Hyperthyroid Group Research Articles

Visfatin, PON-1 Levels in Iraqi Hyperthyroidism Patient's with Dyslipidemia.

In the study, it is aimed to research the likely role of visfatin in hyperthyroid and subclinical hyperthyroid status related to dislipidemia, after determining the visfatin and PON-1 levels thirty healthy individuals were enrolled in this study as control group and thirty hyperthyroidism patient's with dyslipidemia they were treated with. The subjects aged ranged (30-50) years and with BMI (25-29) kg/m2. Serum was used in determination of lipid profile total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), very low density lipoprotein (VLDL), thyroid threonine (T3) and thyroxin (T4), thyroid stimulating hormone (TSH), visfatin and paraoxonase-1 (PON-1). The results showed significant increase in T3, T4, TC, TG, LDL and VLDL in patient group when comparing to control group. While significant decrease was found in TSH and HDL in patient group when comparing to control group. The results also represented significant increase in visfatin levels in patient group comparing to control group. While there are significant reducation in PON-1 levels in patient group comparing to control group. The conclusion could be drown from this study that visfatin and PON-1 effected hyperthyroidism patient's with dyslipidemia All the patients in hyperthyroid group were heterozygotes for Familial Hypercholesterolemia is a disorder that is passed down through families. It causes LDL (bad) cholesterol level to be very high. The condition begins at birth and can cause heart attacks at an early age.

Course of sepsis in rats with thyroid dysfunction.

Numerous studies show the relationship between sepsis and thyroid hormones. Virtually all these studies investigate changes in post-sepsis thyroid hormones and the relationship between these changes and the progression of the disease. Our aim in this study was to investigate the progression of sepsis in rats with thyroid dysfunction. The study involved four groups, each containing seven female Wistar albino rats: Group 1: Sham, Group 2: Control (Sepsis), Group 3: Hyperthyroidism-Sepsis, and Group 4: Hypothyroidism-Sepsis. Group 1 only received laparotomy. Group 2 only had sepsis. Sepsis was induced in Group 3 and Group 4 following formation of hyperthyroidism and hypothyroidism, respectively. After 24 hours, relaparotomy and thoracotomy were performed, and tissue and blood samples were drawn. Dysfunctions seen in the liver, lungs, and kidneys during sepsis and other findings of sepsis were milder in the hyperthyroidism group in comparison to both the control and hypothyroidism groups. The results of Simon's grade, histopathological organ damage, and laboratory parameters revealed that the progression of sepsis was milder in the hyperthyroid group than in the hypothyroid and euthyroid groups. The progression in the hypothyroid group was the most severe. Therefore, the results of the study raise the question of whether immediate treatment in cases of hypothyroidism and slow return of thyroid function to normal levels in cases of hyperthyroidism are adequate treatment approaches in patients who may develop sepsis or septic shock." To determine the answer to this question, more detailed studies are required with a higher number of subjects.

The main autoimmune and nonautoimmune etiologies of endogenous hyperthyroidism do not seem to influence the increased prevalence of morphometric vertebral fractures and osteoporosis in Portuguese men

ObjectivesThe purpose of this study was to evaluate the effects of hyperthyroidism and their etiology on bone mineral density (BMD), on body soft tissue composition, on the prevalence of vertebral fractures detected by vertebral fracture assessment (VFA) and on the trabecular bone score (TBS). MethodsFrom an initial population of 119 Portuguese men (78 with hyperthyroidism [HT]+ 41 controls [CTs]) admitted to the Endocrinology Department we selected 41 men aged over 50 with clinical hyperthyroidism to participate; each one was matched by age and height with a control person. BMD (g/cm2) at the lumbar spine, hip, radius 33% and whole body and the total body masses (kg) were studied by dual-energy X-ray absorptiometry (DXA). VFA with Genant semiquantitative method was used to detect fractures. The TBS was obtained from lumbar spine DXA images. No patient had been treated previously for hyperthyroidism or osteoporosis. Adequate statistical tests were used. ResultsIn the hyperthyroidism group, total lean mass (CT 58.16 ± 7.7 vs. HT 52.3 ± 5.7, P = 0.03) and distal radius BMD (CT 0.769 ± 0.05 vs. HT 0.722 ± 0.08, P = 0.005) were lower; there was a significantly higher prevalence of osteoporosis (CT 9.7% vs. HT 29.3%, P = 0.015) and vertebral fractures (CT 2.4% vs. HT 24.4%, P = 0.007). TBS was similar in both groups (CT 1.328 ± 0.11 vs. HT 1.356 ± 0.11, P = not significant). Comparing patients with Graves' disease with patients with toxic goiter, there were no differences regarding BMD, BMD qualification, prevalence of fractures and TBS and just total lean mass was significantly lower in patients with Graves' disease. ConclusionsThese results suggest that in a group of hyperthyroid men aged over 50 there are significant decreases in cortical bone BMD and lean mass and a higher prevalence of osteoporosis and silent vertebral fractures, but the etiology of the hyperthyroidism does not seem to influence it. Besides the antithyroid drugs, some patients may benefit from bone-directed treatments.

Relationship of metabolic syndrome and its components with thyroid dysfunction in Algerian patients

AimsThe aim of this study is to evaluate the prevalence of the metabolic syndrome and its compounds in subjects with different thyroid status. Materials and methodsA prospective cross-sectional study was conducted in the internal medicine department at El Okbi Hospital of Guelma (East of Algeria) from January 2014 to September 2015. Eighty six patients attending the specialist consultation for suspected thyroid disorders were included in the study. Gender; blood pressure; body mass index; and serum levels of fasting glucose, total cholesterol (TC), high-density-lipoprotein cholesterol (HDL-C), low-density-lipoprotein cholesterol, and triglyceride were compared between subjects with hypothyroidism, hyperthyroidism and euthyroidism. Results and conclusionThyroid dysfunction was found in 59.3% (n=42) patients, hypothyroidism (45.3%) was the major thyroid dysfunction followed by hyperthyroidism (14.0%). Overall, the prevalence of metabolic syndrome was 48.8% (n=42). Subjects with hypothyroidism had significantly higher level of BMI, WC, TC, LDL-C, and higher prevalence of abdominal obesity (84.6%, p<0.01) and hypertension (51.2%, p<0.05). The hyperthyroid group had significantly lower level of TC, LDL-C and HDL-C but a higher level of SBP and UA. Furthermore, abdominal obesity, hypertension and low HDL-C level were the most common metabolic syndrome compounds found in the hyperthyroid group compared to the euthyroid group. We found a positive association between TSH level and the prevalence of the metabolic syndrome.

Study of Serum Irisin in Patients with Thyroid Dysfunction

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

Level of cystatin C in functional thyroid disorders and its relation to GFR

Thyroid hormones affect the development and physiology of the kidneys. Hypothyroidism and hyperthyroidism affect glomerular filtration rate (GFR), tubular function, renal blood flow, and structure of the kidney. Cystatin C is a non-glycosylated neuroendocrine protein. It is freely filtered at the glomerulus and completely reabsorbed and catabolized by cells of tubules. Cystatin C levels, affected by the thyroid state, is being increased in hyperthyroidism and decreased in hypothyroidism. The current study was conducted on 66 patients of thyroid disorder and 21 healthy control subjects. Total T3, total T4, and TSH were measured by cobas e 411. Human Cystatin C was measured using ELISA kit based on sandwich enzyme-linked immunosorbent assay. Cystatin C was significantly increased in both total hyperthyroid and clinical hyperthyroid groups as compared to control (p < 0.001). eGFRCys C and eGFRCr-Cys C were significantly decreased in hyperthyroid and clinical hyperthyroid (p < 0.001). Cystatin C was significantly reduced in hypothyroid group and subgroups comparing to control group (p < 0.001, p < 0.001, and p = 0.004, respectively). As regard to eGFRCys C, it was significantly an overestimate clearance in hypothyroid group and subgroups when compared to normal subjects (p < 0.001, p < 0.001, and p = 0.002, respectively). Thyroid dysfunction affects cystatin C level as well as cystatin-based eGFR so it is not suitable in thyroid dysfunction specially in clinical dysfunction.

Thyroid states regulate subcellular glucose phosphorylation activity in male mice.

The thyroid hormones (THs), triiodothyronine (T3) and thyroxine (T4), are very important in organism metabolism and regulate glucose utilization. Hexokinase (HK) is responsible for the first step of glycolysis, catalyzing the conversion of glucose to glucose 6-phosphate. HK has been found in different cellular compartments, and new functions have been attributed to this enzyme. The effects of hyperthyroidism on subcellular glucose phosphorylation in mouse tissues were examined. Tissues were removed, subcellular fractions were isolated from eu- and hyperthyroid (T3, 0.25 µg/g, i.p. during 21 days) mice and HK activity was assayed. Glucose phosphorylation was increased in the particulate fraction in soleus (312.4% ± 67.1, n = 10), gastrocnemius (369.2% ± 112.4, n = 10) and heart (142.2% ± 13.6, n = 10) muscle in the hyperthyroid group compared to the control group. Hexokinase activity was not affected in brain or liver. No relevant changes were observed in HK activity in the soluble fraction for all tissues investigated. Acute T3 administration (single dose of T3, 1.25 µg/g, i.p.) did not modulate HK activity. Interestingly, HK mRNA levels remained unchanged and HK bound to mitochondria was increased by T3 treatment, suggesting a posttranscriptional mechanism. Analysis of the AKT pathway showed a 2.5-fold increase in AKT and GSK3B phosphorylation in the gastrocnemius muscle in the hyperthyroid group compared to the euthyroid group. Taken together, we show for the first time that THs modulate HK activity specifically in particulate fractions and that this action seems to be under the control of the AKT and GSK3B pathways.

Association of Polybrominated Diphenyl Ethers (PBDEs) and Polychlorinated Biphenyls (PCBs) with Hyperthyroidism in Domestic Felines, Sentinels for Thyroid Hormone Disruption

BackgroundHyperthyroidism is the most common endocrine disorder observed in domestic felines; however, its etiology is largely unknown. Two classes of persistent organic pollutants, polybrominated diphenyl ethers (PBDEs) and polychlorinated biphenyls (PCBs) are known to interfere with thyroid hormone (TH) signaling and regulation; thus, it is postulated that they contribute to the etiopathogenesis of feline hyperthyroidism and pose a risk to humans and other species. In this case-control study, the concentrations of 13 PBDE and 11 PCB congeners were measured by gas chromatography mass spectrometry in serum or plasma samples from 20 hyperthyroid and 31 control cats in order to investigate the association between concentration of PBDE and PCB congeners and feline hyperthyroidism. Logistic regression analysis was used to determine whether elevated concentrations of individual congeners were associated with a higher risk of feline hyperthyroidism.ResultsHyperthyroid cats had higher concentrations of four PBDE congeners (BDE17, BDE100, BDE47, and BDE49) and five PCB congeners (PCB131, PCB153, PCB174, PCB180, and PCB196), compared to control cats. In addition, the sum of both PBDE and PCB congener concentrations were elevated in the hyperthyroid group compared to control cats; however, only the increased PCB concentrations were statistically significant. The sum total PBDE concentrations in our feline samples were approximately 50 times greater than concentrations previously reported in human populations from a geographically similar area, whereas sum total PCB concentrations were comparable to those previously reported in humans.ConclusionsThese observational findings support the hypothesis that PBDEs and PCBs may contribute to the etiopathogenesis of hyperthyroidism in felines. As domestic house cats are often exposed to higher concentrations of PBDEs than humans, they may serve as sentinels for the risk of TH disruption that these pollutants pose to humans and other species.

Evaluation of interrelationships between thyroid function, autoimmunity, insulin resistance and lipid profile in Graves' disease

Introduction: Thyroid hormones modulate the lipoprotein and glucose metabolisms. In hyperthyroidism, insulin resistance is a frequent finding. The aim of our study was to assess the interrelationships between thyroid function, autoimmunity, lipid profile, glucose metabolism and other cardiovascular risk factors in patients with Graves’ disease. Material & Methods: We recorded free T3, free T4, TSH, TSH receptor antibodies, parameters of the lipid profile, glucose metabolism (including insulin resistance markers like homeostasis model assessment for insulin resistance - HOMA-IR), C reactive protein and homocysteine in 126 patients with Graves’ disease in the first cycle of treatment with methimazole (92.9% females, mean age 44.9 ± 15.2 years). Patients were divided in subgroups according to: TSH receptor antibodies [positive (n = 57) or negative (n = 69)] and thyroid function [euthyroidism (n = 74), subclinical (n = 29) or clinical hyperthyroidism (n = 22)]. Spearman correlations, t-tests and Mann-Whitney tests were performed for statistical analysis. Results: Comparing the positive and negative TSH receptor antibodies groups, significantly lower apolipoprotein B (80.3 ± 23.9 vs 89.7 ± 23.8 mg/dL; p = 0.047) and TSH [0.180 (0.002-1.080) vs 1.020 (0.235-2.055) μUI/mL; p < 0.001] were found in the positive TSH receptor antibodies group. Comparing with the normal thyroid function group, patients in the clinical hyperthyroid group presented significantly lower apolipoprotein B (70.9 ± 25.8 vs 89.8 ± 24.0 mg/dL; p = 0.007] and higher fasting glucose (96.0 ± 24.4 vs 86.4 ± 10.0 mg/dL; p = 0.019), insulin [10.4 (6.2-15.8) vs 7.5 (4.8-9.7) μUI/mL; p = 0.021], HOMA-IR [2.09 (1.29-4.53) vs 1.55 (0.96-2.13); p = 0.023] and C reactive protein [0.57 (0.20-0.93) vs 0.20 (0.07-0.38) mg/L; p = 0.005]. No significant differences were found between the subclinical hyperthyroid and the normal groups. There was a negative correlation between TSH and the TSH receptor antibodies (r = -0.386; p < 0.001). Apolipoprotein B was positively correlated with TSH (r = 0.236; p = 0.016), and negatively with the TSH receptor antibodies (r = -0.211; p = 0.030). Both free T3 and free T4 were positively correlated with fasting insulin (r = 0.268; p = 0.008 and r = 0.226; p = 0.025, respectively) and HOMA-IR (r = 0.258; p = 0.010 and r = 0.259; p = 0.010, respectively). Free T4 was also positively correlated with fasting glucose (r = 0.269; p = 0.008). Conclusion: In patients with Graves’ disease, the interrelationships between thyroid function, autoimmunity, insulin resistance and lipid profile may contribute to the increased cardiovascular risk. The lipid profile suggests a hypolipidemic effect.

Use of First-phase Insulin Secretion in Early Diagnosis of Thyroid Diabetes and Type 2 Diabetes Mellitus.

Background:A relationship between hyperthyroidism and insulin secretion in type 2 diabetes mellitus (T2DM) has been reported. Therefore, this study explored the use of first-phase insulin secretion in the differential diagnosis of thyroid diabetes (TDM) and T2DM.Methods:In total, 101 patients with hyperthyroidism were divided into hyperthyroidism with normal glucose tolerance (TNGT), hyperthyroidism with impaired glucose regulation (TIGR), and diabetes (TDM) groups. Furthermore, 96 patients without hyperthyroidism were recruited as control groups (normal glucose tolerance [NGT], impaired glucose regulation [IGR], and T2DM). The following parameters were evaluated: homeostasis model assessment (HOMA)-IR, HOMA-β, modified β-cell function index (MBCI), peak insulin/fasting insulin (IP/I0), AUCins-OGTT, and AUCins-OGTT/AUCglu-OGTT from the oral glucose tolerance test (OGTT) insulin release test were utilized to assess the second-phase insulin secretion, while the IP/I0, AIR0′~10′, and AUCins-IVGTT from the intravenous glucose tolerance test (IVGTT) insulin release test were used to assess the first-phase insulin secretion.Results:In the OGTT, the HOMA-β values of the TNGT and TDM groups were higher than those of the NGT and T2DM groups (all P < 0.05). In the hyperthyroidism groups, the MBCI of the TDM group was lower than that of the TNGT and TIGR groups (all P < 0.05). Among the control groups, the MBCI values of the IGR and T2DM groups were lower than that of the normal glucose tolerance (NGT) group (all P < 0.05). In the IVGTT, insulin secretion peaked for all groups at 2–4 min, except for the T2DM group, which showed a low plateau and no secretion peak. The IP values of the TNGT, TIGR, and TDM groups were higher than those of the NGT, IGR, and T2DM groups (all P < 0.05). The Ip/I0, AIR0′~10′, and AUCins-IVGTT values of the TDM group were higher than those of the T2DM group but were lower than those of the TNGT, TIGR, NGR, and IGR groups (all P < 0.05). Compared with the other five groups, the Ip/I0, AIR0′~10′, and AUCins-IVGTT values of the T2DM group were significantly decreased (all P < 0.05). The Ip/I0 and AUCins-IVGTT values of the TNGT group were higher than those of the NGT group (all P < 0.05).Conclusions:β-cell function in TDM patients is superior to that in T2DM patients. First-phase insulin secretion could be used as an early diagnostic marker to differentiate TDM and T2DM.

Relationship between the abnormal diastolic vortex structure and impaired left ventricle filling in patients with hyperthyroidism.

Intraventricular hydrodynamics plays an important role in evaluating cardiac function. Relationship between diastolic vortex and left ventricular (LV) filling is still rarely elucidated. The aim of this study was to evaluate the evolution of vortex during diastole in hyperthyroidism (HT) and explore the alteration of hydromechanics characteristics with sensitive indexes.Forty-three patients diagnosed with HT were classified into 2 groups according to whether myocardial damage existed: simple hyperthyroid group (HT1, n = 21) and thyrotoxic cardiomyopathy (HT2, n = 22). Twenty-seven age- and gender-matched healthy volunteers were enrolled as the control group. Offline vector flow mapping (VFM model) was used to analyze the LV diastolic blood flow patterns and fluid dynamics. Hemodynamic parameters, vortex area (A), circulation (C), and intraventricular pressure gradient (ΔP), in different diastolic phases (early, mid, and late) were calculated and analyzed.HT2, with a lower E/A ratio and left ventricular ejection fraction (LVEF), had a larger left atrium diameter (LAD) compared with those of the control group and HT1 (P < .05). Compared with the control group, the vortex size and strength, intraventricular pressure gradient during early and mid-diastole were higher in HT1 and lower in HT2 (P < .05). And in late diastole, the vortex size and strength, intraventricular pressure gradient of HT2 became higher than those of the control group (P < .05). Good correlation could be found between CE and E/A (P < .05), CM and ΔPM (P < .01), CL and FT3 (P < .05).VFM is proven practical for detecting the relationship between the changes of left ventricular diastolic vortex and the abnormal left ventricular filling.

The relationship between subclinical thyroid dysfunction and the risk of fracture or low bone mineral density: a systematic review and meta-analysis of cohort studies.

Our aim was to assess the risk of fractures or low bone mineral density (BMD) associated with subclinical thyroid dysfunction among cohorts. We systematically searched Medline (via PubMed), EMBASE, Cochrane Library, Web of Science, CENTRAL and SinoMed up to 31 July 2016 to identify cohort studies which have analyzed associations between subclinical thyroid dysfunction and fracture or BMD. A total of 19 population-based cohorts including 79,368 participants with relationships between subclinical thyroid dysfunction and fractures or BMD were identified as eligible for this meta-analysis. Subclinical hypothyroidism was associated with relative risks (RRs) of 1.34 (95% confidence interval [CI] 1.14, 1.58; I 2=32%) for hip fracture, 1.27 (95% CI 1.02, 1.58; I 2=51.9%) for any location of fracture, and 1.25 (95% CI 1.04, 1.50) for forearm fracture. Subclinical hyperthyroidism was associated with RRs of 1.71 (95% CI 1.06, 2.76; I 2=0.0%) for spine fracture, 1.20 (95% CI 1.03, 1.39; I 2=0.0%) for non-spine fracture, 1.44 (95% CI 1.21, 1.71; I 2=0.0%) for hip fracture, and 1.38 (95% CI 1.21, 1.58; I 2=0.0%) for any location of fracture. Subgroup analysis was conducted according to whether thyroid/anti-thyroid drug users were excluded or not and the results were similar. The change in BMD at the hip (weighted mean difference [WMD]=-0.060, 95% CI -0.116, -0.004; I 2=0.0%) and femoral neck (WMD=-0.046, 95% CI -0.077, -0.015; I 2=0.0%) was significantly decreased in the subclinical hyperthyroidism group compared with the euthyroidism groups in females. We failed to find any associations between the change in BMD and subclinical hypothyroidism. The overall quality of evidence was low in all outcomes. Subclinical hyperthyroidism and subclinical hypothyroidism were associated with an increased risk of fractures. Although subclinical hyperthyroidism was related to reduced BMD, no evidence could prove a definite association between subclinical hypothyroidism and the risk of low BMD.

Perfluorinated alkyl substances in serum of the southern Chinese general population and potential impact on thyroid hormones

In this study, eight perfluorinated alkyl substances (PFASs) and five thyroid hormones (TSH, FT4, FT3, TGAb, and TMAb) were determined in 202 human serum samples of the general population of Guangdong, Guangxi and Hainan provinces in southern China. Σ8PFASs concentrations ranged from 0.85 to 24.3 ng/mL with a mean value of 4.66 ng/mL. The PFASs composition profiles of human serum samples nearly make no difference at different locations. A significant increase was observed for ∑8PFASs, PFOS, and PFHxS concentrations with age (p < 0.01). Gender-related differences were found; PFOS, PFHxS, PFBS, and PFOA levels were higher in males (p < 0.05), and the mean concentration of ∑8PFASs was 1.5 times greater in males (6.02 ng/mL) than in females (4.15 ng/mL). PFOS and ∑8PFASs were significantly negatively correlated with FT3 and FT4 and positively correlated with TSH while PFPeA and PFHxA were significantly positively correlated with TGAb and TMAb in all the samples. The opposite associations between FT3, TSH and PFOS, PFOA and PFHxS levels in hypothyroidism and hyperthyroidism group indicate that the PFOS, PFOA and PFHxS enhance the negative feedback mechanisms of the thyroid gland.

KECEMASAN DAN GANGGUAN FUNGSI TIROID PADA WANITA USIA SUBUR

Background. Thyroid function disorders can be determined by thyroid levels and thyroid stimulating hormone (TSH) in the blood. In normal condition, thyroid hormones will play an important role in metabolism, system oxidation process, the growth process and protein synthesis. This hormones have an effect to all cells in the human body through the amino acids transport mechanism and electrolytes from extra cellular fluids into the cells, enzyme protein synthesis in cells and increase intracellular processes. Changes of thyroid function can interfere cognitive function, behavioral problems, and change of feeling (mood), included an anxiety. Objective. This study aimed to determine the differences of anxiety in patients with hyperthyroidism, euthyroid, and hypothyroidism in Klinik Litbang GAKI Magelang. Methods. This study was conducted using cross sectional method. Samples are 507 women of childbearing age who visited Klinik Litbang GAKI during 2013. The research variables are TSH status and level of anxiety. The level of anxiety was measured using the Beck Anxiety Inventory (BAI) which has 21 items and also measure the physical, cognitive, and emotional aspects. The socio-demographic data were obtained through interviews. The statistical analysis used was Anova test. Result. Subjects with hyperthyroidism, hypothyroid, and euthyroid were 33.3%, 7.3%, and 59.4% respectively. Many subjects especially above 36 years old experience moderate and severe anxiety level. There was no statistically significant differences in age group between hyperthyroid, euthyroid, and hypothyroid. Anova test results showed that the hyperthyroidism group has higher anxiety scores compared with euthyroid group. Conclusion. Impaired hyperthyroidism experienced by childbearing age women would be more prone to experience psychological problems particularly anxiety.

A meta-analysis of the association of serum ischaemia-modified albumin levels with human hypothyroidism and hyperthyroidism.

Serum levels of ischaemia-modified albumin (IMA) have been studied as a novel and simple measure of oxidative stress (OXS) in different thyroid pathologies. However, results of available studies in the literature were not consistent. This meta-analysis was attempted to quantify the overall effect size for serum IMA levels in human hypothyroidism (HT) and hyperthyroidism (HYT) and to study its associations with the thyroid profile. Databases of PubMed/Medline, EMBASE, Google Scholar, Web of Science and Science Direct were searched for articles. Data on serum IMA levels in HT, HYT patients and euthyroid controls were extracted to compute standardized mean differences (SMD) by the random-effects model. The associations between IMA and thyroid profile were computed by the meta-analysis of correlation coefficients. IMA levels in HT patients (SMD=1.12; Z=2.76; P=0.006) and HYT patients (SMD=1.64; Z=2.57; P=0.01) were significantly higher than in euthyroid controls and the thyroid treatment showed a favourble effect on serum IMA levels. There were strong and significant correlations between IMA and hormonal status in HT and HYT groups. This meta-analysis showing increased IMA level in both HT and HYT patients and its association with thyroid profile suggests that serum IMA could be used as a simple measure of increased OXS in thyroid dysfunction.

Leptin, NPY, Melatonin and Zinc Levels in Experimental Hypothyroidism and Hyperthyroidism: The Relation to Zinc.

Since zinc mediates the effects of many hormones or is found in the structure of numerous hormone receptors, zinc deficiency leads to various functional impairments in the hormone balance. And also thyroid hormones have important activity on metabolism and feeding. NPY and leptin are affective on food intake and regulation of appetite. The present study is conducted to determine how zinc supplementation and deficiency affect thyroid hormones (free and total T3 and T4), melatonin, leptin, and NPY levels in thyroid dysfunction in rats. The experiment groups in the study were formed as follows: Control (C); Hypothyroidism (PTU); Hypothyroidism+Zinc (PTU+Zn); Hypothyroidism+Zinc deficient; Hyperthyroidism (H); Hyperthyroidism+Zinc (H+Zn); and Hyperthyroidism+Zinc deficient. Thyroid hormone parameters (FT3, FT4, TT3, and TT4) were found to be reduced in hypothyroidism groups and elevated in the hyperthyroidism groups. Melatonin values increased in hyperthyroidism and decreased in hypothyroidism. Leptin and NPY levels both increased in hypo- and hyperthyroidism. Zinc levels, on the other hand, decreased in hypothyroidism and increased in hyperthyroidism. Zinc supplementation, particularly when thyroid function is impaired, has been demonstrated to markedly prevent these changes.

Association between N-desethylamiodarone/amiodarone ratio and amiodarone-induced thyroid dysfunction.

We used a retrospective data mining approach to explore the association between serum amiodarone (AMD) and N-desethylamiodarone (DEA) concentrations and thyroid-related hormone levels. Laboratory data sets from January 2012 to April 2016 were extracted from the computerized hospital information system database at the National Cerebral and Cardiovascular Center (NCVC). Data sets that contained serum AMD and DEA concentrations and thyroid function tests, including thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3), were analyzed. A total of 1831 clinical laboratory data sets from 330 patients were analyzed. Data sets were classified into five groups (euthyroidism, hyperthyroidism, subclinical hyperthyroidism, hypothyroidism, and subclinical hypothyroidism) based on the definition of thyroid function in our hospital. Most abnormal levels of thyroid hormones were observed within the therapeutic range of serum AMD and DEA concentrations. The mean DEA/AMD ratio in the hyperthyroidism group was significantly higher than that in the euthyroidism group (0.95±0.42 vs. 0.87±0.28, p=0.0209), and the mean DEA/AMD ratio in the hypothyroidism group was significantly lower than that in the euthyroidism group (0.77±0.26 vs. 0.87±0.28, p=0.0038). The suppressed TSH group (0.98±0.41 vs. 0.87±0.28, p<0.001) and the elevated FT4 level group (0.90±0.33 vs. 0.84±0.27, p=0.0037) showed significantly higher DEA/AMD ratios compared with normal level groups. The elevated TSH group showed a significantly lower DEA/AMD ratio compared with the normal group (0.81±0.25 vs. 0.87±0.28, p<0.0001). High and low DEA/AMD ratios were associated with AMD-induced hyperthyroidism and hypothyroidism, respectively. The DEA/AMD ratio may be a predictive marker for AMD-induced thyroid dysfunction.

Evaluation of cardiovascular autonomic reactivity by cold pressor test in thyroid dysfunction in adults: A prospective case-control study

Background: Changes, in thyroid status, have pronounced effects on cardiovascular system reflecting autonomic dysfunction and increased morbidity. Exact interaction between autonomic nervous activity and thyroid hormones is controversial. Aims and Objective: The cold pressor test (CPT) was used to evaluate cardiac autonomic function in thyroid patients and compared with age and sex-matched healthy controls (18-45 years). Materials and Methods: This was a prospective case–control study. By clinical examination and serum levels of (T3, T4 and TSH) three groups hypothyroid, hyperthyroid and control group were categorized and blood pressure (BP) responses to CPT were evaluated in these groups. Statistical analysis was performed using student’s t-test. Results: In hyperthyroid group, rise in systolic BP after CPT is not as that of control group. However, the difference in mean rise is statistically highly significant. While in hypothyroid group rise in diastolic BP is statistically highly significant as compared to that of control group. Conclusion: In hypothyroidism, lack of direct action of thyroid hormones is compensated by increased basal sympathetic tone which exhibits blunted sympatho - excitatory responses leading to aortic stiffness and resistance. This prevents fall in systolic pressure and further reduces vagal tone. Hence, rise in systolic BP after CPT declined but insignificant (P > 0.05). In hyperthyroidism, significant decrease (P 0.05) in diastolic BP after CPT suggests direct action of thyroid hormone on vascular smooth muscles causing vasodilatation and reduced vagal tone decreasing sympathetic activity. Thus, the study revealed thyroid dysfunction leads to sympathovagal imbalance affecting cardiac autonomic function.

Sclerostin and bone metabolism markers in hyperthyroidism before treatment and interrelations between them.

Sclerostin, which is a glycoprotein produced by osteocytes, reduces the formation of bones by inhibiting the Wnt signal pathway. Thyroid hormones are related with Wnt signal pathway and it has been reported that increased thyroid hormones in hyperthyroidism fasten epiphysis maturation in childhood, and increase the risk of bone fractures by stimulating the bone loss in adults. The aim of this study was to examine the sclerostin serum levels, the relation between sclerostin and thyroid hormones as well as the biochemical markers of the bone metabolism in patients with hyperthyroidism (including multinodular goiter and Graves' disease), whose treatments have not started yet. No difference was found in the serum sclerostin levels between the hyperthyroidism group (n=24) and the control group (n=24) (p=0.452). The serum osteocalcin levels and 24-hour urinary phosphorus excretion were found to be higher in the hyperthyroid group than in the control group (p<0.001, p=0.009). A positive correlation was determined between the sclerostin and bone alkaline phosphatase levels (p<0.001); a negative correlation between the osteocalcin and thyroid stimulating hormone (TSH) (p<0.05); a positive correlation between the osteocalcin and thyroid hormones (FT3,FT4) (p<0.001); and a positive correlation between the deoxypyridinoline and hydroxyproline (p<0.001). No correlation was determined between sclerostin and TSH,FT3,FT4 (p>0.05). Therefore, we consider that a long-term study that covers the pre-post treatment stages of hyperthyroidism, including both the destruction and construction of the skeleton would be more enlightening. Moreover, the assessment of the synthesis of sclerostin in the bone tissue and in the serum level might show differences.

Ameliorating Role of Folic Acid in Eltroxine Induced Hyperthyroid and Oxidative Stress in Rat Cortex, Hypothalamus and Hippocampus

Normal brain development requires the presence of thyroid hormones (TH). The present study aimed to declare the effect of hyperthyroidism on oxidative stress parameters in brain tissues (cortex, hypothalamus and hippocampus) and the role of folic acid supplementation in treatment. Thirty adult rats were divided into 5 groups (Group 1, Control; Group 2, Folic acid; Group 3, Hyperthyroid; Group 4, Co-treated hyperthyroid with folic acid; Group 5, Post treated hyperthyroid with folic acid). The current results showed a significant increase in the concentrations of T3 & T4 in hyperthyroid rats when compared with control group. In contrast, TSH showed a significant decrease in hyperthyroid rats when compared with the control group. Calcium was significantly increased in hyperthyroid group when compared with control group. Catalase and MDA were increased, while total protein in brain tissues was decreased in hyperthyroid rats (G3) when compared with control group. Total thiol in brain tissues showed a significant decrease in hyperthyroid group when compared with control group. Treatment with folic acid showed enhancement in oxidative stress parameters in post treated group more than co treated group.