Hypothyroid Group Research Articles

SERUM CARBOXYMETHYL-LYSINE AND SOLUBLE RECEPTOR FOR ADVANCED GLYCATION END PRODUCTS IN HYPERTHYROID AND HYPOTHYROID PATIENTS.

The formation and accumulation of advanced glycation end products (AGEs) are enhanced with increased oxidative stress and inflammatory conditions. A hyperthyroid and hypothyroid state is associated with oxidative stress. This study aimed to evaluate skin AGE deposition, serum carboxymethyl-lysine (CML), and serum soluble receptor for AGEs (sRAGE) levels in hypothyroid and hyperthyroid patients. A total of 203 subjects were included in this cross-sectional study. After excluding diabetes mellitus, 103 newly diagnosed hypothyroid patients, 50 newly diagnosed hyperthyroid patients, and 50 control (euthyroid) subjects were enrolled. All tests were done before beginning the appropriate treatment. Accumulated AGEs in the skin collagen were measured by skin autofluorescence (SAF) using an AGE Reader. SAF measurements were 1.82 ± 0.04, 1.80 ± 0.40, and 1.63 ± 0.30 arbitrary units for the hypothyroid, hyperthyroid, and euthyroid groups, respectively (p = 0.04). Serum CML levels were 8.2 ± 2.8, 10.2 ± 2.0, and 8.0 ± 3.3 ng/mL for the hypothyroid, hyperthyroid, and euthyroid groups, respectively (p = 0.01). sRAGE levels were similar between the groups. Serum thyroid-stimulating hormone and SAF measurements were positively correlated (r = 0.25, p = 0.02) in the hypothyroid group and negatively correlated in the hyperthyroid group (r = -0.36, p = 0.04). There was no correlation between CML and sRAGE levels. SAF measurements are increased in both hypo- and hyperthyroid normoglycemic patients. Serum CML levels are increased in hyperthyroid patients. Hypo and hyperthyroid states might be associated with acceleration of AGE accumulation and may have a long term effect on metabolic memory.

Higher serum thyroid autoantibody value is a risk factor of hypothyroidism in children and young adults with chronic thyroiditis.

.Thyroid function in patients with chronic thyroiditis (CT) varies depending on the clinical course. Serum antithyroglobulin antibody (TgAb) and antithyroid peroxidase antibody (TPOAb) levels may be used to predict hypothyroidism in CT. In this retrospective cohort study, patients with CT, defined as having a high TgAb or TPOAb value, were divided into a hypothyroid group (HG) and euthyroid group (EG), after a mean follow-up of 2.5 years. The definitions of the two groups was based on the maximum TSH value from the initial measurement to the most recent follow-up: HG was defined as TSH 10.0 μIU/mL or higher, and EG was defined as TSH < 10.0 μIU/mL. There were 20 and 113 patients in the HG and EG, respectively. There were no significant differences in age, sex, underlying diseases, or TgAb and TPOAb levels between the groups. Receiver operating characteristic curve analyses of TgAb and TPOAb values for predicting thyroid function showed areas under the curve of 0.714 and 0.757, respectively. The value with the highest diagnostic accuracy was 106 IU/mL for TgAb and 16 IU/mL for TPOAb. Thus, TgAb > 106 IU/mL and TPOAb > 16 IU/mL may predict hypothyroidism in children and young adults with CT.

Effect of Bisphenol A-Mediated RBP-4 on Pregnancy Outcomes in Nonobese Pregnant Female with Subclinical Hypothyroidism.

Hypothyroidism is a systemic hypometabolic syndrome caused by the thyroxine resistance or a reduction in its extent. It is an endocrinopathy secondary to gestational diabetes and occurs usually without significant symptoms. This study explored the effect of bisphenol A (BPA)-mediated retinol-binding protein 4 (RBP-4) on pregnancy outcomes in a nonobese pregnant female with subclinical hypothyroidism. Three hundred nonobese pregnant females who had that established pregnancy files and had regular obstetric examinations from January 2021 to March 2022 were enrolled and classified with 100 cases in each group as early pregnancy (6–12 weeks of gestation), second-trimester (13–24 weeks of gestation), and third-trimester groups (25–36 weeks of gestation). Thirty pregnant women with subclinical hypothyroidism were selected as subjects, and another thirty pregnant women with normal thyroid function were selected as the normal control group. Thyroid function (thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free T4 (FT4), and thyroid peroxidase antibody (TPO-Ab)) was measured by immunoelectrochemiluminescence. The level of BPA in urine was determined by solid-phase extraction high-performance liquid chromatography-tandem mass spectrometry. Serum RBP4 levels were determined by enzyme-linked immunosorbent assay. The level of TSH in the third-trimester group was higher than that in the first- and second-trimester groups, while the levels of FT3, FT4, and TPO-Ab were lower than those in the other two groups (P < 0.05). TSH in the second-trimester group was higher than that in the first-trimester group, while FT3, FT4, and TPO-Ab levels were lower than those in the first-trimester group (P < 0.05). The levels of BPA and RBP4 in gestational diabetes mellitus and hypertension were higher than those in the nongestational period, and the levels of BPA and RBP4 in gestational intrahepatic cholestasis and anemia were higher than those in the nongestational period, and the levels of BPA and RBP4 in preterm delivery were higher than those in nongestational period (P < 0.05). Also, the level of urinary BPA in the hypothyroidism group was higher than that in the normal control group (P < 0.05) and the level of serum RBP4 in the hypothyroidism group was higher than that in the normal control group (P < 0.05). According to multivariate logistic regression analysis, age ≥30 years and the ascending BPA and RBP4 were risk factors for subclinical hypothyroidism during pregnancy in the nonobese female. BPA and RBP-4 are closely related to the pregnancy outcome of nonobese subclinical hypothyroidism in the pregnant female. The degree of BPA and RBP-4 in adverse pregnancy outcomes is increased, which is the risk factor for nonobese subclinical hypothyroidism.

Pregnancy Outcomes in Women with Thyroid Diseases.

Introduction: Overt hyperthyroidism and hypothyroidism are associated with pregnancy complications; however, most women with these conditions are diagnosed before conception and are under treatment during pregnancy, especially in high-income countries. The purpose of this study was to investigate pregnancy complications among these women. Methods: A retrospective cohort study was conducted, and data on pregnant women who gave birth to a singleton at Nagoya University Hospital in Japan in 2005-2014 was collected. The pregnancy outcomes were divided and compared among three groups: the control group (n = 3531), the hyperthyroidism group (n = 48), and the hypothyroidism group (n = 61). Additionally, risk factors for placental abruption were evaluated by multivariable logistic regression analysis. Moreover, in hyperthyroidism, thyroid function at the placentation period was compared between placental-related diseases and nonplacental-related disease groups, and the latter group included placental abruption and preeclampsia. Results: The incidence of placental abruption was higher in hyperthyroidism than in control and hypothyroidism groups. Hyperthyroidism was independently associated with an increased risk of placental abruption (adjusted odds ratio, aOR = 8.21, 95% confidence interval, CI: 1.76-38.34), as well as preeclampsia (aOR = 4.10, 95% CI: 1.13-14.76) and preterm labor (aOR = 3.38, 95% CI: 1.19-9.64). Additionally, thyroid-stimulating hormone (TSH) at the placentation period was significantly lower in the placental-related disease group than in the nonplacental-related disease group (p < 0.05). Conclusions: Pregnancy outcomes in women with hyperthyroidism and hypothyroidism would be comparable with those without thyroid disease. Hyperthyroidism was an independent risk factor for placental abruption as well as preterm labor and preeclampsia. However, its frequency was extremely low, and further research is required to validate our findings.

Frequency of oral Lichen Planus among hypothyroid patients

Objective: Recent investigations have suggested a correlation between thyroid diseases, particularly hypothyroidism(HT), and oral lichen planus (OLP). Objective: This study aimed to assess the frequency of OLP in HT patients.Material and Methods: This analytical descriptive study evaluated 100 HT patients including 94 females and6 males, who were selected by convenience sampling. The subjects were clinically examined for OLP. The meanage of patients was 42.49±1.29 years. Also, 100 age- and sex-matched healthy controls were examined. Thedata were analyzed using chi-square test and Fisher’s exact test via SPSS. Results: Of all, 14 (14%) HT patients(12 females and 2 males) had OLP while only one case of OLP was found in the control group. The differencebetween the two groups in the frequency of OLP was significant (P=0.001). The odds ratio (OR) of developingOLP was calculated to be 16.11 in HT patients. Reticular form was the most common type of OLP in patients(50%). The buccal mucosa was the most common site of involvement (92.85%). The mean age of patients withOLP was 42.93±1.29 years with a median of 46±1.29 years in HT group. Conclusion: The frequency of OLPwas significantly higher in HT patients such that HT patients had higher odds of developing OLP by 16 folds.KEYWORDSHypothyroidism; Oral lichen planus; Frequency; Comparison.

Association of insulin resistance and lipid profile with serum T3, T4, and TSH in patients with hypothyroidism

Background: Hypothyroidism is a common endocrine derangement met with in clinical practice. Deficiency of thyroid hormones can have a significant effect on lipid and carbohydrate metabolism. Aims and Objectives: The aim of the study was to study the association of insulin resistance and lipid profile with serum triiodothyronine (T3), tetraiodothyronine (T4), and thyroid-stimulating hormone (TSH) in hypothyroidism. Materials and Methods: A comparative cross-sectional study was conducted in a tertiary care hospital after obtaining clearance from the Institutional Ethics Committee. Thirty primary hypothyroid subjects were selected as cases based on their TSH values (&gt;4 uIU/mL) and thirty normal subjects as controls after proper exclusion and after getting the informed consent. Their fasting plasma glucose levels, lipid profile, and serum T3, T4, TSH were measured. Homeostasis model Assessment using OXFORD HOMA 2 CALCULATOR was used to determine the insulin resistance (HOMA-IR). Results: The mean values of HOMA-IR, total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides were significantly higher in hypothyroid group than in normal controls. HOMA-IR showed a significant negative correlation with T3 and T4. The correlations of HOMA-IR, total cholesterol, LDL cholesterol, and triglycerides with TSH were positive. Conclusion: The present study shows that hypothyroidism leads to an elevated insulin resistance and dyslipidemia.

Rat thyroid graft transplantation after cryopreservation with scintigraphic standardization for an experimental study

PurposeBudget cuts among other factors undermine the use of state-of-the-art equipment by many research groups. This doesn't mean that their scientific data are not reliable or top-notch. Resort to adaptations is a recurrent need in their reality. The aim of this study was to assess whether scintigraphy with 99mTcO4 is effective in evaluating the functionality of thyroid grafts after cryopreservation in rats. Material and methods24 rats were randomly distributed into 3 groups: Control Group (CG), without surgical procedure, Hypothyroidism Group (HTG), submitted to total thyroidectomy, and Transplanted Group (TG), with total thyroidectomy and cryopreservation of the thyroid gland for 7 days followed by grafting of a thyroid lobe. A protocol using a gamma camera imaging was conducted fourteen weeks after transplantation, and the whole body 99mTc, focusing on the topic of heterotopic thyroid uptake was evaluated. ResultsThe images acquired had good quality with no noise and artifacts that could jeopardize its analysis. On the 14th day, HTG displayed no thyroid uptake, and the TG had a clear uptake of the thyroid graft in the topography of the biceps femoris muscle. Presented data also showed that both equipment spatial resolution and alignment (4.375 mm) did not interfere with the physiological uptake of 99mTc by the thyroid graft. ConclusionThe viability and functionality of cryopreserved thyroid autotransplantation in rats who underwent total thyroidectomy were successfully accessed by the scintigraphy protocol developed.

Serum Prooxidant-Antioxidant Balance and hs-CRP in Patients with Clinical and Subclinical Hypothyroidism

Background:Oxidative stress (OS) is caused by an imbalance between prooxidant substance production and antioxidant defense. OS is involved in physiologic interactions in the body and the pathogenesis of various disorders. This study aimed to evaluate serum prooxidant-antioxidant balance (PAB) as a selective prooxidant, antioxidant defense, and acute phase reactant protein in patients with subclinical and clinical hypothyroidism.Methods:This case-control study was conducted in three groups including clinical hypothyroidism (32 patients), subclinical hypothyroidism, (42 cases), and healthy controls (32 individuals). This study was performed in the Endocrine Clinic of Arash Training and Research Hospital, Tehran, 2017. In the study groups, thyroid hormones including T4 and Thyroid Stimulating Hormone (TSH), fasting blood glucose (FBG), lipid profile, PAB, and hs-CRP as inflammatory markers were measured and compared between the groups.Results:Among 106 participants, 95.3% were females, the gender balance was similar across groups and mean age was 30.79 ± 7.65 years. FBG and lipid profile except for cholesterol level were not significantly different between the three study groups. However, cholesterol level in the clinical hypothyroid group was significantly higher than the other two groups. PAB was higher in subclinical hypothyroidism compared to healthy controls after adjustment for age and TSH levels (P value: 0.04) but there was no significant difference in the clinical hypothyroid group in comparison with healthy controls. In addition, there was no significant difference in high-sensitivity C-reactive protein (hs-CRP) between the three study groups.Conclusions:This study suggests that that subclinical hypothyroidism increases PAB in comparison to healthy control which could indicate OS response in patients with subclinical hypothyroidism, respectively.

Relationship between subclinical hypothyroidism and distal-symmetric diabetic polyneuropathy in type 2 diabetes mellitus referred to Kosar Hospital in Semnan and related indicators in 2019-2020.

Introduction:Diabetes is one of the most common metabolic diseases and one of its important complications is diabetic neuropathy. Due to the relationship between diabetes and thyroid disorders, the present study was performed to determine the association between subclinical hypothyroidism and end-stage diabetic polyneuropathy in patients with type 2 diabetes.Materials and Methods:In this descriptive, analytical study, 154 patients with type 2 diabetes referred to Kosar Hospital in Semnan were evaluated. After recording their demographic information, samples were received for biochemical testing. The patients’ neuropathy was then evaluated based on the United Kingdom screening test (UKST). The results were recorded in the data collection form and then analyzed using SPSS Statistics 22 software.Results:In this study, 154 patients were studied, including 49 with subclinical hypothyroidism and 105 with euthyroid. The results of the present study showed that the mean age of patients in the subclinical hypothyroid group was 60.08 years and in the euthyroid group was 60.77 years. Mean ± standard deviation (SD) of the patients’ age, blood pressure, duration of diabetes, body mass index, fasting blood sugar (FBS) and Glucose, and 2-hour post prandial (2HPP) were not statistically significant between the two groups. The frequency of neuropathy severity based on clinical signs during examination and symptoms mentioned by the patients in the two groups was statistically significant (P = 0.005 and P = 0.001, respectively). The severity of neuropathy was not significantly associated with thyroid-stimulating hormone (TSH) levels (P > 0.05).Conclusion:From the results of the present study, it can be concluded that the severity of neuropathy based on the clinical signs during examination and the symptoms mentioned by the patient in diabetic patients is related to subclinical hypothyroidism. Further studies are recommended.

Thyroid Dysfunction and its Effect on Red Blood Cell Parameters

Background: Thyroid hormones are necessary for the growth and development, cellular differentiation, physiological function and metabolic regulation of almost all tissues in our body. Thyroid disorders are accompanied by alteration in hematological profile. This study aims to evaluate the effect of thyroid dysfunction on red blood cell parameters.&#x0D; Materials and Methods: This case-control observational study was conducted in the Department of Clinical Biochemistry, KIST Medical College and Teaching Hospital (KISTMCTH), Lalitpur, Nepal from January 2021 to June 2021.Total number of recruited subjects was 248, out of which 67 were labeled as hypothyroid, 7 were hyperthyroid and 174 were euthyroid as control. Subjects for all three groups were between 16-93 years old. Thyroid hormone profile of patients was determined by Siemens ADVIA Centaur CP immunoassay analyzer and hematological parameters by automated hematology analyzer Sysmex XN-550. Results were analyzed by SPSS 21 software and a chi-square test was applied to see significant differences among the groups.&#x0D; Results: The mean age of all study participants was 42.08±17.27 years and female constituted 74.6% of total subjects. Analysis of the data obtained a statistically significant difference in the mean hemoglobin (p&lt;0.001) between hypothyroid and euthyroid groups. The difference was not significant for hemoglobin (p=0.252) among hyperthyroid and euthyroid groups. There was no statistical significant difference between thyroid cases and control for MCV, MCH and MCHC.&#x0D; Conclusion: The current study concluded that thyroid dysfunction have a significant effect on red blood cell parameters. Hematological parameters should be evaluated in patient with thyroid dysfunction.

Thyroid hormones inhibit apoptosis of macrophage induced by oxidized low-density lipoprotein.

Increasing evidence suggests that hypothyroidism aggravates atherosclerosis. Macrophage apoptosis plays a significant role in the development of atherosclerotic plaque. We aimed to explore the effect of thyroid hormones on macrophage apoptosis induced by oxidized low-density lipoprotein (oxLDL). Peripheral blood samples from 20 patients (normal group, hypothyroidism group, coronary artery disease [CAD] group, hypothyroidism + CAD group) were collected to perform messenger RNA microarray analysis. Bioinformatics analysis identified apoptosis and mitogen-activated protein kinase (MAPK) signaling as differentially expressed pathways between CAD and hypothyroidism + CAD group. In vitro, thyroid hormones concentration-dependently promoted cell survival and inhibited apoptosis in oxLDL-treated RAW264.7 macrophages, along with elevated extracellular signal-regulated kinases 1 and 2 (Erk1/2) phosphorylation. The STRING database showed an interaction of thyroid hormone receptor alpha1 (TRα1) and MAPK pathway. TRα1 knockdown increased cell apoptosis and decreased Erk1/2 phosphorylation. Erk1/2 inhibitor aggravated macrophage apoptosis. Moreover, thyroid hormones inhibited oxidative stress in oxLDL-treated macrophages. The study indicates that thyroid hormones concentration-dependently attenuate oxLDL-induced macrophage apoptosis through activating TRα1-Erk1/2 pathway and inhibiting oxidative stress, which implies a potential mechanism of hypothyroid-accelerated atherosclerosis.

Aerobic Exercise Mediated Increase in BDNF Expression Ameliorates Depression in Propylthiouracil-Induced Hypothyroidism in Adult Rats.

• Hypothyroidism is associated with depressive symptoms. • Swimming exercise for 4 weeks alleviated depressive behavior in hypothyroid rats. • The enhanced irisin/BDNF axis activity following moderate aerobic exercise was positively correlated with climbing time in forced swimming test and with brain serotonergic system activity. • It is concluded that moderate aerobic exercise alleviated hypothyroidism-associated depression via increased BDNF expression. : The prevalence of depression with hypothyroidism is high. : To study the ability of aerobic exercise to improve hypothyroidism associated depression and to explore the underlying mechanisms. 21 adult male rats, allocated in three groups; Euthyroid, Hypothyroid (oral propyl-thiouracil for 45 days), Exercise-treated hypothyroid group (30 minutes, swimming, 4 weeks). Forced swim test and histopathological brain examination were performed. Serum free T3, T4, TSH, irisin, brain neurochemical, oxidant-antioxidant and apoptotic markers were measured . : Swimming exercise increased serum T3, T4, climbing and swimming times, brain serotonin, BDNF expression, glutathione peroxidase, antiapoptotic Bcl-2 and serum irisin levels and decreased TSH, immobility time, MDA, BAX/Bcl-2 ratio. Climbing time was positively correlated with BDNF, serotonin and T3. : Moderate aerobic exercise alleviated hypothyroidism-associated depression, via increased BDNF expression, which enhances hippocampal neurogenesis, serotonergic system activity and combat neuronal apoptosis.

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.

Assessment of the state of the oxidant-antioxidant system and lipid peroxidation in patients with chronic pancreatitis combined with hypothyroidism

Changes in oxidative-antioxidant homeostasis is one of the pathogenetic links in the onset and progression of many nosologies, including chronic pancreatitis (CP) and hypothyroidism (HТ), however, data on the development of oxidative stress (OS) with a combination of CP and HP are insufficient, therefore, determining the role of these systems with a comorbid course of these pathologies is an urgent issue of our time.The aim of the work is to study the state of the oxidative and antioxidant system in patients with CP and CP combined with HT.Material and methods. 96 people were examined, including 26 patients with chronic pancreatitis (group 1), 24 patients with hypothyroidism (group 2), 26 patients with chronic pancreatitis on the background of hypothyroidism (group 3), 20 almost healthy individuals (group 4). Evaluation of the oxidative-antioxidant system and lipid peroxidation was assessed by determining the content of malonic aldehyde in blood plasma (MA pl.) And erythrocytes (MA er.), The level of reduced glutathione, glutathione peroxidase (GP) and glutathione-S-trans-ion (GT). Enzyme activity was calculated per 1 g of hemoglobin (HB).Research results. The analysis of the obtained results revealed clear patterns of changes in the state of the oxidative-antioxidant system and lipid peroxidation in patients with chronic pancreatitis on the background of hypothyroidism. Namely, violation of lipid peroxidation in patients with comorbid pathology, accompanied by an increase in the content of MA er. by 44.87% and the content of MA in blood plasma by 46.42%; oxidative-antioxidant system: decrease in HF in the blood by 51,61%, combined of a compensatory increase in BP - by 48.03% and HT - by 34.76%.Conclusion. Under the conditions of comorbidity of CP and HT, there is a violation of the oxidative-antioxidant system and the state of lipid peroxidation, which is characterized by a significant increase in MA in erythrocytes and MA in plasma against a decrease in glutathione and which complicates the course of the underlying disease, its diagnosis and treatment.

Irisin as a Potential Biomarker Associated with Myocardial Injuries in Patients with Severe Hypothyroidism.

Objective Irisin, a novel myokine, has recently been considered to produce a cardioprotective effect. Potential biomarkers for myocardial injuries in patients with severe hypothyroidism have yet to be identified. We aimed to investigate whether serum irisin may serve as a promising biomarker for early detecting the myocardial injuries in patients with severe hypothyroidism. Methods This cross-sectional study comprised 25 newly diagnosed drug-naive patients with severe primary hypothyroidism and 17 age- and sex-matched healthy controls. Circulating irisin levels and cardiac magnetic resonance (CMR) were evaluated in each participant. Left ventricular (LV) myocardial injuries were detected by CMR-based T1 mapping technique using a modified look-locker inversion recovery (MOLLI) sequence, which is quantified as native T1 values. Results Compared with healthy controls, the severe hypothyroidism group had significantly lower levels of serum irisin, especially those with pericardial effusion (P < 0.05). The severe hypothyroidism subjects exhibited lower peak filling rates (PFRs) and higher native myocardial T1 values than controls (P < 0.05). Additionally, the ROC analysis displayed that the sensitivity and specificity of serum irisin for diagnosing pericardial effusion in patients with severe hypothyroidism were 73.3% and 100.0%, respectively. The AUC was 0.920 (0.861–1.000) (P < 0.001). The cutoff value was 36.94 ng/mL. Moreover, the results in subgroup analysis revealed that the native T1 values of the low-irisin group were significantly higher than that of the high-irisin group (P < 0.05). According to multivariate linear regression analysis, serum irisin concentrations were negatively and independently correlated with native myocardial T1 values after adjustment for age, sex, and other conventional confounding factors (β = −1.473, P < 0.05). Conclusions Irisin may be a potential biomarker for predicting myocardial injuries in patients with severe hypothyroidism.

Maternal Hypothyroidism in Rats Reduces Placental Lactogen, Lowers Insulin Levels, and Causes Glucose Intolerance.

Hypothyroidism increases the incidence of gestational diabetes mellitus (GDM) but the mechanisms responsible are unknown. This study aimed to assess the pathophysiological mechanisms by which hypothyroidism leads to glucose intolerance in pregnancy. Hypothyroidism was induced in female Sprague-Dawley rats by adding methimazole (MMI) to drinking water at moderate (MOD, MMI at 0.005% w/v) and severe (SEV, MMI at 0.02% w/v) doses from 1 week before pregnancy and throughout gestation. A nonpregnant cohort received the same dose for the same duration but were not mated. On gestational day 16 (GD16), or nonpregnant day 16 (NP16), animals were subjected to an intraperitoneal glucose tolerance test. Tissues and blood samples were collected 4 days later. Hypothyroidism induced a diabetic-like phenotype by GD16 in pregnant females only. Pregnant MOD and SEV females had reduced fasting plasma insulin, less insulin following a glucose load, and altered expression of genes involved in insulin signaling within skeletal muscle and adipose tissue. Hypothyroidism reduced rat placental lactogen concentrations, which was accompanied by reduced percentage β-cell cross-sectional area (CSA) relative to total pancreas CSA, and a reduced number of large β-cell clusters in the SEV hypothyroid group. Plasma triglycerides and free fatty acids were reduced by hypothyroidism in pregnant rats, as was the expression of genes that regulate lipid homeostasis. Hypothyroidism in pregnant rats results in a diabetic-like phenotype that is likely mediated by impaired β-cell expansion in pregnancy. This pregnancy-specific phenomenon is likely due to reduced placental lactogen secretion.

Hematological changes in hypothyroidism and hyperthyroidism in adults

Thyroid function disorders are among the most common endocrine diseases. Thyroid disorders can cause certain forms of anemia, more commonly in hypothyroidism. Slightly decreased TLC, relative neutropenia, relative lymphocytosis or relative eosinophilia may be found in thyroid disorders. These observations confirmed the association between thyroid gland dysfunction and hemopoiesis.1) To study the pattern of hematological changes in thyroid dysfunction 2) To correlate thyroid function tests with complete blood count &amp; red cell indices findings 3) To correlate complete blood count investigations and peripheral blood smear findings with serum TSH levels.It was an Observational study conducted during 18 months of period from March 2018 to October 2019 with 100 subjects of hypothyroidism, 80 subjects of hyperthyroidism and 100 euthyroid subjects as control group. CBC was done on automated cell counter. PBS was stained with Leishman stain and observed under microscope. TFTwas done by immunoassay method.It was done with SPSS Software.: Predominance of female was seen in hypothyroidism and hyperthyroidism. Significant decrease was seen in RBC, Hb, HCT, MCV and MCH in hypothyroid group, while in hyperthyroid group RBC, Hb and HCT were significantly decreased as compared with euthyroid control group. Both groups showed significant increase in RDW as compared with control group.It is important to carefully evaluate the thyroid hormones in cases of unexplained anemias. So, periodic evaluation for probable hematological changes should be done in all the patients with hypothyroidism and hyperthyroidism.

Association of subtle alterations in thyroid function with presarcopenia in patients with type 2 diabetes mellitus.

ABSTRACTAims/IntroductionTo investigate the association of subtle alterations in thyroid function with presarcopenia among patients with type 2 diabetes mellitus.Materials and MethodsA total of 1,865 adult patients with type 2 diabetes mellitus were enrolled in this cross‐sectional study, excluding patients with overt thyroid dysfunction. Skeletal muscle mass measured by dual energy X‐ray absorptiometry was used to assess presarcopenia. Logistic regression models were used to estimate the effects of thyroid hormones on presarcopenia, and subgroup analyses were carried out in different strata of age, sex and body mass index, respectively.ResultsCompared with the euthyroid group (Euthy), the subclinical hyperthyroidism group had an increased odds of presarcopenia (multivariate‐adjusted odds ratio 1.99, 95% confidence interval 1.09–3.63), but the subclinical hypothyroidism group did not (P > 0.05). In the subclinical hyperthyroidism group, age and body mass index <24 kg/m2 were independent risk factors for presarcopenia. In the overall Euthy group, an increased odds of presarcopenia was correlated with the elevated free thyroxine : free triiodothyronine ratio (all P for trend <0.05), whereas not with increment in free triiodothyronine level (P for trend >0.05). Additionally, in Euthy subgroup analyses stratified by middle‐age, sex and body mass index, a similar association was noted (all P for trend <0.05), but not in the older‐aged patients (P for trend >0.05).ConclusionsSubclinical hyperthyroidism was an independent risk factor for presarcopenia in patients with type 2 diabetes mellitus, but subclinical hypothyroidism was not. In the Euthy group with type 2 diabetes mellitus, a high free thyroxine : free triiodothyronine ratio was a good index of presarcopenia in addition to older age.

Reticulocyte Hemoglobin Equivalent: Diagnostic Performance in Assessment of Iron Deficiency in Patients with Hypothyroidism.

Introduction Iron deficiency affects approximately 30% of the world population and is frequently encountered in hypothyroid patients. Early recognition and prompt treatment of iron deficiency in hypothyroid patients lead to a favorable outcome. The aim of this study is to prove the usefulness of reticulocyte hemoglobin equivalent (Ret-He) as a reliable and effective tool in diagnosis of iron deficiency in hypothyroid patients. Materials and Methods 154 patients with hypothyroidism were included in the study. They were divided into 4 groups. Group 1 included 66 hypothyroid patients without iron deficiency. They were taken as controls. Group 2 included 66 hypothyroid patients with iron deficiency anemia (IDA). Group 3 included 12 hypothyroid patients with iron deficiency but without anemia (ID). Group 4 included 10 hypothyroid patients which had concomitant iron deficiency with anemia of chronic disorder (ACDC). Ret-He was measured by analyzing blood samples on System XN 350. Thyroid profile, serum ferritin, and biochemical data were measured by an automated analyzer. Statistical analysis was performed by using SPSS 23. Results Ret-He was significantly lower with (p < 0.001) in group 2 (hypothyroid patients with IDA), group 3 (hypothyroid patients with ID), and in group 4 (hypothyroid patients with ACDC) as compared to controls in group 1 (hypothyroid patients without iron deficiency). After ROC analysis area under the curve (AUC) of Ret-He for hypothyroid patients with IDA was 0.96 at cutoff 28.5 pg with sensitivity of 93% and specificity of 90%. AUC of Ret-He in the hypothyroid group with ACDC was 0.99 at cutoff 30.8 pg with sensitivity of 90% and specificity of 90%. AUC of Ret-He in hypothyroid patients with ID was 0.97 at cutoff 31.7 pg with sensitivity of 91% and specificity of 70%. Conclusion Ret-He is a reliable, rapid, and cost-effective tool for diagnosing iron deficiency in hypothyroid patients.

Hypothyroidism is Strongly Correlated with Mean Platelet Volume and Red Cell Distribution Width

Abstract: Objective: Hypothyroidism is characterized with insufficient production and release of thyroid hormones, and cause a variety symptoms including cold intolerance, constipation, deceleration in movement, and hair loss. It is associated with increased inflammatory burden. Therefore, we aimed to observe red cell distribution width (RDW) and mean platelet volume (MPV) levels, novel predictors of inflammation, in patients with hypothyroidism and to compare to those in healthy subjects. Materials and Methods: The subjects with hypothyroidism that show up in internal medicine outpatient clinics of Abant Izzet Baysal University Hospital between January 2020 and January 2021 were enrolled to the retrospective study. Healthy volunteers were enrolled as control subjects. MPV and RDW of the study groups were compared. Results: The median RDW level of hypothyroid and control groups were 13.3 (10-20.7) % and 15.3 (11.8-21.3) %, respectively (p&lt;0.001). The median MPV level of hypothyroid and control groups were 10.2 (6.4-12.4) fL and 8.1 (5.4-11.5) fL, respectively (p&lt;0.001). MPV levels greater than 9.47 fL have 80% sensitivity and 72% specificity in predicting hypothyroidism (AUC: 0.66 [95% CI: 0.58-0.74]; p&lt;0.001). RDW levels greater than 13.4% have 80% sensitivity and 50% specificity in predicting hypothyroidism (AUC: 0.67 [0.82 [95% CI: 0.59-0.75]; p&lt;0.001). Conclusion: We suggest that elevated MPV and reduced RDW levels should alert physicians for hypothyroidism in otherwise healthy subjects. Keywords: Hypothyroidism, Red cell distribution width, Mean platelet volume, Inflammation, Thyroid hormones, Predictor, Retrospective study.