Prognostic study and influencing factors analysis for the dynamic changes of serum FT3, FT4 and TSH levels in patients with hemorrhagic stroke under 45 years of age / 公共卫生与预防医学

Objective To discuss the epidemiological characteristics of the dynamic changes of serum FT3, FT4, and TSH levels in patients with hemorrhagic stroke under the age of 45, and to discuss the prognostic evaluation effects and influencing factors of these indicators. Methods From January 2017 to January 2020, 227 patients with multicenter hemorrhagic stroke in our hospital were selected for analysis. Collect and analyze prognosis (death, rebleeding, no adverse prognosis) at baseline and 12 months of follow-up; monitor serum FT3, FT4, and TSH levels during treatment at the same time during follow-up, 7 days after treatment, and 14 days after treatment. Observe the trend characteristics of dynamic changes. The assay method is enzyme-linked immunosorbent assay. At the end of the follow-up, the subjects were divided into three groups: death, rebleeding, and no adverse prognosis according to the prognostic outcome of the 12-month short-term follow-up. The epidemiological characteristics of patients with different prognosis and the dynamic change trend of FT3, FT4 and TSH in the same serum were compared. The interconnectedness. Results There were no statistically significant differences in gender and age between the three groups (P>0.05), but the differences in hypertension, hyperglycemia, and hyperlipidemia were statistically significant (P0.05). The FT4 level of the case group was significantly higher than that of the control group at all times (P0.05). The TSH level of the case group was significantly higher than that of the control group at all times (P0.05). With the decrease of the patient's age, the serum FT3 level has a gradually increasing trend, and the serum FT4, TSH level, mortality and rebleeding rate have a gradually decreasing trend (P<0.05). Conclusion The continuous decrease of FT3 level and the continuous increase of FT4 and TSH levels are potentially associated with the poor prognosis of patients with hemorrhagic stroke, which is worthy of clinical attention.

Hipotiroidismo en pacientes del Centro de Especialidades Médicas; IESS-La Libertad

Resumen El hipotiroidismo es el cuadro clínico resultante de la disminución en la producción de hormonas tiroideas. Objetivo. Fue caracterizar el hipotiroidismo en pacientes que acudieron al laboratorio clínico del Centro de Especialidades IESS de la Libertad, durante el período enero 2018 - enero 2020 mediante la medición de niveles de FT3, FT4, TSH. Materiales y Métodos. Se realizó un estudio de tipo descriptivo, de diseño documental. El universo constituye 2451 pacientes con sospecha de enfermedad tiroidea que acudieron al servicio de laboratorio del Centro de Especialidades IESS, La Libertad durante el período enero 2018 a enero 2020. Se procedió a revisar archivos de historial de resultados de los pacientes atendidos en el laboratorio. Resultados. 617 pacientes cumplen criterios de hipotiroidismo primario lo cual representa una prevalencia del 25,2%. El hipotiroidismo subclínico, constituye el 70,8%, el hipotiroidismo clínico representa el 29,2%, estos fueron más frecuentes en mujeres. En cuanto al grupo etario el hipotiroidismo subclínico se presenta con mayor frecuencia en el grupo de adultos 44,9 % y en adultos jóvenes 24,8 %. En referencia a las comorbilidades asociadas; tanto en el hipotiroidismo clínico y subclínico las más representativas en orden de frecuencia son: hipertensión arterial (35%), dislipidemia (25,8%) y diabetes mellitus (14,1%). Conclusiones . Existe una alta prevalencia de hipotiroidismo primario, los hombres se clasifican mayoritariamente con hipotiroidismo clínico, las mujeres tienen mayor frecuencia de hipotiroidismo subclínico. La presencia de comorbilidades como hipertensión arterial, dislipidemias y diabetes mellitus tipo II están presentes en los pacientes hipotiroideos estudiados.

Abstract Hypothyroidism is the clinical picture resulting from decreased thyroid hormone production. Objective. Was to characterize hypothyroidism in patients attending the clinical laboratory of the Centro de Especialidades IESS de la Libertad, during the period January 2018 - January 2020 by measuring levels of FT3, FT4, TSH. Materials and Methods . A descriptive study of documentary design was performed. The universe constituted 2451 patients with suspected thyroid disease who attended the laboratory service of the Centro de Especialidades IESS, La Libertad during the period January 2018 to January 2020. We proceeded to review the results history files of the patients attended in the laboratory. Results. 617 patients met criteria for primary hypothyroidism which represents a prevalence of 25.2%. Subclinical hypothyroidism constitutes 70.8%, clinical hypothyroidism represents 29.2%, these were more frequent in women. Regarding the age group, subclinical hypothyroidism was more frequent in adults 44.9% and in young adults 24.8%. In reference to the associated comorbidities; both in clinical and subclinical hypothyroidism the most representative in order of frequency are: arterial hypertension (35%), dyslipidemia (25.8%) and diabetes mellitus (14.1%). Conclusions. There is a high prevalence of primary hypothyroidism, men are mostly classified with clinical hypothyroidism, women have a higher frequency of subclinical hypothyroidism. The presence of comorbidities such as arterial hypertension, dyslipidemias and type II diabetes mellitus are present in the hypothyroid patients studied.

Resumo O hipotireoidismo é o quadro clínico resultante da diminuição da produção de hormônios da tireóide. Objetivo. Caracterizar o hipotireoidismo em pacientes que freqüentam o laboratório clínico do Centro de Especialidades IESS de la Libertad, durante o período de janeiro de 2018 a janeiro de 2020, medindo os níveis de FT3, FT4, TSH. Materiais e métodos. Foi realizado um estudo descritivo do projeto documental. O universo consistia de 2451 pacientes com suspeita de doença da tireóide que compareceram ao serviço laboratorial do Centro de Especialidades IESS, La Libertad, durante o período de janeiro de 2018 a janeiro de 2020. Procedemos à revisão dos arquivos de histórico dos resultados dos pacientes atendidos no laboratório. Resultados. 617 pacientes preencheram os critérios para o hipotireoidismo primário, o que representa uma prevalência de 25,2%. O hipotireoidismo subclínico constituía 70,8%, o hipotireoidismo clínico 29,2%, e estes eram mais frequentes nas mulheres. Em termos de faixa etária, o hipotireoidismo subclínico foi mais freqüente em adultos (44,9%) e em adultos jovens (24,8%). Em referência às co-morbidades associadas; tanto no hipotireoidismo clínico como no subclínico, as mais representativas em ordem de frequência são: hipertensão arterial (35%), dislipidemia (25,8%) e diabetes mellitus (14,1%). Conclusões . Há uma alta prevalência de hipotireoidismo primário, os homens são na maioria classificados com hipotireoidismo clínico, as mulheres têm uma maior frequência de hipotireoidismo subclínico. A presença de co-morbidades como hipertensão, dislipidemia e diabetes mellitus tipo II estão presentes nos pacientes hipotireóides estudados.

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.

Prevalence of thyroid dysfunction in neonatal population

Background: The objectives of this study was to study the prevalence of thyroid disorders in high risk neonatal populations and to study association of maternal thyroid dysfunction with neonatal thyroid problems and outcome.Methods: This was an observational study, conducted in NICU at Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. The study included neonates born to mothers with thyroid disorder or with clinical features suggestive of thyroid dysfunction. Neonates with history of maternal thyroid dysfunction were screened at 72 to 96 hrs of postnatal age. Those with TSH >10 mIU/L or free T4 <1.1 ng /ml were followed up after two weeks. The neonates with clinical features suggestive of thyroid dysfunction were screened at presentation and those with abnormal thyroid profile were followed up after two weeks. Results obtained were statistically analyzed using SPSS 17.0 software.Results: Out of 260 neonates screened, 208 neonates were born to mothers with hypothyroidism, 6 neonates had increased levels of TSH during first week which normalised on follow up during third week. One neonate born to hyperthyroid mother, showed increased TSH levels during first week and 2nd week which declined to normal level on follow up at 3rd week. Out of 51 neonates with clinical features suggestive of thyroid dysfunction, born to euthyroid mothers, 3 neonates had increased levels of TSH on presentation which normalised on further follow up. Thus, majority of high risk neonates at birth show transient hypothyroidism.Conclusions: None of the neonate was labelled as hypothyroid, all the 10 neonates showed transient hyperthyrotropinemia.

Influence of obesity on serum levels of thyroid hormones among Indian adult population

Background: Obesity and thyroid dysfunction are two most common clinical conditions that have been linked together closely in adult. The link has become more relevant in the context of an unprecedented rise in the prevalence of obesity worldwide. Obesity is normally observed by patients as being secondary dysfunction on serum levels of thyroid hormones. Objective: The Purpose of this study to assess serum thyroid hormones levels (fT3, fT4, TSH) variation in patients with obesity and normal thyroid function among Indian adults and to correlate serum levels of thyroid hormones with their classes of Body Mass Index (BMI).Methods: Authors performed a retrospective study of adult patients who were examined and analyzed serum levels of thyroid hormones at authors centre between February 2018 to November 2019.Results: A total of 231 adult patients were included. 122(52.8%) were males, mean age was 35.4±10.4 and mean BMI 34.2±5.8 respectively. Obesity was found higher in female 58(53.2%) than male 37(30.3%) participants (p<0.001), respectively. The mean TSH serum levels were significantly increased with increased BMI (2.04±1.19,2.51±1.22 and 3.39±1.19; p=<0.001).  No association was found of serum fT4 (p=0.227) and serum fT3 (p=0.063) with BMI.Conclusions: Mean TSH serum levels showed a significantly increased with increased BMI. BMI was negatively associated with serum fT4 but had no association with serum fT3.

A Prospective Study of Incidence of Hypothyroidism after Hemithyroidectomy in a Tertiary Care Hospital in North Odisha

The risk of hypothyroidism after hemithyroidectomy is variable and not well studied. Our aim was to evaluate the incidence of post-hemithyroidectomy hypothyroidism and identify possible risk factors which indicate whether patients require thyroid function monitoring after surgery. Methods: This study was conducted amongst 60 patients who had undergone hemithyroidectomy in the Department of Surgery, F. M Medical College, Odisha from Jan 2018 to April 2019. Thyroid hormone test were done to determine the incidence of hypothyroidism. The incidence of hypothyroidism was analyzed. Results: We observed that 15% of cases developed overt and 5% developed sub-clinical hypothyroidism following hemi-thyroidectomy. Maximum number of cases was diagnosed within 18 weeks of surgery. Conclusion: Incidence of hypothyroidism following hemithyroidectomy in our study is high amounting to 20% which includes both subclinical as well as overt cases. Overt cases being treated with Levothyroxine and subclinical cases had been followed up carefully.

Association of Thyroid Hormones with Prolactin, Follicle Stimulating Hormone and Luteinizing Hormone in Female Infertility

Human infertility is a major health problem worldwide having its impact on the social, psychological, economical and sexual life of a couple. Methods: Total of 80 subjects (Out of which 50 infertile female and 30 normal fertile female) were selected on gynecology infertility outpatient department between age group of 20 to 44 years. Out of 50 infertile women, 34 were of primary infertility and 16 of secondary infertility. Results: Statistically significant higher serum TSH levels were noted in the infertile subject with euthyroid (p=0.03) and hypothyroidism (p<0.001) when their distributions were compared to their respective fertile subjects. The rise in serum FT3 and FT4 in the infertile subjects with hyperthyroidism was found to be not significant as compared to the fertile subjects with hyperthyroidism. The mean serum prolactin concentration in the infertile female with euthyroid was significantly higher (p<0.01) than the fertile subjects with euthyroid. The infertile women with hypothyroidism had statistically significant higher prolactin levels than the other three categories (the fertile female and the infertile subjects with euthyroid and hyperthyroidism) (p<0.01). Conclusion: High prevalence of hypothyroidism was seen in infertile female. These disorders may lead to menstrual irregularities resulting in infertility.

Study of Liver Function Tests in Patients of Hypothyroidism

The liver is fundamental in metabolizing thyroid hormones,and hepatocytes are often affected in thyroid disease. Thyroiddisorders often accompany abnormal serum enzyme levelsand disturbances in liver functions. These thyroid-liverassociations may cause diagnostic confusions. Neglect of thesefacts may result in over or under diagnosis of associated liveror thyroid diseases and thereby cause errors in patient care.Aim of the present study was to determine the biochemicalmarkers of liver function test Aspartate transaminase (AST),Alanine transaminase (ALT) and Alkaline phosphatase (ALP)in patients with hypothyroidism and to find their possiblecorrelation with thyroid profile.Material and Methods: The study included 50 patients withsubclinical hypothyroidism (TSH 6.0-9.9miu/l), 50 patientswith overt hypothyroidism (TSH ≥10.0 miu/l) and 50 agematched normal euthyroid controls. In all study groups FT3,FT4, TSH, AST ALT and ALP were estimated. Thyroid profileand LFT were estimated using fully autoanalyser. p value<0.05 considered as significant.Results: Subjects with both subclinical hypothyroidism andovert hypothyroidism had significantly raised serum AST,ALT and ALP (p<0.0001) compared to controls. Further, TSHshowed significant positive correlation with AST, ALT andALP (P<0.001) in both subclinical and overt hypothyroidism,Conclusion: Hypothyroid patients should be regularlychecked for biochemical parameters of LFT. As early detectionand treatment can prevent the further complications relatedto the disorder and will be helpful during the management ofhypothyroid patients.

Effect of Carbamazepine on the Serum Level of Thyrotropin-Releasing Hormone

Background: The thyroid gland is endocrine gland located in front and lower side of neck. Thyroid gland secretes two types of thyroid hormones that are triiodothyronine (T3) and tetraiodothyronine (T4). The hypothalamus is a center for regulation of thyroid hormones. It senses the low hormone levels and in turn releases thyrotropin-releasing hormone (TRH). TRH stimulates anterior pituitary to release TSH which then acts on the thyroid gland to maintain normal level of T3 and T4. The objective of study is to determine the effects of carbamazepine on TRH in euthyroid rabbits.Methods: An experimental study performed on 30 rabbits. These were divided into three groups having 10 rabbits in each group. 10 rabbits were treated with 10mg/kg/day of CBZ (OD), other 10 with 35mg/kg/day CBZ (three divided doses) and 10 rabbits served as control. T3, FT4, TSH and TRH levels were evaluated at baseline and after 21 days of treatment in all three groups by Electro-chemiluminescence immunoassay and ELISA respectively.Results: Comparison of the hormone levels of the control group and the group having a dose of 10 mg/kg/day for 21 day of treatment. Comparative results showed serum level of T3 (P=0.031), FT4 (P=0.030), and TRH (P=0.044) levels significantly lower than the control group and TSH (P=0.057) levels remain unaltered. It was also found that group having a dose of 35 mg/kg/day; TDS showed decrease in T3 (P value 0.001), FT4 (P=0.001), TSH (P=0.003) and TRH (P=0.001) level as compared to control group.Conclusions: Our data suggest that Carbamazepine monotherapy does alter thyroid hormones and its central regulatory hormone TRH. Decrease in TRH level increase level of depression and suicidal thoughts and also risk of tertiary hypothyroidism. These findings could have very important clinical implications.

Relación entre hipotiroidismo y cáncer de tiroides en el Hospital Pablo Arturo Suárez de la ciudad de Quito de enero 2014 a diciembre 2017 / Relationship between hypothyroidism and thyroid cancer at Hospital Pablo Arturo Suárez of Quito from January 2014 to December 2017

Introducción: el Ecuador es un lugar endémico de patología de la glándula tiroides, el cáncer tiroideo se encuentra dentro de las cinco neoplasias tanto en hombres como mujeres y el hipotiroidismo presenta una mayor incidencia comparada con otros países con mayor población en Sudamérica como Brasil y Perú. Objetivo: describir la relación entre hipotiroidismo y carcinoma de tiroides en el Hospital Pablo Arturo Suárez en los años 2014 a 2017. Métodos: se realizó un estudio transversal. Los datos se obtuvieron de las historias clínicas registradas en estadística. Resultados: se registraron 105 casos de cáncer de tiroides: 15 varones (14.3%) y 90 mujeres (85.7%). En los paraclínicos prevaleció el hipotiroidismo subclínico con promedio de TSH (tirotropina): de 5.5 uUl/mL y FT4 (tetrayodotironina libre) de 0.9 ng/dL, un 62% de los pacientes con cáncer de tiroides presentó alteración de la TSH: (50.5%) con hipotiroidismo subclínico y un (11.4%) con hipotiroidismo manifiesto. Conclusión: la neoplasia de tiroides se asoció en mayor porcentaje con hipotiroidismo subclínico.

Introducction: Ecuador is an endemic place of thyroid pathology, thyroid cancer is within the five neoplasms in men and women and hypothyroidism has a higher incidence compared to other countries with greater population in South America like Brazil and Peru. Objective: to describe the relationship between hypothyroidism and thyroid carcinoma at the Hospital Pablo Arturo Suárez in the years 2014 to 2017. Methods: a cross-sectional study was conducted in Quito-Pichincha-Ecuador. Data were obtained from clinical records registered in statistics. Results: 105 cases of thyroid cancer were reported: 15 men (14.3%) and 90 women (85.7%). In the paraclinics, subclinical hypothyroidism with an average of TSH prevailed: 5.5 uUl / mL and FT4 of 0.9 ng / dL. 62% of patients with thyroid cancer had TSH alteration: (50.5 %) with subclinical hypothyroidism and (11.4%) with symptomatic hypothyroidism. Conclusion: thyroid neoplasia was associated with subclinical hypothyroidism.

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.

Curative efficacy of euthyrox in treatment of hypothyroidism during pregnancy and its effect on levels of TSH,FT3 and FT4 / 中国生化药物杂志

Objective To study curative efficacy of euthyrox in treatment of hypothyroidism during pregnancy and its effect on levels of TSH , FT3 and FT4.Methods 100 patients of hypothyroidism during pregnancy who received therapy from June 2014 to June 2015 in our hospital were selected as research objects, and divited into control group and observation group,50 cases in each group.The control group was treated with Fugui Dihuang wan, while the observation group was treated with euthyrox on the basis of control group.Then the levels of TSH,FT3 and FT4, pregnancy outcome, neonatal adverse outcome, treatment outcome of two groups after treatment were compared.Results After treatment, the level of TSH in observation group was lower than the control group, the levels of FT3 and FT4 was higher than the control group ( P<0.05 ); Incidence of pregnancy complications in observation group was less than the control group [12.00%(6/50)vs 40.00%(20/40)](P<0.05);Total neonatal adverse outcomes [8.00%(4/50) vs 26.00%(13/50)](P<0.05); The total effective rate of observation group was statistically higher than that in the control group [96.00%(48/50) vs 80.00%(40/50)](P<0.05).Conclusion Euthyrox is well for hypothyroidism during pregnancy, which can improve TSH, FT3 and FT4 levels, relieve clinical symptoms.

Comparación de los niveles séricos de tsh y t4 ubre en bovinos / Tsh and free t4 serum levels comparison in cattle

El presente estudio tuvo como objetivo determinar los niveles de TSH y T4 libre (T4L) en bovinos, diferenciados por género y edad, y conocer su comportamiento frente a dichas variables. Se obtuvieron 133 muestras de sangre de bovinos F1 en estado de ayuno y con ellas se establecieron cuatro grupos (36 machos y 20 hembras menores de 18 meses y 47 machos y 30 hembras mayores de 24 meses). Se determinaron los niveles de TSH y T4L mediante inmunoensayo enzimàtico. Los valores promedio de TSH (pül/ml) fueron de 1,86 para las hembras jóvenes y adultas, 1,88 para los machos jóvenes y 1,99 para los machos adultos. El valor P del test F fue mayor a 0,05 en todos los grupos y, por lo tanto, no hay diferencia estadísticamente significativa, con una confiabilidad del 95%. Los valores promedio de T4L (ng/dl) para hembras jóvenes, hembras adultas, machos jóvenes y machos adultos fueron de 0,84; 0,62; 0,67 y 0,85, respectivamente. El valor P del test F fue menor a 0,05 en todos los grupos, indicando diferencia estadísticamente significativa, con 95% de confiabilidad. En conclusión, no se encontraron efectos de sexo y edad sobre las concentraciones de TSH, mientras que los niveles de T4L exhiben diferencia significativa entre estas variables; en efecto, entre los bovinos jóvenes, las hembras tienen niveles màs elevados; por su parte, en los adultos, son los machos los que presentan valores superiores.

The present study was aimed to determine the levels of TSH and free T4 (T4L) in cattle differentiated by gender and age, and know their correlation with these variables. Blood samples of 133 bovines F1 were obtained in fasting state, establishing four groups (36 males and 20 females under 18 months and 47 males and 30 females over 24 months). Levels of TSH and free T4 were measured using enzymatic immunoassay. The average of TSH values (pUI/ml) were 1.86 for young and adult females, 1.88 for young males, and 1.99 for adult males. The P-value of test F was greater to 0.05 in all groups; therefore, there is not statistically significant difference, with a 95% confidence. The average of free T4 values (ng/dl) for young females, adult females, young males and adult males were 0.84; 0.62; 0.67 and 0.85 respectively. The P-value was less than 0.05 in all groups, indicating a statistically significant difference, with a confidence of 95%. In conclusion, we found no effect of sex and age on concentrations ofTsH; instead, free T4 levels show statistically significant difference between these variables, finding in the young animals, that females have higher T4 levels, and in adults, males present higher values of T4.

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.

Timing of Levothyroxine in the Treatment of Primary Hypothyroidism.

Aim: Timing of levothyroxine (L-thyroxine) administration seems beneficial for early obtaining thyroid state. The present study aimed at investigating the best time of L-thyroxine administration that can achieve earlier normalization of thyroid stimulating hormone (TSH) and free thyroxine (FT4) levels in patients with primary hypothyroidism. Study Design: Eighty two patients with primary hypothyroidism were recruited between November 2012 and July 2013 during their consultation to Al-Faiha Specialized Diabetes, Endocrine and Metabolism Center, Basrah, Iraq. The patients were divided into two equal groups; group A were receiving L-thyroxine daily, one hour before breakfast, group B: the dose of L-thyroxine was given at the evening. TSH, FT4, Body mass index (BMI), blood pressure, lipid profile were measured before, 30, 60 and 90 days after treatment with L-thyroxine. Results: The mean reduction in TSH from baseline for the evening treatment was 13.6±22.2 mIU/ml which was slightly and insignificantly higher than the value of the morning treatment (11.3±22.5 mIU/ml), P = .63, df = 80, 95% CI: -12.17, 7.5). The mean increase in FT4 from baseline for the evening treatment was 5.7±4.9 pmol/l which was lower than 7.6±6 pmol/l in the morning treatment, (P = .12, df = 80, 95% CI: - 0.5, 4.3). There was no effect of treatment timing on lipid profile, blood pressure, and BMI. Conclusions: There were no differences between the morning and evening treatment with L-thyroxine on early normalization of TSH and FT4.

Establishment of Trimester-Specific Reference Intervals for Thyroid Hormones in Korean Pregnant Women

BACKGROUND: Establishment of trimester- and assay-specific reference intervals for every population is recommended. The aim of this study was to establish a trimester- and assay-specific reference interval for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in Korean pregnant women. METHODS: From April 2012 to December 2012, 531 pregnant women receiving prenatal care and 238 age-matched, non-pregnant women were enrolled in this study. After excluding patients with pregnancy-associated complications or thyroid-specific autoantibody, 465 pregnant and 206 non-pregnant women were included. Non-parametric analysis (2.5-97.5th percentile) was performed to determine the reference interval. Levels of TSH and FT4 were determined by electrochemiluminescence immunoassay (Elecsys thyroid tests, Roche Diagnostics, Germany). RESULTS: The TSH reference intervals were 0.01-4.10, 0.01-4.26, and 0.15-4.57 mIU/L for the first, second, and third trimester, respectively. From the first trimester to the third trimester, the median TSH levels showed a significantly increasing trend (P<0.0001). The FT4 reference intervals were 0.83-1.65, 0.71-1.22, and 0.65-1.13 ng/dL for the first, second, and third trimester, respectively, showing a significantly decreasing trend (P<0.0001). CONCLUSIONS: Establishing trimester-specific reference intervals in pregnant women is essential for accurate assessment of thyroid function. Our population-specific and method-specific reference intervals will be useful for screening Korean pregnant women for thyroid disease.

Assessment of thyroid function in euthyroid obese medical students.

Background: It is well known that Thyroid Hormones play a key role in regulating energy homeostasis. The association between thyroid hormones and energy expenditure is well established. There is inverse relationship between obesity and energy expenditure. There is a limited data on thyroid function in euthyroid obese young individuals. Objectives: The present study was designed to evaluate the relationship between thyroid function and obesity in euthyroid young individuals. Materials & Methods: Obesity was defined as per Body Mass Index. (BMI)Undergraduate medical students were grouped as normal, overweight and obese as per their Body Mass Index Thyroid function was assessed by measuring fT3, fT4 and TSH levels by using automated chemiluminescence immunoassay system. Results: We found that the levels of TSH showed significant increase in overweight and obese subjects (p< 0.001) however there was no statistical difference in the levels of fT3and fT4 in overweight and obese students as compared to normal(p> 0.05). Interpretation & Conclusion: Our results suggest that thyroid function though within the normal range could be one of several factors acting in concert to determine body weight in a population. Even slightly elevated serum TSH levels are associated with an increase in BMI.

Age Related Change in Thyroid Function.

Background: Thyroid hormones play a vital role in metabolism, sensitivity of tissues to other hormones and also in oxygen consumption of almost all cells of the body. However, mild to moderate decrease in function of thyroid gland may occur with advancing age even in apparently healthy elderly subjects. Objectives: To observe age related change in thyroid function status in apparently healthy elderly subjects in Bangladesh. Methods: This cross sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka between 1st January 2011 and 31st December 2011. Sixty apparently healthy elderly subjects of both sexes aged 50 to 75 years were taken as study group. They were collected from Probin Nibash Hitoishi Shangha, Agargaon, Dhaka. In addition, 30 apparently healthy young adult subjects aged 20-40 years were included as control. For assessment of thyroid function, serum free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) levels were estimated by ELISA method. Statistical analysis was done by one way ANOVA, Bonferroni test and Pearson’s Correlation Coefficient test as applicable. Results: In this study, mean serum free thyroxine (FT4) and free triiodothyronine (FT3) levels were significantly (p<0.001) lower and serum thyroid stimulating hormone (TSH) level was significantly (p<0.001) higher in apparently healthy elderly subjects in comparison to those of the healthy young subjects. Again, serum FT4 and FT3 levels were negatively correlated whereas serum TSH level was positively correlated with age of the subjects. Conclusion: The present study revealed a progressive decrease in thyroid function with advancement of age.

Thyroid Status in Patients with Low Serum Ferritin Level.

Iron deficiency is the most important but preventable nutritional problem in Bangladesh. Thyroid peroxidase, an iron containing enzyme, is essential for initial two steps of thyroid hormone synthesis which is a component of tissue iron. Tissue iron diminishes early in the course of iron deficiency. So thyroid hormone level may be altered in iron deficient patients. This case-control study was carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) from July 2006 to June 2007. This study was done to find out the changes of thyroid hormonal activity in iron deficiency. In this study 72 subjects were selected from the out-patient department of the hospital. Patients with low serum ferritin level <12 mgm/L were selected as cases (n=36) and healthy persons with normal serum ferritin level were taken as controls. Serum ferritin, thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) were measured in all study subjects. Values were expressed as mean ± SD. Unpaired 't' test and Pearson's correlation test were performed to see the level of significance and p value <0.05 was taken as significant. Serum ferritin level in cases and controls were 6.78±4.05 mgm/L and 79.04±28.08 mgm/L respectively which showed significant difference (P<0.0001). Serum TSH concentration in cases and controls were 3.32±1.54 mIU/L and 1.89±0.86 mIU/L respectively. Serum FT4 concentration in cases and controls were 11.66±1.77 pmol/L and 13/10±1.36 pmol/L respectively and that of FT3 were 3.00±0.68 and 3.31±0.61 pmol/L respectively. All showed significant difference between groups. Serum ferritin and Serum TSH showed significant negative correlation in controls whereas in cases they showed negative correlation which was not statistically significant. Both serum FT4 and FT3 revealed positive correlation with serum ferritin but that too was not significant statistically. Though the study failed to show any significant positive correlation between serum ferritin and thyroid hormones, lower level of thyroid status in iron deficient patients suggest that it could be a reflection of disturbed activities of iron dependent enzymes such as thyroid peroxidase that impairs thyroid hormone synthesis. However, a large scale study is recommeded to establish the fact. This study showed that there was significant difference in thyroid hormonal status between iron deficient patients and normal healthy persons. Therefore it can be concluded that iron deficiency may impair normal thyroid hormone status.

Effects of heroin dependence on rat's calcitonin positive cells in thyroid gland and serum FT_3, FT_4, TSH / 解剖学报

Objective To investigate the effect of the heroin addicts on rat's thyroid C cells, the secretion of calcitonin(CT) and serum FT_3, FT_4, TSH. Methods Adulthood 55 male SD rats were randomly divided into normal control group(NCG), saline control group(SCG) and heroin dependence group(HDG). Heroin-dependent rat models were set up by the way of subcutaneous injection of heroin and the thyroid glands were excised on the 10th, 17th, 24th, 31st, and 38th days after models were set up. Tissues were assessed by immunohistochemical SABC method, cell counting, image analysis method and chemiluminescence techniques. ResultCompared with the normal control group(NCG)and saliane control group( SCG), the immune staining intensity was weakened;the number of CT positive cells was reduced(P<0.05);the average gray value was significantly higher(P<0.05) and showed a gradual increase in the CT positive cells of heroin dependence group(HGD). The concentration of TSH in HDG was not statistically significant as compared with the NCG. The concentration of FT_3 in HDG decreased gradually on the 10th day and the 17th day as compared with the NCG.(P<0.05). The concentration of FT_4 in HDG increased gradually on the 24th day and the 38th day as compared with the NCG.(P<0.05). Conclusion During heroin dependence period, the number and functional of CT positive cells has decreased. The changes of concentration of FT_3 and FT_4 suggest that the function of thyroid gland has changed.