Affect Thyroid Function Research Articles

Iron Deficiency, a Risk Factor of Thyroid Disorders in Reproductive-Age and Pregnant Women: A Systematic Review and Meta-Analysis.

BackgroundIron deficiency (ID) is concerned as the most common nutritional deficiency worldwide. The effects of ID on thyroid function and autoimmunity in pregnant women and reproductive-age women are controversial. The aim of the current study was to summarize the evidences and evaluate the relationship between ID and thyroid disorders.MethodsIn this systematic review and meta-analysis, studies published on the Cochrane, Embase, Medline, and PubMed databases by October 2020 were searched. A total of 636 studies which discussed the correlation between ID and thyroid disorders were eligible in the initial search. Pooled mean differences (MD) and 95% confidence intervals (CI) were calculated for the assessment of thyrotropin (TSH) and free thyroxine (FT4) levels. Combined odd ratios (OR) and 95% CI were calculated for the assessment of the prevalence of overt and subclinical hypothyroidism, positive thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb).ResultsFor women of reproductive age, ID could significantly increase the risk of positive TPOAb (OR: 1.89; 95% CI: 1.17, 3.06: P = 0.01) and both positive TPOAb and TgAb (OR: 1.48; 95% CI: 1.03, 2.11: P = 0.03). The meta-analysis of pregnant women showed that pregnant women with ID had increased serum TSH levels (MD: 0.12; 95% CI: 0.07, 0.17; P < 0.00001) and decreased FT4 levels (MD: −0.73; 95% CI: −1.04, −0.41; P < 0.00001). Meanwhile, the prevalence of overt (OR: 1.60; 95% CI: 1.17, 2.19; P = 0.004) and subclinical (OR: 1.37; 95% CI: 1.13, 1.66; P = 0.001) hypothyroidism in pregnant women with ID was significantly increased.ConclusionsID may adversely affect thyroid function and autoimmunity of pregnant and reproductive-age women and it is very necessary for monitoring iron nutritional status and early treatment of ID for them.

Evaluation of Thyroid Hormones Levels in Libyan Patients with Chronic Renal Failure Before and AFTER Maintenance Hemodialysis

Data from recent studies revealed that kidney diseases might affect the thyroid function in various ways. A variety of alterations in thyroid hormone levels and metabolism have also been reported in patients with chronic renal failure (CRF) in some studied population. In addition, it was reported that serum levels of both T3 and T4 might altered immediately after a hemodialysis (HD) treatment than before. Therefore, this study was aimed to investigate the level of triiodothyronine (T3) and thyroxine (T4) in CRF Libyan patients before and after HD. This study was carried out on 46 CRF patients (30 male and 16 female) with a mean age of 47.46 ±15.75 years. These patients were treated at the hemodialysis unit of Educational Central Zelitin Hospital, Zelitin, Libya. None of these patients apparently have any thyroid problems and no history of drug intake that may affect thyroid function. Blood samples were taken from each patient to measure serum levels of T3 and T4, before and after HD. In addition, the effect of several variables include age, gender, body mass index (BMI), presence of both hypertension and, diabetes mellitus and duration of kidney dialysis on serum levels of T3and T4 before and after HD were also studied. After HD, there was a statistically significant increase in the serum levels of T3, T4. The age, gender, BMI, duration of kidney dialysis and the presence of hypertension and diabetes mellitus did not have any significant effect on the serum level of T3 and T4 before and after HD. However, the serum levels of T3 and T4 were still in the normal range in these examined patients either before or after HD. From these findings, it can be concluded that these CRF patients may be in a euthyroid state, because the serum levels of T3 and T4 were in the normal range. In addition, HD was seem to improve the T3 and T4 thyroid hormone concentrations, suggesting that HD might activate the secretion of thyroid glandand catabolism. The other variables did not play any role in thyroid hormone levels in these patients either before or after HD. It is highly recommended that large scale evaluation of thyroid hormone levels in Libyan CRF patients is performed more patients, especially elderly patients.

Multiple toxicity of propineb in developing zebrafish embryos: Neurotoxicity, vascular toxicity, and notochord defects in normal vertebrate development

A dithiocarbamate (DTC) fungicide, propineb, affects thyroid function and exerts immunotoxicity, cytotoxicity, and neurotoxicity in humans. Long-term exposure to propineb is associated with carcinogenicity, teratogenicity, malfunction of the reproductive system, and abnormalities in vital signs during organ development. However, there is no evidence of acute toxicity attributable to propineb in zebrafish. Therefore, in the present study, we assessed the toxicity of propineb in zebrafish by studying its adverse effects on embryo development, angiogenesis, and notochord development. Embryos with propineb exposure developed morphological and physiological defects and in larvae, apoptosis and notochord defects were induced in the early development stage. Transgenic fli1:eGFP zebrafish exposed to propineb showed abnormal larval development with defects in angiogenesis and deformed vasculature. Propineb induced irreversible damage to the neural development of embryos and neurogenic defects in developing zebrafish in transgenic olig2:dsRED zebrafish. These results show that exposure to propineb triggers abnormalities in different organ systems of zebrafish and suggests the physiological complexity of the response to propineb.

Evaluation of Thyroid Hormones Levels in Libyan Patients with Chronic Renal Failure before and after Maintenance Hemodialy

Data from recent studies revealed that kidney diseases might affect the thyroid function in various ways. A variety of alterations in thyroid hormone levels and metabolism have also been reported in patients with chronic renal failure (CRF) in some studied population. In addition, it was reported that serum levels of both T3 and T4 might alter immediately after a hemodialysis (HD) treatment than before. Therefore, this study was aimed to investigate the level of triiodothyronine (T3) and thyroxine (T4) in CRF Libyan patients before and after HD. This study was carried out on 46 CRF patients (30 males and 16 females) with a mean age of 47.46 ± 15.75 years. These patients were treated at the hemodialysis unit of Educational Central Zelitin Hospital, Zelitin, Libya. None of these patients apparently have any thyroid problems and no history of drug intake that may affect thyroid function. Blood samples were taken from each patient to measure serum levels of T3 and T4, before and after HD. In addition, the effects of several variables including age, gender, body mass index (BMI), presence of both hypertension and, diabetes mellitus and duration of kidney dialysis on serum levels of T3 and T4 before and after HD were also studied. After HD, there was a statistically significant increase in the serum levels of T3, T4. The age, gender, BMI, duration of kidney dialysis and the presence of hypertension and diabetes mellitus did not have any significant effect on the serum level of T3 and T4 before and after HD. However, the serum levels of T3 and T4 were still in the normal range in these examined patients either before or after HD. From these findings, it can be concluded that these CRF patients may be in a euthyroid state, because the serum levels of T3 and T4 were in the normal range. In addition, HD was seemed to improve the T3 and T4 thyroid hormone concentrations, suggesting that HD might activate the secretion of thyroid gland and catabolism. The other variables did not play any role in thyroid hormone levels in these patients either before or after HD. It is highly recommended that large scale evaluation of thyroid hormone levels in Libyan CRF patients is performed by more patients, especially elderly patients.

Assessment of thyroid function of newly diagnosed SARS-CoV-2 infected patients in Nigeria.

Introductionthe outbreak and rapid spread of the novel SARS-CoV-2, the causative agent of the coronavirus disease 2019 (COVID-19), has evolved into an unprecedented global pandemic. The infection impairs several human organs and systems, however, it is not clear how it affects thyroid function. The study therefore aimed at measuring plasma levels of thyroid hormones and Hs-CRP in COVID-19 patients and apparently healthy uninfected controls to assess the possible effect of SAR-CoV-2 infection on thyroid function.Methodsin this cross-sectional study carried out between May-August 2020, 90 consenting participants comprising 45 COVID-19 patients and 45 apparently healthy uninfected controls were recruited. Plasma FT3, FT4, TSH and Hs-CRP were measured using Enzyme Linked Immunosorbent Assay (ELISA) method. Data was analysed using SPSS version 20 and statistical significance set at p < 0.05.Resultsthe mean plasma FT3 and TSH concentrations were significantly higher in COVID-19 patients compared to controls (p < 0.001, p < 0.001 respectively). Euthyroidism was observed in all uninfected controls, whereas 35 (77.8%) COVID-19 patients were euthyroid. Sick euthyroid and subclinical hypothyroidism was observed in 7 (15.6%) and 3 (6.7%) COVID-19 patients, respectively.Conclusionthough there was a preponderance of euthyroidism among COVID-19 patients, significantly higher mean plasma levels of TSH and FT3, sick euthyroid syndrome and subclinical hypothyroidism observed among some COVID-19 patients may be indicative of disease-related thyroid function changes. Hence, there is need to pay attention to thyroid function during and after treatment of COVID-19.

Correlation Analysis of Th17/Treg Cells and PTPN22 Gene Polymorphism in HT Patients with Different Iodine Nutritional Status

Background: The incidence of Hashimoto's thyroiditis (HT) may be related to environmental, immune, and genetic factors. Different iodine nutritional status can affect thyroid function. Th17/Treg cell imbalance is involved in the pathogenesis of autoimmune thyroid diseases, and PTPN22 is an important susceptibility gene related to autoimmune diseases. To study the relationship between Th17/Treg cells and cytokines and PTPN22 gene polymorphism in HT patients with different iodine nutritional status is to determine the role of immune and genetic factors in the pathogenesis of HT. Objective: To investigate the correlation between Th17/Treg cells and factors protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene-1123G>C site (rs2488457) polymorphism in peripheral blood mononuclear cells (PBMC) of Hashimoto's thyroiditis (HT) patients with different iodine nutritional status. Methods: 100 HT patients and 60 healthy subjects in Cang Zhou are selected from 2019 to 2020. Flow cytometry and real-time fluorescent quantitative PCR are used to detecting the proportion and ratio of Th17 and Treg cells in PBMC, as well as retinoic acid-related orphan receptor-γt (ROR-γt) and fork head/winged spiral transcription factor 3 (Foxp3) mRNA expression levels. Single allele-specific primer-polymerase chain reaction (SASP-PCR) technology is taken to sequence PTPN gene promoter-1123SNP leading to calculate the gene Type and allele frequency. Results: Th17 and Treg cells and factors in the PBMC of HT patients have a certain correlation with the-1123G>C locus of PTPN22 gene (rs2488457). The distribution frequency of rs2488457 genotype is consistent with Hardy Weinberg's law of genetic equilibrium. The distribution frequencies of various genotypes and alleles are significantly different between HT patients and the control group (P<0.05). PTPN22 gene-1123G>C site C/G, C/C genotype can increase of the risk of HT, while G/G genotype can decrease of the risk of HT. In Conclusion: The polymorphism of rs2488457 is related to susceptibility to HT. Carrying C/G and C/C genotypes may be risk factors for HT, and G/G genotypes may be protective factors for HT, but it has nothing to do with iodine nutrition status.

Association between Serum Albumin and Hypothyroidism in Preeclampsia: A Case-control Study

Introduction: Preeclampsia is a cause of high morbidity and mortality in pregnant women. Serum albumin is found to be low in preeclampsia. Few recent studies have shown a state of hypothyroidism in preeclampsia. Aim: To find the association between the serum albumin and thyroid hormone levels in preeclampsia and seek to find if hypoalbuminemia increases the risk of hypothyroidism. Materials and Methods: A case-control study was done at Department of Biochemistry and the Department of Obstetrics and Gynaecology of Government Medical College, Thiruvananthapuram, Kerala, with 40 preeclampsia cases and 40 normal pregnant controls, in 30-38 week gestation. Serum albumin and thyroid profile-Total T3, Total T4, Thyroid Stimulating Hormone (TSH), freeT3 (fT3), freeT4 (fT4) were tested. Statistical analysis was done with Student’s t-test, Chi-square, Fischer’s t-test and Pearson’s correlation coefficients. Results: The mean serum albumin was significantly lesser in preeclampsia (3.11±0.39) than in controls (3.7±0.14 g/dL). Thyroid hormones were significantly decreased in preeclampsia. TSH was significantly raised (3.76±1.55 mIU/L) in preeclampsia compared to normal pregnant ladies (2.3±0.94 mIU/L). In cases with hypoalbuminemia, risk for hypothyroidism was 2.85 times compared to those with normal albumin but was not statistically significant. In severe preeclampsia, there was a two times increased risk. There was a negative correlation of TSH and positive correlation for fT4 with serum albumin. However, this was statistically not significant. Conclusion: Hypothyroidism in preeclampsia was not significantly correlated with hypoalbuminemia in this study. Thus hypoalbuminemia did not significantly increase the risk for hypothyroidism in our study. Further studies are needed to determine the risk factors affecting thyroid function in preeclampsia.

Outcome of critically ill patients with non-thyroidal illness

Background: During period of critical illness, there are diverse alterations in the hypothalamus-pituitarythyroid (HPT) axis. This diversity in critically ill patients and the etiological relationship between underlying disease and non-thyroidal illness (NTI) is poorly understood. The aims of this study were to examine the features of NTI and outcomes in critically ill patients admitted in Critical Care Medicine (CCM) Department, BIRDEM General Hospital.&#x0D; Methods: A total of 86 patients admitted to CCM department, BIRDEM General Hospital during the period of July to December 2015 , having nonthyroidal illness, detected by thyroid function tests during ICU stay were enrolled in this study. All patients discharged from hospital were followed up for a period of 6 months. Patients with known thyroid diseases or taking medications that affect thyroid function were excluded. Condition at hospital discharge and mortality in the ICU or later at home after discharge within next 6 months was assessed as outcomes.&#x0D; Results: Mean age of the study subjects was 63.87(±13.5)years and 45(52.3%)of the study subjects were female. Most of the study subjects had diabetes (84.88%) and hypertension (82.55%).Mean (±SD) of FT3 (pmol/l), FT4(pmol/l), TSH (uIU/ml) were 2.85(±1.35),12.74(±8.17) and 2.81(±8.57)respectively. Among the total study subjects 44.18% patients died in ICU and 2.32% patients after shifting to ward. Among the patients having pneumonia, Myocardial Infarction(MI) /Arrhythmia, Stroke, Sepsis and Gastrointestinal disease, 50.94% 51.02%, 56.0%,53.85%,37.50% died in hospital (ICU or after shifting toward).The 46 patients ,who were discharged from hospital were followed up for next 6 months.&#x0D; Conclusion: NTI is a transient adaptive response affecting individuals with acute and chronic illness and is more common among patients admitted in intensive care unit (ICU). The prognosis of patients having NTI depends on severity of thyroid dysfunction.&#x0D; Birdem Med J 2021; 11(1): 47-51

Effect of high-nitrate beetroot juice consumption on thyroid gland hormones and iodine levels in adults

Dietary nitrate supplementation has been widely investigated by the scientific community due to its beneficial effects on the cardiovascular system. However, there is evidence suggesting a possible effect of nitrate in scavenger iodine from the thyroid gland, which may affect thyroid hormone synthesis. Therefore, this study evaluated the effect of seven days of a nitrate-rich beetroot juice supplementation on thyroid hormones and iodine concentrations in healthy adults. Thirteen healthy adults were enrolled in a randomized, double-blind, crossover and placebo-controlled study. Participants ingested 140 mL of nitrate-rich beetroot juice (8.12 ± 3.61 mmol/day) or placebo (nitrate-depleted BJ) during one week. Before and after the supplementation period, blood and urine were drawn for analysis of thyroid hormones, iodine, nitrate and nitrite. No significant changes were observed in plasma triiodothyronine, thyroxine, nitrate and nitrite, and urinary iodine concentrations. In conclusion, these results suggest that one-week supplementation with a nitrate-rich beetroot juice intake does not affect thyroid function.

L-T4 Therapy in the Presence of Pharmacological Interferents.

Pharmacological interference on L-thyroxine (L-T4) therapy can be exerted at several levels, namely from the hypothalamus/pituitary through the intestine, where the absorption of exogenous L-T4 takes place. A number of medications interfere with L-T4 therapy, some of them also being the cause of hypothyroidism. The clinician should be aware that some medications simply affect thyroid function tests with no need of modifying the dose of L-T4 that the patient was taking prior to their prescription. Usually, the topic of pharmacological interference on L-T4 therapy addresses the patient with primary hypothyroidism, in whom periodic measurement of serum thyrotropin (TSH) is the biochemical target. However, this minireview also addresses the patient with central hypothyroidism, in whom the biochemical target is serum free thyroxine (FT4). This minireview also addresses two additional topics. One is the costs associated with frequent monitoring of the biochemical target when L-T4 is taken simultaneously with the interfering drug. The second topic is the issue of metabolic/cardiovascular complications associated with undertreated hypothyroidism.

A comparative study on serum thyroid hormone level in asphyxiated preterm and term newborn in cord blood at birth and 72 hrs of life, in a tertiary care center

Introduction: Thyroid hormone is essential for somatic growth and neurodevelopment. Its level is influenced by various factors. Perinatal asphyxia which altered several homones in neonate still less is known about the effect on neonatal thyroid hormone levels. Our study is to evaluate the effect of perinatal asphyxia, that alters the thyroid function in both term and preterm asphyxiated newborn by comparing cord blood and 72 hours venous blood. Materials and Methods: A prospective case-control study was carried out at Tertiary care Gayatri Hospital. we evaluated thyroid function in 40 asphyxiated term newborns and 40 preterm newborns (34-36 wks) with with history of low apgar score at birth (< 6 at 1 and 5 min) with acidosis (pH < 7.20), and 40 normal healthy preterm, born by spontaneous vaginal delivery were taken. In all the cases proper maternal and perinatal history was taken and categorized accordingly. Cord blood and 72 hours after birth venous blood were collected in both babies and compared the level of thyroid hormones (T3, T4, TSH) via radioimmunoassay. Results: There was no significant difference in thyroid hormone, observed in cord blood and in venous sample 72 hours after birth in asphyxiated preterm as compared to term baby. Conclusion: Perinatal asphyxia affects thyroid function but there were less studies done so far over asphyxiated premature baby, to know the association between thyroid hormone level and asphyxia as term babies. So a larger study is needed to support and confirm our observations. Keywords: Hypoxic Ischemic Encephalopathy (HIE), Thyroid stimulating Hormone (TSH), Non-thyroidal illness syndrome.

The Impact of Smoking on the Association between Perfluoroalkyl Acids (PFAS) and Thyroid Hormones: A National Health and Nutrition Examination Survey Analysis.

Perfluoroalkyl acids (PFAS) are known endocrine disrupting chemicals, potentially affecting thyroid function. Smoking has been associated with PFAS levels as well as with thyroid function. The impact of smoking on the association between PFAS and thyroid function remains to be elucidated, so the objective was to assess the effect of PFAS exposure on thyroid function in the general population, stratified by smoking status, using the National Health and Nutrition Examination Survey (NHANES). NHANES adult participants who were part of the 2011–2012 laboratory subsample and had PFAS and thyroid function measured were included (n = 1325). Adjusted linear regression models and stratified analyses were performed. There was a significant positive association between perfluorooctanesulfonic acid (PFOS) (p = 0.003), perfluorononanoic acid (PFNA) (p = 0.014), total PFAS (p = 0.004) concentrations and free T4 (FT4). No significant associations were found between perfluorooctanoic acid (PFOA), PFOS, perfluorohexane sulfonate (PFHxS), PFNA, total PFAS and total T4 (TT4) or thyroid stimulating hormone (TSH). In non-smokers, a significant positive association was found between PFOS (p = 0.003), PFHxS (p = 0.034), PFNA (p = 0.012), total PFAS (p = 0.003) and FT4 while no significant associations were found in smokers. The present study showed that increased PFAS exposure was associated with increased FT4 in non-smokers, while no association was found in smokers. These results confirm that smoking modifies the association between PFAS exposure and thyroid function.

Graves' disease: introducing new genetic and epigenetic contributors.

Autoimmune thyroid disease (AITD) accounts for 90% of all thyroid diseases and affects 2-5% of the population with remarkable familial clustering. Among AITDs, Graves' disease (GD) is a complex disease affecting thyroid function. Over the last two decades, case-control studies using cutting-edge gene sequencing techniques have detected various susceptible loci that may predispose individuals to GD. It has been presumed that all likely associated genes, variants, and polymorphisms might be responsible for 75-80% of the heritability of GD. As a result, there are implications concerning the potential contribution of environmental and epigenetic factors in the pathogenesis of GD, including its initiation, progression, and development. Numerous review studies have summarized the contribution of genetic factors in GD until now, but there are still some key questions and notions that have not been discussed concerning the interplay of genetic, epigenetic, and immunological factors. With this in mind, this review discusses some newly-identified loci and their potential roles in the pathogenicity of GD. This may lead to the identification of new, promising therapeutic targets. Here, we emphasized principles, listed all the reported disease-associated genes and polymorphisms, and also summarized the current understanding of the epigenetic basis of GD.

Thyroid Function of Infants Breastfed by Mothers with Graves Disease Treated with Inorganic Iodine: A Study of 100 Cases.

ContextWe previously reported that inorganic iodine therapy in lactating women with Graves disease (GD) did not affect the thyroid function in 25 of 26 infants despite their exposure to excess iodine via breast milk.ObjectiveTo further assess thyroid function in infants nursed by mothers with GD treated with inorganic iodine.DesignCase seriesSettingTajiri Thyroid Clinic, JapanParticipantsOne hundred infants of lactating mothers with GD treated with potassium iodide (KI) for thyrotoxicosisMain Outcome MeasuresInfant blood thyrotropin (TSH) and free thyroxine (FT4) levels were measured by the filter paper method. Subclinical hypothyroidism was defined as TSH ≥10 μIU/mL and ≥5 μIU/mL in infants aged <6 and ≥6 months, respectively.ResultsOverall, 210 blood samples were obtained from 100 infants. The median infant age was 5 (range, 0-23) months; median maternal KI dose, 50 (4-100) mg/day; median blood TSH level, 2.7 (0.1-12.3) μIU/mL; and median blood FT4 level, 1.04 (0.58-1.94) ng/dL. Blood TSH level was normal in 88/100 infants. Twelve infants had subclinical hypothyroidism; among them, blood TSH levels normalized after maternal KI withdrawal or stopping breastfeeding in 3 infants. In 7 infants, blood TSH levels normalized during KI administration without stopping breastfeeding. Two infants could not be followed up.ConclusionIn Japan, inorganic iodine therapy for lactating women with GD did not affect thyroid function in most of the infants. Approximately 10% of infants had mild subclinical hypothyroidism, but blood TSH level normalized during continued or after discontinuing iodine exposure in all followed up infants.

A Case Series of Patients With Central Hypothyroidism From Oxcarbazepine Therapy

Many medications can impact thyroid function. Antiseizure medications have been shown to disrupt thyroid function in adults, but information is limited about how antiseizure medications may affect thyroid function in children. Oxcarbazepine is an analog of carbamazepine designed to minimize effects from the hepatic P450 metabolic enzymes. We have found that in the pediatric population, serum free thyroxine is reduced and thyroid-stimulating hormone concentrations are unchanged in patients taking oxcarbazepine with the mechanism thus being central hypothyroidism.

Chronic Pesticides Exposure and Thyroid Functions among Farmers in Almnaif District - Ismailia Governorate, Egypt

Background: There is growing evidence that environmental exposure, specifically to pesticides, a potential risk factor for endocrine system malfunction. Aim: The study aims at contributing to improve the wellbeing and productivity of farmers through a better understanding of chronic pesticides exposure and its effect on thyroid functions. Patients and Methods: An analytical cross-sectional study was conducted on 43 farmers with active involvement in the preparation, storage, and spraying of the pesticides and 43 participants not occupationally exposed to pesticides. All participants were interviewed using a structured questionnaire including sociodemographic characteristics, pesticides exposure characteristics, and safety measures. The blood levels of plasma cholinesterase enzyme, and thyroid hormones (TSH, T4) were measured for all participants. Results: The mean duration of exposure was 20.60±11.06 years. The pesticide-exposed farmers had a statistically significant lower level of plasma cholinesterase enzyme (3969.93±1841.84 U/L) compared to the control group (4879.29±1950.08 U/L) (p =0.032). While the exposed group had a lower level of thyroxine hormone (T4) (6.91±1.91 µg/dl) compared to the control group (7.79±2.10µg/dl), with a statistically significant difference between the two groups (p =0.045). Conclusion: Exposure to organophosphates and carbamates affects thyroid function in the form of a decrease in the circulating level of thyroxine hormone, increase in the TSH level.

Laparoscopic Sleeve Gastrectomy-Induced Decreases in FT3 and TSH are Related to Fasting C-Peptide in Euthyroid Patients with Obesity.

ObjectiveLaparoscopic sleeve gastrectomy (LSG) is one of the most effective therapies to treat obesity. However, whether LSG affects thyroid function remains elusive. Due to a lack of longitudinal research, we explored changes in thyroid function in euthyroid patients with obesity before and after LSG.MethodsIn total, 109 participants (59 obese patients, 30 normal controls and 20 overweight subjects) were recruited from the Second Xiangya Hospital of Central South University (CSU). All patients underwent LSG, and metabolic indicators and free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were evaluated at baseline, 6 and 12 months postoperatively.ResultsCompared to the normal control group, the concentrations of FT4 were decreased and TSH were increased in the obese group at baseline. Thyroid hormone levels in all participants were within the normal range during the 12 months after LSG. The concentrations of FT3 (4.83 ± 0.06 vs 5.03 ± 0.08, P = 0.023) and TSH (1.67 ± 0.11 vs 2.25 ± 0.18, P = 0.000) significantly decreased from baseline to 12 months postoperatively, while the concentrations of FT4 significantly increased (17.40 ± 0.52 vs 15.80 ± 0.32, P = 0.004). The decrease in fasting C-peptide (FCP) was related to the decline in FT3 and TSH during 12 months after LSG.ConclusionObesity is closely related to thyroid function. LSG promoted a significant decrease in FT3 and TSH and a significant increase in FT4 in euthyroid patients with obesity after LSG. The decline in FCP may be involved in the decrease in FT3 and TSH after LSG.

Euthyroid sick syndrome in hip fractures: Evaluation of postoperative anemia

IntroductionIncidence of hip fractures is increasing with upward estimates representing one of the most current health problems. According to some authors this condition is associated with an early mortality rate ranging between 20% and 35% and low outcomes. One of the predictive factors of poor outcome after hip fracture is anaemia. In fragile patients, hormonal changes due to fracture and surgical trauma, may occur in the hypophyseal hypothalamus axis which may lead to the Euthyroid Sick Syndrome (ESS). This pathological condition is characterized by a reduction in the concentration of triiodothyronine (T3) with normal or slightly reduced thyrotropin (TSH) values and with or without a reduction (cancellata) ​​of thyroxine (T4). ESS has been associated to an increased mortality in elderly patients. Materials and methodsInclusion criteria were: age > 65y, X-ray diagnosis of proximal femoral fracture classified as AO 31A or 31B requiring surgical treatment, admittance to the emergency room within 72 hours from trauma. Exclusion criteria were: any thyroid-related pathology, concomitant acute coronary syndrome, active pneumonia, concomitant neoplastic disease, assumption of medications able to affect thyroid function, refusal to undergo surgical treatment. All patients underwent routine blood testing and a complete thyroid-hormone profile dosage before surgical operation. The same blood tests performed before surgical operation were repeated on the first and third post-operative days. ResultsThirtytwo patients met the inclusion criteria and were enrolled after they accepted to participate to the study. Sixteen patients presented with ESS on admission and 16 patients did not. The mean age was 82,5 yo. There was no statistically significant difference in bleeding risk factors among the two groups. In the ESS group there was a number of blood transfusions of 1.06 units higher than the control group (p=0.01). ConclusionsWe have demonstrated that patients with ESS have a higher need of red blood cells transfusion compared to patients without ESS and, thus they have a higher risk to developanemia in the peri-operative period. We believe it would be useful to diagnose ESS in fragile patients at their arrival to the emergency room and apply a peri-operative therapeutic protocol to prevent anemia.

Evaluation of Iron Status with Abnormalities of Thyroid Function in Children

Introduction and aim: Iron deficiency can negatively affect thyroid function. This research was done to find out whether children's thyroid levels and iron status are related.&#x0D; Methodology: A cross-sectional research of 300 children attending the outpatient clinic of Pediatric Department at Damietta General Hospital, was carried out., Their ages were between 6 and 12 years. Hemoglobin (Hb), serum irons, overall iron binding capacities, triiodothyronine (t3), thyroxine (t4), thyroid releasing hormones, free thyroxine, free triiodothyronine, and percent transferrin saturation were measured in blood samples.&#x0D; Results: In the group, there were 235 children who were euthyroid (78.3%), overtly hypothyroid (1.7%), subclinically hypothyroid (17.7%), as well as subclinically hyperthyroid (2.3%). Children who were anemic and iron-deficient frequently had hypothyroidisms, both overt and subclinical. When compared to non-anemic and iron-sufficient children, Hb levels and transferrin saturation showed a strong positive association (r = 0.322, p&lt; 0.001), although fT3 and fT4 showed only modest correlations (r = 0.069, p = 0.358, and r = -0.022, p = 0.676, respectively). In comparison to non-anemic and iron-sufficient kids, the likelihood of hypothyroidisms (overt and subclinical) in anemic and iron-deficient kids was 6.624 (95% CI: 3.233-11.796, p&lt; 0.001) and 1.828 (95% CI: 1.182-3.338, p = 0.034), accordingly.&#x0D; Conclusion: Children frequently have anemia, iron insufficiency, and thyroid dysfunctions. Children in this group who were iron-deficient and anemic showed impaired thyroid functions.

Gut dysbiosis is associated with primary hypothyroidism with interaction on gut-thyroid axis

Background Previous studies have shown that the gut microbiome is associated with thyroid diseases, including Graves' disease, Hashimoto's disease, thyroid nodules, and thyroid cancer. However, the association between intestinal flora and primary hypothyroidism remains elusive. We aimed to characterize gut microbiome in primary hypothyroidism patients. Methods Fifty-two primary hypothyroidism patients and 40 healthy controls were recruited. The differences in gut microbiota between the two groups were analyzed by 16S rRNA sequencing technology. Fecal microbiota transplantation (FMT) was performed in mice using flora from both groups; changes in thyroid function were then assessed in the mice. Results There were significant differences in α and β diversities of gut microbiota between primary hypothyroidism patients and healthy individuals. The random forest analysis indicated that four intestinal bacteria (Veillonella, Paraprevotella, Neisseria, and Rheinheimera) could distinguish untreated primary hypothyroidism patients from healthy individuals with the highest accuracy; this was confirmed by receiver operator characteristic curve analysis. The short chain fatty acid producing ability of the primary hypothyroidism patients' gut was significantly decreased, which resulted in the increased serum lipopolysaccharide (LPS) levels. The FMT showed that mice receiving the transplant from primary hypothyroidism patients displayed decreased total thyroxine levels. Conclusions Our study suggests that primary hypothyroidism causes changes in gut microbiome. In turn, an altered flora can affect thyroid function in mice. These findings could help understand the development of primary hypothyroidism and might be further used to develop potential probiotics to facilitate the adjuvant treatment of this disease.