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1.
Article in Chinese | WPRIM | ID: wpr-913155

ABSTRACT

Objective To investigate the value of serum free triiodothyronine (FT3) level in predicting the 90-day prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF). Methods Related clinical data were collected from 122 patients with HBV-ACLF who were hospitalized in Beijing YouAn Hospital, Capital Medical University, from September 2018 to January 2020, and according to their prognosis on day 90 after confirmed diagnosis, they were divided into survival group with 77 patients and death group with 45 patients. ELISA was used to measure the serum level of FT3, which was then compared between the two groups; a logistic regression analysis was used to investigate the risk factors for prognosis and establish an FT3-related predictive model; the area under the receiver operating characteristic (ROC) curve (AUC) of the predicted probability value was used to evaluate the discriminatory ability of the predictive model, and a linear regression analysis was used to evaluate calibration degree. AUC was used to compare the predictive value of this model and Model for End-Stage Liver Disease (MELD) score. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups; univariate and multivariate logistic regression analyses were used to investigate the influencing factors for prognosis. Results The death group had a significantly lower serum level of FT3 than the survival group (2.27±0.38 pmol/L vs 2.69±0.55 pmol/L, t =4.526, P < 0.001). FT3 (odds ratio [ OR ]=0.534, 95% confidence interval [ CI ]: 0.300-0.950, P =0.013) was an independent protective factor against poor prognosis, while age ( OR =1.047, 95% CI : 1.013-1.082, P =0.007), total bilirubin (TBil) ( OR =1.096, 95% CI : 1.059-1.134, P < 0.001), international normalized ratio (INR) ( OR =1.101, 95% CI : 1.029-1.178, P < 0.005), and creatinine (Cr) ( OR =4.583, 95% CI : 2.102-7.992, P < 0.001) were independent risk factors. In terms of discriminatory ability, the FT3-related predictive model had an AUC of 0.869 (95% CI : 0.831-0.907, P < 0.001), and for calibration ability, R 2 =0.340, P =0.268. The FT3-related formula was better than MELD score in predicting prognosis ( P < 0.05). Conclusion FT3 is an independent influencing factor for 90-day prognosis in patients with HBV-ACLF, and the FT3-related predictive model based on FT3 in combination with age, TBil, INR, and Cr has a good value in predicting 90-day prognosis.

2.
Article in Chinese | WPRIM | ID: wpr-909277

ABSTRACT

Objective:To investigate the clinical efficacy of methimazole in the treatment of hyperthyroidism.Methods:A total of 110 patients with hyperthyroidism who received treatment in Zhuji Central Hospital between January 2016 and June 2019 were included in this study. They were randomly assigned to receive treatment either with propylthiouracil (control group, n = 55) or methimazole (observation group, n = 55) for 6 successive months. Thyroid function indicators, bone metabolism indicators, clinical efficacy, and adverse events were compared between the control and observation groups. Results:After treatment, free triiodothyronine (FT 3), free thyroxine (FT 4) and thyroid stimulating hormone (TSH) levels in the observation group were (4.46 ± 1.02) pmol/L, (14.45 ± 2.16) pmol/L and (1.89 ± 0.64) mU/L respectively, which were significantly lower than those in the control group [(6.37 ± 1.38) pmol/L, (18.54 ± 4.46) pmol/L and (3.47 ± 0.99) mU/L, t = 8.254, 6.121, 9.940, all P < 0.05). Calcitonin level in the observation group was significantly higher than that in the control group [(68.62 ± 6.75) ng/L vs. (61.45 ± 6.47) ng/L, t = 5.687, P < 0.05]. Bone Gla-protein level in the observation group was significantly lower than that in the control group [(6.38 ± 1.64) ng/L vs. (8.21 ± 2.19) ng/L, t = 4.960, P < 0.05]. Total effective rate in the observation group was significantly higher than that in the control group [92.73% (51/55) vs. 78.18% (43/55), χ2= 4.681, P < 0.05]. Adverse reaction rate in the observation group was significantly lower than that in the control group [9.09% (5/55) vs. 25.45% (14/55), χ2= 5.153, P < 0.05]. Conclusion:Methimazole is safe and effective in the treatment of hyperthyroidism, which can effectively improve thyroid function and bone metabolism. This study is of certain clinical significance and innovation.

3.
Article | IMSEAR | ID: sea-212585

ABSTRACT

Background: There are limited data about the factors affecting the response time to medical treatment in Graves’ disease (GD) although many studies examined the predictors of the relapse after drug withdrawal. The aim of the current study was to evaluate the time for becoming euthyroid under antithyroid drug (ATD) therapy and the parameters influencing this period in patients diagnosed as GD.Methods: Patients with newly-diagnosed GD and decided to treat with ATD initially between March 2017 and September 2018 were retrieved retrospectively. Sociodemographic features as well as laboratory parameters like thyroid function tests and thyroid-stimulating hormone-receptor antibody (TRab) at the time of diagnosis were recorded.Results: Out of 41 patients, 63.4% (n=26) were female. The mean age was 36.1±11.7 years and 43.9% (n=18) of them were smoking. The time between the initiation of treatment and the duration of becoming euthyroid was 2.4±1.8 months. No significant difference was noted between age, gender, and smoking status and the time to become euthyroid under ATD treatment. This period was significantly positively correlated with levels of free triiodothyronine, free thyroxine, and negatively correlated with thyroid-stimulating hormone. Response to ATD therapy was higher in patients with pre-treatment TRab levels <10 IU/l than TRab ≥10 IU/l (p=0.011).Conclusions: Pretreatment thyroid function tests and TRab levels may be taken into consideration before deciding treatment in patients with newly diagnosed GD. It would be useful to design more comprehensive studies so that this proposal can find a response in clinical practice.

4.
Rev. Méd. Clín. Condes ; 31(2): 122-129, mar.-abr. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1223502

ABSTRACT

La relación entre función tiroidea y trastornos del ánimo se ha observado desde hace más de 50 años. Las hormonas tiroideas, actúan en el cerebro modulando génicamente proteínas asociadas a la fisiopatología de los trastornos del ánimo y potenciando los sistemas de neurotransmisión serotoninérgica y noradrenérgica. En el tratamiento de un episodio depresivo, la normalización de hormonas tiroideas es fundamental, y debe realizarse en todo paciente con sintomatología anímica, especialmente en aquellos con respuestas insuficientes a tratamiento, que requieren niveles de hormonas más estrictos que lo recomendado para población general. En pacientes eutiroideos, la potenciación con triyodotironina ha sido probada, pero también se ha utilizado T4 en altas dosis en casos resistentes, en que se postula que pudiese existir un estado de resistencia a hormonas tiroideas, no reflejado en los niveles hormonales periféricos evaluados rutinariamente. Las enzimas deiodasas, el receptor de hormona tiroidea, y el transportador de hormona tiroidea en la barrera hematoencefálica son blancos a investigar. Los objetivos de la presente revisión son ofrecer orientaciones respecto del uso de hormonas tiroideas en pacientes con trastornos del ánimo, una puesta al día sobre la relación entre hormonas tiroídeas y sistema nervioso central, y las interacciones entre psicofármacos y función tiroidea.


The relationship between thyroid function and mood disorders has been observed for more than 50 years. Thyroid hormones act in the brain genetically modulating proteins associated with the pathophysiology of mood disorders and potentiating the serotonergic and noradrenergic neurotransmission systems. In the treatment of a depressive episode, the normalization of thyroid hormones is essential, and should be performed in all patients with mood symptoms, especially in those with insufficient responses to treatment, which require more stringent hormone levels than recommended for the general population. In euthyroid patients, potentiation with triiodothyronine has been proven, but T4 has also been used in high doses in resistant cases, in which it is postulated that there might be a state of resistance to thyroid hormones, not reflected in the peripheral hormonal levels evaluated routinely. The enzymes deiodasas, the thyroid hormone receptor, and the thyroid hormone transporter in the blood brain barrier are white to investigate. The objectives of this review are to provide guidance regarding the use of thyroid hormones in patients with mood disorders, an update on the relationship between thyroid hormones and central nervous system, and the interactions between psychoactive drugs and thyroid function.


Subject(s)
Humans , Thyroid Diseases/psychology , Thyroid Diseases/epidemiology , Mood Disorders/psychology , Mood Disorders/epidemiology , Thyroid Diseases/drug therapy , Thyroid Gland/physiopathology , Thyroid Hormones/therapeutic use , Bipolar Disorder , Mood Disorders/drug therapy , Depression , Antidepressive Agents/therapeutic use
5.
Article | IMSEAR | ID: sea-211960

ABSTRACT

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.

6.
Med. lab ; 24(2): 93-109, 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1097051

ABSTRACT

Los desórdenes de la glándula tiroides son comunes y pueden afectar hasta el 10% de la población en general. En muchas ocasiones los síntomas pueden ser inespecíficos, por lo que el médico en busca de un trastorno tiroideo debe llegar a un diagnóstico funcional y anatómico. Las mediciones séricas de las hormonas tiroideas confirman si hay un exceso, un déficit o si las concentraciones son normales. Para ello, se requiere un rango de referencia de la población local, y específicamente por grupos de edad, para una correcta interpretación de las pruebas de función tiroidea. Las hormonas tiroideas juegan un papel fundamental en el sistema endocrino, controlan el metabolismo general del cuerpo, el desarrollo neural, el crecimiento normal y la maduración de los huesos, así como funciones cardiovasculares y renales, entre otras. En esta revisión se pretende dar una aproximación a las pruebas tiroideas más relevantes, partiendo de la biosíntesis y secreción de las hormonas tiroideas, hasta llegar al abordaje para un diagnóstico inicial del paciente con trastorno tiroideo, mencionando los aspectos más importantes de los diferentes patrones tiroideos. El tratamiento detallado de cada uno de ellos, supera las expectativas de esta revisión


Thyroid gland disorders are common and can affect up to 10% of the general population. In many cases the symptoms can be nonspecific, so the physician in search for a thyroid disorder should reach a functional and anatomical diagnosis. Serum measurements of thyroid hormones confirm if there is an excess, a deficit, or if concentrations are normal. For this, reference ranges of the local population, and specifically by age groups, are required for a correct interpretation of thyroid function tests. Thyroid hormones play a fundamental role in the endocrine system, control of the general metabolism of the body, neural development, normal growth and maturation of bones, as well as in cardiovascular and renal functions, among others. In this review, the most relevant thyroid tests will be described, starting with the biosynthesis and secretion of thyroid hormones, and continuing with an approach to reach an initial diagnosis. Finally, the most important aspects of the different thyroid patterns will be mentioned. It is beyond the scope of this review, to describe the treatment for thyroid disorders.


Subject(s)
Humans , Thyroid Diseases , Thyroid Function Tests , Thyroid Hormones , Thyroxine , Triiodothyronine , Thyrotropin
7.
Rev. cientif. cienc. med ; 23(1): 52-60, 2020. ilus
Article in Spanish | LILACS | ID: biblio-1126279

ABSTRACT

El hipotiroidismo es un trastorno endocrino en el cual la glándula tiroides tiene su función disminuida; teniendo como consecuencia paralela la perdida de homeostasia del cuerpo alterando así su adecuado funcionamiento. Para diagnosticar la enfermedad, sumado a la clínica, se recurre a medir los niveles sanguíneos de hormonas tiroideas. Como el sistema cardiovascular y la glándula tiroides están relacionados fisiológicamente, los trastornos de la glándula tiroides afectan de gran manera al sistema cardiovascular. Se detallan los mecanismos intracelulares y extracelulares de las hormonas tiroideas; y, utilizando esta información, se explican todos los cambios morfológicos y fisiológicos que esta patología causa en el corazón y en las células de músculo liso. Además, se dan a conocer las implicaciones que la enfermedad tiene a nivel del miocardio, sobre la hemodinámica, su relación con la insuficiencia cardíaca congestiva, la hipertensión y los efectos en general sobre los vasos sanguíneos, con el objetivo de describir la relación entre hipofunción tiroidea clínica y subclínica como factor de riesgo determinante para el desarrollo de alteraciones cardiovasculares.


Hypothyroidism is an endocrine disorder in which the thyroid gland has a diminished function; having as a consequence the loss of homeostasis of the body, therefore, altering its proper functioning. To diagnose this disease, physical examination, blood tests and thyroid stimulating hormone tests are utilized. Since the cardiovascular system and the thyroid gland are physiological related, the general disorders of the thyroid gland greatly affect the cardiovascular system. The intracellular and extracellular mechanisms of thyroid hormones are detailed; and, using this information, all the morphological and physiological changes that this pathology causes in the heart and on smooth muscle cells are explained. In addition, the implications of the disease on the myocardium, on hemodynamics, its relation to congestive heart failure, hypertension and general effects on blood vessels are revealed, with the objective of describing the relationship between clinical and subclinical thyroid hypofunction as a determining risk factor for the development of cardiovascular disorders.


Subject(s)
Thyroid Hormones , Cardiovascular System , Heart Failure , Hypothyroidism , Myocardium
8.
Acta Pharmaceutica Sinica B ; (6): 2183-2197, 2020.
Article in English | WPRIM | ID: wpr-881105

ABSTRACT

The dynamic or flowing tumor cells just as leukemia cells and circulating tumor cells face a microenvironment difference from the solid tumors, and the related targeting nanomedicines are rarely reported. The existence of fluidic shear stress in blood circulation seems not favorable for the binding of ligand modified nanodrugs with their target receptor. Namely, the binding feature is very essential in this case. Herein, we utilized HSPC, PEG-DSPE, cholesterol and two

9.
Article in Chinese | WPRIM | ID: wpr-799692

ABSTRACT

Objective@#To evaluate the clinical effect of Jianpi-Huatan-Huoxue Decoction combine with levothyroxine sodium tablets in the treatment of subclinical hypothyroidism (SCH).@*Methods@#According to the random digital table method, 105 patients with SCH from January 2017 to December 2018 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were divided into control group (52 cases) and research group (53 cases). The control group was treated by takinglevothyroxine sodium tablets orally, while the research group was treated with Jianpi-Huatan-Huoxue Decoction based oncontrol group. The two groups both were treated for 3 months. The clinical efficacy of the two groups were evaluated and compared. The content of TSH, FT3, FT4, IL-10, IL-2 and IL-2R were detected by double antibody sandwich ELISA. The content of TC, TG, LDL-C and HDL-C were detected by automatic biochemical analyzer.@*Results@#The total effective rate was 94.3% (50/53) in the research group and 75.0% (39/52) in the control group, and the difference between the two groups was statistically significant (χ2=7.601, P=0.006). After the treatment, the content of TSH (4.39 ± 1.05 mU/L vs. 8.20 ± 2.11 mU/L, t=11.747) in the research group was significantly lower than the control group (P<0.05), the content of FT3 (5.53 ± 1.33 μmol/L vs. 4.15 ± 1.26 μmol/L, t=5.456) and FT4 (18.54 ± 5.56 μmol/L vs. 16.18 ± 5.12 μmol/L, t=2.261) were significantly higher than the control group (P<0.05), the serum level of IL-10 was significantly higher than the control group (t=3.218, P=0.002), and the levels of IL-2 and IL-2R were significantly lower than the control group (t=11.203, 2.849, P<0.05), the levels of TC, TG and LDL-C were significantly lower than the control group (t=2.764, 9.473, 9.628, P<0.05), and the levels of HDL-C was significantly higher than the control group (t=4.506, P<0.05).@*Conclusions@#Jianpi-Huatan-Huoxue Decoction can improve the thyroid function and blood lipid level of patients with SCH, regulate the level of inflammatory factors, and improve the curative effect.

10.
Article in Chinese | WPRIM | ID: wpr-855765

ABSTRACT

AIM: To investigate changes in serum thyroid hormone levels in psychiatric patients after risperidone monotherapy or polytherapy treatment. METHODS: Twenty-nine in-patients who received risperidone monotherapy treatment and 25 in-patients who received polytherapy treatment of risperidone and other second-generation antipsychotics were included. Changes in thyroid hormone levels after treatment were retrospectively analyzed. RESULTS: After risperidone monotherapy treatment, serum levels of free thyroxine (FT4) and total thyroxine (TT4) significantly decreased, and serum TSH levels significantly increased (changes from baseline: FT4: median -2.52 pmol/L, P<0.001; TT4: -21.17 nmol/L, P=0.012; TSH: median 0.49 mIU/L, P=0.001). After risperidone polytherapy treatment, serum levels of free triiodothyronine (FT3), total triiodothyronine (TT3) and FT4 significantly decreased, and serum TSH levels significantly increased (changes from baseline: FT3: median -0.37 pmol/L, P=0.001; TT3: median -0.17 nmol/L, P=0.008; FT4: median -2.25 pmol/L, P<0.001; TSH: median 0.97 mIU/L, P=0.029). After risperidone monotherapy treatment, moderately positive relation was found between changes in serum TT4 levels and average daily dose of risperidone. No statistical difference was found on the incidence of subclinical thyroid dysfunction between the two therapeutic regimen (6.9% vs. 12.0%, P=0.862). CONCLUSION: To avoid other disease caused by abnormal thyroid hormone levels, changes in serum thyroid hormone levels should be noticed after risperidone treatment.

11.
Article in Chinese | WPRIM | ID: wpr-849679

ABSTRACT

Objective To investigate the clinical significance of serum ceruloplasmin (CER), hyaluronic acid (HA) and free thyroxine 3 (FT3) in detecting liver fibrosis in patients with chronic hepatitis B (CHB). Methods One hundred and thirty-six cases of CHB patients, 44 cases of post-CHB cirrhosis patients, 20 cases with HBsAg-positive hepatocellular carcinoma (HCC), and 50 healthy controls were randomly selected from July 2014 to January 2018. Serum CER was detected by immune scattering turbidimetry, and direct chemiluminescence method was used for the detection of HA and FT3, one-way ANOVA analysis or rank sum test was used to compare the levels of serum CER, HA, FT3 and other related indexes between each group and the control group. Analysis of the correlation between CER, HA, FT3 and diagnosis model of liver fibrosis was performed and its results were analyzed using the receiver operating characteristic (ROC) curves. Results (1) The level of serum CER in severe CHB and decompensated liver cirrhosis group was significantly lower than that in control group (P<0.05). The concentration of HA in severe CHB and liver sclerosis groups was significantly higher than that in control group, and the difference was statistically significant (P<0.05). And the concentration of FT3 in cirrhotic group and HCC group was significantly different from that in control group (P<0.05). (2) CER was negatively correlated with APRI (r=-0.202, P=0.004) and FIB-4 (r=-0.200, P=0.006), HA was positively correlated with APRI (r=0.491, P<0.000) and FIB-4 (r=0.514, P<0.000), and FT3 was positively correlated with APRI (r=-0.246, P<0.001) and FIB-4 (r= 0.361, P<0.000). (3) The AUC (area under the curve) of FT3, HA and CER for the diagnosis of cirrhosis were 0.831, 0.826 and 0.668, respectively. In order from high to low, the diagnostic efficacy of the groups was CER+HA+FT3, HA+FT3, CER+HA and CER+FT3. Conclusion The levels of serum CER, HA and FT3 in patients with CHB are correlated with the degree of liver fibrosis, and has an important reference value for diagnosis of post-CHB cirrhosis.

12.
Article | IMSEAR | ID: sea-194429

ABSTRACT

Background: Thyroid dysfunction has been subject of academical and therapeutically interest not only to the endocrinologist but also to the disciplines of medicine. Statistical data and studies on hypothyroidism are scanty, clinical picture is varied, investigations are usually not available at all levels and therefore to enlarge clinical profile of hypothyroidism minimal base line investigation, clinical approach and effects of replacement therapy and complications are to be studied.Methods: Observational cross-sectional study conducted among patients with hypothyroidism registered at the Air Force Central Medical Establishment (AFCME) New Delhi.Results: Among 50 patients with hypothyroidism were enrolled in this study during the study period. Idiopathic hypothyroidism was present in 98% patients while only one patient (2%) had Hashimotto’s thyroiditis. Generalized weakness was the commonest presenting symptom followed by lethargy and anorexia. Thyroid swelling was diffuse in nature with no predilection to right or left lobe enlargement. Hypertension (40%) and ischemic heart diseases (36%) were the most common comorbid condition. Mean serum TSH was elevated while serum T3 and T4 values were reduced. Antithyroid antibody titre was positive in more than seventy percentage of patients. X-ray among patients revealed cardiomegaly in ten patients (20%), pulmonary Koch’s in (4%) of patient and in rest of patients x-ray chest PA view was normal. ECG changes showed low voltage on electrocardiogram in (20%) of patients and sinus bradycardia in (24%) of patients. Most of the patients were put on replacement therapy (L. thyroxine) in dose of 1.6 - 1.7 mcg/kg/day.Conclusions: Hypothyroidism as a clinical entity is common between 4th and 6th decade of life and seen more among females. Though etiology remained unknown in majority of the patients, weakness, and lethargy were the common clinical presentation.

13.
Article | IMSEAR | ID: sea-189101

ABSTRACT

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.

14.
Article | IMSEAR | ID: sea-202473

ABSTRACT

Introduction: Miscarriage is the spontaneous loss of theconceptus before 20 weeks of gestation. Several disordersare known to contribute to recurrent miscarriage including:chromosomal anomalies; anti-cardiolipin antibodies;endocrine disorders such as poorly controlled diabetesmellitus; hyperprolactinaemia and thyroid diseases; andpelvic anatomic abnormalities. Study aimed to investigate theendocrine dysfunction in recurrent pregnancy lossMaterial and Methods: A prospective study comprising 70subjects was carried out. Fifty cases of recurrent abortionsconstituted the study group. Twenty healthy multipara femalesof same reproductive age group constituted the controlgroup. Venous blood samples were collected, and serum wasanalyzed for hormone analysis (T3, T4, TSH, LH, FSH, PRL,Testosterone) by ELISA method.Results: The mean prolactin level in cases of recurrentabortions was 19.96 ng/ml, while in controls was 11.77 ng/ml. The p value was 0.006 which was found to be statisticallyhighly significant. The mean TSH level in recurrent abortionscases was 5.81 mIU/L, while in controls was 1.95 mIU/L. Thep value was 0.004 which was found to be statistically highlysignificant.Conclusion: The patients with recurrent abortions hadsignificantly raised levels of TSH and Prolactin. Theprevalence of thyroid disorder and hyperprolactinemiawere higher in pregnant women with a history of recurrentabortion compared with healthy pregnant control population.Universal screening of pregnant females for endocrine profilecan improve the foetal outcome as well as social well-beingof females.

15.
Rev. Assoc. Med. Bras. (1992) ; 65(7): 988-992, July 2019. tab, graf
Article in English | LILACS | ID: biblio-1013006

ABSTRACT

SUMMARY OBJECTIVE The objective of this study was to investigate the effects of low triiodothyronine syndrome (LT3S) on platelet function and clotting factors in patients with nephrotic syndrome(NS). METHODS Patients with primary nephrotic syndrome were divided into two groups, normal thyroid function (group A) and LT3S (group B), based on whether they had LT3S or not. Healthy subjects were selected as the control group (group C). Blood coagulation function was detected in each group. The platelet activation function (CD62P, CD63) was determined by flow cytometry. The platelet aggregation rate was detected by an optical method using adenosine diphosphate and arachidonic acid as inducers. RESULTS The proportion of primary nephrotic syndrome with LT3S was 23.2% (69/298). Compared with group C, group A had higher CD62P and PAgTADP, and group B had higher CD62P, CD63, PAgTAA, and PAgTADP; the difference was statistically significant (all P < 0.05). There was no significant difference in renal pathology between group A and group B (X2 = 4.957, P = 0.421). Compared with group A, the 24-hour urine protein, CD63, PAgTAA, and PAgTADP were higher in group B, and APTT and Alb were lower. The difference was statistically significant (P < 0.05). Logistic regression analysis showed that LT3S was associated with CD36 (OR: 3.516; 95% CI: 1.742~8.186; P = 0.004) and PAgTAA (OR: 0.442; 95% CI: 1.001~1.251; P = 0.037). CONCLUSION NS patients are prone to LT3S. Patients with LT3S may have abnormal platelet activation and increase of platelet aggregation.


RESUMO OBJETIVO O objetivo deste estudo foi investigar os efeitos da síndrome do baixo triiodotironina (LT3S) na função plaquetária e nos fatores de coagulação em pacientes com síndrome nefrótica (SN). MÉTODOS Pacientes com síndrome nefrótica primária foram divididos em dois grupos, função tireoidiana normal (grupo A) e LT3S (grupo B), com base na presença ou não de LT3S. Indivíduos saudáveis foram selecionados como grupo de controle (grupo C). A função de coagulação do sangue foi analisada em cada grupo. A função de ativação plaquetária (CD62P, CD63) foi determinada por citometria de fluxo. A taxa de agregação plaquetária foi detectada por um método óptico usando adenosina difosfato e ácido araquidônico como indutores. RESULTADOS A proporção de síndrome nefrótica primária com LT3S foi de 23,2% (69/298). Em comparação com o grupo C, o grupo A apresentou níveis mais altos de CD62P e PAgTADP, e o grupo B apresentou maiores CD62P, CD63, PAgTAA e PAgTADP; a diferença teve significância estatística (P < 0,05). Não houve diferença significativa na patologia renal entre o grupo A e o grupo B (X2 = 4,957, P = 0,421). Em comparação com o grupo A, a proteína em urina de 24 horas, CD63, PAgTAA e PAgTADP foram maiores no grupo B, já APTT e Alb foram mais baixos. A diferença apresentou significância estatística (P < 0,05). A análise de regressão logística mostrou uma associação entre LT3S e CD36 (OR: 3,516; 95% IC: 1,742~8,186; P = 0,004) e PAgTAA (OR: 0,442; 95% IC: 1,001~1,251; P = 0,037). CONCLUSÃO Pacientes com síndrome nefrótica estão propensos à síndrome do baixo triiodotironina (LT3S). Pacientes com LT3S podem ter ativação plaquetária anormal e aumento da agregação plaquetária.


Subject(s)
Humans , Male , Female , Adult , Triiodothyronine/blood , Blood Platelets/physiology , Euthyroid Sick Syndromes/physiopathology , Euthyroid Sick Syndromes/blood , Nephrotic Syndrome/physiopathology , Nephrotic Syndrome/blood , Platelet Count , Platelet Function Tests , Reference Values , Triiodothyronine/deficiency , Platelet Activation/drug effects , Platelet Activation/physiology , Platelet Aggregation/drug effects , Platelet Aggregation/physiology , Regression Analysis , Flow Cytometry , Middle Aged , Nephrotic Syndrome/complications
16.
Article | IMSEAR | ID: sea-194380

ABSTRACT

Background: Derangements in stress hormone levels i.e. steroids, thyroid hormones is routinely encountered in almost all the seriously ill patients, which have been found to be associated with morbidity and mortality. The present study was planned to assess the thyroid hormone derangements in seriously ill patients, with respect to mortality.Methods: The present study was a retrospective, observational, record-based study done at Krishna Institute of Medical Sciences, Karad, Maharashtra, India.Results: Out of total 170 patients, 108 were females (63.5%) and 62 (36.4%) were males. On age wise analysis, it was found that majority of the patients were in the age group >50 years comprising of 78 (45.8%) patients. Thyroid hormonal status was deranged in 94 patients (55%), out of which 53 (31%) died and 41 patients (24%) were alive. Most common derangement was seen in free T3 (triiodothyronine), with 60% of the patients showing lowered values, 35% showing raised values and 5% showing normal values. T4 (thyroxine) levels were normal in major bulk of the patients.Conclusions: Serum T3 levels should be routinely done in critically ill patients, to detect any thyroid disorders, which might go undetected until it is too late.

17.
Article | IMSEAR | ID: sea-204066

ABSTRACT

Background: Nephrotic syndrome is a condition which is characterized by proteinuria, hypoproteinemia, hypercholesterolemia and significant edema. In children with nephrotic syndrome, it is probable to determine a hypothyroid state because of significant loss of thyroxine (T4), triiodothyronine (T3) in presence of proteinuria. The objectives of this study were to evaluate the level of serum free T3, free T4, and TSH in children with nephrotic syndrome and its correlation with healthy controls.Methods: A comparative study was carried out on total of 60 children (divided into two equal groups of 30 cases and 30 controls) in the age group of 1-18 years of either sex admitted to Department of Paediatrics. Maharishi Markandeshwar institute of Medical Sciences and Research. Mullana, Ambala, Haryana over a from January 2017 to September 2018. Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH) were done in all 60 children and compared.Results: Among cases 18 (60%) were males and 12 (40%) were females. 63.4% of the cases were in the age group 1-10 years and 36.6% were in age group 11-18 years. Studied patients showed lowered FT3 and FT4 and raised TSH in comparison with normal values.Conclusions: Hypothyroidism should be actively sought for in children with nephrotic syndrome as it is a treatable complication.

18.
Journal of Medical Postgraduates ; (12): 689-695, 2019.
Article in Chinese | WPRIM | ID: wpr-818305

ABSTRACT

Objective Higher expression of B-cell activating factor (BAFF) in patients with Graves' disease can activate B cells and increase proportion of plasma cells. However, the mechanism is still unclear. This study aims to investigate the effects of T3 on the BAFF level and plasma cell ratio in bone marrow, spleen and peripheral blood of mice, and to explore the mechanism of T3 in affecting the mature and differentiation of B cells. Methods 80 C57BL/6J mice were randomly divided into control group and T3 group, and were given isotonic saline or T3 5/10μg once a day for 6 weeks, respectively. The levels of T3 in peripheral blood of each group were measured with ELISA. Flow cytometry was used to detect the proportion of B220+CD138+ plasma cells and IgM, IgG and IgD expression of B cells in the spleen, bone marrow and peripheral blood. Immunohistochemistry, Western blot and PCR were performed to determine the expression of BAFF in spleen and thyroid. ELISA was used to determine the expression of BAFF in peripheral blood. Results Compared with control group, the levels of T3 in peripheral blood, diet and drinking water in the T3 group were significantly increased after 6 weeks T3 intervention. The mRNA and protein expression of BAFF in spleen mononuclear cells of T3 group (2.03±0.52, 0.50±0.03) were higher than those in control group (1.06±0.19, 0.05±0.01) (P<0.01). HE staining showed that the white medulla in the spleen of the T3 group increased and merged. Flow cytometry indicated that the proportion of spleen plasma cells and antibody expression of B cells in T3 group [(3.92±1.55)%, (75.76±8.88)%] increased compared with control group [(2.43±1.18)%, (65.26±8.38)%] (P<0.05); Proportion of bone marrow plasma cells [(8.48±3.62)%] and antibody expression [(40.63±18.96)%] in T3 group were significantly increased compared with control group [(4.96±3.11)%, (22.89±7.32)%](P<0.05); Peripheral plasma cell ratio [(8.56±4.27)%] and antibody expression [(76.15±9.44)%] were lower than those in control group [(14.70±4.76)%, (84.20±3.98)%](P<0.05); Compared with control group [(5.98±0.78) pg/mL], the BAFF level in peripheral blood increased [(7.61±1.72) pg/mL] (P<0.01). Immunohistochemistry showed that the expression of BAFF increased in mononuclear cells of thyroid of the T3 group. Conclusion T3 could activate BAFF expression in bone marrow, spleen, peripheral blood and thyroid mononuclear cells, and induce differentiation of bone marrow and spleen B cells, thus causing pathological changes in thyroid tissue. Such mechanisms might play an important role in the pathogenesis of thyroid autoimmune diseases.

19.
Journal of Medical Postgraduates ; (12): 1248-1253, 2019.
Article in Chinese | WPRIM | ID: wpr-818177

ABSTRACT

Objective High levels of triiodothyronine (T3) can lead to hyperthyroid heart disease, but its mechanism is unclear. This study aims to investigate the effects of T3 on the expression of B-cell activating factor (BAFF) in cardiomyocytes and to explore its possible role in the pathogenesis of hyperthyroid heart disease. Methods Sixty healthy C57BL/6J mice were selected and randomly divided into two groups: the experimental group and the control group. The experimental group received intraperitoneal injection of T3 at 5 μg/ml, one time/d, for 42 consecutive days. The concentrations of serum T3 and tetraiodothyronine (T4) were detected by radioimmunoassay; ELISA was used to determine BAFF expression in peripheral blood, and the cardiac index and the transverse diameter of myocardial cells in each group were determined. Immunohistochemistry and Western blot were used to detect the expression of BAFF protein in myocardium and of myocardial tumor necrosis factor-α (TNF-α) protein; the expression of BAFF mRNA in myocardium was detected by Real-Time PCR; flow cytometry (FCM) was used to detect changes in the proportion of B-cells in the heart. Results Compared with the control group, the serum T3 concentration, cardiac index, BAFF and myocardial cell transverse diameter of the experimental group significantly increased (P<0.05), and the T4 concentration decreased (P<0.05). Under the light microscope, the cardiomyocytes of the control group were normal, while those of the experimental group were hypertrophied and disordered in structure. Compared with the control group (0.765±0.164), BAFF protein expression significantly increased in the experimental group (1.865±0.290) (P<0.05). Compared with the control group (0.537±0.089), the expression of TNF-α protein significantly increased in the experimental group (0.737±0.065) (P<0.05). Correlation analysis of T3 with BAFF gene expression in cardiomyocytes and BAFF level in peripheral blood showed that T3 was positively correlated with both the former with a correlation coefficient of 0.637 (P<0.01) and the latter with 0.778 (P<0.01). For FCM, compared with the control group [(12.40±1.09)%], the proportion of myocardial B-cells increased in the experimental group [(16.12±0.631)%] (P<0.05). Conclusion High concentration of T3 can promote the expression of BAFF in myocardial cells and lead to the activation of B-cells, thus increasing the inflammatory response and leading to myocardial hypertrophy.

20.
Article in English | WPRIM | ID: wpr-764090

ABSTRACT

BACKGROUND AND OBJECTIVES: Levothyroxine (L-T4) monotherapy to normalize TSH level might be not sufficient to restore serum free triiodothyronine (fT3) levels in hypothyroid patients. This study aimed to compare the thyroid hormone levels in euthyroid L-T4 treated athyreotic patients and euthyroid healthy control subjects. MATERIALS AND METHODS: We included 69 euthyroid L-T4 treated athyreotic female patients after total thyroidectomy and radioactive iodine ablation therapy and 90 euthyroid healthy female. Serum fT3 and free thyroxine (fT4) levels were simultaneously measured using two different assay kits (A and B). RESULTS: The serum fT4 level was higher in the athyreotic patients (kit A: p<0.001, kit B: p=0.046), and the serum fT3 level was higher in control subjects (kit A: p=0.047, kit B: p=0.102). In the control group, the serum fT3 level was stable and not correlated with the TSH level (kit A: tau=−0.10, p=0.18, kit B: tau=−0.06, p=0.40). However, in the patient group, the serum fT3 level was negatively correlated with the TSH level (kit A: tau=−0.22, p=0.012, kit B: tau=−0.31, p<0.001). All thyroid hormone parameters measured by kit A showed higher area under the curve values than those measured by kit B for distinguishing the patients from the control subjects. CONCLUSION: The serum fT3 levels in L-T4 treated athyreotic euthyroid patients were significantly lower than and varied from those of euthyroid healthy control subjects. Thus, L-T4 monotherapy might not be appropriate for some athyreotic patients to maintain optimal T3 levels.


Subject(s)
Female , Healthy Volunteers , Humans , Iodine , Thyroid Gland , Thyroid Hormones , Thyroidectomy , Thyroxine , Triiodothyronine
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