BACKGROUND The association between hypothyroidism and depression is well established,but the underlying mechanisms remain unclear.AIM To explore the potential role of the gut microbiota in depressive-like behaviors in...BACKGROUND The association between hypothyroidism and depression is well established,but the underlying mechanisms remain unclear.AIM To explore the potential role of the gut microbiota in depressive-like behaviors in a mouse model of hypothyroidism,with a focus on bacterial composition.METHODS Hypothyroidism was induced in mice using propylthiouracil.Depressive-like behaviors were assessed using the sucrose preference test(SPT),forced swimming test(FST),tail suspension test(TST),and open field test(OFT).Inflammatory cytokines,including interleukin-6(IL-6),IL-1β,tumor necrosis factor-α,and IL-10,were quantified,together with colon histopathology scores,brain-derived neurotrophic factor,nuclear factorκB,inhibitor of nuclear factorκB,and tight junction proteins(occludin,claudin-1,zonula occludens-1).Gut microbial composition was determined by 16S rRNA gene sequencing of fecal samples.RESULTS Propylthiouracil-treated mice exhibited pronounced depressive-like behaviors,intestinal barrier dysfunction,elevated peripheral and central inflammation,and gut microbiota dysbiosis.Pearson correlation analysis showed that Bilophila and Psychrobacter abundance positively correlated with sucrose preference in the SPT and locomotor activity in the OFT,and negatively correlated with immobility times in the FST and TST.Gordonibacter abundance was positively correlated with locomotion in the OFT and negatively correlated with immobility in the FST and TST.Prevotellaceae_UCG_001 was inversely correlated with immobility in the FST and TST.Streptococcus was positively associated with sucrose preference in the SPT.CONCLUSION The observed associations between specific bacterial taxa and behavioral indices support a potential connection between gut microbiota composition and depressive symptoms in mice with hypothyroidism.展开更多
BACKGROUND Congenital hypothyroidism(CH)is a prevalent childhood endocrine disorder associated with irreversible neurological consequences.Its global incidence is on the rise.AIM To estimate CH incidence in Jordan and...BACKGROUND Congenital hypothyroidism(CH)is a prevalent childhood endocrine disorder associated with irreversible neurological consequences.Its global incidence is on the rise.AIM To estimate CH incidence in Jordan and assess the potential utility of incorporating(fT4)measurements into the screening process.METHODS This retrospective analysis examined thyroid function test results for infants born at our center between 2016 and 2020.Infants born before 28 weeks and those screened after 14 days of life were excluded.Screening occurred between days 3 and 7 of life,and thyroid-stimulating hormone(TSH)and T4 levels were measured concurrently from peripheral venipuncture blood samples.A TSH cutoff of<5 mIU/L was considered normal.Values between 5 and 20 mIU/L were equivocal,requiring repeat tests.TSH levels exceeding 20 mIU/L were considered critical.RESULTS A total of 10521 infants were included in the study,and 26 were diagnosed with CH,yielding an incidence of 1 in 400 live births.Females constituted 57.7%of CH cases.All CH cases had initial TSH values exceeding 5.0 mIU/L,with clustering above 20 mIU/L.Six CH infants had Down syndrome,accounting for 23.1%of CH cases.CONCLUSION Our study revealed a high incidence of CH in Jordan,marking a significant increase from previously reported rates.We recommend a national study to investigate risk factors and underlying causes of CH in our population.Furthermore,we advocate for the use of TSH alone with a cutoff value of<5 mIU/L for screening purposes.展开更多
Background:Hepatocellular carcinoma(HCC)is one of the most prevalent malignant tumors worldwide,and endocrine,metabolic,and immune factors influence its occurrence and progression.Hypothyroidism(HT)is a common endocri...Background:Hepatocellular carcinoma(HCC)is one of the most prevalent malignant tumors worldwide,and endocrine,metabolic,and immune factors influence its occurrence and progression.Hypothyroidism(HT)is a common endocrine disorder that may affect cancer risk;however,its relationship with HCC remains unclear.Objective:This study aimed to investigate the potential molecular and immune mechanisms underlying the association between HT and HCC,with a focus on the regulatory effects of HT-related genetic variants on the hepatic tumor immune microenvironment.Methods:Single-nucleotide polymorphisms(SNPs)associated with HT and HCC identified through Mendelian randomization were functionally annotated using the Ensembl Genome Browser and mapped to candidate genes.Functional enrichment and pathway analyses were performed with Metascape.Differentially expressed target genes between HCC and normal liver tissues were screened using GEPIA2,and their protein expression levels were validated in the Human Protein Atlas(HPA)database.The association between target gene expression and immune cell infiltration was further evaluated using TIMER2.0.Results:A total of 68 candidate genes were analyzed.Enrichment analysis revealed that these genes are involved in IFN-γ-mediated immune responses,PI3K/AKT and RAC1 signaling pathways,and other immune regulatory processes.Among them,HLA-DQA1,HLA-DPB1,HLA-DQA2,and PVT1 showed significant differential expression in HCC.HLA-DQA1,HLA-DPB1,and HLA-DQA2 were positively correlated with CD8⁺T cells,regulatory T cells(Tregs),and M2 macrophages,suggesting that these genes may exert bidirectional effects on antitumor immunity and immunosuppression.PVT1 may influence the immune microenvironment by regulating myeloid cell recruitment and extracellular matrix remodeling.Conclusion:HLA-DQA1,HLA-DPB1,HLA-DQA2,and PVT1 may reduce the risk of HCC by enhancing IFN-γ-mediated antitumor immunity and modulating key signaling pathways,while also contributing to immune microenvironment remodeling.These findings provide mechanistic insights into the protective effects of HT on HCC and suggest potential targets for immunotherapeutic strategies.展开更多
That herbs with the"hot"property used to treat"cold"syndromes is a guiding principle of clinical prescription and medication in traditional Chinese medicine(TCM).However,this theory of TCM is still...That herbs with the"hot"property used to treat"cold"syndromes is a guiding principle of clinical prescription and medication in traditional Chinese medicine(TCM).However,this theory of TCM is still in the‘black box'stage,and few in-depth studies have examined the biological mechanisms underpinning the hot properties of herbs.展开更多
Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate t...Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.展开更多
Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From d...Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From database foundation to January 14,2025,PubMed,Web of Science,Cochrane,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),and China Biomedical Literature Database(CBM)were searched for relevant information.Randomized clinical trials(RCTs)evaluating the efficacy and safety of TSRQ therapy combined with THRT for Hashimoto’s hypothyroidism were eligible for inclusion.Following quality assessment,data were analyzed using Stata 15.1 to conduct a meta-analysis and systematic review.Subgroup analysis was used to identify the sources of heterogeneity.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was adopted to evaluate the certainty of the evidence.Results This study included 30 RCTs,comprising 2687 patients with Hashimoto’s hypothyroidism.Overall methodological quality was acceptable,with no studies exhibiting a high risk of bias.Meta-analysis demonstrated that TSRQ therapy combined with THRT significantly enhanced serum free triiodothyronine(fT3)levels[standardized mean difference(SMD)=0.76,95%confidence interval(CI):0.57 to 0.94,P<0.001]and free thyroxine(fT4)levels(SMD=0.86,95%CI:0.61 to 1.11,P<0.001),while reducing thyroid-stimulating hormone(TSH)levels(SMD=–0.99,95%CI:–1.20 to–0.78,P<0.001)compared with THRT alone.Furthermore,the combination therapy significantly decreased anti-thyroid peroxidase antibody(TPOAb)levels(SMD=–1.46,95%CI:–1.79 to–1.13,P<0.001)and anti-thyroglobulin antibody(TgAb)levels(SMD=–1.46,95%CI:–1.80 to–1.11,P<0.001).TSRQ therapy did not adversely impact the safety profile of THRT.However,while some sources of heterogeneity have been identified(e.g.,specific detection methodologies,I²=0.0%,P=0.938),there remains a portion of unexplained heterogeneity(e.g.,publication year,I²=93.4%,P<0.001),which has undermined confidence in these pooled estimates.The evidence ratings for fT3,fT4,and TSH were limited,and those for TPOAb and TgAb were even more limited.Conclusion TSRQ therapy combined with THRT may strengthen thyroid function and modulate immune dysregulation in patients with Hashimoto’s hypothyroidism without increasing adverse event incidence.展开更多
Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To exp...Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P 3 level in group B was statistically significantly lower than that in group A (P s = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P 3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P 3, the risk of hypertension increased (P 4, the risk of hypertension significantly increased (P 3 and FT4 are the influencing factors of hypertension. The lower the FT3 level, the higher the FT4 level, the higher the risk of hypertension. FT3 and FT4 may be potential biomarkers of depression in hypertensive patients. Thyroid function assessment is recommended in patients with hypertension.展开更多
Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, ...Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, justifying the present report. Case Report: We reported the cases of 3 female patients, diagnosed with hypothyroidism, presenting in addition pulmonary stenosis. The diagnosis was late in all the patients and we noticed clinical improvement under levothyroxine. Conclusion: Association congenital hypothyroidism and cardiac defect is not rare. Our patients are female with no history of consanguinity, presenting congenital hypothyroidism with a gland in situ associated with pulmonary stenosis. Systematic screening of other births defects is thus recommended in affected patients.展开更多
Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additional...Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additionally,to compare these indicators between SH patients and healthy individuals,providing a new theoretical basis for the clinical prevention and treatment of cardiovascular diseases.Method:Clinical data from 50 SH patients(23 males and 27 females)and 50 healthy outpatient examinees(22 males and 28 females)were analyzed.The participants were selected from January 2022 to December 2023 at Loudi Central Hospital.EFT,AVP,and AA-IMT were measured,and their correlations were analyzed.Results:SH patients had significantly higher EFT and AA-IMT levels than the control group,while their AVP was significantly lower,with these differences being statistically significant(P<0.05).Correlation analysis revealed a significant negative correlation between EFT and AVP(P<0.001),a significant positive correlation between EFT and AAO-IMT(P<0.001),and a significant negative correlation between AVP and AAO-IMT(P<0.001).Multivariate binary logistic regression analysis identified increased EFT,decreased AVP,and increased AAO-IMT as independent risk factors for SH patients.Conclusion:In SH patients,EFT and AAO-IMT are elevated,whereas AVP is reduced.EFT and AVP are significantly correlated with AAO-IMT.EFT and AAO-IMT can serve as reliable indicators for evaluating subclinical atherosclerosis in SH patients,providing a diagnostic basis for clinical practice.展开更多
Thyroid-stimulating hormone (TSH) assay is considered a decisive diagnostic method for thyroid disorders. The lack of different TSH immunoassay standardization often leads to misdiagnosis of subclinical hypothyroidism...Thyroid-stimulating hormone (TSH) assay is considered a decisive diagnostic method for thyroid disorders. The lack of different TSH immunoassay standardization often leads to misdiagnosis of subclinical hypothyroidism (SCH). This study aims to differentiate between two analytical platforms for TSH measurement, namely Abbott Laboratories and Snibe Diagnostics. This study employed 173 thyroid profile samples to detect SCH. Initially, the sample was run on Abbott and then by Snibe immunoassay. Statistical analysis showed a significant difference of 0.87 mIU/L (P < 0.001) between the TSH values of the two assays. The proposed study corroborates with previous literature by manifesting notable differences in the TSH measurements of two different assays. The findings revealed some insights regarding the differences between the two assays, which conclude that the diagnosis of SCH requires vigilance because of inadequate assay standardization. Thus, future research involving larger cohorts with standardization efforts is imperative to improve the reliability of TSH measurements using different analytical platforms.展开更多
Juvenile hypothyroidism is an unfrequent form of hypothyroidism that affects children. If not diagnosed and treated properly, it may cause severe neurological disorders during growth. The most frequent difficulties ar...Juvenile hypothyroidism is an unfrequent form of hypothyroidism that affects children. If not diagnosed and treated properly, it may cause severe neurological disorders during growth. The most frequent difficulties are found in school performance, difficulties in concentration, hyperactivity or fatigue and damage on the onset of puberty. Starting levothyroxine as a drug of choice is essential, and it should be made according to the age and weight of the child. Laboratory tests for control should be requested periodically, along with a strict control of the child’s development and growth. The family-doctor relationship, along with a clear guidance on the importance of treatment, is critical to achieve a successful treatment. This article is a review about the main clinical features of hypothyroidism in childhood, especially in developing countries, providing key aspects of adherence and characteristics of its follow-up.展开更多
Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, ...Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distress syndrome (RDS), Intrauterine fetal death (IUFD), and congenital anomaly were found with a higher percentage in overt hypothyroidism. Conclusion: Since the impact of hypothyroidism on fetomaternal morbidities have been identified so screening for hypothyroidism to be included as a routine screening test and should be treated accordingly to improve maternal and fetal outcome.展开更多
Consumptive hypothyroidism is often the clinical condition that results from neoplasms producing their own selenodionases that convert T4 needed to be converted to active T3 into an active form of thyroid hormone, rT3...Consumptive hypothyroidism is often the clinical condition that results from neoplasms producing their own selenodionases that convert T4 needed to be converted to active T3 into an active form of thyroid hormone, rT3. This often requires treatment with high doses of IV T4, with or without doses of T3 as well, until the neoplasm is treated. This principle is demonstrated in the below case of a 65 y/o female with medical history significant for Ia Kappa multiple myeloma, complete heart block s/p AICD placement, and papillary thyroid cancer status post thyroidectomy in 2020, who had initially presented <span>with persistent bone pain, progressive encephalopathy and failure to thrive</span> with more than a 50 lb weight loss over a few months. Labs on presentation <span>were not remarkable for progression of her underlying multiple myeloma</span>, however<span style="font-family:;" "="">,</span><span style="font-family:;" "=""> she was found to have a new significantly elevated TSH. She underwent imaging with a CT chest, abdomen, and pelvis, which showed new hepatic lesions, subcutaneous nodules, and new pulmonary nodules with associated lymphadenopathy and a left-sided pleural effusion. CT-guided liver biopsy evinced a metastatic neuroendocrine carcinoma, further supported by an elevated calcitonin and chromogranin. She was treated with high dose IV T4 at 1.38 mcg/kg however continued to worsening thyroid function labs. She was then started on Liothyronine at 20 mcg and subsequently improved. This <span>patient’s case illustrates the importance of considering consumptive hypo</span>thy<span>roidism when thyroid profile abnormalities and symptoms of severe hypo</span>thyroidism are seen in the context of malignant neoplasms, and further illu<span>strates the important of considering T3 as part of the treatment regimen</span> when IV T4 is not resulting in improvement.</span>展开更多
Objective： To study the clinical therapy and prognosis in children with transient congenital hypothyroidism （CH）. Methods： Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosa...Objective： To study the clinical therapy and prognosis in children with transient congenital hypothyroidism （CH）. Methods： Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine （L-T4）. Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients （DQ）. A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared with a control group of 29 healthy peers. Results： The initial L-T4 dosage administered was 3.21-5.81μg/（kg·d） with an average of （16.25±3.87）μg/d. Mean duration of therapy was （28.09±9.56） months. No significant difference was found between study group and control group in the DQ test （average score （106.58±14.40） vs （102.4±8.6）, P〉0.05） and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion： AL-T4 dosage of 3.21-5.81μg/（kg·d） was found sufficient for the treatment of transient CH. The treated children showed satisfactory overall mental and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2-3 years of follow-up.展开更多
Clinicians should be cognizant of the close relationship that exists between two of the most common endocrine disorders, primary hypothyroidism and diabetes mellitus. This applies to patients with both type 1 and type...Clinicians should be cognizant of the close relationship that exists between two of the most common endocrine disorders, primary hypothyroidism and diabetes mellitus. This applies to patients with both type 1 and type 2 diabetes mellitus(T1DM and T2 DM respectively). However, the association is greater in T1 DM, probably because of the shared autoimmune predisposition. In patients with T2 DM, the relationship is somewhat weaker and the explanation less clear-cut. Factors such as dietary iodine deficiency, metformin-induced thyroid stimulating hormone suppression and poor glycemic control may all be implicated. Further translational research is required for greater clarification. Biochemical screening for abnormal thyroid function in individuals who have diabetes is warranted, particularly in females with T1 DM, and therapy with L-thyroxine appropriately instituted if hypothyroidism is confirmed.展开更多
We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult,non-pregnant woman.Her condition was triggered by unrecognized primary hypothyroi...We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult,non-pregnant woman.Her condition was triggered by unrecognized primary hypothyroidism,which regressed after thyroid hormone replacement therapy.This case highlights the need for clinicians and radiologists to familiarize themselves with the clinical and imaging features detected in case of these complications of primary hypothyroidism,which are not well known in the medical and radiological profession.Such improved knowledge will help avoid delays in diagnosis,progression to lifethreatening complications,and unnecessary surgery.展开更多
We have investigated comprehensively the effects of thyroid function on gallstone formation in a mouse model. Gonadectomized gallstone-susceptible male C57BL/6 mice were randomly distributed into three groups each of ...We have investigated comprehensively the effects of thyroid function on gallstone formation in a mouse model. Gonadectomized gallstone-susceptible male C57BL/6 mice were randomly distributed into three groups each of which received an intervention to induce hyperthyroidism, hypothyroidism, or euthyroidism. After 5 weeks of feeding a lithogenic diet of 15% （w/w） butter fat, 1% （w/w） cholesterol, and 0.5% （w/w） cholic acid, mice were killed for further experiments. The incidence of cholesterol monohydrate crystal formation was 100% in mice with hyperthyroidism, 83% in hypothyroidism, and 33% in euthyroidism, the differences being statistically significant. Among the hepatic lithogenic genes, Tr~ was found to be up-regulated and Rxr down-regulated in the mice with hypothyroidism. In contrast, Lxra, Rxr, and Cyp7al were up-regulated and Fxr down-regulated in the mice with hyperthyroidism. In conclusion, thyroid dysfunction, either hyperthyroidism or hypothyroidism, promotes the formation of cholesterol gallstones in C57BL/6 mice. Gene expression differences suggest that thyroid hormone disturbance leads to gallstone formation in different ways. Hyperthyroidism induces cholesterol gallstone formation by regulating expression of the hepatic nuclear receptor genes such as Lxra and Rxr, which are significant in cholesterol metabolism pathways. However, hypothyroidism induces cholesterol gallstone formation by promoting cholesterol biosynthesis.展开更多
Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occur...Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.展开更多
Background Subclinical hypothyroidism （SCH） has recently been acknowledged as an unconventional risk factor for coronary artery disease （CAD） and characterized by poor prognosis, which may be due to atheroscleroti...Background Subclinical hypothyroidism （SCH） has recently been acknowledged as an unconventional risk factor for coronary artery disease （CAD） and characterized by poor prognosis, which may be due to atherosclerotic plaque characteristics. We conducted this study to observe coronary plaque characteristics in coronary artery disease patients with concomitant SCH. Methods Patients with coronary artery disease were enrolled in the study and divided into an SCH group （patients, n = 26; plaques, n = 35） and a non-SCH group （patients, n = 52; plaques, n = 66）. They were divided 1：2 according to propensity-matched analysis including age, diabetes mellitus, gender, CAD severity and culprit vessel. Optical coherence tomography （OCT） imaging was performed on all patients, and images were analyzed by two inde- pendent investigators. Lipid-rich plaques （LRP）, the precursor of vulnerable plaques, were defined as having more than one quadrant occu- pied with lipid pool. Maximum lipid arcs were simultaneously recorded. Fibrotic plaques and calcific plaques were also identified. The pres- ence of coronary dissection, plaque erosion, thrombus, macrophage, calcific nodule, thin-cap fibroatheroma and micro channel were all noted. Results The ratio of LRP in SCH group was significantly higher than that in non-SCH group （54% vs. 30.3%, P = 0.037）. That was the case as well for the maximum lipid arcs value （181.5°± 61.6° vs. 142.1° 4± 35.9°, p = 0.046）. While thin-cap fibroatheroma （TCFA） was detected, no difference was identified between the two groups in either TCFA ratio （20% vs. 16.7%, P = 0.579） or fibrous cap thickness （57.5 4± 14.0 vs. 63.5 4±10.7 gin, P = 0.319）. Other OCT characteristics such as dissection, plaque erosion, thrombus, macrophage shadow and calcific nodule were also similar. ConcLusion Higher ratio of LRP with greater lipid arc in SCH patients may be related to the plaque instability and poor prognosis in CAD patients with SCH.展开更多
In the present study, we investigated the effects of hypothyroidism on the morphology of astrocytes and microglia in the hippocampus of Zucker diabetic fatty rats and Zucker lean control rats. To induce hypothyroidism...In the present study, we investigated the effects of hypothyroidism on the morphology of astrocytes and microglia in the hippocampus of Zucker diabetic fatty rats and Zucker lean control rats. To induce hypothyroidism, Zucker lean control and Zucker diabetic fatty rats at 7 weeks of age orally received the vehicle or methimazole, an anti-thyroid drug, treatment for 5 weeks and were sacrificed at 12 weeks of age in all groups for blood chemistry and immunohistochemical staining. In the me- thimazole-treated Zucker lean control and Zucker diabetic fatty rats, the serum circulating triiodo- thyronine （T3） and thyroxine （＇I＂4） levels were significantly decreased compared to levels observed in the vehicle-treated Zucker lean control or Zucker diabetic fatty rats. This reduction was more prominent in the methimazole-treated Zucker diabetic fatty group. Glial fibrillary acidic protein im- munoreactive astrocytes and ionized calcium-binding adapter molecule 1 （Iba-1）-immunoreactive microglia in the Zucker lean control and Zucker diabetic fatty group were diffusely detected in the hippocampal CA1 region and dentate gyrus. There were no significant differences in the glial fibril- lary acidic protein and Iba-1 immunoreactivity in the CA1 region and dentate gyrus between Zucker lean control and Zucker diabetic fatty groups. However, in the methimazole-treated Zucker lean control and Zucker diabetic fatty groups, the processes of glial fibrillary acidic protein immunoreac- tive astrocytes and Iba-1 immunoreactive microglia, were significantly decreased in both the CA1 region and dentate gyrus compared to that in the vehicle-treated Zucker lean control and Zucker diabetic fatty groups. These results suggest that diabetes has no effect on the morphology of as- trocytes and microglia and that hypothyroidism during the onset of diabetes prominently reduces the processes of astrocytes and microglia.展开更多
基金Supported by Beijing Science and Technology Project,No.Z191100006619059.
文摘BACKGROUND The association between hypothyroidism and depression is well established,but the underlying mechanisms remain unclear.AIM To explore the potential role of the gut microbiota in depressive-like behaviors in a mouse model of hypothyroidism,with a focus on bacterial composition.METHODS Hypothyroidism was induced in mice using propylthiouracil.Depressive-like behaviors were assessed using the sucrose preference test(SPT),forced swimming test(FST),tail suspension test(TST),and open field test(OFT).Inflammatory cytokines,including interleukin-6(IL-6),IL-1β,tumor necrosis factor-α,and IL-10,were quantified,together with colon histopathology scores,brain-derived neurotrophic factor,nuclear factorκB,inhibitor of nuclear factorκB,and tight junction proteins(occludin,claudin-1,zonula occludens-1).Gut microbial composition was determined by 16S rRNA gene sequencing of fecal samples.RESULTS Propylthiouracil-treated mice exhibited pronounced depressive-like behaviors,intestinal barrier dysfunction,elevated peripheral and central inflammation,and gut microbiota dysbiosis.Pearson correlation analysis showed that Bilophila and Psychrobacter abundance positively correlated with sucrose preference in the SPT and locomotor activity in the OFT,and negatively correlated with immobility times in the FST and TST.Gordonibacter abundance was positively correlated with locomotion in the OFT and negatively correlated with immobility in the FST and TST.Prevotellaceae_UCG_001 was inversely correlated with immobility in the FST and TST.Streptococcus was positively associated with sucrose preference in the SPT.CONCLUSION The observed associations between specific bacterial taxa and behavioral indices support a potential connection between gut microbiota composition and depressive symptoms in mice with hypothyroidism.
文摘BACKGROUND Congenital hypothyroidism(CH)is a prevalent childhood endocrine disorder associated with irreversible neurological consequences.Its global incidence is on the rise.AIM To estimate CH incidence in Jordan and assess the potential utility of incorporating(fT4)measurements into the screening process.METHODS This retrospective analysis examined thyroid function test results for infants born at our center between 2016 and 2020.Infants born before 28 weeks and those screened after 14 days of life were excluded.Screening occurred between days 3 and 7 of life,and thyroid-stimulating hormone(TSH)and T4 levels were measured concurrently from peripheral venipuncture blood samples.A TSH cutoff of<5 mIU/L was considered normal.Values between 5 and 20 mIU/L were equivocal,requiring repeat tests.TSH levels exceeding 20 mIU/L were considered critical.RESULTS A total of 10521 infants were included in the study,and 26 were diagnosed with CH,yielding an incidence of 1 in 400 live births.Females constituted 57.7%of CH cases.All CH cases had initial TSH values exceeding 5.0 mIU/L,with clustering above 20 mIU/L.Six CH infants had Down syndrome,accounting for 23.1%of CH cases.CONCLUSION Our study revealed a high incidence of CH in Jordan,marking a significant increase from previously reported rates.We recommend a national study to investigate risk factors and underlying causes of CH in our population.Furthermore,we advocate for the use of TSH alone with a cutoff value of<5 mIU/L for screening purposes.
文摘Background:Hepatocellular carcinoma(HCC)is one of the most prevalent malignant tumors worldwide,and endocrine,metabolic,and immune factors influence its occurrence and progression.Hypothyroidism(HT)is a common endocrine disorder that may affect cancer risk;however,its relationship with HCC remains unclear.Objective:This study aimed to investigate the potential molecular and immune mechanisms underlying the association between HT and HCC,with a focus on the regulatory effects of HT-related genetic variants on the hepatic tumor immune microenvironment.Methods:Single-nucleotide polymorphisms(SNPs)associated with HT and HCC identified through Mendelian randomization were functionally annotated using the Ensembl Genome Browser and mapped to candidate genes.Functional enrichment and pathway analyses were performed with Metascape.Differentially expressed target genes between HCC and normal liver tissues were screened using GEPIA2,and their protein expression levels were validated in the Human Protein Atlas(HPA)database.The association between target gene expression and immune cell infiltration was further evaluated using TIMER2.0.Results:A total of 68 candidate genes were analyzed.Enrichment analysis revealed that these genes are involved in IFN-γ-mediated immune responses,PI3K/AKT and RAC1 signaling pathways,and other immune regulatory processes.Among them,HLA-DQA1,HLA-DPB1,HLA-DQA2,and PVT1 showed significant differential expression in HCC.HLA-DQA1,HLA-DPB1,and HLA-DQA2 were positively correlated with CD8⁺T cells,regulatory T cells(Tregs),and M2 macrophages,suggesting that these genes may exert bidirectional effects on antitumor immunity and immunosuppression.PVT1 may influence the immune microenvironment by regulating myeloid cell recruitment and extracellular matrix remodeling.Conclusion:HLA-DQA1,HLA-DPB1,HLA-DQA2,and PVT1 may reduce the risk of HCC by enhancing IFN-γ-mediated antitumor immunity and modulating key signaling pathways,while also contributing to immune microenvironment remodeling.These findings provide mechanistic insights into the protective effects of HT on HCC and suggest potential targets for immunotherapeutic strategies.
基金supported by the Chief Scientist of Qi-Huang Project of the National Traditional Chinese Medicine Inheritance and Innovation“One Hundred Million”Talent Project,China(Grant No.:[2021]No.7)the National Famous Old Traditional Chinese Medicine Experts Inheritance Studio Construction Program of National Administration of Traditional Chinese Medicine,China(Grant No.:[2022]No.75)+3 种基金the Seventh Batch of National Famous Old Traditional Chinese Medicine Experts Experience Heritage Construction Program of National Administration of Traditional Chinese Medicine,China(Grant No.:[2022]No.76)Heilongjiang Touyan Innovation Team Program,China(Grant No.:[2019]No.5)the Natural Science Foundation of Zhejiang Province(Grant No.:LQN25H280009)the Research Project of Zhejiang Chinese Medical University,China(Grant No.:2023RCZXZK22).
文摘That herbs with the"hot"property used to treat"cold"syndromes is a guiding principle of clinical prescription and medication in traditional Chinese medicine(TCM).However,this theory of TCM is still in the‘black box'stage,and few in-depth studies have examined the biological mechanisms underpinning the hot properties of herbs.
基金by grants from the Jiangsu Province 333 High-level Talent Training Project(Grant No.LGY2016010)the Nanjing Science and Technology Development Plan(Grant No.201715003)the Jiangsu Province Six Talent Peaks(Grant No.WSN-030).
文摘Dear Editor,Observational studies in epidemiology have identified a correlation between hypothyroidism and cholelithiasis[1–2].However,the causal relationship between the two diseases remains unclear.To investigate the potential causal relationship,we employed a two-sample bidirectional Mendelian randomization(MR)analysis.
基金National Natural Science Foundation of China(82305090)Shanghai Municipal Health Commission(20234Y0168)National Key Research and Development Program of China(2017YFC1703301)。
文摘Objective To evaluate the effectiveness and safety of the tonifying spleen and reinforcing Qi(TSRQ)therapy combined with thyroid hormone replacement therapy(THRT)for treating Hashimoto’s hypothyroidism.Methods From database foundation to January 14,2025,PubMed,Web of Science,Cochrane,Embase,China National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(VIP),and China Biomedical Literature Database(CBM)were searched for relevant information.Randomized clinical trials(RCTs)evaluating the efficacy and safety of TSRQ therapy combined with THRT for Hashimoto’s hypothyroidism were eligible for inclusion.Following quality assessment,data were analyzed using Stata 15.1 to conduct a meta-analysis and systematic review.Subgroup analysis was used to identify the sources of heterogeneity.The Grading of Recommendations Assessment,Development and Evaluation(GRADE)system was adopted to evaluate the certainty of the evidence.Results This study included 30 RCTs,comprising 2687 patients with Hashimoto’s hypothyroidism.Overall methodological quality was acceptable,with no studies exhibiting a high risk of bias.Meta-analysis demonstrated that TSRQ therapy combined with THRT significantly enhanced serum free triiodothyronine(fT3)levels[standardized mean difference(SMD)=0.76,95%confidence interval(CI):0.57 to 0.94,P<0.001]and free thyroxine(fT4)levels(SMD=0.86,95%CI:0.61 to 1.11,P<0.001),while reducing thyroid-stimulating hormone(TSH)levels(SMD=–0.99,95%CI:–1.20 to–0.78,P<0.001)compared with THRT alone.Furthermore,the combination therapy significantly decreased anti-thyroid peroxidase antibody(TPOAb)levels(SMD=–1.46,95%CI:–1.79 to–1.13,P<0.001)and anti-thyroglobulin antibody(TgAb)levels(SMD=–1.46,95%CI:–1.80 to–1.11,P<0.001).TSRQ therapy did not adversely impact the safety profile of THRT.However,while some sources of heterogeneity have been identified(e.g.,specific detection methodologies,I²=0.0%,P=0.938),there remains a portion of unexplained heterogeneity(e.g.,publication year,I²=93.4%,P<0.001),which has undermined confidence in these pooled estimates.The evidence ratings for fT3,fT4,and TSH were limited,and those for TPOAb and TgAb were even more limited.Conclusion TSRQ therapy combined with THRT may strengthen thyroid function and modulate immune dysregulation in patients with Hashimoto’s hypothyroidism without increasing adverse event incidence.
文摘Background: Cardiovascular diseases, such as hypertension and coronary heart disease, are often accompanied by thyroid and mental diseases, the harm of which poses great threats to patients’ health. Objective: To explore the correlation between free triiodothyronine (FT3), free thyroxine (FT4) and hypertension in depression patients with hypothyroidism and its clinical guiding value. Methods: A total of 548 patients diagnosed with hypothyroidism in Wuxue First People’s Hospital of Hubei Province from January 2018 to September 2022 were enrolled. According to whether complicated with depression, they were divided into hypothyroidism without depression group (group A) and hypothyroidism with depression group (group B). The gender, age, comorbidities (such as depression, hypertension, diabetes, dyslipidemia, acute myocardial infarction), FT3, FT4, and thyroid stimulating hormone (TSH) levels were recorded. Spearman rank correlation was used to analyze hypertensive patients with hypothyroidism. Multivariate binary Logistic regression was used to analyze the influencing factors of hypertension in patients with hypothyroidism. Results: The TSH level, the number of hypertension, coronary heart disease and hyperlipidemia in group B were statistically significantly higher than those in group A (P 3 level in group B was statistically significantly lower than that in group A (P s = 0.092), coronary heart disease (rs = 0.000), hyperlipidemia (rs = 0.000), diabetes (rs = 0.000), and age (rs = 0.000), and negatively correlated with FT3 (rs = 0.000) (P 3 and FT4 were the influencing factors of hypertension. The risk of hypertension in patients with coronary heart disease and hyperlipidemia significantly increased by 3.425 and 1.761 times (P 3, the risk of hypertension increased (P 4, the risk of hypertension significantly increased (P 3 and FT4 are the influencing factors of hypertension. The lower the FT3 level, the higher the FT4 level, the higher the risk of hypertension. FT3 and FT4 may be potential biomarkers of depression in hypertensive patients. Thyroid function assessment is recommended in patients with hypertension.
文摘Introduction: Congenital hypothyroidism is the most common causes of preventable mental retardation. It is associated with other births defects like cardiac malformations. Descriptions in Sub Saharan Africa are rare, justifying the present report. Case Report: We reported the cases of 3 female patients, diagnosed with hypothyroidism, presenting in addition pulmonary stenosis. The diagnosis was late in all the patients and we noticed clinical improvement under levothyroxine. Conclusion: Association congenital hypothyroidism and cardiac defect is not rare. Our patients are female with no history of consanguinity, presenting congenital hypothyroidism with a gland in situ associated with pulmonary stenosis. Systematic screening of other births defects is thus recommended in affected patients.
基金Innovation Project of Loudi Science and Technology Bureau(Project No.Lou Caijiaozhi(2022)No.2)。
文摘Objective:To explore the correlation between epicardial fat thickness(EFT),aortic velocity propagation(AVP),and abdominal aortic intima-media thickness(AA-IMT)in patients with subclinical hypothyroidism(SH).Additionally,to compare these indicators between SH patients and healthy individuals,providing a new theoretical basis for the clinical prevention and treatment of cardiovascular diseases.Method:Clinical data from 50 SH patients(23 males and 27 females)and 50 healthy outpatient examinees(22 males and 28 females)were analyzed.The participants were selected from January 2022 to December 2023 at Loudi Central Hospital.EFT,AVP,and AA-IMT were measured,and their correlations were analyzed.Results:SH patients had significantly higher EFT and AA-IMT levels than the control group,while their AVP was significantly lower,with these differences being statistically significant(P<0.05).Correlation analysis revealed a significant negative correlation between EFT and AVP(P<0.001),a significant positive correlation between EFT and AAO-IMT(P<0.001),and a significant negative correlation between AVP and AAO-IMT(P<0.001).Multivariate binary logistic regression analysis identified increased EFT,decreased AVP,and increased AAO-IMT as independent risk factors for SH patients.Conclusion:In SH patients,EFT and AAO-IMT are elevated,whereas AVP is reduced.EFT and AVP are significantly correlated with AAO-IMT.EFT and AAO-IMT can serve as reliable indicators for evaluating subclinical atherosclerosis in SH patients,providing a diagnostic basis for clinical practice.
文摘Thyroid-stimulating hormone (TSH) assay is considered a decisive diagnostic method for thyroid disorders. The lack of different TSH immunoassay standardization often leads to misdiagnosis of subclinical hypothyroidism (SCH). This study aims to differentiate between two analytical platforms for TSH measurement, namely Abbott Laboratories and Snibe Diagnostics. This study employed 173 thyroid profile samples to detect SCH. Initially, the sample was run on Abbott and then by Snibe immunoassay. Statistical analysis showed a significant difference of 0.87 mIU/L (P < 0.001) between the TSH values of the two assays. The proposed study corroborates with previous literature by manifesting notable differences in the TSH measurements of two different assays. The findings revealed some insights regarding the differences between the two assays, which conclude that the diagnosis of SCH requires vigilance because of inadequate assay standardization. Thus, future research involving larger cohorts with standardization efforts is imperative to improve the reliability of TSH measurements using different analytical platforms.
文摘Juvenile hypothyroidism is an unfrequent form of hypothyroidism that affects children. If not diagnosed and treated properly, it may cause severe neurological disorders during growth. The most frequent difficulties are found in school performance, difficulties in concentration, hyperactivity or fatigue and damage on the onset of puberty. Starting levothyroxine as a drug of choice is essential, and it should be made according to the age and weight of the child. Laboratory tests for control should be requested periodically, along with a strict control of the child’s development and growth. The family-doctor relationship, along with a clear guidance on the importance of treatment, is critical to achieve a successful treatment. This article is a review about the main clinical features of hypothyroidism in childhood, especially in developing countries, providing key aspects of adherence and characteristics of its follow-up.
文摘Background: Thyroid disorders are the most common endocrine disorders in pregnancy accounting for 10% of subclinical hypothyroidism in all pregnancies. Screening for hypothyroidism is essential in all pregnant women, especially in Nepal, a low-income region where women have an increased risk of developing iodine deficiency during pregnancy. Hence this study is to analyze fetomaternal outcomes in maternal hypothyroidism complicating pregnancies. Methods: This retrospective observational study was carried out at Paropakar Maternity and Women Hospital, a tertiary center located in Kathmandu, Nepal. The Subjects of this study were 330 antenatal women with a singleton pregnancy with hypothyroidism admitted for delivery in the obstetrics ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residency, and socioeconomic status. Women with multiple pregnancies and any preexisting medical disorders including heart disease, diabetes, and hypertension were excluded. Routine hematological parameters and estimations of T3, T4, and thyroid stimulating hormone (TSH) were conducted. Patients with hypothyroidism were divided into overt and subclinical and were subsequently assessed for maternal and fetal complications. The occurrence of maternal outcomes and perinatal outcomes were recorded. Result: Out of 470 total hypothyroid cases, 330 were enrolled in the study and the remaining 140 were excluded. In our study, the incidence of hypothyroidism in pregnancy was 2.11% with 1.7% of subclinical hypothyroidism and 0.31% of overt hypothyroidism. The mean age of the patient was >30 years with 53.3% (n = 176) primigravida. Mostly 70.3% (n = 232) from rural areas. Pre-Eclampsia, gestational diabetes abruptio placenta, and postpartum hemorrhage were the adverse maternal outcome with a higher percentage of these in overt hypothyroidism which was statistically significant. Concerning fetal outcome APGAR score <6 in 5 min, Intrauterine growth restriction (IUGR), NICU admission, neonatal Respiratory distress syndrome (RDS), Intrauterine fetal death (IUFD), and congenital anomaly were found with a higher percentage in overt hypothyroidism. Conclusion: Since the impact of hypothyroidism on fetomaternal morbidities have been identified so screening for hypothyroidism to be included as a routine screening test and should be treated accordingly to improve maternal and fetal outcome.
文摘Consumptive hypothyroidism is often the clinical condition that results from neoplasms producing their own selenodionases that convert T4 needed to be converted to active T3 into an active form of thyroid hormone, rT3. This often requires treatment with high doses of IV T4, with or without doses of T3 as well, until the neoplasm is treated. This principle is demonstrated in the below case of a 65 y/o female with medical history significant for Ia Kappa multiple myeloma, complete heart block s/p AICD placement, and papillary thyroid cancer status post thyroidectomy in 2020, who had initially presented <span>with persistent bone pain, progressive encephalopathy and failure to thrive</span> with more than a 50 lb weight loss over a few months. Labs on presentation <span>were not remarkable for progression of her underlying multiple myeloma</span>, however<span style="font-family:;" "="">,</span><span style="font-family:;" "=""> she was found to have a new significantly elevated TSH. She underwent imaging with a CT chest, abdomen, and pelvis, which showed new hepatic lesions, subcutaneous nodules, and new pulmonary nodules with associated lymphadenopathy and a left-sided pleural effusion. CT-guided liver biopsy evinced a metastatic neuroendocrine carcinoma, further supported by an elevated calcitonin and chromogranin. She was treated with high dose IV T4 at 1.38 mcg/kg however continued to worsening thyroid function labs. She was then started on Liothyronine at 20 mcg and subsequently improved. This <span>patient’s case illustrates the importance of considering consumptive hypo</span>thy<span>roidism when thyroid profile abnormalities and symptoms of severe hypo</span>thyroidism are seen in the context of malignant neoplasms, and further illu<span>strates the important of considering T3 as part of the treatment regimen</span> when IV T4 is not resulting in improvement.</span>
文摘Objective： To study the clinical therapy and prognosis in children with transient congenital hypothyroidism （CH）. Methods： Fifty-seven children with CH diagnosed after neonatal screening were treated with low-dosage levothyroxine （L-T4）. Follow-up evaluation included the determination of TT3, TT4 and TSH serum levels and the assessment of thyroid gland morphology, bone age, growth development and development quotients （DQ）. A full check-up was performed at age 2, when the affected children first discontinued the L-T4 treatment for 1 month, and one year later. Development quotients were compared with a control group of 29 healthy peers. Results： The initial L-T4 dosage administered was 3.21-5.81μg/（kg·d） with an average of （16.25±3.87）μg/d. Mean duration of therapy was （28.09±9.56） months. No significant difference was found between study group and control group in the DQ test （average score （106.58±14.40） vs （102.4±8.6）, P〉0.05） and 96.49% of the CH children achieved a test score above 85. Bone age, 99mTc scans and ultrasonographic findings were all normal, and evaluation of physical development was normal too, as were the serum levels of TT3, TT4 and TSH after one year of follow-up. Conclusion： AL-T4 dosage of 3.21-5.81μg/（kg·d） was found sufficient for the treatment of transient CH. The treated children showed satisfactory overall mental and physical development at age 2. So it is possible for CH children to stop taking medicine if their laboratory findings and physical development are all normal after regular treatment and 2-3 years of follow-up.
文摘Clinicians should be cognizant of the close relationship that exists between two of the most common endocrine disorders, primary hypothyroidism and diabetes mellitus. This applies to patients with both type 1 and type 2 diabetes mellitus(T1DM and T2 DM respectively). However, the association is greater in T1 DM, probably because of the shared autoimmune predisposition. In patients with T2 DM, the relationship is somewhat weaker and the explanation less clear-cut. Factors such as dietary iodine deficiency, metformin-induced thyroid stimulating hormone suppression and poor glycemic control may all be implicated. Further translational research is required for greater clarification. Biochemical screening for abnormal thyroid function in individuals who have diabetes is warranted, particularly in females with T1 DM, and therapy with L-thyroxine appropriately instituted if hypothyroidism is confirmed.
文摘We report an unusual case of spontaneous ovarian hyperstimulation syndrome and pituitary hyperplasia mimicking macroadenoma in an adult,non-pregnant woman.Her condition was triggered by unrecognized primary hypothyroidism,which regressed after thyroid hormone replacement therapy.This case highlights the need for clinicians and radiologists to familiarize themselves with the clinical and imaging features detected in case of these complications of primary hypothyroidism,which are not well known in the medical and radiological profession.Such improved knowledge will help avoid delays in diagnosis,progression to lifethreatening complications,and unnecessary surgery.
基金Project supported by the National Natural Science Foundation of China(No.81001084)
文摘We have investigated comprehensively the effects of thyroid function on gallstone formation in a mouse model. Gonadectomized gallstone-susceptible male C57BL/6 mice were randomly distributed into three groups each of which received an intervention to induce hyperthyroidism, hypothyroidism, or euthyroidism. After 5 weeks of feeding a lithogenic diet of 15% （w/w） butter fat, 1% （w/w） cholesterol, and 0.5% （w/w） cholic acid, mice were killed for further experiments. The incidence of cholesterol monohydrate crystal formation was 100% in mice with hyperthyroidism, 83% in hypothyroidism, and 33% in euthyroidism, the differences being statistically significant. Among the hepatic lithogenic genes, Tr~ was found to be up-regulated and Rxr down-regulated in the mice with hypothyroidism. In contrast, Lxra, Rxr, and Cyp7al were up-regulated and Fxr down-regulated in the mice with hyperthyroidism. In conclusion, thyroid dysfunction, either hyperthyroidism or hypothyroidism, promotes the formation of cholesterol gallstones in C57BL/6 mice. Gene expression differences suggest that thyroid hormone disturbance leads to gallstone formation in different ways. Hyperthyroidism induces cholesterol gallstone formation by regulating expression of the hepatic nuclear receptor genes such as Lxra and Rxr, which are significant in cholesterol metabolism pathways. However, hypothyroidism induces cholesterol gallstone formation by promoting cholesterol biosynthesis.
文摘Gastrointestinal duplications are an uncommon congenital abnormality that manifest before the age of two in 80% of cases. Ileal duplication is the most common while colonic duplication, either cystic or tubular, occurs in 10%-15% of cases and remains asymptomatic and undiagnosed in most cases. Mostly occurring in pediatric patients, colonic duplication is encountered in adults in only a few cases. The most common clinical manifestations are abdominal pain and intestinal obstruction. Rarely, duplications present with signs of acute abdomen or acute bleeding. This study reports a case of colonic duplication in an adult who presented with chronic constipation. Complete diagnostic workup was made on several occasions during the previous eight year period, but no pathology was found and chronic constipation was attributed to hypothyroidism caused by long standing Hashimoto thyroiditis. Nultislice CT, performed because of abdominal distension, defined colonic pathology but the definite diagnosis of duplication of the transversal colon was made at operation. The cystic duplication and the adjacent part of the ascending and transversal colon were excised enblock. This study implies that colonic duplication, though uncommon, should be included in the differential diagnosis of chronic constipation even when precipitating factors for constipation, such as hypothyroidism are present.
文摘Background Subclinical hypothyroidism （SCH） has recently been acknowledged as an unconventional risk factor for coronary artery disease （CAD） and characterized by poor prognosis, which may be due to atherosclerotic plaque characteristics. We conducted this study to observe coronary plaque characteristics in coronary artery disease patients with concomitant SCH. Methods Patients with coronary artery disease were enrolled in the study and divided into an SCH group （patients, n = 26; plaques, n = 35） and a non-SCH group （patients, n = 52; plaques, n = 66）. They were divided 1：2 according to propensity-matched analysis including age, diabetes mellitus, gender, CAD severity and culprit vessel. Optical coherence tomography （OCT） imaging was performed on all patients, and images were analyzed by two inde- pendent investigators. Lipid-rich plaques （LRP）, the precursor of vulnerable plaques, were defined as having more than one quadrant occu- pied with lipid pool. Maximum lipid arcs were simultaneously recorded. Fibrotic plaques and calcific plaques were also identified. The pres- ence of coronary dissection, plaque erosion, thrombus, macrophage, calcific nodule, thin-cap fibroatheroma and micro channel were all noted. Results The ratio of LRP in SCH group was significantly higher than that in non-SCH group （54% vs. 30.3%, P = 0.037）. That was the case as well for the maximum lipid arcs value （181.5°± 61.6° vs. 142.1° 4± 35.9°, p = 0.046）. While thin-cap fibroatheroma （TCFA） was detected, no difference was identified between the two groups in either TCFA ratio （20% vs. 16.7%, P = 0.579） or fibrous cap thickness （57.5 4± 14.0 vs. 63.5 4±10.7 gin, P = 0.319）. Other OCT characteristics such as dissection, plaque erosion, thrombus, macrophage shadow and calcific nodule were also similar. ConcLusion Higher ratio of LRP with greater lipid arc in SCH patients may be related to the plaque instability and poor prognosis in CAD patients with SCH.
基金supported by the National Research Foundation of Korea Grant funded by the Korean Government(MEST),Republic of Korea,No.2010-0007712
文摘In the present study, we investigated the effects of hypothyroidism on the morphology of astrocytes and microglia in the hippocampus of Zucker diabetic fatty rats and Zucker lean control rats. To induce hypothyroidism, Zucker lean control and Zucker diabetic fatty rats at 7 weeks of age orally received the vehicle or methimazole, an anti-thyroid drug, treatment for 5 weeks and were sacrificed at 12 weeks of age in all groups for blood chemistry and immunohistochemical staining. In the me- thimazole-treated Zucker lean control and Zucker diabetic fatty rats, the serum circulating triiodo- thyronine （T3） and thyroxine （＇I＂4） levels were significantly decreased compared to levels observed in the vehicle-treated Zucker lean control or Zucker diabetic fatty rats. This reduction was more prominent in the methimazole-treated Zucker diabetic fatty group. Glial fibrillary acidic protein im- munoreactive astrocytes and ionized calcium-binding adapter molecule 1 （Iba-1）-immunoreactive microglia in the Zucker lean control and Zucker diabetic fatty group were diffusely detected in the hippocampal CA1 region and dentate gyrus. There were no significant differences in the glial fibril- lary acidic protein and Iba-1 immunoreactivity in the CA1 region and dentate gyrus between Zucker lean control and Zucker diabetic fatty groups. However, in the methimazole-treated Zucker lean control and Zucker diabetic fatty groups, the processes of glial fibrillary acidic protein immunoreac- tive astrocytes and Iba-1 immunoreactive microglia, were significantly decreased in both the CA1 region and dentate gyrus compared to that in the vehicle-treated Zucker lean control and Zucker diabetic fatty groups. These results suggest that diabetes has no effect on the morphology of as- trocytes and microglia and that hypothyroidism during the onset of diabetes prominently reduces the processes of astrocytes and microglia.
