Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore it is anticipated that thyroid hormones may have a role in the pathogenesis of non alcoholic ...Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore it is anticipated that thyroid hormones may have a role in the pathogenesis of non alcoholic fatty liver disease(NAFLD) and non alcoholic steatohepatitis(NASH). In this study, we reviewed the current literature on the association between thyroid dysfunction and NAFLD/NASH. A search for English language medical literature reporting an association between thyroid dysfunction and NAFLD/NASH in humans was conducted across PubMed, ISI Web of Science, and Scopus in August, 2013. Out of 140 studies initially identified through the search, 11 relevant articles were included in the final review. Thyroid dysfunctions in the form of overt or subclinical hypothyroidism are prevalent among patients with NAFLD/NASH. Hypothyroidism appears to be an independent risk factor for NAFLD/NASH in some studies; however, other newly published studies failed to find such anassociation. The results of the studies on the role of thyroid abnormalities in NAFLD/NASH are inconsistent, and further research is recommended to determine the relationship between hypothyroidism and NAFLD/NASH and the underlying mechanisms.展开更多
AIM: To investigate the relationship among pretreatment serum CXC chemokine ligand 10(CXCL10),thyroid peroxidase antibody(TPOAb) levels and thyroid dysfunction(TD) in Chinese hepatitis C patients.METHODS: One hundred ...AIM: To investigate the relationship among pretreatment serum CXC chemokine ligand 10(CXCL10),thyroid peroxidase antibody(TPOAb) levels and thyroid dysfunction(TD) in Chinese hepatitis C patients.METHODS: One hundred and thirty-nine treatmentnaive genotype 1 chronic hepatitis C patients with no history of TD or treatment with thyroid hormones were enrolled in this study.Patients underwent peginterferon alfa-2a/ribavirin(Peg IFNα-2a/RBV) treatment for 48 wk,followed by detection of clinical factors at each follow-up point.Hepatitis C virus(HCV) antibodies were analyzed using microsomal chemiluminescence,and serum HCV RNA was measured by real-time PCR assay at 0,4,12,24 and 48 wk after the initiation of therapy and 24 wk after the end of therapy.To assess thyroid function,serum thyroid stimulating hormone(TSH),free thyroxine(FT4),free triodothyronine(FT3) and TPOAb/thyroglobulin antibody(TGAb) levels were determined using chemiluminescent immunoassays every 3 mo.Serum CXCL10 levels were determined at baseline.RESULTS: The prevalence of TD was 18.0%.Twentyone(84.0%) out of twenty-five patients exhibited normal thyroid function at week 24 after therapy.The rate of sustained virological response to Peg IFNα-2a/RBV in our study was 59.0%(82/139),independent of thyroid function.Pretreatment serum CXCL10 levels were significantly increased in patients with euthyroidstatus compared with patients with TD(495.2 ± 244.2 pg/m L vs 310.0 ± 163.4 pg/m L,P = 0.012).Patients with TD were more frequently TPOAb-positive than non-TD(NTD) patients(24.2% vs 12.3%,P = 0.047) at baseline.Three of the one hundred and fifteen patients without TPOAb at baseline developed TD at the end of treatment(37.5% vs 2.6%,P = 0.000).Female patients exhibited an increased risk for developing TD compared with male patients(P = 0.014).CONCLUSION: Lower pretreatment serum CXCL10 levels are associated with TD,and TD prevalence increases in female patients and patients who are positive for TPOAb at baseline.展开更多
Iodinated contrast media(ICM)has the potential to cause thyroid dysfunction in some patients.However,it is unclear whether this relationship exists in children.We conducted a systematic review and meta-analysis aim to...Iodinated contrast media(ICM)has the potential to cause thyroid dysfunction in some patients.However,it is unclear whether this relationship exists in children.We conducted a systematic review and meta-analysis aim to obtain a general overview of the relationship between ICM exposure and the risk of thyroid dysfunction in children.Methods:Computer search of Web of Science,EMbase,PubMed,Cochrane Library,collection of relevant literature on ICM and thyroid dysfunction in children,the search period was from the establishment of the database to July 2021.Meta-analysis was performed using Stata 14.0 software.Results:A total of 8 literatures with 3497 children.The incidence of hypothyroidism in children with ICM exposure was 0.05(95%CI:0.05,0.12),P<0.0001.Subgroup analysis showed that the incidence of hypothyroidism in ICM exposed children in the European region was 0.21(95%CI:0.13,0.30),P<0.0001,a statistically significant difference.Conclusion:The current evidence shows that children exposed to ICM are at risk for hypothyroidism,with a higher risk in neonates,especially children with congenital heart disease.展开更多
Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the pr...Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction(SCTD).Therefore,we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.Methods:This prospective cohort study investigated 6631 participants(mean age:(45.0±10.2)years;55.1%men).Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire.SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine.Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.Results:During follow-up period,a total of 262 new cases of SCTD were identified,the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years.After adjusting potential confounding factors,the multivariable hazard ratios(95%confidence intervals)for subclinical hypothyroidism were 1.00(reference)for almost never,0.53(0.29,0.97)for 1-3 times/week and 0.30(0.10,0.87)for≥4 times/week(P for trend=0.02).It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals,the final hazard ratios(95%confidence intervals)were 0.14(0.03,0.73)(P for trend<0.01).Conclusions:This population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population,especially in obese individuals.展开更多
<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present ...<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. <b>Materials and Methods:</b> We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. <b>Results: </b>A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 70) years. The main etiology of heart failure was hypertension</span><span style="white-space:normal;font-family:;" "=""> (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 months were more likely to have hypothyroidism (OR: 5.3, [95% CI: 1.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 21.5], p = 0.013). <b>Conclusion: </b>The burden of thyroid dysfunction was high in this group of patients with HF. These were mainly low T3 syndrome and sub-clinical hypothyroidism. These were associated with heart failure with reduced ejection fraction and those with more than one hospitalization within the past 12-months</span><span style="white-space:normal;font-family:;" "="">.</span>展开更多
Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred ...Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred to a governmental referral hospital in Qom,Iran from March to August 2022 were collected.The thyroid disorders were determined according to the 2017 American Thyroid Association guidelines.The predictors of a mother's hypothyroidism and its fetal and maternal consequences were assessed.Independent t-test,Chi-square test,and logistic regression were used for bivariate and multivariate analysis.Results:293 women were included.The prevalence of hypothyroidism and hyperthyroidism based on the thyroid stimulating hormone classification was 32.5%and 2.0%.The prevalence of subclinical and overt hypothyroidism was 6.1%and 4.1%,and the prevalence of subclinical and overt hyperthyroidism was 2.4%and 1.4%,respectively.Family history of thyroid disorders was the most important predictor of hypothyroidism during pregnancy(OR=2.6,95%CI=1.0-6.6,P=0.002),while preterm delivery(OR=2.2,95%CI=1.3-6.8,P=0.220)and elevated neonate thyroid stimulating hormone(OR=1.2,95%CI=1.1-1.3,P=0.041)were the most important consequence of hypothyroidism.Conclusions:Hypothyroidism is a highly prevalent thyroid disorder in high-risk pregnant women.Thyroid function screening should be performed in all pregnant women to increase the detection of subclinical and overt hypothyroidism during pregnancy.展开更多
The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases a...The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases after birth.Environmental endocrine-disrupting compounds(EDCs)have been proven to harm THs in newborns.Phthalates(PAEs),a typical class of EDCs,are commonly used in toys,childcare materials,and food contact materials,which have been closely connected with neonatal thyroid dysfunction and thyroid-related diseases.As restrictions on PAEs becomemore stringent in neonatal field,numerous PAE alternatives are emerging.Associations between exposure to PAEs and their alternatives and dysfunctions in THs have been explored.Hence,we summarized the body burdens and regional characteristics of PAEs and their alternatives in neonatal urine,cord blood,and meconium.Subsequently,the influences of PAEs and their alternatives on thyroid dysfunction,prematurity,low birth weight,fetal growth restriction,respiratory dysfunction,immune disorders,neurological disorders,and reproductive disorders in newborns were evaluated.Furthermore,we scrutinized the effects of PAEs and their alternatives on the neonatal thyroid from signaling,substance transport,and hormone production to explore the underlying mechanisms of action on neonatal thyroid and thyroid-related disorders.As the declining global trends of healthy newborns and the potential impacts of PAEs and their alternatives on thyroid function,a more comprehensive study is needed to discuss their effects on newborns and their underlying mechanisms.This review facilitates attention to the effects of PAEs and their alternatives on thyroid and thyroid-related disorders in newborns.展开更多
BACKGROUND Thyroid dysfunction during pregnancy is an important disease affecting the health of mothers and children.Two-dimensional(2D)shear wave elastography(SWE)is the newest ultrasonic elastography technology and ...BACKGROUND Thyroid dysfunction during pregnancy is an important disease affecting the health of mothers and children.Two-dimensional(2D)shear wave elastography(SWE)is the newest ultrasonic elastography technology and its value in differentiating benign and malignant thyroid nodules has been widely recognized.However,the value of 2D SWE in evaluating and predicting thyroid function is unclear.AIM To explore prospectively the value of 2D SWE quantitative analysis for the evaluation of thyroid function in the first trimester.METHODS We included outpatients of reproductive age in the Department of Gynecology in Shanghai Changning Maternity and Infant Health Hospital between March 2023 and March 2024 who had conventional ultrasound examination and 2D SWE of the thyroid.They also underwent transvaginal ultrasound examination to confirm early intrauterine pregnancy and serum thyroid stimulating hormone(TSH)level was measured.The patients were divided into pregnant with normal TSH,pregnant with abnormal TSH,and nonpregnant with normal TSH.Conventional ultrasound and 2D SWE results were compared among the three groups.RESULTS A total of 108 patients were included in the study;57 in the pregnant with normal TSH group,18 in the pregnant with abnormal TSH group and 33 were in the nonpregnant with normal TSH group.Thyroid size,thyroid echotexture,2D SWE quantitative parameters including mean elasticity in the region of interest and maximal elasticity in the region of interest showed no significant differences among the three groups(P>0.05).CONCLUSION Conventional ultrasound and 2D SWE features could not reflect the level of serum TSH.展开更多
The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additio...The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additional contributors such as hypothalamic dysfunction,neurosecretory disturbances,and chronic inflammation have been identified.Endocrine disorders including hypothyroidism,adrenal insufficiency,hypogonadotropic hypogonadism,hypoparathyroidism,osteoporosis,and growth axis impairment-are prevalent and often underdiagnosed.Diagnostic challenges include normal hormone levels in early stages,necessitating the use of dynamic endocrine testing and pituitary magnetic resonance imaging to detect subclinical dysfunction.Risk is modulated by sex,age,and chelation adherence.Early identification and proactive,multidisciplinary management of endocrine sequelae are essential in reducing morbidity and maintaining functional independence in this aging patient population.展开更多
构建使用了PD-1抑制剂的肿瘤患者出现甲状腺功能障碍的风险预测模型,分析使用PD-1肿瘤抑制剂导致的甲状腺功能障碍的相关风险因素,设计监测预警系统。选取2020年—2023年广西医科大学附属肿瘤医院1225例使用PD-1抑制剂肿瘤患者的临床资...构建使用了PD-1抑制剂的肿瘤患者出现甲状腺功能障碍的风险预测模型,分析使用PD-1肿瘤抑制剂导致的甲状腺功能障碍的相关风险因素,设计监测预警系统。选取2020年—2023年广西医科大学附属肿瘤医院1225例使用PD-1抑制剂肿瘤患者的临床资料,包括人口学特征、既往史、实验室检测等63个变量。本文选取相关性前10/20/30/40/50/60个变量的4种传统机器学习模型进行性能比较。通过F1分数、灵敏度、准确率、精确率、特异性曲线下面积(Area Under the Curve,AUC)评估以上预测模型的性能,并利用Shapley加性解释(Shapley Additive Explanation,SHAP)可视化解释本文的机器学习模型。与促甲状腺激素相关性排名前10的变量依次为:羟丁酸脱氢酶、乳酸脱氢酶、淋巴细胞绝对值、天门冬氨酸转移酶、钙离子、碱性磷酸酶、谷氨酰转肽酶、单核细胞绝对值、红细胞分布宽度SD、胆碱酯酶。建立了使用PD-1抑制剂的肿瘤患者出现甲状腺功能障碍的风险预测模型,并在全局解释和局部解释的层面上分别作出模型预测结果影响的解释。展开更多
Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a medi...Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.展开更多
The improvement in accuracy of in vitro diagnosis has always been the focus of early screening of thyroid dysfunction.We constructed a microfluidic chip based on a polystyrene polymer substrate.Total triiodothyronine(...The improvement in accuracy of in vitro diagnosis has always been the focus of early screening of thyroid dysfunction.We constructed a microfluidic chip based on a polystyrene polymer substrate.Total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyrotropin(TSH) in human whole blood samples were analysed by fluorescence immunoassay to evaluate thyroid function.The results indicate that the microfluidic chip shows a good linear relationship in the detection of TT3,TT4,FT3,FT4,and TS H standards,and the correlation coefficient(r) is not less than0.9900.In addition,the chip also has strong anti-interference(RSD%≤5%) and good repeatability(CV≤8%),and its inter-batch differences are small(CV ≤15%).The results of practical application in clinical thyroid function mea surement indicated its high accuracy(r≥0.9900).It provides a new method for the determination of thyroid function and lays a foundation for subsequent clinical application.展开更多
Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody (TRAb) levels and the antithyroid drug(ATDs) use in pregnant women with Graves' disease in their neona...Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody (TRAb) levels and the antithyroid drug(ATDs) use in pregnant women with Graves' disease in their neonatal thyroid function. Methods:The serum TRAb and T3,T4,FT3,FT4,TSH levels in 68 pregnant women with Graves' disease and their newborns were detected by radio receptor assay(RRA) and electrical chemiluminescence immunoassay (ECLIA),respectively.Based on the maternal serum TRAb levels and the use of antithyroid drugs during pregancy, the newborns were divided into different groups.The incidence of neonatal thyroid dysfunction and its risk factors were analyzed. Results:The results showed the incidence of abnormal thyroid function of newborns was 29.4%(20/68).The proportion of neonatal thyroid dysfunction in women with high TRAb levels in the third trimester of pregnancy were significantly higher than these with normal TRAb(P<0.01).In 23 newborns whose mothers were normal in serum TRAb levels and took no ATDs during pregnancy,only one case had thyroid dysfunction within two weeks after birth,while in other 45 newborns whose mothers had a high level of serum TRAb and/or took ATDs during pregnancy, 19 developed thyroid dysfunction within two weeks after birth. Conclusion:Neonatal thyroid function depends on the balance between the transplacental TRAb and ATDs. TRAb measurement in pregnant women with Graves' disease is of significance in evaluation of neonatal thyroid function. Elevated level of serum TRAb in the third trimester of pregnancy is a risk factor for neonatal thyroid dysfunction.展开更多
To evaluate the characteristics and synthesis activity of osteoblasts extracted from the calvaria of offspring of rats exposed to maternal hyperthyroidism.Twelve adult Wistar rats were divided into two groups,one cont...To evaluate the characteristics and synthesis activity of osteoblasts extracted from the calvaria of offspring of rats exposed to maternal hyperthyroidism.Twelve adult Wistar rats were divided into two groups,one control and one treated with daily administration of L-thyroxine by an orogastric tube(50μg/animal/day)during pregnancy.Three days after delivery and confirmation of the mothers’hyperthyroidism,the offspring were euthanized for the extraction of osteoblasts from the calvaria.At 7,14,and 21 days,proliferation activity was assessed using MTT assay,while alkaline phosphatase(ALP)activity was assessed by the BCIP/NBT method.At 21 days,the total area of the mineralized matrix stained by von Kossa was evaluated by morphometry.The expression of gene transcripts for Runx2,Bmp2,Fgfr1,collagen type 1(Col1),osteocalcin(Oc),and osteopontin(Op)were evaluated by real-time RT-PCR.Means were compared using the Student’s t-test.FA activity was significantly higher at 14 and 21 days in cultures of osteoblasts extracted from offspring exposed to maternal hyperthyroidism,while MTT conversion was significantly lower at 21 days in this group.Osteoblast cultures of neonates exposed to maternal hyperthyroidism also showed a larger total area of mineralized matrix and greater expression of gene transcripts for Oc and Op.Maternal hyperthyroidism increases the activity of matrix synthesis,alkaline phosphatase activity,and expression of gene transcripts for osteocalcin and osteopontin in the osteoblasts,extracted from the calvaria of the offspring,which may be one of the mechanisms of premature fusion of cranial sutures.展开更多
文摘Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore it is anticipated that thyroid hormones may have a role in the pathogenesis of non alcoholic fatty liver disease(NAFLD) and non alcoholic steatohepatitis(NASH). In this study, we reviewed the current literature on the association between thyroid dysfunction and NAFLD/NASH. A search for English language medical literature reporting an association between thyroid dysfunction and NAFLD/NASH in humans was conducted across PubMed, ISI Web of Science, and Scopus in August, 2013. Out of 140 studies initially identified through the search, 11 relevant articles were included in the final review. Thyroid dysfunctions in the form of overt or subclinical hypothyroidism are prevalent among patients with NAFLD/NASH. Hypothyroidism appears to be an independent risk factor for NAFLD/NASH in some studies; however, other newly published studies failed to find such anassociation. The results of the studies on the role of thyroid abnormalities in NAFLD/NASH are inconsistent, and further research is recommended to determine the relationship between hypothyroidism and NAFLD/NASH and the underlying mechanisms.
基金Supported by National Major Project for Infectious Diseases Control,No.2012ZX10002003-004-003National Natural Science Foundation of China,No.81373056PhD Program Foundation of Ministry of Education of China,No.20090001110081
文摘AIM: To investigate the relationship among pretreatment serum CXC chemokine ligand 10(CXCL10),thyroid peroxidase antibody(TPOAb) levels and thyroid dysfunction(TD) in Chinese hepatitis C patients.METHODS: One hundred and thirty-nine treatmentnaive genotype 1 chronic hepatitis C patients with no history of TD or treatment with thyroid hormones were enrolled in this study.Patients underwent peginterferon alfa-2a/ribavirin(Peg IFNα-2a/RBV) treatment for 48 wk,followed by detection of clinical factors at each follow-up point.Hepatitis C virus(HCV) antibodies were analyzed using microsomal chemiluminescence,and serum HCV RNA was measured by real-time PCR assay at 0,4,12,24 and 48 wk after the initiation of therapy and 24 wk after the end of therapy.To assess thyroid function,serum thyroid stimulating hormone(TSH),free thyroxine(FT4),free triodothyronine(FT3) and TPOAb/thyroglobulin antibody(TGAb) levels were determined using chemiluminescent immunoassays every 3 mo.Serum CXCL10 levels were determined at baseline.RESULTS: The prevalence of TD was 18.0%.Twentyone(84.0%) out of twenty-five patients exhibited normal thyroid function at week 24 after therapy.The rate of sustained virological response to Peg IFNα-2a/RBV in our study was 59.0%(82/139),independent of thyroid function.Pretreatment serum CXCL10 levels were significantly increased in patients with euthyroidstatus compared with patients with TD(495.2 ± 244.2 pg/m L vs 310.0 ± 163.4 pg/m L,P = 0.012).Patients with TD were more frequently TPOAb-positive than non-TD(NTD) patients(24.2% vs 12.3%,P = 0.047) at baseline.Three of the one hundred and fifteen patients without TPOAb at baseline developed TD at the end of treatment(37.5% vs 2.6%,P = 0.000).Female patients exhibited an increased risk for developing TD compared with male patients(P = 0.014).CONCLUSION: Lower pretreatment serum CXCL10 levels are associated with TD,and TD prevalence increases in female patients and patients who are positive for TPOAb at baseline.
基金This study supported by the Chongqing Technology Innovation and Application Development Project(No.cstc2019jscx-msxmX0242)Training program of talent innovation ability of Army Medical Center of PLA,NO.2019CXHLC014。
文摘Iodinated contrast media(ICM)has the potential to cause thyroid dysfunction in some patients.However,it is unclear whether this relationship exists in children.We conducted a systematic review and meta-analysis aim to obtain a general overview of the relationship between ICM exposure and the risk of thyroid dysfunction in children.Methods:Computer search of Web of Science,EMbase,PubMed,Cochrane Library,collection of relevant literature on ICM and thyroid dysfunction in children,the search period was from the establishment of the database to July 2021.Meta-analysis was performed using Stata 14.0 software.Results:A total of 8 literatures with 3497 children.The incidence of hypothyroidism in children with ICM exposure was 0.05(95%CI:0.05,0.12),P<0.0001.Subgroup analysis showed that the incidence of hypothyroidism in ICM exposed children in the European region was 0.21(95%CI:0.13,0.30),P<0.0001,a statistically significant difference.Conclusion:The current evidence shows that children exposed to ICM are at risk for hypothyroidism,with a higher risk in neonates,especially children with congenital heart disease.
基金supported by grants from the National Natural Science Foundation of China (81941024)Tianjin Major Public Health Science and Technology Project (21ZXGWSY00090)+2 种基金National Health Commission of China (SPSYYC 2020015)Food Science and Technology Foundation of Chinese Institute of FoodScience and Technology (2019-12)2014 and 2016 Chinese NutritionSociety (CNS) Nutrition Research Foundation -DSM Research Fund(2016-046, 2014-071 and 2016-023), China
文摘Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction(SCTD).Therefore,we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.Methods:This prospective cohort study investigated 6631 participants(mean age:(45.0±10.2)years;55.1%men).Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire.SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine.Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.Results:During follow-up period,a total of 262 new cases of SCTD were identified,the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years.After adjusting potential confounding factors,the multivariable hazard ratios(95%confidence intervals)for subclinical hypothyroidism were 1.00(reference)for almost never,0.53(0.29,0.97)for 1-3 times/week and 0.30(0.10,0.87)for≥4 times/week(P for trend=0.02).It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals,the final hazard ratios(95%confidence intervals)were 0.14(0.03,0.73)(P for trend<0.01).Conclusions:This population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population,especially in obese individuals.
文摘<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. <b>Materials and Methods:</b> We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. <b>Results: </b>A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 70) years. The main etiology of heart failure was hypertension</span><span style="white-space:normal;font-family:;" "=""> (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 months were more likely to have hypothyroidism (OR: 5.3, [95% CI: 1.3 </span><span style="white-space:normal;font-family:;" "="">-</span><span style="white-space:normal;font-family:;" "=""> 21.5], p = 0.013). <b>Conclusion: </b>The burden of thyroid dysfunction was high in this group of patients with HF. These were mainly low T3 syndrome and sub-clinical hypothyroidism. These were associated with heart failure with reduced ejection fraction and those with more than one hospitalization within the past 12-months</span><span style="white-space:normal;font-family:;" "="">.</span>
基金funded financially by the Vice Chancellor for Research and Technology Development at Qom University of Medical Sciences.
文摘Objective:To evaluate thyroid dysfunction prevalence and its consequences in high-risk pregnant women and their children.Methods:In this retrospective cohort study,data from high-risk pregnant women who were referred to a governmental referral hospital in Qom,Iran from March to August 2022 were collected.The thyroid disorders were determined according to the 2017 American Thyroid Association guidelines.The predictors of a mother's hypothyroidism and its fetal and maternal consequences were assessed.Independent t-test,Chi-square test,and logistic regression were used for bivariate and multivariate analysis.Results:293 women were included.The prevalence of hypothyroidism and hyperthyroidism based on the thyroid stimulating hormone classification was 32.5%and 2.0%.The prevalence of subclinical and overt hypothyroidism was 6.1%and 4.1%,and the prevalence of subclinical and overt hyperthyroidism was 2.4%and 1.4%,respectively.Family history of thyroid disorders was the most important predictor of hypothyroidism during pregnancy(OR=2.6,95%CI=1.0-6.6,P=0.002),while preterm delivery(OR=2.2,95%CI=1.3-6.8,P=0.220)and elevated neonate thyroid stimulating hormone(OR=1.2,95%CI=1.1-1.3,P=0.041)were the most important consequence of hypothyroidism.Conclusions:Hypothyroidism is a highly prevalent thyroid disorder in high-risk pregnant women.Thyroid function screening should be performed in all pregnant women to increase the detection of subclinical and overt hypothyroidism during pregnancy.
基金supported by the National Natural Science Foundation of China(No.22225605)the National Key Research and Development Program of China(No.2023YFC3706600)the Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDB0750200).
文摘The number of newborns born with diseases is increasing recently.Thyroid hormones(THs)are closely related to the growth and development of the newborn in the mother's womb and to the carriage of related diseases after birth.Environmental endocrine-disrupting compounds(EDCs)have been proven to harm THs in newborns.Phthalates(PAEs),a typical class of EDCs,are commonly used in toys,childcare materials,and food contact materials,which have been closely connected with neonatal thyroid dysfunction and thyroid-related diseases.As restrictions on PAEs becomemore stringent in neonatal field,numerous PAE alternatives are emerging.Associations between exposure to PAEs and their alternatives and dysfunctions in THs have been explored.Hence,we summarized the body burdens and regional characteristics of PAEs and their alternatives in neonatal urine,cord blood,and meconium.Subsequently,the influences of PAEs and their alternatives on thyroid dysfunction,prematurity,low birth weight,fetal growth restriction,respiratory dysfunction,immune disorders,neurological disorders,and reproductive disorders in newborns were evaluated.Furthermore,we scrutinized the effects of PAEs and their alternatives on the neonatal thyroid from signaling,substance transport,and hormone production to explore the underlying mechanisms of action on neonatal thyroid and thyroid-related disorders.As the declining global trends of healthy newborns and the potential impacts of PAEs and their alternatives on thyroid function,a more comprehensive study is needed to discuss their effects on newborns and their underlying mechanisms.This review facilitates attention to the effects of PAEs and their alternatives on thyroid and thyroid-related disorders in newborns.
基金Supported by the Natural Science Foundation of Shanghai,No.22ZR1458200Medical Ph.D Innovative Talent Base Project of Changning District,No.RCJD2021B09+1 种基金Key Specialty of Changning District,No.20231004Shanghai Changning Maternity and Infant Health Hospital Start-Up Project,No.2020Y-14.
文摘BACKGROUND Thyroid dysfunction during pregnancy is an important disease affecting the health of mothers and children.Two-dimensional(2D)shear wave elastography(SWE)is the newest ultrasonic elastography technology and its value in differentiating benign and malignant thyroid nodules has been widely recognized.However,the value of 2D SWE in evaluating and predicting thyroid function is unclear.AIM To explore prospectively the value of 2D SWE quantitative analysis for the evaluation of thyroid function in the first trimester.METHODS We included outpatients of reproductive age in the Department of Gynecology in Shanghai Changning Maternity and Infant Health Hospital between March 2023 and March 2024 who had conventional ultrasound examination and 2D SWE of the thyroid.They also underwent transvaginal ultrasound examination to confirm early intrauterine pregnancy and serum thyroid stimulating hormone(TSH)level was measured.The patients were divided into pregnant with normal TSH,pregnant with abnormal TSH,and nonpregnant with normal TSH.Conventional ultrasound and 2D SWE results were compared among the three groups.RESULTS A total of 108 patients were included in the study;57 in the pregnant with normal TSH group,18 in the pregnant with abnormal TSH group and 33 were in the nonpregnant with normal TSH group.Thyroid size,thyroid echotexture,2D SWE quantitative parameters including mean elasticity in the region of interest and maximal elasticity in the region of interest showed no significant differences among the three groups(P>0.05).CONCLUSION Conventional ultrasound and 2D SWE features could not reflect the level of serum TSH.
文摘The increasing longevity of patients with transfusion-dependent homozygous beta-thalassemia has brought endocrine complications to the forefront of longterm care.While iron overload remains a central mechanism,additional contributors such as hypothalamic dysfunction,neurosecretory disturbances,and chronic inflammation have been identified.Endocrine disorders including hypothyroidism,adrenal insufficiency,hypogonadotropic hypogonadism,hypoparathyroidism,osteoporosis,and growth axis impairment-are prevalent and often underdiagnosed.Diagnostic challenges include normal hormone levels in early stages,necessitating the use of dynamic endocrine testing and pituitary magnetic resonance imaging to detect subclinical dysfunction.Risk is modulated by sex,age,and chelation adherence.Early identification and proactive,multidisciplinary management of endocrine sequelae are essential in reducing morbidity and maintaining functional independence in this aging patient population.
文摘构建使用了PD-1抑制剂的肿瘤患者出现甲状腺功能障碍的风险预测模型,分析使用PD-1肿瘤抑制剂导致的甲状腺功能障碍的相关风险因素,设计监测预警系统。选取2020年—2023年广西医科大学附属肿瘤医院1225例使用PD-1抑制剂肿瘤患者的临床资料,包括人口学特征、既往史、实验室检测等63个变量。本文选取相关性前10/20/30/40/50/60个变量的4种传统机器学习模型进行性能比较。通过F1分数、灵敏度、准确率、精确率、特异性曲线下面积(Area Under the Curve,AUC)评估以上预测模型的性能,并利用Shapley加性解释(Shapley Additive Explanation,SHAP)可视化解释本文的机器学习模型。与促甲状腺激素相关性排名前10的变量依次为:羟丁酸脱氢酶、乳酸脱氢酶、淋巴细胞绝对值、天门冬氨酸转移酶、钙离子、碱性磷酸酶、谷氨酰转肽酶、单核细胞绝对值、红细胞分布宽度SD、胆碱酯酶。建立了使用PD-1抑制剂的肿瘤患者出现甲状腺功能障碍的风险预测模型,并在全局解释和局部解释的层面上分别作出模型预测结果影响的解释。
基金sponsored by the Fujian Provincial Health Technology Project[2020CXA020]Fujian Provincial Natural Science Funding[2020J01093]Construction of Fujian Provincial Scientific and Technological Innovation Platform[2019Y2001]
文摘Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.
文摘The improvement in accuracy of in vitro diagnosis has always been the focus of early screening of thyroid dysfunction.We constructed a microfluidic chip based on a polystyrene polymer substrate.Total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyrotropin(TSH) in human whole blood samples were analysed by fluorescence immunoassay to evaluate thyroid function.The results indicate that the microfluidic chip shows a good linear relationship in the detection of TT3,TT4,FT3,FT4,and TS H standards,and the correlation coefficient(r) is not less than0.9900.In addition,the chip also has strong anti-interference(RSD%≤5%) and good repeatability(CV≤8%),and its inter-batch differences are small(CV ≤15%).The results of practical application in clinical thyroid function mea surement indicated its high accuracy(r≥0.9900).It provides a new method for the determination of thyroid function and lays a foundation for subsequent clinical application.
文摘Objective:To investigate the clinical significance of serum thyroid stimulating hormone(TSH) receptor antibody (TRAb) levels and the antithyroid drug(ATDs) use in pregnant women with Graves' disease in their neonatal thyroid function. Methods:The serum TRAb and T3,T4,FT3,FT4,TSH levels in 68 pregnant women with Graves' disease and their newborns were detected by radio receptor assay(RRA) and electrical chemiluminescence immunoassay (ECLIA),respectively.Based on the maternal serum TRAb levels and the use of antithyroid drugs during pregancy, the newborns were divided into different groups.The incidence of neonatal thyroid dysfunction and its risk factors were analyzed. Results:The results showed the incidence of abnormal thyroid function of newborns was 29.4%(20/68).The proportion of neonatal thyroid dysfunction in women with high TRAb levels in the third trimester of pregnancy were significantly higher than these with normal TRAb(P<0.01).In 23 newborns whose mothers were normal in serum TRAb levels and took no ATDs during pregnancy,only one case had thyroid dysfunction within two weeks after birth,while in other 45 newborns whose mothers had a high level of serum TRAb and/or took ATDs during pregnancy, 19 developed thyroid dysfunction within two weeks after birth. Conclusion:Neonatal thyroid function depends on the balance between the transplacental TRAb and ATDs. TRAb measurement in pregnant women with Graves' disease is of significance in evaluation of neonatal thyroid function. Elevated level of serum TRAb in the third trimester of pregnancy is a risk factor for neonatal thyroid dysfunction.
基金supported by grants from the Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)Fundação de Amparo a Pesquisa de Minas Gerais(Fapemig)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior(Capes).
文摘To evaluate the characteristics and synthesis activity of osteoblasts extracted from the calvaria of offspring of rats exposed to maternal hyperthyroidism.Twelve adult Wistar rats were divided into two groups,one control and one treated with daily administration of L-thyroxine by an orogastric tube(50μg/animal/day)during pregnancy.Three days after delivery and confirmation of the mothers’hyperthyroidism,the offspring were euthanized for the extraction of osteoblasts from the calvaria.At 7,14,and 21 days,proliferation activity was assessed using MTT assay,while alkaline phosphatase(ALP)activity was assessed by the BCIP/NBT method.At 21 days,the total area of the mineralized matrix stained by von Kossa was evaluated by morphometry.The expression of gene transcripts for Runx2,Bmp2,Fgfr1,collagen type 1(Col1),osteocalcin(Oc),and osteopontin(Op)were evaluated by real-time RT-PCR.Means were compared using the Student’s t-test.FA activity was significantly higher at 14 and 21 days in cultures of osteoblasts extracted from offspring exposed to maternal hyperthyroidism,while MTT conversion was significantly lower at 21 days in this group.Osteoblast cultures of neonates exposed to maternal hyperthyroidism also showed a larger total area of mineralized matrix and greater expression of gene transcripts for Oc and Op.Maternal hyperthyroidism increases the activity of matrix synthesis,alkaline phosphatase activity,and expression of gene transcripts for osteocalcin and osteopontin in the osteoblasts,extracted from the calvaria of the offspring,which may be one of the mechanisms of premature fusion of cranial sutures.
