ABSTRACT
Background: One of the utmost prominent illnesses in India is thyroid disease, and it has a significant impact on women of childbearing age. Various metabolic processes are regulated by the thyroid gland. Therefore, any abnormalities in this organ may cause those physiological functions to become dysfunctional. The postpartum period and pregnancy both frequently include thyroid problems. Method: Total 50 women are included as the sample. A convenient sampling method was used. A structured knowledge questionnaire was used to gather information, and Chi-square analysis was used to uncover the relationship between knowledge about thyroid disorders with socio-demographic factors. Result: The post-test results show that 50% of women were having good knowledge and 42% of women were having average knowledge. According to the pre-test, (68%) of women had inadequate knowledge and (32%) average knowledge. The computed knowledge 憈�-value (14.05) for the degree of freedom 49 and 0.05% level of significance was considerably greater than the table value (1.96). As a result, the planned teaching method worked. Conclusion: After evaluation of knowledge on the subject of thyroid disorders, it was found that most women had average knowledge regarding thyroid disorders. As a result, research has shown that STP was quite helpful in raising women's awareness of thyroid issues.
ABSTRACT
Background: Diabetes mellitus and thyroid diseases are the two common endocrinopathies seen in the adult population. Insulin and thyroid hormones are intimately involved in cellular metabolism. Excess or deficit of either of these hormones could result in the functional derangement of the other. Methods: This study was conducted on the Type 2 diabetic patients to know the prevalence of thyroid abnormalities. The duration of study over a period of one year. Results: T he result of this study revealed that thyroid profile in patients with type 2 diabetes mellitus 20% of patients with type 2 diabetes mellitus had abnormal thyroid profile. Conclusion: This study concludes that Routine screening for thyroid dysfunction in type 2 diabetes mellitus patients may be justified especially in females
ABSTRACT
Background:The thyroid function is changed during early stage of pregnancy. Various thyroid disorders throughout pregnancy are related with grave maternal and fetal outcomes. The geographical variation in the prevalence of hypothyroidism during pregnancy is very wide and generally assessed for thyroid disorders are recommended in the pregnancy. Therefore, present study aimedto estimate the prevalence of thyroid disorders in pregnant women of North Gujarat, India.Methods:The present cross-sectional study was done on 200 pregnant women in the department of general medicine at Banas medical college and our trust-based hospital in North Gujarat, India, over a period of one year from July 2020 to June 2021. The patients' demographic profile was recorded; detailed history and meticulous examination were performed in the entire cases. Serum thyroid-stimulating hormone (TSH), T3(triiodothyronine)and T4 (thyroxine) were analyzed.Results:The overall prevalence of various thyroid disorders 13%. The most frequent thyroid disorder reported was subclinical hypothyroidism encompassing of 8%, followed by overt hypothyroidism 3% in women and the prevalence of subclinical hyperthyroidism was 2% which was least in our study.Conclusions:In our study, we conclude that subclinical hypothyroidism is more common than hyperthyroidism in pregnant women. Therefore, we suggested that thyroid function tests should be include along with other routine investigations during pregnancy to identify thyroid dysfunction and minimize the feto-maternal complications during pregnancy and after birth
ABSTRACT
Abstract Lithium carbonate is a commonly prescribed drug for bipolar disorders. In addition to its action on the central nervous system, lithium has systemic effects on multiple organs such as kidney, heart, motor end plate, thyroid and parathyroid glands. It can cause hypothyroidism, hyperthyroidism, goiter and oph thalmopathy by different mechanisms. It increases intrathyroid iodine content or compete for iodine transport, resulting in low iodine uptake by the thyroid. It also inhibits the coupling of iodotyrosine residues to form iodothy ronines and inhibits the release of T4 and T3. Lithium has direct actions on parathyroid glands by antagonizing the calcium sensing receptor, which may induce hypercalcemia or even hyperparathyroidism, requiring surgery in some cases. Furthermore, it inhibits the expression of aquaporins, mainly aquaporin 2, in the renal collecting tubule by unknown mechanisms leading to nephrogenic diabetes insipidus. This adverse effect is usually reversible after drug withdrawal. However, some patients may present irreversible kidney damage due to chronic interstitial nephropathy.
Resumen El carbonato de litio es un fármaco que se prescribe comúnmente para el tratamiento de trastornos bipolares. Además de su acción sobre el sistema nervioso central, el litio tiene repercusiones sistémicas, afectando a múltiples órganos como el riñón, el corazón, la placa motora terminal y glándulas tiroides y paratiroides. Puede causar hipotiroidismo, hipertiroidismo, bocio y oftalmopatía por diferentes mecanismos; también aumentar el contenido de yodo intratiroideo o competir por el transporte de yodo, lo que resulta en una baja captación tiroidea de yodo. Inhibe el acoplamiento de residuos de yodotirosina para formar yodotironinas e inhibe la liberación de T4 y T3. Tiene acciones directas sobre las glándulas paratiroides antagonizando el receptor sensor de calcio, lo que puede inducir hipercalcemia e incluso hiperparatiroidismo, y puede requerir cirugía en algunos casos. Inhibe la expresión de acuaporinas en el túbulo colector renal, prin cipalmente acuaporina 2, por mecanismos que aún no se conocen, produciendo diabetes insípida nefrogénica; este efecto adverso suele ser reversible tras la suspensión del fármaco. Sin embargo, algunos pacientes pueden presentar daño renal irreversible por nefropatía intersticial crónica.
ABSTRACT
Introduction@#Among the endocrine, nutritional, and metabolic disease and thyroid disorders occupy a significant place. According to the World Health Organization, 8-18% of the world’s population suffer from thyroid disorders. In our country, no research on the prevalence of the disorders has been conducted before, and this research methodology was discussed by the Scientific committee of the National Center for Public Health and was approved by resolution No.156 of the Ethics Committee of the Ministry of Health on 2020. @*Materials and Methods@#In order to determine the prevalence of thyroid disease in the country, we collected the actual number of thyroid disorders registered in 9 districts of the capital city and 330 soums of 21 aimags for a total of 10 years from 2011 to 2020. The prevalence of thyroid disorders was mapped using Arc view and GIS software.@*Results@#Endocrine, nutritional and metabolic disease account for 2.3% of all outpatient cases. Endocrine, nutritional, and metabolic disease accounted for an average of 168.3 per 10000 population over the past 10 years, and thyroid disorders accounted for 45 or 26.7% of endocrine, nutritional, and metabolic diseases. Thyroid disorders are highest in people aged 40-49 years. </br>Thyroid toxicity is the most common type of thyroid disease in Mongolia, accounting for 56.2%, with an average of 17.2 per 10000 population in 2011-2020. However, iodine deficiency-related thyroid disease accounts for 5.5% of all thyroid disorders, with an average of 2.5 per 10000 population in 2011-2020. In 2011, it decreased by 2.2 per 10000 population, and by 2020, it decreased by 0.2 per thousand to 2.0, but in the last 5 years, it has increased by an average of 2.4 per 10,000 population, and in the last 5 years it has increased by 0.2 per thousand, or 2.6 per 10,000 population. Morbidity is high in the Khangai and Central regions.
ABSTRACT
Introduction@#Thyroid hormones are produced by the thyroid gland and are essential for regulating the basal metabolic rate. Abnormalities in the levels of these hormones lead to two classes of thyroid diseases – hyperthyroidism and hypothyroidism. Detection and monitoring of these two general classes of thyroid diseases require accurate measurement and interpretation of thyroid function tests. The clinical utility of machine learning models to predict a class of thyroid disorders has not been fully elucidated. @*Objective@#The objective of this study is to develop machine learning models that classify the type of thyroid disorder on a publicly available thyroid disease dataset extracted from a machine learning data repository. @*Methods@#Several machine learning algorithms for classifying thyroid disorders were utilized after a series of pre-processing steps applied on the dataset. @*Results@#The best performing model was obtained by with XGBoost with a 99% accuracy and showing very good recall, precision, and F1-scores for each of the three thyroid classes. Generally, all models with the exception of Naïve Bayes did well in predicting the negative class generating over 90% in all metrics. For predicting hypothyroidism, XGBoost, decision tree and random forest obtained the most superior performance with metric values ranging from 96-100%. On the other end in predicting hyperthyroidism, all models have lower classification performance as compared to the negative and hypothyroid classes Needless to say, XGBoost and random forest did obtain good metric values ranging from 71-89% in predicting hyperthyroid class. @*Conclusion@#The findings of this study were encouraging and had generated useful insights in the application and development of faster automated models with high reliability which can be of use to clinicians in the assessment of thyroid diseases. The early and prompt clinical assessment coupled with the integration of these machine learning models in practice can be used to determine prompt and precise diagnosis and to formulate personalized treatment options to ensure the best quality of care to our patients.
Subject(s)
Machine LearningABSTRACT
ABSTRACT This position statement was prepared to guide endocrinologists on the best approach to managing thyroid disorders during the coronavirus disease (COVID-19) pandemic. The most frequent thyroid hormonal findings in patients with COVID-19, particularly in individuals with severe disease, are similar to those present in the non-thyroidal illness syndrome and require no intervention. Subacute thyroiditis has also been reported during COVID-19 infection. Diagnosis and treatment of hypothyroidism during the COVID-19 pandemic may follow usual practice; however, should avoid frequent laboratory tests in patients with previous controlled disease. Well-controlled hypo and hyperthyroidism are not associated with an increased risk of COVID-19 infection or severity. Newly diagnosed hyperthyroidism during the pandemic should be preferably treated with antithyroid drugs (ATDs), bearing in mind the possibility of rare side effects with these medications, particularly agranulocytosis, which requires immediate intervention. Definitive treatment of hyperthyroidism (radioiodine therapy or surgery) may be considered in those cases that protective protocols can be followed to avoid COVID-19 contamination or once the pandemic is over. In patients with moderate Graves' ophthalmopathy (GO) not at risk of visual loss, glucocorticoids at immunosuppressive doses should be avoided, while in those with severe GO without COVID-19 and at risk of vision loss, intravenous glucocorticoid is the therapeutic choice. Considering that most of the thyroid cancer cases are low risk and associated with an excellent prognosis, surgical procedures could and should be postponed safely during the pandemic period. Additionally, when indicated, radioiodine therapy could also be safely postponed as long as it is possible.
Subject(s)
Humans , Thyroid Diseases/therapy , COVID-19 , Thyroid Gland , Brazil , Graves Ophthalmopathy/therapy , Pandemics , Hyperthyroidism/therapy , Iodine RadioisotopesABSTRACT
Background: Abnormal uterine bleeding (AUB) means any bleeding that is not normal in amount, duration, frequency, and cyclicity. It is a common disorder occurring in reproductive age group females. It can be understood as bleeding that occurs from the uterus outside the normal parameters and there are no structural defects in the genital tract. One of the most common associations with AUB is thyroid dysfunctions. Hence, this study aimed to see the incidence of thyroid-related disorders in AUB and also to assess the menstrual pattern.Methods: A total 100 women suffering from AUB who presented to OPD of the gynecology department of L D Hospital Srinagar, Jammu and Kashmir were recruited in the study. All females in 19 to 45 years of age group with abnormal uterine bleeding were included excluding those with a previously known thyroid disorder, abortion history within 3 months, etc. Thyroid function tests were done in all along with ultrasonography of the pelvis region. Data were analyzed using SPSS software v.23.0. and Microsoft office 2007.Results: The bleeding abnormality that was found in most of the women was heavy menstrual bleeding. Out of the 100 patients taken into study 11 had thyroid disorders, out of which subclinical hypothyroidism was most prevalent accounting for 8 cases, 2 cases were found to have hypothyroidism and 1 case of hyperthyroidism was detected.Conclusions: Abnormal uterine bleeding has a strong association with thyroid disorders. The most common type of disorder is subclinical hypothyroidism. Thus, all patient of AUB must be evaluated for thyroid dysfunction.
ABSTRACT
ABSTRACT Objective Type 2 diabetes mellitus (T2DM) is a worldwide health problem, and medical nutrition therapy is essential for improving the quality of life of patients with type 2 diabetes. Salt restriction may lead to iodine deficiency in these patients. Moreover, type 2 diabetes can be an indirect reason for thyroid disorders. This study was conducted to determine the relationship between dietary iodine intake, urinary iodine excretion and thyroid functions in people with T2DM. Materials and methods Iodine nutritional status was determined by a one day 24-h dietary recall and food-frequency questionnaire. Iodine status was detemined by urinary iodine excretion with morning urine sample. Results Iodine intake according to one day 24-h dietary recall was lower in T2DM patients [94.8 (76.0-112.0) μg] than people in control group [137.1 (123.1-165.4) μg] (p < 0.05). Iodine intake determined by food-frequency questionnaire rich in iodine was lower in T2DM patients [93.1 (84.4-113.9) μg] than people in control group [140.2 (125.1-166.1) μg] (p < 0.05). Mild iodine deficiency was found in %38.8 of diabetic and %55.1 of healthy individuals (p < 0.05). No significant relationship was found between urinary iodine excretion and thyroid function tests in groups (p > 0.05). However, the relationship between dietary iodine excretion and urinary iodine intake in the diabetic group was lower than in the control group (p < 0.05). Conclusion With this respect, the results showed that while planning medical nutrition therapy for diabetic individuals, the risk of iodine deficiency should be considered.
Subject(s)
Humans , Diabetes Mellitus, Type 2 , Quality of Life , Thyroid Gland , Nutritional Status , IodineABSTRACT
Background: Thyroid gland may have a group of a medical condition that affects its main function. The thyroid gland is located at the front of the neck and produces thyroid hormones. The released hormones go through the blood to many body organs for regulating their function, meaning that it is an endocrine organ. These hormones normally act in the body to regulate energy use, infant development, and childhood development. The study aimed to assess the epidemiology of thyroid disorders among cases in the south-western region, Saudi Arabia, and to assess the reporting quality for these cases data.Methods: A retrospective record based descriptive approach was used through reviewing medical records of all cases that were admitted and diagnosed as thyroid related disorders for different indications in the main hospital (king Khalid Hospital) during the period from January 2018 to January 2020. Data extracted throng pre-structured questionnaire including patient's bio-clinical data, preoperative radiological and laboratory investigations. Also, laryngoscope pre and post operatively was reviewed to record findings.Results: The study included 405 cases with thyroid disorders whose ages ranged from 15 to 71 years old with a mean age of 30.5±10.6 years. Females were 82.7% of the included cases, and 83.8% were Saudi. Thyroid related symptoms were recorded for 1-2 years among 58.1% of the cases and for more than 5 years among 15.8%. Thyroid enlargement was recorded for 73.1% of the cases. The multinodular enlargement was recorded for 53.5% of the cases followed with diffuse thyroid enlargement (27.3%). Regarding the type of surgery undergone, total thyroidectomy was the most recorded followed with lobectomy.Conclusions: The study revealed that the majority of the cases were females at middle age presented with benign lesions with Euthyroid status. The most important conclusion was the significant remarkable underreporting of the different clinical data for the cases with many missing items.
ABSTRACT
Background: Infertility is the inability of a couple to achieve pregnancy over an average period of one year (in a woman under 35 years of age) or 6 months (in a woman above 35 years of age) despite adequate, regular (3-4 times per week), unprotected sexual intercourse. It is of two types, primary infertility and secondary infertility. It can be due to the woman, the man, or both men and woman. Though there are several factors plays role in the causing infertility, endocrine hormones play a crucial role in it. Among all the hormones, thyroid and prolactin hormone have profound effects on reproduction and pregnancy.Methods: A prospective analytical study was conducted among 200 female patients, of age group 20-40 years, attending the outpatient department of obstetrics and gynecology. Sent for analysis of thyroid profile and prolactin levels. The data of the patients who have been completely followed up after six months was entered in excel sheet and analyzed using SPSS (version 16).Results: In this study the mean age of the study participants were 31.33±4.12 years and 4 of them were below 25 years of age. There is high prevalence of hypothyroidism (23.5%) and hyperprolactinemia (31%) was noted among the infertile females.Conclusions: The assessment of thyroid function and prolactin levels is mandatory in the work up of all infertile women, especially those presenting with menstrual irregularities. Also, early initiation of treatment may help in restoring the fertility among the infertile woman.
ABSTRACT
AUB is a common and complicated clinical entity. Thyroid disorders are the most common endocrine disorders in India with a prevalence of 26% in women and its incidence increases with age.Menstrual disturbances may accompany or may even precede thyroid disorders. We wanted to study the correlation between thyroid disorders and abnormal uterine bleeding in women of reproductive age group.METHODSThis is cross-sectional study conducted on 165 subjects who fulfilled the eligibility criteria in the Department of OBGY, AVBRH, Sawangi for a period of 2 years. Thorough clinical examination, ultrasonography and thyroid function tests of the patients was done. RESULTSIn this study, maximum number of patients were in the age group of 21-30 years. Regarding bleeding patterns, maximum patients had complaints of menorrhagia (46.06%). 77.58% of patients were euthyroid, 12.12% were subclinical hypothyroid, 17.88% were overt hypothyroid and 2.42% patients were hyperthyroid. Among both subclinical and overt hypothyroid patients, the most common menstrual irregularity was menorrhagia in 55% followed by polymenorrhagia, acyclical bleeding, polymenorrhoea, oligomenorrhoea and metrorrhagia. Among hyperthyroidism, the most common menstrual irregularity was oligomenorrhoea in 75% followed by hypomenorrhoea in 25%.CONCLUSIONSOur study concludes that the work up of any patient with AUB should essentially consist of T3 and T4 levels along with TSH levels as a mandatory part otherwise cases of subclinical hypothyroidism may be missed if only TSH levels are measured
ABSTRACT
Background: In females, hypothyroidism can cause menstrual disturbances mainly oligomenorrhea. Thyroid dysfunction has also been linked to reduced fertility and pregnancy complications. Several studies have been done to evaluate gonadal dysfunctions in overt hypothyroidism but very few studies are there regarding subclinical hypothyroidism. Present study evaluates the gonadal functions of women with subclinical hypothyroidism.Methods: Total 20 females of age 18 to 35 years with newly diagnosed subclinical hypothyroidism were taken as cases and 20 age and body mass index (BMI) matched healthy females were taken as controls. Both in cases and controls, basal FSH, LH, estradiol were measured on 3rd or 4th day of menstrual cycle at 8 AM on fasting. Thereafter Leuprolide 20 mcg/kg was given subcutaneously on the same day. One hour after injection, LH and estradiol were measured. Basal and stimulated values were compared between both groups.Results: Basal LH was significantly higher in controls (6.63�38 m IU/ml) when compared to cases (6.06�10 m IU) with a p value 0.01 (<0.05). No significant differences were found between stimulated LH and estradiol in both the groups.Conclusions: In mild thyroidal failure the response of pituitary gonadotrophs to leuprolide is normal in contrast to overt hypothyroidism where the response is sluggish. This is the first study to be done in subclinical hypothyroid subjects to asses both basal and stimulated gonadotropin levels. Further studies are required in large samples to confirm these findings.
ABSTRACT
Background: Pregnancy induced thyroid disorders, gestational diabetes mellitus (GDM) and gestational hypertension are common problems in women with gestational period. Published literate shows wide range of prevalence in pregnancy induced disorders in other states of India, and as of now the exact prevalence in our study population is not studied. Hence, there present study was aimed to know the prevalence of pregnancy induced disorders in pregnant women in South Indian population.Methods: A total of 120 subjects were followed-up at the time of recruitment to entire gestational period. Standard guidelines were followed for the assessment of thyroid hormone levels, glucose tolerance test (OGTT) and blood pressure values at different intervals and positions. Apart from detailed clinical history has been taken and routine basic and obstetrical investigations were done.Results: Prevalence of thyroid dysfunction (15.0%), gestational diabetes mellitus (11.7%) and gestational hypertension (9.2%) was reported in the present study population. Subclinical hypothyroidism was highest prevalence amount thyroid disorders. Gestational diabetes subjects have mean blood glucose levels of 230.68±17.48 mg/dL with OGTT test. Gestational hypertensive patients had SBP of 152.4±10.8 and DBP of 96.6±6.4; pre-hypertensive subjects had SBP of 134.2±5.48 and DBP of 6.8±4.6 respectively.Conclusions: Our study findings were slightly higher than normal prevalence’s which are reported earlier by various authors. We suggested that early screening, diagnosis and treatment are warranted for the prevention of maternal and fetal complications in Indian population.
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, Ninety patients with AUB were included and were evaluated for the cause including thyroid abnormality. Thyroid function tests were done in all patients.Results: Among 90 patients, 22 patients were diagnosed as hypothyroidism and 9 as hyperthyroidism, women with AUB 59 (65.4%) were euthyroid. Among 31 women with thyroid abnormality, heavy menstrual bleeding was seen in 14 (45.1%) women, 11 (35.4%) had Polymenorrhagia, 6 (19.3%) had oligomenorrhea. The frequent menstrual abnormality in women with hypothyroidism (22 women) was heavy menstrual bleeding in 9 (40.9%) women, 5 (22.7%) had oligomenorrhea, 8 (36.3%) had Polymenorrhagia. Out of 9 women with hyperthyroidism, 3 (33.3%) had oligomenorrhoea, 4 (44.4%) had heavy menstrual bleeding, 2 (22.2%) had Polymenorrhagia.Conclusions: AUB might be because of structural or non-structural causes. Thyroid abnormalities may present in perimenopausal women with abnormal uterine bleeding, therefore proper identification of the cause of AUB is needed to give appropriate treatment to the patient. And to avoid unnecessary surgical intervention.
ABSTRACT
Background: Abnormal uterine bleeding (AUB) is a common clinical presentation in gynecology. Alteration in thyroid hormones level has been associated with menstrual disturbances. This study is aimed to know the prevalence of thyroid disorders amongst AUB patients and also the different patterns of menstrual abnormalities associated with thyroid disorders.Methods: 100 Patient of clinically diagnosed AUB were taken from gynecology OPD at RNT Medical College Udaipur from October 2019 to March 2019. All the patients from 19 to 45 age groups presenting with menstrual disturbances were tested for thyroid function by measuring ST3, ST4, and S.TSH. Statistical analysis done by percentage formula.Results: Out of 100 women of AUB, majority were in the age group of 31-40 years (38%). 44% presented with menorrhagia. 65% were euthyroid, 17% had subclinical hypothyroidism, 15% had overt hypothyroidism and 3% were diagnosed as hyperthyroid. Subclinical hypothyroidism, overt hypothyroidism and hyperthyroidism were detected mostly in the age group of 31-40 years. The commonest bleeding abnormalities in hypothyroid patient were oligomenorrhoea while most of the hyperthyroid cases were having menorrhagia.Conclusions: The study concludes that biochemical evaluation of thyroid function is an easy, reliable method and should be made mandatory in all cases of AUB.
ABSTRACT
Diabetes mellitus and thyroid disorders are the most common endocrine disorders worldwide. Various studies have found that diabetes and thyroid disorders mutually influence each other and both disorders tend to coexist. Objective: To study the prevalence of different forms of thyroid dysfunctions, their risk factors and clinical implications in cases of type 2 diabetes mellitus. Methods: The study was conducted on 300 patients of Type 2 diabetes mellitus. All the patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH). The correlation of prevalence of thyroid disorder with gender distribution, age distribution, HbA1C, duration of diabetes, hypertension, BMI, microvascular complication and dyslipidaemia was done. The observations and interpretations were recorded and results obtained were statistically analysed. Results: There was a high prevalence (20%) of thyroid disorders in patients of type 2 diabetes mellitus. Most common was subclinical hypothyroidism (11.66%) which was further found to be more in females, in middle to elderly patients, less than 5 years duration and patients with normal BMI. Conclusion: Screening for thyroid disorders should be done in all diabetic patients. Treatment of thyroid disorder in diabetics may be beneficial for their glycemic control and prevention of progression of microvascular complication.
ABSTRACT
Data on the association between subclinical thyroid dysfunction and coronary artery disease (CAD) is scarce. We aimed to analyze the association between thyroid function and CAD using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We included subjects with normal thyroid function (0.4-4.0 mIU/L, and normal free thyroxine, FT4, or 0.8 to 1.9 ng/dL), subclinical hypothyroidism (SCHypo; TSH>4.0 mIU/L and normal FT4), and subclinical hyperthyroidism (SCHyper; TSH<0.4 mIU/L and normal FT4) evaluated by coronary computed tomography angiography. We excluded individuals using medications that interfere in thyroid function or with past medical history of cardiovascular disease. Logistic regression models evaluated the presence of CAD, segment involvement score (SIS) >4, and segment severity score (SSS) >4 of coronary arteries as the dependent variables, and quintiles of TSH and FT4 as the independent variables, adjusted for demographical data and cardiovascular risk factors. We included 767 subjects, median age 58 years (IQR=55-63), 378 (49.3%) women, 697 euthyroid (90.9%), 57 (7.4%) with SCHypo, and 13 (1.7%) with SCHyper. No association between TSH and FT4 quintiles and CAD prevalence was noted. Similarly, no association between TSH levels and the extent or severity of CAD, represented by SIS>4 and SSS>4 were seen. Restricting analysis to euthyroid subjects did not alter the results. TSH levels were not significantly associated with the presence, extent, or severity of CAD in a middle-aged healthy population.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thyroid Diseases/blood , Thyroxine/blood , Coronary Artery Disease/blood , Thyrotropin/blood , Thyroid Diseases/complications , Thyroid Diseases/diagnostic imaging , Thyroid Function Tests , Coronary Artery Disease/complications , Coronary Artery Disease/diagnostic imaging , Brazil , Biomarkers/blood , Cross-Sectional Studies , Risk Factors , Longitudinal Studies , Coronary Angiography , Computed Tomography AngiographyABSTRACT
Background: The disorders of thyroid glands are most common in female population compared to male population. Maximum numbers of patients were in the second to fifth decade. Patients of benign multinodular goitre formed the largest proportion of the cases in the study. The second most common lesion detected was solitary nodules. Ultrasound was able to detect an increase in gland size. Both micro-calcification and macro-calcification were easily detected by ultrasound study. Ultrasound was able to detect lymph node metastasis and cystic degeneration. High-resolution ultrasonography (USG) is the most sensitive imaging modality available for examination of the thyroid gland and associated abnormalities. Ultrasound scanning is non-invasive, widely available, less expensive, and does not use any ionizing radiation. Further, real time ultrasound imaging helps to guide diagnostic and therapeutic interventional procedures in cases of thyroid disease. Methods: All patients are examined in supine position with hyper extended neck, using a high frequency lineararray transducer (7-15 MHz) in Toshiba USG machine that provides adequate penetration and high resolution image. Scanning is done both in transverse and longitudinal planes. Results: Out of 120 patients, maximum number of patients were between the age of 20 to 50 years and 70% of patients were female but only 30% were males. Ultrasound can detect multiple nodules in 52 patients (43.33%) and single nodule in 20 patients (16.66%). Conclusion: Ultrasound was able to predict micro-calcifications in malignancies and the presence of macro-calcifications in benign nodules. This finding was of considerable importance for predicting malignancy in the nodules. Ultrasound was able to detect lymph node involvement in malignancies.
ABSTRACT
Thyroid diseases are common, and use of levothyroxine is increasing worldwide. We investigated the influence of gender, race and socioeconomic status on the diagnosis and treatment of thyroid disorders using data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort study of civil servants (35-74 years of age) from six Brazilian cities. Diagnosis of thyroid dysfunction was by thyrotropin (TSH), and free thyroxine (FT4) if TSH was altered, and the use of specific medications. Multivariate logistic regression models were constructed using overt hyperthyroidism/hypothyroidism and levothyroxine use as dependent variables and sociodemographic characteristics as independent variables. The frequencies of overt hyper- and hypothyroidism were 0.7 and 7.4%, respectively. Using whites as the reference ethnicity, brown, and black race were protective for overt hypothyroidism (OR=0.76, 95%CI=0.64-0.89, and OR=0.53, 95%CI=0.43-0.67, respectively, and black race was associated with overt hyperthyroidism (OR=1.82, 95%CI=1.06-3.11). Frequency of hypothyroidism treatment was higher in women, browns, highly educated participants and those with high net family incomes. After multivariate adjustment, levothyroxine use was associated with female gender (OR=6.06, 95%CI=3.19-11.49) and high net family income (OR=3.23, 95%CI=1.02-10.23). Frequency of hyperthyroidism treatment was higher in older than in younger individuals. Sociodemographic factors strongly influenced the diagnosis and treatment of thyroid disorders, including the use of levothyroxine.