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Objective:To investigate the prognostic value of serum free triiodothyronine (FT3) in patients with hepatitis E-related acute liver failure (HEV-ALF).Methods:Clinical data of 88 patients with HEV-ALF and 86 patients with acute hepatitis E (AHE) were collected from the member hospitals of Chinese Consortium for the Study of Hepatitis E between January 2016 and December 2021; the data of 100 health subjects who underwent health check-up in Suzhou Municipal Hospital were also collected as healthy control (HC) group. Serum FT3 levels were analyzed in all subjects. HEV-ALF patients were divided into survival group ( n=73) and death group ( n=15) according to their 30 day survival. Correlation between serum FT3 level and prognosis of HEV-ALF patients were analyzed by Cox regression and orthogonal partial least squares discriminant analysis (OPLS-DA). The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the predictive value of serum FT3 levels for predicting the prognosis of patients, and its prediction efficacy was compared with conventional Model for End-Stage Liver Disease (MELD), King’s College Hospital criteria (KCH) and Child-Pugh models. Results:The levels of serum FT3 in HEV-ALF patients were significantly lower than those in AHE patients and HC group ( P=0.006 or <0.001). Cox regression analysis showed that international standardized ratio ( HR=17.984, 95% CI 2.804-115.362), hepatic encephalopathy ( HR=12.895, 95% CI 2.386-69.695) and total cholesterol ( HR=2.448, 95% CI 1.108-5.409) were independent risk factors for death in HEV-ALF patients, and serum FT3 level ( HR=0.323, 95% CI 0.119-0.876) was a protective factor. OPLS-DA results showed serum FT3 levels had high predictive value. ROC curve analysis results showed that the area under the curve was 0.828 (95% CI 0.733-0.900, P<0.001), the sensitivity was 80.00%, and the specificity was 78.08%. DCA showed that FT3 has good prediction ability and decision-making level serum FT3 levels in patients with improvement and fluctuation were significantly higher than those in the patients with deterioration ( P<0.05 or <0.01). Conclusion:Serum FT3 levels are closely related to the prognosis of HEV-ALF patients and it may be used as a biomarker for the prognosis of patients with HEV-ALF.
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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.
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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.
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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.
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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.
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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.
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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.
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Objective To study the relationship between thyroid hormone level and 24h urine protein quanti-tation in patients with severe preeclampsia. Methods From August 2015 to October 2017,180 patients with severe preeclampsia who were treated in the Third People's Hospital of Qingdao were selected. The level of thyroid-stimula-ting hormone ( TSH) was detected by chemiluminescence particles immune method. According to the test results,the patients were divided into normal group (n=110,TSH=0. 3-3. 3mU/L) and hypothyroidism group (n=70,TSH>3. 3mU/L). Another 240 healthy pregnant women who admitted in the Third People's Hospital of Qingdao during the same period were selected as control group. The TSH,free triiodothyronine (FT3),free thyroxine (FT4) levels and 24h urine protein quantitation were compared among the three groups. The correlation between the level of thyroid hormone and 24h urine protein quantitation,the results of thyroid autoantibody in patients with severe preeclampsia were analyzed.Results The FT4,FT3 levels in the normal group were (11.92±2.54)pmol/L,(5.22 ±1.25)pmol/L, respectively,which in the hypothyroidism group were (9. 02 ± 1. 09) pmol/L,(3. 92 ± 1. 57) pmol/L,respectively, which were all lower than those in the control group (t=6. 657,16. 758,13. 221,18. 245,all P<0. 05),which in the hypothyroidism group were lower than those in the normal group (t=9. 031,6. 149,all P<0. 05). The TSH,24h urine protein quantitation levels in the normal group were (2. 56 ± 0. 86) mU/L,(66. 51 ± 18. 52) mg,respectively, which in the hypothyroidism group were (5. 87 ± 3. 02) mU/L,(79. 14 ± 12. 58) mg,respectively,which were all higher than those in the control group(t=2. 330,7. 197,16. 417,13. 335,all P<0. 05),which in the hypothyroidism group were higher than those in the normal group (t=10. 883,5. 014,all P<0. 05). There was positive correlation between serum TSH and 24h urine protein quantitation in patients with severe preeclampsia (r=0. 254,P=0. 001). There was negative correlation between FT4 and 24h urine protein quantitation (r= -0. 182,P=0. 025). There was no correlation between serum FT3 and 24h urine protein quantitation (r= -0. 080,P=0. 330). The positive rates of TPO Ab,TG Ab were 12. 86％,18. 57％ in hypothyroidism group,there were no statistically significant differences compared with 10. 91％,14. 55％ in the normal group (χ2 =0. 158,0. 513;P=0. 691,0. 474). Conclusion There is correlation between thyroid hormone levels and 24h urine protein quantitation in patients with severe preeclampsia. It has great significance for clinical treatment of severe preeclampsia by detecting the level of thyroid hormone.
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Thyroid disorders are common, affecting more than 10% of people in the US, and laboratory tests are integral in the management of these conditions. The repertoire of thyroid tests includes blood tests for thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine, thyroglobulin (Tg), thyroglobulin antibodies (Tg-Ab), thyroid peroxidase antibodies (TPO-Ab), TSH receptor antibodies (TRAb), and calcitonin. TSH and free thyroid hormone tests are frequently used to assess the functional status of the thyroid. TPO-Ab and TRAb tests are used to diagnose Hashimoto's thyroiditis and Graves' disease, respectively. Tg and calcitonin are important tumor markers used in the management of differentiated thyroid carcinoma and medullary thyroid carcinoma (MTC), respectively. Procalcitonin may replace calcitonin as a biomarker for MTC. Apart from understanding normal thyroid physiology, it is important to be familiar with the possible pitfalls and caveats in the use of these tests so that they can be interpreted properly and accurately. When results are discordant, clinicians and laboratorians should be mindful of possible assay interferences and/or the effects of concurrent medications. In addition, thyroid function may appear abnormal in the absence of actual thyroid dysfunction during pregnancy and in critical illness. Hence, it is important to consider the clinical context when interpreting results. This review aims to describe the above-mentioned blood tests used in the diagnosis and management of thyroid disorders, as well as the pitfalls in their interpretation. With due knowledge and care, clinicians and laboratorians will be able to fully appreciate the clinical utility of these important laboratory tests.
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Embarazo , Anticuerpos , Biomarcadores de Tumor , Calcitonina , Enfermedad Crítica , Diagnóstico , Enfermedad de Graves , Pruebas Hematológicas , Yoduro Peroxidasa , Fisiología , Receptores de Tirotropina , Tiroglobulina , Pruebas de Función de la Tiroides , Glándula Tiroides , Neoplasias de la Tiroides , Tiroiditis , Tirotropina , Tiroxina , TriyodotironinaRESUMEN
Objective To investigate clinical characteristics of patients with liver failure accompanied with non-thyroid sick syndrome (NTIS) and the predictive value for short-term prognosis.Methods Ninety patients with liver failure hospitalized in Tianjin Second People's Hospital from January 2013 to December 2017 were retrospectively enrolled.Among them,75 patients (liver failure group) were randomly selected to establish prognostic models and the other 15 were selected for model validation.Another 75 patients at the same time of hospitalization with chronic hepatitis were randomly selected as the control group.The serum free triiodothyronine (FT3),free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured by chemiluminescence.The clinical characteristics and survival rates 3 months after admission of patients with liver failure accompanied with NTIS were analyzed.The predictive value of the model for end-stage liver disease (MELD) score,Child-Turcotte-Pugh (CTP) score,chronic liver failure-sequential organ failure assessment (CLIF-SOFA) score,FT3-MELD model and FT3 for prognosis of liver failure were evaluated.Quantitative data were analyzed with Student's t-test and Mann-Whitney U test.Count data were analyzed with chi-square test.Results The liver failure group had significantly lower levels of FT3,TSH and albumin (Alb),but higher levels of total bilirubin (TBil),international normalized ration (INR),serum creatinine (Cr) and FT4 than the control group.NTIS was diagnosed in 50 patients with liver failure (50/75,66.67％).There were 32 deaths in patients with NTIS and 7 in patients with non-NTIS.The difference was statistically significant (x2 =8.654,P =0.003).INR,Cr,FT3,MELD score,CTP score and CLIF-SOFA score were significantly different between the survival and death groups (t =-3.037,t =-2,720,t =4.100,t =-4.221,t =-3.471,and t =-3.901,respectively;all P ＜ 0.01).A negative correlation was observed between FT3 and MELD score (r =-0.439,P ＜ 0.01).The area under the receiver's operating characteristic (ROC) curve of the FT3-MELD model was 0.816,with the optimal cut-off-point of 0.121 7,sensitivity of 0.769 and specificity of 0.833.The areas under the curve of the FT3,MELD score,CTP score and CLIF-SOFA score were 0.794,0.775,0.699,and 0.739,respectively.Conclusions Liver function and thyroid function are poor in patients with liver failure accompanied with NTIS.The FT3-MELD model is superior to CTP score and CLIF-SOFA score in predicting the short-term prognosis in patients with liver failure.
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Objective To establish trimester-specific reference intervals of thyroid hormones for pregnancy in normal iodine intake.Methods A total of 716 pregnant women were selected as research subjects ,and another 307 normal women without pregnancy were served as control group .The serum thyroid stimulating hormone (TSH), free thyroxine(FT4),free three iodine thyroid gland originalacid(FT3) were measured by chemiluminescent microparticle immunoassay.The changes of thyroid indicators in different gestational period were analyzed ,and the thyroid reference range during pregnancy was established .Results The levels of TSH,FT3 and FT4 in non-pregnant women and women in different pregnancy were significantly different (F =78.901,249.571,137.090,all P <0.05),in which the TSH increased with the increase of gestational age ,while the FT3 and FT4 decreased with the increase of gestational age.The reference range of TSH in the early ,middle and late gestational weeks were 0.12-4.82mIU/L,0.60-4.25mIU/L,0.37-4.03mIU/L;the reference range of FT3 in the early,middle and late gestational weeks were 3.81-6.10pmol/L,3.40-5.20pmol /L,3.00-5.00pmol /L;and the reference range of FT4 in the early,middle and late gestational weeks were 12.85-22.12pmol/L,10.81-17.66pmol /L,10.96-18.20pmol /L,respectively. The diagnostic rates for thyroid dysfunction of reference values ,non-pregnancy reference values and reference values established by American Thyroid Society (ATA) were 5.17%,5.45% and 6.01%,respectively,which showed no statistically significant difference among the three groups (χ2 =0.498,P >0.05).However,the difference among the three diagnostic criteria for subclinical hypothyroidism was statistically significant ( χ2 =9.661, P <0.05 ). Conclusion The thyroid function indicators of pregnant women are significantly different from those of normal people,and there are differences in different stages of pregnancy .Establishing a region-specific reference range can effectively prevent misdiagnosis or missed diagnosis of thyroid disease and reduce adverse pregnancy outcome .
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Objective To study thyroid function in patients with depression.Methods The average levels of TSH,FT3,FT4 in 5 316 patients with depression were compared with 5 316 healthy controls.The average levels of TSH,FT3,FT4 were compared between male and female patients with depression.The differences of thyroid disease detection rate were compared between elder and group younger group.Results The differences of TSH,FT3,FT4 levels between the depression patients and healthy controls have statistically significant(P＜0.05).The differences of TSH,FT3,FT4 levels between the male depression patients and the female depression patients have statistically significant (P＜ 0.05).The hyperthyroidism prevalence were as follows:6.50 ％ versus 6.10 ％ (P＞0.05),compared between older and younger depression patients.The subclinical hypothyroidism prevalence 24.30 ％ versus 9.40 ％ (P＜0.05),compared between older and younger depression patients.The hypothyroidism prevalence 14.30 ％ versus 2.90％ (P＜0.05),compared between older and younger depression patients.Conclusion Depression is easily caused by low thyroid hormone levels.Women and elder people with hypothyroidism should more prevent depression.Thyroid hormones can be used as routine screening index of depression,but not specific indicators.
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Objective To study thyroid function in patients with depression.Methods The average levels of TSH,FT3,FT4 in 5 316 patients with depression were compared with 5 316 healthy controls.The average levels of TSH,FT3,FT4 were compared between male and female patients with depression.The differences of thyroid disease detection rate were compared between elder and group younger group.Results The differences of TSH,FT3,FT4 levels between the depression patients and healthy controls have statistically significant(P＜0.05).The differences of TSH,FT3,FT4 levels between the male depression patients and the female depression patients have statistically significant (P＜ 0.05).The hyperthyroidism prevalence were as follows:6.50 ％ versus 6.10 ％ (P＞0.05),compared between older and younger depression patients.The subclinical hypothyroidism prevalence 24.30 ％ versus 9.40 ％ (P＜0.05),compared between older and younger depression patients.The hypothyroidism prevalence 14.30 ％ versus 2.90％ (P＜0.05),compared between older and younger depression patients.Conclusion Depression is easily caused by low thyroid hormone levels.Women and elder people with hypothyroidism should more prevent depression.Thyroid hormones can be used as routine screening index of depression,but not specific indicators.
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Objective To investigate the relationship of thyroid hormones and serum lipid profile during Pregnancy. Methods 30 cases of healthy pregnant women were recruited in the study. The thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and serum lipid profile were examined at 9 ~ 12, 14 ~ 17, 23 ~ 26 and 37 ~ 40 weeks of gestation and the correlations between them were analyzed. Results Positive correlation could be found between serum TSH and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). Negative correlations could be found between serum FT3, FT4 and total cholesterol (CHOL), triglyceride (TRIG), low density lipoprotein cholesterol (LDL-C), ApolipoproteinA-I (APOA-I), ApolipoproteinB (APOB). And no correlation was found between serum thyroid hormones and high density lipoprotein cholesterol (HDL-C). Conclusion The thyroid hormones were closely related to serum lipid profile except of HDL-C.
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Objective To research the levels of thyroid hormone in patients with Sheehan′s syndrome .Methods The difference of thyroid‐stimulating hormone(TSH) or free triiodothyronine(fT3 ) or free thyroxine(fT4 ) levels was compared between 100 pa‐tients with sheehan′s syndrome and 100 cases of female healthy controls included in this study .The difference for TSH or fT3 or fT4 levels was compared between before and after treatment in Sheehan′s syndrome patients .The difference of TSH or fT3 or fT4 levels was compared when time from a large bleeding to disease onset below 1 year ,1‐5 years and over 5 years respectively in Shee‐han′s syndrome patients .Results The difference of TSH or fT3 or fT4 levels between patients with Sheehan′s syndrome and female healthy controls had obvious statistical significance .TSH :1 .60(0 .79 -2 .86)mU/L versus 3 .08(1 .97 -5 .08)mU/L ,fT3 :2 .09 (1 .44-3 .69)pmol/L versus 4 .86(4 .49-5 .40)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .56(13 .63 -16 .11)pmol/L (P<0 .001 for comparisons respectively) .The difference of TSH or fT3 or fT4 levels between before and after treatment had obvi‐ous statistical significance .TSH :1 .60(0 .79-2 .86)mU/L versus 1 .16(0 .57-2 .11)mU/L ,fT3 :2 .09(1 .44-3 .69)pmol/L versus 3 .27(2 .38-4 .11)pmol/L ,fT4 :8 .01(3 .45 -12 .64)pmol/L versus 14 .32(10 .48 -15 .92)pmol/L(P<0 .05 for comparisons re‐spectively) .Time from a large bleeding to disease onset were below 1 year ,1-5 years and over 5 years ,TSH levels were respective‐ly 2 .85(2 .21-3 .51)、1 .82(1 .24-2 .98) and 1 .52(0 .65-2 .64)mU/L(P<0 .05 for comparisons) .The fT3 levels were respective‐ly 3 .74(2 .24-4 .45) ,2 .54(1 .87-3 .32) and 1 .89(1 .13-3 .11)pmol/L(P<0 .05 for comparisons) .The fT4 levels were respec‐tively 12 .21(10 .45-14 .32) ,8 .52(5 .13-12 .34) and 7 .85(3 .12 -10 .12)pmol/L(P<0 .05 for comparisons) .Conclusion TSH could serve as an identifiable index for sheehan′s syndrome and primary hypothyroidism .The time from a large bleeding to the dis‐ease onset is longer ,the anterior pituitary function is more serious .Thyroid hormone should be monitored regularly in order to pre‐vent the happening of hyperthyroidism during the process of the treatment .For postpartum hemorrhage patients ,thyroid hormone should be early detected and combine with the clinical manifestations .They should early diagnose and timely treat in order to pre‐vent the sheehan′s syndrome and its crisis .
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Objective To investigate the changes of thyroid hormones in pregnant women of different gestation by analyzing the test results from pregnant women .Methods Authors collected serum from 1 764 pregnant women and 121 healthy women(not pregnant ,control group) .And the levels of thyroid stimulating hormone(TSH) ,free triiodothyronine(FT3 ) and free thyroxine (FT4 ) in serum were tested by chemiluminescence microparticle immunization analysis(CMIA) method .Results The level of TSH (1 .06 mIU/L) in early-gestation women was lower than that in control group(P<0 .05) ,but increased in mid-gestation and late-gestation ,there was significant difference among early-gestation ,mid-gestation and late-gestation women(P<0 .05) .The levels of FT3 and FT4 in early-gestation women were higher than those in control group(P<0 .05) ,but decreased during mid-gestation and late-gestation ,there was significant difference among early-gestation ,mid-gestation and late-gestation women(P<0 .05) .Conclusion Thyroid hormones of pregnant women change in different gestation periods ,different reference values have to be adapted to evaluate thyroid gland function .
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Objective To further research the urinary monitoring of the maternal thyroid functional status ,the levels of urine thyroid hormones were analyzed during pregnancy .Methods This study recruited 30 cases of healthy pregnant women at 9-12 ges-tational weeks .Their random urine specimens were collected every four weeks until delivery .The concentrations of urine thyrotro-pin(uTSH) ,urine free triiodothyronine(uFT3) and urine free tetraiodothyronine(uFT4) were detected by electrochemical lumines-cence immunoassay(ECLIA) .The urine retinol binding protein(uRBP) was detected by enzyme immunoassay (EIA) .After correc-ted by uRBP ,the statistical analysis was done to analyze the variation of the ratio of uTSH and uRBP (uTSH/uRBP) ,the ratio of uFT3 and uRBP(uFT3/uRBP)and the ratio of uFT4 and uRBP(uFT4/uRBP)during pregnancy .Results The median levels of u-rine thyroid hormone parameters were obtained from the healthy pregnant women every four weeks and were compared among dif-ferent stages .The difference of uFT3/uRBP and uFT4/uRBP was statistically significant (F= 6 .222 ,P< 0 .05 ;F= 5 .078 ,P<0 .05) ,and the levels of them varied linearity during pregnancy (F=27 .480 ,P<0 .05 ;F=23 .959 ,P<0 .05) .The difference of uT-SH/uRBP had no statistical significance(F=2 .731 ,P=0 .054) .Conclusion After corrected by uRBP ,the levels of uFT3 and uFT4 of healthy pregnant women decreased linearity among different gestational stages ,and the levels of uTSH had no noticeable change .
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@#BACKGROUND: Although non-thyroidal illness syndrome (NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine (fT3) levels in trauma patients requiring massive transfusion have not been reported. METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions (>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of fT3, free thyroxine (fT4), and thyroid-stimulating hormone (TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation. RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial fT3 levels in group M (1.95±0.37 pg/mL) were significantly lower than those in group C (2.49±0.72 pg/mL;P<0.01) and remained low until 1 week after admission. Initial inter-group fT4 and TSH levels were not significantly different. TSH levels at 1 week (1.99±1.64 μIU/mL) were higher than at admission (1.48±0.5 μIU/mL) in group C (P<0.05). CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.
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Objective The prognosis of patients with acute myocardial infarction (AMI) is related to age,comorbidities,and other factors,in which non-thyroid sick syndrome (NTIS) may also be an important factor.In this study,determination of blood free triiodothyronine (FT3) was used to explore the short-term and long-term mortality relationship of NTIS with acute myocardial infarction.Methods A total of 1 019 cases of newly diagnosed patients with acute myocardial infarction were enrolled.According to FT3 levels,the enlisted subjects were divided into Quartile 1-4 groups; survival group and non-survival group; normal thyroid function and NTIS group.The enrolled subjects were followed-up for 6-90 months,with the median follow-up time of 44.5 months.Using logistic regression and Cox hazards model,the relationships of short-term and long-term mortality in AMI with NTIS or FT3 were compared.Results The incidence of NTIS in patients with AMI was 27.78％.With the progressively decreasing FT3 and FT3/FT4 ratio,the mortality rates were progressively increased (Quartile 1 group 9.4％,Quartile 2 group 13.8％,Quartile 3 group 14.3％,Quartile 4 group 34.0％,P＜0.01).After being adjusted,FT3 was the strongest influencing factor of mortality within 30 days (RR =0.212,95％ CI 0.125-0.359).Multivariate Cox regression analysis showed that FT3 was independently associated with long-term mortality (RR =0.674,95％ CI 0.514-0.885).Kaplan-Meier showed significant difference in mortality between quartile 1-3 groups and the Quartile 4 group.Even FT3 level was within the low normal range,it was related with the mortality in AMI.Conclusions NTIS is common in patients with AMI.After being adjusted,FT3 was the strongest predictor of mortality within 30 days,and low FT3level in AMI patients was an independent risk factor for long-term all-cause mortality.Even FT3 level was within the normal range,it was still related with mortality in myocardial infarction.
RESUMEN
Background: Thyroid hormones play a vital role in metabolism, sensitivity of tissues to other hormones and also in oxygen consumption of almost all cells of the body. However, mild to moderate decrease in function of thyroid gland may occur with advancing age even in apparently healthy elderly subjects. Objectives: To observe age related change in thyroid function status in apparently healthy elderly subjects in Bangladesh. Methods: This cross sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka between 1st January 2011 and 31st December 2011. Sixty apparently healthy elderly subjects of both sexes aged 50 to 75 years were taken as study group. They were collected from Probin Nibash Hitoishi Shangha, Agargaon, Dhaka. In addition, 30 apparently healthy young adult subjects aged 20-40 years were included as control. For assessment of thyroid function, serum free thyroxine (FT4), free triiodothyronine (FT3) and thyroid stimulating hormone (TSH) levels were estimated by ELISA method. Statistical analysis was done by one way ANOVA, Bonferroni test and Pearson’s Correlation Coefficient test as applicable. Results: In this study, mean serum free thyroxine (FT4) and free triiodothyronine (FT3) levels were significantly (p<0.001) lower and serum thyroid stimulating hormone (TSH) level was significantly (p<0.001) higher in apparently healthy elderly subjects in comparison to those of the healthy young subjects. Again, serum FT4 and FT3 levels were negatively correlated whereas serum TSH level was positively correlated with age of the subjects. Conclusion: The present study revealed a progressive decrease in thyroid function with advancement of age.