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1.
Braz. j. biol ; 81(3): 592-600, July-Sept. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153379

ABSTRACT

Abstract Understanding the relation between the environmental stress factors and the hypothalamus-pituitary-thyroid (HPT) axis efficiency can reduce the susceptibility to thyroid diseases. In our study, thyroid dysfunction was induced in female rats by administration of 40 mg Na F/kg.bd.wt/day for a month. Co-administration of the water extract of Arca noae (300 mg/kg. bw) was tested as a treatment for Na F induced thyroid dysfunction. A group of rats injected Arca noae extract only (300 mg/kg.bd.wt) was performed to observe the impact of the extract on the (HPT) axis in addition to the normal control group. Results showed that there was a significant decrease in serum triglycerides, total protein and albumin levels in the fluoride supplemented group in addition to abnormal levels of TSH, (T4) and (T3) compared to the control group. In the treated group there was an improvement in the proteins level and lipid profile but pseudo-corrected serum (T4) and (T3) levels were observed in addition to a continuous increase in TSH level. Histological findings confirmed the harmful effect of fluoride on both the non treated and the treated groups. Consequently, fluoride supplementation must be considered as a harmful stress that may affect permanently the HPT axis.


Resumo Compreender a relação entre os fatores de estresse ambiental e o eixo hipotálamo-hipófise-tireoide (HPT) pode reduzir a suscetibilidade a doenças da tireoide. Em nosso estudo, a disfunção tireoidiana foi induzida em ratos fêmeas pela administração de 40 mg Na F/kg.bw/dia durante um mês. A administração concomitante do extrato aquoso de Arca noae (300 mg/kg.Pc) foi testada como tratamento para a disfunção tireoidiana induzida por Na F. Um grupo de ratos injetados apenas com extrato de Arca noae (300 mg/kg. Pc) foi pré-formado com o intuito de observar o impacto do extrato no eixo (HPT), além do grupo controle normal. Os resultados mostraram que houve uma diminuição significativa nos níveis séricos de triglicerídeos, proteína total e albumina no grupo suplementado com fluoreto, além de níveis anormais de TSH, (T4) e (T3) em comparação ao grupo controle. No grupo tratado, houve uma melhora no nível de proteínas e perfil lipídico. Os níveis séricos pseudocorrigidos (T4) e (T3) foram observados, além de um aumento contínuo no nível de TSH. Os achados histológicos confirmaram o efeito prejudicial do flúor nos grupos não tratado e tratado. Consequentemente, a suplementação de flúor é considerada um estresse prejudicial que pode afetar permanentemente o eixo HPT.


Subject(s)
Animals , Female , Rats , Thyroid Diseases , Thyrotropin , Thyroxine , Aquatic Organisms
2.
Oncol. (Guayaquil) ; 31(2): 131-140, 31 de agosto 2021.
Article in Spanish | LILACS | ID: biblio-1284451

ABSTRACT

Introducción: La acromegalia se produce por un adenoma hipofisario somatotropo, que secreta una excesiva producción de GH e IGF1, se relaciona con mayor riesgo de tumores malignos, no guardando asociación con un patrón especifico de presentación y el objetivo de este estudio es analizar la evolución del cáncer papilar de tiroides en acromegalia. Casos: Se trata de tres pacientes diagnosticados de carcinoma papilar de tiroides (CPT) con diferente pronóstico, con características faciales, y sintomatología como cefalea, alteraciones del campo visual, alteraciones menstruales, que condujeron a la realización de estudios bioquímicos, de imagen y al diagnóstico de acromegalia. Evolución: La aparición de cáncer de tiroides varía en el tiempo de evolución de la acromegalia, en dos de los casos lo antecedió y en el tercero se presentó a la par con esta patología. La respuesta al tratamiento en el CPT es indeterminada en la primera paciente y \excelente en los otros casos; en una paciente se alcanzó remisión. Conclusiones: la coexistencia de acromegalia con cáncer tiroides es posible, que los cambios acrales, faciales y la sintomatología expansiva del tumor conducen al diagnóstico de acromegalia y que la identificación de malignidades no guarda relación con la evolución de la enfermedad.


Introduction: Acromegaly is produced by a somatotropic pituitary adenoma, which secretes an excessive production of GH and IGF1, it is related to a higher risk of malignant tumors, not being associated with a specific pattern of presentation and the objective of this study is to analyze the evolution of papillary thyroid cancer in acromegaly. Cases report: These were three patients diagnosed with CPT with different prognosis, with facial characteristics, and symptoms such as headache, visual field alterations, menstrual alterations, which led to biochemical and imaging studies and the diagnosis of acromegaly. Evolution: The appearance of thyroid cancer in the time of evolution of acromegaly is different, in two of the cases it preceded it and in the third it was presented alongside this pathology. The re-sponse to treatment in CPT is indeterminate in the first patient and excellent in the other cases; re-mission was achieved in one patient. Conclusions: It is concluded that the coexistence of acromegaly with thyroid cancer is possible, that the acral and facial changes and the expansive symptomatology of the tumor lead to the diag-nosis of acromegaly and that the identification of malignancies is not related to the evolution of the disease.


Introdução: A acromegalia é produzida por um adenoma hipofisário somatotrópico, que secreta uma produção excessiva de GH e IGF1, está relacionada a um maior risco de tumores malignos, não estando associada a um padrão específico de apresentação e o objetivo deste estudo é analisar a evolução de câncer papilar de tireoide na acromegalia. Casos: São três pacientes com diagnóstico de carcinoma papilífero de tireoide (CPT) de prognóstico diferente, com características faciais e sintomas como cefaleia, alterações do campo visual, alterações menstruais, que levaram à realização de estudos bioquímicos, de imagem e diagnóstico de acromegalia. Evolução: O aparecimento do câncer de tireoide varia com o tempo de evolução da acromegalia, em dois dos casos ela o precedeu e no terceiro foi apresentado concomitantemente a esta patologia. A resposta ao tratamento no CPT é indeterminada no primeiro paciente e excelente nos demais casos; a remissão foi alcançada em um paciente. Conclusões: a coexistência de acromegalia com câncer de tireoide é possível, que as alterações acrais e faciais e a sintomatologia expansiva do tumor levam ao diagnóstico de acromegalia e que a identificação de neoplasias não está relacionada à evolução da doença.


Subject(s)
Humans , Adult , Middle Aged , Growth Hormone , Thyroid Cancer, Papillary , Iodine Radioisotopes , Thyroglobulin/classification , Thyrotropin , Suppression , Endothelial Growth Factors
3.
Rev. chil. endocrinol. diabetes ; 14(2): 59-64, 2021. tab, ilus
Article in Spanish | LILACS | ID: biblio-1283550

ABSTRACT

INTRODUCCIÓN: El hipotiroidismo subclínico (HSC) se define bioquímicamente por una elevación en la concentración sérica de la hormona estimulante de la tiroides (TSH), con niveles normales de tiroxina libre (T4L). La asociación entre el HSC y el daño cardiovascular ha sido un tema controversial. OBJETIVO: determinar la asociación entre el HSC y el desarrollo de la enfermedad cardiovascular mediante la cuantificación de la proteína C reactiva ultrasensible PCR-us y la determinación de lípidos circulantes asociados a la enfermedad cardiovascular y la ateroesclerosis. MÉTODOS: Estudio descriptivo, correlacional de corte transversal realizado en el Hospital IESS de Riobamba, Ecuador en el periodo comprendido desde enero a diciembre de 2019. Se estudiaron 70 individuos (40 pacientes con HSC y 30 controles) con edades entre 18 y 75 años. Se realizaron las historias clínicas y el examen físico a cada paciente y la toma de las muestras sanguíneas para determinar la concentración sérica de los siguientes parámetros bioquímicos y hormonales: colesterol total, triglicéridos, HDL colesterol y LDL colesterol, TSH, T4L y PCR-us. RESULTADOS: Se encontró un incremento significativo en la concentración de colesterol total (p<0.0001), LDL colesterol (p<0.01) y PCR-us (p<0.0001) en los pacientes con HSC vs los controles. Se observó una correlación positiva (p<0.0001; r=0.9148) entre la TSH y la PCR-us en los pacientes con HSC. CONCLUSIÓN: los pacientes con HSC experimentan una elevación en los niveles séricos de PCR-us la cual está correlacionada con un incremento en la concentración sérica de TSH. Estos parámetros asociados a un aumento del colesterol total y de la LDL colesterol sugieren un estado inflamatorio de bajo grado que podría estar asociado con el desarrollo de aterosclerosis y daño cardiovascular.


INTRODUCTION: Subclinical hypothyroidism (SH) is defined biochemically by an elevation in serum thyroid stimulating hormone (TSH) concentration, with normal levels of free thyroxine (T4L). The association between SH and cardiovascular damage has been a controversial issue. OBJECTIVE: to determine the association between SH and the development of cardiovascular disease through the quantification of the high sensitivity C-reactive protein (hs-PCR) and the determination of circulating lipids associated to cardiovascular disease and atherosclerosis. METHODS: Observational, correlational cross-sectional study with patients captured in the internal medicine office as well as those attending screening activities at the IESS Hospital in Riobamba- Ecuador, in the period from January to December 2019. Seventy individuals (40 patients with SH and 30 controls) between the ages of 18 and 75 years were studied. Each patient's medical history and physical examination were performed, and blood samples were taken to determine the serum concentration of the following biochemical and hormonal parameters: total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol, TSH, T4L and hs-PCR. RESULTS: A significant increase in the concentration of total cholesterol (p<0.0001), LDL cholesterol (p<0.01) and hs-PCR (p<0.0001) was found in patients with SH vs. controls. A positive correlation (p<0.0001; r=0.9148) was observed between TSH and hs-PCR in patients with SH. CONCLUSION: patients with SH experience an elevation in serum hs-PCR levels which is correlated with an increase in serum TSH concentration. These parameters associated with an increase in total cholesterol and LDL cholesterol suggest a low-grade inflammatory state that may be associated with the development of atherosclerosis and cardiovascular damage.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , C-Reactive Protein/analysis , Cardiovascular Diseases/etiology , Hypothyroidism/blood , Thyrotropin/blood , Body Mass Index , Cross-Sectional Studies , Ecuador , Atherosclerosis , Hypothyroidism/complications , Cholesterol, HDL/blood , Cholesterol, LDL/blood
4.
Frontiers of Medicine ; (4): 101-107, 2021.
Article in English | WPRIM | ID: wpr-880948

ABSTRACT

Primary hypothyroidism commonly occurs after radiotherapy (RT), and coincides with increased circulating thyroid-stimulating hormone (TSH) levels.We tested therefore the protective effect of suppressing TSH with L-thyroxine during RT for medulloblastoma/PNET and Hodgkin lymphoma (HL) in a prospective cohort study. From1998 to 2001, a total of 37 euthyroid children with medulloblastoma/PNET plus 14 with HL, scheduled for craniospinal irradiation and mediastinum/neck radiotherapy, respectively, underwent thyroid ultrasound and free triiodothyronine (FT3), free thyroxine (FT4), and TSH evaluation at the beginning and end of craniospinal iiradiation. From 14 days before and up to the end of radiotherapy, patients were administered L-thyroxine checking every 3 days TSH to ensure a value < 0.3 μIU/mL. During follow-up, blood tests and ultrasound were repeated; primary hypothyroidism was considered an increased TSH level greater than normal range. Twenty-two/37 patients with medulloblastoma/PNET and all the 14 patients with HL were alive after a median 231 months from radiotherapy with 7/22 and 8/14 having correctly reached TSH levels < 0.3 μIU/mL and well matched for other variables. Twenty years on, hypothyroidism-free survival rates differed significantly, being 60% ± 15% and 15.6% ± 8.2% in TSH-suppressed vs. not-TSH suppressed patients, respectively (P = 0.001). These findings suggest that hypothyroidism could be durably prevented in two populations at risk of late RT sequelae, but it should be confirmed in a larger cohort.


Subject(s)
Cerebellar Neoplasms , Child , Hodgkin Disease/radiotherapy , Humans , Hypothyroidism/prevention & control , Medulloblastoma/radiotherapy , Prospective Studies , Thyrotropin
5.
Chinese Medical Journal ; (24): 1064-1069, 2021.
Article in English | WPRIM | ID: wpr-878160

ABSTRACT

BACKGROUND@#Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR).@*METHODS@#The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism.@*RESULTS@#The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids.@*CONCLUSION@#Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.


Subject(s)
Lipid Metabolism/genetics , Mendelian Randomization Analysis , Thyroid Function Tests , Thyroid Gland , Thyrotropin , Thyroxine , Triiodothyronine
6.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(4): 587-590, dez 30, 2020. fig
Article in Portuguese | LILACS | ID: biblio-1355171

ABSTRACT

Introdução: o presente artigo analisou e avaliou a prevalência de dinapenia em associação da idade dos Hormônio Estimulador da tireoide (TSH) e T3 em idosos da Universidade Aberta à Terceira Idade ­ UATI. A tireoide produz e secreta os hormônios triiodotironina (T3) e tiroxina (T4), responsáveis por controlar o metabolismo celular. O termo dinapenia tem sido utilizado para descrever a diminuição da força muscular relacionada à idade separando desta forma, a dinapenia da redução da massa muscular. Metodologia: trata-se de um estudo de corte transversal que investigou 63 mulheres com idade entre 60 e 95 anos, resultando numa idade média das participantes foi de 69,6 anos, não institucionalizadas, matriculados no projeto "Universidade Aberta à Terceira Idade (UATI)", da Universidade Estadual da Bahia (UNEB). A força de preensão palmar (FPP) foi avaliada em quilograma (kg), por meio do dinamômetro digital manual da marca INSTRUTHERM. Resultados: foram diagnosticados com dinapenia as pacientes que possuíram a FPP inferior a 20 kg. Descobriu-se que 23 idosas (36,51%) foram diagnosticadas com dinapenia. A correlação entre as variáveis TSH e dinapenia foi positiva e fraca Spearman=0.17 (p-valor= 0.22). Assim, a relação entre o FPP e a idade não parece ser linear possuindo uma correlação negativa e fraca: Spearman= -0.11 (p-valor= 0.39). Conclusão: o nível sérico de TSH e idade não tiveram associação significativa com a presença de dinapenia. Houve associação entre T3 sérico e dinapenia, porém não é possível identificar em qual quartil está essa associação.


Introduction: this article analyzed and evaluated the prevalence of dynapenia in association with the age of thyroid stimulating hormones (TSH) and T3 in the elderly at Universidade Aberta do Idoso ­ UATI. The thyroid produces and secretes the hormones triiodothyronine (T3) and thyroxine (T4) responsible for the control of cellular metabolism. The term dynapenia has been used to describe the decrease in muscle strength related to age, separating dynapenia from the reduction of muscle mass. Methodology: this is a cross-sectional study that investigated 63 women between 60 and 95 years old, resulting in an average age of participants of 69.6 years old, non-institutionalized, registered in the project the Open University Of The Elderly (UATI)", of Bahia State University (UNEB). The Hand Grip Strength (HGS) was measured in kilograms (kg), using the INSTRUTHERM manual digital dynamometer. Results: patients with FPP less than 20 kg were diagnosed with dynapenia. It was found that 23 elderly women (36.51%) were diagnosed with dynapenia. The correlation between TSH and dynapenia variables was positive and weak Spearman = 0.17 (p-value = 0.22). Thus, the relationship between (FPP) and age does not appear to be linear with a weak and negative correlation: Spearman = -0.11 (p-value = 0.39). Conclusion: the serum TSH level and age had no significant association with the presence of dynapenia. There was an association between(T3) and serum dinapenia, but it is not possible to identify in which quartile this association is found.


Subject(s)
Humans , Female , Aged , Aged, 80 and over , Thyroid Gland , Thyroxine , Aged , Thyrotropin , Hormones , Demography
7.
Rev. cuba. endocrinol ; 31(3): e254, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156400

ABSTRACT

Introducción: Los valores de tirotropina (TSH) pueden modificarse marcadamente durante el embarazo, en relación con diversos factores clínicos y bioquímicos. Objetivo: Identificar los factores clínicos y bioquímicos asociados con la tirotropina en embarazadas aparentemente sanas. Métodos: Estudio descriptivo, transversal, con 247 gestantes aparentemente sanas del municipio Plaza de la Revolución., en el periodo comprendido de septiembre de 2015 a enero de 2019. Variables analizadas: edad materna y gestacional, trimestre del embarazo, color de la piel, paridad, hábito de fumar, antecedentes familiares de enfermedad tiroidea (APF), consumo de suplementos con yodo, índice de masa corporal (IMC), presencia de bocio al examen físico, TSH, tiroxina total (T4t) y libre (T4l), triyodotironina total (T3t) y libre (T3l), gonadotropina coriónica (hCG), anticuerpos contra la peroxidasa tiroidea (AcTPO) y la tiroglobulina (AcTg) y yoduria. Resultados: La TSH (1,66 ± 0,91mUI/L) tuvo una asociación negativa con la edad materna (r = -0,17; p = 0,008), la paridad (nulíparas 1,80 ± 0,90 mUI/L, multíparas 1,45 ± 0,89 mUI/L; p = 0,003), los APF (positivos 1,56 ± 0,91 mUI/L, negativos 1,81 ± 0,89 mUI/L; p = 0,03), la T4t (r = -0,15; p = 0,02), la T4l (r = -0,23; p = 0,000) y la hCG (r = -0,52; p = 0,001). Mostraron una relación directa la edad gestacional (r = 0,25; p = 0,000) y el uso de suplementos yodados (consumo 1,96 ± 0,72mUI/L, no consumo 1,62 ± 0,93 mUI/L; p = 0,03). Conclusiones: La tirotropina presenta una relación inversa con la edad materna, la paridad, los antecedentes familiares de enfermedad tiroidea, la T4 total y libre, y la gonadotropina coriónica, y una relación directa con la edad gestacional y el consumo de suplementos con yodo(AU)


Introduction: Thyrotropin (TSH) values can be sharply modified during pregnancy, in relation to various clinical and biochemical factors. Objective: Identify clinical and biochemical factors associated with thyrotropin in seemingly healthy pregnant women. Methods: Descriptive, cross-sectional study with 247 seemingly healthy pregnant women from Plaza de la Revolution municipality in the period from September 2015 to January 2019. Variables analyzed: maternal and gestational age, trimester of pregnancy, skin color, pregnancies, smoking habit, family history of thyroid disease (APF), consumption of iodine supplements, body mass index (BMI), presence of goiter to physical examination, TSH, total and free (T4l) thyroxine (T4t), total (T3t) and free (T3l) triiodothyronine, chorionic gonadotropin (hCG), antibodies against thyroid peroxidase (AcTPO) and thyroglobulin (AcTg) and urinary iodine. Results: TSH (1.66 ± 0.91mUI/L) had a negative association with maternal age (r = -0.17; p x 0.008), pregnancy (nulliparas 1.80 ± 0.90 mUI/L, 1.45 ± 0.89 mUI/L; p x 0.003), APF (positive 1.56 ± 0.91 mUI/L, negative 1.81 ± 0.89 mUI/L; p x 0.03), the T4t (r = -0.15; p s 0.02), the T4l (r = -0.23; p x 0.000) and the hCG (r = -0.52; p x 0.001). They showed a direct relationship with gestational age (r x 0.25; p x 0.000) and the use of iodine supplements (consumption 1.96 ± 0.72mUI/L, not consumption 1.62 ± 0.93 mUI/L; p x 0.03). Conclusions: Thyrotropin has an inverse relationship with maternal age, pregnancies, family history of thyroid disease, total and free T4, and chorionic gonadotropin, and a direct relationship with gestational age and consumption of iodine supplements(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Thyroid Diseases/etiology , Thyrotropin/administration & dosage , Body Mass Index , Gestational Age , Goiter/etiology , Epidemiology, Descriptive , Cross-Sectional Studies , Maternal Age , Observational Studies as Topic
8.
Rev. méd. Chile ; 148(6): 740-745, jun. 2020. tab
Article in English | LILACS | ID: biblio-1139366

ABSTRACT

ABSTRACT Background: Hypothyroidism occurs in 1-2% of the general population, is associated with significant morbidity and requires continuous treatment with levothyroxine. Aim: To determine the effectiveness, adherence and safety of levothyroxine therapy in patients with hypothyroidism. Material and Methods: The Morisky-Green adherence test was applied, and effectiveness was determined by measuring thyroid-stimulating hormone (TSH) in 330 patients with with hypothyroidism; the mean age was 64+-15 years and 76% was women. Results: Median TSH was 2.09 mIU/L (interquartile range: 1.16-3.61 mIU/L). Two hundred thirty-five (71%) patients had TSH levels in the euthyroid range, 64 (19%) in the hypothyroid range and 31 (9%) in the hyperthyroid range. Complete, moderate and lack of adherence with levothyroxine was reported in 283 (86%), 29 (9%) and 18 (5%) of patients, respectively. The presence of anemia (odds ratio (OR): 0.37, 95% confidence intervals (CI): 0.15-0.98) or the need of doses over 100 µg/day (OR: 0.47, 95%CI: 0.28-0.80) increased the probability of having an abnormal TSH level. Conclusions: In a large proportion of these patients, TSH levels were controlled, and most patients were adherent to levothyroxine therapy.


Antecedentes: El hipotiroidismo se presenta entre el 1-2% de la población general, genera importante morbilidad y requiere tratamiento con levotiroxina de manera continua. Objetivo: Determinar la efectividad, adherencia y seguridad de la terapia con levotiroxina en pacientes con hipotiroidismo. Material y Métodos: Se aplicó test de adherencia de Morisky-Green y se determinó efectividad mediante medición de TSH en 330 pacientes con edad promedio 63 ± 15 años (76% mujeres). Resultados: La mediana de TSH fue 2,09 mUI/l, (rango intercuartílico: 1,16mUI/l-3,61mUI/l). Un total de 235 (71,2%) tenían cifras de TSH en rango de estado eutiroideo, 64 (19,4%) se catalogaron hipotiroideos y 31 (9,4%) hipertiroideos. El 86% (n = 283) manifestó tener adherencia completa al medicamento, 29 (9%) moderada y 18 (5%) se clasificaron poco adherentes. Tener diagnóstico de anemia (razón de riesgo (RR): 0,37; intervalos de confianza (IC) 95%: 0,15-0,98) o necesitar dosis mayores de 100 µg/día (RR: 0,47; IC95%: 0,28-0,80) elevaron la probabilidad de no controlar el hipotiroidismo. Conclusiones. Una alta proporción de pacientes se encuentran controlados y con mucha frecuencia son adherentes a la terapia con levotiroxina.


Subject(s)
Humans , Female , Middle Aged , Aged , Thyroxine/therapeutic use , Hyperthyroidism , Hyperthyroidism/drug therapy , Thyrotropin , Prescriptions
9.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 73-79, Jan.-Mar. 2020. tab
Article in English | LILACS | ID: biblio-1090558

ABSTRACT

Abstract Introduction Papillary and follicular thyroid carcinoma are common head and neck cancers. This cancer expresses a thyroid stimulating hormone (TSH) receptor that plays a role as a cancer stimulant substance. This hormone has a diagnostic value in the management of thyroid carcinoma. Objective The present study aimed to determine the difference in TSH levels between differentiated thyroid carcinoma and benign thyroid enlargement. Methods The present research design was a case-control study. The subjects were patients with thyroid enlargement who underwent thyroidectomies at the Dr. Sardjito General Hospital, Yogyakarta, Indonesia. Thyroid stimulating hormone levels were mea- sured before the thyroidectomies. The inclusion criteria for the case group were: 1) differentiated thyroid carcinoma, and 2) complete data; while the inclusion criteria for the control group were: 1) benign thyroid enlargement, and 2) complete data. The exclusion criteria for both groups were: 1) patients suffering from thyroid hormone disorders requiring therapy before thyroidectomy surgery, 2) patients receiving thyroid suppression therapy before the thyroidectomy was performed, and 3) patients suffering from severe chronic diseases such as renal insufficiency, and severe liver disease. Results There were 40 post-thyroidectomy case group patients and 40 post-thyroidect- omy control group patients. There were statistically significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement (p = 0.001; odds ratio [OR] = 8.42; 95% confidence interval [CI]: 3.19-36.50). Conclusion Based on these results, it can be concluded that there were significant differences in TSH levels between the groups with differentiated thyroid carcinoma and benign thyroid enlargement.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Thyroid Neoplasms/diagnosis , Thyrotropin/blood , Adenocarcinoma, Follicular/diagnosis , Thyroid Cancer, Papillary/diagnosis , Thyroidectomy , Thyroid Neoplasms/surgery , Thyroid Neoplasms/pathology , Biomarkers, Tumor/blood , Case-Control Studies , Adenocarcinoma, Follicular/pathology , Diagnosis, Differential , Thyroid Cancer, Papillary/pathology
11.
Arch. endocrinol. metab. (Online) ; 64(1): 52-58, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088768

ABSTRACT

ABSTRACT Objective This study aimed to present the impact of age and gender on thyroid hormone levels in a large Chinese population with sufficient iodine intake. Subjects and methods A total of 83643 individuals were included and were stratified by age and gender. The median, 2.5th and 97.5th of thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and FT3/FT4 ratio were calculated for both genders for every decade from 18 to over 80 years. TSH, FT3, FT4, FT3/FT4 distribution in each age group was evaluated for females and males using smoothing splines in the generalized additive models (GAM). TSH concentrations were compared in the different age groups in gender. Results In the over 80s age group, the TSH level (median: 2.57 mIU/L, 2.5th-97.5th: 0.86-7.56 mIU/L) was significantly higher than other age groups, irrespective to gender (P<0.001). Females had a higher TSH value than males in all age groups (P<0.001). Results of the smoothing curves showed that TSH increased with age, FT3 concentration was higher in males than in females and the tendency of the FT3/FT4 ratio was basically similar to that of FT3. TSH concentration in the 50s age group (median 2.48 mIU/L for females versus 2.00 mIU/L for males) was significantly higher than that in the 30s age group (median 2.18 mIU/L for females versus median 1.85 mIU/L for males). Conclusions In accord with increasing TSH values during aging, females and older adults have lower FT3 values and lower FT3/FT4 ratios, while the FT4 values remain stable.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Thyroxine/blood , Triiodothyronine/blood , Thyrotropin/blood , Sex Factors , Age Factors , Reference Values , Thyroid Function Tests , Retrospective Studies , Asian Continental Ancestry Group
12.
Arch. endocrinol. metab. (Online) ; 64(1): 66-70, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088765

ABSTRACT

ABSTRACT Objective Familial Mediterranean fever (FMF) is an autosomal recessive autoinflammatory disorder that is frequently seen in the eastern Mediterranean region. The thyroid gland can be affected in FMF patients through autoimmunity or amyloidosis. Here, we aimed to evaluate the structure and functions of the thyroid gland in addition to possible autoimmunity in FMF patients. Subjects and methods The study was conducted by the Endocrinology and Metabolism and Internal Medicine Departments. Thirty FMF patients and 30 age and gender-matched healthy controls were enrolled in the study. Free thyroxin (fT4), free triiodothyronine (fT3), thyroid-stimulating hormone (TSH), and anti-thyroid peroxidase (anti-TPO) autoantibodies were investigated. Detailed thyroid grayscale and Doppler Ultrasonography examinations and shear-wave elastosonography (SWE) were performed in the patient and control groups. Results Anti-TPO was detected in 24% (n = 7) of the patients. On the grayscale US, mean thyroid volumes were similar between the FMF and the control groups (p > 0.05). By Doppler US, thyroid vascularity observed was detected in 10.3% (n = 3) of the patients. SWE revealed that the mean velocity value of right vs. left lobe in the patient group was 1.77 ± 0.45 m/s and 1.95 ± 0.51 m/s, respectively. Compared to the control group, the mean velocity values were significantly higher in the right (p = 0.004) and left (p = 0.01) lobes of the patient group. The mean stiffness value in the patient group was also significantly higher in the right and left lobes [10.13 ± 5.65 kPa (p = 0.005) and 12.24 ± 6.17 kPa (p = 0.02), respectively]. Conclusion Recognizing the complications of FMF early in the course of the disease is as important as the early diagnosis of the disorder. Based on this, thyroid functions and changes in its structure should be evaluated carefully for early diagnosis of a possible coexisting thyroid disorder. Arch Endocrinol Metab. 2020;64(1):66-70


Subject(s)
Humans , Male , Female , Adult , Familial Mediterranean Fever/physiopathology , Familial Mediterranean Fever/immunology , Autoantibodies/immunology , Autoimmunity/immunology , Familial Mediterranean Fever/diagnostic imaging , Autoantibodies/blood , Thyroid Gland/immunology , Triiodothyronine/immunology , Triiodothyronine/blood , Thyrotropin/immunology , Thyrotropin/blood , Case-Control Studies , Ultrasonography, Doppler , Iodide Peroxidase/immunology , Iodide Peroxidase/blood
13.
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
14.
Clinics ; 75: e1594, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133448

ABSTRACT

OBJECTIVE: Fine-needle aspiration cytology is the risk stratification tool for thyroid nodules, and ultrasound elastography is not routinely used for the differential diagnosis of thyroid cancer. The current study aimed to compare the diagnostic parameters of ultrasound elastography and fine-needle aspiration cytology, using surgical pathology as the reference standard. METHODS: In total, 205 patients with abnormal thyroid function test results underwent ultrasound-guided fine-needle aspiration cytology on the basis of the American College of Radiology Thyroid Imaging-Reporting and Data System classification and strain ultrasound elastography according to the ASTERIA criteria. Histopathological examination of the surgical specimens was performed according to the 2017 World Health Organization classification system. Moreover, a beneficial score analysis for each modality was conducted. RESULTS: Of 265 nodules, 212 measured ≥1 cm. The strain index value increased from benign to malignant nodules, and the presence of autoimmune thyroid diseases did not affect the results (p>0.05 for all categories). The sensitivities of histopathological examination, ultrasound elastography, and fine-needle aspiration cytology for detection of nodules measuring ≥1 cm were 1, 1, and 0.97, respectively. The working area for detecting nodule(s) in a single image was similar between strain ultrasound elastography and fine-needle aspiration cytology for highly and moderately suspicious nodules. However, for mildly suspicious, unsuspicious, and benign nodules, the working area for detecting nodule(s) in a single image was higher in strain ultrasound elastography than in fine-needle aspiration cytology. CONCLUSION: Strain ultrasound elastography for highly and moderately suspicious nodules facilitated the detection of mildly suspicious, unsuspicious, and benign nodules.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Thyroid Gland/diagnostic imaging , Thyroid Neoplasms/diagnosis , Thyroid Nodule/diagnostic imaging , Biopsy, Fine-Needle/methods , Elasticity Imaging Techniques/methods , Thyroid Gland/pathology , Thyroid Neoplasms/pathology , Thyrotropin/blood , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity , Thyroid Nodule/pathology , Diagnosis, Differential
15.
Article in Chinese | WPRIM | ID: wpr-826378

ABSTRACT

To tailor the subsequent treatment and follow-up strategy,this study dynamically assessed the response to initial therapy in non-distant metastatic differentiated thyroid cancer (DTC) patients with intermediate and high risk. A total of 184 non-distant metastatic DTC patients (intermediate-risk 111 cases and high-risk 73 cases) were retrospectively enrolled in this study. Based on the results of initial response assessment (6-12 months after initial therapy),patients were divided into two groups:excellent response (ER) group (=113) and non-excellent response (non-ER) group (=71). We compared the differences in clinicopathological features between these 2 groups and evaluated the changes of dynamic response to therapy at the initial and final assessments after initial therapy in all patients. Compared with the ER group,the non-ER group showed a larger tumor size (=2771.500,=0.000),higher proportion of extrathyroidal invasion (=4.070,=0.044),and higher preablative-stimulated thyroglobulin levels (=1367.500,=0.000). ER was achieved in 31% of patients in the initial non-ER group [including indeterminate response (IDR) and biochemical incomplete response (BIR)] at the final follow-up only by thyroid stimulating hormone (TSH) suppression therapy,among which 63.6% were with intermediate risk (especially the patients with IDR) and 36.4% at high risk. In addition,5.2%(6/113) of patients in the initial ER group were reassessed as IDR,BIR,or even structural incomplete response at the end of the follow-up (among which one patient developed into cervical lymph node recurrence,as confirmed by pathology);the TSH level in these patients fluctuated at 0.56-10.35 μIU/ml and was not corrected in time during the follow-up after initial therapy. Some of non-distant metastatic DTC patients with intermediate and high risks who presented initial non-ER may achieve ER only by TSH suppression therapy over time;in contrast,the patients presented initial ER may develop into non-ER without normalized TSH suppression therapy. The dynamic risk assessment system may provide a real-time assessment of recurrence risk and tailor the subsequent treatment and follow-up strategies.


Subject(s)
Follow-Up Studies , Humans , Neoplasm Metastasis , Neoplasm Recurrence, Local , Retrospective Studies , Risk Assessment , Thyroglobulin , Blood , Thyroid Neoplasms , Diagnosis , Therapeutics , Thyrotropin
16.
Article in English | WPRIM | ID: wpr-816634

ABSTRACT

In 2017, the first Korean nationwide data on serum thyroid stimulating hormone (TSH) levels, serum free thyroxine (fT4) levels, and urinary iodine concentration (UIC) were published based on a population of 7,061 Koreans who participated in the Korea National Health and Nutrition Examination Survey VI. The mean TSH level was 2.16 mIU/L, with a reference interval of 0.59 to 7.03 mIU/L (men 2.09 mIU/L, women 2.24 mIU/L, P<0.001). A U-shaped association was found between serum TSH levels and age. The mean fT4 level was 1.25 ng/dL, and its reference interval was 0.92 to 1.60 ng/dL (men 1.29 ng/dL, women 1.20 ng/dL, P<0.0001). Serum fT4 levels decreased with age (P for trend <0.0001). Serum thyroid peroxidase antibody (TPOAb) was detected in 7.30% of participants (men 4.33%, women 10.62%). TPOAb titers tended to increase with age, and were higher in women than in men. The median UIC was 294 µg/L, and UIC showed a U-shaped relationship with age. According to the World Health Organization recommendations, only 23% of participants were in the adequate range of iodine intake, while 65% were in the above requirements or excessive, and 12% in insufficient. The prevalence of overt hyperthyroidism and hypothyroidism in Koreans was 0.34% to 0.54% and 0.73% to 1.43%, respectively.


Subject(s)
Female , Humans , Hyperthyroidism , Hypothyroidism , Iodide Peroxidase , Iodine , Korea , Male , Nutrition Surveys , Prevalence , Thyroid Gland , Thyrotropin , Thyroxine , World Health Organization
17.
Article in English | WPRIM | ID: wpr-816623

ABSTRACT

BACKGROUND: Studies on the relationship between thyroid function and anemia in the euthyroid range are scarce. We aimed to evaluate the association between anemia and serum free thyroxine (fT4) and thyrotropin (TSH) in euthyroid adults.METHODS: Data on 5,352 participants aged ≥19 years were obtained from the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). Anemia was defined as hemoglobin (Hb) <13 and <12 g/dL for men and women, respectively.RESULTS: Overall, 6.1% of participants had anemia, and more women (9.9%) had anemia than men (2.8%, P<0.001). In multivariate analysis, serum fT4 levels, but not TSH, were positively associated with serum Hb levels in both sexes (P<0.001, each). Serum Hb levels linearly reduced across decreasing serum fT4 quartile groups in both sexes (P<0.001, each). After adjusting for potential confounding factors, participants with low-normal fT4 had 4.4 (P=0.003) and 2.8 times (P<0.001) higher risk for anemia than those with high-normal fT4 among men and women, respectively. When participants were divided into two groups at 50 years of age, in younger participants, men and women with the first quartile were at higher risk of anemia than men with the second quartile (odds ratio [OR], 3.3; P=0.029) and women with the forth quartile (OR, 3.2; P<0.001), respectively. This association was not observed in older participants.CONCLUSION: These results suggest that a low-normal level of serum fT4 was associated with a lower serum Hb level and a higher risk of anemia in euthyroid adults, especially in younger participants.


Subject(s)
Adult , Anemia , Female , Humans , Korea , Male , Multivariate Analysis , Nutrition Surveys , Thyroid Function Tests , Thyroid Gland , Thyrotropin , Thyroxine
18.
Article in English | WPRIM | ID: wpr-816622

ABSTRACT

BACKGROUND: Recently, there has been some controversy regarding the role of radioactive iodine (RAI) ablation in the treatment of low-risk differentiated thyroid carcinoma (DTC), especially papillary thyroid microcarcinoma (PTMC). This study aimed to compare quality of life (QoL) parameters between patients with PTMC who underwent total thyroidectomy (TT) alone and those who underwent TT with RAI ablation.METHODS: In this cross-sectional study, patients with PTMC who underwent TT with/without RAI remnant ablation were prospectively enrolled between June 2016 and October 2017. All patients completed three questionnaires: the 12-item short-form health survey (SF-12), thyroid cancer-specific quality of life (THYCA-QoL) questionnaire, and fear of progression (FoP) questionnaire.RESULTS: The TT and TT with RAI groups comprised 107 and 182 patients, respectively. The TT with RAI group had significantly lower serum thyrotropin (TSH) levels than the TT group. However, after matching for TSH levels between the groups (n=100 in both groups), there were no significant differences in baseline characteristics. According to the SF-12, the score for general health was significantly lower in the TT with RAI group than in the TT group (P=0.047). The THYCA-QoL also showed a significant difference in the “felt chilly” score between groups (P=0.023). No significant differences in FoP scores were observed between the groups.CONCLUSION: Patients with PTMC who underwent TT with RAI ablation experienced more health-related problems than those managed with TT alone. These findings support the idea that RAI ablation should be carefully considered in patients with low-risk DTCs.


Subject(s)
Cross-Sectional Studies , Health Surveys , Humans , Iodine , Prospective Studies , Quality of Life , Thyroid Gland , Thyroid Neoplasms , Thyroidectomy , Thyrotropin
19.
Article in English | WPRIM | ID: wpr-880304

ABSTRACT

BACKGROUND@#The absence of thyroid cysts may indicate latent thyroid damage, as demonstrated in our previous study. However, the association between the absence of thyroid cysts and latent functional damage of the thyroid is unknown. At low thyroid hormone productivity, which may be associated with latent functional damage of the thyroid, the association between thyroid-stimulating hormone (TSH) and hypertension might be enhanced. Therefore, we evaluated the association between TSH level and hypertension stratified by thyroid cyst status.@*METHODS@#We conducted a cross-sectional study of 1724 euthyroid Japanese individuals aged 40-74 years who participated in an annual health checkup in 2014.@*RESULTS@#In the study population, 564 and 686 participants had thyroid cysts and hypertension, respectively. A significant positive association was observed between TSH and hypertension in subjects without a thyroid cyst but not in subjects with thyroid cysts. There was a significant positive association between hypertension and TSH in subjects without a thyroid cyst (odds ratio [OR] 1.27; 95% confidence intervals [CI] 1.01, 1.61) but not in subjects with thyroid cysts (OR 0.79; CI 0.57, 1.09) in the model fully adjusted for known confounding factors. The correlation between the TSH and free triiodothyronine (fee T3) levels (simple correlation coefficient [r] = - 0.13, p < 0.01) was stronger in the subjects without thyroid cysts than in those with thyroid cysts (r = - 0.03, p = 0.525).@*CONCLUSIONS@#TSH is positively associated with hypertension only in individuals without thyroid cysts. The correlation between the TSH and free T3 levels was stronger in the subjects without thyroid cysts than in those with thyroid cysts. Therefore, the absence of thyroid cysts could be related to the association between TSH level and hypertension, possibly by indicating that the subjects without thyroid cysts had limited thyroid hormone reserves. Therefore, the absence of thyroid cysts could indicate the latent functional damage of the thyroid.


Subject(s)
Aged , Cross-Sectional Studies , Cysts/etiology , Female , Humans , Hypertension/metabolism , Japan , Male , Middle Aged , Thyroid Diseases/etiology , Thyroid Gland/pathology , Thyrotropin/metabolism
20.
Article in Chinese | WPRIM | ID: wpr-879779

ABSTRACT

OBJECTIVE@#To study the incidence rate of non-thyroidal illness syndrome (NTIS) in critically ill children with or without sepsis and the association of NTIS with interleukin-6 (IL-6) and interleukin-10 (IL-10).@*METHODS@#A retrospective analysis was performed on the medical data of 97 children with sepsis (sepsis group) and 80 non-sepsis children with bacterial infection (non-sepsis group). The correlations of IL-6 and IL-10 with the thyroid function parameters triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) were analyzed.@*RESULTS@#There were no significant differences in age and sex between the sepsis and non-sepsis groups (P>0.05). Compared with the non-sepsis group, the sepsis group had a significantly higher Sequential Organ Failure Assessment score, a significantly longer length of hospital stay, and a significantly higher rate of use of ventilator (P0.05), but the pooled analysis of the two groups showed that IL-6 level was negatively correlated with T3 and T4 levels (P<0.001).@*CONCLUSIONS@#Children with sepsis have a higher incidence rate of NTIS than those without sepsis. The high level of IL-6 may be associated with the development of NTIS.


Subject(s)
Child , Critical Illness , Euthyroid Sick Syndromes , Humans , Interleukin-10/blood , Interleukin-6/blood , Retrospective Studies , Sepsis , Thyrotropin , Thyroxine
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