Thyroid Autoantibodies Research Articles

Letter to the editor in response to: Serum thyroid autoantibodies in malignant thyroid nodules (Awal TR et al.)

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Assessment of Immunological, Skeletal, and Thyroid Function Abnormalities in Paediatric Morphoea

Abstract Background: Morphoea is a sclerosing disorder of skin and subcutaneous tissue. Paediatric morphoea shows increased prevalence of various auto-immune diseases, bone deformities, and systemic abnormalities. There is paucity of studies on various immunological, skeletal, and thyroid function abnormalities in paediatric morphoea. Aims and Objectives: To describe immunological, skeletal, and thyroid function abnormalities present in paediatric morphoea patients. Materials and Methods: This cross-sectional study was conducted from January 2021 to March 2023 in the Dermatology outpatient department in a tertiary care hospital. All paediatric morphoea patients were included in this study. All were subjected to detailed history, clinical examination, and investigations including complete blood count, serum IgE, anti-nuclear antibody, thyroid function tests, anti-thyroid peroxidase antibodies, and radiological investigations. Results: A total of 42 children were recruited, out of which 61.90% were females and 38.09% were males. The majority were in the age group of 4–8 years. The most common type of morphoea was encoup de sabre. Anaemia was present in 14.28% patients. Serum IgE levels were raised in 33.33% patients. Thyroid stimulating hormone was raised in 11.9% patients. 33.33% had raised anti-thyroid peroxidase levels. Anti-nuclear antibody titres and rheumatoid factor were raised in 7.14% and 4.76% patients, respectively. Magnetic resonance imaging brain revealed abnormalities in three patients as hyper-intensities in subcortical white matter. Conclusion: Morphoea in children can be associated with varied immunological, osteoarticular, and neurological abnormalities. This study highlights the multi-system involvement in morphoea and the need for larger data and well-designed therapeutic trials for generating evidence-based treatment of this potentially disfiguring disease.

Thyroid antibodies in Hashimoto's thyroiditis patients are positively associated with inflammation and multiple symptoms.

Hashimoto's thyroiditis (HT) is an autoimmune disease, characterized by abnormal elevation in thyroid peroxidase antibody (TPO-Ab) and/or thyroglobulin antibody (TG-Ab). Patients have multiple symptoms despite adequate hormone substitution. In the present study, we aimed to quantify the relationship between thyroid antibodies and multiple symptoms, inflammation and health-related life quality. A total of 108 HT patients with clinical euthyroid status and 57 heathy controls were recruited. Clinical parameters were determined by laboratory examination, and the symptoms burden and life quality were obtained by a Hashimoto's Thyroiditis Symptom Questionnaire and a SF-36 Questionnaire, respectively. Compared with healthy controls, multiple extrathyroidal symptoms were significantly more serious in HT patients despite euthyroid status, mainly including that related to digestive system (abdominal distension, constipation and diarrhea), endocrine system (chilliness, gain weight and facial edema), neuropsychiatric system (forgetfulness, anxiety, depressed, fatigue, insomnia, irritability, and indifferent) and mucocutaneous system (dry skin, pruritus, and hair loss). Furthermore, serum TPO-Ab and TG-Ab were both inversely correlated with health-related life quality of general health and vitality parameters, and positively correlated with pro-inflammatory factors of TNF-α and IFN-γ, as well as severity of abdominal distension, diarrhea, chilliness, forgetfulness and fatigue. Moreover, TG-Ab level was positively associated with depressed, insomnia and indifferent. HT patients suffered from a variety of symptoms, and the elevated thyroid antibodies were inversely associated with health-related life quality and positively associated with inflammation and multiple extrathyroidal symptoms.

Longitudinal assessment of thyroid function in dogs with hypoadrenocorticism: Clinical outcomes and prevalence of autoantibodies.

Knowledge about primary hypoadrenocorticism coexisting with immune-mediated thyroiditis (Schmidt's syndrome) in dogs is limited. To evaluate thyroid function in dogs with naturally occurring hypoadrenocorticism before and during treatment. Sixty-six client-owned dogs. Measurement of canine thyroid stimulating hormone (cTSH), total thyroxine (T4), free thyroxine, and autoantibodies against thyroglobulin, T4, and total triiodothyronine. Thirty-eight dogs were assessed before and 28 during treatment. Follow-up data were available for 24/38 and 17/28 dogs, with median follow-up duration of 3.8 years (range, <1.0-8.8 years) and 4 years (range, 1.1 weeks to 10.5 years), respectively. Canine thyroid stimulating hormone was above the reference range at the time of diagnosis of hypoadrenocorticism in 10 of 38 dogs but decreased into the reference range in 7 for which follow-up data was available. Hypothyroidism was confirmed in 5 dogs at a median age of 11 years (range, 7-15 years). In 4 dogs, the condition was diagnosed after a median treatment duration of 5.75 years (range, 2.6-10 years), while in 1 dog, the diagnosis was made concurrently. One dog had detectable thyroid autoantibodies. Hypothyroidism occurs as a rare concurrent condition in dogs with hypoadrenocorticism, potentially at any phase of treatment. Close monitoring of cTSH levels in these dogs could be beneficial, as early changes might indicate the onset of hypothyroidism. The low prevalence of detectable thyroid autoantibodies suggests that nonimmune mechanisms might contribute to thyroid dysfunction.

Warthin-like Papillary Thyroid Carcinoma: A Case Report and Review of the Literature.

Warthin-like subtype of papillary thyroid carcinoma (WLPTC) is a rare subtype of papillary thyroid carcinoma. This PTC subtype shows some pattern resemblance to Warthin tumors of the salivary gland, which confers its name but is a not genetically similar to salivary Warthin tumor, with the most frequent genetic change in WLPTC being BRAF p.V600E, the most frequent genetic driver of PTC. Warthin-like subtype of papillary thyroid carcinoma is found to have a favorable prognosis. We report a 44-year-old woman who presented with anterior neck swelling and elevated levels of antithyroid peroxidase antibodies. Fine-needle aspiration cytology showed features of papillary thyroid carcinoma and lymphocytic thyroiditis. On histopathological examination, thyroid follicular cells have oncocytic cytoplasm with infiltration of the tumor and fibrovascular cores by a dense lymphoplasmacytic infiltrate. Numerous multinucleated giant cells in the tumor are a notable feature. The final diagnosis is Warthin-like papillary thyroid carcinoma arising in association with chronic lymphocytic (Hashimoto) thyroiditis. Along with this case report, we perform a literature review of WLPTC between 2010 and 2024.

A Case of Euthyroid Graves’ Ophthalmopathy With Negative Thyroid Antibodies

A Case of Euthyroid Graves’ Ophthalmopathy With Negative Thyroid Antibodies

Relationship between thyroid-stimulating hormone and blood lipids in patients with first-episode depression

BackgroundPrevious studies demonstrated thyroid stimulating hormone (TSH) plays an important role in regulating lipid metabolism, but the relationship between the two is controversial. Meanwhile, it has not been reported in a population with major depressive disorder (MDD).MethodsWe divided 1718 first-episode and drug naïve patients with MDD into a TSH abnormal group (TSH-AB) and a TSH normal group (TSH-NOR). The participants in the two groups were assessed by the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and the positive subscale of Positive and Negative Syndrome Scale. The patients’ blood was tested for TSH, free T3, free T4, fasting blood glucose, lipid indexes and body mass index was recorded.ResultsThe participants in the TSH-AB group had significantly higher HAMD scores, HAMA scores and total scores of positive symptoms, as well as higher incidence of suicide attempts than those in the TSH-NOR group, accompanied by significantly higher thyroglobulin antibodies, thyroid peroxidase antibodies, fasting blood glucose values, total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) levels compared with those of TSH-NOR patients. However, the high-density lipoprotein cholesterol (HDL-C) of TSH-AB patients was lower than those of TSH-NOR patients. TSH values were positively correlated with TC, TG, and LDL-C values, and negatively correlated with HDL-C value.ConclusionTSH was highly correlated with abnormal lipid metabolism in patients with MDD. The specific molecular mechanism of the relationship between TSH, lipid metabolism and the development of depression needs to be further in-depth investigation.

The impact of CTLA-4 gene polymorphism on the content of organ-specific antibodies in patients with autoimmune thyroiditis among the population of Azerbaijan

BACKGROUND: The risk of developing immune tolerance to self-antigens in autoimmune thyroiditis is largely associated with a mutation in the CTLA-4 gene, the product of which negatively regulates T-cell activity. AIM: To study the A49G (rs231775) CTLA-4 polymorphism in patients with autoimmune thyroiditis in a sample of Azerbaijani residents and the effect of the frequency of identified alleles and genotypes on the level of antibodies to thyroid peroxidase and thyroglobulin. MATERIAL AND METHODS: A study was conducted in 2021–2023 involving 170 patients with autoimmune thyroiditis and 65 individuals without thyroid pathology or other autoimmune diseases, who formed a comparison group. The groups were matched by gender and age. Based on the patient history, thyroid status study results, thyroid ultrasound data, and organ-specific antibody assessment, the patients were diagnosed with autoimmune thyroiditis. The routine thyroid status study results in the comparison group were within normal limits. Genotyping of the A49G (rs231775) polymorphism was performed using polymerase chain reaction followed by digestion of the reaction product with PspEI restriction endonuclease. The results of the quantitative studies were presented as the median (Me) and interquartile range (25th quartile; 75th quartile). The correspondence of genotype frequencies to the Hardy–Weinberg equilibrium was assessed using the χ2 criterion. RESULTS: The results revealed a statistically significant increase in the frequency of the G allele (48%) compared to the control group [33.8%; p=0.039, χ2=4.27, odds ratio (OR) 1.865, 95% confidence interval (CI) 1.028–3.382] and a decrease in the frequency of the A allele (51.2%) relative to the control group (66.1%; p=0.0389, χ2=4.27, OR=0.536, CI=0.296–0.973). In 22.4% of patients with the GG genotype (p=0.005, χ2=7.86, OR=0.237, 95% CI=0.088–0.635) and 55.6% of patients with the G allele (p=0.0012, χ2=10.43, OR=0.360, 95%, CI=0.192–0.674), thyroglobulin antibody titers were more than 100 IU/ml. Thyroid peroxidase antibody levels of 100 IU/ml or more were recorded in 22.7% of study participants with the GG genotype (p=0.030) and 50.0% with the G allele (p=0.048). CONCLUSION: Elevated titers of antibodies to thyroid peroxidase and thyroglobulin were detected in patients from the population of Azerbaijan with the G allele and homozygous genotype GG of the +49A/G polymorphism of the CTLA-4 gene.

Clinicopathological and molecular markers for the identification of Hashimoto’s thyroiditis as a possible predisposing and prognostic factor of papillary thyroid carcinoma

Background: The papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, while Hashimoto’s thyroiditis (HT) is the most common inflam¬matory thyroid disease. The coincidental coexistence or the possible predisposing, protective or aggravating role of HT in the development of PTC have been repeatedly examined. Aim: The aim of the present study was to eval¬uate histopathological and clinical data obtained from pa¬tients with HT, PTC, and PTC+HT so as to investigate the possible association of HT with PTC. Methodology: The study’s cohort consisted of 114 patients (67 PTC, 29 PTC+HT, and 18 HT patients). A full record of their clini¬copathological and clinical laboratory data was followed by extensive statistical analysis in order to reveal possi¬ble correlations between the existence of each disease and various clinicopathological parameters. The study was conducted from 2019 to 2023 at the Hippokration General Hospital of Athens (Greece). Results: A signifi¬cant increase in the levels of thyroid-stimulating hormone (TSH; p=0.031), anti-thyroglobulin antibodies (Anti-Tg; p&lt;0.001), and anti-thyroid peroxidase antibodies (Anti-TPO; p&lt;0.001) was observed in the PTC+HT group. These patients also have smaller tumors (p=0.015) and a younger age of disease onset (p&lt;0.001), while the ma¬jority of PTC+HT patients were women (p=0.023) and had infiltrated lymph nodes (p=0.002). Furthermore, the majority of patients with infiltration of the capsule be¬longed to the PTC+HT group (57.1%; p=0.032). Conclu¬sion: PTC+HT represents a less aggressive clinical state, as good prognostic markers of PTC correlate with the presence of HT. In PTC+HT patients, the PTC tends to have early onset age and the primary tumor is often small, while the majority of PTC+HT patients are women.

Immune checkpoint inhibitors-related thyroid dysfunction: influencing factor analysis, prediction model development, and management strategy proposal

BackgroundWith the extensive utilization of immune checkpoint inhibitors (ICIs) across various cancers, ICIs-related thyroid dysfunction (ICI-TD) has become a growing concern in clinical practice. This study aimed to devise an individualized management strategy for ICI-TD to enhance the early identification and proactive management in cancer patients.MethodsWe designed and conducted a three-phase study. Initially, we analyzed the influencing factors through a systematic review and meta-analysis, which adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Moreover, the study protocol was registered with PROSPERO (CRD42019131133). Subsequently, prediction models for ICI-TD were developed utilizing 11 algorithms based on the real-world cohort data from July 20, 2018 (the approval date of the first ICIs, Pembrolizumab in China), to October 31, 2022. Considering discrimination, calibration, and clinical utility, we selected the model with the best performance for web calculator development. Finally, individualized management strategies for ICI-TD were proposed by combining evidence-based analysis with practical considerations.ResultsThe systematic review encompassed 21 observational studies involving 4,145 patients, revealing associations between ICI-TD and factors such as female gender, age, receipt of Pembrolizumab (versus other ICIs), and baseline levels of thyroid-stimulating hormone, free thyroxine, and antithyroid antibodies. In the prediction model development phase, 621 participants were enrolled, with 36 patients developing ICI-TD. The model based on the LightGBM algorithm demonstrated superior performance, leading to the development of a web calculator. Based on these findings and existing guidelines, individualized monitoring and treatment pathways for pharmacists were devised.ConclusionThis study offers comprehensive insights into managing ICI-TD, potentially enhancing tailored cancer immunotherapy management.

A study of autoimmune thyroid disease in pregnant women and its effect on fetal and maternal outcome

ABSTRACT Introduction: Anti-thyroid antibodies not only cause thyroid dysfunction but have independent adverse outcomes in the fetus and mother during pregnancy and after birth. Chronic lymphocytic thyroiditis as a presentation of immune system deregulation may be associated with a generalized activation of the immune system at the fetus–maternal unit, the placenta. This interference could be associated with pregnancy morbidities in m o t h e r a n d fetus. This study was done to find out the frequency of autoimmune thyroid disease and its effect on maternal and fetal outcomes in a tertiary care facility in Jharkhand. Method: This is an Observational Prospective Study done during an 18-month period on 254 pregnant women in their second trimester who came to the antenatal clinic (ANC) clinic with singleton pregnancy at RIMS Ranchi. Result: 222 (87.4%) out of the 254 pregnant women had anti- TPO antibodies less than 35 IU/ml. Anti-thyroid peroxidase (anti-TPO) antibody positivity with values greater than 35 IU/ml was found in 32 patients (12.6%). Anti-TPO antibody mean value was 22.54 ± 19.67 IU/ml. Among the 222 individuals who tested negative for the anti-TPO antibody, 7 (3.3%) had miscarriages, 182 (88.3%) gave birth vaginally, and 33 (14.9%) underwent a cesarean section. Of the 32 individuals who tested positive for the anti-TPO antibody, 2 (6.3%) had miscarriages, 24 (75.0%) had vaginal deliveries, and 6 (18.8%) had cesarean sections. Using the Chi-square test, a P value of 0.549 was calculated, indicating statistical insignificance (Pearson Chi-square test value = 0.200a). Conclusion: Anti-TPO antibody positivity was significantly related to miscarriage and anemia. Other complications like preterm delivery, pre-eclampsia, and low birth weight were higher in anti-TPO antibody-positive patients as compared to anti-TPO antibody-negative patients. However, these findings were not statistically significant.

Correlation of thyroid function and sensitivity to thyroid hormone with spinal bone mineral content, bone mineral density, and osteoporotic vertebral fracture: A cross-sectional study based on NHANES.

Previous studies have demonstrated that thyroid hormone plays an important role in normal bone development, bone metabolism, and establishment of peak bone mass. However, the correlation of thyroid status with bone mineral content (BMC), bone mineral density (BMD), and osteoporotic vertebral fracture (OVF) is rarely discussed. The current study probes into the potential association between thyroid status and spinal BMC, BMD, and OVF from a novel perspective of thyroid function (TF) and sensitivity to thyroid hormone based on the National Health and Nutrition Examination Survey database. A total of 1844 participants were included in this study. The association of thyroid status with outcome variables, like spinal BMC, BMD, and OVF, was analyzed using thyroid function indices and sensitivity to thyroid hormone indices as influence factors. The correlation of them were assessed using univariate and multivariable weighted linear regression, weighted logistic regression models, restricted cubic spline model, and subgroup analyses. The results of this study showed that the association of free triiodothyronine (FT3)/free thyroxine (FT4) with BMC remained negatively associated after adjustment for all covariates. Higher thyroid peroxidase antibody (TPOAb) was significantly associated with an increased risk of developing OVF in both unadjusted and adjusted models. In addition, the results of the restricted cubic spline model were consistent with the weighted multivariate regression analysis after adjustment. The results of this cross-sectional study showed that higher FT3/FT4 and TPOAb were associated with decreased spinal BMC and the increased risk of OVF, indicating a complex link between thyroid status and bone health. Therefore, patients with hyperthyroidism, hypothyroidism, autoimmune thyroid disease, or abnormal peripheral thyroid sensitivity, especially who with elevated TPOAb or FT3/FT4, should focus on the prevention of vertebral osteopenia, osteoporosis, and OVF.

Metabolic and Endocrine Correlates of Subclinical Hypothyroidism in Young Adults with First-Episode and Drug-Naive Major Depressive Disorder

BackgroundMajor Depressive Disorder (MDD) is often associated with Subclinical Hypothyroidism (SCH), but the clinical and biochemical characteristics in young, first-episode, drug-naive patients remain unclear. This study aims to examine the prevalence and clinical correlates of SCH in this population to enhance screening and management strategies. MethodA cross-sectional study included 917 young Chinese patients (aged 18-35) diagnosed with first-episode, drug-naive MDD. Comprehensive clinical assessments were conducted, involving demographic data, psychiatric evaluations using the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Positive and Negative Syndrome Scale (PANSS), alongside biochemical measurements such as thyroid stimulating hormone, thyroid peroxidase antibodies (TPOAb), fasting blood glucose (FBG), total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Binary logistic regression identified clinical correlates of SCH. ResultsThe prevalence of SCH among the study population was 58%. Logistic regression analysis identified significant predictors of SCH, including higher HAMD scores (OR = 1.26), TPOAb (OR = 1.003), FBG (OR = 2.28), TC (OR = 1.66), SBP (OR = 1.11), and DBP (OR = 1.07). In contrast, lower HDLC levels (OR = 0.28) were inversely associated with SCH. ConclusionThe high prevalence of SCH in young, first-episode, drug-naive MDD patients emphasizes the need for comprehensive metabolic and endocrine evaluations. Regular monitoring of thyroid function, glucose levels, blood pressure, and lipid profiles is crucial for early detection and intervention, potentially improving clinical outcomes in this vulnerable group.

The role of alemtuzumab in the development of secondary autoimmunity in multiple Sclerosis: a systematic review

BackgroundSecondary autoimmune disease (SAID) in the context of alemtuzumab treatment is one of the main safety concerns that may arise following administration in people with multiple sclerosis (pwMS). Contributing factors underlying this adverse event are not well understood. The purpose of this systematic review was to appraise the literature investigating the role of alemtuzumab in the development of SAID in pwMS following treatment and identify potential biomarkers/ risk factors that may be predictive of onset of this manifestation.MethodsRelevant publications were retrieved from PubMed, Embase, and Web of Science using a three-pronged search strategy containing the following keywords: “multiple sclerosis”; “alemtuzumab”; and “autoimmunity”. Studies that fulfilled the specified eligibility criteria and investigated SAID development after alemtuzumab in pwMS were included in the final analysis.Results19 papers were included in the final review. Approximately, 47.92% of pwMS treated with alemtuzumab experienced SAID. A variety of biomarkers and risk factors were noted in the development of SAID, with a focus on immunological changes, including: increased homeostatic proliferation and T cell cycling, along with consistently elevated baseline serum IL-21 levels and thyroid autoantibodies. There was no significant association between known human leukocyte antigen (HLA) risk alleles, lymphocyte profile or dynamics and SAID development.ConclusionsWhile the mechanism underlying SAID following alemtuzumab is not fully understood, potential biomarkers and risk factors that may assist in elucidating mechanisms underlying this phenomenon have been documented in several independent studies. Following immunodepletion from alemtuzumab, an IL-21 driven increase in homeostatic proliferation and T cell cycling may disrupt tolerance mechanisms leading to an increase in the propensity toward alemtuzumab-induced autoimmunity. Further research is necessary to clarify the physiological changes after alemtuzumab therapy that trigger SAID in pwMS.

Analysis of vitamin D metabolism, thyroid and autoimmune markers in the vitiligo pathways and their possible interaction with sleep.

Vitiligo is an autoimmune skin disease that can be influenced by stress, including that resulting from sleep deprivation and sleep disturbances. Sleep is essential in the regulation of several hormonal, metabolic and autoimmune pathways that may have important roles in vitiligo. This study aimed to investigate the potential interplay between hormonal, metabolic, and autoimmune markers in vitiligo patients, and the possible influence of sleep quality in these vitiligo pathways. A cohort of 30 vitiligo patients and 26 healthy controls were assessed for various laboratory markers, including thyroid-stimulating hormone (TSH), parathyroid hormone (PTH), serum calcium, 1.25(OH)2D, 25(OH)D, anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and antinuclear antibodies (ANA). The study evaluated sleep quality using the Pittsburgh Sleep Quality Index (PSQI). Positive anti-TPO were found in the vitiligo group, but did not in the control group. Vitamin D 25(OH)D mean levels were clinically insufficient in both groups (< 30mg/dL). Reactive ANA was analyzed with 2 variables related to vitiligo: phototherapy and skin activity. No statistical correlation was found in the chi-square test on this relationship. Descriptive findings have shown that the positivity to anti-TPO and anti-TG, associated or not with reactive ANA, was higher in vitiligo group. Great part (85.7%) of vitiligo group were "poor sleepers" (PSQI > 5), which has increased (88.2%) when considering only individuals with signs of vitiligo activity. Autoimmune hypothyroidism and positive anti-TPO are expected in vitiligo, although this marker is not usually measured in the first laboratory screening to this disease. Adequate vitamin D levels may be a key adjuvant in skin pigmentation, and be related to sleep quality and immune regulation, as this vitamin can be related to better sleep and immunomodulation in autoimmune diseases. Evaluating ANA before phototherapy can be controversial, but it should be considered in cases with a poor response to this treatment, or when there is a higher risk of other autoimmune diseases. Poor sleep predominated in the vitiligo group, based on PSQI scores that reported worse subjective sleep in these patients. Worse sleep predominated in individuals with signs of skin activity and reactive autoimmune markers. Screening these components could be important in the management of vitiligo, as maintaining body homeostasis can help to improve the disease course. Sleep should be considered as a potential modulator of several multidirectional vitiligo pathways.

Association and interaction between overweight/obesity and suicide attempts in young first-episode and drug-naïve patients with major depressive disorder

AimsThis research's objective was to explore the correlation of overweight/obesity and suicide attempts in young patients with major depressive disorder (MDD) and the related factors of suicide attempts in patients with/without overweight/obesity. MethodsThis study included 520 young patients with MDD who were first-episode and drug-naïve (FEDN), with an average age of 20.50±2.36 years. Height and weight of each subject were measured, and overweight was classified as 24≤BMI<28, and obesity as BMI≥28.Biochemical indicators were detected including blood glucose, lipid, and thyroid function indicators. Depressive symptoms, anxiety symptoms, and psychotic symptoms were evaluated using Hamilton Rating Scale for Depression (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. ResultsOverweight/obesity was a separate factor influencing suicide attempts in subjects(p<0.05, OR=0.57, 95%CI: 0.34-0.95). Higher HAMD, HAMA scores, levels of total cholesterol (TC), thyroid stimulating hormone (TSH), and prevalence of thyroid peroxidase antibody abnormalities were seen in overweight/obese individuals who attempted suicide(all p values < 0.01).While in patients without overweight/obesity, those who attempted suicide had higher HAMD, HAMA, PANSS positive subscale scores, levels of TSH, fasting blood glucose, TC, blood pressure, prevalence of TSH abnormalities, and lower levels of high-density lipoprotein cholesterol(all p values < 0.01). ConclusionsIn young FEDN patients with MDD, overweight/obesity might influence the incidence of suicide attempts and related influences.

Circulating Autoantibodies in Adults with Hashimoto's Thyroiditis: New Insights from a Single-Center, Cross-Sectional Study.

Hashimoto's thyroiditis (HT) is a common autoimmune thyroid disorder characterized by elevated anti-thyroid peroxidase (A-TPO) antibodies. HT frequently coexists with other autoimmune conditions, which are marked by organ-specific and non-organ-specific autoantibodies, reflecting a deregulated immune response. However, the burden and clinical significance of these circulating autoantibodies in adult patients with HT remains unclear. A cross-sectional study was conducted at the University Hospital "R. Dulbecco" in Catanzaro, Italy, from November 2023 to May 2024, involving 200 euthyroid adults. The study population comprised 100 A-TPO-positive HT patients and 100 A-TPO-negative controls, matched for age and sex. Laboratory assessments included thyroid function tests and detection of autoantibodies [e.g., antinuclear antibodies (ANA), anti-parietal cell antibodies (APCA), and anti-neutrophil cytoplasmic antibodies (ANCA)]. Cytokine profiles were also measured using sensitive chemiluminescent multi-array technology. HT patients were predominantly female (77.0%) with a median age of 56 years. Compared to controls, HT patients had higher median thyroid stimulating hormone (TSH) levels (2.215 vs. 1.705 μIU/mL, p = 0.025). Circulating autoantibodies were more prevalent in the HT group, with higher rates of APCA positivity (16.3% vs. 4.1%, p = 0.008) and atypical ANCA positivity (27.3% vs. 10.2%, p = 0.003). This suggests an increased risk for autoimmune gastritis and systemic inflammation. Additionally, HT patients with positive atypical ANCA showed elevated inflammatory cytokines, particularly interleukin-1 alpha (IL-1α), in female patients (p = 0.035). HT is significantly associated with a higher prevalence of circulating autoantibodies, such as APCA and atypical ANCA, which may indicate a heightened risk for autoimmune gastritis and broader autoimmune involvement. Detecting these autoantibodies in HT patients could serve as markers for more severe autoimmune dysfunction. These findings emphasize the need for proactive screening, especially in older patients and those with elevated A-TPO levels. Further research is essential to better understand the clinical implications and develop targeted management strategies for these patients.

THYROID DYSFUNCTION IN PATIENTS WITH TYPE 1 DIABETES AT A TERTIARY CARE HOSPITAL

Individuals with diabetes mellitus (DM) are reporting thyroid dysfunction at an alarming rate, and there's evidence that thyroid dysfunction—whether overt or subclinical—affects overall glycaemic control. 12.3% of individuals with Type 1 DM have overt hypothyroidism, while around 24.8% of patients have abnormal thyroid autoantibody levels. Objective: This study aimed to determine Thyroid dysfunction in patients with type 1 diabetes at a tertiary care hospital. Methods: The present descriptive study was carried out at Hayatabad Medical Complex Peshawar from January 2024 to June 2024 after obtaining permission from the ethical committee of the institute. A total of 110 participants were enrolled in the study. We included all T1DM patients of both genders. All participants with T1DM visiting the OPD were screened. The primary test for assessing thyroid function was TSH, which has an acceptable range from 0.5 to 5 mIU/ml. Triiodothyronine (T3) and free thyroxin (FT4) levels were also measured. On a Cobos 6000 machine (Roche), thyroid function tests (TFTs) were performed. Data was analyzed through SPSS version 22.0. Results: A total of 110 participants of both genders of different age groups were enrolled in this study. 63.63% of them were females and 36.36% were males. 18 individuals (16.36%) had subclinical hypothyroidism, 14 individuals (12.7%) were hypothyroid, and 78 of them (70.90%) were euthyroid. We did not identify any occurrences of hyperthyroidism in current research. In comparison to the rest of the population, individuals with hypothyroidism had significantly different mean Thyroid stimulating hormone, FT4 and FT3 levels (p &lt;0.0001). The mean differences for age, the period of diabetes, randomized blood sugar (RBS), and HbA1c were not statistically significant. When the data was examined for subclinical hypothyroidism, however, there was a substantial variance for mean Thyroid stimulating hormone (p &lt;0.0001) but not for FT4 or FT3. Likewise, there was no difference seen in age (p= 0.35) or gender (p= 0.63). Conclusion: Type 1 diabetes individuals often suffer from thyroid dysfunctions particularly hypothyroidism (12.7%) and subclinical hypothyroidism (16.36%). The analysis of thyroid-stimulating hormone levels and other hormonal markers for thyroid function is the most crucial approach.

Iodine Nutritional Status and Thyroid Autoimmunity in Chinese Children and Adolescents Aged 6-17 Years.

Background: Thyroid autoimmunity (TAI), marked by thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb), affects over 10% of the general population, with children and adolescents experiencing significant impacts on growth and quality of life despite lower prevalence rates compared to adults. Methods: In the context of over 20 years of universal salt iodization (USI) in China, this study investigated the relationship between iodine nutritional status and TAI in children and adolescents aged 6-17. Results: Our findings suggest that while iodine levels are generally sufficient (median urinary iodine concentration [UIC] was 205.2 µg/L), TAI remains a significant concern due to its potential impact on growth and development. TAI was significantly associated with age, sex, and urban-rural residency (p < 0.05). Positive TPOAb and TgAb were identified as risk factors for subclinical hypothyroidism (OR = 2.274, 95% CI: 1.171-1.916). Although some literature suggests that excessive iodine may exacerbate TAI and others propose iodine deficiency as a risk factor, this study did not find a significant overall association between iodine status and TAI. Notably, a low urinary iodine-to-creatinine ratio (UI/Cr) level was linked to an increased risk of TgAb positivity in males (OR = 3.470, 95% CI: 1.200-10.036). In individuals with negative thyroid antibodies, increased BMI (OR = 1.062, 95% CI: 1.032-1.093) and high UI/Cr levels (OR = 1.510, 95% CI: 1.175-1.941) were risk factors for subclinical hypothyroidism, whereas older age (OR = 0.710, 95% CI: 0.555-0.908 for the age 9-11 group; OR = 0.681, 95% CI = 0.484-0.959 for the age 12-17 group) and high UIC levels (OR = 0.739, 95% CI: 0.554-0.985) were associated with reduced risk. No significant associations were observed in the thyroid antibody-positive group. Conclusions: These results highlight the importance of considering individual TAI status when devising iodine supplementation policies.

Autoimmune thyroiditis: an update on treatment possibilities.

Autoimmune thyroiditis (AIT) is due to an autoimmune process that destroys thyrocytes, leading to hormonal disorders. AIT is more common in women, and the aetiology is multifactorial. The destruction of thyroid cells may release free thyroid hormones into the bloodstream, causing hyperthyroid symptoms. With further destruction of thyroid cells, patients develop euthyroidism and eventually chronic hypothyroidism. The diagnosis of AIT is based on clinical symptoms, positive anti-thyroid antibodies, ultrasound, and histological features. The main goal of treatment is correcting hormonal disorders and achieving euthyroidism. Treatment of AIT involves replacing thyroid hormone deficiency with the use of synthetic hormones. Prophylactic levothyroxine (L-T4) treatment of euthyroid patients with AIT may reduce both serological and cellular markers of autoimmunisation. Attention should be paid to the starting dose of L-T4, potential drug interactions, and drug formulation. A follow-up should be planned to determine the optimal dose. The authors highlighted that a healthy lifestyle and supplementing selected vitamins and microelements appropriately are essential. In selected clinical conditions, thyroidectomy should be considered. There are also alternative therapeutic strategies, such as herbal medicine and acupuncture, but their effectiveness has yet to be conclusively confirmed in research studies. Monitoring the thyroid gland enlargement and the possibility of developing nodular goitre is integral to patient care over AIT patients. In conclusion, treating AIT is complex, involving thyroid hormone replacement therapy, taking care of a healthy diet and lifestyle, and proper supplementation. It requires an individual approach. Regular follow-up is necessary to control the disease and minimise its effects.