Parameters affecting the period for being euthyroid in newly-diagnosed Graves’ disease treated with antithyroid agent

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.

Clinical study of Jianpi-Huatan-Huoxue Decoction combine with levothyroxine sodium tablets in the treatment of subclinical hypothyroidism / 国际中医中药杂志

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.

A Prospective Study of Incidence of Hypothyroidism after Hemithyroidectomy in a Tertiary Care Hospital in North Odisha

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.

Thyroid function studies in children of nephrotic syndrome

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.

An Optimal Capillary Screen Cut-off of Thyroid Stimulating Hormone for Diagnosing Congenital Hypothyroidism: Data from a Pilot Newborn Screening Program in Delhi

Objective: To determine an appropriate cut-off of capillaryThyroid stimulating hormone (TSH) for congenitalhypothyroidism.Study design: Cross-sectional.Participants: 174,000 neonates born in different hospitals ofDelhi, India, from November 2014 to October 2016.Main outcome measures: Correlation between initial andrepeat capillary TSH level and subsequent venous free thyroxine(fT4) level.Results: 102 newborns with initial/ repeat capillary TSH level of≥20 mIU/L (n=174) were confirmed to have congenitalhypothyroidism at mean (SD) age of 5 (4) days. A goodcorrelation between capillary TSH level and confirmatory venousfT4 level and postnatal age of sampling was obtained (r -0.6,-0.4). The area under the ROC curve (AUC) was 0.81 (95%CI0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L tobe a good predictor of subsequent high venous TSH level.Conclusion: A cut off of ≥20 mIU/L for capillary TSH screeningbeyond 24 hours of life is optimal in the Indian setting for decidingfurther recall and workup, keeping a balance between sensitivityand recall rate.

Thyroid function of twin-pregnant women in early pregnancy / 中华医学杂志(英文版)

Background@#Serum human chorionic gonadotrophin (hCG) is higher in twin than that in singleton pregnancies. As hCG stimulates the thyroid to produce more free thyroxine (FT4), which may lead to decreased thyroid-stimulating hormone (TSH) levels, the reference ranges of thyroid-related indicators may differ between singleton and twin pregnancies in the first trimester. This study aimed to establish reference ranges for thyroid-related indicators in early twin pregnancies and to compare them with singleton pregnancies.@*Methods@#Data of 820 twin-pregnant women were extracted from the established database of all pregnant women who delivered at Peking University First Hospital from October 2013 to May 2018; 160 who met National Academy of Clinical Biochemistry criteria were included to establish TSH and FT4 reference ranges. We screened 480 (3:1 paired) women with singleton pregnancies from the same database as controls. The Mann-Whitney test for TSH and FT4 levels was applied for comparisons between singleton and twin pregnancies.@*Results@#First-trimester reference ranges (4–12 gestational weeks) for twin pregnancies were: TSH 0.69 (0.01–3.35) mIU/L and FT4 16.38 (12.45–23.34) pmol/L. Median TSH was significantly lower at 7 to 12 gestational weeks than that at 4 to 6 gestational weeks (0.62 vs. 0.96 mIU/L, Z = -1.964, P = 0.049); FT4 was not significantly different between the two groups. Compared to singleton pregnancies, median TSH was significantly lower (0.69 vs. 1.27 mIU/L, Z = -6.538, P = 0.000), and FT4 was significantly higher (16.38 vs. 14.85 pmol/L, Z = -7.399, P = 0.000) in twin pregnancies in the first trimester.@*Conclusions@#Specific reference ranges for thyroid-related indicators for twin pregnancies are needed to avoid a misdiagnosis of thyroid dysfunction. Moreover, establishment of separate reference ranges for 4 to 6 and 7 to 12 gestational weeks in twin pregnancies may be considered.

Relationship between thyroid hormone level and urine protein quantitation in patients with severe preeclampsia / 中国基层医药

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.

Laboratory Testing in Thyroid Conditions - Pitfalls and Clinical Utility

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.

Niveles de hormonas tiroideas en recién nacidos muy prematuros y prematuros extremos / Thyroid hormone Levels in very preterm neonates and extremely preterm

INTRODUCCIÓN: La función tiroidea del prematuro se ve alterada por la relativa inmadurez del eje hipotálamo-hipófisis-tiroides, junto a otros factores como la incidencia de enfermedades o el uso de algunos fármacos. Actualmente existe controversia sobre los niveles normales de tiroxina libre (T4L) en recién nacidos prematuros. Nuestro objetivo fue determinar la distribución de los valores de hormonas T4L y TSH, en recién nacidos menores de 32 semanas o 1.500g de peso al nacer, a los 15 días de edad cronológica, en el servicio de neonatología Hospital Dr. Hernán Henríquez Aravena, Temuco. Pacientes y MÉTODO: Estudio de corte trasversal, se analizaron los resultados de T4L y TSH desde una base de datos a 308 recién nacidos, los que fueron categorizados en tres rangos de edad gestacional: 31 a 34, 28 a 30 y 23 a 27 semanas. Se utilizó Chi-cuadrado de Pearson para asociaciones entre variables categóricas, y T-Test o ANOVA para comparaciones entre variables continuas. RESULTADOS: Observamos diferencias significativas entre los valores promedio de T4L por rangos de edad gestacional (p = 0,000), estos fueron 1,13 ng/dl para el rango de 31 a 34 semanas, 1,03 ng/dl para el rango de 28 a 30 semanas y 0,92 ng/dl para el rango de 23 a 27 semanas; no observamos diferencias significativas en los niveles de TSH por categorías de edad gestacional (p = 0,663). CONCLUSIONES: Establecimos la distribución de los niveles de T4L y TSH en nuestra población de recién nacidos muy prematuros y prematuros extremos, encontrando diferencias con reportes anteriores.

INTRODUCTION: The thyroid function of the pretern infant is altered by the relative immaturity of the hypothalamus-pituitary thyroid gland axis, along with other factors such as the incidence of diseases or the use of some drugs. Currently, there is controversy over normal levels of free thyroxine (FT4) in preterm infants. Our objective was to determine the distribution of FT4 and TSH values in newborn younger than 32 weeks or 1500 g of birth weight at 15 days of chronological age, in the neonatology service at Dr. Hernán Henríquez Aravena Hospital, Temuco. PATIENTS AND METHOD: Cross-sectional study; the results of FT4 and TSH from a database of 308 newborns, were analyzed, which were categorized into three gestational age ranges, 31-34, 28-30 and 23-27 weeks. It was used Pearson Chi-square for comparisons between categorical variables, and T-Test or ANOVA for categorical-variable ratios. RESULTS: Significant differences were observed between the average values of FT4 by gestatio nal age ranges (p = 0.000), these were 1.13 ng/dl for the range of 31 to 34 weeks, 1.03 ng/dl for the range of 28 to 30 weeks and 0.92 ng/dl for the range of 23 to 27 weeks; we did not observe significant differences in TSH levels by gestational age categories (p = 0.663). CONCLUSIONS: We established the distribution of FT4 and TSH levels in our population of very preterm and extremely preterm infants, finding differences with previous papers.

Study on the establishment of trimester-specific reference intervals of thyroid hormones for pregnancy under normal iodine intake / 中国基层医药

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 .

Impact of free thyroxine levels and other clinical factors on bare metal stent restenosis

ABSTRACT Objective Thyroid hormones have both direct and indirect effects on thermogenesis such as modulating vascular smooth muscle cell proliferation. However, the influence of more subtle changes in thyroid hormones on coronary atherosclerosis remains a matter of speculation. Smooth muscle cells play a crucial role in the pathogenesis of in-stent restenosis (ISR). However, the relationship between free thyroxine (fT4) and ISR has not been studied. In the present study, we aimed to assess the role of preprocedural serum fT4 level on the development of ISR in patients undergoing coronary bare metal stent (BMS) implantation. Materials and methods We enrolled and analyzed clinical, biochemical, and angiographic data from 705 consecutive patients without a history of primary thyroid disease [mean age 60.3 ± 9.3 years, 505 (72%) male]; all patients had undergone BMS implantation and further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural serum fT4 levels. Results ISR was observed in 53 (23%) patients in the lowest tertile, 82 (35%) patients in the second tertile, and 107 (46%) patients in the highest fT4 tertile (p < 0.001). Using multiple logistic regression analysis, five characteristics emerged as independent predictors of ISR: diabetes mellitus, smoking, HDL-cholesterol, stent length, and preprocedural serum fT4 level. In receiver operating characteristics curve analysis, fT4 level > 1.23 mg/dL had 70% sensitivity and 73% specificity (AUC: 0.75, p < 0.001) in predicting ISR. Conclusion Higher preprocedural serum fT4 is a powerful and independent predictor of BMS restenosis in patients with stable and unstable angina pectoris.

The research about changes of thyroid function in patients with depression / 国际检验医学杂志

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.

The research about changes of thyroid function in patients with depression / 国际检验医学杂志

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.

Free Thyroxine, Anti-Thyroid Stimulating Hormone Receptor Antibody Titers, and Absence of Goiter Were Associated with Responsiveness to Methimazole in Patients with New Onset Graves' Disease

BACKGROUND: Anti-thyroid drug therapy is considered a treatment of choice for Graves' disease; however, treatment response varies among individuals. Although several studies have reported risk factors for relapse after initial treatment, few have assessed responsiveness during the early treatment period. Our study aimed to identify the clinical characteristics for responsiveness to methimazole. METHODS: We included 99 patients diagnosed with Graves' disease for the first time. Drug responsiveness was defined as the correlation coefficients between decreasing rates of free thyroxine level per month and methimazole exposure dose. According to their responsiveness to treatment, the patients were classified into rapid or slow responder groups, and age, sex, free thyroxine level, and thyrotropin binding inhibiting immunoglobulin (TBII) titers were compared between groups. RESULTS: The mean patient age was 44.0±13.5 years and 40 patients were male (40%). The mean TBII titer was 36.6±74.4 IU/L, and the mean free thyroxine concentration was 48.9±21.9 pmol/L. The rapid responder group showed higher TBII titer and free thyroxine level at diagnosis, while age, sex, smoking, and presence of goiter did not differ between the two groups. Logistic regression analyses revealed that high level of serum thyroxine, high titer of TBII, and absence of goiter were significantly associated with a rapid response, while age, sex, and smoking were not significant factors for the prediction of responsiveness. CONCLUSION: In patients with new onset Graves' disease, high level of free thyroxine, high titer of TBII, and absence of goiter were associated with rapid responsiveness to methimazole treatment.

Analysis of thyroid function and thyroid in pregnant women / 国际检验医学杂志

Objective To analyze thyroid function and thyroid in pregnant women .Methods According to duration of pregnan‐cy ,1 500 pregnant women were divided into early pregnancy group ,second trimester group and late pregnancy group .Free triiodo‐thyronine (FT3) ,free thyroxine (FT4) ,thyroid stimulating hormone (TSH) ,anti‐thyroid peroxidase antibody (TPOAb) and thy‐roglobulin antibody (TGAb) were detected ,and compared with non‐pregnant healthy women .Results Levels of FT3 ,FT4 and TSH ,and positive rates of TPOAb and TGAb in pregnant women were different with non‐pregnant women (P<0 .05) .Morbidity rate of thyroid disease in pregnant women were higher than non‐pregnant women (P<0 .05) .FT3 ,FT4 and TSH levels were dif‐ferent among early pregnancy group ,second trimester group and late pregnancy group (P< 0 .05) .Positive rates of TGAb and TPOAb in late pregnancy group were lower than early pregnancy group and second trimester group (P<0 .05) .Conclusion Thy‐roid hormone levels and positive rates might be different among women at different duration of pregnancy .Screening of thyroid re‐lated parameters in pregnant women could be important .

The research for levels of thyroid hormone in patients with Sheehan′s syndrome / 国际检验医学杂志

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 .

Establish the reference value about index of serum thyroid specific during pregnancy women / 国际检验医学杂志

Objective To establish the reference value about index of serum thyroid specific during pregnancy ,Improve the birth population quality in this district .Methods Collect the blood serum sample of normal pregnant women according to Diagnosis and treatment of thyroid disease during pregnancy and postpartum Guide,to establish the reference value about index of serum thyroid specific during pregnancy .Total 167 cases were collect ,the first trimester were 47 cases ,the second trimester were 86 cases ,and the third trimester were 34 cases .The TSH and FT4 were detected in the cobas e 601 .The mean and standard deviation of TSH and FT4 in the three period of pregnancy were performed with SPSS14 .0 then established the the 95% confidence interval of TSH and FT4 of the three period of pregnancy .That was the the reference value about index of serum thyroid specific during pregnancy .Re‐sults The reference value of the TSH was 0 .05-2 .90 mIU/L in the first trimester ,FT4 was 12 .5-18 .3 pmol/L in the first tri‐mester ;The reference value of TSH was 0 .2-3 .63 mIU/L in the second trimester ,FT4 was 9 .99-16 .2 pmol/L in the second tri‐mester ;The reference value of TSH was 0 .17-4 .90 mIU/L in the third trimester ,FT4 was 9 .34-13 .9 pmol/L in the third tri‐mester .Conclusion Electrochemiluminescence detect the reference value about index of serum thyroid specific during pregnancy on Cobas e 601 ,could improve the detection rate of local gestational thyroid dysfunction ,and lay a solid foundation for the prenatal and postnatal care and improve the quality of the population .

Research on correlation between thyroid hormones and serum lipid profile during pregnancy / 实用医学杂志

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.

The investigation of thyroid function reference range during pregnancy in Chaoshan area / 国际检验医学杂志

Objective To investigate and establish thyroid function reference range during 3 pregnant stages in Chaoshan area:thyrotropin (TSH),free thyroxin (FT4).Methods 863 healthy pregnant women visited antenatal clinic in the Second Affiliated Hospital were included in this study.By detecting serum levels of TSH,FT4,thyroglobulin antibody (TgAb),and thyroid peroxi-dase antibody (TPOAb)in these women,the euthyroid reference ranges of serum TSH and FT4 in different pregnant stages were established based on the standards of the United States National Institute of Clinical Biochemical (NACB)guidelines.Results The ranges of serum TSH in the first,second and third trimester of pregnancy were 0.13-3.93 mIU/L,0.14-4.55mlU/L,and 0.42-3.85 mIU/L,respectively.The ranges of serum FT4 levels in these 3 stages were 12.00-23.34 pmol/L,6.27-12.65pmol/ L, and 9.80-18.20 pmol/L,respectively.The range of serum TSH levels in our study were similar with the reference range recom-mended by the guidelines in China,but were different compared with the American Thyroid Association (ATA)guidelines.Conclu-sion TSH,FT4 levels show dynamic changes during different stages of pregnancy.The thyroid function ranges of healthy pregnant women in Chaoshan area are quite different compared with non-pregnant population and pregnant women in distinct area.Due to the differences of diet,iodine intake,economy and culture in Chaoshan area,regional thyroid function reference ranges specific for differ-ent stages of pregnant women should be established.

Analysis of thyroid hormones changes in pregnant women of different gestation / 国际检验医学杂志

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 .