Hormone Values Research Articles

The predictive role of intraoperative parathyroid hormone measurement on postoperative parathyroid function in patients undergoing total thyroidectomy

Hypocalcemia is a common complication of thyroidectomy, particularly total thyroidectomy. The higher incidence of hypocalcemia following total thyroidectomy is primarily due to inadvertent damage to the parathyroid glands during surgery. This study aims to investigate the predictive value of intraoperative parathyroid hormone (IOPTH) in determining hypocalcemia during hospitalization and the recovery of parathyroid function after total thyroidectomy, as well as the factors that may influence IOPTH. In this retrospective study, we analyzed a cohort of 164 patients who underwent total thyroidectomy at our institution between 2018 and 2019. IOPTH was measured either 15 min after bilateral thyroidectomy combined with area VI lymph node dissection, or 15 min after bilateral thyroidectomy alone. We plotted ROC curves for IOPTH and ΔPTH% in relation to hypocalcemia during hospitalization and recovery of parathyroid function. Additionally, we explored risk factors for the development of hypocalcemia during hospitalization and factors that may influence IOPTH. IOPTH and ΔPTH% demonstrated good specificity and sensitivity for predicting hypocalcemia during hospitalization and for assessing recovery of parathyroid function. Lower preoperative PTH levels, chronic lymphocytic thyroiditis, and intraoperative parathyroid auto-transplantation were identified as risk factors for IOPTH < 15 pg/mL. IOPTH and ΔPTH% are predictive of hypocalcemia during the postoperative hospital stay and recovery of parathyroid function. Patients with chronic lymphocytic thyroiditis, intraoperative parathyroid auto-transplantation, and low preoperative PTH levels should be closely monitored for the recovery of parathyroid function after surgery.

Twenty-year follow-up of a randomized clinical trial of unilateral thyroid lobectomy with or without postoperative levothyroxine treatment.

The aim of this study was to validate in 20-year follow-up (FU) the outcomes reported in World J Surg 2010; 34(6):1232-8 on recurrent nodular goiter in the contralateral thyroid lobe among patients after thyroid lobectomy (TL) for multinodular goiter (MNG) receiving versus not receiving postoperative prophylactic levothyroxine (LT4) treatment. Some 150 consenting patients underwent TL for MNG in 2000-2003. They were randomized to two groups, 75 patients each: (a) receiving prophylactic LT4 treatment postoperatively (dose range 75-125 microg/day to maintain thyroid-stimulating hormone values within 0.27-1.0mU/L), and (b) not receiving LT4. Sixty-month FU was extended to 240months for all the consenting patients. The primary outcome was prevalence of recurrent goiter. The secondary outcome was re-intervention rate for recurrent goiter. The outcomes were stratified according to individual iodine metabolism status assessed by urinary iodine excretion. During the 5-year FU (5 patients were lost) recurrent goiter was found in patients receiving versus not receiving LT4 in 1.4% versus 16.7% (p=0.001) whereas during 20-year FU (29 patients were lost) it was 3.3% versus 30.0% of patients, respectively (p=0.031). During 20-year FU 4.9% versus 30.0%, respectively, of patients receiving versus not receiving LT4 required contralateral thyroid lobe treatment/surgery (p=0.028). LT4 decreased recurrence rate among iodine-deficient patients (10.0% vs. 70.0%, respectively; p=0.037) but not among iodine-sufficient patients (0.0% vs. 10.0%, respectively; p=0.056). Twenty-year FU data confirmed that prophylactic LT4 treatment significantly decreased the recurrence of nodular goiter and the need for completion intervention/surgery, mostly among patients with iodine deficiency.

Polycystic Ovary Morphology, Subclinical Hypothyroidism, and the Cutoff Value of Thyroid-Stimulating Hormone, a Population-Based Study.

Although numerous studies have explored the link between polycystic ovary syndrome (PCOS) and thyroid dysfunction, the relationship between polycystic ovary morphology (PCOM) and thyroid issues remains unclear. This study aimed to examine the association between PCOM and subclinical hypothyroidism (SCH) as well as the threshold for thyroid-stimulating hormone (TSH). Data were drawn from the Iranian PCOS prevalence study and the Khuzestan PCOS prevalence study. Eligible participants were divided into two groups: those with PCOM (n = 120) and a control group (n = 630). A logistic regression model was employed to assess the impact of PCOM on SCH, with odds ratios and 95% confidence intervals calculated. Additionally, a quantile regression model was used to evaluate the effect of PCOS on TSH levels. The results indicated no significant association between PCOM and SCH (adjusted OR: 1.38, 95% CI: 0.80-2.37; p = 0.243). Furthermore, after adjusting for confounding factors such as age, body mass index (BMI), and number of pregnancies, no significant differences were found in TSH levels between the PCOM and control groups. The prevalence of SCH and the TSH threshold were similar in both groups. Further comprehensive population-based studies with detailed thyroid evaluations are recommended.

Adolescent microsurgical varicocelectomy and changes in sperm parameters: A matched cohort analysis.

Varicocele, a common vascular abnormality surrounding the testis, is known to be associated with impaired semen parameters and male infertility in adults. However, its impact on the adolescent and young adult (AYA) population is less well known. The study aimed to assess the improvement in sperm parameters following varicocelectomy in the AYA population, comparing them to matched adult counterparts, and investigating potential advantages of early intervention. A retrospective analysis was conducted using a comprehensive database at the University of Miami spanning from 2012 to 2023. We included AYA (under 25 years of age) men who underwent varicocelectomy. To ensure comparability, they were matched with adult patients (over 30 years of age) based on preoperative follicle-stimulating hormone (FSH) values and varicocele grade in a 1:2 ratio. Semen parameters were evaluated before and after surgery, including sperm count, motility, morphology, and overall semen quality. We included 45 patients in the Adolescents and Young Adults (AYA) category, and matched them with 116 adults based on FSH and varicocele grade, all of whom underwent microsurgical varicocelectomy. The AYA group exhibited greater improvements post-varicocelectomy compared to the matched cohort. Furthermore, postoperative sperm concentration in the AYA men demonstrated a remarkable increase, with a 1.7-fold increase in mean concentration compared to the adult group (p<0.001). Additionally, motility also displayed significant enhancement among the AYA men, with a final mean total motile sperm count (TMSC) improvement of 2.25-fold compared to the adult cohort (p=0.002). This study highlights the potential benefits of varicocelectomy as a viable treatment option for adolescents and young adults with varicocele, particularly those with impaired semen parameters. By intervening at an earlier stage of development, patients in this age group can achieve significant improvements in semen quality, as compared to their adult counterparts. These findings underscore the importance of considering varicocelectomy as a valuable therapeutic approach for the younger demographic, potentially alleviating future fertility concerns.

Evaluation of Thyroid Activity in Patients with Liver Cirrhosis

Abstract Background: Liver cirrhosis is increasingly becoming a public health problem. The aim of study is to evaluate the relationship levels thyroid stimulating hormone (TSH), triiodothyronine (T3), free thyroxine (fT4) and and liver cirrhosis(LC) severity, measured by Child-Pugh (CP) and MELD scores. Methods: 419 patients diagnosed with liver cirrhosis were included in the study. Biological tests for TSH, T3, fT4 on admission and discharge were used. All analysis was performed using, One-Sample Wilcoxon test and Kruskal-Wallis test. Results: The mean values for TSH were statistically significant higher compared to normal values only at admission (p&lt;.05), and the mean values for T3 were statistically significant lower both on admission (p&lt;.001) and on discharge (p&lt;.001). No effect was observed for fT4. TSH on the admission and discharge moments were statistically significant differences (p&lt;.001), T3 (p&lt;.001) and fT4 (p&lt;.004). The CP also influenced the hormone's values for TSH at admission (p&lt;.01 and discharge (p&lt;.001), and T3 at admission (p&lt;.001) and discharge (p&lt;.001) but not for fT4. For MELD score, a low power positive associations were observed only with TSH, on admission and discharge and negative associations with F3, in both situations. Conclusions: Elevated TSH levels at admission, coupled with their negative correlation with the CP score and differences between TSH-CP group C and groups A and B, highlighting the necessity for vigilant endocrine monitoring in hepatic patients. Also, admission T3 levels are lower than normal and negatively correlate with cirrhosis severity and MELD scores underscore potential clinical utility of monitoring thyroid function in assessing disease progression and improving patient survival outcomes.

Interactions between pregnant women's nutrition habits, psychological well-beings, sleep quality and biochemical parameters.

Hormonal changes during pregnancy may cause various changes in biological, physiologic and psychosocial areas. The main objective of this study was to analyze the relationship between dietary habits, psychological well-being, sleep quality and biochemical parameters of pregnant women. The study was conducted on a total of 93 patients who applied to Ankara Koru Sincan Hospital Gynecology and Obstetrics Outpatient Clinic for routine pregnancy control between November-December 2023, were between the ages of 18-45, had a live singleton fetus, had no diagnosed psychiatric disease or chronic disease, and agreed to participate in the study. Anthropometric measurements and biochemical findings of the individuals were recorded with a questionnaire including the psychological well-being scale (PWBS) and Pittsburgh sleep quality index (PSQI). According to the study, PSQI scores during the second and third trimesters are significantly higher than the first trimester. It was observed that while individuals have bad sleep quality during the second and third trimesters, they have good sleep quality during the first trimester (χ2 = 14.736; P < 0.001). In the biochemical results, the thyroid-stimulating hormone (TSH) value in the second trimester was higher (P > 0.05). Weight gain during pregnancy, age and trimester have a negative effect on sleep quality. When the effects of lifestyles and eating habits of pregnant women on the process are considered, there is a relationship between smoking/alcohol consumption, less physical activity, poor eating habits, sleep quality and depressive symptoms. Factors such as age, educational background, trimester period and other basic sociodemographic variables are also involved.

Long-term Outcome of a Chihuahua With Idiopathic Syndrome of Inappropriate Antidiuretic Hormone Secretion.

An approximately 3 yr old female Chihuahua was presented for evaluation of polyuria and polydipsia noted by the owner after adoption. Serum biochemistry and urinalysis revealed hyponatremia, hypochloremia, hypo-osmolality, and normal fractional excretion of sodium. Serum antidiuretic hormone concentration was 5.54 pg/mL and serum copeptin concentration was 135.40 pg/mL. The antidiuretic hormone value was above the reported range for healthy dogs and was considered inappropriate in light of serum osmolality. Idiopathic syndrome of inappropriate antidiuretic hormone secretion was considered the most likely diagnosis after excluding other potential causes, such as diuretic use, renal disease, adrenal disease, and thyroid dysfunction. The dog remains clinically well 2 yr after diagnosis without specific treatment other than minimal dietary salt supplementation. This case is unique because of the absence of systemic or neurologic signs, good long-term outcome without treatment, and use of novel diagnostic testing.

Changes of the Heart Rhythm in Imbalance of Thyroid Gland Hormones and its Morphology in Outbred Rats

To analyze the relationship between the occurrence of atrial fibrillation (AF) and thyroid dysfunction caused by low concentrations of free triiodothyronine (FT3), free triiodothyronine and free thyroxine (FT3 and FT4), and high concentrations of free thyroxine (FT4) with normal values of thyroid-stimulating hormone (TSH) in experiments on outbred rats. The pathogenesis of AF with low concentrations of FT3, FT3 and FT4, and a high concentration of FT4 was studied in an experiment on 146 outbred rats. In the experiment, hypothyroidism, euthyroidism, and thyrotoxicosis were modeled by changing the concentrations of thyroid hormones, and the effect of these conditions on ECG and the incidence of AF was evaluated. The types of the hypothalamic-pituitary-thyroid system response to the L-thyroxine administration in experimental hypothyroidism were identified. A relationship was determined between AF paroxysms and threshold values of thyroid hormones at low concentrations of FT3, FT3 and FT4, and a high concentration of FT4 with normal TSH values. It was shown that achieving the euthyroid status did not reduce the incidence of AF paroxysms by more than 70.0%. In AF with low FT3, low FT3 and FT4, and high FT4, the dose of L-thyroxine must be adjusted.

Lesión bilateral de ligamento cruzado craneal y neuropatía periférica en un canino Golden Retriever con hipotiroidismo: Reporte de caso

The case of a 6 -year -old female Golden Retriever is presented. She was limping in the left posterior limb. A 4/4 grade lameness, pain by palpating the knee, and a negative drawer test, but positive tibial compression was identified. No proprioceptive deficit or signs compatible with lesions joints in X-rays images were found. There was no response to treatment with Meloxicam and Tramadol and because a suspicion of partial rupture of the cranial cruciate ligament, the transposition of tibial tuberosity (TTT) procedure was chosen. The patient returned with lameness in the right hind limb right nine months later and after ruling out other causes of limp, the TTT was successfully performed in the affected limb. However, 18 months later he developed signs of peripheral neuropathy. Metabolic, infectious and hormonal profile analyses revealed increased serum alkaline phosphatase, decreased thyroxine (free T4) and thyroid-stimulating hormone (TSH) values within normal ranges according to the reference laboratory. Based on the patient's history and laboratory findings, the diagnosis was hypothyroidism, and the decision was made to supplement the patient with sodium levothyroxine. Remission of the nervous symptoms was observed 45 days after treatment.

EFFECT OF BASTI CHIKITSA IN THE MANAGEMENT OF BEEJA AND KSHETRA DUSHTI JANYA BANDHYATVA IN ELDERLY WOMEN: A CASE REPORT

Pregnancy or motherhood beyond the edge of reproductive age is referred to as pregnancy in elderly gravida. Generally, reproductive potential decreases as women get older, one of the common reasons being Anti-Mullerian hormone (AMH) levels. This is a case study of a 38-year-old female patient who consulted the OPD at the National Institute of Ayurveda (NIA) Jaipur, Rajasthan, India, with the chief complaint of being unable to conceive for 2 years. Her Anti-Mullerian hormone (AMH) value was 0.83 ng/ml on 22-7-2023. Ultrasonography, dated December 13, 2023, suggested a bulky heterogenous uterus with intramural fibroid (2.4×1.9 cm) with polycystic ovarian disease and pelvic inflammatory changes. Based on these clinical presentations and USG findings, the patient was diagnosed with infertility due to abnormal ovarian and uterine factors, which were correlated with beeja and kshetra dushti janya bandhyatva in Ayurvedic terms. Mainly, Vata dosha symptoms were observed in the patient. Therefore, Yoga basti followed by Matra basti was given with shamana chikitsa using garbhasthapana dravya to eliminate Vata dosha. Her complete nidana parivarjana was done. After 2 months of treatment, the patient conceived. She missed her period and did her urine pregnancy test on 01-3-24, which was found to be positive. This case study concluded that Basti chikitsa is beneficial in managing beeja (ovarian factor) and kshetra (uterine factor) dushti janya bandhyatva in elderly women.

Association of Spexin Hormone Levels with Metabolic Disturbance in Women with Polycystic Ovarian Syndrome

Background: Polycystic ovarian syndrome is affecting around 5–15% of females. Spexin hormone, identified as neuropeptide Q, has been newly recognized by bioinformatics methods. Objective: To evaluate the relationship concerning levels of spexin hormone with metabolic disruption in women with polycystic ovarian syndrome. Patients and Methods: A case-control study carried out in the department of Obstetrics and Gynecology in Al-Imamain Al-Khademain medical city/Baghdad, Iraq, from Jan 1, 2022, to the end of Dec 31, 2022. The study sample comprises, 192 participants aged 18-45 years were joined and allocated into a case group (96 women with PCOS) and a control group (96 women without PCOS). Results: Mean value of spexin hormone was (2.7±0.3 ng/mL) in the PCOS group, while it was (3.5±0.7 ng/mL) in the control group; fasting blood sugar shows significant association with a negative, weak correlation with Spexin in patients (P-value= 0.005), Insulin shows significant association with inverse correlation with Spexin in patients (P-value= 0.04), Homeostasis model valuation of insulin resistance (HOMA-IR) shows significant association with inverse correlation with Spexin in patients (P-value= 0.003). Spexin had a significant inverse correlation with LH, SHBG, testosterone, FAI, and Dehydroepiandrosterone. Conclusion: Serum level of spexin hormone was meaningfully decreased in patients with PCOS than that in healthy women.

Effect of follicle-stimulating hormone dose on the risk of being classified as suboptimal responders according to the POSEIDON criteria.

The purpose of this study is to investigate the impact of daily follicle-stimulating-hormone (FSH) dose on the likelihood of suboptimal response to ovarian stimulation (OS) for in vitro fertilization (IVF) according to POSEIDON's criteria. A tri-center retrospective cohort study (2015-2017) including women with normal anti-Müllerian hormone (AMH ≥ 1.2ng/mL) and antral follicle count (AFC ≥ 5) values per POSEIDON's criteria, undergoing their first IVF/ICSI cycle using conventional OS (FSH ≥ 150IU/day). Suboptimal response was the retrieval of 4-9 oocytes. In previous research, we detected an AMH ≤ 2.97ng/mL and AFC ≤ 12 as the optimal cut-offs predicting suboptimal response. Therefore, we examined the effect of daily FSH dose (≤ 300IU versus > 300IU) on suboptimal response risk for each AMH and AFC value within these thresholds (AMH between 1.20 and 2.97ng/mL, by 0.01ng/mL increments; and an AFC between 5 and 12, by unit increments). Analysis involved contingency tables and multivariable logistic regression. Included were 4005 patients with AMH and AFC values in the specific range, among whom 2131 (53.2%) were suboptimal responders. Among 177 AMH groups analyzed, apart from three distributed irregularly, daily FSH doses > 300IU versus lower doses (≤ 300IU) did not decrease suboptimal response risk; similarly, higher doses did not decrease risk at the eight AFC values examined (p > 0.05 for all). Using multivariable logistic regression, FSH doses were not associated with suboptimal response risk. Conversely, female age, AMH, AFC, and gonadotropin type were associated with suboptimal response. In women with AMH values between 1.20 and 2.97ng/mL and/or AFC between 5 and 12, FSH dose increase did not decrease suboptimal response risk. Individualizing the gonadotropin regimen and considering LH activity supplementation to FSH may mitigate risks.

New calcimimetics for secondary hyperparathyroidism in CKD G5D: do they offer advantages?

Secondary hyperparathyroidism is one of the most frequent metabolic abnormalities found in patients with chronic kidney disease. The calcium-sensing receptor senses extracellular calcium and is the principal regulator of parathyroid hormone secretion. Cloning of the calcium-sensing receptor led to the development of calcimimetics, drugs that decrease parathyroid hormone secretion through the positive allosteric modulation of this receptor. Cinacalcet was the first oral calcimimetic approved by the US Food and Drug Administration (FDA) in 2004 for the treatment of secondary hyperparathyroidism in adult patients on dialysis. Although cinacalcet has demonstrated safety and effectiveness, it has two main problems: gastrointestinal side effects that result in poor adherence, and the inhibitory action on CYP2D6 with the possibility of interactions with commonly used medications. To address the problem of oral compliance, Etelcalcetide, a small synthetic polycationic peptide IV calcimimetic was introduced in 2017. This drug showed a 10% greater decrease in serum parathyroid hormone values compared to cinacalcet but no better gastrointestinal tolerance, with greater risk of hypocalcemia. Several structural modifications were introduced in cinacalcet to produce a new compound called evocalcet. This drug, which was introduced in Japan in 2018, has considerably enhanced bioavailability and decreased both the inhibitory effect on CYP2D6 and half of the gastrointestinal side effects of cinacalcet. Finally, a novel non-peptidic injectable calcimimetic agent, upacicalcet, became available in Japan in 2021. This agent has greater clearance by hemodialysis and shows no effect on gastric emptying. More studies are needed comparing the old calcimimetics to the new ones to establish their future role in the treatment of secondary hyperparathyroidism in chronic kidney disease (CKD) G5D.

Synergistic Effect of Some Molecular Biomarkers in The Development of Preeclampsia and Abortion in Pregnant Women Suffer from Toxoplasmosis

The current study summarized the effect of toxoplasmosis, which is caused by parasitic infection with protozoan known as Toxoplasma gondii, on pregnant women who suffer from repeated miscarriages, especially in the first trimester of pregnancy, this research documented the reduction of sex hormones values in healthy pregnant women, association with down ROP16 regulation(T.gondii-I virulence factor). While the average of the same parameters was increased in pregnant women who suffered from toxoplasmosis, which in turn led to inhibition of the transcription factor NFKB in parasite`s infected women, and inhibition of the patient's immune response. On the other hand, both of ROP16 and NFKB genes play a critical role in an increase of miR146 transcription, it consider a significant factor that activate epigenetic effect perhaps play role in reducing of host's immune system. At the end the placental cell signaling pathway was modified and increased atrophy of placental trophoblast with association of serious complications led at the end to emergence of early abortion.

Exenatide improves cisplatin induced ovarian damage through NLRP3, Nrf-2, and TLR4 pathways.

Cisplatin (CP) toxicity causes ovarian damage by oxidative stress, inflammation and fibrosis. The aim of the present study is to investigate the possible beneficial effects of exenatide on the experimental ovarian damage model produced by CP. For 14 rats, CP was administered by intraperitoneally (i.p) twice a week for 5 weeks. No drug was administered to the remainder of rats (n = 7) (Group 0). The rats taken CP were divided into two groups. Group 1 rats (n = 7) were given 1 mL/kg/day saline i.p., and Group 2 rats (n = 7) was given with 20 μg/kg/day exenatide. The number of primordial, primary, secondary, and tertiary follicle was significantly lower in Group1 compared with Group 0 and Group 2. The ovarian fibrosis percent was significantly higher in Group 1 than Group 0 and 2. The plasma anti-Mullerian hormone value was lower in Group1compared with Group 0 and 2. Over Nuclear factor-erythroid factor 2-related factor 2 level, Over Toll-like receptor 4 level and over nucleotide-binding domain leucine-rich repeat and pyrin domain containing receptor 3 were higher in Group 1 compared with Group 0 and 2. Exenatide has possible beneficial effect on ovarian damage induced by CP by anti-inflammatory actions and can be a promising candidate for ovarian damage caused by CP.

Systemic iodine levels increase with povidone-iodine irrigation, but does this affect thyroid functions? A case-control study.

Intraoperative irrigation with diluted povidone iodine (PI) can be used to reduce the incidence of infection-related complications in arthroplasty surgeries. Since PI is associated with many interventions, especially skin antisepsis, its systemic effects are being studied. The aim of our study is to evaluate the systemic effects of PI, which we use as an irrigation solution, by means of urine iodine and thyroid function tests. In this case-control study, 96 patients who underwent knee or hip arthroplasty were included and divided into two groups according to the irrigation solution. In the first group, PI was added to the standard irrigation. The second group was considered as the control group and only standard irrigation was applied. Urine iodine, thyroid stimulating hormone, free T3 and free T4 values were compared in the preoperative and postoperative periods of these two groups. In this way, the effect of absorbed iodine on thyroid functions was investigated. In the diluted PI group, urinary iodine levels were measured at maximum levels (450µg/L) in the early postoperative period in most of the patients. The statistically significant difference in urinary iodine levels between the PI group and the control group, which started in the early postoperative period, continued until the last follow-up on the 14th postoperative day. In terms of thyroid functions, the observed differences were not statistically significant. Studies to reduce periprosthetic infection show that PI can be preferred for irrigation before the closure of the joint area in total joint arthroplasty. Although the success of this treatment in periprosthetic infection has been investigated, its systemic examination has not been demonstrated. It was determined that PI treatment, which was seen to decrease in the systemic circulation within 14 days, did not show a statistically significant change in terms of thyroid functions when used at the determined concentration and duration. These results should be evaluated with larger and longer-term studies. Clinical trials ID no. NCT05599841.

Effects of D3K2 With Periodontal Therapy in Diabetes Mellitus and Stage I-II Periodontitis Patients.

The aim of this study is to look into the clinical and biochemical outcomes of D3K2 supplementation in addition to nonsurgical periodontal treatment (NSPT) for patients suffering from diabetes mellitus (DM) and periodontitis. Thirty-eight participants with DM and periodontitis were randomized into two different groups. The test group provided NSPT with D3K2 whereas the control group received NSPT with placebo. Clinical periodontal parameters were recorded and serum and gingival crevicular fluid (GCF) were sampled at baseline and at the third and the sixth months after treatment. Glycated hemoglobin A1c (HbA1c), fasting blood glucose (FBG), 25(OH)D3, parathyroid hormone (PTH), calcium (Ca) and magnesium (Mg) values were determined in blood samples. GCF and serum interleukin (IL)-1β and IL-10 levels were analyzed using enzyme-linked immunosorbent assay. All clinical periodontal parameters were importantly decreased at the third and sixth months after treatment compared to baseline in both groups. At the sixth month, 25(OH)D3 levels in the test group were observed to be statistically significantly higher than in the control group (p = 0.02). Serum IL-1β showed a statistically significant decrease at the sixth month compared to baseline and the third month in control group. According to this study, there is limited additional benefit of D3K2 given with NSPT in individuals with DM and periodontitis.

7147 A Retrospective Evaluation of Biochemical and Clinical Criteria of Permanent Hypoparathyroidism After Total Thyroidectomy and Their Associated Outcomes

Abstract Disclosure: D.G. Su: None. S. Tsou: None. W. Shen: None. Q. Duh: None. C. Graves: None. I. Suh: None. Background: Postoperative hypoparathyroidism (hypoPT) is the most common complication of total thyroidectomy and carries long-term morbidity. However, reported incidences vary widely due to nonstandardized measurement practices and absence of a universally accepted definition. This study aims to evaluate various definitions of hypoPT and to identify influencing factors such as diagnosis and operative duration. Methods: We performed a retrospective analysis of patients with a diagnosis of hypoPT (ICD-9: E20, E20.0, E20.8, E20.9, E89.2) between January 2012 and January 2019 at a single large academic institution, and only included those who had underwent a total thyroidectomy six months prior. Definitions based on low parathyroid hormone (PTH) values (PTH &amp;lt; 10 pg/mL), low calcium levels (corrected calcium [Ca] &amp;lt; 8.5 mg/dL or ionized Ca [iCa] &amp;lt; 1.1 mmol/L), and postoperative supplementation (elemental calcium or vitamin D) were evaluated at 6 and 12 months postoperatively. Postoperative hypocalcemic symptoms were graded by disease severity (based on the presence of numbness/paresthesia, muscle spasms/aches, and Chvostek/Trousseau signs). Patient demographics, operative and pathological characteristics, and use of parathyroid autotransplantation were recorded. Results: Of 879 patients with hypoPT ICD-9 diagnoses, 124 (14%) underwent a total thyroidectomy and were included. Our cohort was 64% female with a median age of 52.9 years. Fifty-one patients (41%) had low PTH levels, 49 (39%) had low calcium levels, and only 26 (21%) had both low PTH and calcium. Of 94 patients (76%) with hypocalcemic symptoms, 68 (73%) required long-term calcium or vitamin D supplementation. Twenty-eight (22.6%) patients had either an ED visit or readmission for hypocalcemia postoperatively. One hundred seven patients (86%) had a pathologic diagnosis of malignancy, of which 37% had extrathyroidal extension, 25% vascular invasion, and 36% positive margins. Those who underwent parathyroid autotransplantation (33%) were less likely to meet biochemical definition of hypoPT (p = 0.0312). Dosage of calcium/vitamin D supplementation did not correlate with symptom grade. Conclusions: Postoperative hypocalcemic symptoms and long-term calcium/vitamin D supplementation were the most common characteristics found in our permanent hypoPT cohort. However, substantial heterogeneity in defining postoperative hypoPT exists, with no definition capturing the full spectrum of affected patients. Further research is necessary to develop reliable diagnostic criteria or biomarkers for hypoPT prediction and management. Presentation: 6/2/2024

Obesity may impair response to ovarian stimulation. A retrospective observational study on oocyte quality.

Ovulatory dysfunction is more common in women with obesity. Body fat distribution is also crucial because anovulatory women have a greater waist circumference and more abdominal fat than ovulatory women of similar BMI. The primary aim of the present study is to determine whether there is a relationship between BMI and reproductive characteristics, including hormonal values, antral follicle count (AFC), endometrial assessment at transvaginal ultrasound evaluation (TVUS) during controlled ovarian stimulation (COS), and oocyte retrieval after Ovum Pick-Up (OPU). Data from a cohort of 183 patients were analyzed and divided into three groups based on weight status: normal weight, overweight, and obesity. Evaluated reproductive characteristics included: age, basal values of follicle-stimulating hormone (FSH), luteinizing hormone (LH), 17-beta-estradiol (E2), thyroid stimulating hormone (TSH), anti-müllerian hormone (AMH), antral-follicle-count (AFC), duration of COS, E2, and progesterone at the last monitoring, TVUS endometrial thickness at the last monitoring before OPU, FOI after OPU. Additionally, the number of meiosis II oocytes retrieved (MII), the total dose of FSH administered, the ratio between MII and total FSH administered, and OSI were registered. AMH levels were significantly lower in obese patients compared to normal weight and overweight women (1.05 IQR 1.20, 1.58 IQR 2.16, 1.32 IQR 1.38, respectively, p-value = 0.032). When looking at the MII/FSH ratio, the normal weight group showed a median value of 3.3 with an IQR of 4.0, the overweight group showed a median value of 2.3 with an IQR of 1.9, and the obese group had a median value of 2.6 with an IQR of 2.8. Those data were statistically significant (p-value = 0.049). These results emphasize the importance of considering weight status in fertility assessment and treatment planning.

Comparative effects of curcumin, nano curcumin and their combination on reproductive traits and spawning performance of red tilapia (Oreochromis Niloticus X O. Mossambicus)

Curcumin, the main polyphenol component of turmeric powder, has garnered increasing attention as an effective supplement in fish diets. A comparative trial was conducted to evaluate the impacts of dietary supplementation with different forms of curcumin (free, in combination, or nanoparticles) on hemato-biochemical parameters, reproductive capacity, and related gene expressions of red tilapia (Oreochromis niloticus x O. mossambicus) broodstock. Fish (n = 168) were fed an isonitrogenous (30% CP), isocaloric (18.72 MJ kg − 1) diet containing basal diet (Control), 60 mg kg-1 of either free curcumin (Cur), curcumin/nano-curcumin blend (Cur/NCur), or nano-curcumin (NCur) for 56 days. Red tilapia broodstock (155 ± 5.65 g) were stocked at a male: female ratio of 1:3. Blood samples and gonads were collected to assess hemato-biochemical parameters, reproductive capacity, and related gene expression at the end of the feeding trial. The results indicated that the values of hematological parameters (RBCs, WBCs, hemoglobin), total protein, albumin values, and reproductive hormones (T, LH, and FSH) were significantly increased, while liver function enzymes were decreased in the NCur group (P < 0.05). Reproductive performances (GSI, gonad maturation, total number of fry per female) were significantly improved in the NCur group compared with those in other groups (p < 0.05). The expression of reproductive genes (CYP19A1A, FSHR, LHR, FOXL2A, ESR1, ESR2A, and PGR) were significantly up‐regulated in the gonads of fish fed NCur. Collectively, feeding red tilapia diets containing NCur led to noticeably better results followed by Cur/NCur blend, then free Cur compared to the control diet. These results indicate the superiority of NCur over its free or blended form, suggesting that a diet containing about 60 mg/kg of NCur is beneficial for enhancing hemato-biochemical parameters, improving reproductive performance, and enhancing the gonadal architecture of red tilapia.