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
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
目的:评估免疫检查点抑制剂(ICIs)治疗广泛期小细胞肺癌(ED-SCLC)的疗效及发生免疫相关性甲状腺功能紊乱(ir-TD)的风险。方法:系统检索并分析PubMed、Embase、Cochrane Library、Web of Science和Scopus 5个数据库截至2023年8月所有关于...目的:评估免疫检查点抑制剂(ICIs)治疗广泛期小细胞肺癌(ED-SCLC)的疗效及发生免疫相关性甲状腺功能紊乱(ir-TD)的风险。方法:系统检索并分析PubMed、Embase、Cochrane Library、Web of Science和Scopus 5个数据库截至2023年8月所有关于ICIs治疗ED-SCLC的相关研究。结果:通过筛选951篇相关文献,最终有6项研究共2995例患者被纳入Meta分析。与对照组相比,ICIs治疗能显著延长患者的总生存期(HR:0.74,95%CI:0.68~0.81,P<0.001)及无进展生存期(HR:0.68,95%CI:0.60~0.78,P<0.001),客观缓解率(ORR)(RR:1.11,95%CI:1.01~1.23,P=0.03)也优于对照组。然而,ICIs治疗明显增加了甲状腺功能减退(RR:5.80,95%CI:2.18~15.44,P=0.0004)和甲状腺功能亢进(RR:2.76,95%CI:1.76~4.32,P<0.001)的发生风险。结论:ICIs治疗ED-SCLC能明显改善患者预后,延长患者生存期,整体安全性良好,但增加了ir-TD的发生风险。展开更多
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>
文摘目的:评估免疫检查点抑制剂(ICIs)治疗广泛期小细胞肺癌(ED-SCLC)的疗效及发生免疫相关性甲状腺功能紊乱(ir-TD)的风险。方法:系统检索并分析PubMed、Embase、Cochrane Library、Web of Science和Scopus 5个数据库截至2023年8月所有关于ICIs治疗ED-SCLC的相关研究。结果:通过筛选951篇相关文献,最终有6项研究共2995例患者被纳入Meta分析。与对照组相比,ICIs治疗能显著延长患者的总生存期(HR:0.74,95%CI:0.68~0.81,P<0.001)及无进展生存期(HR:0.68,95%CI:0.60~0.78,P<0.001),客观缓解率(ORR)(RR:1.11,95%CI:1.01~1.23,P=0.03)也优于对照组。然而,ICIs治疗明显增加了甲状腺功能减退(RR:5.80,95%CI:2.18~15.44,P=0.0004)和甲状腺功能亢进(RR:2.76,95%CI:1.76~4.32,P<0.001)的发生风险。结论:ICIs治疗ED-SCLC能明显改善患者预后,延长患者生存期,整体安全性良好,但增加了ir-TD的发生风险。
