Normal Thyroid Function Group Research Articles

Subclinical hypothyroidism increases insulin resistance in normoglycemic people.

To investigate the effect of simple subclinical hypothyroidism (SCH) and type 2 diabetes mellitus (T2DM) combined with SCH on insulin resistance. A total of 622 people with newly diagnosed T2DM were selected as the study subjects, and 621 normoglycemic people were selected as control subjects. According to the diagnostic criteria of thyroid diseases, the subjects were divided into a normal thyroid function group and a subclinical hypothyroidism group. Both groups received a physical examination, and blood samples were collected. The measurement indexes included FPG, FINS, OGTT2hPG, OGTT2hINS, HbA1c, TC, TG, HDL-C, LDL-C, TSH, FT3 and FT4. HOMA-IR, HOMA-β, and TFQI (thyroid feedback quantile index) were calculated. There was no significant difference in age or sex distribution between the T2DM group and the normoglycemic group (P>0.05). The prevalence of thyroid dysfunction in the T2DM group was significantly higher than that in the normoglycemic group (16.39% vs. 11.27%, P<0.05), and among the different types of thyroid dysfunction, the prevalence of SCH was the highest at 14.95% (P<0.05). There was no significant difference in BMI, waist-hip ratio, blood lipid profile, HOMA-β, and HOMA-IR values between the T2DM with subclinical hypothyroidism group (T2DM+SCH+ group) and the normal thyroid function group (T2DM+SCH- group) (P>0.05). The BMI, waist-hip ratio and HOMA-IR values of the normoglycemic group with subclinical hypothyroidism (T2DM-SCH+ group) were significantly higher than those of the normoglycemic group with normal thyroid function (T2DM-SCH- group) (P<0.05), and there were no significant differences between the T2DM+SCH- and T2DM+SCH+ groups (P>0.05). HOMA-β values were significantly higher in the T2DM-SCH+ group than in the T2DM-SCH-, T2DM+SCH- and T2DM+SCH+ groups (P<0.05). As the TFQI value increased, the body weight, waist-hip ratio, diastolic blood pressure, FPG, OGTT2hPG and HbA1c values gradually increased in the T2DM group and normoglycemic group (P<0.05). HDL-C, FINS, OGTT2hINS and HOMA-β values gradually decreased (P<0.05). Subclinical hypothyroidism only increases insulin resistance in normoglycemic people. As the sensitivity of the central thyroid decreases, the risk of developing diabetes increases.

[Correlation Analysis between Thyroid Function Abnormality and Efficacy in Patients 
with Advanced Non-small Cell Lung Cancer after Immunotherapy].

Thyroid function abnormality (TFA) is one of the common adverse reactions in patients with advanced non-small cell lung cancer (NSCLC) treated with immunotherapy, but the risk factors of TFA and its relationship with efficacy are not completely clear. The purpose of this study was to explore the risk factors of TFA and its relationship with efficacy in patients with advanced NSCLC after immunotherapy. The general clinical data of 200 patients with advanced NSCLC in The First Affiliated Hospital of Zhengzhou University from July 1, 2019 to June 31, 2021 were collected and analyzed retrospectively. χ² test and multivariate Logistic regression were used to explore the risk factors of TFA. Kaplan-Meier curve was drawn and Log-rank test was used for comparison between groups. Univariate and multivariate Cox analysis was used to explore the efficacy factors. A total of 86 (43.0%) patients developed TFA. Logistic regression analysis showed that Eastern Cooperative Oncology Group Performance Status (ECOG PS), pleural effusion and lactic dehydrogenase (LDH) were factors influencing TFA (P<0.05). Compared with normal thyroid function group, the median progression-free survival (PFS) of patients in the TFA group was significantly longer (19.0 months vs 6.3 months, P<0.001), and the objective response rate (ORR) (65.1% vs 28.9%, P=0.020) and disease control rate (DCR) (100.0% vs 92.1%, P=0.020) of the TFA group were better than those of the normal thyroid function group. Cox regression analysis showed that ECOG PS, LDH, cytokeratin 19 fragment (CYFRA21-1) and TFA were factors influencing prognosis (P<0.05). ECOG PS, pleural effusion and LDH may be risk factors affecting the occurrence of TFA and TFA may be a predictor of the efficacy of immunotherapy. Patients with advanced NSCLC who have TFA after immunotherapy may obtain better efficacy.

Clinical features and prognosis of patients hospitalized with heart failure and low T3 syndrome

Objective: To investigate the association between triiodothyronine (T3) and inflammatory factors, and its potential effect on long-term outcomes in hospitalized patients with heart failure (HF). Methods: A total of 2 475 patients with HF admitted in Heart Failure Care Unit were consecutively enrolled in this retrospective cohort study from December 2006 to June 2018. Patients were divided into low T3 syndrome group (n=610, 24.6%) and normal thyroid function group (n=1 865, 75.4%). The median follow-up time was 2.9 (1.0, 5.0) years. A total of 1 048 all-cause deaths were recorded at the final follow-up. The effects of free T3 (FT3) and high-sensitivity C-reactive protein (hsCRP) on the risk of all-cause death were evaluated by Cox regression analysis and Kaplan-Meier analysis. Results: The age of the total population was 19-95 (57±16) years, 1 823 cases (73.7%) were male. Compared to those with normal thyroid function, albumin [(36.5±5.4) vs. (40.7±4.7) g/L], hemoglobin [(129.4±25.1) vs. (140.6±20.6) g/L], total cholesterol [3.6 (3.0, 4.4) vs. 4.2 (3.5, 4.9) mmol/L] (all P<0.001) were lower, Whereas age [(60.5±16.0) vs. (55.2±15.4) years], creatinine [105.0 (83.6, 137.0) vs. 87.8 (75.6, 106.3) mmol/L], log N-terminal B-type natriuretic peptide [(8.2±1.3) vs. (7.2±1.4) ng/L] were higher in LT3S patients (all P<0.001). In Kaplan-Meier survival analysis, patients with lower FT3 and higher hsCRP had significantly lower cumulative survival (P<0.001), lower FT3 combined with higher hsCRP subgroup had the highest risk of all-cause death (Ptrend<0.001). In multivariate Cox regression analysis, LT3S was an independent predictor of all-cause mortality (HR=1.40, 95%CI 1.16-1.69, P<0.001). Conclusion: LT3S is an independent predictor of poor prognosis in patients with heart failure. FT3 combined with hsCRP improve the predictive value of all-cause death in hospitalized patients with heart failure.

Endothelial dysfunction correction in patients with hypertension, dyslipidaemia, and decreased thyroid function

Endothelial dysfunction is considered a universal predictor of numerous diseases, development of the complications and their adverse course. The study aimed to investigate the endothelium-dependent vasodilation among patients with arterial hypertension, dyslipidemia and different functional state of the thyroid gland and feasibilities of its correction by means of hypolipidaemic and metabolic therapy. 99 patients with arterial hypertension and dyslipidemia were examined, among them were 65 hypothyroid persons (group 1) and 34 individuals with normal thyroid function (group 2). The effects of lipid-lowering combination therapy with ezetimibe and rosuvastatin or monotherapy with statins, and metabolic therapy with L-arginine aspartate during 3 months on endothelium-dependent vasodilation were studied. At the beginning of the study, the values of endothelial-dependent vasodilation in group 1 compared to those in group 2 were reliably smaller by 9.38%. After 3 months of treatment, this indicator in group 1 reliably increased by 11.11%, while 19 (29.23%) patients showed its normalization. The best values of the endothelium-dependent vasodilation was demonstrated by examinees in group 2 – the indicator reliably increased by 15.76 %, while 17 (50%) patients showed its normalization. Together, the greater increase in the percentage of endothelium – dependent vasodilation was observed among subgroups of patients that in complex treatment received combination hypolipidaemic therapy with ezetimibe and rosuvastatin, and metabolic therapy with L-arginine. The best indicators of endothelium-dependent vasodilation were demonstrated by examinees of both groups who, in addition to combination hypolipidaemic therapy, received metabolic therapy. Decreased thyroid gland function negatively affected the values of endothelium-dependent vasodilation and overweighted the possibilities of endothelial dysfunction correction in this cohort of patients. The results of the study can be applied in internal medicine clinic for complex treatment of comorbid hypertensive and hypothyroid patients

Objective evaluation of thyroid function in postmenopausal women

Background: Thyroid dysfunction is more prevalent among elderly female. Assessment of thyroid dysfunction in the postmenopausal women is difficult due to their age, associated comorbidities, and ongoing treatment. Aims and Objectives: The aim of the study was to evaluate the thyroid status, presence of relative estrogen dominance and correlation of thyroid status with reproductive hormones in postmenopausal women. Materials and Methods: This cross-section study consists 40 postmenopausal women between age group 45 and 55 years. All participants were subjected to measure serum thyroid stimulating hormone (TSH) levels. Based on TSH levels, subjects were divided into normal thyroid function group (n = 12) and abnormal thyroid function group (n = 12). Serum was assayed for thyroxin binding globin (TBG), thyroid peroxidase antibody (TPO), estrogen, progesterone, and progesterone to estrogen ratio (P: E) in subjects of both the groups. Results: Around, 12 (30%) postmenopausal women had TSH values outside the range of 0.3–6.5 μIU/mL. TPO was positive only in one subject and 12.5% showed elevated TBG levels in abnormal thyroid group. Mean estrogen levels were significantly high, mean progesterone levels were significantly low and P: E was low in abnormal thyroid level group. A significant difference (P &lt; 0.05) was observed on comparing the mean values of serum estrogen, progesterone, and P: E ratio among the groups. A significant positive correlation between TSH and serum estrogen, progesterone, and P: E and inverse correlation between estrogen and P: E was observed in abnormal thyroid level group. Conclusion: The thyroid dysfunction in postmenopausal women is associated with estrogen dominance. Therefore, menopausal women should be routinely screened for thyroid dysfunction, as part of their annual examination.

Immune checkpoint blockade PD-1 therapy for primary liver cancer: incidence and influencing factors of thyroid dysfunction

ObjectivesTo investigate the incidence and influencing factors of thyroid dysfunction (TD) in patients with primary liver cancer (PLC) induced by PD-1 monoclonal antibodies.MethodsClinical data were collected from 195 PLC patients treated with PD-1. They were divided into TD group and normal thyroid function (NTF) group, and further divided into TD subgroups, the differences between groups and subgroups were analyzed.ResultsA total of 113 of 195 (57.9%) PLC patients developed TD. The positive rate of thyroid antibody (20.6% vs. 0%, P = 0.041) and the median value of TSH (6.20 vs. 2.16 mU/L, P = 0.000) in TD group were higher than those in NTF group. Ten patients (8.8%) had the CTCAE grade of TD above grade 3, of which 2 patients died of liver failure. There were 20 patients (17.7%) in hyperthyroidism group and 93 patients (82.3%) in hypothyroidism group. The decompensated cirrhosis in hyperthyroidism group was lower than that in hypothyroidism group (33.3% vs. 65.6%, P = 0.010), and the proportion of patients who had previously received surgical treatment was higher than that in hypothyroidism group (35.0% vs. 9.7%, P = 0.003); The proportion of clinical hyperthyroidism was higher than that of clinical hypothyroidism (70.0% vs. 31.2%, P = 0.001), the proportion of decompensated liver cirrhosis in clinical hyperthyroidism group was lower than that in clinical hypothyroidism group (23.1% vs. 68.0%, P = 0.022), and the proportion of previous or combined surgical resection was much higher than that in clinical hypothyroidism group (42.9% vs. 7.1%, P = 0.018); The proportion of decompensated cirrhosis in primary TD group was lower than that in secondary TD group (36.5% vs. 83.3%, P = 0.002), and the proportion of patients using antitumor targeted drugs was higher than that in secondary TD group (73.1% vs. 45.0%, P = 0.014).ConclusionPatients with PLC had high incidence of TD after receiving PD-1 treatment, primary or subclinical hypothyroidism was the main manifestation type, which was related to the degree of disease and treatment.

Risk Factors for Thyroid Dysfunction in Patients with Advanced Non-Small-Cell Lung Cancer Treated with PD-1 Antibody.

Objective To analyze the health status of thyroid function in patients with advanced non-small-cell lung cancer cured with PD-1 antibody and to explore the risk factors of thyroid dysfunction. Methods 100 patients from Hunan Provincial People's Hospital with advanced non-small-cell lung cancer hospitalized from January 2021 to March 2022 were selected. All patients were treated with a PD-1 antibody. The differences in sex, age, operation history, chemotherapy history, radiotherapy history, and thyroid nodules between patients with abnormal thyroid function and normal thyroid function after treatment were compared. Moreover, the risk factors of thyroid dysfunction were analyzed. Results The proportion of women in the normal thyroid function group was lower compared to the abnormal thyroid function group. And the proportion of patients with the course of the disease within 1 year in the normal thyroid function group was higher compared to the abnormal thyroid function group. The incidence of thyroid color ultrasound nodules in the normal thyroid function group was remarkably higher compared to the abnormal thyroid function group (P < 0.05). The proportion of patients with nodules in the abnormal thyroid function group was remarkably higher compared to the normal thyroid function group. Among the 36 patients who developed abnormal thyroid function, the incidence of hyperthyroidism (hyperthyroidism) and subclinical hyperthyroidism (subclinical hyperthyroidism) was 33.33%. The incidence of hypothyroidism (hypothyroidism) and hypothyroidism (subclinical hypothyroidism) was 66.66%. The cumulative incidence rates after 3 cycles, 6 cycles, and 12 cycles were 63.88%, 83.33%, and 94.44%, respectively. T4 and FT3 levels decreased more than the normal group following therapy. The results showed that females, course of disease more than one year, and thyroid nodule were independent risk factors of thyroid dysfunction. Conclusion Female gender, disease duration of more than 1 year, and thyroid nodules were independent risk factors for thyroid dysfunction after PD-1 antibody therapy. Therefore, clinical treatment should focus on patients with the above factors, and early intervention should be implemented to avoid the occurrence of thyroid dysfunction after PD-1 antibody treatment.

Systematic review and meta-analysis on the influence of thyroid dysfunction in early pregnancy on pregnancy outcomes under ultrasound guidance.

Thyroid dysfunction during pregnancy has a certain impact on pregnancy outcomes and neonatal growth, but there is no systematic evaluation of the influence of thyroid dysfunction during early pregnancy under ultrasound guidance on pregnancy outcomes. PubMed, Web of Science, Springer, and Science Direct databases were used to screen clinical studies on the effect of thyroid dysfunction during pregnancy on pregnancy outcomes from January 2010 to June 2021. Meta-analysis of data was conducted using RevMan 5.3 software. Differences of indicators were compared between the normal and abnormal thyroid function groups, including the ratio of primiparas, anemia, intrauterine growth restriction, perinatal fetal death, preterm delivery, fetal distress syndrome, cesarean section, preeclampsia, placental abruption, postpartum hemorrhage, and neonatal complications. Heterogeneity of results was assessed by chi-square test and I2 test in RevMan5.3. A total of 788,867 pregnant women were included in 13 studies. Cochrane scores were grade B or above, and Jadad scale scores were higher than 3. Anemia [odds ratio (OR) =0.82, 95% confidence interval (CI): 0.70-0.96, Z=2.48, P=0.01], premature birth (OR =0.56, 95% CI: 0.36-0.86, Z=2.66, P=0.008), fetal distress syndrome (OR =0.76, 95% CI: 0.68-0.85, Z=4.74, P<0.00001), Apgar score <7 (OR =0.52, 95% CI: 0.34-0.80, Z=2.97, P=0.003), preeclampsia (OR =0.65, 95% CI: 0.48-0.87, Z=2.91, P=0.004), placental abruption (OR =0.27, 95% CI: 0.19-0.38, Z=7.31, P<0.00001), and the rate of postpartum hemorrhage (OR =0.62, 95% CI: 0.42-0.92, Z=2.38, P=0.02) were dramatically higher in the abnormal thyroid function group compared with the normal group. Few studies were included on the effect of thyroid dysfunction on abortion, and further validation is needed. Thyroid dysfunction was proven to be associated with a variety of adverse pregnancy outcomes.

Follow-up study of preterm infants with thyroid dysfunction after medication.

To study the effect of levothyroxine sodium tablets on the growth and development and thyroid function in preterm infants with thyroid dysfunction. A retrospective analysis was performed for 82 preterm infants who were born in the Department of Obstetrics of the First People's Hospital of Yunnan Province, from January 1, 2013 to December 31, 2017, and these infants were hospitalized after birth in the Department of Neonatology of the hospital. They were regularly followed up to observe growth and development and thyroid function at the outpatient service of the Department of Neonatology. According to thyroid function test results, they were divided into an abnormal thyroid function group (observation group; n=31) and a normal thyroid function group (control group; n=51). The infants in the observation group were given oral administration of levothyroxine sodium tablets, while those in the control group were not given any treatment. The two groups were compared in terms of the physical and intelligence development and thyroid function of preterm infants with various gestational ages (28-<32 weeks, 32-<34 weeks, and 34-<37 weeks) after regular follow-up to the corrected age of 12 months. There were no significant differences in physical development indices (body length, body weight, and head circumference) between the observation and control groups at various gestational ages after follow-up to the corrected age of 12 months (P>0.05). There were no significant differences between the two groups in the scores of each functional area of the Gesell Developmental Scale among the preterm infants with a gestational age of 28-<32 weeks and 32-<34 weeks after follow-up to the corrected age of 12 months (P>0.05). For the preterm infants with a gestational age of 34-<37 weeks, compared with the control group, the observation group had a significantly lower score of gross motor ability at the age of 3 and 12 months, significantly lower scores of fine motor ability, language ability, and adaptation ability at the age of 12 months (P<0.05), and a significantly lower score of personal-social ability at the age of 3 months (P<0.05). However, the score of personal-social ability in the observation group was not significantly different from the control group at the age of 12 months (P>0.05). After 2-4 weeks of treatment with levothyroxine sodium tablets, the thyroid function of the 31 preterm infants with thyroid dysfunction returned to normal. Among the 31 infants, 21 (68%) achieved complete drug withdrawal, with normal results of neonatal screening (100%); 10 infants (32%) failed to achieve drug withdrawal, and only 2 (20%) out of the 10 infants had normal neonatal screening results (P<0.05). Early diagnosis and reasonable treatment can reduce the impact on growth and development in preterm infants with thyroid dysfunction. Most preterm infants tend to have transient thyroid dysfunction, while those with positive results of neonatal screening are more likely to develop permanent thyroid dysfunction.

Serum levels of anti-thyroid autoantibodies in different thyroid function status

Background Thyroid disorders are one of the most prevalent medical conditions, especially in women. Autoimmune thyroid diseases are the most common causes in which the patient's immune system attacks thyroid gland with generation of thyroid autoantibodies. However, antibody testing is not widely available for routine clinical practice. Aim This study was conducted to determine the level of autoantibodies against thyroid peroxidase (anti-TPO), thyroglobulin (anti-TG), and thyrotropin receptor (TRAB) in different status of thyroid function. Patients and methods Thyroid function tests included thyroid-stimulating hormone (TSH), Free T3 ( FT3), and Free T4 (FT4) with anti-thyroid autoantibodies (anti-TG, anti-TPO, and TRAB). Results Anti-TG level was significantly increased in patients with hypothyroidism when compared with patients with normal thyroid function and control group. Anti-TPO level was significantly increased in patients with hypothyroidism when compared with those with normal thyroid function and control group, and it was significantly increased in patients with hyperthyroidism when compared with patients with normal thyroid function and control group. There was a nonstatistically significant increase in TRAB level in patients with hyperthyroidism when compared with patients with hypothyroidism, those with normal thyroid function, and control group. There was a significant moderate positive correlation between TRAB level and FT3 level and with FT4 level, and in the correlation study between thyroid autoantibodies with each other, there was a significant strong positive correlation between anti-TPO and anti-TG. Conclusion Anti-TPO and anti-TG have a role in the pathogenesis and diagnosis of autoimmune thyroid disorders, and their tests should be requested for patients with thyroid dysfunction.

Thyroid dysfunction is associated with the loss of hepatitis B surface antigen in patients with chronic hepatitis B undergoing treatment with α-interferon.

ObjectiveTo investigate the influence of thyroid dysfunction on the antiviral efficacy of α-interferon in adult patients with chronic hepatitis B (CHB).MethodsWe performed a retrospective study of 342 patients with CHB who underwent interferon treatment for >12 weeks. Patients with thyroid dysfunction before or during treatment were defined as the thyroid dysfunction group (n = 141) and those with normal thyroid function were defined as the normal thyroid function group (n = 201). The prevalences of hepatitis B virus (HBV) DNA undetectability, low hepatitis B surface antigen (HBsAg) titre (<250 IU/mL), HBsAg loss, and hepatitis B envelope antigen loss were compared.ResultsDuring interferon treatment, 69 of 270 (25.6%) participants with normal thyroid function at baseline developed thyroid dysfunction, whereas 11 of 72 (15.3%) with thyroid dysfunction at baseline regained normal thyroid function. The thyroid dysfunction group had significantly higher prevalences of low HBsAg titre (29.8% vs. 18.9%) and HBV DNA undetectability (66.0% vs. 40.3%). Multivariate logistic regression analysis showed that thyroid dysfunction was associated with HBsAg loss (odds ratio 4.945, 95% confidence interval 1.325–18.462).ConclusionsThese results suggest that thyroid dysfunction is not an absolute contraindication, but is associated with HBsAg loss, in patients with CHB undergoing α-interferon treatment.

The Relationship Between Metabolic Parameters, Age, and Thyroid Status: A Cross-Sectional Study-Based National Survey of Iodine Nutrition, Thyroid Disease.

AimThe relationship between thyroid status and metabolic factors was investigated as well as iodine nutrition in the general population and among the elderly population.MethodsWe performed a cross-sectional survey of 2483 subjects to assess the status of national iodine nutrition and incidence of thyroid disease. The general and elderly populations were divided into normal thyroid function (NTF) and subclinical hypothyroidism (SCH) groups. The anthropometric parameters and biochemical indicators were then analyzed.ResultsOverall, 327 participants were diagnosed with thyroid diseases, 73 (22.32%) of whom were 65 years or older. For the general population, compared with the NTF group, individuals in the SCH group were older, presented with higher systolic blood pressure, fasting blood glucose, serum cholesterol, and urinary iodine concentration (all p<0.05) but lower blood uric acid (UA) (p<0.05). Linear regression analysis further revealed that age and triglyceride (TG) serum levels positively correlated with serum thyroid-stimulating hormone (TSH) levels. Multiple regression analyses revealed that age, TG, waist circumference (WC), and body mass index were independent predictors for abnormal TSH serum levels. For the elderly population, compared with NTF group, individuals in the SCH group were substantially older (p<0.05) but presented with lower UA (p<0.05). Pearson linear regression analysis revealed a positive correlation between age (p=0.003) as well as TG levels (p<0.001) and serum TSH levels. In contrast, WC (p=0.003) was negatively related to TSH serum levels. Further multiple regression analysis revealed that age, TG, WC and heart rate were independent predictors of blood TSH.ConclusionThe large-scale national study of iodine nutrition, thyroid disease has shown a vital relationship between metabolic indicators and serum TSH levels. Age and metabolic diseases increase the likelihood of developing thyroid diseases, both the general population and among the elderly.

Association Between Thyroid Function and Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

PurposeChronic obstructive pulmonary disease (COPD) was the fourth leading cause of death in the world. Many studies have shown that COPD often exists with thyroid dysfunction; however, the relationship between thyroid function and COPD is often ignored in clinical. We retrospectively analyze the serum thyroid hormone levels in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and explore the association between thyroid function and AECOPD.MethodsThe study included patients hospitalized for AECOPD in our institution between January 2018 and September 2020. Patients with AECOPD were divided into moderate-to-severe and very severe groups based on lung function, and into normal and abnormal thyroid function groups based on thyroid hormone levels. Collected data and compared data between groups to identify risk factors for thyroid dysfunction in patients with AECOPD.ResultsThe cohort included 97 in the moderate-to-severe group (72.39%) and 37 in the very severe group (27.61%). Compared with the very severe group, the moderate-to-severe group had higher triglyceride (P=0.017), high-density lipoprotein (P<0.05), partial pressure of carbon dioxide (PaCO2; P<0.05), and serum thyroid-stimulating hormone (TSH; P<0.001). FEV1 as a percentage of the predicted value (FEV1%pred) was positively correlated with TSH and FT3 (r=0.329, r=0.192, respectively, both P<0.05). Duration of hospitalization was negatively correlated with TSH (r=−0.256, P=0.003). Among the 134 subjects, 98 (73.13%) had normal thyroid function and 36 (26.87%) had abnormal thyroid function. The two groups significantly differed regarding forced vital capacity (FVC), forced expiratory volume in 1 second, FEV1%pred, and albumin level. Logistic regression analysis showed that high FVC correlated with a low risk of thyroid dysfunction in AECOPD.ConclusionIn patients with AECOPD, TSH is related to lung function and duration of hospitalization, and high FVC reduces the risk of thyroid dysfunction.

Association between thyroxine level and nonalcoholic fatty liver disease

Objective  To investigate the association between thyroxine level and nonalcoholic fatty liver disease (NAFLD). Methods  A retrospective analysis was performed for 3289 subjects who underwent physical examination in PLA Rocket Force Characteristic Medical Center from July 2015 to April 2019, and according to medical history and thyroid function, they were divided into subclinical hypothyroidism group with 210 subjects and normal thyroid function group with 3079 subjects. According to the results of abdominal color Doppler ultrasound, the normal thyroid function group was divided into NAFLD group with 516 subjects and non-NAFLD group with 2563 subjects; according to body mass index (BMI), the normal thyroid function group was divided into non-obese group (BMI Results  The subclinical hypothyroidism group had a higher prevalence rate of NAFLD than the normal thyroid function group (22.38% vs 16.76%, χ2=4.380, P=0.036), and in the subclinical hypothyroidism group, the NAFLD patients had a higher level of TSH than the non-NAFLD patients(Z=-1.994, P=0.046). In the subclinical hypothyroidism group, there were no significant differences in thyroid parameters between the NAFLD group and the non-NAFLD group (all P > 0.05); after stratification based on age and body type, in the obese-young and middle-aged subgroup, male sex, low free thyroxine, fasting blood glucose, and triglyceride were independent risk factors for NAFLD (odds ratio=4.729, 0.067, 1.814, and 1.717, P=0.003, 0.010, 0.011, and 0.014). The cut-off values of free thyroxine, fasting blood glucose, and triglyceride were 1.123 ng/dL, 5.15 mmol/L, and 1.02 mmol/L, respectively, in predicting NAFLD, and the area under the ROC curve was 0.832 for combined prediction. Conclusion  There is a high prevalence rate of NAFLD in the population with subclinical hypothyroidism, and when thyroid function is within the normal range, low free thyroxine is associated with the onset of NAFLD in the young and middle-aged obese people.

ISOLATED MATERNAL HYPOTHYROXINEMIA AND ITS PERINATAL OUTCOME IN NORTH MACEDONIA.

SUMMARYIsolated maternal hypothyroxinemia (IMH) is defined as the presence of low maternal total thyroxine (TT4) level in conjunction with normal maternal thyroid-stimulating hormone (TSH) level. The aim was to investigate whether IMH is associated with adverse pregnancy outcome in North Macedonia. Dried blood spot samples were obtained from 359 pregnant women meeting the inclusion criteria and analyzed for TT4 and TSH. Postpartum data were entered from their medical histories. Out of 359 women, 131 (37.42%) belonged to IMH group. There were statistically significant differences in birth weight (p=0.043), intrauterine growth restriction (IUGR) (p=0.028), Apgar score at 1 min <7 (p=0.018) and cesarean section for dystocia/disproportion (p=0.024) between the IMH and normal thyroid function (NTF) groups. In regression analysis, TSH was a significant variable predicting Apgar score (βst=0.05597, p=0.047), body mass index predicting birth weight (βst=0.02338, p=0.045) and TT4 predicting small for gestational age/IUGR (βst=-0.089834, p=0.029) in IMH group. TT4 was a strong predictor of birth weight (βst=-0.004778, p=0.003) and premature delivery (βst=0.028112, p=0.004) in NTF group. The impact of IMH in pregnancy remains controversial. IMH was associated with an increased maternal BMI and higher birth weight of neonates. Overweight could be a potential risk factor for thyroid dysfunction in pregnant women, and specifically IMH. The worst fetal outcome was seen in IMH mothers examined in second trimester. We found TSH, TT4 and BMI to be strong predictors of perinatal outcomes.

Research on Renal Injury in Hashimoto&amp;apos;s Thyroiditis Patients with Different Thyroid Function

Objective: To assess the relationship between thyroid function and renal injury in Patients with Hashimoto's Thyroiditis. Method: To select 156 diagnosed HT patients as the research object, according to whether there is renal injury, they were divided into renal injury group with 21 cases and non-renal injury group with 135 cases. According to the thyroid function, they were divided into HT hyperthyroidism group (Group A) with 19 cases, normal HT thyroid function group (Group B) with 37 cases, HT subclinical hypothyroidism group (Group C) with 61 cases, and HT hypothyroidism group (Group D) with 39 cases. Besides, 40 cases of healthy check-up people are selected as the control group. ECLIA is adopted to test the thyroid function index of each group, Serum cystatin C and 24-hour urinary microalbumin were measured by immunoturbidimetry, serum creatinine was measured by creatine oxidase method, and the endogenous creatinine clearance rate was calculated. Result: TSH, TPOAb and TGAb in renal injury group were distinctly higher than those in non-renal injury group, while FT3 and FT4 were distinctly lower than those in non-renal injury group; Comparison of serum creatinine in Hashimoto groups, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, Group B is obviously higher than Group A, Group A is significantly lower than other groups; Comparison of cystatin C and creatinine clearance of each group, Group D is significantly lower than other groups, Group C is obviously lower than Group A, Group B, and the control group, Group B is obviously lower than Group A, Group A is significantly higher than other groups; Comparison of 24-hour urinary microalbumin of each group, Group D is significantly higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, and the differences have statistic significance (P<0.05). The correlation analysis shows that FT3, FT4 are in negative correlation with serum creatinine and in positive correlation with cystatin C and creatinine clearance; TSH, TPOAb, TGAb is in positive correlation with 24-hour urinary microalbumin. Conclusion: There are obvious differences in renal function indexes of HT patients with different thyroid function states, which may be related to the effect of thyroid hormones and autoantibodies.

The Research on the Correlation of Thyroid Function and Serum Immunological Indexes in Patients with Hashimoto&amp;apos;s Thyroiditis

Objective: To assess the correlation of thyroid function and serum immunological indexes in patients with Hashimoto's thyroiditis. Method: To select 172 patients who have been clinically confirmed with HT. And they were divided into Hashimoto hyperthyroidism group within 39 cases, Hashimoto hypothyroidism group within 92 cases and normal Hashimoto's thyroid function group within 41 cases on the basis of Thyroid function. Besides, 50 healthy controls were control group. ECLIA was adopted to test the Thyroid function and antibody indicators of every group, and ELISA was employed to detect Th1 type cytokines (IL-2, IFN-γ) and Th2 type cytokines (IL-6, IL-10). Result: Every group with Hashimoto's thyroiditis was evidently higher than the normal one as well as the Hashimoto hypothyroidism group was higher than the Hashimoto hyperthyroidism group and the normal one in TPOAb and TGAb levels, in which the difference has statistical significance (P 0.05); Moreover, the IL-2, IFN-γ levels of the Hashimoto hyperthyroidism group and the normal Hashimoto's thyroid function group were distinctly higher than that of the Hashimoto hypothyroidism group; And the IL-6 and IL-10 levels were obviously higher than the Hashimoto hyperthyroidism group as well as the normal Hashimoto's thyroid function group (P<0.05). Besides, the TSH was positively correlated with the TPOAb and the IL-10. And FT4 was negatively correlated with the TPOAb, TGAb, IL-6. Not only the FT3 and TGAb but also the TT4 and IL-6 were in negative correlation. But the other indexes have no correlation. Conclusion: The patients with Hashimoto's thyroiditis have high TPOAb and TGAb levels. In addition, the TPOAb, TGAb and cytokines levels in the serum of HT patients with different thyroid function have evidently discrepancy, which may be closely related to the occurrence and development of the disease.

The Relationship Between Thyroid Function and T Lymphocyte Subsets in Patients with Hashimoto&amp;apos;s Thyroiditis

<i>Objective</i>: To assess the relationship between thyroid function and T lymphocyte subsets in Patients with Hashimoto's Thyroiditis. <i>Method</i>: To select 131 diagnosed HT patients as the research object, which is divided into HT hyperthyroidism group (Group A) with 18 cases, normal HT thyroid function group (Group B) with 35 cases, HT subclinical hypothyroidism group (Group C) with 42 cases, and HT hypothyroidism group (Group D) with 36 cases in accordance with thyroid function. Besides, 40 cases of healthy check-up people are selected as the control group. ECLIA is adopted to test the thyroid function index of each group, and FCM is adopted to test T lymphocyte subsets. <i>Result</i>: Compare CD3⁺T lymphocytes of each group, Group D is obviously higher than Group A, Group B, and the control group, and the difference has statistic significance (P<0.05); Compare CD3⁺CD4⁺T lymphocyte and CD4⁺/CD8⁺ of each group, Group D is obviously higher than other groups, Group C is obviously higher than Group A, Group B, and the control group, Group A and Group B are obviously higher than the control group, and the differences have statistic significance (P<0.05); Compare CD3⁺CD8⁺T lymphocytes of each group, Group D is obviously lower than other groups, Group C is obviously lower than Group A, Group B, and the control group, the difference has statistic significance (P<0.05). The correlation analysis shows that TSH is in positive correlation with CD4⁺/CD8⁺, FT3 is in positive correlation with CD3⁺CD8⁺T, and FT4 is in positive correlation with CD3⁺CD8⁺T and in negative correlation with CD4⁺/CD8⁺. <i>Conclusion</i>: HT patients have the imbalance of T lymphocyte subsets, and the T lymphocyte subsets ratio of HT patients of different thyroid function has obvious differences, which may have close relationship with the occurrence and development of HT.

Low triiodothyronine syndrome is associated with platelet function in patients with nephrotic syndrome.

The objective of this study was to investigate the effects of low triiodothyronine syndrome (LT3S) on platelet function and clotting factors in patients with nephrotic syndrome(NS). Patients with primary nephrotic syndrome were divided into two groups, normal thyroid function (group A) and LT3S (group B), based on whether they had LT3S or not. Healthy subjects were selected as the control group (group C). Blood coagulation function was detected in each group. The platelet activation function (CD62P, CD63) was determined by flow cytometry. The platelet aggregation rate was detected by an optical method using adenosine diphosphate and arachidonic acid as inducers. The proportion of primary nephrotic syndrome with LT3S was 23.2% (69/298). Compared with group C, group A had higher CD62P and PAgTADP, and group B had higher CD62P, CD63, PAgTAA, and PAgTADP; the difference was statistically significant (all P < 0.05). There was no significant difference in renal pathology between group A and group B (X2 = 4.957, P = 0.421). Compared with group A, the 24-hour urine protein, CD63, PAgTAA, and PAgTADP were higher in group B, and APTT and Alb were lower. The difference was statistically significant (P < 0.05). Logistic regression analysis showed that LT3S was associated with CD36 (OR: 3.516; 95% CI: 1.742~8.186; P = 0.004) and PAgTAA (OR: 0.442; 95% CI: 1.001~1.251; P = 0.037). NS patients are prone to LT3S. Patients with LT3S may have abnormal platelet activation and increase of platelet aggregation.

Sexual function and depressive symptoms in men with overt hyperthyroidism.

Although hyperthyroidism is characterised by female predominance, its presence may lead to the development of numerous complications in both sexes. This study was aimed at investigating sexual function and depressive symptoms in men with overt hyperthyroidism of autoimmune and non-autoimmune origin. The study population consisted of three age-matched groups: men with overt hyperthyroidism and Graves' disease (group A; n = 20), men with overt hyperthyroidism and toxic multinodular goitre or toxic adenoma (group B; n = 21), and men with normal thyroid function (group C; n = 23). As well as measuring serum hormone levels and antibody titres, and determining calculated parameters of thyroid homeostasis, all included patients filled in questionnaires evaluating sexual function (International Index of Erectile Function-15: IIEF-15) and assessing the presence and severity of depressive symptoms (Beck Depression Inventory-Second Edition - BDI-II). Compared with control subjects, men with overt hyperthyroidism obtained lower scores for erectile function, intercourse satisfaction, orgasmic function and overall satisfaction. Scores for erectile function, orgasmic function, and sexual desire differed between both groups of men with thyroid hyperfunction and inversely correlated with thyrotropin receptor antibody titres. The BDI-II score was higher in patients with Graves' disease than in men with normal thyroid function. The obtained results indicate that overt hyperthyroidism in men causes multidimensional impairment of sexual function, which is particularly pronounced if excessive hormone production results from Graves' disease.