Diagnosis Of Thyroid Dysfunction Research Articles

Study of Thyroid Function Tests in Patients with Metabolic Syndrome

Study of Thyroid Function Tests in Patients with Metabolic Syndrome

Association of COVID-19 Infection with Subsequent Thyroid Dysfunction: An International Population-Based Propensity Score Matched Analysis.

Background: The COVID-19 pandemic's impact on thyroid function is a growing concern. Previous studies have produced inconclusive results, and there is a lack of comprehensive research into the long-term risks of thyroid dysfunction following COVID-19 infection. Methods: In this retrospective cohort study, we used data from the TriNetX international database, which includes electronic health records from a broad, diverse patient population. We compared patients with COVID-19 (cases) to those without (controls), matching for age, sex, race, and comorbidities using propensity score matching. The primary outcome was the diagnosis of thyroid dysfunction (thyrotoxicosis or hypothyroidism) within a 12-month period, analyzed using hazard ratios (HRs) and Kaplan-Meier curves, and stratified by age and sex. Results: Initially, the study included 1,379,311 COVID-19 patients and 6,896,814 non-COVID-19 patients from the TriNetX database. After matching, the cohorts were comparable in demographics and baseline characteristics. This study consistently demonstrated a significant increase in the risk of thyroid dysfunction, including thyrotoxicosis and hypothyroidism, among COVID-19 patients compared to non-COVID-19 patients. In the short term (3 months postexposure), the COVID-19 group exhibited a HR of 2.07 (95% confidence interval [CI] 2.01-2.12) for thyroid dysfunction, which included both thyrotoxicosis (HR 2.10, CI 1.92-2.29) and hypothyroidism (HR 2.08, CI 2.01-2.13). This heightened risk persisted over the long term (up to 12 months), with HRs indicating an ∼2.01-fold increased risk for overall thyroid dysfunction, a 1.8-fold increased risk for thyrotoxicosis, and a 2.04-fold increased risk for hypothyroidism. Subgroup analysis, stratified by age and sex, revealed a notably higher risk of thyroid dysfunction in patients aged 65 and above (HR 2.18, CI 2.11-2.25), compared to those in the under-65 age group (HR 1.97, CI 1.91-2.03). Both male and female patients were associated with an elevated risk, with females showing a slightly higher association with thyroid dysfunction (HR 2.12, CI 2.06-2.16) compared to males (HR 1.76, CI 1.69-1.82). Conclusions: COVID-19 infection was associated with an increased risk of thyroid dysfunction, including thyrotoxicosis and hypothyroidism, regardless of age or sex, during a 12-month follow-up period. Further research is required to validate these findings.

Thyroid-function reference ranges in the diagnosis of thyroid dysfunction in adults.

Thyroid-function reference ranges in the diagnosis of thyroid dysfunction in adults.

Clinical characteristics and the treatment modalities of Graves' orbitopathy in a tertiary referral center in Turkey: changes over two decades.

To evaluate the changes in demographics, clinical findings, and treatment modalities in Graves' orbitopathy (GO) patients at a tertiary referral center in Turkey over the last two decades. The clinical data of 752 GO patients were evaluated retrospectively. Patients were divided into 2 groups according to the first ophthalmic examination date; Group 1(n:344) between January 1998 and December 2007 and Group 2(n:408) between January 2008 and December 2017. The number of nonsmokers was significantly higher in Group 2 (44.0 vs. 26.5%, p < 0.001). The time from the diagnosis of thyroid dysfunction and referral to our center was 32.4months in Group 1 and 34.8months in Group 2, (p = 0.166). The most common treatment of hyperthyroidism was antithyroid medications. Radioiodine ablation treatment rate was significantly lower in Group 2 (14.8 vs. 9.1%, p < 0.001). The time between the diagnosis of thyroid disease and orbital involvement was 22.0 vs. 26.6months in Groups 1 and 2, respectively (p = 0.009). The time elapsed between the diagnosis of orbital disease and referral to our clinic was 21.0months vs. 22.4months in Group 1 and 2, respectively (p = 0.068). Orbital disease was most commonly mild, and inactive. Mild and moderate to severe GO and the mean Clinical Activity Score significantly increased, and the rate of sight-threatening disease and orbital decompression surgery significantly decreased in Group 2 (p = 0.042; p < 0.001, respectively). Mild and inactive orbital disease was the most common form of GO. The severity of GO is declining over the last two decades in Turkey.

A U-shaped association between serum albumin with total triiodothyronine in adults.

BackgroundThyroid dysfunction is a common thyroid disorder in our life and its symptoms are non‐specific, therefore the diagnosis of thyroid dysfunction is important for patients. Albumin (ALB) can carry thyroid hormones to their sites of action as a way to achieve rapid delivery of thyroid hormones to the tissues. The purpose of this study was to investigate the relationship between serum ALB levels and total triiodothyronine (TT3) in adults.MethodsData from the 2007–2012 National Health and Nutrition Examination Survey (NHANES) were used to examine the association between ALB and TT3 using multivariate logistic regression models. Fitting smoothed curves and generalized weighted models were also used.ResultsThe analysis included a total of 7933 participants that we found an independent positive relationship between ALB and TT3 among participants [0.006 (0.003, 0.009)]. In men, there was a significant positive correlation between ALB and TT3, whereas in women ALB and TT3 suggested a significant negative correlation. Moreover, our study revealed that the independent association between the levels of ALB and TT3 was significant in Non‐Hispanic White, but not in Non‐Hispanic Black. Notably, we found a U‐shaped association between ALB and serum TT3 in total participants (inflection point for ALB: 41 g/L) and females after adjusted covariates (inflection point for ALB: 46 g/L).ConclusionsWe found a U‐shaped relationship between serum ALB and TT3 with infection point at 41 g/L for ALB, which may provide a reference for future screening in adults with thyroid dysfunction.

Histopathological variation in thyroid dysfunction associated with musculoskeletal disorder patients

Thyroid dysfunction has been associated with musculoskeletal disorders and there isan increased number of evidences that proves their association. Thyroid dysfunction especially in the form of hypo and hyperthyroidism has been linked to several connective tissue conditions. The primary objective of this study is to establish the histopathological variations in individuals with thyroid dysfunction with a musculoskeletal disorder.In this study with 300 subjects with a diagnosis of thyroid dysfunction, the histopathology of the thyroid tissues was analysed along with their variations.As a part of the histological findings, the following were analysed and evaluated. The hyperplasia of the synovial lining,cellularity of synovial stroma, inflammatory infiltrate, lymphoid follicles and vascularity were noted in muscle tissues. It was found that the histopathological variants increased as the severity of the thyroid dysfunction here in the case of hypothyroidism.

Щитовидная железа у женщин в пери- и постменопаузе: физиология и заболевания

The incidence of most thyroid diseases – hypothyroidism, nodular goiter, and cancer – is highest among peri- and postmenopausal women. Diagnosis of thyroid dysfunction in this group of patients is difficult, since the symptoms may be nonspecific, with complaints typical for the climacteric period. Interpreting thyroid function tests, physiological changes in the secretion and metabolism of thyrotropin and thyroid hormones, as well as the effect of concomitant diseases, must be considered. Unrecognized thyroid dysfunction leads to an increased risk of cardiovascular disease, bone fractures, cognitive impairment, depression, and mortality. Thyroid dysfunction therapy differs in peri- and postmenopausal women of reproductive age; hypothyroidism should be treated with caution because high doses of L-thyroxine can lead to cardiac arrhythmias and an increased risk of bone osteoporosis, and hyperthyroidism should preferably be treated with radioactive iodine. Thyroid cancer often affects women over the age of 50, the diagnostic and therapeutic approach is the same as in the general population, but the prognosis of cancer is worse than in younger patients. The article presents data concerning the differential diagnosis of menopausal symptoms and thyroid gland pathology in perimenopausal women, as well as the peculiarities of therapy for revealed thyroid disorders in this age group.

Analysis of thyroid dysfunction in patients with sudden sensorineural hearing loss.

BackgroundSudden sensorineural hearing loss (SSHL) refers to the sudden occurrence of unexplained sensorineural hearing loss. The present study showed that different systemic diseases had different influence on the occurrence and hearing outcome of SSHL. Thyroid hormone is one of the important factors for the development of fetal ear and auditory function. However, the distribution of thyroid dysfunction in SSHL patients and the effect of thyroid dysfunction on the occurrence and hearing outcome of SSHL has not been studied.MethodsIn this study, a retrospective analysis had been done in 676 patients with SSHL. We had described the distribution of thyroid function in patients with SSHL in detail, and by the statistical method, analyzed the relationship between the hearing outcome and thyroid dysfunction, respectively.ResultsIn all patients, 24.41% (165/676) had abnormal thyroid function testing results. The onset age of SSHL in FT3 abnormal group (including low and high group) was younger than that in normal FT3 group. Recovery group had more patients with lower-than-normal T3 level as compared to non-recovery patients. Significant associations between T3 levels and hearing outcome were observed in the subgroup with longer time elapse between symptom onset and treatment (≥14 d).ConclusionThe incidence of thyroid dysfunction in SSHL is significantly higher than in the general population. There was obvious relationship between T3 and FT3 item of thyroid dysfunction and the onset time and hearing outcome of SSHL, which indicated that T3 or FT3 indicator may be one of the affecting factors for the SSHL. Early screening and diagnosis of thyroid dysfunction, especial T3 level, may help to evaluate the prognosis in SSHL patients.

THYROID DYSFUNCTION IN WOMEN OF REPRODUCTIVE AGE WHO PARTICIPATED IN HOSTILITIES AND SUFFERED CONTUSIONS

The article presents data on the prevalence of thyroid hormonal disorders and the establishment of their relationship between the state of mental health and the functional state of body systems in women who participated in hostilities who suffered contusions. We aimed to assessing the prevalence and effectiveness of the diagnosis of thyroid dysfunction in women of childbearing age with impaired reproductive health who participated in hostilities and suffered contusions, to improve treatment and rehabilitation measures and quality of life of these women.

Challenges in Interpreting Thyroid Stimulating Hormone Results in the Diagnosis of Thyroid Dysfunction.

The pituitary hormone, thyrotropin (TSH), is regarded as the primary biomarker for evaluating thyroid function and is useful in guiding treatment with levothyroxine for patients with hypothyroidism. The amplified response of TSH to slight changes in thyroid hormone levels provides a large and easily measured signal in the routine care setting. Laboratories provide reference ranges with upper and lower cutoffs for TSH to define normal thyroid function. The upper limit of the range, used to diagnose subclinical (mild) hypothyroidism, is itself a matter for debate, with authoritative guidelines recommending treatment to within the lower half of the range. Concomitant diseases, medications, supplements, age, gender, ethnicity, iodine status, time of day, time of year, autoantibodies, heterophilic antibodies, smoking, and other factors influence the level of TSH, or the performance of current TSH assays. The long-term prognostic implications of small deviations of TSH from the reference range are unclear. Correction of TSH to within the reference range does not always bring thyroid and other biomarkers into range and will not always resolve the patient's symptoms. Overt hypothyroidism requires intervention with levothyroxine. It remains important that physicians managing a patient with symptoms suggestive of thyroid disease consider all of the patient's relevant disease, lifestyle, and other factors before intervening on the basis of a marginally raised TSH level alone. Finally, these limitations of TSH testing mitigate against screening the population for the undoubtedly substantial prevalence of undiagnosed thyroid disease, until appropriately designed randomised trials have quantified the benefits and harms from this approach.

PREVALENCE OF HYPOTHYROIDISM IN TYPE 2 DIABETES MELLITUS

Introduction: Thyroid hormone deficiency can lead to adverse health effects even death, if left untreated. It is a pathological condition known as hypothyroidism. Most common symptoms of hypothyroidism in adults are weight gain, fatigue, lethargy, cold intolerance, constipation, and dry skin. These clinical presentations can differ with age and sex, among other factors. Thyroid Stimulating Hormone (TSH), is associated with an increased risk of developing a number of clinical conditions, like cardiovascular diseases, diabetes, lung disease, malignant condition, and psychiatric disorders, both before and after the diagnosis of thyroid dysfunction. Type 2 Diabetes Mellitus (T2DM) is the chronic endocrine disease which is characterized by hyperglycemia resulting in impaired insulin secretion insulin resistance.&#x0D; Material and Methods: This prospective observational study was carried out at OPD of Dept. of Medicine at Govt. Doon Medical College and Hospital. The study period was between jan2019 to August 2019. The anthropometric measurements and demographic characteristics of patients included in the study were recorded. The clinical details and medications are entered into Excel sheet of Microsoft Excel 2013. Biochemical tests were done and reports were entered.&#x0D; Results: Prevalence of hypothyroidism in T2DM is found to be 10.94% in our study. Average BMI was observed to be 28.01 kg/m2 with SD of 3.39 kg/m2. Level of T3 and T4 were observed to be 0.98(0.23) ng/ml and 1.24(0.29) ng/ml respectively. Fasting blood glucose level was 133.05(17.81) mg/dl and post prandial blood glucose level was 201.54(27.33) mg/dl. Among all 112 patients, 71(63.39%) of cases had a family history of diabetes.&#x0D; Conclusion: It is noted that one-tenth of patients with type 2 diabetes mellitus has hypothyroidism. BMI was noted to be more than 28 kg/m2 among all patients. Hypothyroidism may be prevalent in T2DM patients due to duration of diabetes, obesity. To confirm the findings, more studies in this area are required.&#x0D; Keywords: T2DM, Hypothyroidism, TSH, T3, T4.

Proportions of thyroid disorders in bhopal- a hospital based study

Introduction: Thyroid disorder are multifactorial with contributions from genetic and environmental factors. The principal diseases of thyroid gland are goitre, hypothyroidism, hyperthyroidism, thyroiditis and neoplasms. Estimation of thyroid hormones and TSH are essential in arriving at a diagnosis of thyroid dysfunction. Objectives: To find out spectrum of thyroid dysfunction among study participants and to assess the association of thyroid disorders with socio-demographic variables Material and Methods: This was a facility based cross sectional study in Department of Biochemistry, for a period of one year from 1st April 2017 to 31st March 2018. All the individuals reporting for thyroid function tests in Biochemistry department for first time were included in the study using systematic random sampling. All participants included in the study were interviewed and information was recorded on a questionnaire. Observations: The mean age of study participants was 31.9±12.0 years. 414 (67.9%) participants were euthyroid, 158 (25.9%) were diagnosed as hypothyroid (21.8% subclinical and 4.1% overt), while only 38 (6.2%) were diagnosed as hyperthyroid (3.1 subclinical and 3.1 overt). Keywords: Thyroid, Hypothyroidism, Hyperthyroidism, Spectrum, Bhopal.

Thyroid functions and levels of some trace elements in children with beta-thalassemia major

Background High plasma iron in β-thalassemia major (BTM) leads to enhanced generation of reactive oxygen species, oxidative stress, and endocrine disorders. We aimed to assess thyroid function and trace elements [copper (Cu) and zinc (Zn)] in patients of BTM and to evaluate the relation, if any, of thyroid function with iron store in the form of ferritin levels. Patients and methods A total of 30 children with BTM and 30 healthy controls were enrolled and interviewed at the Al-Azhar University. Complete blood count, random blood sugar, liver enzymes, and creatinine were measured in all participants. Iron level, total iron-binding capacity, ferritin level, Zn level, and Cu level in sera were determined. Thyroid function was also assessed by evaluating free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) levels. Results There were significantly increased serum iron, ferritin, Cu, and Zn levels, whereas total iron-binding capacity was depleted in patients with BTM as compared with healthy controls. There were significant positive correlations between ferritin level and both serum Cu and Zn (r=0.536 and 0.513, respectively), with P value less than 0.05. Moreover, there were significant positive correlations between TSH level and both serum Cu and Zn (r=0.416 and 0.355, respectively), with P value less than 0.05. Thyroid function represented by FT3, FT4, and TSH did not correlate with serum ferritin level. Conclusion Careful monitoring of ferritin, Cu, Zn, TSH, FT4, and FT3 levels at regular intervals is recommended for early diagnosis of thyroid dysfunctions in patients with BTM.

Diagnosis of thyroid dysfunction in human blood using non-invasive method: infra red light emitting diode technique

The thyroid is a bilobed butterfly like organ situated on the front of the neck. It secretes hormone like T3 and T4. The incidence of hypo and hyper thyroidism is in the increasing trend due to life style changes. Thyroid hormone has a number of important functions involving the growth and metabolism of the body especially in the children. Growth is very important and it is regulated by this hormone. Hence the importance of this hormone is very much understood. The main aim of this study is to estimate the levels of T3 and T4 by using IR LED technique. This is the most non-invasive, less time consuming and most economical method. This is highly useful in endemic areas to conduct a mass study and evaluation of the disease. IR LED technique is a non-invasive method by which different wave lengths (1000, 750 and 800 nm) is absorbed by the hormone molecules in the blood. Based upon this absorption level hormone level may be assessed. The principle of IR LED technique is to transmit the IR rays of different wavelength which after reflecting from the soft tissues of the finger received by the photo diode which indicate the values. Based upon this absorbance level values of the output is displayed in the liquid crystal display as normal or hyper or hypothyroidism.

Age- and gender-specific reference intervals of TSH and free T4 in an iodine-replete area: Data from Korean National Health and Nutrition Examination Survey IV (2013-2015).

BackgroundEstablishment of the reference interval of thyroid-stimulating hormone (TSH) is critical in the diagnosis of thyroid dysfunction and is affected by age, gender, iodine nutrition, and ethnicity. The aim of this study was to determine the reference intervals of TSH and free thyroxin (FT4) from a large, nationwide data of Korea where iodine intake is more than adequate.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey VI that measured serum TSH, FT4, and thyroid peroxidase antibody from 7,061 individuals (urinary iodine measurement in 6,565). Age- and gender-specific reference intervals were established from 95% confidence limits from the 2.5 to 97.5 percentile of TSH (log-transformed) and FT4 in reference populations.ResultsThe geometric mean of TSH was 2.16 ± 0.01 mIU/L, with the lowest value found in the middle aged group (2.04 ± 0.02 mIU/L) and higher values noted in age groups of 10–19 and over 70 years (2.38 ± 0.02 and 2.32 ± 0.07 mIU/L, respectively). The association of TSH and age was U-shaped. The overall reference interval of TSH was 0.59–7.03 mIU/L. Mean FT4 was 1.25 ± 0.003 ng/dL (16.09 ± 0.039 pmol/L), and it showed a small but continuous decrease after 20 years of age (P < 0.001). There was a significant positive correlation between TSH and urine iodine concentration (r = 0.154, P < 0.001).ConclusionsThe reference interval of TSH in Korea, where iodine intake is above the requirement, was 0.59–7.03 mIU/L and showed U-shaped change with age, which was a similar pattern to iodine intake. The reference interval of FT4 was 0.92–1.60 ng/dL. The geometric mean and upper limit of TSH were higher than those of Western populations, reflecting the paramount importance of iodine intake on thyroid function.

The Correlation Analysis on Glycolipid Metabolism, CysC and Homocysteine of Thyroid Dysfunction

The objective is to discuss about the correlation of Glycolipid Metabolism, Cystatin C (CysC) and Homocysteine (Hcy) of thyroid dysfunction. 100 cases of hyperthyroidism, hypothyroidism and the control group are chose respectively to measure Fiber Bragg Grating (FBG), Blood Lipid, Thyroid Hormone (TH), CysC and Hcy, calculate the blood lipid ratio and make analysis. As a result, Thyroid Carcinoma (TC), Thyroglobulin (TG), Low-density Lipoprotein Cholesterol (LDL-C), High-density Lipoprotein Cholesterol (HDL-C), TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, Lipid comprehensive index (LCI) and non-HDL-C of hyperthyroidism group are obviously lower than the control group. The decrease of LCI is the most prominent. Hcy is slightly lower than the control group. FBG and CysC are obviously higher than the control group. TC, TG, LDL-C, TG/HDL-C, LDL-C/HDL-C, LCI and non-HDL-C, Hcy of hypothyroidism group are higher than the control group (P＜0.05), and FBG, HDL-C and CysC are lower than the control group (P＜0.05). Various kinds of TH have the highest connection with TC, followed by non-HDL-C, LDL-C and LCI. It comes to the conclusion that patients with thyroid dysfunction easily appear the disorder of glucose and lipid metabolism. The change in blood lipid ratio is more pronounced than that of single lipid indicator and is closely related to CysC and Hcy. Dynamic monitoring of Thyroid Stimulating Hormone (TSH), blood lipid ratio, CysC and Hcy is of great value in the diagnosis of thyroid dysfunction and the prediction of Cardiovascular Disease (CVD) in concurrent Coronary Heart Disease (CHD) and so on.

Study of Serum Irisin in Patients with Thyroid Dysfunction

Background: irisin, identified as a proteolytic cleavage product of the fibronectin type III domain-containing protein 5 (FNDC5), It is a novel myokine secreted by contracting skeletal muscle, possibly mediating some exercise health benefits via ‘browning’ of white adipose tissue. Irisin causes a significant increase in total body energy expenditure and resistance to obesity-associated insulin resistance in mice, while controversy still exists concerning irisin origin, regulation and function in humans. Aim of the work: our study aimed to detect relation of thyroid status (hypo, hyperthyroid) with serum irisin, ck and peripheral neuropathy. Patient and methods: this study was conducted on 60 candidates consisted of 40 patients with thyroid dysfunction selected from Endocrine outpatient Clinic and Inpatient Department of Ain Shams University Hospitals and 20 healthy volunteers from April 2016 to October 2016. Informed consent was obtained from all participants. Patients of both genders, age more than 18 years old, 20 patients with hypothyroidism, 20 patients with hyperthyroidism and 20 healthy volunteers. We excluded significant renal, hepatic and cardiac disease, severe associated acute illness or depression, pregnant females, diabetes, hypercortisolism, hypocortisolism, muscular or neurological disorders, routinely taking drugs as statins, intensively involved in a sport or any strenuous physical activity. All participants were subjected to full medical history taking, general clinical examination and laboratory investigations as thyroid and thyroid-related hormone concentrations as well as a thyroid ultrasound examination and thyroid scan for patients with hyperthyroidism. Serum irisin level, CK and nerve conduction velocity were measured. Results: irisin level was higher in hyperthyroid group than euthyroid group with a significant difference. In comparison with normal NCV candidates and reduced NCV candidates with other variables there was only border line significant difference with irisin p-value. Non significant value of irisin and CK level were detected for diagnosis of hypothyroidism. Irisin has highly significant value for diagnosis of hyperthyroidism with (sen 95%, sp 42.5). Increased BMI is the only independent predictor for hypothyroidism by using multivariable binary logistic regression analysis. Decreased BMI and irisin are independent predictors for hyperthyroidism. Conclusion: serum irisin level is one of predictors for hyperthyroidism, on the other hand irisin does not have a significant value to predict hypothyroidism. Serum irisin was found to be higher in patients with hyperthyroidism in comparison with euthyroid participant with non statistically significant difference between hypo and hyperthyroidism. Serum CK level does not have a significant value in diagnosis of thyroid dysfunction (hypothyroidism or hyperthyroidism). Serum irisin level was low in thyroid dysfunction cases with delayed NCV compared to thyroid dysfunction cases and normal NCV with border line significant difference.

Association Between Non-Infectious Uveitis and Thyroid Dysfunction: A Case Control Study.

Several reports suggested a relation between uveitis and thyroid disease or dysfunction. However, no study has investigated the association between uveitis and thyroid dysfunction. The purpose of this study was to compare the prevalence of thyroid dysfunction in patients with and without non-infectious uveitis. This was a retrospective, case-control study. Two hundred thirty-five non-infectious uveitis patients (uveitis group) and 600 controls (control group) were included in the study, of whom 492 (58.9%) were females. No differences were demonstrated between the uveitis and control groups with regard to baseline characteristics, including age, sex, and the presence of systemic diseases such as diabetes, hypertension, and cardiac disease. Rheumatologic and gastrointestinal disease were more common in the uveitis group (p < 0.001 and p = 0.007, respectively). Overall, thyroid dysfunction was noted in 61 (7.3%) patients, of whom 55 had hypothyroidism and six had hyperthyroidism. Seventeen out of 235 (7.2%) uveitis patients and 44/600 (7.3%) controls were diagnosed with thyroid dysfunction-a similar proportion in both groups (p = 0.96). Of these, all uveitis patients and 38 (86.4%) patients in the control group had a diagnosis of hypothyroidism (p = 0.63). A higher percentage of women was found among uveitis patients with thyroid dysfunction compared with uveitis patients without thyroid dysfunction (p = 0.002). The most common uveitis type was anterior uveitis. No significant difference was found in uveitis types between patients with or without a diagnosis of thyroid dysfunction. The prevalence of thyroid dysfunction was similar in both groups, and no association was found between non-infectious uveitis and thyroid dysfunction in this study. These findings suggest there is no need for routine thyroid function evaluation in patients with non-infectious uveitis.

The thyroid gland in postmenopausal women: physiology and diseases.

The incidence of most thyroid diseases: hypothyroidism, nodular goitre, and cancer is highest among postmenopausal and elderly women. The diagnosis of thyroid dysfunction in this group of patients is difficult because the symptoms can be nonspecific or common with menopausal and ageing complaints. In the interpretation of thyroid function tests the physiological changes in secretion and metabolism of thyrotropin (TSH) and thyroid hormones must be considered, as well as the influence of comorbidities. Unrecognised thyroid dysfunction leads to increased: cardiovascular risk, bone fractures, cognitive impairment, depression, and mortality. Therapy of thyroid dysfunction is different in postmenopausal and elderly women than in young people; hypothyroidism should be treated with caution, because high doses of L-thyroxine can lead to cardiac arrhythmias and increased bone turnover, and hyperthyroidism should be preferentially treated with radioiodine. Thyroid status beneficially influencing longevity relates to low thyroid function.Thyroid nodules and cancer often affect women over 50 years old; the diagnostic and therapeutic approach is the same as in the general population, but the surgical risk and cancer prognosis is worse than in young patients.

Marcadores de función tiroidea (I). Evaluación de la actividad glandular

Las hormonas tiroideas desempeñan un papel fundamental en el metabolismo de todos los órganos y sistemas. La disfunción tiroidea (DT) es un importante problema de salud pública que afecta al 10% de la población general. El diagnóstico actual de la DT se realiza de acuerdo con la concentración plasmática de hormonas determinadas en el laboratorio. El resultado permite clasificarla en clínica (TSH y hormonas tiroideas fuera del rango de normalidad) y subclínica (TSH alterada de forma aislada). El desarrollo de ensayos de tercera generación para la determinación de TSH ha supuesto un gran avance en el diagnóstico de la DT. Sin embargo ha aumentado el debate sobre el significado patológico de la morbilidad asociada a la DT subclínica, hasta el punto de que los expertos mantienen posturas divergentes sobre el mejor método diagnóstico y las necesidades terapéuticas de esta situación tan prevalente. Ello es así porque carecemos de la capacidad de conocer cuales son los pacientes con enfermedad tiroidea subclínica que desarrollarán las complicaciones propias de la disfunción clínica. La consecuencia práctica de todo ello es que con toda probabilidad estamos tratando de forma inadecuada a pacientes con hipotiroidismo subclínico: en algunos casos los sobretratamos, mientras que en otros no les proporcionamos la hormona que necesitan.