Risk Of Thyroid Disease Research Articles

Excessive Iodine Intake During Lactation Is Not Related to the Incidence of Thyroid Disease: A 3-Year Follow-Up Study

Objectives: This study aimed to investigate the relationship between excessive postpartum iodine intake and the incidence of thyroid disease in mothers, as well as child growth and development. Methods: Of 1054 participants in the 2019 nationwide survey that assessed maternal postpartum iodine intake, 684 mothers participated in a follow-up study. Data on maternal thyroid disease incidence and child growth and development from infant or toddler health checkups were collected. Iodine and nutrient intake were assessed using a food frequency questionnaire, and serum thyroid hormones (triiodothyronine (T3), thyroid-stimulating hormone (TSH), and free thyroxine (free T4)) were measured. Relative risks (RRs) were estimated using Poisson regression analysis. Results: Among the 684 participants, 23 (3.4%) were diagnosed with thyroid disease by a physician during the follow-up period. The incidence of maternal thyroid disease was not significantly associated with excessive iodine intake, even after adjusting for confounding factors. Additionally, excessive maternal iodine intake was not related to subclinical hypothyroidism in mothers or child growth and development. Conclusions: After a three-year follow-up, no relationship was observed between high postpartum iodine intake and the risk of thyroid disease. Large-scale longitudinal studies are required to evaluate the long-term effects of excessive postpartum iodine intake on maternal health and child growth and development.

The Impact of COVID-19 Vaccination on Thyroid Disease in 7 Million Adult and 0.2 Million Adolescent Vaccine Recipients.

Emerging reports have raised concerns regarding the potential link between COVID-19 vaccination and thyroid dysfunction, specifically thyroiditis. This study aimed to investigate the potential association between COVID-19 vaccination and the prevalence of thyroid diseases using data from a Korean national cohort. This study included 7,579,210 adult and 241,063 adolescent vaccine recipients. A self-controlled case series design was applied to estimate the incidence rate ratio (IRR) of thyroid disease during the 55-day post-vaccination period (first and second dose) compared to the baseline period (non-exposure period) using conditional Poisson regression. In the adult population, IRRs for hyperthyroidism, hypothyroidism, subacute thyroiditis, and thyroid eye disease were 0.98 (95% CI 0.89-1.09), 0.91 (95% CI 0.84-0.98), 1.27 (95% CI 0.94-1.72), and 0.68 (95% CI 0.50-0.93) after the first vaccine dose and 0.96 (95% CI 0.87-1.06), 0.93 (95% CI 0.87-0.99), 1.32 (95% CI 0.96-1.80), and 1.06 (95% CI 0.81-1.38) after the second vaccine dose. While the risk of hyperthyroidism recurrence did not increase after vaccination, we observed an increased risk of hypothyroidism exacerbation. Subgroup analyses based on age, sex, and vaccine type revealed no significant differences in the incidence of thyroid diseases. In adolescents aged 12-17 years, no increase in the risk of thyroid disease was observed after vaccination. This extensive national self-controlled case series analysis found an increased risk of exacerbation of hypothyroidism following COVID-19 vaccination. However, no significant association was observed between COVID-19 vaccination and an increased risk of most other thyroid diseases. These findings contribute to increasing evidence supporting the safety of COVID-19 vaccination in relation to thyroid health.

The risk of thyroid cancer after hysterectomy and oophorectomy: a meta-analysis.

The purpose of this meta-analysis is to assess whether there is an association between hysterectomy and oophorectomy and risk of primary thyroid cancer. PubMed, Cochrane Library, Embase, and Web of Science were searched for eligible studies published from database inception to May 13, 2024, using medical subject headings (MeSH) and keywords. All statistical analyses were performed using Stata statistical software (version 14.0). If P > 0.1 and I2 ≤ 50%, a fixed-effects model was adopted. If I2 > 50% a random-effects model was adopted. The funnel plot and Egger's test were used to evaluate publication bias. A total of 11 studies explored the association between a history of hysterectomy, oophorectomy and the risk of thyroid cancer. The pooling analysis shows that a history of hysterectomy, oophorectomy is associated with an increased risk of thyroid cancer (HR = 1.597; 95% CI: 1.467-1.738; I2 = 57.1%, P = 0.01 < 0.1). In the subgroup analysis, a follow-up duration exceeding 20 years is linked to an elevated risk of thyroid cancer (HR = 1.772; 95% CI: 1.301-2.414; I² = 81.70%, P = 0.004 > 0.001). Hysterectomy combined with salpingo-oophorectomy is associated with a higher risk of thyroid cancer incidence (HR = 1.633; 95% CI: 1.449-1.841; I² = 51.10%, P = 0.069 > 0.001). Studies that balanced smoking, alcohol consumption, and history of thyroid disease demonstrated an association between hysterectomy and increased risk of thyroid disease (HR = 1.734; 95% CI: 1.591-1.891; I² = 31.30%, P = 0.225 > 0.001). Our meta-analysis reveals a heightened risk of primary thyroid cancer following hysterectomy and oophorectomy. These findings underscore the importance of considering potential cancer risks when determining surgical approaches and implementing preventive measures prior to these procedures.The meta-analysis was conducted in adherence to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (1). The protocol was pre-registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform, with the registration number CRD42024546451. https://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier CRD42024546451.

The causal effects of inflammatory and autoimmune skin diseases on thyroid diseases: evidence from Mendelian randomization study.

To clarify the controversy between inflammatory or autoimmune skin diseases and thyroid diseases, we performed two-sample Mendelian randomization (MR) analyses. Genetic data on factors associated with atopic dermatitis (AD, n=40,835), seborrheic dermatitis (SD, n=339,277), acne (n=363,927), rosacea (n=299,421), urticaria (n=374,758), psoriasis (n=373,338), psoriasis vulgaris (n=369,830), systemic lupus erythematosus (SLE, n=14,267), vitiligo (n=353,348), alopecia areata (AA, n=361,822), pemphigus (n=375,929), bullous pemphigoid (BP, n=376,274), systemic sclerosis (SSc, n=376,864), localized scleroderma (LS, n=353,449), hypothyroidism (n=314,995 or n=337,159), and hyperthyroidism (n=281,683 or n=337,159) were derived from genome-wide association summary statistics of European ancestry. The inverse variance weighted method was employed to obtain the causal estimates of inflammatory or autoimmune skin diseases on the risk of thyroid diseases, complemented by MR-Egger, weighted median, and MR-pleiotropy residual sum and outlier (MR-PRESSO). AD, SLE, SD, and psoriasis vulgaris were associated with an increased risk of hypothyroidism, whereas BP was associated with a lower risk of hypothyroidism (all with p < 0.05). The multivariable MR analyses showed that AD (OR = 1.053; 95%CI: 1.015-1.092; p = 0.006), SLE (OR = 1.093; 95%CI: 1.059-1.127; p < 0.001), and SD (OR = 1.006; 95%CI: 1.002-1.010; p = 0.006) independently and predominately contributed to the genetic causal effect on hypothyroidism after adjusting for smoking. The results showed no causal effects of inflammatory or autoimmune skin diseases on hyperthyroidism. The findings showed a causal effect of AD, SLE, SD on hypothyroidism, but further investigations should be conducted to explore the pathogenic mechanisms underlying these relationships.

P-724 Long-term health outcomes of 19 years follow-up of mothers conceived after oocyte donation based on the registry of a large healthcare organization

Abstract Study question Short term outcomes of oocyte donation (OD) pregnancies are known. Yet, long term effect of OD pregnancies on mother’s health are lacking. Summary answer Comparing women after OD pregnancies to spontaneous pregnancies or nulliparous women, a higher risk of thyroid diseases was found (1.41, p &amp;lt; 0.0001 and 2.13, p &amp;lt; 0.0001, respectively) What is known already Short term outcomes of oocyte donation pregnancies show increased risk of placental disease and pregnancy-related hypertensive disorders. Study design, size, duration This retrospective cohort study, conducted from 2000 to 2018, utilized the computerized records of a major healthcare provider. It compared the demographic data and long-term health outcomes of mothers who had undergone OD pregnancies with three groups: In Vitro Fertilization using autologous oocytes, spontaneously pregnancies, and nulliparous women. Participants/materials, setting, methods The study tracked the onset of chronic diseases from the date of delivery to the diagnosis of any chronic disease. The risk of various diseases and mortality among these groups was assessed using a Cox proportional hazards model. This model adjusted for variables such as age at the index date, number of children, body mass index (BMI), and smoking habits. Statistical significance was determined using two-sided p-values, with a threshold of P &amp;lt; 0.05. Main results and the role of chance Regarding long-term outcomes, no difference was found between mothers after oocyte donation comparted to mothers after IVF (See table 1).. When comparing oocyte donation pregnancies to mothers after spontaneous conception, mothers after oocyte donation had less lower prevalence of rheumatology diseases (6% vs 8.9%) and more higher prevalence of thyroid diseases (21.9% vs. 17.6%). However, in cox regression, taking into account smoking, number of birth and mom’s age, we only found a higher risk of thyroid diseases (OD 1.41, p &amp;lt; 0.0001). Lastly, oocyte donation pregnancies compared to nulliparous had more thyroid diseases (21.9% vs. 6.7%, p &amp;lt; 0.001), also in cox regression (OD 2.13, p &amp;lt; 0.0001) Limitations, reasons for caution The temporal aspect of chronic disease diagnosis; a diagnosis made at a specific point does not preclude the presence of the disease at an earlier time. Also, the infrequency of some conditions within our study population could have reduced the statistical power to detect differences or associations. Wider implications of the findings The longer-term health outcome for women conceiving after OD is reassuring, and is very similar to that of IVF children and naturally conceived children, exempt for higher risk of thyroid disease. The main recommendation should be a yearly surveillance of thyroid function. Trial registration number 0046-18-BBL

Risk of thyroid diseases in patients with psoriasis: A systematic review and meta-analysis of cohort studies

Abstract Background: An autoimmune etiology has been indicated for thyroid diseases. However, few studies have examined the association between psoriasis and thyroid diseases. Objectives: Explore the risk of thyroid disease in patients with psoriasis. Methods: We conducted a systematic review and meta-analysis of cohort studies to assess the risk of thyroid disease in patients with psoriasis. We searched PubMed, Cochrane Library, and EMBASE from their inception to April 4, 2024. Two authors independently selected the studies, assessed their quality, and extracted the data. Any disagreements were resolved through discussions with a third author. Risk ratio (RR) and 95% confidence intervals (CI) were used to present the results. Results: Three cohort studies were included. The risks of thyroiditis (RR: 1.74, 95% CI: 1.23–2.47), hyperthyroidism (RR: 1.22, 95% CI: 1.14–1.32), and hypothyroidism (RR: 1.42, 95% CI: 1.29–1.57) were higher among the patients with psoriasis than those in the control group. Conclusion: Individuals with psoriasis have a higher risk of developing thyroid disease. Further studies that provide data on different sex and age groups are needed to clarify whether any specific subgroup of patients with psoriasis has an elevated risk of developing thyroid disease.

Causal relationships of mental diseases and thyroid diseases based on a Mendelian randomization study.

Evidence from observational researches have suggested that mental diseases are able to affect thyroid diseases. However, the causal relationship between mental diseases and the risk of thyroid diseases still remains unclear. Herein, we conducted a two-sample Mendelian randomization (MR) statistical analysis method to assess the causality between mental diseases and thyroid diseases. Initially, publicly available genome-wide association studies summary data were leveraged to obtain single-nucleotide polymorphisms based on set parameters. Subsequently, a two-sample MR was utilized to analyze causal relationships between mental diseases (Alzheimer disease, bipolar disorder, major depressive disorder, Parkinson disease, schizophrenia) and thyroid diseases (hyperthyroidism/thyrotoxicosis, hypothyroidism) with removing outliers based on MR-PRESSO method. Finally, 8 regression MR methods (inverse variance weighted [IVW], IVW fixed effects, c, MR Egger, weighted median, penalized weighted median, simple mode, weighted mode) were performed to evaluate bias and effectiveness, of which IVW was considered as the primary method. Our results demonstrated that most of mental diseases have no causal relationships with thyroid diseases except bipolar disorder and hyperthyroidism/thyrotoxicosis based on IVW method [odds ratio: 0.999, 95% confidence interval: 0.998-1.000, P = .028], and bipolar disorder and hypothyroidism based on IVW method [odds ratio: 0.997, 95% confidence interval: 0.995-0.999, P = .002]. Then we subsequently conducted a consistent robustness analysis to assess heterogeneity and horizontal pleiotropy. Our method reports causal relationships exist mental diseases and the risk of thyroid diseases. Subsequent researches are still warranted to determine how mental diseases influence the development of thyroid diseases.

Thyroid diseases and female sexual dysfunctions.

Female sexual dysfunctions (FSDs) have received little attention in the context of thyroid diseases, despite the high prevalence of both conditions. This review aims to update and summarize the state of knowledge on the association between thyroid diseases and FSDs and to investigate the complex mechanisms through which thyroid hormone imbalance can impact female sexual health in the context of the biopsychosocial model. A comprehensive literature search was performed through the PubMed, MEDLINE, and Scopus databases, using the following keywords: "female sexual function," "sexual dysfunction," "hypoactive sexual desire disorder," "thyroid disease," "thyroiditis," "hypothyroidism," and "hyperthyroidism." To date, well-designed studies that describe the relationship between FSDs and thyroid disorders are lacking. However, despite the limitations on available studies, current data indicate that sexual alterations are frequently associated with thyroid diseases in women. A complex interplay of direct and indirect hormonal and nonhormonal mechanisms has been hypothesized, including hormonal changes, neurotransmitter imbalance, reduced nitric oxide release, mood disorders, and other systemic consequences of both hypothyroidism and hyperthyroidism. Thyroid hormone receptors have also been identified in the genitourinary system. In a clinical setting, physicians should investigate the sexuality of patients consulting for thyroid disease. At the same time, an evaluation of thyroid function should be performed in patients presenting with FSD, especially after menopause, when the risk of thyroid diseases and FSDs increases strongly.

Cartographic evaluation of the risk of natural elements' deficiency in the soil cover provoking spatial variation of the endemic morbidity level (on example of thyroid morbidity among population of the Central Federal District, Russia).

The main goal of the study is to evaluate the contribution of the natural geochemical risk in the central part of the Eastern European Plain to the spatial distribution of human diseases provoked by the deficiency of biologically significant microelements (Co, Cu, and I) in the environment. The Central Federal District (CFD) of Russia, located in the Eastern European Plain is characterized by a deficiency of Co, Cu, and I in the environment (soils, local food). To access the risk of thyroid diseases associated with Co, Cu, and I content in soils of the CFD based on published data of trace elements concentrations and digital soil map we create maps of the elements variation in soil cover allowing to estimate their mean concentration in the regions. The obtained cartographic estimates are comparable with the previously published assessments and averaged study results at the regional level. Comparison with medical data on thyroid disease morbidity from 2013 to 2017 at the regional level showed a significant inverse correlation with the cartographic estimates of soil I and combined (Co + Cu + I) status with due consideration of soil structure (12 regions, except for those affected by technogenic radioiodine contamination and Moscow urbanized regions). The urban population suffered from thyroid diseases to a higher extent in comparison with the rural population, which corresponds to our previous estimates. The results confirmed the possibility of assessing the geochemical risk of endemic diseases based on geochemical soil maps and identifying the negative contribution of micronutrient deficiency in the environment to endemic morbidity in the population.

Association between urinary organophosphate ester metabolite exposure and thyroid disease risk among US adults: National Health and Nutrition Examination Survey 2011-2014.

Organophosphate esters (OPEs) may interfere with thyroid function, but the relationship between OPEs and thyroid disease remains unclear. This study aims to elucidate the relationship between OPEs exposure and thyroid disease risk in the general population in the United States. Data were obtained from the 2011-2014 National Health and Nutrition Examination Survey cycle. All participants were tested for seven OPE metabolites in their urine and answered questions about whether they had thyroid disease through questionnaires. Logistic regression was employed to analyze the association between exposure to individual OPE metabolites and thyroid disease. Weighted Quantile Sum (WQS) regression modeling was utilized to assess exposure to mixed OPE metabolites and risk of thyroid disease. Bayesian kernel machine regression(BKMR) models to analyze the overall mixed effect of OPE metabolites. A total of 2,449 participants were included in the study, 228 of whom had a history of thyroid disease. Bis(1,3-dichloro-2-propyl) phos (BDCPP), Diphenyl phosphate (DPHP) and Bis(2-chloroethyl) phosphate (BCEP) were the top three metabolites with the highest detection rates of 91.75%, 90.77% and 86.57%, respectively. In multivariate logistic regression models, after adjustment for confounding variables, individuals with the highest tertile level of BCEP were significantly and positively associated with increased risk of thyroid disease (OR=1.57, 95% CI=1.04-2.36), using the lowest tertile level as reference. In the positive WQS regression model, after correcting for confounding variables, mixed exposure to OPE metabolites was significantly positively associated with increased risk of thyroid disease (OR=1.03, 95% CI=1.01-1.06), with BCEP and DPHP having high weights. In the BKMR model, the overall effect of mixed exposure to OPE metabolites was not statistically significant, but univariate exposure response trends showed that the risk of thyroid disease decreased and then increased as BCEP exposure levels increased. The study revealed a significant association between exposure to OPE metabolites and an increased risk of thyroid disease, with BCEP emerging as the primary contributor. The risk of thyroid disease exhibits a J-shaped pattern, whereby the risk initially decreases and subsequently increases with rising levels of BCEP exposure. Additional studies are required to validate the association between OPEs and thyroid diseases.

Thyroid Diseases After Total Knee Replacement: A Multi-center, Propensity-score-matched Cohort Study.

Thyroid diseases are prevalent endocrine disorders that significantly affect overall health. Although the impact of pre-existing thyroid dysfunction on total knee replacement (TKR) outcomes has been studied, the potential for TKR to increase the risk of developing thyroid disorders remains unexplored. We examined electronic medical records from a large U.S. research network in the TriNetX research network. The study focused on patients with osteoarthritis, comparing those who had total knee replacement surgery (TKR) between 2005 and 2018 to a non-TKR group who did not have the surgery. Propensity score matching was employed to control for critical confounders. The hazard ratios (HRs) for the risk of thyroid diseases in TKR patients versus non-TKR controls were assessed. Post-matching, the TKR cohort demonstrated a significantly higher risk of developing thyroid diseases compared to the non-TKR cohort (unadjusted HR=1.218, 95%CI=1.169-1.269). This elevated risk persisted after adjusting for confounders (adjusted HR=1.126, 95%CI=1.061-1.196). Stratification analysis indicated that female TKR patients and those aged ≥65 years were at higher risk of developing thyroid diseases than their respective control groups. This study suggests a potential link between TKR and an increased risk of thyroid diseases, particularly among older adults and females. Potential mechanisms include inflammatory processes, surgical stress, autoimmune responses, and pharmacological effects. Healthcare providers should be vigilant in monitoring and managing thyroid dysfunction in TKR patients. Further research is necessary to elucidate the underlying mechanisms and develop preventive strategies.

A genome-first approach to characterize DICER1 pathogenic variant prevalence, penetrance and cancer, thyroid, and other phenotypes in 2 population-scale cohorts

PurposePopulation-scale, exome-sequenced cohorts with linked electronic health records (EHR) permit genome-first exploration of phenotype. Phenotype and cancer risk are well characterized in children with a pathogenic DICER1 (HGNC ID:17098) variant. Here, the prevalence, penetrance, and phenotype of pathogenic germline DICER1 variants in adults were investigated in 2 population-scale cohorts. MethodsVariant pathogenicity was classified using published DICER1 ClinGen criteria in the UK Biobank (469,787 exomes; unrelated: 437,663) and Geisinger (170,503 exomes; unrelated: 109,789) cohorts. In the UK Biobank cohort, cancer diagnoses in the EHR, cancer, and death registry were queried. For the Geisinger cohort, the Geisinger Cancer Registry and EHR were queried. ResultsIn the UK Biobank, there were 46 unique pathogenic DICER1 variants in 57 individuals (1:8242; 95% CI: 1:6362-1:10,677). In Geisinger, there were 16 unique pathogenic DICER1 variants (including 1 microdeletion) in 21 individuals (1:8119; 95% CI: 1:5310-1:12,412). Cohorts were well powered to find larger effect sizes for common cancers. Cancers were not significantly enriched in DICER1 heterozygotes; however, there was a ∼4-fold increased risk for thyroid disease in both cohorts. There were multiple ICD10 codes enriched >2-fold in both cohorts. ConclusionEstimates of pathogenic germline DICER1 prevalence, thyroid disease penetrance, and cancer phenotype from genomically ascertained adults are determined in 2 large cohorts.

Iodine in soils, pasture vegetation cuttings, and local food products of certain regions of Russia affected by the Chernobyl nuclear power plant accident

Natural iodine deficiency, which in some regions of Russia provokes thyroid diseases, increases the consequences of the entry of short-lived radioactive isotopes of this element into the food chain as a result of the Chernobyl accident (1986). The aim of the work is to assess the risk of morbidity of the population of the Kaluga, Bryansk and Oryol regions with thyroid cancer at the level of individual settlements based on experimental data. The iodine content in soils and vegetation cuttings of pastures in geochemically contrasting landscapes, as well as in cows' milk and potatoes of private household farms in the regions affected by the Chernobyl accident in 1986: Bryansk (2021), Oryol (2022) and Kaluga (2023) regions was studied. Joint expeditions of the Laboratory of Environmental Biogeochemistry of GEOKHI RAS and the Department of Human Ecology and Bioelementology of the Institute of Ecology of RUDN, carried out on the initiative and with the participation of the authors, revealed a significant variation of iodine concentration in soils and food products, which may be crucial for assessing the risk of thyroid diseases, including thyroid cancer, among the local rural population. The iodine content was found to be highly variable in both topsoil (0.31-3.04 mg/kg) and grass cuttings (0.14-0.29 mg/kg) of the study area. The maximum natural and technogenic risk of thyroid cancer morbidity in the rural population as a result of the consequences of the Chernobyl accident of 1986 is specific for the studied settlements of Zhizdrinsky district of Kaluga region, Bolkhovsky, Dmitrovsky and Sverdlovsky districts of Oryol region, Rognedinsky district of Bryansk region.

Exploring blood metabolites and thyroid disorders: a bidirectional mendelian randomization study.

Human blood metabolites have demonstrated close associations with thyroid disorders in observational studies. However, it's essential to determine whether these correlations imply causation. Mendelian Randomization (MR) offers a promising approach to investigate these patterns. The primary aim of our investigation is to establish causality between blood metabolites and three thyroid disorders: TC, GD, and HT. We employed a two-sample bidirectional MR analysis approach to assess the relationships between 452 blood metabolites and the three aforementioned thyroid disorders. Causal links were estimated using the IVW method, with sensitivity analyses conducted via MR-Egger, Weighted Median, and MR-PRESSO. We assessed potential heterogeneity and pleiotropy using MR-Egger intercept and Cochran's Q statistic. Additionally, we conducted pathway analysis to identify potential metabolic pathways. We found 46 metabolites that showed suggestive associations with thyroid disease risk, especially Aspartate (ORIVW=7.41; 95%CI: 1.51-36.27; PIVW=0.013) and C-glycosyltryptophan (ORIVW=0.04; 95%CI: 0.00-0.29; PIVW=0.001) impacted TC, Kynurenine (ORIVW=2.69; 95%CI: 1.08-6.66; PIVW=0.032) and 4-androsten-3beta,17beta-diol disulfate 2 (ORIVW=0.78; 95%CI: 0.48-0.91; PIVW=0.024) significantly impacted GD, and Alpha-ketoglutarate (ORIVW=46.89; 95%CI: 4.65-473.28; PIVW=0.001) and X-14189-leucylalanine (ORIVW=0.31; 95%CI: 0.15-0.64 PIVW=0.001) significantly impacted HT. We also detected 23 metabolites influenced by TC and GD. Multiple metabolic pathways have been found to be involved in thyroid disease. Our MR findings suggest that the identified metabolites and pathways can serve as biomarkers for clinical thyroid disorder screening and prevention, while also providing new insights for future mechanistic exploration and drug target selection.

FRI528 Trends And Components Of Thyroid Status Evaluation In Commercially Insured Adults In The US, 2006-2020

Abstract Disclosure: E.J. Morris: None. N.M. Singh Ospina: None. S. Maraka: None. S.M. Vouri: Employee; Self; Pfizer, Inc. Background. In clinical practice, evaluation of thyroid function can be used to monitor patients with thyroid dysfunction, to clarify the etiology of a patient’s symptom, or as screening. Although studies suggest variability and possibly overuse of TSH testing, no contemporary assessment of TSH testing trends and components of thyroid testing are available. Methods. We conducted a longitudinal assessment of commercially insured adults to characterize thyroid function testing among patients without pre-existing thyroid disease. We identified all adults 18-64 years old with at least 365 days of continuous enrollment between January 1, 2006 to July 31, 2020 using IBM MarketScan Commercial Claims Databases. This nationwide administrative claims database contains beneficiary-level clinical information related to diagnoses, procedures, and prescriptions. To identify patients without or at high risk for thyroid disease we excluded those with evidence of medication use for treatment of thyroid dysfunction or interfering with thyroid function, diagnosis of thyroid disease, or pregnancy. Descriptive statistics were used to summarize relevant characteristics of patients undergoing TSH testing, TSH tests per 1,000 eligible person-months, and composition of thyroid function testing. Results. Among 67,353,280 patients meeting eligibility criteria, we identified 25,606,518 TSH tests and 15,138,211 patients with ≥ 1 TSH test. Patients contributing an episode of TSH testing were most commonly 45-54 years old (29.8%) and female (63.6%). Dyslipidemia (34.2%) and fatigue (21.4%) were the most common associated comorbidities. TSH testing rates remained relatively consistent throughout the study period with 11.4 and 11.7 TSH tests per 1,000 person-months in the first and last study months, respectively. Among all study months, we observed a mean of 12.2 TSH tests per 1,000 person-months. TSH testing rates dropped sharply in the spring of 2020 (4.2 TSH tests per 1,000 person-months). Females showed a nearly twofold higher rate of TSH testing compared to males (16.1 TSH tests per 1,000 person-months vs. 8.6 TSH tests). TSH testing rates increased consistently with age (8.2 TSH tests per 1,000 person-months among individuals 18-34 years old vs. 15.4 TSH tests among individuals 55-64 years old). The evaluation of thyroid function was completed only with TSH in most episodes (70.8%), followed by combination of TSH and FT4 testing (14.8%). Evaluation of thyroid autoimmunity was included in 2.7% of testing episodes. Panels including RT3, THBR or Tg represented 4.5% of the episodes. Conclusion. TSH testing frequency among commercially insured individuals without thyroid disease appears stable, with higher frequency found in females and with increasing age. Testing most commonly includes only TSH. The appropriateness of thyroid function evaluation will require further investigation. Presentation: Friday, June 16, 2023

THU164 Design Of The New InsiGHTS Trial: A Multicenter, Phase 2, Randomized, Open-label, Active Controlled Study To Investigate The Safety, Tolerability, And Efficacy Of Lonapegsomatropin In Prepubertal Individuals With Turner Syndrome

Abstract Disclosure: K.O. Klein: Advisory Board Member; Self; Abbvie, Tolmar. Consulting Fee; Self; Abbvie, Tolmar. Grant Recipient; Self; Arbor. Research Investigator; Self; Abbvie, Arbor. Speaker; Self; Abbvie. P. Backeljauw: Advisory Board Member; Self; Ascendis Pharma. Consulting Fee; Self; Novo Nordisk, Novartis Pharmaceuticals, Ascendis Pharma, BioMarin Pharmaceutical, Tolmar, Cavalry Biosciences, Ipsen. Research Investigator; Self; Novo Nordisk, Novartis Pharmaceuticals, Ipsen. Speaker; Self; Ascendis Pharma. S. Abdelrahman: Employee; Self; Ascendis Pharma. P. Lai: Employee; Self; Ascendis Pharma. M. Mao: Employee; Self; Ascendis Pharma. A. Shu: Employee; Self; Ascendis Pharma. Background: Turner syndrome (TS) is characterized by the complete or partial absence of one X chromosome. Common clinical features include skeletal disproportion (growth failure, skeletal dysplasia, and low bone mass) and premature ovarian insufficiency in addition to a range of comorbidities including increased risk of thyroid disease, heart abnormalities, and diabetes mellitus. At this time, individuals with TS are treated with daily somatropin (human growth hormone [hGH]) which is effective at promoting height gain and may improve body composition. However, daily somatropin therapy has been associated with poor adherence which may result in reduced therapeutic efficacy. Lonapegsomatropin, a once-weekly prodrug of somatropin, is currently FDA- and EMA-approved for the treatment of pediatric GHD, and safety and efficacy have been established in 3 phase 3 trials. Lonapegsomatropin uses TransCon® technology, which combines a parent drug transiently linked to an inert carrier to achieve sustained release of somatropin. The phase 2 New InsiGHTS trial investigates the safety, tolerability, and efficacy of once-weekly lonapegsomatropin in individuals with TS. Methods: In this phase 2, parallel arm, dose-finding study, eligible prepubertal individuals with TS (aged 1 to 10 years) from the US are planned for inclusion with the aim of randomizing 48 individuals, 1:1:1:1, to lonapegsomatropin (0.24, 0.30, 0.36 mg/kg/week) or daily somatropin (0.05 mg/kg/day [0.35 mg/kg/week], a dose consistent with treatment guidelines) and stratifying them by chronological age (&amp;lt;4 and ≥4 years). The primary objective is to compare once-weekly lonapegsomatropin to daily somatropin in promoting linear growth at 26 weeks. Secondary objectives include additional growth parameters, safety, adherence, and pharmacokinetic/ pharmacodynamic measures that will be assessed at specified timepoints over the 104 week treatment period. Enrolled individuals must be diagnosed with TS (confirmed by genetic testing), GH-treatment naïve, exhibit impaired growth, have bone age ≤ chronological age, and be biochemically euthyroid. Exclusion criteria include diagnosis of diabetes mellitus, history of celiac disease or known clinically significant congenital or acquired cardiac dysfunction that might interfere with growth, and treatment with growth-influencing medication, among others. Dose reductions will be allowed at any time if average insulin-like growth factor-1 standard deviation score &amp;gt; +2.5; and/or in case of adverse events. Conclusions: The phase 2 New InsiGHTS trial is the first time that once-weekly lonapegsomatropin will be studied in individuals with TS. New InsiGHTS will provide an opportunity to examine the impact of lonapegsomatropin in a population whose short stature is not due to GH deficiency. Presentation: Thursday, June 15, 2023

Риск заболеваний щитовидной железы, связанных с йодной недостаточностью, ликвидаторов последствий аварии на Чернобыльской АЭС ‒ работников предприятий атомной промышленности

Purpose: Assessment of thyroid disease risk associated with iodine deficiency, liquidators of the Chernobyl accident consequences, employees of nuclear industry enterprises depending on the doses of different types of exposure. Material and methods: The dose-risk assessment study included 12663 men, 1327 of whom had occupational exposure data. A Poisson’s process with intensity parameter was chosen as a statistical model of morbidity risk. The statistical package of epidemiological data analysis EPICURE was used for the estimation of excess relative risk (ERR) of thyroid diseases related to iodine deficiency. There was conducted a cohort epidemiological study of a group of liquidators who worked in the 30-km zone in 1986‒1990 over a period of more than thirty years depending on the dose received both during liquidation of the Chernobyl accident consequences and during professional work with radioactive substances (RS) and ionizing radiation sources (IRS). Results: As a result of the study direct estimates of radiogenic risk of thyroid diseases associated with iodine deficiency in the liquidators of the Chernobyl accident consequences were obtained for the first time using the data on doses of Chernobyl and the sum of these doses with the doses of occupational exposure. It is shown that the risk of disease per unit dose (ERR/Zv) for dose loads received both at liquidation of Chernobyl accident consequences and for total doses give different results. Conclusion: Assessment of the risk of thyroid diseases associated with iodine deficiency, liquidators of the Chernobyl NPP accident consequences and workers of nuclear industry enterprises, serviced by FMBA health care institutions of Russia using the doses of different types of exposure gives different results. Correct results of assessing the risk of radiation-related diseases can only be given by the register using the total radiation dose (occupational, accidental, medical, natural), as required by the directive documents.

The use of iodine-based contrast materials in computed tomography and the risk of thyroid disease: what should a general practitioner know?

The use of iodine-based contrast materials in computed tomography and the risk of thyroid disease: what should a general practitioner know?

Navigating Thyroid Dysfunction and Comorbidities Among University Students in Abbottabad, Pakistan - A Cross-Sectional Evaluation of Screening Tool for Thyroid Dysfunction.

Thyroid dysfunction has a direct role in diagnosing, and assessment and indicates the development of thyroid carcinoma. This study aimed to assess thyroid dysfunction through medical camps in different age and sex groups in students of Comsats University Abbottabad Pakistan. In this study, a cross-sectional survey design was used. For data collection, a two-day medical camp was set in the Comsats University Abbottabad campus. The students were examined physically for symptoms of thyroid dysfunction using the survey questionnaire specifically designed for this study. The current research revealed that 78 out of 1032 students, or 7.6% of the population, had thyroid disease. Although 39.3% (=406) were found to have low risk, followed by 36.7% (n=379) had moderate risk and 23.9% (n=247) had high risk of thyroid dysfunction. Altogether, 6.1% (n=63) of the students had high blood pressure (BP), 3.2% (n=33) had high cholesterolemia, 3.4% (n=33) had angina, and 0.9% (n=9) had diabetes mellitus (DM). In relation, students who exhibit signs and symptoms that last longer than five weeks include 42.2% (n=435) who felt the need for excessive sleep, 35.3% (n=364) who felt tired, 36.8% (n=380) who had trouble concentrating and 30.1% (n=311) who had palpitations. The high risk of thyroid being seen predominantly in students between the ages of 15-20 years (31.2%, n=148), as opposed to other age groups (p=0.001). Similar to this, women having a higher risk of thyroid disease (26.5%) than men (22.8%) (p =0.001). In conclusion, few students suffer with thyroid found to have high risk of thyroid disease. This method of questionnaire-based screening for thyroid dysfunction is cost-effective, with no additive risk of adverse effects from excessive screening, and could help in the early detection of thyroid and help avoid excess costs related to thyroid dysfunction and cancer screening.

Nutrition and thyroid disease.

The aim of this review was to determine, based on the most recent findings, the involvement of trace elements and vitamins critical for thyroid function and combating thyroid disease. Nutritional guidance is pivotal to reducing the risk of thyroid disease and to managing it when it arises, this meaning the prescription of diets rich in such micronutrients as iodine, selenium, iron, zinc, and vitamins B12, D3, and A. Most of the above micronutrients are good antioxidants, building up an anti-inflammatory profile, reducing thyroid autoantibodies and body fat, and improving thyroid function. Diets are increasingly being prescribed, especially for those suffering from Hashimoto's thyroiditis. Notable among prescribed diets is the Mediterranean diet. Rich in critical elements, it benefits patients at the immune endocrine and biomolecular levels. Importantly, it is likely that widespread adherence to the Mediterranean diet, together with a reduction of meat consumption and potential elimination of gluten and lactose may improve inflammation and have an impact on public health while possibly diminishing thyroiditis symptoms. It is hoped that this review can direct policymakers towards undertaking cost-effective interventions to minimize deficiency of essential minerals and vitamins and thus protect both general and thyroid health.