History Of Thyroid Dysfunction Research Articles

High rates of same-sex attraction/gender nonconformity in the offspring of mothers with thyroid dysfunction during pregnancy: proposal of prenatal thyroid model

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. Despite mounting efforts to determine the biological background, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to 17 years. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction. Twelve overlapping cases with both same-sex attraction and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (P<0.0001, by Fisher's exact test). The association was also significant for each sex (P<0.0001, by Fisher's exact test). There is evidence that thyroid gland plays a crucial and decisive role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the off-spring.

High Rates of Same-Sex Attraction/Gender Nonconformity in the Offspring of Mothers with Thyroid Dysfunction During Pregnancy: Proposal of Prenatal Thyroid Model.

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. Despite mounting efforts to determine the biological background, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to 17 years. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction. Twelve overlapping cases with both same-sex attraction and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (P<0.0001, by Fisher’s exact test). The association was also significant for each sex (P<0.0001, by Fisher’s exact test). There is evidence that thyroid gland plays a crucial and decisive role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the offspring.

Maternal Thyroid Dysfunction During Pregnancy May Lead to Same-sex Attraction/gender Nonconformity in the Offspring: Proposal of Prenatal Thyroid Model

Both youngsters and adults with same-sex attraction are at greater risk for negative health outcomes. It is argued that early biological events generated by genes and prenatal sex hormones determine an individual's sexual orientation. However, despite mounting efforts, a satisfactory conclusion has not been reached and there is a need to explore alternate factors like functioning of thyroid system during pregnancy. This study was conducted to explore the relationship between maternal thyroid dysfunction in pregnancy and same-sex attraction/gender nonconformity in the offspring. A retrospective chart review was undertaken of 790 eligible children and adolescents who had been admitted to child psychiatry between 2005 and 2013. This population consisted of 520 (65%) males and 270 (35%) females, aged 8 to17 years. Children who were victims of sexual and physical abuse and who had mental retardation, autism and psychosis were not included. Fifteen mothers (1.8%) were found to have a history of thyroid dysfunction during pregnancy. Sixteen youngsters (2%) had a history of same-sex attraction/gender nonconformity. Twelve overlapping cases with both same-sex attraction/gender nonconformity and maternal thyroid dysfunction during pregnancy were identified, which was extremely significant (p < 0.0001, by Fisher's exact test). The association was also significant for each sex (p < 0.0001, by Fisher's exact test). There is evidence that thyroid gland and its hormones play a crucial role in determining sexual orientation in people. Maternal thyroid dysfunctions during pregnancy may result in homosexual orientation in the offspring.

Thyroid dysfunction in Chinese hepatitis C patients: Prevalence and correlation with TPOAb and CXCL10

To investigate the relationship among pretreatment serum CXC chemokine ligand 10 (CXCL10), thyroid peroxidase antibody (TPOAb) levels and thyroid dysfunction (TD) in Chinese hepatitis C patients. One hundred and thirty-nine treatment-naive genotype 1 chronic hepatitis C patients with no history of TD or treatment with thyroid hormones were enrolled in this study. Patients underwent peginterferon alfa-2a/ribavirin (PegIFNα-2a/RBV) treatment for 48 wk, followed by detection of clinical factors at each follow-up point. Hepatitis C virus (HCV) antibodies were analyzed using microsomal chemiluminescence, and serum HCV RNA was measured by real-time PCR assay at 0, 4, 12, 24 and 48 wk after the initiation of therapy and 24 wk after the end of therapy. To assess thyroid function, serum thyroid stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3) and TPOAb/thyroglobulin antibody (TGAb) levels were determined using chemiluminescent immunoassays every 3 mo. Serum CXCL10 levels were determined at baseline. The prevalence of TD was 18.0%. Twenty-one (84.0%) out of twenty-five patients exhibited normal thyroid function at week 24 after therapy. The rate of sustained virological response to PegIFNα-2a/RBV in our study was 59.0% (82/139), independent of thyroid function. Pretreatment serum CXCL10 levels were significantly increased in patients with euthyroid status compared with patients with TD (495.2 ± 244.2 pg/mL vs 310.0 ± 163.4 pg/mL, P = 0.012). Patients with TD were more frequently TPOAb-positive than non-TD (NTD) patients (24.2% vs 12.3%, P = 0.047) at baseline. Three of the one hundred and fifteen patients without TPOAb at baseline developed TD at the end of treatment (37.5% vs 2.6%, P = 0.000). Female patients exhibited an increased risk for developing TD compared with male patients (P = 0.014). Lower pretreatment serum CXCL10 levels are associated with TD, and TD prevalence increases in female patients and patients who are positive for TPOAb at baseline.

Prevalence and characteristics of anemia associated with thyroid disorders in non-pregnant Saudi women during the childbearing age: A cross-sectional study.

Little is known about the prevalence of thyroid disorders and their associated anemia in the Kingdom of Saudi Arabia. The aim of the current study was to measure the prevalence and types of thyroid disorders and their relationship with anemia frequency and types in non-pregnant Saudi females during the childbearing age. Blood samples were collected from 600 non-pregnant females (between ≥18 and ≤45 years) with no history of thyroid dysfunction, chronic diseases, and/or anemia to measure serum thyroid stimulating hormone (TSH), free T4, erythrocyte indices, and iron parameters. Thyroid disorders were detected in 118 participants (19.6%), and occult hypothyroidism was the most prevalent type (70/118) followed by overt hypothyroidism (38/118) and hyperthyroidism (10/118). Anemia was detected in 52 females with abnormal thyroid (44%) and the prevalence was significantly higher (p < 0.05) compared to euthyroid (14.3%). The red blood cell (RBC) count, hemoglobin, hematocrit value, serum iron, and serum ferritin were significantly lower in thyroid disorder compared to euthyroid group (p < 0.05). Erythrocyte indices correlated significantly with serum free T4, while iron parameters correlated with serum TSH (p < 0.05). Thyroid disorders are common in non-pregnant females in the Western province of Saudi Arabia, and they are associated with an increase in the prevalence of both anemia and iron deficiency. Further studies are needed to determine the underlying mechanism (s) contributing to the development of thyroiditis-induced anemia in the kingdom and the role of thyroid hormones in iron metabolism.

History of Thyroid Disorders in Relation to Clinical Outcomes in Atrial Fibrillation

BackgroundAtrial fibrillation is the most common cardiac complication of hyperthyroidism. The association between history of hyperthyroidism and stroke remains unclear. We sought to determine whether history of thyroid dysfunction is a thromboembolic risk factor in patients with atrial fibrillation. MethodsPatients with atrial fibrillation seen in an academic institution between 2000 and 2010 were identified and followed-up. Clinical events (stroke/systemic embolism, bleeding, all-cause death) were recorded and related to thyroid status and disorders. Associations were examined in time-dependent models with adjustment for relevant confounders. ResultsAmong 8962 patients, 141 patients had a history of hyperthyroidism, 540 had a history of hypothyroidism, and 8271 had no thyroid dysfunction. Mean follow-up was 929 ± 1082 days. A total of 715 strokes/systemic embolism were recorded, with no significant difference in the rates of these events in patients with a history of thyroid dysfunction vs those without thyroid problems in either univariate or multivariable analysis (hazard ratio [HR] 0.85; 95% confidence interval [CI], 0.41-1.76 for hyperthyroidism; HR 0.98; 95% CI, 0.73-1.34 for hypothyroidism). There were 791 bleeding events; history of hypothyroidism was independently related to a higher rate of bleeding events (HR 1.35; 95% CI, 1.02-1.79). No significant difference among the 3 groups was observed for the incidence of death. ConclusionsHistory of hyperthyroidism was not an independent risk factor for stroke/systemic embolism in atrial fibrillation, whereas hypothyroidism was associated with a higher risk of bleeding events. These data suggest no additional benefit from the inclusion of thyroid dysfunction in thromboembolic prediction models in atrial fibrillation.

Reference intervals for thyroid markers in early pregnancy determined by 7 different analytical systems

The aim of the study was to verify differences between reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4), as well as the cut-off for anti-thyroid peroxidase antibodies (TPO Ab) in pregnant women. Additionally, to compare these reference intervals with those recommended by the manufacturers for a healthy population. Levels of TSH, FT4, and TPO Ab were determined in a group of pregnant women (n = 216) with no history of thyroid dysfunction. Simultaneously, reference intervals for thyroid function tests were established with 7 different analytical systems representing those immunoassays most often used globally. The reference intervals for FT4 were slightly different, according to the system used by each manufacturer. Those for Architect, Centaur, Modular E170, and RIA Immunotech were slightly higher than those for Immulite 2500 and AIA 2000; the lowest being for UniCel DxI (8.13–13.2 pmol/L). For TSH, a higher interval (0.25–3.86 mU/L) is recommended for Modular E170 and IRMA Immunotech; and a lower one (0.17–2.81 mU/L) for Immulite 2500 and AIA 2000. The established cut-off limits for TPO-Ab differ according to the system used and are similar to those recommended by their manufacturers.

The influence of prior hyperthyroidism on euthyroid graves' ophthalmopathy.

Background. To investigate the influence of previous exposure to elevated thyroid hormones in euthyroid Graves' ophthalmopathy. Design. Retrospective, observational case series in university setting Median follow-up of 1 year with ranges of 0,8–7,6 years. Study performance of 10 years. Participants. We reviewed the clinical records of 731 Graves' ophthalmopathy patients. There were 88 (12%) patients with onset of Graves' ophthalmopathy during euthyroidism: 37 (5%) patients had ophthalmopathy without known history of thyroid dysfunction (group A) and 51 patients (6%) had onset of ophthalmopathy 6 months or more euthyroid after completion of antithyroid therapy (group B). Main Outcome Measures. Graves' ophthalmopathy was graded using the EUGOGO severity criteria. Unilaterality was investigated. TSH receptor antibody and thyroid peroxidase antibody were measured as markers of Graves' disease. Results. Group A had more often a normal ocular motility (46%) and less proptosis (14 ± 4 mm) compared to group B (22%, 16 ± 4 mm) (P = 0.032 and 0.028, resp.). TSH receptor antibody was more frequently elevated in group B (94%) than in group A (17%) (P < 0.001). Conclusion. Patients with euthyroid Graves' ophthalmopathy present more often with ocular muscle restriction and proptosis when previously exposed to elevated thyroid hormones.

Thyroid dysfunction after hematopoietic stem cell transplantation in children: older age and acute GVHD might be risk factors of thyroid dysfunction during 3 months after HSCT

We evaluated short term changes in thyroid function in patients who underwent hematopoietic stem cell transplantation (HSCT) during childhood. And we attempted to find clinical and treatment risk factors for thyroid dysfunction during 3 months after HSCT We studied 170 patients (102 boys and 68 girls) who underwent HSCT at the Catholic HSCT center from January, 2004 to December, 2009. Patients with a past history of thyroid dysfunction were excluded. The mean age at HSCT were 10.0±4.8. Thyroid function tests were measured before HSCT and at 1, 3 months after HSCT. The normal reference value of T3 was 0.8–2.1 ng/mL, free T4 was 0.8–2.2 ng/dL, and TSH was 0.17–6.0 mIU/L. The disease and disease status for HSCT were acute lymphoblastic leukemia (ALL) [first complete remission (CR) = 21, second CR =22], acute myeloid leukemia (AML) (first CR = 74, second CR = 5), chronic myeloid leukemia (first chronic phase = 8), and non-malignant hematological disease (severe aplastic anemia = 32, hemophagocytic lymphohistiocytosis = 3, Fanconi anemia = 5). Out of 170 patients, 169 (99.4 %) underwent allotransplantation. aGVHD (grade II~IV) developed in 79 patients. In 170 subjects, 59 patients received a TBI-based, 81 underwent BU-based, and 30 received reduced intensity conditioning regimens before HSCT. Forty-eight (28.2 %) out of 170 patients showed thyroid dysfunction during 3 months after HSCT (31: euthyroid sick syndrome, 7: subclnical hyperthyroidism, 4: subclinical hypothyroidism, 4: hypothyroxemia, 2: overt hyperthyroidism and 1: high T4 syndrome). In a univariate logistic regression analysis, the Age at HSCT (p=0.003) and acute GVHD (p=0.006) showed relationships with thyroid dysfunction during 3 months after HSCT. We could not find any statistical relationships with sex, diagnosis and conditioninig regimens. In a univariate logistic regression analysis, euthyroid sick syndrome (p=0.006) showed a strong relationships with motality. In our study, 28.2 % patients experienced thyroid dysfunction during 3 months after HSCT. Euthyroid sick syndrome was most frequent, although subclnical hyperthyroidism, overt hyperthyroidism or subclinical hypothyroidism were also observed. Older age and acute GVHD might be risk factors of thyroid dysfunction during 3 months after HSCT. There was a significant correlation between euthyroid sick syndrome and motality.

Catheter Ablation of Paroxysmal Atrial Fibrillation in Patients with Previous Amiodarone‐Induced Hyperthyroidism: A Case–Control Study

Many patients with atrial fibrillation (AF) receive amiodarone. Amiodarone-induced hyperthyroidism (AIH) may develop as a complication. We hypothesized that pulmonary vein (PV) isolation in patients with paroxysmal AF and history of AIH may yield a lower success rate. Among 704 patients who underwent AF ablation in our center between 2007 and 2010, we identified 20 patients (mean age 58.3 ± 5.0 years; 11 males) with paroxysmal AF and overt AIH in the past. The control group consisted of 40 patients with amiodarone-refractory AF and no thyroid dysfunction. All patients underwent circumferential PV isolation. During redo procedures all tachycardias were targeted for ablation. During a 12-month follow-up, in the AIH group 6 (30%) patients were arrhythmia free after a single procedure, in comparison to 25 (62.5%) controls (P = 0.01). Atrial tachycardia (AT) was registered in 7 (35%) AIH patients and in 1 (2.5%) control patient (P = 0.001). AF recurred in 10 (50%) AIH versus 15 (37.5%) control patients (P = 0.2). Redo ablation was performed in 7 (35%) AIH patients and in 3 (7.5%) non-AIH patients (P = 0.01). During a redo procedure a PV-unrelated tachycardia was diagnosed in 5 (25%) AIH patients (vs 0 in the controls, P = 0.003). After the last performed ablation, 12 (60%) AIH patients and 28 (70%) controls had no recurrence, P = 0.56. AIH was an independent predictor of ATs. PV isolation alone has a lower efficacy for preventing recurrence in paroxysmal AF in AIH patients. After repeat ablations, overall freedom from tachyarrhythmias is similar to patients with no history of thyroid dysfunction.

The presence of thyroid peroxidase antibody of IgG2 subclass is a risk factor for thyroid dysfunction in chronic hepatitis C patients

To investigate the prevalence of thyroid dysfunction (TD) and IgG subclasses of thyroid autoantibodies (TAs) and to determine the predictive factors of TD in chronic hepatitis C (CHC) patients. Three hundred and twelve untreated hepatitis C virus-infected patients without a history of TD or treatment with thyroid hormones were enrolled in a cross-sectional study. Clinical and biological factors were statistically analyzed to determine the correlation between TD and this patient population. The incidence of TD WAS 12.5% in CHC patients. Clinical hypothyroidism (5.8%) and subclinical hypothyroidism (3.8%) were more frequent than clinical hyperthyroidism (1.6%) and subclinical hyperthyroidism (1.3%). The percentage of TA-positive patients was significantly higher in people 60 years than in those 60 years (31.9 VS 18.6%; P=0.042). Positive thyroid peroxidase antibody (TPOAb) was more frequent, and alanine aminotransferase (ALT) levels were lower in patients who displayed TD (TPOAb: 62.1 vs 10.8%, P=0.000; ALT: 43.5 vs 51 IU/l, P=0.046). The positive percentage of TPOAb IgG2 subclass in the TD group was significantly higher than that of patients without TD (66.7 vs 16.7%, P=0.005). Multiple logistic regression analysis indicated that only TPOAb IgG2 subclass positivity was an independent risk factor for TD in CHC patients (odds ratio=8; 95% CI: 1.225-52.246; P=0.030). TPOAb IgG2 subclass positivity is a risk factor for TD in CHC patients before antiviral treatment. IgG2 subclass of TPOAb might play an important role in the presence of TD in CHC patients.

Thyroid Function during Pregnancy: Who and How Should We Screen?

In the past several years there has been considerable discussion in both the scientific and lay literature about the merits of prenatal screening for thyroid disorders. Much of this debate was initiated by a 1999 study showing an association between an underactive thyroid gland during pregnancy and delayed neurodevelopment in the offspring. (Suggested references on this topic are also included in the Data Supplement that accompanies the online version of this Q&A at http://www.clinchem.org/content/vol58/issue10.) That study begs the question: “Should all pregnant women be screened for hypothyroidism?” Several medical associations have weighed in on this subject. Guidelines from the American Association of Clinical Endocrinologists indicate that thyroid-stimulating hormone (TSH)6 screening should be routine before pregnancy or during the first trimester. If the TSH is >10 mIU/L or if the TSH is 5–10 mIU/L and the patient has goiter or positive anti–thyroid peroxidase (TPO) antibodies, then thyroid hormone replacement therapy should be initiated. The American Thyroid Association and the Endocrine Society agree that there are not enough data for or against universal screening but also acknowledge that lack of evidence of benefit doesn't mean that there is no benefit. They recommend only the screening of pregnant women who are at high risk of overt hypothyroidism [e.g., history of thyroid dysfunction, TPO-antibodies positive, goiter]. If the TSH is >10 mIU/L, this indicates overt hypothyroidism, and thyroid hormone replacement therapy should be initiated. However, the American College of Obstetricians and Gynecologists has recommended against screening all pregnant women for hypothyroidism. This group argues that there is lack of clear evidence that the identification and treatment of women with subclinical hypothyroidism will improve maternal or infant outcomes. Here we ask 4 experts in the area of thyroid disease during pregnancy for their opinions on the effects of thyroid deficiency during pregnancy and …

Abstract 16854: Iodine Deficiency and Risk of Coronary Heart Disease Events Among Low Risk Healthy US Adults

Background: Prevalence of iodine deficiency (ID) has increased among general US population. No study has evaluated ID's effect on primary risk of coronary heart disease (CHD) events. Objective: Evaluate the relationship between ID and CHD risk Design: Cross-sectional Methods: We evaluated 10,037 adults, free of cardiovascular disease and diabetes, participating in National Health and Nutrition Examination Surveys . Participants were assigned Framingham risk score (FRS) per Adult Treatment Plan guidelines. Urine iodine levels (mcg/L) were used to define ID per World Health Organization criteria: Group 1 -: None(≥100), Group 2 -: Mild(50-99) and Group 3 -: Moderate-severe(&lt;50). Multivariate regression analysis was performed to analyze the effect of ID on the risk of having higher FRS. Results: Mean FRS increased with higher degrees of ID (Group 1: 7.5±8.1 vs Group 3: 9.4±7.4, p&lt;0.001). ID significantly predicted (p&lt;0.001) higher FRS after adjusting for race, body mass index, history of thyroid dysfunction, hemoglobin A1c, high sensitivity C-reactive protein, estimated glomerular filtration rate, serum T4, serum thyroid stimulating hormone and selenium levels [beta co-efficient 0.69(95% confidence interval (CI):0.38-1.00) for group 2 and 1.46(95% CI:1.08-1.84) for group 3 compared to group 1]. Similar results were observed when FRS was evaluated in categories. (Table 1) Conclusion: ID is associated with CHD risk independent of thyroid dysfunction and traditional cardiovascular risk factors. Further validation of our study results is warranted since ID is easily remediable through public health policies.

Lower Free Thyroxin Associates with a Less Favorable Metabolic Phenotype in Healthy Pregnant Women

A lower free T(4) (fT4), within the euthyroid range, has been shown in adults to associate with an adverse metabolic phenotype. Thyroid physiology changes significantly during gestation and affects maternal and fetal well-being. The aim of the study was to test the hypothesis that a lower serum fT4 in healthy euthyroid pregnant women is related to a less favorable metabolic phenotype and to fetal or placental weight. DESIGN, SETTING, PATIENTS, AND OUTCOME MEASURES: We examined associations of thyroid function tests (TSH and fT4) and the free T(3) (fT3)-to-fT4 ratio (as a proxy of deiodinase activity) with a metabolic profile [preload and postload glucose, glycosylated hemoglobin (HbA1c), high molecular-weight (HMW)-adiponectin, homeostasis model of assessment for insulin resistance (HOMA-IR), and serum lipids] in 321 healthy pregnant women. All women were euthyroid and had negative anti-thyroid peroxidase antibodies. None received thyroid hormone replacement. Blood tests were performed in women between 24 and 28 wk gestation. Placentas and newborns were weighed at birth. Circulating TSH did not relate to metabolic parameters, but decreasing fT4 and increasing fT3-to-fT4 ratio associated with a less favorable metabolic phenotype, as judged by higher postload glucose, HbA1c, fasting insulin, HOMA-IR, and triglycerides, and by a lower HMW-adiponectinemia (all P ≤ 0.005). In multiple regression analyses, fT4 was independently associated with HbA1c (β = -0.135; P = 0.038), HMW-adiponectin (β = 0.218; P < 0.001), and placental weight (β = -0.185; P < 0.005), whereas the fT3-to-fT4 ratio was independently associated with maternal body mass index (β = 0.265; P < 0.001), HMW-adiponectinemia (β = -0.237; P < 0.002), HOMA-IR (β = 0.194; P = 0.014), and placental weight (β = 0.174; P = 0.020). In pregnant women without a history of thyroid dysfunction, lower concentrations of fT4 and a higher conversion of fT4 to fT3, as inferred by changes in the fT3-to-fT4 ratio, were found to be associated with a less favorable metabolic phenotype and with more placental growth.

Can Quetiapine-Induced Hypothyroidism be Reversible Without Quetiapine Discontinuation?

Recent clinical trials and case reports have recorded dose-related thyroid function test abnormalities during quetiapine treatment usually requiring drug discontinuation or initiation of thyroid replacement therapy. The authors highlight the potential reversibility of quetiapine-induced hypothyroidism without quetiapine discontinuation in 2 in-patients (a 51-year-old schizophrenic woman and a 46-year-old bipolar man) to which quetiapine (300 and 350 mg/d, respectively) was administered. Both patients had a negative personal and family history of thyroid dysfunction. Significant decreases in T4/free T4 levels and a marked elevation in thyroid-stimulating hormone level were recorded without any clinical signs of hypothyroidism 3 weeks after quetiapine initiation. Antithyroid antibody titers remained within reference range. Thyroid function tests returned to normal 6 weeks after quetiapine initiation, although quetiapine was continued at the same daily dose without thyroid replacement therapy. These are the first cases reporting spontaneous resolution of quetiapine-induced hypothyroidism without quetiapine discontinuation. We suggest careful thyroid monitoring for patients initiating quetiapine. However, physicians can wait in cases of quetiapine-induced hypothyroidism if a close laboratory monitoring is available because thyroid dysregulation may soon resolve.

Thyroid Medication Use and Subsequent Development of Dementia of the Alzheimer Type

Associations between medication use and the development of Alzheimer disease have been investigated since the late 1900s. Thyroid hormone supplementation is rarely a studied medication class in this area of research. We examined data from participants enrolled in longitudinal studies at the Washington University Alzheimer's Disease Research Center for associations between thyroid disease, thyroid hormone supplementation therapy, and subsequent development of dementia of the Alzheimer type (DAT). Data collected between April 1992 and June 2008 from 499 participants, 184 men and 315 women, were analyzed. Mean age was 76.9 years (SD = 9.2). At baseline, 61 participants reported thyroid medication use and 87 were identified as having a history of thyroid dysfunction. These participants progressed to a DAT diagnosis more rapidly than individuals not taking thyroid medication (hazard ratios [HR]: 1.67, 95% CI: 0.99-2.78, P = .054). Although an interesting trend was seen, baseline thyroid disease was not significantly (P = .093) associated with time to DAT diagnosis. Our findings suggest that utilization of thyroid medication may be associated with the development of DAT.

Influence of thyroid hormones on satellite association in man and the origin of chromosome abnormalities.

The satellite association pattern was studied in cells from six hyperthyroid patients before and after antithyroid treatment. The same phenomenon was studied in cells from four healthy control individuals, without any history of thyroid dysfunction. The control cells were cultured in the following media: 1. medium with foetal calf serum and 2–3. media with serum from each of two patients with hyperthyroidism. All analyses were blind studies and were based on 1200 cells (50 cells in each individual sample). Chromosomes No. 21 and 14 (the latter to a lower extent) had a significantly higher association tendency, when the patients were hyperthyroid. The increase in association tendency of No. 21 and 14 was also found when cells from the control individuals were cultured in medium with serum from hyperthyroid patients. Also, chromosome No. 21 and 14 formed association pairs with each other more frequently when the cells were cultured in medium with excess of the thyroid hormones: thyroxin and triiodothyronin. It was concluded that these hormones increase the tendency to satellite association of chromosomes 21 and 14, and may therefore also increase the risk of nondisjunction and of translocation between these chromosomes.

Prevalence of Polycystic Ovary Syndrome in Women with Type 2 Diabetes in Kerman, Iran

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by chronic anovulation and hypergonadism that affects 5-10% of women of reproductive age. Patients with this syndrome are at high risk of developing type 2 diabetes mellitus in future. This study was carried out to determine the prevalence of PCOS in patients with type 2 diabetes mellitus. One hundred consecutive women under 45 years of age with type 2 diabetes treated with diet or hypoglycemic drugs, referring to Kerman Diabetic Center, Kerman, Iran, in 2005 were identified. Patients with galactorrhea or history of thyroid dysfunction were excluded from the study. Data were collected through questionnaire-based interviews and were then analyzed. Ninety two women, of which 18 (19.5%) had clinical symptoms of PCOS, enrolled in the study. The mean age of subjects was 38.8 +/- 5.9 years. We found no significant relation between PCOS and familial type 2 diabetes or gestational diabetes. The mean body mass index (BMI) was 28.19 +/- 4.44 kg/m(2) in patients with PCOS and 26.06 +/- 3.83 kg/m(2) in non-PCOS patients (p = 0.043). The prevalence of abdominal obesity was higher among PCOS patients than non-PCOS patients (38.9% vs. 14.8%, p = 0.011). In our study, abdominal obesity was more among type 2 diabetic women with PCOS. Therefore, central or abdominal obesity might be considered as an important risk factor for type 2 diabetes in women with PCOS.

Thyroid dysfunction (TD) among chronic hepatitis C patients with mild and severe hepatic fibrosis

Background: Thyroid dysfunction (TD) is associated to chronic hepatitis C (HCV) and interferon (IFN) therapy. The prevalence of TD at baseline and during IFN therapy among stages of hepatic fibrosis is unknown.Goals: To examine the frequency of TD at baseline and during Peg-IFN therapy among patients with severe and mild fibrosis.Study: 100 patients were treated with Peg-IFN and divided in 2 groups (50 each), according to liver histology; Metavir 0-2 (mild fibrosis) and Metavir 3-4 (severe fibrosis). Baseline TD was defined as history of TD, or abnormal thyroid stimulating hormone (TSH) or antiperoxidase thyroid auto-antibodies (TPO-Ab). Frequency of TD during therapy was defined as TD that required treatment.Results: 20% in the severe fibrosis group and 10% in the mild fibrosis group, had TD at baseline. Most of the cases, 31.4% were female as compared to 6.25% males. During therapy, 24% of patients in the severe fibrosis group, compared to 12% in the mild fibrosis, had TD. Most patients had biochemical hypothyroidism, and 66% were female, compared to 33.33 % male. TPO-Ab predicted TD during therapy in 50% of cases while those negative only had 16.6% TD during IFN therapy.Conclusions: Patients with severe fibrosis have more TD events at baseline and during treatment with Peg IFN alfa-2a. Patients with more hepatic fibrosis require careful attention to diagnose and manage TD. More research in the immune mechanisms of hepatic fibrosis progression and autoimmune complications is needed.

Adverse effects of thyroid dysfunction on pregnancy and pregnancy outcome: Epidemiologic study in Slovenia

Objective. To evaluate the consequences of maternal thyroid dysfunction for pregnancy outcome.Methods. A retrospective analysis involving all pregnant women who delivered in Slovenia in the 1997–1999 triennium; those having a medical history of thyroid dysfunction and/or taking thyroid medications were allotted to the study group (n = 748) and the remaining ones to the control group (n = 52 253).Results. Significantly higher incidences of infertility (5.5% vs. 3.7%, p < 0.05), menstrual cycle irregularities (3.2% vs. 1.9%, p < 0.05), hypertensive disorders (7.0% vs. 4.2%, p < 0.05), threatened preterm delivery (9.1% vs. 5.6%, p < 0.001), and delivery before 32 weeks (2.7% vs. 1.5%, p < 0.05) were found in the study than in the control group. There were no significant differences in the incidences of miscarriage, non-gestational diabetes mellitus, proteinuria, hyperemesis, intrahepatic cholestasis of pregnancy, intrauterine growth restriction, placental abruption, preterm delivery, small for gestational age newborns (SGA), and stillbirths.Conclusions. This is the first study to evaluate the incidence of thyroid dysfunction for the whole population of pregnant women in Slovenia using a retrospective analysis. Thyroid dysfunction adversely affects pregnancy and pregnancy outcome but to a lesser extent than presented in previous studies. An evaluation of thyroid function in the women who experience menstrual cycle irregularities, infertility, and complications during pregnancy, labor and delivery would be advisable.