Thyroid Globulin Antibody Research Articles

Clinical predictive value of pre-pregnancy tests for unexplained recurrent spontaneous abortion: a retrospective study.

Early prediction and intervention are crucial for the prognosis of unexplained recurrent spontaneous abortion (uRSA). The main purpose of this study is to establish a risk prediction model for uRSA based on routine pre-pregnancy tests, in order to provide clinical physicians with indications of whether the patients are at high risk. This was a retrospective study conducted at the Prenatal Diagnosis Center of Henan Provincial People's Hospital between January 2019 and December 2022. Twelve routine pre-pregnancy tests and four basic personal information characteristics were collected. Pre-pregnancy tests include thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine thyroid (FT4), thyroxine (TT4), total triiodothyronine (TT3), peroxidase antibody (TPO-Ab), thyroid globulin antibody (TG-Ab), 25-hydroxyvitamin D [25-(OH) D], ferritin (Ferr), Homocysteine (Hcy), vitamin B12 (VitB12), folic acid (FA). Basic personal information characteristics include age, body mass index (BMI), smoking history and drinking history. Logistic regression analysis was used to establish a risk prediction model, and receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were employed to evaluate the performance of prediction model. A total of 140 patients in uRSA group and 152 women in the control group were randomly split into a training set (n = 186) and a testing set (n = 106). Chi-square test results for each single characteristic indicated that, FT3 (p = 0.018), FT4 (p = 0.048), 25-(OH) D (p = 0.013) and FA (p = 0.044) were closely related to RSA. TG-Ab and TPO-Ab were also important characteristics according to clinical experience, so we established a risk prediction model for RSA based on the above six characteristics using logistic regression analysis. The prediction accuracy of the model on the testing set was 74.53%, and the area under ROC curve was 0.710. DCA curve indicated that the model had good clinical value. Pre-pregnancy tests such as FT3, FT4, TG-Ab, 25-(OH)D and FA were closely related to uRSA. This study successfully established a risk prediction model for RSA based on routine pre-pregnancy tests.

Vitamin D, selenium, and antidiabetic drugs in the treatment of type 2 diabetes mellitus with Hashimoto's thyroiditis.

Diabetes and thyroiditis are closely related. They occur in combination and cause significant damage to the body. There is no clear treatment for type-2 diabetes mellitus (T2DM) with Hashimoto's thyroiditis (HT). While single symptomatic drug treatment of the two diseases is less effective, combined drug treatment may improve efficacy. To investigate the effect of a combination of vitamin D, selenium, and hypo-glycemic agents in T2DM with HT. This retrospective study included 150 patients with T2DM and HT treated at The Central Hospital of Shaoyang from March 2020 to February 2023. Fifty patients were assigned to the control group, test group A, and test group B according to different treatment methods. The control group received low-iodine diet guidance and hypoglycemic drug treatment. Test group A received the control treatment plus vitamin D treatment. Test group B received the group A treatment plus selenium. Blood levels of markers of thyroid function [free T3 (FT3), thyroid stimulating hormone (TSH), free T4 (FT4)], autoantibodies [thyroid peroxidase antibody (TPOAB) and thyroid globulin antibody (TGAB)], blood lipid index [low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), triacylglycerol (TG)], blood glucose index [fasting blood glucose (FBG), and hemoglobin A1c (HbA1c)] were measured pre-treatment and 3 and 6 months after treatment. The relationships between serum 25-hydroxyvitamin D3 [25 (OH) D3] level and each of these indices were analyzed. The levels of 25 (OH) D3, FT3, FT4, and LDL-C increased in the order of the control group, test group A, and test group B (all P < 0.05). The TPOAB, TGAB, TC, TG, FBG, HbA1c, and TSH levels increased in the order of test groups B, A, and the control group (all P < 0.05). All the above indices were compared after 3 and 6 months of treatment. Pre-treatment, there was no divergence in serum 25 (OH) D3 level, thyroid function-related indexes, autoantibodies level, blood glucose, and blood lipid index between the control group, test groups A and B (all P > 0.05). The 25 (OH) D3 levels in test groups A and B were negatively correlated with FT4 and TGAB (all P < 0.05). The combination drug treatment for T2DM with HT significantly improved thyroid function, autoantibody, and blood glucose and lipid levels.

Spectrum of Thyroid Dysfunction in Patients with Chronic Kidney Disease in Benin City, Nigeria.

There is an indication of abrupt rise in chronic kidney disease (CKD) in Nigeria and thyroid function involvement has not been sufficiently evaluated. This study determined thyroid gland function among subjects with CKD in Benin City, Nigeria. A total of 184 randomized CKD patients attending specialist clinic and 80 healthy control subjects were recruited for this study. A well-structured questionnaire was used to obtain data on socio-demography. Blood specimens were collected and used for the determination of thyroid function parameters; thyroid stimulating hormone (TSH), triiodothyronine (T3), free triiodothyronine (fT3), thyroxine (T4), free thyroxine (fT4), thyroid peroxidase antibody (TPO-Abs), thyroid globulin antibody (Tg-Abs) and Deiodinase enzyme Type 1 (D1). SPINA GD and SPINA GT were calculated using Michaelis-Menten model. The CKD was classified into stages using Modification of Drug in Renal Disease (MDRD) formula. Thyroid dysfunctions observed were clinical hyperthyroidism 1 (0.54%), non-thyroidal illness 78 (42.4%), clinical hypothyroidism 11 (6.0%), sub-clinical hyperthyroidism 3 (1.60%), and sub-clinical hypothyroidism 11 (6.0%), while euthyroid were 80 (43.5%). SPINA GD of CKD patients (33.85 ± 10.94) was not significantly different when compared with controls (24.85 ± 1.57), whereas, SPINA GT was significantly higher (p < 0.01) among CKD patients (3.74 ± 0.31) than controls (2.68 ± 0.11). Autoimmune thyroid disease demonstrated by positive Tg-Abs and TPO-Abs were observed among approximately 7.9% of CKD patients. Serum TPO-Abs concentration increased with CKD progression. Thyroid dysfunction is involved in the pathogenesis of CKD patients. The etiologies are multifactorial and immunological mechanisms of autoimmune thyroid disease may be a contributing factor.

Relationship between thyroid antibody levels and ovarian reserve function in infertile chinese women with normal thyroid-stimulating hormone

BackgroundTo analyze the relationship of thyroid peroxidase antibody and thyroid globulin antibody levels with ovarian reserve function in infertile women.MethodsThe data of 721 infertile patients who visited the hospital from January 2019 to September 2022 and whose thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels were in the normal range, were retrospectively analyzed. These patients were divided into two sets of three groups—the negative group, the 2.6 IU/ml ~ 100 IU/ml group and the TPOAb > 100 IU/ml group according to the TPOAb (thyroid peroxidase antibody) level, or the TgAb (anti-thyroglobulin antibody) negative group, the 14.58 IU/ml ~ 100 IU/ml group and the TgAb > 100 IU/ml group according to the TgAb level. They were compared for differences in ovarian reserve function index and thyroid hormone levels and analyzed for the relationship among thyroid antibody levels, ovarian reserve function, and thyroid hormone levels.ResultsWhen TSH > 2.5 mIU/L, the bFSH (basal follicle stimulating hormone) level in the TPOAb > 100 IU/ml group (9.10 ± 1.16 IU/L) was significantly higher than that in the TPOAb negative group (8.12 ± 1.97 IU/L) and the 2.6 IU/ml ~ 100 IU/ml group (7.90 ± 1.48 IU/L) (P < 0.05); when TSH ≤ 2.5 mIU/L, there were no statistically significant differences in the bFSH and AFC (antral follicle count) number at different TPOAb levels. Whether TSH ≤ 2.5 mIU/L or TSH > 2.5 mIU/L, there were no statistically significant differences in the bFSH and AFC number at different TgAb levels (P > 0.05). FT3/FT4 ratio in the TPOAb 2.6 IU/ml ~ 100 IU/ml group and the > 100 IU/ml group was significantly lower than in the negative group. FT3/FT4 ratio in the TgAb 14.58 ~ 100 IU/ml group and the > 100 IU/ml group was also significantly lower than in the TgAb negative group (P < 0.05). TSH level in the TPOAb > 100 IU/ml group was significantly higher than in the 2.6 ~ 100 IU/ml group and the TPOAb negative group, but there were no statistically significant differences among different TgAb groups.ConclusionsWhen TPOAb > 100 IU/ml and TSH > 2.5 mIU/L, it may affect the ovarian reserve function in infertile patients, and the mechanism may be associated with increased TSH and the imbalance of FT3/FT4 ratio caused by the increase of TPOAb.

Clinical Significance of Elevated Serum IL-36γ Levels in Patients with Early-Stage Hashimoto’s Thyroiditis

Background: Hypothyroidism was the diagnosed and treated as a result of health related quality of life issues. The aim of this study was that to evaluate the effect of IL-36 γ, Tg-Ab and TOP-Ab in the Hashimoto’s Thyroiditis (HT). Study design: This was a cross sectional study conducted at Rawal Institute of health sciences, Islamabad duration of study was six month, from April 2022 to September 2022. Methods: A total number of the patients was n=150 which divided into two group, control and HT group. To perform EISA for the estimation of free triiodothyronine 3, 4 (FT3, FT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TOP-Ab) and thyroid globulin antibody (Tg-Ab). The data was analyzed by SPSS 21. Results: The serum IL-36γ show correlation with the TOP-Ab and FT3 in HT. The IL-36γ was significantly higher in HT as compared to the control group; p&lt;0.001**. The IL-36γ show significant negative correlation with TOP-Ab (&lt;0.001**, r-0.126) and non- significant positive correlation with FT3 (0.321, r= + 0.28) in HT patients. The Tg-Ab was show non- significant correlation with IL-36 γ; (P&lt;=0. 928, r = 0.323). Conclusions: IL-36 γ is diagnostic marker and show negative correlation with TPO-Ab in the patient serum of HT. Il-36 γ had significantly high in the HT patients. IL-36 γ may involve to the progression of pathogenesis and enhance the inflammatory responses. In HT, Tg-Ab was significantly reduced than TPO-Ab but both contribute to the production of thyroid hormones. Keywords: Interleukin, Thyroxin, Thyroid stimulating hormone, Peroxidase.

Survey on the prevalence and related factors of thyroid disorders in different iodine intake regions in China in 2015-2017

Objective: To observe the prevalence and related factors of thyroid diseases in different iodine intake areas from 2015 to 2017 after the implementation of national salt iodization policy in China for 20 years. Methods: A cross-sectional survey. Multi-stage stratified cluster random sampling was used to randomly select subjects meeting the inclusion criteria from 31 provinces, municipalities and autonomous regions in China from January 2015 to December 2017, and stratified by age and sex. The survey included questionnaire, physical examination and thyroid ultrasonography. At the same time, the concentrations of serum thyrotropin, thyroxine, thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urinary iodine were measured.To determine whether the patient has a certain thyroid disease according to the above results. Different iodine nutrition areas were defined according to urinary iodine concentration, and the influence of iodine nutrition status in different iodine intake areas on thyroid diseases was analyzed. Results: A total of 78 470 adults were included, including 39 893 in the area of moderate iodine, 28 779 in the area of adequate iodine, and 9 798 in the area of excessive iodine.In the above three regions, the prevalence of subclinical hyperthyroidism (hyperthyroidism) was 0.45% (95%CI: 0.39%-0.52%), 0.50%(95%CI: 0.35%-0.70%)and 0.27%(95%CI: 0.20%-0.35%), respectively, with statistical significance(χ²=6.92, P=0.003). The prevalence of subclinical hypothyroidism (hypothyroidism) was 11.36% (95%CI: 10.73%-12.02%), 13.57%(95%CI: 11.70%-15.69%) and 16.18%(95%CI: 12.41%-20.82%), respectively, with statistical significance(χ²=5.08, P=0.009). The prevalence rates of Graves' disease, TPOAb, goiter and thyroid nodule among the three regions were statistically significant (all P<0.05). There were no significant differences in the prevalence of clinical hyperthyroidism and clinical hypothyroidism and the positive rate of TgAb among the three regions (all P>0.05). Multivariate logistic regression model analysis showed that excess iodine was a risk factor for subclinical hypothyroidism (OR=1.24, 95%CI: 1.06-1.44), and a protective factor for thyroid nodules (OR=0.73, 95%CI: 0.57-0.94). Iodine overdose was a risk factor for subclinical hypothyroidism (OR=1.47, 95%CI: 1.08-2.01), while it was a protective factor for subclinical hyperthyroidism (OR=0.56, 95%CI: 0.41-0.77), and TPOAb positive (OR=0.93, 95%CI: 0.87-0.99), goiter (OR=0.33, 95%CI: 0.17-0.66) and thyroid nodule (OR=0.77, 95%CI: 0.61-0.97). Conclusions: There are significant differences in the prevalence of subclinical hyperthyroidism, subclinical hypothyroidism, positive TPOAb, thyroid nodule and goiter in different iodine intake regions. Different iodine intake levels have an effect on the incidence of thyroid diseases.

Clinical significance of elevated serum IL-36γ levels in patients with early-stage Hashimoto's thyroiditis

ObjectivesHashimoto's thyroiditis (HT) is the predominant cause of primary hypothyroidism. Interleukin (IL)-36γ is a member of the IL-36 family. Recently, IL-36γ was shown to possess proinflammatory properties in autoimmune diseases. However, the role of IL-36γ in HT is insufficiently understood. The purpose of the present study was to investigate the potential relationship between IL-36γ and HT. Design & methodsWe included 100 subjects, among whom, 52 had early-stage HT and 48 were healthy controls (HC). The subjects' basic clinical information was obtained through physical examination and clinical histories of signs and symptoms. Thyroid function and measurements of thyroid-stimulating hormone (TSH), free triiodothyronine 3, free triiodothyronine 4 (FT4), thyroid peroxidase antibody (TPO-Ab), and thyroid globulin antibody were measured using a fully automated chemiluminescent immunoassay analyzer. The expression levels of serum IL‐36γ were determined using an enzyme-linked immunosorbent assay. ResultsThe serum IL-36γ level in the HT group was significantly higher compared with that of the HC group [91.91 (67.52, 130.90) pg/mL vs 62.50 (44.61, 91.53) pg/mL, P < 0.0001]. Correlation analysis showed a negative correlation between serum IL-36γ and TPO-Ab titers in the HT group (r = -0.3507, P = 0.0054). According to receiver operating characteristic curve analysis, the area under the curve (AUC) for IL-36γ was 0.7278 (P < 0.0001), and the AUC for IL-36γ combined with TSH and FT4 was 0.8109 (P < 0.0001). ConclusionsThe present study indicates that serum IL-36γ expression is increased in patients with HT and negatively correlates with TPO-Ab. Our findings suggest that IL-36γ may be involved in the development of HT and may therefore serve as a potential new diagnostic biomarker for HT.

Relationship between insulin resistance and thyroid cancer in Chinese euthyroid subjects without conditions affecting insulin resistance

BackgroundsIn recent years, many studies have shown that insulin resistance is related to the occurrence of thyroid cancer, but there are few reports on whether the two are related under the premise that thyroid function is normal and the metabolic components related to insulin resistance are excluded. This study aims to analyze the insulin resistance of patients with differentiated thyroid cancer after excluding the population with abnormal metabolic components, and to study the risk factors of thyroid cancer in this population.Methods61 subjects diagnosed with differentiated thyroid carcinoma (DTC) formed the DTC group and 262 subjects with benign nodules formed the control group. Body mass index (BMI, kg/m2), waist circumference (WC), lipid profiles, and free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TGAb), alanine transaminase (ALT), aspartate aminotransferase (AST), fasting plasma glucose (FPG), fasting serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured.ResultsMean subjects age (P = 0.021), BMI (P = 0.049), WC (P = 0.01), serum insulin concentration (P = 0.006), and HOMA-IR level (P = 0.005) were significantly greater in the DTC group than in the control group. Multivariate binary logistic regression analysis identified advanced age (OR = 1.027 [1.003–1.051], P = 0.029) and an increased HOMA-IR level (OR = 1.572 [1.277–1.935], P < 0.001) as significant risk factors for thyroid cancer.ConclusionsIR may increase the risk of thyroid cancer development even in the absence of conditions affecting insulin resistance.

Clinical Observation of Levothyroxine Sodium Combined with Selenium in the Treatment of Patients with Chronic Lymphocytic Thyroiditis and Hypothyroidism and the Effects on Thyroid Function, Mood, and Inflammatory Factors.

The purpose of this study was to investigate the therapeutic effects of levothyroxine sodium combined with selenium treatment and single levothyroxine sodium treatment on patients with chronic lymphocytic thyroiditis and hypothyroidism and to analyze the effects of different treatment regimens on patients' thyroid function, mood, and inflammatory factors, with the aim of providing a reference for clinical treatment. The subjects of the current study were 138 chronic lymphocytic thyroiditis (CLT) patients with hypothyroidism admitted to our hospital from May 2016 to September 2019 and were randomly divided into a control group taking levothyroxine sodium (LT4) treatment and a combined group of LT4 combined with selenium treatment, with 69 cases each. Patients in both groups were evaluated for efficacy after 3 months of treatment, and their thyroid function was observed by total triiodothyronine (TT3), total thyroxine (TT4), thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroid globulin antibody (TGAb), and their mood changes were observed by Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores. The levels of inflammatory factors such as interleukin-2 (IL-2), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α) were measured, and the occurrence of adverse drug reactions during the treatment period was observed and recorded in all patients. The results showed that the total effective rate of the combined group was significantly higher than that of the control group. The levels of TT3, TT4, TSH, TgAb, and TPOAb, SAS and SDS scores, and levels of inflammatory factors such as IL-2, IL-10, and TNF-α were significantly improved in both groups after treatment. Compared with the control group, TGAb, TPOAb, IL-2, TNF-α levels, and SAS and SDS scores decreased more and IL-10 levels increased more in the combined group, while the differences of other indexes were not statistically significant. This suggests that LT4 has certain efficacy in treating CLT with hypothyroidism, and the combined selenium treatment can improve the therapeutic effect of LT4 and can play a greater role in improving patients' mood and immune and inflammatory responses.

Metformin Reverses Hashimoto's Thyroiditis by Regulating Key Immune Events.

BackgroundHashimoto’s thyroiditis (HT) is a common autoimmune disease characterized by high levels of thyroid peroxidase antibody (TPOAb) and thyroid globulin antibody (TgAb) as well as infiltration of lymphocytes in thyroid. In recent years, metformin has been proven to be effective in a variety of autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis and multiple sclerosis.MethodsThis study systematically explored the therapeutic effect of metformin on HT and its underlying mechanism by comprehensively utilizing methods including animal model, in vitro cell culture and differentiation, mRNA sequencing and 16S rRNA sequencing.FindingsWe found that metformin indeed had a therapeutic effect on mice with HT mainly by reducing TgAb and lymphocyte infiltration in thyroid tissue. In addition, metformin also significantly suppressed the number and function of Th17 cells and M1 macrophages polarization in HT mice. Furthermore, metformin can inhibit the differentiation and function of Th17 in vitro. The results of mRNA sequencing of thyroid tissue illustrated that the therapeutic effect of metformin on HT was mainly achieved by regulating immune pathways. 16S RNA sequencing of the intestinal flora found that the intestinal flora of HT mice differs significantly from that of the normal mice and also were altered by metformin treatment.InterpretationThese experiments provided a preliminary theoretical basis for the clinical application of metformin in the treatment of HT.

Lifestyle is associated with thyroid function in subclinical hypothyroidism: a cross-sectional study

BackgroundFew studies have focused on the association between lifestyle and subclinical hypothyroidism (SCH). The purpose of this study was to investigate the association between lifestyle and thyroid function in SCH.MethodsThis study was a part of a community-based and cross-sectional study, the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 159 participants with SCH (81 males and 78 females) and 159 euthyroid (87 males and 72 females) participants without any missing data were included in the analysis. General information and lifestyle information including sleep, exercise, diet and smoking habits of the participants was collected by questionnaire and Pittsburgh sleep quality index scale (PSQI) was collected. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urine iodine concentration (UIC) were tested. Thyroid homeostasis parameter thyroid’ s secretory capacity (SPINA-GT), Jostel’s TSH index (TSHI), thyrotroph T4 sensitivity index (TTSI) were calculated. Logistic regression and multiple linear regression were performed to assess associations.ResultsCompared with euthyroid subjects, patients with SCH were more likely to have poor overall sleep quality (15.1 vs.25.8 %, P = 0.018) and l less likely to stay up late on weekdays (54.7 vs. 23.9 % P < 0.001). In SCH group, exercise was the influencing factor of TSH (β= -0.224, P = 0.004), thyroid secretory capacity (β = 0.244, P = 0.006) and thyrotropin resistance (β = 0.206, P = 0.009). Iodine excess was the influencing factor of thyroid secretory capacity (β = 0.209, P = 0.001) and pituitary thyroid stimulating function (β = 0.167, P = 0.034). Smoking was the influencing factor of pituitary thyroid stimulating function (β = 0.161, P = 0.040). Staying up late on weekends was the influencing factor of thyroid secretory capacity (β = 0.151, P = 0.047). After adjusting for possible confounders, logistic regression showed that those with poor overall sleep quality assessed by PSQI and iodine excess had an increased risk of SCH (OR 2.159, 95 %CI 1.186–3.928, P = 0.012 and OR 2.119, 95 %CI 1.008–4.456, P = 0.048, respectively).ConclusionsLifestyle including sleep, smoking, diet and exercise was closely related to thyroid function especially thyroid homeostasis in SCH.

Metformin Reverses Hashimoto's Thyroiditis by Regulating Key Immune Events

Background: Hashimoto's thyroiditis (HT) is a common autoimmune disease characterized by high levels of thyroid peroxidase antibody (TPOAb) and thyroid globulin antibody (TgAb) as well as infiltration of lymphocytes in thyroid. In recent years, metformin has been proven to be effective in a variety of autoimmune diseases, such as systemic lupus erythematosus, rheumatoid arthritis and multiple sclerosis. Methods: This study systematically explored the therapeutic effect of metformin on HT and its underlying mechanism by comprehensively utilizing methods including animal model, in vitro cell culture and differentiation, mRNA sequencing and 16S rRNA gene sequencing. Findings: We found that metformin indeed has a therapeutic effect on mice with HT mainly by reducing TgAb and lymphocyte infiltration in thyroid tissue. In addition, metformin also significantly inhibits the formation of Th17 cells and M1 macrophages in vivo. Furthermore, metformin can inhibit the differentiation and function of Th17 in vitro. The results of mRNA sequencing of thyroid tissue showed that the therapeutic effect of metformin on HT is mainly achieved by regulating immune disorders. 16S RNA sequencing of the intestinal flora found that the intestinal flora of HT mice differ significantly from that of the normal mice and also are altered by metformin treatment. Interpretation: This experiments provide a preliminary theoretical basis for the clinical application of metformin in the treatment of HT. Funding Statement: The present work was supported by grants from the National Natural Science Foundation of China (No.81873636 and No.81900710), Shanghai Natural Science Foundation (No.18ZR1433800). Declaration of Interests: The authors declare no conflict of interest. Ethics Approval Statement: All patients and healthy controls have signed informed consent. The study was approved by the ethical committees of Zhoupu Hospital and performed in accordance with relevant guidelines and regulations. All animal experiment procedures were approved by the Animal Ethics Committee of Fudan University.

Effect of large dosage of Prunella on Hashimoto's thyroiditis

Introduction:Hashimoto's Thyroiditis (HT) is one of the common autoimmune diseases, which can lead to thyroid reduction, increase the risk of tumor, and seriously affect women's reproductive health. Many other autoimmune diseases are easy to occur, seriously harming people's health.large dose herb Prunella or compound prescription contain large dose Prunella for treatment of HT has already been confirmed. However, due to the lack of evidence, there is no specific method or suggestion, it is necessary to carry out a systematic evaluation on Prunella and provide effective evidence for further research.Methods and analysis:The following databases will be searched from their inception to October 2020: Electronic database includes PubMed, Embase, Cochrane Library, Web of Science, Nature, Science online, Chinese Biomedical Database WangFang, VIP medicine information, and China National Knowledge Infrastructure. Main results: serum thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TGAb), other results: serum thyroid stimulating hormone (TSH), serum free triiodothyronine (FT3), serum free thyroid hormone (FT4). Data will be extracted by 2 researchers independently, risk of bias of the meta-analysis will be evaluated based on the Cochrane Handbook for Systematic Reviews (SR)of Interventions. All data analysis will be conducted by data statistics software Review Manager V.5.3. and Stata V.12.0.Results:The results of this study will systematically evaluate the efficacy and safety of large dose prunella salicorrhizae in the intervention of people with HT.Conclusion:The systematic review of this study will summarize the current published evidence of large dose prunella for the treatment of HT, which can further guide the promotion and application of it.Ethics and Communication:This study is a systematic review, the outcomes are based on the published evidence, so examination and agreement by the ethics committee are not required in this study. We intend to publish the study results in a journal or conference presentations.Open Science Fra mework (OSF) registration number:October 21, 2020.osf.io/fcyqp. (https://osf.io/fcyqp)

Correlation Analysis of Thyroid Function and Autoantibodies in Graves’ Disease Patients with Different Iodine Nutritional Status

Objective: To investigate the correlation between thyroid function stratification and autoantibody titers in patients with Graves’ disease (GD) under different iodine nutrition conditions. Methods: The levels of serum thyroid hormones, autoantibodies and urinary iodine in 100 patients with different thyroid function GD [GD-A, GD-B] and 60 healthy subjects are detected by electrochemical immunoluminescence and iodine-catalyzed arsenic-cerium method. Results: The proportion of GD patients with the sum of iodine overdosage and iodine overdosage group is consistent with iodine adequate group, which is significantly higher than iodine deficiency group, and the (Median Urine Iodine, MUI) of GD-A group is significantly higher than GD-B group. Urinary iodine levels in GD group and GD-A group are positively correlated with serum FT3 and FT4 (P<0.05), and negatively correlated with (thyroid stimulating hormone, TSH) (P<0.05). The levels of serum (thyroid peroxidase antibody, TPOAb) and (thyroid globulin antibody, TGAb) in each GD group are significantly higher than those in the control group. Serum TSH levels in the high TPOAb group and high TgAb group are lower than those in the low TPOAb group, low TgAb group and control group, respectively. The levels of FT3 and FT4 are higher than those of the low TPOAb group and the low TgAb group, however, there is no significant difference between the FT3 of low TgAb and T3 and T4 levels that belong to the control group, high TPOAb group, high TgAb group, low TPOAb group, and low TgAb group. In conclusion: GD patients with different thyroid functions have corresponding changes in their thyroid hormone and autoantibody levels under different iodine nutrition conditions, which indicates that iodine nutrition status involve in and play an important role in the development of GD with different thyroid functions and different antibody levels.

DINP aggravates autoimmune thyroid disease through activation of the Akt/mTOR pathway and suppression of autophagy in Wistar rats

Di-isononyl phthalate (DINP) is used as a substitute for traditional phthalates, in a wide range of applications. However, there is growing concern regarding its toxicity. Studies have indicated that DINP is related to thyroid hormone disorder and that phthalates can affect thyroid normal function. In this study, we aim to determine any effects of DINP exposure on autoimmune thyroid disease (AITD), the most common autoimmune disease, and to understand the underlying causal mechanism. AITD model Wistar rats were exposed to 0.15 mg/kg, 1.5 mg/kg or 15 mg/kg DINP. We assessed the thyroid globulin antibody levels, Th1/Th2 balance, histopathological changes and caspase-3 levels in the thyroid. The data show that exposure to DINP does indeed aggravate AITD. To explore the underlying mechanisms, we examined the levels of microtubule-associated protein 1 light chain 3 B (LC3B), Sequestosome 1 (SQSTM1) and the appearance of autophagosomes or autolysosomes to assess autophagy in the thyroid. The results show that DINP can suppress normal autophagy. We found that DINP induced an exacerbation of oxidative stress and the activation of the Akt/mTOR pathway, indicating that oxidative stress and activation of mTOR may play a key role in these processes. Moreover, the activation of mTOR also promoted the expression of IL-17. Importantly, blocking oxidative stress with VE or blocking Akt/mTOR with rapamycin mitigated the exacerbation of AITD and the suppression of normal autophagy. All these results indicate that exposure to DINP, especially high doses of DINP, can aggravate oxidative stress and activate the Akt/mTOR pathway. This exposure then leads to a suppression of normal autophagy and expression of IL-17 in the thyroid, resulting in an eventual exacerbation of AITD.

Role of thyroid ultrasound combined with thyroglobulin in the diagnosis of postoperative recurrence of thyroid cancer.

To study the application value of thyroid ultrasound combined with thyroglobulin (Tg) in the diagnosis of postoperative recurrence of thyroid cancer, so as to provide a reference for clinical practice. Eighty patients with thyroid cancer who underwent operative treatment for more than 2 times in our hospital from January 2014 to December 2016 were selected as the objects of study. After operation, residual thyroid tissues were removed via131Iodine (131I) treatment, the serum Tg and thyroid globulin antibody (TgAb) were detected, and the cervical ultrasound was performed. At 1 week after 131I treatment, the systemic single photon emission computed tomography (SPECT) was performed. Finally, the application values of serum Tg, TgAb and ultrasound in the diagnosis of postoperative recurrence of thyroid cancer were analyzed. The sensitivity, specificity and accuracy of Tg level in detecting of recurrence and metastasis of differentiated thyroid cancer were 78.5%, 73.3% and 77.5%, respectively, and it was difficult to show whether the postoperative recurrence and metastasis of thyroid cancer occurred through the expression level of serum TgAb. Moreover, TgAb in different concentrations had an effect on the diagnosis of metastasis of differentiated thyroid cancer via Tg. When the TgAb level ≥100 IU/mL, the sensitivity, specificity and accuracy of Tg diagnosis were 51.9%, 50.0% and 51.7%, respectively. When the TgAb level <100 IU/mL, the sensitivity, specificity and accuracy of Tg diagnosis were 94.6%, 71.4% and 88.2%, respectively. Besides, the sensitivity, specificity and accuracy of ultrasonic diagnosis of lymphatic metastasis after the treatment of differentiated thyroid cancer were 78.5%, 60.0% and 75.0%, respectively. The sensitivity, specificity and accuracy of ultrasound combined with Tg in the diagnosis of thyroid cancer were 97.4%, 75.0% and 93.6%, respectively. The difference in the metastasis rate of thyroid cancer was not statistically significant between patients with papillary carcinoma and patients with follicular carcinoma after treatment (P>0.05). Thyroid ultrasound combined with Tg is of high clinical value in the diagnosis of postoperative recurrence of thyroid cancer, which can significantly improve the sensitivity, specificity and accuracy of clinical diagnosis. The TgAb level can be detected when Tg is used to monitor the postoperative recurrence and metastasis of thyroid cancer, providing a reference for the clinical prevention and treatment.

Characteristics and survival of patients with metachronous or synchronous double primary malignancies: breast and thyroid cancer.

BackgroundClinical experiences suggest that breast cancer (BC) and thyroid cancer (TC) occur metachronously or synchronously in a patient more frequently than it would by chance. This study was conducted to investigate the clinicopathological characteristics and survival of these double primary malignancies.Methods18732 patients with first primary BC and 12877 female patients with first primary TC were performed in this retrospective case-controlled study. The control groups were matched with both age at diagnosis and time of surgery (±2 years). The clinicopathological factors, Overall survival (OS), and HRs were evaluated by SPSS.ResultsThere were 91(0.49%) BC patients developed metachronous second primary TC (B-T group), and 117 (0.91%) TC patients developed metachronous second primary BC (T-B group). The expression of estrogen and progesterone receptors, and the value of Ki-67, were significantly higher in the B-T group than control. The median value of thyroid globulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) were higher in T-B group than control (p <0.05). The duration before second primary cancer was shorter for the B-T group than the T-B group (4.09 years vs. 5.82 years, p<0.001). B-T group patients showed poorer survival than BC only patients (p=0.044).ConclusionsIn general, the overall risk of the occurrence of a second primary TC or BC elevated highly in patients with BC or TC. Detailed mechanisms need to be studied to explore the association between these two cancers. Early detection and effective prevention for the first primary BC or TC patients are necessities for reducing the incidence of the second primary cancer and improving the OS.

Tako-tsubo cardiomyopathy observed in a patient with sepsis and transient hyperthyroidism

A 55-years-old woman, with a history of hypertension and ischemic stroke with residual left hemiparesis, was admitted to our hospital because of dyspnoea with clinical evidence of acute pulmonary edema. She was found to have a sinus tachycardia with ST-elevation in leads D1, aVL and V1-V4 in the electrocardiogram, and akinesis of the left ventricular apex with overall left ventricular systolic function being severely impaired and an ejection fraction of 28% on echocardiography. Orotracheal intubation was performed and mechanical ventilation was immediately started. Emergency cardiac catheterization was performed 2 h after the symptom onset. Coronary angiography showed no significant coronary artery disease. Blood analysis revealed an increase in the creatine kinase MB fraction, a significant positive detection in troponin T, a white blood cell count of 35000 per microliter, C-reactive protein of 59,9 mg/dl, and transient elevation in the concentration of free triiodothyronine, free thyroxine, thyroid globulin antibody, and thyroid peroxidase antibody. The symptoms improved during the next days, and follow-up echocardiography 18 days later showed complete resolution of the left ventricular dysfunction. These data suggest that tako-tsubo cardiomyopathy may be induced in patients with sepsis and transient hyperthyroidism.

Clinical analysis of 20 cases of Hashimoto's thyroiditis complicated with subacute thyroiditis

Clinical data were retrospectively analyzed in 20 cases with Hashimoto's thyroiditis complicated with subacute thyroiditis from February 2009 to April 2013.85％ of the patients showed elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).Thyroid peroxidase antibody (TPOAb) was found in 95 ％ of the patients,while thyroid globulin antibody (TgAb) in 100％.Uptakes of radioactive iodine were lowered.Symptoms such as fever or pain were ameliorated quickly after treatment with glucocorticoids or non-steroidal anti-inflammatory drugs. Key words: Hashimoto's thyroiditis; Subacute thyroiditis; Autoimmune; Coexistence

Clinical analysis of 65 cases of hyperemesis gravidarum with gestational transient thyrotoxicosis.

We investigated thyroid function and the impact of gestational transient thyrotoxicosis (GTT) on pregnancy outcome in patients with hyperemesis gravidarum (HG; n = 143) who were hospitalized for rehydration. Serum thyroid-stimulating hormone (TSH), free T3 (FT3), free T4 (FT4), thyroid globulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and hCG were measured after admission. The total prevalence of thyrotoxicosis in HG was 48.3%; GTT was the main form (45.5%). The total incidence of GTT increased significantly if serum hCG was more than 80,000 IU/L, subclinical GTT if serum hCG was 80,000-140,000 IU/L and clinical GTT if serum hCG was more than 180,000 IU/L. GTT did not require antithyroid therapy. The course of TSH, FT3 and FT4 were followed in 34 cases of GTT; thyroid function normalized by the second trimester. Of 65 patients with GTT, two underwent abortions due to unplanned pregnancies, two delivered prematurely and two infants had macrosomia. There were no other complications. All newborns (n = 63) of mothers with GTT had normal TSH levels. GTT is common in HG. The severity of GTT is related to serum hCG levels. In patients with HG and GTT, thyroid function normalized by the second trimester without antithyroid treatment. GTT did not affect pregnancy outcomes.