Serum Thyroid-stimulating Hormone Levels Research Articles

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>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.

The Perfect Storm: Co-occurrence of Agranulocytosis and Thyroid Storm Successfully Managed with Lithium Therapy.

A thyroid storm is a medical emergency that requires high clinical suspicion and emergency treatment. We report an unusual case of thyroid storm and agranulocytosis managed with lithium therapy. The patient is a 32-year-old woman with a history of Graves' disease on methimazole therapy who presented to the emergency department with fever and palpitations. She was diagnosed with COVID-19 infection a week ago. She was febrile and tachycardic with fine tremors on examination. Routine laboratory workup showed agranulocytosis. Serum thyroid-stimulating hormone levels are <0.01 µIU/ml (normal range is 0.45-5.33) with elevated T4 and T3 (10.4 pcg/ml [2.1-4.1 pcg/ml], 4.34 ng/dl [0.61-1.24 ng/dl]). Burch-Wartofsky Point Scale score was 60 points, highly suggestive of thyroid storm. A clinical diagnosis of thyroid storm was made. The precipitating factor in this case was identified as the recent COVID-19 infection. Adding to the conundrum is the co-existent agranulocytosis, precluding the usage of antithyroid medications. She was treated with beta-blockers, intravenous fluids, and steroid therapy to suppress T4 to T3 conversion. Lithium was started, given her neutropenia and thyroid storm. She responded to oral lithium therapy and was discharged. During follow-up, her symptoms were controlled and leucopenia resolved. In conclusion, COVID-19 is a recognized precipitating factor for thyroid storms. It is very rare to see co-existent thyroid storm and agranulocytosis, and lithium can be a useful option in such cases. This case report adds to the minimal literature existing on lithium use in patients with thyroid storm.

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.

The Prevalence of Left Ventricular Diastolic Dysfunction in Subclinical Hypothyroidism Patients

Background: Elevated serum thyroid-stimulating hormone (TSH) levels together with normal blood levels of free thyroxine (FT4) and free triiodothyronine (FT3) are the hallmarks of subclinical hypothyroidism (SCH). SCH is common, especially in older persons and women, and it has been linked to a number of harmful cardiovascular consequences, such as left ventricular diastolic dysfunction (LVDD). The study investigated the incidence of LVDD in females with SCH and identify key predictors of this condition. Methods: A total of 1,248 female patients aged 20 to 50 years with SCH were included. Inclusion criteria were elevated TSH (5-10 micro unit/L) with normal FT3 (2.77-5.27 pg/ml) and FT4 (0.78-2.19 ng/dl) levels. Patients underwent 2D Echocardiography to assess LVDD. Descriptive statistics, chi-square testing, and logistic regression analysis were used to analyse the data. Result: LVDD was identified in 25% of the patients. The prevalence increased with age, being highest (28.2%) in the 40-50 age group. Significant associations were found between thyroid function and LVDD, with higher TSH and lower FT3 and FT4 levels linked to increased LVDD risk (p&lt;0.001). Echocardiographic parameters showed higher LV mass and wall thickness in LVDD patients. Doppler echocardiographic parameters indicated impaired diastolic function. Logistic regression identified age, serum FT3, serum FT4, serum TSH levels, LV mass index, and E/A ratio as independent predictors of LVDD. Conclusion: Female SCH patients have high rates of LVDD, which is linked to thyroid function. Older age and greater TSH were risk factors for LVDD, but higher FT3 and FT4 were protective. SCH individuals with LVDD had significant heart structural and functional abnormalities on echocardiography. Recommendations: Regular cardiovascular screening and proactive management of thyroid function are recommended for patients with SCH to prevent the progression of cardiac dysfunction. Further research should explore the benefits of early intervention and the potential role of thyroid hormone replacement therapy in reducing cardiovascular risks. Keywords: Subclinical hypothyroidism, Left ventricular diastolic dysfunction, Thyroid function, Echocardiography, Cardiovascular risk

Correlation analyse between thyroid hormone levels and severity of schizophrenia symptoms.

The imbalance of hormone levels in the body is closely related to the occurrence and progression of schizophrenia, especially thyroid hormones. To study the relationship between triiodothyronine (T3), thyroxine (T4), free T3 (FT3), free T4 (FT4), thyroid stimulating hormone (TSH) and schizophrenia. In this study, 100 schizophrenia patients were selected from our hospital between April 2022 and April 2024. Their clinical data were analyzed retrospectively. Based on the Positive and Negative Syndrome Scale (PANSS) score, patients were divided into mild (1-3 points, n = 39), moderate (4 points, n = 45), and severe groups (5-7 points, n = 16). Additionally, 55 healthy individuals served as a control group. Venous blood samples were collected to measure T3, T4, FT3, FT4, TSH, and cortisol concentrations, analyzing their relationship with PANSS scores. The serum levels of T3, FT3, FT4, TSH and cortisol in the schizophrenia group were lower than those in the control group (P < 0.05). With the increase of the severity of the disease, the concentrations of T3 and T4 decreased, while the concentrations of TSH and cortisol increased (P < 0.05). The concentrations of TSH and cortisol were positively correlated with the PANSS score, while T3 and T4 were negatively correlated with the PANSS score (P < 0.05). The receiver operating characteristic curve results showed that T3, T4, TSH, and cortisol had good efficacy in the diagnosis of schizophrenia. Logistic results showed that decreased T3 level, decreased T4 level, decreased TSH level and increased cortisol level may be independent risk factors for schizophrenia. Thyroid hormone levels are associated with the severity of schizophrenia symptoms, which can provide new solutions for the diagnosis and treatment of schizophrenia.

The impact of COVID-19 infection on thyroid function.

Extensive research on COVID-19 has revealed a notable link between the disease and thyroid disorders, highlighting complex interactions between thyroid hormones, immunomodulatory signaling molecules within the thyroid gland, and viral infections. This study evaluated the relationship between thyroid function and COVID-19 in Iraqi patients at Adiwaniyah Teaching Hospital. The cohort for this investigation comprised all patients who were admitted to the isolation center at the Teaching Hospital during the timeframe extending from January 2024 to June 2024. Each participant included in this research underwent comprehensive evaluations of their thyroid function, which is composed of the measurement of thyroid-stimulating hormone (TSH), total triiodothyronine (T3), and serum total thyroxine (T4) levels. Results showed that the serum T4 levels in all participants included in the study were observed to range from 20 to 182 (ng/dl), with the average concentration recorded at 87.26 ± 38.29 (ng/dl); no statistically significant disparity was noted in the mean serum T4 levels relative to the severity of the disease (p = 0.291). The serum TSH levels across all enrolled individuals spanned from 0.03 to 82 (mU/L), with a mean concentration of 5.55 ± 12.36 (mU/L); similarly, there was no statistically significant difference in the mean serum TSH levels when assessed against the disease severity (p = 0.926). According to the serum thyroid hormone concentrations, the cohort was stratified into 17 (24.6%) individuals classified as hypothyroid, 34 (49.3%) categorized as euthyroid, and 18 (26.1%) identified as hyperthyroid. Furthermore, no significant correlation was identified between the disease's severity and the participants' thyroid status (p = 0.556). In conclusion, patients with COVID-19 are liable to develop thyroid function abnormalities that may explain several of the long-term symptoms associated with the disease.

The role of serum S100B and serum thyroid stimulating hormone levels in vitiligo.

Vitiligo is a depigmenting disorder characterized by melanocyte loss, which results in pigment dilution of the skin. Vitiligo is commonly associated with thyroid disorders and thyroid stimulating hormone (TSH) is a sensitive marker to detect thyroid disorders. S100B is damage associated molecular pattern (DAMP) molecule released when there is melanocyte damage. In this study, we are estimating the serum TSH and S100B levels in vitiligo patients and controls and correlating them with disease activity. A cross-sectional study was conducted on 39 cases of vitiligo and controls. Demographic details were collected, the cases were examined and Vitiligo European Task Force (VETF) scoring was performed. Serum S100B was analyzed using an ELISA kit and serum TSH levels were estimated. Age of the participants ranged from 14 to 81 years with a mean and standard deviation of 44.08 ± 16.078 years. Female preponderance was noted. Vitiligo vulgaris was the most common presentation. Serum TSH (p = 0.32) and S100B (p = 0.22) levels between cases and controls were not statistically significant. Serum S100B level had a weak positive correlation with the spreading component of VETF score and it was statistically significant (p = 0.004). Mucosal vitiligo had higher levels of serum S100B levels compared to other types of vitiligo. In our study both serum TSH and S100B levels have demonstrated limited utility in distinguishing between vitiligo patients and controls. S100B showed a weak correlation with VETF scores indicating its potential (though limited) as a disease activity marker. Therefore, the potential of using this as a biomarker is debatable, and further multicentric studies with a larger sample size are required to establish the correlation.

Exploring Serum Anti-thyroid Peroxidase Antibodies and High-Sensitivity C-reactive Protein as Inflammatory Markers in Subclinical Hypothyroidism: A Comprehensive Study.

Background and aim Subclinical hypothyroidism (SCH) is a biochemical condition defined by elevated thyroid-stimulating hormone (TSH) levels with normal free thyroxine (FT4) levels, often occurring without overt clinical symptoms. Emerging evidence suggests a role for autoimmune and inflammatory processes, with anti-thyroid peroxidase antibodies (anti-TPO) and high-sensitivity C-reactive protein (hsCRP) as potential markers of thyroid autoimmunity and systemic inflammation. This study evaluates the significance of these markers in SCH to elucidate their association with disease progression and clinical symptoms. This study aims to assess the roles of anti-TPO and hsCRP as inflammatory markers in SCH and to examine their correlations with clinical symptoms, lipid profiles, and cardiovascular risk, to stratify patients based on their autoimmune and inflammatory profiles. Methodology A retrospective, cross-sectional study was conducted on 220 patients, including 170 diagnosed with SCH and 50 euthyroid controls. Patients were categorized into SCH with anti-TPO positivity (SCH+), SCH without anti-TPO positivity (SCH-), and euthyroid controls. Serum TSH, FT4, anti-TPO, and hsCRP levels were analyzed using chemiluminescent immunoassay (CLIA), enzyme-linked immunosorbent assay (ELISA), and turbidimetric immunoassay. Statistical analyses, including Kruskal-Wallis and correlation tests, evaluated associations between hsCRP, anti-TPO, and clinical parameters. Results SCH+ participants demonstrated significantly higher levels of TSH (7.6 ± 2.1 mIU/L), hsCRP (4.2 ± 1.6 mg/L), and anti-TPO antibodies (116.5 ± 34.8 IU/mL) compared to SCH- and controls (P < 0.001). hsCRP was elevated in 52.2% of SCH+ individuals, indicating a systemic inflammatory state, compared to 32.1% in SCH- and 16% in controls. Significant correlations were observed between hsCRP and TSH (r = 0.62, P < 0.001) and between hsCRP and anti-TPO (r = 0.58, P < 0.001) in SCH+ participants. SCH+ patients exhibited a higher prevalence of fatigue, cold intolerance, and lipid abnormalities, with total cholesterol and LDL levels markedly elevated compared to other groups. Conclusions Anti-TPO and hsCRP are valuable markers for identifying systemic inflammation and autoimmune activity in SCH, particularly in anti-TPO-positive individuals. Their integration into routine evaluation may help stratify SCH patients based on cardiovascular and metabolic risk, guiding early therapeutic interventions. Further, longitudinal studies are needed to explore their prognostic value and therapeutic implications.

Exploring Gender Differences in the Relationship Between Thyroid Function and Aggressive and Impulsive Behaviors in Patients with Major Depressive Disorder.

Major depressive disorder (MDD) is a widespread mental health condition with significant global impact. Exploring the gender differences in the interplay between thyroid function, aggression, and impulsivity offers valuable insights into its multifactorial nature and management. A cross-sectional study was conducted at Anhui Mental Health Center and included 113 MDD patients (56 males, 57 females) and 102healthy controls (45 males and 57 females). Thyroid function was assessed through serum thyroid hormone levels, and impulsivity and aggression were measured using the Buss-Perry Aggression Questionnaire (BPAQ) and Barratt's Impulsiveness Scale version 11 (BIS). Potential confounding factors such as age, education, and Hamilton Depression Rating Scale (HAMD) scores were adjusted for. Both male and female MDD patients showed significant changes in serum thyrotropin levels (F(1,213)=10.996, p=0.001), impulsivity (F(1,213)=151.521, p<0.05), and aggression (F(1,213)=44.411, p<0.05) compared to healthy controls. MANCOVA revealed significant differences in attentional impulsivity, motor impulsivity, physical aggression, anger, hostility, and self-directed aggression (all p<0.05). Moreover, significant differences between genders were observed in these areas (all p<0.05). In males, TSH levels were inversely related to several behavioral dimensions (all p<0.05), while no such correlation was found in females. This study highlights the role of thyroid function, especially TSH levels, in influencing impulsivity and aggression in male MDD patients, suggesting a gender-specific physiological-behavioral relationship. The findings contribute to the development of gender-specific treatment strategies. In the future, longitudinal studies with larger sample sizes should be conducted to explore molecular mechanisms for more personalized treatments.

Effect of thyroid dysfunction on apoptosis markers: Caspase-3 and Bcl-2 among Iraqi patients

Thyroid hormones are considered vital for cellular life history starting from its proliferation, differentiation, and ending up with its apoptosis. However, there are very limited human studies concerning the effect of thyroid dysfunction on the levels of apoptosis markers. Therefore, the aim of this cross-sectional study was to examine the effect of thyroid dysfunction (hyperthyroidism and hypothyroidism) on the levels of serum caspase-3, B-cell lymphoma (Bcl-2) and thyroid stimulating hormone (TSH) among patients in Babylon, Iraq. The study included 52 male patients (aged 25-50 years) with thyroid dysfunction, visited the Endocrinology center in Al-imam al-Sadiq hospital located in Babylon province, Iraq during the period from November 2023 to May 2024. Patients were split into two groups (patients with hypothyroidism, N=26; patients with hyperthyroidism, N=26), in addition to 26 subjects without thyroid dysfunction as a control group. Levels of serum caspase-3, Bcl-2, and TSH were measured in all study subjects. The results indicated that levels of serum caspase-3 were significantly increased in both patients’ groups compared to the control group (p&lt;0.001), while serum Bcl-2 was significantly increased in patients with hypothyroidism compared to other study groups (p&lt;0.001). Levels of TSH were significantly greater among patients with hypothyroidism comparing to other groups (p&lt;0.001). It can be concluded that patients with hyperthyroidism and hypothyroidism enhance apoptosis through activation of caspase-3 specifically.

The Influence of Subclinical Hypothyroidism on Endocrine and Metabolic Characteristics in Patients with Polycystic Ovary Syndrome.

To analyze the influence of subclinical hypothyroidism (SCH) on endocrine and metabolic characteristics in patients with polycystic ovary syndrome (PCOS). A total of 198 cases of PCOS patients admitted to our hospital from January 2022 to December 2023 were selected for the study. According to the presence or absence of SCH, patients were divided into the SCH group (n = 40) and the non-SCH group (n = 158). Differences in demographic characteristics, thyroid hormones, sex hormones, and glucose and lipid metabolism were analyzed between the two groups. Additionally, the correlation between SCH and various endocrine and metabolic indicators in PCOS patients was assessed. There was no statistically significant difference in demographic characteristics between the two groups (P > 0.05). Compared to the non-SCH group, the SCH group had significantly higher levels of serum luteinizing hormone (LH), prolactin (PRL), triglycerides (TG), total cholesterol (TC), fasting insulin (FINS), and homeostasis model assessment of insulin resistance (HOMA-IR) (P < 0.05), Conversely, the SCH group had significantly lower levels of serum follicle-stimulating hormone (FSH), estradiol (E2), thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) (P < 0.05). Correlation analysis indicated that LH, FSH, E2, PRL, TSH, TG, TC, FINS, HOMA-IR were positively correlated with PCOS complicated by SCH, while FT3, FT4 were negatively correlated. SCH in PCOS patients is associated with endocrine and metabolic dysfunction, primarily affecting thyroid hormone levels, sex hormones, and glucose and lipid metabolism. Assessing thyroid function is essential for the comprehensive evaluation and management of PCOS patients.

Differentiations in Illness Duration, Thyroid-Stimulating Hormone, Glucose and P300 Latency Between Drug-Naïve Unipolar and Bipolar Depression: A Comparative Cross-Sectional Study.

Distinguishing bipolar depression (BD) from unipolar depression (UD) remains a major clinical challenge, especially in drug-naïve patients. The present study aimed to investigate whether demographic, clinical, and biochemical parameters can help differentiate drug-naïve BD from UD. Drug-naïve patients with UD and BD were recruited from Shandong Mental Health Center. Ninety-four inpatients (61 UD and 33 BD) were assessed using the 17-item Hamilton Depression Rating Scale (HAMD-17) and P300 latency. Fasting serum levels of free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), as well as fasting plasma glucose (FPG), lipid, C-reactive protein (CRP), and uric acid (UA) indicators were measured. Patients with BD had longer illness duration and P300 latency and lower FT3 levels, but higher levels of TSH and FPG than patients with UD (all P<0.05). Binary logistic regression analysis indicated illness duration, TSH, FPG, and P300 latency were significantly associated with BD. Illness duration, TSH, FPG, and P300 latency achieved an area under the ROC curve of 0.777, 0.699, 0.646, and 0.635, respectively, in discriminating unipolar and bipolar depression. Increased illness duration, serum TSH and FPG levels, and P300 latency were independent risk factors for BD. Demographic, clinical, biochemical, and electrophysiological markers identified may have the potential to distinguish BD from UD.