Thyrotropin Research Articles

Role of serum fasting glucagon in hypothyroidism-related nonalcoholic fatty liver disease

BackgroundA bidirectional relationship between hypothyroidism and nonalcoholic fatty liver disease (NAFLD) has been proposed. Fasting hyperglucagonemia in patients with hypothyroidism induced NAFLD needs to be further clarified. The aim of the present study was to determine fasting serum glucagon levels in hypothyroid adults with and without NAFLD. The possible association between fasting glucagon and NAFLD in patients with hypothyroidism was also evaluated.MethodsThis study was comprised 60 patients with uncontrolled hypothyroidism and 30 healthy controls matched for age and sex. Patients with hypothyroidism were divided into 2 groups: 30 patients with NAFLD and 30 patients without NAFLD. Diagnosis of NAFLD was based on the combination of hepatic steatosis index (HSI) at a cutoff value of 36 and measurements of steatosis using fibroScan. Anthropometric measurements, lipids profile, homeostasis model assessment of insulin resistance (HOMA-IR), free thyroxine (FT4), triiodothyronine (FT3), thyroid stimulating hormone (TSH) and serum fasting glucagon were assessed.ResultsSerum fasting glucagon concentration was significantly higher in hypothyroid patients with and without NAFLD than in healthy controls; glucagon was also significantly higher in the hypothyroid patients with NAFLD than in those without NAFLD. Fasting glucagon was significantly correlated with waist circumference (WC), body mass index (BMI), TSH, HSI and fibroScan parameters in hypothyroid patients with NAFLD. Fasting glucagon predicts NAFLD in patients with hypothyroidism at a cutoff value 85 ng/L with 90% sensitivity, 100% specificity and p < 0.001. With multivariable analysis, age, BMI and TSH were significant positive predictors of NAFLD in patients with hypothyroidism.ConclusionFasting glucagon concentration may play a role in the development of NAFLD in patients with hypothyroidism. However, the exact underlying mechanism needs further studies.

Management of Thyroid Disorders during Pregnancy: A Survey of Physicians from the Middle East and North Africa

Abstract Objectives We explored the clinical practice of screening and managing hyperthyroidism and hypothyroidism during pregnancy in the Middle East and North Africa. Methods We used an online questionnaire based on clinical case scenarios to a regional physician database and invited those managing pregnant women with thyroid disease to respond. Results We analyzed 136 eligible responses. For a woman with newly diagnosed Graves' disease (GD) and wishing to conceive, 77.5% of the respondents would initiate antithyroid drugs (ATDs), while 20.3% would recommend definitive treatment with radioiodine or surgery. In the case of a relapsed GD before pregnancy, 84.3% preferred definitive treatment. For a woman with newly diagnosed GD during pregnancy, 39.4% will start propylthiouracil (PTU), 8.5% with methimazole/carbimazole, while 50.0% will start with PTU and then switch to methimazole after the first trimester. Respondents used several combinations of tests to monitor the dose of ATDs, and the thyroid test results they targeted were inconsistent, though nearly half of the respondents targeted achieving low serum thyroid-stimulating hormone (TSH) with free thyroxine (or total T4) in the upper end of the normal range. For a lactating woman with GD, 80.3% would give ATDs without stopping lactation. For the management of gestational thyrotoxicosis, 45.1% chose to follow-up, and 40.8% treated patients with PTU. Although the timing of TSH receptor antibody measurement in pregnant hyperthyroid patients was variable, 53% of respondents would check it at least once during pregnancy. The starting dose of L-thyroxine for a woman diagnosed with overt hypothyroidism in pregnancy, preconception management of euthyroid women with known thyroid autoimmunity, and approach related to ovarian hyperstimulation in women with thyroid peroxidase antibodies were widely variable. For women with known hypothyroidism, 34.6% of respondents would increase the L-thyroxine dose by 30 to 50% as soon as pregnancy is confirmed. Concerning screening, 42.7% of respondents perform universal evaluation and 70% recommend TSH &lt; 2.5 mUI/L in the first trimester and TSH &lt; 3 mUI/L in the second and third trimester as target results in known hypothyroid women. Conclusion Physicians' clinical practices regarding thyroid disorders in pregnant women vary. This highlights the need for focused training and quality assurance to achieve more consistent care.

Knowledge, attitudes, and practices regarding the postoperative management and TSH suppression therapy among patients with thyroid cancer

BackgroundPatient adherence to thyroid-stimulating hormone (TSH) suppression therapy is crucial for optimizing prognosis.MethodsThis study aimed to examine the knowledge, attitude, and practice (KAP) toward TSH suppression therapy among patients. This cross-sectional study was conducted at our Hospital between March 2023 and October 2023 and included patients receiving TSH suppression therapy. A self-designed questionnaire was employed to collect their demographic characteristics and KAP. The analysis included 528 valid questionnaires.ResultsThe mean knowledge, attitude, and practice scores were 11.66 ± 5.82 (possible range: 0-22), 33.31 ± 4.97 (possible range: 0-40), and 24.46 ± 3.46 (possible range: 0-34), respectively, indicating poor knowledge, favorable attitudes, and moderate practice. The knowledge scores were correlated to the attitude (r=0.399, P&amp;lt;0.001) and practice (r=0.401, P&amp;lt;0.001) scores, while the attitude scores were correlated to the practice scores (r=0.512, P&amp;lt;0.001). The structural equation modeling revealed that knowledge directly influenced attitude (β=0.34, P&amp;lt;0.001) and practice (β=0.13, P&amp;lt;0.001) and indirectly influenced practice through attitude (β=0.10, P&amp;lt;0.001).ConclusionsPatients receiving TSH suppression therapy in Zhanjiang demonstrated poor knowledge, favorable attitudes, and moderate practices toward TSH suppression therapy.

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

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

A Retrospective Case-Control Study Examining the Association of Thyroid-Stimulating Hormone Suppression and Vascular Wall Inflammation on [18F]FDG-PET/CT.

Background: This retrospective case-control study aimed to investigate the effects of thyroid-stimulating hormone (TSH) suppression on vascular wall inflammation, assessed by [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT). Vascular [18F]FDG-uptake is highly correlated with arterial inflammation, which represents a major risk factor for atherosclerotic plaques. Methods: Forty patients with differentiated thyroid cancer underwent [18F]FDG-PET/CTs under TSH suppression therapy following surgical removal of the thyroid and subsequent radioiodine ablation. The [18F]FDG-uptake was measured in the carotid arteries, aortic arch, and the ascending, descending, and abdominal aorta. All measurements in the PET scans were normalized to body weight and corrected for blood pool activity in the superior vena cava, creating target-to-background ratios (TBRs). Twenty-five patients with euthyroid hormone status were used as a control group. In addition, to evaluate long-term changes, the follow-up PET/CTs of 24 thyroid carcinoma patients under continued TSH suppression therapy were analyzed. Results: In patients with TSH suppression, significantly higher arterial [18F]FDG-uptake (p < 0.001) was observed in the ascending aorta, aortic arch, abdominal aorta, carotid artery, and for all arterial vessels combined (mean TBRmax ± standard deviation [SD]: 1.8 ± 0.4, 1.8 ± 0.3, 1.9 ± 0.4, 1.4 ± 0.3, 1.7 ± 0.2, respectively) compared with the euthyroid control group (TBRmax ± SD: 1.4 ± 0.2, 1.4 ± 0.2, 1.4 ± 0.2, 1.1 ± 0.2, 1.3 ± 0.1, respectively). In the subgroup of patients who received an additional follow-up scan after a mean duration of 1.9 ± 1.1 years of continued TSH suppression therapy, no significant changes in arterial [18F]FDG-uptake were found in the five arterial sites when both scans were compared over time (p > 0.05). Conclusions: Our study suggests that patients under TSH suppression may experience a significant increase in vascular [18F]FDG-uptake, a marker of arterial inflammation, and, therefore, might be at higher risk for cardiovascular disease. Interestingly, the duration of TSH suppression was not significantly associated with vascular [18F]FDG-uptake in our study, indicating that the observed increase in arterial inflammation may not be influenced by the duration of TSH suppression.

Sinopharm COVID-19 Vaccination during Pregnancy Triggers Thyroid Stimulating Hormone Levels in Newborns.

The effects of covid vaccination on the fetus and placenta make pregnant women a special group in the vaccination series. Coronavirus vaccines are associated with endocrine complications such as thyroid disease.The study included pregnant women who received the corona virus disease 2019 (COVID-19) vaccine. Pregnant women were divided into three study groups; group A (who have not received the COVID-19 vaccine), group B (who received the Sinopharm vaccine during pregnancy), and group C (who received the Sinopharm vaccine before pregnancy). Blood samples were taken to measure thyroid stimulating hormone (TSH) levels in infants 3 to 5 days old. Neonatal TSH values below 5 mU/L are considered normal.Sinopharm/BBIBP-CorV during and/or before pregnancy was associated with a slight increase in mean TSH in newborns.Vaccination with Sinopharm/BBIBP-CorV during or before pregnancy may slightly increase neonatal TSH levels, but this is not clinically significant. · COVID-19 vaccines linked to endocrine disruption.. · Sinopharm CorV during pregnancy triggers TSH in infants.. · Sinopharm vaccination in pregnancy increases neonatal TSH levels..

Role of PROP1 in postnatal pituitary gland maturation.

Mutations in the pituitary-specific transcription factor PROP1 are the most common, known cause of hypopituitarism in humans. Prop1 is the first pituitary-specific gene in the hierarchy of transcription factors that regulate pituitary development. It is essential for regulating the transition of pituitary stem cells to hormone-producing cells in an epithelial to mesenchymal-like transition process. It is also critical for activation of the lineage specific transcription factor POU1F1 in early organogenesis. Prop1 deficient mice have pituitary dysmorphology and lack the cells that produce growth hormone (GH), thyroid stimulating hormone (TSH), and prolactin (PRL). Prop1 is expressed in stem cells postnatally, but it is not known whether postnatal expression is necessary for completion of pituitary gland growth or organ maintenance. We tested whether PROP1 has a role in postnatal pituitary development by generating a conditional allele and deleting a crucial exon after birth. We determined that postnatal expression of Prop1 is important for appropriate expansion of the POU1F1 lineage and for robust expression of TSH, GH, and PRL in the early postnatal period. However, by 2 weeks of age, compensatory proliferation of committed POU1F1-expressing cells, but not SOX2-expressing stem cells, have normalized pituitary function. Thus, PROP1 appears to be dispensable after birth in mice.

Effects of vitamin D3 and calcium supplementation on bone of young adults after thyroidectomy of differentiated thyroid carcinoma.

Differentiated thyroid carcinoma (DTC) is the most frequent endocrine cancer, with a high incidence in young population. Patients with postoperative DTC are usually considered with increased risk of bone loss, possibly due to the thyroid stimulating hormone (TSH) suppression therapy. However, it remains unclear whether vitamin D and calcium supplementation is beneficial on bone metabolism of young patients with vitamin D malnutrition after thyroidectomy of DTC. In this one-year prospective study, adult men younger than 50 years or premenopausal women with DTC and vitamin D insufficiency or deficiency were enrolled after thyroidectomy, who were administered with daily supplements of 1000-2000 IU vitamin D3 and 600 mg of elemental calcium (calcium-D3) or not. Propensity score matching (PSM) was applied to identify baseline-matched cohorts. A total of 458 patients with a median age of 37 (range 21-50) years were enrolled, with 94 (20.5%) patients supplemented with calcium-D3. After PSM, we identified baseline-matched cohorts of 246 DTC patients, of which 82 patients were supplemented with calcium-D3 and 164 were not. After 12 months' supplementation, lower serum levels of β-CTX (0.27 ± 0.15 vs. 0.35 ± 0.18 ng/ml, P = 0.004), PTH (36.2 ± 12.7 vs. 45.2 ± 14.6 pg/ml, P < 0.001) and higher BMD at lumbar spine (1.8% vs. 0.7%, P = 0.050) and total hip (1.1% vs. -0.4%, P < 0.001) were observed compared to the control group. Among all the 458 patients, increase of 25OHD levels was closely associated with decrease of PTH, ALP and β-CTX levels and improvement in total hip BMD throughout the one-year study period. Vitamin D and calcium supplements can reduce PTH levels and bone loss, possibly contributing to protecting bone of young DTC patients with vitamin D malnutrition after thyroidectomy.

The Human Thyroid-Derived CI-huThyrEC Cell Line Expresses the Thyrotropin (TSH) Receptor and Thyroglobulin but Lacks Other Essential Characteristics of Thyroid Follicular Cells

Background: Thyroid hormone synthesis requires the normal function of thyroid follicular cells and adequate nutritional intake of iodine. For in vitro studies on thyroid cell pathophysiology, the immortalized FRTL5 rat thyroid cell line and a derivative thereof, the PCCL3 cell line, are widely used. However, a permanent human thyroid cell line is currently lacking. A recent report described a cell line obtained from human thyroid cells designated as Cl-huThyrEC. Methods: Four clones of Cl-huThyrEC cells were obtained and cultured in the presence of thyroid stimulating hormone (TSH). The expression of key genes defining the thyroid follicular cell phenotype was determined by reverse-transcription PCR (RT-PCR) in FRTL5, PCCL3, and Cl-huThyrEC cells. The latter were cultured as monolayers and as organoids in Matrigel. Iodide uptake was measured and compared among the cell lines. Results: Gene expression analysis reveals that Cl-huThyrEC cells express the thyroid-restricted transcription factors (PAX8, NKX2.1, FOXE1), the TSH receptor (TSHR), and thyroglobulin (TG), but they do not express the sodium-iodide symporter (NIS), thyroid peroxidase (TPO), and pendrin (SLC26A4). In functional studies, Cl-huThyrEC cells are unable to concentrate iodide. Conclusions: Despite the expression of certain key genes that are limited or restricted to thyroid follicular cells, Cl-huThyrEC cells lack some of the essential characteristics of thyroid follicular cells, in particular, NIS. Hence, their utility as a model system for thyroid follicular cells is limited.

Metabolic predictors and risk stratification of post-thyroidectomy hypocalcemia: A retrospective analysis and predictive machinery model

Introduction Post-thyroidectomy hypocalcemia remains a significant surgical complication with varying reported incidence rates. While traditional focus has centered on surgical factors, the role of metabolic predictors in calcium homeostasis disturbances remains incompletely understood. Methods We conducted a single-center retrospective analysis of 1,760 thyroidectomy patients based on data obtained from King Abdullah International Medical Research Center (KAIMRC), Saudi Arabia, evaluating metabolic predictors and long-term calcium homeostasis patterns. Preoperative assessment included thyroid function tests, glycemic control, vitamin D status, and anthropometric measurements. We have followed the TRIPOD + AI statement which provide updated guidance for reporting clinical prediction models that use regression or machine learning methods, We developed a risk stratification model using multivariate logistic regression and implemented mixed-effects modeling for longitudinal analysis. Recovery patterns were evaluated through standardized follow-up at immediate postoperative, one-month, three-month, six-month, and one-year timepoints. Results Post-thyroidectomy hypocalcemia occurred in 585 patients (33.2%, 95% CI: 31.0-35.4%). Preoperative thyroid stimulating hormone (TSH) levels appeared to be the strongest predictor (OR 2.24, 95% CI 1.71-2.93, p&lt;0.0001), followed by T3 (OR 1.34, 95% CI 1.19-1.51) and glycated hemoglobin (Hemoglobin A1C), (OR 1.18, 95% CI 1.07-1.30). Our risk stratification system, including TSH, vitamin D, and immediate postoperative calcium, achieved superior discrimination (AUC=0.921) and effectively categorized patients into low (6.5%), intermediate (14.6%), and high-risk (83.2%) groups. Recovery patterns revealed a non-linear trajectory, with an unexpected decline at six months (79.71%) before maximal improvement at one year (88.61%). Conclusions Our findings highlight and demonstrate the significant role of metabolic factors in post-thyroidectomy hypocalcemia risk and challenge the current standard recovery assumptions, suggesting the need for extended monitoring protocols and comprehensive metabolic assessment in perioperative management.

V-PRO Blood Collection Tubes: Validation for Clinical Chemistry and Immunoassay Tests.

In accredited laboratories, each component of diagnostic products-such as laboratory instruments, reagents, and blood collection tubes must be validated before integration into routine patient testing. BD Vacutainers are commonly used in clinical laboratories compared to other blood collection tubes, while V-PRO tubes have recently been introduced to the market without prior laboratory validation. This study compares V-PRO tubes to BD Vacutainers to assess the validity of using V-PRO tubes for blood testing. Blood samples were collected simultaneously into two different brands of tubes (V-PRO and BD) from 60 subjects. A standardized procedure was employed for sample collection, and analysis. A total of 28 chemistry tests and 20 immunoassays were analyzed using Abbott instruments, while high-performance liquid chromatography was used for testing glycated hemoglobin. The biases of V-PRO compared to BD were evaluated against current desirable quality specifications for bias derived from biological variation. For technical validation, a designated survey was distributed to various institutes using both tube types in their laboratories. The V-PRO tube exhibited biases exceeding the desirable limits for CO2 (3.2%), magnesium (2.0%), thyroid-stimulating hormone (11.7%), and estradiol (-8.5%). Survey results indicated a higher percentage of major pre-analytical, analytical, and post-analytical errors when using the V-PRO tube compared to the BD Vacutainer. Laboratories currently using BD vacutainers should exercise caution if they intend to perform chemistry and immunoassay tests with V-PRO tubes. The technical validation outcomes for V-PRO were not acceptable due to significant faults identified in comparison to BD Vacutainer.

Recovery of hypopituitarism in macroprolactinomas: a comparison of medical vs. surgical treatment. Results from a European multicenter study.

Macroprolactinomas not only cause hypogonadism, but also other pituitary dysfunctions, like deficiency of adrenocorticotrophic hormone (ACTH) and thyroid-stimulating hormone (TSH). While dopamine agonist treatment shows varying recovery rates of these insufficiencies, surgical outcomes are less studied, and a direct comparison between treatments is lacking. To evaluate recovery of pituitary dysfunction in medically vs. surgically treated patients with macroprolactinoma. Retrospective multicenter study including 104 patients with macroprolactinoma (44 surgically vs. 60 medically treated) with at least two hormonal deficiencies before treatment. Before surgery, all patients presented with hypogonadotropic hypogonadism, 25 (57%) with ACTH-deficiency, and 32 (73%) with TSH-deficiency. 10 months post-surgery, prolactin normalized in 25 (57%) patients, while 19(43%), 15 (60%) and 10(31%) recovered from hypogonadism, ACTH-deficiency, and TSH-deficiency, respectively. Before medical therapy, hypogonadism was observed in all patients, ACTH-deficiency in 31 (52%), and TSH-deficiency in 50 (83%). After 12 months under dopamine agonists, prolactin levels normalized in 36 (60%) patients, 25(42%) recovered from hypogonadism, 17 (55%) from ACTH-deficiency, and 14(28%) from TSH-deficiency. No significant difference in recovery rates between surgical and medical treatment for hypogonadism (OR 1.633, p = 0.338), ACTH-deficiency (OR 0.462, p = 0.319), or TSH-deficiency (OR 0.584, p = 0.339) was observed. Large initial tumor size was a significant negative predictor of recovery for all hormone deficiencies (always p < 0.05), while prolactin normalization was a predictor of recovery of hypogonadism (p < 0.001). Both surgical and medical treatment allow for hormonal recovery in patients with macroprolactinoma, with no significant advantage for either approach. Initial tumor size and prolactin-normalization are predictors of recovery outcomes.

K-Means Clustering Reveals Long-Term Thyrotropin Receptor Antibody Patterns in Graves’ Disease: Insights from a 10-Year Study with Implications for Graves’ Orbitopathy

Background/Objectives: We aimed to explore long-term trajectories of thyroid-stimulating hormone receptor antibody (TRAb) in patients with Graves’ disease (GD) and to identify key factors associated with TRAb normalization. We also investigated whether these trajectories correlate with Graves’ orbitopathy (GO) comorbidity. Methods: We retrospectively reviewed 403 patients with GD who had an initial TRAb level ≥ 1.5 IU/L between 2010 and 2021, monitoring their TRAb levels for at least 3 years. K-means clustering was performed to categorize patients into distinct TRAb change patterns (A, B, C, D). We employed a Cox regression–based time-to-event model, expressing results as “Survival ratio” rather than the conventional Hazard ratio, to reflect the proportion of patients achieving TRAb normalization over time. Key variables included age, sex, initial TRAb, and GO comorbidity. Results: Four unique TRAb patterns emerged, differing primarily in baseline TRAb levels, duration of GD, and treatment approaches. Pattern A demonstrated the highest TRAb normalization rate (96%), whereas Patterns B (80%), C (29%), and D (13%) showed lower probabilities. Regrouping into A vs. BCD further emphasized the distinct normalization profile of Pattern A. A higher “Survival ratio” was observed in female patients and those with baseline TRAb &lt; 6.14 IU/L. In contrast, patients whose TRAb levels were ≥6.14 IU/L frequently exhibited persistently elevated values over a decade. GO comorbidity did not significantly differ among the four patterns. Conclusions: K-means clustering revealed four unique TRAb change patterns in GD, with baseline TRAb (stratified by the median of 6.14 IU/L) and sex emerging as significant predictors of normalization. These findings highlight the importance of early TRAb monitoring and tailored therapeutic strategies, particularly for those with persistently elevated TRAb levels.

Diagnostic value of microRNA-129-5p and TSH combination for papillary thyroid cancer with cervical lymph node metastasis.

The papillary thyroid cancer (PTC) incidence is on the increase. We explored the diagnostic value of microRNA (miR)-129-5p & serologic indicator thyroid-stimulating hormone (TSH) test in PTC with cervical lymph node metastasis (LNM). According to the pathological "gold standard," 198 PTC patients were assigned into the LNM (n = 93)/non-LNM (n = 105) groups, with their medical records collected. The serum free-triiodothyronine (FT3)/free-thyroxine (FT4)/TSH/thyroglobulin (Tg)/thyroglobulin antibody levels were assessed using an electrochemiluminescence immunoassay device. Serum miR-129-5p expression was determined by reverse transcription quantitative polymerase chain reaction. Correlations between serum miR-129-5p/TSH levels with pathological indicators were analyzed by Spearman correlation coefficient. Independent influencing factors for cervical LNM in PTC patients was analyzed by logistic multivariate regression analysis. Diagnostic value of miR-129-5p combined with serologic indicator TSH test in PTC patients with cervical LNM and lateral cervical LNM was analyzed by the receiver operating characteristic curve. The two groups varied obviously in primary tumor size/Tg level. Serum miR-129-5p expression in the LNM group was reduced, and negatively correlated with Tg and primary tumor size, while the serologic indicator TSH level showed positive correlations with Tg and primary tumor size. Independent influencing factors for PTC with cervical LNM were miR-129-5p/TSH/Tg levels. miR-129-5p and serologic indicator TSH levels had high diagnostic value for PTC patients with cervical LNM and lateral cervical LNM, with their combination showing higher diagnostic value. miR-129-5p and serologic indicator TSH had high diagnostic value for diagnosing PTC patients with cervical LNM, providing high reference value for the formulation of thyroid tumor resection.

Relationship between thyroid-stimulating hormone levels and the severity of vitamin D deficiency by age group.

Researchers have long been captivated by the complex molecular interactions between vitamin D and the thyroid gland. Hypothyroidism affects 2% to 4% of women of reproductive age and can impact fertility through anovulatory cycles, luteal phase defects, hyperprolactinemia, and sex hormone imbalances. This study investigated the relationship between thyroid disease and the severity of vitamin D deficiency across different age groups. A retrospective study was conducted of 286 patient samples from individuals aged 18 to 60 years who were processed in the clinical biochemistry laboratory of our hospital. Samples were tested for thyroid-stimulating hormone (TSH) and vitamin D (specifically, vitamin D3) levels. The study samples were categorized into four clinically relevant groups based on TSH levels and into three groups based on serum 25-hydroxyvitamin D (25(OH)D) levels. Most of the samples were from female patients (n=269), and the most common age group was 18 to 35 years (n=191, 66.78%). Subclinical hypothyroidism was identified in 120 patients, while vitamin D deficiency was present in 237 (82.87%) participants. A significant association was observed between vitamin D deficiency and the presence of thyroid disorders. Additionally, a significant negative correlation was found between TSH and vitamin D levels. Polycystic ovary syndrome was noted in 103 female patients (36.01%). TSH and 25(OH)D levels should be screened in all women of reproductive age, not just those in high-risk groups, as subclinical and occult hypothyroidism may otherwise go undiagnosed. Furthermore, TSH should be considered the primary screening test.

A study of the association of thyroid-stimulating hormone levels with microvascular complications in type 2 diabetes mellitus patients at a tertiary care center

Background: Diabetes mellitus (DM) and hypothyroidism are two of the most common metabolic diseases worldwide. The prevalence of both conditions is drastically on the rise and if untreated is associated with long-term complications. Several studies have established the association between hypothyroidism and microvascular complications of diabetes. However, with the ever increasing diagnosis of sub-clinical hypothyroidism among diabetics, its association with the microvascular complications of DM needs to be studied. Aims and Objectives: The aims of this study were to study the association between thyroid-stimulating hormone (TSH) levels and microvascular complications of type 2 DM (T2 DM). DM is a metabolic disease which affects various organs of the body. The prevalence of T2 DM is on the rise much more rapidly, which is due to increasing obesity and reduced activity levels. Undiagnosed thyroid dysfunction may affect metabolic control and enhance cardiovascular and other chronic complication in diabetic patients. Materials and Methods: A total of 50 T2 DM patients were enrolled in this cross-sectional study. Subjects were evaluated for thyroid function, microvascular complications such as peripheral neuropathy, diabetic retinopathy, and diabetic kidney disease. TSH was divided into three levels: 0.27–2.49 mU/L, 2.5–4.2 mU/L, and &gt;4.2 mU/L. The association between TSH levels and microvascular complications of T2 DM was studied. Results: Our study found a statistically positive association elevated TSH and microalbuminuria, macroalbuminuria, low GFR, and impaired vibration sense. Our study found no association between elevated TSH and retinopathy. Conclusion: It is ideal to screen all patients with T2 DM for thyroid dysfunction as elevated TSH levels in these patients can be an indicator of underlying microvascular complications.

Associations between exposure to sodium/iodide symporter inhibitors and markers of thyroid function: A systematic review and meta-analysis.

Associations between exposure to sodium/iodide symporter inhibitors and markers of thyroid function: A systematic review and meta-analysis.

Serum Selenium Status in Autoimmune Thyroid Disorders: A Case-control Study

Introduction: Selenium is a trace element essential for normal health, playing a crucial role in thyroid hormone synthesis and metabolism. In Autoimmune Thyroid Disorders (AITD), selenium deficiency can exacerbate inflammation, impair thyroid hormone production and escalate tissue damage. Assessing the selenium status as part of comprehensive management strategies for AITD is crucial. Aim: To evaluate the selenium levels and autoantibody levels in AITD and to establish the risk of AITD among patients with low selenium. Materials and Methods: This case-control study was conducted at the Department of Surgery, Medicine, Biochemistry and Physiology, MOSC Medical College, Kolenchery, Kerala, India from July 2022 to May 2023. A total of 134 participants were enrolled, including 67 cases with AITD and 67 matched controls. Serum selenium levels, thyroid function {Triiodothyronine (T3), Thyroxine (T4),Thyroid Stimulating Hormone (TSH)} and thyroid autoantibodies {anti-Thyroid Peroxide (TPO) and antiThyroglobulin (TGO)} were evaluated using blood samples collected in the morning (6-8 AM). Statistical analysis was performed with Pearson’s correlation coefficient to assess relationships and Chi-square tests evaluated the association between selenium status and AITD. Odds Ratios (OR) for AITD in relation to selenium levels were calculated. Results: Study population comprised of 38 hypothyroid and 29 hyperthyroid subjects, along with 67 euthyroid controls. Mean selenium levels among AITDs cases (0.088±0.07 μg/ mL) were statistically significantly lower in comparison to controls (0.12±0.01 μg/mL). OR for association between serum selenium and AITD was 8.6 (95% CI 0.619-3.677; p&lt;0.0001). Observed Relative Risk (RR) for low selenium to have AITD was 1.95. The Chi-square value of 8.59 with p=0.0034 indicated a statistically significant association between AITD and low selenium status. Conclusion: Selenium levels among hypothyroid and hyperthyroid subjects were significantly lower comparison to age- and sex-matched euthyroid controls. The calculated OR of 8.60 and an RR of 1.95 highlight selenium's potential role in thyroid health, particularly in regulating immune response and hormone metabolism.

The Impact of Concomitant Hypothyroid Disease on the Course of Inflammatory Bowel Disease.

Inflammatory bowel disease (IBD) is a chronic, immune-mediated inflammatory disorder of the gastrointestinal tract. In IBD, systemic inflammation and immune dysregulation may also impact extraintestinal organs, such as the thyroid gland. Despite this, little is known about the influence of concomitant hypothyroidism on the clinical course of IBD. A retrospective analysis was conducted among adult patients with IBD and at least one thyroid stimulating hormone (TSH) measurement within a large healthcare network. Patient charts were reviewed, and baseline demographics, disease characteristics, biomarkers, healthcare utilization, medication use, and other comorbidities were extracted. Patients were stratified by those with IBD only and those with concomitant IBD and hypothyroidism. Multivariable logistic regression was used to identify factors associated with concomitant hypothyroidism. Concomitant disease as an independent predictor for lab abnormalities and increased healthcare utilization was also assessed using multivariable logistic and negative binomial regression. We identified 287 adult patients with IBD, including 146 (50.9%) with Crohn's disease (CD) and 141 (49.1%) with ulcerative colitis (UC). Among this sample, 178 (62.0%) patients had concomitant hypothyroidism. Concomitant disease was associated with older age (adjOR 1.04, 95% CI 1.02, 1.06), female sex (adjOR 1.78, 95% CI 1.01, 3.16), and the presence of other extraintestinal manifestations (adjOR 2.30, 95% CI 1.06, 5.00). Concomitant disease was also found to be a significant predictor for increased healthcare utilization, specifically, higher number of radiation-based abdominal imaging (RBAI) studies (adjIRR: 1.89, 95% CI 1.08, 3.32). Patients with both IBD and hypothyroidism have an increased likelihood of other extraintestinal manifestations compared to individuals who have IBD without hypothyroidism. Furthermore, patients with concomitant disease exhibited greater healthcare utilization, specifically, increased rates of RBAI studies. The presence of concomitant hypothyroidism may be associated with a more severe course of IBD.

Radiotherapy-induced Hypothalamic-Pituitary axis dysfunction in adult Brain, head and neck and skull base tumor patients - A systematic review and Meta-Analysis.

Radiotherapy-induced Hypothalamic-Pituitary axis dysfunction in adult Brain, head and neck and skull base tumor patients - A systematic review and Meta-Analysis.