Hypothyroid Group Research Articles

Hypothyroidism modulates mitochondrial dynamics and mitophagy in the heart of rats under fed and fasting conditions

AimsInvestigate the impact of hypothyroidism on mitochondrial dynamics and mitophagy in the heart under fed and fasting conditions. MethodsHypothyroidism was induced in male Wistar rats with methimazole (0.03 %) for 21 days. Half of the euthyroid and hypothyroid groups underwent a 48-h fasting. Mitochondrial number and ultrastructure were evaluated by transmission electron microscopy. Fusion, fission, mitophagy, oxidative stress, and mitochondrial oxidative phosphorylation system (OXPHOS) components were analyzed by Western Blot and qPCR. ResultsHypothyroidism increased DRP1 activation and the p-DRP1/OPA1 ratio, indicating a shift toward mitochondrial fission over fusion. Under fasting, hypothyroidism prevented the increases in mitochondrial size, elongation, OPA1, and OXPHOS seen in euthyroid fasted rats. Hypothyroidism also raised 4-HNE content, an oxidative stress product, increased mitochondrial injury, and exacerbated fasting-related mitochondrial damage. This was accompanied by elevated Parkin levels in both fed and fasted hypothyroid groups, but without changes in PINK1 levels or Parkin activation. While fasting upregulated Bnip3l and Map1lc3b expression in euthyroid rats, hypothyroidism suppressed this response, though it did not prevent fasting-induced Bnip3 increases. ConclusionsHypothyroidism increases the activation of mitochondrial fission machinery and oxidative stress, and induces mitochondrial damage without activation of mitophagy proteins, suggesting disrupted mitophagy signaling. It also interferes with fasting-induced mitochondrial dynamics adaptations, highlighting the essential role of thyroid hormones in metabolic adaptation to fasting.

Potential therapeutic impacts of vitamin D on hypothyroid-induced heart and kidney fibrosis and oxidative status in male rat.

There are several interactions between thyroid hormones (THs) and kidney and heart function. Consequently, THs deficit results in profound changes in renal and cardiac function regulation. Interestingly, emerging evidence suggests that vitamin D (Vit D) may benefit to fibrotic lesions in various tissues. Herein, this study was designed to investigate the potential impact of Vit D on renal and cardiac fibrosis in hypothyroid rats. Forty male Wistar rats were divided into four groups as follow: control, hypothyroid (0.05% PTU in drinking water), and hypothyroid + Vit D (PTU and doses of 100 or 500 IU/kg/day, by gavage) groups. After 6 weeks, biochemical parameters such as creatinine and urea in serum samples, and oxidative stress markers including malondialdehyde (MDA), total thiol groups, and superoxide dismutase (SOD) in renal and cardiac tissues homogenate were measured. Also, renal and cardiac fibrosis was evaluated histologically using Masson's trichrome staining. Hypothyroidism significantly increased creatinine and urea. Also, in hypothyroid group renal and cardiac fibrosis as well as MDA were increased, while anti-oxidative markers including total thiol group and SOD were decreased. Administration of Vit D significantly improved these alterations in oxidative stress markers and fibrosis in renal and cardiac tissues. In conclusion, this study highlighted that Vit D supplementation reduced renal and cardiac fibrosis and improved oxidative stress. These results support the emerging experimental findings linking Vit D being introduced as a potential therapeutic agent.

Unveiling Oxidative Stress Dynamics: A Comparative Study of Biochemical and Anti-Oxidative Parameters in Thyroid Dysfunction

Background: The prevalence of thyroid dysfunction is significant, and its association with oxidative stress and biochemical changes is well recognized. Thyroid hormones are crucial in maintaining oxidative balance and regulating the body's metabolic processes to protect against cellular damage.Objectives: The study aimed to compare biochemical and oxidative stress parameters in rat models of hypothyroidism and hyperthyroidism.Materials and Methods: This research, conducted from September 14 to October 21, 2023, involved 21 male Wistar divided into hypothyroid (n=7), hyperthyroid (n=7), and control (n=7), respectively. Hypothyroidism and hyperthyroidism were induced using propylthiouracil (PTU) and levothyroxine (LTX), respectively. The study assessed serum biochemical parameters, including uric acid (UA), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC), as well as oxidative stress parameters, such as total antioxidant capacity (TAC) after 5-weeks.Results: The study found that the hypothyroid group exhibited decreased TAC (40±4) compared to the hyperthyroid (45±6) and control (50±5; p=0.012) groups. UA levels were higher in hypothyroid rats (4.2±1.0 mg/dL). Both hypothyroid (200±18 U/L) and hyperthyroid (210±20 U/L) rats showed increased LDH levels compared to the control group (180±15 U/L). Additionally, LDL cholesterol was elevated in hypothyroid (55±8 mg/dL) and reduced in hyperthyroid rats (30±5 mg/dL), while HDL decreased in both groups.Conclusion: Hypothyroidism is associated with significantly lower TAC and higher levels of UA and LDH, indicating oxidative stress and cellular damage. Conversely, hyperthyroidism leads to altered lipid metabolism, as evidenced by decreased LDL and HDL cholesterol levels. Keywords: Anti-oxidants, Lipid metabolism, Rats, Thyroid disorders.

Hypothyroidism in a Psychiatric Outpatient Population of People With Intellectual Disabilities.

Hypothyroidism is a chronic health condition which causes physical, cognitive and psychiatric symptoms. The prevalence of hypothyroidism in adults with intellectual disabilities is under researched. Hypothyroidism was examined among 463 patients within an outpatient intellectual disability psychiatric team. Clinic records were utilised for this study, including sociodemographic, psychiatric and physical health diagnoses. Among the 463 patients, 43 (9%) had hypothyroidism. Compared to those without hypothyroidism, the hypothyroid group were significantly older, more likely to be female, and had increased rates of high cholesterol, diabetes, Down's Syndrome and dementia. Rates of hypothyroidism within this cohort of patients with intellectual disabilities were high (9%). The results suggest hypothyroidism in intellectual disability should be the focus of prospective research, in larger, more representative samples. This study indicates a need for increased awareness of, and resources for hypothyroidism in health services.

Obesity-related subclinical hypothyroidism in childhood: Elevated triglycerides but not basal metabolicrate.

Studies on the associations between obesity-related subclinical hypothyroidism with basal metabolic rate and risk factors of cardiovascular disease in children and adolescents are scarce. Retrospective cohort study of children with obesity (n = 294) from the Uppsala Longitudinal Study of Childhood Obesity cohort. Differences in basal metabolic rate quantified by indirect calorimetry, and the cardiovascular risk factors; body mass index, blood lipids, fasting and 2 h oral glucose tolerance test glucose, glycated haemoglobin and insulin resistance, between subjects with and without subclinical hypothyroidism were investigated. The associations of baseline thyroid stimulating hormone (TSH) and ΔTSH with change in cardiovascular risk factors over time were assessed. Subjects with subclinical hypothyroidism had elevated triacylglycerides but no alterations in basal metabolic rate or other measured cardiovascular risk factors. ΔTSH was positively associated with Δtriacylglycerides, Δtotal-cholesterol and ΔLDL-cholesterol, independently of age, sex, Δbody mass index and ΔT4. In the subclinical hypothyroidism group, 92% of individuals normalised their TSH 0.9-2.9 years later. Children with obesity and subclinical hypothyroidism did not have an altered basal metabolic rate but elevated triacylglycerides. During the follow-up period, TSH changed in parallel with several blood lipids. Elevated TSH often normalised without pharmaceutical intervention within 3 years. The present study found that subclinical hypothyroidism in paediatric obesity is related to elevated triglycerides. The present study found that subclinical hypothyroidism is not associated to basal metabolic rate in paediatric obesity. TSH change over time correlated with the change in triglycerides and LDL and total cholesterol. Among subjects with subclinical hypothyroidism at baseline 92% normalised without pharmaceutical intervention within 3 years. This research adds to the knowledge of the longitudinal, natural course of elevated TSH in paediatric obesity which is expected to help to make informed decisions regarding follow-up and evaluation of this patient group.

Efficacy of ozone versus mesenchymal stem cell-derived microvesicles in ameliorating testicular changes after hypothyroidism in adult albino rats: a histological and immunohistochemical study

ABSTRACT This study was performed to: detect the histological, immunohistochemical, and biochemical alterations that may occur in the testes of adult rats in induced hypothyroidism. And to investigate which one, ozone or MSCs-MVs have better therapeutic effect on testicular changes after hypothyroidism. Eighty-four male adult rats were separated into: control group, hypothyroidism group: rats will be given carbimazole for 30 days, ozone group: rats treated as hypothyroidism group then will be injected with ozone intraperitoneal for 7 days. MSC-MVs group: rats treated as hypothyroidism group then will be injected with a single intravenous dose MSC-MVs. Specimens of testes were handled for light, electron microscope, and immunohistochemical of vimentin and S100. Biochemical analysis for; MDA and TNFα; serum testosterone, TSH, T3, and T4 was done, also, sperm count and morphology assay. Morphometric and statistical analysis were performed. Hypothyroidism group showed disorganized seminiferous tubules. A noticeable gap was between the basement membrane and the germinal epithelium. Wide interstitium had congested vessels and acidophilic homogenous material. Vacuolated germinal epithelium and few germ cells had dark nuclei with noticeable separation of between the basement membrane and the germinal epithelium. Ozone and MSCs-MVs induced improvement in all the previous parameters and restoration of spermatogenesis. In Conclusion MSCs-MVs has better ameliorative effect than ozone on hypothyroidism-exposed testes.

Role of Zinc Alpha2-Glycoprotein and Retinol-Binding Protein-4 in Iraqi Women with Thyroid Dysfunctions

Thyroid dysfunction (TD) and diabetes mellitus (DM) are two of the most frequent chronic endocrine disorders. This study included 60 women with thyroid disorders: 30 with hypothyroidism and 30 with hyperthyroidism, aged between 20 and 40 years. This study used 30 healthy women aged 20-40 years as a control group. Anthropometric measurements of Body Mass Index (BMI), hematological analysis of glycated hemoglobin (HbA1c), biochemical parameters (Thyroid-stimulating hormone TSH, Free triiodothyronine FT3, Free thyroxine FT4, Fasting Blood Sugar FBS), and adipokine concentrations zinc-α2-glycoprotein (AZGP-1) and retinol-binding protein-4 (RBP-4) were performed for all participants. The results revealed that the serum levels of zinc-α2-glycoprotein and retinol-binding protein-4 are significantly higher in hyperthyroidism (P<0.0001) compared to both healthy and hypothyroid women. Besides that, zinc-α2-glycoprotein has a negative correlation with TSH in the hyperthyroidism group. In the hypothyroidism group, it correlates positively with retinol-binding protein-4. In addition to that, retinol-binding protein-4 is positively correlated with FT3 and FT4 and negatively correlated with BMI in the hyperthyroidism group. For this reason, we conclude that these adipokines can aid in the diagnosis and monitoring of thyroid disorders, thereby preventing the onset of disease complications associated with type 2 diabetes mellitus. It is important to highlight that women with hypothyroidism are more likely than those with hyperthyroidism to develop diabetes.

Evaluating cardiac electrophysiological markers for predicting arrhythmic risk in hypothyroid patients

ABSTRACT Objectives This study aimed to evaluate the impact of hypothyroidism and levothyroxine (LT4) treatment on arrhythmic risk by concurrently analyzing multiple electrocardiogram (ECG) parameters such as the Index of Cardio-Electrophysiological Balance (iCEB), frontal QRS-T angle, Tpeak-Tend (Tp-e) interval/QT interval ratio, and QT dispersion (QTd). Methods This cross-sectional study included 132 adult patients with primary hypothyroidism who had been receiving LT4 treatment, and 132 demographically matched healthy controls. The hypothyroid group was also stratified by thyroid-stimulating hormone (TSH) levels (subclinical <4.5 and overt ≥ 4.5). Participants underwent a series of thyroid function and ECG measurements. Results The hypothyroid and healthy control groups were matched for age and gender (p = 0.080; p = 0.176). Participants with hypothyroidism had higher Tp-e/QT ratios, iCEB, median frontal QRS-T angle, and corrected QT dispersion (cQTd) than healthy controls (p = 0.004; p = 0.025; p = 0.004; p = 0.004, respectively). In the overt group, the Tp-e/QT ratio, iCEB, and median frontal QRS-T angles were all higher (p = 0.012, p = 0.037, and p = 0.016, respectively). Logistic regression analysis indicated that a higher iCEB score (β = 0.60, p = 0.003) was significant for the detection of arrhythmia risk. ROC analysis showed that iCEB had the highest sensitivity (0.80), moderate specificity (0.60), and AUC 0.70. Conclusion Patients with hypothyroidism have a higher risk of arrhythmia. To assess this risk, it is important to analyze the Tp-e interval, iCEB, frontal QRS-T angle, and QTd. Differentiating between patients with subclinical and overt hypothyroidism can help minimize the risk of arrhythmia. iCEB is the most effective method for identifying arrhythmic risk. Using all these parameters can improve the accuracy of arrhythmic risk detection in patients with hypothyroidism.

Study of Leaky Gut syndrome and its Correlation to Hashimoto’s Thyroid Disease with Respect to Antibodies Titre

Abstract Background Hashimoto's thyroiditis (HT) is the most common autoimmune disease worldwide, characterized by chronic inflammation and circulating auto antibodies against thyroid peroxidase and thyroglobulin. Alterations in the gut microbiota are associated with autoimmune diseases development. There is increasing evidence that gut microbiota is an important environmental factor directly or indirectly influencing the progression of thyroid diseases and that thyroid diseases can exacerbate disturbances in the microbiota Objective To evaluate serum zonulin levels and stool lactobacillus acidophilus growth as markers of leaky gut syndrome in patients with Hashimoto's thyroiditis. Methods This was a case control study that was conducted on 80 Egyptian subjects age (20 – 60 years old) &amp; were divided into 60 patients with Hashimoto's thyroiditis and 20 control, the patient group was further divided into 3 equal groups according to the thyroid functions state (Euthyroid, sub clinical hypothyroid and overt hypothyroidism), evaluation of serum zonulin and stool lactobacillus acidophilus growth and correlation with TPO antibody titer was done. Results Our study showed statistically significant increase in serum zonulin level which was positively correlated to TPO level in Hashimoto's thyroiditis patients implicating a possible presence of leaky gut syndrome, this was present in the hypothyroid group significantly than the Euthyroid Hashimoto's group, as it was also associated with lactobacillus acidophilus stool culture positivity which may reflect a bacterial dysbiosis. Conclusion This data may reflect the interaction between the gut microbiota and possible leaky gut syndrome association with Hashimoto’s thyroiditis. However, whether this data is a result from Hashimoto's disease or a cause, this need a further evaluation.

Comorbid Hypothyroidism and Low-Alanine Aminotransferase-Associated Sarcopenia Associated with Shortened Survival: A Retrospective Study of 16,827 Patients over a 21-Year Period

Background: Hypothyroidism is very common worldwide. It is known to be associated with frailty which, in turn, is associated with increased morbidity and mortality in the elderly. Low ALT blood activity is an established marker for sarcopenia and frailty. The incidence and outcomes of the association between low ALT values and hypothyroidism, as manifested in elevated blood TSH levels, is unknown. The objective of this study was to assess if low ALT values could improve the prediction of clinical outcome in hypothyroid patients. Methods: This was a retrospective analysis of hospitalized patients in a large, tertiary hospital. Results: Over a period of 21 years, an overall population of 16,827 patients were identified as eligible to participate in this study. Within the study population, 726 (4.3%) were classified as suffering from hypothyroidism (TSH values &gt; 6 MIU/L) and 2184 (13%) were classified as patients with sarcopenia (ALT &lt; 12 IU/L). Within our patient population, hypothyroidism was associated with sarcopenia in a statistically significant manner (p = 0.011). Patients classified as suffering from both hypothyroidism and sarcopenia had significantly shorter survival: A multivariate analysis showed that the frail and hypothyroid group of patients had a statistically significant risk of mortality in the next 5 years (HR = 3.6; CI 2.75–4.71; p &lt; 0.001). Conclusions: Sarcopenia and frailty are common comorbidities, bearing negative long-term clinical outcomes. Low ALT values could serve as a useful biomarker for screening of patients already diagnosed with hypothyroidism.

Features of atherosclerotic lesions of the coronary arteries in patients with myocardial infarction and concomitant newly diagnosed hypothyroidism

Objective: to assess the incidence of newly diagnosed subclinical and manifest hypothyroidism in patients with ST-segment elevation myocardial infarction (STEMI) and to identify angiographic features of coronary artery lesions in this combined pathology.Materials and methods: in all patients with STEMI, the level of thyroid-stimulating hormone (TSH) was determined, and thyroid function was assessed if the TSH level deviated from the norm. Stage I of the study included 441 patients, stage II included 133 patients with STEMI. Depending on the presence of newly diagnosed hypothyroidism, patients were divided into 3 groups: 1st — patients without hypothyroidism (n = 57), 2A group — with subclinical hypothyroidism (n = 42) and 2B group — with manifest hypothyroidism (n = 34). All patients underwent coronary angiography and percutaneous coronary intervention.Results: newly diagnosed hypothyroidism occurred in 27.44% of patients with STEMI: subclinical — in 19.73%, manifest — in 7.7% of cases. Patients with concomitant overt hypothyroidism had significantly more severe atherosclerotic lesions of the coronary arteries compared to patients without hypothyroidism.Conclusion: a high incidence of newly diagnosed hypothyroidism in patients with STEMI was established (27.44% of cases). Multivessel coronary lesions were recorded more often in patients with overt hypothyroidism than in patients with subclinical hypothyroidism and without hypothyroidism.

Therapeutic Potential of the Algerian Ground Nut (Bunium bulbocastanum) Dietary Supplement in the Treatment of Thyroid-induced Dysfunction and Associated Growth Performance and Meat Quality in Rabbits (Oryctolagus cuniculus)

Background: Both traditional usage and initial scientific findings suggest that Bunium bulbocastanum, commonly known as Talghouda tuber nut, may offer health benefits, particularly for thyroid dysfunction. This study aims to investigate the therapeutic potential of dietary supplementation in managing pharmacologically thyroid-induced dysfunction and its effects on growth performance and meat quality in rabbits. Methods: Thirty 45-day-old male Lionhead rabbits were divided into three groups, each with two subgroups. The Control groups received either a standard diet (C) or a diet supplemented with 35% dried Talghouda (Csup). The Hypothyroid group included rabbits induced with hypothyroidism using carbimazole at a dose of 5 mg/kg BW/day (HytCar) and those subsequently treated with dried Talghouda (HytTal). Similarly, hyperthyroid group comprised rabbits induced with hyperthyroidism using levothyroxine (HyrLevo) and those treated with dried Talghouda (HyrTal). Thyroid function was assessed by measuring serum levels of T3, T4 and TSH. Additionally, growth performance and meat quality parameters were evaluated. Result: Talghouda supplementation significantly influenced thyroid hormone levels in rabbits, elevating T3 and T4 in the hyperthyroid groups (HyrLevo and HyrTal) compared to controls, while suppressing TSH in hyperthyroid groups and elevating it in hypothyroid groups. Talghouda treatment improved growth performance, evidenced by increased weight gain and higher eviscerated carcass weights in the hyperthyroid-treated groups. Meat quality also improved, with favourable pH, dry matter percentage and mineral content observed in the Talghouda-treated hypothyroid group. These findings suggest that Bunium bulbocastanum is a viable natural intervention for managing thyroid dysfunction while maintaining or enhancing growth and meat quality in rabbits, offering promising pharmacological and economic benefits.

The Association Between Hypothyroidism and Cognitive Function Change in Women across the Menopause Transition: The Study of Women's Health Across the Nation.

Background: Patients treated for hypothyroidism with levothyroxine (LT4) monotherapy may present with persistent hypothyroidism symptoms, including cognitive symptoms, despite having a normal thyroid stimulating hormone (TSH) level. It remains unclear whether LT4 monotherapy is sufficient to normalize cognitive function outcomes over time. Methods: This is a multisite longitudinal study of a diverse group of women during midlife representing 5 ethnic/racial groups from 7 enrollment sites across the United States in the Study of Women's Health Across the Nation. Women were screened for a history of thyroid disease and the use of LT4. The study consisted of two primary groups: women with LT4-treated hypothyroidism and control women without thyroid disease. Each participant completed up to 9 cognitive assessments over the study period testing processing speed, working memory, and episodic memory (immediate and delayed recall). Multivariable generalized linear mixed models of scores for each cognitive assessment were developed to determine the association between LT4-treated hypothyroidism and cognitive function trajectories. Covariates included sociodemographic, clinical characteristics, and menopausal status (pre/early peri, late peri, and surgical/post). Sensitivity analyses were conducted to assess the impact of abnormal TSH levels and practice effects (i.e., improvements in scoring after repeated testing). Results: Of the 2033 women who were included in the study, 227 (11.2%) met criteria for LT4-treated hypothyroidism. At baseline, both processing speed and working memory scores were higher in LT4-treated women (mean processing speed scores: 56.5 vs 54.4; p value = 0.006; mean working memory scores: 6.8 vs 6.4; p value = 0.018). However, when considering the effect of LT4-treated hypothyroidism over time, there were no significant differences in the rate of cognitive decline (in any measure) between the hypothyroidism and control groups with or without covariate adjustment. The results were similar when considering LT4-treated women with abnormal TSH levels or after minimizing practice effects. Conclusions: We observed no difference in cognitive decline between women with LT4-treated hypothyroidism and women without thyroid disease. For similar aged patients with cognitive complaints, if thyroid function testing is normal, clinicians should consider causes other than inadequate thyroid hormone treatment to explain these symptoms.

Comparative analysis of clinical profile, laboratory profile and outcome in COVID-19 patients with and without hypothyroidism.

Previous studies suggest that patients' thyroid status might directly impact the course of Coronavirus disease 2019 (COVID-19). The objective of the study was to determine the clinical profile of COVID-19 patients with hypothyroidism and compare it with that of COVID-19 patients without hypothyroidism. Retrospective observational study. The study was conducted in a tertiary healthcare centre in Tamil Nadu between May and June 2021. The study included 117 patients admitted with hypothyroidism and COVID-19 as well as 117 age and Gender matched COVID-19 patients without hypothyroidism. Data regarding the demography, comorbidities, presenting symptoms, method of diagnosis of COVID-19, computed tomography (CT) severity score, Interleukin 6 (IL-6), D-dimer, oxygen requirement, number of days in hospital and outcome were collected for both groups. Data analysis was conducted, and p<0.05 was considered statistically significant. The study comprised 234 patients over two months, from May to June 2021. Distribution of presenting symptoms showed that the hypothyroidism group presented with a higher incidence of fever (66.67%), loose stool (18.80%) and myalgia (7.69%). Results show that RTPCR+, O2 Requirement, death, D-dimer, IL-6, number of days admitted as well as CT-severity did not show any statistically significant differences (p>0.05) between both groups. The outcomes also showed that both groups reported four mortalities. The results of the study help conclude that the hypothyroidism status of a COVID-19 patient is not associated with higher severity of clinical symptoms, deranged laboratory values as well as mortality. None declared.

Calcium-Phosphorus Metabolism in Females with Autoimmune Thyroiditis and Hypothyroidism

Thyroid dysfunction is frequently associated with disturbances of calcium and phosphorus homeostasis. Previous studies on bone and mineral metabolism in women with autoimmune thyroiditis (AIT) and hypothyroidism have conflicting results. The aim of the present work was to study the parameters of calcium-phosphorus metabolism in women with newly diagnosed autoimmune hypothyroidism and to compare them with those of the control group of healthy women. The study included 64 women with newly diagnosed autoimmune hypothyroidism. A comparison was made with the data of 75 age-, BMI- and menopausal state-matched healthy women. FT3, FT4, TSH, TPO-Ab, TG-Ab, total and ionized serum calcium, inorganic phosphate, magnesium, parathyroid hormone (PTH) and 25(OH) vitamin D were studied. Total and ionized calcium were lower in hypothyroid women in the absence of statistically significant difference compared to the controls. Intergroup analysis revealed no differences in serum phosphorus and 25(OH)D levels. Serum magnesium and PTH were significantly higher in hypothyroid group. These results coincide with some of the studies that examine the parameters of bone and mineral metabolism in hypothyroidism. Bone turnover is suppressed due to impaired mobilization of calcium from the bone, leading to decreased serum calcium levels and elevated PTH. We found a significant effect of thyroid hormones on magnesium homeostasis. The study did not find differences in vitamin D status between the groups. The observed inverse correlation between 25(OH)D and TgAb supports the concept of pathogenic relationship between vitamin D and the development of AIT.

A Cross-Sectional Study on the Prevalence of Subclinical Hypothyroidism in Metabolic Syndrome Patients at a Tertiary Care Hospital.

Metabolic syndrome (MetS) is defined as a "constellation" of cardiometabolic risk factors, characterized by hypertension, atherogenic dyslipidemia, hyperglycemia, prothrombotic and proinflammatory conditions which, jointly, increase the risk of suffering cardiovascular diseases (CVD) and type 2 diabetes mellitus.Thyroid dysfunction is also believed to affect parameters such as high-density lipoprotein (HDL) cholesterol, triglycerides, plasma glucose, and blood pressure, in turn increasing the risk of CVD. Subclinical hypothyroidism (SCH), which independently raises the risk of CVDs and their associated complications, is more frequently detected in patients with MetS compared to the general population. When both conditions coexist, the risk of CVD and its complications is significantly heightened. The objective of the study was to find out the prevalence of SCH in patients with MetS. A prospective cross-sectional study was conducted in the Department of General Medicine, New Civil Hospital, Surat, Gujarat, India. Eighty patients who fulfilled the criteria for MetS by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), were taken into the study. A detailed history, anthropometric measurements, blood pressure, fasting blood glucose, lipid profile, and thyroid profile (Free T3, Free T4, and serum thyroid-stimulating hormone (TSH)) were undertaken. The thyroid profile was done by chemiluminescence immunoassay (CLIA) method. Out of 80 patients with MetS, 48 were female and 32 were male, with the overall mean age of the study population being 46.5±9.5 years. Among them, 23.7% of the population was found to be having thyroid dysfunction. Among the thyroid dysfunction, SCH was highly prevalent (18.8%), 3.8% patients had overt hypothyroidism and 1.3% patients had subclinical hyperthyroidism. There were no overt hyperthyroid patients in our study.HDL (mg/dl) and TSH (mIU/L) were significantly higher in the SCH group as compared to other types of hypothyroidism group (p-value < 0.05). There is a statistically significant prevalence of SCH (18.8%) in MetS patients. It is clear from the study that one-fifth of MetS patients or every fifth patient with MetS had SCH. Thus, looking proactively for SCH in MetS and treating it would prevent conversion to overt hypothyroidism and complications of MetS.

Comparison of Factors Influencing Gestational Outcomes in Healthy Versus Hypothyroid Women from Karachi, Pakistan.

Gestational outcomes are known to be negatively correlated with hypothyroidism. This study was designed to compare the maternal factors affecting gestational outcomes in women with and without hypothyroidism. This retrospective analysis was carried out in a tertiary hospital in Karachi, Pakistan, between 2008 and 2016. A standardized form was used to collect information on the age of the mother, gestational duration at the prenatal appointment, gestational diabetes mellitus (GDM), hypertension, and past records of miscarriages in hypothyroid and healthy pregnant women. Gestational outcomes were recorded as live birth or pregnancy loss. Statistical analysis was performed to examine overt versus sub-clinical hypothyroidism and among those diagnosed before versus during gestation. A collective of 708 women were enlisted in the hypothyroid pregnant group and 759 were recruited in healthy controls. Pregnancy loss was 9.9% (n=70) in hypothyroid women, whereas it was 14.3% (n=108) in the control group. The age of the mother, gestational duration at the prenatal appointment, and past records of miscarriages were discovered to be related to a higher chance of pregnancy loss in a multivariable analysis, but GDM (OR 0.04, CI 0.06-0.32, P=0.002) and hypothyroidism (OR 0.62, CI 0.43-0.89, P=0.01) exhibited a protective effect. This study found the age of the mother, gestational duration at a prenatal appointment, and past records of miscarriages to be associated with negative outcomes in hypothyroidism. These factors remained significant in overt as well as subclinical hypothyroid women.

Clinical Significance of Thyroid Autoantibodies in Differential Diagnosis and Predicting the Course of Programmed Cell Death Protein-1 Inhibitor-Induced Thyroid Dysfunction

ObjectiveThyroid immune-related thyrotoxicosis is one of the most common adverse effects in patients treated with programmed cell death protein-1 (PD-1) inhibitors. We investigated the significance of levels of serum anti-thyroglobulin antibodies (TgAbs), anti-thyroid peroxidase antibodies (TPOAbs), and thyroid-stimulating hormone receptor antibodies (TRAbs) in the identification of anti-PD-1-induced thyroid thyrotoxicosis. MethodsWe divided 161 patients with thyroid dysfunction who received PD-1 inhibitors at our hospital between January 2022 and June 2024 into 3 groups: primary hypothyroidism group, primary hyperthyroidism group, and destructive thyroiditis group. The characteristics of the 3 groups were determined, and the positivity rates of serum TgAbs, TPOAbs, and TRAbs were assessed. An additional 42 patients diagnosed with Hashimoto’s thyroiditis were selected as the control group for PD-1 inhibition-induced destructive thyroiditis. Age, sex, and time of transition from thyrotoxicosis to hypothyroidism in the 2 groups were compared. ResultsIn the primary hypothyroidism group, only 1 case was TPOAbs-positive (1/1%). In the destructive thyroiditis group, the positivity rate for TPOAbs or TgAbs was 92.9%, and TPOAbs and TgAbs were negative in the primary hyperthyroidism group. TRAbs were undetectable in all 3 groups. There were statistically significant differences in age, sex, and time from thyrotoxicosis to hypothyroidism in the PD-1 induced destructive thyroiditis and Hashimoto’s thyroiditis groups. ConclusionsIn patients with thyrotoxicosis caused by PD-1 inhibitors, serum TgAb, and TPOAb levels can be used to distinguish between primary hyperthyroidism and destructive thyroiditis. This study provides insights into novel treatment targets and effective management strategies for PD-1-induced thyrotoxicosis.

Targeting the Manifestations of Subclinical and Overt Hypothyroidism Within the Hippocampus.

The past decade has witnessed a surge of articles describing the neurocognitive sequelae and associated structural and functional brain abnormalities of patients with overt hypothyroidism (OH) and subclinical hypothyroidism (SCH). Findings show effects primarily within the frontal lobes with usually worse outcomes for OH than SCH. Several recent studies have also indicated hypothyroid patients may have smaller hippocampi, a key structure for memory. The JCEM paper by Zhang and colleagues applies 2 novel approaches for analyzing hippocampal structure and function. One uses an automated processing tool that segments the hippocampus into distinct subregions, and the other performs connectivity analysis to assess the relationships between specific hippocampal subregions and cortical areas. Relatively large samples of OH and SCH patients and healthy controls received a test of global cognitive functioning and underwent structural and functional magnetic resonance imaging. Results showed hypothyroid groups scored significantly below controls on the memory scale and also had smaller hippocampal volumes in selective subregions. Effects were stronger for SCH than OH groups, who also showed different patterns of interconnectivity between hippocampal subregions and specific frontal lobe areas. To make sense of these findings, I explored the rodent and human literatures on thyroid hormone's role in hippocampal functioning and on hippocampal subfields and their purported functions and interconnections. Because current results suggest SCH may represent a distinct clinical entity with unique brain manifestations, I hypothesized 2 explanations for these findings, one involving transporter defects in the brain barriers and the other, differential neurodegeneration of the blood-brain barrier vascular unit.

The role of non-invasive oscillometric method to detect aortic stiffness in patients with subclinical hypothyroidism

Introduction Subclinical hypothyroidism (SCH) is a biochemical condition that is diagnosed when peripheral free thyroid hormone levels are within normal reference laboratory range but serum thyroid-stimulating hormone (TSH) levels are mildly elevated. The aim of this study was to investigate the relationship between SCH and arterial stiffness using two different non-invasive methods, including echocardiography and oscillometric arteriography. Material and Methods The study included 33 newly diagnosed SCH patients and 34 age- and gender-matched healthy controls. Systolic and diastolic diameters and elastic parameters of the aorta were calculated by 2D Transthoracic echocardiography (TTE). Central blood pressure and aortic stiffness values of patient groups were measured noninvasively from the brachial artery using Mobil-O-Graph arteriography. Pulse wave velocity (PWV) and augmentation index (AIx) were used as arterial stiffness indicators. Results There was no significant difference between SCH and control groups with regard to age, gender, and body mass index (BMI). Aortic strain and aortic distensibility, were significantly lower in the SCH group than in the control group (p < 0.001). PWV and AIx which measured by Mobil-O-Graph arteriography were found to be significantly higher in the subclinical hypothyroid group compared to the control group (p < 0.05). Conclusion Aortic stiffness assessed by TTE and Mobil-O-Graph arteriography deteriorated in patients with SCH after excluding other cardiovascular risk factors. The assessment of aortic stiffness by the oscillometric method was easy and useful for widespread clinical use.