Hypothyroid Group Research Articles

Significance of FDG-PET standardized uptake values in predicting thyroid disease.

This study aimed to determine a standardized cut-off value for abnormal 18F-fluorodeoxyglucose (FDG) accumulation in the thyroid gland. Herein, 7013 FDG-PET/CT scans were included. An automatic thyroid segmentation method using two U-nets (2D- and 3D-U-net) was constructed; mean FDG standardized uptake value (SUV), CT value, and volume of the thyroid gland were obtained from each participant. The values were categorized by thyroid function into three groups based on serum thyroid-stimulating hormone levels. Thyroid function and mean SUV with increments of 1 were analyzed, and risk for thyroid dysfunction was calculated. Thyroid dysfunction detection ability was examined using a machine learning method (LightGBM, Microsoft) with age, sex, height, weight, CT value, volume, and mean SUV as explanatory variables. Mean SUV was significantly higher in females with hypothyroidism. Almost 98.9% of participants in the normal group had mean SUV < 2 and 93.8% participants with mean SUV < 2 had normal thyroid function. The hypothyroidism group had more cases with mean SUV ≥ 2. The relative risk of having abnormal thyroid function was 4.6 with mean SUV ≥ 2. The sensitivity and specificity for detecting thyroid dysfunction using LightGBM (Microsoft) were 14.5 and 99%, respectively. Mean SUV ≥ 2 was strongly associated with abnormal thyroid function in this large cohort, indicating that mean SUV with FDG-PET/CT can be used as a criterion for thyroid evaluation. Preliminarily, this study shows the potential utility of detecting thyroid dysfunction based on imaging findings.

Elimination of the color discrimination impairment along the blue-yellow axis in patients with hypothyroidism after treatment with levothyroxine as assessed by the Farnsworth-Munsell 100 hue test.

Our previous study has shown that individuals with untreated hypothyroidism display significantly higher partial error scores (P E S) along the blue-yellow axis compared to the red-green axis than normal individuals using the Farnsworth-Munsell 100 hue test [J. Opt. Soc. Am. A37, A18 (2020)JOAOD60740-323210.1364/JOSAA.382390]. We wished to determine how color discrimination may change when hypothyroidism has been treated to the point of euthyroidism. Color discrimination was reassessed for 17 female individuals who had undergone treatment for hypothyroidism, and the results were compared with 22 female individuals without thyroid dysfunction. No statistically significant difference was found in the total error score (T E S) for the first and second measurements for both groups (p>0.45). The P E S for the hypothyroid group improved significantly in the previously impaired color regions after the treatment. Color discrimination defects found in untreated hypothyroidism can be negated with treatment of the condition over an appropriate time period.

Evaluation of an Association of Thyroid Disorder and Dyslipidemia in Patients with Cardiovascular Disease: A Cross-sectional Study

Background: Subclinical Hypothyroidism (SCH) is defined as normal serum free thyroid hormone levels coexisting with elevated serum Thyroid-Stimulating Hormone (TSH) levels. SCH is a common condition observed in clinical practice with several unique features. The present study was conducted to find prevalence of subclinical hypothyroidism in patients with myocardial infarction and demographic differences between patients with and without SCH. Materials and Methods: A total of 100 patients with Myocardial Infarction of Adult (age &gt; 18 years) males and females were selected from the patients attending Medicine OPD, IPD or Intensive Care Unit (ICU) in GMC, Azamgarh. Clinical examination, laboratory investigations for myocardial infarction, thyroid status and lipid profile was done in all patients in our study. All Patients with TSH values &gt; 10mU/L or &lt; 0.04mU/L or Known cases of Thyroid abnormalities were excluded from the study. Statistical analysis was done using excel and SPSS software. Results: Out of 100 patients 44 patients of MI had subclinical hypothyroid were as rest 56 patients were euthyroid. In both the groups no statistical difference was seen in the type of Myocardial infarction. There was significant difference in lipid profile (p&lt;0.05) in SCH group as compared to euthyroid group. Conclusion: Patients with Subclinical hypothyroid and MI had more lipid abnormalities as compared to Euthyroid group although the type of myocardial infarction was similar in both the groups. Males had more myocardial infarction as compared to females in both the subclinical hypothyroid and euthyroid groups.

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

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

Abnormal Shape of Placenta as a Consequence of Maternal Thyroid Disorders-Does It Leave Any Microscopic Changes?

Introduction: Thyroid disorders are common in the reproductive age group of women and these can cause significant perinatal outcomes.Though the effect of abnormal thyroid hormones on the foetus and its development is established, their effect on the placenta and its contribution towards the effect is not elaborately studied. Aim: To compare the microscopic features of euthyroid placentae with those of mothers with thyroid dysfunction. Materials and Methods: This is prospective observational study wherein placentae received from October 1 ,2017 to March 31, 2019 in the Department of pathology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India, were collected, processed and analysed. A total of 539 cases were received for histopathological examination during this period, of these 64 cases had abnormal antenatal thyroid profile. These were compared grossly and microscopically with the control group of 64 euthyroid cases. Results: The total sample of the study comprised of case group(n=64) and control group(n=64), mean age: mean age of the women 26.91±4.1 years. The case group samples included 3 hyperthyroid cases and 61 hypothyroid cases.In the control group, 3 (2.3%) foetuses were dead as compared to 6 (4.7%) foetuses in hypothyroid group and 3 (2.3% of total, 100% of hyperthyroid group) foetuses in hyperthyroid group (p&lt; 0.001). Abnormal shape of the placenta was seen in 1 (0.8%) case in normal group as compared to 3 (2.3%) in hypothyroid group and 1 (0.8%) case in hyperthyroid group (p=0.018). However, there weren’t any significant microscopic changes. Conclusions: Maternal thyroid disorders result in abnormal shape of placenta and hence resulting in foeto-maternal insufficiency and subsequent foetal growth restriction and adverse foetal outcome.

Prevalence and Complications of Subclinical and Overt Hypothyroidism in Pregnancy at North Indian Tertiary Care Center.

Thyroid disorders are one of the commonest endocrine problems among pregnant women. It is often argued that it is not only overt, but subclinical thyroid dysfunction also has similar adverse effects on maternal and fetal outcomes. There is a huge deficiency of data from the Indian population to assess the prevalence of thyroid dysfunction in pregnancy. This study aimed to determine the prevalence of thyroid disorders in pregnancy and their impact on obstetrical outcomes in the Indian population. The study also had the objective of finding a correlation between maternal and fetal thyroid-stimulating hormone (TSH) levels in hypothyroid pregnancies. Around 1055 pregnant women in the first and second trimesters were enrolled in the study. A detailed history was noted and general examinations were done. Apart from routine obstetrical investigations, TSH level estimation was done. If the TSH level was deranged, then free T4 (fT4) and free T3 (fT3) levels were also estimated. Furthermore, 50 hypothyroid and euthyroid pregnant women from the same cohort were followed till delivery. Their obstetrical and perinatal outcomes were noted. The prevalence of thyroid dysfunction was 36.5% in this study, which was quite high in the population. Moreover, hypothyroid groups were prone to have pregnancy-induced hypertension (P = 0.03), intrauterine growth restriction (P = 0.05), and preterm delivery (P = 0.04) as compared to control. Cesarean section rate for fetal distress was significantly higher among pregnant hypothyroid women (P = 0.05). Neonatal respiratory distress and low appearance, pulse, grimace, activity, and respiration (APGAR) () scores were significantly more in the hyperthyroidism group (P = 0.04 and P = 0.02, respectively). Maternal TSH was significantly correlated with hemoglobin levels, HbA1c, and systolic blood pressure. Significant adverse effects on maternal and fetal outcomes were seen emphasizing the importance of routine antenatal thyroid screening.

A clinical evaluation of KapivaGet Slim Juice for weight management in overweight to obese adults with and without hypothyroidism

Obesity and overweight are global health concerns affecting over 1 billion people, as per the WHO. Phytoconstituent-based supplements are alternatives to anti-obesity drugs because of fewer side effects and less stringent guidelines during drug approvals. This clinical trial assessed the potential of Kapiva Get Slim Juice to effectively manage weight, anthropometry and improve QOL.It was a parallel-arm, open label study testing safety and efficacy of Kapiva Get Slim Juice in overweight to obese patients (Group A) andoverweight to obese patients with hypothyroidism (Group B) by comparing pre-and post-treatment status of the patients from the same group. In both groups A and B, Kapiva Get Slim Juice resulted in an average weight reduction of 7.05 kg and 5.67 kg, respectively, over 90 days. Both groups exhibited significant reductions in BMI, waist circumference, hip circumference, mid-upper arm circumference, waist/hip ratio, body fat percentage, and visceral fat percentage. Participants reported enhanced QOL, improved physical and emotional aspects, and reduced symptoms.The product was safe and well-tolerated, and there were no adverse events.It can be concluded from the study that Kapiva Get Slim juice provides a promising solution for individuals looking to manage their weight effectively and enhance their overall well-being. Its efficacy, safety, and potential to address various symptoms related to obesity and hypothyroidism make it a valuable addition to weight management products in the market

Effect of Low T3 Syndrome on Severity of Coronary Artery Disease in Patients with Acute Coronary Syndrome: A Cross-sectional Study

Introduction: Low Triiodothyronine (T3) syndrome is a hormonal imbalance that significantly influences cardiovascular haemodynamics by altering the vascular endothelial function by influencing the Nitric Oxide (NO) production. In Acute Coronary Syndrome (ACS) inflammation disrupts plaque which stimulates thrombosis, coagulation, activation of sympathetic system and release of cytokines mainly Interleukin 6 (IL-6), which is a pleotropic and pro-inflammatory cytokine, which exerts inhibitory effect on thyroid axis function. Aim: To study the association of low T3 syndrome and severity of Coronary Artery Disease (CAD) in ACS. Materials and Methods: This cross-sectional study was conducted in the Intensive Critical Care Unit (ICCU)under the Department of Cardiology, Karnataka institute of Medical Sciences, Hubli, Karnataka, India, from July 2021 to August 2022. A total of 120 consecutive ACS patients were taken for the study and all underwent Coronary Angiography (CAG). Severity of CAD was assessed with the help of Gensini risk scoring system. The patients were divided based on thyroid function status. Low T3 syndrome was defined as &lt;0.846 ng/ mL with normal values of Thyroxine (T4) and Thyroid Stimulating Hormone (TSH). Receiver operating characteristic curves were generated to correlate low T3 syndrome and angiographic severity of CAD. Multinominal logistic regression analysis demonstrated LT3S is an independent risk factor for CAD. The Chi-square test was used for ordered categorical data with the severity of coronary artery lesions. Results: The severity of coronary artery lesions in the low T3 syndrome group (n=29, 24.16%) and hypothyroidism (n=20, 16.6%) group was significantly greater than that of euthyroid group (n=71, 59.1%), with all the groups’ (p-value=0.047). Multinominal logistic regression analysis demonstrated that low T3 syndrome was an independent risk factor of CAD for moderate (Odds ratio=2.34, 95%CI: 0.47-11.39, p&lt;0.02) and severe (Odds ratio=8.56, 95%CI: 1.52-47.9, p&lt;0.015) lesions. Conclusion: The patients with low T3 syndrome are associated with more severe and diffuse CAD and low T3 syndrome is an independent risk factor for ACS.

Evaluation of Serum Creatinine and Serum Uric Acid In Hypothyroid Patients: A Cross-sectional Study

Introduction: Hypothyroidism, a prevalent endocrine disorder, leads to a generalised metabolic slowdown due to insufficient thyroid hormone production, potentially resulting in elevated levels of serum uric acid and creatinine, thus affecting renal function and purine metabolism. Aim: To assess serum creatinine and serum uric acid levels in hypothyroid patients while establishing correlations with their thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels. Materials and Methods: A comparative cross-sectional study was conducted in the Department of Biochemistry, Government Medical College, Kozhikkode, Kerala, India. The study involved 140 participants, including 70 recently diagnosed hypothyroid patients and 70 age- and sex-matched euthyroid individuals. Thyroid hormone levels (FT3, FT4) and TSH were quantified using the Cobas e411 electro-chemiluminescence technique. Serum creatinine levels were measured using the Modified Jaffe’s method, and serum uric acid levels were assessed through the Uricase method (Enzokit). Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 21.0, and tables and graphs were generated using Microsoft Word and Excel. Results: The mean age of study participants of control group was 39.02 years and of the hypothyroid group was 36.80 years. The comparative cross-sectional analysis revealed significantly higher levels of serum uric acid and serum creatinine in hypothyroid patients compared to euthyroid controls. Specifically, hypothyroid patients exhibited a mean serum uric acid level of 10.77±2.34 mg/dL, while euthyroid controls had a mean of 4.37±0.94 mg/dL. Mean serum creatinine levels for hypothyroid patients and euthyroid controls were 2.16±0.80 mg/dL and 0.75±0.14 mg/dL, respectively. Notably, a significant positive correlation was observed between serum uric acid and serum creatinine levels with TSH (r=0.42, p-value&lt;0.001 and r=0.45, p=0.00, respectively). Conclusion: The study identified significantly higher levels of serum uric acid and creatinine in hypothyroid patients compared to euthyroid individuals, potentially attributed to haemodynamic changes and disruptions in purine metabolism. Regular monitoring of these parameters is crucial for individuals with hypothyroidism.

Study of Auditory Brainstem Evoked Response at Varying Frequencies in Subclinical Hypothyroid Subjects.

Hearing deterioration in hypothyroid subject was documented by Kemp. Cristiane et al. reported delayed waves latency in subclinical hypothyroid subjects. Recording of auditory brain stem evoked response in subclinical hypothyroid subjects at 80 dB and varying frequencies has been done. Case control study. Group 1, N = 30 control subjects, free T3, free T4, thyroid stimulating hormone (TSH) within normal range. Group 2, N = 30 subclinical hypothyroid subjects, TSH was between 4.6-8 microIU/L. Student Unpaired t test was done. Those on epileptic, neuroleptics, depression, psychosis drugs, inflammatory, proliferative, traumatic ear disorder, smokers, on tobacco, COVID-19 positive subjects, altered sensorium, drug abuse, diabetes mellitus, neuropathy, hypertension, cardiac arrhythmia, family history of hearing disorder, and furosemide drug were excluded. Auditory brainstem evoked response (ABER) done. Mean ± SD of Brainstem evoked response auditory (BERA) waves III, V, interpeak latencies at 80 dB, 2, 4,6 KHz reported delay and significant in subclinical hypothyroid group as compared to control. BERA study at 6 KHz and 80 dB detects central neuropathy earlier in subclinical hypothyroid patients.

Study of Possible Changes in Lipid Profiles between Premenopausal and Postmenopausal Women with Hyperthyroidism and Others with Hypothyroidism

Menopause is the lack of menstrual cycle for at least six months. Due to hormonal changes, the alternation of lipid profile as a risk factor related to heart disease increases during menopause . One hundred twenty Iraqi women, aged between 40-65 years, were selected for this study. They were divided into two groups: 60 premenopausal and 60 postmenopausal women, and then each group was further divided into two subgroups: 20 women with hyperthyroidism and 20 with hypothyroidism, as well as 20 healthy women as control group. Blood samples were collected to estimate hormonal parameter by enzyme linked immunosorbent assay (ELISA) and lipid profile using enzymatic technique. The results showed that alterations in lipid profile included decrease in the cholesterol levels, triglyceride, LDL and VLDL. Whereas HDL increased in hyperthyroidism as compared to hypothyroidism and control groups in premenopausal women. In women with postmenopause, alterations of lipid profiles included a decrease in the cholesterol level, triglyceride, high density lipoprotein (HDL), very low density lipoprotein (VLDL) except an increase in low density lipoprotein (LDL) in hyperthyroidism as compared to hypothyroidism and control groups. Also, the level of lipid profiles increased in hypothyroidism rather than hyperthyroidism both in pre and postmenopause. According to this study, the conclusion was reached that there was an increase in the lipid profile level in postmenopausal women than premenopausal women with hypothyroidism when compared to hyperthyroidism.

Immune checkpoint blockade PD-1 therapy for primary liver cancer: incidence and influencing factors of thyroid dysfunction

ObjectivesTo investigate the incidence and influencing factors of thyroid dysfunction (TD) in patients with primary liver cancer (PLC) induced by PD-1 monoclonal antibodies.MethodsClinical data were collected from 195 PLC patients treated with PD-1. They were divided into TD group and normal thyroid function (NTF) group, and further divided into TD subgroups, the differences between groups and subgroups were analyzed.ResultsA total of 113 of 195 (57.9%) PLC patients developed TD. The positive rate of thyroid antibody (20.6% vs. 0%, P = 0.041) and the median value of TSH (6.20 vs. 2.16 mU/L, P = 0.000) in TD group were higher than those in NTF group. Ten patients (8.8%) had the CTCAE grade of TD above grade 3, of which 2 patients died of liver failure. There were 20 patients (17.7%) in hyperthyroidism group and 93 patients (82.3%) in hypothyroidism group. The decompensated cirrhosis in hyperthyroidism group was lower than that in hypothyroidism group (33.3% vs. 65.6%, P = 0.010), and the proportion of patients who had previously received surgical treatment was higher than that in hypothyroidism group (35.0% vs. 9.7%, P = 0.003); The proportion of clinical hyperthyroidism was higher than that of clinical hypothyroidism (70.0% vs. 31.2%, P = 0.001), the proportion of decompensated liver cirrhosis in clinical hyperthyroidism group was lower than that in clinical hypothyroidism group (23.1% vs. 68.0%, P = 0.022), and the proportion of previous or combined surgical resection was much higher than that in clinical hypothyroidism group (42.9% vs. 7.1%, P = 0.018); The proportion of decompensated cirrhosis in primary TD group was lower than that in secondary TD group (36.5% vs. 83.3%, P = 0.002), and the proportion of patients using antitumor targeted drugs was higher than that in secondary TD group (73.1% vs. 45.0%, P = 0.014).ConclusionPatients with PLC had high incidence of TD after receiving PD-1 treatment, primary or subclinical hypothyroidism was the main manifestation type, which was related to the degree of disease and treatment.

The influence of Olmesartan on the Renin-angiotensin-aldosterone System of Rats with Thyroid Dysfunction

Background : The thyroid gland and its hormones participate and have a critical part in the development and function of different parts of the body like the kidney, which is the most important site of renin synthesis and release which is followed by angiotensin and aldosterone formation. As needs are; any abnormality in this gland’s function can harm the Renin-Angiotensin -Aldosterone System. We aimed to discover the effects of using an Angiotensin Receptor Blocker (Olmesartan) on the Renin-Angiotensin-Aldosterone System (RAAS) in rats with abnormal thyroid functions. Methods : Thirty rats were used and three groups were formed. 6 rats (First group) were the control. 12 rats (Second group) was the hypothyroid group (6 rats control, 6 rats given Olmesartan). 12 rats (the Third group) was the hyperthyroid group (6 rats control, 6 rats given Olmesartan). L-Thyroxine and Propylthiouracil (PTU) were given orally daily for induction of hyperthyroidism and hypothyroidism respectively. Blood pressure measurement was done on days 1 and 40th day of the study. The rats were sacrificed on day 40th of the study. Results : In hyperthyroid rats, T4 was raised and the use of Olmesartan on these rats caused a lowering of this parameter. Renin levels increased in hyperthyroid rats treated with Olmesartan. Angiotensin I increased in hyperthyroid rats. Systolic BP increased in hyperthyroid rats and the use of Olmesartan on these rats caused a lowering of this parameter. Diastolic BP and Mean BP both increased in the hyperthyroid rats. T3 and T4 levels dropped and TSH increased in hypothyroid and hypothyroid treated with Olmesartan rats. The level of Renin decreased in hypothyroid rats and increased in Olmesartan-treated rats. Angiotensin I decreased in hypothyroid and Olmesartan-treated hypothyroid rats. Blood Pressure components decreased in both hypothyroid and hypothyroid treated with Olmesartan rats. Conclusions : Olmesartan was able to decrease T4 level along with Systolic BP in hyperthyroid rats. It also decreased Angiotensin I and Blood Pressure components in hypothyroid rats.

SEROLOGICAL AND MOLECULAR EVALUATION OF MRP14 IN THYROIDITIS AND ITS ROLE IN PRO-INFLAMMATORY CHEMOKINES ACTIVATION

This study was aimed to investigate the involvement of Myeloid Related Protein 14 (MRP14) in the production of CXC Motif Chemokine Ligand 9 (CXCL9) in thyroiditis patients. The first group composed of 27 hypothyroidism (HO) patients (12 men and 15 women), age average about 46 years old. The second group had 43 patients (8 men and 35 women) with hyperthyroidism (HR), their mean of age was 42, while 30 healthy persons act as control group (HC) had an average age of 33.47 of men (13) and women (17). The three groups were testing for triiodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) furthermore, testing the thyroglobulin (TG), anti-thyroperoxidase (a-TPO), anti-TSH receptor (TSHR) and serum level of MRP14 by Enzyme-Linked Immunosorbent Assay (ELISA). The results showed a high significant (P&lt; 0.0001) increase in MRP14 levels in hypothyroid group vs hyperthyroidism 123.1 ± 22.39 and 109.8 ± 4.479 ng/ml respectively. MRP14 showed a positive correlation with T4 and a negative correlation with anti-TSHR in HR patients. The gene expression of MRP14 and CXCL9 were assayed to all groups by RT-PCR, results showed a high expression of MRP14 as well as of CXCL9 in the patient groups which showed a high expression of CXCL9 in HO patients. Therefore, the results obtained from the study indicate that the higher concentration of MRP14 expression in Thyroiditis patients might play an important role in the development of the disease mediated by stimulating the secretion of pro-inflammatory chemokines.

Platelet abnormalities in autoimmune thyroid diseases: A systematic review and meta-analysis.

Some degree of platelet index abnormality has been found clinically in the autoimmune thyroid disease (AITD), but the findings are not uniform. The PubMed, Web of Science, Cochrane Library, and Embase databases were searched for relevant articles published up to August 16th, 2022, with no restrictions on the language of the articles. Reference lists of eligible articles were also searched. A random effect model was used to pool the standardized mean difference (SMD) and 95% confidence interval (95% CI) of platelet count (PLT), mean platelet volume (MPV), and platelet distribution width (PDW) between AITD patients and healthy controls, and subgroup analyses were performed. A total of 19 articles with 6173 people (3824 AITD patients and 2349 healthy people) were included in the meta-analysis. The results showed that PLT and MPV values were significantly increased in AITD patients when compared with healthy people (SMD: 0.164, 95% CI: 0.044 to 0.285; SMD: 0.256, 95% CI: 0.013 to 0.500), while no significant difference was found in PDW between the AITD group and the control group (SMD: 0.060, 95% CI: -0.164 to 0.284). Subgroup analysis according to disease type and thyroid function revealed that for PLT, this difference was only found in the Hashimoto's thyroiditis (HT) and hypothyroid groups, but not in the Graves' disease (GD) and hyperthyroid groups. For MPV, the results were the opposite of those for PLT: MPV was significantly higher in the GD, hyperthyroid, and euthyroid groups than in the control group, but not in the HT and hypothyroid groups. Sensitivity analysis showed that the stability of the pooled MPV was not good. No publication bias was found. PLT and MPV are significantly elevated in patients with AITD, with PLT being more significantly elevated in HT and hypothyroidism, and MPV being more significantly increased in GD and hyperthyroidism. Appropriate clinical attention can be paid to the thyroid function of patients when abnormal platelet indices are found, and conversely, the consequences of abnormal platelet parameters such as elevated MPV lead to an increased occurrence of cardiovascular events, which should also be addressed in the AITD population. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022341823.

Serum metabolomic analysis in patients with Hashimoto's thyroiditis.

Hashimoto's thyroiditis, an autoimmune thyroid disease, shows high morbidity worldwide, particularly in female. Patients with Hashimoto's thyroiditis have an increasing risk of hypothyroidism during the occurrence and progression of Hashimoto's thyroiditis. In recent years, metabolomics has been widely applied in autoimmune diseases, especially thyroid disorders. However, metabolites analysis in Hashimoto's thyroiditis is still absent. A total of 92 samples were collected, including 35 cases in the control group, 30 cases in the Hashimoto's thyroiditis with euthyroidism group, and 27 cases in the Hashimoto's thyroiditis with subclinical hypothyroidism group. SPSS 25.0 for statistical analysis and ROC curve, SIMCA 14.0, Metaboanalysis for multifactor analysis, and Origin 2021 for correlation analysis. 21 metabolites were identified. 10 metabolites were obtained from control group versus HTE group, 8 serum metabolites were abnormal between control group and HTS group, 3 metabolites were derived from HTE group versus HTS. Kyoto Encyclopedia of Genes and Genomes Enrichment analysis showed that fatty acid degradation, Arginine, and proline metabolism have a significant impact on HTE, while lysine degradation, tyrosine metabolism play an important role HTS group, compared to control group. In the comparison between the HTE and HTS group, Valine, leucine, and isoleucine degradation and Valine, leucine, and isoleucine biosynthesis exists a key role. Correlation analysis shows clinical are not related to metabolites. ROC curve indicates SM, LPC, PC can efficiency in identification patients with HT in different clinical stage from healthy individuals. Serum metabolites were changed in HT. Phospholipids such as SM, LPC, PC influence the pathogenesis of Hashimoto's thyroiditis. Fatty acid degradation and lysine degradation pathways have an impact on different clinical stage of HT.

Evaluation of visual functions in Iranian hypothyroid adults.

The aim of this study was to investigate the effects of hypothyroidism on visual functions such as visual acuity, refractive errors, colour vision, and contrast sensitivity, among hypothyroid adults. Forty-three patients with clinical hypothyroidism along with 43 age- and sex-matched healthy individuals underwent visual examinations, including visual acuity, refractive errors, eye deviations with the cover test, colour vision with the D15 test, and contrast sensitivity with Pelli-Robson test. It was indicated that visual acuity, refractive errors, phoria, and colour vision had no significant difference between the hypothyroid and control groups. Contrast sensitivity decreased in hypothyroid subjects as compared with controls. The mean values of binocular contrast sensitivity were 1.85 ± 0.09 log in the hypothyroid group and 1.93 ± 0.09 log in controls, which showed a statistically significant difference (p=.03). Our findings illustrated a reduced contrast sensitivity in adult hypothyroidism. Since CS is related to functioning and quality of life, a comprehensive and detailed eye examination may be beneficial for hypothyroidism patients.

Prevalence of thyroid dysfunction in pregnancy and its association with feto-maternal outcomes: A prospective observational study from a tertiary care institute in Northern India

BackgroundThyroid dysfunction in pregnancy is one of the most prominent endocrinological disorders. Physiological changes in thyroid status and non-adaptation to these changes during pregnancy lead to thyroid dysfunction resulting in feto-maternal complications. In this context, we undertook this study to estimate the prevalence of thyroid disorders in pregnant women and their association with feto-maternal outcomes. MethodsThis prospective observational study was carried out in a tertiary care institute in Punjab, North India. We recruited 347 pregnant women who visited the OPD (Out Patient Department) through consecutive sampling, out of which 300 were included in our final analysis. A detailed history and clinical examination were made. Apart from routine ante-natal investigations, we estimated the TSH levels. In case of abnormal TSH values, free T4 and T3 levels were assessed. Study participants were followed till 12 weeks post-delivery to observe their obstetrical and perinatal outcomes. ResultsOverall prevalence of thyroid disorders in pregnancy was 33.9%, with hypothyroidism (31.6%) being more common than hyperthyroidism (2.3%). A significant association was found between thyroid disorders and feto-maternal complications (p value < 0.001). Adverse maternal effects observed in the hypothyroid group as compared to the euthyroid group were preeclampsia (14.7% vs. 5.6%), anemia (7.4% vs. 6.1%), abortion (7.4% vs. 0.5%) and meconium-stained liquor (5.3% vs. 2.5%). Abortion (71.4%) was the main complication in the hyperthyroid group. Adverse neonatal outcomes were low and very low birth weight, low Apgar scores, respiratory distress syndrome, and meconium aspiration syndrome. ConclusionWe observed a high prevalence of thyroid disorders and their relative adverse effects. Universal screening of all women in the pre-conception period or as early as pregnancy is diagnosed, is recommended to reduce subsequent feto-maternal morbidity and mortality.

Thymoquinone protects the testes of hypothyroid rats by suppressing pro-inflammatory cytokines and oxidative stress and promoting SIRT1 testicular expression.

Background: Hypothyroidism has been linked to many testicular structural and dysfunctional changes in males. Thymoquinone (TQ) has shown a potent testicular protective effect through its antioxidant, anti-inflammatory, antiapoptotic, fertility-enhancing, and endocrine modulatory activities. Objectives: This study aimed to investigate the efficacy of TQ in preserving the testicular structure of a model of experimentally induced hypothyroidism in rats and identify the mechanism behind this effect. Materials and methods: Propylthiouracil (PTU) was used to induce hypothyroidism in adult male Wistar rats, who were then treated with TQ (50mg/kg/body weight) for 4weeks and compared to the untreated rats. Thyroid hormonal profile, oxidants/antioxidants profile, and serum testosterone levels were assessed. Gene expression and immune expression of SIRT1 and pro-inflammatory cytokines TNF-α and NF-κB were also assessed in the testicular tissue. Results: TQ administration successfully improved PTU-induced disturbance in the thyroid hormonal profile (T3, T4, and TSH), serum testosterone level, and pancreatic antioxidants compared to the untreated hypothyroid group. TQ significantly downregulated (p = 0.001, p ˂ 0.001) TNF-α and NF-κB transcription, while it significantly upregulated (p = 0.01) SIRT1 transcription in the testes of hypothyroid rats. TQ markedly relieved the histopathological testicular changes induced by PTU and significantly increased (p = 0.002, p = 0.01) the sectional area of seminiferous tubules and germinal epithelial height, respectively. TUNEL-positive apoptotic germinal cells were significantly decreased (p ˂ 0.001), while PCNA-positive proliferating germinal cells and androgen receptor expression were significantly increased (p ˂ 0.001) in the testes of TQ-treated hypothyroid rats. Conclusion: Thymoquinone could limit the hypothyroidism-induced structural changes in the testis, mostly through the upregulation of SIRT1 expression, which seems to mediate its promising antioxidant, anti-inflammatory and antiapoptotic effects that were evident in this study. Therefore, TQ is recommended as an adjuvant safe supplement in managing hypothyroidism, especially in males.

ODP394 Prevalence of Anxiety and Depressive Symptoms in Children and Adolescents with Congenital Adrenal Hyperplasia (CAH)

Abstract Background CAH is a life-long inherited condition in which individuals require multiple daily doses of medication and are at risk for life-threatening adrenal crises. Adult studies have demonstrated increased rates of psychiatric morbidity with CAH. Given the chronicity and severity of CAH, children are at risk for psychiatric morbidity as well. This study aimed to examine the prevalence of anxiety and depressive symptoms in children and adolescents with CAH. Method: This was a cross-sectional cohort study in which children and adolescents (ages 7-17 years) with CAH (classical or non-classical, on steroid treatment) and their parents were recruited from our institution's urban outpatient clinics from May to December 2021. Healthy, well-controlled children and adolescents with congenital or autoimmune hypothyroidism (HT) and their respective parents served as control participants. Children and adolescents completed questionnaires, based on age eligibility: Screen for Child Anxiety Related Disorders (SCARED), Children's Depression Inventory 2 Self Report – Short (CDI-2), and Patient Health Questionnaire modified for Adolescents (PHQ-A). Parents completed respective parent-proxy questionnaires. Higher scores indicated greater symptoms of anxiety and depression. "At risk" scores were specific to each questionnaire. Measures were completed at a clinic visit, and demographic and past medical history were collected via a separate survey and the electronic medical record. Results A total of 58 child-parent dyads completed questionnaires. Thirty-two children had CAH (66% female, age 11.4 ±2.6 years, CAH duration 8.9 ±3.9 years) and 26 had HT (73% female, age 12.7 ±2.9 years, HT duration 6. 0±4.2 years). Thirty-two, 30 and 13 CAH children and 25, 26 and 16 HT children completed the SCARED, CDI-2 and PHQ-A, respectively. There was no significant difference in level of anxiety and depressive symptoms in children with CAH as compared to the HT group (SCARED 19 ±12 vs. 26±17, P=0.200; CDI-2 53±11 vs. 55±11, P=0.400). The CAH group had fewer depressive symptoms than the HT group on the PHQ-A (4±6 vs 6±5, P=0. 038). There was no difference in rate of "at risk" scores between the CAH and HT groups (SCARED 33% vs. 44%, P=0.400; CDI-2 24% vs. 31%, P=0.500; PHQ-A 15% vs. 31%, P=0.400). No adolescent participants were found to have active suicidal ideation or intent. Children with CAH were more likely to score higher than parent-proxy responses for anxiety-related disorder (19 ±12 vs. 10±8, P=0. 003) and depressive symptoms (CDI-2 53±11 vs. 49±10, P=0. 046). Conclusions Prevalence of anxiety and depressive symptoms does not appear to be higher in children and adolescents with CAH as compared to controls. There is a lack of agreement between child and parent-proxy responses with parents endorsing fewer anxiety and depression symptoms than children. Findings suggest that children with CAH may benefit from routine mental health evaluations as part of CAH care and not only after voiced parental concern. Presentation: No date and time listed