Changes In Thyroid Function Research Articles

Association between thyroid function and lipid profiles, apolipoproteins, and high-density lipoprotein function

Thyroid hormone regulates lipid metabolism. In particular, it has been reported to regulate plasma high-density lipoprotein cholesterol (HDL-C) levels and the activity of molecules involved in HDL metabolism. We investigated changes in the concentrations of lipids and apolipoproteins and in the function of HDL according to acute dynamic changes in thyroid function. Concentrations of plasma lipids and apolipoproteins, paraoxonase-1 activity, and cholesterol efflux were measured in 27 patients with differentiated thyroid carcinoma who underwent total thyroidectomy and radioactive iodine (RAI) treatment, at 3 distinct times: After surgery (baseline subclinical hyperthyroid state), on the day of undergoing RAI treatment (overt hypothyroid state), and 3 months post-RAI treatment (subclinical hyperthyroid state). The mean free T4 and thyroid-stimulating hormone concentrations were 0.24±0.06ng/dL and 91.2 (77.8-118.2) μIU/mL, respectively, on the day of RAI treatment. Total cholesterol, triglyceride, low-density lipoprotein cholesterol, and apoB levels, and the apoA-I/II ratio were significantly increased in the overt hypothyroid state and recovered to baseline values with levothyroxine replacement. HDL-C and apoE levels were persistently elevated despite levothyroxine replacement. Paraoxonase-1 activity, corrected for apoA-I, decreased in the overt hypothyroid state but recovered with levothyroxine replacement (P=.009). Cholesterol efflux also decreased significantly in the overt hypothyroid state (21.5±5.1% vs 18.9±2.9%, P=.005), but remained low despite recovery of thyroid function. Changes in thyroid function are associated not only with changes in the concentrations of various plasma lipid components but also with changes in HDL function.

Ultrasound-guided microwave ablation in the treatment of benign thyroid nodules in 435 patients.

The objective of the present study was to investigate the effectiveness and safety of ultrasound-guided microwave ablation in the treatment of benign thyroid nodules. A total of 474 benign thyroid nodules in 435 patients who underwent ultrasound-guided microwave ablation from September 2012 to August 2015 were included. Nodule volume and thyroid function were measured before treatment and at 1, 3, 6, and 12 months and subsequently after every 6 months. The nodule volume reduction rate and changes of thyroid function were evaluated. The volume of all thyroid nodules significantly decreased after ultrasound-guided microwave ablation. The average volume was 13.07 ± 0.95 ml before treatment, and 1.14 ± 0.26 ml at 12-months follow-up. The mean volume reduction rate was 90% and the final volume reduction rate was 94%. The volume reduction rate of mainly cystic nodules was significantly higher than that of simple solid and mainly solid nodules (all P < 0.05). The pretreatment volume of nodules was positively correlated with the final volume reduction rate at final follow-up ( P = 0.004). No serious complications were observed after treatment. In conclusion, ultrasound-guided microwave ablation is an effective and safe technique for treatment of benign thyroid nodules, and has the potential for clinical applications. Impact statement Ultrasound-guided MWA is an effective and safe technique for the treatment of benign thyroid nodules. It can significantly reduce the nodule volume, improve the patients' clinical symptoms, has less complication, guarantees quick recovery, meets patients' aesthetic needs, and shows less interference on the physiological and psychological aspects of the body. MWA should be a good complement to traditional open surgery and has potentials in clinical applications.

Changes of thyroid stimulating antibody and thyroid stimulating blocking antibody in treatment of anti-thyroid drugs and combining with levothyrocine to hyperthyroidism

Objective Changes of thyroid stimulating antibody(TSAb) and thyroid stimulating blocking antibody(TSBAb) in the treatment of anti-thyroid drugs(ATDs), and the effect of ATDs combining with levothyrocine(LT4) on TSAb and TSBAb were analyzed. Methods Using recombinant Trxfus. TSHRn protein and Trxfus. TSHRc protein as antigens, and TSH receptor antibody(TRAb)-N(TSAb binding hot spots), TRAb-C(TSBAb binding hot spots)in the serum of thyroid disease patients were measured with ELISA. The changes of TRAb-N, TRAb-C over 36 months in 117 TRAb-N positive Graves′ patients with hyperthyroidism were analyzed retrospectively. In the course of treatment, 41 cases as A group with ATDs and LT4 treatment, 76 cases as B group with only ATDs, The changes of TRAb-N and TRAb-C were observed in the two groups. Results (1)According to the change of TRAb-N, 117 TRAb-N positive Graves′ patients with hyperthyroidism were different. In group Ⅰ, 10 patients continued to have persistently positive TSAb and continued to have hyperthyroidism, remission rate 0%. In group Ⅱ, 17 patients showed complicated TRAb-N changes, 12 of 17 patients got relapse, 5 of 17 patients got remission, remission rate 29.4%. And in group Ⅲ, with TRAb-N dropping gradually, 15 of 89 patients got relapse, 74 of the 89 patients got remission, remission rate 83.1%. Three groups were significantly different with χ2 test(P 0.05). Conclusion TSAb and TSBAb can be used to document TRAb-function, which is significant for us to predict the changes of thyroid function. During ATDs treatment, the temporary early low-dose application of LT4 did not significantly affect TSAb and TSBAb. (Chin J Endocrinol Metab, 2017, 33: 662-667) Key words: Anti-thyroid drugs; Levothyrocine; Thyroid stimulating antibody; Thyroid stimulating blocking antibody

TSH-independent release of thyroid hormones through cold exposure in aging rats.

Thyroid function decreases and cold exposure response becomes impaired with increasing age. We investigated the age-related changes in thyroid structure and function and cold-induced changes in the thyroid activity of aging rats. Thirty-two male Sprague–Dawley rats were randomly divided into four groups (8 rats per group): young (7 months) and old (22 months) groups exposed to room temperature and cold stress. The active follicle ratio and serum free T3, T4 and TSH, and TSH receptor (TSHR) concentrations in the thyroid tissues of the rats from each group were compared. At room temperature, old rats had significantly lower active follicle ratio and free T3 and T4 concentrations than young rats. Furthermore, old rats displayed higher TSH level than young. Exposure to cold temperature led to significantly increased active colloid ratio and free T3 and T4 concentrations among old rats, but no significant differences were found among young rats. Additionally, no significant changes in the TSH and TSHR levels were observed after cold exposure in both young and old rats. Old rats have lower thyroid function than young rats under normal temperature. Aging rats are more susceptible to cold stress than young rats, and cold-induced thyroid activation occurs independently of TSH.We investigated the age-related changes in the thyroid structure and function and cold-induced changes in the thyroid activity of aging rats. Aging rats have structurally less active thyroid follicles and functionally lower thyroid hormone levels than young rats. Furthermore, old rats are more susceptible to cold stress than young rats, and cold-induced thyroid activation occurs independently of TSH.

Effect of Sleeve Gastrectomy on Thyroid Function in Chinese Euthyroid Obese Patients.

Changes in thyroid function following bariatric surgery in euthyroid obese patients have yielded inconsistent results. Nevertheless, no data exist on changes in thyroid function after bariatric surgery in Chinese obese subjects. The objective of this study is to evaluate the influence of weight reduction on thyroid function following laparoscopic sleeve gastrectomy (LSG) in patients with normal thyroid function. Serum free thyroxine (FT4), free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH) levels were retrospectively analyzed before and 12 months after LSG in euthyroid patients with morbid obesity. Correlation between weight loss after LSG and changes in thyroid function were investigated. In total, 16 patients who underwent LSG were included in the study. Mean BMI change from 35.78 to 23.66 kg/m (P<0.000) after LSG was associated with a mean reduction in the TSH from 2.31 to 1.54 mU/L (P=0.022), whereas FT4 (15.19±0.33 pmol/L at baseline and 14.85±0.58 pmol/L at 12 mo after LSG; P=0.583) and FT3 (4.98±0.15 pmol/L at baseline and 4.77±0.60 pmol/L at 12 mo after surgery; P=0.406) levels remained steady. Decrease in TSH was significantly correlated with decrease in BMI at 12 months after surgery but did not correlate with excess weight loss and total weight loss. Weight loss after LSG is accompanied by significant decrease in serum TSH level but no change in serum FT4 and FT3 levels. However, further work is required to elucidate the mechanism.

Acute Thyroid Profile Changes During External Beam Irradiation of Neck.

Thyroid gland is irradiated to a considerable dose in conventional radiotherapy of head neck cancer and significant proportion of patients later develop hypothyroidism. This study is an effort to shed light on acute changes in thyroid function after irradiation those are less clearly defined. Values were recorded before radiation treatment, after 4week of irradiation, after completion of treatment, 1month after completion of treatment and after 4months of completion of treatment. A repeated measures ANOVA with a Greenhouse-Geisser correction determined that mean T3, T4 and TSH levels differed statistically significantly between time points. Post hoc test using the Bonferroni correction revealed statistical significance difference in values of T3, T4 and TSH done at specific intervals. External irradiation in cancer therapeutic doses affects thyroid function and sets at a new point with increased TSH, but in reference ranges, to maintain required thyroxin level.

Effect of Laparoscopic Roux-en-Y Gastric Bypass Surgery on Thyroid Hormone Levels in Chinese Patients, Could It Be a Risk for Thyroid Nodules?

The study aimed to evaluate the changes in thyroid function and the risk of thyroid tumors after Roux-en-Y gastric bypass (RYGB) surgery. This was a retrospective study of 117 patients with type 2 diabetes (T2D) and obesity who underwent laparoscopic RYGB (LRYGB) and were followed up for 36months. Thyroids were examined with ultrasonography. Binary logistic regression analysis was used for predictors of thyroid tumors, and receiver operating characteristic curve determined cutoff points. Sixty-two patients (53.0%) were female. The mean age was 47.3±11.8years, and the mean follow-up duration was 36.4±5.2months. Fifty-one patients (43.6%) were diagnosed with thyroid nodules (TN) by ultrasonography before surgery. Overall, free triiodothyronine (FT3) and free thyroxine (FT4) levels decreased after LRYGB, while thyroid-stimulating hormone (TSH) levels remained stable, and all were within normal limits. Reduction in A1C was correlate with change in FT3 (P=0.043) and FT4 (P=0.001). Forty-one patients (35.0%) had TN or had progressive TN after LRYGB, while two patients were diagnosed with malignant tumors at 12months. The preoperative body fat ratio and FT3/FT4 ratio were clinical predictors of TN progression. LRYGB effectively treated obese patients with T2D. Serum FT3 and FT4 levels decreased to within normal limits after LRYGB. Changes in TSH were not correlated with weight loss. Patients after LRYGB had a potential risk of thyroid nodule progression, preoperative high body fat ratios, or low FT3/FT4 ratios that had higher risks of TN.

Maternal thyroid function in women undergoing controlled ovarian hyperstimulation during in-vitro fertilization and its relation to reproductive outcome.

We conducted a study to evaluate the changes in thyroid function during controlled ovarian hyperstimulation (COH) and its association with the outcome of assisted reproductive technique (ART). This is a prospective cohort study done in University Hospital Fertility Clinic for one year duration. A total of 88 euthyroid women who underwent COH as part of planned in-vitro fertilization (IVF) were invited to participate in this study. Serum thyroid function of each women will be monitored before stimulation (T1), day 10-13 of cycle (T2), during oocyte retrieval (T3), one week following embryo transfer (T4), and at four weeks after embryo transfer (T5). Reproductive outcome of IVF will be observed and documented. Nine women had ongoing singleton pregnancy, seven suffered from miscarriage, while the rest had implantation failure. Serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) increased throughout stimulation, peaking at 32-36 hours after hCG administration compared to baseline (1.250 vs. 1.740 mIU/L and 13.94 vs. 15.25 pmol/L). It remains elevated until one week following embryo transfer. The increment of serum TSH exceeded the upper limit, acceptable for first trimester (<1.60 mIU/L). However, the evolution of serum TSH and fT4 did not significantly differ with pregnancy outcome. In euthyroid women, thyroid function changed significantly during COH, but these changes were not different between the three reproductive outcomes. Thus, we do not suggest continuous thyroid function monitoring during COH.

Association between endocrine function and radiation exposure

Background: To observe the relationship of change in endocrine function within radiation exposure and try to evaluate the correlated factors about thyroid function and glucose metabolism. Methods: A total of 1,784 subjects from physical examination organization for occupational health from year 2015 to 2016 were investigated. Results: The abnormal proportion of T3 and T4 of female were higher than male. Glucose level showed a significant increase in overweight (5.35±1.01) and decrease in underweight group (4.77±0.47) compared with normal group (5.05±0.85). Subjects whose exposure time longer than 3 years were likely to get higher T4 level than those less than 3 years (P Conclusions: Changes in thyroid function and glucose metabolism may appear after long time exposure to radiation.

Thyroid volume and serum calcitonin changes during pregnancy.

Pregnancy has a profound impact on thyroid homeostasis which results in change of thyroid function and thyroid volume (TV). Moreover, calcitonin (CT), and its gene-related peptide have been demonstrated to play an important role in the implantation process. To evaluate changes in TV and serum CT levels during pregnancy. One hundred and fifty-five pregnant women were consecutively enrolled at the first trimester of gestation and underwent clinical, biochemical and sonographic assessment at enrollment, at the second and third trimesters and at 6months after delivery. Throughout gestation serum TSH exceeded the upper specific first trimester cut-off in 5% of patients. TV significantly increased at the third trimester of gestation and returned to baseline levels at 6 months after delivery, while serum CT levels did not show significant changes. TV directly correlated with BMI or gestational weight gain at each trimester of pregnancy, while no significant association between serum CT levels and either weight or TV were found. Finally, in none of the patients with nodular goiter an increase in the volume of the nodules was noted. The appearance of a nodule was recorded during the second trimester in one patient. This study confirms a prevalence of thyroid autoimmunity/hypertropinemia in 3-5% of pregnant women and shows that serum CT does not change in relation to the transient increase in TV occurring during gestation. An adequate daily iodine supplementation might be particularly useful during pregnancy to limit the TSH increase and the resulting thyroid gland and nodule enlargement.

Efficacy and safety of a single radiofrequency ablation of solid benign non-functioning thyroid nodules.

The objective of our study is to evaluate the clinical outcomes and safety of radiofrequency thermal ablation (RFA) for benign thyroid nodules (BTNs) over a 1-year follow-up. This is a monocentric retrospective study. Forty-eight patients with solid, non-functioning BTNs were treated by RFA using a 17G internally cooled electrode. We categorized thyroid nodules as small (≤ 12 mL), medium (12 to 30 mL), or large (over 30 mL). BTNs volume reduction, thyroid function, cosmetic and compressive score changes and side effect evaluation at 6 and 12 months were evaluated. BTN volume decreased significantly from baseline to 6 (mean percentage decrease of BTN volume was 66.8 ± 13.6%, p < 0.001). At 12 months, the mean percentage reduction of BTN volume compared to six months was 13.7 ± 17.1% (p < 0.001). At 6-month, symptom score had improved significantly (p < 0.001) while it does not change significantly between 6 and 12 months. In particular, symptom score improved significantly in the medium (p < 0.001) and large (p < 0.01) subgroups. Cosmetic score improved significantly between baseline and 6 months (p < 0.001) and between 6 and 12 months (p < 0.01). In all the subgroups, cosmetic score improved significantly between baseline and 6 months, while between 6 and 12 months it improved significantly only in the large group (p < 0.05). RFA was well tolerated. Only one patient experienced permanent right paramedian vocal cord palsy. A single RFA treatment was effective in reducing BTNs volume, in particular small and medium nodules. Cosmetic score improved in all treated BTNs while symptom score only got better in the medium and large BTNs.

KECEMASAN DAN GANGGUAN FUNGSI TIROID PADA WANITA USIA SUBUR

Background. Thyroid function disorders can be determined by thyroid levels and thyroid stimulating hormone (TSH) in the blood. In normal condition, thyroid hormones will play an important role in metabolism, system oxidation process, the growth process and protein synthesis. This hormones have an effect to all cells in the human body through the amino acids transport mechanism and electrolytes from extra cellular fluids into the cells, enzyme protein synthesis in cells and increase intracellular processes. Changes of thyroid function can interfere cognitive function, behavioral problems, and change of feeling (mood), included an anxiety. Objective. This study aimed to determine the differences of anxiety in patients with hyperthyroidism, euthyroid, and hypothyroidism in Klinik Litbang GAKI Magelang. Methods. This study was conducted using cross sectional method. Samples are 507 women of childbearing age who visited Klinik Litbang GAKI during 2013. The research variables are TSH status and level of anxiety. The level of anxiety was measured using the Beck Anxiety Inventory (BAI) which has 21 items and also measure the physical, cognitive, and emotional aspects. The socio-demographic data were obtained through interviews. The statistical analysis used was Anova test. Result. Subjects with hyperthyroidism, hypothyroid, and euthyroid were 33.3%, 7.3%, and 59.4% respectively. Many subjects especially above 36 years old experience moderate and severe anxiety level. There was no statistically significant differences in age group between hyperthyroid, euthyroid, and hypothyroid. Anova test results showed that the hyperthyroidism group has higher anxiety scores compared with euthyroid group. Conclusion. Impaired hyperthyroidism experienced by childbearing age women would be more prone to experience psychological problems particularly anxiety.

The relationship between thyroid function and metabolic changes in Chinese women with polycystic ovary syndrome

Objectives: Aim was to evaluate endocrine, metabolic and thyroid parameters which could help to explore the relationship between thyroid function and metabolic changes in Chinese polycystic ovary syndrome (PCOS) patients.Methods: Within a prospective study in PCOS patients compared with healthy women, thyroid parameters were assessed, as well as changes of endocrine, metabolic and clinical characteristics.Results: 144 PCOS patients and 48 normo-ovulatory women matched by age as controls were included. There were significant increases of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3) and total thyroxine (TT4) in the PCOS patients. Body mass index (BMI), waist and hip ratio (WHR), luteinizing hormone (LH), LH/follicle-stimulating hormone (FSH) and total testosterone (T) were significantly higher in PCOS compared with the controls. Total cholesterol (CHO), triglycerides (TG) and apolipoprotein B (ApoB) levels in PCOS were higher, whereas high-density lipoprotein (HDL) and apolipoprotein A (ApoA) were lower compared with the controls. Insulin and homeostatic model assessment of insulin resistance (HOMA-IR) were significantly higher in patients with PCOS.Conclusions: Our study confirms the well-known negative metabolic changes in PCOS patients. The small increases of TSH, TT3 and TT4 level may be related with these metabolic changes in PCOS patients. Further studies may improve the understanding of the relationship between thyroid function and metabolic changes.

Longitudinal Changes in Thyroid Hormones During Conception Cycles and Early Pregnancy

Objective: The aim of this study was to characterize changes in free triiodothyronine (fT3), free thyroxine (fT4) and thyroid-stimulating hormone (TSH) during the follicular and luteal phase and during subsequent early pregnancy in individual women. Method: TPOAb negative women with a viable pregnancy (n=49) had fT3, fT4 and TSH measured longitudinally in serum samples at baseline/non-pregnant (gestation week 0), ovulation (gestation week 2), mid-luteal phase (gestation week 3) and twice weekly from gestation weeks 4 to 6.5. Patient groups received in their conception cycle either no medication (n=13), low ovarian stimulation, (n=17) or controlled ovarian hyperstimulation (COH) for IVF treatment (n=19). Results: Women receiving COH had a transient drop in TSH at the time of ovulation followed by a peak at midluteal (p=0.024). Levels of fT3 and fT4 at each gestation week were not significantly different between the treatment groups, whereas TSH levels were significantly higher at all gestation weeks (p=0.036) in the COH group compared to the natural and low stimulation groups. There were significant changes in thyroid function once pregnancy was established (gestation week 4) through to gestation week 6.5, with a gradual decrease in serum fT3 (r=-0.104, p=0.030) and TSH (r=-0.123 p=0.031), whilst fT4 levels remained constant. 3 women (6.1%) had TSH levels >4.0 mU/L during their pregnancy although these were isolated measurements. Conclusion: Thyroid hormones in individual women did not remain constant but showed discrete changes. TSH was significantly lower at time of ovulation in women who received high doses of ovarian stimulation medication for IVF, and was higher throughout pregnancy than for the other groups. Serum fT3 and TSH decreased significantly during early pregnancy irrespective of medication given in the conception cycle.

Thyroid dysfunction in early pregnancy and spontaneous abortion

Background: Pregnancy is associated with significant but reversible changes in thyroid function. Abnormal thyroid hormone levels could give rise to increased malplacentation increase to malplacentation that underlies the association between maternal thyroid dysfunction and adverse obstetric outcomes such as fetal brain damage, preterm births, and fetal death. Aim: The present study was planned to predict the risk of abortion in pregnancy by studying the relation between thyroid profile and rate of abortion. Methods: This prospective observational study was carried out in 100 pregnant women with a singleton pregnancy of 6–12 weeks of gestation in the Department of Biochemistry in collaboration with the Department of Obstetrics and Gynaecology, Pt. B.D. Sharma, PGIMS, Rohtak. The patients were divided into three groups, namely, Group 1 (n = 30, control group) included normal pregnant women with no history of abortion; Group 2 (n = 35) included pregnant females with previous history of abortion; and Group 3 (n = 35) comprised pregnant women coming with chief complaint of bleeding per vaginum. A volume of 5 mL blood sample was taken and serum was separated using centrifugation. Triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) levels were estimated by chemiluminiscence. Results: T3, T4 and levels were comparable in all the three groups and the difference was not statistically significant. TSH levels were found to be negatively correlated with T3 and T4 values in the three groups. Only, 13% of the patients had spontaneous abortion. Nearly 6.66% of the patients in Group 1, 11.42% in Group 2 and 19.99% of patients in Group 3 ended up in abortion. TSH was found to be strongly associated with abortion in all the three groups (P ≤ 0.001). TSH levels were significantly higher in the first trimester in women who had an abortion than pregnant women who had a successful continuation of pregnancy. Conclusions: TSH was strongly associated with abortion in the first trimester in all the three groups.

Evaluation of the safety and efficacy of radiofrequency ablation for treating benign thyroid nodules.

Background: Radiofrequency ablation (RFA) is a relatively new procedure for treating benign thyroid nodules. The purpose of this study was to evaluate the safety and efficacy of RFA for treating benign thyroid nodules so as to serve as a reference for future clinical practice.Methods: This study retrospectively analyzed the clinical data of patients receiving percutaneous RFA for treating thyroid nodules from November 2014 to July 2015 in our medical center. One hundred and eight patients with a total of 380 nodules received ultrasound-guided RFA for treating thyroid nodules. Comparisons of the volume change of thyroid nodules before and after RFA treatment, post-treatment complication, and change of thyroid function, were carried out afterwards.Results: Before treatments, all patients received fine needle aspiration biopsy (FNA) which supported the diagnosis of benign tumor. There were 13 males and 95 females included in the study. Twenty-six cases (24.07%) had single nodule, and 82 cases (75.93%) had multiple nodules. Before treatments, the thyroid functions (FT3, FT4, and TSH) were normal originally or adjusted to normal range by endocrinology treatment. The preoperative nodules had minimum volume of 0.01mL, maximum volume of 70.89 mL, and mean volume of 1.02 ± 4.24mL. The volume of nodules one month and three months after RFA were 0.29 ± 0.72mL and 0.15 ± 0.87mL, respectively. In addition, volume reduction ratio (VRR) of nodules one month and three months after RFA were 64.12% and 85.54%, respectively. Both volume of nodules and VRR had statistically significant differences for pre-operative and post-operative comparison (P<0.05). Thyroid functions were in normal range after treatments, and there was no serious complications.Conclusions: Ultrasound-guided RFA treating benign thyroid nodules had the advantages of definite efficacy, safety, strong in control ability, no incision, less damage to surrounding normal tissues and no effect on thyroid function. It can be used as one of the main treatment methods for treating benign thyroid nodules.

Marijuana Exposure is Associated with Minimal Changes in Thyroid Function in NHANES Surveys

Marijuana Exposure is Associated with Minimal Changes in Thyroid Function in NHANES Surveys

Correlation of enhanced oxidative stress with altered thyroid profile: Probable role in spontaneous abortion.

Background:Spontaneous abortion or miscarriage is defined as the loss of a clinically recognized pregnancy that occurs before 20 weeks of gestational age. Changes in thyroid function can impact greatly on reproductive function before, during, and after conception. Oxidative stress affects both implantation and early embryo development by modifying the key of transcription. Malondialdehyde (MDA) is a major breakdown product of split off from lipid peroxidation. Superoxide dismutase (SOD) is responsible for detoxification of superoxide anion and required for normal health and reproduction.Aim:The aim of this study was to define the involvement of thyroid hormones, MDA and SOD levels and to establish MDA levels as an index of lipid peroxidation in women with spontaneous abortion by comparing the results with healthy pregnant females as controls.Materials and Methods:A cross-sectional case-control study was designed with two groups of women with 30 each in healthy pregnancy and with spontaneous abortion.Results:Demographic characteristics such as maternal age, paternal age, gestational age, body mass index, waist-hip ratio as well as biochemical parameters such as blood pressure, hemoglobin (Hb), sugar levels were found to be similar in both the participating groups. Characteristics like gravida and parity were found to be higher in the study group and differ significantly from control group. Spontaneous abortion before 24 weeks of gestational age was found to be associated with significant increase in mean serum thyroid stimulating hormone (TSH) (P = 0.0115) and MDA (P = 0.0001) levels and a significant decrease in mean serum T3 (P = 0.0003) and SOD (P = 0.0005) levels. The linear (Pearson) correlation analysis demonstrated a significant positive correlation of TSH with MDA and negative correlation with SOD in women with spontaneous abortion.Conclusion:The study demonstrates that altered thyroid profile, increased lipid peroxidation in terms of increased MDA levels and decreased SOD levels might be involved in the termination of otherwise wanted pregnancy.

High prevalence of anti-TSH receptor antibody in fibromyalgia syndrome.

Fibromyalgia syndrome (FMS) is defined as chronic widespread pain that cannot be accounted for by any other medical disorder. Our aim was to explore the prevalence of thyroid autoimmunity in patients with FMS. For determining thyroid function in 207 FMS patients, we tested for the titers of free tri-iodothyronine, free thyroxine, thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibody (TPOAb), anti-thyroglobulin antibody (TgAb) and anti-TSH receptor antibody (TRAb). Twenty-five patients who had either subclinical hyper- or hypothyroidism, or overt hypothyroidism were excluded. Sixty-nine FMS patients with autoimmune thyroid diseases (AITD) (37.9%, 69/182) were identified. The prevalence of positivity for TRAb, TgAb and TPOAb was 20.3% (n = 37), 16.5% (n = 30) and 13.2% (n = 24), respectively. Compared to control populations in previous studies, the prevalence of TRAb positivity was high, and titers of TRAb were low (1.0-1.5 IU/L). The prevalence of TPOAb and TgAb positivity was not significantly higher than that reported in FMS patients in previous studies. Clinical symptom profiles were identical for FMS patients with and without AITD. We found a high prevalence of AITD among 207 patients with clinically defined FMS, with TRAb being especially prominent among these patients. Further study is needed to evaluate changes in thyroid function among FMS patients with AITD.

Thyroid hormone dysfunction during pregnancy: A review

Thyroid dysfunctions such as hypothyroidism, thyrotoxicosis and thyroid nodules may develop during pregnancy leading to abortion, placental abruptions, preeclampsia, preterm delivery and reduced intellectual function in the offspring. Epidemiological data have shown the significant role of maternal thyroid hormone in fetal neurologic development and maternal health. It has been suggested that the deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neuro-intellectual development in the early life of the child. Pregnancy poses an important challenge to the maternal thyroid gland as hormone requirements are increased during gestation as a result of an increase in thyroid- binding globulin, the stimulatory effect of HCG on TSH receptors, and increased peripheral thyroid hormone requirements. Maternal thyroid dysfunction is associated with increased risk for early abortion, preterm delivery, neonatal morbidity and other obstetrical complications. Early diagnosis for thyroid dysfunction of pregnant women and treatment of thyroid dysfunction during pregnancy is important and cost effective to avoid both fetal and maternal complications secondary to thyroid dysfunction. Therefore the aim of this review was to assess the thyroid function changes occurring during pregnancy, the different disorders with their maternal and fetal implications, the laboratory diagnosis and the best ways of management of these conditions.