Serum Thyroid Hormone Research Articles

Association between thyroid hormones and cognitive functioning in euthyroid elderly adults: a cross-sectional preliminary study from the NHANES 2011–2012 survey

ObjectiveChanges in serum thyroid hormone levels may affect cognitive functioning in euthyroid individuals. This study used representative data from the National Health and Nutrition Examination Survey (NHANES) to comprehensively examine the association of thyroid hormones with different tests of cognitive functioning among US elderly people aged ≥60 years.MethodsThis study was a cross-sectional preliminary study with a total of 734 participants from the NHANES 2011-2012 survey. Thyroid function was measured using competitive binding immune-enzymatic assays, while cognitive functioning was measured using a series of assessments, including the Consortium to Establish a Registry for Alzheimer’s Disease-Word Learning (CERAD W-L), Animal Fluency Test, and Digit Symbol Substitution Test (DSST). Weighted multiple linear regression models and binary logistic regression analyses were used to examine the association between thyroid hormone levels and cognitive functioning. All statistical analyses were performed using SPSS version 20.0, and R software.ResultsWeighted multivariable linear regression showed that FT3 was negatively associated with the Animal Fluency Test and DSST (β=-0.113, 95% CI: -3.279, -0.803, P=0.001; β=-0.062, 95% CI: -6.565, -0.470, P=0.024, respectively) after adjustment for potential covariates. subgroup analysis stratified by sex revealed a negative association between FT3 levels and the Animal Fluency Test in men (β=-0.163, 95% CI: -4.643, -1.153, P=0.001). For female participants, FT3 was negatively associated with not only the Animal Fluency Test but also DSST (β=-0.099, 95% CI: -3.543, -0.093, P=0.039; β=-0.093, 95% CI: -10.288, -1.326, P=0.011). Binary logistic regression showed that the significantly increased adjusted odds ratios (aORs) (95% CI) between the risk of impaired cognitive functioning and FT3 across Q3 and Q4 compared with Q1 were 2.025 (1.092, 3.753) and 2.365 (1.261, 4.433), respectively, for DSST in overall participants. Furthermore, there were significant differences between participants with and without impaired cognitive functioning for serum FT3 levels in overall participants based on DSST score (P=0.020).ConclusionsThere was a significant inverse relationship between FT3 levels within the normal range and cognitive functioning after adjusting for potential covariates. Future longitudinal cohort studies should be conducted to determine the causal relationship between thyroid hormone levels and cognitive functioning.

Thyroid hormones and prognosis in adults with status epilepticus: a retrospective study

ObjectivesThyroid hormone levels have been indicated to be associated with the functional outcome in critical illness. However, the studies on thyroid hormones and status epilepticus (SE) are rare. This study aimed to evaluate the predictive value of serum thyroid hormone levels on admission for unfavorable outcome in adult patients with SE.MethodsWe investigated and validated the predictive value of serum thyroid hormone levels on admission for the prognosis of adult SE patients. We extracted the clinical information and outcomes of patients. Modified Rankin scale (mRS) scores were applied to assess the patients’ functional outcome, and mortality at 30 days after SE onset was identified. Serum levels of thyroid hormones including free thyroxin (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) were detected on admission.ResultsWe first analyzed the discovery cohort of 87 patients with SE. We found that 35.6% (31/87) of the patients had a poor outcome at discharge, and 18.4% (16/87) of the patients died during hospital stay and at 30-day follow up. The serum FT3 levels in the non-survivors group were significantly lower than those in the survivors group. Low T3 syndrome occurred in 29.9% (26/87) of SE cases and patients with low T3 syndrome were more likely to have unfavorable outcomes. Furthermore, we observed similar results in the external cohort, which validated our findings.ConclusionsSerum FT3 levels measured on admission are independently associated with 30-day mortality in SE patients. Additionally, low T3 syndrome may be a promising candidate for predicting SE prognosis.

Relationship of serum iron and thyroid hormone in obesity and after laparoscopic sleeve gastrectomy

BackgroundIron is an essential element for thyroid function. However, no study focuses on the association between iron and thyroid in individuals with obesity. Our research aimed to investigate the iron status in relation to baseline thyroid hormone levels and after laparoscopic sleeve gastrectomy (LSG).MethodsA total of 216 subjects with obesity were enrolled and divided into low and high iron groups depending on the median value. The association between iron and thyroid hormone was analyzed and compared before and after LSG at the 6-month follow-up in patients who underwent LSG.Results1) In all, Total Triiodothyronine (TT3) was significantly higher in high iron than low iron group (P = 0.008). TT3 and thyroid stimulating hormone (TSH) were significantly higher in high iron than low iron group (1.92 ± 0.61 vs. 1.69 ± 0.28 nmol/l, P = 0.029; 2.93 ± 1.66 vs. 1.88 ± 1.03 mU/l, P = 0.002) in females while not in males (all P > 0.05). 2) Iron was significantly positively associated with free triiodothyronine (FT3), free thyroxine (FT4), TT3 and TSH (all P < 0.05). Adjusted for body mass index (BMI), total cholesterol (TCH), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS) and homeostatic model assessment of insulin resistance (HOMA-IR), FT3, FT4 and TSH were still significantly associated with iron (all P < 0.05). 3). Regression analysis showed that iron was significantly associated with FT4 (β = 0.338, P = 0.038). 3) LSG led to decreased FT3, FT3, TT3, total thyroxine (TT4) and TSH at 6 months follow-up (all P < 0.05). Changed FT4 was significantly associated with changed iron (r = 0.520, P = 0.009). Subjects with iron decreased had more significant decreased TT4 than subjects without iron decreased (P = 0.021).ConclusionSerum iron overload is significantly associated with impaired thyroid function in subjects with obesity. LSG led to improved thyroid function which is associated with a change in iron.Trial RegistrationNCT04548232 registration date is on October 9, 2022, registered in https://register.clinicaltrials.gov/.

Associations between gestational exposure to perfluoroalkyl substances, fetal growth, and the mediation effect of thyroid hormones

Prenatal exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) may cause adverse birth outcomes. Thyroid hormones may play a key role in mediating the effects of PFAS. We enrolled 374 mother-infant pairs from the Ezhou birth cohort study between 2019 and 2020. Eight PFASs and six thyroid hormones were measured in maternal serum during the first trimester of pregnancy. Neonatal growth metrics, including birth weight, length, head circumference, and gestational age, were acquired. Multivariate linear regression was performed to determine the associations between maternal serum PFAS and thyroid hormone levels and birth outcomes and a mediation analysis was also conducted. Except for perfluoroheptanoic acid (41.2%), the other seven PFAS detection rates were more than 85%, and the highest median concentration was observed for PFOSA with levels of 5.21 ng/mL. After controlling for typical confounders, we observed a decrease in birth length (cm) with increasing serum concentrations of perfluorononanoic acid (PFNA) (β = -0.54; 95% CI = -1.0, -0.08) and perfluorohexane sulfonate (PFHxS) (β = -0.64; 95% CI = -0.86, -0.42). Additionally, a decrease in birth head circumference was observed with increasing concentrations of perfluorooctanote (PFOA) (β = -0.73, 95% CI = -1.19, -0.27) and PFHxS (β = -0.30; 95% CI = -0.53, -0.07). Maternal free triiodothyronine (FT3) mediated 36.7% of the negative association between PFNA and birth length, and free thyroxine (FT4) mediated 30.8% of the effect of PFOA on head circumference. When performing stratified analysis by infant sex, the associations might differ between boys and girls. Our study suggested prenatal exposure to some PFASs was negatively associated with birth length and circumference, and FT3 and FT4 may partly mediate the association.

Magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

BackgroundThyroid hormones have an effect on every organ system, in particular, the heart responds to minimal changes in serum thyroid hormone level. Thyroid hormone causes a lot of changes in the cardiovascular system, such as increased heart rate, contractility, systolic hypertension, changes in peripheral vascular resistance, atrial fibrillation (AF), and hypercoagulability from the direct effect of thyroid hormone on cardiac myocyte and /or due to increased metabolic state. However, the magnitude of such heart abnormalities and its associated factors were not well studied in Ethiopia.ObjectiveTo determine the magnitude of cardiac abnormality and its associated factors among hyperthyroidism patients on follow-up at Tikur Anbessa Specialized Hospital (TASH), Addis Ababa, Ethiopia, 2022.MethodsAn institution-based cross-sectional study was carried out among 318 hyperthyroid patients who were on follow-up at the endocrine clinic of TASH, Addis Ababa, Ethiopia from June to October 2022. The data were collected using a pretested structured interviewer administered questionnaire. The data were entered into the computer using EpiData version 3.1 and analyzed using SPSS version 25 software. Bivariable and multivariable logistic regression models were fitted to determine the association between the independent and dependent variables. Adjusted odds ratio with its 95% confidence interval and p-value < 0.05 were used to declare the presence and strength of statistically significant associations.ResultIn this study a total of 318 hyperthyroid patients were participated, most (90.9%) of them were females. The overall prevalence of heart failure among hyperthyroid patients was 17.0% (95% CI = 13.0, 21.6). More than half (52.7%) and one third (33.2%) of the participants showed abnormal electrocardiographic and echocardiographic findings respectively. Marital status (not married) [AOR = 2.37, 95% CI (1.03, 5.44)], pattern of hyperthyroidism [AOR = 13.09, 95% CI (4.70, 36.41)], being Asthmatic [AOR = 7.63, 95% CI (1.55, 37.52)], type of medication [AOR = 3.49, 95% CI (1.11, 11.02)] and duration of treatment [AOR = 4.95, 95% CI (2.05,11.99)] were significantly associated with cardiac abnormality.ConclusionA significant portion of hyperthyroid patients overburdened by cardiac abnormalities. Being unmarried, overt hyperthyroid, Asthmatic, long stay on treatment and type of treatment were significantly associated with cardiac abnormality. Hence, attention should be given for cardiac abnormalities while treating hyperthyroid patients.

Serum per- and polyfluoroalkyl substance (PFAS) levels and health-related biomarkers in a pilot study of skiers in New England

BackgroundPer- and polyfluoroalkyl substances (PFAS), synthetic chemicals with adverse health effects, are used extensively in consumer products. Ski waxes, applied to the base of skis, contain up to 100% PFAS by mass, but exposure and health effects are poorly characterized. ObjectivesOur objectives were to quantify serum PFAS concentrations among skiers and explore associations with reported ski wax use and biomarkers of cardiometabolic, thyroid, and immune health. MethodsWe recruited 30 active adult skiers to provide non-fasting blood samples and complete questionnaires. We quantified 18 PFAS using mass spectrometry, and measured serum lipids, thyroid hormones, and immunoglobulins. We explored associations of individual and aggregate measures of serum PFAS with wax use indicators and health biomarkers using multivariable regression models, adjusted for age and gender identity. ResultsNine PFAS (PFBS, PFHpS, PFHxS, Sm-PFOS, n-PFOS, PFDA, PFNA, PFUnDA, n-PFOA) were detected in 100% of participants, and MeFOSAA in 93%. Compared to NHANES, median serum concentrations (ng/ml) were similar, but higher in coaches (e.g., PFOAall: 1.1, PFOAcoaches: 2.7, PFOANHANES: 1.2; PFNAall: 0.5, PFNAcoaches: 1.7, PFNANHANES: 0.4). Factors reflecting wax exposure were positively associated with PFAS: e.g., >10 years as a snow sport athlete, compared to ≤10 years, was associated with 3.2 (95% CI: 0.7, 5.6) ng/ml higher aggregate PFAS, as defined by National Academies of Science, Engineering, and Medicine (NASEM). An IQR (6.3 ng/ml) increase in NASEM PFAS was associated with 32.1 (95% CI: 7.0, 57.2), 35.5 (13.5, 57.5), and 12.8 (0.6, 25.1) mg/dl higher total cholesterol, LDL-C, and sdLDL-C, respectively. DiscussionOur study provides early evidence that recreational skiers, particularly coaches, are exposed to PFAS through ski wax. Several PFAS were associated with higher serum lipids among these physically active adults. Interventions to remove PFAS from fluorinated wax could decrease direct exposure to skiers and reduce PFAS release into the environment.

12611 The Thyroid Adapts Remarkably to Overnutrition to Mitigate Hypothyroidism

Abstract Disclosure: J. Rampy: None. A. Torres Manzo: None. K. Hoffsmith: None. M.A. Loberg: None. H. Wang: None. V.L. Weiss: None. N. Carrasco: None. Obesity affects &amp;gt;40% of the U.S. population and is one of today’s biggest public health concerns. Losing weight is challenging, and maintaining weight loss even more so, owing to the many biochemical and hormonal changes that occur in the pathogenesis of obesity, some of which do not reverse after weight loss. Thyroid hormones (THs) have far-reaching effects on whole-body energy balance. Their synthesis and release by the thyroid are finely regulated by central mechanisms to control serum TH levels. THs are also regulated by nutrient sensing, so that their levels modulate energy expenditure to match energy intake. Given the reciprocal and fine-tuned relationship between THs and energy balance, one would expect strong upregulation of TH levels to counteract diet-induced weight gain, but this is not consistently reported in obesity studies. Thus, we hypothesized that overnutrition impairs thyroid function, preventing a sustained increase in TH levels. We tested this hypothesis in male C57Bl/6J mice fed a high-fat diet and sucrose water. Strikingly, overnutrition decreased T4 levels after just 5 days—and within 3 weeks, we observed mild hypothyroidism, with increased thyroid stimulating hormone (TSH) levels and goiter. After 6 weeks, intrathyroidal T4 levels were significantly decreased, whereas the expression of the TH precursor thyroglobulin (TG) was unchanged, despite high TSH stimulation. Furthermore, we found increased expression of several ER stress-related proteins, including BiP, p-eIF2α, and PDI. These results suggest that TG was not upregulated because overnutrition-induced ER stress impaired protein translation. Remarkably, even though T4 levels were low, the thyroid maintained normal T3 levels, likely due to the pronounced histological and vascular changes we observed, which should promote TH availability. Some changes were consistent with the classical growth effects of TSH stimulation, while others were likely due to upregulation of adrenomedullin 2, a TSH-responsive angiogenic vasodilator. Preliminary studies in female mice showed similar results. Notably, we have observed similar histological changes in human thyroids, which strongly correlate with BMI. Collectively, our results, despite the unchanged T3 levels, are consistent with a struggling thyroid and a mildly hypothyroid state. Existing data suggest that low T4 can itself be problematic, particularly in metabolic tissues that generate T3, the more biologically active form, from T4 to levels beyond those of the T3 available from the bloodstream. Reversibility of this state is being investigated in ongoing experiments. The causal role that overnutrition plays in thyroid impairment and decreased TH availability in the pathogenesis of obesity has scarcely begun to be elucidated. Our work sheds new light on how overnutrition changes thyroid function and highlights the remarkable adaptability of the thyroid. Presentation: 6/1/2024

7494 Glycerol Phenylbutyrate Treatment of Two Patients with Monocarboxylate Transporter 8 Deficiency

Abstract Disclosure: A. Zung: None. N. Sonntag: None. U. Schweizer: None. E. Banne: None. D. Braun: None. Context: Monocarboxylate transporter 8 (MCT8) deficiency is a rare genetic disease that leads to severe global developmental delay. MCT8 facilitates thyroid hormone (TH) transport across the cell membrane, and the serum TH profile is characterized by high T3 and low T4 levels. Currently, the two thyromimetic agents 3,5-diiodothyropropionic acid (DITPA) and triiodothyroacetic acid (TRIAC) have been evaluated in the treatment of these patients, as they both partially restore intracellular TH action independent of MCT8. Recent studies have shown that the chemical chaperone sodium phenylbutyrate (NaPB) restored mutant MCT8 function and increased TH content in patient-derived induced pluripotent stem cells, making it a potential treatment for MCT8 deficiency. Objective: We aimed to assess the efficacy and safety of glycerol phenylbutyrate (GPB) in MCT8 deficiency. Methods: We treated two monozygotic twins aged 14.5 years with MCT8 deficiency due to P321L mutation with escalating doses of GPB over 13 months. We recorded TH, serum markers of peripheral hyperthyroidism, vital signs, anthropometric measurements and neurocognitive functions by several neurodevelopment validated tests. Resting metabolic rate (RMR) was measured by indirect calorimetry. Serum metabolites of GPB were monitored as a safety measure. In-vitro effects of NaPB were evaluated in MDCK1 cells stably expressing the MCT8P32[1]L mutation. Results: NaPB restored mutant MCT8 expression in MDCK1 cells and increased T3 transport into cells carrying the P321L mutation. GPB treatment yielded a dose-dependent decrease in FT3 and an increase in FT4 serum levels. The patients showed an elevation in cholesterol levels in parallel with GPB dose, but sex-hormone binding protein (SHBG), another marker of peripheral hyperthyroidism was not affected. The patients showed a significant weight gain simultaneously with a reduction in RMR. Only minor neuro-cognitive improvement was observed, mainly in hyperreflexia score, slight improvement in gross motor functions and a mild progression in cognitive functions. Serum metabolites of GPB did not exceed the toxic range but elevated liver transaminases restricted the dose intensification of GPB. Conclusions: In the first report of GPB treatment in MCT8 deficiency patients we found an improvement in TH profile and body-mass index (BMI). The reduction in T3 levels could contribute to the remarkable increase in BMI-SDS, since various aspects of peripheral hyperthyroidism in MCT8 deficiency, including poor weight gain, were attributed to elevated T3. The limited effects of GPB treatment on cognitive and motor functions can derive from the advanced age of the patients at the time of the intervention. Presentation: 6/2/2024

12602 The Effect of Three-Month Semaglutide Treatment on Serum TSH and Thyroid Hormones in Individuals with Obesity

Abstract Disclosure: P. Konopka: None. A. Janucik: None. A. Citko: None. A. Paszko: None. A.J. Kretowski: None. L. Szczerbinski: None. Background: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) play a crucial role in managing obesity and diabetes, significantly influencing glycemic control and weight management. Previous studies showed that GLP-1 RAs therapy affects thyroid-stimulating hormone (TSH) levels; however, they were limited by small sample sizes and did not extensively cover newer agents like semaglutide. Thus, the aim of this study was to assess the impact of a three-month semaglutide treatment on thyroid hormones and TSH levels in individuals with obesity, without diabetes, and examine the relationship of these changes with weight loss. Methods: We analyzed data from 290 patients participating in the GAROS study, excluding those on medications affecting thyroid function or with a known history of thyroid disease. All participants underwent a three-month treatment with oral semaglutide, followed by a three-month discontinuation phase. Measurements of TSH, free triiodothyronine (fT3), free thyroxine (fT4), and body weight were taken at baseline, at the end of the treatment period, and three months post-treatment discontinuation. To compare changes in TSH, fT3, and fT4 levels, as well as weight, across the study timelines we used non-parametric tests due to the non-normal distribution of the data. We also employed multiple linear regression models to evaluate the association between thyroid hormone changes and weight loss, both in the aggregate and stratified by sex. Results: Initial fT3, fT4, and TSH levels were 3.13 pg/ml (SD=0.38), 0.94 ng/dl (SD=0.10), and 1.64 mIU/l (SD=0.82), respectively. Post-treatment, fT3 decreased on average by 0.33 pg/ml (p&amp;lt;0.001), TSH by 0.32 mIU/l (p&amp;lt;0.001), and fT4 increased by 0.06 ng/dl (p&amp;lt;0.001). Upon discontinuation, fT3 and fT4 levels did not fully return to baseline values but showed a significant shift in that direction (p&amp;lt;0.001 for fT3 and p=0.006 for fT4, compared to baseline). Conversely, TSH levels adjusted back to their baseline values (p=0.26). Notably, changes in fT4 levels, unlike fT3 and TSH, were significantly negatively associated with weight changes during (p=0.030) and post-treatment (p=0.008), across sex-stratified analyses. Conclusions: Semaglutide treatment significantly alters thyroid hormones and TSH levels in patients with obesity, with some effects reversible post-discontinuation. Except for fT4, these hormonal changes appear to be independent of the weight loss effects of semaglutide. Although the magnitude of these alterations might not be clinically significant, they do imply that GLP-1 RAs may have additional physiological effects. The exact nature of the interaction between semaglutide and thyroid function, however, remains to be fully elucidated, highlighting the need for further research to clarify these mechanisms. Presentation: 6/2/2024

7786 Successful Use of Lithium in Hyperthyroidism Following a Carbimazole-Induced Agranulocytosis: A Case Report

Abstract Disclosure: J.G. Sazon: None. D.V. Bawal: None. J.V. Chua: None. J. Reyes: None. Graves' disease (GD) constitutes a significant proportion of global thyrotoxicosis cases. Carbimazole is an ATD with a notably and a rare yet severe complication of ATD with substantial adverse implications for health, is agranulocytosis. This condition is reversible if recognized early and treated accordingly. We report a case of successful use of lithium prior to radioiodine ablation (RAI) in management of thyrotoxicosis in the context of Carbimazole-induced agranulocytosis. This is a case of a 38-year-old female newly-diagnosed with Graves' Disease presenting with palpitations. Diagnostics showed FT4 &amp;gt;100 (11.9 – 21.6 pmol/L), TSH at &amp;lt;0.005 (0.270 – 4.200 mIU/L) and positive TSH receptor antibodies (TRAb) at 13.9 IU/L (normal value: &amp;lt;1.76 IU/L). Electrocardiogram revealed Atrial Fibrillation. She was initiated on Carbimazole 30 mg/tab OD, Apixaban 10 mg/tab OD, and Bisoprolol 10mg/tab OD. After 28 days of drug-intake, she developed fever (TMax 38.5°C) and work-up revealed severe neutropenia with an ANC of 0. Peripheral blood smear showed agranulocytosis. A seven-day course of piperacillin-tazobactam and moxifloxacin was administered, along with G-CSF at a dose of 300ug BID. Subsequently, was scheduled for Radioactive Iodine (RAI) therapy for definitive treatment. In the interim, with persistent tachycardia and elevated thyroid function tests (FT3 22.20 pmol/L, FT4 47.24 pmol/L) Lithium 450mg/tab BID and Prednisone 40mg/day was initiated, providing significant relief from hyperthyroid symptoms. RAI was administered with a dose of 24mci. Ten days post-RAI, thyroid hormone levels further improved. Four weeks after RAI, repeat tests revealed hypothyroidism. Levothyroxine was initiated at 12.5 mcg and gradually adjusted. Pre-RAI administration of lithium serves to mitigate alterations in serum thyroid hormone concentrations and augments the efficacy of RAI therapy. In this study, the utilization of lithium aimed to regulate thyrotoxicosis and preemptively curtail the elevation of FT4 levels. Lithium emerges as a particularly suitable therapeutic option for patients experiencing adverse effects related to ATDs prior to undergoing definitive therapies such as RAI or thyroidectomy. Furthermore, imperative to the prevention of agranulocytosis, an enhanced understanding of its deleterious effects through patient education is deemed vital. Presentation: 6/2/2024

Association of hepatitis B virus and thyroid hormones during pregnancy.

This study aims to evaluate the correlation between serum thyroid hormone levels and hepatitis B virus (HBV) DNA and HBV genotypes in pregnant women with chronic hepatitis B. A total of 96 pregnant women with chronic HBV-infected pregnant women between January 2020 and December 2022 were selected as the observational study subjects. About 50 HBV-uninfected pregnant women during the same period were selected as the control group. Serum thyroid hormone levels at different stages of pregnancy, including free triiodothyronine (FT3), free thyroxine (FT4), thyroid stimulating hormone (TSH), thyroperoxidase antibody (TPOAb), and thyroglobulin antibody (TGAb), were compared between the 2 groups. Thyroid hormones levels were also compared between HBV-DNA-positive and HBV-DNA-negative women in the HBV-infected pregnancy group, and to determine the correlation between thyroid hormones levels and HBV-DNA load and HBV genotype in HBV-DNA-positive pregnant women. The TSH levels in mid and late pregnancy and TPOAb levels in early, mid, and late pregnancy of HBV-infected pregnant women were higher than those in the same period in HBV-uninfected pregnant women (P < .05). The TPOAb and TGAb levels in early, mid, and late pregnancy of HBV-DNA-positive pregnant women were higher than those in the same period in HBV-DNA-negative pregnant women (P < .05). The HBV-DNA load and FT3 or FT4 levels were negatively correlated (P < .05), and the HBV-DNA load and TGAb levels were positively correlated (P < .05). However, there was no statistical difference in thyroid hormone levels between different HBV genotypes (P > .05). The thyroid hormone levels will change in pregnant women infected with hepatitis B virus, and there is a certain correlation between HBV-DNA load and thyroid hormone levels. Therefore, timely monitoring of thyroid hormones and HBV-DNA load can provide early prevention and treatment for HBV infection in pregnant women, ensuring the health of pregnant women and fetuses.

Olfaction and thyroid hormones in patients with subjective cognitive decline, non-amnestic and amnestic mild cognitive impairment.

Thyroid hormones may affect olfaction in different stages of cognitive impairment: subjective cognitive decline (SCD), non-amnestic (naMCI) and amnestic mild cognitive impairment (aMCI). Additionally, biometric parameters, depression, and neuropsychological performance are considered as possible influencing factors. Aretrospective single-center data analysis was conducted during the observation period 2001-2023, with n = 495 (52.3% female) SCD, naMCI and aMCI subjects, aged ≥50years, at the General Hospital of Vienna. The criterion olfactory function was objectively measured by Sniffin' Sticks© odor identification and subjectively through the Assessment of Self-Reported Olfactory Functioning test. Serum thyroid hormone levels, mainly thyroid-stimulating hormone, as well as T3, T4, fT3, and fT4, were used to assess thyroid function. Statistical analyses using IBM SPSS® 29.0.0 covered adjusted multiple linear regression models with hierarchical blocks to predict olfactory performance considering β‑weights. Of the study participants, 4.2% had hypothyroidism and 2.4% had hyperthyroidism. The majority exhibited normal thyroid function. One third (33.5%; 95% confidence interval, CI 29.4-37.0%) were hyposmic. The results indicate no substantial association between thyroid and olfactory functions. Increasing age (β = 0.20), lower performance in the Neuropsychological Test Battery Vienna (NTBV) dimensions verbal memory (β = -0.33) and attention (β = -0.12) appear to be risk factors for lower olfaction. Adiscrepancy between subjective and objective olfaction was found. Thyroid and olfactory functions had no substantial relationship. Higher fT4 correlated weakly with lower odor identification. Increasing age and decreased performance in two out of six NTBV dimensions are relevant prognostic factors for olfactory dysfunction.

Associations between Thyroid Hormones and Cognitive Impairment in Patients with Parkinson's Disease.

This study aims to explore the correlation of serum thyroid hormone levels to cognitive impairments in Parkinson's disease (PD) patients. In this retrospective study, 106 Chinese patients without cognitive impairments and 94 patients with cognitive impairments, including 55 with mild cognitive impairment (PD-MCI) and 39 with PD dementia (PDD), were analyzed. Clinical data regarding the PD assessments, including disease duration, Unified Parkinson's Disease Rating Scale (UPDRS) Part 3 scores, and Hoehn and Yahr (H-Y) staging, were analyzed. Cognitive functions were evaluated using the Montreal Cognitive Assessment score. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3), were measured using ELISA. Significantly altered H-Y staging, disease duration, and UPDRS Part 3 scores were observed in PD patients with cognitive impairment compared with those without. Serum levels of FT3 were significantly decreased, while FT4 and TSH levels were significantly elevated in PD patients with cognitive impairment compared with those without. Combined detection of TSH, FT3, and FT4 showed value in distinguishing PD patients with and without cognitive impairment. Furthermore, a comparison of serum levels between PD-MCI and PDD patients revealed significant association between thyroid hormone levels and the degree of cognitive impairment in PD patients. Our findings suggest a relationship between changes in serum thyroid hormone levels and cognitive impairments in PD patients. Thyroid hormone levels, particularly FT3, may serve as potential markers for cognitive dysfunction in PD.

Cardioprotective effect of Vitamin D on cardiac hypertrophy through improvement of mitophagy and apoptosis in an experimental rat model of levothyroxine -induced hyperthyroidism.

Mitochondria are known to be involved in mediating the calorigenic effects of thyroid hormones. With an abundance of these hormones, alterations in energy metabolism and cellular respiration take place, leading to the development of cardiac hypertrophy. Vitamin D has recently gained attention due to its involvement in the regulation of mitochondrial function, demonstrating promising potential in preserving the integrity and functionality of the mitochondrial network. The present study aimed to investigate the therapeutic potential of Vitamin D on cardiac hypertrophy induced by hyperthyroidism, with a focus on the contributions of mitophagy and apoptosis as possible underlying molecular mechanisms. The rats were divided into three groups: control; hyperthyroid; hyperthyroid + Vitamin D. Hyperthyroidism was induced by Levothyroxine administration for four weeks. Serum thyroid hormones levels, myocardial damage markers, cardiac hypertrophy indices, and histological examination were assessed. The assessment of Malondialdehyde (MDA) levels and the expression of the related genes were conducted using heart tissue samples. Vitamin D pretreatment exhibited a significant improvement in the hyperthyroidism-induced decline in markers indicative of myocardial damage, oxidative stress, and indices of cardiac hypertrophy. Vitamin D pretreatment also improved the downregulation observed in myocardial expression levels of genes involved in the regulation of mitophagy and apoptosis, including PTEN putative kinase 1 (PINK1), Mitofusin-2 (MFN2), Dynamin-related Protein 1 (DRP1), and B cell lymphoma-2 (Bcl-2), induced by hyperthyroidism. These results suggest that supplementation with Vitamin D could be advantageous in preventing the progression of cardiac hypertrophy and myocardial damage.

Serum levels of perchlorate and chlorate in pregnant women from south China and the related health risk with thyroid function

Perchlorate and chlorate are recognized as ubiquitously inorganic pollutants inenvrionment owing to their high solubility in water and resistance to degradation. Previous studies have confirmed the potential adverse effects of perchlorate and chlorate on human thyroid function, along with implications for fetal growth and development. The fetus grows and develops pregnant women's womb and absorbs nutrients from her body. However, there is still limited information on prenatal exposure to perchlorate and chlorate and the related health risks, especially in China. In this study, a total of 430 serum specimens obtained from pregnant females residing in Southern China were analyzed to ascertain the levels of perchlorate and chlorate, and explore the relationship between perchlorate and chlorate and thyroid function by linear regression, WQS, and QGC. The measured serum levels of perchlorate and chlorate were comparatively elevated, demonstrating median values of 0.693 μg/L and 1.36 μg/L, respectively. The estimated exposure dose of perchlorate in 19.7% of pregnant women exceeded the USEPA reference dose, indicating potential health risks. Although no significant association was found between serum perchlorate and thyroid hormone levels, the exposure to perchlorate for pregnant women in Southern China is cause for concern given their sensitivity to chemicals during pregnancy and the relatively high internal exposure levels.

Investigating the Relationship Between Serum Thyroid Hormone and Vitamin D Levels in Women with Melasma

Patches and macules of hyperpigmentation characterize melasma, a prevalent condition of skin pigmentation. Known risk factors for melasma include a genetic predisposition, sun exposure, and pregnancy. Melasma may have a connection to thyroid issues, according to previous research. Considering that vitamin D influences and promotes melanocytes' melanin formation, this study sought to examine the correlation between thyroid problems, blood vitamin D levels, and melasma in female patients seen at Al-Mahmoudiya Hospital. Both Wood's light investigation and clinical evaluation by seasoned dermatologists verified the melasma diagnosis. There were 80 participants in total, with 40 assigned to the melasma group and 40 to the control group. Their ages and sexes were matched. In all groups, blood samples were taken to assess levels of TSH, Anti-TPO, T3, T4, and vitamin D. Melasma patients' clinical pigmentation severity was assessed using the standard mMASI score. I used SPSS (IBM Statistical Package for the Social Sciences) version 21 to conduct the statistical analysis. Melasma patients were more likely to have thyroid problems (50%) and lower vitamin D serum levels (47.5%), compared to the control group (27.5%) and healthy individuals (40%). The levels of thyroid hormone (T3) and vitamin D were found to be considerably higher in the case group as compared to the control group (P&lt;0.05). A relationship was found between Anti-TPO and mMASI Score (P&lt; 0.05) when the relationship between age, thyroid hormones, vitamin D, and mMASI Score was investigated. Melasma and pigmentation intensity are linked to thyroid autoimmune diseases. The most prevalent clinical form of melasma is the centro facial variant as well.

Distinct transcriptional profiles in rat thyroid glands after developmental exposure to three in vitro thyroperoxidase inhibiting chemicals

Thyroperoxidase (TPO) is central in thyroid hormone (TH) synthesis and inhibition can lead to TH deficiency. Many chemicals can inhibit TPO activity in vitro, but how this may manifest in the developing thyroid gland at the molecular level is unclear. Here, we characterized the thyroid gland transcriptome of male rats developmentally exposed to the in vitro TPO-inhibitors amitrole, 2-mercaptobenzimidazole (MBI), or cyanamide by use of Bulk-RNA-Barcoding (BRB) and sequencing. Amitrole exposure caused TH deficiency and 149 differentially expressed genes in the thyroid gland. The effects indicated an activated and growing thyroid gland. MBI caused intermittent changes to serum TH concentrations in a previous study and this was accompanied by 60 differentially expressed genes in the present study. More than half of these were also affected by amitrole, indicating that they could be early effect biomarkers of developmental TH system disruption due to TPO inhibition. Further work to validate the signature is needed, including assessment of substance independency and applicability domain.

Graves' hyperthyroidism treated with potassium iodide: early response and after 2 years of follow-up.

As thionamide is associated with various adverse effects, we re-evaluated the practical efficacy of potassium iodide (KI) therapy for Graves' hyperthyroidism (GD). We administered KI (mainly 100 mg/day) to 324 untreated GD patients and added methimazole (MMI) only to those remaining thyrotoxic even at 200 mg/day. When the patient became hypothyroid, MMI, if taken was stopped, then levothyroxine (LT4) was added without reducing the KI dose. Radioactive iodine (RI) therapy or thyroidectomy was performed whenever required. We evaluated the early effects of KI at 2-4 weeks and followed patients for 2 years. At 2 weeks, serum thyroid hormone levels decreased in all 324 patients. At 4 weeks, fT4, fT3, and both fT4 and fT3 levels became normal or low in 74.7%, 50.6%, and 50.6% of patients, respectively. In a cross-sectional survey over 2 years, GD was well-controlled with KI or KI + LT4 (KI-effective) in >50% of patients at all time points. Among 288 patients followed for 2 years, 42.7% remained 'KI-effective' throughout the 2 years (KI Group), 30.9% were well-controlled with additional MMI given for 1-24 months, and 26.4% were successfully treated with ablative therapy (mainly RI). Among 'KI-effective' patients at 4 weeks, 76.5% were classified into the KI Group. No patients experienced adverse effects from KI. KI therapy was useful in the treatment of GD. A sufficient dose of KI was effective in >50% of GD patients from 4 weeks to 2 years, and 42.7% (76.5% of 'KI-effective' patients at 4 weeks) remained 'KI-effective' throughout the 2 years.

Correlation of serum thyrotropin and thyroid hormone levels with diabetic kidney disease: a cross-sectional study

ObjectiveThe relationship between thyrotropin (TSH), free triiodothyronine (FT3), free thyroxine (FT4) and diabetic kidney disease (DKD) is still controversial, and this study analyzed the correlation between TSH, FT3, FT4 and DKD in patients with type 2 diabetes mellitus (T2DM).MethodsT2DM patients (1216) were divided into five groups based on serum TSH, FT3, and FT4 levels, differences in urinary albumin excretion rate (UACR), estimated glomerular filtration rate (eGFR) were compared. Binary logistic regression verified independent correlations among TSH, FT3, FT4 and UACR, eGFR. TSH and FT3 predictive values for DKD were analyzed using receiver operating characteristic (ROC) curves.ResultsThe prevalence of albuminuria with decreased eGFR was higher in T2DM patients with subclinical hypothyroidism and overt hypothyroidism than that in patients with normal thyroid function. TSH positively correlated with UACR (r = 0.133, p < 0.001) and positively correlated with eGFR (r = -0.218, p < 0.001), FT3 negatively correlated with UACR (r = -0.260, p < 0.001) and positively correlated with eGFR (r = 0.324, p < 0.001). With the change from the lower normal level to the increased level of TSH and the change from the higher normal level to the reduced level of FT3, the prevalence of albuminuria gradually increased, the prevalence of decreased eGFR gradually increased in TSH groups and FT3 groups. After adjusting for age, BMI, duration of diabetes, TPOAb, TGAb, smoking, drinking, hypertension, the use of anti-diabetic medications (metformin, sodium–glucose cotransporter 2 inhibitors), HbA1c, CRP, TC, TG, LDL-C, and HDL-C, both TSH and FT3 correlated with increased UACR (TSH: OR 1.253, p = 0.001; FT3: OR 0.166, p < 0.001) and decreased eGFR (TSH: OR 1.245, p < 0.001, FT3: OR 0.579, p < 0.001), but this correlation of TSH with eGFR < 60 mL/min/1.73 m2 was not found in male. The area under the ROC curve (AUC) for FT3 was greater than that for TSH (FT3: 0.64; TSH: 0.61).ConclusionsIncreased TSH and reduced FT3 levels were associated with DKD in T2DM patients, but in a sex-dependent manner. FT3 had a higher predictive value for DKD.

Evaluation of thyroid hormones in type 1 diabetes mellitus

Background and objective: Increased blood sugar levels (hyperglycemia) and lack of insulin are a hallmark of Type 1 diabetes mellitus (T1DM), which is a chronic autoimmune illness results from the destruction of pancreatic beta –cells. The most common causes of hypothyroidism and hyperthyroidism are autoimmune diseases Hashimoto's thyroiditis and Graves’ disease, respectively. Because type 1 diabetes includes autoimmunity as a pathophysiological trigger, it is not uncommon to investigate patients with both diabetes and thyroid problems. The aim of the study is to evaluate serum thyroid hormones in patients with type1 diabetes mellitus. Methods: In this study 104 participants were included, 52 patients with type1 diabetes, and 52 healthy individuals. Blood samples were taken, and serum thyroid hormones levels were measured and the results of cases and controls were analyzed and compared using SPSS program. Results: It was found that the levels of T4 among non- diabetic participants were higher than those of diabetic patients. (P &lt;0.001). There is a negative correlation between BMI and fasting blood glucose in T1 diabetic patients according to regression test it has been shown that any increase in the FBG leads to decrease in the BMI. Conclusion: The present study shows that type 1 diabetes mellitus may affect thyroid gland and thyroid hormone levels, that may result in thyroid dysfunction.