Mean Free T4 Research Articles

Iodine and Thyroid Function Status, and Anti-thyroid Peroxidase Antibody among Pregnant Women in Eastern Nepal.

Iodine deficiency, thyroid dysfunction and development of thyroid autoimmunity during pregnancy may affect mother and the developing fetus. This study was carried out to find iodine status, thyroid dysfunction and thyroid autoimmunity among pregnant women. Ninety two pregnant women from three districts of eastern Nepal (Sunsari, Morang and Jhapa) were enrolled for the study, and urine and blood samples were collected. Urinary iodine concentration (UIC), free thyroxine (free T4), thyroid stimulating hormone (TSH), thyroglobulin and anti-thyroid peroxidase (TPO) antibody levels were estimated. The median UIC, mean free T4 and TSH, median thyroglobulin and anti-TPO antibody in the pregnant women were 282.2 (158.42-376) μg/L, 1.14±0.41 ng/dL, 4.57±2.56 IU/mL, 6.5 (4.0-11.0) ng/mL, 1.52 (0.97-2.23) IU/mL respectively. In sufficient (<150 μg/L), adequate (150-249 μg/L) and above requirements (250-499 μg/L) iodine intake was observed in 17 (18.5%), 22 (23.9%) and 53 (57.6%) women respectively. Subclinical hypothyroidism and overt hypothyroidism were seen in 18 (19.5%) and 1(1.1%) women, respectively. Elevated thyroglobulin (>40 ng/mL) and positive anti-TPO antibody was observed in three (3.26%) women for both. Iodine intake was sufficient among pregnant women recently, however, chronic iodine deficiency persisted in small fraction of pregnant women. Mild thyroid dysfunction was common, and thyroid autoimmunity was present in small portion of Nepalese pregnant women population.

Association between thyroid function and lipid profiles, apolipoproteins, and high-density lipoprotein function

Thyroid hormone regulates lipid metabolism. In particular, it has been reported to regulate plasma high-density lipoprotein cholesterol (HDL-C) levels and the activity of molecules involved in HDL metabolism. We investigated changes in the concentrations of lipids and apolipoproteins and in the function of HDL according to acute dynamic changes in thyroid function. Concentrations of plasma lipids and apolipoproteins, paraoxonase-1 activity, and cholesterol efflux were measured in 27 patients with differentiated thyroid carcinoma who underwent total thyroidectomy and radioactive iodine (RAI) treatment, at 3 distinct times: After surgery (baseline subclinical hyperthyroid state), on the day of undergoing RAI treatment (overt hypothyroid state), and 3 months post-RAI treatment (subclinical hyperthyroid state). The mean free T4 and thyroid-stimulating hormone concentrations were 0.24±0.06ng/dL and 91.2 (77.8-118.2) μIU/mL, respectively, on the day of RAI treatment. Total cholesterol, triglyceride, low-density lipoprotein cholesterol, and apoB levels, and the apoA-I/II ratio were significantly increased in the overt hypothyroid state and recovered to baseline values with levothyroxine replacement. HDL-C and apoE levels were persistently elevated despite levothyroxine replacement. Paraoxonase-1 activity, corrected for apoA-I, decreased in the overt hypothyroid state but recovered with levothyroxine replacement (P=.009). Cholesterol efflux also decreased significantly in the overt hypothyroid state (21.5±5.1% vs 18.9±2.9%, P=.005), but remained low despite recovery of thyroid function. Changes in thyroid function are associated not only with changes in the concentrations of various plasma lipid components but also with changes in HDL function.

MP17-06 THYROID HORMONES AND BENIGN PROSTATIC HYPERPLASIA

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Basic Research & Pathophysiology1 Apr 2017MP17-06 THYROID HORMONES AND BENIGN PROSTATIC HYPERPLASIA Jun Ho Lee, Young Bin Kim, Gyeong Eun Min, and Dong-Gi Lee Jun Ho LeeJun Ho Lee More articles by this author , Young Bin KimYoung Bin Kim More articles by this author , Gyeong Eun MinGyeong Eun Min More articles by this author , and Dong-Gi LeeDong-Gi Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.595AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Thyroid hormones play an important role in cell differentiation, growth, and metabolism. Several investigators have documented the role of thyroid hormones in the development of prostate cancer. However, to date there are only limited data available regarding thyroid hormone levels in benign prostatic hyperplasia (BPH). METHODS A total of 5708 men aged 40 to 59 years who had participated in a health examination were included in the study. Lower urinary tract symptoms (LUTS)/BPH were assessed by international prostate symptom score (IPSS), prostate volume, maximal flow rate (Qmax), and a full metabolic workup. Serum levels of thyroid-stimulating hormone (TSH) and free thyroxine (T4) were measured using chemiluminescence immunoassay by commercial kits. We divided participants into quartiles based on their TSH and free T4 levels: first quartile, Q1; second quartile, Q2; third quartile, Q3; and fourth quartile, Q4. We then investigated their relationship using the chi-squared test, the Cochran-Armitage trend test, logistic regression analyses, and a propensity score matched case-control study. RESULTS The mean age of the study group was 51.1 ± 5.2 years, and the mean free T4 and median TSH were 1.05 ± 0.14 and 1.44 (0.96-2.13)ng/mL, respectively. In addition, the ratio of metabolic syndrome and low testosterone (<3.5 ng/mL) were 41.9% and 11.8%, respectively. There was a significant increase in the percentage of men with IPSS>7, Qmax<10 mL/sec, and prostate volume ≥30 mL, with increase of free T4 quartile (IPSS>7(%): Q1:57.2, Q2:56.7, Q3:60.3, Q4:62.5, P=.001; Qmax<10 mL/sec(%): Q1:3.5, Q2:3.2, Q3:4.1, Q4:4.8, P=.038; total prostate volume ≥30 mL(%): Q1:15.2, Q2:16.4, Q3:18.0, Q4:19.3, P=.002). After adjusting for age, body mass index, testosterone, and metabolic syndrome, the odds ratio for prostate volume ≥30 mL of free T4 Q3 and free T4 Q4 were significantly higher than free T4 Q1 [odds ratio; 5-95 percentile interval), P value; Q1:.000 (references); Q2:1.140(.911-1.361), P=.291; Q3:1.260 (1.030-1.541), P=.025; Q4:1.367(1.122-1.665), P=.002]. After adjusting for age, body mass index, testosterone, metabolic syndrome, and prostate volume, the odds ratio for IPSS>7 of free T4 Q4 were significantly higher than that of free T4 Q1 (odds ratio (5-95 percentile interval), P value; Q1:.000 (references); Q2:.969 (.836-1.123), P=.677; Q3:1.123 (.965-1.308), P=.133; Q4:1.221 (1.049-1.420), P=.010). However, the odds ratio for Qmax<10 mL/sec was not significantly different between free T4 quartile groups after adjusting confounding factors. In propensity score matched analysis (matched for age, metabolic syndrome, testosterone, and body mass index at a 1:1 ratio), 1362 cases (Q4 of free T4) and 1362 control subjects (Q1, Q2, and Q3 of free T4) were included for comparison. The ratio of prostate volume ≥30 mL (15.1% vs. 19.3%, P = .004) and mean prostate volume (23.7±6.7 vs. 24.6±7.3 mL, P=.001) was higher in the case group than in the control group. Qmax and IPSS were not different between case and control groups. TSH was not significantly related to IPSS, Qmax, and total prostate volume in univariate and multivariate analyses. CONCLUSIONS Prostate volume, IPSS, and Qmax are significantly related to free T4, and prostate volume is significantly and independently related to total prostate volume in this study. We found a potential role of thyroid hormone in developing BPH. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e213-e214 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jun Ho Lee More articles by this author Young Bin Kim More articles by this author Gyeong Eun Min More articles by this author Dong-Gi Lee More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

PERUBAHAN KADAR IODIUM URIN, TSH, DAN T4 BEBAS PADA WUS SETELAH PEMBERIAN GARAM DOSIS 30-35 ppm KIO3

Background. In several countries, iodine deficiency has been turned into iodineexcess. These iodine excess due to poor monitoring of iodine concentration onsalt, which cause high and uneven iodine rations. The objective of the study wasto determine if intervention of 30-35 ppm iodized salt improves UIE, TSH and fT4level in childbearing age women. Methods. This is a quasi-experimental study byproviding 30-35 ppm KIO3 iodized salt for 6 months on childbearing age women inIDD mild endemic area (n=71). The control group were only measured by iodine saltconsumption of each monthly used (n=76). The study conducted in in Bener villagePurworejo. Urinary iodine concentration (UIC), TSH and fT4 were measured atbaseline and endline. TSH and fT4 level were measured using ELISA method. UIEwas analysed using APDM method. Result. Subject characterisitcs of each groupare not much different. Iodine concentration median (range) of treatment group andcontrol group were 149 (20-400) μg/ L and 160 (28 – 698) μg/ L, respectively. MeanTSH level which were normal before intervention (3.03 ± 1.19 μIU/ ml vs 2.52 ±1.29 μIU/ ml), improved significantly after intervention compared to the control group(2.03 ± 1.28 μIU/ ml vs 2.71 ± 1.66 μIU/ ml). Mean free T4 level which were normalbefore intervention (1.29 ± 0.29 ng/ dl vs 1.32 ± 0.24 ng/ dl), decreased significantlyafter intervention compared to the control group (1.04 ± 0.24 ng/ dl vs 1.18 ± 0.43ng/ dl). Conclusion. 30 – 35 ppm iodized salt Intervention for 6 months was able toprovide iodine requirement, improve level of TSH and maintain level of fT4 in normallevel.Keywords: iodine urine concentration, iodized salt intervention, thyroid function,women of childbearing age

The effect of growth hormone replacement on the thyroid axis in patients with hypopituitarism: in vivo and ex vivo studies.

Alterations in the hypothalamic-pituitary-thyroid axis have been reported following growth hormone (GH) replacement. The aim was to examine the relationship between changes in serum concentration of thyroid hormones and deiodinase activity in subcutaneous adipose tissue, before and after GH replacement. A prospective, observational study of patients receiving GH replacement as part of routine clinical care. Twenty adult hypopituitary men. Serum TSH, thyroid hormones - free and total thyroxine (T4) and triiodothyronine (T3) and reverse T3, thyroglobulin and thyroid-binding globulin (TBG) levels were measured before and after GH substitution. Changes in serum hormone levels were compared to the activity of deiodinase isoenzymes (DIO1, DIO2 and DIO3) in subcutaneous adipose tissue. The mean daily dose of growth hormone (GH) was 0·34 ± 0·11 mg (range 0·15-0·5 mg). Following GH replacement, mean free T4 levels declined (-1·09 ± 1·99 pmol/l, P = 0·02). Reverse T3 levels also fell (-3·44 ± 1·42 ng/dl, P = 0·03) and free T3 levels increased significantly (+0·34 ± 0·15 pmol/l, P = 0·03). In subcutaneous fat, DIO2 enzyme activity declined; DIO1 and DIO3 activities remained unchanged following GH substitution. Serum TSH, thyroglobulin and TBG levels were unaltered by GH therapy. In vitro analysis of subcutaneous adipose tissue from hypopituitary human subjects demonstrates that GH replacement is associated with significant changes in deiodinase isoenzyme activity. However, the observed variation in enzyme activity does not explain the changes in the circulating concentration of thyroid hormones induced by GH replacement. It is possible that deiodinase isoenzymes are differentially regulated by GH in other tissues including liver and muscle.

Effect of Subclinical Hypothyroidism on the Mean Platelet Volume of Pregnant Women

Subclinical hypothyroidism (SH) is a frequently seen clinical disorder, which needs to be managed strictly in the pregnant population. SH is closely related with newborn complications and also suggested to be risk factor for cardiovascular events. Mean platelet volume (MPV), a determinant of platelet function, is a newly emerging risk marker for cardiovascular events. The aim of this study was to evaluate how MPV values and other hematological parameters are influenced in pregnants with subclinical hypothyroidism. A total of 70 subclinical hypothyroidic pregnants and 40 euthyroid pregnant controls were enrolled in our study. Age, body mass index (BMI), erythrocyte and platelet parameters were all evaluated. Erytocyte parameters and thrombocyte parameters, including MPV, were not statistically significantly different between pregnants with SH and healthy pregnants (p>0.05). Mean free T3 and TSH levels of subclinical hypothyroidic pregnants were statistically significantly different from healthy pregnant (p=0.04 and p

Breed-specific reference intervals for assessing thyroid function in seven dog breeds.

Thyroxine (T4), free T4 (FT4), and thyrotropin (TSH) concentrations were measured in serum from 693 healthy representatives from 7 dog breeds (Alaskan Malamute, Collie, English Setter, Golden Retriever, Keeshond, Samoyed, or Siberian Husky) to determine whether breed-specific reference intervals (RIs) are warranted. Veterinarians reviewed the health history, performed a physical examination, and approved laboratory data for the enrolled dogs. Many purebred dogs had T4 and FT4 concentrations that were at, or below, the lower limits previously determined for non-breed-specific RIs. Mean concentrations of T4, FT4, and TSH varied significantly among breeds. The range of mean concentration of T4 (19.7 nmol/L [1.53 µg/dL] in English Setters to 29.0 nmol/L [2.25 µg/dL] in Keeshonds) and FT4 (12.6 pmol/L [0.98 ng/dL] in English Setters to 20.2 pmol/L [1.57 ng/dL] in Samoyeds) was considerable. Median TSH values ranged from 6.10 mIU/L (0.07 ng/mL; Alaskan Malamute and Golden Retriever) to 17.6 mIU/L (0.26 ng/mL; Collie). Mean T4 and FT4 concentrations were higher in females. Increasing age was associated with decreasing T4 and FT4, and increasing TSH concentration. The substantial ranges across breeds of measures of central tendency (mean, median) for all hormones indicate that breed-specific RIs are warranted. RIs encompassing the central 95% of reference values for all breeds combined, and for individual breeds, were calculated using nonparametric (TSH) and robust (T4, FT4) methods. Use of breed-specific RIs in combination with careful attention to the potential for pre-analytical and analytical variability in test results will improve thyroid function assessment in these breeds.

High prevalence of subclinical hypothyroidism and nodular thyroid disease in patients on hemodialysis.

Chronic kidney disease has been known to affect thyroid hormone metabolism. Low serum levels of T3 and T4 are the most remarkable laboratorial findings. A high incidence of goiter and nodules on thyroid ultrasonography has been reported in patients with end-stage renal disease (ESRD). Our objective is to evaluate the prevalence of laboratorial and morphologic alterations in the thyroid gland in a cohort of patients with ESRD on hemodialysis (HD). Sixty-one patients with ESRD on HD were selected and compared with 43 healthy subjects matched by age, gender, and weight. Patients were submitted to thyroid ultrasonography. T3, free T4 (FT4), thyroid-stimulating hormone, antithyroglobulin, and antithyroperoxidase antibodies were measured. The mean age of patients with ESRD was 47.4 ± 12.3 and 61% were women. ESRD was mainly caused by hypertensive nephrosclerosis and diabetic nephropathy. Mean thyroid volume, as determined by ultrasonography, was similar in both groups. Patients with ESRD had more hypoechoic nodules when compared with the control group (24.1% vs. 7.9%, P = 0.056). Mean serum FT4 and T3 levels were significantly lower in patients with ESRD, and subclinical hypothyroidism was more prevalent in patients with ESRD (21.82% vs. 7.14% control group, P = 0.04). Titers of antithyroid antibodies were similar in both groups. ESRD was associated with a higher prevalence of subclinical hypothyroidism and lower levels of T3 and FT4. Almost a quarter of patients showed thyroid nodules >10 mm. Periodic ultrasound evaluation and assessment of thyroid function are recommended in patients with ESRD on HD.

Health Information-Seeking Behavior Among Hypothyroid Patients at Saveetha Medical College and Hospital.

Hypothyroidism causes considerable morbidity. Low knowledge coupled with inadequate health literacy may lead to poor prevention and management. This study aimed to assess health information-seeking behavior and hypothyroid knowledge among South Indian hypothyroid patients. This cross-sectional study was conducted in October 2013 in Saveetha Medical College, Chennai, India. Hundred clinically diagnosed hypothyroid patients ≥18 years were interviewed in a hospital using a 57-item questionnaire to gather information on their socio-demographics, self-reported disease history, hypothyroid-related knowledge, health information sources, health literacy and health information-seeking behavior. Hypothyroidism was assessed by free T3 and T4 levels. Mean age of participants was 38 years (SD=12) with median age of 39.5 years, majority of the participants being females (77%) and living in urban setting (52%). Mean free T3 level was 0.0137ng/dl (SD= 0.003) and mean free T4 was 0.7ng/dl (SD= 0.06). Ninety three percent of the participants received initial hypothyroidism education from their physicians at the time of diagnosis. Half of the participants had incorrect hypothyroidism-related knowledge; similar between both genders. Participants with inadequate health literacy had poor knowledge about the hypothyroidism. Hypothyroidism-related health information was sought almost exclusively from health professionals, predominantly regarding treatment, linked to their faith in qualified medical assistance. Economic status primarily determined healthcare-seeking behavior. Marital status, education level, annual household income and health literacy were significantly associated with knowledge. Participants having higher educational qualification, higher annual household income and adequate health literacy had considerable knowledge about hypothyroidism. Developing multi-factorial and tailored health education for patients with marginal or inadequate health literacy is needed. Exploring healthcare institutions as a medium for delivery of such education should be explored.

AB0892 Evaluation of Thyroid Function in Children with Familial Mediterranean Fever

BackgroundFamilial Mediterranean fever (FMF) is the most frequent hereditary autoinflammatory disease, characterized by recurrent self-limited attacks of fever and polyserositis. The development of renal amyloidosis type AA is the most...

Thyroid Disease and Indicator of Autoimmune Illness among Vitiligo Patients

Background: The precise pathogenesis remains not fully understood. However, it is thought to involve an autoimmune process directed against melanocytes. Thyroid disorders and autoimmune thyroid diseases have been shown in some reports to be associated with vitiligo. Additionally, there is limited and conflicting data examining the association of antinuclear antibodies (ANA) with vitiligo. Methods: We conducted a cross-sectional study among 50 vitiligo patients diagnosed according to established clinical criteria at King Khalid University Hospital, Riyadh from January 2008 through December 2010. Blood samples were obtained from the study participants and were tested for antinuclear antibodies (ANA), thyroid stimulating hormone (TSH) and free thyroxin hormone (T4). Results: Males represented 62% and the mean age was 28.2±11.0 years. A total of 20 (41.7%) had positive ANA values (titer ≥1:40). The mean TSH level was 2.69±2.17 µIU/mL. The mean free T4 level was 16.40±2.74 pmol/L and all patients were in the normal range (10.3-25.8 pmol/L). There were no statistically significant associations between ANA and age, gender, extent of skin lesion, face inclusion, and free thyroxin levels. On the other hand, positive ANA level had significant association with TSH level (p=0.041). With exception of ANA, TSH level had no statistically significant associations with the above variables. Conclusions: The results of the current study showed higher prevalence of ANA in vitiligo patients, probably suggesting autoimmune process. The current finding may need to be confirmed in a larger prospective multicentric study before recommending periodic screening of patients with vitiligo for thyroid function and antithyroid antibodies.

Long-term outcomes of pediatric Graves’ disease

Remission rates with antithyroid drugs (ATDs) in pediatric Graves' disease (GD) are low. Very few studies report long-term follow-up of GD especially into adulthood. We studied long-term outcomes of pediatric onset GD, including a follow-up into adulthood and factors associated with need for definitive therapy. Sixty-five patients (57 females) with GD, with onset <18 years (median 13, range, 3.5-17) and duration ≥2 years (median 7; range, 2-22) since diagnosis, were included. Medical records were reviewed, and current details were recorded in a questionnaire by telephonic interview. All patients were initially treated with ATDs. Fifty-three patients were treated for ≥2 years. Amongst these, outcomes included relapse after initial remission (n=38), failure of remission (n=8) and long-term remission, defined as remission lasting ≥4 years (n=6). One patient had carbimazole and surgery but died of hepato-renal failure secondary to systemic vasculitis. A total of 44/65 patients were managed with definitive treatment. Those needing definitive treatment had higher mean free T4 (54.6±23.7 vs. 39.5±20.5 pmol/L, p=0.02) and thyrotropin receptor antibody (TRAB) titers (34.1±19.3 vs. 13.8±9.9 IU/L p<0.0001). Long-term sequelae included need for thyroxine replacement (n=42, 64.6%), persistent goiter (12/62, 19.3%) and persistent ophthalmopathy (19/40, 47.5%). Long-term remission rates of pediatric onset GD with ATDs are very low, especially with longer follow-up. Higher pretreatment free T4 and high TRAB titers predict need for definitive treatment.

Dental amalgam implantation and thyroid autoimmunity

Mercury was heavily studied as a factor in the autoimmune processes. We aimed to observe whether mercury of amalgam is associated with Hashimoto disease. 363 patients with Hashimoto's thyroiditis and 365 control subjects were included in to the study. Amalgam fillings were checked by the physician. 363 (49.9 %) patients and 365 (50.1 %) healthy controls were included into the study. Hashimoto's thyroiditis was diagnosed with thyroid hormones, antithyroid antibody levels, and ultrasonographic findings. Control subjects were selected from patients with no known autoimmune diseases. They were controlled with ultrasonography, as well as antibody titers. None of them had Hashimoto's thyroiditis. Sex distribution of the study population was following: 319 (87.9 %) female, 44 (12.1 %) male in the patient group and 277 (75.9 %) male and 88 (24.1 %) female in healthy control subjects, respectively. Mean free T4 values for Hashimoto's thyroiditis and healthy control group were 15.30±0.76, 17.30±0.96 pmol/L and mean TSH values for Hashimoto's thyroiditis and healthy control group were 9.29±20.79, 1.20±0.32 uIU/ml. Frequency of dental amalgam implantation in patients with Hashimoto's thyroiditis was not statistically significantly different from healthy controls (p=186) (t=-1.324) CONCLUSIONS: Some studies identified mercury of amalgam as responsible for autoimmune thyroiditis. We studied whether amalgam fillings are more frequent in Hashimoto's thyroiditis patients and whether it is a causative factor for Hashimoto's thyroiditis. Statistical analysis revealed that there is no relation of amalgam with Hashimoto's thyroiditis (Tab. 1, Ref. 34).

English

BACKGROUND: Sick euthyroid syndrome is an undermined entity seen in many chronic illness. CKD is one of the forerunners in terms of magnitude in the list of chronic illnesses. Also there is evidence of abnormal thyroid metabolism at several levels in uremia. Hence the need to evaluate thyroid function in CKD patients exists, as revealed by recent studies. AIMS: To study thyroid function test in patients of chronic renal failure. Also, to study the correlation between thyroid function test and severity of renal failure, defined by creatinine clearance. MATERIALS & METHODS: In a cross sectional observational case control study, 50 patients of chronic renal failure either on conservative management or on maintenance haemodialysis and 50 normal healthy subjects as control were enrolled. Creatinine clearance was calculated by Cockcroft - Gault Equation. Thyroid function tests were done by C.L.I.A (Chemiluminescence Immunoassay). RESULTS: Of the 50 patients (M:F - 58:42%), with a mean age 40.58 ± 12.65 years, 28 (56%) were on conservative management, 22 (44%) were on hemodialysis for a minimum period of three months. All patients were clinically euthyroid. Thyroid function tests were normal (all parameters within normal range) in 13 (26%) patients. However 37 (74%) out of 50 patients of CKD had deranged thyroid function test (sick euthyroid syndrome). Mean Total T3 in patients of CKD and controls were 71.52 ± 27.88ng/dl and 95.34 ± 16.31ng/dl respectively (p < 0.005). Mean Free T3 in patients of CKD and controls were 2.19 ± 0.70pg/ml and 3.23 ± 0.79pg/ml respectively (p < 0.005). Mean Total T4 in patients of CKD and controls were 6.03 ± 1.60µg/dl and 6.88 ± 1.06µg/dl respectively (p < 0.005). Mean Free T4 in patients of CKD and controls were 1.18 ± 0.55ng/ml and 1.29 ± 0.24ng/dl respectively (no statistically significant difference). Mean TSH in patients of CKD and controls were 2.90 ± 1.39 vs. 2.81 ± 0.99µIU/ml respectively (no statistically significant difference). On applying correlation statistics, no statistically significant correlation was found between creatinine clearance and thyroid function test (r NS). Similarly, no statistically significant correlation was found between blood urea, serum creatinine, and various thyroid function test. CONCLUSION: Our study indicated low Total T3, Free T3 and Total T4 levels in 74% CKD patients as compared to controls. However, Free T4 and TSH level were found to be comparable to controls. Deranged thyroid function in patients of CKD could be due to sick euthyroid syndrome. No statistically significant correlation was

Iodine intake during pregnancy: Effects on thyroid function in mother and child

Abstract Introduction Recent studies in Spain have shown an inadequate iodine intake in a significant proportion of pregnant women. Pregnancy increases thyroid hormone requirements, and adequate iodine intake is therefore needed. Material and methods One hundred and forty-seven women in their third trimester (week 37) of pregnancy provided a blood sample and a 24-h urine sample to test serum and urine iodine levels and completed a food frequency questionnaire to assess iodine intake during pregnancy. Serum TSH levels were measured in the babies born to the 140 mothers in the postpartum group. Results Only 10.9% of pregnant women consumed more than 250 μg iodine daily, and 24.4% of them consumed less than 100 μg daily. Mean free T4 levels were 9.37 pmol/L, and 74 women (54.41%) had levels below the hypothyroxinemia threshold. TSH levels were normal in 135 newborns (96.4%), while 5 (3.6%) had levels higher than 5 μU/mL.

Assessment of thyroid functions in patients with chronic obstructive pulmonary disease

BackgroundChronic obstructive pulmonary disease (COPD) is no longer considered to affect only the lungs and airways but also the rest of the body. The systemic manifestations of COPD include a number of endocrine disorders, such as those involving the pituitary, the thyroid, the gonads, the adrenals and the pancreas. The severity of airway obstruction in chronic obstructive pulmonary diseases (COPD) is associated with the impairment of thyroid gland function. Aim of workThis study was carried out to evaluate thyroid abnormalities in patients with COPD and relationship between pulmonary function tests, arterial blood gases and thyroid functions. Patients and methodsSerum free triiodothyronine (ft3), free thyroxin (ft4), and thyroid stimulating hormone(TSH) were measured in 50 patients with COPD and 50 healthy volunteers (control group) and its relation to some ventilatory function tests (FEV1/FVC, FEV1, FVC%, and FEF25-75) and ABG parameters (PH, Paco2, Pao2, Hco3 and O2 saturation) were studied. ResultsThere was no significant difference in mean levels of TSH, FT3 and FT4 between COPD and control group. The mean values of free T3, free T4, and TSH were within normal limits in both groups however, free T3 values in the case group were toward upper normal limits and the mean values of free T3 were increased in the case group compared to their values in the control group. The mean values of free T3 of the cases were significantly increasing with increased severity of COPD. Significant negative correlations were present between free T3 levels and pulmonary function tests of the cases. Significant negative correlations were present between free T3 levels and both PaO2 and SO2 of the cases and also show a significant positive correlation between free T3 levels and PaCO2 of the cases. ConclusionThyroid function tests among COPD patients showed a significant increase of the mean free T3 values and a non significant decrease of the mean free T4 and TSH values compared to the control group. With increasing severity of COPD, the mean free T3 values showed a significant increase. Significant negative correlations were noticed between free T3 levels and both PaO2 and SO2 of the cases. A significant positive correlation was observed between free T3 levels and PaCO2 of the cases. Significant negative correlations were observed between free T3 levels and pulmonary function tests of the cases.

Ingesta de yodo durante el embarazo: efectos en la función tiroidea materna y neonatal

IntroductionRecent studies in Spain have shown an inadequate iodine intake in a significant proportion of pregnant women. Pregnancy increases thyroid hormone requirements, and adequate iodine intake is therefore needed. Material and methodsOne hundred and forty-seven women in their third trimester (week 37) of pregnancy provided a blood sample and a 24-hour urine sample to test serum and urine iodine levels and completed a food frequency questionnaire to assess iodine intake during pregnancy. Serum TSH levels were measured in the babies born to the 140 mothers in the postpartum group. ResultsOnly 10.9% of pregnant women consumed more than 250μg iodine daily, and 24.4% of them consumed less than 100μg daily. Mean free T4 levels were 9.37pmol/L, and 74 women (54.41%) had levels below the hypothyroxinemia threshold. TSH levels were normal in 135 newborns (96.4%), while 5 (3.6%) had levels higher than 5μU/mL.

Thyroid Autoimmunity and Behçet’s Disease: Is There a Significant Association?

Background. Behcet's disease (BD) could be regarded as an autoimmune disease in many aspects. Autoimmune thyroid disease (ATD) is frequently accompanied by other various autoimmune diseases. Nevertheless, there is not still enough data showing the association between BD and ATD. In addition, no controlled study is present in the PubMed, which evaluates thyroidal autoimmunity using antithyroid peroxidase antibody in a large series of patients with BD. Methods. We aimed to investigate the frequency of ATD in patients with BD. The study included 124 patients with BD and 99 age- and sex-matched healthy volunteers. Results. Autoimmune thyroiditis was noted in 21 cases (16.9%) with BD. In the control group, 22 cases (22.22%) were diagnosed as autoimmune thyroiditis. There was no difference between the groups in respect to thyroid autoantibodies (P > 0.05). There were no statistically significant differences between baseline TSH levels of the BD patients and of the controls (P > 0.05). Statistically, the mean serum free T4 levels of the patients with BD were higher than those of the controls (P < 0.001). Conclusions. No association could be found between BD and ATD. Therefore, it is not of significance to investigate thyroid autoimmunity in BD.

Determinants of Extraocular Muscle Volume in Patients with Graves' Disease

Background. To examine factors contributing to extraocular muscle (EOM) volume enlargement in patients with Graves' hyperthyroidism. Methods. EOM volumes were measured with orbital magnetic resonance imaging (MRI) in 39 patients with recently diagnosed Graves' disease, and compared to EOM volumes of 13 normal volunteers. Thyroid function tests, uptake on thyroid scintigraphy, anti-TSH-receptor antibody positivity and other parameters were then evaluated in patients with EOM enlargement. Results. 31/39 patients had one or more enlarged EOM, of whom only 2 patients had clinical EOM dysfunction. Compared to Graves' disease patients with normal EOM volumes, those with EOM enlargement had significantly higher mean serum TSH (0.020 ± 0.005 versus 0.007 ± 0.002 mIU/L; P value 0.012), free-T4 (52.9 ± 3.3 versus 41.2 ± 1.7 pmol/L; P value 0.003) and technetium uptake on thyroid scintigraphy (13.51 ± 1.7% versus 8.55 ± 1.6%; P value 0.045). There were no differences between the 2 groups in anti-TSH-receptor antibody positivity, the proportion of males, tobacco smokers, or those with active ophthalmopathy. Conclusions. Patients with recently diagnosed Graves' disease and EOM volume enlargement have higher serum TSH and more severe hyperthyroidism than patients with normal EOM volumes, with no difference in anti-TSH-receptor antibody positivity between the two groups.

Minimally invasive parathyroidectomy for primary hyperthyroidism guided by intra-operative parathyroid hormone monitoring

s / International Journal of Surgery 10 (2012) S1–S52 S32 ABSTRACTS course of IA mean free T4 was 30 pmol/L and 11.4 pmol/L respectively (range: 9.4 to 22.7 pmol/L). There were no adverse effects to IA. Therewere no complications following surgery. Conclusions: Iopanoic acid is safe and effective in rapidly controlling thyrotoxicosis prior to total thyroidectomy. 0623: SESTA-MIBI SCANS, CAN THEY PREDICT INTRATHYROID PARATHYROID ADENOMA? Rachel French, R.K. Maitra, Vijay Kurup. North Tees University Hospital, Stockton-on-Tees, UK Aim: To evaluate the role of sesta-mibi scans in predicting intrathyroidal parathyroid adenoma in primary hyperparathyroidism. Method: Retrospective analysis of parathyroidectomies performed in a distric general hospital during the last 6 years(2005-11). Sesta-mibi scans were performed pre-operatively in all patients with primary hyperparathyroidism. Where no adenoma was identified during exploration of neck, a hemithyroidectomy was performed on the side suggested by sestamibi scan. Results: 78 patients had exploration of neck, 82% female, 18% male, with a mean age 62 years. Sestamibi was positive in 60 patients and 54 had parathyroid adenoma identified on exploration. 6 patients after a failed neck exploration underwent hemithyroidectomy . Histology revealed intrathyroidal parathyroid adenoma in 5 patients(83%) . Out of 18 patients with negative scans 14 had an adenoma removed. Sestamibi scans had a sensitivity of 81% and positive predictive value of 98.3%. Conclusion: Sestamibi scan helped to identify 5patients with intrathyroidal parathyroid adenoma when neck exploration was negative. When no adenoma is visible on exploration a hemithyroidectomy at the side suggested by the scan is justified. 0681: MINIMALLY INVASIVE PARATHYROIDECTOMY FOR PRIMARY HYPERTHYROIDISM GUIDED BY INTRA-OPERATIVE PARATHYROID HORMONE MONITORING Alison Lyon , O.O. Komolafe , Christopher Wilson . University of Sydney, Sydney, Australia; Western Infirmary, Glasgow, UK Aim: Intra-operative parathyroid hormone (PTH) levels can demonstrate successful removal of a parathyroid adenoma during minimally invasive parathyroidectomy. However, this technique remains controversial due to variations in blood sampling and excision criteria. In this study, we explored the success rate of our technique. Methods: A consecutive series of 92 patients with histologically confirmed primary hyperparathyroidism was analysed retrospectively. All were treated with a minimally invasive technique. Serum PTH levels were checked prior to gland removal and twenty minutes after gland removal to confirm a decrease of greater than 50%, which was considered to indicate a curative procedure. Results: The median pre-operative PTH level was 14.35ng/L (interquartile range (IQR) 10.7-20.3). The two week post operative median level was 5.4ng/L (IQR 3.4-7) and median adjusted calcium level was 2.39mmol/L (IQR 2.28-2.5). The average intraoperative PTH decrease was 75.6%. Of the 92 patients, 8 (8.7%) required multiple gland removal due to adenoma location differing to that indicated by preoperative imaging (3 were retrosternal). The biochemical cure rate within this cohort was 98%. 2 patients had no intraoperative PTH drop and persisting hypercalcaemia. They underwent further imaging and curative surgery. Conclusion: Intra-operative PTH monitoring is a useful adjunct to minimally invasive parathyroidectomy. 0721: PATIENT OUTCOME FOLLOWING LAPAROSCOPIC BILATERAL ADRENALECTOMY Carol Watson, Craig Parnaby, Patrick ODwyer. Gartnavel General Hospital,