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Objective:To investigate the correlation between serum thyroglobulin antibody (TG-Ab) and thyroid peroxidase antibody (TPO-Ab) cconcentrations and arteriosclerosis development in middle-aged and older adult patients with depression.Methods:A total of 200 middle-aged and older adult patients with depression who received treatment in the Third People's Hospital of Huzhou from January 2018 to October 2019 were included in this study. They were divided into four groups ( n = 50/group) according to TG-Ab and TPO-Ab test results: TG-Ab-positive (group 1), TPO-Ab-positive (group 2), TG-Ab-positive and TPO-Ab-positive (group 3), TG-Ab-negative and TPO-Ab-negative (control group). Serum thyroid hormone level, ankle-brachial pressure index (ABI), brachial-ankle pulse wave velocity, and the incidences of intima-media thickening and plaque formation in the lower extremity arteries were compared between groups. Results:Total thyroxine concentration in the control group, groups 1, 2 and 3 was (89.96 ± 2.45) nmol/L, (101.29 ± 3.35) nmol/L, (90.09 ± 2.70) nmol/L, (97.55 ± 2.57) nmol/L, respectively. There was a significant difference in total thyroxine concentration between groups ( F = 3.85, P < 0.05). Brachial-ankle pulse wave velocity in the control group, groups 1, 2, and 3 was (1 327.55 ± 67.78) cm/s, (1 510.36 ± 83.05) cm/s, (1 422.71 ± 71.40) cm/s, (1 533.95 ± 87.01) cm/s, respectively. There was a significant difference in brachial-ankle pulse wave velocity between groups ( F = 65.12, P < 0.05). The incidence of intima-media thickening in the control group, groups 1, 2, and 3 was 18% (9/50), 50% (25/50), 32% (16/50), 60% (30/50), respectively. The incidence of plaque formation in the control group, groups 1, 2, and 3 was 22% (11/50), 56% (28/50), 40% (20/50), 70% (35/50), respectively. There were significant differences in intima-media thickening and plaque formation between groups ( χ2 = 21.83, 25.77, all P < 0.001). Logistic multivariate regression analysis showed that age ( OR = 0.953) and TG-Ab ( OR = 1.116) were independent risk factors for developing arteriosclerosis in middle-aged and older adult patients with depression ( P < 0.05). Conclusion:TG-Ab-positive results are an independent risk factor for developing arteriosclerosis in middle-aged and older adult patients with depression. TPO-Ab-positive results have a synergistic effect on the occurrence and development of arteriosclerosis in middle-aged and older adult patients with depression. Monitoring serum TG-Ab and TPO-Ab concentrations is of great clinical significance for the prevention and treatment of arteriosclerosis in middle-aged and older adult patients with depression.
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Objective To investigate the effect of low dose of BDE209 on thyroid hormone and thyroid hormone metabolism enzyme-iodothyroninedeiodinases Ⅱ(D2) in off spring mice after pregnancy exposure .Methods Total 64 adult SPF female Kun-ming mice were randomly divided into 4 groups ,which treated with oral gavage of 0 ,50 ,100 ,300 μg · kg -1 · d-1 dose of BDE209 after successful pregnancy ,the exposure continue to 21 days after delivery .10 mice was randomly selected in each offspring group and get the peripheral blood and brain sample ,the serum thyroid hormones level ,oxidative damage and the expression of D2 mRNA in brain were detected .Results Compared with the control group(0μg · kg -1 · d-1 dose of BDE209) ,the TT4 ,TT3 ,FT4 and FT3 levels of offspring mice increased significantly in every exposure group (P< 0 .05);antioxidant enzyme glutathione-S transferees (GST) ,superoxide dismutase (SOD) activity decreased with the BDE209 dose increase (P<0 .05) ,and malondialdehyde (MDA) level increased (P<0 .05);the D2 mRNA relative expression of brain in middle(100μg · kg -1 · d-1 dose of BDE209) and high(300μg · kg -1 · d-1 dose of BDE209) dose group decreased when compared with control group (P< 0 .05) .Conclusion Low level of BDE209 exposure in pregnancy resulted in the increasing of thyroid hormone levels in offspring mice ,which may cause oxidative damage and decrease expression of D2 mRNA in the brain .
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Objective To determine the reference intervals for thyroid function tests during the second half of pregnancy (20-40 gestational weeks),and to assess the relationship between thyroid peroxidase antibody (TPOAb) levels and the incidence of gestational thyroid diseases.Methods Levels of thyroid stimulating hormone (TSH),free thyroxine (FT4),TPOAb and urinary iodine excretion were determined in 4 729 pregnant women,who received prenatal health care at First Affiliated Hospital of Nanjing Medical University from July 2011 to August 2013.Among these women,2 568 were selected using the recommendations of the American National Academy of Clinical Biochemistry,and were divided into five groups according to their gestational age:≥ 20 to ＜24 weeks (682 cases),≥ 24 to ＜28 weeks (1 322 cases),≥ 28 to ＜32 weeks (178 cases),≥ 32 to ＜36 weeks (185 cases) and ≥ 36 to ≤ 40 weeks (201 cases).Reference intervals of thyroid function tests in the second half of pregnancy were calculated.The reference values of thyroid functions in different gestational weeks were compared,and the reference intervals of thyroid functions in the second half of pregnancy were determined.The effects of maternal age and positive TPOAb on gestational thyroid diseases were analyzed.A non-parametric test,analysis of variance or Chi-square test was used for statistical analysis.Results (1) Reference intervals for maternal thyroid function in the second half of pregnancy in our hospital were established [TSH:0.65-5.27 mU/L and FT4:8.74-14.84 pmol/L].(2) The percentage of thyroid diseases was higher using the non-pregnancy reference intervals (TSH:0.27-4.20 mU/L and FT4:12.00-22.00 pmol/L) than using the pregnancy reference intervals [64.0％ (3 025/4 729) vs 16.1％ (763/4 729),x2=47.465,P ＜ 0.01],which manifested as a higher rate of clinical hypothyroidism and simple hypothyroxinemia [5.4％ (255/4 729) vs 0.4％ (20/4 729),x2=14.321;54.1％ (2 560/4 729) vs 9.1％ (429/4 729),x2=47.108;both P＜0.01] and a lower rate of subclinical and clinical hyperthyroidism [1.2％ (58/4 729) vs 3.3％ (155/4 729),x2=6.650;0.3％ (13/4 729) vs 0.6％ (27/4 729),x2=2.062;both P＜0.05].(3) The incidence of clinical hypothyroidism and simple hypothyroxinemia in pregnant women aged ＞30 years was higher than in those aged ≤ 30 years [0.7％ (10/1 377) vs 0.3％ (10/3 352),x2=4.257;11.7％ (161/1 377) vs 8.0％ (268/3 352),x2=16.102;both P＜0.05].The incidence of clinical hypothyroidism and clinical hyperthyroidism in TPOAb positive women was higher than that in TPOAb negative women [2.7％ (9/335) vs 0.3％ (11/4 394),x2=44.009;3.9％ (13/335) vs 1.2％ (52/4 394),x2=16.784;both P＜0.01].Conclusions The established pregnancy-specific reference ranges of thyroid function tests can reduce the missed diagnosis and misdiagnosis of gestational thyroid diseases.Maternal age ＞30 years and positive TPOAb may increase the risk ofgestational thyroid diseases.
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Objective To investigate the current status of screening and management of thyroid diseases during pregnancy,and to provide evidence for further improvement of clinical management.Methods Clinical data of 5 981 pregnant women who delivered at Peking University First Hospital between September 1,2013 and September 30,2014 were analyzed retrospectively.Their average age was (30±4) years (18-47 years) and average gestational week was (39.2± 1.6) weeks (25.5-42.0 weeks).The reference range of thyroid stimulating hormone (TSH) was 0.1-2.5 mU/L recommended by the American Thyroid Association (ATA).The reference range of free thyroxine (FT4) was 11.48-22.70 pmol/L and the cut-off value of thyroid peroxidase antibody (TPOAb) was 34 U/ml both recommended by the kit.The specific reference range of TSH was obtained from normal pregnant women in this study (0.23-4.08 mU/L in the first trimester).Pregnant women with hypothyroidism were divided into two groups according to their TSH level at the first trimester:TSH ≥ 2.5-＜4.08 mU/L group and TSH ≥ 4.08 mU/L group.T test,Chi-square or Fisher's exact test were applied for statistical analysis.Results (1) Screening status:Of the 5 981 pregnant women,there were 13 cases (0.2％) of hyperthyroidism and 146 cases (2.4％) of hypothyroidism diagnosed before conception (133 cases of Hashimoto thyroiditis,eight cases after operation for thyroid cancer,and five cases after 131I therapy because of hyperthyroidism).Among the 5 822 cases requiring screening,4 044 cases (69.5％) received screening tests of TSH,FT4 and TPOAb during early pregnancy according to Chinese Guidelines,and 1 778 cases received neither standard screening nor screening test.(2) Treatment of hypothyroidism:Hypothyroidism treatment rate was only 61.5％ (107/174) according to the reference range recommended by the ATA,lower than that of 88.1％ (52/59) according to the reference range of this study (x2=14.430,P＜0.05).There were 60 cases receiving no treatment in TSH ≥ 2.5-＜4.08 mU/L group.Forty-three of these cases were reexamined,and one of them was abnormal,with a rate of 2.3％ (1/43).There were seven cases without treatment in TSH ≥ 4.08 mU/L group;six of them were reexamined among which one was abnormal,with a rate of 1/6.(3) Thyrotoxicosis:Among the 4 044 pregnant women,99 cases had TSH ＜0.1 mU/L,including 11 cases with FT4 ≥ 22.70 pmol/L (22.82-60.96 pmol/L).Only three cases were positive for thyrotrophin receptor antibody,and then diagnosed as hyperthyroidism and treated with propylthiouracil.(4) Thyroid cancer:Among the 5 981 pregnant women,six cases were diagnosed as thyroid cancer during pregnancy and lactation,with an incidence of 100.3/100 000.Of the six cases,five were diagnosed during pregnancy,and one at one month postpartum.All of the six cases underwent operation and were confirmed to be papillocarcinoma by pathology.Conclusions The screening rate of thyroid diseases during pregnancy is high,but the clinical management is not fully standardized.We suggested that each center should established its own normal reference range for thyroid function test.The incidence of thyroid cancer during pregnancy is increasing,thus attention should be paid to its diagnosis.
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Objective To investigate changes of thyroid function indices and their correlation with blood routine examination results, high-sensitivity c-reactive protein(hsCRP)levels and erythrocyte sedimentation rate(ESR)in 30 inpatients with acute urticaria. Methods Thyroid function indices were retrospectively analyzed in 30 inpatients with acute urticaria (patient group)and 30 healthy controls (control group), including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), anti-thyroglobulin antibody(TG-Ab)and anti-thyroid peroxidase antibody(TPO-Ab). A correlation analysis was done between thyroid function indices and blood routine examination results (white blood cell [WBC]count, neutrophil count, hemoglobin), hsCRP levels and ESR. Results Abnormal thyroid function indices were observed in 23 (23/30, 76.7%) patients with acute urticaria. Compared with the control group, the patient group showed significantly decreased levels of FT3, TT3, TT4 and hemoglobin(t = 6.39, 5.55, 3.57, 3.70, all P < 0.01), but significantly increased positive rates of thyroid autoantibodies (χ2 = 7.68, P < 0.01)as well as WBC counts, neutrophil counts, hsCRP levels and ESR (t = 3.96, 8.73, 2.51, 2.35, all P < 0.05). There was a positive correlation between hemoglobin level and FT3, TT3, TT4 levels(r = 0.63, 0.59, 0.37, all P < 0.05), but a negative correlation between neutrophil count and FT3, TT3, TSH levels(r = -0.45,-0.50, -0.37, all P < 0.05), as well as between TT3 and hsCRP levels (r = -0.39, P < 0.05)in the patient group. Conclusion Patients with severe acute urticaria usually show abnormal thyroid function during attacks, which mainly manifests as low T3 syndrome and high positive rates of thyroid autoantibodies, and may be associated with decreased hemoglobin levels and infection.
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Objective To explore the correlation between thyroid peroxidase antibody (TPOAb) and outcomes during pregnancy and the effects of treatment on outcomes. Methods PubMed, Cochrane Library, Science Direct, Embase, Chinese Biomedicine, and Wanfangdata had been searched. Case-control and cohort studies about TPOAb and pregnancy outcomes were searched according to the inclusion and exclusion criteria. Fifty studies were finally recruited (all of cohort-studies, 10 for English and 5 for Chinese). Review Manager 5.3 were used to test the heterogeneity of the results among the different studies and amalgamate the effect size using fixed or random effect models. Results Meta-analysis showed TPOAb (+)with normal thyroid function increase the risks of miscarriage,and premature delivery, OR calculated were 2.02(95%CI:1.13-3.62, P=0.001)and 1.39(95%CI:1.11-1.76, P=0.005), while showed no relative risk to hypertensive disease,placental abruption in pregnancy and fetal growth restriction, OR calculated were 1.29(95%CI:1.00-1.67, P=0.080),0.42(95%CI:0.12-1.43, P=0.210)and 1.61(95%CI:0.23-11.12, P=0.100). TPOAb(+)with normal thyroid function increase miscarriage in in vitro fertilization and embryo transfer (IVF-ET), OR calculated were 2.14(95%CI:1.43-3.21, P=0.000). Levothyroxine (LT4) for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes, OR calculated were 0.43(95%CI:0.22-0.85, P=0.020). Conclusions TPOAb(+)with normal thyroid function increase the risks of miscarriage,and premature delivery. TPOAb(+) with normal thyroid function increase miscarriage in IVF-ET. LT4 for patients of TPOAb(+)with normal thyroid dysfunction decrease adverse obstetric outcomes.
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Thyroid peroxidase antibody (TPOAb) play an important role in the diagnosis of autoimmune thyroid disease.Chemiluminescence immunoassay (CLIA) is a new method been strongly recommended in recent years.The definition of positive value of TPOAb is inconsistent.The definition of TPOAb positive value is important for exploring the development of autoimmune thyroid disease.TPOAb is significantly increased in Hashimoto's disease and the titer is associated with the degree of infiltration and destruction of thyroid follicular.It is essential to monitor TPOAb in postpartum thyroiditis and early pregnancy.The positive of TPOAb is closely related to the adverse pregnancy outcomes caused by various risk factors.Graves disease combined with Hashimoto's must to be considered.
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Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy. Objective To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody(TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. Methods 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. Results (1) The incidence of SCH in early pregnancy was 13.61%(2 042/15 000). 60.53%(1 236/2 042) accepted levothyroxine treatment and 39.47%(806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM;6.58%, 53/806), fetal growth restriction (FGR;12.28%, 99/806)and low birth weight infants (10.17%, 82/806)in the untreated group were higher than those in the treated group [3.96%(49/1 236), 4.21%(52/1 236), 10.76%(133/1 236), 4.13%(51/ 1 236), 8.90%(110/1 236), 7.52%(93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00%(80/2 000) , 10.70%(214/2 000) , 3.80%(76/2 000), 9.60%(192/2 000), 7.50%(150/2 000), respectively]. The differences were statistically significant (P0.05). (3)The incidences of abortion (11.44%, 23/201), premature delivery (12.44%, 25/201), gestational hypertension disease (22.89%, 46/201), GDM (8.46%, 17/201), FGR (19.90%, 40/201) and low birth weight infants (16.42%, 33/201) in the TPOAb (+) untreated group were higher than those in TPOAb (+) treated group [4.02% (41/1 021), 4.21% (43/1 021), 10.77% (110/1 021), 4.11% (42/1 021), 8.72% (89/1 021), 7.35%(75/1 021), respectively] and the control group, with statistically significant differences (P0.05). (4)There were no statistically significant difference (P> 0.05) in the incidence of abortion (3.72%, 8/215), premature delivery (4.19%, 9/215), gestational hypertension disease (10.70%, 23/215), GDM (4.19%, 9/215), FGR (9.77%, 21/215) or low birth weight infants (8.37%, 18/215) among the TPOAb (-) treated group, the TPOAb (-) untreated group [3.80% (23/605), 4.13%(25/605), 10.91%(66/605), 5.95%(36/605), 9.75%(59/605), 8.10%(49/605), respectively] and the control group. Conclusions (1) The incidence of abortion, premature delivery, gestational hypertension disease, GDM, FGR and low birth weight infants could be increased in women with SCH in early pregnancy.(2) Thyroxine treatment could reduce the incidence of pregnancy complications in women with SCH in early pregnancy.
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Objective To explore effects of thyroid autoantibodies on thyroid hormone ( TH) during pregnancy 5~7 weeks in Shenyang City.Methods In this study, 700 pregnant women (pregnant 5~7 weeks) in Shenyang City were enrolled.Serum thyrot-ropin ( TSH ) and free thyroxine ( FT 4) levels were determined with solid-phase chemiluminescent enzyme immunoassay method (CMIA)and thyroid peroxidase antibody (TPOAb) concentration with electro chemiluminescent assay (ECLIA).Results ⑴ The median urinary iodine ( MUI) of early pregnancy women was 185.5 μg/L.Women were iodine-adequate .⑵The overall prevalence of thyroid diseases in early pregnancy was 8.7%.The prevalence of hyperthyroidism was 1.0%.The prevalence of subclinical hyperthy-roidism was 1.0%.The prevalence of hypothyroidism was 0.1%.The prevalence of Subclinical hypothyroidism was 6.6%.The prev-alence of subclinical hyperthyroidism was lower than that of subclinical hypothyroidism ( P 0.05 ) .⑷The median TSH was 2.2 mU/L in the TPOAb-positive group , and was 1.2 mU/L in the TPOAb-negative group ( P 0.05).⑹A percentage (29.0%) of pregnancy women with positive TPOAb had dysthyroid .A percentage (6.3%) of pregnancy women with negative TPOAb had dysthyroid ( P <0.01).Conclusions Subclinical hypothyroidism was capital thyroid diseases pattern during early pregnancy .The positive TPOAb caused abnormal TSH and dysthyroid .The history of spontaneous abortion was a risk factor of high titer TPOAb .Pregnant women with high titer TPOAb levels had an adverse effect on pregnancy .Moni-toring of maternal serum thyroid autoantibodies and thyroid hormone level can detect abnormal thyroid function or threatened abortion . A timely intervention can improve the procreation quality .
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Objective To investigate the prevalence of hypothyroidism during the second trimester and its relationship with thyroid peroxidase antibody (TPOAb). Methods Two thousand one hundred and forty one pregnant women whose gestational age between 14 to 28 weeks,accepted their prenatal care at the outpatient clinic of International Peace Maternity & Child Health Hospital from March 1,2010 to July 31,2010 were enrolled into this study. Serum TPOAb,thyroidstimulating hormone (TSH) and free thyroxine (FT4) of these women were detected. Logistic regression model was used to analyze the risk factors of subclinical hypothyroidism and positive TPOAb,while Spearman rank correlation was used to analyze the relationship between the levels of TSH,FT4 and TPOAb. Results (1) Subclinical hypothyroidism was detected in 13.36％ (286/2141) patients. Isolated maternal hypothyroxinemia occurs in 0.14％ (3/2141) of pregnant women.No overt hypothyroidism patient was detected and 6.26％ (134/2141) of all pregnant women exhibited positive TPOAb(≥50 U/ml).(2) Positive rate of TPOAb in subclinical hypothyroidism group,isolated maternal hypothyroxinemia group and normal thyroid function group was 13.64％ (39/286),0/3 and 5.06％ (86/1701) respectively,and there was difference among the three groups (x2 =30.82,P＜0.01).The positive rate of TPOAb did not relate to fetal gender,maternal age,gestational age,gravidity and parity.(3) TPOAb had positive relationship with TSH level (r=0.12,P＜0.01),while did not relate to FT4 level (r=-0.04,P=0.09). (4) Positive TPOAb (OR 3.18,95％ CI:2.10-4.83,P＜0.01) and gravidity (OR=1.21,95％ CI:1.02-1.43,P=0.030)were risk factors of subclinical hypothyroidism. Conclusions Hypothyroidism is common during the second trimester. It is necessary to screen TPOAb in pregnant women as TPOAb is an independent and important predictor of subclinical hypothyroidism.
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Objetivos Determinar la frecuencia de hipotiroidismo y su relación con anticuerpos antiperoxidasa y yoduria elevada, con la finalidad de realizar recomendaciones a las autoridades sanitarias sobre el consumo de sal yodada y detección temprana de enfermedad tiroidea. Métodos Participaron 437 personas de la población general de Armenia (Quindío). Se realizaron pruebas ELISA para Tiroxina-L, hormona estimulante de la tiroides, anticuerpos antiperoxidasa y análisis fotocolorimétrico para yoduria. Resultados La prevalencia de hipotiroidismo fue de 18,5 %. Los anticuerpos antiperoxidasa fueron positivos en el 28,9 %, con prevalencia significativamente más alta entre aquellos con hormona estimulante de la tiroides mayor a 10 uUI/ml comparados con valores de 5,1 a 10 uUI/ml (O.R 3,2) y en fumadores (O.R 3,4). La Tiroxina-L fue normal en el 98,2 % de participantes con hormona estimulante de la tiroides mayor a 5 uUI/ml y en el 92 % de aquellos con valores mayores a 10 uUI/ml. El promedio de yoduria fue de 565,1; niveles por encima de 300 µg/l se obtuvieron en un 81,8 % de los participantes. Conclusiones El aumento en la prevalencia de anticuerpos antiperoxidasa positivo a medida que aumentan los valores de hormona estimulante de la tiroides podría evidenciar una elevado riesgo en Armenia de desarrollo de hipotiroidismo de origen autoinmune; a pesar de los elevados niveles de yoduria, no se logró establecer relación con los niveles de anticuerpos antiperoxidasa ni de hormona estimulante de la tiroides.
Objectives Determining the prevalence of hypothyroidism and its interrelationship with peroxidase antibodies and high urinary iodine levels as a means for devising a set of recommendations for health authorities regarding the consumption of iodised salt and the early detection of thyroid disease. Methods 437 people in the municipality of Armenia (Quindío) participated in the study. ELISA tests were performed for free thyroxine, thyroid-stimulating hormone and thyroid peroxidase antibodies; a photocolorimetric analysis was carried out to determine urinary iodine levels. Results Hypothyroidism prevalence was 18.5%. Thyroid peroxidase antibodies were positive in 28.9% of the study population, with significantly higher prevalence amongst those with levels > 10 mIU/mL thyroid-stimulating hormone compared to 5.1 to 10 mIU/mL in those without it (OR 3.2) and smokers (O.R 3,4). Free thyroxine was normal in 98.2% of participants (> 5 mIU/mL thyroid-stimulating hormone levels) and 92% in those in whom > 10 mIU/mL thyroid-stimulating hormone levels were found. The average iodine level was 565.1; levels above 300µg/L were obtained in 81.8% of the participants. Conclusions Increased positive thyroid peroxidase antibody prevalence with increasing thyroid-stimulating hormone values could demonstrate a high risk of developing autoimmune hypothyroidism in Armenia; despite high iodine levels, a relationship with thyroid peroxidase antibodies or thyroid-stimulating hormone levels could not be established.
Subject(s)
Adult , Aged , Humans , Middle Aged , Autoantibodies/blood , Hypothyroidism/epidemiology , Iodine/urine , Thyroiditis, Autoimmune/epidemiology , Autoantigens/immunology , Colombia/epidemiology , Cross-Sectional Studies , Hypothyroidism/blood , Hypothyroidism/urine , Iodide Peroxidase/immunology , Prevalence , Risk Factors , Smoking/blood , Smoking/epidemiology , Thyroiditis, Autoimmune/blood , Thyroiditis, Autoimmune/urine , Thyrotropin/blood , Thyroxine/blood , Urban PopulationABSTRACT
Objective To explore the effect of short-term iron deficiency on thyroid function of rat and its mechanism, and to provide new clues and ideas for prevention and control of iodine deficiency disorders. Methods Twenty-two healthy SPF/VAF level weaning male SD rats were randomly divided into control group(iron content in diet was 65 mg/kg) and iron deficiency group(iron content in diet was 15 mg/kg) by body weight, and 11 in each group respectively. After 4 weeks feeding, body weight and thyroid glands weight were measured, and the relative weight of thyroid gland was calculated. Rat whole blood was collected and serum was separated. Hemoglobin, serum iron levels and total iron binding capacity were tested using biochemical assay;serum free iodine thyroid three original acid (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) levels were detected by chemiluminescence;after thyroid were fixed in formalin, embedded with paraffin and sectioned regularly, and immunohistochemical stained, the protein expression of thyroid peroxidase(TPO) was observed. Results Compared with control group [(243.8 ± 16.4)g], iron deficiency group of animals had less body weight[(214.3 ± 18.1 )g, t = 4.002, P ＜ 0.01];there was a lower absolute thyroid weight in iron deficiency group[(11.9 ± 1.6)mg]than in control group[(13.4 ±1.3)mg, t = 2.369, P ＜ 0.01], but no significant changes of the relative weight of thyroid gland between the two groups[(0.055 ± 0.004),(0.055 ± 0.006)g/kg, t = 0.162, P ＞ 0.05]. Hemoglobin and serum iron in iron deficiency group were ( 100.4 ± 8.9)g/L and (7.0 ± 0.8)μmol/L, which were less than that in control group[( 146.5 ±16.3)g/L, (26.1 ± 5.1 )μmol/L, t = 8.233,12.277, all P ＜ 0.01]. Total iron binding capacity in control group was (74.0 ± 4.6)μ mol/L and that in iron deficiency group[(124.8 ± 6.3)μmol/L], and the difference was significant (t = 21.531, P＜ 0.01). At the same time, their serum hormones FT3, FT4 and FT3/FT4[(4.71 ± 0.53), (29.69 ±2.63)pmol/L, 0.16 ± 0.02]were lower than that in control group[(5.69 ± 0.61),(31.98 ± 2.49)pmol/L, 0.18 ±0.01, t = 4.044,2.096,3.255, P ＜ 0.01 or ＜ 0.05]. The expression of TPO protein decreased in iron deficiency group than in control group. Conclusions Iron deficiency reduces thyroid function, which perhaps is due to the reduction of TPO activity. Combined supplementation of iodine and iron will possibly improve the prevention effect on iodine deficiency disorder in iron deficiency areas.
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Objective To investigate the iodide uptake by U251 glioma cell lines which were transfered with both human sodium/iodide symporter (hNIS) and human thyroperoxidase (hTPO) genes. Methods Recombinant adenosine virus AdTPO was constructed through cloning, recombination, packaging and amplifying. The viral titers were calculated after purification. The protein expression of AdTPO was tested by Western-Blotting and the recombinant plasmids PcDNA3. 1/hNIS were constructed. After hNIS gene was transfected into human glioma cell lines U251 through liposome, the cell lines with stable hNIS expression (hNIS-U251) selected by G418 antibiotics were defined as hNIS-U251 group. Then, hTPO was transducted into hNIS-U251 with adenosine virus (AdTPO-hNIS-U251 group). U251 cells with no plasmid were used as the control group (U251). Cultured cells from each group were studied for 125I uptake as well as 125I efflux rate. Student-Newman-Keuls in multiple range test was used. Results AdTPO-hNIS-U2.51 with stable expression was successfully established by transfecting hNIS and hTPO genes into human glioma cell lines. The 125I uptake by AdTPO-hNIS-U251, hNIS-U251 and U251 cell lines was (74 647.53 ±3605.88), (55 769.96 ±4353.26) and ( 507.67 ± 57.69 ) counts/min, respectively ( F = 836. 17, P ＜ 0.05 ). The uptake compacity by AdTPO-hNIS-U251 was 147 fold higher than that by U251 (q =55.64, P＜0.01 ) and 1.3 fold higher that by hNIS-U251 (q = 14. 17, P ＜0.01 ). 125I efflux rate was prolonged in AdTPO-hNIS-U251 group and its effective half time was 13 min. Conclusion Enhanced 125I uptake by the human glioma cell lines can be achieved with combined transfection of hNIS and hTPO genes.
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Objective:To observe thyroperoxidase (TPO) expression in fine needle aspirated thyroid tumor cells and to assess the value TPO immunostaining in differential diagnosis of benign and malignant thyroid tumors. Methods: Fine needle aspiration (FNA) samples, and frozen tissue sections of 71 surgically resected thyroid tumor specimens were immunostained by with hTPO MoAb47. The staining results were considered positive if 80% or more thyroid cells were positively stained. Results: TPO expression levels in FNA samples and frozen tissue sections of malignant tumors were lower than those of benign tumors (P<0.01), and there was no difference in the results of FNA and frozen tissue sections. We also found that the TPO staining intensity of malignant tumors was markedly lower than that of benign tumors, with significant differences found between the mean densities, relative optic densities, and the intensities of staining color (all P<0.05), but with no significant difference found between the results of FNA samples and frozen tissue sections. TPO staining was positive in 20 of the 22 smears of the benign cystoma and in none of the 4 smears of malignant cystoid lesion (P<0.05). Taking the results of H-E staining as the control, the sensitivity of FNA samples was 95.74% and the specificity was 91.67%; of frozen tissue section were 100% and 66.47%; and of the cystoid lesions smears were 97.44% and 88.46%, respectively. Conclusion: TPO expression level is obviously higher in benign thyroid tumors than those in the malignant ones. FNA samples can be used for TPO immunocytochemistry staining as an adjuvant tool for distinguishing benign and malignant tumors.
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Wistar rats with different levels of iodine nutrition were killed after 3,6 and 12 months of experiments.Serum thyroid hormones were assayed with RIA.The activity of typeⅠdeiodinase(DⅠ)and typeⅡdeiodinase(DⅡ)was measured based on the release of radioiodide from the ~(125)Ⅰ-labeled substrate.The result showed that hypothyroidism reflected by decreased T_4 happened during the initial phase of iodine deficiency.The activity of DⅠand DⅡin rats was raised significantly in iodine deficiency groups.An excess of iodine inhibited DⅠactivity resulting in decreased serum TT_3 and FT_3.However,DⅡactivity increased in rats with iodine excess, attributing to the inactivation of T_3 and T_4 to the substrate of DⅡenzyme.
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Long-term excessive iodine intake resulted in an increased TT_4 level and a decreased TT_3 level in maternal serum,meanwhile,hepatic and renal type 1 deiodinase activity decreased dose-dependently.A significant reduction in type 2 deiodinase ( D2 ) activity of 12.5 d placenta was found in 3.0 mg/L or above groups.For 19.5 d uterus,D2 activity decreased and type 3 deiodinase activity increased.The results suggest that excessive iodine has an effect on the embryonic development by regulating maternal-fetal thyroid hormone metabolism.
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Objective:To observe thyroperoxidase (TPO) expression in fine needle aspirated thyroid tumor cells and to assess the value of TPO immunostaining in differential diagnosis of benign and malignant thyroid tumors. Methods: Fine needle aspiration (FNA) samples and frozen tissue sections of 71 surgically resected thyroid tumor specimens were immunostained by with hTPO MoAb47. The staining results were considered positive if 80% or more thyroid cells were positively stained. Results: TPO expression levels in FNA samples and frozen tissue sections of malignant tumors were lower than those of benign tumors (P
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Objective To express human thyroid peroxidase (hTPO) epitopes gene and apply its products in clinical assay. Methods hTPO epitopes gene was cloned into expression vector pGEX 4T 3 then transformed into E. coli BL21. Expression of hTPO gene was induced by isopropyl ? D thiogalactoside, expressed product (GST hTPO) was purified by affinity chromatography and their immunoactivity was demonstrated. ELISA technique using GST hTPO as antigen was established for determining TPOAb. Serum TPOAb level was determined, and HLA DR antigen, dendritic cells and lymphocytes in the thyroid gland tissue were observed in these same AITD patients.Results GST hTPO acquired from procaryotic expression had high purity and good immunoactivity. The CVs of the ELISA technique established with GST hTPO were between 5.93%～7.59%. A significantly positive correlation was found between the TPOAb levels determined respectively by ELISA and RIA method. Serum TPOAb level and distribution of HLA DR antigen and dendritic cells showed the same ascending tendency following the aggravation of lymphocyte infiltration. Conclusion Product of genetic engineering, GSH hTPO, can be used to establish a clinical assay for TPOAb. The correlation between the level of serum TPOAb and the detriment of thyroid tissue is demonstrated.