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Houmøller AM, Gerlif K, Torp NMU, Andersen SL. Diagnoses of obstetric and postpartum thyroid disease: a Danish validation study. Sci Rep 2024; 14:8777. [PMID: 38627585 PMCID: PMC11021553 DOI: 10.1038/s41598-024-59636-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/12/2024] [Indexed: 04/19/2024] Open
Abstract
Different diagnoses of thyroid disease are available in the 10th International Classification of Diseases (ICD-10), but the validity of diagnoses related to obstetric and postpartum thyroid disease is unknown. This was a retrospective cohort study of all patients in the North Denmark Region with a diagnosis of postpartum thyroiditis (PPT) (ICD-10: O905) from 2016 to 2019 or obstetric thyroid disease in 2019 (ICD-10: O992B (hypothyroidism) or O992C (hyperthyroidism)) registered in the Danish National Hospital Register. Information from nationwide registers and medical records were used to assess the validity. Among patients with an O905-diagnosis (n = 40), abnormal thyroid function test results were seen in all cases. A total of eight patients (20.0%) were positive for thyrotropin receptor antibodies postpartum, however, in low titers, and PPT was verified in 39 of 40 cases (97.5%). Altogether 45 of 50 patients with an O992B-diagnosis (90.0%) correctly had hypothyroidism, whereas hyperthyroidism was found in 25 of 39 patients with an O992C-diagnosis (64.1%). This is the first study to validate ICD-10 diagnoses of obstetric and postpartum thyroid disease. A high validity was seen for PPT (O905) and obstetric hypothyroidism (O992B), whereas for obstetric hyperthyroidism (O992C), the diagnosis could not be verified in one third of the cases.
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Affiliation(s)
- Anne Myrup Houmøller
- Department of Clinical Biochemistry, Aalborg University Hospital, 9000, Aalborg, Denmark
| | - Katrine Gerlif
- Department of Clinical Biochemistry, Aalborg University Hospital, 9000, Aalborg, Denmark
| | - Nanna Maria Uldall Torp
- Department of Clinical Biochemistry, Aalborg University Hospital, 9000, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, 9000, Aalborg, Denmark
| | - Stine Linding Andersen
- Department of Clinical Biochemistry, Aalborg University Hospital, 9000, Aalborg, Denmark.
- Department of Clinical Medicine, Aalborg University, 9000, Aalborg, Denmark.
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Huang LA, Lo SC, Yang YS, Huang CN, Wang CC, Wang YH, Kornelius E. Association of COVID-19 Infection with Subsequent Thyroid Dysfunction: An International Population-Based Propensity Score Matched Analysis. Thyroid 2024; 34:442-449. [PMID: 38407979 DOI: 10.1089/thy.2023.0626] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Background: The COVID-19 pandemic's impact on thyroid function is a growing concern. Previous studies have produced inconclusive results, and there is a lack of comprehensive research into the long-term risks of thyroid dysfunction following COVID-19 infection. Methods: In this retrospective cohort study, we used data from the TriNetX international database, which includes electronic health records from a broad, diverse patient population. We compared patients with COVID-19 (cases) to those without (controls), matching for age, sex, race, and comorbidities using propensity score matching. The primary outcome was the diagnosis of thyroid dysfunction (thyrotoxicosis or hypothyroidism) within a 12-month period, analyzed using hazard ratios (HRs) and Kaplan-Meier curves, and stratified by age and sex. Results: Initially, the study included 1,379,311 COVID-19 patients and 6,896,814 non-COVID-19 patients from the TriNetX database. After matching, the cohorts were comparable in demographics and baseline characteristics. This study consistently demonstrated a significant increase in the risk of thyroid dysfunction, including thyrotoxicosis and hypothyroidism, among COVID-19 patients compared to non-COVID-19 patients. In the short term (3 months postexposure), the COVID-19 group exhibited a HR of 2.07 (95% confidence interval [CI] 2.01-2.12) for thyroid dysfunction, which included both thyrotoxicosis (HR 2.10, CI 1.92-2.29) and hypothyroidism (HR 2.08, CI 2.01-2.13). This heightened risk persisted over the long term (up to 12 months), with HRs indicating an ∼2.01-fold increased risk for overall thyroid dysfunction, a 1.8-fold increased risk for thyrotoxicosis, and a 2.04-fold increased risk for hypothyroidism. Subgroup analysis, stratified by age and sex, revealed a notably higher risk of thyroid dysfunction in patients aged 65 and above (HR 2.18, CI 2.11-2.25), compared to those in the under-65 age group (HR 1.97, CI 1.91-2.03). Both male and female patients were associated with an elevated risk, with females showing a slightly higher association with thyroid dysfunction (HR 2.12, CI 2.06-2.16) compared to males (HR 1.76, CI 1.69-1.82). Conclusions: COVID-19 infection was associated with an increased risk of thyroid dysfunction, including thyrotoxicosis and hypothyroidism, regardless of age or sex, during a 12-month follow-up period. Further research is required to validate these findings.
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Affiliation(s)
- Li-An Huang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shih-Chang Lo
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Sun Yang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chien-Ning Huang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chi-Chih Wang
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Edy Kornelius
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Samuelsson J, Bertilsson R, Bülow E, Carlsson S, Åkesson S, Eliasson B, Hanas R, Åkesson K. Autoimmune comorbidity in type 1 diabetes and its association with metabolic control and mortality risk in young people: a population-based study. Diabetologia 2024; 67:679-689. [PMID: 38252314 PMCID: PMC10904419 DOI: 10.1007/s00125-024-06086-8] [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: 09/29/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024]
Abstract
AIMS/HYPOTHESIS This register-based study aimed to describe autoimmune comorbidity in children and young adults from type 1 diabetes onset, and to investigate whether such comorbidity was associated with a difference in HbA1c or mortality risk compared with children/young adults with type 1 diabetes without autoimmune comorbidity. METHODS A total of 15,188 individuals from the Swedish National Diabetes Register, registered with type 1 diabetes before 18 years of age between 2000 and 2019, were included. Five randomly selected control individuals from the Swedish population (Statistics Sweden) were matched to each individual with type 1 diabetes (n=74,210 [346 individuals with type 1 diabetes were not found in the Statistics Sweden register at the date of type 1 diabetes diagnosis, so could not be matched to control individuals]). The National Patient Register was used to attain ICD-10 codes on autoimmune diseases and the Cause of Death Register was used to identify deceased individuals. RESULTS In the total type 1 diabetes cohort, mean±SD age at onset of type 1 diabetes was 9.5±4.4 years and mean disease duration at end of follow-up was 8.8±5.7 years. Of the individuals with type 1 diabetes, 19.2% were diagnosed with at least one autoimmune disease vs 4.0% of the control group. The HRs for comorbidities within 19 years from onset of type 1 diabetes were 11.6 (95% CI 10.6, 12.6) for coeliac disease, 10.6 (95% CI 9.6, 11.8) for thyroid disease, 1.3 (95% CI 1.1, 1.6) for psoriasis, 4.1 (95% CI 3.2, 5.3) for vitiligo, 1.7 (95% CI 1.4, 2.2) for rheumatic joint disease, 1.0 (95% CI 0.8, 1.3) for inflammatory bowel disease, 1.0 (95% CI 0.7, 1.2) for systemic connective tissue disorder, 1.4 (95% CI 1.1, 1.9) for uveitis, 18.3 (95% CI 8.4, 40.0) for Addison's disease, 1.8 (95% CI 0.9, 3.6) for multiple sclerosis, 3.7 (95% CI 1.6, 8.7) for inflammatory liver disease and 19.6 (95% CI 4.2, 92.3) for atrophic gastritis. Autoimmune disease in addition to type 1 diabetes had no statistically significant effect on HbA1c or mortality risk. CONCLUSIONS/INTERPRETATION To our knowledge, this is the first comprehensive study where young individuals with type 1 diabetes were followed regarding development of a wide spectrum of autoimmune diseases, from onset of type 1 diabetes. In this nationwide and population-based study, there was already a high prevalence of autoimmune diseases in childhood, especially coeliac and thyroid disease. The presence of autoimmune comorbidity did not have a statistically significant effect on metabolic control or mortality risk.
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Affiliation(s)
- John Samuelsson
- Department of Paediatrics, Ryhov County Hospital, Jönköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
| | | | - Erik Bülow
- Centre of Registers in Region Västra Götaland, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sanna Carlsson
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Sanna Åkesson
- The Sahlgrenska Academy, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Björn Eliasson
- Centre of Registers in Region Västra Götaland, Gothenburg, Sweden
- Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ragnar Hanas
- The Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics, NU Hospital Group, Uddevalla, Sweden
| | - Karin Åkesson
- Department of Paediatrics, Ryhov County Hospital, Jönköping, Sweden.
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
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Ma Z, Cao P, Cai M, Lin Q, Long X, Ge M, Yu J, He S, Yu J, Zhang J. Characteristics of vitiligo patients with versus without associated autoimmune thyroid disease. Int J Dermatol 2024; 63:491-496. [PMID: 38108619 DOI: 10.1111/ijd.16951] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/19/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Clinical data are limited in patients with vitiligo with or without autoimmune thyroid disease. OBJECTIVES The objective of the study was to investigate the clinical features and basic data of patients with vitiligo, especially those with autoimmune thyroid disease. METHODS The study was a single-center retrospective study. A total of 1305 patients with vitiligo from June 2018 to May 2023 were included, and the clinical characteristics and basic information of the patients were recorded in detail. RESULTS We identified an association between sex (odds ratio [OR]: 2.380; 95% confidence interval [CI]: 1.772-1.198), vitiligo duration (OR: 1.449; 95% CI: 1.076-1.952), skin involvement exceeding 5% of the body surface area (OR: 3.764; 95% CI: 2.134-6.640), negative emotions (OR: 3.076; 95% CI: 2.292-4.127), vitiligo type (OR: 1.974; 95% CI: 1.096-3.555), family history of AITD (OR: 4.979; 95% CI: 2.687-9.225), and family history of AD (OR: 2.418; 95% CI: 1.410-4.146) and patients with vitiligo. CONCLUSIONS For patients with statistically significant associated risk factors, differential diagnosis and early intervention should be performed.
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Affiliation(s)
- Ze Ma
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Peng Cao
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Menghan Cai
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiuping Lin
- Shishi Hospital of Traditional Chinese Medicine, Quanzhou, China
| | - Xiaoyan Long
- The Second Affiliated Hospital of Guizhou Medical University, Kaili, China
| | - Man Ge
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jipeng Yu
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Sijia He
- Tianjin Medical University, Tianjin, China
| | - Jibin Yu
- Yueyang People's Hospital, Yueyang, China
| | - Junling Zhang
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Islam MR, Sultana N. Prevalence of Thyroid Dysfunction in Type 2 Diabetes Mellitus. Mymensingh Med J 2024; 33:341-349. [PMID: 38557508] [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: 04/04/2024]
Abstract
The level of thyroid hormones is often changed in uncontrolled diabetic patients. Screening for Thyroid dysfunction (TD) among patients with Type 2 Diabetes mellitus (T2DM) should be performed considering the increased prevalence of thyroid disorders. This cross-sectional comparative study was conducted in outpatient department of Endocrinology and Medicine, Mymensingh Medical College Hospital, Mymensingh (MMCH) from 1st March 2020 to 30th August 2021. One hundred (100) patients with type 2 diabetes along with 100 (hundred) non-diabetic controls of same age group were enrolled in the study. After taking clinical data, patients were investigated to estimate Fasting plasma glucose (FPG), serum free tri-iodothyronine (FT3), free thyroxin (FT4) and thyroid stimulating hormone (TSH) level to see thyroid dysfunction. Patients were selected with purposive sampling. Thyroid dysfunction was found to be more in T2DM (15.0%) in comparison with non-diabetic controls (5.0%) and this difference was statistically significant (p=0.018). In both diabetic and non-diabetic groups, subclinical hypothyroidism and hypothyroidism were the most common thyroid dysfunction. Thyroid dysfunction was found more in 40-60 years that suggests the prevalence of thyroid dysfunction are increasing in diabetic patients with advancing age. Thyroid dysfunction was found more among overweight and obese patient in both groups. Mean BMI was found higher among diabetic patient with thyroid dysfunction. Logistic regression showed significant association of Thyroid dysfunction with age >50 years and high FPG level. We found thyroid dysfunction was more prevalent in patients with T2DM than non-diabetics. So, screening for thyroid dysfunction among type 2 diabetic patients by estimating Serum TSH, FT4 level should be performed.
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Affiliation(s)
- M R Islam
- Dr Mohammad Rakibul Islam, Emergency Medical Officer, Mymensingh Medical College Hospital, Mymensingh, Bangladesh; E-mail:
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Deng F, Fan X, Liao J, Tang R, Sun X, Lin J, Zhang G, Pan J. The effect of neuroendocrine abnormalities on the risk of psychiatric readmission after hospitalization for bipolar disorder: A retrospective study. Prog Neuropsychopharmacol Biol Psychiatry 2024; 130:110922. [PMID: 38114056 DOI: 10.1016/j.pnpbp.2023.110922] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023]
Abstract
BACKGROUND The correlation between the endocrine system and bipolar disorder(BD) has been well recognized, yet the influence of neuroendocrine hormones on readmission risk post-hospitalization for BD remains largely unexplored. This retrospective cohort study was to scrutinize the impact of neuroendocrine functionality on the readmission of patients with BD post-hospitalization for mental disorders. METHODS The dataset was derived from the electronic medical records of the First Affiliated Hospital of Jinan University in Guangzhou, China. Both univariate and multivariate logistic regression analysis were conducted on all patients hospitalized for BD, and from 1 January 2017 to October 2022. RESULTS Of the 1110 eligible patients, 83 and 141 patients experienced psychiatric readmissions within 90 and 180 days post-discharge, respectively. Multivariate analysis revealed that high serum TSH levels (aOR = 1.079; 95%CI = 1.003-1.160) and thyroid disease comorbidities (aOR = 2.899; 95%CI = 1.303-6.452) were independently correlated with the risk of 90-day readmission; while increased serum TSH levels (aOR = 1.179; 95%CI = 1.081-1.287) represented a risk factor for 180-day readmission. These results indicate that high serum TSH levels and thyroid disease comorbidities may contribute to an elevated readmission risk in patients with BD following hospitalization. CONCLUSION Routinely evaluating and intervening in thyroid function is crucial in the treatment of BD, as it may aid in preventing re-hospitalization.
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Affiliation(s)
- Fangyi Deng
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China; Department of Psychiatry, Liyuan Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei 430077, China
| | - Xiaoxuan Fan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiwu Liao
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rui Tang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xizhe Sun
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jingjing Lin
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guimei Zhang
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jiyang Pan
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, China.
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Sorensen R. JAAD Game Changer: Vitiligo and overt thyroid diseases: A nationwide population-based study in Korea. J Am Acad Dermatol 2024; 90:596. [PMID: 37666428 DOI: 10.1016/j.jaad.2023.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023]
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Alreshidi NF, Alnabri AA, Alshammari ZF, Alshammari KF, Al-Rashidi YS, Alenazi SSH, Alshammari HF, Alrabie AM. Relationship of thyroid dysfunction and its manifestations in diabetes mellitus patients in the Kingdom of Saudi Arabia. Eur Rev Med Pharmacol Sci 2024; 28:2263-2271. [PMID: 38567589 DOI: 10.26355/eurrev_202403_35730] [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: 04/04/2024]
Abstract
OBJECTIVE Both diabetes mellitus (DM) and thyroid dysfunction (TD) are endocrinopathies that are frequently inclined to coexist in patients. Most studies avoid explicitly supporting or opposing testing thyroid function for diabetic patients as a baseline. The association between hypothyroidism and diabetes is considerable when assessing thyroid functions in diabetic individuals based on clinical suspicion. Therefore, this study aimed to assess the relationship between thyroid dysfunction and its manifestations in DM patients in the Kingdom of Saudi Arabia. SUBJECTS AND METHODS The study included 301 DM subjects. A questionnaire divided into two sections was administered to all participants. The first section involved questions about diabetes control, monitoring, and disease severity. The second section included questions about thyroid disease and the 14-item Hypothyroidism Clinical Prediction (HCP) score we created for our research. The HCP score was obtained by summing up all discrete scores for different symptoms of hypothyroidism. ROC curve analysis was used to assess the predicted hypothyroidism cases based on the most precise cut-off point for the HCP overall score (highest sensitivity and specificity). HCP discriminant ability for detecting hypothyroid cases was assessed considering the Area Under the Curve (AUC) as a measurement. RESULTS Almost 53 (17.6%) diabetes mellitus subjects were previously diagnosed with hypothyroidism. Comparatively, regarding the given cut-off point, the total number of predicted hypothyroidism cases using the HCP score was 149 (49.5%). The most reported symptoms included tiredness (75%), followed by irritability (72%), and difficulty in losing weight (65%). Hypothyroidism was detected/predicted among 60.1% of female diabetics vs. 44.2% of males with recorded statistical significance (p=.006). CONCLUSIONS This study further proves a significant association between diabetes and hypothyroidism in Saudi Arabia. We recommend periodic screening for thyroid dysfunction in the diabetic population in specific cases; since some patients with diabetes are more likely to have hypothyroidism based on their clinical presentation.
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Affiliation(s)
- N F Alreshidi
- College of Medicine, University of Hail, Hail, Saudi Arabia.
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Ezeani IU, Ogbonna SU. Burden of Thyroid Dysfunction Among Type 2 Diabetes Mellitus Patients in South East Nigeria with Emphasis on its Prevalence and Pattern of Presentation: A Case-Controlled Study. West Afr J Med 2024; 41:118-125. [PMID: 38581652] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2024]
Abstract
BACKGROUND Studies from different parts of the world on thyroid dysfunction have shown it to be widespread in patients with type 2 diabetes mellitus (T2DM); however, there is insufficient local data to support this observation. AIM To determine the burden of thyroid dysfunction among patients with T2DM at a Tertiary Hospital in Southeast Nigeria with emphasis on its prevalence and pattern of presentation. METHODS Four hundred and seventy-two subjects were recruited for the study. All the subjects (100%) were of African descent. Three hundred and fifty-four (354) of them were patients with T2DM, while 118 subjects who did not have T2DM served as the controls. This study is a descriptive cross-sectional study involving patients with type 2 diabetes mellitus attending the Diabetes Clinic or receiving treatment in the Medical Wards. Subjects were recruited using systematic sampling. The first patient was selected by simple random sampling, and subsequently, every consecutive subject was selected. Blood samples were tested for HbA1c, fT3, fT4, thyrotropin, and thyroid stimulating hormone. Socio-demographic information was retrieved from patient medical records. We used the Student's t-test for statistical comparison of quantitative variables such as weight, height, blood pressure, serum TSH, and serum T3; while for comparison of proportions, we used a Chi-squared test. We set a p-value of less than 0.05 to be statistically significant. RESULTS Females formed the majority of the study population accounting for 56.5% of the type 2 DM patients and 62.7% of the controls. We observed that the mean age of the type 2 DM patients was 57.5 (±9.3) years, which was similar to the mean age of controls: 57.7±8.9 (p=0.17). We also observed that the mean age at diagnosis of DM was 54±7.6 years, while the mean duration of DM for all the type 2 DM patients was 6.5±2.8 years. We observed that in patients with T2DM, the prevalence of thyroid dysfunction was 12.4% and among the controls, a prevalence of 1.7% was observed (P <0.05). Females formed the majority (75%) of T2DM patients with thyroid dysfunction and hypothyroidism was the most common type of thyroid dysfunction (93.2%) observed in this study. CONCLUSION The prevalence of thyroid dysfunction in T2DM patients in this study was 12.4% which was high compared to 1.7% observed in the controls (P = 0.001). The majority of those who had thyroid dysfunction were females. About 9 in 10 of all subjects with thyroid dysfunction had hypothyroidism.
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Affiliation(s)
- Ignatius U Ezeani
- Department of Internal Medicine, Federal Medical Center, PMB 7001, Umuahia, Nigeria.Tel: +2348060692131; E-mail:
| | - Stanley U Ogbonna
- Department of Internal Medicine, Federal Medical Center, PMB 7001, Umuahia, Nigeria.Tel: +2348060692131; E-mail:
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Chen DW, Ospina NS, Haymart MR. Social Determinants of Health and Disparities in Thyroid Care. J Clin Endocrinol Metab 2024; 109:e1309-e1313. [PMID: 38057150 PMCID: PMC10876391 DOI: 10.1210/clinem/dgad716] [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: 11/15/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND There have been documented racial and ethnic disparities in the care and clinical outcomes of patients with thyroid disease. CONTEXT Key to improving disparities in thyroid care is understanding the context for racial and ethnic disparities, which includes acknowledging and addressing social determinants of health. Thyroid disease diagnosis, treatment, and survivorship care are impacted by patient- and system-level factors, including socioeconomic status and economic stability, language, education, health literacy, and health care systems and health policy. The relationship between these factors and downstream clinical outcomes is intricate and complex, underscoring the need for a multifaceted approach to mitigate these disparities. CONCLUSION Understanding the factors that contribute to disparities in thyroid disease is critically important. There is a need for future targeted and multilevel interventions to address these disparities, while considering societal, health care, clinician, and patient perspectives.
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Affiliation(s)
- Debbie W Chen
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
| | - Naykky Singh Ospina
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Megan R Haymart
- Division of Metabolism, Endocrinology & Diabetes, University of Michigan, Ann Arbor, MI 48109, USA
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Morris EJ, Vouri SM, Maraka S, Singh Ospina N. Trends and Components of Thyroid Status Evaluation in Commercially Insured Adults in the United States, 2006-2020. J Clin Endocrinol Metab 2024; 109:611-618. [PMID: 37889845 PMCID: PMC10876400 DOI: 10.1210/clinem/dgad632] [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: 07/11/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 10/29/2023]
Abstract
CONTEXT Thyroid-stimulating hormone (TSH) is one of the most ordered laboratory tests. OBJECTIVE Determine trends of TSH testing rates and components of thyroid function testing. METHODS This was a retrospective analysis of adults 18-64 years old without evidence of thyroid disease with at least 365 days of continuous enrollment between 2006 and 2020 in the IBM MarketScan Claims Database. The main outcome measures were trends of TSH tests/1000 eligible patient-months stratified by age, sex, and region and composition of thyroid function testing. RESULTS Among 67 353 280 patients meeting eligibility criteria, we identified 25 606 518 TSH tests and 15 138 211 patients with ≥1 TSH test. Patients contributing an episode of TSH testing were most commonly 45-54 years old (29.8%) and female (63.6%). TSH testing rates remained consistent throughout the study period with 11.4 and 11.7 TSH tests/1000 person-months in the first and last study months, respectively (mean 12.2 TSH tests/1000 person-months). TSH testing rates dropped sharply in the spring of 2020 (4.2 TSH tests/1000 person-months). Females showed a nearly 2-fold higher rate of TSH testing than males (16.1 TSH tests/1000 person-months vs 8.6 TSH tests/1000 person-months). TSH testing rates increased with age (8.2 TSH tests/1000 person-months among individuals 18-34 years old vs 15.4 TSH tests/1000 person-months among individuals 55-64 years old). No difference in TSH testing rates was noted between regions. Thyroid function testing episodes included only TSH in most cases (70.8%). CONCLUSION TSH testing rates among commercially insured individuals without known thyroid disease appears stable over time, with higher frequency in females and with increasing age.
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Affiliation(s)
- Earl J Morris
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Scott M Vouri
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
| | - Spyridoula Maraka
- Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Endocrine Section, Medicine Service, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Naykky Singh Ospina
- Division of Endocrinology, Department of Medicine, University of Florida, Gainesville, FL 32608, USA
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12
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Lin Y, Lin R, Wang W, Xie M, Li Y, Zhang Q. Association between urinary organophosphate ester metabolite exposure and thyroid disease risk among US adults: National Health and Nutrition Examination Survey 2011-2014. Front Endocrinol (Lausanne) 2024; 15:1329247. [PMID: 38405137 PMCID: PMC10884265 DOI: 10.3389/fendo.2024.1329247] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/22/2024] [Indexed: 02/27/2024] Open
Abstract
Background Organophosphate esters (OPEs) may interfere with thyroid function, but the relationship between OPEs and thyroid disease remains unclear. This study aims to elucidate the relationship between OPEs exposure and thyroid disease risk in the general population in the United States. Method Data were obtained from the 2011-2014 National Health and Nutrition Examination Survey cycle. All participants were tested for seven OPE metabolites in their urine and answered questions about whether they had thyroid disease through questionnaires. Logistic regression was employed to analyze the association between exposure to individual OPE metabolites and thyroid disease. Weighted Quantile Sum (WQS) regression modeling was utilized to assess exposure to mixed OPE metabolites and risk of thyroid disease. Bayesian kernel machine regression(BKMR) models to analyze the overall mixed effect of OPE metabolites. Result A total of 2,449 participants were included in the study, 228 of whom had a history of thyroid disease. Bis(1,3-dichloro-2-propyl) phos (BDCPP), Diphenyl phosphate (DPHP) and Bis(2-chloroethyl) phosphate (BCEP) were the top three metabolites with the highest detection rates of 91.75%, 90.77% and 86.57%, respectively. In multivariate logistic regression models, after adjustment for confounding variables, individuals with the highest tertile level of BCEP were significantly and positively associated with increased risk of thyroid disease (OR=1.57, 95% CI=1.04-2.36), using the lowest tertile level as reference. In the positive WQS regression model, after correcting for confounding variables, mixed exposure to OPE metabolites was significantly positively associated with increased risk of thyroid disease (OR=1.03, 95% CI=1.01-1.06), with BCEP and DPHP having high weights. In the BKMR model, the overall effect of mixed exposure to OPE metabolites was not statistically significant, but univariate exposure response trends showed that the risk of thyroid disease decreased and then increased as BCEP exposure levels increased. Conclusion The study revealed a significant association between exposure to OPE metabolites and an increased risk of thyroid disease, with BCEP emerging as the primary contributor. The risk of thyroid disease exhibits a J-shaped pattern, whereby the risk initially decreases and subsequently increases with rising levels of BCEP exposure. Additional studies are required to validate the association between OPEs and thyroid diseases.
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Affiliation(s)
- Yuxin Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Ruipeng Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Weikang Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Manling Xie
- Laboratory Center, The Major Subject of Environment and Health of Fujian Key Universities, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yun Li
- Food and Chemical Institute, Anhui Province Institute of Product Quality Supervision & Inspection, Hefei, China
| | - Qian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
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13
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Song JL, Hu JW, Li LR, Xu ZL, Li JJ, Sun SR, Chen C. Association of thyroid autoimmunity with extra-thyroid diseases and the risk of mortality among adults: evidence from the NHANES. Front Endocrinol (Lausanne) 2024; 15:1323994. [PMID: 38405150 PMCID: PMC10884096 DOI: 10.3389/fendo.2024.1323994] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Background Thyroid autoimmunity is one of the most prevalent autoimmune diseases. However, its association with extra-thyroid diseases and mortality risk in the general population remains uncertain. Our study aims to evaluate the association of thyroid autoimmunity with extra-thyroid disease and the risk of mortality. Methods A prospective cohort study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) with participants from 2007-2008, 2009-2010, and 2011-2012, tracking their mortality until 2019. Associations between thyroid autoimmunity, which was defined as having positive thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb), and extra-thyroid disease including diabetes, hypertension, cardiovascular disease, chronic lung disease, arthritis, cancer and chronic renal disease and the risk of mortality were investigated. Results A total of 7431 participants were included in this study. Positive The prevalence of positive TgAb was 7.54%, and positive TPOAb prevalence was 11.48%. TgAb was significantly associated with diabetes (Model 1: OR=1.64, 95% CI:1.08-2.50; Model 2: OR=1.93, 95% CI: 1.21-3.08) and hypertension (Model 1: OR=0.67, 95% CI: 0.49-0.91; Model 2: OR=0.62, 95% CI: 0.44-0.88). TPOAb was associated with a lower prevalence of chronic lung disease (model 1: OR=0.71, 95% CI: 0.54-0.95; model 2: OR=0.71, 95% CI: 0.53-0.95). No associations were observed between TgAb, TPOAb and other extra-thyroid diseases. Neither TgAb nor TPOAb were associated with all-cause mortality or heart disease mortality. Conclusion TgAb was linked to a higher prevalence of diabetes and a lower prevalence of hypertension, while TPOAb was associated with a decreased prevalence of chronic lung disease. However, neither TgAb nor TPOAb posed a risk for all-cause mortality or heart disease mortality.
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Affiliation(s)
| | | | | | | | | | - Sheng-Rong Sun
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chuang Chen
- *Correspondence: Chuang Chen, ; Sheng-Rong Sun,
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Vasilopoulou A, Patsiou V, Bekiaridou A, Papazoglou AS, Moysidis DV, Spaho M, Zergioti M, Kostakakis D, Kyriakideli ME, Lampropoulou CI, Kartas A, Samaras A, Baroutidou A, Tzikas A, Ziakas A, Giannakoulas G. Prognostic implications of thyroid disease in patients with atrial fibrillation. Heart Vessels 2024; 39:185-193. [PMID: 38087071 PMCID: PMC10784350 DOI: 10.1007/s00380-023-02341-x] [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: 09/12/2023] [Accepted: 11/08/2023] [Indexed: 01/12/2024]
Abstract
Atrial fibrillation (AF) is often accompanied by thyroid disease (THD). This study aimed to explore the relationship between THD and the occurrence of significant clinical outcomes in patients with AF. This post hoc analysis utilized data from the MISOAC-AF trial (NCT02941978), which enrolled hospitalized patients with AF. Patients were categorized based on their THD history into hyperthyroidism, hypothyroidism, or euthyroidism. Cox regression models were employed to calculate unadjusted and adjusted hazard ratios (aHRs). The primary outcomes of interest included all-cause mortality, cardiovascular death, and hospitalizations during the follow-up period. The study included 496 AF patients (mean age 73.09 ± 11.10 years) with available THD data, who were followed-up for a median duration of 31 months. Among them, 16 patients (3.2%) had hyperthyroidism, 141 (28.4%) had hypothyroidism, and 339 (68.4%) had no thyroid disease. Patients with hypothyroidism exhibited higher rates of hospitalization during follow-up (aHR: 1.57, 95% CI 1.12 to 2.20, p = 0.025) compared to the euthyroid group. Elevated levels of thyroid-stimulating hormone (TSH) were correlated with an increased risk of cardiovascular mortality (aHR: 1.03, 95% CI 1.01 to 1.05, p = 0.007) and hospitalizations (aHR: 1.06, 95% CI 1.01 to 1.12, p = 0.03). Conversely, lower levels of triiodothyronine (T3) were associated with higher risks of all-cause mortality (aHR: 0.51, 95% CI 0.31 to 0.82, p = 0.006) and cardiovascular mortality (aHR: 0.42, 95% CI 0.23 to 0.77, p = 0.005). Among patients with AF, hypothyroidism was associated with increased hospitalizations. Furthermore, elevated TSH levels and decreased T3 levels were linked to higher cardiovascular and all-cause mortality risks, respectively.
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Affiliation(s)
- Anthi Vasilopoulou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Vasiliki Patsiou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Alexandra Bekiaridou
- Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, NY, USA
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, NY, USA
| | - Andreas S Papazoglou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Dimitrios V Moysidis
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Marina Spaho
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Martha Zergioti
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Dimitrios Kostakakis
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Maria-Eirini Kyriakideli
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Chrysanthi-Ioanna Lampropoulou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Anastasios Kartas
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Athanasios Samaras
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Amalia Baroutidou
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - Apostolos Tzikas
- Interbalkan European Medical Center, Asklipiou 10, Pylaia, Thessaloniki, Greece
| | - Antonios Ziakas
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece
| | - George Giannakoulas
- First Department of Cardiology, School of Medicine, Faculty of Health Sciences, AHEPA University Hospital, Aristotle University of Thessaloniki, St. Kiriakidi 1, 54636, Thessaloniki, Greece.
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15
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Zhai Y, Wang B, Han W, Yu B, Ci J, An F. Correlation between systemic inflammatory response index and thyroid function: 2009-2012 NHANES results. Front Endocrinol (Lausanne) 2024; 14:1305386. [PMID: 38317709 PMCID: PMC10841575 DOI: 10.3389/fendo.2023.1305386] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/27/2023] [Indexed: 02/07/2024] Open
Abstract
Aims This study investigates the relationship between the Systemic Inflammatory Response Index (SIRI) and thyroid function. Methods Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 2009-2012, we excluded participants lacking SIRI or thyroid function data, those under 20 years, and pregnant individuals. SIRI was determined using blood samples. We conducted weighted multivariate regression and subgroup analyses to discern the independent relationship between SIRI and thyroid function. Results The study included 1,641 subjects, with an average age of 47.26±16.77 years, including 48.65% males and 51.35% females. The population was divided into three SIRI-based groups (Q1-Q3). Q3, compared to Q1, exhibited higher age-at-onset, greater male prevalence, and increased levels of FT3, FT4, TT4, leukocytes, and triglycerides. This group also showed a higher incidence of diabetes, hypertension, and smoking. Notably, Q1 had lower LDL and HDL levels. SIRI maintained a positive association with FT4 (β = 0.01, 95% CI = 0.00-0.03, P for trend = 0.0071), TT4 (β = 0.20, 95% CI = 0.10, 0.31, P for trend=0.0001), and TPOAb (β = 8.0, 95% CI = 1.77-14.30, P for trend = 0.0120), indicating that each quartile increase in SIRI corresponded to a 0.01 ng/dL increase in FT4, a 0.2 g/dL increase in TT4, and an 8.03 IU/mL rise in TPOAb. The subgroup analysis suggested the SIRI-thyroid function correlation was influenced by hypertension. Conclusion Inflammation may impact the development and progression of thyroid function disorders. Proactive anti-inflammatory treatment might mitigate thyroid abnormalities.
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Affiliation(s)
- Yuze Zhai
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Benjun Wang
- Department of Anal Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Weiwei Han
- Department of Anal Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Bianfang Yu
- Department of Anal Surgery, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jichen Ci
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Fan An
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
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16
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Bin Dayel S, Hussein RS, Atia T, Abahussein O, Al Yahya RS, Elsayed SH. Is thyroid dysfunction a common cause of telogen effluvium?: A retrospective study. Medicine (Baltimore) 2024; 103:e36803. [PMID: 38181279 PMCID: PMC10766245 DOI: 10.1097/md.0000000000036803] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/06/2023] [Indexed: 01/07/2024] Open
Abstract
Telogen effluvium (TE) is a common cause of hair loss characterized by excessive resting hair shedding. Thyroid dysfunction is one of the possible causes of TE. On the other hand, the link between thyroid disorder and TE is still being debated. The aim of this retrospective is to investigate the link between thyroid dysfunction and TE. This retrospective study included 500 female patients with TE who had thyroid function testing between January 2012 and December 2022. Patients were eligible if they had a confirmed TE diagnosis and thyroid function tests within 3 months of being diagnosed with TE. The thyroid function of the participants was classified as euthyroid, hypothyroidism, or hyperthyroidism. The severity of hair loss was determined using the severity of alopecia tool (SALT) score. The study included 500 TE females, 248 of whom were euthyroid, 150 had hypothyroidism, and 102 had hyperthyroidism. The hypothyroid group had a significantly higher mean SALT score than the other 2 groups. Furthermore, patients in the hypothyroid group had a higher proportion of severe hair loss. The mean SALT score did not differ significantly between groups with normal thyroid function and those with hyperthyroidism. A common cause of TE is thyroid dysfunction, particularly hypothyroidism. Patients with hypothyroidism have more severe hair loss than those with normal thyroid function or hyperthyroidism. To effectively identify and manage such cases, thyroid function testing should be included in the diagnostic workup of patients with TE.
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Affiliation(s)
- Salman Bin Dayel
- Dermatology Unit, Department of Internal Medicine, College of Medicine. Prince Sattam Bin Abdulaziz University, AL-Kharj, Saudi Arabia
| | - Ramadan S. Hussein
- Dermatology Unit, Department of Internal Medicine, College of Medicine. Prince Sattam Bin Abdulaziz University, AL-Kharj, Saudi Arabia
| | - Tarek Atia
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, AL-Kharj, Saudi Arabia
| | - Othman Abahussein
- Dermatology Unit, Department of Internal Medicine, College of Medicine. Prince Sattam Bin Abdulaziz University, AL-Kharj, Saudi Arabia
| | - Rand S. Al Yahya
- Dermatology Unit, Department of Internal Medicine, College of Medicine. Prince Sattam Bin Abdulaziz University, AL-Kharj, Saudi Arabia
| | - Shereen H. Elsayed
- Department of Rehabilitation Sciences, Faculty of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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17
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Gong B, Wang Y, Zhang JA, Zhang Q, Zhao J, Li J, Wang X, Han Y, Yu Z, Zhang C, Peng B, Xing Y, Li Q, Wang P, Li Y, Teng W, Shan Z. Effects of altitude on thyroid disorders according to Chinese three-rung, ladder-like topography: national cross-sectional study. BMC Public Health 2024; 24:26. [PMID: 38167020 PMCID: PMC10762831 DOI: 10.1186/s12889-023-17569-5] [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] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Chinese topography appears a three-rung ladder-like distribution of decreasing elevation from northwest to southeast, which is divided by two sloping edges. Previous studies have reported that prevalence of thyroid diseases differed by altitude, and geographical factors were associated with thyroid disorders. To explore the association between three-rung ladder-like regions and thyroid disorders according to unique Chinese topographic features, we conducted an epidemiological cross-sectional study from 2015-2017 that covered all 31 mainland Chinese provinces. METHODS A total of 78,470 participants aged ≥ 18 years from a nationally representative cross-sectional study were included. Serum thyroid peroxidase antibody, thyroglobulin antibody, and thyroid-stimulating hormone levels; urine iodine concentration; and thyroid volume were measured. The three-rung ladder-like distribution of decreasing elevation from northwest to southeast in China was categorized into three topographic groups according to elevation: first ladder, > 3000 m above sea level; second ladder, descending from 3000-500 m; and third ladder, descending from 500 m to sea level. The third ladder was further divided into groups A (500-100 m) and B (< 100 m). Associations between geographic factors and thyroid disorders were assessed using linear and binary logistic regression analyses. RESULTS Participants in the first ladder group were associated with lower thyroid peroxidase (β = -4.69; P = 0.00), thyroglobulin antibody levels (β = -11.08; P = 0.01), and the largest thyroid volume (β = 1.74; P = 0.00), compared with the other groups. The second ladder group was associated with autoimmune thyroiditis (odds ratio = 1.30, 95% confidence interval [1.18-1.43]) and subclinical hypothyroidism (odds ratio = 0.61, 95%confidence interval [0.57-0.66]) (P < 0.05) compared with the first ladder group. Group A (third ladder) (500-100 m) was associated with thyroid nodules and subclinical hypothyroidism (P < 0.05). Furthermore, group B (< 100 m) was positively associated with autoimmune thyroiditis, thyroid peroxidase and thyroglobulin antibody positivity, and negatively associated with overt hypothyroidism, subclinical hypothyroidism, and goiter compared with the first ladder group(P < 0.05). CONCLUSION We are the first to investigate the association between different ladder regions and thyroid disorders according to unique Chinese topographic features. The prevalence of thyroid disorders varied among the three-rung ladder-like topography groups in China, with the exception of overt hyperthyroidism.
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Affiliation(s)
- Boshen Gong
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Youmin Wang
- Department of Endocrinology, The First People's Hospital of An-Hui Medical University, Hefei, Anhui, 230000, P. R. China
| | - Jin-An Zhang
- Department of Endocrinology, Shanghai University of Medicine & Health Science Affiliated Zhoupu Hospital, Shanghai, 201318, P. R. China
| | - Qiao Zhang
- Department of Endocrinology and Metabolism, Guiqian International General Hospital, Guiyang, Guizhou, 550004, P. R. China
| | - Jiajun Zhao
- Department of Endocrinology, Hospital Affiliated With Shandong University, Jinan, Shandong, 250012, P. R. China
| | - Jiashu Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Xichang Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yutong Han
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ziwei Yu
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Chenyu Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Bingcong Peng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yumin Xing
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Qiuxian Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Ping Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Yongze Li
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
| | - Zhongyan Shan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Diseases, The First Affiliated Hospital of China Medical University, No. 155, Nanjing Bei Street, Shenyang, Liaoning Province, 110001, P. R. China.
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Ashrafi S, Hatami H, Bidhendi-Yarandi R, Panahi MH. The prevalence of thyroid disorders in COVID-19 patients: a systematic review and meta-analysis. BMC Endocr Disord 2024; 24:5. [PMID: 38166835 PMCID: PMC10759498 DOI: 10.1186/s12902-023-01534-9] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES To conduct a systematic review and meta-analysis to evaluate the prevalence of thyroid disorders in COVID-19 patients. DATA SOURCES Scopus, PubMed, ISI Web of Science, and Google Scholar databases were used in this review. We also consider the results of grey literature. STUDY SELECTIONS Cohort, cross-sectional, and case-control studies were included. DATA EXTRACTION AND SYNTHESIS The required data were extracted by the first author of the article and reviewed by the second author. The Pooled prevalence of outcomes of interest was applied using the meta-prop method with a pooled estimate after Freeman-Tukey Double Arcsine Transformation to stabilize the variances. OUTCOMES AND MEASURED The different thyroid disorders were the main outcomes of this study. The diseases include non-thyroidal illness syndrome, thyrotoxicosis, hypothyroidism, isolated elevated free T4, and isolated low free T4. RESULTS Eight articles were included in our meta-analysis(Total participants: 1654). The pooled prevalence of events hypothyroidism, isolated elevated FT4, isolated low FT4, NTIS, and thyrotoxicosis were estimated (Pooled P = 3%, 95% CI:2-5%, I2: 78%), (Pooled P = 2%, 95% CI: 0-4%, I2: 66%), (Pooled P = 1%, 95% CI: 0-1%, I2: 0%), (Pooled P = 26%, 95% CI: 10-42%, I2: 98%), and (Pooled P = 10%, 95% CI: 4-16%, I2: 89%), respectively. CONCLUSION Thyroid dysfunction is common in COVID-19 patients, with a high prevalence of non-thyroidal illness syndrome (NTIS) and thyrotoxicosis. Our meta-analysis found a 26% prevalence of NTIS and a 10% prevalence of thyrotoxicosis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022312601.
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Affiliation(s)
- Sadra Ashrafi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Hatami
- Department of Public Health, School of Public Health & Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Bidhendi-Yarandi
- Department of Biostatistics and Epidemiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Hossein Panahi
- Safety Promotion and Injury Prevention Research Center, Research Institute for Health Sciences and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Fernandes LDC, Arruda ACBB, Baeninger LG, Almeida DP, Villagelin D. Thyroid abnormality in patients with psoriasis: prevalence and association with severity. An Bras Dermatol 2024; 99:80-89. [PMID: 37598033 DOI: 10.1016/j.abd.2022.12.007] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/07/2022] [Accepted: 12/26/2022] [Indexed: 08/21/2023] Open
Abstract
BACKGROUND Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized. OBJECTIVE To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control. METHODS In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests - thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity - Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review. RESULTS Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p=0.8), presence of psoriatic arthritis (p=0.87), or use of immunobiological therapy (p=0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p<0.0001). STUDY LIMITATIONS Absence of a control group from the same center. CONCLUSION This was one of the first Brazilian studies on the prevalence of thyroid abnormality in patients with psoriasis.
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Affiliation(s)
| | | | - Lisa Gava Baeninger
- Department of Dermatology, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
| | - Debora Pedroso Almeida
- Department of Dermatology, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
| | - Danilo Villagelin
- Department of Internal Medicine, Universidade Estadual de Campinas, Campinas, SP, Brazil; Department of Endocrinology and Metabology, Hospital da Pontifícia Universidade Católica de Campinas, Campinas, SP, Brazil
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20
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Zhang X, Wang X, Hu H, Xu Y, Zhang J, Wang Z, Wei R, Li Q. Prevalence of self-reported thyroid disease among adults with depression. J Psychosom Res 2024; 176:111557. [PMID: 38056108 DOI: 10.1016/j.jpsychores.2023.111557] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/29/2023] [Accepted: 11/25/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Thyroid disorders are a common comorbidity in patients with depression, yet there is limited information available about the clinical epidemiology of thyroid diseases in this specific population. This study aims to describe the prevalence of thyroid disease among US adults with depression from 2007 to 2018. METHODS This cross-sectional study used nationally representative data collected through the National Health and Nutrition Examination Survey (NHANES) between January 1, 2007, to December 31, 2018. Age-standardized prevalence of thyroid disease among depressed patients was calculated within 4-year survey periods (2007-2010, 2011-2014, and 2015-2018), and adjusted to the 2000 U.S. standard population. RESULTS In our weighed sample, 6.1% of depressed individuals and 4.3% of non-depressed individuals reported thyroid disease between 2007 and 2018 (P < 0.0001). The age-standardized prevalence of thyroid disease in patients with depression increased over time, from 5.4% (95%CI, 4.6%-6.2%) in 2007-2010 to 6.8% (95%CI, 5.8%-8.0%) in 2015-2018 (P for trend = 0.0270). Furthermore, thyroid disease prevalence was highest in non-Hispanic white individuals, increased with age, and tended to be higher in women. Mean depression scores in patients with thyroid disease (9.1; 95%CI, 8.7-9.5) did not significantly different from those without thyroid disease (9.1; 95%CI, 9.0-9.3) (P = 0.96). CONCLUSION The age-standardized prevalence of thyroid disease among US adults with depression exhibited a consistent increase from 2007 to 2018, with the highest rate occurring in older, non-Hispanic white individuals, and women.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Huanrong Hu
- Jiangxi Provincial People's Hospital, the First Affiliated Hospital of Nanchang Medical College, Jiangxi, China; The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Yuying Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiwei Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zongxue Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rui Wei
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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21
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Xue Q, Ma Y, Li X, Deng L, Wang J. Low triiodothyronine syndrome and depression: a cross-sectional study in the elderly based on comprehensive geriatric assessment. Endokrynol Pol 2024; 75:42-50. [PMID: 38497389 DOI: 10.5603/ep.97956] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 12/03/2023] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Thyroid diseases such as low triiodothyronine syndrome (LT3S) are more common in the elderly population. Comprehensive geriatric assessment (CGA) has been proposed as a supplementary tool for evaluating medical, functional, psychological, and frailty status and various geriatric syndromes. This study aimed to evaluate the impact of thyroid diseases on overall health status using a novel CGA strategy. MATERIAL AND METHODS 477 patients were enrolled between January 2019 and December 2022. A structured CGA was conducted by a multidisciplinary team to identify older high-risk patients. Multivariate regression was performed to assess independent factors associated with thyroid status and CGA. RESULTS The prevalence of abnormal thyroid hormone levels in the elderly was 34.2%. LT3S and anti-thyroglobulin antibody (anti-TgAb)-positivity or anti-thyroid peroxidase antibody (anti-TPOAb)-positivity were the main manifestations of thyroid diseases in elderly patients. The patients with LT3S had a higher prevalence of diabetes (p = 0.023), were older (p = 0.000), more often female (p = 0.014), with higher C-reactive protein (p = 0.001), and with lower body mass index (BMI) (p = 0.002), albumin (Alb) (p = 0.000), and haemoglobin (Hb) (p = 0.000) than patients with normal thyroid function. The CGA results showed higher rates of malnutrition and depression in patients with LT3S. Further multivariate logistic regression analysis showed that Hb [odds ratio (OR): 0.975; 95% confidence interval (CI): 0.959-0.990; p = 0.002] and LT3S (OR: 2.213; 95% CI: 1.048-4.672; p = 0.037) were independently associated with depression. Female (OR: 0.393; 95% CI: 0.160-0.968; p = 0.042), Alb (OR: 0.892; 95% CI: 0.811-0.981; p = 0.018), Hb (OR, 0.964; 95% CI: 0.939-0.989; p = 0.006), and LT3S (OR: 3.749; 95% CI: 1.474-9.536; p = 0.006) were independently associated with malnutrition. CONCLUSIONS LT3S was closely related to depression and malnutrition. Physicians should be more concerned about elderly patients with LT3S for their physical and mental status. Regular thyroid function checks might help to detect depression earlier.
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Affiliation(s)
- Qian Xue
- Department of Gerontology, Peking University People's Hospital, Beijing, China
| | - Yanru Ma
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States
| | - Xia Li
- Department of Gerontology, Peking University People's Hospital, Beijing, China
| | - Lihua Deng
- Department of Gerontology, Peking University People's Hospital, Beijing, China
| | - Jingtong Wang
- Department of Gerontology, Peking University People's Hospital, Beijing, China.
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22
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Xiong J, Hu H, Huang Y, Zhang J, He J. Lack of associations between thyroid dysfunction and obstructive sleep apnea-hypopnea syndrome: A meta-analysis. Medicine (Baltimore) 2023; 102:e36531. [PMID: 38065875 PMCID: PMC10713133 DOI: 10.1097/md.0000000000036531] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a comprehensive syndrome with endocrine and metabolic complications. This review aims to explore the correlation between thyroid hormone levels and the severity of OSAHS in patients. METHODS The protocol for this meta-analysis has been registered on PROSPERO. Searches were carried out from the inception of the databases to July 18, 2023, utilizing 6 databases (PubMed, CNKI, EMBASE, Web of Science, Cochrane Library, China Biology Medicine, and Wanfang). Standardized mean difference (SMD) and correlation coefficients were used as the effect size measures. Additionally, random effects or fixed effects models were used for pooled analysis. Moreover, data were statistically evaluated with the help of STATA 11.0 and R 4.1.3. RESULTS This study included 23 articles that satisfied the pre-defined criteria. The prevalence of hypothyroidism and subclinical hypothyroidism in OSAHS patients was 6% and 8%, whereas hyperthyroidism had a prevalence of 2%. Moreover, thyroid hormone levels in OSAHS individuals exhibited no significant difference relative to healthy subjects. Subgroup analysis based on disease severity also established no significant changes in thyroid hormone levels between OSAHS individuals and controls. There was no significant correlation between the Apnea-Hypopnea Index (AHI) and free triiodothyronine (FT3), serum thyroid stimulating hormone (TSH), and free thyroxine (FT4) levels. CONCLUSION The prevalence of thyroid dysfunction is relatively low in OSAHS individuals. Thyroid hormone levels show no significant difference between OSAHS patients and healthy subjects. Furthermore, there is no significant correlation between AHI and serum TSH, FT3, and FT4 levels. Based on existing data, the relationship between OSAHS and thyroid function remains controversial, and further in-depth research is warranted to validate the connection and elucidate the underlying mechanisms.
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Affiliation(s)
- Juan Xiong
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Emergency Department, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Hongxia Hu
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Obstetrics, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Yuanyuan Huang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jiexi Zhang
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
| | - Jie He
- Clinical Medical College of Chengdu Medical College, Chengdu, Sichuan, China
- Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Chengdu Medical College, Chengdu, Sichuan, China
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Ghaemmaghami Z, Firoozbakhsh P, Gholami D, Khodabandelu S, Baay M, Alemzadeh-Ansari MJ, Mohebbi B, Hosseini Z, Boudagh S, Pouraliakbar H, Pasebani Y, Rafati A, Khalilpour E, Khalili Y, Arabian M, Maleki M, Bakhshandeh H, Sadeghipour P. Increased prevalence of thyroid dysfunction in Tehran - HAMRAH study. BMC Endocr Disord 2023; 23:270. [PMID: 38053115 DOI: 10.1186/s12902-023-01524-x] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/29/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND The aim of the current study is to assess the prevalence of different categories of thyroid dysfunction and their associated risk factors among the modern urban population of Tehran, the capital of Iran. METHODS The present investigation is a sub-study of the HAMRAH study, a population-based prospective study designed to assess the prevalence of traditional cardiovascular risk factors and their changes through a 10-year follow-up. 2228 (61% female) adults aged between 30 and 75 years old and with no overt cardiovascular diseases were selected through a multistage cluster randomized sampling. Blood levels of thyroid-stimulating hormone (TSH), thyroxin (T4), and triiodothyronine (T3) were measured with the aim of assessing the prevalence of abnormal thyroid function status among the modern urban Iranian population, and in order to report the total prevalence of participants with clinical hypo- or hyperthyroidism, the number of individuals taking thyroid-related drugs were added to the ones with overt thyroid dysfunction. A subgroup analysis was also performed to determine the associated risk factors of thyroid dysfunction. RESULTS The prevalence of thyroid dysfunction among the total population was 7% (95%CI: 5.9 - 8%) and 0.4% (95% CI: 0.1 - 0.6%) for subclinical and overt hypothyroidism, and 1.6% (95% CI: 1 - 2%) and 0.2% (95% CI: 0 - 0.3%) for subclinical and overt hyperthyroidism, respectively. Clinical thyroid dysfunction was detected in 10.3% of the study population (9.4% had clinical hypo- and 0.9% had clinical hyperthyroidism). In the subgroup analysis, thyroid dysfunction was significantly more prevalent among the female participants (P-value = 0.029). CONCLUSIONS In the current study, the prevalence of different categories of abnormal thyroid status, and also the rate of clinical hypo- and hyperthyroidism was assessed using the data collected from the first phase of the HAMRAH Study. In this study, we detected a higher prevalence of clinical and subclinical hypothyroidism among the Iranian population compared to the previous studies.
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Affiliation(s)
- Zahra Ghaemmaghami
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Parisa Firoozbakhsh
- Cardio-Oncology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Delara Gholami
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Sajad Khodabandelu
- Department of Biostatistics and Epidemiology, Student Research Committee, School of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammadreza Baay
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran
| | - Mohammad Javad Alemzadeh-Ansari
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran
| | - Bahram Mohebbi
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran
| | - Zahra Hosseini
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran
| | - Shabnam Boudagh
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Tehran, Iran
| | - Hamidreza Pouraliakbar
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Yeganeh Pasebani
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Ali Rafati
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Ehsan Khalilpour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran
| | - Yasaman Khalili
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Maedeh Arabian
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Majid Maleki
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran
| | - Hooman Bakhshandeh
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Vali-Asr Ave, Tehran, 1995614331, Iran.
| | - Parham Sadeghipour
- Cardiovascular Intervention Research Center, Rajaie Cardiovascular Medical and Research Center, University of Medical Sciences, Vali-Asr Ave, 1995614331, Tehran, Iran.
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Lee KE, Oh HE, Kim SJ, Cho GJ, Oh MJ, Han SW, Lee SB, Shin JE. Association of maternal thyroid disease with obesity in child. Eur J Obstet Gynecol Reprod Biol 2023; 291:225-229. [PMID: 37924630 DOI: 10.1016/j.ejogrb.2023.10.031] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
OBJECTIVES During pregnancy, many women develop thyroid disorders, which can result in fetal and neonatal development defects. We investigated whether maternal thyroid dysfunction would affect their children's growth and obesity. STUDY DESIGN We conducted a nationwide population-based cohort study using a combination of data from several Korean nationwide registries to investigate the association between maternal thyroid dysfunction, offspring growth, and obesity. Childhood growth was repeatedly measured at three periods of age from 42 to 80 months, using body mass index (BMI). RESULTS A total of 1,123,499 women were enrolled in this study; 78,902 (7.0 %) had pre-pregnancy thyroid disease. Significant association was found between maternal hyperthyroidism and obesity in all children aged 42-66 months (42-54 months, adjusted odds ratio (aOR) 0.93, 95 % confidence interval (CI) 0.89-0.98; 54-66 months, aOR 0.93, 95 % CI 0.87-0.99), but not at later ages. In the analysis by sex, maternal hyperthyroidism was associated with childhood obesity in boys, whereas it was not associated with those in girls of any age. No association was observed between maternal hypothyroidism and child BMI or obesity. CONCLUSIONS The association between maternal thyroid function and obesity in offspring is attenuated from early to late childhood, suggesting that many other factors may be involved in developing childhood obesity.
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Affiliation(s)
- Kyung Eun Lee
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Ha Eun Oh
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Sa Jin Kim
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Geum Joon Cho
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea.
| | - Min-Jeong Oh
- Department of Obstetrics and Gynecology, College of Medicine, Korea University, Seoul, Korea.
| | - Sung Won Han
- School of Industrial Management Engineering, Korea University, Seoul, Korea.
| | - Soo Bin Lee
- School of Industrial Management Engineering, Korea University, Seoul, Korea.
| | - Jae Eun Shin
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Lee YJ, Kim MH, Lim DJ, Lee JM, Chang SA, Lee J. Exploring the Association between Thyroid Function and Frailty: Insights from Representative Korean Data. Endocrinol Metab (Seoul) 2023; 38:729-738. [PMID: 37915301 PMCID: PMC10764995 DOI: 10.3803/enm.2023.1769] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/13/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGRUOUND This study investigates the association between thyroid function and frailty in the old patients using representative data. METHODS The study was conducted using data from the Korea National Health and Nutrition Examination Survey conducted from 2013 to 2015. The study population included 2,416 participants aged 50 years and older with available thyroid function test data. Frailty assessment was performed using the Fried frailty phenotype. The prevalence of frailty was analyzed across different thyroid diseases and thyroid function parameters. RESULTS The significant association between thyroid dysfunction and frailty was observed in overt hyperthyroidism and subclinical hyperthyroidism. After adjusting for various factors, the association between thyroid dysfunction and frailty remained significant. On the other hand, overt hypothyroidism did not show a significant association with frailty in the adjusted analysis. For individuals with overt hyperthyroidism and subclinical hyperthyroidism, higher levels of free thyroxine (FT4) were significantly associated with an increased risk of frailty (aOR >999; 95% CI, >999 to 999). Among individuals with overt hypothyroidism, lower level of FT4 levels and high thyrotropin (TSH) levels showed a significant association with frailty risk (FT4: aOR, <0.01; TSH: aOR, 999). In participants with subclinical hypothyroidism, there were no significant associations between parameters for thyroid and frailty risk. CONCLUSION These findings suggest that thyroid dysfunction, particularly overt hyperthyroidism and subclinical hyperthyroidism, may be associated with an increased risk of frailty in the old patients.
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Affiliation(s)
- Youn-Ju Lee
- Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
- Medical Excellence Inc., Seoul, Korea
| | - Min-Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sang Ah Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Bambini F, Gatta E, D'Alessio R, Dondi F, Pignata G, Pirola I, Bertagna F, Cappelli C. Thyroid disease and autoimmunity in obese patients: a narrative review. Endokrynol Pol 2023; 74:VM/OJS/J/96255. [PMID: 37994585 DOI: 10.5603/ep.96255] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/18/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION The high prevalence of obesity and thyroid diseases worldwide justifies di per se their simultaneous coexistence. In recent decades, there has been a parallel and significant rise in obesity and thyroid diseases in industrialised countries, although the underlying mechanisms are complex and not well known. MATERIAL AND METHODS The authors accomplished a comprehensive literature search of original articles concerning obesity and thyroid status. Original papers exploring the association between these two morbidities in children and adults were included. RESULTS A total of 79 articles were included in the present analysis. A total of 12% of obese children (mean age 10.9 ± 1.4 years) showed a thyroid disease, and they were younger than healthy obese children (10.9 ± 1.2 vs. 11.0 ± 0.4 years, p < 0.001). Isolated hyperthyrotropinaemia was the most frequent finding in children (10.1%). Autoimmune thyroid disease was more frequent in puberal age. Thyroid antibodies and subclinical hypothyroidism were more frequent in obese that in non-obese patients (7% vs. 3%, p < 0.001; 10% vs. 6%, p < 0.001). Among obese adults, 62.2% displayed a thyroid disease; those affected were younger (35.3 ± 6.8 vs. 41.0 ± 1.9 years, p < 0.001), heavier [body mass index (BMI): 39.4 ± 6.3 vs. 36.1 ± 2.3 kg/m², p < 0.001], and more frequently female (13% vs. 8%, p < 0.001). The most frequent disease was overt hypothyroidism (29.9%). BMI appears to be correlated with TSH levels in obese adults. Overt hypothyroidism was significantly more frequent in obese patients (7% vs. 3%, p < 0.005), but no difference was found in thyroid antibodies (15% vs. 14%, p = 0.178). CONCLUSIONS An undeniable relationship between obesity and thyroid impairments exists. Isolated hyperthyrotropinaemia is frequently seen in obese children, often followed by spontaneous resolution. Subclinical hypothyroidism should never be treated in children or adults with the aim of reducing body weight.
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Affiliation(s)
- Francesca Bambini
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy
| | - Elisa Gatta
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy
| | | | - Francesco Dondi
- Nuclear Medicine, University of Brescia, ASST Spedali Civili di Brescia, Italy
| | - Giusto Pignata
- Department of General Surgery 2, ASST Spedali Civili di Brescia, Italy
| | - Ilenia Pirola
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy
| | - Francesco Bertagna
- Nuclear Medicine, University of Brescia, ASST Spedali Civili di Brescia, Italy
| | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, SSD Endocrinologia, University of Brescia, Azienda Socio-Sanitaria Territoriale (ASST) Spedali Civili di Brescia, Brescia, Italy.
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Grigoriadis G, Koufakis T, Kotsa K. Epidemiological, Pathophysiological, and Clinical Considerations on the Interplay between Thyroid Disorders and Type 2 Diabetes Mellitus. Medicina (Kaunas) 2023; 59:2013. [PMID: 38004062 PMCID: PMC10673571 DOI: 10.3390/medicina59112013] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/12/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023]
Abstract
Thyroid disorders (TD) and diabetes mellitus (DM) are the two endocrinopathies with the highest prevalence in the general population that frequently coexist. Thyroid dysfunction is more common in people with type 2 diabetes mellitus (T2DM) compared to normoglycemic individuals. Untreated TD can impair glycemic control, increasing the risk of diabetes complications. Hyperinsulinemia can affect the morphology of the thyroid gland by promoting the proliferation of thyroid tissue and increasing the size of thyroid nodules. Metformin can confer benefits in both endocrinopathies, while other antidiabetics, such as sulfonylureas, can negatively affect thyroid function. Animal and human observational data suggest an increased risk of medullary thyroid carcinoma after treatment with glucagon-like peptide-1 receptor agonists. However, randomized trials have so far been reassuring. Furthermore, some observational studies suggest an association between thyroid cancer and T2DM, especially in women. This narrative review aims to shed light on the epidemiological, pathophysiological, and clinical aspects of the interplay between TD and T2DM. Taking into account the important clinical implications of the coexistence of T2DM and TD, proper screening and management strategies are needed for both endocrinopathies to ensure optimal patient care.
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Affiliation(s)
- Gregory Grigoriadis
- Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Theocharis Koufakis
- Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
| | - Kalliopi Kotsa
- Division of Endocrinology and Metabolism and Diabetes Center, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA University Hospital, 54636 Thessaloniki, Greece;
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28
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Garofalo V, Condorelli RA, Cannarella R, Aversa A, Calogero AE, La Vignera S. Relationship between Iron Deficiency and Thyroid Function: A Systematic Review and Meta-Analysis. Nutrients 2023; 15:4790. [PMID: 38004184 PMCID: PMC10675576 DOI: 10.3390/nu15224790] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/05/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
Objective: Iron deficiency (ID) is the most prevalent nutritional deficiency worldwide. Low levels of serum ferritin (SF) could affect the thyroid gland and its functioning. The purpose of this systematic review and meta-analysis is to summarize the main currently available evidence and analyze data on the relationship between ID and thyroid function. Methods: This study included all articles evaluating the relationship between ID and thyroid function. Quality assessment was performed using Cambridge Quality Checklists. The search strategy included the following combination of Medical Subjects Headings terms and keywords: "iron deficiency", "thyroid function", "thyroid disease", "thyroid dysfunction", and "hypothyroidism". A meta-analysis was performed to evaluate whether thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels differed between patients with ID and healthy controls without ID. For statistical comparison between cases and controls, the mean difference (MD) was calculated, and a subgroup analysis of pregnant and non-pregnant women was performed. Cochran's Q testing and heterogeneity indices (I2) were used to assess statistical heterogeneity. Sensitivity analysis and publication bias analyses were also performed, both qualitatively and quantitatively. Finally, a meta-regression analysis was performed to evaluate the correlation between serum TSH or FT4 levels and SF in the study population. Results: Ten cross-sectional studies were identified and reviewed. Patients with ID showed TSH (MD: -0.24 mIU/L; 95% CI -0.41, -0.07; I2 = 100%, p = 0.005), FT4 (MD: -1.18 pmol/L; 95% CI -1.43, -0.94; I2 = 99%, p < 0.000001), and FT3 (MD: -0.22 pmol/L; 95% CI -0.32, -0.12; I2 = 99%, p < 0.00001) levels that were significantly lower. Subgroup analysis confirmed significantly lower TSH, FT4, and FT3 levels in pregnant women. Non-pregnant women showed significantly lower serum FT4 and FT3 levels but no difference in TSH values. Meta-regression analysis showed that serum TSH and FT4 levels were positively correlated with SF levels. Our systematic review of the literature found that ID significantly increases the prevalence of thyroid autoantibody (anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies) positivity both individually and collectively. Conclusion: Studies currently published in the literature indicate a possible relationship between ID, thyroid function, and autoimmunity, especially in some patient groups. Data analysis shows that thyroid hormone levels are lower in patients with ID and, in particular, in pregnant women. Further studies are needed to understand the role played by iron in thyroid metabolism.
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Affiliation(s)
- Vincenzo Garofalo
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rosita A. Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
- Cleveland Clinic Foundation, Glickman Urological & Kidney Institute, Cleveland, OH 44195, USA
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy;
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy; (V.G.); (R.C.); (A.E.C.); (S.L.V.)
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29
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Kollerits E, Zsila Á, Matuszka B. Quality of life, social support, and adherence in female patients with thyroid disorders. BMC Womens Health 2023; 23:567. [PMID: 37919706 PMCID: PMC10623692 DOI: 10.1186/s12905-023-02718-0] [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] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 10/17/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND According to the 2010 European Health Interview Survey, 51% of women in Hungary have a chronic disease, and is among the poorest quartile in the EU countries. Thyroid diseases affected more than 650,000 women in 2021 based on a recent report by the Hungarian Central Statistical Office. Despite the high prevalence rates, quality of life in these patients is scarcely researched in Hungary. To fill this gap, this study aims to explore the associations of the quality of life of thyroid patients in Hungary with social support and adherence. METHODS A cross-sectional study was conducted via an online questionnaire. Data from 885 female Hungarian thyroid patients with pharmacological treatment (M = 35.6 years, SD = 10.7, age range: 18-73 years) were analyzed. Participants were divided into two patient groups based on the type of thyroid disorder: hypothyroidism (n = 824; 93.1%) and hyperthyroidism (n = 61; 6.9%). Group comparisons, correlations, and a mediation model were performed to explore differences between thyroid patients. RESULTS No differences were found between patients with different types of thyroid disorders in quality of life, adherence, and social support. Consistent, weak associations were found between quality of life and social support in both patient groups. Higher perceived social support partially explained the relationship between adherence and life quality in thyroid patients. CONCLUSIONS: No substantial differences were found between patients with different types of thyroid disease in mental well-being indicators. These patients are psychologically more vulnerable and need a socially supportive environment to recover, because higher adherence is associated with a better quality of life, and social support can facilitate this process.
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Affiliation(s)
- Eliza Kollerits
- ELTE Doctoral School of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary.
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary.
| | - Ágnes Zsila
- ELTE Institute of Psychology, Kazinczy u. 23-27, Budapest, 1075, Hungary
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
| | - Balázs Matuszka
- Institute of Psychology, Pázmány Péter Catholic University, Mikszáth Kálmán tér 1., Budapest, 1088, Hungary
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30
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Zhang X, Wang X, Hu H, Qu H, Xu Y, Li Q. Prevalence and Trends of Thyroid Disease Among Adults, 1999-2018. Endocr Pract 2023; 29:875-880. [PMID: 37619827 DOI: 10.1016/j.eprac.2023.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Thyroid disease is a prominent endocrine disorder, yet the clinical epidemiology of this condition remains unclear. This study aims to describe the recent trends in the prevalence of thyroid disease in US adults from 1999-2018. METHODS This cross-sectional study used nationally representative data collected through the National Health and Nutrition Examination Survey (NHANES) from January 1, 1999 to December 31, 2018. Patients with thyroid disease were defined as patients who reported having a thyroid disease and were on thyroid-related treatment. Age-standardized prevalence of thyroid disease was calculated within 4-year survey periods (1999-2002, 2003-2006, 2007-2010, 2011-2014, and 2015-2018). RESULTS During the NHANES 1999-2018, a total of 57 540 participants were examined. The age-standardized prevalence of thyroid disease was 5.05% (95% CI, 4.55%-5.60%) from 2015-2018, signifying a significant increase from the 1999-2002 period (P <.0002). However, prevalent thyroid disease remained steady between 2003 and 2014. The highest prevalence of thyroid disease was observed in non-Hispanic Whites (8.1%; 95% CI, 7.3%-9.0%), individuals aged ≥60 years (15.4%; 95% CI, 13.3%-17.8%), and tended to be higher in women (7.6%; 95% CI, 6.8%-8.5%). Multiple regression analysis revealed that age, women sex, non-Hispanic White and Mexican American, body mass index, higher education and incomes were independently associated with increased risks of thyroid disease. CONCLUSION The age-standardized prevalence of thyroid disease among US adults increased from 1999-2003, remained stable between 2003 and 2014, and then saw an increase from 2014-2018, with the highest rate observed among elders, women, and non-Hispanic Whites.
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Affiliation(s)
- Xuexue Zhang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Xujie Wang
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China; China Academy of Chinese Medical Sciences, Beijing, China
| | - Huanrong Hu
- Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Jiangxi, China; The First Affiliated Hospital of Nanchang University, Jiangxi, China
| | - Hua Qu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
| | - Yuying Xu
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qiuyan Li
- Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
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31
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Ruggeri RM, Spagnolo CC, Alibrandi A, Silvestris N, Cannavò S, Santarpia M. Predictors of thyroid adverse events during cancer immunotherapy: a real-life experience at a single center. J Endocrinol Invest 2023; 46:2399-2409. [PMID: 37076759 DOI: 10.1007/s40618-023-02096-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/07/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Thyroid dysfunction is among the most common immune-related adverse events (irAEs) of immune checkpoint inhibitors (ICIs) therapy. Data regarding potential predictors of the development of thyroid irAEs are still limited and sometimes conflicting. PATIENTS AND METHODS We assessed potential risk factors and clinical outcomes associated with the onset of thyroid irAEs in a cohort of patients with different types of cancer treated with ICIs at a single center. Clinical and biochemical data, including thyroid function tests and autoantibodies at baseline and during treatment, were collected, and the onset of thyroid irAEs was recorded. Patients with thyroid dysfunction and/or under levothyroxine therapy before starting ICI were excluded. RESULTS 110 patients (80 M, 30 F, aged 32-85 years; 56.4% non-small-cell lung cancer, 87% treated with anti-PD-1) with complete information were included in the study. Among them, 32 (29%) developed thyroid irAEs during ICIs therapy. Primary hypothyroidism was the most common irAEs, occurring in 31 patients (28.18% of the whole cohort), including 14 patients who experienced a transient thyrotoxicosis. About 60% of irAEs occurred within the first 8 weeks of therapy. At multivariate analysis, anti-thyroid autoantibodies positivity at baseline (OR 18.471, p = 0.022), a pre-existing (autoimmune and non-autoimmune) thyroid disorder (OR 16.307, p < 0.001), and a family history of thyroid diseases (OR = 9.287, p = 0.002) were independent predictors of the development of thyroid irAEs. CONCLUSION Our data confirm the high frequency of thyroid dysfunctions (mostly hypothyroidism) during ICIs, and provide data on valuable predictors of thyroid toxicities that may help clinicians in identifying patients at risk for developing irAEs.
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Affiliation(s)
- R M Ruggeri
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy.
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy.
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy.
- Endocrine Unit, Department of Clinical and Experimental Medicine, "Gaetano Martino" University Hospital, 98125, Messina, Italy.
| | - C C Spagnolo
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
| | - A Alibrandi
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
| | - N Silvestris
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
| | - S Cannavò
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
| | - M Santarpia
- Endocrinology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Medical Oncology Unit, Department of Human Pathology of Adulthood and Childhood DETEV "G. Barresi", University of Messina, Messina, Italy
- Unit of Statistical and Mathematical Sciences, Department of Economics, University of Messina, Messina, Italy
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Yan DE, Hu L, Shen YF, Lai XY, Zhang MY, Zhou M, Chen C, Liu MM, Wu LT, Liu LQ, Fan QW, Min WL, Wan SC, Zou F, Li J, Cai X, Lei SH, Xiong Y, Yang Y, Yu R, Gao WW, Zhang Y, Chen T. Iodine status and its association with prevalence of thyroid diseases in adults from Jiangxi Province, China. Endocrine 2023; 82:335-342. [PMID: 37308773 DOI: 10.1007/s12020-023-03413-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 11/29/2022] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Iodine is an essential element for the biosynthesis of thyroid-stimulating hormone (TSH). Both excessive and deficient iodine are major risk factors for thyroid diseases, including thyroid dysfunction, thyroid nodules, and thyroid autoimmunity (TAI). This study aimed to elucidate the relationship between iodine status and the prevalence of thyroid diseases through a national cross-sectional epidemiological survey in Jiangxi province (China). METHODS This population-based, cross-sectional study enrolled 2636 Chinese local inhabitants who aged over 18 years old from April to August in 2015. Physical examination was performed and biochemical indices, urinary iodine concentration (UIC), and TSH level were measured. The Chi-square test, nonparametric test, and 4 multivariate logistic regression models adjusted for risk factors were applied to analysis. Spearman correlation coefficients were calculated to investigate the relationship between iodine intake level and the prevalence of thyroid diseases. RESULTS The median UIC was 176.4 μg/L, and a significant difference was found in median UIC between men (182.45 μg/L) and women (169.25 μg/L) (P = 0.03). Among these study subjects, 14.4%, 44.5%, 26.1%, and 15.0% had deficient, adequate, more than adequate, and excessive iodine concentrations, respectively. The prevalence rates of hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, subclinical hypothyroidism, thyroid nodules, and TAI were 0.91%, 0.57%, 0.34% and 7.89%, 9.45%, and 12.7%, respectively. Significant differences were found in iodine status, waist circumstance, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), TSH, thyroid nodules, and TAI between men and women (P < 0.05). Compared with those with adequate UIC, subjects with excessive UIC had higher prevalence rates of thyroid dysfunction (odds ratio (OR) = 1.74, 95% confidence interval (CI): 1.40-2.54) and thyroid nodules (OR = 3.33, 95%CI 1.32-8.42). In addition, subjects with deficient and excessive UIC were at the higher risk of TAI compared with those with adequate UIC (OR = 1.68, 95%CI: 1.19-2.60; OR = 1.52, 95%CI: 1.04-2.96, respectively). UIC was positively correlated with the prevalence rates of thyroid nodules (r = -0.44, P < 0.01) and TAI (r = -0.055, P < 0.01). On the contrary, UIC was negatively correlated with the risk of thyroid dysfunction (r = -0.24, P > 0.05). CONCLUSION Adult inhabitants from Jiangxi province in the TIDE study were in the adequate iodine status. Excessive iodine status was noted as a risk factor for thyroid dysfunction and thyroid nodules. In addition, both iodine deficiency and excessive iodine were risk factors for TAI.
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Affiliation(s)
- Di-En Yan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Department of Endocrinology, Ji'an Central Hospital, Ji'an, 343000, Jiangxi, China
| | - Lei Hu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Yun-Feng Shen
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China.
| | - Xiao-Yang Lai
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China.
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China.
| | - Mei-Ying Zhang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Min Zhou
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Chao Chen
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Mei-Mei Liu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Li-Ting Wu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Li-Qun Liu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Qi-Wei Fan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Wen-Lan Min
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Si-Cong Wan
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Fang Zou
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Jing Li
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Xia Cai
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Shui-Hong Lei
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Yan Xiong
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Ya Yang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Rong Yu
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Wei-Wei Gao
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Ying Zhang
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
| | - Ting Chen
- Department of Endocrinology and Metabolism, the Second Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi, China
- Institute for the Study of Endocrinology and Metabolism in Jiangxi Province, Nanchang, 330006, Jiangxi, China
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Athanassiou L, Kostoglou-Athanassiou I, Kaiafa G, Tsakiridis P, Koukosias N, Mitsoulis S, Savopoulos C, Athanassiou P. Thyroid Disease and Systemic Lupus Erythematosus. Medicina (Kaunas) 2023; 59:1911. [PMID: 38003960 PMCID: PMC10673127 DOI: 10.3390/medicina59111911] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/23/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Thyroid disease has been associated with autoimmune disorders. As systemic lupus erythematosus (SLE) is a systemic autoimmune disease with diverse manifestations spanning across all organ systems, the relationship of SLE with thyroid disorders needs investigation. In particular, the relationship of SLE with autoimmune thyroid disease has attracted the interest of the research community. The aim was to evaluate the relationship of SLE with autoimmune thyroid disease. Materials and Methods: A cohort of 45 consecutive patients with a mean age of 47.97 years (range 21-79 years) and 45 age- and sex-matched controls were prospectively studied over a period of 12 months for the presence of thyroid disease and the prevalence of antithyroid antibodies. Results: Four patients (8.9%) were found to suffer from primary hypothyroidism, five (11.11%) from subclinical hypothyroidism and one (2.22%) from hyperthyroidism, whereas one (2.22%) of the controls had primary hypothyroidism and one (2.22%) had hyperthyroidism. Five patients (11.11%) had a thyroid hormone profile that was compatible with the presence of euthyroid sick syndrome. Thyroid peroxidase (TPOab) and thyroglobulin (Tgab) antibodies were detected in 20/45 and 15/45 of the SLE population and in 7/45 and 5/45 of the controls, respectively (p < 0.05, chi-square test). Conclusions: In conclusion, the incidence of clinical thyroid disease is greater amongst SLE patients than in a control population, and in a significant number of these patients, antithyroid antibodies are detectable. Thus, a subset of lupus patients appears to be predisposed to the development of thyroid disease, and this should be considered when evaluating patients with SLE.
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Affiliation(s)
- Lambros Athanassiou
- Department of Rheumatology, Asclepeion Hospital, Voula, 16673 Athens, Greece;
| | | | - Georgia Kaiafa
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (G.K.); (C.S.)
| | - Pavlos Tsakiridis
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Nikolaos Koukosias
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Spyridon Mitsoulis
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
| | - Christos Savopoulos
- First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece; (G.K.); (C.S.)
| | - Panagiotis Athanassiou
- Department of Rheumatology, St. Paul’s Hospital, 55134 Thessaloniki, Greece; (P.T.); (N.K.); (S.M.)
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Zhang Q, Jiao X, Lai X. Clinical Characters and Influence Factors of Immune Checkpoint Inhibitor-related Thyroid Dysfunction. J Clin Endocrinol Metab 2023; 108:2916-2923. [PMID: 37183427 PMCID: PMC10583978 DOI: 10.1210/clinem/dgad260] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/14/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
CONTEXT Explore the clinical characteristics and influencing factors of immune thyroid dysfunction (ITD) caused by immune checkpoint inhibitors (ICIs) in the treatment of malignant tumors. METHODS This was a retrospective study of cancer patients treated with ICIs between January 2019 and December 2021 at the Second Affiliated Hospital of Nanchang University. According to the occurrence of thyroid dysfunction, patients were divided into an ITD group and non-ITD group. We describe the clinical characteristics, autoantibody levels, and their impact on prognosis of patients with ICI-related ITD. RESULT A total of 560 cases meeting the criteria were included, with a median follow-up time of 11.0 months. The incidence of ITD was 50.7%. Baseline TSH levels (OR, 1.935/mcIU/L; 95% CI, 1.613-2.321; P < .001) and combination targeted therapy (OR, 2.101; 95% CI, 1.433-3.079; P < .001) were most strongly associated with the occurrence of ITD. The median time to ITD in patients receiving medication with ICIs was 73 (34.5-149) days. Of the 87 patients initially diagnosed with hyperthyroid ITD, 46 (52.9%) progressed to hypothyroidism over the course of the disease. Baseline anti-thyroglobulin antibody abnormalities were strongly associated with the occurrence of ITD (OR, 67.393; 95% CI, 5.637-805.656; P = .001). Overall survival was significantly lower in patients who did not develop ITD than in those who did (hazard ratio, 0.523; 95% CI, 0.599-0.97; P < .001). CONCLUSION The incidence of ICI-related ITD is high, and the course of the disease is rapidly changing, and thyroid function in patients treated with immunotherapy should be monitored to detect ITD and permit early intervention.
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Affiliation(s)
- Qin Zhang
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi 330006, Nanchang, China
| | - Xiaojuan Jiao
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi 330006, Nanchang, China
| | - Xiaoyang Lai
- Department of Metabolism and Endocrinology, The Second Affiliated Hospital of Nanchang University, Jiangxi 330006, Nanchang, China
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Abbas W, Elmugabil A, Hamdan HZ, Rayis DA, Adam I. Iron deficiency and thyroid dysfunction among sudanese women in first trimester of pregnancy: a cross-sectional study. BMC Endocr Disord 2023; 23:223. [PMID: 37833658 PMCID: PMC10571453 DOI: 10.1186/s12902-023-01487-z] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 10/11/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Pregnant women are more susceptible to iron deficiency (ID), and it can lead to several maternal and perinatal adverse effects. There are some published data on the effect of ID on thyroid function, but none of the studies were conducted in sub-Saharan African countries including Sudan. This study was conducted to investigate association between ID (ferritin < 15 µg/L) and thyroid functions [thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4)] among Sudanese women in the first trimester of pregnancy. METHOD A cross-sectional study was conducted in Saad Abuelela Maternity Hospital, Sudan. Obstetric/sociodemographic characteristics were gathered through questionnaires. Hemoglobin, serum ferritin, TSH, FT3, and FT4 were measured in all pregnant women. Continuous variables were compared with either independent sample t-test if they were normally distributed, or with Mann-Whitney U- test if they were not-normally distributed. Spearman correlations were performed between the continuous variables. RESULTS In total, 127 pregnant women with mean [standard deviation (SD)] age of 27.0 (5.5) years and gestational age of 10.5 (3.0) weeks, respectively, were enrolled in this study. Forty-seven (37.0%) of these 127 women had ID. While the median [interquartile range (IQR)] of the parity, TSH, and FT3 were not different between women with ID and women without ID, the median (IQR) of FT4 was significantly lower in women with ID compared with women without ID [1.020 (0.910‒1.120) vs. 1.095 (0.990‒1.217) pmol, P = 0.014]. Serum ferritin was inversely correlated with FT3, (r = -0.225, P = 0.011). There was no significant correlation between serum ferritin, TSH, and FT4. CONCLUSIONS Iron deficiency was common during the first trimester of pregnancy and was associated with thyroid dysfunctions. Therefore, ID should be evaluated to avoid thyroid dysfunction.
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Affiliation(s)
- Wisal Abbas
- Faculty of Medicine, Kordofan University, Elobeid, Sudan
| | | | - Hamdan Z Hamdan
- Department of Basic Medical Sciences, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, 51911, Saudi Arabia
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, Al-Neelain University, P.O. BOX 12702, Khartoum, Sudan
| | - Duria A Rayis
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Sharma VK, Niraula A, Tuladhar ET, Bhattarai A, Raut M, Dubey RK, Baidya S, Parajuli N. Autoimmune thyroid status in subclinical thyroid disorders in patients attending a tertiary care center in Nepal: a hospital-based cross-sectional study. BMC Endocr Disord 2023; 23:221. [PMID: 37821852 PMCID: PMC10566047 DOI: 10.1186/s12902-023-01480-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 10/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Thyroid dysfunction is the leading endocrine disorder worldwide. Iodine deficiency disorders, which were once the major etiology of thyroid dysfunctions, now have been succeeded by autoimmune thyroid diseases with the rise in aberrant salt ionization protocols. This study endeavors to access the level of thyroid autoantibodies viz. anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (TGA), and anti-thyroid stimulating hormone receptor (TRAb) in individuals with subnormal thyroid profiles. METHODS This hospital-based cross-sectional study was conducted at the Department of Clinical Biochemistry, Tribhuvan University for a period of six months. Using non-probability (purposive) sampling method, a total of 60 patients were enrolled with subnormal thyroid profiles to include the population who have not yet started medication. Thyroid hormones (free T3, free T4, TSH) and thyroid antibodies (anti-TPO, TGA, and TRAb) were measured. For non-parametric data, Chi-square test and Kruskal-Wallis test were used. Spearman's correlation was done to determine the association between variables. RESULTS Out of 60 participants, the majority of the population between 25 and 44 years were diagnosed with thyroid dysfunction with female preponderance. Among all, 40% (n = 24) had subclinical hyperthyroid states while, 60% (n = 36) had subclinical hypothyroid states, and 75% (n = 45) of the total exhibited positive thyroid antibodies. In subclinical hypothyroid patients with TSH above 10 µIU/ml, anti TPO (58.5%) and TGA (66.7%) positivity were highly prevalent. On the other hand, TRAb was exclusively positive in hyperthyroid condition (50% among the group) which is by far the first of its kind reported in Nepal. CONCLUSION The rise in autoimmune thyroid disease among the Nepalese population infers that addressing iodine deficiency simply through salt iodinization may not be adequate to deal with the rising burden of thyroid disorders, especially in iodine-depleted areas. Also, the increasing prevalence of thyroid autoantibodies positivity in subclinical hypothyroidism in the Nepalese population accounts for the arduous screening and monitoring of autoimmune thyroid disorders in Nepal.
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Affiliation(s)
- Vijay Kumar Sharma
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
| | - Apeksha Niraula
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Eans Tara Tuladhar
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Aseem Bhattarai
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Mithileshwer Raut
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Raju Kumar Dubey
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Sujata Baidya
- Department of Clinical Biochemistry, Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Naresh Parajuli
- Department of Internal Medicine (Endocrinology), Maharajgunj Medical Campus, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
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Zhang X, Zhou J, Xie Z, Li X, Hu J, He H, Li Z. Exploring blood metabolites and thyroid disorders: a bidirectional mendelian randomization study. Front Endocrinol (Lausanne) 2023; 14:1270336. [PMID: 37876541 PMCID: PMC10591305 DOI: 10.3389/fendo.2023.1270336] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/26/2023] [Indexed: 10/26/2023] Open
Abstract
Background Human blood metabolites have demonstrated close associations with thyroid disorders in observational studies. However, it's essential to determine whether these correlations imply causation. Mendelian Randomization (MR) offers a promising approach to investigate these patterns. Aims The primary aim of our investigation is to establish causality between blood metabolites and three thyroid disorders: TC, GD, and HT. Methods We employed a two-sample bidirectional MR analysis approach to assess the relationships between 452 blood metabolites and the three aforementioned thyroid disorders. Causal links were estimated using the IVW method, with sensitivity analyses conducted via MR-Egger, Weighted Median, and MR-PRESSO. We assessed potential heterogeneity and pleiotropy using MR-Egger intercept and Cochran's Q statistic. Additionally, we conducted pathway analysis to identify potential metabolic pathways. Results We found 46 metabolites that showed suggestive associations with thyroid disease risk, especially Aspartate (ORIVW=7.41; 95%CI: 1.51-36.27; PIVW=0.013) and C-glycosyltryptophan (ORIVW=0.04; 95%CI: 0.00-0.29; PIVW=0.001) impacted TC, Kynurenine (ORIVW=2.69; 95%CI: 1.08-6.66; PIVW=0.032) and 4-androsten-3beta,17beta-diol disulfate 2 (ORIVW=0.78; 95%CI: 0.48-0.91; PIVW=0.024) significantly impacted GD, and Alpha-ketoglutarate (ORIVW=46.89; 95%CI: 4.65-473.28; PIVW=0.001) and X-14189-leucylalanine (ORIVW=0.31; 95%CI: 0.15-0.64 PIVW=0.001) significantly impacted HT. We also detected 23 metabolites influenced by TC and GD. Multiple metabolic pathways have been found to be involved in thyroid disease. Conclusion Our MR findings suggest that the identified metabolites and pathways can serve as biomarkers for clinical thyroid disorder screening and prevention, while also providing new insights for future mechanistic exploration and drug target selection.
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Affiliation(s)
- Xuan Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Department of General Surgery, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Jiating Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Zilan Xie
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Jiaqing Hu
- Department of Emergency Medicine, Trauma Center, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Hengzheng He
- Department of General Surgery, The Second People’s Hospital of Hunan, Changsha, Hunan, China
| | - Zhi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China
- Institute of Clinical Pharmacology, Central South University, Changsha, Hunan, China
- Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, Changsha, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
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Yazdanifar MA, Bagherzadeh-Fard M, Habibi MA, Vahedian M, Bagherzadeh M, Masoumi M. The association between thyroid dysfunction, autoimmune thyroid disease, and rheumatoid arthritis disease severity. BMC Endocr Disord 2023; 23:212. [PMID: 37798692 PMCID: PMC10552414 DOI: 10.1186/s12902-023-01473-5] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 09/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Rheumatoid Arthritis (RA) and autoimmune thyroid disease (AITD) are the two most prevalent coexisting autoimmune diseases due to their similar pathogenesis. Considering the potential effect of AITD on the severity of RA disease, this study aimed to determine the association between thyroid dysfunction, anti-thyroid peroxidase (anti-TPO) positivity, AITD, and RA disease severity in the Iranian population. METHODS Three hundred and fifty RA patients who presented to Shahid Beheshti tertiary care center, Qom, Iran, were included in this cross-sectional study. The data were collected through the patient's medical records, interviews, physical examinations, and laboratory tests. The RA disease activity score in 28 joints for RA with erythrocyte sedimentation rate (DAS-28-ESR) was used to divide patients into three subgroups, remission (DAS-28-ESR ⩽ 2.6), mild-to-moderate (2.6 < DAS-28-ESR ⩽ 5.1), and severe disease activity (DAS-28-ESR > 5.1). RESULTS Using the aforementioned method, 111, 96, and 138 patients were put into remission, mild-to-moderate, and severe disease activity groups, respectively. Anti-TPO antibody positivity rate was 2.93 times more prevalent among patients with severe disease compared to the remission subgroup (OR: 2.93; P-value < 0.001). Patients suffering from a more severe disease were almost 2.7 times more probable to have AITD (OR = 2.71; P-value < 0.001) and they were 82% more likely to have thyroid dysfunction compared to patients in remission (OR = 1.82; P-value = 0.006). CONCLUSIONS It was demonstrated that thyroid dysfunction, anti-TPO antibody positivity, and AITD were significantly more common among RA patients with more severe disease activity.
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Affiliation(s)
| | | | | | - Mostafa Vahedian
- Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran
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van der Ham K, Stekelenburg KJ, Louwers YV, van Dorp W, Schreurs MWJ, van der Wal R, Steegers-Theunissen RPM, Laven JSE. The prevalence of thyroid dysfunction and hyperprolactinemia in women with PCOS. Front Endocrinol (Lausanne) 2023; 14:1245106. [PMID: 37854182 PMCID: PMC10579902 DOI: 10.3389/fendo.2023.1245106] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/05/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Ovulatory dysfunction is usually caused by an endocrine disorder, of which polycystic ovary syndrome (PCOS) is the most common cause. PCOS is usually associated with estrogen levels within the normal range and can be characterized by oligo-/anovulation resulting in decreased progesterone levels. It is suggested that decreased progesterone levels may lead to more autoimmune diseases in women with PCOS. In addition, it is often claimed that there is an association between hyperprolactinemia and PCOS. In this large well-phenotyped cohort of women with PCOS, we have studied the prevalence of thyroid dysfunction and hyperprolactinemia compared to controls, and compared this between the four PCOS phenotypes. Methods This retrospective cross-sectional study contains data of 1429 women with PCOS and 299 women without PCOS. Main outcome measures included thyroid stimulating hormone (TSH), Free Thyroxine (FT4), and anti-thyroid peroxidase antibodies (TPOab) levels in serum, the prevalence of thyroid diseases and hyperprolactinemia. Results The prevalence of thyroid disease in PCOS women was similar to that of controls (1.9% versus 2.7%; P = 0.39 for hypothyroidism and 0.5% versus 0%; P = 0.99 for hyperthyroidism). TSH levels were also similar (1.55 mIU/L versus 1.48 mIU/L; P = 0.54). FT4 levels were slightly elevated in the PCOS group, although within the normal range (18.1 pmol/L versus 17.7 pmol/L; P < 0.05). The prevalence of positive TPOab was similar in both groups (5.7% versus 8.7%; P = 0.12). The prevalence of hyperprolactinemia was similarly not increased in women with PCOS (1.3%% versus 3%; P = 0.05). In a subanalysis of 235 women with PCOS and 235 age- and BMI-matched controls, we found no differences in thyroid dysfunction or hyperprolactinemia. In according to differences between PCOS phenotypes, only the prevalence of subclinical hypothyroidism was significantly higher in phenotype B (6.3%, n = 6) compared to the other phenotypes. Conclusion Women with PCOS do not suffer from thyroid dysfunction more often than controls. Also, the prevalence of positive TPOab, being a marker for future risk of thyroid pathology, was similar in both groups. Furthermore, the prevalence of hyperprolactinemia was similar in women with PCOS compared to controls.
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Affiliation(s)
- Kim van der Ham
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Karlijn J. Stekelenburg
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Yvonne V. Louwers
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Wendy van Dorp
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Marco W. J. Schreurs
- Department of Immunology, Laboratory Medical Immunology, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Ronald van der Wal
- Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands
| | | | - Joop S. E. Laven
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Erasmus University Medical Centre, Rotterdam, Netherlands
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Wang Q, Lu X, Xu L, Liang H. Gender variations in the impact of hyperuricemia on thyroid disorders. Endocr Res 2023; 48:77-84. [PMID: 37382510 DOI: 10.1080/07435800.2023.2231092] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 06/23/2023] [Indexed: 06/30/2023]
Abstract
This study aimed to examine the impact of hyperuricemia on various thyroid disorders with emphasized focus on differences resulting from different genders. 16094 adults aged ≥18 years were enrolled in this cross-sectional study using a randomized stratified sampling strategy. Clinical data including thyroid function and antibodies, uric acid, and anthropometric measurements were measured. Multivariable logistic regression was used to determine the association between hyperuricemia and thyroid disorders. Women who have hyperuricemia are at a significantly increased risk of developing hyperthyroidism. Women's risk of overt hyperthyroidism and Graves' disease may be markedly increased by hyperuricemia. Men with hyperuricemia did not differ significantly in their chance of acquiring any thyroid disorders.
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Affiliation(s)
- Qiang Wang
- Medical Education Administrate Office, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, China
| | - Xixuan Lu
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Li Xu
- Department of Radiology, The 942th Hospital of the People's Liberation Army Joint Logistics Support Force, Yinchuan, China
| | - Haiyan Liang
- Department of Endocrinology, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University, Yinchuan, China
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Habib A, Ansari MM, Basra AA, Nazeer H, Ahmed A, Shaheen S. A case-control study to assess the association of Alopecia areata with thyroid dysfunction and thyroid Autoimmunity. J Ayub Med Coll Abbottabad 2023; 35:640-644. [PMID: 38406952 DOI: 10.55519/jamc-04-12361] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
BACKGROUND Several previous studies have suggested a positive association between Alopecia Areata and thyroid disorders. However, there is a paucity of such studies in our country. Our study aimed to know the frequency of thyroid dysfunction and thyroid autoimmunity in patients reporting to Dermatology Outdoors with Alopecia Areata (AA) and to compare it with normal controls. METHODS This was a Case-Control study conducted at the Dermatology outpatient of a tertiary care hospital in Pakistan. 102 patients with AA and 102 age and sex-matched controls were enrolled. The age of onset of the disease, the involved sites and the presence of other associated diseases were noted. Venous blood samples were taken from patients and controls for Thyroid function tests and Anti- Thyroid peroxidase antibodies (Anti-TPO Ab). The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. RESULTS The mean age of onset of the disease was 30.37±12.53. 91.2% of patients had the classic patch type of AA. The most commonly involved site was Scalp. Associated diseases were found in eight (7.8%) patients. Thyroid dysfunction was found in two patients and none of the Controls. Both the patients had Subclinical thyroid disease. The p-value was 0.157, which was not statistically significant. Thyroid autoimmunity (raised Anti-TPO Ab titre) was detected in five (4.90%) patients and none of the Controls. The p-value was 0.024, which was statistically significant. CONCLUSIONS AA is significantly associated with Thyroid autoimmunity but there is no significant association between AA and clinical or subclinical thyroid disease.
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Affiliation(s)
- Aamir Habib
- Department of Dermatology, Combined Military Hospital, Bahawalpur, Pakistan
| | | | - Arslan Ahmed Basra
- Department of Dermatology, Combined Military Hospital, Bahawalpur, Pakistan
| | - Hafsa Nazeer
- Department of Dermatology, Combined Military Hospital, Bahawalpur, Pakistan
| | - Asfa Ahmed
- Department of Dermatology, Combined Military Hospital, Bahawalpur, Pakistan
| | - Sohail Shaheen
- Department of Dermatology, Combined Military Hospital, Bahawalpur, Pakistan
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Ettleson MD. Cardiovascular outcomes in subclinical thyroid disease: an update. Curr Opin Endocrinol Diabetes Obes 2023; 30:218-224. [PMID: 37288727 PMCID: PMC10527066 DOI: 10.1097/med.0000000000000818] [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] [Indexed: 06/09/2023]
Abstract
PURPOSE OF REVIEW Subclinical thyroid disease is defined by a thyroid stimulating hormone (TSH) level outside of the normal range with normal circulating thyroid hormone levels. Excess adverse cardiovascular outcomes have been observed in certain patient populations with subclinical hypothyroidism (SCH) and hyperthyroidism (SCHr). The role of thyroid hormone and antithyroid treatments for subclinical thyroid disease remains debated. RECENT FINDINGS Cardiovascular disease appears to be a major mediator of all-cause mortality in patients with SCH, in particular those aged at least 60 years of age. In contrast, pooled clinical trial results did not find that levothyroxine reduced the incidence of cardiovascular events or mortality in this patient population. The association between SCHr and atrial fibrillation is well established; however, a 5-year follow-up of older patients with mild (TSH 0.1-0.4 mIU/l) SCHr found no increased incidence of atrial fibrillation. Separately, SCHr was associated with derangements in endothelial progenitor cell function that may underlie vascular disease independent from effects on cardiac function. SUMMARY The impact of treatment of subclinical thyroid disease on cardiovascular outcomes remains uncertain. Additional prospective and trial data are needed to evaluate treatment effects on cardiovascular outcomes in younger populations.
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Affiliation(s)
- Matthew D. Ettleson
- University of Chicago, Section of Endocrinology, Diabetes, and Metabolism, Chicago, IL
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Yilmaz D, Baykan O, Baykan H. The frequency of thyroid dysfunction in patients with a diagnosis of depressive disorder. Niger J Clin Pract 2023; 26:1575-1578. [PMID: 37929538 DOI: 10.4103/njcp.njcp_72_23] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Objective Thyroid dysfunctions are among the most common endocrine disorders in society. An increase or decrease in thyroid hormone levels may present with neurological and/or psychiatric symptoms. In this study, we aimed both to determine the prevalence of this disorder in our region by determining the frequency of thyroid dysfunction in patients diagnosed with major depressive disorder in our outpatient clinic and to raise awareness during the evaluation process of patients. Material and Method Thyroid-stimulating hormone (TSH) levels of 1035 patients diagnosed with major depressive disorder in our hospital between January 2020 and January 2022 were retrospectively scanned from the hospital information management system and those outside the reference ranges (0.38-5.33 mIU/L) were determined. Results It was observed that TSH was not within the reference ranges in approximately 7% of the patients diagnosed with depressive disorder. 1035 patients were included in the study. When the blood results of 1035 patients included in the study were examined retrospectively, 32 of them had TSH values below 0.38 mIU/L. TSH value was found to be above 5.33 mIU/L in 44 of them. Conclusion Obtained data have shown that thyroid dysfunctions can be encountered frequently in patients presenting with depressive complaints. It is thought that the evaluation of patients with depressive complaints in terms of thyroid dysfunction, and the treatment of the underlying thyroid dysfunction will contribute to the regression of psychiatric symptoms.
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Affiliation(s)
- D Yilmaz
- Mental Health and Diseases, Balikesir University, Faculty of Medicine, Balikesir, Turkey
| | - O Baykan
- Department of Medical Biochemistry, Balikesir University, Faculty of Medicine, Balikesir, Turkey
| | - H Baykan
- Mental Health and Diseases, Balikesir University, Faculty of Medicine, Balikesir, Turkey
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Kazakou P, Tzanetakos D, Vakrakou AG, Tzartos JS, Evangelopoulos ΜE, Anagnostouli M, Stathopoulos P, Kassi GN, Stefanis L, Kilidireas C, Zapanti E. Thyroid autoimmunity following alemtuzumab treatment in multiple sclerosis patients: a prospective study. Clin Exp Med 2023; 23:2885-2894. [PMID: 36641771 PMCID: PMC10543528 DOI: 10.1007/s10238-022-00981-3] [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] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/20/2022] [Indexed: 01/16/2023]
Abstract
Autoimmune thyroid disease (AITD) is the most common adverse effect in alemtuzumab (ALZ) treated relapsing-remitting (RR) multiple sclerosis (MS) patients. The objective of this prospective study was to analyze the occurrence, timing of onset, clinical course, and laboratory characteristics of AITD post-ALZ. We evaluated 35 RRMS patients treated with ALZ at a single academic MS center; clinical and laboratory data were collected before ALZ initiation and thereafter quarterly on follow-up with a median of 43.5 months. Seventeen out of 31 patients (54.8%) with no prior history of thyroid dysfunction developed AITD with a mean onset of 19.4 months ± 10.2 (SD) after the first ALZ cycle; Graves' disease (GD) (n = 9); hypothyroidism with positive stimulating thyrotropin receptor antibodies (TRAb) (n = 1); Hashimoto thyroiditis (HT) (n = 6); HT with hypothyroidism (n = 1). Interestingly, seven of nine (77.7%) GD patients showed a fluctuating course. Three out of four patients with preexisting thyroid disease remained stable, whereas one with prior HT and hypothyroidism developed fluctuating GD. All patients with GD commenced antithyroid drugs (ATDs); five continued on "block and replace" treatment; one required radioactive iodine, and one total thyroidectomy. Our analysis showed earlier onset of ALZ-induced AITD in comparison to most other ALZ cohorts; overall, these patients required complex therapeutic approaches of the AITD. We observed a higher rate of fluctuating GD, with earlier onset and lower remission rate than previously reported, which in the majority of patients required prolonged "block and replace" therapy in the minimum dose of each therapeutic agent or more definitive interventions.
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Affiliation(s)
- Paraskevi Kazakou
- Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, Alexandra Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
| | - Dimitrios Tzanetakos
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece.
| | - Aigli G Vakrakou
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - John S Tzartos
- Second Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, Greece
| | - Μaria-Eleptheria Evangelopoulos
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Anagnostouli
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Panos Stathopoulos
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia N Kassi
- Department of Endocrinology, Alexandra Hospital, Athens, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Kilidireas
- Multiple Sclerosis & Demyelinating Diseases Unit, 1st Department of Neurology, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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Tena Vivó G, Parellada Esquius N, Cunillera Puértolas O, Albareda Riera M, Isidro Albaladejo M, Vila Ballester L. Description of thyroid disorders the year before conception: a population-based study. Front Endocrinol (Lausanne) 2023; 14:1236505. [PMID: 37818089 PMCID: PMC10561644 DOI: 10.3389/fendo.2023.1236505] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/14/2023] [Indexed: 10/12/2023] Open
Abstract
Objective This study aimed to monitoring the prevalence of previously identified thyroid disorders and hypothyroidism monitoring before pregnancy. Material and methods A retrospective cross-sectional study of women whose pregnancies occurred between 2014 and 2016 was conducted, including 120,763 pregnancies in Catalonia (Spain). The presence of thyroid disorders in women was based on disease diagnostic codes and/or prescription of levothyroxine or antithyroid drugs. To evaluate the thyroid disorder diagnosis and monitoring, thyrotropin (TSH), free T4 (FT4), antiperoxidase antibody (TPOAb), and anti-TSH receptor antibody (TRAb) records were gathered and categorised according to the reference values of each laboratory. Results The prevalence of recorded thyroid disorders before the last menstrual period was 5.09% for hypothyroidism and 0.64% for hyperthyroidism,showing a significant increase with age. A thyroid monitoring test was not performed in the year before the last menstrual period in approximately 40% of women with a known thyroid disorder. Amongst the women with hypothyroidism who underwent a TSH test, 31.75% showed an above-normal result. Amongst women previously unknown to have thyroid disorders, 3.12% had elevated TSH levels and 0.73% had low TSH levels. Conclusion A high percentage of Catalan women with a known thyroid disorder were not properly monitored during the year before pregnancy. Amongst those monitored, more than one-third had TSH values outside the reference range. Therefore, it is important to evaluate women with thyroid disorders during pre-pregnancy visits.
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Affiliation(s)
- Glòria Tena Vivó
- Hospital de Viladecans, Obstetrics & Gynecology Viladecans, Barcelona, Spain
| | - Neus Parellada Esquius
- Institut Català de la Salut Gerència Territorial Metropolitana Sud, Epidemiology and Research, L'Hospitalet de Llobregat, Catalunya, Spain
| | - Oriol Cunillera Puértolas
- Unitat de Suport a la Recerca Metropolitana Sud, Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina, l'Hospitalet de Llobregat, Catalunya, Spain
| | - Mercè Albareda Riera
- Endocrinology and Nutrition Division, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain
| | - Mónica Isidro Albaladejo
- Institut Catalá de la Salut (ICS), Sexual and Reproductive Primary Health Care, Sant Boi de Llobregat, Spain
| | - Lluís Vila Ballester
- Endocrinology and Nutrition Division, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain
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Zhang L, Du Y, Zhou J, Li J, Shen H, Liu Y, Liu C, Qiao C. Diagnostic workup of endocrine dysfunction in recurrent pregnancy loss: a cross-sectional study in Northeast China. Front Endocrinol (Lausanne) 2023; 14:1215469. [PMID: 37795359 PMCID: PMC10545878 DOI: 10.3389/fendo.2023.1215469] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023] Open
Abstract
Objective To evaluate the prevalence of abnormal endocrine dysfunction for recurrent pregnancy loss (RPL) amongst patients with two versus three or more pregnancy losses. Methods This cross-sectional study retrospectively collected pre-pregnancy data of 537 women diagnosed with RPL in Shengjing Hospital of China Medical University from 2017 to 2022, including the baseline data of patients and the test results of endocrine factors. Several endocrine dysfunction included in this study were: thyroid dysfunction, obesity, hyperprolactinemia, polycystic ovary syndrome and blood glucose abnormality. Furthermore, vitamin D level were collected to study its relationship with endocrine dysfunction. Finally, we subdivided the patients according to the number of previous pregnancy loss and compared the prevalence of endocrine dysfunction between subgroups. Results Among 537 RPL patients, 278 (51.8%) patients had abnormal endocrine test results. The highest incidence of endocrine dysfunction was thyroid dysfunction (24.39%, 131/537), followed by hyperprolactinemia (17.34%, 85/490), obesity (10.8%, 58/537), polycystic ovary syndrome (10.50%, 56/533), and abnormal blood glucose (5.29%, 27/510). Only 2.47%(13/527) of patients have vitamin D level that reach the standard. After subdividing the population according to the number of pregnancy loss, we did not find that the incidence of endocrine dysfunction (P=0.813), thyroid dysfunction (P=0.905), hyperprolactinemia (P=0.265), polycystic ovary syndrome (P=0.638), blood glucose abnormality (P=0.616) and vitamin D deficiency (P=0.908) were different among patients with two versus three or more pregnancy losses. However, obesity (P=0.003) was found more frequently observed in patients with more times of pregnancy loss. Conclusion The prevalence of endocrine dysfunction in RPL population is high. There is no difference in the prevalence of endocrine dysfunction, except for obesity, among patients with two or more pregnancy losses, which may suggest investigations of endocrine dysfunction when patients have two pregnancy losses.
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Affiliation(s)
| | | | | | | | | | | | | | - Chong Qiao
- Obstetrics and Gynaecology Department, Shengjing Hospital of China Medical University, Shenyang, China
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Zhou X, Iwama S, Kobayashi T, Ando M, Arima H. Risk of Thyroid Dysfunction in PD-1 Blockade Is Stratified by the Pattern of TgAb and TPOAb Positivity at Baseline. J Clin Endocrinol Metab 2023; 108:e1056-e1062. [PMID: 37084392 DOI: 10.1210/clinem/dgad231] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/01/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
CONTEXT Positive antithyroglobulin (TgAb) and/or antithyroid peroxidase antibodies (TPOAb) at baseline indicate a high risk of thyroid immune-related adverse events (irAEs) induced by antiprogrammed cell death-1 antibodies (anti-PD-1-Ab). However, whether the positivity patterns of both antibodies are associated with the risk of thyroid irAEs is unknown. OBJECTIVE The aim of the present study was to clarify the association of the pattern of TgAb and TPOAb positivity at baseline with the risk of thyroid irAEs induced by anti-PD-1-Ab. METHODS Patients (n = 516) were evaluated for TgAb and TPOAb at baseline and prospectively for thyroid function every 6 weeks for 24 weeks after initiating anti-PD-1-Ab. RESULTS Fifty-one (9.9%) patients developed thyroid irAEs (thyrotoxicosis in 34, hypothyroidism without prior thyrotoxicosis in 17). Twenty-five patients subsequently developed hypothyroidism following thyrotoxicosis. The cumulative incidence of thyroid irAEs differed among 4 groups classified by the presence of TgAb/TPOAb at baseline (group 1: TgAb-(-)/TPOAb-(-), 4.6% [19/415]; group 2: TgAb-(-)/TPOAb-(+), 15.8% [9/57]; group 3: TgAb-(+)/TPOAb-(-), 42.1% [8/19]; group 4: TgAb-(+)/TPOAb-(+), 60.0% [15/25]) as follows: groups 1 vs 2-4 (P ≤ .001) and groups 2 vs 3 (P = .008) and 4 (P < .001). There were different incidences of thyrotoxicosis (groups 1-4, 3.1%, 5.3%, 31.6%, 48.0%, respectively; P < .001) in groups 1 vs 3 and 4, and groups 2 vs 3 and 4, and of hypothyroidism (groups 1-4: 2.9%, 15.8%, 31.6%, 60.0%, respectively; P < .001) in groups 1 vs 2 to 4, and groups 2 vs 4. CONCLUSION The risk of thyroid irAEs was affected by the pattern of TgAb and TPOAb positivity at baseline; there were high risks of thyrotoxicosis in patients with TgAb-(+) and of hypothyroidism in patients with TgAb-(+) and those with TPOAb-(+).
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Affiliation(s)
- Xin Zhou
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8550, Japan
| | - Shintaro Iwama
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8550, Japan
| | - Tomoko Kobayashi
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8550, Japan
| | - Masahiko Ando
- Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Showa-ku, Nagoya 466-8550, Japan
| | - Hiroshi Arima
- Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Showa-ku, Nagoya 466-8550, Japan
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Légeret C, Kutz A, Jessica B, Mundwiler E, Köhler H, Bernasconi L. Prevalence of markers of beta cell autoimmunity and thyroid disease in children with coeliac disease. BMC Pediatr 2023; 23:468. [PMID: 37716983 PMCID: PMC10504759 DOI: 10.1186/s12887-023-04294-6] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Over the last decades, the prevalence of coeliac disease (CD), an autoimmune disorder, rose to 1-2%. Whether patients with CD have higher risk of developing other autoimmune disorders such as type 1 diabetes, Hashimoto thyroiditis, or Graves` disease remains unclear. AIM The aim of this study was to determine the prevalence of biomarkers of beta cell and thyroid autoimmunity in children with CD. METHODS Retrospective cross-sectional cohort study comparing pediatric patients suffering from CD with age and sex-matched healthy controls (HC). Participant`s serum was tested by immunoassay for following autoantibodies (aAb): TSH-receptor antibodies (TRAb), anti-thyroglobulin (anti-Tg), anti-thyroid peroxidase (anti-TPO), anti-glutamic acid decarboxylase (anti-GAD), anti-zinc transporter 8 (anti-ZnT8), anti-islet antigen 2 (anti-IA2) and anti-insulin. RESULTS A total of 95 patients with CD (mean age 8.9 years; 63% female) and 199 matched healthy controls (mean age 9.2 years; 59.8% female) were included in the study. For patients with CD, a seroprevalence of 2.1% (vs. 1.5% in HC) was calculated for anti-GAD, 1.1% for anti-IA2 (vs. 1.5% in HC), 3.2% for anti-ZnT8 (vs. 4.2% in HC), and 1.1% (vs. 1% in HC) for anti-insulin. For thyroid disease, a seroprevalence of 2.2% for TRAb (vs. 1% in HC), 0% for anti-TPO (vs. 2.5% in HC) and 4.3% for anti-Tg (vs. 3.5% in HC) was found for patients with CD. CONCLUSION This study suggests a higher prevalence of autoimmune antibodies againstthyroid in children with CD compared to HC, whilst it is similar for pancreatic antibodies. Prospective cohort studies are needed to first evaluate the occurrence of autoimmune antibodies against beta cells and thyroid over a longer follow-up time and second to explore their clinical relevance.
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Affiliation(s)
- Corinne Légeret
- Medical Faculty, University Children's Hospital Basel, Spitalstrasse 33, Basel, 4056, Switzerland.
| | - Alexander Kutz
- Division of Pharmacoepidemioloy and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Suite 3030, Boston, 02120, MA, USA
- Medical University Department, Division of General Internal and Emergency Medicine, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Brunner Jessica
- Institute of Laboratory Medicine, Kantonsspital Aarau AG, Tellstrasse 25, Aarau, 5001, Switzerland
| | - Esther Mundwiler
- Institute of Laboratory Medicine, Kantonsspital Aarau AG, Tellstrasse 25, Aarau, 5001, Switzerland
| | - Henrik Köhler
- Medical Faculty, University Children's Hospital Basel, Spitalstrasse 33, Basel, 4056, Switzerland
- Children's Hospital Aarau, Kantonsspital Aarau AG, Tellstrasse 25, Aarau, 5001, Switzerland
| | - Luca Bernasconi
- Institute of Laboratory Medicine, Kantonsspital Aarau AG, Tellstrasse 25, Aarau, 5001, Switzerland
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Lee F, Gallo MV, Schell LM, Jennings J, Lawrence DA, On The Environment ATF. Exposure of Akwesasne Mohawk women to polychlorinated biphenyls and hexachlorobenzene is associated with increased serum levels of thyroid peroxidase autoantibodies. J Toxicol Environ Health A 2023; 86:597-613. [PMID: 37335069 DOI: 10.1080/15287394.2023.2226685] [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] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), and dichlorodiphenyltrichloroethane (p,p'-DDT) were reported to influence immunological activity. As endocrine-disrupting chemicals (EDC), these pollutants may disrupt normal thyroid function and act as catalysts for development of autoimmune thyroid disease by directly and indirectly affecting levels of thyroid peroxidase antibodies (TPOAbs). Native American communities are disproportionately exposed to harmful toxicants and are at an increased risk of developing an autoimmune disease. The aim of this study was to determine the association between POPs and TPOAbs in serum obtained from Native American women. This assessment was used to measure whether increased risk of autoimmune thyroid disease occurred as a result of exposure to POPs. Data were collected from 183 Akwesasne Mohawk women, 21-38 years of age, between 2009 and 2013. Multivariate analyses were conducted to determine the association between toxicant exposure and levels of TPOAbs. In multiple logistic regression analyses, exposure to PCB congener 33 was related to elevated risk of individuals possessing above normal levels of TPOAbs. Further, HCB was associated with more than 2-fold higher risk of possessing above normal levels of TPOAbs compared to women with normal levels of TPOAbs. p,p'-DDE was not associated with TPOAb levels within this study. Exposure to PCB congener 33 and HCB was correlated with above normal levels of TPOAbs, a marker of autoimmune thyroid disease. Additional investigations are needed to establish the causes and factors surrounding autoimmune thyroid disease which are multiple and complex.
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Affiliation(s)
- Florence Lee
- Department of Anthropology, University at Albany, Albany, NY, USA
| | - Mia V Gallo
- Department of Anthropology, University at Albany, Albany, NY, USA
- Center for the Elimination of Minority Health Disparities, University at Albany, Albany, NY, USA
| | - Lawrence M Schell
- Department of Anthropology, University at Albany, Albany, NY, USA
- Center for the Elimination of Minority Health Disparities, University at Albany, Albany, NY, USA
- Department of Epidemiology and Biostatistics, University at Albany, Albany, NY, USA
| | - Julia Jennings
- Department of Anthropology, University at Albany, Albany, NY, USA
| | - David A Lawrence
- Wadsworth Center/New York State Department of Health, Albany, NY, USA
- Biomedical Sciences and Environmental Health Sciences, University at Albany, Albany, NY, USA
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Palomba S, Colombo C, Busnelli A, Caserta D, Vitale G. Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature. Front Endocrinol (Lausanne) 2023; 14:1251866. [PMID: 37635968 PMCID: PMC10453810 DOI: 10.3389/fendo.2023.1251866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. Objective To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Methods Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. Results PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. Conclusion PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.
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Affiliation(s)
- Stefano Palomba
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Carla Colombo
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Busnelli
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Donatella Caserta
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Giovanni Vitale
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Milan, Italy
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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