Clinico-cytomorphological features and thyroid function tests of different thyroid lesions – A hospital-based cross-sectional study

Background: Thyroid gland is an endocrine organ. The non-neoplastic and neoplastic conditions affecting the gland can manifest as the swelling of the gland with thyroid dysfunction. Based on cytology, the diseases can be categorized into non-neoplastic, benign neoplastic, and malignant neoplastic conditions and according to hormone status, the lesions of thyroid can be categorized in hypothyroid, euthyroid, or hyperthyroid condition. Aims and Objectives: Our study was done to find out the various cytomorphological spectrum of thyroid diseases and to record their common clinical presentation along with hormonal status in a tertiary care hospital in Northern Odisha. Materials and Methods: A total of 220 cases of thyroid disorder were taken for analysis over a period of 2 years. Patients demographic data, brief clinical features, finding on FNAC (cytomorphology), and thyroid function status were analyzed with appropriate statistical method. Results: The predominant age group affected was 21–40 years and total female to male patient ratio was 5.5:1. Most common presentations were heat intolerance (22.27%), cold intolerance (28.63%), and tachycardia (27.72%) apart from thyroid enlargement. Most common non-neoplastic lesion were multinodular and colloid goiter constituting 38.18% of total cases and most common neoplastic lesion was papillary carcinoma constituting 14.55% of total cases. Thyroid function test showed predominantly euthyroid states for all conditions. Conclusion: As the rest part of India, this part of Odisha also showed that thyroid disorders are more common in females and the most affected age group is 21–40 years. Multinodular and colloid goiter are the most common thyroid lesions. Most of the cases present with euthyroid state.

Correlation Analysis between Thyroid Function Abnormality and Efficacy in Patients with Advanced Non-small Cell Lung Cancer after Immunotherapy / 中国肺癌杂志

BACKGROUND@#Thyroid function abnormality (TFA) is one of the common adverse reactions in patients with advanced non-small cell lung cancer (NSCLC) treated with immunotherapy, but the risk factors of TFA and its relationship with efficacy are not completely clear. The purpose of this study was to explore the risk factors of TFA and its relationship with efficacy in patients with advanced NSCLC after immunotherapy.@*METHODS@#The general clinical data of 200 patients with advanced NSCLC in The First Affiliated Hospital of Zhengzhou University from July 1, 2019 to June 31, 2021 were collected and analyzed retrospectively. χ² test and multivariate Logistic regression were used to explore the risk factors of TFA. Kaplan-Meier curve was drawn and Log-rank test was used for comparison between groups. Univariate and multivariate Cox analysis was used to explore the efficacy factors.@*RESULTS@#A total of 86 (43.0%) patients developed TFA. Logistic regression analysis showed that Eastern Cooperative Oncology Group Performance Status (ECOG PS), pleural effusion and lactic dehydrogenase (LDH) were factors influencing TFA (P<0.05). Compared with normal thyroid function group, the median progression-free survival (PFS) of patients in the TFA group was significantly longer (19.0 months vs 6.3 months, P<0.001), and the objective response rate (ORR) (65.1% vs 28.9%, P=0.020) and disease control rate (DCR) (100.0% vs 92.1%, P=0.020) of the TFA group were better than those of the normal thyroid function group. Cox regression analysis showed that ECOG PS, LDH, cytokeratin 19 fragment (CYFRA21-1) and TFA were factors influencing prognosis (P<0.05).@*CONCLUSIONS@#ECOG PS, pleural effusion and LDH may be risk factors affecting the occurrence of TFA and TFA may be a predictor of the efficacy of immunotherapy. Patients with advanced NSCLC who have TFA after immunotherapy may obtain better efficacy.

Short-term outcomes among patients with subclinical hypothyroidism undergoing primary percutaneous coronary intervention

Objectives: This study aimed to examine possible associations between previously undiagnosed subclinical hypothyroidism and short-term outcomes and mortality in a sample of Iraqi patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Design: This is a prospective observational cohort study. Setting: The study was conducted in a single tertiary referral centre in Baghdad, Iraq. Participants: Thyroid-stimulating hormone and free T4 levels were measured in 257 patients hospitalised with STelevation myocardial infarction who underwent primary percutaneous coronary intervention between January 2020 and March 2022. Main outcome measures: Adverse cardiovascular and renal events during hospitalisation and 30-day mortality were observed. Results: Previously undiagnosed subclinical hypothyroidism was detected in 36/257 (14%) ST-elevation myocardial infarction patients and observed more commonly in females than males. Patients with subclinical hypothyroidism had significantly worse short-term outcomes, including higher rates of suboptimal TIMI Flow (< III) (p =0.014), left ventricular ejection fraction ≤ 40% (p=0.035), Killip class >I (p=0.042), cardiogenic shock (p =0.016), cardiac arrest in the hospital (p= 0.01), and acute kidney injury (p= 0.044). Additionally, 30-day mortality was significantly higher in patients with subclinical hypothyroidism (p= 0.029). Conclusion: Subclinical hypothyroidism previously undiagnosed and untreated had a significant association with adverse short-term outcomes and higher short-term mortality within 30 days compared to euthyroid patients undergoing primary percutaneous coronary intervention. Routine thyroid function testing during these patients' hospitalisation may be warranted.

Influencing factors for thyroid function among radiation workers in Wuhan City / 预防医学

Objective@# To investigate the thyroid functions and influencing factors among radiation workers in Wuhan City, so as to provide insights into occupational health monitoring among radiation workers.@*Methods @#Radiation workers receiving physical examinations in Wuhan Prevention and Treatment Center for Occupational Diseases from January to October 2022 were enrolled, and participants' gender, age, smoking, alcohol consumption, medical history, medication use, types of occupational radiation and work duration were collected. Triiodothyronine (TT3), thyroxine (TT4), free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) were measured using a magnetic microparticle-based chemiluminescence immunoassay. Personnel dose equivalent was monitored using thermoluminescent dosimetry, and annual cumulative radiation dose was estimated. Factors affecting thyroid function were identified using a multivariable linear regression model.@*Results@#Totally 978 radiation workers were recruited, with a median age of 32.00 (interquartile range, 10.00) years, and including 782 men (79.96%) and 196 women (20.04%). There were 246 smokers (25.15%), 257 workers with alcohol consumption (26.28%) and 489 with a history of radiation work (50.00%). The median annual cumulative radiation dose was 0.20 (interquartile range, 0.24) mSv. The percentage of abnormal thyroid function was 14.72%. Multivariable logistic regression analysis showed that women (OR=1.925, 95%CI: 1.061-3.490), history of radiation work (OR=2.810, 95%CI: 1.119-7.057) and involving in medical application (OR=1.915, 95%CI: 1.101-3.332) were associated with abnormal thyroid function.@*Conclusions@#The percentage of abnormal thyroid function was 14.72% among radiation workers in Wuhan City. History of exposure to ionizing radiation, types of occupational radiation and gender were main factors affecting thyroid function.

Impaired sensitivity to thyroid hormones is associated with ischemic stroke in young and middle-aged euthyroid population / 西安交通大学学报(医学版)

【Objective】 To investigate the association of thyroid indices with the prevalence of ischemic stroke in young and middle-aged euthyroid population. 【Methods】 For this retrospective study, 620 euthyroid patients aged from 18 to 65 years were divided into ischemic stroke group (n=308) and non-ischemic stroke group (n=312). The characteristics of the study population; serum thyroid indices, i.e., free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH), were collected from biochemical test results. Multivariate conditional logistic regression analyses were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for thyroid indices and ischemic stroke. 【Results】 Compared with non-ischemic stroke group, significant differences were observed in age, gender, weight, smoking status, drinking status, history of hypertension and diabetes, SBP, DBP, FBG, TC, HDL-C, LDL-C, FT3, FT4, FT3/FT4, TFQI, and PTFQI in ischemic stroke patients (all P0.05). Logistic regression analysis revealed that lower FT3 [OR (95% CI) =0.722 (0.547~0.955) , P=0.022] and FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.001] , FT4 [OR (95% CI) =1.099 (1.011~1.194) , P=0.026] were significantly associated with an increased risk of ischemic stroke. After stratified analysis by hypertension, FT4 [OR (95% CI) =1.133 (1.021~1.257) , P=0.019] , lower FT3/FT4 ratio [OR (95% CI) =0.723 (0.600~0.870) , P=0.003] , TFQI [ OR (95% CI) =1.854 (1.026~3.350) , P=0.041] , and PTFQI [OR (95% CI) =1.871 (1.065~3.288) , P=0.029] were significantly associated with an increased risk of ischemic stroke in patients combined with hypertension, while after stratified analysis by diabetes, we only found that lower FT3/FT4 ratio [OR (95% CI) =0.730 (0.559~0.953) , 0.704 (0.536~0.944) , P=0.021] and FT4 [OR (95% CI) =1.170 (1.025~1.335) , P=0.026] were significantly associated with an increased risk of ischemic stroke in patients combined with diabetes. 【Conclusion】 FT3, FT4, and FT3/FT4 ratio are associated with an increased risk for ischemic stroke in young and middle-aged euthyroid population; TFQI and PTFQ are associated with an increased risk for ischemic stroke in patients combined with hypertension.

Clinical effects of Jiakang Pingxiao prescription combined with methiimidazole on hyperthyroidism / 中国基层医药

Objective:To investigate the clinical effects of Jiakang Pingxiao prescription combined with methiimidazole on hyperthyroidism. Methods:A total of 100 patients with hyperthyroidism admitted to Shanxian Central Hospital from February 2018 to January 2021 were included in this study. They were randomly divided into a study group and a control group, with 50 patients in each group. The control group was treated with methiimidazole, and the study group was treated with Jiakang Pingxiao prescription combined with methiimidazole. Thyroid function, serum levels of osteocalcin (OCN), β-CTx, hypersensitive C-reactive protein, and interleukin-6 (IL-6) were compared between the two groups. Results:After treatment, serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) in the study group were (3.10 ± 1.36) mU/L, (5.76 ± 1.25) pmol/L, (15.22 ± 1.95) pmol/L, respectively, which were significantly lower than (4.88 ± 1.47) mU/L, (7.13 ± 1.32) pmol/L, (19.07 ± 2.02) pmol/L in the control group ( t = 5.27, 4.71, 6.29, all P < 0.05). Serum OCN, β-CTx, hS-CRP, and IL-6 in the study group were (17.36 ± 2.62) μg/L, (0.32 ± 0.04) μg/L, (4.07 ± 0.86) mg/L, and (1.38 ± 0.21) pg/L, respectively, which were significantly lower than (26.05 ± 2.88) μg/L, (0.51 ± 0.09) μg/L, (6.23 ± 0.91) mg/L, (1.89 ± 0.28) pg/L in the control group ( t = 12.37, 10.40, 7.39, 8.57, all P < 0.05). The incidence of adverse reactions in the study group was significantly lower than that in the control group [6.00% (3/50) vs. 12.00% (3/50), χ2 = 14.78, P < 0.05). Conclusion:Jikang Pingxiao prescription combined with methiimidazole can effectively reduce the inflammatory responses in patients with hyperthyroidism, inhibit the expression of OCN and β-CTX in the serum, and improve thyroid function. The combined method is scientific and reasonable, and is suitable for clinical application. It has good therapeutic effects on hyperthyroidism and is worthy of clinical promotion.

The effect of water improvement on iodine nutritional status and thyroid function of pregnant women in areas with high water iodine level / 中华地方病学杂志

Objective:To investigate the impact of switching to low iodine drinking water in areas with high water iodine levels on the iodine nutritional status and thyroid function of pregnant women.Methods:A cross-sectional survey was conducted in Gaoqing County, Zibo City, Shandong Province. Pregnant women who underwent prenatal examinations at the Obstetrics Clinic of Gaoqing County People's Hospital from 2019 to 2021 were selected as the survey subjects. With reference to the Criteria for the Classification of Water Source High Iodine Areas and High Iodine Disease Areas (GB/T 19380-2016), pregnant women with drinking water iodine > 100 μg/L were considered as the high water iodine group and ≤100 μg/L was the non-high water iodine group. Basic information, one random urine sample, fasting blood sample, 24-hour urine sample and drinking water sample of pregnant women were collected, and thyroid ultrasound examination was performed on pregnant women. Urinary iodine (UI) concentration (UIC) and drinking water iodine concentration (WIC) were measured by inductively coupled plasma mass spectrometry, and 24-hour urinary iodine excretion (UIE) and daily iodine intake (TII) of pregnant women were calculated. Serum thyroid hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), thyroid peroxidase antibody (TPOAb) and anti-thyroid autoantibodies (TgAb) were determined by automatic chemiluminescence immunoassay. Creatinine (CR) was determined using deproteinized endpoint microplate method and UI/CR was calculate. Results:A total of 797 pregnant women were included, and the UIC was 150.2 (88.1, 281.3) μg/L, the iodine nutrition was generally at an appropriate level. Among them, 584 pregnant women in the non-high water iodine group had a UIC of 120.9 (74.9, 191.5) μg/L, which was at the iodine deficiency level; 213 pregnant women in the high water iodine group had a UIC of 321.1 (201.9, 569.1) μg/L, which was at the iodine super-appropriate level; the differences in WIC, UIC, UIE, TII, and UI/CR between the two groups were statistically significant ( Z = 21.63, 13.34, 15.14, 15.14, 11.81, P < 0.001). After stratification by different gestational periods, the differences were statistically significant when comparing WIC and TSH in pregnant women in the non-high water iodine group and UI/CR in pregnant women in the high water iodine group by gestational period ( H = 59.13, 7.30, 13.60, P < 0.05). A total of 744 pregnant women were tested for thyroid function, and 128 cases of TSH > 2.5 mU/L, 15 cases of hypothyroxemia, and 19 cases of subclinical hypothyroidism were detected, with detection rates of 17.2%, 2.0%, and 2.6%, respectively. The differences were statistically significant when comparing TSH and TPOAb levels and the proportion of pregnant women with TSH > 2.5 mU/L in the high water iodine and non-high water iodine groups ( Z = 3.04, - 2.17, χ 2 = 6.94, P = 0.002, 0.030, 0.008). The thyroid glands of pregnant women were examined in 720 cases, and 30 cases of goiter and 150 cases of thyroid nodules were detected, with detection rates of 4.2% and 20.8%, respectively. The median thyroid volume was 8.92 ml in the high water iodine group and 8.60 ml in the non-high water iodine group, which were both within the normal range, with no statistically significant difference between the groups ( Z = - 0.75, P = 0.455). Conclusions:After changing to low iodine water, the overall iodine nutrition of pregnant women in Gaoqing County is now at an appropriate level, and the reduction of water iodine effectively reduces the risk of TSH abnormalities in local pregnant women. However, pregnant women in the non-high water iodine group are iodine deficiency, and pregnant women in the high water iodine group are at iodine super-appropriate, and the iodine nutrition level of pregnant women in this area is highly variable, which causes the "illusion" that the overall iodine level of local pregnant women is suitable.

Correlation between iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:Through the detection of iodine nutrition level and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang), to preliminary study the pregnant women's iodine nutrition level, thyroid function status and the relationship between the two and influencing factors.Methods:From March to June in 2020, stratified cluster random sampling method was adopted. Two counties (cities) in Southern and Northern Xinjiang were selected as survey sites, and about 100 pregnant women (a total of 412) were selected from each county (city) as survey subjects. Random urine samples and blood samples were collected to detect urinary iodine and serum thyroid function indicators [thyroid stimulating hormone (TSH), free triiodothyronine (FT 3), free thyroxine (FT 4), anti-thyroglobulin antibody (Tg-Ab) and anti-thyroid peroxidase antibody (TPO-Ab)]. Results:The median and interquartile range [ M ( Q1, Q3)] of pregnant women's urinary iodine was 228.4 (143.15, 327.95) μg/L. Serum FT 3, FT 4 and TSH levels [ M ( Q1, Q3)] were 4.22 (3.92, 4.61), 13.79 (12.63, 15.26) pmol/L and 1.82 (1.26, 2.52) mU/L, respectively. The overall positive rates of Tg-Ab and TPO-Ab were 5.61% (23/412) and 11.95% (49/412), respectively. The positive rates of Tg-Ab and TPO-Ab in Southern and Northern Xinjiang were 4.78% (10/209), 10.05% (21/209), 6.40% (13/203) and 13.79% (28/203), respectively. The positive rates of Tg-Ab and TPO-Ab in Northern Xinjiang were higher than those in Southern Xinjiang, but the difference was not statistically significant (χ 2 = 1.31, 2.17, P > 0.05). The positive rate of TPO-Ab in pregnant women was the influencing factor of abnormal thyroid function, and the odds ratio ( OR) [95% confidence interval ( CI)] was 3.22 (1.31 - 7.93). Conclusions:Pregnant women in Xinjiang are generally at an appropriate level of iodine, but the state of thyroid function still needs continuous attention. In addition, it is necessary to strengthen the thyroid function examination of pregnant women with positive thyroid autoantibodies to prevent and control the occurrence of abnormal thyroid function in pregnant women.

Factores clínicos y ambientales asociados a la tiroiditis de Hashimoto / Clinical and environmental factors associated with Hashimoto's thyroiditis

Introducción: La tiroiditis de Hashimoto es una enfermedad tiroidea autoinmune poligénica y multifactorial resultante de una interacción compleja de factores genéticos y ambientales. Objetivo: Determinar la posible asociación de los factores clínicos y ambientales con los niveles de anticuerpos antitiroideos y las pruebas de función tiroidea en la tiroiditis de Hashimoto. Métodos: Estudio observacional, descriptivo y transversal con 120 personas con diagnóstico de tiroiditis de Hashimoto. Variables estudiadas: edad, sexo, color de la piel, estado nutricional, paridad, hábito de fumar, consumo de alcohol, preparados estrogénicos, antecedentes familiares de enfermedad autoinmune tiroidea y personales de otras enfermedades autoinmunes. Se realizaron determinaciones de anticuerpos AbTPO, TSH, T3 y T4. Resultados: Predominio del sexo femenino (92,5 por ciento), de pacientes de piel blanca (50,8 por ciento) y con sobrepeso corporal (40 por ciento). El 73 por ciento no consumían preparados estrogénicos. El 20 por ciento tenían antecedentes familiares de enfermedad tiroidea y personales de diabetes mellitus tipo 1 (7,5 por ciento). La media del anticuerpo en pacientes con antecedentes de infecciones virales fue superior a los que no tuvieron este antecedente (732,6 vs. 624,6). El resto de las variables no mostraron diferencias entre las medias del anticuerpo. Ninguno de los factores estudiados mostró asociación con el estado de la función tiroidea. (p>0,05). Conclusiones: No existió asociación entre los factores clínicos y ambientales en relación a los niveles de Ac TPO y el estado de la función tiroidea, con predominio del hipotiroidismo manifiesto al diagnóstico de la TH(AU)

Introduction: Hashimoto's thyroiditis is a polygenic and multifactorial autoimmune thyroid disease, resulting from a complex interaction of genetic and environmental factors. Objective: To determine the possible association of clinical and environmental factors with antithyroid antibody levels and thyroid function tests in HT. Methods: An observational, descriptive, cross-sectional study was carried out with 120 subjects diagnosed with Hashimoto's thyroiditis. We studied variables such as age, sex, skin color, nutritional status, parity, smoking, alcohol consumption, estrogen preparations, family history of autoimmune thyroid disease and personal history of other autoimmune diseases. Additionally, AbTPO, TSH, T3 and T4 antibody determinations were made. Results: Predominance of the female sex (92.5 percent), white skin (50.8 percent) and body overweight (40 percent). 73 percent did not consume estrogenic preparations. Twenty percent had family history of thyroid disease and personal history of type 1 diabetes mellitus (7.5 percent). The mean antibody in patients with history of viral infections was higher than those without this history (732.6 vs. 624.6). The rest of the variables did not show differences between the means of the antibody. None of the factors studied showed association with the state of thyroid function. (p > 0.05). Conclusions: There was no association between clinical and environmental factors in relation to Ac TPO levels and the state of thyroid function, with a predominance of overt hypothyroidism at diagnosis of HT(AU)

Thyroid and lipid profile in chronic kidney disease in Southern India

Background: The progression of chronic kidney disease(CKD) is linked to a multitude of comorbidities, such as thyroid dysfunction, dyslipidemia, and cardiovascular disease. Objective were to determinethe thyroid and serum lipid profile of CKD patients and to establish correlation between severity of renal disease with these 2metabolic parameters.Methods: This was a prospective study conducted among the 100 CKD patients over 1 year admitted in the department of urology and nephrology at our hospital. Results: There were 66 (66%) male patients and 36 (36%)female patients among the 100 patients. There were no patients in grade 1, whereas there were 2, 20, 66, and 12 patients in grades 2-5 CKD, respectively. In each grade of CKD, the mean age, eGFR, urea, creatinine, thyroid profile, and lipid profile were computed individually. The levels of urea, creatinine, and eGFR differed significantly across CKD grades 2-5. The thyroid profile differed significantly across CKD grades 2-5. The lipid profile differed significantly across CKD grades 2-5, with p=0.000, >0.05, 0.000, >0.05, >0.05 for total cholesterol, triglycerides, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) levels, respectively.Conclusions: The number of patients increases with decreasing T3 and T4 and increasing thyroid stimulating hormone (TSH) proportionate to the severity of the renal failure. In addition, hypothyroidism is becoming more common in people with chronic renal disease. Serum triglycerides, LDL, and VLDL levels rise statistically significantly in CKD grades 3-5 patients.

Echocardiographic Evaluation of Patients with Goiter in a Nigerian Tertiary Hospital

Background: Goiter is endemic in iodine deficient areas of the world including Nigeria. Cardiovascular disorder is a cause of morbidity in patients with thyroid diseases. These cardiovascular disorders are more likely to be found in patients with hypothyroid or hyperthyroid goiter. Large euthyroid goiter can potentially compromise respiration with potentials for secondary cardiac changes. Despite these, echocardiography is not a routine assessment of these patients. This study set out to determine the baseline cardiac function in a cohort of patients with endemic goiter using echocardiography. Materials and Methods: A comparative study of One hundred goiter patients presenting consecutively at the out-patient clinic of a tertiary hospital and 50 age and gender matched healthy non-goitrous control subjects. They all had thyroid function tests, cardiovascular evaluation and echocardiography done. Results: The mean ages of the goiter and the control groups were 46.92 + 13.85 and 46.58 + 11.62 years respectively (P=0.8510). The goiter population comprised 12 males and 88 females while the control group had 6 males and 44 females. 47% of the goiter subjects were hyperthyroid, while 44% and 9% were euthyroid and hypothyroid respectively. All the control subjects were euthyroid. Systolic and diastolic dysfunction were seen in 18% and 24% of the goiter group respectively, compared to 2% and 5% of the control group (P<0.0001). Hyperthyroid and hypothyroid subgroups had higher rates of both systolic and diastolic dysfunction. Systolic dysfunction was seen in 6.4%, 4.5% and 100% of the hyperthyroid, euthyroid and hypothyroid subgroups respectively while diastolic dysfunction was seen in 23.4%, 9.2 and 100% of the subgroups. Prevalence of systolic and diastolic dysfunction in the euthyroid and control subjects were 4.5% vs 2% (P=0.1228) and 9.2% vs 5% (P=0.2018). Conclusion: This study concluded that cardiac dysfunction is common in both hypothyroid and hyperthyroid goiter population while the prevalence of cardiac dysfunction in the euthyroid population is not influenced by the presence of goiter. This may suggest that routine echocardiography is unnecessary in patient with euthyroid goiter

Status of thyroid function and intelligence quotient of children in areas with different iodine nutrition levels in Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:To learn about the status of thyroid function and intelligence quotient (IQ) of children in areas with different iodine nutrition levels in Xinjiang Uygur Autonomous Region, and to explore the health risk of children with median urinary iodine of 200 - 299 μg/L, and to provide a basis for scientific iodine supplementation.Methods:In May 2019, in Xinjiang Uygur Autonomous Region, Altay Prefecture and Kashgar Prefecture were selected, where the median urinary iodine of children aged 8 to 10 years were 100 - 199 and 200 - 299 μg/L for three consecutive years (2017 - 2019). A stratified random sampling method was used to select 400 children aged 8 to 10 years in each of the two regions, urine and blood samples were collected to detect urinary iodine and thyroid function [thyrotropin stimulating hormone (TSH), free thyroxine (FT 4), free triiodothyronine (FT 3), anti-thyroglobulin antibody (TgAb), and anti-thyroperoxidase antibody (TPOAb)]. At the same time, children's IQ was measured and determined by Second Revision of Combined Raven's Test (CRT-C2) in China and Second Revision of Combined Raven's Test for Children-the Rural, in China (CRT-RC2). Results:The median urinary iodine of children aged 8 to 10 years in Altay Prefecture and Kashgar Prefecture was 188.6 and 250.1 μg/L, respectively. There was no statistically significant difference in thyroid function indexes TSH and FT 3 levels between the two regions ( Z = - 0.58, t = 0.49, P > 0.05), while there was statistically significant difference in FT 4 level ( t = 60.08, P < 0.001). There was no statistically significant difference in TgAb positive rate [3.6% (14/394), 4.0% (16/399)] between the two regions (χ 2 = 0.11, P = 0.736), but the difference of TPOAb positive rate [9.6% (38/394), 30.6% (122/399)] was statistically significant (χ 2 = 53.93, P < 0.001), while the difference of dual antibody positive rate [0.8% (3/394), 2.0% (8/399)] was not statistically significant ( P = 0.134). There was no statistically significant difference in the detection rates of subclinical hypothyroidism [8.9% (35/394), 11.0% (44/399)], subclinical hyperthyroidism [1.0% (4/394), 1.3% (5/399)] and hyperthyroidism [0.3% (1/394), 0.8% (3/399)] in children between the two regions ( P > 0.05). The IQ results of children in the two regions were 96.55 ± 11.36 and 89.57 ± 12.35, respectively, and there was no significant difference between them ( t = 2.79, P = 0.095). Conclusions:The thyroid function status of children is similar in the two regions with median urinary iodine of 100 - 199 μg/L and 200 - 299 μg/L in children aged 8 to 10 years, but the TPOAb positive rate is significantly different. Children whose iodine nutritional level is at or above the appropriate level have no obvious changes in intelligence. It is suggested that median urinary iodine at 200 - 299 μg/L is a relatively safe iodine nutrition state.

Iodine nutritional status and thyroid function of pregnant women in the areas of oral lipiodol pills in Xinjiang Uygur Autonomous Region / 中华地方病学杂志

Objective:To learn about the iodine nutritional status and thyroid function of pregnant women in the areas of oral lipiodol pills in Xinjiang Uygur Autonomous Region (Xinjiang).Methods:In October 2019, using the probability proportionate to size sampling (PPS sampling) method, Aksu Prefecture (Aksu) of Xinjiang was divided into 5 sampling areas according to the directions of east, west, south, north and middle. One county was selected from each area, one township was selected from each county according to the directions of east, west, south, north and middle, and 20 pregnant women were selected from each township. The general demographic data of pregnant women were collected by questionnaires, and 24-hour urine samples, household salt samples and drinking water samples were collected for iodine detection, and serum samples were collected for thyroid function index detection.Results:A total of 555 pregnant women were investigated, including 121, 234 and 200 women in the early, middle and late pregnancy, with an average age of 26 years. Among them, the median of urinary iodine of women in early, middle and late pregnancy was 209.53, 204.27 and 225.29 μg/L, respectively, which was all in the appropriate state. The median of salt iodine was 24.70, 26.00 and 26.20 mg/kg, respectively, and the median of water iodine was 4.85, 3.30 and 4.85 μg/L, respectively. There were no significant difference in urinary iodine, salt iodine and water iodine during different pregnancy ( H= 1.61, 4.38, 2.63, P > 0.05). The prevalence rate of subclinical hypothyroidism, subclinical hyperthyroidism and hyperthyroidism in pregnant women was 4.32% (24/555), 0.54% (3/555) and 0.36% (2/555), respectively; and the highest prevalence rate was in the middle pregnancy, which was 7.26% (17/234), 1.28% (3/234) and 0.85% (2/234), respectively. The positive rate of autospecific antibody in pregnant women with normal thyroid function was 13.15% (73/555). The positive rate of thyroid peroxidase antibody (TPOAb) and thyroglobulin (TgAb) was 11.35% (63/555), 8.11% (45/555), respectively. After excluding the pregnant women with positive thyroid autospecific antibody, the range ( P2.5- P97.5) of thyroid stimulating hormone (TSH) in different pregnancy were close to or slightly higher than the recommended reference value in the "Guideline on Diagnosis and Management of Thyroid Diseases During Pregnancy and Postpartum (2nd ed)". Except that the P2.5 value of free thyroxine (FT 4) in early pregnancy was lower than the reference value, the FT 4 range in other pregnancy showed the same trend as that of TSH. The results of Spearman correlation analysis showed that free triiodothyronine (FT 3) and FT 4, TPOAb and TgAb, TgAb and FT 4 were positively correlated ( r= 0.497, 0.504, 0.216, P < 0.05), and TSH and FT 3 was negatively correlated ( r = - 0.194, P < 0.05) in the early pregnancy; FT 3 and FT 4, TPOAb and TgAb were positively correlated in the middle and late pregnancy ( r = 0.188, 0.527, 0.177, 0.623, P < 0.05); TSH was negatively correlated with FT 3 in the late pregnancy ( r = - 0.165, P < 0.05); there was no correlation between urinary iodine and thyroid function indexes ( P > 0.05). Conclusions:The water iodine in the outer environment of the oral lipiodol pills area Aksu in Xinjiang is low, and the iodine nutrition level of pregnant women is appropriate. Except that the P2.5 value of FT 4 in the early pregnancy is lower than the reference value, the TSH range close to or of women during each pregnancy and the FT 4 range of women in the middle and late pregnancy are slightly higher than the reference value, which still need continuous monitoring.

Research progress on effects of PM2.5 exposure during pregnancy on maternal and infant thyroid function / 环境与职业医学

Ambient air pollution has become a widespread global public health problem. As one of the main components of ambient air pollution, fine particulate matter (PM2.5), with its small diameter and large surface area, can carry a variety of toxic substances and enter the blood circulation directly through the blood-air barrier, damaging various tissues and organs of human body. Studies have shown that PM2.5 exposure during pregnancy can disrupt the mother's and child's thyroid function. Since the fetal thyroid gland does not begin to develop until around the sixth week of pregnancy, the fetal thyroid hormone is almost entirely dependent on the mother during early stages of pregnancy, and maternal thyroid hormone level play a crucial role in the growth and development of fetus. When a mother is exposed to PM2.5 during pregnancy, placenta, the "bridge" between mother and fetus, is also affected to some extent, including changes in placental iodine uptake and oxidative stress, inflammation, and DNA methylation in placental tissue. Exposure to PM2.5 during pregnancy also alters maternal thyroid hormone level and normal placental function, which can have a detrimental effect on pregnancy outcomes, such as preterm birth, low birth weight, and neurological abnormalities. This paper reviewed the effects of PM2.5 exposure during different trimesters on maternal and infant thyroid function, placental function, and pregnancy outcomes, aiming to provide more accurate protection of maternal and fetal health.

Effect of L-T4 gel combined with metformin on the content of Ach and MCT8 in hippocampus of rats with hypothyroidism / 中华内分泌外科杂志

Objective:To study the effects of L-T4 gel combined with metformin on Ach and MCT8 content in hippocampus of hypothyroidism model rats.Methods:40 rats were randomly divided into 5 groups, normal control group (CON group) , hypothyroidism group (Hypo group) , L-T4 replacement group (L-T4 group) , metformin treatment group (MET group) and combined treatment group (L-T4+MET group) by random number table. Rats in CON group were given normal drinking water, and rats in the other four groups were given drinking water containing 0.05% propylthiouracil for 6-week hypothyroidosis modeling. At the 5th week of modeling, rats in MET group were given 1ml/100g metformin solution by intragastric administration, and rats in L-T4 group were applied with L-T4 gel agent at a dose of 0.1g/100g. L-t4+MET group were treated with L-T4 gel and metformin solution. At the end of 6-week modeling, the blood of abdominal aorta was collected, and the hippocampal tissue of the brain was quickly separated on an ice platform. Meanwhile, the trachea and thyroid were cut out and photographed to record their size. They were stored in a -80℃ refrigerator or soaked in 4% paraformaldehyde for fixation and used for immunohistochemical staining. T-test was used to confirm the difference between the data of each group, one-way analysis of variance was used to compare the means between multiple groups, and chi-square test was used when the count data were expressed as percentage ( χ2) . P<0.05 was used to indicate statistical significance between the data, and the difference was statistically significant. Results:Nishner staining showed that the optical density of the Hypo group was lower than that of the CON group ( t=8.944, P<0.001) , the optical density of the MET group was higher than that of the Hypo group ( t=4.472, P<0.001) , and the optical density of the L-T4 group was higher than that of the Hypo group ( t=4.472, P<0.001) . The optical density of rats in the combined treatment group was higher than that in the Hypo group ( t=8.944, P<0.001) , and recovered to the level of the CON group ( P=1.000) . After 2 weeks of treatment, the total thyroxine level (TT4) of the Hypo group was lower than that of the CON group ( t=14.536, P<0.001) , and the TT4 level of the MET group was higher than that of the Hypo group ( t=6.924, P<0.001) . TT4 level of L-T4 group was higher than that of Hypo group ( t=4.892, P<0.001) , TT4 level of combined treatment group was higher than that of Hypo group ( t=12.890, P<0.05) , and recovered to the level of CON group ( t=0.494, P=0.709) . After the study, the thyroid tissue of each group was collected. The thyroid tissue weight of the Hypo group was higher than that of the CON group ( t=7.906, P<0.001) , the thyroid tissue weight of the MET group and L-T4 group was lower than that of the Hypo group (MET: t=2.000, P<0.001; L-T4: t=3.000, P<0.001) , but higher than that of the CON group (MET: t=3.000, P<0.001; L-T4: t=2.000, P<0.001) . The thyroid weight of L-T4+MET group was similar to that of CON group ( P=1.000) . HE staining showed that the size of thyroid follicles was different in the combined treatment group, and the number of glial and absorbed vacuoles basically recovered similar to that of CON. After treatment, the Ach level in the Hypo group was lower than that in the CON group ( t=3.618, P<0.001) , the Ach level in the MET group was higher than that in the Hypo group ( t=3.121, P=0.016) , the Ach level in the L-T4 group was higher than that in the Hypo group ( t=3.321, P=0.027) , and the Ach level in the combined treatment group was higher than that in the Hypo group ( t=3.202, P=0.001) . And recovered to the level of CON group ( t=3.362, P=0.605) . After treatment, the MCT8 level in the Hypo group was higher than that in the CON group ( t=11.254, P<0.001) , the MCT8 level in the MET group was lower than that in the Hypo group ( t=5.679, P<0.001) , and the MCT8 level in the L-T4 group was lower than that in the Hypo group ( t=5.813, P<0.001) . The MCT8 level of the combined treatment group was lower than that of the Hypo group ( t=8.624, P<0.001) , and recovered to the level of the CON group ( t=0.587, P=0.477) . Conclusion:L-T4 gel combined with metformin has a good therapeutic effect on hypothyroidism, which can increase the level of Ach and decrease the level of MCT8 in hippocampus.

Effect of ionizing radiation on thyroid function among medical workers in department of cardiovascular medicine / 中国辐射卫生

@#<b>Objective</b> To examine the possible effect of ionizing radiation on thyroid function among medical workers in the department of cardiovascular medicine. <b>Methods</b> Forty-six medical workers in the department of cardiovascular medicine with exposure to ionizing radiation were enrolled as the study subjects. Subjects’ demographic features were collected. Serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) levels were measured using chemiluminescence assay, and the annual personal dose equivalent (<i>H</i>p (10)) received in 2019 and the fiver-year cumulative <i>H</i>p (10) from 2015 to 2019 were measured using a thermoluminescent personal dosimeter. The associations of altered thyroid functions with subjects’ age, sex, previous history of thyroid diseases, family history of thyroid diseases, working post, work seniority, and previous history of exposure to ionizing radiation were evaluated using an exact logistic regression model. <b>Results</b> The incidence of subclinical hypothyroidism (elevated serum TSH level without alteration in fT3 or fT4 level) was 6.5% among the study subjects. The <i>H</i>p (10) was 0 to 4.5 mSv among the subjects in 2019, with a mean dose of (0.2 ± 0.7) mSv and a median dose of 0 mSv, and the five-year cumulative <i>H</i>p (10) from 2015 to 2019 was 0 to 11.6 mSv, with a mean dose of (0.8 ± 2.3) mSv and a median dose of 0 mSv. The exact logistic regression analysis showed that the altered thyroid functions were not significantly associated with age, sex, previous history of thyroid diseases, family history of thyroid diseases, working post, work seniority, or previous history of exposure to ionizing radiation (all <i>P</i> > 0.05). <b>Conclusion</b> Long-term exposure to low-dose ionizing radiation may be associated with an increased risk of subclinical hypothyroidism among medical workers in the department of cardiovascular medicine.

Neonatal hyperthyroidism: clinical analysis of 7 cases / 中国新生儿科杂志

Objective:To study the clinical features of neonatal hyperthyroidism.Methods:From September 2013 to September 2020, clinical data of neonates with hyperthyroidism admitted to the neonatal intense care unit of our hospital were retrospectively collected and analyzed.Results:A total of 7 neonates were included. The average gestation age was (35.8±2.3) weeks with 5 cases had GA<37 weeks. The median age of diagnostic was 16 d (7~18 d). The common clinical manifestations included tachycardia, irritability, low-grade fever, hyperhidrosis, bulimia, poor weight gain, diarrhea and jaundice. The levels of serum free triiodothyronine (FT 3) and thyroxine (FT 4) were elevated in all 7 cases and thyroid stimulating hormone (TSH) were decreased. The Doppler ultrasound of thyroid gland in two neonates revealed enlarged thyroid gland with abundant blood flow. All 7 mothers had hyperthyroidism with 4 mothers provided the history of hyperthyroidism and the other 3 were also confirmed after their infants were diagnosed. All 7 infants were treated with anti-thyroid drugs (ATD) and 2 were additionally given β-blockers to control heart rate. The median ATD duration was 40 d (7~58 d). 2 cases (both preterm infants) had slight decrease in FT 4 during medication. FT 4 of all 7 cases returned to normal before TSH. Conclusions:Neonatal hyperthyroidism has various and nonspecific clinical manifestations. Early diagnosis and timely treatment are important to prevent short-term and long-term adverse outcomes. Whether their mothers provide definite history of thyroid disorder or not, the thyroid function of the suspected neonates should be carefully monitored.

Effect of oral iodized oil pills on thyroid function of pregnant women / 中华地方病学杂志

Objective:To evaluate the effect of oral iodized oil pills on iodine nutrition and thyroid function of pregnant women in Xinjiang Uygur Autonomous Region (Xinjiang).Methods:From May to July 2017, one county was selected from Ili Prefecture without taking iodized oil pills, Aksu Prefecture taking iodized oil pills once a year, and Kashgar Prefecture taking iodized oil pills twice a year in Xinjiang as survey sites, respectively; 100 pregnant women (evenly distributed in early, middle and late pregnancy) were selected from each survey county, the general data, urine and blood samples were collected, and urinary iodine and thyroid function indicators [free triiodothyronine (FT 3), free thyroxine (FT 4), thyrotropin (TSH), anti thyroglobulin antibody (TgAb), and anti thyroid peroxidase antibody (TPOAb)] were tested. Results:A total of 308 pregnant women were investigated, and 289 were finally included in the analysis, with an average age of 25 years; the body mass index (BMI) was (22.69 ± 3.07) kg/m 2. The occupation distribution was mainly farmer, accounting for 93.77% (271/289); most of them had junior high school education or below, accounting for 71.97% (208/289). The median urinary iodine of early, middle and late pregnant women in Kashgar Prefecture was 712.87, 604.50 and 656.23 μg/L, respectively, which were in iodine excess state. The iodine nutrition level of early pregnant women in Ili Prefecture and Aksu Prefecture was in iodine super suitability state, and the iodine nutrition level of middle and late pregnant women was in the iodine suitability state. The difference of median urinary iodine in early, middle and late pregnancy women between different regions was statistically significant ( Z = 53.02, 49.60, 44.66, P < 0.001). In addition, the urinary iodine of women in Kashgar Prefecture during each pregnancy period was significantly higher than that in Ili Prefecture and Aksu Prefecture ( P < 0.05). There were statistically significant differences in the levels of FT 3 among women in early pregnancy, FT 4 and TSH among women in middle pregnancy between different regions ( F = 4.59, 10.92, Z = 8.61, P < 0.05 or < 0.001). Among them, the level of FT 3 in early pregnancy in Kashgar Prefecture was lower than that in Ili Prefecture ( P < 0.05); the level of FT 4 in Kashgar Prefecture during middle pregnancy was higher than that in Ili Prefecture, and the level of TSH was lower than that in Ili Prefecture ( P < 0.05). There was no significant difference in TgAb positive rate, TPOAb positive rate and double antibody positive rate of early, middle and late pregnant women between different regions ( P > 0.05). The detection rates of hypothyroxinemia in early pregnant women in Ili Prefecture, Aksu Prefecture and Kashgar Prefecture were 13.9% (5/36), 3.2% (1/31) and 0 (0/33), respectively, and there was a statistically significant difference between different regions ( P = 0.036). The detection rates of subclinical hyperthyroidism in middle pregnant women were 0 (0/35), 0 (0/40), 17.6% (6/34), respectively, and there was a statistically significant difference between different regions ( P = 0.001). Conclusions:The results of urinary iodine in the three regions are in line with the iodine nutrition distribution under their respective iodine supplement strategies. Pregnant women in Kashgar Prefecture present iodine excess status after taking iodized oil pills; at the same time, the serum FT 3, FT 4 and TSH levels of pregnant women in Kashgar Prefecture are affected by iodine nutrition levels. Although it is scientific and effective to implement the intensified iodine supplement measures for pregnant women, it is still necessary to further study the suitability of oral iodine oil pills to ensure that pregnant women are at an suitability iodine nutrition level.

Relationship between the blood test results of thyroid function and intolerance to 14 kinds of foods in physical examination population / 中华健康管理学杂志

Objective:To investigate the relationship between the blood test results of seven items of thyroid function and intolerance to 14 kinds of foods in physical examination population.Methods:Total of 45 764 participants who received physical examination and accepted 14-kind food intolerance and 7-item thyroid function detection from August 2016 to September 2019 in Chinese People′s Liberation Army General Hospital were included in this study. The data were analyzed based on age, gender, body mass index, smoking and drinking status, and laboratory test indexes. Chi square test and univariate or multivariate logistic regression were applied to analyze the correlation between food intolerance and thyroid function in the physical examination population.Results:In the subjects, there were 29 361 cases (64.16%) with at least intolerance to one kind of food, and 15 011 (32.80%) were in Grade 1, 9 037 (19.75%) in grade 2 and 5 313 (11.61%) in grade 3. The positive rate of egg intolerance was the highest (34.06%), and that of beef intolerance was the lowest (1.24%). Of the participants, 11 337 (24.77%) had at least one item thyroid dysfunction, among them, the highest abnormal rate was found in thyroid stimulating hormone (TSH), followed by anti-thyroglobulin antibodies and anti-thyroid peroxidase antibodies. The proportion (26.32%) of abnormal thyroid function in the participants with at least intolerance to one kind of food was significantly higher than that (22.00%) in the participants without intolerance to the 14 kinds of foods ( χ2=105.78, P<0.001). After adjusting for other significantly related factors, the positive results of intolerance to 14 kinds of foods was still the significant influencing factor of thyroid function abnormalities ( OR=1.14, Z=5.68, 95% CI: 1.09-1.20, P<0.001). Further analysis showed that, after adjusted for age, gender, smoking and drinking status, intolerance to four kinds of foods (egg, soybean, crab and pork) were the significant influencing factors of abnormal thyroid function. Conclusions:Food intolerance is an independent risk factor of thyroid dysfunction. Among them, egg, soybean, crab and pork may be the most important food varieties should be paid more attention to.

Study of cytomorphological features of thyroid lesions and its correlation with thyroid function tests.

Background: Fine needle aspiration cytology along with ultrasound and assessment of thyroid function status remains the mainstay of evaluation of thyroid swellings. According to the guidelines put forth by American Thyroid Association, serum estimation of TSH should be part of initial assessment of thyroid swellings. Present study aims to assess the cytomorphological features of various thyroid lesions, classify them in different categories based on The Bethesda System of Reporting Thyroid Cytology and correlate them with thyroid hormone status of patients. Methods: 165 cases of thyroid lesions were subjected to FNAC, smears were categorised according to The Bethesda System of Reporting Thyroid Cytopathology and cases were also assessed for T3, T4, TSH hormone levels. Results: On interpretation of FNAC non-neoplastic lesions outnumbered the neoplastic lesions and Colloid goitre accounted for the majority of the cases (40.6%). Among the neoplastic lesions, follicular neoplasms were most common. Cytologically majority of the lesions belonged to category II (benign) as per the Bethesda System. On evaluation of thyroid function majority of the cases (69.1%) were euthyroid and were interpreted as either colloid goitre or adenomatoid nodule, whereas most patients of lymphocytic thyroiditis presented with either hypo or hyperthyroidism. Majority of malignant cases also turned out to be hypothyroid (9/12 Cases). None of the malignant case presented with hyperthyroidism. Conclusions: Thyroid cytology proves to be a reliable, simple and cost-effective first line diagnostic procedure. FNAC together with thyroid function test can be used for early and accurate diagnosis of various thyroid lesions, and reduces unnecessary intervention.