy of transsphenoidal adenomectomy evaluated at 12 months after surgery. RESULTS Acromegaly remission was achieved in 19 (42%) of 45 patients at 12 months after surgery. Pituitary microadenomas and the absence of paracellular invasion, corresponding to Knosp Grade 02, had low prognostic value for long-term remission due to low sensitivity (31.6%) and low specificity (38.5%), respectively. The highest prognostic value for acromegaly remission was showed for 24 hours post-surgery GH level with cut-off 1.30 ng/ml with sensitivity of 96.2% (95% confidence interval 81.199.8%) and specificity of 84.2% (95% confidence interval 62.494.4%). CONCLUSION The study demonstrated the possibility of using GH level at 24 after surgery as a predictor for acromegaly remission. GH level 1.30 ng/ml at 24 hours after surgery showed better predictive value for long-term remission compared with the presence of microadenomas and Knosp Grade 02. The absence of decrease of GH level on the first day after surgery may serve as a reason for more close monitoring of patients in the postoperative period. Further studies in a larger number of observers are required to confirm our findings.
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Affiliation(s)
| | - U A Tsoy
- Almazov National Medical Research Center
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13
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Bayrasheva VK, Pchelin IY, Dobronravov VA, Babenko AY, Chefu SG, Shatalov IS, Vasilkova VN, Hudiakova NV, Ivanova AN, Andoskin PA, Grineva EN. Short-term renal and metabolic effects of low dose vildagliptin treatment added-on insulin therapy in non-proteinuric patients with type 2 diabetes: open-label randomized prospective study. Arch Endocrinol Metab 2020; 64:418-426. [PMID: 32267348 PMCID: PMC10522081 DOI: 10.20945/2359-3997000000220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 09/02/2019] [Indexed: 11/23/2022]
Abstract
Objective The aim of this randomized comparative study was to assess renal and metabolic effects of vildagliptin in insulin-treated type 2 diabetes (T2DM) patients without overt chronic kidney disease. Subjects and methods We randomized 47 insulin-treated non-proteinuric patients with satisfactory controlled T2DM and estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m 2 either to continue insulin therapy (control) or to receive combined insulin-vildagliptin treatment (VIG group). We assessed eGFR using serum creatinine (eGFRcreat), cystatin C (eGFRcys), and both (eGFRcreat-cys), and urinary creatinine-adjusted excretion of albumin (UACR), type IV collagen (uCol IV/Cr), and neutrophil gelatinase-associated lipocalin (uNGAL/Cr) at baseline and after 6 months of treatment. Results Study groups were comparable in terms of age and sex (60.1 ± 6.1 years and 42.9% men in control group vs. 60.8 ± 5.2 years and 39.1% in VIG group). After 6 months of treatment, there were no significant changes in main assessed parameters in control group. VIG group demonstrated significant decrease in HbA1c, diastolic blood pressure, frequency of hypoglycemia, and high-sensitivity C-reactive protein level as compared to the changes in control group. While eGFRcreat, UACR, and uNGAL/Cr showed no significant changes after vildagliptin addition, eGFRcys, eGFRcreat-cys, and uCol IV/Cr changed significantly in comparison with control group (+7.0% [3.7;13.3]; +5.1% [1.4;8.5]; -32,8% [-55.8;-24.4], respectively, p < 0.01 each). Correlation and regression analysis revealed glucose-independent pattern of these changes. Conclusion Addition of vildagliptin to ongoing insulin therapy in patients with T2DM was associated with a reduction in uCol IV/Cr and an increase in eGFRcys and eGFRcreat-cys, independent of T2DM control parameters.
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Affiliation(s)
- Valentina K Bayrasheva
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Ivan Y Pchelin
- Department of Faculty Therapy, Saint Petersburg State University,, Saint Petersburg, Russia
| | - Vladimir A Dobronravov
- Research Institute of Nephrology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Alina Yu Babenko
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
| | - Svetlana G Chefu
- Experimental Research Laboratory, Laser Medicine Center, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Ivan S Shatalov
- Scientific and Research Institute of Bioengineering, Saint Petersburg National Research University of Information, Technologies, Mechanics and Optics, Saint Petersburg, Russia
| | - Volha N Vasilkova
- Department of Internal Medicine No.1 with the Course of Endocrinology, Gomel State Medical University, Gomel, Belarus
| | - Natalia V Hudiakova
- Department of Faculty Therapy, Saint Petersburg State University,, Saint Petersburg, Russia
| | - Alexandra N Ivanova
- Department of Faculty Therapy, Saint Petersburg State University,, Saint Petersburg, Russia
| | - Pavel A Andoskin
- Laboratory of Protein Biochemistry, State Research Institute of Highly Pure BioSubstances, Saint Petersburg, Russia
| | - Elena N Grineva
- Institute of Endocrinology, Almazov National Medical Research Centre, Saint Petersburg, Russia
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Derakhshan A, Peeters RP, Taylor PN, Bliddal S, Carty DM, Meems M, Vaidya B, Chen L, Knight BA, Ghafoor F, Popova PV, Mosso L, Oken E, Suvanto E, Hisada A, Yoshinaga J, Brown SJ, Bassols J, Auvinen J, Bramer WM, López-Bermejo A, Dayan CM, French R, Boucai L, Vafeiadi M, Grineva EN, Pop VJM, Vrijkotte TG, Chatzi L, Sunyer J, Jiménez-Zabala A, Riaño I, Rebagliato M, Lu X, Pirzada A, Männistö T, Delles C, Feldt-Rasmussen U, Alexander EK, Nelson SM, Chaker L, Pearce EN, Guxens M, Steegers EAP, Walsh JP, Korevaar TIM. Association of maternal thyroid function with birthweight: a systematic review and individual-participant data meta-analysis. Lancet Diabetes Endocrinol 2020; 8:501-510. [PMID: 32445737 PMCID: PMC8168324 DOI: 10.1016/s2213-8587(20)30061-9] [Citation(s) in RCA: 109] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Adequate transplacental passage of maternal thyroid hormone is important for normal fetal growth and development. Maternal overt hypothyroidism and hyperthyroidism are associated with low birthweight, but important knowledge gaps remain regarding the effect of subclinical thyroid function test abnormalities on birthweight-both in general and during the late second and third trimester of pregnancy. The aim of this study was to examine associations of maternal thyroid function with birthweight. METHODS In this systematic review and individual-participant data meta-analysis, we searched MEDLINE (Ovid), Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and Google Scholar from inception to Oct 15, 2019, for prospective cohort studies with data on maternal thyroid function during pregnancy and birthweight, and we issued open invitations to identify study authors to join the Consortium on Thyroid and Pregnancy. We excluded participants with multiple pregnancies, in-vitro fertilisation, pre-existing thyroid disease or thyroid medication usage, miscarriages, and stillbirths. The main outcomes assessed were small for gestational age (SGA) neonates, large for gestational age neonates, and newborn birthweight. We analysed individual-participant data using mixed-effects regression models adjusting for maternal age, BMI, ethnicity, smoking, parity, gestational age at blood sampling, fetal sex, and gestational age at birth. The study protocol was pre-registered at the International Prospective Register of Systematic Reviews, CRD42016043496. FINDINGS We identified 2526 published reports, from which 36 cohorts met the inclusion criteria. The study authors for 15 of these cohorts agreed to participate, and five more unpublished datasets were added, giving a study population of 48 145 mother-child pairs after exclusions, of whom 1275 (3·1%) had subclinical hypothyroidism (increased thyroid stimulating hormone [TSH] with normal free thyroxine [FT4]) and 929 (2·2%) had isolated hypothyroxinaemia (decreased FT4 with normal TSH). Maternal subclinical hypothyroidism was associated with a higher risk of SGA than was euthyroidism (11·8% vs 10·0%; adjusted risk difference 2·43%, 95% CI 0·43 to 4·81; odds ratio [OR] 1·24, 1·04 to 1·48; p=0·015) and lower mean birthweight (mean difference -38 g, -61 to -15; p=0·0015), with a higher effect estimate for measurement in the third trimester than in the first or second. Isolated hypothyroxinaemia was associated with a lower risk of SGA than was euthyroidism (7·3% vs 10·0%, adjusted risk difference -2·91, -4·49 to -0·88; OR 0·70, 0·55 to 0·91; p=0·0073) and higher mean birthweight (mean difference 45 g, 18 to 73; p=0·0012). Each 1 SD increase in maternal TSH concentration was associated with a 6 g lower birthweight (-10 to -2; p=0·0030), with higher effect estimates in women who were thyroid peroxidase antibody positive than for women who were negative (pinteraction=0·10). Each 1 SD increase in FT4 concentration was associated with a 21 g lower birthweight (-25 to -17; p<0·0001), with a higher effect estimate for measurement in the third trimester than the first or second. INTERPRETATION Maternal subclinical hypothyroidism in pregnancy is associated with a higher risk of SGA and lower birthweight, whereas isolated hypothyroxinaemia is associated with lower risk of SGA and higher birthweight. There was an inverse, dose-response association of maternal TSH and FT4 (even within the normal range) with birthweight. These results advance our understanding of the complex relationships between maternal thyroid function and fetal outcomes, and they should prompt careful consideration of potential risks and benefits of levothyroxine therapy during pregnancy. FUNDING Netherlands Organization for Scientific Research (grant 401.16.020).
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Affiliation(s)
- Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Robin P Peeters
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, UK
| | - Sofie Bliddal
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - David M Carty
- Department of Diabetes, Endocrinology and Clinical Pharmacology, Glasgow Royal Infirmary, Glasgow, UK; Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Margreet Meems
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital National Health Service Foundation Trust, University of Exeter Medical School, Exeter, UK
| | - Liangmiao Chen
- Department of Endocrinology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Bridget A Knight
- National Institute for Health Research Exeter Clinical Research Facility, Royal Devon and Exeter Hospital National Health Service Foundation Trust, University of Exeter Medical School, Exeter, UK
| | - Farkhanda Ghafoor
- National Health Research Complex, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Polina V Popova
- Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Faculty Therapy, St Petersburg Pavlov State Medical University, Saint Petersburg, Russia
| | - Lorena Mosso
- Department of Endocrinology, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, USA; Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Eila Suvanto
- Department of Obstetrics and Gynecology, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Aya Hisada
- Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute (IDIBGI), Dr Josep Trueta Hospital, Girona, Spain
| | - Juha Auvinen
- Center for Life Course Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Wichor M Bramer
- Medical Library, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute (IDIBGI), Dr Josep Trueta Hospital, Girona, Spain
| | - Colin M Dayan
- Thyroid Research Group, Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff University, Cardiff, UK
| | - Robert French
- School of Medicine, Cardiff University, Cardiff, UK; Centre for Multilevel Modelling, University of Bristol, Bristol, UK
| | - Laura Boucai
- Department of Medicine, Division of Endocrinology, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, NY, USA
| | - Marina Vafeiadi
- Department of Social Medicine, University of Crete, Heraklion, Greece
| | - Elena N Grineva
- Almazov National Medical Research Centre, Saint Petersburg, Russia; Department of Faculty Therapy, St Petersburg Pavlov State Medical University, Saint Petersburg, Russia
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| | - Tanja G Vrijkotte
- Department of Public Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA, USA
| | - Jordi Sunyer
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Ana Jiménez-Zabala
- Biodonostia Health Research Institute, San Sebastian, Spain; Public Health Division of Gipuzkoa, Basque Government, San Sebastian, Spain
| | - Isolina Riaño
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Pediatrics, Hospital Universitario Central de Asturias (Oviedo), Spain
| | - Marisa Rebagliato
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; School of Medicine, Universitat Jaume I, Castelló de la Plana, Spain
| | - Xuemian Lu
- Department of Endocrinology, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - Tuija Männistö
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Northern Finland Laboratory Center Nordlab, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Christian Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Erik K Alexander
- Division of Endocrinology, Hypertension and Diabetes, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott M Nelson
- School of Medicine, University of Glasgow, Glasgow, UK; National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, UK
| | - Layal Chaker
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Epidemiology, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Elizabeth N Pearce
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA, USA
| | - Mònica Guxens
- ISGlobal, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain; Department of Child and Adolescent Psychiatry/ Psychology, Erasmus University Medical Centre-Sophia Children's Hospital, Rotterdam, Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynaecology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - John P Walsh
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; Medical School, University of Western Australia, Crawley, WA, Australia
| | - Tim I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands; Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, Netherlands.
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15
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Nikitina IL, Yukhlina YN, Vasilieva EY, Nagornaya II, Grineva EN, Kelmanson IA. Plasma kisspeptin levels in boys with hypogonadotropic delayed puberty. MINERVA ENDOCRINOL 2020; 45:79-88. [PMID: 31994363 DOI: 10.23736/s0391-1977.20.03101-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND In hypogonadotropic forms of delayed puberty (DP), hypophyseal follicle-stimulating (FSH) and luteinizing (LH) hormones, normally released with GnRH stimulation, are detected low. Since kisspeptin (KP) is a strong stimulant of GnRH neurons, it is considered to have a role in DP etiology. It may be hypothesized that abnormal plasma levels of KP are indicative of DP. The study aimed at evaluation and comparison of plasma KP levels in boys of pre-pubertal age, with normal puberty and diagnosed primary hypogonadotropic forms of DP. METHODS The study comprised 22 boys with verified hypogonadotropic DP (age 14-17 years), 25 boys with normal puberty (age 14-17 years), and 28 pre-pubertal boys (age 6-9 years). Triprorelin stimulation test was performed in DP patients. Plasma KP values were compared between three groups. RESULTS Statistically significant difference was found for the overall distribution of the plasma KP values across different groups (Kruskal-Wallis H=21.95, P<0.001). The highest values were found in the DP group (median: 45.0 pg/mL). Median values in the pre-pubertal boys and in the normal pubertal adolescents were equal to 13.8 pg/mL. No statistically significant difference was found for plasma KP levels in the DP boys who had either positive or negative response to Triptorelin stimulation test. Plasma KP level exceeding 16.9 pg/mL was a reliable predictor of hypoganadotropic DP (sensitivity 72.7%, specificity 92.0%). CONCLUSIONS Plasma KP levels are elevated in hypogonadotropic DP cases and may serve as a useful diagnostic tool in evaluating boys with DP.
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Affiliation(s)
- Irina L Nikitina
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia
| | - Yulia N Yukhlina
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia
| | - Elena Y Vasilieva
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia
| | - Irena I Nagornaya
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia
| | - Elena N Grineva
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia
| | - Igor A Kelmanson
- The V.A. Almazov National Medical Research Center, St. Petersburg, Russia -
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16
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Pustozerov EA, Tkachuk AS, Vasukova EA, Anopova AD, Kokina MA, Gorelova IV, Pervunina TM, Grineva EN, Popova PV. Machine Learning Approach for Postprandial Blood Glucose Prediction in Gestational Diabetes Mellitus. IEEE Access 2020; 8:219308-219321. [DOI: 10.1109/access.2020.3042483] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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17
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Korevaar TIM, Derakhshan A, Taylor PN, Meima M, Chen L, Bliddal S, Carty DM, Meems M, Vaidya B, Shields B, Ghafoor F, Popova PV, Mosso L, Oken E, Suvanto E, Hisada A, Yoshinaga J, Brown SJ, Bassols J, Auvinen J, Bramer WM, López-Bermejo A, Dayan C, Boucai L, Vafeiadi M, Grineva EN, Tkachuck AS, Pop VJM, Vrijkotte TG, Guxens M, Chatzi L, Sunyer J, Jiménez-Zabala A, Riaño I, Murcia M, Lu X, Mukhtar S, Delles C, Feldt-Rasmussen U, Nelson SM, Alexander EK, Chaker L, Männistö T, Walsh JP, Pearce EN, Steegers EAP, Peeters RP. Association of Thyroid Function Test Abnormalities and Thyroid Autoimmunity With Preterm Birth: A Systematic Review and Meta-analysis. JAMA 2019; 322:632-641. [PMID: 31429897 PMCID: PMC6704759 DOI: 10.1001/jama.2019.10931] [Citation(s) in RCA: 185] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 07/08/2019] [Indexed: 01/27/2023]
Abstract
Importance Maternal hypothyroidism and hyperthyroidism are risk factors for preterm birth. Milder thyroid function test abnormalities and thyroid autoimmunity are more prevalent, but it remains controversial if these are associated with preterm birth. Objective To study if maternal thyroid function test abnormalities and thyroid autoimmunity are risk factors for preterm birth. Data Sources and Study Selection Studies were identified through a search of the Ovid MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials, and Google Scholar databases from inception to March 18, 2018, and by publishing open invitations in relevant journals. Data sets from published and unpublished prospective cohort studies with data on thyroid function tests (thyrotropin [often referred to as thyroid-stimulating hormone or TSH] and free thyroxine [FT4] concentrations) or thyroid peroxidase (TPO) antibody measurements and gestational age at birth were screened for eligibility by 2 independent reviewers. Studies in which participants received treatment based on abnormal thyroid function tests were excluded. Data Extraction and Synthesis The primary authors provided individual participant data that were analyzed using mixed-effects models. Main Outcomes and Measures The primary outcome was preterm birth (<37 weeks' gestational age). Results From 2526 published reports, 35 cohorts were invited to participate. After the addition of 5 unpublished data sets, a total of 19 cohorts were included. The study population included 47 045 pregnant women (mean age, 29 years; median gestational age at blood sampling, 12.9 weeks), of whom 1234 (3.1%) had subclinical hypothyroidism (increased thyrotropin concentration with normal FT4 concentration), 904 (2.2%) had isolated hypothyroxinemia (decreased FT4 concentration with normal thyrotropin concentration), and 3043 (7.5%) were TPO antibody positive; 2357 (5.0%) had a preterm birth. The risk of preterm birth was higher for women with subclinical hypothyroidism than euthyroid women (6.1% vs 5.0%, respectively; absolute risk difference, 1.4% [95% CI, 0%-3.2%]; odds ratio [OR], 1.29 [95% CI, 1.01-1.64]). Among women with isolated hypothyroxinemia, the risk of preterm birth was 7.1% vs 5.0% in euthyroid women (absolute risk difference, 2.3% [95% CI, 0.6%-4.5%]; OR, 1.46 [95% CI, 1.12-1.90]). In continuous analyses, each 1-SD higher maternal thyrotropin concentration was associated with a higher risk of preterm birth (absolute risk difference, 0.2% [95% CI, 0%-0.4%] per 1 SD; OR, 1.04 [95% CI, 1.00-1.09] per 1 SD). Thyroid peroxidase antibody-positive women had a higher risk of preterm birth vs TPO antibody-negative women (6.6% vs 4.9%, respectively; absolute risk difference, 1.6% [95% CI, 0.7%-2.8%]; OR, 1.33 [95% CI, 1.15-1.56]). Conclusions and Relevance Among pregnant women without overt thyroid disease, subclinical hypothyroidism, isolated hypothyroxinemia, and TPO antibody positivity were significantly associated with higher risk of preterm birth. These results provide insights toward optimizing clinical decision-making strategies that should consider the potential harms and benefits of screening programs and levothyroxine treatment during pregnancy.
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Affiliation(s)
- T I M Korevaar
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Arash Derakhshan
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Peter N Taylor
- Thyroid Research Group, Systems Immunity Research Institute, School of Medicine, Cardiff University, Cardiff, England
| | - Marcel Meima
- Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands
- Academic Center for Thyroid Diseases, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Liangmiao Chen
- Department of Endocrinology and Rui'an Center of the Chinese-American Research Institute for Diabetic Complications, Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Sofie Bliddal
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - David M Carty
- Department of Diabetes, Endocrinology, and Clinical Pharmacology, Glasgow Royal Infirmary, Glasgow, Scotland
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, Scotland
| | - Margreet Meems
- Departments of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Bijay Vaidya
- Department of Endocrinology, Royal Devon and Exeter Hospital NHS Foundation Trust, University of Exeter Medical School, Exeter, England
| | - Beverley Shields
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, England
| | - Farkhanda Ghafoor
- National Health Research Complex, Shaikh Zayed Medical Complex, Lahore, Pakistan
| | - Polina V Popova
- Almazov National Medical Research Centre, St Petersburg, Russia
- Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, St Petersburg, Russia
| | - Lorena Mosso
- Department of Endocrinology, Pontificia Universidad Catolica de Chile, Santiago
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, Massachusetts
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Eila Suvanto
- Department of Obstetrics and Gynecology and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Aya Hisada
- Center for Preventive Medical Science, Chiba University, Chiba, Japan
| | - Jun Yoshinaga
- Faculty of Life Sciences, Toyo University, Gunma, Japan
| | - Suzanne J Brown
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital, Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Wichor M Bramer
- Medical Library, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Biomedical Research Institute, Dr Josep Trueta Hospital, Girona, Spain
| | - Colin Dayan
- Thyroid Research Group, Institute of Molecular and Experimental Medicine, School of Medicine, Cardiff University, Cardiff, England
| | - Laura Boucai
- Division of Endocrinology, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Weill Cornell University, New York, New York
| | - Marina Vafeiadi
- Department of Social Medicine, University of Crete, Heraklion, Greece
| | - Elena N Grineva
- Almazov National Medical Research Centre, St Petersburg, Russia
- Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, St Petersburg, Russia
| | - Alexandra S Tkachuck
- Almazov National Medical Research Centre, St Petersburg, Russia
- Department of Internal Diseases and Endocrinology, St Petersburg Pavlov State Medical University, St Petersburg, Russia
| | - Victor J M Pop
- Departments of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
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18
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Karpov DS, Grineva EN, Kiseleva SV, Chelarskaya ES, Spasskaya DS, Karpov VL. [Candida glabrata Rpn4-like Protein Complements the RPN4 Deletion in Saccharomyces cerevisiae]. Mol Biol (Mosk) 2019; 53:274-281. [PMID: 31099777 DOI: 10.1134/s002689841902006x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/08/2018] [Indexed: 06/09/2023]
Abstract
Expression of Saccharomyces cerevisiae proteasomal genes is regulated in a coordinated manner by a system that includes the ScRpn4 transcription factor and its binding site known as PACE. Earlier we showed that, Rpn4-like proteins from the biotechnologically important yeast species Komagataella pfaffii (Pichia pastoris), Yarrowia lipolytica, and Debaryomyces hansenii are capable of complementing the RPN4 deletion in S. cerevisiae in spite of their low structural similarity to ScRpn4. The opportunistic yeast pathogen Candida glabrata has a gene coding for a Rpn4-like protein, which has not been characterized experimentally yet. The С. glabrata ortholog ScRpn4 was expressed heterologously and found to restore the stress resistance and expression of proteasomal genes in a mutant S. cerevisiae strain with a RPN4 deletion. This complementation required the unique N-terminal region of CgRpn4. The results indicate that CgRpn4 acts as a transcriptional activator of proteasomal genes. The S. cerevisiae model can be used for further structural and functional analyses of CgRpn4.
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Affiliation(s)
- D S Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
- Orekhovich Institute of Biomedical Chemistry, Moscow, 119121 Russia
| | - E N Grineva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - S V Kiseleva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - E S Chelarskaya
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - D S Spasskaya
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - V L Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
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Tsiberkin AI, Tsoy UA, Cherebillo VY, Polezhaev AV, Gussarova NV, Grineva EN. [Evaluation of transsphenoidal adenomectomy outcomes in acromegaly using different remission criteria]. Zh Vopr Neirokhir Im N N Burdenko 2019; 83:98-104. [PMID: 30900693 DOI: 10.17116/neiro20198301198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED For a long time, surgical removal of somatotropinoma using the transsphenoidal approach has been the first stage of treatment in most acromegaly patients. For the past decades, the efficacy criteria for surgical treatment of acromegaly have significantly changed, which requires appropriate correction. PURPOSE We aimed to evaluate the results of transsphenoidal adenomectomy in acromegaly patients using various criteria for disease remission. MATERIAL AND METHODS The study included patients with newly diagnosed acromegaly who underwent transnasal transsphenoidal endoscopic adenomectomy performed by a single neurosurgeon. The surgical treatment outcomes were evaluated 6 months after operative intervention based on levels of IGF-1, OGTT, and GH. The obtained data were analyzed using different threshold values for the level of GH nadir during OGTT: criteria A <2.0 ng/ml, criteria B <1.0 ng/ml, and criteria C <0.4 ng/ml to assess acromegaly remission, along with matching of the IGF-1 level to the reference range for a given gender and age. RESULTS The study included 70 patients (52 females and 18 males) with a mean age of 52.2±11.5 years (29 to 73 years). The baseline IGF-1 level exceeded the upper limit of the reference range 3.3±1.4 (1.1-7.3)-fold, on average. The baseline mean basal GH level was 34.2±41.7 (1.2-192.0) ng/ml. The mean pituitary adenoma size was 16.7±8.6 (4.3-46.0) mm; 18 (26%) out of 70 patients had pituitary microadenoma, and 52 (74%) patients had macroadenoma. Six months after surgery, acromegaly remission met criteria A in 47 (67%) patients, criteria B in 28 (40%) patients, and criteria C in 18 (26%) patients. CONCLUSION Our findings demonstrate that evaluation of transsphenoidal adenomectomy outcomes in treatment of acromegaly patients depends on the criteria chosen for assessing remission. This feature should be considered when comparing outcomes of surgical treatment for acromegaly in different years. Probably, introduction of the 2010 criteria should be accompanied by revision of the previous remission indicators.
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Affiliation(s)
- A I Tsiberkin
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - U A Tsoy
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - V Yu Cherebillo
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - A V Polezhaev
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - N V Gussarova
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - E N Grineva
- Almazov National Medical Research Center, St. Petersburg, Russia
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Zykov VA, Tuchina TP, Lebedev DA, Krylova IB, Babenko AY, Kuleshova EV, Grineva EN, Bayramov AA, Galagudza MM. Effects of glucagon-like peptide 1 analogs in combination with insulin on myocardial infarct size in rats with type 2 diabetes mellitus. World J Diabetes 2018; 9:149-156. [PMID: 30254724 PMCID: PMC6153122 DOI: 10.4239/wjd.v9.i9.149] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/03/2018] [Accepted: 07/10/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To evaluate the effects of glucagon-like peptide-1 analogs (GLP-1a) combined with insulin on myocardial ischemia-reperfusion injury in diabetic rats.
METHODS Type 2 diabetes mellitus (T2DM) was induced in male Wistar rats with streptozotocin (65 mg/kg) and verified using an oral glucose tolerance test. After anesthesia, the left coronary artery was occluded for 40 min followed by 80 min reperfusion. Blood glucose level was measured during surgery. Rats were randomized into six groups as follows: (1) control rats; (2) insulin (0.1 U/kg) treated rats prior to ischemia; (3) insulin (0.1 U/kg) treated rats at reperfusion; (4) GLP-1a (140 mg/kg) treated rats prior to ischemia; (5) GLP-1a (140 mg/kg) treated rats at reperfusion; and (6) rats treated with GLP-1a (140 mg/kg) prior to ischemia plus insulin (0.1 U/kg) at reperfusion. Myocardial area at risk and infarct size was measured planimetrically using Evans blue and triphenyltetrazolium chloride staining, respectively.
RESULTS There was no significant difference in the myocardial area at risk among groups. Insulin treatment before ischemia resulted in a significant increase in infarct size (34.7% ± 3.4% vs 18.6% ± 3.1% in the control rats, P < 0.05). Post-ischemic administration of insulin or GLP-1a had no effect on infarct size. However, pre-ischemic administration of GLP-1a reduced infarct size to 12% ± 2.2% (P < 0.05). The maximal infarct size reduction was observed in the group treated with GLP-1a prior to ischemia and insulin at reperfusion (8% ± 1.6%, P < 0.05 vs the control and GLP-1a alone treated groups).
CONCLUSION GLP-1a pre-administration results in myocardial infarct size reduction in rats with T2DM. These effects are maximal in rats treated with GLP-1a pre-ischemia plus insulin at reperfusion.
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Affiliation(s)
- Vladislav A Zykov
- Almazov National Medical Research Centre, St-Petersburg 197341, Russia
| | - Taisiia P Tuchina
- Almazov National Medical Research Centre, St-Petersburg 197341, Russia
| | - Denis A Lebedev
- Almazov National Medical Research Centre, St-Petersburg 197341, Russia
| | - Irina B Krylova
- Institute of Experimental Medicine, St-Petersburg 197376, Russia
| | - Alina Y Babenko
- Almazov National Medical Research Centre, St-Petersburg 197341, Russia
| | | | - Elena N Grineva
- Almazov National Medical Research Centre, St-Petersburg 197341, Russia
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Zinovieva OL, Grineva EN, Prokofjeva MM, Karpov DS, Krasnov GS, Prassolov VS, Mashkova TD, Lisitsyn NA. [Treatment with anti-cancer agents results in profound changes in lncRNA expression in colon cancer cells]. Mol Biol (Mosk) 2018; 51:841-848. [PMID: 29116072 DOI: 10.7868/s0026898417050123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/10/2017] [Indexed: 11/23/2022]
Abstract
Using real-time RT-PCR in combination with bioinformatics, we have shown for the first time that the treatment of HCT-116 and HT-29 colon cancer cells with two anti-cancer agents (doxycycline or 3,3'-diindolylmethane) results in profound changes in the intracellular content of several lncRNAs (by up to 100 times). Since many of these RNAs are secreted by tumors into the bloodstream, the obtained results provide a basis for developing more sensitive protocols for serological monitoring of tumor relapse and metastasis, as well as for search of new anti-cancer drugs.
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Affiliation(s)
- O L Zinovieva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - E N Grineva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - M M Prokofjeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - D S Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - G S Krasnov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - V S Prassolov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - T D Mashkova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia
| | - N A Lisitsyn
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, 119991 Russia.,
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Vasileva LB, Puzanov MV, Tkachuk AS, Popova PV, Zazerskaya IE, Grineva EN, Dmitrieva RI. P549Is ANGPTL4 marker the epigenetical program predisposition to CAD in offspring? Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- L B Vasileva
- Federal Almazov Medical Research Centre, Institute of Molecular Biology and Genetics, Saint Petersburg, Russian Federation
| | - M V Puzanov
- Federal Almazov Medical Research Centre, Biobank, Saint Petersburg, Russian Federation
| | - A S Tkachuk
- Federal Almazov Medical Research Centre, Institution of Endocrinology, Saint Petersburg, Russian Federation
| | - P V Popova
- Federal Almazov Medical Research Centre, Institution of Endocrinology, Saint Petersburg, Russian Federation
| | - I E Zazerskaya
- Federal Almazov Medical Research Centre, Institute of Perinatology and Pediatrics, Saint Petersburg, Russian Federation
| | - E N Grineva
- Federal Almazov Medical Research Centre, Institution of Endocrinology, Saint Petersburg, Russian Federation
| | - R I Dmitrieva
- Federal Almazov Medical Research Centre, Institute of Molecular Biology and Genetics, Saint Petersburg, Russian Federation
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Popova PV, Shilova ES, Tkachuk AS, Dronova AV, Anopova AD, Nikolaeva AE, Grineva EN. First trimester thyroid function in pregnant women residing in Saint Petersburg (Russia): reference values and risk of gestational diabetes. Diabetes mellitus 2018. [DOI: 10.14341/dm9283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background. Subclinical hypothyroidism during pregnancy and gestational diabetes mellitus (GDM) is known to be associated with maternal and child morbidity. The concept of subclinical dysfunction of the thyroid gland in pregnant women depends on the population-specific and trimester-specific reference values so fixed universal cutoff concentrations for thyroid-stimulating hormone (TSH) that were recommended earlier now are put under the question. Population-specific and trimester-specific reference values have not been defined for pregnant women residing in Saint Petersburg. The data concerning the association of maternal thyroid status with GDM development are controversial.
Aims. The aim of the study was to determine the reference values of TSH and free thyroxin (fT4) in the first trimester of pregnancy in women living in St. Petersburg, and to assess the relationship between thyroid status and the risk of subsequent development of GDM.
Materials and methods. The levels of TSH, fT4 and thyroid peroxidase antibodies (TPO-Ab) were analyzed in 503 pregnant women before the 14th week of gestation. The women underwent oral glucose tolerance test (OGTT) at 2428 weeks to find out those with GDM. The association between thyroid function, thyroid autoimmunity and the risk of GDM we estimated.
Results. The reference values for TSH were 0.07 4.40 mU /L, and for fT4 11.7 20.3 pmol/L. The prevalence of subclinical hypothyroidism in the 503 pregnant women was 16.9% according to the diagnostic criteria of TSH 2.5 mIU / L and 3.8% using our calculated reference interval. Hypothyroxinemia was registered in 5,3% using reference values recommended by diagnostic tests manufacturer and in 2,8% according to our calculated reference interval for fT4. GDM was diagnosed in 23% of women. Logistic regression analysis showed associations of hypothyroxinemia and TPO-Ab-positivity with the increased risk of GDM that remained significant after adjustments on age and body mass index (BMI) [adjusted OR (95% CI) = 7.39 (1.2742.93) for hypothyroxinemia, p=0.026; and adjusted OR (95% CI) = 2.02 (1.014.04) for TPO-Ab-positivity, p=0.047).
Conclusions. Reference intervals for first trimester TSH and fT4 have been established for pregnant women living in St. Petersburg. Hypothyroxinemia and TPO-Ab-positivity were associated with the increased risk of GDM.
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Puzanov MV, Vasilyeva LB, Popova PV, Grineva EN, Dmitrieva RI. New Approach to Cryopreservation of Primary Noncultivated Human Umbilical Vein Endothelium in Biobanking. Biopreserv Biobank 2018; 16:114-119. [PMID: 29363992 DOI: 10.1089/bio.2017.0086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
It is widely accepted that endothelial dysfunction (ED) is a common feature and a risk factor for cardiovascular diseases and metabolic disorders. Cultures of human umbilical vein endothelial cells (HUVECs) are routinely used in cell-based models to study in vitro molecular and cellular mechanisms of development of different aspects of ED. The methods of the HUVEC extraction and expansion are well developed and standardized. However, when large collections of samples are needed for certain projects, or when samples from a rare population of patients should be collected for future experimental use, HUVEC samples should be transferred to a biobank to be saved in liquid nitrogen for a long period of time until the required collection is completed. This scenario is not always convenient since it requires a lot of effort, a large quantity of expensive culture reagents with limited expiration periods, and sometimes special facilities and well-trained cell biologists among the biobank staff. In this project, we evaluated a method of HUVEC cryopreservation, where the stage of cell culturing and expansion before the transfer of samples to the biobank is eliminated. A total of 55 samples of umbilical cord (UC) were obtained from women immediately after delivery. A primary endothelium pellet derived from 17 UC samples was isolated, frozen, and placed in long-term storage in a liquid nitrogen freezer. Other samples were used to obtain HUVEC cultures. We have demonstrated that cryopreservation of primary endothelium pellets from UC veins without culturing and expansion steps does not affect the physiological features of HUVECs. This new approach would improve the efficiency of biobanking logistics, especially in the case of banking of large collections of endothelial samples.
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Affiliation(s)
- Maksim V Puzanov
- 1 Biobank, Federal Almazov North-West Medical Research Centre , Saint-Petersburg, Russian Federation
| | - Liudmila B Vasilyeva
- 2 Institute of Molecular Biology and Genetics , Federal Almazov North-West Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Polina V Popova
- 3 Institute of Endocrinology , Federal Almazov North-West Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Elena N Grineva
- 3 Institute of Endocrinology , Federal Almazov North-West Medical Research Centre, Saint-Petersburg, Russian Federation
| | - Renata I Dmitrieva
- 2 Institute of Molecular Biology and Genetics , Federal Almazov North-West Medical Research Centre, Saint-Petersburg, Russian Federation
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Kirilenko BM, Grineva EN, Karpov DS, Karpov VL. [Inhibition of the expression of proteasomal genes Saccharomyces cerevisiae by artificial transcriptional repressor]. Mol Biol (Mosk) 2016; 50:703-712. [PMID: 27668608 DOI: 10.7868/s0026898416040054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 02/12/2016] [Indexed: 11/23/2022]
Abstract
26S proteasome is an ATP-dependent protease complex that takes part in cell homeostasis maintenance by the selective degradation of regulatory and damaged proteins. The proteasomal genes expression in Saccharomyces cerevisiae yeast is coordinately regulated by the system, which consists of the Rpn4 transcription factor and its binding site, called PACE. The ability to modulate proteasomal activity by changing the expression of its genes is an essential tool that can be used in fundamental studies devoted to the mechanisms of proteasome dependent cell processes, as well as in applied research for developing strategies to correct proteasome activity in some pathological processes. In this work, we present a detailed description of our SaxBricks method that allows one to construct DNA-binding domains with custom specificity from nucleotide- specific TAL domains. Having applied the SaxBricks method, we created a modular transcriptional repressor for Rpn4-dependent genes that effectively suppresses the expression of proteasomal genes.
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Affiliation(s)
- B M Kirilenko
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow
| | - E N Grineva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow
| | - D S Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow.,Institute of Biomedical Chemistry, Moscow, 119121 Russia.,
| | - V L Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow
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Abstract
Obesity and metabolic syndrome are among the major problems of modern society. The increase in obesity is associated with a corresponding increase in type 2 diabetes, cardiovascular disease and cancer. A huge amount of scientific research has been devoted to the development of methods to reduce obesity and its complications. In recent years, attention has shifted towards studying the intestinal microbiota not only as a possible component of the pathological process but also as a target of therapeutic intervention. Recent evidence, primarily from investigations in animal models, suggests that the intestinal microbiota affects nutrient acquisition and energy regulation. This review will discuss the role of the intestinal microbiota in metabolic processes as well as the latest developments on the improvement of disturbances specific to obesity and metabolic syndrome.
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Popova P, Castorino K, Grineva EN, Kerr D. Gestational diabetes mellitus diagnosis and treatment goals: measurement and measures. MINERVA ENDOCRINOL 2016:R07Y9999N00A16012902. [PMID: 26824326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gestational diabetes mellitus (GDM) is defined as diabetes diagnosed during pregnancy that is not clearly overt diabetes. It is the most common complication of pregnancy and is the most common type of diabetes during pregnancy. Its high prevalence is determined by the increasing epidemic of obesity and by the diagnostic criteria applied. New criteria are currently accepted by a number of professional societies, but considerable controversies still exist concerning diagnosis of GDM. GDM can cause significant short term and long term problems for mother and offspring, including but not limited to cesarean delivery, birth trauma, as well as the development of type 2 diabetes in mother and offspring in the future. Although the consequences of poorly controlled GDM are evident, there continues to be controversy regarding the most appropriate diagnostic criteria, the metabolic aims in controlling GDM, the ability to diagnose GDM in early pregnancy, and the efficiency of treatment in order to improve pregnancy outcomes. This review focuses on current recommendations of professional medical societies and evidence base for GDM diagnosis and glycemic goals of treatment. Available evidence for the optimal time and frequency of self-monitoring of blood glucose and the role of glycated haemoglobin in GDM is also provided in this review.
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Affiliation(s)
- Polina Popova
- Institution of Endocrinology, Almazov Federal North-West Medical Research Centre, Saint- Petersburg, Russia -
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Popova P, Tkachuk A, Dronova A, Gerasimov A, Kravchuk E, Bolshakova M, Rozdestvenskaya O, Demidova K, Nikolaeva A, Grineva EN. Fasting glycemia at the first prenatal visit and pregnancy outcomes in russian women. MINERVA ENDOCRINOL 2016:R07Y9999N00A160003. [PMID: 26795554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The aim of the study was to evaluate the associations between fasting glycemia (FG) at the first prenatal visit and adverse pregnancy outcomes. MATERIALS AND METHODS Medical records of 1,584 pregnant women with a recorded level of FG before 24 weeks of gestation were examined. Subjects with pregestational diabetes or delivery before 24 weeks were excluded. 823 women underwent oral glucose tolerance test (OGTT) at 24-32 weeks of pregnancy. FG values were devided into five groups starting with <4.1 mmol/L as the first group, with subsequent increases of 0.5 mmol/L between groups and >5.6 mmol/L as the last group. The main outcomes were gestational diabetes mellitus (GDM) development, macrosomia, primary cesarean delivery, shoulder dystocia or birth injury. RESULTS With increasing FG levels at first prenatal visit, the frequency of GDM (among women who underwent OGTT) increased from 18.3% in the lowest category to 44.4% in the highest (odds ratio (OR) 2.94; 95% confidence interval (CI) 1.39-6.19) and the frequency of hyperbilirubinemia increased from 4.5% to 18% respectively (OR 4.7; 95% CI 1.8-12.5). After adjustment for maternal age and BMI, only the highest glucose category (5.6< FG< 7 mmol/L) was significantly associated with the increased risk of the above mentioned outcomes. The of frequency of shoulder dystocia/birth injury (OR 24.5; 95% CI 2.8-214.8) and preeclampsia (OR 2.7 ; 95% CI 1.2 - 5.9) was increased in the highest glucose category compared to the intermediary categories. CONCLUSION Only the highest glucose category (5.6< FG< 7 mmol/L) at the first prenatal visit was strongly associated with some adverse pregnancy outcomes.
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Affiliation(s)
- Polina Popova
- Institution of Endocrinology, Almazov Federal North-West Medical Research Centre, Saint-Petersburg, Russia -
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Bayrasheva VK, Babenko AY, Dobronravov VA, Dmitriev YV, Chefu SG, Pchelin IY, Ivanova AN, Bairamov AA, Alexeyeva NP, Shatalov IS, Grineva EN. Uninephrectomized High-Fat-Fed Nicotinamide-Streptozotocin-Induced Diabetic Rats: A Model for the Investigation of Diabetic Nephropathy in Type 2 Diabetes. J Diabetes Res 2016; 2016:8317850. [PMID: 28090542 PMCID: PMC5206480 DOI: 10.1155/2016/8317850] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 10/30/2016] [Accepted: 11/08/2016] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes (DM2) could be reproduced in rats with alimentary obesity by using low doses of streptozotocin (LD-STZ) as well as STZ in high doses with preliminary nicotinamide (NA) administration. However, STZ could induce tubulotoxicity. Aim. To develop rat model of DN in NA-STZ-induced DM2 and compare it with LD-STZ-model in order to choose the most relevant approach for reproducing renal glomerular and tubular morphofunctional diabetic changes. Starting at 3 weeks after uninephrectomy, adult male Wistar rats were fed five-week high-fat diet and then received intraperitoneally either LD-STZ (40 mg/kg) or NA (230 mg/kg) followed by STZ (65 mg/kg). Control uninephrectomized vehicle-injected rats received normal chow. At weeks 10, 20, and 30 (the end of the study), metabolic parameters, creatinine clearance, albuminuria, and urinary tubular injury markers (NGAL, KIM-1) were evaluated as well as renal ultrastructural and light microscopic changes at weeks 20 and 30. NA-STZ-group showed higher reproducibility and stability of metabolic parameters. By week 10, in NA-STZ-group NGAL level was significantly lower compared to LD-STZ-group. By week 30, diabetic groups showed early features of DN. However, morphofunctional changes in NA-STZ-group appeared to be more pronounced than those in STZ-group despite lower levels of KIM-1 and NGAL. We proposed a new rat model of DM2 with DN characterized by stable metabolic disorders, typical renal lesions, and lower levels of tubular injury markers as compared to LD-STZ-induced diabetes.
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Affiliation(s)
- Valentina K. Bayrasheva
- Institute of Endocrinology, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
- Department for Pathophysiology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- *Valentina K. Bayrasheva:
| | - Alina Yu. Babenko
- Institute of Endocrinology, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
| | - Vladimir A. Dobronravov
- Research Institute of Nephrology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Yuri V. Dmitriev
- Institute of Experimental Medicine, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
| | - Svetlana G. Chefu
- Department for Pathophysiology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
- Institute of Experimental Medicine, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
| | | | - Alexandra N. Ivanova
- Saint Petersburg State University, Saint Petersburg, Russia
- Komarov Botanical Institute of the Russian Academy of Sciences, Saint Petersburg, Russia
| | - Alekber A. Bairamov
- Institute of Endocrinology, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
| | - Nina P. Alexeyeva
- Department of Statistical Modelling, Mathematics and Mechanics Faculty, Saint Petersburg State University, Saint Petersburg, Russia
| | - Ivan S. Shatalov
- Saint Petersburg National Research University of Information, Technologies, Mechanics and Optics, Saint Petersburg, Russia
| | - Elena N. Grineva
- Institute of Endocrinology, Federal Almazov North-West Medical Research Centre, Saint Petersburg, Russia
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Popova PV, Grineva EN, Gerasimov AS, Kravchuk EN, Ryazantseva EM, Shelepova ES. The new combination of risk factors determining a high risk of gestational diabetes mellitus. MINERVA ENDOCRINOL 2015; 40:239-247. [PMID: 25288096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of this study was to identify early markers of gestational diabetes mellitus (GDM) and to reveal the most significant of them. METHODS A total of 548 pregnant women were screened for GDM between weeks 24 and 28 of gestation, as defined by International Association of Diabetes In Pregnancy Study Groups (IADPSG) criteria, in a retrospective case-control study. First trimester maternal fasting glucose, anthropometric parameters and blood pressure were obtained from medical records. Classification Tree Method was used to identify combination of early pregnancy risk factors that predict the highest risk of the development of GDM in later pregnancy. RESULTS The combination of Body Mass Index (BMI) >38.6 kg/m² with, abdominal circumference >91.5 cm and fasting glucose >4.5 mmol/L was associated with a 13-fold increased risk of GDM as compared to women who do not have this combination of symptoms (OR 13.2 95% CI: 2.7-63.3, P<0.001). In women with BMI less than 38,6 kg/m ² the combination of fasting glucose >4.5 mmol/L, abdominal circumference >91.5 cm with the presence of polycystic ovary syndrome (PCOS) was associated with a 6-fold increased risk of GDM as compared with women who do not have this combination of symptoms (OR=7.6, 95% CI: 1.9-30.02, P=0.003). CONCLUSION A higher BMI, abdominal circumference, fasting glycemia in the first trimester of pregnancy and the presence of PCOS predict increased GDM risk. Taking these combinations into consideration may facilitate identification of women at particular risk for GDM.
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Affiliation(s)
- P V Popova
- Institution of Endocrinology, Almazov Federal Medical Research Centre, St Petersburg, Russia -
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31
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Tsoy UA, Sviryaev YV, Korostovtseva LS, Semenov AP, Vaulina DA, Nepran VI, Kravchenko SO, Konradi AO, Grineva EN. [Clinical features of obstructive sleep apnea syndrome in patients with acromegaly]. TERAPEVT ARKH 2015; 87:47-52. [PMID: 26087634 DOI: 10.17116/terarkh201587447-52] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AIM To investigate the incidence of sleep-related breathing disorders (SRBDs) in patients with active acromegaly (AM), to specify risk factors influencing apnea/hypopnea index (AHI), and to reveal the specific features of obstructive sleep apnea (OSA) in patients with AM versus those with OSA without AM. SUBJECTS AND METHODS Fifty patients with active AM were examined and divided into 3 groups: control group 1 did not differ from the study group in body mass index (BMI); control group 2 did not similar in AHI from the AM group. Polysomnography was done in all the patients. RESULTS SRBDs were detected in 40 (80%) patients. Obstructive apnea was found in all cases. Correlation analysis revealed the relationships between AHI and gender (AHI was higher in the men), BMI, disease duration, and insulin-like growth factor 1 (GF-1). There were no correlations between AHI and gender, maximum adenoma size, and growth hormone levels. Compared with control group 1, the AM group had a statistically significantly higher median AHI [16 (1-92) and 4.7 (0-31.3) episodes per hour of sleep (p < 0.001)]. In control group 2, the median BMI was considerably higher than in the control group [29.2 (19.9-44.3) and 35 (24-56) kg/m2 (p < 0.001). CONCLUSION The detection rate of SRBDs in patients with active AM was 80%, with obstructive disorders being prevalent. There was a positive relationship between SRBD severity and BMI, AM duration, IGF-1 level. Compared to the controls, the patients with AM developed SRBDs similar in severity with lower BMI; severer SRBDs were detected in the patients with active AM with the similar BMI.
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Affiliation(s)
- U A Tsoy
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - Yu V Sviryaev
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - L S Korostovtseva
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - A P Semenov
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - D A Vaulina
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - V I Nepran
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - S O Kravchenko
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - A O Konradi
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
| | - E N Grineva
- V.A. Almazov Federal Medical Research Center, Ministry of Health of Russia, Saint Petersburg, Russia
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Melnichenko GA, Dedov II, Belaya ZE, Rozhinskaya LY, Vagapova GR, Volkova NI, Grigor’ev AY, Grineva EN, Marova EI, Mkrtumayn AM, Trunin YY, Cherebillo VY. Cushing’s disease: the clinical features, diagnostics, differential diagnostics, and methods of treatment. ACTA ACUST UNITED AC 2015. [DOI: 10.14341/probl201561255-77] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The present guidelines on diagnostics, differential diagnostics, and methods of treatment of Cushing’s disease have been developed by a group of Russian specialists.
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Dedov II, Melnichenko GA, Sviridenko NY, Troshina EA, Fadeev VV, Belovalova IM, Sheremeta MS, Rumyantsev PL, Petunina NA, Grineva EN, Strongin LG, Neroyev VV, Katargina LA, Saakian SV, Panteleeva OG, Valsky VV, Brovkina AF, Atarshikov DS, Bessmertnaya EG, Lipatov DV, Astakhov YS, Saydasheva EI, Zolotarev AV, Dogadova LI. Federal clinical recommendations on diagnostics and treatment of endocrine ophthalmopathy associated with autoimmune thyroid pathology. ACTA ACUST UNITED AC 2015. [DOI: 10.14341/probl201561161-74] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Endocrine ophthalmopathy (EOP) is a multidisciplinary problem at the intersection of endocrinology and ophthalmology. The patients presenting with this condition experience deficit of adequate medical aid due to the poor cooperation between ophthalmologists and endocrinologists. There are practically no specialized centres in this country where the patients with EOP could receive the combined treatment of this pathology including the surgical intervention. Taken together, late diagnostics and delayed seeking the efficacious medical assistance, the absence of stable compensation of the functional disorders of the thyroid gland, erroneous identification of the phase of the disease, and incorrect choice of the methods for its treatment, the lack of coordination and consistency in the actions of ophthalmologists and endocrinologists are responsible for the low effectiveness of EOP treatment. On the other hand, the absence of the unified approach to diagnostics and treatment of endocrine ophthalmopathy, the necessity of introducing the international experience gained in this field into the routine clinical practice and pooling efforts of representatives of different medical disciplines (endocrinologists, ophthalmologists, radiologists, endocrine surgeons, and neurosurgeons) created the prerequisites for the solution of the EOP problems and gave impetus to the development of the recommendations being proposed.
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Karonova TL, Andreeva AT, Beljaeva OD, Bazhenova EA, Globa PJ, Vasil'eva EJ, Grineva EN. [Anxiety/depressive disorders and vitamin D status]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:55-58. [PMID: 26977917 DOI: 10.17116/jnevro201511510255-58] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To search for the association between vitamin D status and anxiety and depression. MATERIAL AND METHODS Authors examined 310 residents of St. Petersburg (137 men and 173 women). Anxiety and depression were measured with the HADS. RESULTS AND CONCLUSION In people with vitamin D deficiency, anxiety and depression were noted in 32.5% and 11.0%, respectively. There were negative correlations between serum 25(OH)D level and anxiety (r= -0,11, p=0.03). Symptoms of depression were not correlated with vitamin D status (r= -0.08, p=0.09) but were correlated with the age (r=0.12, p=0.02). After excluding other risk factors for psychogenic disturbances (obesity, hypertension and impaired glucose metabolism) we concluded that serum 25(OH)D could be an independent risk factor for anxiety (R2=0.02, p=0.01) in the population studied.
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Affiliation(s)
- T L Karonova
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg; GBOU VPO 'Pervyj Sankt-Peterburgskij gosudarstvennyj meditsinskij universitet im. akad. I.P. Pavlova' Minzdrava RF, Sankt-Peterburg
| | - A T Andreeva
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg
| | - O D Beljaeva
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg; GBOU VPO 'Pervyj Sankt-Peterburgskij gosudarstvennyj meditsinskij universitet im. akad. I.P. Pavlova' Minzdrava RF, Sankt-Peterburg
| | - E A Bazhenova
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg; GBOU VPO 'Pervyj Sankt-Peterburgskij gosudarstvennyj meditsinskij universitet im. akad. I.P. Pavlova' Minzdrava RF, Sankt-Peterburg
| | - P Ju Globa
- GBOU VPO 'Pervyj Sankt-Peterburgskij gosudarstvennyj meditsinskij universitet im. akad. I.P. Pavlova' Minzdrava RF, Sankt-Peterburg
| | - E Ju Vasil'eva
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg
| | - E N Grineva
- FGBU 'Severo-Zapadnyj federal'nyj meditsinskij issledovatel'skij tsentr' Minzdrava RF, Sankt-Peterburg
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Nikitina IG, Sabirova EI, Solopova ON, Surzhikov SA, Grineva EN, Karpov VL, Lisitsyn NA, Beresten' SF. [A new immuno-PCR format for serological diagnosis of colon cancer]. Mol Biol (Mosk) 2014; 48:117-123. [PMID: 25842832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Anew immuno-PCR format is described that is based on detection of membrane protein CDH17 in serum exosomes. Format application allows distinction between sera samples of healthy donors and colon cancer patients. Obtained results open a possibility of serological colon cancer diagnosis in high risk groups.
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Grineva EN, Karonova T, Micheeva E, Belyaeva O, Nikitina IL. Vitamin D deficiency is a risk factor for obesity and diabetes type 2 in women at late reproductive age. Aging (Albany NY) 2013; 5:575-81. [PMID: 23924693 PMCID: PMC3765584 DOI: 10.18632/aging.100582] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
It was suggested that glucose metabolism and body fat content depend on serum levels of 25-hydroxyvitamin D [25(OH)D]. We studied 320 healthy women at late reproductive age of 40 to 52 years old (mean age 46.1±4.5) from St. Petersburg (North-West region of Russia). 25(OH)D levels were from 19.4 to 134.0 nMol/L (mean 52.9±22.7). Vitamin D deficiency (lower than 50 nMol/L) and insufficiency (50-75 nMol/L) was revealed in 59.1% and 27.8% of women, respectively. The study showed that low 25(OH)D levels were associated with obesity (r=-0.35, p<0.01), increased plasma glucose levels after OGTT (r=-0.31, p<0.01) and decreased insulin sensitivity index (r=-0.28, p<0.01). We found that 25(OH)D levels below 50 nMol/L were associated with obesity risk (OR 2.25[1.05-3.95], CI 95%) but not with risk of impaired glucose metabolism (1.07[0.54-2.12],CI95%). Our results showed that vitamin D insufficiency is highly prevalent in the population of healthy women. Low 25(OH)D levels correlated with high body fat, glucose levels and decreased insulin sensitivity. We conclude that vitamin D deficiency is a potential risk factor for obesity and development of insulin resistance leading to diabetes type 2.
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Affiliation(s)
- E N Grineva
- Almazov's Centre of Heart, Blood and Endocrinology, Petersburg, 197134, Russia
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Kravchuk EN, Grineva EN, Galagudza MM, Bairamov AA. [The effect of metformin on myocardial tolerance to ischemia in rats with diabetes mellitus type 2]. Patol Fiziol Eksp Ter 2013:32-34. [PMID: 24640771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The effect of metformin on myocardial sensitivity to ischemia in rats with neonatal streptozotocin T2DM was investigated using the model of global ischemia-reperfusion in the isolated perfused heart. Metformin administration had no effect on infarct size. At the same time, infarct size in T2DM was significantly lower than in controls, which is indicative of the phenomenon of metabolic preconditioning in T2DM. The protocol of metformin administration used in this study had not afforded a significant cardioprotective effect in animals with T2DM.
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Nikitina IG, Bukurova IA, Krasnov GS, Grineva EN, Karpov VL, Lisitsyn NA, Beresten' SF. [Structure and function of enteric alpha defensins in norm and pathology]. Mol Biol (Mosk) 2012; 46:31-36. [PMID: 22642099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This review summarizes currently available data on enteric alpha defensins structure, their functions in the innate and adaptive immunity systems and the role in development of intestinal illnesses.
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Dalmatova АВ, Grineva EN. [Evaluation of methylprednisolone pulse therapy versus combined therapy with prednisolone and cyclosporine in the treatment of infiltrative ophthalmopathy in Graves' disease]. Probl Endokrinol (Mosk) 2007; 53:27-30. [PMID: 31627654 DOI: 10.14341/probl200753527-30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Indexed: 06/10/2023]
Abstract
The study was undertaken to evaluate the efficiency of methylprednisolone pulse therapy versus combined therapy with prednisolone and cyclosporine in the treatment of Graves' infiltrative ophthalmopathy. Twenty-four euthyroid patients (15 females and 9 males) aged 28 to 71 years who had severe active ophthalmopathy were randomized into 2 groups. Group 1 patients received pulse therapy with methylprednisolone while Group 2 patients were treated with a combination of prednisolone and cyclosporine. The efficiency of therapy was evaluated by the changes in indices by the clinical activity score (CAS), soft tissue inflammation (STI), average exophthalmos, the dysfunction of extraocular muscles, the total diameter of extraocular muscles by the data of computed tomography 2 weeks before the initiation of therapy and 36 weeks after its discontinuation. Following 2-week therapy, the patients from both groups had lower CAS, diminished inflammatory soft tissue manifestations by the STI scale, and alleviated average exophthalmos. Thirty-six weeks after therapy discontinuation, the values returned to the baseline ones in Group 1 patients whereas the achieved positive effect is retained in Group 2 patients.
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Affiliation(s)
- А В Dalmatova
- I.P. Pavlov First St. Petersburg State Medical University
| | - E N Grineva
- I.P. Pavlov First St. Petersburg State Medical University
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Dedov II, Melnichenko GA, Fadeyev VV, Gerasimov GA, Vetshev PS, Grineva EN, Kuznetsov NS, Vanushko VE, Beltsevich DG, Sviridenko NY, Troshina EA, Petunina NA, Mazurina NV, Garbuzov PI, Rumyantsev PO, Ilin AA, Artemova AM. [Clinical guidelines developed by the Russian Association of Endocrinologists for the diagnosis and treatment of nodular goiter]. Probl Endokrinol (Mosk) 2005; 51:40-42. [PMID: 31627597 DOI: 10.14341/probl200551540-42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Indexed: 06/10/2023]
Abstract
The guidelines presented do not pretend to be a systematic presentation of all aspects of the diagnosis and treatment of nodular goiter and are not intended to replace guidelines for various medical disciplines. In real clinical practice, situations may arise that are beyond the scope of the recommendations presented, in connection with which the final decision regarding a specific patient and responsibility for him lies with the attending physician.The recommendations presented are mainly devoted to the diagnosis and treatment of nodular (multinodular) euthyroid colloid, differently proliferating goiter in adults (over 18 years of age) and are the agreed opinion of the RAE experts who developed them. Nodular (multinodular) toxic goiter, tumors (malignant and benign), as well as other diseases that can manifest themselves by nodular formations of the thyroid gland (thyroid gland), are discussed mainly in the context of differential diagnosis. The recommendations also do not affect the features of diagnosis and treatment of nodular goiter in children and adolescents.
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Affiliation(s)
| | | | | | | | | | - E N Grineva
- I.P. Pavlov First St. Petersburg State Medical University
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Grineva EN, Goriushkina EV, Malakhova TV, Tsoĭ UA. [Follicular and Hurthle cell tumors of the thyroid gland. Possibilities of preoperative differential diagnosis]. Vopr Onkol 2004; 50:41-5. [PMID: 15088519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Changes suspicious for malignancy were detected in 127 patients who, according to scintigraphic examination of the thyroid, had "cold" nodules. As a consequence, all the patients were operated on and fine-needle aspiration findings were compared with the histological results. Thyroid cancer was identified in 18.9%. No differences in age between cases of benign, malignant follicular and Hurthle cell tumors were reported. Mean nodule size in patients with follicular and Hurthle cell adenoma (2.5 +/- 1.21 cm) differed from that in patients with thyroid cancer (3.35 +/- 1.86, p < 0.001). No differences in nodule size were observed in cases of micro-macrofollicular colloid goiter and thyroid cancer. The frequency of the latter was higher in Hurthle cell tumor (10 out of 23, 43.58%) than in thyroid tumor (14 out of 104, 13.56%), p = 0.002. Risk for thyroid cancer detection was higher in patients revealing nuclear atypia (10 out of 14 thyroid cancer patients, 71.4%) as compared with as low as 20 out of 79 adenoma patients, 25.32% (p = 0.03).
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Affiliation(s)
- E N Grineva
- I.P. Pavlov State Medical University, St. Petersburg
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Grineva EN, Malakhova TV, Tsoĭ UA, Smirnov BI. [Efficacy of thyroxine and potassium iodide treatment of benign nodular thyroid lesions]. TERAPEVT ARKH 2003; 75:72-5. [PMID: 14520857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
AIM To study efficacy of thyroxine (TX) and potassium iodide (PI) in the treatment of benign nodular thyroid lesions (BNTL). MATERIAL AND METHODS 118 patients with BNTL (colloid or colloid hypercellular as shown by thin needle aspiration biopsy, 'cold" or "warm" by scyntigraphy findings) were randomized into two groups: 59 patients were given thyroxin and the other 59 patients PI. The day dose of TX (75-150 mcg) was prescribed according to serum concentration of TTH trying to diminish it to 0.5 mIU/l and lower. PI dose was 200 mcg/day. Most of the patients were treated for 6 months. The response was evaluated with ultrasound investigation which measured thyroid volume, the size and number of the nodes in it before and in the end of therapy. The treatment was found effective if the dominant node decreased in size by 50% and more compared to pretreatment values. RESULTS The size of the dominant node decreased by 50% and more in 14 of 59 (23.73%) patients on TX and in 20 of 59 (33.90%) patients on PI. Both TX and PI prevented growth of the dominant node size and number of the nodes in approximately 2/3 cases. TX was more effective in young patients (40.92 +/- 3.45 years) vs older ones (47.50 +/- 1.46 years, p = 0.047) and patients with colloid nodes. PI was more effective in patients with shorter node existence (3.93 +/- 1.21 and 8.59 +/- 1.74 months, p = 0.02). TX reduced thyroid volume from 20.42 +/- 1.69 to 15.18 +/- 1.30 ml (p = 0.001), PI--from 18.34 +/- 1.57 to 15.36 +/- 1.25 ml (p = 0.001). CONCLUSION TX and PI can inhibit or prevent the growth of thyroid benign nodes in approximately 2/3 patients especially in young patients with colloid nodes (TX) and in short existence of the node (PI).
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Mamaev NN, Grineva EN, Laevskaia ND, Blagosklonnaia IV. [Functional activity of human thyrocytes in diffuse toxic goiter, autoimmune thyroiditis and thyroid nodules using nucleolar silver staining]. Arkh Patol 1994; 56:58-62. [PMID: 8037597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
A comparative study of the thyrocyte nucleolar organizer region (NOR) activity was performed on silver - stained thyroid gland aspiration biopsies from controls, 39 patients with Graves' disease (GD), 15 other patients with Hashimoto thyroiditis (HT), and 71 patients with nodules which underwent surgery. Thyrocyte nucleoli from unchanged thyroid gland were round and small-sized. Their number ranged from 1.34 up to 1.96 per nucleus (mean 1.61 +/- 0.07). The average number of silver (Ag) grains ranged from 3.0 to 6.9 per nucleus (mean - 5.36 +/- 0.36). Compared to the controls the patients with GD revealed thyrocyte nucleoli with increased mean number of AG - grains per nucleus (9.84 +/- 0.24). There was a close correlation between thyrocyte NOR activity, on the one hand, and the level of T3 or T4 hormones and thyroid gland size, on the other. In patients with AT the argentophilla of thyrocyte nucleoli was intermediate between that of controls and patients with GD. This group of patients revealed an increased NOR activity of thyroid gland lymphocytes. Nucleoli of malignant thyroid cells were larger and more irregular than those of benign cells. The mean number of malignant cell nucleoli (2.55 +/- 0.22) was greater than that of the control group (1.61 +/- 0.07; p < 0.05) being identical with those of follicular adenomas (2.47 +/- 0.11) and nodular goiter (2.46 +/- 0.11). The mean number of Ag-grains in the malignant cells (14.9 +/- 0.79) was higher than that in FA (7.95 +/- 0.2; p < 0.0001) and NG (8.0 +/- 0.12; p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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