Mean T4 Research Articles

Prolonged TSH receptor A subunit immunization of female mice leads to a long-term model of Graves' disease, tachycardia, and cardiac hypertrophy.

A transient model for human Graves' disease was successfully established in mice using up to 3 immunizations with recombinant adenovirus expressing the extracellular A-subunit of the human TSH receptor (TSHR) (Ad-TSHR). We studied extension of adenovirally induced TSHR A-subunit immunization in mice by using a novel protocol of long-term 3- and 4-weekly injections. Generation of TSHR binding stimulatory antibodies (capacity to stimulate cAMP activity in TSHR-expressing test cells), goiter, and histological thyroid alterations were maintained for at least 9 months in all Ad-TSHR-immunized mice. In response to injection of 10(10) plaque-forming units of Ad-TSHR, also elevated mean serum T4 levels were observed throughout the study. Moreover, cardiac organ involvement (tachycardia and hypertrophy) were consistently observed in these mice. Higher doses of Ad-TSHR (10(11) plaque-forming units) did not produce consistent elevation of T4 and were not associated with a clear increase in heart rate vs controls, probably because these high doses provoked an immune response-induced tachycardia on their own. In summary, a long-term model of Graves' disease induced by a relatively simple protocol of continuing monthly immunizations should allow to investigate long-term disease mechanisms and may possibly obviate the need for more complicated disease models. Moreover, the clinical outcome predictor of tachycardia and cardiac involvement was reliably detected in the model.

Thyroid hormones and prolactin levels in infertile women in southern Nigeria.

Human infertility is a complex global health problem. It has multiple social consequences which are especially profound for thyroid hormones in infertility with the aim of determining the degree of association of thyroid hormones with hyperprolactinemia in our population. The serum levels of prolactin, T3, T4 and TSH were determined in 90 hyperprolactinemic infertile women, 90 normoprolactinemic infertile women and 50 fertile women. The hormones were assayed using Enzyme Linked Immunosorbent Assay kits. Analysis of variance and Pearson's correlation were used to analyze the data, with the significant p-level set at 0.05. A significantly higher mean serum prolactin and TSH were observed among the infertile groups compared to the fertile controls (p<0.05). The mean serum T3 and T4 were significantly lower in the hyperprolactinemic infertile women compared to the fertile controls (p<0.05). The mean TSH and T3 of normoprolactinemic infertile women and controls were comparable (p>0.05). However, the mean T4 was significantly lower in normoprolactinemic infertile women compared to the fertile controls (p<0.05). In all the groups, TSH correlated inversely with T3 and T4, while T3 correlated positively with T4. It was only in the control group that prolactin correlated positively and significantly with TSH. It is therefore concluded that hyperprolactinemia with thyroid dysfunction may be a major contributory hormonal factor in infertility among infertile women and as such, estimation of prolactin, T3, T4 and TSH should be included in the workup for infertile women especially those with hyperprolactinaemia.

Thyroid dysfunction and autoantibodies in first degree relatives of North Indian children with autoimmune thyroiditis

Background: Family studies in developed countries show an increased prevalence of thyroid autoantibodies in first degree relatives of children with autoimmune thyroiditis (AIT). Such data is scarce from developing country setups. Materials and Methods: Thyroid profiles and autoantibodies were evaluated in 50 first degree relatives of 50 children with AIT. Results: Eleven (22%) subjects had raised thyroid stimulating hormone (TSH); 4 fathers (42.5%), 3 mothers (12%), 1 brother (33%) and 3 (23%) sisters. Three (6%) showed thyroid profiles consistent with hypothyroidism. Levels of triiodothyronine (T 3 ) were raised in 7 (28%) mothers and 2 (15.4%) sisters while 2 (8%) mothers and 3 (23.1%) sisters also had increased thyroxine (T 4 ) levels; none had low TSH or clinical evidence of hyperthyroidism. Anti-thyroid peroxidase (TPO) antibodies were positive in 9 (18%) subjects; 4 mothers (4/25, 16%) 3 fathers (3/9, 33%) and 2 sisters (2/13, 15.4%). Mean T 3 levels were lower, mean T4 were similar and mean TSH levels were higher in TPO-positive as compared TPO-negative subjects. Anti-Tg antibody positivity was found in 32 (64%) subjects; 14 (56%) mothers, 7 (77.7%) fathers and 11 (84.6%) sisters. Mean thyroid hormone levels were similar in Anti-Tg positive and negative subjects. Two (8%) mothers, 1 (7.7%) sister and 2 (22.2%) fathers had both antibodies in their serum; their thyroid profiles were similar to subjects with anti-TPO positivity. Conclusions: Thyroid dysfunction is present in first degree relatives of North Indian children with AIT. Anti-TPO antibodies are less common but have strong correlation with thyroid dysfunction. Conversely, anti-thyroglobulin (TG) antibodies are commonly detected but correlate poorly with thyroid dysfunction.

Environmental, urinary iodine status and prevalence of goitre among schoolchildren in a high altitude area of Saudi Arabia.

Objective:This study aimed to assess the iodine deficiency, prevalence of goitre among schoolchildren and measuring environmental iodine in Taif city, Saudi Arabia.Methods:A cross-sectional multistage cluster-sampling methodology was done on 1887 schoolchildren. Their urinary iodine concentration (UIC) and goitre prevalence was assessed. Blood level of triiodothyronin, thyroxine and thyroid-stimulating-hormone was carried out for students with normal, mild; moderate and sever iodine deficiency. The iodine content of salt, water and soil was also assessed.Results:Goitre prevalence was 7.4% and about 71% of the participants had UIC less than 100μg/L. An inverse relationship between median UIC and the percent prevalence of goitre was found. The mean serum T3, T4 and TSH were 1.05ng/dL, 6.81µg/dL, and 5.69mIU/L, respectively. A significant positive correlation was found between the mean value of urinary iodine and the mean value of both T3 and T4. While a significant negative correlation between the mean value of urinary iodine and the mean value of TSH was also noted.Conclusions:The results revealed the presence of a potential public health problem of iodine deficiency among school going children in high altitude areas of Saudi Arabia. There is a need to monitor and evaluate the salt iodization process, and distribute adequately iodized salt in the affected areas.

Prenatal exposure to endocrine disrupting chemicals in relation to thyroid hormone levels in infants - a Dutch prospective cohort study.

BackgroundEndocrine disrupting chemicals (EDCs) present in the environment may disrupt thyroid hormones, which in early life are essential for brain development. Observational studies regarding this topic are still limited, however as the presence of chemicals in the environment is ubiquitous, further research is warranted. The objective of the current study was to assess the association between exposure markers of various EDCs and thyroxine (T4) levels in newborns in a mother-child cohort in the Netherlands.MethodsExposure to dichlorodiphenyldichloroethylene (DDE), three di-2-ethylhexyl phthalate (DEHP) metabolites, hexachlorobenzene (HCB), polychlorinated biphenyl (PCB)-153, perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) was determined in cord plasma or breast milk, and information on T4 levels in heel prick blood spots was obtained through the neonatal screening programme in the Netherlands. Linear regression models were composed to determine associations between each of the compounds and T4, which were stratified for gender and adjusted for a priori defined covariates.ResultsMean T4 level was 86.9 nmol/L (n = 83). Girls in the highest quartile of DDE and PFOA exposure showed an increased T4 level compared to the lowest quartile with both crude and fully adjusted models (DDE > 107.50 ng/L, +24.8 nmol/L, 95% CI 0.79, 48.75; PFOA > 1200 ng/L, +38.6 nmol/L, 95% CI 13.34, 63.83). In boys a lower T4 level was seen in the second quartile of exposure for both PFOS and PFOA, however after fully adjusting the models these associations were attenuated. No effects were observed for the other compounds.ConclusionDDE and perfluorinated alkyl acids may be associated with T4 in a sex-specific manner. These results should however be interpreted with caution, due to the relatively small study population. More research is warranted, as studies on the role of environmental contaminants in this area are still limited.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-106) contains supplementary material, which is available to authorized users.

Autoimmune Thyroid Disorders in Patients With Vitiligo

Background: Vitiligo is a common skin pigmentation disorder affecting 0.5-2% of the general population. The pathogenesis of vitiligo is not well-known; however, some evidences have shown the role of autoimmune processes. Increased prevalence of thyroid autoimmune disorders in patients with vitiligo has been reported. Objectives: We aimed to assess the prevalence of autoimmune thyroid disorders among patients with vitiligo who referred to Sina Hospital of Hamadan in west of Iran in 2008. Patients and Methods: This case-control study comprised 45 patients with vitiligo and 45 healthy individuals (control group). Data on age, gender, family history of vitiligo, distribution pattern and duration of the disease were collected through a questionnaire. Fasting blood samples of the patients were tested to measure blood thyroid stimulating hormone (TSH), thyroxin (T4), and anti-thyroid peroxidase (anti-TPO) levels. Results: The mean ages of cases and controls were 30.71 ± 4.8 and 30.31 ± 3.7 years old, respectively. Totally, 86.7% of cases had generalized lesions. In 32.2% of cases, trunk was the first involved region. Average duration of the disease was 7.76 years. The mean T4 level was 1.55 ± 0.27 pmol/L in case and 1.48 ± 0.22 pmol/L in control groups. The mean blood TSH levels were 1.94 ± 1.42 mIU/L in case and 2.8 ± 6.51 mIU/L in control groups and the mean anti-TPO levels were 136.82 ± 45.54 and 86.87 ± 23.05 IU/mL in case and control groups, respectively. None of the aforementioned differences were statistically significant. Conclusions: Our findings showed that the small difference in thyroid test results between the two groups was not statistically significant. According to our findings, patients with vitiligo were not at a higher risk for either autoimmune or functional thyroid disorders in comparison with the healthy ones.

PO-0357 Prenatal Exposure To Endocrine Disrupting Chemicals (edcs) In Relation To Thyroid Hormone Levels In Infants

Background The presence of chemicals in the environment is ubiquitous. EDCs in particular may disrupt thyroid hormones, which in early life are essential for brain development. As observational studies regarding this topic are still limited, the objective of the current study was to assess the association between prenatal exposure to various EDCs and thyroxine (T4) levels in newborns in a mother-child cohort in the Netherlands. Methods Exposure to amongst others dichlorodiphenyldichloroethylene (DDE), perfluorooctanesulfonic acid (PFOS), and perfluorooctanoic acid (PFOA) was determined in cord plasma or breast milk, and information on T4 levels in heel prick blood spots was obtained through the Dutch neonatal screening programme. Linear regression models were composed for each compound and T4. Models were stratified for gender and adjusted for a priori defined covariates. Results Mean T4 level was 86.9 nmol/L (n = 83). Girls in Q4 of DDE and PFOA exposure showed an increased T4 level compared to Q1, a difference which remained significant in the fully adjusted model (DDE ≥ 110.01 ng/L, +22.2 nmol/L, 95% CI 1.37, 43.04; PFOA ≥ 1201 ng/L, +30.7 nmol/L, 95% CI 13.38, 48.05). In boys a lower T4 level was seen in Q2 for both PFOS and PFOA, however after adjusting the models these associations were attenuated. Conclusion DDE, PFOS and PFOA were associated with T4 in a sex-specific manner. As the study population was relatively small, results should be considered as exploratory. More research is warranted, as studies on the role of exposure to environmental contaminants in thyroid hormone homeostasis are still limited.

Thyroid function profile in cord blood and postnatal changes at 24 and 72hours in healthy term Nigerian neonates

Background: Studying the acute postnatal changes of newborn thyroid function is essential for determining the best timing of screening for congenital hypothyroidism. There is paucity of literature on neonatal thyroid function and particularly the postnatal changes in Nigeria.Objectives: To describe the profile of thyroid function in cord blood and the postnatal changes at 24hours and 72hours in healthy term neonates delivered in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.Subjects and methods: This was a prospective, descriptive and cross sectional study conducted over a six month period (between July-December 2009). Forty seven consecutively delivered healthy term neonates had their serum T3, T4, TSH assayed at birth, 24 and 72hours using the Enzyme linked immunosorbent assay (ELISA) technique. Data obtained are presented as mean, median and standard deviation (SD). Paired- t- testwas used for statistical inference.Results: The mean (SD) of the serum hormone concentrations in cord blood, and venous blood at 24hours and 72hours, respectively were as follows: T3, 0.58 (0.56) nmol/l, 1.15 (0.77)nmol/l, 0.83 (0.74)nmol/l; T4, 91 (83.1)nmol/l, 121.5 (106.4)nmol/l, 104.2 (84.2) nmol/l; and TSH, 5.95 (5.81)mU/l, 8.61 (8.34)mU/l, 2.52 (2.61) mU/ l.. The mean serum T3, T4 and TSH at 24hours were higher than cord blood levels (p&lt;0.001, 0.03, 0.05 respectively). The mean serum T3 and T4 at 72hours, were higherthan cord blood levels (p = 0.07, 0.44), whereas TSH at 72hours was significantly lower than cord blood levels; (p&lt;0.001).Conclusions: There was a rise, above cord level, of T3, T4 and TSH at 24hours, and a decline at 72hours, the latter being most marked in TSH. It is recommended that serum TSH taken at or greater than 72hours of life may be utilized for screening for congenital hypothyroidism in term babies,using postnatal age appropriate reference ranges. Serum T3, T4 should then be assayed for confirmation in all neonates with a positive TSH screening.Key words: Thyroid profile, postnatal changes, Term, Healthy neonates.

Profile of umbilical cord blood TSH ,T4 and influence of perinatal factors on thyroid functions in Newborns

Background: Congenital Hypothyroidism, if not treated well in time, may be disastrous for growth and development of child ,therefore early detection of congenital hypothyroidism is important, either by TSH or T4, or both by newborn screening . Influence of several perinatal factors have to be considered while interpreting values of thyroid functions in newborns. The present study is to determine Umbilical cord blood TSH and T4 profile in Newborns and to study influence of Perinatal factors on Umbilical cord blood TSH and T4 . Methods: Umbilical cord blood samples were collected for assessment of TSH and T4 in 830 newborns. The influence of Perinatal factors such as gestational age ,weight, sex, mode of delivery, Ecclampsia, Ante partum haemorrhage , Birth Asphyxia ,Premature rupture of membranes and maternal HIV status on the newborns TSH ,T4 were analyzed . Results: Mean TSH and T4 levels between Pre term and Term and between Term and Post term was statistically significant .Whereas, only T4 level between Preterm and Post term ,was statistically significant . Mean TSH levels, when compared in babies with & without severe birth asphyxia was also statistically significant . Other perinatal factors did not affect cord TSH and T4 levels ,as it was not statistically significant . Conclusion: Perinatal factors have influence over values of Cord blood TSH and T4 levels and a caution in their interpretation should be considered . Key words: TSH (Thyroid stimulating hormone), CH (Congenital Hypothyroidism), APH (Ante Partum Hemorrhage).

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 hormone changes in early kidney transplantation and its correlation with delayed graft function.

Thyroid hormones affect kidney function and may alter with changes in kidney function, as well. We evaluated changes in serum levels of triiodothyronine (T3), thyroxin (T4), and thyroid-stimulating hormone (TSH) early after kidney transplantation and their relationship with delayed graft function (DGF). Fifty-five consecutive kidney allograft recipients were enrolled in the study. Serum levels of T3, T4, and TSH were measured on the day before transplantation, and also on posttransplant days 1, 3, 7, 14, and 21. Results were compared between patients with a normal allograft function and those with DGF. The mean T3 level decreased from 110.41 +/- 49.79 ng/dL before transplantation to 80.78 +/- 51.42 ng/dL on the 1st day after transplantation (P = .04), while T4 reduction reached a significant level on the 3rd day after transplantation (8.27 +/- 3.27 microg/dL to 5.50 +/- 2.57 microg/dL, P = .004). Patients with DGF experienced a significantly greater decrease in the serum level of T3 at the end of the 1st week after transplantation compared with patients with normal kidney function (P = .02). This significant decrease in T3 continued until the end of the 2nd week. Serum levels of T4 reduced comparably in the two groups, until the end of the 1st week, when it showed a significantly more reduction in the patients with DGF (P = .04). Both T3 and T4 reduced early after kidney transplantation, and this reduction was significantly more prominent in those with DGF. This is compatible with a consequence rather than a cause of DGF, explained in the setting of sick euthyroid syndrome.

Energy Metabolism and Thyroid Function of Mice with Deleted Wolframin (Wfs1) Gene

There is no data about the energy metabolism of patients with Wolfram syndrome caused by mutations in the wolframin (Wfs1) gene. The aim of this study was to investigate the role of Wfs1 in energy metabolism and thyroid function in Wfs1 deficient mice (Wfs1KO). 16 male (8 Wfs1KO, 8 wild type (wt)) and 16 female (8 Wfs1KO, 8wt) mice aged 11-13 weeks were studied alone in a specific metabolic cage for 48 h. Body weight, food, water and O2 consumption, motor activity, CO2 and heat production of mice were recorded. At the age of 14-20 weeks, plasma levels of thyroxine (T4), TSH and leptin were measured and histology of thyroid tissues examined. Mean CO2 and heat production was not different between the groups. Mean O2 consumption was higher in the Wfs1KO females compared to the Wfs1KO males (3 410.0±127.0 vs. 2 806.0±82.4 ml/kg/h; p<0.05), but not compared to the wt mice. The mean movement activity was not different between the groups except that the Wfs1KO females reared up more often than the wt females (199.8±63.46 vs. 39.26±24.71 cnts/48 h; p<0.05). Both male and female Wfs1KO mice had significantly lower body mass and food intake than wt mice. Male Wfs1KO mice also lost more weight in metabolic cage than wt males (20.43±0.41 vs. 16.07±0.86%; p<0.05) indicating more pronounced response to isolation. Male Wfs1KO mice had significantly lower levels of plasma leptin than wt male mice (3.37±0.40 vs. 5.82±0.71 ng/ml; p<0.01). Thyroid function measured by serum TSH and T4 levels was not different between Wfs1KO and wt groups, but both Wfs1KO and wt male mice had significantly higher mean T4 levels than female mice. The histology of thyroid tissue of Wfs1KO males showed a trend to a smaller mean number of epithelial cells per follicle than the wt male mice.Although Wfs1KO mice were smaller and lost more weight during the experiment, their energy metabolism was not different from wt mice except that the female Wfs1KO mice consumed more O2. As mice in this study were relatively young, longitudinal studies in older mice are necessary to clarify whether Wfs1 has a role in energy metabolism when the disease progresses further.

Indirect estimation of age-related reference limits of thyroid parameters: A cross-sectional study of outpatients’ results

Objectives. Defining adequate reference limits (RLs) for thyroid hormones is an important task for support monitoring and the treatment of subclinical thyroid disease. We determined whether there are age-related RLs for thyroid parameters in male and female outpatients free of overt thyroid disease. Design. We analyzed 22,860 results (11,440 male and 11,420 female outpatients above the age of 18) for thyrotropin (TSH), free thyroxine (fT4) and total triiodothyronine (T3) that were stored in our laboratory information system between 2008 and 2011. We calculated the 2.5th and 97.5th centiles for the analyzed thyroid parameters. Results. Our results indicate higher TSH levels with ageing, with a significant difference (p < 0.05) between the 97.5th centiles for males and females older than 70 (5.07 mIU/L and 4.10 mIU/L), but also a significant difference between male and female fT4 from 31 to 40 and from 41 to 50 years old (18.4 vs 14.9 pmol/L and 19.0 vs 15.9 pmol/L, p < 0.05), respectively. Overall indirect estimates of the 97.5th centiles for TSH for males and females were not significantly different and were below the generally recommended upper limit (4.01 mIU/L and 4.20 mIU/L, respectively). In addition, we found no statistically significant change in mean T3 values in the analyzed population. Conclusions. This cross-sectional study indicates change in TSH and fT4 levels with ageing and gender-related upper limits. This suggests that by using indirect estimation a laboratory could provide clinicians with more accurate gender- and age-specific RLs for thyroid parameters.

English

BACKGROUND: Beta-thalassemia syndromes are a group of hereditary blood disorders characterized by reduced or absent beta globin chain synthesis, resulting in transfusion dependent severe anemia, leading to iron overload, resulting in hypothyroidism as the most common endocrine problem. OBJECTIVE: There is lack of information about frequency of hypothyroidism in thalassemic patients in central part of India, so this was undertaken to determine the frequency of hypothyroidism in patients suffering from homozygous s-thalassemia and to study its correlation with serum ferritin and transfusion index. METHOD: This descriptive study included 60 diagnosed thalassemia major patients aged 2-18 years. Demographic data as well as history of blood transfusion, from which transfusion index was estimated, was taken. Serum total T3, T4 and TSH by sandwich ELISA method using Eliscan kit, serum ferritin level by sandwich ELISA method using Accu-bind kit were measured from fasting blood sample. Hypothyroidism was defined by a TSH level >6.4μIU/ml. RESULTS: Study of the thyroid panel among all 60 patients showed a mean TSH level of 4.65±2.41 μIU/ml. Mean total T3 and total T4 levels were 1.35±0.48 ng/ml and 7.4±1.93 μg/dl respectively. Mean serum ferritin level was 557.25±198.66 ng/dl. Hypothyroidism was detected in 14 (23.33%) out of 60 β thalassemia patients. Out of these, compensated hypothyroid (normal T3 and T4 with raised TSH) was seen in 9 patients (15%) and decompensated hypothyroid (Decrease T3 or T4 and Raised TSH) was seen in 5 patients (8.33%). There was significant positive correlation of TSH levels with serum ferritin levels, age and transfusion index. However total T3 and total T4 did not show any correlation with serum ferritin levels, age or transfusion index. CONCLUSION: Hypothyroidism, are more common in second decade of life. Early recognition and hence prevention of these complications will definitely help to improve both the longevity & quality of life of these patients.

JOURNAL OF PEDIATRIC CRITICAL CARE

Title-Alterations of thyroid function in critically ill children Aims & Objective- To study thyroid hormonal changes in critically ill children and correlate them with outcome. Methods-In this prospective study total serum T3, T4and TSH levels were estimated at admission and at discharge or prior to death in fiftycritically ill cases admitted to PICU.Fifty healthy children were taken as controls. PRISMII score was used to predict outcome. Hormone levels were compared between cases and control and then between survivors and non survivors. Results- Mean T3 (59.86±16.09 vsl23.04±26.21)and T4 levels (5.38±1.30vs8.70±1.82) in cases were significantly (P-0.000) lower than that of controls,however no significant difference in the mean TSH values (2.21±1.91 vs2.18±1.06) were noted. Fourteen (28%) cases expired. Admission T3 level (44.71±13.35 Vs65.75±l3.01) was significantly (p-0.000) lower in non survivors than survivors but there was no significant difference in T4 (4.86±1.57Vs5.57±1.15) and TSH(2.17±1.69 Vs 2.28±2.12 ) levels. Serum T3 (65.75±13.01vs96.36±25.48),T4(5.57±1.15vs8.52±3.19) andTSHlevels(2.28±2.12 vs3.06±1.61)improved in survivors butfailed to improve innon survivors. LowT3 and T4 at admission were associated with high risk of mortality (odds ratio 14.8, p-0.000). PRISMII score and T4 in second sample were significant predictors of death. Conclusioii-In critically ill children T3, T4 levels are low, while TSH values may not change. T3 levels reflect patient’s clinical status and T4 levels can predict death.

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.

Thyroid function in type 2 diabetes mellitus and in diabetic nephropathy.

Diabetic patients have higher prevalence of thyroid disorders than the general population which may have an influence on diabetic management. The present study compared the levels of thyroid hormones, serum creatinine, glycated haemoglobin and urine microalbumin between type 2 diabetics without any complications, type 2 diabetics with nephropathy and age and sex matched normal controls. The mean serum T3 level in type 2 diabetics without any complications was 91.27 ± 14.56 ng/dl , in type 2 diabetics with nephropathy was 88.5320 ± 30.87 ng/dl and in controls was 134.98 ± 28.55 ng/dl. The mean serum T4 level in type 2 diabetics without any complications was 7.73 ± 1.42 μg/dl, in type 2 diabetics with nephropathy was 7.25 ± 2.72 μg/dl and in controls was 8.61 ± 1.73 μg/dl. The mean serum TSH level in type 2 diabetics without any complications was 3.99 ± 1.87 μIU/ml, in type 2 diabetics with nephropathy was 4.27 ± 1.62 μIU/ml and in controls was 2.07 ± 1.09 μIU/ml. Correlations between T3, T4, TSH with serum creatinine, glycated haemoglobin were not statistically significant in type 2 diabetes without any complications and diabetic nephropathy. We found a statistically significant correlation between T3 and urine microalbumin in patients with diabetic nephropathy. Failure to recognize the presence of abnormal thyroid hormone levels may be a primary cause of poor management of diabetes mellitus type 2. Therefore there is a need for the routine assay of thyroid hormones in type 2 diabetics and diabetic nephropathy in order to improve the quality of life and reduce the morbidity.

Association of Psoriasis Severity with Serum Prolactin, Thyroid Hormones, and Cortisol before and after Treatment

Background. Prolactin (PRL) level is proposed to be associated with the severity of psoriasis although the previous studies reported different results. Objective. To find the association between PRL levels and severity of psoriasis before and after treatment. In addition, we aimed to find a difference in prolactin, thyroid stimulating hormone (TSH), thyroid hormones (T3 and T4), and cortisol levels between patients with psoriasis and normal controls. Methods. First, the levels of hormones were measured in 30 patients with psoriasis and 30 matched controls. The severity was assessed by psoriasis area and severity index (PASI). Then, patients were treated, and PASI was assessed every week until achieving PASI-75 response. At this time, the hormones were measured again and compared to the baseline. Results. No statistical significant difference was observed in the mean PRL, T3, T4, TSH, and cortisol levels between cases and controls. Comparing to the baseline, a significant decrease in PRL levels and a significant increase in T3 and serum cortisol levels were observed after treatment (P < 0.05), while the changes in other hormones were not significant. Conclusion. After treatment, PRL significantly decreased, and T3 and cortisol levels significantly increased. No correlation between hormone levels and improvement of PASI score existed.

A levothyroxine dose recommendation for the treatment of children and adolescents with autoimmune thyroiditis induced hypothyroidism

To determine a levothyroxine (T4) dose recommendation for the treatment of autoimmune thyroiditis (AIT)-induced hypothyroidism. T4 doses in 75 children and adolescents with newly diagnosed AIT were prospectively collected and compared to T4 doses of patients with congenital hypothyroidism (CH, n=22). Sixty-four patients with AIT and 22 patients with CH were included in the analysis. The thyroid-stimulating hormone declined significantly from 25.8 ± 50.1 to 2.1 ± 1.5 μIU/mL (AIT group; p<0.01) and from 338.7 ± 380.7 to 1.9 ± 1.6 μIU/mL (CH group; p<0.01). The required T4 dose for patients with AIT was 1.5 ± 0.5 μg/kg per day (≥ 6 to <10 years: 2.0 ± 0.4 μg T4/kg per day; ≥ 10 to <12 years: 1.6 ± 0.4 μg T4/kg per day; ≥ 12 to <14 years: 1.5 ± 0.6 μg T4/kg per day; ≥ 14 years: 1.4 ± 0.6 μg T4/kg per day). It deviated significantly from the CH patients' mean T4 dose of 2.8 ± 0.7 μg T4/kg per day, p<0.01. CH patients with athyreosis required an average dose of 3.1 ± 0.5 μg T4/kg per day; patients with ectopia, 2.6 ± 0.7 μg T4/kg per day; and patients with dyshormonogenesis, 2.5 ± 0.6 μg T4/kg per day. Juvenile patients with AIT require significantly lower T4 doses than patients with CH.

Thyroid Status in Diabetes Mellitus

The study was carried out to estimate thyroid hormones (T3, T4 and TSH) level in diabetic patients and to compare it with normal controls in an attempt to find out the importance of thyroid hormone estimation in diabetic cases. Sixty cases of diabetes mellitus who attended Diabetic Clinic, RIMS during the period from October 2008 to March 2010 were taken as the cases and 30 healthy individuals were selected as control group. Serum total Tri-iodothyronine (T3), thyroxine (T4), thyroid stimulating hormone and blood sugar were estimated in the cases and controls. The study showed that diabetes was more prevalent in the age group of 51-65 years, and more in males (52%). The mean fasting blood sugar (126.17 ± 37.92 mg%) and serum TSH level (4.58 ± 2.90 mIU/L)were increased significantly (r=0.884, p>0.05) whereas serumT4 level (5.79 ± 4.39 μg/dl) was decreased significantly in diabetic cases when compared with controls. Mean T3 level of diabetic cases was higher than controls but it was insignificant. Diabetes mellitus cases with statistically significant higher TSH value have complications like hypertension, retinopathy, nephropathy etc. A statistically significant, negative correlation (r=-0.942, p<0.05) was seen between Serum T4 and blood sugar in the cases. Therefore, routine assessment of thyroid hormone level in addition to other biochemical variables in the early stage of diabetes will help in the management of these patients.