Arterial stiffness in hyperthyroid patients is deteriorated due to thyroid hormones

ABSTRACT Objective The aim of this study is to evaluate and compare arterial stiffness, which is an independent risk indicator for cardiovascular diseases (CVDs), between patients with overt hyperthyroidism, subclinical hyperthyroidism, euthyroidism by antithyroid therapy and healthy volunteers with pulse wave analysis (PWA). Subjects and methods A total of 102 volunteers were included in the study (30 in the overt hyperthyroid group, 28 in the subclinical hyperthyroid group and 14 with euthyroidism by antithyroid therapy and 30 healthy). The arterial stiffness measurements of the participants in the study were performed with the Mobil-O-Graph PWA device (I.E.M. GmBH, Stolberg, Germany), which makes cuff based oscillometric measurement from the brachial artery. Results Systolic blood pressure, pulse rate, central systolic blood pressure, cardiac output, heart rate-corrected augmentation index (Aix@75) and pulse wave velocity (PWV) measurements were significantly higher in the hyperthyroid group than in the control group. The heart rate and PWV in the subclinical hyperthyroid group were significantly higher than the control group. In the euthyroid group, systolic blood pressure, central systolic blood pressure, cardiac output, cardiac index and PWV were found significantly higher than the control group. There was also a negative correlation between Aix@75 and thyroid-stimulating hormone (TSH), and a positive correlation between Aix@75 and free thyroid hormones. Conclusion In our study, we observed that the arterial stiffness was adversely affected by an overt or subclinical increase in thyroid hormones and this correlated with thyroid hormone levels. We recommend that PWV measurement, which is a simple method for detecting CVD risk, can be used in these patients.

Radioiodine plus recombinant human thyrotropin do not cause acute airway compression and are effective in reducing multinodular goiter

Recombinant human thyrotropin (rhTSH) reduces the activity of radioiodine required to treat multinodular goiter (MNG), but acute airway compression can be a life-threatening complication. In this prospective, randomized, double-blind, placebo-controlled study, we assessed the efficacy and safety (including airway compression) of different doses of rhTSH associated with a fixed activity of 131I for treating MNG. Euthyroid patients with MNG (69.3 ± 62.0 mL, 20 females, 2 males, 64 ± 7 years) received 0.1 mg (group I, N = 8) or 0.01 mg (group II, N = 6) rhTSH or placebo (group III, N = 8), 24 h before 1.11 GBq 131I. Radioactive iodine uptake was determined at baseline and 24 h after rhTSH and thyroid volume (TV, baseline and 6 and 12 months after treatment) and tracheal cross-sectional area (TCA, baseline and 2, 7, 180, and 360 days after rhTSH) were determined by magnetic resonance; antithyroid antibodies and thyroid hormones were determined at frequent intervals. After 6 months, TV decreased significantly in groups I (28.5 ± 17.6 percent) and II (21.6 ± 17.8 percent), but not in group III (2.7 ± 15.3 percent). After 12 months, TV decreased significantly in groups I (36.7 ± 18.1 percent) and II (37.4 ± 27.1 percent), but not in group III (19.0 ± 24.3 percent). No significant changes in TCA were observed. T3 and free T4 increased transiently during the first month. After 12 months, 7 patients were hypothyroid (N = 3 in group I and N = 2 in groups II and III). rhTSH plus a 1.11-GBq fixed 131I activity did not cause acute or chronic changes in TCA. After 6 and 12 months, TV reduction was more pronounced among patients treated with rhTSH plus 131I.

Caracterización clínica y funcional en pacientes con diagnóstico inicial de tiroiditis de Hashimoto en el año 2007 / Clinical and functional characterization in patients with initial diagnosis of Hashimoto's thyroiditis in 2007

La tiroiditis de Hashimoto constituye una afección tiroidea autoinmune de lenta evolución, y es la primera causa de hipotiroidismo con bocio en zonas con adecuada ingesta de yodo. Identificar las características clínicas (edad, sexo, antecedentes patológicos familiares de enfermedad tiroidea y presencia de bocio), así como el estado de función tiroideo en el momento del diagnóstico de la tiroiditis de Hashimoto. Se realizó un estudio descriptivo y transversal con 41 pacientes con diagnóstico inicial de tiroiditis de Hashimoto durante el año 2007, a los cuales se les llenó un modelo de encuesta, y se les hizo examen físico del tiroides, así como dosificación de hormona estimulante del tiroides y tiroxina total. Los datos se analizaron utilizando el método porcentual y se expusieron en tablas. Se obtuvo un predominio del sexo femenino con un 78 pr ciento, y según edad y sexo el grupo más frecuente ocurrió en las mujeres de 50 a 59 años con un 29,26 por ciento. El 60,97 de los pacientes presentó antecedentes patológicos familiares de enfermedad tiroidea. Todos los pacientes presentaron bocio, y fue el más frecuente el grado 2, con un 60,97 por ciento. El 58,53 de los pacientes estaba funcionalmente eutiroideo. La tiroiditis de Hashimoto fue más frecuente en el sexo femenino y en la quinta década de la vida, la presencia de antecedentes patológicos personales fue muy frecuente, y todos los pacientes presentaron bocio en el momento del diagnóstico, más frecuente de grado 2. La mayoría de los casos tuvo una función tiroidea normal(AU)

Hashimoto's thyroiditis is an autoimmune thyroid affection of slow evolution and it is the first cause of hypothyroidism with goiter in zones with an adequate ingestion of iodine. To identify the clinical characteristics (age, sex, family pathological history of thyroid disease and presence of goiter), as well as the state of thyroid function at the moment of diagnosing Hashimoto's thyroiditis. A descriptive cross-sectional study was conducted in 41 patients with initial diagnosis of Hashimoto's thyroiditis during 2007. They were surveyed and they underwent a thyroid medical examination. The thyroid stimulating hormone dosage and the total thyroxin were determined. The data were analyzed by using the percentage methods, and they were exposed in tables. A predominance of the female sex (78 percent) was observed. According to age and sex, the most frequent group was the group of females aged 50-59 with 29.26 percent. 60.97 percnet of the patients had family pathological history of thyroid disease. All the patients presented goiter and the grade II was the most common, with 60.97 percent. 58.53 percent of the patients were functionally euthyroideal. Hashimoto's thyroiditis was more frequent among females and in the fifth decade of life. The presence of personal pathological history was very usual and all the patients had goiter on the diagnosis. The grade II goiter was the most observed. Most of the patients had a normal thyroid function(AU)

Níveis de TSH e sintomas depressivos em mulheres acima de 35 anos do município do Rio de Janeiro / Levels of TSH and depressive symptoms in women above 35 years of municipality in Rio de Janeiro

Alguns estudos vêm apontando o hipotireoidismo como um fator de risco para depressão; entretanto, esta associação é ainda controversa. O presente estudo estimou a prevalência de sintomas depressivos numa amostra probabilística de mulheres e investigou se existe uma associação entre níveis de TSH e a presença de sintomas depressivos. Foi conduzido um estudo transversal de base populacional onde avaliou-se uma amostra de mulheres com 35 ou mais anos de idade, residentes no município do Rio de Janeiro (RJ), que foram entrevistadas e tiveram amostras de sangue coletadas. O desenho de amostra proposto para a pesquisa seguiu um modelo de amostragem probabilística por conglomerado, em três estágios de seleção, tendo por base os setores censitários do município. A função tireoidiana foi medida pelo TSH sérico, a partir das amostras coletadas no domicílio. Para avaliação da presença ou ausência de sintomas depressivos utilizou-se um instrumento padronizado e validado (PRIME-MD). Foram também coletados dados sócio-demográficos e outras informações de saúde da participante. A prevalência de sintomas depressivos, freqüências e associações foram calculadas levando-se em conta o desenho de amostra complexo, utilizando procedimentos específicos do pacote estatístico SAS (versão 9.1). Da amostra de 1500 mulheres, 1298 foram entrevistadas, sendo o percentual de não-resposta igual a 13,5 por cento. A amostra final foi composta por 1249 participantes, onde foi encontrada uma prevalência de sintomas depressivos igual a 45,9 por cento. Em relação aos níveis de TSH, 4,8 por cento da amostra apresentaram-se acima do ponto de corte adotado (≥6,0 mUI/ml). Destas, 61,9 por cento apresentaram sintomas depressivos, contra 44,9 por cento entre as mulheres com TSH<6,0 (p=0,04). A análise ajustada mostrou que mulheres com nível de TSH≥6,0 tiveram uma chance duas vezes maior de apresentarem sintomas depressivos do que aquelas com TSH normal (OR=2,04). Ao excluir da análise as...

Validación analítica de un juego de reactivos para cuantificar la tirotropina humana sérica / Analytical validation of a reageant set for cuantification of human serum thyrotropin

Se presentan los resultados de la evaluación analítica de un ensayo de segunda generación (IRMA-I125-hTSH-BGTâ) producido y comercializado por el Centro de Isótopos. Se determina la sensibilidad analítica y funcional, intervalo de referencia, imprecisión y exactitud del diagnosticador. El método presentó sensibilidad analítica de 0,014 mUI/ L y funcional de 0,11 mUI/L. La imprecisión intraensayo fue de 4,34; 4,04 y 1,60 por ciento y la imprecisión interensayo de 12,96; 4,30; 5,98 y 10,21 por ciento para 4 sueros controladores de la calidad con concentraciones de 0,42; 9,77; 27,03 y 1,31 mUI/L, respectivamente. Los estudios de exactitud mostraron en la prueba de linealidad y paralelismo, rectas y coeficientes de correlación muy cercanos a 1 (E1, m = 0,992; r = 0,998 -C2, m = 1,008; r = 0,998 - C3, m =1,013; r = 0,999), sin que existieran diferencias significativas (p < 0,05) entre las pendientes ni entre las varianzas de las rectas descritas. Estas fueron paralelas entre sí; la recuperación media fue de 105,50 por ciento y la exactitud promedio de 102,75. El intervalo de referencia fue de 0,52-3,92 mUI/L; n = 215 y 95,33 por ciento. El método presenta sensibilidades analítica y funcional, correspondientes a los ensayos de hTSH de segunda generación, y es preciso y exacto. Dicho diagnosticador reúne los criterios analíticos para su comercialización en la red de laboratorios con servicios de endocrinologìa y medicina nuclear del país(AU)

The results of the analytical evaluation of a second-generation assay (IRMA-I125-hTSH-BGT®)) produced and commercialized by the Center of Isotopes are presented. Analytical and functional sensitivity, reference interval, imprecision and accuracy of the diagnostic method were determined. The method had an analytical and functional sensitivity of 0,014 mUI/ L and 0,11 mUI/L respectively. The intra-assay imprecision was 4,34; 4,04 y 1,60 percent and the interassay imprecision was 12,96; 4,30; 5,98 y 10,21 % for 4 quality control sera at concentrations of 0,42; 9,77; 27,03 y 1,31 mUI/L respectively. The accuracy studies showed in the linearity and parallelism test straight lines and correlation coefficients very close to 1 (E1, m= 0,992; r= 0,998 -C2, m= 1,008; r=0,998 - C3, m=1,013; r=0,999), without significant differences (p<0,05) among the slopes or among the variances of the described straight lines; they were parallel to each other. The median recovery was 105,50 percent and average accuracy was 102,75 percent. The reference interval was 0.52-3,92 mUI/L; n=215; 95,33 percent. The method presents analytical and functional sensitivity rates that match those of the second-generation hTSH assays in addition to being precise and accurate. This diagnostic method complies with the analytical criteria for it being commercialized in the laboratory network that provides endocrinology and nuclear medicine services throughout the country(AU)