Hypothyroid Patients Research Articles

Effect of Levothyroxine on Lipid Profile in Hypothyroid Patients Attending in a Tertiary Care Hospital

Background: Hypothyroidism is a common endocrine disorder in our country and is associated with many biochemical abnormalities.Clinical data suggest that levothyroxine replacement therapy has beneficial effect on lipid profile. Objective: The present study intends to find out the effect of levothyroxine replacement therapy on lipid profile in hypothyroid patients. Methods: A prospective analytical study was done in Endocrinology Outpatient Department of Dhaka Medical college and Hospital, Dhaka from January 2022 to December 2022. A total of 30 newly diagnosed hypothyroid patients were included according to selection criteria. The patient’s demographic, past, present history and relevant data needed for the study were collected by face-to-face interview by using structured questionnaire. Baseline data of serum free thyroxine (FT4), thyroid stimulating hormone (TSH), fasting lipid profile, Blood pressure and clinical features of hypothyroidism were recorded in a data collection form during first visit and after 3 months follow up. All patients were treated with tablet levothyroxine and dose was adjusted 4-6 weekly till patients were biochemically euthyroid. Results: 30 hypothyroid patients were followed up for 3 months. There was significant improvement in hypothyroid symptoms after thyroxine replacement. The mean age of the patient was 35.40±11.52 years. Mean FT4 level was significantly increased from 8.06±3.78 to 16.40±3.95(p<0.001). There was significant reduction in mean TSH from 32.55±37.31 to 2.52±2.71(p<0.001). Mean Total cholesterol, TG, LDL-C level was significantly decreased from 193.27±41.69, 173.33±63.71, 119.58±40.11 to 177.80±38.17, 155.87±58.25, 103.07±26.25 (p=0.022, 0.044, 0.042) respectively, but HDL has decreased from 45.04±13.14mg/dl to 43.11±10.78 mg/dl (p=0.415) though not significantly. Conclusion: Thyroxine replacement therapy improves lipid profiles and enhances quality of life. Levothyroxine directly reduces TC, LDL-C, and TG levels but not HDL-C. J Rang Med Col. September 2024; Vol. 9, No. 2: 61-66

An Observational Study on the Reversibility of Left Ventricular Diastolic Dysfunction, Impaired Left Ventricular Ejection Fraction and Abnormal Left Ventricular Mass with Levothyroxine Replacement in Primary Hypothyroid Patients of Indian Origin

An Observational Study on the Reversibility of Left Ventricular Diastolic Dysfunction, Impaired Left Ventricular Ejection Fraction and Abnormal Left Ventricular Mass with Levothyroxine Replacement in Primary Hypothyroid Patients of Indian Origin

Effects of Metformin Therapy on Thyroid Volume and Functions in Patients with Newly Diagnosed Type 2 Diabetes Mellitus: A Single-center Prospective Study.

Patients with impaired glucose metabolism have increased thyroid volume and a higher prevalence of nodules. Yet, some studies show that there is an improvement in these thyroid parameters after diabetes treatment. Our observational study aimed to reveal the effect of treatment on thyroid function, thyroid volume, and the presence of nodules in newly diagnosed type 2 diabetes mellitus (T2DM) patients who were started on metformin treatment. Euthyroid and subclinically hypothyroid patients with a serum TSH level of <10 mU/L, who were newly diagnosed with T2DM and started on metformin as an antidiabetic treatment and not used any thyroid medication previously, were included in our study. Patients' characteristics were recorded. Baseline and 6th-month serum thyroid function tests were scheduled. Baseline and 6th-month thyroid gland characteristics were examined by thyroid ultrasonography. A total of 101 (37 males, 64 females) newly diagnosed T2DM patients with euthyroid (n=95) or subclinical hypothyroidism (n=6) were included in the study. The mean age of the patients was 53.02 ± 11.9 years, and the mean BMI was 29.60 ± 3.9 kg/m2. Fifty-two (52%) patients were classified as obese. Body weight, BMI, serum TSH, ALT, Anti-TPO levels, and thyroid volume decreased significantly in the 6th-month compared to baseline values (p = 0.000; p = 0.000; p = 0.011; p = 0.022; p = 0.000, respectively). Serum anti-Tg, fT4, fT3 levels, and thyroid nodule count did not change significantly. A high agreement was found between the baseline and 6thmonth nodule counts (gamma= 0.886; p < 0.001) and the presence of multi-nodularity in the thyroid (gamma= 0.941; p < 0.001), but no significant change was observed. Anti-TPO levels showed a significant decrease in both with and without obesity groups at the end of 6 months (p = 0.003, p = 0.009, respectively). Serum TSH level decreased significantly only in non-obese subjects (p = 0.004), and thyroid volume decreased significantly only in obese subjects (p = 0.000). Our results suggest that metformin treatment significantly reduces body weight, BMI, thyroid volume, and serum TSH, ALT, and Anti-TPO levels in patients with newly diagnosed T2DM. Moreover, serum TSH levels showed a significant decrease in non-obese subjects, while thyroid volume showed a significant decrease in obese subjects.

A prospective observational study on thyroid dysfunction in women with abnormal uterine bleeding: In a Teritary care hospital

Background: One of the most common diseases in gynecology, abnormal uterine bleeding (AUB) has a major negative impact on women's quality of life. Unusual bleeding in women can be brought on by thyroid conditions. The purpose of the study is to determine how common thyroid abnormalities are in women who have irregular uterine bleeding. It also looks at the menstrual patterns linked to thyroid disorders. The study concluded that hypothyroidism patients have menorrhagia, hyperthyroidism patients may experience dysmenorrhea, and thyroid dysfunction may result in irregular uterine hemorrhage. Materials and procedures: Premenopausal women with abnormal uterine bleeding (AUB) participated in a prospective observational study conducted in the gynecology department of a tertiary care hospital in Trivandrum between November 2022 and April 2023 (a period of six months). Result: Of the 75 patients who were chosen, 71 (94.7%) had AUB-induced hypothyroidism and 4 (5.3%) had AUB-induced hyperthyroidism. Regarding the menstrual pattern, 83.1% of patients with hypothyroidism and 100% of patients with hyperthyroidism reported experiencing menorrhagia or dysmenorrhea. The study concludes that there is a considerable correlation between thyroid issues and abnormal uterine hemorrhage. The majority of female AUB patients exhibit both hyperthyroidism and hypothyroidism. The most common menstrual pattern linked to hypothyroidism was menorrhagia. Dysmenorrhea was thought to be the most prevalent monthly abnormality in hyperthyroidism.

Preliminary investigations of plasma lipidome and selenium levels in adults with treated hypothyroidism and in healthy individuals without selenium deficiency

The present preliminary study aimed to provide a targeted lipidomic analysis of Hashimoto (HT) and non-HT patients with well-controlled hypothyroidism as well as in healthy adults, and is the first to demonstrate the association of several components of the human lipidome with hypothyroidism in relation to the total plasma selenium content. All the patients and age-, sex-, and BMI-matched healthy controls met the very strict qualification criteria. Se levels were analyzed by ICP-MS, and lipidome studies were conducted using TQ-LC/MS. The 40 acylcarnitines, 90 glycerophospholipids, and 15 sphingomyelins were identified and quantified. PCaaC26:0 and PCaaC40:1 were negatively correlated with Se concentrations. Other lipids that were negatively correlated with Se concentrations but did not present significant differences between the three groups in the Kruskal–Wallis ANOVA test were PCaaC32:0, PCaeC30:0, PCaeC36:5, SMC18:0, and SM C18:1. In the multiple linear regression analyses, Se levels showed negative relationship, whereas different phosphatidylcholines: PCaaC24:0, PCaaC26:0, PCaeC30:1, PCaeC34:0, PCaeC36:4, PCaeC42:0 were positively associated with the presence of (H). Different lipidome components were identified in healthy and hypothyroid patients regardless of the cause of that condition. Studies on larger populations are needed to determine cause-and-effect relations and the potential mechanisms underlying these associations.

Correlation between thyroid dysfunction and efficacy of immune checkpoint inhibitors in patients with advanced solid tumors

BackgroundImmune checkpoint inhibitors (ICIs) are currently the first line of tumor immunotherapy for the treatment of a wide range of tumors. However, the main side effect of immune checkpoint inhibitors is that they cause immune-related adverse events (irAEs) in patients. The relationship between the occurrence of immune side effects in patients and efficacy is controversial. The objective of this study was to confirm the relationship between patients who develop thyroid dysfunction after immune checkpoint inhibitors and efficacy.MethodsThis study was a retrospective real-world clinical study, and a total of 50 patients with advanced tumors treated with immune checkpoint inhibitors at Anqing People's Hospital from 2020.8 to 2022.5 were retrospectively collected. Among them, 30 patients with hypothyroidism and 20 patients with normal or hyperthyroidism occurred, and the treatment effects and prognostic differences between the two groups were compared.FindingAfter PD1 treatment in all patients, there were 10 cases of partial remission(PR), 18 cases of stable disease(SD) and 2 cases of progressive disease(PD) in patients who developed hypothyroidism, with a disease control rate(DCR) of 93.3% and objective remission rate(ORR) of 33.3%. There were 0 complete remission (CR) patient, 3 PR patients, 11 SD patients, 6 PD patients, 70.0% DCR and 15.0% ORR in patients who did not develop hypothyroidism. The DCR and ORR of patients who developed hypothyroidism were better than those of non-hypothyroid patients, and the difference was statistically significant (P < 0.05). Kaplan–Meier survival analysis showed that progression-free survival (PFS) reached 9.2 months (95% CI 7.726–10.779) in patients who developed hypothyroidism and did not hypothyroidism patients have a PFS of 7.3 months (95% CI 5.604–8.505), with a statistically significant difference (P = 0.0341 < 0.05). Further subgroup analysis revealed that among patients who developed hypothyroidism, PFS was 3.3 months (95% CI 0.630–5.440) in patients with cholangiocarcinoma, 6.89 months (95% CI 5.604–8.505) in patients with non-small cell lung cancer, > 12 months in patients with hepatocellular carcinoma, and 11.05 months (95% CI 9.308–12.792) in patients with esophageal cancer months and PFS for patients with gastric cancer was 9.74 months (95% CI 6.979–12.502).InterpretationWhen patients with advanced tumors were treated with immune checkpoint inhibitors, DCR and ORR were higher in patients who developed hypothyroidism, and patients had better PFS. The benefits were greater in patients with gastric, esophageal, and hepatocellular carcinomas.

Estimation of Selected Metals in the Tissues of Prostate Carcinoma Patients

It Indicated that the Prostate cancer is common it affects nearly one-third of male over the age of 45. For two fundamental reasons, prostate cancer (PCa) is a serious health issue and a good prospect for tissue-scale, individualized modeling of cancer progression. In vivo validation might be allowed due to its compact size and the ability to measure serum PSA, a for prostate cancer blood biomarker can be diagnosed with support if certain markers identified by immunohistochemistry on tissue sections can aid in the diagnosis of adenocarcinoma that is primary in the prostate gland or metastatic. The biology of prostate cancer can be deeply understood by the gene identification and gene patterns expression. Using the Affymetrix Uranium95a, U95b, and Uranium95c chip sets (37,777 genes and expression sequence tags), Comprehensive gene expression is performed study on 152 hompsapien samples, which were from men of all ages and included cancer tissues, prostate tissues next to tumors, and prostate tissue of donor. In the prostate tissues, the majority of metals show a random distribution; nevertheless, patients show comparatively more unpredictability than controls. However, our findings indicate that the pattern of gene expression in cancer-related tissues is altered to such an extent that it resembles the effects of a cancer field. In contrast to controls, PCA and CA demonstrated how hazardous metals interfered with the critical metals' normal physiological and metabolic roles in the prostate tissues of both patient groups. In comparison to hyperthyroid patients and controls, hypothyroid patients' prostate tissues had greater mean levels of Fe, Ni, Cr, and Hg. Additionally; we discovered that by employing a unique model, Prostate cancer aggressiveness can be predicted by gene expression patterns.

Efficacy of levothyroxine monotherapy in achieving clinical euthyroidism and its impact on weight loss in women with hypothyroidism and obesity

In light of research indicating that normal TSH levels do not necessarily reflect clinical euthyroidism in hypothyroid patients, and given the patient dissatisfaction with levothyroxine (LT4) monotherapy, we evaluate the response to weight loss treatment in patients with obesity and primary hypothyroidism who are euthyroid under LT4 therapy, with a focus on weight and metabolic parameters. The retrospective study included 138 subjects with obesity (BMI ≥ 30 kg/m2), 69 women with hypothyroidism on levothyroxine, and 69 age- and BMI-matched women without thyroid disease. Secondary causes of obesity, medications that may affect thyroid functions and metabolic parameters, chronic and oncological disease, pregnancy, TSH outside the reference range, follow-up periods of less than one year, and bariatric surgery were the exclusion criteria. Patients’ characteristics and metabolic responses to weight reduction treatment consisting of calorie restriction, moderate exercise, and metformin if needed were evaluated. TSH and fT4 levels were higher, and fT3 and T3/T4 ratios were lower all within the reference ranges in hypothyroid women. They were less insulin resistant. Both patient’ groups experienced a significant decrease in body weight, BMI, and atherogenic index of plasma (AIP) during the follow-up (p = 0.001). Insulin resistance was not changed. The groups’ body weight, BMI, HOMA-IR, and AIP changes were similar at the end of the study (p = 0.876, p = 0.850, p = 0.555, p = 0.293). The results suggest that achieving euthyroid status via levothyroxine monotherapy in hypothyroid women leads to weight loss responses comparable to those in women with normal thyroid. This supports the effectiveness of current hypothyroidism treatment strategies, emphasizing TSH level normalization, in achieving clinical euthyroidism concerning weight loss outcomes.

EGFR Evalutation among the Hypothyroid Patients Attending at a Tertiary Center of Chattogram

Background: Hypothyroidism is a prevalent endocrine illness that affects people all over the world. The modulation of renal hemodynamics and basal metabolic rate is disrupted in hypothyroidism. The kidney is generally involved in thyroid hormone metabolism, breakdown and excretion. Chronic renal hypoperfusion affects the hypothalamic pituitary-thyroid axis, resulting in low circulating thyroid hormone levels, changed peripheral hormone metabolism, decreased tissue thyroid hormone content and altered thyroid iodine storage. Recent research has linked an increased risk of hypothyroidism to a decreased estimated Glomerular Filtration Rate (eGFR). The purpose of the study is to determine the association between eGFR with hypothyroidism in a tertiary care hospital of Chattogram. Materials and methods: A cross-sectional study was done during July 2022 to June 2023 including 100 diagnosed hypothyroidism cases attending in Chittagong Medical College Hospital. Serum Thyroid Stimulating Hormone (TSH) serum free thyroxine (FT4) serum creatinine, and blood urea were measured. The estimated glomerular filtration rate (eGFR) were determined. The result were analysed using SPSS version 25. Results: The mean age was 42.76±10.18 years with 93% female. Most of the patients (92%) were in a subclinical hypothyroid state and 8% were in an overt hypothyroid state. The mean ±SD serum creatinine levels and urea levels were 0.8±0.2mg/dl and 25.4±6.5 mg/dl, respectively. The mean eGFR was 75.36±7.54 ml/min/1.73 m2. There was a significant decrease in mean eGFR in the &lt; 60 ml/min/1.73m2 group among the study population. There was a significant association between decreased eGFR and hypothyroidism. Serum TSH had significantly shown a negative correlation with eGFR. Serum TSH level had a significant positive correlation with serum creatinine (r=0.56, p&lt;0.05) and serum urea (r=0.25, p&lt;0.05). There was a significant eGFR difference between subclinical hypothyroidism and overt hypothyroidism. Conclusion: It can be concluded from this study that the hypothyroidism was significantly correlated with decreased eGFR. IAHS Medical Journal Vol 7(1), June 2024; 86-90

Dosha status distribution of Thyropro39 scale derived data for Quality of life in hypothyroidism patients- A cross-sectional study

Thyropro 39 scale is widely used to assess quality of life in hypothyroid patients treated with Ayurvedic system of medicine. Dosha assessment is fundamental to Ayurveda at all stages of treatment. Research is conducted to detect the distribution of Dosha oriented features in a QoL study using Thyropro 39 scale. This hospital based cross sectional study was conducted between June 2021 to June 2022, where 47 (50%) of 94 patients recruited were on regular Levothyroxine supplement. The participants were interviewed and the distribution of features collected in various domains of Thyropro 39 was analysed for Dosha related features. The results showed predominantly the features of Vata dosha in both intensity and distribution, while the features of both Pitta and Kapha doshas were not noticable with the Thyropro39 scale. Domain of symptoms, related to functions of different units of Vata like Udana, Prana, Vyana and Samaana and to the functions of Pachaka, Alochaka &amp; Bhrajaka pitta had affected 3.19% of the group, in quiet a bit intensity. The domains of tiredness (57.44%), nervousness &amp; tension (61.69%), psychological well being (57.45%), mood swings (59.59%) reported quiet and bit and very much intensity showing Vata aggravated status. The domains of vitality (37.23%), memory &amp; concentration (66.44%), relationships (87.22%), daily activities (85.09%) reported not at all or some intensity, Vata showing its depleted status.

Genetic predisposition to thyroid dysfunction: a case–control study investigating TSHR gene polymorphism (rs2268458) in Indians

BackgroundVariations in the TSHR gene have been implicated in a spectrum of thyroid diseases. Previous studies have implicated variations in the TSHR gene, including SNPs rs179247, rs12101255, and rs2268458, in thyroid diseases, but their association with hypothyroidism and hyperthyroidism in the Indian population has not been investigated.AimIn this study, we aimed to examine the relationship between candidate SNP rs2268458 and susceptibility to hypothyroidism and hyperthyroidism in the Indian population. We carried out a case–control genetic screening of the TSHR gene.MethodsWe analyzed the variant of the TSHR gene using the PCR–RFLP technique in a total of 318 participants, including 130 controls and 188 individuals with thyroid disorders (124 hypothyroid and 64 hyperthyroid). Demographic information was collected, and biochemical parameters were assessed using enzymatic methods. Statistical analysis was performed using SPSS-23.ResultsThe SNP rs2268458 demonstrated a significant association with hypothyroid and hyperthyroid patients (p-value < 0.05). Using the dominant genetic model, we calculated an odds ratio of 3.52 (confidence interval: 2.09–5.93, p-value: 0.0001) for the risk of hypothyroidism and an odds ratio of 2.34 (confidence interval: 1.26–4.31, p-value: 0.0001) for the risk of hyperthyroidism.ConclusionThis pioneering study in the Indian population reveals a significant association between the C allele of TSHR gene SNP rs2268458 and an increased risk of developing both hypothyroidism and hyperthyroidism. Our findings suggest that the C allele may be a common genetic risk factor for thyroid dysfunction in Indians.

Assessment of Serum FABP-4 Levels in Hypothyroidism Patients: A Comparative Analysis With a Control Group and Their Correlation With Liver Function Tests and Biochemical Factors.

The association of serum FABP4 and other biochemical-related parameters is important to determine complications of hypothyroidism. This study aimed to evaluate serum FABP-4 levels in hypothyroidism patients in comparison with a control group. Forty-five patients with hypothyroidism and 45 healthy volunteers were included in this study. Liver function tests, thyroid hormones panel, lipid profile and serum FABP-4 levels were measured and compared in both groups, and their correlations were analysed. Serum FABP-4 levels were significantly higher in patients with hypothyroidism compared to the control group (p = 0.002), and serum FABP-4 level in males was higher than it in females (p = 0.022). There was a significant difference between patients with hypothyroidism and the control group in the levels of AST (p = 0.012). Moreover, serum FABP-4 levels were negatively correlated with age (p = 0.016) and positively correlated with weight (p = 0.044). In our study, there was a notable increase in serum FABP-4 concentration among hypothyroidism subjects. The data suggest that FABP-4 could potentially be a superior diagnostic indicator for hypothyroidism when contrasted with a control cohort in future studies.

Study Of Calcium Magnesium And Phosphorus In Hypothyroidism - A Case Control Study

Background: Thyroid disorders are the most common endocrine abnormality in the world secondary to diabetes mellitus. Thyroid hormones are essential for growth, neuronal development, reproduction and regulation of energy metabolism. It influences the metabolism of all substrates including minerals. Many studies have shown that mineral metabolism is frequently disturbed in thyroid disorders. Materials and Methods: The study was conducted on sixty newly confirmed hypothyroid cases based on the thyroid profile and sixty euthyroid cases were recruited as controls. Blood samples were collected from all the patients for the estimation of serum T3, T4, FT3, FT4, TSH, calcium, phosphorus and magnesium by auto analyzer method. Modified spectrophotometric micro-method was used to measure Serum copper using Bathocuprine Disulphonate Disodium Salt (BCDS) and Guanidine hydrochloride salt. The Statistical software namely SPSS 18.0, and R environment ver.3.2.2 were used for the analysis of the data. Results: It was found that the levels of serum sodium, potassium and calcium were significantly decreased in cases than the controls. Serum magnesium and phosphorus were significantly elevated in cases than controls. Conclusion: Serum calcium, magnesium and phosphorous levels are significantly altered in patients having hypothyroidism. Thyroid diseases have wide spread systemic manifestations including their effects on bone and mineral metabolism. Also thyroid hormone affects the glomerular filtration rate, renal blood flow, tubular reabsorption and excretion of minerals which have direct effect on Calcium, Magnesium and phosphorous level. Thus monitoring of these minerals in hypothyroid patient will be of great benefit in improving clinical manifestation and can be treated appropriately

Application of Human Plasma Targeted Lipidomics and Analysis of Toxic Elements to Capture the Metabolic Complexities of Hypothyroidism.

Hypothyroidism (HT) affects millions worldwide and can lead to various lipid disorders. The metabolic complexity and the influence of toxic elements in autoimmune and non-autoimmune HT subtypes are not fully understood. This study aimed to investigate the relationships between plasma lipidome, toxic elements, and clinical classifications of HT in unexposed individuals. Samples were collected from 120 adults assigned to a study group with Hashimoto's disease and non-autoimmune HT, and a healthy control group. Quantification of 145 pre-defined lipids was performed by using triple quadrupole tandem mass spectrometry (TQ MS/MS) in multiple reactions monitoring (MRM) mode via positive electrospray ionization (ESI). Levels of toxic elements were determined using inductively coupled plasma mass spectrometry (ICP-MS). Significant associations between altered levels of several components of the plasma lipidome and Al, Cd, Ni, As, and Pb with HT were found. We show metabolic differences in lysophosphatidylcholines (LPC) and phosphatidylcholines (PC) between HT and controls, with distinct predicted activation patterns for lysolecithin acyltransferase and phospholipase A2. There are significant changes in the lipidome profiles of healthy subjects compared to euthyroid HT patients treated with L-thyroxine, which are related to the type of hypothyroidism and non-occupational exposure to toxic elements.

A longitudinal observational study on activated partial thromboplastin time in hypothyroidism and effect of thyroxine supplementation

Background: Hypothyroidism is a common condition characterized by thyroid hormone deficiency, which, if untreated, can lead to severe health consequences and even death. Due to the wide range of clinical presentations and non-specific symptoms, hypothyroidism is primarily diagnosed biochemically. It can result from congenital thyroid abnormalities or iodine deficiency. Aims and objectives: Aim: To evaluate the correlation between hypothyroidism and Activated Partial Thromboplastin Time (aPTT) and assess the effect of thyroxine supplementation. Objective: To study the impact of levothyroxine supplementation on aPTT in hypothyroid patients. Materials and methods: This observational study was conducted at the General Medicine outpatient clinic and inpatient wards at Al-Ameen Medical College and Hospital, Vijayapura, from September 2022 to March 2024. A total of 80 hypothyroid patients of both sexes were included. TSH, Free T4, and aPTT levels were measured with appropriate aseptic precautions. Results: The majority of subjects were females (90%), with the highest proportion (31.3%) aged 26-35 years. The mean ± SD of pre-thyroxine TSH was 25.453 ± 19.9073, which significantly decreased to 4.299 ± 0.6738 post-thyroxine. aPTT values also decreased significantly post-treatment. A positive correlation was found between TSH and aPTT, while aPTT had a negative correlation with T3 and T4 levels. Conclusion: aPTT is significantly elevated in hypothyroid patients and shows a positive correlation with TSH levels. Regular monitoring of aPTT should be included in the follow-up of hypothyroid patients.

Characteristics of blood lipid and metabolic indicators in subclinical hypothyroidism patients: a retrospective study.

The characteristics of blood lipid and metabolic indicators were analyzed in patients with subclinical hypothyroidism (SCH), and the effect of type 2 diabetes mellitus (T2DM) on SCH patients was determined. The physical examination data of 2,119 residents in a university community were retrospectively divided into 2 groups (SCH and non-SCH groups). Furthermore, the SCH group was divided into SCH-T2DM and SCH-non-T2DM subgroups, and the data between the groups were analyzed. The SCH group had significantly higher levels of triglycerides (p = 0.044), total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.019), very low-density lipoprotein cholesterol (p = 0.044), 2-h plasma glucose (p = 0.023), and globulin (p = 0.000) compared to the non-SCH group. The SCH-T2DM group was older (p < 0.001), had a greater BMI (p = 0.028), a more rapid heart rate (p = 0.025), and a greater waist circumference (p < 0.001) than the SCH-non-T2DM group based on the subgroup analysis. The SCH-T2DM group had significantly higher dyslipidemia and dysglycemia levels than the SCH-non-T2DM group. Patients with SCH with or without T2DM may have dyslipidemia and dysglycemia and should be evaluated accordingly.

Evaluating cardiac electrophysiological markers for predicting arrhythmic risk in hypothyroid patients

ABSTRACT Objectives This study aimed to evaluate the impact of hypothyroidism and levothyroxine (LT4) treatment on arrhythmic risk by concurrently analyzing multiple electrocardiogram (ECG) parameters such as the Index of Cardio-Electrophysiological Balance (iCEB), frontal QRS-T angle, Tpeak-Tend (Tp-e) interval/QT interval ratio, and QT dispersion (QTd). Methods This cross-sectional study included 132 adult patients with primary hypothyroidism who had been receiving LT4 treatment, and 132 demographically matched healthy controls. The hypothyroid group was also stratified by thyroid-stimulating hormone (TSH) levels (subclinical <4.5 and overt ≥ 4.5). Participants underwent a series of thyroid function and ECG measurements. Results The hypothyroid and healthy control groups were matched for age and gender (p = 0.080; p = 0.176). Participants with hypothyroidism had higher Tp-e/QT ratios, iCEB, median frontal QRS-T angle, and corrected QT dispersion (cQTd) than healthy controls (p = 0.004; p = 0.025; p = 0.004; p = 0.004, respectively). In the overt group, the Tp-e/QT ratio, iCEB, and median frontal QRS-T angles were all higher (p = 0.012, p = 0.037, and p = 0.016, respectively). Logistic regression analysis indicated that a higher iCEB score (β = 0.60, p = 0.003) was significant for the detection of arrhythmia risk. ROC analysis showed that iCEB had the highest sensitivity (0.80), moderate specificity (0.60), and AUC 0.70. Conclusion Patients with hypothyroidism have a higher risk of arrhythmia. To assess this risk, it is important to analyze the Tp-e interval, iCEB, frontal QRS-T angle, and QTd. Differentiating between patients with subclinical and overt hypothyroidism can help minimize the risk of arrhythmia. iCEB is the most effective method for identifying arrhythmic risk. Using all these parameters can improve the accuracy of arrhythmic risk detection in patients with hypothyroidism.

Cost-Effectiveness Analysis Comparing Conventional and Digital Software Supported Management for Hypothyroidism.

Wearable devices can now leverage the established correlation between thyroid function and heart rate to monitor thyroid function alongside exercise levels and heart rate. The objective was to assess the cost-effectiveness of introducing a wearable/mobile-based thyroid function digital monitoring solution for the management of hypothyroidism compared to the conventional management approach. A decision-analytic Markov state-transition simulation model employed for utilizing a simulated cohort of 10,000 40-year-old patients with hypothyroidism to estimate costs and health outcomes. Cost-effectiveness from the healthcare sector perspective was evaluated using a 4.5% annual discount rate and the costs adjusted to 2022 levels, and lifetime outcomes were presented through incremental cost-effectiveness 49 ratios (ICERs). Deterministic and probabilistic sensitivity analyses evaluated the robustness of the results. The digital monitoring solution supported group yielded an additional 0.65 QALYs with an incremental cost of $11700.87, resulting in an ICER value of $17988.97 per QALY gained. Digital-powered software could be an optimal strategy in 99% of iterations against willingness-to-pay thresholds of $32,255/QALY gained. The ICER was most sensitive to the annual cost of a digital monitoring solution for hypothyroidism. The incorporation of the digital monitoring solution has demonstrated positive cost-effectiveness in hypothyroidism management when compared to the standard care. The cost of the digital monitoring solution and its sensitivity are key factors in determining cost-effectiveness. Striking a balance among the cost of digital monitoring support, the precision of hormonal level monitoring, and its effectiveness for the specific group of hypothyroid patients in real-world clinical practice is essential.

Correlation of Heart Rate Recovery with Cardiorespiratory Fitness in Polycystic Ovary Syndrome with Hypothyroid Patients

Correlation of Heart Rate Recovery with Cardiorespiratory Fitness in Polycystic Ovary Syndrome with Hypothyroid Patients

Effect of Yoga Therapy on Hypothyroidism: A Systematic Review.

Hypothyroidism (HT) is the most prevalent endocrine disorder, affecting approximately one in 10 out of 35 adults, with a higher prevalence in females and the elderly. This systematic review (SR) aimed to discuss the effects of yoga on markers and comorbid conditions of HT. The SR was registered with the PROSPERO (PROSPERO 2022 CRD42022312990). Google Scholar, PubMed, Cochrane, and EMBASE were searched for the relevant English language interventional studies published from 31 December 1947 to 31 December 2023 by using the keywords 'meditation OR breath regulation OR yoga OR yoga nidra AND hypothyroidism OR hypothyreosis OR underactive thyroid OR low thyroid'. Of the 4078 screened studies, eight eligible studies (three RCTs, two pilot studies, two pre-post trials, and one case study) with 421 HT patients (392 females and 29 males) and three to six-month yoga interventions were included. Two independent review authors extracted study characteristics and synthesised them descriptively. RCTs and NRSIs were assessed for risk-of-bias (RoB) using Cochrane tools RoB2 and ROBINS-1. The findings suggest that yoga effectively improves the thyroid profile, lipid profile, heart rate variability, pulmonary functions, anxiety, depression, and quality of life among HT patients. Yoga may be an inexpensive add-on preventive and therapeutic option for HT. The clinical and methodological heterogeneity among the studies did not allow for meta-analysis (MA). Well-designed MAs are warranted by including rigorous RCTs to draw valid conclusions and defined mechanisms regarding the efficacy of yoga practices/interventions on HT.