Diagnosed Thyroid Dysfunction Research Articles

The Interplay between Mitochondrial Metabolism and Nasal Mucociliary Function as a Surrogate Method to Diagnose Thyroid Dysfunction: Insights from a Population-Based Study.

Aim and Background. This study aims to explore alternative diagnostic methods to assess thyroid function in patients unable to undergo blood tests for thyroid-stimulating hormones (TSH) and thyroxine (T4), such as individuals with trypanophobia, severe medical conditions, or coagulopathy. Considering the impact of thyroid dysfunction on mitochondrial metabolism and the essential role of proper mitochondrial function in ciliary motility, we postulate that assessing nasal ciliary function could serve as a surrogate diagnostic approach for thyroid dysfunction. Methods. This cross-sectional study was performed on individuals with no history of thyroid diseases. The primary endpoint was the diagnostic value of the nasal mucociliary (NMC) test using Iranica Picris (Asteraceae) aqueous extract in differentiating hypo- or hyperthyroidism cases from euthyroid cases. Results. 232 individuals were recruited (71% females, 86% euthyroid). Receiver operating characteristic (ROC) analysis showed a good diagnostic value for the NMC test in differentiating overt hypothyroidism (area under the ROC curve [AUROC] = 0.82, p = 0.004) and its fair value in diagnosing subclinical hyperthyroidism (AUROC = 0.78, p = 0.01) from the euthyroid condition. The NMC test had a significant positive correlation with TSH (r = 0.47, p < 0.001) and a significant negative correlation with T4 (r = -0.32, p < 0.001). The NMC rate was significantly different in distinct thyroid function groups (p < 0.001). Compared with euthyroid cases, the post-hoc analysis showed that the NMC test is significantly higher in overt hypothyroidism (15.06 vs. 21.07 min, p = 0.003) and significantly lower in subclinical hyperthyroidism (15.05 vs. 10.9 min, p = 0.02). Conclusions. The Iranica Picris-based NMC test might serve as a diagnostic method to distinguish overt hypothyroidism and subclinical hyperthyroidism.

Prevalence of Thyrotropin Receptor Antibodies and Clinical Profile of Patients with Alopecia Areata: A Cross-Sectional Study

Introduction: Alopecia areata (AA) is associated with thyroid dysfunction and abnormal levels of thyroglobulin and thyroid peroxidase autoantibodies. One study detected high prevalence of thyrotropin receptor antibodies (TRAbs) in AA patients. Our aim was to investigate the prevalence of TRAb levels in AA patients and to assess their association with thyroid hormones, other thyroid antibodies, AA severity, and other epidemiological variables. Methods: In this observational study, 139 patients (97 females, 42 males), aged 12 and above, with newly presenting, relapsing, or treatment-resistant AA were included. Medical histories were reviewed, alopecia severity was assessed using the Severity of Alopecia Tool (SALT), and blood tests measured thyroid hormones and autoantibodies. Results: The prevalence of TRAb was significantly higher in AA patients (23.6%) compared to the general population (1–2%) (p < 0.001). Elevated TRAb titers did not correlate with diagnosed thyroid dysfunction or treatment, abnormal thyroid function tests and autoantibodies, AA severity, duration, and onset. Male patients exhibited a significantly higher prevalence of abnormal TRAb titers compared to females (75.0% vs. 21.3%, p = 0.002). Conclusion: A significant proportion of AA patients presented with elevated TRAb levels, independent of thyroid hormone titers, other thyroid autoantibodies, or SALT score. Prevalence of abnormal TRAb levels was higher in males.

Menstrual Cycle Characteristics in Women With and Without Thyroid Disease.

This study was designed to evaluate the frequency and type of menstrual disorders in thyroid dysfunction. The relationship between thyroid dysfunction and menstrual disorders has been known for a long time. The menstrual cycle should be checked in women with thyroid dysfunction. On the contrary, women with menstrual irregularities should be investigated for thyroid dysfunction. Women who presented to our hospital's internal medicine and endocrinology clinics that recently diagnosed thyroid dysfunction were included. The patients were divided into five groups (subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, overt hyperthyroidism, and euthyroid) according to thyroid functions. They were questioned regarding the amount, frequency, and duration of menstrual bleeding. The prevalence of menstrual disturbances, including secondary amenorrhea, hypomenorrhea, oligomenorrhea, hypermenorrhea, polymenorrhea, menorrhagia, metrorrhagia, and menometrorrhagia, was examined in 485 patients and 108 healthy controls. Hypermenorrhea was significantly more common in patients with overt hypothyroidism (33%) than in controls (6%) (p<0.05). The types and frequencies of menstrual disorders in patients with hyperthyroidism and those with normal thyroid function were not significantly different from those in controls. Menstrual abnormalities frequently occur in women with thyroid dysfunction. Therefore, menstrual dysfunction should be considered when treating patients with thyroid abnormalities.

Risk of Incident Thyroid Dysfunction in the Post-Acute Phase of COVID-19: A Population-Based Cohort Study in Hong Kong

ObjectiveThe evidence of thyroid dysfunction in the post-acute phase of SARS-CoV-2 infection is limited. This study aimed to evaluate the risk of incident thyroid dysfunction in the post-acute phase of COVID-19. MethodsThis retrospective, propensity-score matched, population-based study included COVID-19 patients and non-COVID-19 individuals between January 2020 and March 2022, identified from the electronic medical records of the Hong Kong Hospital Authority. The cohort was followed up until the occurrence of outcomes, death, or 31 January 2023, whichever came first. Patients with COVID-19 were 1:1 matched to controls based on various variables. The primary outcome was a composite of thyroid dysfunction (hyperthyroidism, hypothyroidism, initiation of antithyroid drug or levothyroxine, and thyroiditis). Cox regression was employed to evaluate the risk of incident thyroid dysfunction during the post-acute phase. ResultsA total of 84 034 COVID-19 survivors and 84 034 matched controls were identified. Upon a median follow-up of 303 days, there was no significant increase in the risk of diagnosed thyroid dysfunction in the post-acute phase of COVID-19 (hazard ratio [HR] 1.058, 95% confidence interval 0.979-1.144, P = .154). Regarding the secondary outcomes, patients with COVID-19 did not have increased risk of hyperthyroidism (HR 1.061, P = .345), hypothyroidism (HR 1.062, P = .255), initiation of antithyroid drug (HR 1.302, P = .070), initiation of levothyroxine (HR 1.086, P = .426), or thyroiditis (P = .252). Subgroup and sensitivity analyses were largely consistent with the main analyses. ConclusionOur population-based cohort study provided important reassuring data that COVID-19 was unlikely to be associated with persistent effects on thyroid function.

Thyroid dysfunction among patients assessed by thyroid function tests at a tertiary care hospital: a retrospective study.

previous studies in African populations have not extensively described the spectrum of thyroid dysfunction using the profile of thyroid hormones. Although iodine deficiency is a common thyroid disorder in Africa, it does not represent the entire spectrum of thyroid dysfunction seen in patients. This retrospective study aimed to describe the spectrum of thyroid dysfunction among patients seen at the Korle-Bu Teaching Hospital (KBTH), a tertiary care hospital in Accra, Ghana. a retrospective analysis of medical records of all consultations on thyroid disorders seen at the Internal Medicine Department of KBTH between January 2019 and December 2021 was conducted. Information on patient demographics, and thyroid hormone profiles (triiodothyronine - FT3, thyroxine - FT4, and thyroid stimulating hormone - TSH) were extracted and subjected to descriptive statistics. The thyroid hormone profiles of the subjects were analyzed and classified into thyroid dysfunction categories using guidelines from the American Thyroid Association (ATA). out of the 215 patients with thyroid disorders enrolled, 85.1% (n=183) were females and 14.9% (n=32), were males. The mean age of patients was 45±14 years, with most of the patients within the age range of 31-50 years (49.3%; n=106). The most reported thyroid function dysfunction was primary hyperthyroidism (57.7%), followed by primary hypothyroidism (22.3%), subclinical hyperthyroidism (9.3%), euthyroid sick syndrome (6.5%), and subclinical hypothyroidism (4.6%) respectively. primary hyperthyroidism was the most commonly diagnosed thyroid dysfunction. Hyperthyroidism has been associated with cardiac morbidity and mortality. Timely interventions are required to reduce the morbidity risks and burden associated with the hyperthyroid state.

Screening and Management of Thyroid Dysfunction During Pregnancy

Thyroid hormone is known to play a crucial role in implantation and embryonic development, as well as in the development of the nervous and musculoskeletal systems of fetus. In particular, thyroid dysfunction is associated with various pregnancy-related complications such as miscarriage, preterm birth, fetal growth restriction, and preeclampsia. Previous studies have primarily focus on the adverse effects of hypothyroidism on fetal neurodevelopment. However, the physiological and metabolic alterations occurring during pregnancy in thyroid physiology make it difficult to diagnose thyroid dysfunction. Therefore, obstetricians should have a comprehensive understanding of physiological changes of the thyroid and be familiar with the latest guidelines regarding the complications and management of thyroid dysfunction during pregnancy.

P-684 Subclinical hypothyroidism and ovarian reserve indices in women with normogonadotropic anovulation

Abstract Study question Does subclinical hypothyroidism (SCH) affect ovarian reserve indices in women with Polycystic Ovary syndrome (PCOS) or other forms of Hypothalamic-Pituitary-Ovarian Axis Dysfunction (HPOD)? Summary answer SCH increases Anti-Müllerian hormone (AMH) concentration, but has no influence on Follicle-stimulating hormone (FSH). What is known already In PCOS, anovulation is caused by the arrest of growing follicles due to increased frequency and amplitude of luteinizing hormone (LH) pulses, resulting in increased number of pre-antral and antral follicles, and concentration of AMH. In other cases of HPOD, the causes of anovulation are more diverse and have not yet been clearly identified. Thyroid hormones can modify the function of the HPO axis, affecting the maturation of follicles. While overt hypothyroidism is treated to improve ovulation and fertility, the effect of subclinical hypothyroidism (SCH) and the presence of circulating antithyroid antibodies (ATA) on ovarian function is uncertain. Study design, size, duration A prospective cohort tertiary single-center study (consent no. 1072.6120.172.2022) included women aged 18-45, examined due to menstrual disorders and/or infertility, from July to August 2022. Only women without previously diagnosed thyroid dysfunction were included. All enrolled women gave informed written consent to participate in the study. Participants/materials, setting, methods Women underwent routine gynecological examination and pelvic ultrasound. Blood sample was tested for AMH, FSH, Luteinizing hormone (LH), Thyroid-stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies concentrations. The Rotterdam-ESHRE-ASRM criteria were used to diagnose PCOS and its phenotypes. HPOD was diagnosed according to WHO classification. SCH was defined as TSH &amp;gt; 2.5 uIU/ml with normal thyroid function. The above parameters within subpopulations were calculated using regression analysis, Kruskal-Wallis and post-hoc tests. Main results and the role of chance The study included 51 euthyroid women aged 18-40. PCOS was diagnosed in 42/51 (82.35%) women, including PCOS-A phenotype in 31/51 (60.78%), PCOS-B in 5/51 (9.8%), PCOS-D in 6/51 (11.76%) women, and HPOD in 9/51 (17.65%) women. There was a significant positive correlation between the concentration of TSH and AMH in the studied population - with the increase of TSH value, the concentration of AMH increased (r = 0.4, p = 0.0035). The mean AMH concentration significantly differed between the groups and equaled to 55.4, 39.4, 31.1, 24.0 pmol/l in PCOS-A, PCOS-B, PCOS-D and HPOD (p = 0.05), respectively. The mean anti-TPO concentration was significantly different between the groups and was equal to 18.2, 19.0, 14.6, 10.9 U/ml in PCOS-A, PCOS-B, PCOS-D and HPOD (p = 0.05), respectively. There was no significant difference in FSH, LH, TSH, anti-TG concentrations between the groups. Limitations, reasons for caution The limitations of the study are small study group and single-center nature. Wider implications of the findings SCH increases the concentration of AMH, which in PCOS may exacerbate the symptoms of anovulation. Whether treatment of subclinical hypothyroidism affects ovarian reserve indices and improves ovarian function remain a subject of further research. Trial registration number 1072.6120.172.2022

Thyroid Dysfunction in Chronic Kidney Disease: A Study from North Kerala

Introduction: Chronic kidney disease (CKD) is a leading cause of morbidity and mortality Worldwide. The understanding of metabolic and hormonal abnormalities in milder forms of renal dysfunction is expanding, but the knowledge of thyroid dysfunction in people with CKD is still limited. The growth, differentiation, and regulation of physiological mechanisms in all tissues, including the kidney, depend on thyroid hormones. They are essential for maintaining the balance of electrolytes and water. Prevalence of hypothyroidism in end stage renal disease (ESRD) has been estimated to be in the range of 0 to 9%. Patients with ESRD also have a higher prevalence of goitre. Although there are several indicators that can predict both overall mortality and the severity of renal impairment, thyroid dysfunction is one of the major ones. In order to improve the outcome, it is wise for the internist and treating physician to be aware of thyroid dysfunction. The importance of knowing the prevalence of thyroid dysfunction in CKD patients also lies in the fact that it adds to the already high cardiovascular mortality risk in this patient group.&#x0D; Objectives&#x0D; &#x0D; To find the proportion of thyroid dysfunction in patients with chronic kidney disease.&#x0D; To study the correlation between thyroid dysfunction and severity of renal diseases.&#x0D; &#x0D; Methodology&#x0D; A single center cross sectional study conducted in Departments of General Medicine and Nephrology in a tertiary care hospital in Calicut, Kerala. In the study period of 12 months, among patients admitted in Medical Ward after applying inclusion and exclusion criteria, 100 patients were included in the study. Patients who fulfilled the criteria for CKD and who are on conservative management and haemodialysis were taken up for the study. Thyroid profile was done in all patients who fulfilled the criteria. The prevalence of thyroid dysfunction in chronic kidney disease was described and analyzed in terms of percentages and averages. One way ANOVA test was used to analyze various parameters like T3, T4, Blood urea and Serum creatinine in relation to various grades of renal failure.&#x0D; Results&#x0D; Low T3 levels were seen in 65% and subclinical hypothyroidism was seen in 17% of the study subjects. Low T4 was seen in only 6% of the study subjects. There was no significant association observed between CKD stages and T3, T4, TSH values categorized as low, high and normal.&#x0D; Conclusion&#x0D; Low T3 syndrome was the commonest abnormality detected. This may be viewed as protective mechanism to conserve protein in chronic kidney disease patients. Subclinical hypothyroidism was the second most common abnormality detected and the number of patients with subclinical hypothyroidism progressively increased with the severity of chronic kidney disease. As subclinical hypothyroidism is associated with increased cardiovascular mortality in CKD patients, adult patients with CKD should be routinely screened for subclinical hypothyroidism and further studies are required concentrating on improving clinical and biochemical criteria to diagnose thyroid dysfunction in CKD.

The Association of Leptin Levels in Iraqi Women with Newly Diagnosed Thyroid Dysfunction

The Association of Leptin Levels in Iraqi Women with Newly Diagnosed Thyroid Dysfunction

Thyroid dysfunction in type 2 diabetes mellitus patients attending diabetic clinic in a tertiary care centre: a cross-sectional study

Background: Thyroid disease and type 2 diabetes mellitus are two common co-existing endocrinopathies found in the general population. Since thyroid dysfunction complicates the metabolic derangement observed in diabetes, its treatment is necessary in order to achieve stability of metabolic control. Therefore, the aim of the present investigation was to estimate the functional thyroid disorders and the associated factors in type 2 diabetes patients.Methods: In 230 diabetic patients, the blood sugar level and thyroid function tests were performed and compared. Most of the patients were in the age group of 51-60 years (36.08%).Results: The prevalence of thyroid dysfunction in diabetic patients was 15.21% with a higher rate in female patients. Subclinical hypothyroidism (12.17%) was the commonest thyroid dysfunction.Conclusions: The data suggest that subclinical hypothyroidism was more prevalent in type 2 diabetes mellitus, and may confer a greater risk of diabetic complications. It is therefore important to diagnose thyroid dysfunction in diabetic patients and the practice should be inculcated in diabetic care.

Newly diagnosed thyroid dysfunction presented as female sexual dysfunction: First report from Basrah- Iraq

ABSTRACT Introduction Overt and subclinical thyroid dysfunction may present as female sexual dysfunction (FSD), through their hormonal effect or due to their consecutive psychiatric disorders. Objective To evaluate effect of thyroid dysfunction on FSD in reproductive-aged married premenopausal women in Basrah- Iraq. Methods We received 673 reproductive aged women with different sexually-related complaints. There were 229 women who fulfill the criteria of FSD diagnosis for more than 6 months, with exclusion of any women with any condition, medication, or intervention which might disturb the sexual function. The 229 women were tested by a cascade of hormonal investigations, including: thyrotropin stimulating hormone (TSH), free thyroxine (FT4), total testosterone (TT) with sex hormone binding globulin (SHBG), calculated free testosterone (cFT), estradiol (E2), and prolactin (PRL). We had diagnosed 42 women with different thyroid dysfunction and considered them as (case group), versus 187 women with normal thyroid function and considered as (control group). We used the Arabic Version of Female Sexual Function Index (ArFSFI) Scoring, which contains 19 questions in six different sexual domains (desire, arousal, lubrication, orgasm, satisfaction, and pain). A total score &amp;lt;26.55 points suggested FSD. Cut-off points for each domain (desire=4.28, arousal=5.08, lubrication=5.45, orgasm=5.05, satisfaction=5.04, and pain=5.51). We used independent sample t-test to study different FSFI domain scores, biochemical parameters, and some personal-related characteristics between women in both groups. Subgroup analysis in the thyroid dysfunction group was done from the point of autoimmunity, and thyroid hormone levels. Results The prevalence of subclinical thyroid dysfunction in FSD was 8.30%, compared 10.04% for overt thyroid dysfunction. The women in both groups were nearly matched in their age, weight, parity, duration of marriage, and FSD. All the 229 women across the two group described severely reduced FSFI scores, which were markedly around the third of the cut-off values for all scores. The PRL, TT, SHBG, cFT, and E2 levels did not bear any significant difference in both groups. The status of thyroid autoimmunity did not affect the sexual domains scores levels between women with autoimmune thyroid dysfunction and those women without. The pattern which extended to include all the studied hormones, except E2. There were normal levels of E2 for both groups, yet, women with autoimmune thyroid dysfunction had significantly higher normal E2 than women with nonautoimmune thyroid dysfunction. The pattern of nonsignificant association did not change during further subgroup analysis between women with autoimmune hypothyroidism and hyperthyroidism. Conclusions This study was a negative case-control study. Although we get markedly reduced FSFI scores for all domains, we did not have a significant difference in women with overt, subclinical, autoimmune, or nonautoimmune thyroid dysfunction compared to control group. Any causal relation of any hormone could not be verified. Disclosure Work supported by industry: no.

Abstract 96: Etiological profile of thyroid disorders in neonates at a tertiary care hospital in South India

Background: Thyroid disorders are commonest endocrine disorder in India, studies reveal a high prevalence. Normal thyroid function is critical for early neurocognitive development, which emphasizes strict neonatal screening.Aim: To estimate the prevalence, clinical profile and associated co-morbidities of thyroid dysfunction in neonates.Materials and Methods: A cross-sectional observational study was conducted at a tertiary care hospital in south India. Neonates referred to Endocrinology department with diagnosed thyroid dysfunction were included. Demographic data, clinical features, thyroid profile and relevant investigations of the recruited children were noted.Results: A total of 180 neonates (105 female) with thyroid function abnormalities were included with prevalence of 8/1000 over 6 years study. Graves was noted in 6, majority of the hypothyroidism was due to Hashimoto's (111), subclinical (27), congenital central (11), ectopic thyroid and dys-hormonogenesis in 6 each, transient hypothyroidism in 4. A host of co-morbidities, developmental delay and maternal risk factors were identified.Conclusion: There is a high occurrence of autoimmune hypothyroidism in paediatric age group in south India and need for similar studies from different regions of the country covering larger population are in dire need as early diagnosis may abate subsequent residual sequelae.

CLINICIANS DILEMMA: FALSELY UNDETECTED TSH LEVELS DUE TO TSH ISOFORM ON POPULAR COMMERCIAL IMMUNOASSAY IN INDIAN SUBJECT AND RETROSPECTIVE ANALYSIS

Introduction: TSH is one of the most routinely measured tests the clinical laboratory to diagnose and monitor thyroid diseases. TSH as the preferred screening test as recommended by The American Thyroid Association and the American Association of Clinical Endocrinologists for diagnosing thyroid dysfunction. Third-generation Ultra serum TSH assays have a functional sensitivity of 0.001 uIU/mL and have been considered highest among biochemical assay for assessing thyroid disorders. However, as observed in many clinical laboratories sometimes results of TSH assays are discordant among different immunoassay platforms.&#x0D; Case Report: TSH values of a 56 years old male on Siemens Attelica while TSH was found to be elevated on Abbott Architect 1000 and Beckman Coulter DXI800. Retrospective analysis revealed few other cases (8/190) approx. 4.2 % showed discordant TSH values. This was found to be possibly because of mutation in TSH beta region (R55G).&#x0D; Conclusion: Our present study suggest that these individuals who shows &lt;0.001 values on Siemens Attelica must be tested with other platforms to assure appropriate management of disease. Further, clinicians and laboratory staff need to be aware about TSH variants along with other reported interferences.

Prevalence of thyroid disorder among young adults in the rural areas of Wardha district: A cross-sectional study.

Recently, it has been revealed that most thyroid disorders occur among females and that the factors contributing to this are infertility and sex hormone imbalance. Other research studies showed both genders are equally affected. Therefore, this study aims to estimate the prevalence rate of thyroid disorder among young adults in the rural areas of Wardha district and correlate the results with demographic variables. A cross-sectional research design was used in this study. One thousand males and females were involved in the study. The Calbiotech Thyroxine Elisa kit was used to check the prevalence rate of thyroid disorder. Data were analysed using the Statistical Package for Social Sciences (SPSS) and released in 2016. Among the rural villages of Wardha district, Seloo, Salod (Hirapur) and Kelzar were included in the study. It was found that in Seloo, 154 (49.04%) young adults had normal thyroid function, 105 (33.44%) had hyperthyroidism and 55 (17.52%) participants had hypothyroidism. Salod (Hirapur) showed 210 (47.95%) with normal thyroid function, 149 (34.02%) with hyperthyroidism and 79 (18.04%) with hypothyroidism. In Kelzar, there were 121 (48.79%) with normal thyroid function, 80 (32.26%) with hyperthyroidism and 47 (18.95%) with hypothyroidism. Prevalence of thyroid disorder revealed that majority of the thyroid problems were found among females in the rural areas of Wardha district. There are various problems in rural areas, such as lack of medical facilities and laboratory facilities to diagnose thyroid dysfunction early. It is recommended that health check-up camps be conducted in rural areas and health education be given to young adults about thyroid disorders and their prevention measures for promotion of health free from a thyroid disorder.

AACE2021-A-1053: Newly Diagnosed Thyroid Dysfunction Presented as Female Sexual Dysfunction: The First Study from Basrah, Iraq

Overt and subclinical thyroid dysfunction may present as female sexual dysfunction (FSD) due to their hormonal effect on consecutive psychiatric disorders. Our objective was to evaluate the impact of thyroid dysfunction on FSD in reproductive-aged married premenopausal women in Basrah- Iraq.

Age-specific correlation between thyroid hormone concentrations and ultrasound thyroid volume for diagnosing thyroid dysfunction in preterm infants: a single-centre, prospective, observational study protocol

IntroductionThyroid disorders are commonly concomitant with premature birth; however, indications to start therapy remain unclear due to lack of gestational age-specific reference ranges and thyroid ultrasound nomograms. We aim to...

The Spread of Thyroid Diseases and the Algorithm for Diagnosing Thyroid Dysfunction

Diseases of the thyroid gland are considered one of the most common endocrinopathies. This is due to the influence of ecologically unfavorable environmental factors, bad habits, malnutrition, comorbid conditions and genetic predisposition. Determining an algorithm for diagnosing thyroid dysfunction for the timely detection of diseases is expedient and relevant. The objective: to analyze the state of the spread of thyroid diseases among the population of the Kiev region and to determine the diagnostic algorithm based on the identification of the main clinical syndromes of thyroid dysfunction. Materials and methods. Among the adult population of the Kiev region, a high level of morbidity and spread of thyroid diseases is recorded. The increase in the number of cases occurred, first of all, due to the newly diagnosed patients with hypothyroidism, thyroiditis. The manifestation of most diseases is associated with the development of thyroid dysfunction. Under the hypothyroidism one can observe and diagnose the following: a syndrome of neuropsychiatric disorders with slowing down of motor activity, decrease in cognitive functions; syndrome of vegetative-trophic disorders with cutaneous mucinosis, polyneuropathy; syndrome of cardiovascular changes with decreased myocardial contractility, slow blood flow, progressive development of atherosclerosis; anemic syndrome; digestive tract syndrome with impaired motor and secretory functions of the gastrointestinal tract; syndrome of hormonal disorders with decreased secretion of thyroid hormones, especially T4, increased levels of TSH (in primary hypothyroidism) or decreased TSH (in secondary and tertiary). Results. Thyrotoxicosis in patients is determined by an enlarged thyroid gland with the development of: thyrotoxic cardiomyopathy and systolic arterial hypertension; thyrotoxic encephalopathy, syndrome of neuropsychiatric disorders with a predominance of excitation processes, vascular dysfunction; thyrotoxic ophthalmopathy, ectodermal disorders syndrome along with a decrease in TSH production and an increase in the level of free fractions T4, T3. Conclusions. The algorithm for diagnosing hypofunction and hyperfunction of the thyroid gland provides for: clarification of complaints and anamnesis data, examination of the patient, additional laboratory and instrumental examination, which includes the study of the thyroid status, possible autoaggression, analysis of metabolic processes, assessment of pathomorphological changes in the thyroid gland.

Serum Raman spectroscopy combined with multiple algorithms for diagnosing thyroid dysfunction and chronic renal failure.

In this study, 60 samples taken from patients with thyroid dysfunction, 40 samples taken from patients with chronic renal failure (CRF) and 60 samples taken from healthy people were classified. We used partial least squares (PLS) to extract features to reduce the dimension of the spectral data to discriminate among the different samples. The Decision Trees (DT), Extreme Learning Machine (ELM), Probabilistic Neural Network (PNN), Back Propagation Neural Network (BPNN) and Learning Vector Quantization (LVQ) algorithms were used to build classification models and compare the results. The PLS-PNN algorithm distinguished between patients with thyroid dysfunction and patients with chronic renal failure with up to a 96.67 % accuracy rate, the PLS-BP algorithm distinguished between patients with chronic renal failure and healthy people with up to a 98.33 % accuracy rate, and the PLS-PNN algorithm and the PLS-DT algorithm distinguished between healthy people and patients with chronic renal failure with up to a 100 % accuracy rate. The results showed that serum Raman spectroscopy can be used in conjunction with classification algorithms to rapidly and accurately diagnose and distinguish between thyroid dysfunction and chronic renal failure.

Serum Raman spectroscopy combined with a multi-feature fusion convolutional neural network diagnosing thyroid dysfunction

In this study, serum samples from 199 patients with thyroid dysfunction and 183 people with normal thyroid function were collected by Raman spectroscopy, and the data were dimensions-reduced by PCA. The reduced data were input into a multi-feature fusion convolutional neural network (MCNN), the improved AlexNet, VGGNet, GoogLeNet and ResNet, Support Vector Machine (SVM) and Decision Tree (DT) for classification, and the results of the seven classification algorithms were compared. Their classification accuracy are 94.01 %, 91.91 %, 90.34 %, 93.46 %, 92.42 %, 82.78 % and 80.89 %, respectively. The results of this study indicate that the combination of serum Raman spectra and MCNN has a good diagnostic effect for identifying thyroid dysfunction, and it is feasible to improve the classic deep learning models for Raman spectrum classification.

SUN-431 Case Finding Versus Routine Screening of Thyroid Dysfunction in Pregnancy

Background:Thyroid dysfunction in pregnancy is associated several adverse outcomes. This has triggered a debate about whether universal screening should be implemented. Despite recommendations against universal screening, the clinical practice of many caregivers may differ. We aimed to assess the sensitivity of using targeted high-risk case finding for diagnosing thyroid dysfunction in pregnancy compared to routine screening in pregnant Saudi women, and to evaluate if gestational diabetes (GDM) specifically affected the risk.Methods:A cross-sectional study in two hospitals under the Ministry of National Guards Health affairs of Saudi Arabia; King Abdulaziz Hospital, Al-Ahsa, and Imam Abdulrahman bin Faisal Hospital, Dammam. Pregnant ladies attending the Family medicine, Obstetrics and Gynecology, and Endocrinology clinics in both hospitals were assessed by the caring physician based on a check list for risk stratification for thyroid dysfunction as per the 2012 Endocrine society clinical practice guidelines for management of thyroid dysfunction in pregnancy. Presence of one risk factor defined high risk. All patients had a routine serum TSH measured as universal screening is commonly practiced in both institutions, the physician doing the risk stratification was not aware of the TSH result. Sensitivity and specificity for the case finding approach was calculated using and abnormal TSH value as the gold standard for presence of thyroid dysfunction. The institutions lab reference TSH 0.35 – 4.94 mIU/L was used as cutoff.Results:1571 pregnant women were included in the study; mean age 29.3± 6.2 years, 396 (23.5%) were primigravida. The mean TSH value was 1.898 ± 1.459 mlU/L. 1178 (75%) pregnant women had an indication for screening based on presence of at least one risk factor, of which 95 (8.1%) tested abnormal for TSH. 393 women had no risk factors, of which 379 (96.4%) had normal TSH, (Chi square 9.3, p-value 0.002). [Sensitivity 87.2%, (95%CI 79.4% – 92.8%), Specificity 25.9%, (95%CI 23.7% – 28.3%)]. Total abnormal TSH values was 109 (6.9%), 43 were abnormal high (i.e. hypothyroid); of which 40 screened positive by case finding approach [Sensitivity 93.02%, (95%CI 80.9% – 98.5%), Specificity 25.52%, (95%CI 23.4% – 27.8%)]. Moreover, 178 (11.3%) women screened positive for GDM at some stage in pregnancy out of which only 5 (2.8%) had an abnormal TSH value, while of the 1393 pregnant women who screened negative for GDM 1289 (92.5%) had a normal TSH value, (Chi square 5.3, p-value 0.02). [Sensitivity 4.6%, (95%CI 1.5% – 10.4%), Specificity 88.2%, (95%CI 86.4% – 89.8%)].Conclusion:Targeted high-risk case finding predicts thyroid dysfunction in pregnant Saudi women with high sensitivity supporting its utility in screening our pregnant population. Gestational diabetes is highly prevalent in Saudi women, but does not increase risk of thyroid dysfunction in pregnancy.