Serum FT4 Levels Research Articles

Thyroid under siege: Unravelling the toxic impact of real-life metal mixture exposures in Wistar rats

This study explored the effect of a toxic metal(oid) mixture (cadmium, lead, arsenic, mercury, chromium, and nickel) on thyroid function in Wistar rats exposed for 28 or 90 days. Dose levels were determined based on prior human-biomonitoring investigation. The experiment included control (male/female rats, 28 and 90 days) and treated groups, reflecting the lower confidence limit of the Benchmark Dose (BMDL) for hormone levels (M1/F1, 28 and 90 days), median concentrations (M2/F2, 28 and 90 days), 95th percentile concentrations (M3/F3, 28 and 90 days) measured in a human study, and reference values for individual metals extracted from the literature (M4/F4, 28 days only). Blood and thyroid gland samples were collected at the experimental termination. Serum TSH, fT3, fT4, T3, and T4 levels were measured, and SPINA-GT and SPINA-GD parameters were calculated. In silico analysis, employing the Comparative Toxicogenomic Database and ToppGene Suite portal, aimed to reveal molecular mechanisms underlying the observed effects. Results showed greater sensitivity in the female rats, with significant effects observed at lower doses. Subacute exposure increased TSH, fT3, and T3 levels in females, while subchronic exposure in males decreased TSH and fT3 levels and increased fT4. Subacute exposure induced changes even at allegedly safe doses, emphasizing potential health risks. Histological abnormalities were observed in all the treated groups. In silico findings suggested that toxic metal exposure contributes to thyroid disorders via oxidative stress, disruption of micronutrients, interference with hormone synthesis, and gene expression dysregulation. These results indicate that seemingly safe doses in single-substance research can adversely affect thyroid structure and function when administered as a mixture. These findings highlight the complex impact of toxic metal exposure on thyroid health, emphasizing that adhering to accepted safety limits for single-substance research fails to account for adverse effects on thyroid structure and function upon exposures to metal mixtures.

Predictive value of bone turnover markers and thyroid indicators for bone metabolism in GD patients after treatment.

To investigate the relationship between bone turnover markers (BTMs) and thyroid indicators in Graves' disease (GD) and to further assess predictive value of changes in early stage retrospectively. We studied 435 patients with GD and 113 healthy physical examiners retrospectively and followed up these two groups of patients after 6 months. We investigated the correlations between BTMs and other 15 observed factors, and analyzed the predictive value of FT3 and FT4 before and after treatment (FT3-P/FT3-A, FT4-P/FT4-A) on whether BTMs recovered. The levels of thyroid hormones and BTMs in GD group were significantly higher than those in control group (P < 0.05) and decreased after 6 months of treatment. FT3, W, Ca and ALP were independent factors in predicting the elevation of OST. Duration of disease, FT3, TSH and ALP were independent factors in predicting the elevation of P1NP. Age, duration of disease, TRAb and ALP were independent factors in predicting the elevation of CTX-1. The AUC of FT3-P/FT3-A and FT4-P/FT4-A for predicting OST recovery were 0.748 and 0.705 (P < 0.05), respectively, and the cut-off values were 0.51 and 0.595. There was no predictive value for P1NP and CTX-1 recovery (P > 0.05). BTMs were abnormally elevated in GD and were significantly correlated with serum levels of FT3, FT4, TRAb, Ca, and ALP. FT3 decreased more than 51% and FT4 dropped more than 59.5% after 6 months of treatment were independent predictors for the recovery of BTMs in GD.

Influence of medication for lifestyle diseases on thyroid function during health examinations

IntroductionVarious drugs reportedly influence thyroid function. Lifestyle diseases such as diabetes, dyslipidemia, and hypertension are prevalent worldwide, and patients often take medications for these conditions. However, the relationship between these drugs and thyroid function, especially in the general population, remains incompletely understood. MethodsThis study aimed to investigate the independent effects of medications for lifestyle diseases on thyroid function through a retrospective cohort study of medical checkup participants who visited the Enshu Hospital between April 2010 and December 2020 (n = 2814). The clinical history as well as concurrent measurements including TSH, free thyroxine (FT4), and estimated glomerular filtration rate were reviewed to consider various confounding factors influencing thyroid function in individuals. ResultsWhen factors influencing FT4 levels were assessed through simple and multiple linear regression analyses, sulfonylureas (β = 0.041, p = 0.030), α-glucosidase inhibitors (β = 0.039, p = 0.036), and thiazolidinediones (β = 0.053, p = 0.004) emerged as independent predictors of elevated FT4 levels. Subsequent analyses, including unpaired t-tests after analysis of covariance adjusted for propensity scores, confirmed the association for thiazolidinediones (15.7 vs. 17.2 pmol/L, p = 0.027). Investigating the factors influencing thyroid-stimulating hormone levels revealed no significant predictors among various medications. ConclusionsSulfonylureas, α-glucosidase inhibitors, and thiazolidinediones independently contribute to elevated serum FT4 levels. While the clinical relevance might be limited, it is essential for physicians to consider these medications, especially thiazolidinediones, when interpreting thyroid function testing.

Bone mineral density in adults growth hormone deficiency with different ages of onset: a real-world retrospective study.

Bone mineral density (BMD) impairment is one of the critical factors for long-term quality of life in adults growth hormone deficiency (AGHD). This study aims to investigate the annual changes in BMD in AGHD patients with different ages of onset and to identify predicting factors that influence BMD. AGHD patients (n = 160) with available data for 4 years follow-up from a major tertiary medical center in China were retrospectively included (110 [68.8%] childhood-onset, 119 [74.4%] male). BMD of the axial bone (including total hip, neck of femur, and L1-4) derived from dual X-ray absorptiometry and final height were investigated at the first visit, 12 months, 24 months, 36 months, and 48 months thereafter. Low BMD was defined as Z-score ≤ -2. The prevalence of low BMD was 30.0% at baseline and 12.5% at 4 years of follow-up. The CO AGHD group presented a significantly lower BMD than the AO AGHD group at the baseline (P = 0.009). In contrast, the CO AGHD group had significantly greater median annual BMD change than the AO AGHD group (0.044 vs. -0.0003 g/cm2/year in L1-4, P < 0.001), indicating a significant difference in the overall BMD trend between CO and AO groups. Childhood-onset (odds ratio [OR] 0.326, P = 0.012), low serum testosterone (OR 0.847; P = 0.004) and FT4 (OR 0.595; P = 0.039) level were independent risk factors for BMD loss. The annual changes of BMD show a different pattern in AGHD patients with varying ages of onset. Patients with CO AGHD have a lower bone mass, and in general, appropriate replacement therapy is necessary for long-term bone health in AGHD patients.

Are resting metabolic rate and clinical symptoms affected by variation of serum thyroid stimulating hormone levels within the normal range in healthy and women with hypothyroidism? A case–control study

BackgroundIt is unclear whether variation in thyroid stimulating hormone (TSH) levels within the reference range affect energy expenditure and clinical symptoms and even within the normal range of TSH levels, resting energy expenditure may alter. The aim of the present study was to determine whether treated hypothyroid subjects and healthy subjects with a low-normal TSH range (0.3–2.3 mIU/L) have better clinical outcomes and increased energy expenditure than those with a high-normal TSH range (2.3–4.3 mIU/L). MethodsThis was a case-control study of 160 overweight/obese women with TSH levels across the reference range of 0.3-4.3 mU/l. Subjects were paired in four groups: healthy subjects with low-normal target TSH (n =40), healthy subjects with high-normal target TSH (n =40), subjects with treated hypothyroidism with low-normal target TSH (n =40), and subjects with treated hypothyroidism with high-normal target TSH (n =40). Resting energy expenditure (RMR), dietary intake, body composition, physical activity, and biochemical markers were assessed. ResultsSubjects with low-normal (≤2.3 mU/L) and high-normal (>2.3 mU/L) TSH levels did not differ in terms of RMR, serum T3 levels, and clinical symptoms except fatigue (P=0.013). However, serum fT4 levels were found to be significantly different between the study groups (P=0.002). Serum fT4 concentration was the highest in subjects with treated hypothyroidism with low-normal target TSH. ConclusionVariation in serum TSH levels within the reference range did not significantly affect REE and clinical symptoms except fatigue in healthy and women with hypothyroidism.

Associations among thyroid hormone levels and mean corpuscular volume in adults in the US: A cross-sectional examination of the NHANES 2007-2012 dataset.

Mean corpuscular volume (MCV) is an important indicator used to determine the etiology of anemia and is associated with a variety of diseases. However, the link between thyroid function and MCV has yet to be clarified. This study was thus developed to assess relationships between thyroid function and MCV in a population of adults in the US. Results from the National Health and Nutrition Examination Survey study performed from 2007 to 2012 were used to conduct a cross-sectional analysis. Key thyroid-related variables included in this analysis were thyroid-stimulating hormone, total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), free thyroxine (FT4), antithyroglobulin, thyroglobulin, and antithyroid peroxidase levels. Generalized linear regression models were employed when estimating associations between MCV quartiles and thyroid parameters in 8104 adults 18 + years of age. In these participants, the weighted mean (SD) MCV was 89.36 (0.16) fL, with thyroid-stimulating hormone levels of 1.86 (0.03) mIU/mL, FT3 levels of 3.20 (0.01) pg/mL, FT4 levels of 0.80 (0.01) ng/dL, TT3 levels of 115.09 (0.64) ng/dL, and TT4 levels of 7.81 (0.04) μg/dL. When analyses were not adjusted, higher MCV values were related to reduced serum levels of FT3, TT3, or TT4. Following adjustment for possible confounding variables, this significant negative correlation between MCV and levels of FT3, TT3, and TT4 remained, and subgroup analysis revealed that this negative correlation was present in the male group and in the age group >50 years, but not in the female group and in the age group less than or equal to 50 years. These results suggest a significant negative correlation between MCV and FT3, TT3, and TT4, and this negative correlation originated more from the male population and those older than 50 years of age. The underlying mechanisms warrant additional investigation.

The Association Between Thyroid Hormones and Renal Function in Euthyroid Chinese Individuals: A Population-Based Cross-Sectional Study.

Objective This population-based cross-sectional study aimed to investigate the association between thyroid hormones and renal function in euthyroid Chinese individuals, as the relationship between thyroid hormones and renal function in this population remains unclear. Methods A total of 661 participants were included in the study after excluding individuals with thyroid diseases, incomplete clinical measurements, or those taking medications affecting thyroid function. Participants were categorized into three groups based on serum thyroid hormone and antibody levels. The study adjusted for covariates and assessed the glomerular filtration rate (GFR) and urine albumin-to-creatinine ratio (ACR) in relation to thyroid hormone levels. Results After adjusting for covariates, the study found a significant increase in GFR in the middle and highest tertiles of free triiodothyronine (FT3) and the highest tertile of total triiodothyronine (TT3). Serum FT3 and TT3 levels were significantly associated with GFR. Additionally, the study observed a significantly lower GFR in the highest tertile of thyroid-stimulating hormone (TSH) compared to the lowest tertile. However, thyroid hormone and antibody levels were not associated with the ACR. Furthermore, the highest tertiles of TT3 and total thyroxine (TT4) were associated with a decreased risk of chronic kidney disease (CKD). Conclusion In our study among euthyroid Chinese individuals, we observed a significant association between thyroid functionand GFR. Specifically, lower FT3, TT3, and higher TSH were associated with reduced GFR, indicating a potential role for thyroid hormones in maintaining renal function. Furthermore, lower levels of TT3and TT4were associated with an increased risk of CKD. These findings suggest a direct link between thyroid and renal function, even in euthyroid individuals, emphasizing the need for further investigation to elucidate the underlying mechanisms and potential therapeutic implications.

Correlation between a low serum free triiodothyronine level and mortality of severe pulmonary tuberculosis patients

BackgroundThis study aimed to assess the relationship between a low serum free triiodothyronine (FT3) level and the mortality of severe pulmonary tuberculosis (TB) patients.MethodsWe performed a retrospective study and reviewed the medical records of patients with severe pulmonary TB between January 2016 and June 2022. The patient demographics, Acute Physiology and Chronic Health Evaluation (APACHE) II score, survival or death at 28 and 90 days after hospital admission, and serum FT3 level were recorded. Bivariate regression analysis was performed to study the relationship between mortality and the FT3 level. The Kaplan–Meier method and the log-rank test were used to compare the survival rates between patients with different serum FT3 levels.ResultsOur study included 495 severe pulmonary TB patients, with 383 (77.4%) patients having a low serum FT3 level. The low-serum FT3 group had high 28-day and 90-day mortalities. The patients who had died by 28 or 90 days after hospital admission had a low FT3 level. Survival analysis showed that the patients with a low serum FT3 level had a low probability of survival at 28 days and at 90 days after hospital admission.ConclusionThe serum FT3 level was correlated with the 28-day and 90-day mortalities in patients with severe pulmonary TB. The serum FT3 level should be monitored in these patients to help manage their disease.

Subclinical central hypothyroidism in patients with hypothalamic-pituitary disease: does it exist?

Central hypothyroidism (CH) is characterized by decreased thyroid hormone production due to insufficient stimulation of an otherwise normal thyroid gland by TSH. In patients with established hypothalamic-pituitary disease, a low FT4 concentration is considered highly specific, although poorly sensitive, for the diagnosis of CH. That would be comparable to diagnosing primary hypothyroidism in patients at risk only when serum FT4 concentrations are below the reference range, missing all patients with subclinical primary hypothyroidism and preventing proper therapy in patients in which thyroxine replacement is clearly beneficial. Cardiac time intervals, especially the isovolumic contraction time (ICT), have been considered the gold standard of peripheral thyroid hormone action. Using Doppler echocardiography, we have previously shown a very high proportion of prolonged ICT in patients with hypothalamic-pituitary disease and serum FT4 levels indistinguishable from controls. As ICT decreased/normalized after thyroxine-induced increases in FT4 concentrations within the normal reference range, prolonged ICT was considered a bona fide diagnostic biomarker of subclinical CH. Those findings challenge the usual interpretation that FT4 concentrations in the mid-reference range exclude hypothyroidism in patients with hypothalamic-pituitary disease. Rather, subclinical central hypothyroidism, a state analogous to subclinical primary hypothyroidism, seems to be frequent in patients with hypothalamic-pituitary disease and normal FT4 levels. They also challenge the notion that thyroid function is usually the least or the last affected in acquired hypopituitarism. The relevance of Doppler echocardiography to correctly diagnose and monitor replacement therapy in both clinical and subclinical forms of CH should improve quality of life and decrease cardiovascular risk, as already demonstrated in patients with clinical and subclinical primary hypothyroidism.

Low-normal free triiodothyronine as a predictor of post-operative atrial fibrillation after surgical coronary revascularization.

Recent studies have focused on the association between thyroid function within normal range and cardiovascular diseases, especially on free triiodothyronine (FT3) levels. This study aims to evaluate the effects of normal FT3 level on new-onset atrial fibrillation (AF) in patients with surgical coronary revascularization. The patients who underwent surgical coronary revascularization were enrolled in the retrospective study. Thyroid function was tested after an overnight fast on the first morning of hospitalization. Serum FT3 level was divided into quartile groups within the normal range. Hazards ratios (HRs) of FT3 level for AF were analyzed by COX proportional hazard model. This study included 503 patients with a mean [standard deviation (SD)] age of 63 (±9) years, and 396 (78.73%) were male. Post-operative AF (POAF) occurred in 120 (23.86%) patients at a median of two days after surgical coronary revascularization. The cumulating incidence of AF was significantly higher in the FT3 quartile 1 (Q1) group especially in older patients as evidenced by Kaplan-Meier analysis. Additionally, the patients who experienced AF had longer hospital stays, the same result was also found in the FT3 Q1 group. Further study demonstrated that low-normal FT3 was an independent predictor of POAF [HR =1.52, 95% confidence interval (CI): 1.01, 2.28, P=0.045]. Low-normal FT3 is associated with an increased risk of POAF and is an independent predictor of POAF. Patients who experienced AF have longer hospital stays. The findings may help to identify patients with surgical coronary revascularization at a higher risk for the development of AF.

Minipuberty period of children with atopic dermatitis compared to healthy children.

Atopic dermatitis (AD) is an inflammatory, pruritic, noncontagious, chronic relapsing skin disease. Skin barrier abnormalities, excessive T helper 2 activity, and immune dysregulation are held responsible. Androgens have a negative effect on the integrity of the epidermal skin barrier, while estrogen has a positive effect. We aimed to investigate whether hormones make a difference between healthy children and children with AD during minipuberty. A total of 96 infants (postnatal 4-13 weeks), 48 diagnosed with AD and 48 controls, were included. Each group consisted of 23 girls (47.9%) and 25 boys (52.1%). Anthropometric examinations and hormone measurements were compared. The two groups, having similar age, sex, body mass index, and weight-for-length standard deviation scores, were compared. Serum free thyroxine (FT4) levels were found to be lower and insulin-like growth factor binding protein-3 (IGFBP3) levels were found to be higher in children with AD (p < 0.001 and p = 0.038, respectively). In girls with AD, estradiol, FT4, and insulin-like growth factor-1 (IGF-1) levels were found to be lower, but thyroid-stimulating hormone (TSH) levels were found to be higher (p = 0.023, p < 0.001, p = 0.038, and p = 0.034, respectively). In boys with AD, the FT4 level was found to be lower (p = 0.023). Serum FT4 and TSH levels were within normal reference ranges in all comparisons. Especially in girls with AD, decreased estradiol and IGF-1 levels were observed compared to the controls during minipuberty. In the logistic regression model, decreased levels of serum estradiol, dehydroepiandrosterone sulfate, FT4, and IGF-1, and increased levels of IGFBP3 were associated with an increased likelihood of exhibiting atopic dermatitis.

Atrial Fibrillation and Associated Factors Among Hyperthyroidism Patients Attending at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia.

The most prevalent heart symptom of hyperthyroidism is atrial fibrillation. Other than sinus tachycardia, which occurs with hyperthyroidism, atrial fibrillation is the most prevalent cardiac arrhythmia. Hyperthyroidism results in excess mortality from increased incidence of circulatory diseases and dysrhythmias. The aims of the study was prevalence and associated factors of atrial fibrillation among hyperthyroidism adult patients attending the University of Gondar Referral Hospital, Northwest Ethiopia. This study aimed to determine the prevalence and associated factors of atrial fibrillation among adult hyperthyroid patients attending the University Of Gondar Referral Hospital, Ethiopia. Using a consecutive sampling technique, 228 patients with hyperthyroidism participated in an institution-based cross-sectional study. A standardized questionnaire that had been pretested was used to gather the data that was designed to include socio-demographic data, clinical presentation, biochemical profile, and electrocardiography findings through chart review and interviews. The data were manually curated. Atrial fibrillation was present in 32 (14%) patients, with a 95% CI of 9.6 to 19.2. The identified predictor variables were age >61 years (Adjusted Odd Ratio = 4.2, 95% CI = 1.5-11.7), female sex (Adjusted Odd Ratio = 4.0, 95% CI = 1.4-12.0), and high serum FT4 >23.9 pmol/l (Adjusted Odd Ratio = 8.0, 95% CI = 2.1-30.0). The prevalence of atrial fibrillation among hyperthyroidism patients was 14%. Being female, being older, and having high serum FT4 levels were significantly associated with AF in hyperthyroid patients.

Study of Feto-Maternal Outcome in Pregnancy with Subclinical Hypothyroidism

Background: Hypothyroidism has a great impact on pregnancy. But there is a controversy about the maternal and perinatal outcomes of subclinical hypothyroidism (SCH). This study was placed to know the significant effects. Methods and Materials: A descriptive longitudinal study was held in Z. H. Sikder Women’s Medical College &amp; Hospital, Dhaka, Bangladesh. 400 pregnant women were included in this study with purposive sampling. All antenatal patients from booking visit at 1st trimester to delivery were monitored by serum TSH and serum FT4 levels in each trimester and fetal outcomes were also monitored. 200 pregnant women were diagnosed as subclinical hypothyroidism (SCH) with random screening of initial thyroid function tests. Another 200 pregnant women were euthyroid. The study period was 3 years, from January 2020 to December 2022. To evaluate the thyroid status, maternal serum samples were collected in each trimester, total three times. Maternal outcomes, which we studied, were gestational hypertension, gestational diabetes mellitus, maternal anemia, antepartum hemorrhage, postpartum hemorrhage, placental abruption, preterm delivery, premature rupture of membranes (PROM), caesarean deliveries; perinatal outcomes were low birth weight (LBW), intrauterine growth restriction (IUGR), low Apgar score, stillbirth, congenital anomaly and NICU admission. Result: This study includes 400 pregnant women, among which 200 were euthyroid and 200 were with SCH. The mean age was 27.12 ± 0.05 years in pregnancy with euthyroid group and 26.31 ± 0.25 in pregnancy with SCH group. Among the pregnancy with euthyroid group, 141 women were nullipara and 59 women were nullipara. Among the pregnancy with SCH group, 87 women were nullipara and 113 women were nullipara. Serum TSH level was 4.44 ± 0.11 in 1st trimester, 4.74 ± 0.19 in 2nd trimester, 5.45 ± 0.17 in 3rd trimester. Serum free T4 level was 8.29 ± 0.13 in 1st trimester, 6.65 ± 0.15 in 2nd trimester, 6.67 ± 0.34 in 3rd trimester. In pregnancy with SCH group gestational hypertension, miscarriage, placental abruption and premature rupture of membranes (PROM) were significantly higher (p&lt;0.001). Antepartum hemorrhage (APH), preterm delivery and Caesarian deliveries were also higher in this group (p&lt;0.05). Among the neonatal outcomes, low birth weight and intrauterine growth restriction (IUGR) babies were more born in pregnancy with SCH group. Anti TPO antibody titer was significantly higher in pregnant women with SCH. Conclusion: Subclinical hypothyroidism (SCH) is associated with increased risk of gestational hypertension, premature rupture of membranes (PROM), abruptio placentae and fetuses have more risk of IUGR and LBW. Therefore, routine maternal thyroid function test should be done to protect from adverse maternal and fetal outcome.

Investigation Roles of Erythropoietin, Testosterone, and Thyroid Hormones in Patients with Chronic Liver Disease

Chronic liver disease (CLD) is characterized as a steady decline in liver functions that lasts longer than six months, including the generation of clotting factors and other proteins, detoxification of toxic metabolic products, and bile excretion. CLD is a continual process of inflammation, damage, and regeneration of the liver parenchyma that results in fibrosis and cirrhosis. The study aims to determine the predictive role of erythropoietin, testosterone, and thyroid function markers in the pathogenesis of liver dysfunction in Iraqi patients. The current research investigation was conducted out in Baquba Teaching Hospital / Diyala governorate from November 2022 to January 2023. 50 blood samples were taken from patients who came to the Baquba Teaching Hospital and those with chronic liver disease for inspection and diagnosis by the consultant doctor in the advisory units/Baquba Teaching Hospital. 30 healthy people's blood samples were taken as a control group. The serum levels of erythropoietin, testosterone, TSH, FT3, and FT4 indicators in the samples were determined using the Roche Cobas e411. The current study's findings revealed that 61-70 and &gt;70 years scored highest age groups (28% and 26%) than ≤40 years that scored least age groups (6%) with significant differences (p&lt;0.05). The levels of erythropoietin and TSH were higher in patients than healthy. In contrast, the levels of testosterone, FT3, and FT4 were low in patients than healthy with significant differences (p&lt;0.05). According to Pearson correlations, erythropoietin is a substantial positive association with FT4 (r= 0.293* Sig.=0.039). Depending on receiver operating characteristic (ROC) curve, the present study showed the Erythropoietin, Testosterone, TSH, FT3, and FT4 markers scored the highest sensitivity (86%, 90%, 94%, 96%, and 100%) and specificity (90%, 90%, 94%, 100%, and 72%) respectively, in screening patients with Chronic liver disease (CLD). We came to the conclusion that illness severity increased with age. Erythropoietin, testosterone, and thyroid function are good prognostic markers in screening chronic liver disease that is associated with gonadal and thyroid disorders.

Association between thyroid hormone levels in the acute stage of stroke and risk of poststroke depression: A meta-analysis.

Thyroid hormones have been indicated to be associated with depression, but their relationship with poststroke depression (PSD) remains controversial. Therefore, we performed a meta-analysis to explore the correlation between thyroid hormone levels in acute stroke and PSD. We searched databases for eligible studies. Standard mean differences (SMD) and 95% confidence intervals (CI) were applied to evaluate the association among levels of thyroid hormones, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), in acute stroke patients and the risk of PSD. A total of 13 studies were included in the analysis. Compared to non-PSD patients, PSD patients had remarkably lower serum TSH and FT3 levels (TSH: SMD=-0.59, 95%CI=-1.04 to -.15, p=.009; FT3: SMD=-0.40, 95%CI=-.51 to -.30, p=.000) and higher serum FT4 levels (SMD=0.33, 95%CI=.07-.59, p=.013). Subgroup analysis showed that there may be a more statistically significant association between FT3 and the risk of PSD compared to TSH and FT4. Our results suggested that patients with lower serum TSH and FT3 levels as well as higher serum FT4 levels in the acute stage of stroke may be more susceptible to PSD.

Effects of Hormone Replacement Therapy on Autoimmune Markers and Clinical Outcomes in Pediatric Patients with Hashimoto's Thyroiditis

Objective: Hashimoto’s Thyroiditis (HT), a chronic autoimmune thyroiditis, is the predominant cause of hypothyroidism in regions without iodine deficiency. HT is characterized by the loss of immunological tolerance of the thyroid gland, leading to autoimmune attacks. This study aimed to compare the autoantibody profiles, along with clinical and laboratory findings, of patients diagnosed with Hashimoto’s disease who were either receiving treatment or followed without treatment. Material and Methods: Clinical manifestations, laboratory data, and thyroid ultrasonography (USG) findings of patients diagnosed with Hashimoto’s thyroiditis receiving hormone therapy and those followed without treatment were compared in our clinic. Results: Among a total of 249 patients, 116 received hormone replacement therapy, while 133 were followed without treatment. The mean age of all patients was 13.91±3.71 years, with a mean age at diagnosis of 11.51±3.79 years. After twelve months of follow-up, the untreated group showed an increase in serum fT4 and antiTPO levels (p=0.012 and p=0.001), with no significant difference found in serum TSH, fT3, and antiTG levels. Those receiving treatment exhibited a significant decrease in serum TSH levels and a significant increase in serum fT4 levels (p=0.002 and p&amp;lt;0.001, respectively). Although there was an increase in serum antiTPO and antiTG levels over time, no change was detected in serum fT3 levels. Clinical improvement was significantly greater in the treatment group (p=0.044). Conclusion: It has been concluded that early initiation of hormone replacement therapy in Hashimoto’s thyroiditis can mitigate negative clinical effects during follow-up, contributing to patient comfort and alleviating clinical complaints.

Interaction between triglyceride-glucose index and thyroid hormones on coronary artery disease risk in patient with euthyroid.

Triglyceride-glucose (TyG) index is an effective indicator in indentifying in pre-diabetes, diabetes, and coronary artery disease (CAD). However, the value of TyG index combined with thyroid hormones (THs) to affect CAD has not been fully evaluated. Here, we investigated the association between TyG index and THs and further studied the impacts of TyG index and THs on CAD in euthyroid. Subjects (1,297) with euthyroid who underwent selective coronary angiography (CAG) were enrolled in the present study, including 893 patients with CAD and 404 controls. The association between TyG index and THs were analyzed by linear regression models. Multivariate logistic regression analysis was used to evaluate the interaction of TyG and THs with the risk of CAD. According to the cutoff value of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and TyG index, the patients were respectively separated into four groups: low TyG/FT3 (low or high), high TyG/FT3 (low or high), low TyG/FT4 (low or high), high TyG/FT4 (low or high), low TyG/TSH (low or high), high TyG/TSH (low or high). The baseline analysis showed that FT4 level differs among the three groups according to the tertile of the TyG index. Multiple linear regression analysis revealed decreased serum FT3 level and serum FT4 level as an independent risk factor for elevated TyG index. After adjusting for confounding variables, multiple logistic regression analysis showed that patients with lower TyG index and higher FT3 level had an important protective effect on CAD when considering patients with lower TyG index and FT3 level as reference(OR = 0.536, 95% CI: 0.369-0.778, P = 0.001). Patients with higher TyG index and FT4 level (lower or higher) had a significantly increased risk of CAD (OR 1.656, 95% CI: 1.117-2.455; OR = 1.920, 95% CI: 1.279-2.848, respectively). The area under the curve for the combined diagnosis of CAD by TyG index and FT3 level is 0.615. These findings suggest that TyG is independently negatively correlated with FT3 or FT4 in euthyroid. In addition, there was a significant interaction between TyG index and THs on the risk of CAD.

Study of thyroid functions in transfusion dependent thalassemia patients of pediatric age group with reference to serum ferritin level in a tertiary care centre

Hypothyroidism is one of the most common endocrine complication in transfusion dependent thalassemia patients. Its prevalence and severity is variable and the natural history is poorly described. The frequency of hypothyroidism in Beta Thalassemia Major (BTM) children ranges from 6 to 30%. To determine the levels of serum TSH and FT4 in patients with transfusion-dependent thalassemia (TDT), as well as their relationship to the degree of iron excess indicated by serum ferritin levels. This observational descriptive study was undertaken on 200 patients (5 to15 yrs of age) in the department of Pediatrics in SCB Medical College, Cuttack, Odisha, India from to after obtaining clearance from institutional ethical committee. Out of total 200 TDT children, 141(70.50%) were euthyroid and 59(29.50%) were hypothyroid. Among hypothyroid children, 9(4.5%) had overt hypothyroidism and 50(25%) children had subclinical hypothyroidism. In children &amp;#60;10 years of age group there was a positive correlation between serum ferritin and rise in serum TSH (p &amp;#60; 0.05, r= .553). The rise in serum ferritin was statistically not significant with fall in serum FT4 (p &amp;#60; 0.05, r= .122). In children &amp;#62;10 years of age group, there was positive correlation between serum TSH and serum ferritin (p &amp;#60; 0.05,r=.845). There was an inverse relation between rise in serum ferritin and fall in serum FT4 (p &amp;#60; 0.05, r= -.406). Hypothyroidism was associated in significant number of transfusion dependent thalassemia patients. Adequate iron chelation therapy to keep serum ferritin level within normal limit and early detection of hypothyroidism preferably below 10 years of age will prevent hypothyroidism and its complications in transfusion dependent thalassemia.

Low levels of free triiodothyronine are associated with risk of cognitive impairment in older euthyroid adults

Accumulated evidence showed that thyroid diseases induced cognitive decline. However, the relationship between thyroid hormones (THs) and cognition in older euthyroid people is still unclear. Our study aimed to estimate the association between THs within the euthyroid range and cognition in community-dwelling older adults in China. Data were extracted from a cohort study on the health status of rural older adults from the Guizhou province in China (HSRO). Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were measured using the electrochemiluminescence immunoassay. Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). Linear regression and a binary logistic regression model were used to explore the relationship between THs and cognition in euthyroidism (TSH level of 0.27 ~ 4.20mIU/L). A total of 957 euthyroidism individuals were included in this study, with a mean (SD) age of 71.34 (6.35) years. In individuals with euthyroidism, serum TSH and FT3 levels were positively associated with cognition (TSH:β = 0.06, 95% CI 0.01 ~ 0.11, P = 0.03; FT3:β = 0.07, 95% CI 0.01 ~ 0.12, P = 0.01); and serum FT3 and TSH levels were significantly associated with cognitive domains (P < 0.05). Further, euthyroid individuals in the lowest serum FT3(OR = 1.96; 95% CI 1.27 ~ 3.03) quartile had a twofold increased risk of cognitive impairment compared to those in the highest quartile after adjusting for potential confounding factors. These findings suggested that low levels of FT3 could be an independent risk factor for cognitive impairment in older euthyroid adults. Additionally, a positive linear association exists between serum FT3 levels and cognitive domains (such as immediate memory, language, and attention). Further studies are needed to determine the underlying mechanisms and the community significance of these findings.

Lack of associations between thyroid dysfunction and obstructive sleep apnea-hypopnea syndrome: A meta-analysis.

Obstructive sleep apnea-hypopnea syndrome (OSAHS) is a comprehensive syndrome with endocrine and metabolic complications. This review aims to explore the correlation between thyroid hormone levels and the severity of OSAHS in patients. The protocol for this meta-analysis has been registered on PROSPERO. Searches were carried out from the inception of the databases to July 18, 2023, utilizing 6 databases (PubMed, CNKI, EMBASE, Web of Science, Cochrane Library, China Biology Medicine, and Wanfang). Standardized mean difference (SMD) and correlation coefficients were used as the effect size measures. Additionally, random effects or fixed effects models were used for pooled analysis. Moreover, data were statistically evaluated with the help of STATA 11.0 and R 4.1.3. This study included 23 articles that satisfied the pre-defined criteria. The prevalence of hypothyroidism and subclinical hypothyroidism in OSAHS patients was 6% and 8%, whereas hyperthyroidism had a prevalence of 2%. Moreover, thyroid hormone levels in OSAHS individuals exhibited no significant difference relative to healthy subjects. Subgroup analysis based on disease severity also established no significant changes in thyroid hormone levels between OSAHS individuals and controls. There was no significant correlation between the Apnea-Hypopnea Index (AHI) and free triiodothyronine (FT3), serum thyroid stimulating hormone (TSH), and free thyroxine (FT4) levels. The prevalence of thyroid dysfunction is relatively low in OSAHS individuals. Thyroid hormone levels show no significant difference between OSAHS patients and healthy subjects. Furthermore, there is no significant correlation between AHI and serum TSH, FT3, and FT4 levels. Based on existing data, the relationship between OSAHS and thyroid function remains controversial, and further in-depth research is warranted to validate the connection and elucidate the underlying mechanisms.