Blood Thyroid-stimulating Hormone Levels Research Articles

Evaluation of the relationship of digital phototrichogram findings of patients with diffuse hair loss with blood TSH, ferritin and vitamin B12 levels.

Telogen effluvium (TE) is a type of alopecia that is frequently seen in women. Among factors resulting in hair loss, many reasons such as endocrine diseases, nutrition disorders, stress, anemia, low ferritin levels, vitamin B12 deficiency, and thyroid diseases are found. A digital phototrichogram is one of the non-invasive methods of diagnosis in the evaluation of alopecia. In this study, it was aimed to compare biochemical parameters of female patients with diffuse hair loss with phototrichogram findings. 108 female patients with diffuse hair loss were included in the study. Patients were divided into two groups: acute and chronic TE, and a hair pull test was applied. Total blood count, blood biochemistry, iron, iron binding capacity, ferritin, thyroid stimulating hormone (TSH), sT3, sT4, folic acid, and vitamin B12 levels were examined. The telogen/anagen ratios and hair densities of patients were determined with a phototrichogram. The serum biochemical parameters (aspartate aminotransferase, alanine aminotransferase, urea, creatinine), TSH, sT3, sT4, and folic acid levels of patients were within normal limits. Telogen ratio, anagen ratio, hair density, number of shed hairs, family history, blood ferritin, TSH, and vitamin B12 levels were found to be similar between groups having acute and chronic TE. In our study, while mean anagen and telogen ratios with trichoscan were similar to literature data, no statistically significant correlation was determined between patients' ages and examined trichoscan findings (p>0.05). The hair pull test positivity of patients with chronic TE was higher compared to patients with acute TE (p<0.05). In patients with positive hair pull tests, the telogen ratio and hair density were found to be higher. In the group with <40 ng/mL ferritin level, the mean telogen ratio was detected to be significantly higher than the mean anagen ratio (p<0.05). No significant correlation was determined between vitamin B12 and TSH levels in patients and phototrichogram findings (p>0.05). The findings of this study showed that ferritin has an important role in diffuse hair loss, and the phototrichogram method is an auxiliary method for the physician in the diagnosis of TE.

The association of pro-oxidant/antioxidant balance and blood parameters in patients with beta-thalassemia major: a cross-sectional study.

Oxidative stress due to iron accumulation in patients with beta-thalassemia major (BTM) causes complications such as tissue damage and destruction. This study aimed to assess the association between the serum prooxidant/antioxidant balance (PAB) and blood parameters in patients with BTM. This cross-sectional study included 92 patients with BTM. In this study, PAB was measured using an enzyme-linked immunosorbent assay (ELISA). Serum ferritin, blood urea nitrogen (BUN), creatinine (Cr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), thyroid-stimulating hormone (TSH), total cholesterol (TC), triglyceride (TG), complete blood cell count (CBC), and history of blood transfusion were recorded. The association of the blood parameters was assessed across the tertiles (T) of serum PAB (highest T vs. lowest T). The results showed that high serum ferritin was directly associated with serum PAB [odds ratio (OR), 12.80; 95% confidence interval (CI), 2.98‒54.91; T3 vs. T1]. Also, direct associations were found for high TC (OR, 4.97; 95% CI, 1.42‒17.32; T3 vs. T1), high ALT (OR, 4.95; 95% CI, 1.33‒18.46; T3 vs. T1) and high TSH (OR, 3.78; 95% CI, 1.10‒13.02; T3 vs. T1). The findings of the present study showed that serum PAB levels were directly associated with ferritin, ALT, TC, and TSH levels. This indicates that improvements in blood parameters, especially ferritin and TSH levels, occur by ameliorating oxidative stress in patients with BTM.

СРАВНИТЕЛЬНАЯ ОЦЕНКА ПРОДУКЦИИ ТИРЕОТРОПНОГО ГОРМОНА, КОРТИЗОЛА И СЕРОТОНИНА КАК МАРКЕРОВ НЕЙРОЭНДОКРИННОЙ РЕГУЛЯЦИИ ПРОЦЕССОВ АДАПТАЦИИ К ОСОБЕННОСТЯМ УЧЕБНОГО ПРОЦЕССА У МАЛЬЧИКОВ – ШКОЛЬНИКОВ РАЗЛИЧНЫХ ВОЗРАСТНЫХ ГРУПП

School education is associated with the development of intellectual, neuropsychic and physical overstrain in schoolchildren, which causes the formation of the complex of adaptive reactions to changed environmental conditions. The purpose of the research was to perform a comparative assessment of the levels of thyroid-stimulating hormone, cortisol and serotonin in male schoolchildren (pupils of the Russian second pillar educational institutions) with different physical activity intensity. Materials and methods used: a single-center one-stage study with control groups was conducted in March-April 2019. The observation groups consisted of 173 boys from the secondary cadet school whose education was characterized by a prolonged and more frequent physical activity; the control groups consisted of boys from the standard secondary general education school. The four observation groups and the four corresponding control groups were formed according to the age, as follows: groups marked “1” were formed from the first-grade students solely; groups “2” - from second to fourth grades students; groups “3” - from sixth to seventh grades students; and groups “4” - from students of the nineth to eleventh grades. The levels of cortisol, serotonin (5-HT) and thyroid-stimulating hormone (TSH) were determined by enzyme immunoassay. Results: the average serum serotonin level in male schoolchildren from the observation groups of 6th to 7th and 9th to 11th grades students was significantly (p=0.002 to 0.003) - up to 1.6 times - higher than the average 5-HT level in children from the corresponding control groups; the average cortisol level in all schoolboys from cadet school was significantly (p=0.023 to 0.050) lower - by up to 1.3 times - than the values obtained in control groups (i.e. standard secondary school students); and the blood TSH levels were significantly (p=0.036 to 0.050) - about 2 times - lower in all observation groups vs. the control groups of pupils. Conclusion: the obtained results allow formulating a hypothesis of schoolboys with higher physical activity levels in transitional (7 years old) and pre-puberty ages (11 to 12 years old) within intensive adaptation processes to schooling activities having imbalance in glucocorticoid and serotonergic regulation.

Increased prevalence of thyroid dysfunction in Tehran – HAMRAH study

BackgroundThe aim of the current study is to assess the prevalence of different categories of thyroid dysfunction and their associated risk factors among the modern urban population of Tehran, the capital of Iran.MethodsThe present investigation is a sub-study of the HAMRAH study, a population-based prospective study designed to assess the prevalence of traditional cardiovascular risk factors and their changes through a 10-year follow-up. 2228 (61% female) adults aged between 30 and 75 years old and with no overt cardiovascular diseases were selected through a multistage cluster randomized sampling. Blood levels of thyroid-stimulating hormone (TSH), thyroxin (T4), and triiodothyronine (T3) were measured with the aim of assessing the prevalence of abnormal thyroid function status among the modern urban Iranian population, and in order to report the total prevalence of participants with clinical hypo- or hyperthyroidism, the number of individuals taking thyroid-related drugs were added to the ones with overt thyroid dysfunction. A subgroup analysis was also performed to determine the associated risk factors of thyroid dysfunction.ResultsThe prevalence of thyroid dysfunction among the total population was 7% (95%CI: 5.9 − 8%) and 0.4% (95% CI: 0.1 − 0.6%) for subclinical and overt hypothyroidism, and 1.6% (95% CI: 1 − 2%) and 0.2% (95% CI: 0 − 0.3%) for subclinical and overt hyperthyroidism, respectively. Clinical thyroid dysfunction was detected in 10.3% of the study population (9.4% had clinical hypo- and 0.9% had clinical hyperthyroidism). In the subgroup analysis, thyroid dysfunction was significantly more prevalent among the female participants (P-value = 0.029).ConclusionsIn the current study, the prevalence of different categories of abnormal thyroid status, and also the rate of clinical hypo- and hyperthyroidism was assessed using the data collected from the first phase of the HAMRAH Study. In this study, we detected a higher prevalence of clinical and subclinical hypothyroidism among the Iranian population compared to the previous studies.

Results of neonatal screening for congenital hypothyroidism and hyperphenylalaninemia in Zhejiang province from 1999 to 2022.

To analyze the results of neonatal screening for congenital hypothyroidism (CH) and hyperphenylalaninemia (HPA) in Zhejiang province from 1999 to 2022. A total of 11 922 318 newborns were screened from September 1999 and December 2022 in Zhejiang province. The blood thyroid stimulating hormone (TSH) levels were measured by a fluorescence method and blood phenylalanine (Phe) levels were measured by fluorescence method or tandem mass spectrometry. TSH≥9 μIU/mL was considered positive for CH, while Phe>120 μmol/L and/or Phe/Tyr ratio>2.0 were considered positive for HPA. The positive newborns in screening were recalled, and the gene variations were detected by high-throughput sequencing and MassARRAY tests. The overall neonatal screening rate during 1999-2022 was 89.41% (11 922 318/13 333 929) and the screening rate was increased from 6.46% in 1999 to 100.0% in 2022. A total of 8924 cases of CH were diagnosed among screened newborns with an incidence rate of 1/1336. A total of 563 cases of HPA were diagnosed, including 508 cases of classic phenylketonuria (cPKU) and 55 cases of tetrahydrobiopterin deficiency (BH4D), with an incidence rate of 1/21 176. Ninety-seven out of 8924 cases of CH underwent genetic analysis. Gene mutations were detected in 9 CH related genes, the highest frequency mutations were found in DUOX2 gene (69.0%) with c.3329G>A (p.R1110Q) (18.2%) and c.1588A>T (p.K530X) (17.3%) as the hotspot mutations. There were 81 PAH gene variants detected in a total of 250 cases of cPKU, and c728G>A (p.R243Q) (24.4%), c.721C>T (p.R241C) (15.0%) were the hotspot mutations. Meanwhile 7 novel variants in PAH gene were detected: c.107C>A (p.S36*), c.137G>T (p.G46V), c.148A>G(p.K50E), c.285C>T (p.I95I), c.843-10delTTCC, exon4-7del and c.1066-2A>G. There were 12 PTS gene variants detected in 36 cases of BH4D, and c.259C>T (p.P87S) (31.9%) was the hotspot mutation. The incident of CH has increased from 1999 to 2022 in Zhejiang province, and it is higher than that of national and global levels; while the incidence of HPA is similar to the national average. DUOX2 gene variation is the most common in CH patients; c.728G>A (p.R243Q) is the hotspot mutation in cPKU patients, while c.259C>T (p.P87S) is the hotspot mutation in BH4D patients.

SAT467 Monitoring TSH Over Time May Not Be Necessary in Patients With Thyroid Nodules

Abstract Disclosure: S. Kaul: None. A. Gupta: None. Introduction: A substantial number of patients with thyroid nodules receive monitoring of blood thyroid stimulating hormone (TSH) levels after the initial diagnosis. There is not enough literature supporting long-term monitoring of blood TSH levels in these patients with thyroid nodules. The objective of this study was to evaluate the change in blood TSH level in patients with known thyroid nodules over time and to determine if repeat blood TSH testing is required in these patients. We hypothesized that monitoring of blood TSH level is not warranted in patients with thyroid nodules in the absence of a history of medical conditions or medications that are known to affect thyroid hormone levels. Methods: We studied 100 patients aged 18 to 99 years at the Dayton VA Medical Center with at least one thyroid nodule on imaging studies from January 2010 to December 2016 with normal blood TSH level at time of the diagnosis of the thyroid nodule. Subjects with abnormal thyroid hormone level, history of hot thyroid nodule, autoimmune thyroid disease (on imaging or blood work), thyroid or pituitary surgery, radioactive iodine treatment, neck irradiation, or usage of thyroxine or any other medications known to affect thyroid hormone levels were excluded. Blood TSH level at the time of diagnosis of thyroid nodule and after were retrospectively studied and analyzed for 100 subjects. Normal blood TSH level range at time of diagnosis was noted to be 0.35-5.50 uIU/mL or 0.35-4.00 uIU/mL depending on the assay method used. Normal repeat blood TSH level range was noted to be 0.35-5.50 uIU/mL, 0.35-4.00 uIU/mL, or 0.55-4.78 uIU/mL depending on the assay method used. Results: 100 subjects with normal blood TSH at the time of diagnosis of their thyroid nodule had blood TSH level monitoring for an average time period of 5.74 years. Out of the 100, six subjects (6%, 95% CI [2.52%, 12.73%]) developed an abnormal blood TSH level in a mean time period of 6.94 years. One subject’s initial blood TSH level increased from 3.38 uIU/mL to 7.76 uIU/mL after 8.52 years. This subject did not receive treatment with thyroxine. In the other five subjects, blood TSH level decreased to below normal range in a mean time period of 6.63 years and ranged from 0.25-0.52 uIU/mL. Blood TSH level remained within normal range for 94 subjects in a mean time period of 5.67 years. Conclusion: Monitoring of blood TSH level over time may not be required in most patients with thyroid nodules in the absence of symptoms, medical conditions, or medications that are known to affect thyroid hormone levels. Presentation Date: Saturday, June 17, 2023

Association Between Thyroid-Stimulating Hormone Level and Bell's Palsy.

To investigate whether dysregulated thyroid hormone function is associated with Bell's palsy. Cross-sectional. Electronic medical record database of Clalit Health Services (CHS). CHS is an Israeli payer-provider, integrated health care system, serving >4.5 million members (54% of the Israeli population). Older than 18 years with Bell's palsy, during 2002 to 2019. None. A total of 1,374 patients with Bell's palsy who had thyroid-stimulating hormone (TSH) blood levels measured up to 60 days before the palsy were matched (1:2) for age and sex with 2,748 controls who had TSH blood levels and no history of Bell's palsy. Retrospective review of the CHS database, from 2002 to 2019 yielded 11,268 patients with Bell's palsy, of which, 1,374 met the inclusion criteria. Mean age was 57.9 years, and 61.4% were female. A higher percentage of patients in the Bell's palsy group had low TSH (≤0.55 mIU/L) compared with controls (5.7% vs. 3.6%, p < 0.001). Low TSH compared with TSH > 0.55 mIU/L, was independently associated with 1.45-fold increased odds for having Bell's palsy (95% CI 1.11-2.02, p < 0.001), when controlled for age, sex, body mass index, diabetes, hypertension, prior cerebrovascular accident, hemoglobin level, and purchasing thyroid hormone drugs. Among the patients with TSH ≤ 0.55 mIU/L, 95.5% had normal free thyroxin and 97.7% had normal free triiodothyronine levels (subclinical hyperthyroidism). For 47.1% of patients, TSH remained ≤0.55 mIU/L, 3 to 12 months after the Bell's palsy occurred and most patients had normal free thyroxin (95.4%) and normal free triiodothyronine (91.8%). Subclinical hyperthyroidism is independently associated with Bell's palsy after controlling for multiple confounding factors.

Postoperative hypothyroidism and body weight dynamics in patients operated on for diffuse toxic goiter

Postoperative hypothyroidism is a consequence of thyroidectomy. However, observation of patients with diffuse toxic goiter (DTG) after thyroidectomy shows that achieving euthyroidism while taking L-thyroxine, as well as maintaining weight in some cases, is difficult or not possible at all. Thus, the study of thyroid function and body weight dynamics in the first year after thyroidectomy remains an urgent task of clinical thyroidology.Aim. To study thyroid function and body weight dynamics in patients with DTG after various types of surgical treatment.Material and methods. The study included 310 patients with DTG (234 women — 75,5% and 76 men — 24,5%), the average age was 46,46±0,99 years. In all patients with DTG before surgery, after 1 month and 1 year after the operation, the results of hormonal examination (levels of thyroid-stimulating hormone (TSH), free T4), body weight dynamics were evaluated. Levels of TSH and free T4 was determined by enzyme immunoassay. To assess the dynamics of body weight one year after the operation, depending on the change in weight, the patients were divided into 3 groups: group 1 — body weight decreased by more than 5%; group 2 — body weight did not change; group 3 — body weight increased by more than 5%. Statistical analysis of the study results was performed using the SPSS 16.0 program (SPSS Inc., USA).Results. Before surgical treatment, blood TSH levels were normal in all patients, and there were no differences between the groups (p=0,94). In patients after subtotal resection, the average level of TSH in the blood after 1 month. after surgery was significantly higher (p=0,02) than in patients who underwent extirpation of the thyroid gland (TG). Blood TSH was monitored in all patients 1 year after surgery. In patients with thyroid extirpation, the level of TSH in the blood was significantly higher compared to patients who underwent organ-preserving surgery (p=0,01).Next, the body mass index (BMI) was analyzed in the examined groups of patients. When analyzing the BMI of patients before and after surgery, there were no significant differences in both groups: group 1 — before surgery BMI 25,67±0,57 kg/m2, after surgery 25,87±0,60 kg/m2; group 2 — before surgery BMI 25,13±0,40 kg/m2, after surgery 25,67±0,46 kg/m2. In group 1, there was a decrease in weight after surgery during the first year in 14,9% of patients, while in group 2 only in 7,2% of patients (p=0,01). Weight gain was high in both groups: in group 1 — 20,7%, in group 2 — 29,0%, but in the group after thyroidectomy was significantly higher (p=0,04). In patients with weight gain, a positive correlation was found between weight gain during the year and blood TSH 1 year after surgery (p=0,02, r=0,247).Conclusion. The obtained results suggest that after thyroidectomy performed for DTG, patients have a significantly greater increase in BMI and uncompensated hypothyroidism is more common than in patients after subtotal resection of the thyroid gland.

Association between gestational blood lipids and TSH levels and pregnancy outcome of patients with subclinical hypothyroidism.

To investigate the association between gestational blood lipids and thyroid stimulating hormone (TSH) levels and pregnancy outcomes of patients with subclinical hypothyroidism (SCH). In this retrospective observational study, we analyzed the clinical data of 82 patients (case group) with gestational SCH treated in our hospital from January 2021 to January 2022 at gestational weeks 25-33 and grouped them according to whether SCH was well controlled by treatment (case Group-A: well controlled, n=55; case Group-B: poorly controlled, n=27), and the clinical data of 41 pregnant women (control group) undergoing physical examination during the same period. After comparing the blood lipids and TSH levels of the three groups, we compared their adverse pregnancy outcomes to assess the possible correlations between blood lipids and TSH levels and pregnancy outcomes. The levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and TSH in the case Group-B were significantly higher than those in the case Group-A and the control group (P<0.05). Compared with case Group-B and the control group, the incidence of premature delivery, abortion and neonatal growth restriction was higher in case Group-A (P<0.05). Among 82 patients in the case group 42 presented adverse pregnancy outcomes. The levels of TC, TG, LDL-C and TSH in mothers and infants in the adverse outcome group were significantly higher than those in the favorable outcome group (P<0.05). Our Pearson analysis results showed that the levels of TC, TG and LDL-C were positively correlated with the TSH levels and the pregnancy outcomes, and that TSH was positively correlated with pregnancy outcomes (P<0.05). The levels of TC, TG, LDL-C and TSH in patients with poorly controlled SCH were increased during pregnancy, and were associated with the pregnancy outcomes and positively correlated with each other.

Effect of perinatal factors on cord blood thyroid stimulating hormone levels

Background: Screening for congenital hypothyroidism (CH) is a routine practice in most developed countries of the world. This can be done by measuring cord blood thyroid stimulating hormone (CBTSH). Apart from foetal thyroid status and iodine nutrition status of the population, many perinatal factors may also affect CBTSH. The influence of these perinatal factors may affect the sensitivity of CBTSH as a screening tool for CH. The present study was carried out to study the influence of various perinatal factors on CBTSH level. Methods: It was a cross sectional study conducted in tertiary care centre in North Maharashtra. 793 new-borns were included in study. Effects of perinatal factors like maternal age, parity, gender of the baby, birth weight, mode of delivery, gestational age, birth asphyxia on CBTSH was analysed with appropriate scientific method. Results: The mean TSH level in the study group was 7.56±3.9 mIU/l. Among the associated factors vaginal delivery, low gestational age, low birth weight and birth asphyxia were significantly associated with elevated CBTSH values. Hence, any rise in cord blood TSH should be seen in the light of these factors. Conclusions: Among all the associated factors, primi-parity, vaginal delivery, low gestational age, low birth weight and birth asphyxia were significantly associated with elevated CBTSH values. However, no association was observed between CBTSH values and gender of the baby and maternal age.

Indicator of thyroid hormones in newborns from mothers with diffuse-endemic goiter

Introduction. Pathologies of thyroid dysfunction associated with iodine deficiency remain one of the urgent problems throughout the world and are mainly associated with natural iodine deficiency in places where about 30% of the world’s population lives.Objective. Study of the dynamics of thyroid hormones in infants born from mothers with diffuse endemic goiter.Materials and methods. A retrospective study of 68 infants from mothers with diffuse endemic goiter (DEG) was carried out. Research methods included: analysis of anamnestic data, palpation, and ultrasound in mothers, with a study of the level of thyroid hormone in newborns and parturient women.Results. Infants from mothers with DEG have characteristic changes in the level of thyroid hormones in the blood, in particular, in the cord blood, the level of thyroid-stimulating hormone (TSH) is 22.4% higher than in the control group (p &lt; 0.05). The difference between free triiodothyronine (T3) and thyroxine (T4) is on average lower by 8.6% and 4.3%, respectively, (p &lt; 0.05 and p &lt; 0.1). On the 3rd day of life, these fluctuations persist, and the level of TSH in the peripheral blood exceeded up to 20.9%, but there were no pronounced clinical signs of congenital pathology associated with the thyroid gland. At the same time, in the first months of life in infants, there is a lag in weight gain by an average of 9.6% about practically healthy newborns.Conclusion. In infants born to mothers with DEG, there is an increase in the umbilical blood level of TSH up to 22.4% about practically healthy newborns, with a simultaneous decrease in T4 to 4.3%, T3 to 8.6%, without pronounced clinical signs of congenital pathology. In these children, in the first months of life, there is a lag in physiological weight gain of up to 9.6%, which should be taken into account when managing children in an outpatient setting.

Associations between Early Thyroid-Stimulating Hormone Levels and Morbidities in Extremely Preterm Neonates

Introduction: High-end cutoffs of thyroid-stimulating hormone (TSH) have been emphasized for hypothyroidism therapy in extremely preterm infants, but the significance of low TSH levels remains unknown. This study hypothesized that the spectrum of TSH levels by newborn screening after birth signifies specific morbidities in extremely preterm neonates. Methods: The multicenter population cohort analyzed 434 extremely preterm neonates receiving TSH screening at 24–96 h of age in 2008–2019. Neonates were categorized by blood TSH levels into group 1: TSH <0.5 µU/mL, group 2: 0.5 ≤ TSH <2 µU/mL, group 3: 2 ≤ TSH <4 µU/mL, and group 4: TSH ≥4 µU/mL. Neonatal morbidities were categorized using the modified Neonatal Therapeutic Intervention Scoring System. Results: The four groups differed in gestational age, birth weight, and the postnatal age at blood sampling so did the proportions of mechanical ventilation usage (p = 0.01), hypoxic respiratory failure (p = 0.005), high-grade intraventricular hemorrhage (p = 0.007), and periventricular leukomalacia (p = 0.048). Group 1 had higher severity scores for respiratory distress syndrome (RDS; effect size 0.39 [95% confidence interval [CI]: 0.18–0.59]) and brain injury (0.36 [0.15–0.57]) than group 2, which remained significant after adjusting for gestational age, birth weight, dopamine usage, and the postnatal age at TSH screening (RDS: mean + 0.45 points [95% CI: 0.11–0.79]; brain injury: +0.32 [0.11–0.54]). Conclusions: Low TSH levels in extremely preterm neonates are associated with severe RDS and brain injuries. Studies recruiting more neonates with complete thyroid function data are necessary to understand central-peripheral interactions of the hypothalamic-pituitary-thyroid axis.

The effect of thyroid dysfunction on breast cancer risk: an updated meta-analysis.

In a previous systematic review and meta-analysis of studies reporting associations between hyper-/hypothyroidism and breast cancer incidence published through 29 January 2019, we identified a higher risk with diagnosed hyperthyroidism compared to euthyroidism, but no association with diagnosed hypothyroidism. This 2-year updated meta-analysis aims to investigate the role of menopause in this association and the dose-response relationship with blood levels of thyroid-stimulating hormone (TSH) and thyroid hormones. After the exclusion of studies with only mortality follow-up, with thyroid dysfunction evaluated as a cancer biomarker or after prior breast cancer diagnosis, we reviewed 25 studies that were published up to 01 December 2021 and identified in MEDLINE, the COCHRANE library, Embase, or Web of Science; of these, 9 were included in the previous meta-analysis. Risk estimates from 22 of the 25 studies were included in the meta-analysis and pooled using random-effects models. Compared to euthyroidism, hyperthyroidism and hypothyroidism diagnoses were associated with higher (pooled risk ratio (RR): 1.12, 95% CI: 1.06-1.18, 3829 exposed cases) and lower risks (RR = 0.93, 95% CI: 0.86-1.00, 5632 exposed cases) of breast cancer, respectively. The increased risk after hyperthyroidism was greater among postmenopausal women (RR = 1.19, 95% CI 1.09-1.30) and the decreased risk after hypothyroidism was more pronounced among premenopausal women (RR = 0.69, 95% CI 0.53-0.89). Among women with no prior history of thyroid disease, every 1 mIU/L increase in TSH level was associated with a 0.8% (95% CI > 0-1.5%) lower risk of breast cancer. In conclusion, this meta-analysis supports an association between thyroid hormone levels and breast cancer risk, which could be modified by menopausal status.

Effect of Maternal Triclosan Exposure on Neonatal Thyroid-Stimulating Hormone Levels: A Cross-Sectional Study.

Objective This study is aimed at assessing the relationship between maternal urinary triclosan (uTCS) exposure and the thyroid-stimulating hormone (TSH) level of infant cord blood. Methods This cross-sectional study was carried out in 2019-2020 in Isfahan, Iran, and 99 pregnant women participated in the study. Urine samples were collected after the 28th week of pregnancy, and the concentration of TCS was measured using GC/MS. The cord blood levels of TSH (CBL-TSH) were measured. The association between uTCS and CBL-TSH was examined based on the general linear model. Results TCS was detected (≥0.01 ng/mL) in 100% of the urine samples, with the interquartile range (25%-75%) of uTCS levels 0.6-6.23 μg/g Cr. uTCS was not associated with CBL-TSH after adjustment for covariates. A significant relationship was observed between CBL-TSH of neonates born to mothers who had given birth only once compared to mothers who had given birth twice or more times. Conclusions Maternal exposure to TCS did not affect the infant CBL-TSH. However, the high concentrations of TCS in maternal urinary samples indicate the necessity of more precise regulations to decrease the use of this chemical in the industry and increase public awareness about using TCS-free compounds.

Evaluation of the Anti-Inflammatory Impact of Vitamin D on Polycystic Ovary Syndrome and Endometriosis

Objective: Although numerous studies demonstrate the link between vitamin D and its anti-inflammatory effects, the correlations could not be fully explained. Platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) are investigated as biomarkers for diagnosis and follow-up in various obstetrics and gynecological studies. We aimed to evaluate the correlation between the anti-inflammatory effect of vitamin D and inflammatory parameters NLR and PLR in women with polycystic ovary syndrome (PCOS) and endometriosis. Materials and Methods: Serum 25-hydroxy vitamin D (25(OH)D) levels, complete blood count (CBC) parameters, NLR, PLR, Vitamin B12, and thyroid stimulating hormone (TSH) levels of 140 patients who applied to the Department of Obstetrics and Gynecology between 2010-2019 were evaluated. In our study, the levels of 25(OH)D, TSH, vitamin B12 and CBC measurements were analyzed simultaneously. SPSS 22.0 Windows version software was utilized in the data analysis, and p&lt;0.05 was accepted as statistical significance level. Results: There were significant differences in NLR (p=0.026) and lymphocytes count between PCOS and endometriosis groups (p=0.010). When we examined PCOS and endometriosis patients as a patient group; according to 25(OH)D vitamin levels, we found that NLR was significantly higher in the group with 25(OH)D vitamin levels below 20 ng/ml (p=0.017), vit B12 levels were significantly lower (p=0.034). Bivariate correlation analysis showed that vitamin D was negatively correlated with NLR (r=-0.196, p=0.050) in the patients with PCOS but not with endometriosis. Conclusion: This retrospective study assessed the association between vitamin D levels and the new inflammation biomarkers in patients with PCOS and endometriosis. The CBC and neutrophil/lymphocyte ratios are accessible and easily measurable biomarkers, therefore, evaluating the anti-inflammatory effect of vitamin D together with NLR is valuable for both PCOS and endometriosis.

Response to iodine supplementation in the growth and quality of Texel lamb meat

Iodine deficiency determines reproductive problems especially in the production of thyroid hormone, affecting the functions that thyroidal hormones regulate, such as energy metabolism, thermoregulation, reproduction, growth, muscle and bone tissue function. Indeed a certain concentration of iodine in the diet can promote performance in production in terms of fattening and growth. The main goal of the work was the supplementation with iodine salt from weaning to work on the production and quality of carcass and meat of early lambs of the Texel breed. Three random groups were formed. In one group, iodine salt was administered daily individually, in another group salt without iodine and finally a third "control" group without salt aggregate. All these animals were fed on natural field with an energy-protein supplement. The weaning weight and its evolution (daily gain) were determined, fortnightly until the work weight (35 kg) was reached. Blood levels of thyroid-stimulating hormone (TSH) and Selenium (Se) were evaluated. In the carcass were measured the hot and cold carcass weight, pH, colour; GR point and in the meat tenderness will be determined in the Longissimus dorsi muscle. Se concentrations, neutral detergent fiber, crude protein and iodine in pastures were also determined. The results show that no significant differences were found for any of the characters measured.

Preoperative thyroid-stimulating hormone associated risk of differentiated thyroid cancer in patients with thyroid nodules.

In an assessment of risk for differentiated thyroid cancer (DTC) in individuals with human papillary thyroid cancer (PTC) and thyroid nodules a cohort prospective study was undertaken to establish the significance of preoperative thyroid-stimulating hormone (TSH) levels. Confirmed histologically PTC cases in one tertiary care center, and matched healthy individuals were tested for TSH, T3, T4 and T4 free total. The ORs and 95% confidence intervals have been calculated using conditional logistic regression models (CI). The blood TSH levels were related to the higher risk of PTC for men (OR,0,09; 95% Ci, 04-0,21, 95% CI and women) compared with the middle tertile of the TSH levels in the normal range (OR,0,07; 95 percent CI, 0,04-0,1). Over the normal range of TSH levels, an elevated PTC risks were connected amongst women (OR 0,09; 95% CI, 0,04-0,21) but not amongst men (OR,0,07; 95% CI, 0,04-0,1). With an increase in TSH level in the normal range between men and women, the risk for PTC reduced (Ptrend=0.041 and 0.0001). The risk of PTC related to TSH levels has been dramatically elevated above the normal range for men and TSH values below the normal range for women.

Клінічне дослідження ефективності сублінгвальної рідкої форми силденафілу вітчизняного виробництва в пацієнтів із легеневою гіпертензією

Актуальність. Останнім часом все більше світових експертів у галузі кардіології почали звертати увагу на проблему ведення пацієнтів із легеневою артеріальною гіпертензією (ЛАГ). Згідно із сучасними рекомендаціями пацієнтам із ЛАГ слід призначати препарати специфічної терапії одразу після встановлення діагнозу. Одним із найбільш вивчених препаратів для лікування ЛАГ є перший з інгібіторів фосфодіестерази-5 — силденафіл. Метою даного дослідження було довести еквівалентність терапевтичного ефекту рідкої сублінгвальної форми силденафілу вітчизняного виробництва у хворих на ЛАГ ефекту силденафілу імпортного виробництва. Матеріали та методи. У дослідження включили 30 стабільних пацієнтів із ЛАГ. Критеріями включення були підтверджена ЛАГ, при якій показано призначення специфічної терапії, та відсутність критеріїв виключення. Період спостереження становив 6 місяців, під час якого було заплановано 3 візити: 1-й візит — скринінг, 2-й — через 3 місяці терапії, 3-й — фінальний, через 6 місяців від початку лікування. Усім пацієнтам на початку та при кожному візиті дослідження проводили фізикальний огляд, збір скарг та анамнезу хвороби, оцінку супутньої терапії, прихильності до терапії та наявності побічних ефектів, вимірювання офісних систолічного, діастолічного артеріального тисків і частоти серцевих скорочень, тест 6-хвилинної ходьби, лабораторні дослідження N-термінального натрійуретичного пропептиду (NTpro-BNP), рівня тиреотропного гормона крові та концентрації феритину, ехокардіографію, вимірювання індексу CAVI (Cardio-Ankle Vascular Index) та гомілково-плечового індексу. На першому візиті пацієнтів переводили на сублінгвальну рідку форму силденафілу вітчизняного виробництва. Результати. У дослідження було включено більше жінок (76,7 %), середній вік яких становив 39,80 ± 2,17 року, 13,3 % хворих були з ідіопатичною ЛАГ, 3,3 % — з ЛАГ, асоційованою з портальною гіпертензією, 70 % — із ЛАГ, асоційованою із вродженими вадами серця, 13,3 % — із ЛАГ, асоційованою із хронічною тромбоемболічною хворобою серця, у середньому у всіх був ІІ функціональний клас за даними Всесвітньої організації охорони здоров’я. До моменту включення в дослідження 93,3 % пацієнтів приймали таблетовану форму силденафілу. Середній рівень NTpro-BNP на момент включення становив 310,90 ± 66,25 пг/мл, розрахунковий рівень систолічного тиску в легеневій артерії (СТЛА) — 89,21 ± 4,46 мм рт.ст. Після 3 та 6 місяців терапії ми не спостерігали жодної достовірної динаміки офісних систолічного, діастолічного артеріального тиску і частоти серцевих скорочень. Через 6 місяців терапії не відбулося достовірних змін показників, окрім гомілково-плечевого індексу справа, що був дещо знижений на початку дослідження. За динамікою показників тесту 6-хвилинної ходьби також не було виявлено ніякої достовірної зміни. Оцінивши динаміку показників ехокардіографії, ми виявили достовірне, хоча відносно й невелике зниження рівня СТЛА — на 9 мм рт.ст. (р = 0,043), а також достовірне покращання геометрії лівого шлуночка — зменшення індексу ексцентричності лівого шлуночка в систолу на приблизно 8 % (р = 0,006). Ми не спостерігали значних побічних ефектів терапії препаратом, що досліджували, окрім незначного: відчуття неприємного смаку в роті після прийому препарату у 2 пацієнтів, що, однак, не призвело до відміни препарату. ­Висновки. Застосування сублінгвальної форми силденафілу вітчизняного виробництва протягом шести місяців замість таблетованої форми силденафілу імпортного виробництва не викликало клінічного погіршення, збільшення частоти госпіталізацій, забезпечувало стабільні функціональні можливості на фоні серцевої недостатності і добре переносилося хворими з ЛАГ. На фоні шестимісячного лікування спостерігалося покращання показників ехокардіографії: достовірне зниження розрахункового СТЛА на 9 мм рт.ст. (р = 0,043) та індексу ексцентричності лівого шлуночка в систолу приблизно на 8 % (р = 0,006).

Effect of Mode of Delivery on Cord Blood Thyroid Stimulating Hormone Levels- A Cross-sectional Study

Introduction: Cord Blood Thyroid Stimulating Hormone (CBTSH) level estimation is an accepted screening tool for Congenital Hypothyroidism (CH). CBTSH levels are affected by many perinatal factors including mode of delivery. Previous studies have shown conflicting results on effect of mode of delivery of CBTSH levels. Aim: To study CBTSH profile in neonates born at tertiary care referral centre and to analyse the influence of mode of delivery (vaginal vs caesarean) on CBTSH levels. Materials and Methods: This was a cross-sectional study conducted at Mahatma Gandhi Medical College and Hospital from February 2014 to August 2015. Study population included 856 neonates (males=437, females=419). The CBTSH levels were estimated using Electrochemiluminescence Immunoassay ‘ECLIA’ on the Elecsys 2010 analyser. CBTSH levels between vaginally delivered and caesarean section born babies were compared. The values were tabulated as mean and statistically analysed using Statistical Package for the Social Sciences (SPSS) software version 21. Results: Mean CBTSH level of vaginally born neonates were 9.59 (median 7.0) in comparison to 9.11 (median 7.15) in caesarean born babies, this difference was not statistically significant. Conclusion: As per the present study finding mode of delivery did not have any significant effect on CBTSH levels.

Rhinitis in patients with acquired hypothyroidism.

Our aim was to evaluate the rhinological changes during hypothyroid and euthyroid periods in patients with acquired hypothyroidism. The newly diagnosed 40 adult patients with hypothyroidism who presented to the Endocrinology clinic at a tertiary hospital were enrolled in the study. Patients having blood thyroid-stimulating hormone levels greater than 4.95IU/dl were consulted to the ENT clinic. Nasal Obstruction Symptom Evaluation scores, Peak Nasal Inspiratory Flow rates and nasalmucociliary clearancetime of patients were noted before and 4months after the oral levothyroxine sodium tablet treatment. Of the patients included in the study, 34 (85%) were females and 6 (15%) were males. The mean thyroid-stimulating hormone values before the treatment was 10.01 ± 3.31IU/dl and 4.03 ± 2.45IU/dl at the end of the treatment. The difference in values was statistically significant (p < 0.001). The mean mucociliary clearancetime before treatment was 8.03 ± 3.29min and 7.35 ± 2.87min at the end of treatment. The decrease in mucociliary clearancetime was statistically significant (p = 0.001). We did not detect any significant difference between pre- and posttreatment values of nasal obstruction symptom evaluation scores and peak nasal inspiratory flow rates. The patients with hypothyroidism have prolonged mucociliary clearance time in hypothyroid period of the disease. Regarding to this data, we may recommend clinicians to follow-up these patients more closely for respiratory tract diseases and sinonasal infections.