La fonction thyroïdienne au cours du premier trimestre de la grossesse / Thyroid function in the first trimester of pregnancy

Introduction : Les dysthyroïdies représentent les secondes pathologies les plus fré-quentes après le diabète chez la femme enceinte. La thyroïde subit de nombreux changements physiologiques pendant la grossesse et son activité fonctionnelle augmente de 50%. Les hormones thyroïdiennes jouent un rôle im-portant dans les premiers stades du développement du cerveau. Au cours du premier trimestre, le fœtus est dépendant de la production d'hormones thyroïdiennes mater-nelles. Il est donc important de détecter, typer et éventuellement traiter toute anomalie thyroïdienne au début de la grossesse; l'idéal étant bien évidemment une prise en charge de ces pathologies avant la conception.Patients et méthodes - Dans ce travail, nous avons étudié les variations des concen-trations plasmatiques des paramètres du bilan thyroïdien à savoir l'hormone thyréos-timulante (TSH), la thyroxine libre (fT4) et tri-iodothyronine libre (fT3) chez cinquante gestantes au 1ertrimestre de la grossesse.Résultats - Parmi les cinquante femmes enceintes au 1er trimestre concernées par notre étude, 11 étaient au 1er mois, 19 au 2ème et 20 au 3ème mois de grossesse. L'âge moyen de nos gestantes était de 30±6,76 ans avec des extrêmes allant de 17 à 45 ans. Le dosage de la TSH a révélé une valeur moyenne chez nos gestantes de 2,37± 4,01mUI/L avec des extrêmes allant de 0,031 à 26,37mUI/L. La prévalence de l'hypothyroïdie dans notre série était de 8 %. Les deux autres paramètres du bilan thyroïdien (fT3, fT4) ont présenté une élévation de leurs concentrations au premier mois puis une stabilisation au 2ème et 3ème mois de grossesse.Conclusion - Les dysthyroïdies sont fréquentes dans notre population d'étude, elles doivent être systématiquement recherchées chez toute femme enceinte et correcte-ment prises en charge afin de prévenir les complications à la fois maternelles et fœtales.

Introduction - Dysthyroidism represents the second most frequent pathologies after diabetes in pregnant women. The thyroid undergoes many physiological changes during pregnancy and its functional activity increases by 50%. Thyroid hormones play an important role in the early stages of brain development. During the first trimester, the fetus is dependent on the production of maternal thyroid hormones. It is therefore important to detect, type and possibly treat any thyroid abnormality at the start of pregnancy; ideally, of course, taking care of these pathologies before conception. Patients and methods - we studied the variations in the plasma concentrations of the parameters of the thyroid balance, namely the thyroid stimulating hormone (TSH), the free thyroxine (fT4) and the free tri-iodothyronine (fT3) in fifty pregnant women in the 1st trimester of pregnancy. Results - Among the fifty pregnant women in the 1st trimester concerned by our study, 11 were in the 1st month, 19 in the 2nd and 20 in the 3rd month of pregnancy. The average age of our pregnant women was 30 ± 6.76 years with extremes ranging from 17 to 45 years old. The TSH assay revealed an average value in our pregnant women of 2.37 ± 4.01 mUI/L with extremes ranging from 0.031 to 26.37 mUI/L. The prevalence of hypothyroidism in our series was 8%. The other two parameters of the thyroid balance (fT3, fT4) showed an increase in their concentrations in the first month and then stabilization in the 2nd and 3rd month of pregnancy. Conclusion - Dysthyroidism is frequent in our study population, it must be systematically sought in any pregnant woman and properly managed in order to prevent complications both maternal and fetal.

FT3/FT4 ratio predicts non-alcoholic fatty liver disease independent of metabolic parameters in patients with euthyroidism and hypothyroidism

OBJECTIVE: This study was performed to evaluate the effects of metabolic parameters and thyroid dysfunction on the development of non-alcoholic fatty liver disease (NAFLD). METHODS: The current study evaluated a total of 115 patients, 75 female and 40 male. Physical examination and anthropometric measurements were applied to all participants. Hypothyroidism was considered at a thyroid stimulating hormone level ≥ 4.1 mIU/L. Patients with euthyroidism and patients with hypothyroidism were compared. Abdominal ultrasonography was used to diagnose non-alcoholic fatty liver disease. The participants were further compared with regard to the presence of non-alcoholic fatty liver disease. Logistic regression modeling was performed to identify the relationship between non-alcoholic fatty liver disease and independent variables, such as metabolic parameters and insulin resistance. RESULTS: Non-alcoholic fatty liver disease was identified in 69 patients. The mean waist circumference, body mass index, fasting plasma insulin, HOMA-IR (p<0.001) and FT3/FT4 ratio (p=0.01) values were significantly higher in the patients with NAFLD compared to those without it. Multivariate regression analysis revealed that FT3/FT4 ratio, waist circumference and insulin resistance were independent risk factors for non-alcoholic fatty liver disease. CONCLUSION: Insulin resistance, enlarged waist circumference, elevated body mass index, higher FT3/FT4 ratio and hypertriglyceridemia are independent risk factors for NADLF, whereas hypothyroidism is not directly related to the condition.

Evaluation of Clinical Effect of Serum FT_3,FT_4 in Patients With Liver Cirrhosis / 中国医师杂志

Objective To study the relationship between changes of contents of serum free-triiodothyronine(FT 3),Free-thyroxine(FT 4) and liver cirrhosis,and analyse it's clinical significanec.Methods The concentration of serum FT 3 and FT 4 were determined by radioimmunoassay in 69 patients with liver cirrhosis,compared with liver function classification(Child-Pugh).Results Contents of serum FT 3,FT 4 in cirrhosis patients were markedly lower than that of controls(P