High Thyroid-stimulating Hormone Research Articles

Association Between Maternal Thyroid Function in Early Pregnancy and Gestational Diabetes: A Prospective Cohort Study.

Previous studies on the relationship between thyroid gland function and the development of gestational diabetes mellitus (GDM) have reported different results, leading to the need for a cohort study design with a large sample size. We aimed to investigate the relationship between thyroid function in early pregnancy and GDM. This was a prospective cohort study based on the China Birth Cohort Study (CBCS), from February 2018 to December 2020. The study took place at a tertiary maternal and child health hospital. A total of 36 256 pregnant women were successfully recruited based on the CBCS. The main outcome measure was GDM. This study consisted of 26 742 pregnant women who met the inclusion criteria, of whom 3985 (14.90%) were diagnosed with GDM, and the women with GDM were older than their healthy counterparts (33.26 ± 4.01 vs 31.51 ± 3.76 years, P < .001). After removing potential influencing variables, we found that increased thyroid-stimulating hormone (TSH) (adjusted odds ratio [aOR] 1.030, 95% CI 1.007, 1.054, P = .012) and subclinical hypothyroidism (aOR 1.211, 95% CI 1.010, 1.451, P = .039), but not free thyroxine or thyroid peroxidase antibody, were associated with the occurrence of GDM. Further analysis indicated a nonlinear relationship between TSH and GDM (P < .05): when TSH ≤ 1.24 mIU/L, the occurrence of GDM was elevated with increasing TSH, but when TSH > 1.24 mIU/L, this trend was not obvious. High TSH might be associated with increased risk of GDM.

Association between thyroid function and diabetes peripheral neuropathy in euthyroid type 2 diabetes mellitus patients

Previous studies disclosed that a high thyroid stimulating hormone level is an independent risk factor for diabetes peripheral neuropathy (DPN) in subclinical hypothyroidism (SCH) patients with type 2 diabetes mellitus (T2DM). However, whether thyroid metabolism has an effect on DPN in euthyroid T2DM patients remains unknown. The aim of this study was to identify the association between thyroid function and DPN in euthyroid T2DM patients. A set of 580 euthyroid T2DM patients was enrolled in the current study and stratified into DPN and Non-DPN groups. Mann–Whitney U test was performed to analyze the continuous variables of biochemical and thyroid metabolism indicators, and the Chi-square test was used to compare the categorical variables. Spearman correlation analysis was performed to analyze the relationship between clinical indicators and free thyroxine (FT4). By using the logistic regression analysis, the prevalence of DPN in different thyroid function indicators were evaluated. T2DM patients with DPN had obviously lower levels of aspartate aminotransferase (AST), alpha-hydroxybutyric dehydrogenase (α-HBDH), superoxide dismutase (SOD), calcium (Ca), creatinine (Cr), uric acid (UA), retinol binding protein (RBP), total protein (TP), albumin (ALB), alanine aminotransferase (ALT) and FT4 than the T2DM patients without DPN (P < 0.05). FT4 was associated with TP, prealbumin (PA), ALB, SOD, anion gap (AG), Ca, chlorine (Cl), UA, RBP, apoprotein A (Apo A), apoprotein B (Apo B), apoprotein E (Apo E), and total cholesterol (TC). According to the FT4 quartile, participants were sequentially divided into four groups to compare the prevalence of DPN between each group. The data suggested that the prevalence of DPN in these four groups was 53.79%, 53.28%, 54.97%, 38.10%, respectively. Moreover, compared with quartile 4, patients in quartile 1, 2, 3 all had a significantly higher risk of DPN (P = 0.007, P = 0.011, P = 0.004). The level of FT4 was negatively correlated with the prevalence of DPN in euthyroid T2DM patients.

Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis.

High thyroid stimulating hormone (TSH) levels may stimulate papillary thyroid cancer (PTC) cell proliferation; however, the relationship between TSH levels and PTC risk remains controversial. We aim to ascertain the association through a meta-analysis. Literature searches were conducted in PubMed, Embase, and Web of Science databases. After literature screening, the methodological quality was assessed using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality methods. Cochran's Q and I 2 tests were used to evaluate heterogeneity in the meta-analysis. Egger's test was applied to assess publication bias. A total of 12 eligible studies were included in this meta-analysis; all were of moderate and high methodological quality. The pooled results suggested that increased TSH levels were significantly associated with PTC risk; however, the included studies were significantly heterogeneous. Stratification analysis indicated that the heterogeneity might be from the area or type of control. Although significant publication bias existed among the studies, the trim-and-fill method and sensitivity analysis revealed that the combined results were stable and robust. TSH levels are significantly associated with the PTC risk; however, more high-quality studies in large sample sizes are recommended to verify the extrapolation of these findings.

Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature.

Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.

Prevalence and clinical correlates of psychotic symptoms in first-episode untreated female chinese patients with major depressive disorder

BackgroundRecent studies have reported that psychotic symptoms are common in patients with major depressive disorder (MDD). However, few studies have reported the relationship between thyroid function, lipid metabolism and clinical profiles in female MDD patients. Thus, this study aimed to investigate the prevalence of psychotic depression (PD) and its risk factors in first-episode and drug naive (FEDN) depression among the female population in China.MethodsThis was a cross-sectional study involving a representative probability sample of 1,130 FEDN female outpatients with MDD (aged 18 years or older) in China. We collected information relating to socio-demographic characteristics, clinical data and blood samples. The Hamilton Depression Rating Scale 17-item version (HAMD-17), Hamilton Anxiety Rating Scale 14-item version (HAMA-14), and Positive and Negative Syndrome Scale (PANSS) were used to evaluate depressive, anxiety, and psychotic symptoms.ResultsThe prevalence of psychotic symptoms in female MDD patients was 10.97%. The findings revealed significant differences between MDD female patients with psychotic symptoms and non-PD female patients in the following areas: higher HAMD scores, higher HAMA scores, more severe anxiety and an increased risk of suicide attempts. Further logistic regression analysis showed that psychotic symptoms were associated with higher thyroid-stimulating hormone (TSH) levels and an odds ratio of 1.168.ConclusionsOur findings supported the hypothesis that higher TSH levels were correlated with psychotic symptoms in female MDD patients. Therefore, serum TSH levels may be a potential biomarker of PD in female MDD patients. In addition, we found that PD was closely associated with suicide attempts and lipid levels, but did not reach statistical significance.

The relationship between papillary thyroid carcinoma and preoperative TSH level: A cross-sectional study from Syria

Papillary thyroid carcinoma (PTC) is the most common type of thyroid cancer, and thyroid stimulating hormone (TSH) is the major growth factor for thyroid cells. It is also an available, inexpensive test and performed routinely while evaluating thyroid nodules. Yet the relationship between TSH levels and PTC is still controversial. Understanding the relationship between preoperative TSH levels and thyroid cancer helps to break new ground of current prevention, diagnosis, and management approaches of thyroid cancer. A cross-sectional retrospective study of patients underwent total thyroidectomy during 2019 at Al-Assad University Hospital, which included 305 individuals. All patients underwent thyroid ultrasonography and laboratory assessment of serum TSH levels prior to surgery, in addition to recording histological features of resected thyroid samples. The malignancy rate was 21.3%, PTC patients had higher TSH values across the entire study even when gender, age and number of thyroid nodules differed. A statistically significant increase in TSH levels was noticed by moving from the benign thyroid nodular disease (BTND) group to papillary thyroid microcarcinoma (PTMC) group, then to thyroid cancer of larger size (TCLS) group (P = .001). A statistically significant relationship was also found between high TSH levels and lymph node metastases (LNM) (P = .008). TSH concentrations were significantly higher in patients with PTC, and higher TSH values were associated with TCLS and LNM.

Exploring the oral-gut microbiota during thyroid cancer: Factors affecting the thyroid functions and cancer development.

Thyroid cancer (TC) is categorized into papillary, follicular, medullary, and anaplastic. The TC is increasing in several countries, including China, the United States, the United Kingdom, Canada, France, Australia, Germany, Japan, Spain, and Italy. Thus, this review comprehensively covers the factors that affect thyroid gland function, TC types, risk factors, and symptoms. Lifestyle factors (such as nutrient consumption and smoking) and pollutants (such as chemicals and heavy metals) increased the thyroid-stimulating hormone (TSH) levels which are directly related to TC prevalence. The conventional and recent TC treatments are also highlighted. The role of the oral and gut microbiota as well as the application of probiotics on TC are also discussed. The variations in the composition of oral and gut microbes influence the thyroid function indirectly through alteration in metabolites (such as short-chain fatty acids) that are eminent for cellular energy metabolism. Maintenance of healthy gut and oral microbiota can help in regulating thyroid function by regulating iodine uptake. Oral or gut microbial dysbiosis can be considered as an early diagnosis factor or TC marker. High TSH during TC can increase the oral microbial diversity while disrupting the high ratio of Firmicutes and Bacteroidetes in the gut. Supplementation of probiotics as an adjuvant in TC treatment is beneficial. However, needs more extensive research to explore the direct effect of probiotics on thyroid function.

1573-P: Association of Thyroid Hormone Levels with NAFLD in Recent-Onset Diabetes

Nonalcoholic fatty liver disease (NAFLD) is a growing health concern associated with obesity and type 2 diabetes (T2D). Thyroid hormones are important regulators of lipid homeostasis. Indeed, people with hypothyroidism are at greater risk for NAFLD and it has been suggested that humans with T2D are more likely to develop hypothyroidism. However, little is known about the relationship of thyroid function with NAFLD in type 1 diabetes (T1D) and T2D. We hypothesized that (i) low free thyroxin (fT4) and high thyroid-stimulating hormone (TSH) levels are associated with increased hepatocellular lipid content (HCL) and (ii) that fT4 and TSH can identify persons at high-risk for hepatic steatosis in people with recent-onset diabetes. We examined people with T1D (n=358) or T2D (n=596) and 175 healthy participants of the German Diabetes Study (GDS). First, validation of the fatty liver index (FLI) against quantification of HCL by 1H-magnetic resonance spectroscopy revealed a close correlation (ß=0.715, p&amp;lt;0.001; n=446). Second, FLI negatively correlated with fT4 in males (ß=−0.139, p&amp;lt;0.01), but not in females with T2D (ß=−0.086, p=0.26). Likewise, TSH associated positively with FLI in males (ß=0.116, p&amp;lt;0.05), but not in females with T2D (ß=−0.057, p=0.45). TSH and FLI were differently associated between males and females before (p&amp;lt;0.05), but not after (p=0.82) adjustment for BMI. Finally, fT4 had a low diagnostic precision for steatosis (by FLI) as derived from the respective area under the receiver operating curve (0.57, 95% CI [0.53;0.62]; p&amp;lt;0.001) in T2D and was not significant in other groups. TSH had no diagnostic precision for steatosis in any groups. In conclusion, FLI can be used as a surrogate measure of HCL in recent-onset diabetes. The correlation of FLI with lower thyroid function in male T2D suggests a sex-specific interaction between thyroid and liver lipid metabolism, which is mainly driven by body mass. Both, fT4 and TSH offer no relevant efficacy to detect steatosis at least in recent-onset diabetes. Disclosure N. Saatmann: None. M. Schön: None. O.P. Zaharia: None. M. Huttasch: None. K. Strassburger: None. S. Trenkamp: None. Y. Kupriyanova: None. V. Schrauwen-Hinderling: None. S. Kahl: None. V. Burkart: None. R. Wagner: Speaker's Bureau; Novo Nordisk, Sanofi. Advisory Panel; Daiichi Sankyo. M. Roden: Advisory Panel; Eli Lilly and Company. Research Support; Boehringer-Ingelheim, Novo Nordisk, Novartis. Consultant; TARGET PharmaSolutions, Inc. Research Support; Sanofi.

ACE Question

Article| June 2023 ACE Question ASA Monitor June 2023, Vol. 87, 12. https://doi.org/10.1097/01.ASM.0000938796.60441.09 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation ACE Question. ASA Monitor 2023; 87:12 doi: https://doi.org/10.1097/01.ASM.0000938796.60441.09 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: anesthesiology continuing education (ace) Which of the following combinations of free thyroxine (FT4) level and thyroid-stimulating hormone (TSH) level is MOST likely in a patient with subclinical hypothyroidism? About 5% of patients older than 65 years have hypothyroidism. Primary hypothyroidism is due to thyroid gland dysfunction, while secondary hypothyroidism is due to pituitary dysfunction. In primary hypothyroidism, thyroid-stimulating hormone (TSH) is increased due to a negative feedback loop that stimulates the failing gland, while free thyroxine (FT4) is low or low-normal. Low levels of both FT4 and TSH suggest secondary hypothyroidism, often associated with pituitary dysfunction. High FT4 levels with low TSH levels suggest primary hyperthyroidism (Figure). Subclinical hypothyroidism is characterized by normal FT4 and high TSH. High TSH ranges from 5 to 15 mU/L, while normal TSH ranges from 0.3 to 4.5 mU/L. Generally, subclinical hypothyroidism is thought to have little or no perioperative significance. An increasing TSH level is the... You do not currently have access to this content.

Circulating free T3 associates longitudinally with cardio-metabolic risk factors in euthyroid children with higher TSH.

Thyroid hormones play major roles in the regulation of body composition and metabolism, and therefore, the relationship between thyroid hormones and cardio-metabolic risk has been extensively studied in adults. In this study, we aimed to test whether free triiodothyronine (fT3) associates longitudinally with cardio-metabolic risk factors in euthyroid children. A prospective study cohort of 599 apparently healthy school-age children were assessed at baseline (mean age 8.1 ± 2.1 years), of whom 270 children were also assessed at follow-up (4 years later). Circulating thyroid-stimulating hormone (TSH), free thyroxine (fT4), and fT3 were measured, and cardio-metabolic risk was assessed by means of body mass index (BMI), waist circumference, visceral fat (by ultrasound), blood pressure, circulating lipids, and homeostasis model assessment of insulin resistance (HOMA-IR) index, both at baseline and at follow-up. All studied children had normal thyroid function tests. Independent associations between baseline fT3 and both baseline and follow-up BMI, systolic blood pressure, mean arterial blood pressure, triglycerides, and HOMA-IR were found using multivariate regression analysis (adjusting for sex and baseline age and BMI). Analyses of effect sizes showed that for each 1 unit-increase in baseline fT3 (pg/ml), follow-up BMI-standard deviation score (SDS) increased by 0.31 units (z-score) and systolic blood pressure by 6.6 units (mmHg). The observed longitudinal associations were more robust in children belonging to the upper TSH tertile who showed higher TSH levels and were characterized by weighing more and having the highest fT3 levels. In these children, for each 1 unit-increase in baseline fT3 (pg/ml), follow-up BMI-SDS increased by 0.67 units (z-score) and systolic blood pressure by 10.2 units (mmHg). Circulating fT3 associates longitudinally with cardio-metabolic risk factors in euthyroid children with higher TSH. The observed associations of thyroid hormones in these children could conceivably respond to a homeostatic attempt to reduce their cardio-metabolic risk.

Mean Platelet Volume in Patients With Subclinical Hypothyroidism Attending at A Tertiary Care Hospital of Bangladesh

Background: Subclinical hypothyroidism (SCH) is a common endocrine disorder affecting about 3-8% of the general population. On the other hand, mean platelet volume (MPV) is an indicator of platelet activity, and elevated MPV is associated with adverse cardio-metabolic complications. This study was conducted to observe MPV in SCH and to correlate it with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels. Materials and Methods: This cross-sectional observational study was conducted in Medicine and Endocrinology OPD of US- Bangla Medical College &amp; Hospital over twelve (12) months from September 2020 to August 2021. This study included forty (40) cases of newly detected SCH and twenty (20) age &amp; body mass index (BMI) matched euthyroid control subjects as per inclusion and exclusion criteria. Results: SCH group had higher TSH and MPV than controls (P value &lt;0.001 and &lt;0.05 respectively) where age, BMI, and FT4 level were comparable (P value&gt;0.05). MPV shows a positive correlation with BMI in SCH &amp; controls (P values &lt;0.05). MPV shows a significant positive correlation with TSH and a negative correlation with FT4 only in SCH (P&lt;0.05) but not in controls (P value&gt;0.05). Conclusion: Patients with SCH have elevated MPV, so they are at increased risk of developing an adverse cardiovascular outcome. J Dhaka Med Coll. 2022; 31(1) : 61-65

Abstract #1405611: A Case Regarding Severe Hypothyroidism Which Complicated to De Novo Nephrotic Syndrome (Minimal Change Disease)

Hypothyroidism is a condition of an under-reactive thyroid. More prevalent in women, 10% exhibit some degree of thyroid insufficiency. It has numerous metabolic effects and may have an impact on renal physiology and worsening kidney function. Hypothyroidism was cited in certain case studies as a contributing factor to minimal change disease, which we will be highlighting here. We report a case of an 82-year-old female with PMH of graves’ disease status post left thyroidectomy in 2009 and was started on Levothyroxine, reported non-compliance, presented to the emergency department with a complaint of generalized edema mostly lower extremities that is progressively worsening over 2 weeks along with foamy urine. Unremarkable physical exam except for 2+ lower extremity pitting edema. On lab, high thyroid stimulating hormone (TSH) was 65.2 ulU/ml, normal Free Thyroxin (FT4) and low Free Triiodothyronine (FT3) 0.4 pg/ml, Serum Creatinine is 4.35 mg/dl, Urinalysis shows >500 protein, urine protein/Cr was 3, hypoalbuminemia and hyperlipidemia were present. A Glomerulopathy workup was initiated. She was admitted for further testing. Autoimmune kidney diseases were ruled out and a renal biopsy was performed, the specimen revealed Minimal change disease. She was started on Prednisone 60 mg daily and Levothyroxine 125 mcg. Three weeks later, patient showed a good response to therapy with an improvement of symptoms and repeated creatinine was 3.8. Hypothyroidism can be caused by partial or total thyroidectomy. As a highly lipophilic substance, Thyroxine binds to receptors that are expressed in cells all over the body to exhibit its physiological action. In patients with thyroidectomy, exogenous levothyroxine is the thyroid hormone supply to the body. Not having enough supply, can alter kidney function by affecting vascular resistance, re-absorptive process, and renal blood flow. It can also affect the RAAS system, beta-adrenergic receptors, and dopaminergic activation of the renal tubular cells. Gradual worsening of kidney function leads to an increase in the loss of free and bound thyroid hormones and eventually increases thyroxine requirement. GFR is reversibly reduced (by about 40%) in more than 55% of adults with hypothyroidism. Thyroxine treatment is effective by reducing edema, capillary permeability of albumin, and plasma colloid osmotic pressure. Proteinuria can sometimes be reversible by prompt initiation of thyroxine treatment. Also, the severity of symptoms plays a role in recovery. More research is needed to determine the relationship between hypothyroidism and nephrotic syndrome as only a few isolated occurrences were reported in the literature.

Association of thyroid stimulating hormone and time in range with risk of diabetic retinopathy in euthyroid type 2 diabetes.

Diabetic retinopathy (DR) can occur even in well-controlled type 2 diabetes, suggesting residual risks of DR in this population. In particular, we investigated the combined effect of thyroid function and glycaemic control assessed by an emerging metric, time in range (TIR) with DR. In this cross-sectional study, a total of 2740 euthyroid patients with type 2 diabetes were included. Thyroid indicators, including thyroid-stimulating hormone (TSH), free triiodothyronine, free thyroxine, thyroid peroxidase antibody and thyroglobulin antibody, were measured. TIR was measured using continuous glucose monitoring data. Overall, the multivariable-adjusted odds ratios (ORs) for DR across ascending tertiles of TSH were 1.00 (reference), 1.06 (95% confidence interval [CI] 0.85-1.32), and 1.48 (95% CI 1.19-1.85). Even in well-controlled participants who achieved a TIR target of >70% (n=1449), the prevalence of DR was 23.8%, which was significantly related to TSH (OR=1.54, 95% CI 1.12-2.12, highest vs. lowest TSH tertile). Participants were then classified into 6 groups by the joint categories of TIR (>70%, ≤70%) and TSH (tertiles), and the multivariable-adjusted ORs for DR were highest in TIR ≤70% and the highest TSH tertile group (OR=1.96, 95% CI 1.41-2.71) when compared with the TIR >70% and the lowest TSH tertile group. In type 2 diabetic patients with well-controlled glycaemic status, higher TSH within the normal range was associated with an increased risk of DR. The combination of suboptimal TSH and TIR further increased the risk of DR.

Improvement of diagnostic methods of reproductive health disorders in women of early reproductive age with sexual dysfunction and hypoandrogenism

Female sexual dysfunction (FSD) is a global health problem. This is a multifaceted problem that requires the coordinated interaction of many neurotransmitters and hormones, both central and peripheral. In young women with reproductive health problems, the first clinical signs of future imbalances manifest in adolescence. Disruption of adaptation mechanisms at this age leads to the activation of polymorphic genes, resulting in the multifunctional disorders of women’s health in the future. In particular, the role of vitamin D deficiency as a trigger in the formation of many immune‑hormonal imbalances is noted, including formation of methionine metabolism disorders and the accumulation of excess homocysteine in cells. Therefore, improving methods of diagnosing reproductive health disorders in women of early reproductive age with sexual dysfunction and hypoandrogenism can be considered as a method of preventing the formation of conditions in them for future fertility disorders, decreased ovarian reserve, and infertility.&#x0D; Objective — to improve methods to diagnose the reproductive health disorders in women of early reproductive age with sexual dysfunction and hypoandrogenism.&#x0D; Materials and methods. The research included 20 women of early reproductive age with symptoms of FSD and hypoandrogenism (group I) and 20 healthy women (group II). The hormonal reproductive background was determined on the 5—7th day of the menstrual cycle in all examined women, including levels of thyroid‑stimulating hormone (TSH), antibodies to thyroid peroxidase (TPO‑Ab), vitamin D, homocysteine. IBM SPSS Statistics version 25.0 software was used for statistical processing of the obtained data.&#x0D; Results. Vitamin D deficiency significantly raised the probability of decreased levels of luteinizing hormone (LH) (R2=0.705; p&lt;0.001), estradiol (R2=0.320; p=0.022), free testosterone (R2=0.419; p=0.007), dihydroepiandrosterone sulfate (DHEA‑S) (R2=0.697; p&lt;0.001) and increased levels of prolactin (R2=0.691; p&lt;0.001), 17‑OP (R2=0.748; p&lt;0.001). Hyperhomocysteinemia did not significantly affected the changes in the levels of these hormones (p&gt;0.05), but significantly increases the probability of decreased FSH levels (R2=0.376; p=0.012). Moreover, it was established that high TSH levels increased the probability of elevation homocysteine rates (R2=0.561; p=0.001) and decreased levels of reproductive hormones: FSH (R2=0.357; p=0.014), LH (R2=0.626; p&lt;0.001), estradiol (R2=0.451; p=0.004), free testosterone (R2=0.587; p=0.001) and DHEA‑S (R2=0.661; p&lt;0.001). The increased TPO‑Ab levels can serve as a significant predictor of the increased prolactin levels (R2=0.675; p&lt;0.001).&#x0D; Conclusions. Optimization of the medical care to women with FSD should include early diagnosis of vitamin D status and evaluation of homocysteine levels. Determination of women’s hormonal background should include assessments of the levels of TSH and antibodies to thyroperoxidase. An endocrinologist’s consultation is required in case of the reveal of thyroid gland disorders. The assessments of polymorphism of folate‑methionine cycle genes and thrombophilia should be performed in case of high levels of homocysteine.

Clinical Study the Relationship Between High-TSH Degree and Changes of LDL-C in Yunnan Plateau (China) Pregnant Patients’ Serum

Objective: It was to investigate the relationship between high thyrotropin, thyroid stimulating hormone (TSH) degree and changes of low-density lipoprotein cholesterol (LDL-C) in Yunnan Plateau pregnant patients’ serum in China; Methods: All pregnant woman were collected from the Kunming Angel Women's and Children's Hospital from January 2021 to October 2022, who were diagnosed by the endocrinology department, during their pregnancy. Then it analyzed their biochemical indicators levels and blood liquid parameters changes in their serum. Additionally, we investigated their epidemiological data, including the treatment history of hypothyroidism; Results: High-TSH degree and increasing of LDL-C level were both risk factors leading to hypertension, cardiovascular symptoms, symptoms of digestive tract, pregnancy ultrasound indicating small-sized fetus (P＜0.05). Importantly, they reinforce each other on patients. Their increasing caused gestational diabetes mellitus, preterm birth history and autoimmune diseases in Yunnan plateau (China). TSH≥4.3 m IU/L and DL-C≥3.6 mmol/L in the pregnant patients’ serum, which were approved by obstetric professional committee of that Hospital. Furthermore, only in high-TSH degree group, their high cholesterol could cause premature birth, elevated blood sugar, high blood pressure prenatal, postpartum infection and preeclampsia (P＜0.05); Conclusion: These risk factors (high-TSH and LDL-C changes) could affect the health of pregnant, maternal and fetal, which should be taken to manage it so as to improve the perinatal health.

Relationship of Thyroid Function with Metabolic Parameters in Euthyroid Adults

Objective: Thyroid hormones have a significant effect on carbohydrate, lipid metabolism disorders, and insulin resistance (HOMA-IR) development. Vitamin D (25(OH)D) has been shown also can affect not only the musculoskeletal system, but also almost all tissues in the body, including the thyroid in recent years. In the study, we aim of this study is to investigate the relationship between the levels of thyroid-stimulating hormone (TSH) within the reference range and metabolic parameters in adults. Methods: 561 adult outpatients were divided into 2 groups low normal range (0.27-2.5 mIU/mL) and high normal range (2.5-4.2 mIU/mL) according to TSH, and HOMA-IR, 25(OH)D, and lipid levels were compared. Results: A statistically significant positive correlation was found between TSH and HOMA-IR in both the low normal range group (r = 0.123, p = 0.041) and the high normal range group (r = 0.196, p = 0.001). In the high normal range group, the relationship between TSH with vitamin D (r =-0.200, p =0.003), cholesterol (r =0.143, p =0.024), LDL cholesterol (r =0.154, p =0.018), non-HDL cholesterol (r = 0.134, p = 0.035) levels was statistically significant. Conclusion: Our study shows that high normal TSH levels in euthyroid adults are related to higher insulin resistance and lower 25(OH)D levels, and this interaction is a major contributor to dyslipidemia. Thyroid hormones explain the metabolic disorder in the early stages of T2DM. Therefore, we believe that screening TSH levels and determining the optimal TSH target will be beneficial.

A Pilot study on thyroid status, lipid profile creatine kinase in human cardiac patients

Background: The progression of Coronary Heart Disease (CHD) is linked to a multitude of comorbidities, such as thyroid dysfunction, dyslipidemia. Objectives were to determine the thyroid and serum lipid profile, cholesterol, triglycerides and creatin kinase profile of CHD patients and to establish correlation between severity of cardiac disease with these two metabolic parameters.&#x0D; Methods: This was a prospective study conducted among 55 CHD patients over 1 year admitted in the department of cardiology, General Government Hospital, Bikaner.&#x0D; Results: There are 66% male and 36% female patients among the 55 study cases. Majority of the patients (54/55) exhibited higher T3 concentration, whereas one patient has low T4 value accompanied by 14 patients with high TSH value. Three patients have higher value of cholesterol with 17 patients of higher triglycerides levels. Among the patients eleven demonstrated higher creatine kinase values. &#x0D; Conclusions: The numbers of patients increasing with decreasing T3 and increasing thyroid stimulating hormone (TSH) proportionate to the severity of the cardiac failure. In addition, hypothyroidism is becoming more common in people with chronic cardiac disease. Serum triglycerides, LDL and HDL levels rise statistically significantly in CHD patients.&#x0D; Keywords: Dyslipidemia, CHD, Cholesterol, triglycerides, TMB.

Associations of Urinary Phthalate Metabolites with Thyroid Function and the Mediated Role of Cytokines: A Panel Study of Healthy Children.

Evidence on joint association of a phthalate mixture with thyroid function among children and its underlying mechanism is largely unknown. We aimed to explore the associations of 10 urinary phthalate metabolites (mPAEs), either as individuals or as a mixture, with thyroid function indicators [free thyroxine, free triiodothyronine (FT3), and thyroid-stimulating hormone (TSH)] in 144 children aged 4-12 years with up to 3 repeated visits across 3 seasons. Significant and positive associations were observed for mono-(2-ethylhexyl) phthalate (MEHP), mono-iso-butyl phthalate (MiBP), and mono-n-butyl phthalate (MnBP) with TSH, as well as monobenzyl phthalate (MBzP) with FT3 in dose-response manners. The relationship between MEHP and TSH remained robust in multiple-phthalate models. Bayesian kernel machine regression (BKMR) models revealed overall linear associations of the 10 mPAE mixture with higher TSH and FT3 levels, and MEHP and MBzP were major contributors. Meanwhile, MEHP, MiBP, and MnBP were linked to the elevation of multiple cytokines including CCL 27, CCL3, CXCL1, and IL-16. Among them, IL-16 mediated the relationships of MEHP and MiBP with TSH, and the mediated proportions were 24.16% and 24.27%, respectively. Our findings suggested that mPAEs dominated by MEHP were dose-responsively associated with elevated TSH among healthy children and mediated by IL-16.

Comparison of Various Ultrasound-Based Malignant Risk Stratification Systems on an Occasion for Assessing Thyroid Nodules in Hashimoto's Thyroiditis.

To compare the diagnostic performance and unnecessary ultrasound-guided fine-needle aspiration (US-FNA) biopsy rate of the 2015 American Thyroid Association (ATA), 2016 Korean Society of Thyroid Radiology (KSThR), and 2017 American College of Radiology (ACR) guidelines for patients with and without Hashimoto's thyroiditis (HT). This retrospective study included 716 nodules from 696 consecutive patients, which were classified using the categories defined by the three guidelines: ATA, KSThR, and ACR. The malignancy risk in each category was calculated and the diagnostic performance and unnecessary fine-needle aspiration (FNA) rates of the three guidelines were compared. In total, 426 malignant and 290 benign nodules were identified. Patients with malignant nodules had lower total thyroxine levels and higher thyroid-stimulating hormone, thyroid peroxidase antibody, and thyroglobulin antibody levels than those without malignant nodules (all P<0.01). The margin difference was significant in non-HT patients (P<0.01), but comparable in HT patients (P=0.55). The calculated malignancy risks of high and intermediate suspicion nodules in the ATA and KSThR guidelines and moderately suspicious nodules in the ACR guidelines were significantly lower in non-HT patients compared with HT patients (P<0.05). The ACR guidelines showed the lowest sensitivity, highest specificity, and lowest unnecessary FNA rates in patients with and without HT. Compared to non-HT patients, HT patients had significantly lower unnecessary FNA rates (P<0.01). HT was associated with a higher malignancy rate of thyroid nodules with intermediate suspicion according to the ATA, KSThR, and ACR guidelines. The three guidelines, especially ACR, were likely to be more effective and could allow a greater reduction in the percentage of benign nodules biopsied in patients with HT.

Thyroid Autoantibodies in Type -1 Diabetic Mellitus Patients and their Correlation with Thyroid function and Tumor Necrotic Factor-Alpha

Type 1 Diabetes Mellitus (T1DM) is a complicated autoimmune disorder initiated by T-cell-mediated damage of pancreatic beta cells, resulting in insulin deficiency and the development of hyperglycaemia. This disease is most common in childhood and adolescence and frequently co-occurs with other autoimmune conditions like autoimmune thyroiditis. This work aimed to investigate thyroid autoantibodies and their correlation with thyroid functions and tumour necrosis factor-alpha (TNF-α) in T1DM patients. Eighty participants were enrolled in a case-control study, including sixty T1DM patients and twenty healthy controls. Peripheral blood specimens were taken from individuals with proven T1DM and healthy individuals (control group). Body mass index (BMI), fasting blood sugar (FBS), glycated hemoglobulin (HbA1c), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), thyroid autoantibodies, including anti-thyroid peroxidase (anti-TPO) in addition to anti-thyroglobulin (anti-Tg), and TNF- α concentrations were evaluated in T1DM and control groups. Our findings revealed that thyroid autoantibodies were significantly more prevalent in T1DM patients, elevated TSH, and significantly higher TNF-α levels than in the control group, indicating an increased risk for inflammation based on cytokine levels. The current study proved that in T1DM patients' sera compared to the healthy control, thyroid autoantibodies and TNF-α levels were positively correlated. In conclusion, poor diabetes management and high TSH levels may indicate subclinical hypothyroidism, which impacts diabetes control. This is possibly linked to thyroid autoimmunity. Future research is needed to understand how TNF- αcontributes to the progression of diabetes disease and its complications.