Serum FT4 / FT3 Ratio, a Predictive Biochemical Marker for Subclinical Hypothyroidism in Patients with Chronic Kidney Disease.

Subclinical hypothyroidism (ScHt) is an early stage of hypothyroidism which can progress to overt hypothyroidism and lead to adverse metabolic abnormalities. Surge in frequency of hypothyroidism is seen in chronic kidney disease (CKD) cases, including those receiving dialysis. Many studies reported the relation amid thyroid function with metabolic syndrome, though the link among the Free T3: Free T4 and ScHt is not clearly determined. We wanted to investigate the Free T3:Free T4 ratio in predicting ScHt in CKD. MethodsIn this study, 53 known CKD subjects who have not undergone haemodialysis and 60 normal healthy subjects were included. In both study groups, creatinine and estimated glomerulus filtration rate (eGFR) are determined to evaluate the kidney function. Thyroid function parameters namely serum FT3, FT4 and TSH were measured to determine the FT3 / FT4 ratio. ResultsTSH levels were significantly increased in patients with CKD not undergoing dialysis as compared to patients in the control group (P<0.034). Low Free T3 level (P<0.001) and FT3 / FT4 ratio is highly significant (P< 0.001) in study subjects as compared to controls. Area Under the Curve (AUC) of ROC for the continuous variables of serum FT4 / FT3 ratio was 0.914 with CI: 0.832 to 0.997. ConclusionsIndividually FT3, FT4 have very little sensitivity in the diagnosis of sub clinical hypothyroidism in chronic kidney disease. FT4/FT3 ratio determination is a very useful step in diagnosing ScHt with chronic kidney disease.

To Evaluate Subclinical Hypothyroidism in Type 2 Diabetes Mellitus

Introduction: Diabetes is the most common endocrinal disorder seen in clinical practice. The prevalence of diabetes in westis between 6 and 7.6%. Type 2 diabetes mellitus is the predominant form of diabetes accounts for 90% of cases globally.Aims and Objectives: This study aims to know the prevalence of subclinical hypothyroidism in Type 2 diabetes mellitus duringthe study period of 1 year 6 months patients attending Government General Hospital/Government Medical College, Suryapet.Materials and Methods: This study was done on patients attending Government General Hospital/Government Medical College,Suryapet. The total duration of study was 1 year 6 months. Patients attending Government General Hospital who were eitherpreviously or newly diagnosed Type 2 diabetes mellitus were included in the study.Results: Fifty known or newly detected cases of Type 2 diabetes mellitus more than 30 years were selected randomly from thepatients attending to the Diabetic Clinic Government General Hospital during the study period September 2018 to February 2020.Conclusion: Subclinical hypothyroidism has been associated with a greater prevalence of cardiovascular disease and isrelatively common in patients with Type 2 DM. Hence, it effects would be exaggerated in patient with Type 2 DM.

Prevalence of Subclinical Hypothyroidism in Non-Pregnant Females of Childbearing Age Coming to North Bengal Medical College Out Patient Department.

Hypothyroidism is widespread in sub-Himalayan region and is particularly prevalent in females of reproductive age group. Since the signs and symptoms of subclinical hypothyroidism are often overlooked by the patients themselves, the diagnosis gets often delayed. In this study, we tried to estimate the prevalence of subclinical hypothyroidism in reproductive age group female population coming to the outpatient department of a government hospital in North Bengal.METHODSAll the non-pregnant women attending the blood collection center of the Department of Biochemistry, North Bengal Medical College and Hospital, were enrolled in the study after institutional ethics approval. Women of age ranging from 10 years to 65 years were included in the study to compare the possible difference of prevalence existing between different age groups. The women with known thyroid disease and other autoimmune disorders were excluded from the study. Fasting blood samples of study participants were analysed for thyroid hormone profile. In addition, all study participants were tested for Hb%, FBS, LFT, KFT, and lipid profile. Microsoft Excel and SPSS version 22 was used for data analysis.RESULTSSubclinical hypothyroidism prevalence was found to be 13.4% in reproductive age group women. The prevalence is not different from the general population as such. The prevalence of overt hypothyroidism was also similar in overall population and reproductive age group females. The prevalence of subclinical hypothyroidism was found to be higher in females of age group 10-19 years (16.7%) and 60-65 years (16.2%) than that seen in reproductive age group females.CONCLUSIONSThe prevalence of subclinical hypothyroidism is quiet high in female population and the result in this study goes parallel to the findings of other studies. In this study, subclinical hypothyroidism is found to be more prevalent in both higher and lower age group females compared to the females of reproductive age group

​A Study on “Correlation of Thyroid Profile with the Components of Metabolic Syndrome”

Introduction: As there is an exponential rise in the prevalence of metabolic syndrome (MetS) in pandemic proportions as wellas a steady increase in incidence of subclinical hypothyroidism (SCH),Material and Methods: A cross-sectional study of association between these two entities is been carried. Authors studiedthyroid function tests in 100 cases of MetS and 50 controls.Results: The results were analyzed and we found that the prevalence of SCH in MetS was found to be 21% when compared toonly 6% in the control population. This association with SCH is more frequent among women. The thyroid dysfunction in MetSis statistically significantly associated with the serum triglycerides, followed closely by the waist circumference. This associationis not found with the other components of MetS.Conclusion: Due to the alarming rise, in CV mortality and morbidity, the people at risk have to be identified at the earliest andtheir risk factors modified. Hence, diagnosing MetS should become a routine practice among the medical fraternity.

Assessment of carotid intima-media thickness in hypothyroidism and the effect of thyroid replacement therapy

Background: Carotid artery intima-media thickness (CAIMT) measurement in hypothyroidism will help assess the progression of atherosclerosis and timely intervention may prevent vascular complications.Methods: This study included 30 clinical hypothyroid (CH), 30 subclinical hypothyroid (SCH) and 30 euthyroid. As per procedure, informed consent was taken from the patients in prescribed formats before their participation in the study. Patients were divided into 3 groups of CHs, SCH and Controls after obtaining the thyroid function test values. CAIMT on the right side was measured in the three groups for comparison. Other parameters included age, sex, height, weight, body mass index (BMI), total cholesterol and triglycerides. After 4 months of levothyroxine therapy, CAIMT, total cholesterol and triglycerides were reassessed.Results: The CAIMT was increased in CH and SCH group when compared to euthyroid individuals. The mean CAIMT in CH group was 0.60�009cm, in SCH group it was 0.055�010 cm and in controls it was 0.047�006 cm. After 4 months of levothyroxine therapy, there was no change observed in the mean CAIMT values.Conclusions: CAIMT levels were increased in CH and SCH group when compared to euthyroid group. There was no regression of CAIMT after 4 months of levothyroxine therapy

Prevalencia de autoinmunidad tiroidea en mujeres subfértiles / Prevalence of thyroid autoimmunity in subfertile women

Resumen OBJETIVO: estimar la prevalencia de enfermedad tiroidea autoinmunitaria en pacientes subfértiles y saber si existe asociación entre enfermedad tiroidea autoinmunitaria aislada en mujeres eutiroideas y los resultados en técnicas de reproducción asistida. MATERIALES Y MÉTODOS: estudio observacional, transversal, ambispectivo, que evaluó mujeres de 18 a 43 años de edad atendidas en el servicio de Reproducción Humana del Instituto Nacional de Perinatología Isidro Espinosa de los Reyes que tuvieran una determinación del perfil tiroideo con anticuerpos antitiroideos en la primera consulta de infertilidad. RESULTADOS: la prevalencia de enfermedad tiroidea autoinmunitaria en mujeres infértiles fue de 19%. El 48% tuvieron seropositividad para anticuerpos antitiroideos, 32% para anticuerpos antitiroglobulina más anticuerpos antiperoxidasa y 20% restante solo para anticuerpos antitiroglobulina. En el grupo de pacientes con enfermedad tiroidea autoinmunitaria se observó una prevalencia de hipotiroidismo clínico de 8% y subclínico de 48%. La media de TSH para las mujeres con enfermedad tiroidea autoinmunitaria fue de 4.6 μUI/L. Las mujeres con enfermedad tiroidea autoinmunitaria aislada eutiroideas representaron 8.3% de la población y tuvieron una alta tasa de abortos espontáneos previos (45.5%) y de fracaso en técnicas de reproducción asistida (70%). CONCLUSIÓN: la determinación de la autoinmunidad tiroidea debe ralizarse de manera rutinaria en la población de mujeres.

Abstract OBJECTIVE: To estimate the prevalence of autoimmune thyroid disease in subfertile patients who come to the Human Reproduction service of the National Institute of Perinatology Isidro Espinosa de los Reyes, Mexico city. MATERIAL AND METHODS: A retrospective, cross-sectional, observational, ambispective study evaluating 18- to 43-year-old women from the INPer "Isidro Espinosa de los Reyes" human reproduction service with a thyroid profile determination with anti-thyroid antibodies in The first consultation of infertility. RESULTS: The prevalence of TEE in the population of infertile women is 19%. 48% have seropositivity for Ac-TPO, 32% for Ac-tiroglobulina plus Ac-TPO and the remaining 20% only for Ac-tiroglobulina. A prevalence of clinical hypothyroidism of 8% and subclinical of 48% was observed in the group of patients with ATE. The mean TSH for women with ATE was 4.6 μUI/L. Women with isolated euthyroid ETA represent 8.3% of the population and have a high rate of previous spontaneous abortions (45.5%) as well as failure in assisted reproduction techniques (70%). CONCLUSION: Determination of thyroid autoimmunity should be routinely performed in the female population.

Preliminary Evaluation of Clinical Efficacy ofShenqi Unguent on Sub-clinical Hypothyroidism Patients with Qi-deficiency Constitution / 中国中医药信息杂志

Objective To observe the clinical efficacy ofShenqi Unguent on sub-clinical hypothyroidism patients with qi-deficiency constitution.Methods A total of 60 patients were randomly divided into treatment group and control group. The treatment group took the traditional Chinese medicine ofShenqi Unguent, while the control group took euthyrox orally for 6 months. Changes of carotid intima-media thickness (CIMT), thyroid function (FT3, FT4, TSH, TG-Ab, TPO-Ab), and TCM syndrome integral before and after treatment of the two groups were observed. Results After treatment, the TCM syndrome integrals of the treatment group were significantly improved, compared with the control group (P<0.01). Similarly, CIMT of the treatment group were obviously increased, compared with the control group (P<0.05). Meanwhile, levels of serum TG-Ab and TPO-Ab were distinctly reduced than that of the control group (P<0.01).ConclusionShenqi Unguent has marked clinical efficacy on sub-clinical hypothyroidism patients with qi-deficiency constitution.

Prevalencia de hipotiroidismo y anticuerpos antitiroglobulina en pacientes mexicanos con esclerosis sistémica / Systemic sclerosis and hypothyroidism

Objetivo: Investigar la prevalencia de hipotiroidismo y anticuerpos antitiroglobulina (AATg) en pacientes mexicanos con esclerosis sistémica (ES). Material y métodos: Se estudió la función tiroidea en pacientes con ES y controles. Se les determinaron los niveles séricos de triyodotironina, tiroxina, hormona estimulante de la tiroides (TSH) y AATg. Resultados: Fueron 110 pacientes (106 mujeres y 4 hombres), edad promedio de 48.1 ± 28.5 años, versus 80 controles (76 mujeres y 4 hombres), edad promedio 47.5 ± 28.8 años. El hipotiroidismo clínico se encontró en 19% de pacientes con ES y en 1.3% de los controles (p < 0.01). Las medianas respectivamente de triyodotironina en ES y controles fueron: 82 versus 160 ng/dl, p < 0.01; tiroxina 5.4 versus 7 ng/dl, p < 0.01; TSH 8.2 versus 1.1 μUI/ml, p < 0.001. El hipotiroidismo subclínico se observó en 35% de los pacientes con ES y en 0% de los controles. Los valores de TSH en ES y en controles fueron 7.2 versus 1.2 μUI/ml, p < 0.01; triyodotironina 116 versus 160 ng/dl, p ns; tiroxina 7 versus 7 ng/dl, p ns, respectivamente. Los AATg estuvieron presentes en 54% de los pacientes y 2.5% en el grupo control, p < 0.01. Conclusiones: Los pacientes con ES presentan elevada prevalencia de hipotiroidismo, especialmente subclínico, por lo que debe investigarse la función tiroidea para iniciar tratamiento oportuno.

OBJECTIVE: Assess the prevalence of hypothyroidism and anti-thyroglobuline antibodies (AbATg) among Mexican patients with systemic sclerosis (SSc). MATERIAL AND METHODS: Thyroid function was studied in SSs patients and controls. Triiodothyronine, thyroxine, thyroid stimulant hormone (TSH) and AbATg were measured. RESULTS: 110 SSc patients (106 women and 4 men), mean age 48.1 +/- 28.5 yrs versus 80 healthy controls (76 women and 4 men) with mean age 47.5 +/- 28.8 yrs were included. Hypothyroidism was diagnosed in 19% patients compared with 1.3% in the control group. The following results were found; triyodotironina: 82 ng/dl versus 160 ng/dl, p < 0.000; tiroxina: 5.4 ng/dl versus 7ng/dl, p < 0.01; TSH: 8.2 uUl/ mL versus 1.1 +/- 2 uUl/mL, p < 0.000. Subclinical hypothyroidism was observed in 35% patients versus 0% controls, TSH: 7.2 uUl/ml versus 1.2 +/- 1.4 uUl/ml, p < 0. 000; triyodotironina: 116 ng/dl compared with 160 ng/dl, p = ns; tiroxina: 7.0 ng/dl vs. 7.0 ng/dl, p ns; AbATg were positive in patients 54% and 2.5%, p < 0.001 in the control group. CONCLUSIONS: Our study reports a high prevalence of hypothyroidism among SSc Mexican patients, especially of the subclinical type. We need to consider hypothyroidism as a clinical entity often found among SSc patients, and start hormone replacment treatment accordingly.