ABSTRACT
Background The thyroid gland is one of the organs sensitive to ionizing radiation, and there are few studies on the effects of long-term exposure to low doses of ionizing radiation on the thyroid gland of radiation workers. Objective To investigate thyroid abnormalities in workers in medical radiology departments in Guangdong Province and to identify potential influencing factors of thyroid abnormalities. Methods A total of 1657 radiation workers from 48 hospitals in Guangdong Province were selected as survey subjects using convenience sampling, and their personal dose monitoring results and health examination information were retrospectively analyzed to determine the factors affecting thyroid abnormalities. Results The M (P25, P75) of thyroid absorbed dose (DT) was 1.55 (0.65, 3.96) mGy in the 1657 investigated workers. The attribute-specific medians of DT were 1.29, 1.38, 1.99, and 3.51 mGy for departments of diagnostic radiology, interventional radiology, radiotherapy, and nuclear medicine, respectively; and 1.10, 1.55, and 1.80 mGy for job titles of nurse, technician, and physician, respectively. Differences in DT by gender, age, years of radiological work, age of radiation exposure onset, occupational category, and job title were statistically significant (Z=−6.35, H=708.52, 918.20, 31.19, 95.64, 39.28, P<0.05). The positive rate of thyroid abnormalities in investigated workers was 46.53% (771/1657). Among them, the positive rate of abnormal thyroid function was 22.87% (379/1657), that of abnormal thyroid morphology was 33.98% (563/1657), and that of thyroid nodule was 26.55% (440/1657). The differences in thyroid abnormality rates by gender, age, years of radiation work, age of radiation exposure onset, DT, and job title of radiation workers were statistically significant (χ2=51.89, 49.64, 20.54, 18.29, 12.07, 16.16, P<0.05). The differences in abnormal thyroid function positive rate by gender, age of radiation exposure onset, and job title were statistically significant (χ2=26.21, 6.21, 8.32, P<0.05). The differences in the positive rates of abnormal thyroid morphology and nodules were statistically significant by gender, age, years of radiological work, age of radiation exposure onset, DT, and job title (abnormal thyroid morphology, χ2=40.24, 64.17, 37.63, 15.17, 19.28, 15.05; nodules, χ2=31.41, 77.98, 42.11, 19.16, 21.70, 13.52, P<0.05). The positive rates of thyroid abnormality, thyroid morphology abnormality, and nodules all showed a linear increasing trend with increasing age, years of radiation work, and age of radiation exposure onset (P<0.05). The results of logistic regression analysis indicated that the factors influencing thyroid abnormalities were female (OR=2.17, 95%CI: 1.72-2.74), increased years of radiological work (OR=1.04, 95%CI: 1.03-1.06), onset of radiation exposure in age groups of 30-34 and ≥35 years (OR=1.63, 95%CI: 1.12-2.37; OR=2.58, 95%CI: 1.74-3.29), and working in department of diagnostic radiology (OR=1.40, 95%CI: 1.07-1.84). Conclusion Long-term exposure to low doses of ionizing radiation has an effect on thyroid abnormalities in medical radiation workers. Among them, being female, physicians, and working in department of diagnostic radiology are at a higher risk of abnormal thyroid function; being female, increased years of radiation work, and radiation exposure onset at age ≥30 years are associated with a higher risk of reporting abnormal thyroid morphology.
ABSTRACT
Background: AUB is a common but complicated clinical presentation and occurs in 15-20% of women between menarche to menopause and significantly affects the women’s health. Women with thyroid dysfunction often have menstrual irregularities, infertility and increased morbidity during pregnancy. The objective of present study is to find the correlation between thyroid disorders and AUB in perimenopausal women attending gynecology OPD. Methods: In the present study, fifty five patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients. Results: Among 55 patients, 12 patients were diagnosed as hypothyroidism and 7 as hyperthyroidism, women with AUB 36 (65.4%) were euthyroid. Among 19 women with thyroid abnormality, heavy menstrual bleeding was seen in 8 (42%) women, 6 (31.57%) had polymenorrhagia, 5 (26.31%) had oligomenorrhoea. The frequent menstrual abnormality in women with hypothyroidism (12 women) was heavy menstrual bleeding in 5 (41.6%) women, 3 (25%) had oligomennorhoea, 4 (33.3%) had polymenorrhagia. Out of 7 women with hyperthyroidism, 2 (28.57%) had oligomenorrhoea, 3 (42.8%) had heavy menstrual bleeding, 2 (28.57%) had polymenorrhagia. In a total of 55 patients with AUB, 11 (20%) had structural abnormalities in uterus and ovaries. 5 (9%) had adenomyosis, 3 (5.4%) had ovarian cysts, 3 (5.4%) had fibroids. Conclusions: It is important to screen all women for thyroid abnormality who are presenting with AUB especially with non-structural causes of AUB. Correction of thyroid abnormalities also relieves AUB. This will avoid unnecessary hormonal treatment and surgery.
ABSTRACT
Objective To study the effect of maternal subclinical thyroid abnormalities [including subclinical hypothyroidism, hypothyroxinemia and positive anti-thyroid peroxidase antibody (TPOAb) with normal thyroid function] in women during 16-20 weeks of gestation on offspfing's intellectual development and motor function. Methods Sera from 1 268 women during 16-20 weeks of gestation (collected 2 years ago) were obtained and thyroid stimulating hormone (TSH), total thyroxine (TT4), free thyroxine (FT4) and TPOAb levels were measured. Pregnant specific thyroid function reference ranges were used to screen for subclinical hypothyroidism (18 cases), hypothyroxinemia (19 cases) and positive TPOAb (34 cases). From the same cohort, a total of 142 pregnant women who were euthyroid with negative TPOAb were selected as controls (a case: control ratio of 1 : 2). Intellectual and motor development score evaluations were performed in their children at 25-30 months of age. Results In the group of pregnant women with subclinical hypothyroidism, the offspring' s intelligence score was (109.89±13.81) points, which was 8.88 points lower than in the control group (P < 0.01). Similarly, the motor score of the offspring was (108.11±9.93) points, which was 9.98 points lower than in the control group (P < 0.01). In the pregnant women with hypothyroxinemia, the offspring's intelligence score was (112.32±15.10) points, 9.30 points lower than in the control group (P <0.01); the motor score was (112.21±12.26) points, 7.57 points lower than in the control group (P < 0.01). In the pregnant women with positive TPOAb and euthyroid function, the offspring's intelligence score was (112.70±20.64) points, 10.56 points lower than in the control group (P < 0.01); the motor score was (110.64±12.49) points, 9.03 points lower than in the control group (P < 0.01). Conclusion Maternal subclinical thyroid abnormality between 16-20 weeks of gestation adversely may affect offspring intellectual and motor development, suggesting the necessity for screening and treatment of maternal subclinical thyroid abnormality in the early stages of pregnancy.