Thyroid Status Research Articles

Causal relationship between hypothyroidism and temporomandibular disorders: evidence from complementary genetic methods

BackgroundThe role of thyroid health in temporomandibular disorders (TMDs) has been emphasized in observational studies. However, whether the causation exists is unclear, and controversy remains about which specific disorder, such as hypothyroidism or hyperthyroidism, is destructive in TMDs. This study aims to investigate the overall and specific causal effects of various thyroid conditions on TMDs.MethodsMendelian randomization (MR) studies were performed using genetic instruments for thyrotropin (TSH, N = 119,715), free thyroxine (fT4, N = 49,269), hypothyroidism (N = 410,141), hyperthyroidism (N = 460,499), and TMDs (N = 211,023). We assessed the overall effect of each thyroid factor via inverse-variance weighted (IVW), weighted median, and MR-Egger methods, and performed extensive sensitivity analyses. Additionally, multivariable MR was conducted to evaluate the direct or indirect effects of hypothyroidism on TMDs whilst accounting for TSH, fT4 and hyperthyroidism, and vice versa.ResultsUnivariable MR analyses revealed a causal effect of hypothyroidism on an increased risk of TMDs (IVW OR: 1.12, 95% CI: 1.05–1.20, p = 0.001). No significant association between genetically predicted hyperthyroidism, TSH, or fT4 and TMDs. In the multivariable MR analyses, the effects of hypothyroidism on TMDs occurrence remained significant even after adjSusting for TSH, fT4 and hyperthyroidism (multivariable IVW OR: 1.10, 95% CI: 1.03–1.17, p = 0.006). No pleiotropy and heterogeneity were detected in the analyses (p > 0.05).ConclusionsHypothyroidism might causally increase the risk of TMDs through a direct pathway, highlighting the critical role of managing thyroid health in the prevention of TMDs. Clinicians should give heightened attention to patients with hypothyroidism when seeking medical advice for temporomandibular discomfort. However, caution is warranted due to the potential confounders, pleiotropy, and selection bias in the MR study.

Statistical Associations between Vestibular Pathologies and Hypothyroidism: A Retrospective Study.

The association between vestibular pathologies and thyroid hormone disorders has been known for several decades. However, very little information is available on the types of vestibular symptoms that may be affected by altered thyroid hormone levels. The aim of this study was to provide patient data in order to identify statistical associations between vestibular pathologies and thyroid hormone disorders. A retrospective review of the records of 422 patients seen for physiotherapy treatment of vertigo was carried out. Statistical analysis of the data was performed using logistic regression, providing Chi2 and Odds Ratio statistics. Our results show that hypothyroidism statistically significantly increases the expression of certain symptoms, such as vestibular instability and gait disorders, in vestibular pathologies such as Menière's disease or central vertigo. By analyzing patient data, our study provides new evidence of dependence between altered thyroid status and the expression of vestibular pathologies.

Novel and Advanced Ultrasound Techniques for Thyroid Thermal Ablation.

Thyroid radiofrequency ablation and microwave ablation are widely adopted minimally invasive treatments for diverse thyroid conditions worldwide. Fundamental skills such as the trans-isthmic approach and the moving shot technique are crucial for performing thyroid ablation, and advanced techniques, including hydrodissection and vascular ablation, improve safety and efficacy and reduce complications. Given the learning curve associated with ultrasound-guided therapeutic procedures, operators need training and experience. While training models exist, limited attention has been given to ultrasound maneuvers in ablation needle manipulation. This article introduces two essential maneuvers, the zigzag moving technique and the alienate maneuver, while also reviewing the latest ultrasound techniques in thyroid ablation, contributing valuable insights into this evolving field.

THYROID FUNCTION ABNORMALITIES IN PATIENTS WITH CHOLELITHIASIS: A HOSPITAL-BASED CROSS-SECTIONAL STUDY

Objective: The objective of the study is to analyze the association between thyroid function abnormalities and cholelithiasis, focusing on the prevalence and types of thyroid dysfunctions in patients with gallstone disease compared to a healthy control group. Methods: A comparative, hospital-based cross-sectional study was conducted in the department of general surgery at a tertiary care medical college. The study included 60 patients diagnosed with cholelithiasis (Group A) and 60 age-matched healthy individuals (Group B). Detailed history, physical examinations, ultrasound imaging, and thyroid function tests (TFTs) were performed. TFTs included measurements of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone. Patients were categorized based on thyroid status into euthyroid, subclinical and clinical hypothyroidism, and hyperthyroidism. Statistical analysis was performed using SPSS version 21.0, with significance set at p<0.05. Results: The study revealed a female preponderance in cholelithiasis cases (76.67% in Group A vs. 65.00% in Group B). The mean age and BMI were comparable between the groups. Thyroid function abnormalities were more prevalent in the cholelithiasis group (p=0.0251), with a higher incidence of hypothyroidism compared to the control group. Subclinical hypothyroidism was the most common thyroid dysfunction in cholelithiasis patients. Common complaints in the cholelithiasis group included anemia, menstrual irregularities, skin changes, and weakness. Conclusion: The study demonstrates a significant association between cholelithiasis and thyroid function abnormalities, particularly hypothyroidism. The findings suggest the need for routine thyroid function evaluation in patients with cholelithiasis, which could influence management strategies and improve patient outcomes.

ASSOCIATION OF POLYCYSTIC OVARY SYNDROME AND THYROID DYSFUNCTION AMONG REPRODUCTIVE WOMEN: A CROSS-SECTIONAL STUDY

Objective: Polycystic ovarian syndrome (PCOS) is became most common problem in the reproductive age group women who seem to be adversely affected by associated thyroid dysfunction. Ovarian failure and pregnancy-related complications leaded by both factors. The study helps to explore the incidence and etiology of diverse thyroid conditions among PCOS individuals. Methods: This prospective single‑center study with 40 female patients with hyperandrogenism, hirsutism, oligo‐anovulation, and polycystic ovaries patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and Ferriman–Gallwey score with comprised the study population. Normal female subjects were studied as the control population who had normal thyroid function and without PCOS. By measuring of serum thyroid-stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, and testosterone can evaluate thyroid function. Along with ultrasound was performed to confirm the PCOS. By SPSS version 19 Chi-square test and t-test were determined. Results: This case–control study revealed that a statistically significant higher prevalence of PCOS patients was found to have higher mean TSH values that were 5.33±2.51 μIU/mL, the mean for T3 and T4 was 154±138 μg/dL and 11.27±8.47 μg/dL, respectively. The mean FSH values were 07.27±4.49 μIU/mL, the mean LH was 84.27±38.49 μIU/mL, the mean estrogen 342±202 pg/mL, the mean progesterone values were 14.2±8.9 ng/mL and the mean testosterone levels were 69.73±9.28 ng/mL. Conclusion: Thyroid dysfunction shows a high prevalence in PCOS patients. Dysfunction can be treated which helps to manage infertility associated with PCOS.

Prevalence and Pattern of Gestational Thyroid Dysfunction in a Population of South-East Nigerian Women.

Pregnancy serves as a physiological stress test for the thyroid which often leads to dysfunction in women with limited thyroid reserves. The occurrence of gestational thyroid dysfunction is linked to unfavourable obstetric and foetal outcomes. Globally, iodine deficiency is a prominent causative factor for thyroid dysfunction. The study aimed to determine the prevalence and pattern of thyroid dysfunction among pregnant women in Enugu, South-east Nigeria. This hospital-based descriptive cross-sectional and observational study was conducted over six months on selected participants from pregnant women attending antenatal clinics at the study sites. Maternal clinical and demographic risk factors for thyroid dysfunction were evaluated in a cohort of 318 pregnant women. An analysis of variance (ANOVA) was performed to compare participants' thyroid status across different trimesters of pregnancy, and different thyroid and nutritional iodine states. The prevalence of thyroid dysfunction in the study population is 6.6%. Hypothyroidism was detected in 5.3% of the participants, consisting of 3.8% sub-clinical hypothyroidism and 1.6% overt hypothyroidism. Sub-clinical hyperthyroidism accounted for 1.3% of all participants; no overt hyperthyroidism was detected in this study. There is a relatively high prevalence of gestational thyroid dysfunction in the study population with hypothyroidism being the predominant disorder. This highlights the need for region-specific considerations in antenatal care to facilitate early detection and effective management of gestational thyroid dysfunction, thereby mitigating potential adverse maternal and foetal outcomes.

A Randomized Trial of Combination T4 and T3 Treatment and Effect on Tissue Markers of Thyroid Status in Thyroidectomized Patients

A Randomized Trial of Combination T4 and T3 Treatment and Effect on Tissue Markers of Thyroid Status in Thyroidectomized Patients

Correlation of TED Laterality with Thyroid Status among Thyroid Eye Disease (TED) Patients in a Tertiary Hospital in Indonesia

Introduction: Thyroid eye disease (TED), an autoimmune thyroid disorder, is prevalent in Asian countries and exhibits a variety of manifestations. Orbital involvement in TED is usually bilateral but may occur unilaterally in some cases. While it is commonly associated with hyperthyroidism, it also manifests in individuals with hypothyroidism or euthyroidism. The purpose of this study was to investigate the relationship between TED laterality and thyroid status in TED patients treated at the Eye Oncology Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia.Methods: The study was retrospective, analytical and observational. Patients diagnosed with TED who were treated at Dr. Soetomo General Academic Hospital between January 2019 and December 2021 were the focus of this study. SPSS analyses of medical records that satisfied the sample criteria were used to compile the data for this study.Results: There were 88 samples that were dominated by females (57.95%) and aged 41 – 50 (32.96%). Proptosis was the most common clinical manifestation (94.32%), with compressive optic neuropathy was the least common (3,41%). Eyelid retraction occurred in only 22.7% of the patients. TED was categorized into unilateral (44.32%) and bilateral (50%). The majority had hyperthyroidism (70.45%), followed by euthyroidism (25%), and hypothyroidism (4.55%). It was found that there was a significant correlation between thyroid status and TED laterality. Compared to euthyroidism, abnormal thyroid conditions such as hyperthyroidism and hypothyroidism develop bilateral TED more frequently than normal thyroid conditions.Conclusion: There was a correlation between TED laterality and thyroid status among patient TED.

Thyroid Inflammation and Immunity During the COVID-19 Pandemic: A Comprehensive Review and Case Study.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the development of various vaccines. Reports have emerged suggesting a possible association between SARS-CoV-2 vaccination and the onset of thyroid diseases. This review explores the clinical aspects of thyroid disorders following SARS-CoV-2 vaccination, including a case report of a patient with concomitant subacute thyroiditis (SAT) and Graves' disease (GD) with blocking thyrotropin receptor autoantibodies (TSH-R-Ab) following SARS-CoV-2 vaccination. SAT, characterized by transient inflammation of the thyroid gland, has been reported after SARS-CoV-2 vaccination. GD, an autoimmune hyperthyroidism, has also been observed post-vaccination, often with stimulating TSH-R-Ab. Graves' orbitopathy (GO) has been associated with SARS-CoV-2 vaccination in patients with a history of immune thyroid disease. The unique case underscores a very rare thyroid condition of functional hypothyroidism in possible relation to SARS-CoV-2 vaccination and the usefulness of functional analysis of TSH-R-Ab that can provide valuable insights into disease pathogenesis and help to guide treatment. This review highlights the need for continued monitoring and awareness of potential thyroid-related complications following SARS-CoV-2 vaccination.

Iodineminho Study: Iodine Supplementation and Prevalence of Iodine Deficiency In Pregnant Women.

Iodine is necessary for proper brain development. The prevalence of iodine deficiency in Portuguese pregnant women led the health authorities, in 2013, to recommend iodine supplementation for women in preconception, throughout pregnancy, and during lactation. This work aimed to assess the effect of iodine supplementation initiated in the preconception or the first trimester of pregnancy on the prevalence of iodine deficiency and maternal thyroid status. An observational prospective cohort study was conducted that followed the thyroid function and iodine status of women recruited during preconception or in the first trimester of pregnancy. Median urinary iodine concentration (UIC) was significantly higher among women taking iodine supplements (no-supplement group UIC = 63 µg/L; supplement group UIC = 100 µg/L; P = .002) but still below the levels recommended by the World Health Organization. Only 15% of pregnant women had adequate iodine status and 17% showed a UIC of less than 50 µg/L. There was no influence whether iodine supplementation was started during preconception or during the first trimester of gestation (UIC preconception group: 112 µg/L vs UIC pregnancy group: 91 µg/L; P = .569). In the first trimester of pregnancy, total thyroxine levels were lower and free triiodothyronine levels were higher in nonsupplemented women. Thyroglobulin levels were lower in women who started iodine supplementation during preconception compared to nonsupplemented women and women who started iodine supplementation during gestation. In the Minho region of Portugal, fertile women have insufficient iodine intake. Additional public health measures are needed since the current recommendations for iodine supplementation for pregnancy are unsatisfactory to achieve adequate iodine status.

Diagnostic implication of thyroid spherules for cytological diagnosis of thyroid nodules.

Thyroid fine-needle aspiration (FNA) is a principal diagnostic procedure for thyroid nodules. A specific cytomorphological structure, known as the thyroid spherule, is often seen in FNA specimens. The clinical significance of these spherules in terms of diagnosis and prevalence remains largely unexplored. We performed a retrospective study on 310 thyroid FNA specimens and categorized them according to the Bethesda System for Reporting Thyroid Cytopathology. The presence, size and number of thyroid spherules in each specimen were examined and these data were subsequently correlated with the clinicopathological features. Thyroid spherules were almost exclusively detected in benign cases, comprising 7.6% of all benign diagnoses. The average diameter of spherules in benign cases was 84.9 μm. Benign cases and cases with atypia of undetermined significance cases primarily exhibited low cellularity, while follicular neoplasms and malignant cases typically showed moderate to high cellularity. In the subgroup of FNA cases with moderate to high cellularity, spherules were identified in 12 (20%) of 59 benign FNA cases. Within this group, the sensitivity and specificity of thyroid spherules for detecting benign FNA cases were 20% and 100%, respectively. Our results suggest that the presence of thyroid spherules in FNA specimens can serve as a highly specific marker for benign thyroid conditions. The prevalence of spherule detection is strongly influenced by the cellularity. In cases with moderate to high cellularity, the identification of spherules can assist the cytopathologists in diagnosing thyroid FNA cases as benign.

The influence of thyroid status on long-term complications after stenting in patients with acute coronary syndrome without ST-segment elevation.

Backround.It is known that both subclinical hypothyroidism (SHT) and subclinical thyrotoxicosis (STT) can influence the outcome of coronary heart disease. The feasibility of routinely determining thyroid status in patients without obvious signs of thyroid dysfunction with acute coronary syndrome without ST-segment elevation (NSTEACS) to assess the effect on the status of implanted stents has not been determined.Objective.To evaluate the effect of subclinical hypothyroidism and subclinical thyrotoxicosis on lumen loss and the degree of endothelialization of drug-eluting stents after stenting for NSTE-ACS.Design and methods.The study included 173 patients who were urgently stented for NSTE-ACS, and who subsequently underwent repeat coronary angiography within a year on a planned or emergency basis with a targeted assessment of the condition of the installed stents. In 40 patients with everolimus-eluting stents, the condition of the coronary arteries was assessed 6.3 + 0.3 months after stenting using optical coherence tomography (OCT). All patients included in the study had their thyroid status assessed.Results.SHT was detected in 8 (21.6 %) patients with loss of lumen in the stent area and in 26 (19.1 %) patients without loss of lumen, p = 0.73. STT was detected in 2 (5.4 %) and 3 (2.2 %) patients, respectively, p = 0.30. A prognostic analysis performed by logistic regression with forced inclusion as predictors of lumen loss identified the parameters Syntax Score I, stent diameter, and the number of affected coronary arteries. No effect of thyroid status on lumen loss was found. In patients with subclinical hypothyroidism, OCT data revealed insufficient endothelialization of everolimus-eluting stents 6 months after stenting for NSTE-ACS. The percentage of uncovered stent struts depended on TSH levels (r = 0.42, p = 0.007). The higher the TSH level, the higher the healing index and the worse the stent endothelialization (r = 0.37, p = 0.016). Conclusion. Thus, routine determination of thyroid status indicators in patients with NSTE-ACS in order to identify subclinical thyroid dysfunction does not provide significant prognostic information regarding the risk of lumen loss of implanted stents. Considering the potential risk of thrombotic complications associated with insufficient endothelialization of everolimus-eluting stents in the presence of subclinical hypothyroidism, it seems advisable to identify it when deciding on de-escalation of antithrombotic therapy. The question remains open about the need to correct the parameters of subclinical thyroid dysfunction in order to modify the prognosis.

Indicators of lipid metabolism and their relationship with the thyroid status during the dry and post-calving periods in cows with different fertility

In black-and-white cows with reduced fertility, during the dry and early post-calving periods, changes in the functioning of the thyroid system are observed, which differ from those in individuals with high fertility. Such changes may lead to a lack of energy sources during the critical transition period.Purpose: To study the dynamics of changes in the lipid content before and after calving and its association with the content of thyroid hormones in the blood of black-and-white cows with various fertility.Materials and methods. Black-and-white cows of lactation 2-4 were used in the study. The animals were bled 6, 4 and 2 weeks before calving and 1, 3, 7 and 13 weeks after calving. In blood serum samples, the content of lipids was determined using a biochemical analyzer, as well as thyroid hormones and progesterone using ELISA. Cows were inseminated after treatment according to the Ovsynch protocol, and pregnancy was assessed on Day 33 based on ultrasound examination and progesterone levels in the blood.Results. The cows were divided into two groups: I – pregnant individuals (n=17) and II – individuals that remained infertile (n=12). The milk productivity of animals and their BCS before and after calving were similar in the compared groups. Thirteen weeks after calving, the cholesterol content in the blood of cows of group II was 1.2 times lower (p<0.05) compared to this content in animals of group I. At the same time, 6 weeks before calving, the concentration of phospholipids in the blood of individuals of group II was 1.3 times higher than that of individuals of group I (p<0.05). In addition, 3 weeks after calving, the level of triglycerides in cows of group I was 1.2 times higher (p<0.05) than that in animals of group II. During the postpartum period, the blood levels of cholesterol and triglycerides in animals of group I positively correlated with the content of total thyroxine, whereas such a correlation was not detected in group II.Conclusions. Thus, the metabolic state of cows with higher fertility was characterized by an increased supply of lipid energy sources during the post-calving period compared to animals with low fertility. At the same time, the reduced content of triglycerides at the early stage of lactation in the blood of cows that remained infertile points to their increased accumulation by the liver. A positive relationship between the concentration of total thyroxine in the blood and the concentration of triglycerides and cholesterol, revealed during the post-calving period in cows with high fertility, suggests the participation of the thyroid hormone in maintaining the reproductive function of these animals by modulating lipid metabolism.

Effect of Thyroid Dysfunctions on Complete Blood Count in Almatama Town-Sudan

Background: Thyroid hormones have a crucial role in the metabolism and proliferation of blood cells. Thyroid dysfunction causes different outcomes on blood cells such as anemia, erythrocytosis, leukopenia, thrombocytopenia, and in rare cases causes’ pancytopenia. It also alters RBC indices including MCV, MCH, MCHC, and RDW. Objectives: This is a cross-sectional descriptive study conducted in Almatama town during the period from September 2021 to January 2022, aimed to assess the effects of hypothyroidism and hyperthyroidism on blood cell count and RBC indices. Materials and Methods: Fifty patients with thyroid disease (24 hyperthyroidism, 26 hypothyroidism) and 20 healthy subjects served as controls. Whole venous blood samples were collected in EDTA anticoagulant container, mixed well, transferred to the laboratory according to standard procedures to avoid contamination, and then automatically counted for complete blood counts. Results: RBCs, HB, MCV, MCHC, and MCH, had statistically insignificant results in thyroid patients when compared with the control group (P. value 0.225,0.077,0.235,0.498,0.626) respectively. In hyperthyroid RBCs, HB, PCV, MCV, and MCH were statistically insignificant (P. value 0.388,0.951,0.123,0.575,0.148) respectively, and a statistically significant MCHC (P. value 0.0020). In hypothyroid HB, PCV, and MCH were, statistically significant (P. value 0.001,0.010,0.029) respectively, RBCs, MCV, and MCHC were, statistically insignificant (P. value 0.166,0.107,0.125) respectively. Conclusions: The hematological parameters were affected by thyroid disease, In case of patients with unknown hematological dysfunctions, must be evaluated for thyroid hormones. The follow-up of patients with thyroid disorders should have the complete blood count and patients diagnosed with anemia should be considered for thyroid conditions before iron treatment. Cases of anemia that resist therapy should be investigated for the case of thyroid dysfunction.

The role of medical and organizational measures in improving the quality of early detection and clinical examination of autoimmune thyroiditis among the population of the Republic of Belarus

Objective. To evaluate the role of medical and organizational measures in improving the quality of early detection and medical examination of autoimmune thyroiditis in the population of the Republic of Belarus.Materials and methods. The data of population statistics and the State register of persons affected by the Chernobyl catastrophe and other accidents on cases of thyroid pathology, as well as outpatient records of patients were analyzed. Epidemiological, statistical and sociological methods were used.Results. It was noted that different clinical and laboratory variants of autoimmune thyroiditis (AIT) are encountered in clinical practice. Subclinical AIT with sonographic signs of the disease but without diagnostic concentrations of antibodies to thyroid peroxidase (AB/TPO) and disturbances of its function is registered in 14.1 (6.0-24.4) %. AIT with diagnostic concentrations of autoantibodies to AB/TPO, with preserved thyroid function or hypothyroidism occurs in 22.5 (13.534.0) % of the cohort subjects. The frequency of combining AIT with nodular neoplasms of the thyroid increased by the 4th stage of screening and reached 20.7 (11.2-33.4) %.The reasons for different approaches to diagnosis were analyzed and measures to improve organizational and medical measures for early detection and dispensary treatment of patients with AIT were proposed: groups of persons at high risk of AIT and primary hypothyroidism (PHT) were identified, an algorithm for early detection and dispensary treatment was developed, etc.Conclusion. When making a decision to improve the quality of medical care to the population of the Republic of Belarus on early detection and medical examination of patients with AIT, it is necessary to take into account the timeliness of thyroid status studies in the population, compliance with the terms of dynamic observation for persons at high risk of AIT and PHT development, peculiarities of clinical and laboratory variants of AIT course.

Association of thyroid cancer with human papillomavirus infections

While Human Papillomavirus (HPV) particles have been detected in a small proportion of benign thyroid nodules or thyroid cancer cases, a role of HPV in these thyroid conditions has not been established. This study aims to investigate the association of HPV infection with thyroid cancer (TC) using a nationwide population-based study. We retrieved data for this case–control study from Taiwan's Longitudinal Health Insurance Database 2010. The study sample included 3062 patients with TC and 9186 propensity-scored matched controls. We employed multivariate logistic regression models to quantitatively evaluate the association of TC with HPV infections after taking age, sex, monthly income, geographic location and urbanization level of the patient's residence, diabetes, hypertension, and hyperlipidemia into considerations. Chi-squared test revealed that there was a significant difference in the prevalence of prior HPV infections between patients with TC and controls (15.3% vs. 7.6%, p < 0.001). The adjusted odds ratio of prior HPV infections for patients with TC was 2.199 (95% CI = 1.939–2.492) relative to controls. The adjusted ORs of prior HPV infections for patients with TC was similar for males and females. Our research suggests a significant link between HPV infection and the development of TC.

MK-BMC: a Multi-Kernel framework with Boosted distance metrics for Microbiome data for Classification.

Research on human microbiome has suggested associations with human health, opening opportunities to predict health outcomes using microbiome. Studies have also suggested that diverse forms of taxa such as rare taxa that are evolutionally related and abundant taxa that are evolutionally unrelated could be associated with or predictive of a health outcome. Although prediction models were developed for microbiome data, no prediction models currently exist that use multiple forms of microbiome-outcome associations. We developed MK-BMC, a Multi-Kernel framework with Boosted distance Metrics for Classification using microbiome data. We propose to first boost widely used distance metrics for microbiome data using taxon-level association signal strengths to up-weight taxa that are potentially associated with an outcome of interest. We then propose a multi-kernel prediction model with one kernel capturing one form of association between taxa and the outcome, where a kernel measures similarities of microbiome compositions between pairs of samples being transformed from a proposed boosted distance metric. We demonstrated superior prediction performance of (i) boosted distance metrics for microbiome data over original ones and (ii) MK-BMC over competing methods through extensive simulations. We applied MK-BMC to predict thyroid, obesity, and inflammatory bowel disease status using gut microbiome data from the American Gut Project and observed much-improved prediction performance over that of competing methods. The learned kernel weights help us understand contributions of individual microbiome signal forms nicely. Source code together with a sample input dataset is available at https://github.com/HXu06/MK-BMC.

Impact of Thyroid Status on Incident Kidney Dysfunction and Chronic Kidney Disease Progression in a Nationally Representative Cohort

ObjectiveTo examine the relationship between thyroid status and incident kidney dysfunction/chronic kidney disease (CKD) progression. Patients and MethodsWe examined incident thyroid status, ascertained by serum thyrotropin (TSH) levels measured from January 1, 2007, through December 31, 2018, among 4,152,830 patients from the Optum Labs Data Warehouse, containing deidentified retrospective administrative claims data from a large national health insurance plan and electronic health record data from a nationwide network of provider groups. Associations of thyroid status, categorized as hypothyroidism, euthyroidism, or hyperthyroidism (TSH levels >5.0, 0.5-5.0, and <0.5 mIU/L, respectively), with the composite end point of incident kidney dysfunction in patients without baseline kidney dysfunction and CKD progression in those with baseline CKD were examined using Cox models. ResultsPatients with hypothyroidism and hyperthyroidism had higher risk of incident kidney dysfunction/CKD progression in expanded case-mix analyses (reference: euthyroidism): adjusted hazard ratios (aHRs) (95% CIs) were 1.37 (1.34 to 1.40) and 1.42 (1.39 to 1.45), respectively. Incrementally higher TSH levels in the upper reference range and TSH ranges for subclinical, mild overt, and overt hypothyroidism (≥3.0-5.0, >5.0-10.0, >10.0-20.0, and >20.0 mIU/L, respectively) were associated with increasingly higher risk of the composite end point (reference: TSH level, 0.5 to <3.0 mIU/L): aHRs (95% CIs) were 1.10 (1.09 to 1.11), 1.37 (1.34 to 1.40), 1.70 (1.59 to 1.83), and 1.70 (1.50 to 1.93), respectively. Incrementally lower TSH levels in the subclinical (<0.5 mIU/L) and overt (<0.1 mIU/L) hyperthyroid ranges were also associated with the composite end point: aHRs (95% CIs) were 1.44 (1.41 to 1.47) and 1.48 (1.39 to 1.59), respectively. ConclusionIn a national cohort, TSH levels in the upper reference range or higher (≥3.0 mIU/L) and below the reference range (<0.5 mIU/L) were associated with incident kidney dysfunction/CKD progression.

Bidirectional negative relationship between thyrotropin and kidney function during alcohol intoxication in males.

Despite a well-established direct toxic effect of alcohol on renal cells, there is a salutary dose-dependent effect of alcohol consumption on common laboratory parameters related to kidney performance. Alcohol also impacts thyroid hormones, while thyroid status modulates kidney function. The modulation of kidney parameters with thyrotropin (TSH) and thyroid status indicates a possible interaction between alcohol, kidney, and thyroid functions. This retrospective study was conducted to test the hypothesis that the positive effect of alcohol use on the estimated glomerular filtration rate (eGFR) is mediated by alcohol's effect on thyroid hormones. We reviewed the electronic medical records of 767 hospitalized adult patients free of thyroid disorders who received medical care in the Mayo Clinic Health System from June 2019 through June 2022 and had blood alcohol concentration (BAC), serum TSH, and serum creatinine measured during the hospitalization. We calculated the eGFR using both the re-expressed Modification of Diet in Renal Disease (MDRD II) study equation and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) Creatinine equation. We found a significant relationship of BAC with eGFR (CKD-EPI) and TSH in males only. BAC had a positive association with eGFR (b = 0.24, p = 0.0001) and negative with TSH (b=-0.17, p = 0.006). The covariance between the two outcomes (eGFR and TSH) was negative (b = -0.12, p = 0.049). The path analyses using the eGFR MDRD II equation were not significant in males, whereas females had no significant path analyses with either of the eGFR equations. We observed that BAC influences both eGFR and TSH, whereas eGFR and TSH influence each other. After considering important covariates (e.g., age, body mass index, diabetes mellitus, cardiovascular disease, chronic kidney disease, and chronic liver disease) and the negative bidirectional effect of TSH and eGFR, a positive impact of BAC on eGFR was observed in males.

Study of thyroid disorders in ankylosing spondylitis patients on anti-tumor necrosis factor treatment

Abstract: BACKGROUND: Ankylosing spondylitis (AS) is a systemic rheumatic disease characterized mainly by involvement of sacroiliac joints and axial skeleton. Tumor necrosis factor-alpha (TNF-α) inhibitors are biologic agents which are Food and Drug Administration approved to treat AS and also act as a key factor in the treatment of autoimmune thyroid disease. OBJECTIVE: This study aimed to evaluate the thyroid gland disorders (functions and thyroid autoantibodies) in AS patients on anti-TNF-α biologics and their relation to disease activity. PATIENTS AND METHODS: This comparative cross-sectional study included 75 AS patients classified into two groups: Group I: treated with NSAIDs (n = 30) and Group II: treated with anti-TNF-α biologics (n = 45). Thyroid function tests, thyroid autoantibodies, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and human leukocytic antigen B27 were measured. AS disease activity was assessed by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Metrology Index (BASMI) scores. Thyroid ultrasonography was used to detect any thyroid gland nodularity and echogenicity. RESULTS: There were significant differences between both groups regarding BASDAI (P = 0.005), CRP (P = 0.005), thyroid-stimulating hormone (TSH) (P = 0.001), and anti-thyroid peroxidase (anti-TPO) (P = 0.007). A significant difference was found regarding the thyroid status, with more normal thyroid and more hyperthyroid patients in the anti-TNF-treated group (P = 0.003). There were statistically significant positive correlations between BASDAI and CRP (P = 0.007), TSH (P = 0.004), and thyroid anti-TPO antibody (P = 0.008) in the anti-TNF-treated patients. By ultrasound examination of the thyroid gland, 75.6% of the anti-TNF group had normal thyroid gland compared to 56.6% of the other group, and the reported nodules were mostly of benign TIRADS classification. Comparing different subgroups of thyroid nodularity with different treatment regimens revealed significant differences in BASDAI and different laboratory investigations in favor of the anti-TNF-treated patients. CONCLUSION: From this cohort study, we can conclude that thyroid autoimmune disease and thyroid nodules in AS patients can be controlled by treatment with anti-TNF-α biologic drugs better than NSAIDs alone.