Hyperthyroid Group Research Articles

The Relationship Between Thyroid Function and Metabolic Syndrome and Its Components: A Cross-Sectional Study in a Chinese Population.

ObjectiveThe present study examined the relationship between thyroid function status and the prevalence of metabolic syndrome in a Chinese population.MethodsCross-sectional data were obtained from the Thyroid Disease, Iodine Nutrition and Diabetes Epidemiology (TIDE) Survey. A total of 62,408 subjects aged ≥18 years were enrolled. Differences in metabolic indicators and the prevalence of metabolic syndrome according to sex and thyroid function status were compared. Logistic regression was used to analyze the influence of thyroid function on metabolic syndrome and its components.ResultsThe prevalence of metabolic syndrome was generally higher in men than women. Overt hyperthyroidism and subclinical hypothyroidism had a significant effect on metabolism in men. Body mass index (BMI), waist circumference, and triglycerides (TGs) were significantly lower in men in the overt hyperthyroidism group, and BMI, waist circumference, systolic blood pressure (SBP) and TGs were higher in men in the subclinical hypothyroidism group than men in the normal group. Overt and subclinical hypothyroidism had significant impacts on metabolic components in women. BMI, waist circumference, TGs, SBP and DBP in the subclinical and overt hypothyroidism groups were significantly higher than the euthyroid group in women. The relative risk of abdominal obesity and hypertriglyceridemia was increased in women with hypothyroidism. Thyroid dysfunction had different effects on metabolic syndrome and its components before and after menopause.ConclusionThyroid function had important effects on the prevalence of metabolic syndrome. Women with hypothyroidism, especially post-menopausal women, had a higher risk of metabolic syndrome than men.

Effect of restoration of euthyroidism on visfatin concentrations and body composition in women.

Dysregulation of thyroid function has known impact on body metabolism, however, data regarding metabolic outcome after restoration of thyroid function is limited. Therefore, the aim of the study was to investigate the effect of restoration of euthyroidism on serum visfatin, and its associations with insulin resistance and body composition. This is an observational study with consecutive enrollment. Forty-nine hyperthyroid (median age of 34 years) and 44 hypothyroid women (median age of 46 years) completed the study. Laboratory parameters and body composition analysis were assessed before and after the therapy. In the hyperthyroid group, visfatin concentrations increased (P < 0.0001), while glucose concentrations decreased (P < 0.0001). Total body mass and fat mass in the trunk and limbs significantly increased during the treatment. In the hypothyroid group, significant weight loss resulted from decrease of fat and muscle masses in trunk and limbs. Visfatin serum concentrations positively correlated with total fat mass (r = 0.19, P = 0.01) and insulin concentrations (r = 0.17, P = 0.018). In conclusion, restoration of thyroid function is not associated with beneficial changes in body composition, especially among hyperthyroid females.

Erythroid microRNA and oxidant status alterations in l-thyroxine-induced hyperthyroid rats: effects of selenium supplementation.

Hypermetabolic state in hyperthyroidism causes oxidative stress. Erythrocytes are the cells that are involved in oxidant equilibrium in an organism and contain microRNA (miRNA). Selenium, which is an essential element for an organism, has antioxidant properties. The present study was aimed at investigating the effects of selenium supplementation in hyperthyroidism, on pro- and antioxidant enzymes, and miRNA (miR-144 and miR-451) expressions in the erythrocytes. Forty-eight Sprague-Dawley male rats were divided into 6 groups; control group, group fed with 0.5 mg/kg sodium selenite; group fed with 1 mg/kg sodium selenite; hyperthyroid group; hyperthyroid group fed with 0.5 mg/kg sodium selenite; and hyperthyroid group fed with 1 mg/kg sodium selenite. Malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), miR-144, and miR-451 expression levels were studied in erythrocyte hemolysates. MDA levels were increased in the hyperthyroid group compared to the control group, and the group fed with 0.5 mg/kg sodium selenite (P<0.001 and P<0.01, respectively). GSH levels were increased in the hyperthyroid group and the hyperthyroid group fed with 0.5 mg/kg sodium selenite compared to the control group (P<0.001, and P<0.05, respectively). GSH levels of the hyperthyroid group fed with 1 mg/kg sodium selenite were decreased when compared with the hyperthyroid group (P<0.05). SOD levels of the hyperthyroid group were increased when compared with the control group (P<0.05, and P<0.001, respectively). Similarly, SOD levels of the hyperthyroid group fed with 1 mg/kg sodium selenite were lower than the hyperthyroid group (P<0.01). miR-144 values were increased in the hyperthyroid group and the hyperthyroid group fed with 0.5 mg/kg sodium selenite compared to the control group (P<0.001, and P<0.05 respectively). miR-451 expression was increased significantly in the hyperthyroid group compared to the control group (P<0.05). Our findings showed that MDA, SOD and GSH levels increased, and miR-144 and miR-451 expressions changed in hyperthyroidism. Supplementation of 1 mg/kg sodium selenite was more effective than 0.5 mg/kg sodium selenite for normalizing the MDA, GSH, SOD, and miRNA levels in the hyperthyroid group.

Hemato-biochemical alterations and antioxidant status during drug-induced thyroid dysfunction in Wister rats

This study was carried to determine the effect of induced disturbance in thyroid hormones (hyperthyroidism and hypothyroidism in animal model). In this study, sixty adult male Wister strain rats (180-200 gm) were divided into four groups represented by two control groups for both drug-induced hypothyroidism and drug-induced hyperthyroidism groups (15/each). Drug-induced hyperthyroidism group (received 0.4mg thyroxin/100g feed, with normal tap water daily), and drug-induced hypothyroidism group (received 0.2% lithium carbonate (Li2CO3) in drinking water with normal feed daily). Hematological parameters, some serum biochemical parameters, and assessment of oxidative stress represented by MDA levels in hepatic and renal tissues were assessed. Moreover, semi-quantitative scoring and histopathological findings of hepatic and renal tissues were investigated. Results revealed that any alterations in thyroid hormones levels either if hypothyroidism or hyperthyroidism, were significantly affect different clinic-pathological profile of various body function parameters, beside their indirect effect on tissue conditions that represented by histopathological tissue changes with increase in MDA levels. Referring to the obtained results, most of hematological indices, and sodium level appeared lower than normal in drug-induced hypothyroidism; beside that lipid profile and renal function were significantly raised. In contrast, most of hematological parameters, and sodium level were higher than control group findings, while kidney functions were lower than control group readings. Moreover, liver enzymes and MDA readings were significantly higher than control readings, accompanied with significant decrease in albumin levels in both drug-induced hypo- and hyperthyroidism groups assured microscopically findings of hepatic and renal histopathology.

Titin and dystrophin serum concentration changes in patients affected by thyroid disorders

It is well established that thyroid hormones significantly affect skeletal muscle function, causing symptoms like myalgia and muscle weakness. Hypothyroid patients present increased levels of creatine kinase (CK), indicating muscle destruction. Lately, we proposed new serum markers of muscle disturbances in thyroid disorders: titin (TTN) and dystrophin (DMD). The aim of this study is to determine the association between thyroid status, muscle metabolism, and serum levels of TTN and DMD in patients affected by hypoand hyperthyroidism, before and after the treatment. In the study 56 subjects were enrolled. The studied group consisted of 16 patients with newly diagnosed overt hypothyroidism and 20 patients with hyperthyroidism. Twenty healthy controls were also included in the study. Body composition, thyroid hormones, and biochemical markers of muscle deterioration levels were evaluated before and after restoration of euthyroidism. Dystrophin and TTN levels were noticeably lower in the hypothyroid group and hyperthyroid group in comparison with controls, at the border of statistical significance. Along with the thyroid hormones and CK normalisation, DMD levels increased in the hypothyroid group, with no significant lowering of TTN levels. However, TTN concentrations and the fT3/fT4 ratio became significantly lower than in controls. Hyperthyroid patients experienced no significant changes in TTN and DMD. The presented data indicate that TTN and DMD are potential new markers of musculoskeletal deterioration in thyroid disorders. In addition, the shift in TTN and DMD serum concentrations after the treatment of hypothyroidism accompanied by decreased fT3/fT4 ratio suggest the influence of the chosen therapeutic approach on muscle metabolism.

Evaluation of Arginine-Nitric Oxide Pathway in Patients with Hyperthyroidism

There is a reciprocal regulation of arginase and nitric oxide synthase in L-arginine metabolizing pathways. Nitric oxide has been claimed as an important role player in hyperthyroidism in recent years. The fact that arginase is an important part of regulation of arginine has not been investigated yet in terms of nitric oxide synthase activity in hyperthyroidism. This study aims to investigate arginase, manganese (a cofactor of arginase) and total nitrite levels (a metabolite of nitric oxide) and their relationship to the arginine- nitric oxide pathway in patients with hyperthyroidism. Arginase activities, manganese, and total nitrite levels were measured in plasma samples from 50 patients with hyperthyroidism and 50 healthy age- and gender-matched control subjects. Plasma arginase activities were found to be significantly lower and total nitrite level higher in patients with hyperthyroidism than those of controls. Manganese levels were not significantly different in hyperthyroidism group compared to those of controls. Our results demonstrate that the arginine-nitric oxide pathway is implicated in the cardiovascular manifestations of hyperthyroidism which may be of clinical relevance.

Association of Serum Ferritin and Lipid Profile in Patients with Thyroid Disorder

Background: Thyroid hormones are the important modulator of intermediary metabolism. They affect synthesis, mobilization, and degradation of lipids, although degradation is influenced more than synthesis. Serum ferritin levels also have been reported to be altered in patients with thyroid disease. Objective: The present study aims to explore the association of lipid profile with serum ferritin in patients with thyroid disorder. Patients and Methods: In this study, 140 individuals were selected from the outpatient department of the National Diabetes Center/AL-Mustansiriyah University. Serum ferritin, free triiodothyronine (FT3), free tetraiodothyronine, thyroid-stimulating hormone (TSH), and lipid profile were measured. Results: Nonsignificant differences of serum cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, and very low-density lipoprotein levels in hypothyroid, and hyperthyroid and euthyroid groups were observed. The serum ferritin levels indicate a significant increase in hypothyroidism in comparison to their levels in both other groups (hyperthyroidism and euthyroid). Meanwhile, a significant increase of serum ferritin was observed in hyperthyroidism in comparison to that level of the euthyroid group. Ferritin level was found to be negatively high correlated with lipid profile in hypothyroidism, TSH was also negatively correlated with ferritin level. In the hyperthyroidism group, ferritin level was high correlated positively with free thyroxine, whereas a highly significant positive correlation of ferritin with FT3 was observed in the euthyroid group. Conclusion: It can be concluded that the lipid profile in thyroid disorder patients is various according to ferritin level.

Retinal Photograph-Based Deep Learning System for Detection of Hyperthyroidism: A Multicenter, Diagnostic Study

Background: Screening for hyperthyroidism using gold-standard diagnostic criteria in the general population is not cost-effective, leading to a relatively high rate of undiagnosed and untreated patients. This study aimed to establish a deep learning-based system to detect hyperthyroidism based on retinal photographs. Methods: The multicenter, observational study included retinal photographs taken from participants in two hospitals and 24 health care centers throughout China. We first trained two models to identify hyperthyroidism: in model #1, the non-hyperthyroidism individuals were randomly selected, while in model #2, the non-hyperthyroidism group was matched for age and gender with the hyperthyroidism group. After internal validation, we selected the better model for further evaluation using external validation datasets. Results: The study included 22,940 retinal photographs of 11,409 participants for the model development, and 3862 retinal photographs (1870 participants) which were obtained from two hospitals and four medical centers as the external validation datasets. Model #1 achieved a higher area under the receiver operator curve (AUC) than model #2 (0.907, 95% CI: 0.894-0.918 versus 0.850, 95% CI: 0.832-0.866) in the internal validation so that model #1 was used for further evaluation. In external datasets, model #1 reached AUCs ranging from 0.816 (95% CI 0.789-0.846) to 0.849 (95% CI 0.824-0.874) and achieved accuracies between 0.735 (95% CI 0.700-0.773) and 0.796 (95% CI 0.765-0.824). Heatmaps showed a focus of the DL-algorism on large fundus vessels and the optic nerve head. Conclusions: Retinal fundus photographs may serve for DL systems for a cost-effective and non-invasive method to detect hyperthyroidism. Funding Information: This study was supported by the National Natural Science Foundation of China (82071005); The Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority (XTCX201824); the Research Foundation of Beijing Friendship Hospital, Capital Medical University (yyqdkt2018-33); the Capital Health Research and Development of Special (2020-1-2052); Science & Technology Project of Beijing Municipal Science & Technology Commission (Z201100005520045, Z181100001818003); the Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20150201) Declaration of Interests: Authors Lie Ju, Xin Wang, Xin Zhao, Chao He, Yu Zhong Chen, were employed by the company Beijing Eaglevision Technology Co., Ltd, China. Authors Zhao Hui Wang and Jian Xiong Gao were employed by the company iKang Guobin Healthcare Group Co., Ltd, Beijing, China. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Ethics Approval Statement: The Medical Ethics Committee of the Beijing Tongren Hospital, and the Ethics Committee the iKang Corporation approved the study protocol fulfilling the requirements published in the Helsinki declaration. For patients whose fundus images were stored in the retrospective databases at each participating hospital, informed consent was waived by the institutional review boards.

A study of cardiovascular manifestations of thyroid disorders

Background: Dysfunction and anatomic abnormalities of the thyroid gland are among the most common diseases of the endocrine glands. The study has been undertaken with the aim to assess the different cardiovascular manifestations in patients of hypothyroidism and hyperthyroidism in Manipur and find out any correlation of it with age, sex, type of thyroid disorder and BMI. Materials and Method: The study was a cross sectional study of patients who were diagnosed as hypothyroid or hyperthyroid in the Department of Medicine, Regional Institute of Medical Sciences(RIMS), Imphal, Manipur. Clinical parameters including history and clinical examination were recorded including thyroid function testing, ECG, chest X-ray, trans-thoracic echocardiography. Results: Among 59 patients of thyroid disorder studied, 38 patients were found to be hypothyroid and 21 patients hyperthyroid. The average BMI in hypothyroid patient was 27.25. The average BMI in hyperthyroid patients was 25.41 which were lower than hypothyroid. Diastolic hypertension was found in 44.7% of hypothyroid patients. Sinus bradycardia and sinus tachycardia were the most common ECG findings in hypothyroid and hyperthyroid patients respectively. 15.8% had cardiomegaly on chest x-ray in hypothyroid patients while 9.5% had cardiomegaly in hyperthyroid patients. On echocardiographic evaluation, 13.1% and 9.5% had pericardial effusion in hypothyroid and hyperthyroid groups respectively.

The Role of IL6 and osteoprotegerin in bone metabolism in patients with Graves' Disease

Increased bone turnover is a hallmark of hyperthyroidism. The underlying factors of how thyroid hormones affect bone cells are still under the spotlight. Previous studies indicated serum osteoprotegerin (OPG), receptor activator of NF-kB ligand (RANKL), and interleukin-6 (IL-6) as mediators of the effect of thyroid hormones on bone metabolism. Ultimately, the present research aimed to examine the association of IL-6 with OPG and RANKL in patients with hyperthyroidism. We carried out this study with 39 newly diagnosed and untreated Graves? patients and 43 healthy controls. In addition to routine tests, we measured serum OPG, RANKL, and IL-6 levels. Mean age and gender distribution were similar in both groups. The hyperthyroid group had significantly higher OPG (p=0.002) and IL-6 (p<0.001) levels, but RANKL levels were significantly lower in this group (p<0.001). We found OPG not to correlate with free T4 and T3, while it had a moderate and negative correlation with thyrotropin (TSH) (r=-0.372, p=0.001). IL-6 had no correlation with OPG but positively correlated with free T4 (r=0.445, p<0.001) and free T3 (r=0.326, p=0.035). It also negatively correlated with RANKL (r=-0.247, p=0.033). Maintaining skeletal development and integrity is partially regulated by normal balance of thyroid hormones. We concluded that increases in serum OPG and IL-6 levels accompanied hyperthyroidism. However, excessive levels of the hormones might cause drops in serum RANKL levels. Our results suggested that OPG, RANKL, and IL-6 might be involved in the cross-talking among immunity, thyroid function, and bone metabolism in the case of hyperthyroidism.

Research on Renal Injury in Hashimoto&amp;apos;s Thyroiditis Patients with Different Thyroid Function

Objective: To assess the relationship between thyroid function and renal injury in Patients with Hashimoto's Thyroiditis. Method: To select 156 diagnosed HT patients as the research object, according to whether there is renal injury, they were divided into renal injury group with 21 cases and non-renal injury group with 135 cases. According to the thyroid function, they were divided into HT hyperthyroidism group (Group A) with 19 cases, normal HT thyroid function group (Group B) with 37 cases, HT subclinical hypothyroidism group (Group C) with 61 cases, and HT hypothyroidism group (Group D) with 39 cases. Besides, 40 cases of healthy check-up people are selected as the control group. ECLIA is adopted to test the thyroid function index of each group, Serum cystatin C and 24-hour urinary microalbumin were measured by immunoturbidimetry, serum creatinine was measured by creatine oxidase method, and the endogenous creatinine clearance rate was calculated. Result: TSH, TPOAb and TGAb in renal injury group were distinctly higher than those in non-renal injury group, while FT3 and FT4 were distinctly lower than those in non-renal injury group; Comparison of serum creatinine in Hashimoto groups, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, Group B is obviously higher than Group A, Group A is significantly lower than other groups; Comparison of cystatin C and creatinine clearance of each group, Group D is significantly lower than other groups, Group C is obviously lower than Group A, Group B, and the control group, Group B is obviously lower than Group A, Group A is significantly higher than other groups; Comparison of 24-hour urinary microalbumin of each group, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, and the differences have statistic significance (P<0.05). The correlation analysis shows that FT3, FT4 are in negative correlation with serum creatinine and in positive correlation with cystatin C and creatinine clearance; TSH, TPOAb, TGAb is in positive correlation with 24-hour urinary microalbumin. Conclusion: There are obvious differences in renal function indexes of HT patients with different thyroid function states, which may be related to the effect of thyroid hormones and autoantibodies.

Influence of Melissa officinalis methanolic extract on hyperthyroidism in a rat model

Background and objective Thyroid disease represents the most common endocrine abnormality in recent years. This study was conducted to evaluate the effect of Melissa officinalis methanolic extract (MME) on hyperthyroidism in a rat model.Materials and methods Hyperthyroidism was induced by daily subcutaneous injection of L-thyroxine (250 μm/kg body weight) for 14 days. Total phenolic compounds in extract and the in-vitro antioxidant activity of extract were determined. Moreover, identification of methanolic extract component of Melissa officinalis leaves (MME) was done using liquid chromatography–mass spectrometry. After 30 days of MME treatments, blood samples were collected for further biochemical determinations. Liver and kidney were excised for the determination of oxidative stress markers. Thyroid gland was also removed for histopathological examination.Results Various thyroid hormones (total and free triiodothyronine, as well as total and free thyroxine) were seriously affected and increased significantly with hyperthyroidism induction. Significant increases in serum glucose, interleukin-6, and interleukin-8 were detected in hyperthyroid group compared with control values, whereas hemoglobin level has not changed. Compared with control group, hyperthyroidism-induced glutathione depletion and reduction in glutathione peroxidase activity in the liver and kidney tissues, with significant increase in the lipid peroxidation and nitric oxide levels. Upon treatment with MME, significant improvements in thyroid hormones and the other aforementioned parameters were achieved. MME succeeded also in ameliorating the histological picture of the thyroid gland.Conclusions Current results indicate that MME treatment counteracts the oxidative stress induced by L-thyroxine and protects the liver and kidney and regulates blood glucose in hyperthyroidism state. We suggest that MME treatment may be considered for therapeutic use for hyperthyroidism.

Thyroid function abnormality induced by PD-1 inhibitors have a positive impact on survival in patients with non-small cell lung cancer

BackgroundThyroid function abnormality (TFA) is a common immune-related adverse event (irAEs), but the association between it and the efficacy of programmed cell death protein 1 (PD-1) inhibitor in advanced non-small cell lung cancer (NSCLC) is finitely understood. Materials and MethodsWe conducted a single center, retrospective study of advanced NSCLC patients who were treated with PD-1 inhibitors between 10 October 2016 and 1 April 2020. TFA was characterized as new onset subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism and overt hyperthyroidism. Frequency of development of TFA-irAEs, and its relationship with overall survival (OS) and progression free survival (PFS) were evaluated. ResultsIn our study, 191 patients were treated with PD-1 inhibitors. Among them, forty patients (20.9%) developed TFA, of whom 10 (5.2%) presented with subclinical hypothyroidism, 15 (7.9%) with overt hypothyroidism, 6 (3.1%) with subclinical hyperthyroidism and 9 (4.7%) with overt hyperthyroidism. Survival analysis showed that the OS (16.8 months vs. 11.1 months, p < 0.001) and PFS (10.4 months vs. 5.5 months, p < 0.001) were significantly longer in patients with TFA-irAEs than in those without TFA-irAEs. In subgroup analysis of hypothyroidism and hyperthyroidism groups, similar trends were also obtained for both OS and PFS. After adjusting for potential confounding variables, patients with TFA-irAEs had a lower mortality risk (HR 0.334, 95%CI 0.196–0.571) than those without TFA-irAEs. ConclusionsTFA-irAEs is associated with enhanced PD-1 inhibitor efficacy in advanced NSCLC patients and it may be a biomarker for antitumor immune response.

Comparison of Vitamin D Levels, Bone Metabolic Marker Levels, and Bone Mineral Density among Patients with Thyroid Disease: A Cross-Sectional Study.

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases (n = 64, hyperthyroid; n = 53 euthyroid; n = 18, hypothyroid) and healthy controls (n = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm2). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD.

Study on the Changes of Serum Vaspin Level and its Regulatory Mechanism in Patients with Thyroid Dysfunction

Objective: To study the changes of serum vaspin levels in hyperthyroidism and hypothyroidism, and the correlation between serum vaspin and FT3, FT4, TSH and HOMA-IR. Methods: According to the diagnostic criteria of hyperthyroidism and hypothyroidism published in the 8th edition of internal medicine, the patients were divided into hyperthyroidism group (n = 47), male 14, female 33, average age (35 ± 9) years; hypothyroidism group: 23 hypothyroidism patients, 7 males and 16 females, with an average age of (38 ± 10) years. The blood pressure, height and weight of all the participants were measured by a specially assigned person, and the body mass index (BMI = weight (kg) / height (M2) and ankle brachial index (ABI) were calculated. Venous blood samples were drawn from all subjects after fasting for 8 hours in the morning to determine biochemical indexes. Fasting insulin (fins) was measured by chemiluminescence method, insulin resistance index (HOMA-IR, HOMA-IR = FPG × fins / 22.5) was calculated by homeostasis model assessment (HOMA-IR), and HbA1c was determined by high-pressure liquid chromatography. The levels of FT3, FT4 and TSH were detected by radioimmunoassay. Serum vaspin levels were measured by ELISA. Results: The level of BMI in hypothyroidism group was significantly higher than that in hyperthyroidism group and control group (P &lt; 0.01), BMI level in hyperthyroidism group was significantly lower than that in control group (P &lt; 0.05), FT3 and FT4 levels in hyperthyroidism group were significantly higher than those in hypothyroidism group and control group (P &lt; 0.01), TSH level in hypothyroidism group was significantly higher than that in control group and hyperthyroidism group (P &lt; 0.01). The level of FPG in hyperthyroidism group was significantly higher than that in control group (P &lt; 0.01), but there was no significant difference between hyperthyroidism group and hypothyroidism group, and fins level in hypothyroidism group was significantly higher than that in control group and hyperthyroidism group (P &lt; 0.01). The level of HOMA-IR in hyperthyroidism and hypothyroidism group was significantly higher than that in control group (P &lt; 0.01). Compared with the control group and the control group, the blood lipid indexes (TC, LDL-C) in the hyperthyroidism group were lower than those in the control group and hypothyroidism group (P&lt;0.01), and all the blood lipid indexes in the hypothyroidism group were significantly different from those in the control group (P&lt;0.01). The vaspin level of hyperthyroidism group was significantly higher than that of control group and hypothyroidism group, and the latter two groups showed that the level of vaspin in hypothyroidism group was significantly lower than that of control group (P &lt; 0.05). Correlation analysis showed that serum vaspin was positively correlated with FT3 and FT4 (r = 0.255, P = 0.005; r = 0.327, P = 0.001), and negatively correlated with BMI, TC and HDL (r = -0.250, P = 0.006; r = -0.244, P = 0.007; r = -0.258, P = 0.004). ) Conclusion: Serum vaspin level is related to thyroid function. The level of serum vaspin increases in hyperthyroidism and decreases in hypothyroidism. Abnormal changes of fat factor vaspin are associated with thyroid dysfunction.

Abstract 16989: Clinical Outcomes of Atrial Fibrillation With Hyperthyroidism

Introduction: Atrial fibrillation (Afib) is a common cardiac manifestation of hyperthyroidism. The data regarding outcomes of A fib with and without hyperthyroidism are lacking. Hypothesis: We hypothesized that patients with Afib and hyperthyroidism have better clinical outcomes, compared with Afib patients without hyperthyroidism. Methods: We queried National Inpatient Sample database for years 2015 - 2017 using Validated International Classification of Diseases and Clinical Modification (ICD-10-CM) codes for atrial fibrillation and hyperthyroidism. Patients were separated into 2 groups- A fib with hyperthyroidism and A fib without hyperthyroidism. Results: Study was conducted on 68,095,278 pateints. A total of 9,727,295 Afib patients were identified, out of which 90,635(0.9%) had hyperthyroidism. The prevalence of hyperthyroidism was higher in patients with Afib (0.9% vs 0.4%, p value &lt;0.001), compared with patients without A fib. Using multivariate regression analysis after adjusting for various confounding factors, the odds ratio of Afib with hyperthyroidism was 2.08 (CI 2.07 - 2.10 P&lt;.0001). Afib patients with hyperthyroidism were younger, (70.9 vs75.1 years, p&lt;0.0001) and more likely to be female (63.9% vs 47% p&lt;0.0001) as compared with Afib patients without hyperthyroidism. Afib patients with hyperthyroidism had lower prevalence of CAD (36.4% vs 43.8%,p&lt;0.0001), cardiomyopathy(24.1% vs 25.9%,p&lt;0.0001), valvular disease (6.9% vs 7.4%,p&lt;0.0001), hypertension(60.7% vs 64.4%,p&lt;0.0001) , and diabetes mellitus (28.9% vs 31.8%,p&lt;0.0001). Afib with hyperthyroidism group had lower all-cause mortality (3.3% vs 4.8%, p&lt;0.0001), shorter mean length of stay (5.7 ±6.6 vs 5.9±6.6 days,p&lt;0.0001) and hospitalization cost ($14968±21871 vs $15955±22233, p&lt;0.0001). The disposition to home was higher in Afib with hyperthyroidism patients (50.6% vs 41.8 p&lt;0.0001). Conclusions: Presence of hyperthyroidism is associated with Afib in both univariate and multivariate analysis. Afib patients with hyperthyroidism have better clinical outcomes, compared with Afib patients without hyperthyroidism.

Octreotide (somatostatin analog) attenuates cardiac ischemia/reperfusion injury via activating nuclear factor (erythroid-derived 2)-like 2 (Nrf2) signaling pathway in rat model of hyperthyroidism

BackgroundHyperthyroidism is known to increase the risk of ischemic heart diseases. Octreotide has been reported to attenuate ischemia/reperfusion (I/R) injury. Whether it is useful when ischemic heart disease is accompanied with co-morbidities like hyperthyroidism needs more clarifying. So, this study aimed to explore the effect of octreotide on cardiac I/R injury in hyperthyroid rats and to clarify if Nrf2 activation is involved in this effect. Forty adult female Wistar rats were subdivided into control (euthyroid) (n = 10) and hyperthyroid (n = 30) groups. Rats in hyperthyroid group received l-thyroxine (12 mg/L) in drinking water for 35 days, then were randomly divided into three equal subgroups (n = 10): hyperthyroid control positive group, hyperthyroid octreotide treated group, and hyperthyroid octreotide + Nrf2 inhibitor (brusatol) treated group. Isolated hearts were submitted to I/R and evaluated for cardiac hemodynamics and infarct size. Serum T3 and T4, coronary efflux lactate dehydrogenase (LDH) and creatine kinase-myoglobin binding (CK-MB) and cardiac tissue malondialdehyde (MDA) were estimated. Nrf2- regulated gene expressions of HO-1, SOD, GPx, and catalase were assessed.ResultsOctreotide administration to hyperthyroid rats improved baseline and post-ischemic recovery of cardiac hemodynamics, decreased the high coronary efflux LDH and CK-MB and tissue MDA, reduced infarction size, and upregulated the decreased antioxidative enzymes HO-1, SOD, GPx, and catalase mRNA expressions in the hyperthyroid I/R rat hearts. The Nrf2 inhibitor brusatol reversed the cardioprotective effect of octreotide in hyperthyroid I/R rat hearts.ConclusionOctreotide can reduce oxidative stress to effectively alleviate I/R injury in the hyperthyroid rat hearts through upregulation of Nrf2-dependent antioxidative signaling pathways.

Study of the Role of Adiponectin Gene Polymorphism in Patients with Thyroid Disorders

Background: Both hypo & hyperthyroidism are associated with some morbidity & mortality. Adiponectin is a fat cell-derived hormone that protect against atherosclerotic cardiovascular diseases through its enhancing effect on insulin sensitivity. Clinical studies investigating serum adiponectin levels in patients with hypothyroidism and hyperthyroidism have reported conflicting results. Objective: The study aimed to study the role of adiponectin gene polymorphism in patients with thyroid disorders either hypothyroidism or hyperthyroidism. Also, the relation of adiponectin gene polymorphism with obesity and DM. Patients and Methods: Cross sectional study was conducted on one hundred and fifty cases that were classified into hypothyroid group and hyperthyroid group. History, examination and investigation (adiponectin gene) was done. Results: In current study within hypothyroid & hyperthyroid group, there was non-significant relation between gene polymorphism and either total T3, free T3, free T4 or TSH. There was statistically non-significant relation between associated diabetes and either gene or allele polymorphism among patients within hypothyroid group and hyperthyroid group. There was statistically non-significant relation between patient BMI and either gene or allele polymorphism among patients within hypothyroid group and hyperthyroid group. Conclusion: There was no role of adiponectin gene polymorphism and either total T3, free T3, free T4 or TSH. In addition, there was no role of adiponectin gene polymorphism and either obesity and DM.

Study of the Role of Adiponectin Gene Polymorphism in Patients with Thyroid Disorders

Background: Both hypo & hyperthyroidism are associated with some morbidity & mortality. Adiponectin is a fat cell-derived hormone that protect against atherosclerotic cardiovascular diseases through its enhancing effect on insulin sensitivity. Clinical studies investigating serum adiponectin levels in patients with hypothyroidism and hyperthyroidism have reported conflicting results. Objective: The study aimed to study the role of adiponectin gene polymorphism in patients with thyroid disorders either hypothyroidism or hyperthyroidism. Also, the relation of adiponectin gene polymorphism with obesity and DM. Patients and Methods: Cross sectional study was conducted on one hundred and fifty cases that were classified into hypothyroid group and hyperthyroid group. History, examination and investigation (adiponectin gene) was done. Results: In current study within hypothyroid & hyperthyroid group, there was non-significant relation between gene polymorphism and either total T3, free T3, free T4 or TSH. There was statistically non-significant relation between associated diabetes and either gene or allele polymorphism among patients within hypothyroid group and hyperthyroid group. There was statistically non-significant relation between patient BMI and either gene or allele polymorphism among patients within hypothyroid group and hyperthyroid group. Conclusion: There was no role of adiponectin gene polymorphism and either total T3, free T3, free T4 or TSH. In addition, there was no role of adiponectin gene polymorphism and either obesity and DM.

Diaphragmatic ultrasound and pulmonary functions evaluation in thyroid patients: a case-control study

BackgroundDyspnea is a frequent symptom among patients with thyroid disorders. However, its actual causative mechanism is not clear. The diaphragm is the main inspiratory muscle and contraction of the diaphragm is essential for breathing, so any disorder that interferes with contractile muscle function can cause diaphragm dysfunction which is associated with dyspnea. The objective of study is to assess the effect of thyroid disorders on diaphragm excursion and thickness.ResultsDiaphragmatic excursion during tidal, deep, and sniff respiration were significantly decreased in patients with thyroid disorder in comparison to control and significantly decreased in hypothyroid patients (right tidal 1.42 ± 0.29, right deep respiration 5.07 ± 0.72, and sniff 2.15 ± 0.26 cm) than hyperthyroid patients (right tidal 1.61 ± 0.34, right deep respiration 5.63 ± 0.50, and sniff 2.67 ± 0.27 cm) and than the control group (right tidal 2.17 ± 0.27, right deep respiration 6.63 ± 0.33, right sniff 2.89 ± 0.19 cm). Diaphragmatic thickness at end tidal inspiration was significantly decreased in patients with thyroid disorder in comparison to control (p value < 0.05). There was negative correlation between diaphragmatic excursion and duration of disease.ConclusionDiaphragmatic excursion and thickness are affected in hypothyroidism compared to hyperthyroidism and control groups. There is significant negative correlation between diaphragmatic excursion and duration of disease in patients’ group. Respiratory symptoms are more frequent in hypothyroid patients.