Alterations In Thyroid Hormone Levels Research Articles

Thyroid Density in CT Imaging as a Potential Marker of Lung Involvement in COVID-19: A Retrospective Analysis.

Background The SARS-CoV-2 pandemic has underscored the multifaceted impact of the virus on human health, extending beyond the respiratory system to involve other organ systems, including the endocrine system. Emerging evidence suggests a notable interaction between COVID-19 and thyroid function, characterized by alterations in thyroid hormone levels and structural changes within the gland. This study aims to explore the association between thyroid density on CT imaging and lung involvement in patients with COVID-19, potentially offering new insights into the systemic effects of the virus. Methodology A retrospective cross-sectional analysis was conducted on 1,066 patients withCOVID-19 who underwent chest CT scans without contrast at Government Medical College, Omandurar Government Estate, Chennai, which was designated as theCOVID-19 care center from April to June 2021. Thyroid density and lung involvement were quantitatively assessed, and their correlation was analyzed using descriptive and inferential statistics, including the Kruskal-Wallis H test and Shapiro-Wilk test for normality. Results The study population predominantly exhibited normal thyroid density (749, 70.3%), followed by altered (212, 19.9%), nodular (104, 9.8%), and a single instance (0.1%) of absent thyroid density. Despite variability in lung involvement across different thyroid density categories, statistical analysis revealed no significant association between thyroid density and the extent of lung involvement in patients with COVID-19. Conclusions This study found no significant correlation between thyroid density and lung involvement in patients with COVID-19, suggesting that thyroid density on CT imaging may not serve as a reliable marker for lung involvement in this population. Further research is warranted to explore the complex interactions between COVID-19 and thyroid function, as well as the potential implications for patient management and prognosis.

Alterations of Thyroid Hormone Levels and the Risks of Diabetic Retinopathy in T2DM

Background: Diabetes mellitus and thyroid disease are linked endocrinopathies. The association between diabetes mellitus complications and thyroid function is characterized by a complicated interdependent interplay that is difficult to understand. Objective: We conducted this study to determine the association between diabetic retina disease (DRD) incidence and normal thyroid hormone levels in T2DM. Methods: Recruit patients in the study, 134 patients with type 2 diabetes and 36 healthy ones with no DM, were screened in the present case-control study. Diabetic retinopathy was tested for all patients, and anthropometric and thyroid functions were assessed. Regression analyses were employed to evaluate the relationship between thyroid hormones and the risk of developing DR. Results: There were significant differences in triiodothyronine (T3) and thyroxine (T4) serum levels among the DR groups and the healthy control. The levels in each TSH and T4 are positively significant between groups of PDR and NDR, while T3 was negatively associated with NPDR. A significant association was found between increasing levels of T3 and the development of severe DR; thus, PDR was less likely to occur in individuals with high T3 levels‎ [OR 0.014(95% CI, 0.001-0.34) P value is 0.009 after adjustment. The risk of PDR had an increased likelihood of developing PDR at the highest levels of serum TSH and T4 [OR 41.07(1.60-1053.1) P= 0.025, OR 65.91(2.10-2067) P= 0.017, respectively). Conclusion: Diabetes retinopathy in euthyroid Iraqi people may be associated with levels of T3 and T4 in the blood. Patients with higher TSH and T4 concentrations had a greater risk of developing sight-threatening PDR in type 2 diabetics.

Assessment of Thyroid Hormone Level Alterations in Hepatitis B-Positive Serum Using a Quantitative Immunofluorescence Assay: A Randomized Controlled Trial

Assessment of Thyroid Hormone Level Alterations in Hepatitis B-Positive Serum Using a Quantitative Immunofluorescence Assay: A Randomized Controlled Trial

Vandetanib downregulates type 2 deiodinase in fibro/adipogenic progenitors.

Treatment with tyrosine kinase inhibitors (TKIs) has been associated with alterations in circulating thyroid hormone levels, possibly related to perturbations in peripheral thyroid hormone metabolism. In this study, we evaluated the effect of the multi-kinase inhibitor vandetanib on the expression of the three deiodinase selenoenzymes, responsible for the thyroid hormone activation (type 1 and type 2 deiodinases) or for its inactivation (type 3 deiodinase). Here, we show that the multi-kinase inhibitor vandetanib determines a strong cell-specific downregulation of type 2 deiodinase (D2) expression and a significant reduction in D2 enzymatic activity. This occurs in the diffused population of fibro/adipogenic progenitors, which reside in different tissues - including the muscles - and normally express D2. Given the widespread diffusion of mesenchymal cells within the body, our results may explain at least partially the alterations in thyroid hormone levels that occur in vandetanib-treated patients. Our findings represent a step forward into the understanding of the mechanisms by which TKIs induce hypothyroidism and identify a resident cell population in which such an effect takes place.

Alterations of Thyroid Hormone Levels in Children with Intellectual Disability.

The aim of this article was to study the thyroid hormone levels in children with intellectual disabilities and determine the relationship between the thyroid hormone levels and intellectual disability. Participants included 60 children with intellectual disabilities (the study group) and 56 without (the control group). Nuclear medicine in vitro analysis techniques were used in this study. All the controls and patients underwent in vitro analysis, and their serum levels of thyroid hormone, including thyroid-stimulating hormone, total thyroxine (T4), free T4 (FT4), total triiodothyronine (T3), and free T3 (FT3), were tested. The levels of FT4 were lower in the study group than in the control group (p < 0.001). The levels of FT3 were higher in the study group than in the control group (p = 0.003). The levels of TSH were higher in the study group than in the control group, but the difference was not statistically significant (p = 0.363). The total T4 and total T3 levels were lower in the study group than in the control group, but the difference was not statistically significant (p = 0.642, p = 0.124, respectively). The levels of thyroid hormones in the study group differed from the control group. The differences may not be clinically significant beyond their statistical significance. Thyroid hormone levels may affect intellectual disability in children.

Sfrp4 expression in thyroxine treated calvarial cells

AimsEvidence suggests alterations of thyroid hormone levels can disrupt normal bone development. Most data suggest the major targets of thyroid hormones to be the Htra1/Igf1 pathway. Recent discovery by our group suggests involvement of targets WNT pathway, specifically overexpression of antagonist Sfrp4 in the presence of exogenous thyroid hormone. Main methodsHere we aimed to model these interactions in vitro using primary and isotype cell lines to determine if thyroid hormone drives increased Sfrp4 expression in cells relevant to craniofacial development. Transcriptional profiling, bioinformatics interrogation, protein and function analyses were used. Key findingsAffymetrix transcriptional profiling found Sfrp4 overexpression in primary cranial suture derived cells stimulated with thyroxine in vitro. Interrogation of the SFRP4 promoter identified multiple putative binding sites for thyroid hormone receptors. Experimentation with several cell lines demonstrated that thyroxine treatment induced Sfrp4 expression, demonstrating that Sfrp4 mRNA and protein levels are not tightly coupled. Transcriptional and protein analyses demonstrate thyroid hormone receptor binding to the proximal promoter of the target gene Sfrp4 in murine calvarial pre-osteoblasts. Functional analysis after thyroxine hormone stimulation for alkaline phosphatase activity shows that pre-osteoblasts increase alkaline phosphatase activity compared to other cell types, suggesting cell type susceptibility. Finally, we added recombinant SFRP4 to pre-osteoblasts in combination with thyroxine treatment and observed a significant decrease in alkaline phosphatase positivity. SignificanceTaken together, these results suggest SFRP4 may be a key regulatory molecule that prevents thyroxine driven osteogenesis. These data corroborate clinical findings indicating a potential for SFRP4 as a diagnostic or therapeutic target for hyperostotic craniofacial disorders.

THE ASSOCIATION BETWEEN SERUM THYROID HORMONE, VITAMIN D, VITAMIN B12, FOLATE, FERRITIN, AND ZINC LEVELS AND FEMALE INFERTILITY. A COMPASSION WITH HEALTHY PREGNANT SUBJECTS

Alterations in thyroid hormone levels and presence of antithyroid antibodies were implicated in the etiology of infertility or recurrent pregnancy loss. High concentration of homocysteine that occurs in folic acid and vitamin B12 deficiencies may cause cytotoxicity and oxidative stress, and may lead to impaired oocyte maturation and embryo development. Zinc, vitamin D and iron deficiencies were also demonstrated to hamper oocyte quality. The aim of the present study was to assess the association between serum thyroid hormone, vitamin D, vitamin B12, folate, ferritin and zinc levels and female infertility.

Toxic-Induced Nonthyroidal Illness Syndrome Induced by Acute Low-Dose Pesticides Exposure-Preliminary In Vivo Study.

Background and Objectives: Conditions such as trauma, burns, sepsis, or acute intoxications have considerable consequences on the endocrine status, causing “sick euthyroid syndrome”. Organophosphate exposure may induce an increase in acetylcholine levels, thus altering the thyroid’s hormonal status. The present study aims to identify the effects of acetylcholinesterase inhibition on thyroid hormones. Material and methods: A prospective experimental study was conducted on twenty Wistar rats. Blood samples were drawn to set baseline values for thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4). Chlorpyrifos 0.1 mg/kg was administered by oral gavage to induce acetyl-cholinesterase inhibition. After exhibiting cholinergic symptoms, blood samples were collected to assess levels of cholinesterase and thyroid hormones using ELISA. Results: Butyrylcholinesterase levels confirmed major inhibition immediately after intoxication compared to the baseline, certifying the intoxication. A significant increase in T4 levels was noted (p = 0.01) both at 2 h and 48 h after administration of organophosphate in sample rats. Similarly, T3 almost doubled its value 2 h after poisoning (4.2 ng/mL versus 2.5 ng/mL at baseline). Surprisingly, TSH displayed acute elevation with an afterward slow descending trend at 48 h (p = 0.1), reaching baseline value. Conclusions: This study demonstrated that cholinesterase inhibition caused major alterations in thyroid hormone levels, which may be characterized by a transient hypothyroidism status with an impact on survival prognosis.

The Effect of Recombinant Human TSH on Sclerostin and Other Selected Bone Markers in Patients after Total Thyroidectomy for Differentiated Thyroid Cancer.

The direct effect of TSH on bone metabolism in vivo is difficult to capture as the changes of its concentrations are followed by respective alterations of thyroid hormone levels. We evaluated the effect of recombinant human TSH (rhTSH) on sclerostin and other bone markers in 29 patients after total thyroidectomy for differentiated thyroid cancer (DTC), without any signs of disease recurrence, who received L-thyroxine, most at non-suppressive doses. For two consecutive days, the patients were administered a standard dose of 0.9 mg rhTSH, i.m. Concentrations of sclerostin, osteocalcin, β-CrossLaps, PTH, and some other parameters, were measured before and five days after the first rhTSH administration. The greater the increase in TSH concentration (∆TSH), the greater the decrease in: ∆sclerostin (r = −0.672; p < 0.001), ∆β-CrossLaps (r = −0.580; p < 0.001) and ∆osteocalcin (r = −0.405; p = 0.029) levels, were recorded. The degree of TSH increase depended on the baseline PTH (r = 0.651; p < 0.001), age, and creatinine concentrations. rhTSH strongly inhibited bone turnover, thus, TSH—independently of thyroid hormones—exerted a direct protective effect on bone metabolism. Baseline PTH affected the magnitude of TSH increase and the degree of lowering in sclerostin and β-CrossLaps that suggest factors affecting PTH may play a role in the effect of TSH on the bone.

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.

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.

Thyroid function assessment before and after diagnosis of schizophrenia: A community-based study

Alterations in thyroid hormone levels may affect brain and mental disorders. Conversely, schizophrenia and its antipsychotic treatments can affect thyroid hormone levels. However, data on thyroid hormone levels during the course of schizophrenia disorder are scant. The aim of the study was to assess the rate of thyroid hormone disorders in outpatients before and after diagnosis of schizophrenia. A retrospective matched-control design was used. The cohort included 1252 patients suffering from ICD-10 schizophrenia, and 3756 control subjects matched for gender, age, socioeconomic status, and origin. All were identified from the database of a large health management organization. The pertinent clinical data were collected from the electronic medical records. There was no significant between-group difference in the distribution of thyroid-stimulating hormone levels. Before diagnosis, both groups had a similar rate of hypothyroidism. After diagnosis of schizophrenia and initiation of antipsychotic treatment, the rate of hypothyroidism was significantly higher in the patient group. It remained significantly higher after exclusion of patients receiving lithium. The increased rate of hypothyroidism in patients with schizophrenia after, but not before, the diagnosis of schizophrenia suggests that antipsychotic medications may affect thyroid hormone levels. Screening for thyroid disorders is warranted in patients with schizophrenia under antipsychotic treatment.

Aberrant Cardiac Long Noncoding RNA Expression Following Alterations in Thyroid Hormones

BackgroundHeart failure (HF) mortality is on the rise and altered thyroid hormone (TH) function is a major risk factor. HF can be a result of either decreased (hypothyroidism; HypoTH) or increased (hyperthyroidism; HyperTH) serum TH levels. THs regulate cardiac physiology including contractility and relaxation. We recently showed safe, cardioprotective effects with oral treatment of active form of THs in several rodent models of cardiovascular disorders. Moving forward, novel heart‐specific targets in TH pathway are warranted. About 98% of the genome is non‐protein‐coding and over 90% is transcribable. Long noncoding RNA (lncRNA; transcripts &gt;200 nucleotides) genes outnumber protein‐coding genes by several fold. Deiodinase‐3 converts active forms of THs into inactive metabolites, and its chromosomal domain also encode maternally expressed lncRNAs. However, role of lncRNAs in TH‐mediated cardiac effects is unknown. We hypothesize that alterations in TH levels will impair cardiac lncRNA expression.MethodsHypoTH was induced by feeding adult C57BL/6 mice with 0.15% propylthiouracil with 0.1% methimazole for 5 weeks. HyperTH was established by injecting TH (T4; 1 μg/g i.p.) every 48 hours. Females were used because they maintain a more stable body mass over time than males. Furthermore, women have higher incidence of thyroid anomalies. Echocardiography and heart gravimetry were performed and results analyzed by analysis of variance with Tukey's multiple comparisons test (n=3–5/group). We also performed quantitative real‐time PCR using lncRNA‐specific array of 86 different targets following pre‐amplification. Array reproducibility, reverse transcription efficiency, absence of genomic DNA contamination and normalization were ensured.ResultsSerum total T4 levels were decreased in HypoTH (p&lt;0.05) and increased in HyperTH (p&lt;0.01) [Control: 2.17±0.4; HypoTH: 0.8±0.2; HyperTH: 12.8±2.4; ug/dl]. While HypoTH hearts were atrophic (p&lt;0.05), HyperTH hearts showed significant hypertrophy (p&lt;0.0001). Heart weight to body weight ratio was 4.38±0.2 in controls, 3.8±0.1 in HypoTH and 5.9±0.1 in HyperTH. Left and right ventricular ratios also followed similar patterns (p&lt;0.05). Following HypoTH, echocardiographic left ventricular end‐systolic dimension significantly increased (p&lt;0.05) while fractional shortening decreased (p&lt;0.01). Heart rate decreased with HypoTH and increased with HyperTH (p&lt;0.01). We began investigating involvement of lncRNAs related to inflammatory and immune mechanisms that can be relevant in both TH abnormalities and HF. Quantitative real‐time PCR showed that several of these cardiac lncRNAs were differentially expressed following alterations in TH levels (p&lt;0.05). Importantly, two lncRNAs were significantly downregulated (2.9‐ and 1.73‐fold) in HypoTH, but upregulated (3.4‐ and 1.67‐fold) in HyperTH ventricles. Another lncRNA was significantly increased in HypoTH (2.1‐fold), but decreased with HyperTH (7.63‐fold).ConclusionsThis is the first report to present aberrations in cardiac lncRNAs following altered TH levels. Taken together, this demonstrates potential TH‐dependent regulation of lncRNAs in mammalian hearts that may offer clinical significance.Support or Funding InformationNYITCOM

Sfrp4 Expression in Thyroxine Treated Calvarial Cells: A Novel Target

Evidence suggests alterations of thyroid hormone levels can disrupt normal craniofacial development. Most data suggest the major targets of thyroid hormones to be the Htra1/Igf1 pathway. Recent discovery by our group suggests involvement of targets of the WNT pathway, specifically overexpression of antagonist Sfrp4 in the presence of excess thyroid hormone. Here we aimed to model these interactions in vitro to determine if thyroid hormone directly drives Sfrp4 expression in cells relevant to craniofacial development. Affymetrix transcriptional profiling found Sfrp4 to be overexpressed in cranial suture derived cells stimulated with thyroxine in vitro. Bioinformatics interrogation of the SFRP4 promoter identified multiple putative binding sites for thyroid hormone receptors. Experimentation with several cell lines demonstrated that thyroxine treatment induced Sfrp4 expression. However, protein levels did not correlate with induction of gene expression, demonstrating that Sfrp4 mRNA and protein levels are not tightly coupled. Transcriptional and protein analyses demonstrate thyroid hormone receptor binding to the proximal promoter of the target gene Sfrp4. Interestingly functional analysis of stem cells, fibroblasts, or primary culture cells after thyroxine stimulation for alkaline phosphatase activity shows only pre‐osteoblasts are pushed to become positive after thyroid hormone stimulation, suggesting cell type susceptibility. Finally, we added recombinant SFRP4 to pre‐osteoblasts in combination with thyroxine treatment and observed a significant decrease in alkaline phosphatase positivity, suggesting SFRP4 may be a key regulatory molecule that prevents thyroxine driven osteogenesis. The implications for this relationship indicate SFRP4 as a potential diagnostic or therapeutic target for hyperostotic craniofacial disorders.Support or Funding InformationThe authors would like to thank Xing Ming Shi for isolation of the bone marrow mesenchymal cells. The following funding sources were used for this study a grant from the Cleft Palate Foundation, NIH/NIDCR R03DE023350A, 5T32DE017551, and F31DE026684, NIH/NCATS UL1 TR000062, NIH/NIGM P30GM103331, GM103342 and GM103499, and MUSC’s Office of the Vice President for Research.

Polychlorinated biphenyls: Hazardous properties and environmentally sound management in Ukraine

Polychlorinated biphenyls are one of the most dangerous compounds for human health and the environment and are included to Annex C of the Stockholm Convention on Persistent Organic Pollutants. Since Ukraine joined the Stockholm Convention in 2007, the National Implementation Plan of the Stockholm Convention provides the environmentally sound disposal of polychlorinated biphenyls, as well as creation of a monitoring system and sharing information about toxicants. Polychlorinated biphenyls’ have fire resistance, low volatility and stability. Therefore, these substances have been widely used in industry, but on the other hand, they are a problem for the environment. The main hazardous properties of polychlorinated biphenyls are bioaccumulation, stability in the environment, the possibility of formation in accidents (especially in fires) of extremely persistent and toxic aromatic compounds, such as dioxins and furans. Toxic responses to polychlorinated biphenyls are: acute lethality; body weight loss; carcinogenesis; dermal toxi­city; fatty liver; genotoxicity; hepatomegaly; immunosuppressive effects; neurotoxicity; porphyria; reproductive and developmental toxicity; thymic atrophy; thyroid hormone-level alterations. The most likely risks of polychlorinated biphenyls contamination in Ukraine are in the areas of operation, repair or storage of electrical equipment. According to quantity, the leading regions for accumulated polychlorinated biphenyls in Ukraine, are Dnipropetrovsk (459 tons), Volyn (280 tons) and Kyiv regions (255 tons). A comprehensive approach to reducing the risk of polychlorinated biphenyls for human health and the environment involves the improvement of the regulatory framework for managing in all stages of “life cycle”. Obtaining complete and accurate information on the volumes and forms of polychlorinated biphenyls accumulation and creation of modern effective technological support for polychlorinated biphenyls’ degradation are a necessary part of environmentally sound management of polychlorinated biphenyls in Ukraine. The “Polychlorinated Biphenyls Database in Ukraine” information system (2017) was created as a National Polychlorinated Biphenyls Registry in Ukraine. It was designed to systematize, structure, and analyze the large amount of information collected during the inventorising of polychlorinated biphenyls. The best technology of polychlorinated biphenyls degradation must not only provides a high degree of polychlorinated biphenyls’ destruction, but also not lead to the formation of new toxic compounds.

Relationship between hypothyroidism and non-alcoholic fatty liver disease in the Spanish population

BackgroundNon-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in developed countries and is considered the hepatic component of metabolic syndrome (MetS). Recently hypothyroidism has been associated with NAFLD but has never been studied in Spain. ObjectivesTo analyze the relationship between hypothyroidism (clinical and subclinical) and NAFLD. To determine the association between MetS with NAFLD and hypothyroidism. MethodsCross-sectional, retrospective, population study in subjects ≥45 years from primary care centres in Catalonia included in the SIDIAP database. The data was collected between 2009 and 2013. Variables: socio-demographic data, comorbidities, toxic habits, physical examination, analytical tests and diagnosis of MetS. Descriptive analysis and application of statistical tests for the comparison of variables. ResultsSample of 10, 116 individuals with a mean age of 61(10) and a predominance of females (63.6 %). The prevalence of hypothyroidism was 9.1 %, with no significant differences according to the presence of NAFLD (p = .631). Hypothyroidism was associated with higher triglyceride levels and a greater prevalence of obesity (p = .003). Greater alteration of AST was detected in individuals with elevated TSH (p = .012) and decreased levels of T4L (p = .037). Alterations in thyroid hormone levels were not associated with a higher prevalence of NAFLD (TSH p = .072 and T4L p = .447). Hypothyroidism was not considered a risk factor for the development of NAFLD (OR .75:95 %CI: .39–1.44, p = .38). ConclusionsNo association was found between hypothyroidism and NAFLD. Prospective studies are needed to clarify a possible relationship between these two diseases.

Relación entre el hipotiroidismo y el hígado graso no alcohólico en una población española

BackgroundNon-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in developed countries and is considered the hepatic component of metabolic syndrome (MetS). Recently hypothyroidism has been associated with NAFLD but has never been studied in Spain. ObjectivesTo analyze the relationship between hypothyroidism (clinical and subclinical) and NAFLD. To determine the association between MetS with NAFLD and hypothyroidism. MethodsCross-sectional, retrospective, population study in subjects ≥45 years from primary care centres in Catalonia included in the SIDIAP database. The data was collected between 2009 and 2013. Variables: socio-demographic data, comorbidities, toxic habits, physical examination, analytical tests and diagnosis of MetS. Descriptive analysis and application of statistical tests for the comparison of variables. ResultsSample of 10,116 individuals with a mean age of 61(10) and a predominance of females (63.6%). The prevalence of hypothyroidism was 9.1%, with no significant differences according to the presence of NAFLD (p=.631). Hypothyroidism was associated with higher triglyceride levels and a greater prevalence of obesity (p=.003). Greater alteration of AST was detected in individuals with elevated TSH (p=.012) and decreased levels of T4L (p=.037). Alterations in thyroid hormone levels were not associated with a higher prevalence of NAFLD (TSH p=.072 and T4L p=.447). Hypothyroidism was not considered a risk factor for the development of NAFLD (OR .75; 95% CI: .39-1.44; p=.38). ConclusionsNo association was found between hypothyroidism and NAFLD. Prospective studies are needed to clarify a possible relationship between these two diseases.

Free Thyroxine Determination in the Emergency Department Is a Predictor of Acute Pancreatitis Evolution.

The aim of this study was to determine the prevalence and type of thyroid hormone levels alterations in patients with acute pancreatitis (AP) and analyze if variations are useful AP progression predictors. Three groups of patients were analyzed: AP patients (n = 90), abdominal pain patients (n = 30), and healthy control subjects (n = 40). Usual blood parameters for AP diagnosis and prognosis, thyroid-stimulating hormone (or thyrotropin), FT4 (free thyroxine), FT3 (free triiodothyronine), and TT3 (total triiodothyronine) levels were analyzed. Thyroid hormone level alterations were detected only within the AP group (41% of total cases), being the reduction in T3 levels the most frequently detected deviation (15.6% of FT3 and 8.3% of TT3 cases). Alterations were not influenced by age or sex. Free thyroxine average values were also significantly higher in the AP group, compared with the healthy control group (P = 0.0005), resulting as independent predictors of both severity and mortality. Mortality in this group was 50%, with deceased patients showing FT4 levels above the reference limit. Our results show that FT4 level determination during the initial clinical evaluation of patients admitted to the emergency service with AP can be included as a severity indicator to help determine the differential care of these cases.

Zmiany stężeń hormonów tarczycy u pacjentów z rozpoznaniem śmierci mózgu mają związek z non-thyroidal illness syndrome

Alterations in thyroid hormone levels occur in patients with acute neurological disease states. The aim of this study is to study changes in thyroid hormones in patients with brain death (BD). Eleven brain-dead patients were studied prospectively. Thyroid hormones were measured on admission to the intensive care unit, the day before BD diagnosis (BD before), and the day after BD diagnosis (BD day). Thyroid stimulating hormone (TSH) and free triiodothyronine (fT3) concentrations were found to be significantly low on ad-mission, BD before, and BD day compared to age-matched healthy controls. TSH levels were shown to be increasing on BD day. Free thyroxine (fT4) levels were within normal limits in all cases except in one case having low fT4 levels with normal TSH levels. No statisti-cally significant changes were encountered between admission thyroid hormone levels and BD-before and BD-day thyroid hormone levels. Six patients were on steroid therapy when BD-before blood samples were drawn, and no difference in thyroid hormone levels was encountered between steroid users and non-users. Correlation analysis showed a positive correlation between GCS and TSH, but a negative association between fT3 and APACHE II. We have shown that patients with BD have altered thyroid hormones days before BD diagnosis, and these alterations con-tinue until the diagnosis of BD. The changes in thyroid hormones are compatible with non-thyroidal illness syndrome.

Oral and dermal diflubenzuron exposure causes a hypothalamic–pituitary–thyroid (HPT) axis disturbance in the Mongolian racerunner (Eremias argus)

Diflubenzuron (DFB) is a potential endocrine-disrupting chemical. However, its thyroid endocrine effect on reptiles has not been reported. In this study, immature lizards (Eremias argus) were exposed to 20 mg kg−1 DFB once a week for 42 days through oral or dermal routes. Their body weight, plasma thyroid hormone levels, thyroid gland histology and the transcription of hypothalamic–pituitary–thyroid (HPT) axis-related genes in different tissues were assessed to explore the effects of DFB on the HPT axis of lizards. The body weight decreased significantly only after the dermal exposure to DFB. Triiodothyronine (T3) to thyroxine (T4) ratio in the male plasma also significantly increased after the dermal exposure. After oral exposure, the activity of thyroid gland was positively related to the thyroid hormone levels. Furthermore, the alterations in thyroid hormone levels affected the HPT axis-related gene expression, which was tissue dependent and sexually selected. The thyroid hormone receptor genes (trα and trβ) in the brain and thyroid were more sensitive to oral exposure. However, only the dermal treatment affected the trα, trβ and type 2 deiodinase (dio2) genes in the male liver. These results suggest that DFB exposure caused sex-specific changes in the thyroid function of lizards, and the dermal treatment may be an important route for the risk assessment of reptiles.