Serum Thyroid-stimulating Hormone Levels Research Articles

Might Thyroid Function in Patients with Turner Syndrome Have a Significant Impact on Their Muscle Strength?

Turner syndrome (TS) is a genetic disorder caused by abnormalities in one of the X chromosomes. Individuals with TS have a higher incidence of autoimmune thyroid disorders, particularly Hashimoto’s disease, leading to thyroid dysfunction, most commonly hypothyroidism. Hormonal imbalance, growth hormone deficiency, and reduced physical activity contribute to muscle weakness in TS patients, and thyroid dysfunction can exacerbate these effects. The purpose of this study was to evaluate whether thyroid factors affect muscle strength in female patients with TS. The study included 70 women with TS and 88 age- and weight-matched controls. TS diagnoses were genetically confirmed (mosaic karyotypes: n = 20; monosomy X: n = 37; structural abnormalities: n = 7). The main criterion for exclusion from the study was unbalanced thyroid function. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), and thyroid antibodies (anti-thyroid peroxidase antibodies (aTPO), anti-thyroglobulin antibodies (aTG)) were measured, and muscle strength was assessed using hand-held dynamometry. In TS patients, higher TSH levels were positively correlated, and higher fT4 levels were negatively correlated with muscle strength. No such correlations were found in controls. Thyroid compensation may impact musculoskeletal health in TS. Lower-normal TSH levels are associated with reduced muscle strength, and autoimmune thyroid changes like aTPO and aTG may contribute to muscle deterioration. Further research is needed to confirm these findings.

Mammalian birth versus arousal from hibernation: thyroid hormones, common regulators of metabolic transition?

Mammalian birth and arousal from hibernation are both endogenously regulated transitional events, characterized by an increase in metabolic rate (MR) and onset of thermogenesis. Thyroid hormones (THs) are known to be key regulators of metabolic and thermogenic activity. To explore the similarities and differences in the role of THs during mammalian birth as opposed to arousal from hibernation, a comprehensive review is given of the levels and kinetics of serum thyrotropin-releasing hormone (TRH), thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), and reverse triiodothyronine (rT3) in hibernating mammals upon arousal and in mammalian neonates at birth. The results for arousal are more heterogeneous than those for birth, reflecting different hibernation patterns between species as well as varying sampling times and methods. Overall, serum TRH concentrations were found to be decreased, TSH unchanged, and T4, T3, and rT3 mostly increased. In contrast, the data for mammalian birth show a marked increase in serum levels of TRH, TSH, T4, and T3, particularly in human neonates, with inconsistent results for rT3. In conclusion, both during arousal from hibernation and mammalian birth, THs play a critical yet not exclusive role in metabolic transition. In hibernators, the metabolic effects of THs appear to be mediated by the conversion rates in target tissues rather than by their serum levels alone, suggesting a sustained readiness for arousal. This contrasts with mammalian newborns, who at the beginning of their autonomous life experience the first activation of their thyroid gland, resulting in a transitory "hyperthyroid" state.

Redox status of biomarkers in serum of dogs with hypothyroidism and its treatment with levothyroxine sodium

Information regarding canine hypothyroidism in China remains limited, particularly regarding the redox status of affected dogs. Therefore, the objective of this study was to evaluate the redox status of dogs with hypothyroidism and observe how it changed after levothyroxine replacement therapy. A total of 10 healthy dogs (control group) and 10 dogs with hypothyroidism (treatment group) from China Agricultural University Veterinary Teaching Hospital were included in the study. The redox status was assessed in all 20 dogs. Thyroid profiles such as thyroxine (T4), free thyroxine (fT4), and thyroid-stimulating hormone (TSH) and biomarkers of oxidative stress, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-px), and malondialdehyde (MDA), were assessed on day 0 in all dogs and on days 14 and 45 post-levothyroxine sodium treatment in dogs with hypothyroidism. Dogs with hypothyroidism had decreased levels of serum T4 and fT4 and increased levels of serum TSH. Based on SOD, CAT, GSH-px, and MDA, dogs with hypothyroidism had oxidative stress. Following 45-day treatment with levothyroxine sodium (0.02 mg/kg orally twice daily), antioxidant parameters improved progressively: SOD increased from 60.2 to 76.7 U/mL (Day 0-14) and further to 83.3 U/mL (Day 45); CAT from 105.9 to 115.5 mU/mL (Day 0-14) reaching 132.9 mU/mL (Day 45); GSH-Px from 10.2 to 8.4 U/mL (Day 0-14) then 9.7 U/mL (Day 45), while MDA decreased from 8.2→6.8→4.4 μmol/L correspondingly. In conclusion, increased serum TSH and MDA concentrations, in addition to decreased serum T4 and fT4 concentrations and decreased SOD and CAT activities, indicated that there was oxidative stress in dogs with hypothyroidism. However, there were significant improvements in the redox status of biomarkers in the serum of dogs with hypothyroidism after treatment with levothyroxine sodium (0.02 mg/kg twice daily) for 45 days.

Altered thyroid function and neurometabolic features provide clues to understand the comorbidity of bipolar II depression and obsessive-compulsive disorder.

Altered thyroid function and neurometabolic features provide clues to understand the comorbidity of bipolar II depression and obsessive-compulsive disorder.

Spectrum of Thyroid Disorders in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory arthritis involving 0.5-1% of the global population. Coexistence of RA and thyroid dysfunction is now increasingly being recognized. This is due to the shared factors involved in the pathogenesis of RA and autoimmune thyroid disease. Thyroid disorder is an important amplifier of disease activity, thereby impairing the quality of life. To study the prevalence and pattern of thyroid dysfunction in RA patients, to compare the disease activity among RA patients with thyroid dysfunction and those without thyroid dysfunction, and to study the possible association between severe RA and thyroid dysfunction. A hospital-based analytical cross-sectional study was done in 165 RA patients attending the General Medicine and Rheumatology outpatient facilities of the Department of General Medicine, Government Medical College, Kozhikode, from January to December 2019. Study subjects were selected based on the inclusion and exclusion criteria. Relevant investigations were done, which included serum thyroid stimulating hormone (TSH), free thyroxine (free T4), free triiodothyronine (free T3), and anti-thyroid peroxidase antibody (anti-TPO) antibody levels. Data were analyzed using MS Excel and Statistical Package for the Social Sciences (SPSS) software. The prevalence and pattern of thyroid disorders in RA patients were assessed. The association of thyroid dysfunction with disease activity was tested. The prevalence of thyroid dysfunction among RA patients was 38.2%. The most common thyroid disorder observed was subclinical hypothyroidism, which was seen in 33.3% (55) of the study population, followed by overt hypothyroidism in 3.6% (6) of patients. Both subclinical hyperthyroidism and clinical hyperthyroidism were found in only 0.6% of RA patients. There was a significant difference in mean age between RA patients with thyroid dysfunction and euthyroid patients (p-value = 0.001). No significant association was found between the duration of RA and thyroid dysfunction (p-value = 0.253). RA patients with thyroid dysfunction had elevated inflammatory markers compared to those with normal thyroid function. The prevalence of autoimmune thyroid disorder in RA patients is 24.8%. There was a significant association between disease activity and thyroid dysfunction (p-value = 0.001). Patients with thyroid disorders had severe disease compared to euthyroid patients. A significant positive correlation was noted between serum TSH and Disease Activity Score-28 (DAS-28) (Pearson coefficient = 0.768, p-value = 0.000), and between anti-TPO antibody and DAS-28 (Pearson coefficient = 0.794, p-value = 0.000). Thyroid dysfunction is prevalent in 38.2% of RA patients, with subclinical hypothyroidism being the most common thyroid disorder encountered. RA patients with thyroid dysfunction had higher disease activity than euthyroid patients. Hence, thyroid function tests should be a routine investigation in all RA patients, and if found abnormal, they should be treated appropriately.

Vitamin-D Deficiency and Hashimoto's Thyroiditis-Myth or Reality

Objective: To determine the comparison between vitamin D deficiency and Autoimmune Thyroid Disease, especially Hashimoto's Thyroiditis. Study Design: Cross-sectional Study. Place and Duration of Study: Department of Medicine, Combined Military Hospital, Rawalpindi Pakistan, from June 2022 to July 2023. Methodology: In this study, 400 subjects of both genders, between the age of 20-70 years, were enrolled. All the patients who reported for thyroid evaluation at medical Outpatient Department, Combined Military Hospital, Rawalpindi were included in this research. Individuals with renal or hepatic diseases, primary hyperparathyroidism, metabolic bone diseases, epilepsy, subacute thyroiditis, transitory thyroid dysfunction with negative thyroid autoantibodies, and missing lab data were excluded. All the individuals were tested for serum vitamin D, phosphorus, parathyroid hormone, calcium, thyroid function tests including antithyroid antibodies. Vitamin D deficiency and insufficiency were indicated as serum 25(OH)D level <25nmol/L and 25-75nmol/L, respectively. Results: When compared to 110(27.5%) individuals without autoimmune thyroid disease, 290(72.5%) /patients with Autoimmune Thyroid Disease had a higher rate of vitamin D insufficiency (85.3% vs. 55.5%, p=0.001). There was a significant inverse correlation between serum vitamin D levels and serum thyroid-stimulating hormone levels when gender, BMI, age, and sample season were taken into consideration. Conclusion: Deficiency of vitamin D has a strong correlation with Hashimoto's Thyroiditis and Autoimmune Thyroid diseases. High blood serum levels of Thyroid stimulating hormone have an independent correlation with decreased levels of vitamin D.

An Exploratory Cross-Sectional Study on Thyroid Hormone Reference Intervals in Children With Down syndrome.

Accurate evaluation of thyroid dysfunction in children with Down syndrome is challenging because of the lack of age-specific reference intervals in these individuals. This study aimed to establish age-specific reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels in children with Down syndrome. A retrospective cross-sectional study was conducted on children with Down syndrome, aged 6 months to 15 years, who visited the Osaka Women's and Children's Hospital between April 2019 and March 2020. Subjects who had used medications that influenced thyroid function or who lacked thyroid hormone data were excluded from the study. The final analysis included 301 subjects. Serum TSH and FT4 levels were measured, and reference intervals were calculated using nonparametric methods. The reference intervals for TSH in children with Down syndrome were 2.03-14.22, 1.79-12.98, 1.26-10.24, and 0.58-10.11 mIU/L in infants, toddlers, school children, and adolescents, respectively, which were higher than those observed in the general paediatric population. The reference intervals for FT4 were 13.57-26.42, 13.20-22.70, 13.15-22.36, and 11.97-24.77 pmol/L, respectively, which were comparable to those of the general paediatric population. Multivariate regression analyses revealed a significant inverse association between age and the levels of TSH and FT4 (p < 0.01). We provide evidence for age-specific reference intervals for TSH and FT4 levels in children with Down syndrome, which may help clinicians accurately evaluate thyroid hormone status.

TSH upregulates CYP4B1 through the PI3K/AKT/CREB pathway to promote cardiac hypertrophy.

Subclinical hypothyroidism (SCH) is closely associated with heart failure and cardiac hypertrophy, yet the underlying mechanism remains unclear. Cardiomyocytes treated with thyroid-stimulating hormone (TSH) were used as an in vitro model. Cardiac-specific TSHR knockout mice (CKO) were treated with isoproterenol (ISO) to induce cardiac hypertrophy in vivo. Serum FT4, TSH levels, heart weight, body weight and tibial length of mice were evaluated. Heart function was analyzed by M-mode cardiac ultrasonography. The pathological changes in cardiac tissues were detected by immunohistochemistry, hematoxylin-eosin and WGA staining. mRNA levels of ANP, BNP, α-MHC and β-MHC were evaluated by RT-PCR. Western blot was used to detect pathway related proteins. Besides, the transcriptome sequencing analysis and dual-luciferase reporter assays were used to verify the relevant molecular mechanisms. TSH significantly promotes cardiomyocyte hypertrophy in cardiomyocytes. Meanwhile, cardiac-specific TSHR knockout significantly reduced ISO-induced cardiac hypertrophy. This was demonstrated by reductions in cell sizes, decreased HW/BW and HW/TL ratios, along with improved expression of hypertrophic genes. Further transcriptome sequencing results showed that TSH can significantly promote the expression of CYP4B1 in vitro. And the knockdown of CYP4B1 repressed TSH-induced cardiomyocyte hypertrophy. Further mechanistic studies revealed that TSH regulated the expression of CYP4B1 hypertrophy through the PI3K/AKT/CREB signaling pathway. Subsequently, the dual-luciferase assays demonstrated that CREB promotes the transcription of CYP4B1 by binding to its promoter region. Overall, our findings highlight the direct impact of TSH/TSHR on cardiomyocyte hypertrophy and proposed CYP4B1 as a promising target for mitigating cardiac hypertrophy in SCH patients.

Neurological soft signs and thyroid hormones in schizophrenia spectrum disorders.

Neurological soft signs (NSS) are minor sensory and motor deviations linked to neurodevelopmental disorders and schizophrenia spectrum disorders (SSD). Thyroid hormones (TH) are essential for neurodevelopment and are suggested to be altered in SSD. Yet, the relationship between NSS and TH is unclear. We evaluated the relationship between NSS and TH in individuals with SSD. We examined a total of 72 individuals with SSD. We assessed NSS using the Neurological Evaluation Scale (NES) and clinical symptoms using the Positive and Negative Syndrome Scale (PANSS). We collected fasting blood samples to measure serum levels of thyroid-stimulating hormone (TSH), free thyroxine (fT4), and free triiodothyronine (fT3). We used the t-test to compare differences between sex and the Pearson correlation to test for correlations between NSS, TH and psychopathology separately for males and females. We observed a negative correlation between fT4 and NES total score (r = -0.374, p = .032), and NES subdomain "sensory integration" (r = -0.372, p = .033). The correlation between fT4 and "sensory integration" remained largely unchanged when controlling for age, DOI, and antipsychotic dose in OLZ equivalents by performing partial correlation analyses (r = -0.424, p = .049). Serum fT3 and TSH levels exhibited no significant correlation with NES scores but the PANSS negative symptoms score was negatively associated with fT3 (r = -0.472, p < .001). Lower fT4 levels were associated with NSS severity and specific NSS subdomains only in male individuals. In the overall sample, we detected a significant negative correlation between fT3 and negative symptoms. Future studies should examine a larger sample of drug-naïve individuals with SSDs, followed-up longitudinally in time to infer causality.

Is subclinical hypothyroidism associated with cardiovascular disease in the elderly?

Subclinical hypothyroidism (SCH) is diagnosed when thyroid function tests show that the serum thyrotropin (TSH) level is elevated and the serum free thyroxine (FT4) level is normal. SCH is mainly caused by Hashimoto's thyroiditis, the prevalence of which increases with aging. Recently, it has been revealed that SCH is associated with risk factors for cardiovascular diseases (CVDs), including atherosclerosis, dyslipidemia and hypertension, leading to cardiovascular morbidity and mortality. However, there are still controversies regarding the diagnosis and treatment of SCH in elderly patients. In this review, we present recent evidence regarding the relationship between SCH and CVD and treatment recommendations for SCH, especially in elderly patients. Studies have shown that SCH is associated with CVD and all-cause mortality. Patients aged less than 65 years showed significant associations of SCH with CVD risk and all-cause mortality, whereas patients aged 65 or older did not show such associations. It was shown that levothyroxine therapy was associated with lower all-cause mortality and cardiovascular mortality in younger SCH patients (<65-70 years) but not in SCH patients aged 65-70 years or older. In elderly SCH patients, levothyroxine treatment should be considered individually according to the patient's age, serum TSH level, hypothyroid symptoms, CVD risk, and other comorbidities. To further elucidate the impact of SCH on CVD in elderly patients, studies should be conducted using age-specific reference ranges of results of thyroid function tests, focusing on elderly patients, specific serum TSH levels, thyroid antibody status, and cardiovascular risk factors.

Frequency of Subclinical Hypothyroidism (SCH) among Patients of Polycystic Ovarian Disease (PCOD) Presenting in Outpatient Department of Tertiary Care Hospital

Subclinical hypothyroidism is a prevalent endocrine disorder, often associated with polycystic ovarian disease both of which share a complex interplay of hormonal imbalances, contributing to significant metabolic and reproductive disturbances. Objectives: To determine the frequency of subclinical hypothyroidism among patients of polycystic ovarian disease presenting in an outpatient setting. Methods: This descriptive cross-sectional study was conducted at the Obstetrics and Gynaecology Department of Fatima Memorial Hospital, Lahore, from December 2022 to June 2023. 155 female having polycystic ovaries were enrolled using non-probability consecutive sampling. Blood samples of the patients were sent to the pathology lab for measurement of serum thyroid-stimulating hormone (TSH) level and frequency of subclinical hypothyroidism (thyroid-stimulating hormone&gt;5mIU/L despite normal serum free thyroxin (0.8 to 1.8 ng/dL) was noted. Data were entered and analyzed using SPSS version 26. Results: In the current study mean age and BMI of participants having polycystic ovarian disease were calculated as 28.31 ± 7.7 years and 29.5 ± 5.8 kg/m2, respectively. Among 155 participants 43.2% were married and most of them belonged to the urban population and middle socioeconomic class. Subclinical hypothyroidism was found in 14.8% of female suffering from polycystic ovarian disease. Conclusions: It was concluded that this study underscores the high prevalence of subclinical hypothyroidism among patients with polycystic ovarian disease, highlighting the need for routine thyroid function screening in this population. Early detection enables timely interventions and supports a comprehensive approach to managing polycystic ovarian disease and its related comorbidities.

Evaluation of the add on effect of Majoone Sarkhas with levothyroxine in primary hypothyroidism: a randomized standard control adjuvant clinical study.

Primary hypothyroidism is a prevalent endocrine disorder, typically treated with levothyroxine (LT). However, prolonged use of LT may result in complications and suboptimal outcomes for some patients. Majoone Sarkhas (MS), is a polyherbal formulation comprises four plants: Commiphora mukul, Operculina turpethum, Embelia tseriam-cottam, and Dryopteris filix-mas. It is traditionally used in Unani medicine for managing hypothyroidism associated conditions. The aim of this study was to assess the synergistic effect of Majoone Sarkhas in combination with LT for the treatment of primary hypothyroidism. This randomized, single blind, standard clinical trial involved 100 subjects allocated into two groups: an adjuvant treatment group (n=50) and a standard control group (n=50). The adjuvant group received 10 g of MS twice daily in addition LT once daily, while the control group was treated with LT alone once daily. Both groups underwent treatment for 60days. Changes in thyroid-stimulating hormone (TSH), free tri-iodothyronine (FT3), and free-thyroxine (FT4) levels from baseline to the 60th day were recorded and analyzed statistically to evaluate the outcomes. The study showed adjuvant group (MS+LT) had more reduction (4.99 vs. 3.93) in serum TSH level in comparison to control group (LT), which was statistically significant (p<0.001), it also showed increase in serum FT3 (2.88±0.31 vs. 2.97±0.44) and FT4 (1.06±0.17 vs. 1.20±0.27) levels, when compared with baseline values and after completion of trial. The change in thyroid function profiles among adjuvant group, receiving MS with LT in primary hypothyroidism was both clinically and statistically significant. The safety parameters those were followed by serum level of ALT, AST, blood urea and serum creatinine were within the range, indicating the MS is safe medication to be used as an adjuvant therapy with LT (Clinical Trial Registration Code: CTRI/2018/02/011962).

Effects of vitamin D replacement combined with Graves' disease therapy: a retrospective cohort study.

In Graves' disease (GD), an autoimmune disease, antibodies targeting the thyroid stimulating hormone (TSH) receptor cause the production of excessive amounts of thyroid hormone. A significant association was reported between low 25-hydroxy [25(OH)] vitamin D3 (VitD) levels and various autoimmune disorders. Therefore, this study aimed to investigate the effects of VitD deficiency and replacement therapy on laboratory and clinical parameters in GD patients. Forty GD patients and 37 healthy controls were included in this study. The GD patients were divided into two groups: the nonreplacement group was administered antithyroid treatment only (n = 18), and the replacement group was administered antithyroid treatment + VitD replacement (n = 22). Clinical and laboratory data of all the participants were compared at the time of diagnosis and 3 months after treatment. Baseline serum VitD levels in the GD patients were significantly lower than the baseline serum VitD levels in the control group (16.1 ± 9.9 vs. 22.2 ± 8.5 ng/mL, p < 0.005). A significant improvement was observed in the serum VitD levels in the replacement group after three months (14.6 ± 8.3 vs. 40.4 ± 17.2 ng/mL, p < 0.001). A significant increase in the serum TSH levels and a significant decrease in the serum free triiodothyronine (fT3) and free thyroxine (fT4) levels were observed in the replacement and nonreplacement groups at the end of three months. However, there was no significant effect of VitD replacement on the serum TSH, fT3, and fT4 levels. There was no difference in the serum thyroid receptor antibodies levels between the replacement and nonreplacement groups. Although VitD deficiency was detected in the GD patients, there was no significant accelerating effect of VitD replacement on the thyroid hormone levels. These results need to be confirmed with studies that have larger patient numbers and longer follow-up periods.

Prevalence of Congenital Hypothyroidism and Efficacy of Current Cord Sample Screening in the Presence of Metabolic Screening: A Retrospective Cohort Study.

Congenital hypothyroidism (CH) is a critical condition that can lead to severe neurodevelopmental impairments if not diagnosed and treated promptly. Early detection through neonatal screening is essential. This study evaluated the efficacy of cord blood free thyroxin 4 (CBFT4) screening for detecting CH in comparison to serum sample testing and newborn metabolic screening (NBS). The aim was to determine the efficacy of current cord blood screening for congenital hypothyroidism in the presence of metabolic screening and to establish the prevalence of CH in a single tertiary center in Saudi Arabia. This retrospective cohort study was conducted at Johns Hopkins Aramco Healthcare Center and included all newborns born between January 2021 and December 2023. Both cord blood and heel-prick T4 and thyroid-stimulating hormone (TSH) results were collected from the medical records of 3328 newborns. Diagnostic accuracy parameters were calculated for cord blood and serum findings. Demographic and clinical data were analyzed, including maternal risk factors. The CH prevalence was 0.8%, which was confirmed by NBS, and there was a higher initial detection rate of 3.4% based on cord blood screening. The average level of cord blood total thyroxin 4 (CBTT4) was 6.48 ± 0.78 µg/dL, and the cord blood TSH was 5.9 ± 6.4 µIU/mL. Serum FT4 levels were 1.3 ± 0.5 ng/dL, and serum TSH levels were 8.7 ± 24.5 µIU/mL. The sensitivity and specificity of cord blood diagnosis were 50% and 97%, respectively, while serum sample diagnosis had a sensitivity of 62.5% and a specificity of 98.6%. Significant associations were found between lower birth weight (2.146 ± 0.771 kg vs. 2.801 ± 0.662 kg; p = 0.006), lower gestational age (35 ± 3 weeks vs. 37 ± 3 weeks; p = 0.008), and CH. Cord blood TSH levels were significantly higher in CH cases (32.9 ± 55.2 µIU/mL vs. 5.7 ± 3.7 µIU/mL; p < 0.001). Cord blood screening for congenital hypothyroidism demonstrates moderate sensitivity and high specificity, indicating that it is reliable for ruling out the condition but necessitates confirmatory serum testing due to the risk of false positives. The prevalence of CH in this cohort aligns with global estimates. Lower birth weight, lower gestational age, and maternal thyroid disease are significant risk factors for CH. A two-tiered screening approach with follow-up serum testing is recommended to improve diagnostic accuracy and ensure timely intervention.

Effect of thyroid stimulating hormone on the prognosis of coronary heart disease.

Clinical studies have shown that thyroid stimulating hormone (TSH) is associated with increased cardiovascular disease risk and mortality. Even within normal ranges, elevated TSH levels have an impact on the cardiovascular system and have been associated with cardiac dysfunction. The aim of our study was to evaluate the predictive value of admission fasting serum TSH levels in patients with coronary heart disease in relation to long-term major adverse cardiovascular events (MACE) and all-cause mortality. A total of 3515 patients with coronary heart disease who met the inclusion criteria were divided into four groups according to the quantile of TSH levels: Group 1 (TSH, 0.34-1.02 mIU/L, n=878); Group 2 (TSH, 1.03-1.71 mIU/L, n=886); Group 3 (TSH, 1.72-2.84 mIU/L, n=880); and Group 4 (TSH, 2.86-5.50 mIU/L, n=873). MACE and all-cause mortality were also compared. TSH concentrations associated with the risk of MACE, all-cause mortality were assessed using continuous scales (restricted quartic splines) and Cox proportional hazards regression models. A total of 3515 patients with coronary heart disease were eligible for analysis. At a median follow-up of 70 months, patients in group 2 had a lower incidence of MACE compared to the other three groups. All-cause mortality was lower in the 3rd group. Restricted quartic spline analysis also revealed that TSH concentrations were associated with heart failure risk. TSH levels have predictive value for adverse cardiovascular events and heart failure in patients with coronary heart disease.

Role of Biochemical Parameters on Hypertension in Pregnant Females

Pregnancy is a physiological state that involves significant alterations in metabolic, biochemical, physiological, and hematological processes. Pregnancy-induced hypertension (PIH) includes a spectrum of disorders ranging from mild hypertension to severe multi-organ failure. This study aims to investigate the biochemical and demographic variables in pregnant women who are more than 20 weeks’ gestation. Additionally, it seeks to compare the biochemical parameters of patients with pregnancy-induced hypertension to those of normotensive subjects. The study comprised 160 participants, with 80 women classified as hypertensive and 80 as normotensive. Serum levels of calcium, uric acid, and thyroid-stimulating hormone (TSH) were assessed in both groups. Demographic and biochemical parameters were analyzed using the t-test, considering a p-value of &lt;0.05 as statistically significant. The levels of serum calcium, uric acid, and TSH were measured using spectrophotometry and ELISA techniques. The results revealed a statistically significant reduction in serum calcium levels among hypertensive women compared to their normotensive counterparts. In contrast, the hypertensive group exhibited higher levels of uric acid and TSH relative to the normotensive group. Our findings indicate significant differences in serum calcium, uric acid, and TSH levels between the two groups. Although these factors may not directly influence the development of PIH, their interrelationship should not be overlooked. Further research into the underlying pathological mechanisms associated with PIH could improve diagnostic capabilities in future studies.

Association between Helicobacter pylori infection, serum thyroid-stimulating hormone, and thyroxine in the National Health and Nutrition Examination Survey 1999-2000.

Helicobacter pylori has been increasingly implicated in extra-gastric diseases. Current evidence regarding the association between serum thyroid-stimulating hormone (TSH), thyroxine (T4), and H. pylori infection remains inconclusive. Consequently, this study aimed to explore the correlation between TSH and T4 levels and H. pylori infection in a US-based population sample. Data from the US National Health and Nutrition Examination Survey (NHANES), comprising 971 participants aged 30-85 years from 1999 to 2000, were analyzed. Binary logistic regression was employed to analyze the correlation between H. pylori and TSH and T4 levels. The impact of TSH and T4 on H. pylori infection was further assessed using restricted cubic spline (RCS) analysis. In addition, subgroup analyses stratified by sex and age were conducted. Subjects with H. pylori seropositivity demonstrated lower serum TSH levels and higher serum T4 levels compared to those with H. pylori seronegativity. A significant positive correlation was identified between H. pylori seropositivity and T4 levels with increasing quartiles of hormonal levels in both univariate regression models (Q4 vs. Q1: OR = 1.483; 95% CI, 1.033-2.129) and multivariate regression models (Q4 vs. Q1: OR = 1.004; 95% CI, 0.981-1.026). Conversely, a negative correlation was observed between H. pylori seropositivity and TSH levels with increasing quartiles of hormonal levels in univariate regression models (Q4 vs. Q1: OR = 0.579; 95% CI, 0.403-0.831) and in multivariate regression models (Q4 vs. Q1: OR = 0.580; 95% CI, 0.389-0.866). In stratified analyses, the adjusted association of serum T4 levels with H. pylori seropositivity was statistically significant among men (T4: Q4 vs. Q1: OR = 2.253; 95% CI, 1.311-3.873), age over 68 years in TSH levels (Q4 vs. Q1: OR = 0.434; 95% CI, 0.206-0.911), and age 41-54 years in T4 levels (Q4 vs. Q1: OR = 4.965; 95% CI, 2.071-11.903). RCS analysis revealed a non-linear relationship between TSH levels and H. pylori infection. Notably, when TSH < 0.98 IU/ml, the likelihood of H. pylori infection significantly increased. Lower TSH and higher T4 levels were associated with H. pylori infection, particularly among men and elderly individuals.

Assessing left ventricular function in patients with hyperthyroidism across varied heart rates via press-strain loop analysis: a retrospective cross-sectional study.

In the early stages of hyperthyroidism (HTH), cardiovascular symptoms are not prominent, and heart function impairment may occur before structural changes. The non-invasive left ventricular (LV) pressure-strain loop (PSL) allows for early, quantitative assessment of changes in LV systolic function. However, previous studies have not grouped hyperthyroid patients based on the presence or absence of tachycardia. This study aimed to assess the LV function in individuals diagnosed with HTH who exhibit varying heart rates, utilizing the PSL technique. Seventy-eight hyperthyroid patients were recruited between December 2022 and September 2023 using a random method and then stratified into two groups based on the presence or absence of tachycardia, designated as HTH1 (tachycardia) group and HTH2 (non-tachycardia) group, respectively. Additionally, a control group comprising 38 healthy volunteers was included for comparison purposes. Standard echocardiographic parameters and LV global longitudinal strain (GLS) were quantified. Furthermore, LV myocardial work parameters, encompassing global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), were assessed using the PSL technique. The main statistical methods included one-way analysis of variance, LSD-t test, Kruskal-Wallis H test, Bonferroni correction, and χ2 test. Compared to the control group, the systolic blood pressure (SBP), pulse pressure differential, serum free triiodothyronine (FT3) and free thyroxine (FT4) levels of HTH1 and HTH2 subgroups demonstrated elevation, whereas serum thyroid-stimulating hormone (TSH) levels exhibited reduction (P<0.05). Moreover, comparisons between the HTH1 and HTH2 subgroups revealed significantly higher SBP, pulse pressure differential, FT3, and FT4 concentrations in the former relative to the latter (P<0.05). LV ejection fraction (LVEF) exhibited a statistically significant increase in the HTH group compared to the control group (P<0.05). GLS, GWI, and GWE in the HTH group were less compared to the control group, while GWW exhibited an increase in the HTH group relative to the control group (P<0.05). Within the HTH group, both GWI and GWE were significantly lower in the HTH1 subgroup compared to the HTH2 subgroup. PSL method enables the quantitative assessment of LV myocardial work alterations in individuals with HTH exhibiting varying heart rates, which may help clinical physicians make an accurate early diagnosis and take timely treatment measures.

Estimating the Prevalence of Primary Hypothyroidism in Karbala City, and Modulation of Clinical Manifestations Among Patients Receiving Levothyroxine; A Single Center Study

الخلاصة قصور الغدة الدرقية لديه مجموعة واسعة من المظاهر السريرية والأعراض العامة، بما في ذلك على سبيل المثال لا الحصر السمنة، والتعب، وضعف التركيز، والاكتئاب، وألم العضلات على نطاق واسع، واضطرابات الدورة الشهرية، والإمساك. يعد تناول جرعة يومية من ليفوثيروكسين كافيًا للإدارة الناجحة لقصور الغدة الدرقية، لأنه يسهل استعادة مستويات TSH في الدم إلى نطاقها الطبيعي. هناك عدة عوامل يمكن أن تؤثر على امتصاص ليفوثيروكسين في جسم الإنسان، بما في ذلك العمر والوزن ووجود مشاكل طبية أخرى، والمدخول الغذائي . كان الهدف من هذه الدراسة هو تقييم مدى انتشار قصور الغدة الدرقية الأولي والتغيير في العرض السريري المرتبط بالعلاج البديل. الطريقة: كانت هذه دراسة رصدية مقطعية أجريت في مركز الحسن للأيض والغدد الصماء والسكري (HMEDC). أكمل (111) مريضا البحث. قام فريق الدراسة بإنشاء استبيان. تم جمع البيانات من المقابلات وجها لوجه مع المرضى. تشمل البيانات التي تم جمعها من المرضى متغيرات اجتماعية ديموغرافية مختلفة، مستويات الفرتين والهرمون المحفز للغدة الدرقية في الدم ، والتفاعلات الدوائية، بالإضافة إلى العلامات والأعراض التي ظهرت قبل العلاج وبعده. بالإضافة إلى ذلك، يتم أيضًا تسجيل نظام علاج المريض والجرعات المحددة من الليفوثيروكسين التي يتم تناولها. النتائج: بلغ إجمالي عدد الحالات التي زارت مركز الحسن للتمثيل الغذائي والغدد الصماء والسكري (HMEDC) خلال فترة الدراسة 10800 حالة. وكان معدل انتشار أمراض الغدة الدرقية 300 حالة (2.8٪). وبلغت نسبة قصور الغدة الدرقية الأولي من إجمالي عدد حالات قصور الغدة الدرقية 85.1%.(61%) من المرضى لديهم مستويات طبيعية من هرمون TSH بينما (42%) من المرضى وجد أنهم يحتاجون زيادة جرع الليفوثيروكسين. أظهر ما مجموعه (84٪) من المرضى مستويات طبيعية من الفيريتين. أظهر المرضى انخفاضًا في علاماتهم وأعراضهم بعد تناول العلاج. االاستنتاج: أدى العلاج بالليفوثيروكسين إلى تحسين الكلام البطيء والإمساك وقلة الشهية والحساسية للبرد وزيادة الوزن والإرهاق. لا توجد علاقة ملحوظة بين جرعة ليفوثيروكسين وظهور العلامات والأعراض. الكلمات المفتاحية :قصور الغدة الدرقية الأولي,الليفوثيروكسين

Evaluation of the association between thyroid-stimulating hormone with handgrip strength and dynapenia in euthyroid postmenopausal women.

To examine the association between serum thyroid-stimulating hormone (TSH) levels with handgrip strength (HGS) and dynapenia in euthyroid postmenopausal women. This was an exploratory cross-sectional study among 385 participants from the Department of Obstetrics, Gynecology, and Reproduction of the Dexeus Women's University Hospital, Barcelona, Spain. Age, age at menopause, adiposity, alcohol consumption, body mass index (BMI), and smoking status were recorded. TSH was determined by electrochemiluminescence immunoassay. HGS was measured using a digital dynamometer, and physical activity was assessed by the International Physical Activity Questionnaire. Dynapenia was considered when HGS was <20 kg. A directed acyclic graph was designed to identify confounding variables. Multivariable linear and logistic regression models were adjusted by age, age at menopause, adiposity, BMI, glomerular filtration rate, glycated hemoglobin, physical activity, and smoking status. Multivariable linear regression model showed that age ( β = -0.22; 95% CI, -0.28 to -0.16), adiposity ( β = -0.15; 95% CI, -0.22 to -0.07), BMI ( β = 0.15; 95% CI, 0.04-0.25), glomerular filtration rate ( β = -0.04; 95% CI, -0.07 to -0.01), and physical activity ( β = 0.79; 95% CI, 0.07-1.5) were significantly associated with HGS. Instead, serum TSH levels were not significantly associated ( β = 0.21; 95% CI, -0.10 to 0.51). Multivariable logistic regression model showed that dynapenia was associated with age (OR, 1.20; 95% CI, 1.12-1.31) and glomerular filtration rate (OR, 1.03; 95% CI, 1.00-1.05). No significant association between TSH and dynapenia was observed (OR, 0.98; 95% CI, 0.78-1.23). In this study of postmenopausal women, normal TSH levels were not associated with low HGS or dynapenia.