Thyroid hormone sensitivity and obesity phenotype in euthyroid subjects / 中华内分泌代谢杂志

Objective:To explore the relationship between thyroid hormone sensitivity and obesity phenotype in people with normal thyroid function.Methods:In this retrospective study, 6155 euthyroid subjects who underwent a health check-up in the First Hospital of China Medical University between January 2017 and December 2018 were included. Participants were categorized into four obesity phenotypes according to body mass index and metabolic status. Thyroid Feedback Quantile-based Index(TFQI), Parametric TFQI, free triiodothyronine to free thyroxine ratio(FT 3/FT 4), and sum activity of peripheral deiodinases(SPINA-GD) were calculated to evaluate thyroid hormone sensitivity. Results:Compared with metabolically healthy non-obese(MHNO) phenotype, the subjects with metabolically healthy obese(MHO) or metabolically unhealthy obese(MUO) phenotype showed higher FT 3/FT 4ratio. Metabolically unhealthy non-obese(MUNO) and MUO subjects showed lower TFQI. After adjusting for confounders, FT 3/FT 4ratio was positively associated with MHO( OR 1.18, 95% CI 1.11-1.26) and MUO phenotype( OR 1.28, 95% CI 1.19-1.39). With 1 s increase of TFQI, the OR for MUNO phenotype was 0.77(95% CI 0.64-0.94). The results of Parametric TFQI and SPINA-GD were similar to TFQI and FT 3/FT 4ratio, respectively. Conclusion:In euthyroid individuals, thyroid hormone sensitivity was positively associated with increased risk for unhealthy obesity phenotypes.

Can we use vitamin D to prevent and treat COVID-19? / 中华内分泌代谢杂志

Multiple lines of evidence, including anti-inflammatory effects of vitamin D and the association of lower circulating vitamin D levels with the higher risk and worse outcomes in patients with coronavirus disease 2019 (COVID-19), suggested a potential role for vitamin D to prevent and treat COVID-19. However, existing results from quasi-experimental studies and clinical trials do not support routine use of high-dose vitamin D to curb COVID-19. It is still important to emphasize on correction of vitamin D deficiency before more results of ongoing clinical trials become available.

Hyperthyroxinemia secondary to multiple myeloma: One case report / 中华内分泌代谢杂志

The thyroid function test is universally used for the evaluation of thyroid function. However, there are factors other than endocrine diseases, such as special physiological conditions, interference in laboratory measurement, or disorders in other systems that should be taken into consideration. When encountering thyroid function test results that are not in line with clinical manifestation, a comprehensive evaluation is essential for a correct and timely diagnosis. We presented a case of a significant rise in serum total triiodothyronine(TT 3) secondary to multiple myeloma. Through case studies and literature review, we intended to provide clinicians with experience for better interpretation of abnormal thyroid function test results.

Use Stones from Another Mountain to Polish One’s Jade: Learn from MERS Studies toexplore potential mechanisms underlying the effect of diabetes mellitus on COVID-19 / 中华内分泌代谢杂志

Epidemiology studies suggest that comorbid diabetes may have negative impact on the progression and severity of the coronavirus disease 2019 (COVID-19), which first occurred in Wuhan. However, the exact mechanism remains unclear. A recent study on another type of coronavirus infection, Middle East Respiratory Syndrome (MERS), investigated its relationship with diabetes. This essay aims to give a brief introduction to this report and related studies, and to propose suggestions on what we can learn from these investigations to conduct further studies on the potential mechanisms underlying the effect of diabetes mellitus on COVID-19.

Prolonged duration of positive virus-PCR results in patients with COVID-19 may be associated with diabetes mellitus / 中华内分泌代谢杂志

Objective:To investigate the correlation between concomitant diabetes mellitus and clinical features in patients with COVID-19.Methods:Fifty patients with COVID-19 admitted to the Sixth People′s Hospital of Shenyang were divided into 2 groups with and without diabetes mellitus. Indexes such as hospitalization days, duration of positive virus-PCR result, secondary infection, duration of fever, rate of liver dysfunction, and rate of cardiac injury were compared between 2 groups.Results:The average hospitalization durations of diabetes group and control group were(24.0±6.8) and(18.4±5.9) days, respectively, and the duration of positive virus-PCR testing results were(16.0±4.5) and(12.3±4.4) days respectively, suggesting longer hospital stay and longer time for virus clearance in the diabetes group than those in the control group(both P<0.05). The rates of secondary infection, severe subtype, liver dysfunction and cardiac injury in the diabetes group increased, though without significant difference( P>0.05). Conclusion:Prolonged duration of positive virus-PCR result and average days of hospitalization in patients with COVID-19 may be associated with diabetes mellitus.

Using Stones from Another Mountain to Polish One′s Jade: Learn from MERS studies to explore the potential mechanisms underlying the effects of diabetes mellitus on COVID-19 / 中华内分泌代谢杂志

Epidemiology studies suggest that comorbid diabetes may have some negative impacts on the development and progression of the coronavirus disease 2019 (COVID-19). However, the exact mechanisms remain to be unclear so far. A recent study on another type of coronavirus infection, Middle East respiratory syndrome (MERS), was investigated along with its relationship with diabetes. This essay aims to give a brief introduction to this report and related studies, and to propose some suggestions on what we may learn from these investigations to conduct further studies on the potential mechanisms underlying the effects of diabetes mellitus on COVID-19.

Diagnostic value of pyruvate kinase M2 gene for papillary thyroid carcinoma in fine-needle aspiration specimens / 中华内分泌代谢杂志

Objective To investigate the diagnostic value of pyruvate kinase M2 ( PKM2) gene expression in papillary thyroid carcinoma ( PTC). Methods Quantitative real-time PCR ( RT-qPCR) was used to detect the expression of PKM2 mRNA in benign thyroid nodules, PTC, and normal thyroid cells around nodules of fine-needle aspiration (FNA) specimens. Immunohistochemistry ( IHC) was used to detect the expression of PKM2 protein in thyroid tissue after thyroidectomy. The receiver operating characteristic curve was constructed to evaluate the diagnostic value of PKM2 in PTC. Results The expression of PKM2 mRNA was detectable in FNA specimens of thyroid nodules,higher in PTC than those in normal thyroid tissue and benign thyroid nodules (P<0.01). PKM2 expression level was correlated with diameter of PTC ( P<0.05) , but had no correlation with lymph node metastasis, BRAFV600E mutation, and American Joint Committe on Cancer( AJCC) stage ( P>0.05) . The expression level of PKM2 mRNA in FNA specimens of thyroid nodules was paralleled with the expression level of PKM2 protein in postoperation pathological tissues. The accuracy, sensitivity, specificity of PKM2 gene in the diagnosis of PTC were 62.8％, 46.9％, and 95.7％, respectively. The accuracy and sensitivity of PKM2 combined with BRAFV600E were increased to 87.6％and 83.7％. Conclusion Detection of PKM2 gene in FNA specimens is highly specific in the diagnosis of PTC, making it a valuable molecular marker for preoperative diagnosis. The combination of PKM2 and BRAFV600E detection shows a higher diagnosis efficiency.

Management of hypoparathyroidism during pregnancy / 中华内分泌代谢杂志

Hypoparathyroidism during pregnancy is an uncommon clinical problem, By presenting a case of post-surgical hypoparathyroidism during pregnancy, this paper reviewed calcium physiology in pregnancy, as well as characteristics of pregnant women with hypoparathyroidism which differ from those of normal pregnant women in order to help readers better undarstand the complexity of this problem and management of hypoparathyroidism during pregnancy.

Endocrine-related injuries associated with immune checkpoint inhibitors: what endocrinologists and oncologists should know / 中华内分泌代谢杂志

The development of medications known as immune checkpoint inhibitors(ICPis) has been a milestone of cancer therapy. However, the increasing use of ICPis in recent years has caused a diverse spectrum of immune-related adverse events, including endocrine glands injury. ICPis-induced endocrinopathies are new challenges brought by advances of medicine as well as become the hot topics in both endocrinology and oncology. It is important that endocrinologists and oncologists should know how to perform proper assessment and clinical management once ICPis-induced endocrinopathies occur. Interdisciplinary collaboration is required to deal with this medical problem in order to improve overall survival and quality of life for patients with various cancer.

Updates in the Bethesda System for Reporting Thyroid Cytopathology, Version 2 / 中华内分泌代谢杂志

The Bethesda System for Reporting Thyroid Cytopathology ( TBSRTC ) was firstly proposed in 2007. Its first edition was published in 2009. It has been widely adopted as the standardized reporting system. Based on tremendous advancements in the field of thyroidology after the introduction, the second edition of TBSRTC was officially published in October of 2017. Herein, we list and interpret its major changes in the new edition.

The update of AJCC/TNM staging system may change the post-operative assessment of differentiated thyroid cancer / 中华内分泌代谢杂志

Objective To investigate the post-operative mortality risk staging changes of differentiated thyroid cancer resulted from the changes of the AJCC/TNM cancer staging system and to explore its clinical significance. Methods This study included 2 553 patients accepting surgical therapies in Department of Thyroid Surgery from January 2013 to February 2017. Overall,2 553 patients were staged according to the 7th and 8th editions of the AJCC/TNM cancer staging system respectively. Results Compared with the previous staging outcomes,548 patients(21.46%)were downstaged according to the 8th edition of the staging system. Of these 548 patients,438 (17.16%)migrated from an advanced stage(Ⅲ/Ⅳ)to stage Ⅰ/Ⅱ. The difference of the staging outcomes was significant(P<0.01). Because of the change of age cut off,364 patients(14.26%)were downstaged to stage I. Of these 364 patients, 318(12. 46%) migrated from an advanced stage(Ⅲ/Ⅳ) to stage I. Conclusion For the changes of the AJCC/TNM cancer staging system,particularly for the change of age cut off,many patients with DTC would be referred to lower stages, and therefore they would receive less aggressive post-operative management strategies.

Interpretation of 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis: diagnosis and medical treatment / 中华核医学与分子影像杂志

In October 2016,the updated American Thyroid Association (ATA) guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis was officially published,which provided more reliable and detailed information and suggestions on diagnosis and treatment of thyrotoxicosis.This paper interprets the new guidelines,focusing on relevant contents of diagnosis and medical therapies.

What's new in the 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis / 中华内科杂志

The 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis has been officially published in October of 2016,five years after the publication of the previous version.Revised contents in the new guideline are summarized in this review.

Information other than laboratory results should be valued when diagnosing thyroid diseases:Lessons from the misdiagnosis of Graves' hyperthyroidism in a woman taking biotin / 中华内分泌代谢杂志

We report a young woman who was misdiagnosed as Graves' hyperthyroidism due to biotin immunoassay interference. Base on this case, essentials for diagnosis of thyroid diseases are discussed. We propose that in the clinical practice, a patient-centered professionalism should be consistently followed, and information other than laboratory findings should be valued.

Active surveillance for papillary thyroid microcarcinoma: considerations before making a decision / 中华内分泌代谢杂志

For rapidly increasing low-risk papillary thyroid micocarcinoma (PTMC), Japanese scholars have proposed that immediate surgery can be replaced by active surveillance, i.e. observation strategy. The new strategy has brought not only an important update to the management of PTMC, but also controversies from different perspectives. Here we would like to give a thorough review on the observation strategy for PTMC, including its development background, available clinical data, current recommendations/suggestions by guidelines/consensuses, common misunderstandings toward this topic, challenges, and prospective in the future.

What's new in the 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis / 中华内科杂志

The 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis has been officially published in October of 2016,five years after the publication of the previous version.Revised contents in the new guideline are summarized in this review.

Information other than laboratory results should be valued when diagnosing thyroid diseases:Lessons from the misdiagnosis of Graves' hyperthyroidism in a woman taking biotin / 中华内分泌代谢杂志

We report a young woman who was misdiagnosed as Graves' hyperthyroidism due to biotin immunoassay interference. Base on this case, essentials for diagnosis of thyroid diseases are discussed. We propose that in the clinical practice, a patient-centered professionalism should be consistently followed, and information other than laboratory findings should be valued.

Effect of glucagon-like peptide-1 receptor agonists on growth and energy metabolism in human medullary thyroid cancer cells / 中国癌症杂志

Background and purpose:This study aimed to investigate the effect of glucagon-like peptide-1 receptor agonists on proliferation, secretion of calcitonin and energy metabolism of medullary thyroid cancer (MTC) cell.Methods:The MTC cell line (TT) was culturedin vitro. After treatment with exenatide and liraglutide (0, 1, 10 and 100 nmol/L) for 24, 48 and 72 h, the proliferation of TT was analyzed by CCK-8 kit, the calcitonin was measured by calcitonin assay kits, and the energy metabolism of TT was measured by Seahorse XF instrument.Results:When compared with control group, neither exenatide nor liraglutide had effects on proliferation of TT (P>0.05); the calcitonin levels did not change signiifcantly after treatment with GLP-1 receptor agonists (P>0.05). Exenatide and liraglutide did not alter glycolysis and mitochondrial respiration in TT cells in a dose- and time-dependent manner.Conclusion:GLP-1 receptor agonists have no effect on the development of TT. Further collection of the safety data of exenatide and liraglutide on thyroid is still needed.

Recent progress of study in pregnancy and thyroid cancer / 中华内分泌代谢杂志

Thyroid cancer accounts for the most common endocrine malignancies in women during childbearing age.Many questions remain to be answered regarding the association between thyroid cancer and pregnancy.This review will discuss both the effects of pregnancy on thyroid cancer and vice versa.Recommendations on how to manage thyroid cancer in pregnancy will also be cited from a Chinese academic guideline as listed at the end of this review.

Association of serum leptin level with postpartum thyroiditis: A case control study / 中华内分泌代谢杂志

Objective To investigate the association of serum leptin (LEP) levels during the first postpartum year with the occurrence of postpartum thyroiditis (PPT).Methods Fifty-seven PPT patients consisted of 34 with overt PPT and 23 subclinical PPT.37 healthy postpartum women were used as controls.Serum samples were obtained at 4 postpartum date points,i.e.3-days and 3,6,12-months postpartum.LEP level was determined by radioimmunoassav.Results Compared with control women,PPT patients were maintaining significantly higher levels of LEP and LEP/body mass index (BMI) ratio during the first postpartum year.There was no significant difference in serum LEP level or LEP/BMI ratio between overt PPT and subclinical PPT groups.In PPT patients,LEP and LEP/BMI ratio were negatively correlated with serum TSH,and positively correlated with serum FT4 and FT3.Conclusion Sustained high levels of serum LEP after delivery may favor the occurrence of PPT.Further studies are needed to clarify the specific role played by LEP in PPT.