Hyperthyroid Subjects Research Articles

Serum Selenium Status in Autoimmune Thyroid Disorders: A Case-control Study

Introduction: Selenium is a trace element essential for normal health, playing a crucial role in thyroid hormone synthesis and metabolism. In Autoimmune Thyroid Disorders (AITD), selenium deficiency can exacerbate inflammation, impair thyroid hormone production and escalate tissue damage. Assessing the selenium status as part of comprehensive management strategies for AITD is crucial. Aim: To evaluate the selenium levels and autoantibody levels in AITD and to establish the risk of AITD among patients with low selenium. Materials and Methods: This case-control study was conducted at the Department of Surgery, Medicine, Biochemistry and Physiology, MOSC Medical College, Kolenchery, Kerala, India from July 2022 to May 2023. A total of 134 participants were enrolled, including 67 cases with AITD and 67 matched controls. Serum selenium levels, thyroid function {Triiodothyronine (T3), Thyroxine (T4),Thyroid Stimulating Hormone (TSH)} and thyroid autoantibodies {anti-Thyroid Peroxide (TPO) and antiThyroglobulin (TGO)} were evaluated using blood samples collected in the morning (6-8 AM). Statistical analysis was performed with Pearson’s correlation coefficient to assess relationships and Chi-square tests evaluated the association between selenium status and AITD. Odds Ratios (OR) for AITD in relation to selenium levels were calculated. Results: Study population comprised of 38 hypothyroid and 29 hyperthyroid subjects, along with 67 euthyroid controls. Mean selenium levels among AITDs cases (0.088±0.07 μg/ mL) were statistically significantly lower in comparison to controls (0.12±0.01 μg/mL). OR for association between serum selenium and AITD was 8.6 (95% CI 0.619-3.677; p<0.0001). Observed Relative Risk (RR) for low selenium to have AITD was 1.95. The Chi-square value of 8.59 with p=0.0034 indicated a statistically significant association between AITD and low selenium status. Conclusion: Selenium levels among hypothyroid and hyperthyroid subjects were significantly lower comparison to age- and sex-matched euthyroid controls. The calculated OR of 8.60 and an RR of 1.95 highlight selenium's potential role in thyroid health, particularly in regulating immune response and hormone metabolism.

Association between thyroid dysfunction and insulin resistance: a retrospective cohort study

ObjectiveTo evaluate the association between thyroid disease and diabetes markers.DesignRetrospective cohort study.SettingThe study was conducted in a diagnostic setting where the primary care providers recommended the patients to test for...

Exploring the Patterns of Biomarker Variability in Thyroid Dysfunction: Clinical Insights from a Prevalence Perspective

Introduction and Aim: Thyroid disorders, prevalent globally, represent a significant public health issue in India, where approximately 42 million individuals are affected. This study investigates the biochemical, immunological, and inflammatory profiles associated with thyroid dysfunction in northwestern Uttar Pradesh, India. Methods: A prospective, cross-sectional study was conducted with 225 participants from Teerthanker Mahaveer University and Teerthanker Mahaveer Hospital and Research Center, categorized into hypothyroid, hyperthyroid, and euthyroid groups. Data collection involved biochemical analysis of thyroid hormones (T3, T4, TSH), lipid profiles (Cholesterol, Triglyceride, HDL, LDL, VLDL), glycemic indices (Fasting Blood Glucose HbA1c), and inflammatory markers (CRP), alongside immunological assessment of anti-thyroid antibodies (Anti-TPO, Anti-TG). Results: Thyroid function tests revealed significantly elevated TSH levels in hypothyroid subjects and T3 levels in hyperthyroid subjects. Hypothyroid individuals showed higher BMI, fasting blood sugar (FBS), and glycated hemoglobin (HbA1c) levels, while hyperthyroid individuals had elevated triglycerides and reduced HDL cholesterol levels. Elevated anti-TPO and anti-TG antibodies were noted across both thyroid dysfunction groups, indicating an autoimmune component. Inflammatory marker CRP levels were significantly higher in hypothyroid patients. Significant gender differences were observed, with a higher proportion of females in hypothyroid and hyperthyroid groups compared to euthyroid individuals. Conclusion: These findings underscore the impact of thyroid disorders on metabolic and inflammatory pathways, emphasizing the need for tailored diagnostic and therapeutic strategies. The study highlights the complex interplay between thyroid dysfunction and various health markers, advocating for integrated approaches to enhance the management and understanding of thyroid disorders in the Indian context.

Pulmonary Arterial Hypertension in Hyperthyroidism: Age, Ethnic, and Gender Disparities

Objective: Pulmonary arterial hypertension (PAH) affects 2.6% of adults and 36% of people with chronic obstructive pulmonary disease (COPD). Several case reports and small case series suggested a hyperthyroidism-PAH association.
 Design: Retrospective chart review.
 Methods: We undertook a retrospective chart review (1982–2018) to assess PAH prevalence in a multi-ethnic convenience sample of hyperthyroid adults with multiple etiologies. We calculated associations of pulmonary artery maximum systolic pressure (PSAPmax) with subject age, and maximum serum triiodothyronine (T3) and thyroxine (T4), free T3, and T4, minimum serum thyroid-stimulating hormone (TSH), and thyroid antibody titers, comparing PAH prevalence and the odds of being undiagnosed as to hyperthyroidism etiology by gender and ethnicity/race.
 Results: We found a high prevalence of PAH in hyperthyroid people, like that reported for people with COPD. We found no significant association between PSAPmax and any thyroid function test or thyroid antibody titer. As reported more recently in the general population, PSAPmax significantly correlated with age in hyperthyroid people. There was no significant disparity in the prevalence of PAH among White, non-Hispanic Black, and Latinx hyperthyroid people or between genders. The percentage of patients whose hyperthyroidism etiology was undiagnosed was high with significant disparity only between non-Hispanic Black and White people and between men and women. PAH was common in hyperthyroid subjects with any hyperthyroidism etiology.
 Conclusions: 2D-echocardiography should be performed in all hyperthyroid people because PAH is common, especially in older people because of their co-morbidities and poorer prognoses. Further research is needed regarding demographic disparities in being undiagnosed as to hyperthyroidism etiology.
 Principal Verdicts/Significance Statement: We reconfirmed the high PAH incidence in hyperthyroidism, previously reported, but profoundly under-recognized by physicians, to patients’ detriment. Further, we found that the shift in the general PAH population from younger to older individuals is mirrored in hyperthyroid people with PAH. This is concerning because older people have more co-morbidities and worse prognoses, necessitating early, effective intervention. PAH was present with diverse hyperthyroidism etiologies, suggesting that it is multicausal, resulting from autoimmunity, thyroid hormone excess, and goitrous upper airway obstruction and should be considered, regardless of etiology. Our observations that many subjects had no established hyperthyroidism etiology and that males and Blacks were likelier to be undiagnosed are concerning, warranting further study.

Study of Serum Uric Acid Levels in Thyroid Dysfunctions

Background: Hyperuricemia in thyroid dysfunctions has been linked to either impaired renal handling of uric acid or overproduction of uric acid. This study aimed to determine the serum uric acid levels in patients with thyroid dysfunction and to determine the link between thyroid dysfunction and hyperuricemia. Methods: This prospective and quantitative study which was conducted at Department of Biochemistry, Manipal Teaching Hospital determined the serum uric acid concentrations of 30 years or older; male or female participants diagnosed with either hypothyroidism or hyperthyroidism. T3 and T4 was determined by chemiluminiscence immunoassay (CLIA) and OCD VITROS dry chemistry analyzer was used to determine serum uric acid level. Data entry and analysis was done using SPSS version 23. Descriptive statistics using frequency with percentage and inferential statistics using non-parametric tests were used. Results: In a total of 100 participants, prevalence of hyperuricemia was 42% (31% in hypothyroidism and 11% in hyperthyroidism). The mean serum uric acid in overall participants was 6.25 ± 2.04 (6.55 ± 1.84 in hypothyroidism and 6.05 ± 1.71 in hyperthyroidism).Significant association was seen between thyroid status and hyperuricemia (p = 0.001).Also, significant difference (p = 0.02) was seen in serum uric acid between hyperthyroid and hypothyroid patients. Conclusion: Higher prevalence rate of hyperuricemia was found among hypothyroid patients than in hyperthyroid subjects, and a significant association was found between thyroid dysfunction and hyperuricemia. This indicates need for more research to further uncover the mechanisms underlying it.

Does altered thyroid hormone status affect resting systolic blood pressure significantly in premenopausal women? - A cross-sectional comparative study

Background: Hypothyroid or hyperthyroid state affects all the physiological systems including cardiovascular system, central nervous system, digestive system, and blood. Among all adverse changes, systolic blood pressure (SBP) can also be affected in patients with thyroid disorders. Aims and Objectives: The present study was carried out to compare SBP in newly diagnosed patients of hypothyroidism, hyperthyroidism and age and gender matched euthyroid subjects and to assess correlation between Tri-iodothyronine (T3) level and resting SBP. Materials and Methods: The present study was carried out in 90 female subjects in the age group of 30 to 45 years. Diagnosis of hypothyroidism and hyperthyroidism was based on both clinical and biochemical criteria. Subjects were divided in euthyroid, hypothyroid and hyperthyroid groups with each group containing 30 subjects. Resting SBP was measured in all the groups. Results: Hyperthyroid group had significantly higher SBP as compared to euthyroid group and hypothyroid group. The difference in SBP between euthyroid and hypothyroid group was statistically non-significant. There was a significant correlation between Total T3 level and resting SBP. Conclusion: Elevated levels of thyroid hormone increases the cardiac output by increasing heart rate and increasing force of contraction. This elevated cardiac output in hyperthyroid subject is reflected as increase in resting SBP. Hence, thyroid hormone concentration should be kept within normal limits by appropriate therapeutic measures so as to prevent ill effects of resultant elevated SBP.

Neutrophil-to-lymphocyte Ratio is Associated with LV Diastolic Dysfunction in the Overt Hyperthyroid Patients.

BackgroundRecent studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has gradually been identified as a more reliable marker of inflammation, with predictive value for the development of many diseases. However, its association with left ventricular (LV) diastolic dysfunction in overt hyperthyroid patients is unclear. Here, we aimed to explore the relationship between NLR and LV diastolic dysfunction in overt hyperthyroid patients.MethodsFor this study, we retrospected the consecutive medical files of 350 overt hyperthyroid patients. Their medical data and laboratory findings were recorded. According to the presence or absence of LV diastolic dysfunction, the patients with overt hyperthyroidism were divided into two groups. One group with LV diastolic dysfunction included 104 patients and another group with non-LV diastolic dysfunction included 246 patients. The NLR values between the two groups were compared, and the relationship between NLR levels and the prevalence of LV diastolic dysfunction was also explored.ResultsThe NLR value in LV diastolic dysfunction group in the overt hyperthyroid subjects was significantly higher than that in non-LV diastolic dysfunction group [1.100 (0.907-1.580) vs 1.000 (0.761-1.405), P=0.016]. The prevalence of LV diastolic dysfunction in Low- (NLR<0.879), Medium- (0.879< NLR<1.287), and High- (NLR >1.287) NLR level groups were 20.9%, 32.5% and 35.7% respectively. Moreover, increased NLR is associated with increased prevalence of LV diastolic dysfunction, and after adjustment for potential associated factors, NLR remained significantly associated with LV diastolic dysfunction. (OR = 11.753, 95%CI = 1.938-71.267, P = 0.007).ConclusionsOur findings demonstrated that the NLR was associated with LV diastolic dysfunction in the overt hyperthyroid patients, and the prevalence of LV diastolic dysfunction may be positively correlated with NLR levels.

Assessment of glycated hemoglobin levels in non-diabetic subjects with recently diagnosed hypo and hyperthyroidism

Background: Thyroid disorders are highly prevalent in the general population and generally manifest as hypothyroidism or hyperthyroidism. Glycated hemoglobin (HbA1c) is commonly used for the assessment of the long-term glycemic status of diabetic patients. But the HbA1c concentration not only depends on prime glycemia but some other factors. Aims and Objectives: The objective of this study was to measure glycated hemoglobin and thyroid hormone levels and aimed to determine the effects of hypo and hyperthyroidism on glycated hemoglobin in non-diabetic patients. Materials and Methods: This case-control study was conducted on 70 euglycemic individuals each newly diagnosed with hypo and hyperthyroidism. Seventy age and gender-matched controls were recruited. Baseline HbA1c was estimated by high-performance liquid chromatography (HPLC) and thyroid status was measured by chemiluminescent immunoassay (CLIA) method in all cases and controls and then compared. Results: HbA1c values were found to be significantly higher in the hypothyroid group (P &lt; 0.001), whereby its values in hyperthyroid subjects showed no significant difference from controls (P = 0.17). A positive correlation (r=0.67) exists between the levels of thyroid-stimulating hormone (TSH) and HbA1c in hypothyroid patients, but no significant correlation (r= -0.07) was observed for hyperthyroid subjects. Conclusion: HbA1c may not be a reliable indicator of glycemic status in patients with hypothyroidism, and so HbA1c results should be interpreted with caution in such patients.

A COMPARATIVE STUDY OF HOMOCYSTEINE, CYANOCOBALAMINE, FOLATE, LIPID PROFILE AND SERUM CREATININE LEVEL IN HYPERTHYROID SUBJECTS BEFORE AND DURING TREATMENT

Introduction: Hyperthyroidism disorder results from over production of hormones secreted by thyroid gland itself. The present study plan to delineate influence of thyroxin on homocysteine, folate, cyanocobalamine, lipid profile and serum creatinine in hyperthyroid patients before and during treatment with antithyroid drugs. Material and Method: The present study was conducted on 75 pateints of hyperthyroidism of either sex in department of biochemistry, J.L.N. medical college and hospitals, Ajmer. Serum homocysteine, cyanocobalamine, folate level was measured by ELISA while thyroid function test were evaluated by RIA method. Result and discussion: There were significant change in homocysteine, folate, cyanocobalamine, total cholesterol, HDL-cholesterol and LDL-cholesterol in hyperthyroid subjects before and during treatment (P&lt;0.0001) and these emerging evidence suggest that these parameter are influenced by level of thyroxine hormone which were higher in hyperthyroid subjects before treatment with antithyroid drugs. Conclusion: It is concluded that treatment with antithyroid drug reduces the level of thyroxine hormone in hyperthyroid subject increases level of homocysteine and causes dyslipidemia which increases risk of coronary artery disease, angina pectoris in subclinical hyperthyroidism.

Static and dynamic pupillary features in graves’ ophthalmopathy

ABSTRACT Clinical Relevance Pupillary characteristics may be affected in patients with Graves’ ophthalmopathy (GO). However, small changes cannot be observed with clinical examination. Ophthalmologists and optometrists should be aware that dynamic pupillometry may have an important place in the quantitative assessment of pupillary characteristics in this patient population. Background The aim of this study was to compare the static and dynamic pupillary responses of hyperthyroid and euthyroid GO patients and healthy control subjects. Methods The study enrolled 20 hyperthyroid patients with GO (Group 1), 20 euthyroid patients with GO (Group 2) and 40 control subjects with normal thyroid function tests and no known illness (Group 3). Following detailed ophthalmological examination, static and dynamic pupillometry measurements were performed. Dynamic pupillometry measurements including resting diameter, amplitude of pupil contraction, latency of pupil contraction, duration of pupil contraction, latency of pupil dilation, duration of pupil dilation, and velocity of pupil dilation were undertaken. Static pupillometry measurements including scotopic, mesopic, low-photopic, and high-photopic pupil diameters (PD) were undertaken. Data from the right eyes of the participants were used for statistical analysis. Results Regarding the dynamic pupillary measurements, the latency of pupil contraction value was significantly higher (p = 0.007), and the velocity of pupil dilatation was significantly lower (p = 0.004) in Groups 1 and 2 compared to the Group 3. In static pupillary measurements, there were statistically significant differences between the GO group (Group 1 and 2) and Group 3 with regard to scotopic (p = 0.002), mesopic (p = 0.002), and low-photopic PD (p = 0.001). Conclusion Scotopic, mesopic and low photopic PD, latency of pupil contraction and velocity of pupil dilatation values were significantly different in both hyperthyroid and euthyroid GO patients when compared to healthy control subjects.

A study of gonadal dysfunction in women with thyroid disease

Background: Thyroid diseases are among the commonest endocrine disorders. It effects growth, embryonic development, tissue differentiation, maturation, metabolism, increases chronotropic and inotropic action of heart. The aim was to study gonadal dysfunction in women with thyroid disease; to study levels of FSH, LH, prolactin, estrogen and testosterone in hypothyroid and hyperthyroid.Methods: All participants fulfilling the inclusion criteria were interviewed as per proforma and medical details were recorded in proforma sheet and patients were subjected to necessary blood investigations.Results: Among 80 study subjects, majority were in the age group 26-35 years (60.1%) and majority had overt hypothyroid disease (72.5%). Symptoms of hypothyroid subjects mainly were fatigue, weight gain, hair loss, oligomenorrhea. Hyperthyroid subjects had fatigue, palpitations, oligomenorrhea, polymenorrhea. Prolactin had positive correlation with TSH in hypothyroid subjects, their LH, FSH levels were normal and sex steroid levels were low. In contrary, majority of the hyperthyroid subjects had normal prolactin and FSH, high LH and high sex steroid levels.Conclusions: The study demonstrated that thyroid disease in women causes menstrual abnormalities due to altered gonadotropin patterns which in turn alter ovarian hormone pattern. Hypothyroidism is associated with hyperprolactinemia leading to anovulation and abnormal menstrual cycle. Hyperthyroidism is associated with increased levels of LH, estrogen and testosterone with normal levels of PRL and FSH. Screening, identifying and correcting thyroid disease should be undertaken to prevent infertility as early as possible.

BIOCHEMICAL AND CLINICAL CHARACTERIZATION OF IODINE DEFICIENCY DISORDERS IN CENTRAL INDIA

Background: Iodine (I) is a trace element that is required by both humans and animals. It can be found in a variety of chemical forms, including iodine, iodide (I), and iodate (IO3). It is widely distributed across the earth's ecology, with a concentration in the oceans. Iodine entered the natural cycle from the ocean, the atmosphere, and rainfall, as well as from rainfall into streams and rivers. Iodine is absorbed as iodide in human nutrition. Iodine is a necessary micronutrient and a component of thyroid hormones. Fish and seafood have a high iodine level. The amount of iodine in soil and drinking water varies depending on where it comes from. Iodine shortage produces a variety of negative health consequences, which are referred to as iodine deficiency illnesses (IDD). These conditions are caused by a lack of iodine, which causes insufficient thyroid hormone production.&#x0D; Aim: The aim of this study is to characterize the iodine deficiency disorder by biochemical and clinical assessment and to correlate the iodine status with thyroid disorder(s) in adults.&#x0D; Material and Method: The samples for this investigation were taken from patients at the Department of Endocrine Surgery. This study comprised a total of 100 hundred goiter patients, who had their urinary iodine excretion and thyroid hormone levels examined. For all goiter patients, the grading of goitre was established using the WHO/UNICEF/ICCIDD approved criteria. TSH, Free T4, Free T3 by using ELISA Method using commercial kits. Anti-microsomal antibody (AMA) or Thyroperoxidase antibody (TPO-Ab) by using ELISA Method using commercial kits. Anti-thyroglobulin antibody (ATG) estimated by using ELISA Method using commercial kits.&#x0D; Results: The data for each group were presented as Median and inter quarter range (IQR) The median and IQR of Urinary iodine excretion of the hypothyroid, hyperthyroid and Euthyroid goiter subjects were respectively and there was significant difference in the median urinary iodine excretion. The median and IQR of Urinary iodine excretion of the thyroiditis, thyrotoxicosis, cancer of thyroid and benign goiter respectively and there was significant difference in the median urinary iodine excretion.&#x0D; Conclusion: For ages, endemic goitre and cretinism have been recognised as public health issues, and iodine deficiency is thought to be the leading cause of preventable mental retardation. Most countries now include iodine deficiency control as part of their national nutrition policies. To eliminate iodine deficiency, several therapies with high efficacy have been employed, including iodized oil capsules (IOC) and universal salt iodisation (USI). Although some progress has been made, efforts to eliminate this devastating health problem must be hastened. Not only should iodine deficiency be monitored, but so should excessive iodine intake, as this is a problem in various areas, including the camps.&#x0D; Keywords: IDD, Goitre, TSH, IOC, USI, ATG, AMA, T4, T3.

A Conceptual Exploration on the Samprapti Ghatakas of Hyperthyroidism

Thyroid disorders are the commonest endocrine disorders worldwide with devastating health consequences. Hyperthyroidism is commonly referred as an overactive thyroid which enhances the rate of metabolism in multiple levels. Since this disorder is having multisystem effects, the pathology can’t be restricted to the gland only. There is striking similarity between the functions of Dhatwagni and thyroid hormone metabolism. The far reaching metabolic disturbances in thyroid dysfunctions are attributed to Dhatwagni vikruthi. On a close review, it is evident that Ayurvedic concept available in this direction clearly demonstrates the pathology when juxtaposed against the advanced principles of modern medicine. In Ayurveda, the categorization of diseases had been made according to the involved Doshas, Dooshyas, Srotas, Agni, Ojus (the etiopathological factors) which are termed as the Samprapti ghatakas. These descriptions are largely based on factors and way of life prevalent in the period when they were compiled. Detailed studies may be undertaken to ascertain these factors of the diseases which are relevant in the current lifestyle and environment. It is striking that the treatment of hyperthyroidism has not changed greatly in the past several decades. Only conservative management is possible through Anti thyroid drugs, but about a 50% have relapse rate. A global epidemiological study reported a data of 50% of subclinical hyperthyroid subjects have arisen from excessive intake of thyroid hormones. A thorough understanding of the complete disease process with regard to the Samprapti ghatakas involved is of great importance in this subject which forms the basis of systematic approach in the Ayurvedic management.

Comparison of Enzyme-Linked Immunosorbent Assay and Chemiluminescence Immunoassay for Thyroid Stimulating Hormone Analysis in Tertiary Care Hospital Lahore

Objective: To compare enzyme-linked immunosorbent assay and Chemiluminescence immunoassay for thyroid stimulating hormone analysis in human serum. &#x0D; Methodology: This cross-sectional study conducted from 17th March till 13th June. In Punjab Rangers Teaching Hospital, Lahore after approval from Institutional Review Board. Random samples from both genders, between 18-70 years of age were included. Haemolysed, lipemic or icteric specimens were excluded. The sera were assayed for thyroid stimulating hormone (TSH) by enzyme-linked immunosorbent assay (ELISA) and Chemiluminescence immunoassay (CLIA). Data was analyzed by SPSS 24.&#x0D; Results: A total of one hundred and ninety-eight serum samples were processed by ELISA and CLIA in all the samples, with more females as compared to males (1:1.3). ELISA technique identified 134 subjects as Euthyroid, 40 Hypothyroid and 24 Hyperthyroid, while 122 Euthyroid, 48 hypothyroid and 28 hyperthyroid subjects by CLIA. Thyroid stimulating hormone (TSH) levels reference range was taken 0.4-4.5mU/L according to American Thyroid Association. Mean ± SD of TSH was 1.45 ± 0.79; 12.27 ± 11.03 and 0.23 ± 0.17 mU/L respectively by ELISA whereas CLIA indicated Mean ± SD to be 1.93 ± 0.936, 16.04 ± 14.68 and 0.393 ± 0.375 mU/L respectively for Euthyroid, hypothyroid and hyperthyroid. Correlation of coefficient (R2 =0.89) was found significantly positive between both methods. There was a significant difference in hypothyroid and Euthyroid groups.&#x0D; Conclusion: TSH assay by CLIA has shown a wider range of functionality, throughout and borderline cases were identified better as compared to ELISA. Turn-around-time (TAT) decreased, physician satisfaction increased and indirectly benefitting patient treatment and prognosis.

Raised mortality in old adults with a history of hyperthyroidism following iodine fortification.

A transient rise in the occurrence of hyperthyroidism ensued the introduction of iodine fortification (IF) of salt in Denmark. Older adults are at risk of complications to hyperthyroidism that could prove fatal to vulnerable individuals. We evaluated the association between thyroid function and mortality in older adults before and after nationwide implementation of IF. Retrospective cohort study. All 68-year-olds from the general population in the city of Randers were invited to participate in a clinical study in 1988 and followed until death, emigration or end of study (31 December 2017) using Danish registries. Baseline measures comprised of a questionnaire, physical examinationand blood and urine samples. Kaplan-Meier survival curves and Cox regression were used to determine the association between thyroid function and death before and after IF. Time-stratification of results before and after IF was employed due to violation of proportional hazards assumptions in Cox regression. Median urinary iodine concentration was 42 µg/L at baseline consistent with moderate iodine deficiency. Hyperthyroidism (thyrotropin < 0.4 mIU/L) occurred in 37 (9.1%) participants. Kaplan-Meier survival curves showed an increase in mortality among participants with hyperthyroidism after IF. There was no significant association between hyperthyroidism and mortality before IF compared to euthyroid participants, but after IF hyperthyroid subjects had an increased mortality (adjusted hazard ratio: 2.22, 95% confidence interval: 1.44-3.44). IF was associated with raised mortality among older adults with a history of hyperthyroidism and moderate iodine deficiency. Our results highlight the need for cautious iodine supplementation and for monitoring of IF.

Influence of Thyroid Disorders on Liver Function Tests in –Diyala Governorate

Background: Thyroid diseases may disturb liver function; liver disease modulates thyroid hormone metabolism, and a range of systemic diseases disturb both organs. There are clinical and laboratory relations between thyroid and liver diseases. Patients with chronic liver disease may have thyroiditis, hyperthyroidism, or hypothyroidism.aPatients with subacute thyroiditis or hyperthyroidism may have abnormalities in liver function tests, which return to normal as the thyroid disorder improves. Objective: The present study is designed to investigate the effects of thyroid disorders on liver function tests. Patients and Methods: In this study sixty patients were employed and categorized into two groups, thirty patients with hyperthyroidism (13 male and 17female) with age range of 25-45years, (mean 33.38) and thirty patients with hypothyroidism (11male and 19 female) with age range 25-45 years (mean 36.78),while 30 normal healthy individuals were chosen as a control group (15male and 15 female) in the same age range (mean 34.44) were taken for comparison. Blood samples were collected from the patients at Baqubah Teaching Hospital , between April 2020 to July 2020. Basic serum biochemical parameters including, thyroid stimulation hormone (TSH), triiodothyronine(T3) and thyroxin (T4)were assayed for patients and control groups by Cobas e 411 autoanalyzer within eight weeks. Serum normal values for alanine aminotransferase (ALT). ALT (Alanine Aminotransferase), Aspartate aminotransferase (AST), alkaline phosphatase test (ALP), direct bilirubin (DB) and total bilirubin( TSB) were assayed within four days by Cobas integra 400 plus autoanalyzer. Results: The mean value of ALT, AST, ALP,TSB, and DB in patients with hyperthyroidism, and hypothyroidism was significantly increased when compared with their mean values of healthy control (p &lt;0.05).A significant difference was also found in mean values of T3,T4,TSH in hyperthyroidism and hypothyroidism when compared with their mean values of healthy control(p &lt;0.05). Results of this work revealed a significant negative correlation of TSH with ALP and TSB (p&lt;0.05). Further, T4 showed a significant positive correlation with ALP (P&lt;0.05).The same results revealed that there was a significant positive correlation between T3 and ALP with (p&lt;0.05).There was no significant correlations between ALT,AST,DB with TSH,T3,T4.Further,no significant correlations between TSB and T3,T4 (p &gt;0.05). Conclusion: The current study shows that thyroid disorder might cause significant effect on the metabolism of hepatocytes reflected by an increase in biochemical parameters of liver function test AST, ALT ALP,TSB and DB in both hyperthyroidism and hypothyroidism subjects. Keywords: Thyroid diseases ,Alanine aminotransferase , hyperthyroidism, Tetraiodothyronin ,Thyroid stimulating hormone,hypothyroidism

THYROID SWELLING AND IT’S ASSOCIATION WITH THYROID HORMONE STATUS AND BLOOD LIPID PROFILE: A CROSS-SECTIONAL STUDY

Disease of thyroid gland are among the most abundant endocrine disorder in the world second only to diabetes mellitus . Thyroid diseases namely hypothyroidism and hyperthyroidism,constitutes the most common endocrine abnormality in recent years,diagnosed either in subclinical or clinical form.One observational cross sectional study was conducted in the department of ENT, Tripura Medical College &amp; DR.BRAM Teaching hospital involving 75 nos of subjects having thyroid swellings. Mean value of T3,T4 and TSH was different in cases of euthyroid, hypothyroid , hyperthyroid and subclinical hypothyroid subject. It was of statistically significant. Here P value of T3, T4 &amp; TSH according to thyroid hormone status were less than 0.05(α%) level of significance.There was statistically difference in average value of T3,T4 &amp; TSH with different thyroid hormone status at 5% level of significance.We found that 9.3% of the study subjects were having altered lipid profile.We found that 62.5% of hypothyroid subjects were having altered lipid profile . Amongst them,all subclinical hypothyroid subjects were having altered lipid profile.Whereas hyperthyroid subjects were having normal lipid profile.Two (3.07%) euthyroid cases were having altered lipid profile.We found that mean values of total cholesterol, triglyceride, HDL, LDL and VLDL was different in cases of euthyroid , hypothyroid , hyperthyroid and subclinical hypothyroid subject.It was of statistically significant.Here P value of total cholesterol,triglyceride,HDL,LDL and VLDL according to thyroid hormone status were less than 0.05(α%) level of significance. There was statistically difference in average value of total cholesterol,triglyceride,HDL,LDL and VLDL with thyroid hormone status at 5% level of significance.

STUDY OF SERUM GHRELIN IN THYROID PATIENTS

Background: Hypothyroidism is a common endocrine disorder resulting from deciency of thyroid hormone. Hyperthyroidism is a set of disorders that involve excess synthesis and secretion of thyroid hormone by the thyroid gland. Ghrelin is octanoylated peptide containing a 28 amino acid act as an energy balance regulator &amp; play an important role in metabolic process .The aim of the study was to establish possible relationship between them. Materials and methods: The present study is a cross sectional study, was conducted in the Department of Biochemistry, J.L.N. Medical college and associated group of Hospitals, Ajmer (Raj.). 65 hypothyroid subjects (group-II) and 65 hyperthyroid subjects (group-III) attending Medical OPD of J.L.N. Hospitals were included and 130 age-sex matched euthyroid controls (group-I) were selected. Results: In hypothyroid subjects, mean serum Ghrelin levels were found to be signicantly higher in comparison to healthy subjects (p&lt;0.0001). In hyperthyroid subjects, mean serum Ghrelin levels were found to be signicantly lower in comparison to healthy subjects (p&lt;0.0001). Conclusion: The overall ndings of the present study thus conrm that serum Ghrelin level is signicantly higher in Hypothyroid subjects and the level is signicantly lower in the Hyperthyroid subjects, thus we have found positive association between serum TSH level and Ghrelin level. However, further experimental and observational studies are needed to illustrate the role of Ghrelin in Hypothyroidism and Hyperthyroidism.

A comparative study of melasma severity after hyperthyroid therapy in hyperthyroid subjects with melasma

Melasma, and its variant chloasma, is an acquired and chronic disorder of hyperpigmentation, characterized by symmetrical hypermelanoses of the face. The exact pathogenesis of melasma remains unclear. Several hormones are thought to play a role, including thyroid hormones. The study's objectives are to determine the proportion of melasma cases in hyperthyroid patients and to compare the severity of melasma before and after medications of hyperthyroid therapy. A quasi-experimental (pre-post intervention) study was conducted in Jakarta from August 2019 to February 2020. Twenty-three patients either newly diagnosed with hyperthyroidism or that had undergone hyperthyroid therapy for a maximum of 3 months and also had melasma were recruited. The severity of melasma was scored with the modified Melasma Area and Severity Index (mMASI), and dermoscopy of the lesions was performed. The evaluation was performed after 3 months of hyperthyroid therapy. Among the 69 hyperthyroid patients, 45 (65%) had melasma. The mean difference in the mMASI score was 0.49 (p > 0.05). Dermoscopy features did not show any differences between the start and end of the study. There is no significant improvement of melasma severity in hyperthyroid patients after 3 months of hyperthyroid therapy.

Prospective Analysis of Lipid Variations in Hyperthyroid Subjects from Lahore, Pakistan.

Perturbations in the actions of T3 and T4 influence the normal metabolic pathways. Responsiveness of lipid biomarkers like LDL-C, HDL-C, TC, TG, Apo-A, and Apo-B after rehabilitation of thyroid profile attaining euthyroid state was determined. A total of 179 age-matched subjects of both genders were recruited for this research. Sixty healthy controls, thirty-four subclinical, fifty overt hyperthyroid, and thirty-five follow-up subjects having 3 months of Carbimazole therapy were enrolled. Biochemical analysis was performed by chemistry analyzer, RIA, and ELISA. One-way ANOVA was applied for the statistical analysis, while significance (P < 0.05) of means was compared by the Student-Newman-Keuls (SNK) test. Pronounced reduction (P < 0.001) of cholesterol in overt as compared to control and subclinical was noticed, whereas marked improvement (P < 0.001) was evidenced in follow-up. Prominent elevation (P < 0.05) of TG in follow-up was evidenced as compared to control. Overt presented marked reduction of HDL-C as compared to subclinical and control (P < 0.01 and P < 0.001), respectively. Pronounced elevation (P < 0.001) of HDL-C was evidenced after treatment. Overt presented reduction of LDL-C as compared to subclinical and control (P < 0.01 and P < 0.05, respectively). The follow-up group demonstrated considerable (P < 0.001) improvement of LDL-C after treatment and elevation (P < 0.05) as compared to control. Overt presented reduction of Apo-B as compared to subclinical and control (P < 0.05 and P < 0.001, respectively). Improvement (P < 0.05) of Apo-B was evidenced in follow-up. Reduction (P < 0.05) of Apo-A in overt as compared to control and elevation (P < 0.05) in follow-up as compared to overt was evidenced. Conclusively, improvement after treatment was evidenced in lipid profile.