Impact Of Thyroid Disorders Research Articles

Prevalence and Impact of Thyroid Disorders on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

Prevalence and Impact of Thyroid Disorders on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study

The impact of thyroid disorders on the clinical outcome of assisted reproductive techniques: a systematic approach over the last 10 years.

To verify from a systematic literature review the possible effects of thyroid diseases on assisted reproduction techniques. The studies were analyzed from the PubMed, Cochrane Library, LILACS databases. The articles selected for the review included: cross-sectional studies, cohort studies, and clinical trials that addressed the proposed theme and which were published within the period stipulated from January 1, 2012, to March 5, 2022, in English, Portuguese and Spanish. These would later have to go through stages of inclusion as a framework of the type of study and exclusion criteria that were review articles, case reports, abstracts, articles with animal models, and duplicate articles and letters to the editor. Author's name; Number of patients; Clinical outcome; Use of drugs; Control group (in case it had); Clinical outcome. In in vitro fertilization and intracytoplasmic sperm injection it was verified that thyroid diseases can lead to effects such as a reduction in the rate of recovered oocytes, a decrease in the number of embryos, lower pregnancy rates, and increased chances of congenital anomalies in these patients and a reduction in the rate of implantation. Levothyroxine can increase the number of cycle cancellations. Thyroid diseases may have deleterious effects on the clinical outcome of in vitro fertilization and intracytoplasmic sperm injection.

Impact of thyroid disorders on the incidence of non-alcoholic fatty liver disease in Germany.

BackgroundStudies investigating a potential association between hypothyroidism and non‐alcoholic fatty liver disease (NAFLD) showed conflicting results and large‐scale population‐based data from Germany on this topic are currently missing.ObjectiveIt was the aim of this analysis to investigate the impact of thyroid gland disorders on the prevalence of NAFLD in Germany.MethodsIn this case‐control study, using the German disease Analyzer database (IQVIA), NAFLD patients were matched to patients without NAFLD by age, sex, index year, treating physician, diabetes mellitus type II, and obesity. The main outcome of the study was an association between thyroid gland disorders (hypothyroidism, hyperthyroidism and autoimmune thyroiditis) and incident NAFLD and was evaluated using logistic regression analyses.Results57,483 patients with NAFLD were matched to 57,483 patients without liver disease. Mean age of the cohort was 60.3 years (±14.1) and 52.3% were men. In regression analyses, hypothyroidism (OR 1.17, 95% CI 1.10 ‐ 1.24, p < 0.001) as well as autoimmune thyroiditis (OR 1.53, 95% CI 1.35–1.73, p < 0.001) were associated with a higher risk of NAFLD. In contrast, hyperthyroidism was associated with a lower risk of NAFLD (OR 0.85, 95% CI 0.77–0.94, p < 0.001). The effect of hypothyroidism on the prevalence of NAFLD remained significant across men (OR 1.31, 95% CI 1.15–1.48) as well as women (OR 1.12, 95% CI 1.05–1.21).ConclusionHypothyroidism seems to be a risk factor for incident NAFLD.

Prevalence of thyroid disorders in antenatal women and its impact on maternal and foetal outcome

Introduction: Thyroid disorders are the commonest endocrine disorders affecting women of reproductive age group. The most frequent thyroid disorder in pregnancy is maternal hypothyroidism. Antenatal period can be viewed as a state in which a combination of events concurs to modify the thyroidal economy. Thyroid dysfunction has varied impact on pregnancy outcome. In this study we have assessed the prevalence and the impact of thyroid disorders among antenatal woman registered in the Urban Health Training Centre of a Tertiary care teaching hospital in Kerala, Southern India. Materials and Methods: A prospective observational study was done among 451 antenatal women registered in the Urban Health Training centre of a Tertiary care hospital. Prevalence of thyroid disorders was assessed based on TSH, Free T4 and Anti TPO antibody status. Maternal and Foetal outcomes with respect to their Thyroid function status were also evaluated. Results: The prevalence of thyroid dysfunction in pregnancy was 22.39%, subclinical hypothyroidism (20.63%) was the most common thyroid disorder among these women. Statistically significant association was found between thyroid disorders and maternal complications (P value= Conclusions: This study concludes that there is a high prevalence of thyroid disorder in pregnancy. Subclinical hypothyroidism was found to be the major thyroid disorder as per this study. Keywords: Antenatal thyroid disorder, Pregnancy thyroid dysfunction, Maternal complications, Foetal complications.

Thyroid Disorders and In Vitro Outcomes of Assisted Reproductive Technology: An Unfortunate Combination?

Background: The impact of thyroid disorders on in vitro outcomes of assisted reproductive technology (ART) remains controversial. Therefore, the aim of our study was to investigate whether thyroid peroxidase antibodies (TPO-Abs)/thyroid autoimmunity (TAI) or thyroid function (serum thyrotropin [TSH])/subclinical hypothyroidism are associated with an altered number of oocyte retrieval (NOR), fertilization rate (FR), and embryo quality (EQ). Methods: Cross-sectional study in 279 women in a single center, comprising 297 cycles and 1168 embryos. In vitro data (NOR, FR, and EQ) were documented in two groups; one according to thyroid function in women without TAI (TSH ≤2.5 and >2.5 mIU/L) and one according to the presence/absence of TAI (determined by TPO-Abs). EQ was evaluated according to international criteria and classified as excellent/good and poor. Women treated with levothyroxine (LT4) were excluded. Furthermore, the impact of thyroid parameters on outcomes, normal NOR (>6 or 8) and high FR (>60%), was verified in a multivariable logistic regression model. Results: In women without TAI, 27% had TSH levels >2.5 mIU/L, the prevalence of TAI was 8%, and overall, 6% of women had TSH levels >4.2 mIU/L. NOR, FR, and EQ were comparable between study groups. In the regression analysis, women aged ≥30 years and receiving a high ovarian stimulation dosage (>2300 IU/cycle) had lower rates of normal NOR (odds ratio [OR] 0.18 [95% confidence interval, CI 0.04-0.72]; p = 0.016 and OR 0.17 [CI 0.06-0.48]; p < 0.001, respectively). Conclusions: Our results do not suggest an impact of thyroid antibodies/autoimmunity and (dys)function on ART in vitro outcomes.

The Impact of Thyroid Disorders on Clinical Pregnancy Outcomes in a Real-World Study Setting.

Background: Subclinical hypothyroidism (SCH) and thyroid autoimmunity (TAI) have been associated with poor clinical pregnancy outcomes. However, these outcomes also depend on a number of demographic and obstetric variables. Therefore, the aim of this study was to investigate the impact of thyroid disorders on these outcomes, after adjustment for associated demographic and obstetrical parameters. Methods: This is cross-sectional study including 1521 pregnant women who underwent work-up and follow-up in the Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, and had ongoing pregnancies. Thyroid function (thyrotropin [TSH], free thyroxine [fT4]) and TAI (thyroid peroxidase antibodies) was determined at median (Q1-Q3) 13 (11-17) weeks. Baseline parameters and the prevalence of poor clinical pregnancy outcomes were compared between controls (no TAI and TSH <2.51 mIU/L) and three study groups (isolated TAI [TSH <2.51 mIU/L], SCH1 [TSH 2.51-3.7 mIU/L], SCH2 [TSH >3.7 mIU/L]). The impact of the different thyroid groups and demographic/obstetric independent variables on six poor clinical pregnancy outcomes (preeclampsia, intrauterine growth restriction [IUGR], preterm birth, neonatal intensive care unit [NICU] admission, low birth weight, and macrosomia) was investigated in a logistic regression model. Treatment with thyroid hormone before and during pregnancy and assisted and multiple pregnancies were exclusion criteria. Results: In total, 79 preeclampsias (5.2%), 40 IUGRs (2.6%), 79 preterm births (5.2%), 10 admissions to NICU (0.66%), 74 low birth weights (4.9%), and 94 babies with macrosomia (6.2%) were documented. TAI was independently associated with NICU admission (adjusted odds ratio [aOR] 16.92 confidence interval [CI 3.36-85.29]; p < 0.001) and TSH, as a continuous variable in the whole range, with preeclampsia (aOR 1.97 [CI 1.18-3.31]; p = 0.010). Trends were present for an association between SCH2 and preeclampsia (aOR 16.73 [CI 1.43-196.42]; p = 0.025), and for SCH1with NICU admission and low birth weight (aOR 19.36 [CI 1.18-316.97]; p = 0.038 and 21.38 [CI 1.29-353.39]; p = 0.032, respectively). Conclusions: Pregnant women with TAI had a significantly higher risk of an admission of the baby to the NICU, and SCH tended to be associated with a higher risk of preeclampsia and low birth weight. Other poor clinical pregnancy outcomes were not associated with thyroid disorders, but with demographic and obstetric parameters.

A REVIEW: MECHANISTIC INSIGHTS INTO THE EFFECT OF THYROID DISORDERS ON ESTROGEN LEVEL AND BONE MINERAL DENSITY

Thyroid hormone serves as an indispensable component for the optimum functioning of various biological systems. They curb body’s metabolism, regulates the estrogen level, regulates bone turnover, essential for skeletal development and mineralization. Within the scope of knowledge, it is intimately familiar that thyroid disorders have widespread systemic manifestations, among which in hypothyroidism, even though elevated TSH (thyroid-stimulating hormone) may reduce estrogen level which in turn stimulates osteoclasts and thus cause osteoporosis, while hyperthyroidism accelerates bone turnover. Hypothyroidism does not directly interfere with the skeletal integrity, but treatment with levothyroxine for the suppression of TSH to bring the hypothyroid patient to euthyroid state for a long haul; lead to simultaneous reduction in bone mass and in (bone mineral density) BMD.&#x0D; After the initial relevation of the correlation between thyroid disorders and osteoporosis in numerous studies have emphasized that both hypo and hyperthyroidism either directly or indirectly affects the bone mineral density or leads to the progression of osteoporosis.&#x0D; Therefore the present study is aimed and so designed to review all the possible associations between them and the impact of thyroid disorders on estrogen level and bone mineral density.&#x0D; The main findings of this review indicate that both excesses as well as deficiency of thyroid hormone can be potentially deleterious for bone tissue.

The influence of thyroid disorders on bone density and biochemical markers of bone metabolism.

Background Thyroid dysfunction, predominantly hyperthyroidism, has been previously linked to impaired bone mass density (BMD) and increased risk of fractures. On the other hand, data in the field of hypothyroidism (HT) are missing. The purpose of the present study was to investigate the impact of thyroid disorders on bone density serum and urine calcium (Ca) and phosphate (P) as well as serum osteocalcin and alkaline phosphatase and urine hydroxyproline in a series of post-menopausal women. Materials and methods The study was conducted in the Reproductive Endocrinology Outpatient Clinic of our hospital. A consecutive series of post-menopausal women was included, after excluding patients under hormone treatment (including levothyroxine supplementation) and those who received raloxifene, tamoxifen or tibolone during the study period as well as those who received treatment during the previous 12 months were excluded from the present study. Results Overall, 188 women were included in the present study. Among them, 143 women had normal thyroid function, 32 women had hyperthyroidism and 13 women had HT. Correlation of thyroid function indices with osteoporosis indices revealed statistically significant correlations between thyroxine (T4) and free triiodothyronine (T3) with T-, Z-scores and BMD. Logistic regression analysis concerning the impact of HT and hyperthyroidism on T-score, Z-score and bone mass density revealed that both pathological entities negatively affect bone health (p < 0.05). Conclusion The findings of our study suggest that not only hyperthyroidism, but also HT negatively affects BMD. Future studies should investigate this association and corroborate our findings.

Thyroid disorders are associated with impaired response to psychopharmacological treatment of major depression

Introduction: The association of thyroid disorders (TDs) and mood disorders is a well-investigated empirical finding. Although TDs are highly prevalent in patients with major depression (MD), the impact of TDs on treatment outcome has been sparsely investigated. Methods: Treatment Response was analyzed in 704 in-patients with MD participating in the Munich Antidepressant Response Signature (MARS) project, a large observational naturalistic psychopharmacological treatment study. TD was defined by thyroid hormone substitution, morphological thyroid gland abnormalities, or thyroid autoimmunity. Treatment response was measured by weekly Hamilton Depression Rating Scale (HDRS) assessments during 6 weeks. All patients were euthyroid at baseline. TSH levels were analyzed for potential prediction of treatment outcome. Results: MD patients with TD (n = 172) displayed a significantly impaired treatment outcome compared to MD patients without TD (n = 532) in response rates after 6 weeks (p = 7.4E-04), remission rate at discharge (p = 0.018) as well as in mean HDRS change after 6 weeks (p = 0.019). These differences were most pronounced under treatment with Serotonin Reuptake Inhibitors (SSRIs). TSH levels were not associated with treatment outcome. Discussion: Our results suggest that MD patients with comorbid TD may be at risk for impaired treatment outcome. Replication and substantiation of these findings could inform differential antidepressant therapy for these patients.

Thyroid disorders are associated with impaired response to psychopharmacological treatment of major depression

Introduction: The association of thyroid disorders (TDs) and mood disorders is a well-investigated empirical finding. Although TDs are highly prevalent in patients with major depression (MD), the impact of TDs on treatment outcome has been sparsely investigated. Methods: Treatment Response was analyzed in 704 in-patients with MD participating in the Munich Antidepressant Response Signature (MARS) project, a large observational naturalistic psychopharmacological treatment study. TD was defined by thyroid hormone substitution, morphological thyroid gland abnormalities, or thyroid autoimmunity. Treatment response was measured by weekly Hamilton Depression Rating Scale (HDRS) assessments during 6 weeks. All patients were euthyroid at baseline. TSH levels were analyzed for potential prediction of treatment outcome. Results: MD patients with TD (n = 172) displayed a significantly impaired treatment outcome compared to MD patients without TD (n = 532) in response rates after 6 weeks (p = 7.4E-04), remission rate at discharge (p = 0.018) as well as in mean HDRS change after 6 weeks (p = 0.019). These differences were most pronounced under treatment with Serotonin Reuptake Inhibitors (SSRIs). TSH levels were not associated with treatment outcome. Discussion: Our results suggest that MD patients with comorbid TD may be at risk for impaired treatment outcome. Replication and substantiation of these findings could inform differential antidepressant therapy for these patients.

Prevalence and Impact of Thyroid Disorders on Maternal Outcome in Asian-Indian Pregnant Women

Aims. To establish the prevalence and the effect of thyroid dysfunction on pregnancy outcomes in Asian-Indian population. Subjects and Methods. The study cohort comprised of 483 consecutive pregnant women in the first trimester attending the antenatal clinic of a tertiary center in Mumbai, India. Thyroid hormone levels and thyroid peroxidase antibody were estimated. Patients with thyroid dysfunction were assessed periodically or treated depending on the severity. Subjects were followed until delivery. Results. The prevalence of hypothyroidism, Graves' disease, gestational transient thyrotoxicosis, and thyroid autoimmunity (TAI) was 4.8% (n = 24), 0.6% (n = 3), 6.4 % (n = 31), and 12.4% (n = 60), respectively. Forty percent of the hypothyroid patients did not have any high-risk characteristics. Hypothyroidism and TAI were associated with miscarriage (P = 0.02 and P = 0.001, resp.). Conclusions. The prevalence of hypothyroidism (4.8%) and TAI (12.4%) is high. TAI and hypothyroidism were significantly associated with miscarriage.