Markers Of Thyroid Autoimmunity Research Articles

Endometriosis, polycystic ovary syndrome, and the thyroid: a review.

Endometriosis and polycystic ovary syndrome (PCOS) are common gynecological disorders that constitute a significant burden of disease in women of fertile age. The disorders share a link to female reproduction and infertility; however, divergent effects on menstrual cycle, related hormones, and body composition have been proposed. Disorders of the thyroid gland including abnormal thyroid dysfunction (hyperthyroidism or hypothyroidism) and/or markers of thyroid autoimmunity similarly show a female predominance and onset in younger age groups. We reviewed the literature on the association between endometriosis, PCOS, and thyroid disease up until July 1, 2023, and identified 8 original studies on endometriosis and thyroid disease and 30 original studies on PCOS and thyroid disease. The studies were observational and heterogeneous regarding the design, sample size, and definitions of exposure and outcome; however, a tendency was seen toward an association between hyperthyroidism and endometriosis. Especially an association between endometriosis and slightly elevated levels of thyroid-stimulating hormone receptor antibodies has been found and corroborated in studies from different populations. On the other hand, the literature review turned a focus toward an association between hypothyroidism and PCOS, however, with uncertainties as to whether the association is caused by hypothyroidism per se and/or the thyroid autoantibodies (thyroid peroxidase and thyroglobulin antibodies). More evidence is needed to substantiate an association between endometriosis, PCOS, and thyroid disease, and to differentiate between the role of thyroid function and thyroid autoimmunity. Furthermore, studies are warranted to extend knowledge on the different disease characteristics and underlying mechanisms.

Evaluation of thyroid autoimmunity markers in polycystic ovarian syndrome in women

Evaluation of thyroid autoimmunity markers in polycystic ovarian syndrome in women

Is thyroid autoimmunity associated with subclinical atherosclerosis in young women with type 1 diabetes mellitus?

It has been hypothesized that autoimmunity may contribute to cardiovascular complications and may be an important trigger for processes leading to atherosclerosis, especially in type 1 diabetes mellitus (T1DM). This pilot study aimed to answer the question of whether markers of thyroid autoimmunity are associated with increased carotid intima-media thickness (cIMT) in young, asymptomatic T1DM women. The study population consisted of 102 women, including 72 with T1DM and 30 healthy controls. All patients had thyroid hormones within the normal range. According to the antiperoxidase antibodies (aTPO) titre, the T1DM women were divided into an aTPO-positive (T1DM aTPO+) (n = 41) and an aTPO-negative (T1DM aTPO-) (n = 31) group. In all patients, aTPO, thyroglobulin antibody (aTG) titres, thyroid-stimulating hormone (TSH), free thyroxine (FT3), free triiodothyronine (FT4), lipid parameters, glycated haemoglobin, thyroid ultrasonography, and cIMT assessment were evaluated. The association of cIMT with different risk factors related to thyroid autoimmunity was determined. Carotid intima-media thickness was significantly greater in T1DM aTPO+ females (0.66 ± 0.10 mm) than in T1DM aTPO- (0.59 ± 0.11 mm) and healthy controls (0.58 ± 0.10 mm) (p = 0.007, p = 0.001, respectively). In all women cIMT was significantly, positively correlated with aTPO (p = 0.005, r = 0.273), Hashimoto's thyroiditis (HT) duration (p = 0.00015, r = 0.367), levothyroxine dose per week (p = 0.006, r = 0.269), and ultrasound features of HT (p = 0.004, r = 0.281) and inversely with fT3 concentration (p = 0.014, r = -0.243) and FT3/FT4 ratio (p = 0.042, r = -0.201). A logistic regression analysis showed that HT duration (OR: 1.102, 95% CI: 1.008-1.206, p = 0.032) and a positive history family of HT (OR: 3.909, 95%CI: 1.014-15.071, p = 0.045) were risk factors for increased cIMT. However, multivariate regression analysis showed that the studied parameters related to thyroid autoimmunity are not independent risk factors for increased cIMT. We expanded the data on cIMT in young women with T1DM and showed that thyroid autoimmunity, and in particular the duration of exposure to anti-thyroid antibodies, despite adequate levothyroxine substitution, is associated with subclinical atherosclerosis in young women with T1DM. However, thyroid-related parameters are not independent risk factors for increased cIMT in euthyroid women.

Effects of vitamin D on thyroid autoimmunity markers in Hashimoto's thyroiditis: systematic review and meta-analysis.

ObjectiveTo perform a meta-analysis of randomized controlled trials to evaluate the efficacy of vitamin D supplementation on thyroid autoimmunity markers in Hashimoto’s thyroiditis (HT).MethodsThis meta-analysis included randomized controlled clinical trials identified by a systematic search of electronic databases (PubMed®, MEDLINE®, EMBASE, The Cochrane Library, China National Knowledge Infrastructure) from inception to August 2020. All studies included patients with HT that received vitamin D supplementation irrespective of the doses administered or the duration of treatment. The primary and secondary outcome measures were thyroid peroxidase antibody (TPOAb) and/or thyroglobulin antibody (TGAb) titres.ResultsEight studies (n = 652) were included. There was significant heterogeneity between the studies. Using a random-effect model, vitamin D supplementation reduced TPOAb titre (standardized mean difference [SMD]: –1.11; 95% confidence interval [CI]: 1–1.92, –0.29) and TGAb titre (SMD: –1.12; 95% CI: –1.96, –0.28). A subgroup analysis demonstrated that vitamin D supplementation for >3 months resulted in a decrease in TPOAb titre (SMD: –1.66, 95% CI: –2.91, –0.41) but treatment ≤3 months was ineffective. Treatment with vitamin D3 decreased TPOAb titre (SMD: –1.48; 95% CI: –2.53, –0.42) whereas vitamin D did not.ConclusionThese data suggest that vitamin D reduces autoantibody titre in patients with HT.

Pretibial myxedema in a euthyroid patient: a case report

BackgroundPretibial myxedema also known as localized myxedema, thyroid dermopathy, or infiltrative dermopathy and rarely as localized mucinosis is an infrequent manifestation of Graves’ disease. It can appear before, during, or after the thyrotoxic state. Euthyroid pretibial myxedema is a rare presentation with few case reports in the literature. This case highlights the importance of considering pretibial myxedema when characteristic skin lesions are observed in a euthyroid patient.Case presentationA 72-year old male Ethiopian patient with a very rare presentation of biopsy-proven pretibial myxedema in a euthyroid state without history of thyroid disease and absence of thyroid autoimmune markers. Resolution of skin lesion was achieved after topical corticosteroid application.ConclusionAbsence of history of thyroid disorder and normal thyroid function tests should not exclude the diagnosis of pretibial myxedema.

Diagnostic and treatment of subclinical hypothyroidism in pregnant and planning pregnancy patients: modern view of the problem

There is no universal diagnostic and treatment strategy of subclinical hypothyroidism (SHT) in pregnant women and those who are planning pregnancy due to differences in population-specific and trimester-specific thyroid-stimulating hormone (TSH) reference values, influence of thyroid autoimmunity markers on pregnancy outcomes, adherence to fixed universal cutoff concentrations TSH in Russia and multidisciplinary team care with different treatment opinions involving. An absence of universal approach to SHT leads to excess treatment, financial and psychological burden on pregnant women.Up to American Thyroid Association (ATA) Guidelines 2017 and project of Clinical Guidelines of Russian Association of Endocrinologists 2019 a treatment strategy of SHT should be left up to the endocrinologist to choose. In our paper we systematize global scientific and clinical experience of planning and management pregnancies with SHT to help physicians to choose treatment option based on principals of evidence-based medicine.

Evaluation of the thyroid disorders in children with familial Mediterranean fever.

Although it is well-known that autoimmune thyroid diseases are more common in most of the autoimmune connective tissue diseases, the relationship between autoinflammatory diseases and autoimmune thyroid diseases has not well-evaluated yet and still remains unclear. The aim of this study was to investigate the frequency of autoimmune diseases of the thyroid gland and to evaluate thyroid function tests in children with familial Mediterranean fever. Thyroxine, thyroid-stimulating hormone, and thyroid autoimmune markers such as thyroid peroxidase and thyroglobulin antibodies, and thyroid ultrasound findings of 133 patients with familial Mediterranean fever and 70 healthy controls were evaluated. Serum levels of thyroid-stimulating hormone, free thyroxine, and thyroid autoimmunity markers were similar in patients with familial Mediterranean fever compared with healthy controls. There was no relationship between the duration of the disease and thyroid-stimulating hormone, free thyroxine, anti-thyroid peroxidase, and anti-thyroglobulin levels. This study revealed that incidence of thyroid dysfunction and autoimmunity is not increased in patients with familial Mediterranean fever. In conclusion, routine screening of serum thyroid function tests and thyroid antibody levels is not required in patients with familial Mediterranean fever in the absence of clinical symptoms or family history. Key Points • It is well-known that autoimmune thyroid diseases are common in autoimmune diseases. • The relationship between autoimmune thyroid diseases and autoinflammatory diseases like familial Mediterranean fever is still unclear. • In this study, we report the similar frequency of the autoinflammatory thyroid diseases in patients with familial Mediterranean fever and healthy controls. • A routine screening of serum thyroid function tests and thyroid antibody levels may not be required in patients with familial Mediterranean fever in the absence of clinical symptoms or family history.

Study the Association between the Thyroid Autoimmunity Markers and Polycystic Ovary Syndrome in Euthyroid Women

Polycystic ovary syndrome during childbearing age is consider as one of the commonest endocrine disease in reproductive age females, with a prevalence of 4% to 15%. The clinical expression of PCOS is variable, but mostly includes anovulation or oligo-ovulation, clinical or biochemical hyperandrogenism and ovarian polycystic picture in U\S. Objective: To determine the levels and prevalence of thyroid antibodies in euthyroid women has PCOS.Patients and method: A case control study carried in the Infertility clinic of the Babylon Teaching Hospital for maternity and children in Al-Hila city, Babylon governorate, /Iraq in the period from October 1, 2018 to the end of Nov. 2019. Results: the current study found a highly statistically significant association between the studied group among the BMI (P 0.05). Eighty percent of the patients (PCOS) group, and 20% in control group presented with family history with thyroid disease. Anti-TG were negative in (85.72%) of the PCOS group patients, 8.57% of the patients with borderline positive and only (5.71%) were positive (>110 IU/ml). TSH level in PCOS group (2.3 ± 0.5) were increase with significant association than that in control group (2.1 ± 0.8), highly significant increase were found in Anti-TPO, Anti-TG, free testosterone and LH in PCOS group than that in control group (P<0.001).Conclusion: There is increased risk of thyroid disease with increase in thyroid Autoimmunity Markers in PCOS patients.

Study the Association between the Thyroid Autoimmunity Markers and Polycystic Ovary Syndrome in Euthyroid Women

Polycystic ovary syndrome during childbearing age is consider as one of the commonest endocrine disease in reproductive age females, with a prevalence of 4% to 15%. The clinical expression of PCOS is variable, but mostly includes anovulation or oligo-ovulation, clinical or biochemical hyperandrogenism and ovarian polycystic picture in U\S. Objective: To determine the levels and prevalence of thyroid antibodies in euthyroid women has PCOS.Patients and method: A case control study carried in the Infertility clinic of the Babylon Teaching Hospital for maternity and children in Al-Hila city, Babylon governorate, /Iraq in the period from October 1, 2018 to the end of Nov. 2019. Results: the current study found a highly statistically significant association between the studied group among the BMI (P&lt;0.001), while no significant association between the studied groups regarding the age (P&gt;0.05). Eighty percent of the patients (PCOS) group, and 20% in control group presented with family history with thyroid disease. Anti-TG were negative in (85.72%) of the PCOS group patients, 8.57% of the patients with borderline positive and only (5.71%) were positive (&gt;110 IU/ml). TSH level in PCOS group (2.3 ± 0.5) were increase with significant association than that in control group (2.1 ± 0.8), highly significant increase were found in Anti-TPO, Anti-TG, free testosterone and LH in PCOS group than that in control group (P&lt;0.001).Conclusion: There is increased risk of thyroid disease with increase in thyroid Autoimmunity Markers in PCOS patients.

Thyroid autoimmunity markers in women with polycystic ovary syndrome and controls

This study was performed to compare the prevalence of autoimmune thyroid disease (AITD) assessed by thyroid peroxidase antibody (anti-TPO Ab) and thyroid ultrasonography (USG) in Korean women with polycystic ovary syndrome (PCOS) (n = 210) and age-matched controls (n =343). We also compared the clinical features of women with PCOS according to the presence of AITD. Patients and controls were enrolled from a population who visited a screening centre for a general health check-up. There was no difference in the frequency of anti-TPO Ab positivity between the women with PCOS and the controls (4.8% (5/104) in patients and 7.6% (18/238) in controls). The frequency of heterogeneous or hypoechoic parenchyma on USG also did not differ between the patients and controls (9.3% (11/118) in patients and 12.3% (40/325) in controls). Within the PCOS group, the subjects with AITD (who had either Ab positivity or sonographic findings compatible with thyroiditis) showed significantly higher body mass indexes, waist circumferences and homeostasis model assessment for insulin resistance levels than the patients without AITD. In conclusion, AITD was not more prevalent in women with PCOS than in controls. However, among women with PCOS, subjects with AITD showed significantly higher adiposity and insulin resistance index than those without AITD.

Follicular fluid thyroid autoantibodies, thyrotropin, free thyroxine levels and assisted reproductive technology outcome.

ObjectiveAlthough there are substantial data linking thyroid autoimmunity (TAI) and infertility, data regarding assisted reproductive technology (ART) outcomes and TAI markers in follicular fluid (FF) of women undergoing ART are scarce. Objective of the study was to assess the association of the levels of thyroid autoantibodies in FF and ART outcome expressed as the achieved pregnancies.MethodsThis study enrolled 52 women undergoing ART (26 TAI positive subjects and 26 age and body mass index matched TAI negative controls). Blood samples were drawn before the initiation of protocol for controlled ovarian stimulation, and thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), thyroid peroxidase antibodies (TPOAbs) and thyroglobulin antibodies (TgAbs) levels were measured. TSH, fT4, TPOAbs, TgAbs and progesterone levels were also measured in FF.ResultsThere were no significant differences between the groups regarding mean levels of FF TSH and FF fT4. Statistically significant correlation was discovered regarding the levels of serum and FF TPOAbs (0,961, p<0.001 in TAI positive, 0,438, p = 0.025 in TAI negative group) and TgAbs (0,945, p<0.001 in TAI positive, 0,554, p = 0.003 in TAI negative group). Pregnancies rates per initiated cycle and per embryotransfer cycle were significantly different between TAI positive and TAI negative group, (30.8% vs 61.5%), p = 0.026 and (34.8% vs 66.7%), p = 0.029, respectively. Multivariate analysis showed that TAI positive women had less chance to achieve pregnancy (p = 0.004, OR = 0.036, 95% CI 0.004–0.347).ConclusionsHigher levels of thyroid autoantibodies in FF of TAI positive women are strongly correlated with serum levels and may have effect on the post-implantation embryo development.

Vitamin D in Hashimoto's thyroiditis and its relationship with thyroid function and inflammatory status.

Several studies have shown the correlation between vitamin D [25(OH)D] deficiency and thyroid autoimmunity and reducing of thyroid autoantibodies in patients with normal levels of vitamin D combining with thyroid hormone replacement. However, other authors not agree with this association. It is still unclear whether the low 25(OH)D levels are the result of HT disease or a part of its cause. We studied 88 patients with HT regarding vitamin D status and thyroid autoimmunity markers as well as the relationship with cytokines produced by Th1, Th2, and Th17 cells compared with a control group of 71 euthyroid healthy subjects. The present study demonstrated that vitamin D concentrations were similar in patients HT and the control group. The reduction of free T4 levels was a predictor of vitamin D insufficiency for Hashimoto's thyroiditis, but not for the control group. Lower concentrations of TNF-α was a predictor of lower levels of vitamin D. Differences in the association between HT and vitamin D insufficiency remain unresolved in the literature. The thyroid hormone status would play a role in the maintenance of vitamin D sufficiency, and its immunomodulatory role would influence the presence of autoimmune thyroid disease. The positive correlation between free T4 and vitamin D concentrations suggests that adequate levothyroxine replacement in HT would be an essential factor in maintaining vitamin D at sufficient levels.

Ioduria and type 1 diabetes mellitus – Relationships to selected clinical markers of diabetes in adults

There is a lack of data on the state of iodine reserves and the possible consequences of iodine deficits in diabetic patients. The main aims of this study were to: a) obtain information about iodine saturation in patients with type 1 diabetes; b) determine to what extent this saturation differs from the non-diabetic population; and c) determine whether iodine levels are related to several clinical and laboratory parameters characteristic of diabetic syndrome, including thyroid status.Subjects and methods: A total of 54 males and 51 females treated for type 1 diabetes mellitus (DM1) were included in this cross-sectional study. In addition to iodine saturation determined as the concentration of iodine in the first urine sample of the day, we measured clinical, anthropometric, and biochemical parameters in relation to DM1.Results: Measured iodine levels were: median 152μg/l, first quartile 117μg/l, and third quartile 219μg/l. More than 50% of iodine levels varied within the optimal saturation range of 100–200μg/l, while about 14% showed incomplete saturation (<100μg/l), and 34% had increased saturation (>200μg/l).Multi-dimensional regression showed significant positive relationships; (an OPLS model explaining 9% of the variability) between ioduria and male sex, body weight and height, and serum creatinine levels, which to date have not yet been published. Relationships to the other analyzed parameters (glycated hemoglobin, insulin dose, DM duration, body mass index, microalbuminuria, glomerular filtration rate, thyroid function and volume, thyroid autoimmune markers) were not significant.Conclusions: Iodine saturation levels in our study group were within the ICCIDD (WHO) recommendations for optimal/good saturation for the non-diabetic population, and patients with diabetic syndrome did not differ with respect to the chosen normal ioduria concentrations, i.e. 100 or 150μg/l. The question remains, however, whether past attempts to deal with iodine deficits in the Czech Republic are responsible for this satisfactory iodine status of the type 1 diabetic population, or if there are other factors involved.

Association between thyroid function tests and anti-thyroid peroxidase (TPO) antibodies in pregnancy.

Anti-thyroid peroxidase (TPO) antibodies are self-developed antibodies that target the membrane-associated hemoglycoprotein, thyroid peroxidase, of the thyroid cells. They are markers of thyroid autoimmunity and are commonly performed in the work-up of Hashimoto thyroiditis (TPO antibodies prevalence: 90 %) and Grave’s disease (TPO antibodies prevalence: 60–80 %). In patients with subclinical hypothyroidism, the finding of TPO antibodies confers an increased risk of progression to overt hypothyroidism. In pregnancy, the presence of TPO antibodies are associated with adverse outcomes, including miscarriage, preterm delivery, subfertility, perinatal mortality, large for gestational age and low birth weight infants and post-partum thyroiditis [1]. A recent meta-analysis has shown that elevated TPO antibodies in pregnant women are associated with significantly increased risk of preterm birth (odds ratio 2.07) and miscarriage (odds ratio 1.80 in case–control studies; odds ratio 3.90 in cohort studies) [2]. The precise mechanism underlying these complications is unclear at present and is an area of research of great activity. In the same meta-analysis, serum thyroid-stimulating hormone (TSH) was found to be 0.51 mIU/L higher in pregnant women with positive TPO antibodies compared to those with negative TPO antibodies. This finding lends support to the hypothesis that women with positive TPO antibodies have relative hypothyroidism. However, the report found insufficient data on free thyroxine (FT4) and free triiodothyronine (FT3) concentrations for meta-analysis to support this observation. The effect of TPO antibodies on intra-partum maternal thyroid function is less well described. Here, we explored the relationship between thyroid antibodies and thyroid hormones in different trimesters, in a large cohort of clinically euthyroid pregnant women.

Association between thyroid autoimmunity and chronic urticaria in patients versus healthy controls

Introduction There is growing evidence that some cases of chronic idiopathic urticaria are associated with various autoimmune diseases such as thyroid autoimmunity. The association between chronic urticaria (CU) and thyroid disorders has been a subject of controversy. Some reports link CU with hyperthyroidism or hypothyroidism. The frequency of thyroid antibodies in patients with chronic idiopathic urticaria reported in 2009 was 30%, which is higher than that previously reported. Objective This is a case-control study that aimed to detect the presence of markers of thyroid autoimmunity (thyroid autoantibodies with or without underlying abnormal thyroid functions) among a cohort of autologous serum skin test (ASST)-positive patients with CU in comparison with ASST-negative CU patients as well as with healthy controls, and correlating it to the severity of urticaria symptoms. Patients and methods This study was carried out on 80 CU patients attending the Allergy and Immunology Clinic of Ain Shams University Hospitals. CU was diagnosed on the basis of the appearance of continuous recurrent hives for more than 6 weeks. The patients were subdivided into the following groups: group A - 40 CU patients with positive ASST; group B - 40 CU patients with negative ASST. In addition, 40 healthy individuals were included in this study as healthy controls. History and general examination were conducted to all study grouos. Assessment of the Urticaria Activity Score-7 and laboratory investigations including those for complete blood count, erythrocyte sedimentation rate, thyroid function, thyroid Abs, namelyantimicrosomal antibody and antithyroglobulin antibody and total immunoglobulin E (IgE), were done. Results Comparison between the three groups showed that antithyroglobulin antibody was highly statistically significant in group A than in both group B and healthy controls. Moreover, antimicrosomal antibody was also found to be of higher statistical significance in group A than in both group B and healthy controls. Although total IgE had no statistical significance between groups A and B, total IgE was found to be statistically significantly higher in group B than in healthy controls. Level of thyroid stimulating hormone was higher in group A than in controls, and free T3 was lower in group A than in group B. Conclusion We suggest that thyroid diseases have a role in CU, which was confirmed by a higher level of thyroid antibodies in the ASST-positive group than in ASST-negative patients and healthy controls.

Autoimmune thyroid disorders in seropositive versus seronegative rheumatoid arthritis

Background Autoimmune diseases are chronic conditions initiated by the loss of immunological tolerance to self-antigens; they represent a heterogeneous group of disorders that afflict specific target organs or multiple organ systems. Autoimmune thyroid disease (AITD) is a common organ-specific autoimmune disorder affecting mostly middle-aged women. AITD is a term that includes various clinical forms of autoimmune thyroiditis; among these diseases, Hashimoto's thyroiditis and Graves' disease are the two most common types and share many features immunologically. Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to severe disability and premature mortality. Given the same pathogenic mechanisms, autoimmune diseases tend to cluster together, and hence this study was designed to investigate the relationship between AITD and RA, particularly seropositive versus seronegative subtypes. Patients and methods The study included 70 patients with evidence of RA. Their diagnosis was based on the 2010 American College of Rheumatology (ACR)-EULAR classification criteria, and they were subclassified into two groups: group I, comprising 35 patients with seropositive RA (positive to one or both seromarkers), and group II, comprising 35 patients with seronegative RA (negative to both seromarkers). Twenty healthy age-matched and sex-matched controls constituted group III. All of the studied participants underwent detailed history-taking and physical examination, focusing on RA duration of illness, clinical features suggestive of thyroid dysfunction, and disease activity score (DAS28). We determined the complete blood count, erythrocyte sedimentation rate, C-reactive protein, urea, creatinine, alanine aminotransferase, aspartate aminotransferase, thyroid stimulating hormone (TSH), serum total T3 (TT3), serum total T4 (TT4), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), anti-thyroid peroxidase (anti-TPO), thyroglobulin Ab, and TSH receptor antibody (TRAb) levels, and also performed a neck ultrasound. Results It was found that erythrocyte sedimentation rate, C-reactive protein, RF, and anti-CCP were significantly higher in RA patients versus controls, particularly in seropositive versus seronegative patients. No significant difference was found between the studied groups as regards TSH, T3, and T4 levels; however, hypothyroidism was found to be more common than hyperthyroidism in RA patients (29 vs. 3% in group I and 9% in group II). Anti-TPO and antithyroglobulin were significantly higher in RA patients versus controls (P Conclusion Thyroid dysfunction and AITD are common in RA patients, with hypothyroidism being the most common disorder, which is prevalent in 29% of patients regardless of their serostatus. This association was independent of disease activity assessed by DAS28. Increased incidence of thyroid autoimmunity was seen in seropositive RA versus seronegative RA patients, as evidenced by higher levels of thyroid autoimmune markers in the former. TRAbs were detectable in a small subset of patients with RA.

Abstract 4103: Biomarkers of thyroid function and autoimmunity associated with thyroid cancer risk: A nested case-control study

Abstract Background &amp; Objective: The incidence of thyroid cancer has been increased in several countries. However, the markers to predict for high-risk group have not been fully established. We aim to investigate the potential association between the biomarkers of thyroid function/autoimmunity and the risk of thyroid cancer in Korean population, where the incidence rate of thyroid cancer is one of the highest in the world. Design: This study was a nested case-control study within the Cancer Screenee Cohort study, which consisted of 257 incident thyroid cancer patients who were ascertained during mean of 2.2 years of follow-up and 257 controls. Total triidothyronine (TT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and thyroglobulin (Tg), and two markers of thyroid autoimmunity (anti-thyroperoxidase [TPOAb] and anti-thyroglobulin [TgAb] antibodies) were measured. Logistic regression models were used to examine the association between these biomarkers and thyroid cancer risk. Stratified analyses were conducted by sex, BMI, and smoking status. Results: When the markers were categories by tertile distribution of the levels of controls group, highest tertile of FT4 (OR [95% CI] = 1.73[1.11, 2.69]) and middle tertile of TSH (OR [95% CI] = 1.77[1.14, 2.74]) were associated with thyroid cancer risk in multivariate analyses. In addition, normal (30-60 U/mL) (OR [95% CI] = 8.47 [5.39, 13.33]) or elevated levels (60 &amp;gt; U/mL) (OR [95% CI] = 4.48 [2.59, 7.76]) of TPOAb showed an elevated risk for thyroid cancer. Stratified analyses implied that some of these associations could be differed by sex, BMI, or smoking status. Conclusions: This study represented that the levels of biomarkers of thyroid function/autoimmunity, particularly the presence of TPOAb, may be used as diagnostic adjuncts for predicting thyroid cancer risk. Citation Format: Jeongseon Kim, Young Ae Cho, Aesun Shin, Jeonghee Lee, Sun-Young Kong, Eun Kyung Lee, You Jin Lee. Biomarkers of thyroid function and autoimmunity associated with thyroid cancer risk: A nested case-control study. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4103. doi:10.1158/1538-7445.AM2014-4103

Detection of thyroid autoimmunity markers in euthyroid women with polycystic ovary syndrome: a case-control study from syria.

Background:Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women in reproductive age. In many cases, PCOS is associated with infertility and increased risk of miscarriage. Recent studies have detected the presence of several organ specific and nonspecific autoantibodies in women with PCOS.Objectives:The aim of this study was to evaluate the prevalence and levels of thyroid antibodies in euthyroid women with PCOS in Syria.Patients and Methods:This study included 56 euthyroid women with PCOS and 30 healthy women as a control group. PCOS was defined according to the revised 2003 Rotterdam criteria. Thyroid function was evaluated by measurement of serum TSH and FT4 levels. Antithyroid peroxidase and antithyroglobulin antibodies (anti-TPO and anti-TG, respectively) were detected as markers for thyroid autoimmunity. All parameters were measured using electrochemiluminescence immunoassay.Results:Women with PCOS had higher serum levels of anti-TPO in comparison to controls (39.9 ± 59.5 and 18.9 ± 11.2 IU/mL, respectively; P < 0.05) and no significant difference was found in serum levels of anti-TG, TSH, or FT4 between the two groups. Patients with PCOS had a higher prevalence of positive results for anti-TG and/or anti-TPO in comparison to controls (28.6% and 3.3%, respectively; P<0.05), anti-TPO alone (19.6% and 3.3%, respectively; P < 0.05) and anti-TG alone (21.4% and 3.3%, respectively; P < 0.05). No significant associations were found between antibodies and studied hormones.Conclusions:High prevalence of thyroid antibodies in euthyroid patients with PCOS refers to the importance of investigation for thyroid autoimmune state in those patients.

Serum-negative autoimmune thyroiditis: what’s in a name?

Chronic autoimmune thyroiditis (CAT) is the main cause of hypothyroidism in the general population. Autoantibodies to thyroperoxidase (TPO) and to thyroglobulin (Tg) are the circulating hallmark of this autoimmune thyroid disease. Positive tests for TPO Ab and Tg Ab are present in nearly 90 (TPOAb) and 60 % (Tg Ab) of hypothyroid patients with CAT. This implies that despite the high sensitivity of modern assay methods for thyroid auto Ab, there still is a considerable number of patients presenting with hypothyroidism in whom the humoral markers of thyroid autoimmunity are found to be negative. The widespread use of ultrasound in the diagnostic work-up of thyroid diseases allowed to ascertain that most of these patients display a hypoechoic pattern of the thyroid at ultrasound [1]. Further characterization of this echographic finding indicated that this peculiar echopattern is mainly due to lymphocytes infiltrating the thyroid parenchyma, as confirmed by fine needle aspiration biopsy. On this basis, a new clinical entity was identified, the so-called serumnegative chronic autoimmune thyroiditis (SN-CAT). There are no published studies on large series of patients with SN-CAT, which however is not a rare clinical entity. Although epidemiologic data are lacking, the prevalence of the disease can be roughly estimated at around 5 % of patients presenting with hypothyroidism by taking into consideration the rate of hypothyroid patients showing positive tests for thyroid autoantibodies in published studies [2]. It is likely that in the last two decades, a raise in the prevalence of SN-CAT occurred due to the routine use of ultra-sensitive TSH measurements, which increased the detection rate of patients with subclinical hypothyroidism, and to the widespread use of ultrasound in clinical endocrine practice. A brief discussion on the mechanisms involved in autoimmune thyroid diseases may provide arguments for explaining the physiopathology of SN-CAT. Early studies showed that TPO Ab fix complement and bind TPO expressed on the thyroid cell membrane, thus producing in vitro complement-mediated cytotoxicity of cultured human thyroid cells [3]. However, the notion that in vivo TPO is expressed at the inner follicular pole of thyroid cells, where it is un-accessible to circulating TPO-Ab, clearly indicated that the cytotoxic effect of these autoantibodies is a secondary phenomenon, only occurring when the follicle integrity is already disrupted by auto-reactive T cells. Studies in mothers with circulating TPO Ab confirmed this assumption, because their newborns had a normal thyroid gland in spite of the trans-placental passage of TPO Ab [4]. Nowadays, an array of experimental data demonstrate the prominent pathogenic role of cellular immune responses in autoimmune thyroid diseases and the involvement of proinflammatory cytokines and chemokines in producing thyroid cell apoptosis [5]. Thus, it became evident that chronic autoimmune inflammation does not require the presence of auto-Ab to induce thyroid damage [5]. Whichever its physiopathology, when SN-CAT leads to hypothyroidism there is no difference in treating the condition as compared to treating hypothyroidism due to any other etiology. On the other hand, several methodological and clinical aspects should be taken into consideration to render a correct diagnosis of SN-CAT. This is mainly based on the occurrence of a raised serum TSH associated with a hypoechoic pattern of the thyroid parenchyma at M. Rotondi F. Coperchini F. Magri L. Chiovato (&) Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, Fondazione Salvatore Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, 27100 Pavia, Italy e-mail: luca.chiovato@fsm.it

Nonalcoholic fatty liver disease in a cluster of Iranian population: thyroid status and metabolic risk factors.

This study aimed to investigate the prevalence, metabolic risk factors, and thyroid dysfunction among a healthy urban population. In a cross-sectional study, the patients were evaluated for nonalcoholic fatty liver disease (NAFLD) using ultrasonography. The participants' characteristics such as age, sex, weight, height, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, systolic and diastolic blood pressure, and history of diabetes, ischemic heart disease (IHD), hypertension, and hyperlipidemia were recorded using a data gathering form. The patients were compared to those without NAFLD in terms of metabolic factors and thyroid abnormalities. From 832 participants, 127 (15.3%) individuals had NAFLD. Metabolic syndrome was detected in 39 participants (30.70 %) with NAFLD and in 85 participants (12.05%) without NAFLD (P < 0.001) (OR: 3.22; 95 % CI: 2.07-5.01). In multivariate logistic regression analysis BMI, waist-to-hip ratio, and higher serum ALT levels were independent predictors for NAFLD (P < 0.001). There was no statistically significant difference in serum TSH, free T4, and free T3 levels between the participants with NAFLD and the participants without NAFLD (P > 0.05). Neither hypothyroidism nor markers of thyroid autoimmunity were associated with NAFLD in our study population (P > 0.05). Serum TSH was categorized according to 25th, 50th, and 75th percentile to <1.29 mIU/L, 1.29-1.91 mIU/L, 1.91-2.77 mIU/L, and >2.77 mIU/L. Compared with non-NAFLD participants, the diagnosis of NAFLD was significantly higher in the low TSH group (P = 0.004). Central obesity as reflected by waist-to-hip ratio is one of the major risk factors for NAFLD. However, thyroid dysfunction was not correlated with NAFLD and the observed alterations in thyroid hormones are due to sick euthyroid syndrome.