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Sample records for subclinical hypothyroidic patients

  1. Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter

    2018-01-01

    OBJECTIVE: Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated...... with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. METHODS: First, 90...... follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03...

  2. Treatment of Subclinical Hypothyroidism in Obese Patients

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    T Demidova

    2008-03-01

    Full Text Available We observed 20 women suffering from adiposity and subclinical hypothyroidism. Lipid spectrum, carbohydrate metabolism, BP and insulinresistance, the extent and variants of fat tissue distribution, a test with physical exercise, all research in dynamics (in the beginning and 6 months after normalization of TSH level against the background of substitution therapy with L-T4 were evaluated. The positive shifts revealed during the afore mentioned research allow us to express our opinion in favour of carrying out substitution therapy with L-T4 at subclinical hypothyroidism .

  3. Comparison of QT dispersion between subclinical hypothyroid and euthyroid patients

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    Muharrem Kıskaç

    2010-06-01

    Full Text Available Objectives: The aim of this study was to investigate the relationship between subclinical hypothyroid and QTc dispersionindicating local heterogeneity in repolarization of myocardium, which is well known as independent cardiac risk factor for sudden death and ventricular arrhythmia.Materials and Methods: We compared QTc dispersion of subclinical hypothyroid patients, after treatment and healthy control group. We included a total of 50 patients with 41 women and 9 men in the study group. Electrocardiographywith 12 derivations, thyroid hormones, serum electrolytes and basic biochemical parameters were measured.The control group consisted of 25 healthy individuals.QT distances were calculated by using Bazet formula. The difference between the longest QTc and the shortest QTc distance was accepted as QTc dispersion (QTcd.Results: Comparison of subclinical hypothyroid patients, their euthyroidic period after treatment and healthy controlgroup, gave no significant differences in age, body weight, body mass index and free thyroxin values. However,significant difference was found in durations of QTd and QTcd between the subclinical hypothyroid, the control and the euthyroidic groups (p0.05.Conclusion: Our results suggested that subclinical hypothyroidpatients had longer QTc dispersion compared to euthyroidic period and healthy subjects. However there was no QTcd difference between the euthyroidic period and healthy control group.

  4. The prevalence of subclinical hypothyroidism among patients with ...

    African Journals Online (AJOL)

    Objective: The purpose of this study was to determine the prevalence of subclinical hypothyroidism among patients with diabetes mellitus at the Kalafong Diabetes Clinic in Pretoria. Design: Cross-sectional study. Setting and subjects: Five hundred and sixty-five patients with diabetes mellitus (type 1, type 2 or unknown), ...

  5. The prevalence of subclinical hypothyroidism among patients with ...

    African Journals Online (AJOL)

    2012-10-03

    Oct 3, 2012 ... Original Research: The prevalence of subclinical hypothyroidism among patients with diabetes mellitus. 106. 2013 Volume 18 No 2. JEMDSA. Introduction. Diabetes mellitus and its associated complications is a major challenge for both the private and state health sector in South Africa. The number of ...

  6. Myocardial Performance Index for Patients with Overt and Subclinical Hypothyroidism.

    Science.gov (United States)

    Karabulut, Aziz; Doğan, Abdullah; Tuzcu, Alpaslan Kemal

    2017-05-25

    BACKGROUND Hypothyroid has several effects on the cardiovascular system. Global myocardial performance index (MPI) is used in assessment of both left ventricular (LV) systolic and diastolic function. We compared MPI in hypothyroidism patients vs. normal control subjects. MATERIAL AND METHODS Eighty-two hypothyroid patients were divided into 2 groups: a subclinical hypothyroid (SH) group (n=50), and an overt hypothyroid (OH) group (n=32). The healthy control group (CG) constituted of 37 patients. TSH, FT3, and FT4, anti-TPO, anti-TG, insulin, lipid values, and fasting glucose levels were studied. All patients underwent an echocardiographic examination. Myocardial performance indexes were assessed and standard echocardiographic examinations were investigated. RESULTS MPI averages in OH, SH, and control groups were 0.53±0.06, 0.51±0.05, and 0.44±0.75 mm, respectively. MPI was increased in the OH and SH groups in comparison to CG (p<0.001, p<0.001, respectively). CONCLUSIONS MPI value was significantly higher in hypothyroid patients in comparison to the control group, showing that regression in global left ventricular functions is an important echocardiographic finding. Future studies are required to determine the effects of this finding on long-term cardiovascular outcomes.

  7. Factors of early atherosclerosis in patients with essential hypertension, obesity and comorbid subclinical hypothyroidism

    OpenAIRE

    Виктория Николаевна Плиговка; Юлия Николаевна Шапошникова

    2015-01-01

    The study identified the factors of early atherosclerosis in patients with essential hypertension and obesity and comorbid subclinical hypothyroidism.Aim: To identify factors that influence the development of atherosclerosis in patients with obesity, hypertension and comorbid subclinical hypothyroidism.Methods. The study involved 75 patients, including 53 patients in the phase of subclinical hypothyroidism and 22 patients in the phase of euthyroidism. All the patients underwent measurement of...

  8. Increased left atrial pressure in non-heart failure patients with subclinical hypothyroidism and atrial fibrillation

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    Akinori Sairaku

    2016-05-01

    Full Text Available Background The impact of subclinical hypothyroidism on the cardiovascular risk is still debated. We aimed to measure the relationship between subclinical hypothyroidism and the left atrial (LA pressure. Methods The LA pressures and thyroid function were measured in consecutive patients undergoing atrial fibrillation (AF ablation, who did not have any known heart failure, structural heart disease, or overt thyroid disease. Results Subclinical hypothyroidism (4.5≤ thyroid-stimulating hormone 18 mmHg (odds ratio 3.94, 95% CI 1.28 11.2; P = 0.02. Conclusions Subclinical hypothyroidism may increase the LA pressure in AF patients.

  9. Long-Term Outcome in Levothyroxine Treated Patients With Subclinical Hypothyroidism and Concomitant Heart Disease

    DEFF Research Database (Denmark)

    Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager

    2016-01-01

    CONTEXT: Subclinical hypothyroidism is a common condition that may lead to impaired cardiac function. OBJECTIVE: This study sought to examine the effects of levothyroxine treatment in patients with subclinical hypothyroidism and heart disease. DESIGN: This was a register-based historical cohort...... study. SETTING AND PARTICIPANTS: The study was composed of Danish primary care patients and hospital outpatients age 18 years and older with established heart disease who were diagnosed with subclinical hypothyroidism in 1997-2011. Patients were stratified according to whether they claimed a subsequent...... myocardial infaction and stroke, and all-cause hospital admissions. RESULTS: Of 61 611 patients with a diagnosis of cardiac disease having their first time thyroid function testing, 1192 patients with subclinical hypothyroidism (mean age 73.6 [SD ± 13.3] y, 63.8% female) were included, of whom 136 (11...

  10. Factors of early atherosclerosis in patients with essential hypertension, obesity and comorbid subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Виктория Николаевна Плиговка

    2015-05-01

    Full Text Available The study identified the factors of early atherosclerosis in patients with essential hypertension and obesity and comorbid subclinical hypothyroidism.Aim: To identify factors that influence the development of atherosclerosis in patients with obesity, hypertension and comorbid subclinical hypothyroidism.Methods. The study involved 75 patients, including 53 patients in the phase of subclinical hypothyroidism and 22 patients in the phase of euthyroidism. All the patients underwent measurement of anthropometric parameters. They were identified lipid profile, CRP, TSH, T4. Determination of IMT was performed using color Doppler ultrasound machine with a 7.5 MHz linear transducer. Statistical analysis was performed using the software SPSS 13.0.Results. A study of patients showed that the comparison group matched for age, sex, BMI. The levels of atherogenic lipids and CRP were statistically higher in the subclinical hypothyroidism group compared with the control group. A mathematical analysis showed that TSH affects indicators such as the IMT, CRP and BMI.In subclinical hypothyroidism group were statistically significantly higher levels of atherogenic lipids, CRP as compared with the control group. Mathematical analysis showed that the significant factors affecting the development of atherosclerosis in patients with obesity, hypertension and subclinical hypothyroidism are the level of thyroid-stimulating hormone, CRP and BMI.Conclusions: Significant factors affecting the development of atherosclerosis in patients with obesity, hypertension and subclinical hypothyroidism is the TSH, CRP and BMI. The level of TSH above 10.2 mIU/L is associated with the development of atherosclerosis in patients with obesity, hypertension and subclinical hypothyroidism

  11. Subclinical hypothyroidism in childhood.

    LENUS (Irish Health Repository)

    O'Grady, M J

    2012-02-01

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) in association with a normal total or free thyroxine (T4) or triiodothyronine (T3). It is frequently encountered in both neonatology and general paediatric practice; however, its clinical significance is widely debated. Currently there is no broad consensus on the investigation and treatment of these patients; specifically who to treat and what cut-off level of TSH should be used. This paper reviews the available evidence regarding investigation, treatments and outcomes reported for childhood SH.

  12. Selenium supplementation could restore euthyroidism in subclinical hypothyroid patients with autoimmune thyroiditis.

    Science.gov (United States)

    Pirola, Ilenia; Gandossi, Elena; Agosti, Barbara; Delbarba, Andrea; Cappelli, Carlo

    2016-01-01

    The thyroid is an organ with one of the highest selenium concentrations, containing many selenoproteins implicated in thyroid hormone metabolism. Treatment with levothyroxine has been recommended for all subclinical hypothyroid patients with TSH levels > 10 mU/L, whereas for those with TSHSelenium supplementation could restore euthyroidism in one third of subclinical hypothyroidism patients with autoimmune thyroiditis. (Endokrynol Pol 2016; 67 (6): 567-571).

  13. Subclinical hypothyroidism and diabetic nephropathy in Iranian patients with type 2 diabetes.

    Science.gov (United States)

    Mansournia, N; Riyahi, S; Tofangchiha, S; Mansournia, M A; Riahi, M; Heidari, Z; Hazrati, E

    2017-03-01

    Association of subclinical hypothyroidism with type 2 diabetes and its complications has been previously documented. These reports were, however, inconclusive and mainly gathered from Chinese and East Asian populations. In this study, we aimed to determine the prevalence of subclinical hypothyroidism and its relationship with diabetic nephropathy in Iranian individuals with type 2 diabetes, drawn from a white Middle Eastern population with an increasing prevalence of diabetes. In this cross-sectional study, 255 Iranian participants with type 2 diabetes and without history of thyroid disorders were included. Patients with TSH > 4.2 mIU/L and normal T4 were classified as having subclinical hypothyroidism. Diabetic nephropathy was diagnosed based on abnormal 24-h urinary albumin or protein measurements (24-h urinary albumin ≥30 mg/day or 24-h urinary protein ≥150 mg/day). Multivariate logistic regression was employed to obtain the OR for the relationship between subclinical hypothyroidism and diabetic nephropathy. We found that subclinical hypothyroidism and diabetic nephropathy were as prevalent as 18.1 and 41.2 %, respectively, among the participants. We also found that subclinical hypothyroidism was independently associated with higher rates of diabetic nephropathy, after multivariable adjustment (OR [95 % CI] 3.23 [1.42-7.37], p = 0.005). We found that the prevalence of subclinical hypothyroidism in Iranian diabetic population was among the highest rates reported to date. Our data supported the independent association of subclinical hypothyroidism with diabetic nephropathy, calling for further investigations to evaluate their longitudinal associations.

  14. P300 event related potential application to cognitive status assessment of the patients with subclinical hypothyroidism

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    Dejanović M.

    2015-01-01

    Full Text Available Disturbances of thyroid function are often accompanied by cognitive and affective disorders. Assessment of cognitive status in the patients with subclinical hypothyroidism represents a possibility for early diagnostics of cognitive impairment and timely introduction of necessary pharmacotherapy treatment. The aim of this study was to quantify whether there are P3 event related potential (ERP deviations as electrophysiological markers of cognitive activity in patients with subclinical hypothyroidism. P300 potentials were examined in thirty patients with subclinical hypothyroidism and in 30 healthy subjects of the control group. P300 was recorded using the classic auditory oddball paradigm, with 20% of target and 80% of non-target stimuli. The results analysis showed a significantly longer latency P300 and reduced amplitude P300 in subjects with subclinical hypothyroidism compared to euthyroid subjects. There is also a statistically significant negative correlation between the results of a mini mental state examination and the P300 latency at Fz electrode (r= -0.47, p <0.01 and Cz electrode (r= -0.43, p =0.017. P300 ERP is important in the evaluation of patients with subclinical hypothyroidism, due to the sensitivity in the detection cognitive disorders.

  15. Levothyroxine Substitution in Patients with Subclinical Hypothyroidism and the Risk of Myocardial Infarction and Mortality

    DEFF Research Database (Denmark)

    Andersen, Mette Nygaard; Olsen, Anne-Marie Schjerning; Madsen, Jesper Clausager

    2015-01-01

    BACKGROUND: Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects...... of levothyroxine treatment on myocardial infarction (MI), cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism. METHODS AND RESULTS: Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled. Participants were...... identified by individual-level linkage of nationwide registers. Patients with subclinical hypothyroidism at baseline were included in the study. Exclusion criteria included a history of thyroid disease, related medication or medication affecting thyroid function. The total cohort comprised 628,953 patients...

  16. [Improvement in functional capacity after levothyroxine treatment in patients with chronic heart failure and subclinical hypothyroidism].

    Science.gov (United States)

    Curotto Grasiosi, Jorge; Peressotti, Bruno; Machado, Rogelio A; Filipini, Eduardo C; Angel, Adriana; Delgado, Jorge; Cortez Quiroga, Gustavo A; Rus Mansilla, Carmen; Martínez Quesada, María del Mar; Degregorio, Alejandro; Cordero, Diego J; Dak, Marcelo; Izurieta, Carlos; Esper, Ricardo J

    2013-10-01

    To assess whether levothyroxine treatment improves functional capacity in patients with chronic heart failure (New York Heart Association class i-iii) and subclinical hypothyroidism. One hundred and sixty-three outpatients with stable chronic heart failure followed up for at least 6 months were enrolled. A physical examination was performed, and laboratory tests including thyroid hormone levels, Doppler echocardiogram, radionuclide ventriculography, and Holter monitoring were requested. Functional capacity was assessed by of the 6-min walk test. Patients with subclinical hypothyroidism were detected and, after undergoing the s6-min walk test, were given replacement therapy. When they reached normal thyrotropin (TSH) levels, the 6-min walk test was performed again. The distance walked in both tests was recorded, and the difference in meters covered by each patient was analyzed. Prevalence of subclinical hypothyroidism in patients with heart failure was 13%. These patients walked 292±63m while they were hypothyroid and 350±76m when TSH levels returned to normal, a difference of 58±11m (P<.011). Patients with normal baseline TSH levels showed no significant difference between the 2 6-min walk tests. Patients with chronic heart failure and subclinical hypothyroidism significantly improved their physical performance when normal TSH levels were reached. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  17. [Rational therapy of patients with essential hypertension and abdominal obesity with concomitant subclinical hypothyroidism].

    Science.gov (United States)

    Pligovka, V M

    2014-11-01

    It was determined the characteristics of lipid status of patients with essential hypertension, abdominal obesity with concomitant subclinical hypothyroidism--mostly increased levels of total and LDL cholesterol. In assessing the effectiveness of statin therapy in combination with levothyroxine replacement therapy compared with statin monotherapy, combination therapy showed the best result in terms of achievement of target levels of both total cholesterol and LDL. The obtained results allow us to recommend the use of combination therapy for patients with hypertension, abdominal obesity with concomitant subclinical hypothyroidism in order to achieve the target values of LDL and thus to reduce the cardiovascular risk of these patients.

  18. SUBCLINICAL HYPOTHYROIDISM IN METABOLIC SYNDROME AND ROLE OF CRP IN 50 ADULT PATIENTS

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    Pratik Shah

    2017-04-01

    Full Text Available BACKGROUND Metabolic Syndrome (MetS is generally characterised as a clustering of the abnormal levels of blood lipids (low HDL and high triglycerides, impaired fasting glucose, elevated blood pressure, and excess abdominal obesity. The objectives of the study areTo evaluate presence of Subclinical Hypothyroidism in the study population of the patients with metabolic syndrome. To find out relation between Subclinical Hypothyroidism and different parameters of metabolic syndrome. To evaluate whether patients of metabolic syndrome with raised hs-CRP have an increased risk of having hypothyroidism. MATERIALS AND METHODS A total of 50 adult patients who met with inclusion criteria were selected. Patients with metabolic syndrome (MetS who fulfilled the NCEP-ATP III criteria: 3 out of 5 criteria positive. Patients with liver disorders, renal disorders, congestive cardiac failure, pregnant women, patients on oral contraceptive pills, statins and other medications that alter thyroid functions (e.g. lithium, amiodarone or γ-interferon were excluded from the study. RESULTS A total of 50 patients of metabolic syndrome were enrolled. Out of which 36 were euthyroid, 3 were overt hypothyroid and 11 were subclinical hypothyroid. Out of 11 patients of subclinical hypothyroidism, 9 were female and 2 were male patients. Out of 28 females, 9 (32% were SCH while out of 22 males, 2 (9% were SCH. Out of 50 patients, 3 were overt hypothyroid. All 3 patients had BP >130/85, waist circumference was >88 cm and HDL of 130/85, HDL 150 mg/dL and fasting blood glucose of >100 mg/dL were more associated with male patients. CONCLUSION Subclinical Hypothyroidism was present in 22% of study population and more so in females having metabolic syndrome (32%. Hence, it will be worthwhile to screen female metabolic syndrome patients for thyroid function abnormality. Abnormal blood pressure, triglycerides and HDL cholesterol levels were more associated with subclinical hypothyroidism

  19. [Prevalence of subclinical hypothyroidism in pediatric patients with drug-resistant epilepsy].

    Science.gov (United States)

    Aparicio-Claure, Adriana Lorena; Rayo-Mares, Jesús Darío; Nishimura-Meguro, Elisa; Herrera-Márquez, Julia Rocío; Muñoz-Montúfar, Juan Pablo; Núñez-Enríquez, Juan Carlos

    2017-01-01

    In several studies it has been reported a high prevalence of subclinical hypothyroidism in children with epilepsy secondary to the use of monotherapy with valproic acid, carbamazepine and phenytoin. The aim of this article is to determine the prevalence of subclinical hypothyroidism in children with drug-resistant epilepsy treated at the Pediatric Neurology Service of the Hospital de Pediatría, Centro Médico Nacional Siglo XXI in Mexico City. We conducted a descriptive cross-sectional study. All pediatric patients with drug-resistant epilepsy and without structural alteration seen at the pediatric neurology service of our hospital between January 1 and June 1 2015 were included. Results: Prevalence of subclinical hypothyroidism in our sample was of 25%, with most patients receiving polytherapy with valproic acid. The intentional searching for subclinical hypothyroidism in pediatric patients with drug-resistant epilepsy without structural alteration might be considered as part of routine medical care and patients receiving combination therapy with valproic acid they should be considered as a subgroup with an increased risk of developing such comorbidity.

  20. Levothyroxine Substitution in Patients with Subclinical Hypothyroidism and the Risk of Myocardial Infarction and Mortality.

    Directory of Open Access Journals (Sweden)

    Mette Nygaard Andersen

    Full Text Available Subclinical hypothyroidism is associated with a number of cardiovascular risk factors, yet only limited data exist on long-term outcome of levothyroxine treatment of this condition with respect to hard end-points. The aim of this retrospective cohort study was to determine effects of levothyroxine treatment on myocardial infarction (MI, cardiovascular death and all-cause mortality, in patients with subclinical hypothyroidism.Primary care patients aged 18 years and older that underwent thyroid function tests between 2000 and 2009 were enrolled. Participants were identified by individual-level linkage of nationwide registers. Patients with subclinical hypothyroidism at baseline were included in the study. Exclusion criteria included a history of thyroid disease, related medication or medication affecting thyroid function. The total cohort comprised 628,953 patients of which 12,212 (1.9% had subclinical hypothyroidism (mean age 55.2 [SD ± 18.8] years; 79.8% female. Within the first six months 2,483 (20.3% patients claimed a prescription for levothyroxine. During a median follow-up of 5.0 (IQR: 5.2 years, 358 MI's and 1,566 (12.8% deaths were observed. Out of these, 766 of the deaths were cardiovascular related. No beneficial effects were found in levothyroxine treated patients on MI (IRR 1.08 [95% CI: 0.81 to 1.44], cardiovascular death (IRR 1.02 [95% CI: 0.83 to 1.25] or all-cause mortality (IRR 1.03 [95% CI: 0.90 to 1.19], except in patients under the age of 65 years (IRR 0.63 [95% CI: 0.40 to 0.99].Levothyroxine substitution in subclinical hypothyroid patients does not indicate an association with lower mortality or decreased risk of MI.

  1. Comparison of Pre and Post-Treatment Orexin A Levels in Patients with Subclinical Hypothyroidism

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    Muhammed Erdal

    2010-01-01

    Full Text Available Aim: Subclinical hypothyroidism is a clinical condition mostly observed in women, the prevalence of which increases by age. Sleepiness and appetite problems are observed in subclinical hypothyroidism. Orexins play a role in the physiological regulations like the stabilization of cardiovascular functions and the sleep-alert cycle. Similarities in the physiological regulation areas of orexins and the clinical findings of hypothyroidism were influential in the planning of this research. Additionally, homosisteine, which is influential on the cardiovascular system and the plasma level of which changes by eating (as is the case with orexins, was also analyzed. Besides, the change in the lipid profiles of the patients was also observed. Material and Methods: Nineteen pre-menopausal female patients (mean age=39.58±12.58, mean BMI= 26.7±4.9 included in this study. Following 12 hours fasting blood samples were taken from brachial vein. All patients were given 50µg/day L-T4 TSH levels were examined in every 4-6 weeks to adjust the L-T4 doses. When euthyroidism was ensured, a re-evaluation was made 4 months later. Results:  Pre-treatment plasma orexin A levels of 19 patients with pre-menopausal subclinical hypothyroidism increased significantly following a treatment of l-tiroxin for 4 months (pre-treatment orexin level median=1.20 mg/dl (mean: 1.33±0.28 post-treatment median=1.82 mg/dl (mean: 1.70±0.42 p=0.007. A significant change in the level of plasma total homosisteine and lipid profile was not detected. Conclusions: Advanced studies are needed to study the physiological effects of orexin levels in cases with subclinical hypothyroidism and the possible benefits in treatment.

  2. Natural Course of Subclinical Hypothyroidism

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    J P Sytch

    2005-03-01

    Full Text Available Objectives of this retrospective study were to evaluate the natural course of subclinical hypothyroidism (SH and to estimate possible predictable factors of overt hypothyroidism. Population of the study was selected from the patients with spontaneously elevated thyrotropin (TSH and normal free thyroxin (fT4 levels. Overall 87 patients (12 male, 75 female with SH without any therapy with thyroid hormones or iodide drugs or without previous thyroid surgery, thyrostatic therapy, or radioactive iodine therapy were included in the analysis. Results: the main risk factors of overt hypothyroidism in this population were positive thyroid antibodies (odds ratio = 3.99 and high initial level of TSH (>8 mU/l (odds ratio = 4.77. Patient’s age, gender or duration of SH did not affect significantly the risk of overt hypothyroidism. Conclusions: rational substitutive therapy with thyroid hormones was not discussed in this study, however the data suggest that positive thyroid antibodies and relatively high TSH level may be useful to decide upon such therapy in individuals with SH. Key words: hypothyroidism, Hashimotos, thyroiditis, thyrotropin.

  3. Serum cholesterol and triglyceride concentrations in diabetic patients with subclinical hypothyroidism.

    Science.gov (United States)

    Díez, Juan J; Iglesias, Pedro

    2014-10-01

    To assess whether subclinical hypothyroidism is associated to elevations in serum cholesterol and triglyceride levels in patients with type 2 diabetes. From a total population of 1,112 patients with type 2 diabetes screened for thyroid dysfunction (thyrotropin measurement), a group of 325 patients with normal thyroid function and another group of 29 patients with subclinical hypothyroidism were selected. No patient had known dyslipidemia or was taking lipid lowering medication. Patients with subclinical hypothyroidism had serum levels of total cholesterol (4.88 ± 0.74 mmol/L), HDL cholesterol (1.37 ± 0.34 mmol/L), LDL cholesterol (2.94 ± 0.58 mmol/L), and triglycerides (1.05 [0.88-1.41] mmol/L) that did not significantly differ from those found in euthyroid patients (4.79 ± 0.83, 1.33 ± 0.36, 2.87 ± 0.76, and 1.11 [0.81-1.43] mmol/L, respectively). Multiple regression analysis showed no association between TSH and serum lipid levels. These results suggest that, in our population, there are no significant differences in serum cholesterol and triglyceride levels between diabetic patients with normal and reduced thyroid function. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  4. FEATURES PREGNANCY AND BIRTH OUTCOMES IN PATIENTS WITH SUBCLINICAL HYPOTHYROIDISM, LIVING IN THE FAR NORTH

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    Елена Николаевна Кравченко

    2017-02-01

    Results. The medication correction of subclinical hypothyroidism in pregnant women in extreme north indicated less thyroid gland, than in women without medication correcting this condition. In newborns of mothers with subclinical hypothyroidism, there has been an increase in the size of the thyroid gland and reduced Apgar score.

  5. Spontaneous Bacterial Peritonitis in Subclinical Hypothyroidism

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    Dalip Gupta

    2013-11-01

    Full Text Available Hypothyroidism is an uncommon cause of ascites. Here we describe a case of a 75 year-old female patient with spontaneous bacterial peritonitis and subclinical hypothyroidism that resolved with thyroid replacement and antibiotic therapy respectively. Ascitic fluid analysis revealed a gram-positive bacterium on gram staining. A review of the literature revealed just one other reported case of myxoedema ascites with concomitant spontaneous bacterial peritonitis and no case has till been reported of spontaneous bacterial peritonitis in subclinical hypothyroidism.

  6. Pattern of Altered Lipid Profile in Patients with Subclinical and Clinical Hypothyroidism and its Correlation with Body Mass Index.

    Science.gov (United States)

    Humerah, Sobia; Siddiqui, Arif; Khan, Humaira Fayyaz

    2016-06-01

    To compare the lipid profile of the subclinical and clinical hypothyroid patients and to evaluate the correlation between body mass index (BMI) and lipid profile in hypothyroidism. Cross-sectional study. Islamic International Medical College, Riphah International University, Islamabad, and Citi Laboratory, Rawalpindi, from January to December 2013. The subjects were selected through non-probability, purposive sampling. On the basis of thyroid profile, the subjects were divided into 3 groups: euthyroids (n=20), subclinical hypothyroids (n=50), and clinical hypothyroids (n=30). The blood of these subjects was then analyzed for lipid profile. Data was analyzed using SPSS version 18 statistical software. Both hypothyroid groups showed altered lipid profile which was observed to be significantly raised when compared with the euthyroid subjects. Comparison of lipid profile in euthyroid, subclinical, and clinical hypothyroid groups showed significant differences by non-parametric tests (p Hypothyroidism causes alteration of lipid profile. Clinical and subclinical hypothyroid patients have altered lipid profile as compared to euthyroids. Thyroid status monitoring is very important, since it can induce changes in lipid profile. Such dyslipidemic status is significant not only for the management of thyroid disorders but also for common diseases like obesity and coronary atherosclerosis in the population.

  7. Subclinical hypothyroidism: A common finding in adult patients with cyanotic congenital heart disease.

    Science.gov (United States)

    Bak, Peter; Hjortshøj, Cristel S; Gaede, Peter; Idorn, Lars; Søndergaard, Lars; Jensen, Annette S

    2017-12-27

    Cyanotic congenital heart disease is a systemic disease, with effects on multiple organ systems. A high prevalence of subclinical hypothyroidism (SCH) has been reported in a small cohort of cyanotic congenital heart disease patients. Subclinical hypothyroidism has been associated with various adverse cardiovascular effects, as well as an increased risk of progression to overt hypothyroidism. The aim of this study was to examine the prevalence of SCH in cyanotic congenital heart disease patients, consider possible etiologies, and evaluate thyroid function over time. First, 90 clinically stable cyanotic congenital heart disease patients were examined with blood samples (thyroid-stimulating hormone, C-reactive protein, hemoglobin, hematocrit, and N-terminal pro-brain-natriuretic peptide) in a cross-sectional descriptive study. Second, a longitudinal follow-up study of 43 patients originating from the first study part, was carried out. These patients had thyroid function parameters (thyroid-stimulating hormone, thyroid hormones, and thyroid peroxidase antibodies) evaluated biannually. Elevated thyroid-stimulating hormone was present in 24% of the 90 screened patients. During follow-up (6.5 ± 1.0 years), SCH (defined as ≥2 consecutive elevated thyroid-stimulating hormone values) was present in 26%. Three patients progressed to overt hypothyroidism. Patients with SCH were younger (34 ± 12 vs 42 ± 16 years; P = .01) and had a lower oxygen saturation (80 ± 5 vs 84 ± 6%; P = .03). Subclinical hypothyroidism is a very common finding in cyanotic congenital heart disease. This is not associated with increased levels of C-reactive protein, heart failure, or autoimmunity but appears to be associated with cyanosis and age. Since the clinical impact of SCH is uncertain, further studies are needed to determine this. Regular thyroid evaluation is recommended in cyanotic congenital heart disease patients since SCH can develop to overt hypothyroidism. © 2017

  8. Follow-up of congenital heart disease patients with subclinical hypothyroidism.

    Science.gov (United States)

    Martínez-Quintana, Efrén; Rodríguez-González, Fayna

    2015-08-01

    Subclinical hypothyroidism or mild thyroid failure is a common problem in patients without known thyroid disease. Demographic and analytical data were collected in 309, of which 181 were male and 128 were female, congenital heart disease (CHD) patients. CHD patients with thyroid-stimulating hormone above 5.5 mIU/L were also followed up from an analytical point of view to determine changes in serum glucose, cholesterol, N-terminal pro b-type natriuretic peptide, and C-reactive protein concentrations. Of the CHD patients, 35 (11.3%) showed thyroid-stimulating hormone concentration above 5.5 mIU/L. Of them, 27 were followed up during 2.4±1.2 years - 10 were under thyroid hormone replacement treatment, and 17 were not. Of the 27 patients (25.9%), 7 with subclinical hypothyroidism had positive anti-thyroid peroxidase, and 3 of them (42.8%) with positive anti-thyroid peroxidase had Down syndrome. Down syndrome and hypoxaemic CHD patients showed higher thyroid-stimulating hormone concentrations than the rest of the congenital patients (puric acid, lipids, C-reactive protein, or N-terminal pro b-type natriuretic peptide concentrations before and after the follow-up in those CHD patients with thyroid-stimulating hormone above 5.5 mIU/L whether or not they received levothyroxine therapy. CHD patients with subclinical hypothyroidism showed no significant changes in serum thyroxine, cholesterol, C-reactive protein, or N-terminal pro b-type natriuretic peptide concentrations whether or not they were treated with thyroid hormone replacement therapy.

  9. Anesthetic Management of a Surgical Patient with Chronic Renal Tubular Acidosis Complicated by Subclinical Hypothyroidism

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    Hiroe Yoshioka

    2016-01-01

    Full Text Available A 53-year-old man with chronic renal tubular acidosis and subclinical hypothyroidism underwent lower leg amputation surgery under general anesthesia. Perioperative acid-base management in such patients poses many difficulties because both pathophysiologies have the potential to complicate the interpretation of capnometry and arterial blood gas analysis data; inappropriate correction of chronic metabolic acidosis may lead to postoperative respiratory deterioration. We discuss the management of perioperative acidosis in order to achieve successful weaning from mechanical ventilation and promise a complete recovery from anesthesia.

  10. Iodine deficiency and subclinical hypothyroidism are common in cystic fibrosis patients.

    Science.gov (United States)

    Naehrlich, Lutz; Dörr, Helmuth-Günther; Bagheri-Behrouzi, Azadeh; Rauh, Manfred

    2013-04-01

    Disorders of thyroid function have been inconsistently described in cystic fibrosis (CF) patients and in CF transmembrane regulator protein knockout animals. The literature lacks reports on iodine status of CF individuals. We hypothesize, that iodine deficiency is common in CF and account for abnormal thyroid function in CF patients. We investigated 129 children, adolescents, and adults with CF, who were living in the northern part of Bavaria/Germany. Malnutrition and lung function were analyzed. Urinary iodine excretion, TSH (thyroid-stimulating hormone), and ft4 (free thyroxine) were measured and set in relation to population-based, age-adjusted reference ranges. Subclinical hypothyroidism (normal fT4, elevated TSH) was found in 11.6% of subjects, and iodine deficiency in 83.7%. No correlations were found with age, BMI, status of malnutrition, or lung function. Dramatic iodine deficiency was found in our cohort of CF patients. This condition can cause subclinical hypothyroidism; therefore, an individual iodine supplementation program is necessary and should be started immediately. Crown Copyright © 2012. Published by Elsevier GmbH. All rights reserved.

  11. [Subclinical hypothyroidism and cardiovascular risk factors].

    Science.gov (United States)

    Frías López, Ma del C; Tárraga López, P J; Rodríguez Montes, J A; Solera Albero, J; Celada Rodríguez, A; López Cara, M A; Gálvez, A

    2011-01-01

    To determine the prevalence of subclinical hypothyroidism in the general population of an urban health center and describe the clinical characteristics and cardiovascular risk factors in patients with subclinical hypothyroidism. An observational study, retrospective, reviewing the medical histories of patients sampled from June 2005 until July 2007. We analyzed the following variables; facts: age and sex. Family history thyroid disease and other diseases. Personal History: cardiovascular pulmonary autoimmune, alterations gynecology obstetric diabetes, hypertension (HT) dislipemia, obesity, psychiatric alterations and haematological. Laboratory data: novel TSH, free T4, antiperoxidase antibodies, total cholesterol and its fractions. The prevalence of the sample of 100 patients collected over 8 months was 3.8% in the general population over 14 years, of which 79 were women and 21 were men. 13% were type 2 diabetics, 23% had HT and 40% had dyslipidemia. Overweight and obesity were present in 26%. The average level of TSH was 6.92 ± 2.29 μU/ml and the average level of free T4 was 1.16 ± 0.16 ng/ml. Prevalence subclinical hypothyroidism was 3.8%. especially in women with a mean age of 46. The incidence of cardiovascular risk factors in the subjects studied is higher in DM (13%), similar to general population in terms of dyslipidemia (40%) and obesity (23%) and lowest in hypertension (23%). In our study we observed a common pattern in the management of subclinical hypothyroidism, requiring the implementation and promotion of practice guidelines in primary care.

  12. Subclinical hypothyroidism and its relation to obesity in patients before and after Roux-en-Y gastric bypass

    NARCIS (Netherlands)

    Janssen, I.M.C.; Homan, J.; Schijns, W.; Betzel, B; Aarts, E.O.; Berends, F.J.; Boer, H

    2015-01-01

    BACKGROUND: Subclinical hypothyroidism (SH), defined as a raised serum thyroid-stimulating hormone (TSH) with a normal free thyroxine (FT4), is occasionally observed in morbidly obese patients. OBJECTIVES: It is currently not known whether thyroid hormone treatment is indicated. The aim of the

  13. [Effect of treatment with levothyroxine in the lipid profile of the patients with subclinical hypothyroidism].

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    Prats Julià, Montserrat

    2009-01-01

    Controversy surrounds the issue of whether levothyroxine treatment improves lipid profile in patients with subclinical hypothyroidism (SHT). The objective was to detect substantial differences -> or = 20% in total cholesterol (TC) and > or = 15 mg/dl in low-density lipoprotein cholesterol (LDL-c)- in the lipid profiles of patients with subclinical hypothyroidism (SHT) after initiating levothyroxine replacement therapy (T4). Observational retrospective cohort study with paired data. Primary care center in Manresa (Barcelona). 100 patients with SHT treated with levothyroxine. Demographic and clinical variables from the clinical history, as well as temporal data -SHT diagnosis, beginning of T4 treatment and thyroid-stimulating hormone (TSH) normalization, and the quantity of T4 administered to treat SHT-were gathered. Data for TSH, lipid profile and body mass index were recorded at specific moments (beginning of treatment, after 6-18 months on T4, at the euthyroidism stage, and the last value registered in the previous 12 months). The mean age was 61+/-15 [95% confidence interval (CI), 46-76] years and 95% of the patients were women. Obesity was found in 40%, high blood pressure in 39%, dyslipidemia in 37%, diabetes mellitus in 10%, smoking in 7%, and cardiovascular disease in 6% of the patients. No significant differences were detected in TC or in LDL-c after treatment with levothyroxine. Nonsignificant reductions were found in TC (-4 mg/dl; p=0.77) and LDL-c (-10 mg/dl; p=0.31) when euthyroidism was achieved, as well as in TC (-10mg/dl; p=0.58) after 5+/-3 years of treatment. Levothyroxine treatment in patients with SHT does not lead to substantial reductions in TC or LDL-c, independently of TSH concentrations prior to treatment.

  14. Subclinical hypothyroidism: how should it be managed?

    Science.gov (United States)

    Fatourechi, Vahab

    2002-01-01

    The term 'subclinical hypothyroidism' applies to patients who have mildly increased levels of serum thyrotropin hormone (TSH) and normal levels of thyroxine and liothyronine (triiodiothyronine). This very common condition, also called 'mild thyroid failure', accounts for 75% of patients who have increased serum TSH. For patients with sustained increases above 10 mIU/L, there is uniform agreement that thyroxine therapy is indicated. Therapy for milder forms of hypothyroidism is controversial. Some randomized clinical trials favor therapy for mild thyroid failure, but they are inconclusive because they lack stratification for the subgroup of patients with TSH levels below 10 mIU/L. For this subgroup, we recommend individualized management. The presence of goiter, positive thyroperoxidase (TPO) antibodies, manic-depressive disorder, fertility problems, or pregnancy or the anticipation of pregnancy favors the initiation of therapy. Positive TPO antibodies are a strong indication for therapy because of the high likelihood in these patients of progression to overt hypothyroidism; patients who are already receiving thyroxine should have adjustments of their dosage. Children and adolescents with mild thyroid failure should also be treated because of possible adverse effects on growth and development. It has been suggested that subclinical hypothyroidism is a cardiovascular risk factor, however further investigation is needed. The controversy surrounding therapy will not be resolved until more randomized studies are available for the subgroup of patients with TSH <10 mIU/L, and until the question of cardiovascular risk factors is further clarified.

  15. Subclinical hypothyroidism in obese children

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    Aleksandra Januszek-Trzciąkowska

    2013-08-01

    Full Text Available Subclinical hypothyroidism (SH is defined as an elevated thyroid stimulating hormone (TSH associated with normal levels of free thyroxine. In obese persons prevalence of SH is significantly higher than in general population. SH is of particular interest in children with respect to the crucial role of thyroid hormones in the development of central nervous system and linear growth. Currently there is no general consensus on the treatment of SH with L-tyroxine. It is suggested that this hormonal state is rather a consequence that the cause of the overweight status.

  16. [Subclinical hypothyroidism in obese children].

    Science.gov (United States)

    Januszek-Trzciąkowska, Aleksandra; Małecka-Tendera, Ewa

    2013-08-05

    Subclinical hypothyroidism (SH) is defined as an elevated thyroid stimulating hormone (TSH) associated with normal levels of free thyroxine. In obese persons prevalence of SH is significantly higher than in general population. SH is of particular interest in children with respect to the crucial role of thyroid hormones in the development of central nervous system and linear growth. Currently there is no general consensus on the treatment of SH with L-tyroxine. It is suggested that this hormonal state is rather a consequence that the cause of the overweight status.

  17. Thyroxine treatment may be useful for subclinical hypothyroidism in patients with female infertility.

    Science.gov (United States)

    Yoshioka, Waka; Amino, Nobuyuki; Ide, Akane; Kang, Shino; Kudo, Takumi; Nishihara, Eijun; Ito, Mitsuru; Nakamura, Hirotoshi; Miyauchi, Akira

    2015-01-01

    Infertile women sometimes associated with subclinical hypothyroidism (SCH). The guidelines of the American Endocrine Society, and American Association of Clinical Endocrinologists and American Thyroid Association recommend treatment with thyroxine (T4) for patients with SCH who want to have children. We examined 69 female infertile patients with SCH and the effects of levothyroxine (l-T4) therapy on pregnancy rates and pregnancy outcomes were observed. Fifty-eight (84.1%) patients successfully conceived during the T4 treatment period (Group A), although 17 patients (29.3%) had miscarriage afterward. The remaining 11 patients continued to be infertile (Group B). The median TSH value in Group A before the T4 treatment was 5.46 μIU/mL (range 3.1-13.3) and this significantly decreased to 1.25 μIU/mL (range 0.02-3.75) during the treatment (ppregnancy after the treatment was significantly shorter at 0.9±0.9 years (ppregnancy and 68.5±22.8 μg during pregnancy (ppregnancy rate and shorter duration of infertility until pregnancy after T4 treatment strongly suggest that T4 enhanced fertility in infertile patients with SCH.

  18. Epicardial fat thickness and oxidative stress parameters in patients with subclinical hypothyroidism.

    Science.gov (United States)

    Aydogdu, Ali; Karakas, Emel Yigit; Erkus, Emre; Altıparmak, İbrahim Halil; Savık, Emin; Ulas, Turgay; Sabuncu, Tevfik

    2017-03-01

    Thyroid disorders are known to be a risk factor for cardiovascular diseases. Epicardial fat thickness (EFT) and oxidative stress are also believed to be major risk factors for cardiovascular events. The aim of this study was to evaluate the possible relationship between oxidative stress parameters and EFT in patients with subclinical hypothyroidism (SCH). A total of 60 individuals (30 patients with SCH and 30 healthy controls) were recruited for the study. The EFT and oxidative stress parameters of all participants were analyzed at baseline; the same were analyzed in SCH patients after achievement of a euthyroid state. Compared to healthy subjects, SCH patients had significantly higher EFT and oxidative stress parameters ( p oxidative stress parameters both decreased after treatment, but only the decrease of EFT levels was statistically significant after thyroid hormone replacement ( p oxidative stress index ( r = 0.141, p = 0.458). Previous studies have demonstrated that visceral adipose tissue and oxidative stress are major risk factors for cardiovascular events; our study demonstrated that EFT, a visceral adipose tissue, and oxidative stress parameters were higher, and could be used as an indicator for cardiovascular diseases in patients with SCH.

  19. High prevalence of previously unknown subclinical hypothyroidism in obese patients referred to a sleep clinic for sleep disordered breathing.

    Science.gov (United States)

    Resta, O; Pannacciulli, N; Di Gioia, G; Stefàno, A; Barbaro, M P Foschino; De Pergola, G

    2004-10-01

    To evaluate the prevalence of previously unknown hypothyroidism in adult male and female patients with a wide range of body mass index (BMI) values, referred to a Sleep Clinic because of sleep disordered breathing (SDB). Serum concentrations of thyroid stimulating hormone (TSH) and free thyroxin (fT4), as well as forced vital capacity (FVC), PaO2, PaCO2, the Epworth sleepiness scale (ESS), respiratory disturbance index (RDI), loud snoring, and the percentage of total sleep time (TST) with obese adult subjects with no previous diagnosis of hypothyroidism (age: 18-72 years). The prevalence of previously undiagnosed subclinical hypothyroidism in the population as a whole was 11.5%. BMI, TSH and ESS were significantly higher in the hypothyroid than the euthyroid subjects, but there was no significant between-group difference in RDI, TST(saO2hypothyroid individuals, BMI, neck circumference, ESS, RDI and TST(Sao2hypothyroidism than that commonly reported in overweight and obese individuals referred to a Sleep Clinic for polysomnography because of SDB, thus suggesting that thyroid function should be evaluated in all obese patients suffering from SDB despite economic concerns.

  20. Raised serum TSH levels in patients with morbid obesity: is it enough to diagnose subclinical hypothyroidism?

    Science.gov (United States)

    Rotondi, Mario; Leporati, Paola; La Manna, Antonella; Pirali, Barbara; Mondello, Teresa; Fonte, Rodolfo; Magri, Flavia; Chiovato, Luca

    2009-03-01

    Morbid obesity (body mass index (BMI)> or =40 kg/m(2)) is associated with thyroid function disturbances, with a high rate of subclinical hypothyroidism (SH) being the most consistently reported. We evaluated the circulating thyroid function parameters in morbid obese patients and related the results to the presence of circulating thyroid antibodies (Thyr-Ab). Morbid obese patients were consecutively enrolled (n=350). Two control groups were used: control group (CG)1, healthy normo-weight subjects (n=50); CG2, normo-weight patients with SH (n=56) matched for TSH with the obese patients with SH. Serum levels of free triiodothyronine (FT(3)), free thyroxine (FT(4)), TSH, antithyroglobulin antibodies, and antithyroperoxidase antibodies were measured in all patients. i) Compared with CG1, obese patients having thyroid function parameters in the normal range and negative Thyr-Ab showed significantly higher serum TSH and lower free thyroid hormones levels, but a similar FT(4)/FT(3) ratio; ii) SH was recorded in 13.7% obese patients; iii) compared with CG2, obese patients with untreated SH had a significantly lower rate of positive Thyr-Ab (32.1 vs 66.1%; Pobese patients with negative Thyr-Ab; and v) the comparison of the untreated SH patients (obese and normo-weight) with CG1 demonstrated that in SH obese subjects, unlike normo-weight SH patients, the FT(3) levels were significantly lower. This resulted in a normal FT(4)/FT(3) ratio in SH obese patients. Thyroid autoimmunity is not a major cause sustaining the high rate of SH in morbid obese patients. In these patients, the diagnosis of SH itself, as assessed by a raised TSH alone, appears questionable.

  1. Combined Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Subclinical Hypothyroidism Patients with Autoimmune Thyroiditis

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    Maurizio Nordio

    2013-01-01

    Full Text Available Background. Hashimoto's thyroiditis (HT, also known as chronic lymphocytic thyroiditis or chronic autoimmune thyroiditis, is the most common form of thyroiditis affecting more than 10% of females and 2% of males. The present study aims to evaluate the beneficial effect of a combined treatment, Myo-Inositol plus selenomethionine, on subclinical hypothyroidism. Methods. The study was designed as a double-blind randomized controlled trial. Eligible patients were women diagnosed with subclinical hypothyroidism having Tg antibodies (TgAb titer higher than 350 IU/mL. Outcome measures were Thyroid Stimulating Hormone (TSH levels, thyroid peroxidase antibodies (TPOAb and TgAb titer, selenium, and Myo-Inositol plasma concentration. Results. In the present paper, we demonstrated that the beneficial effects obtained by selenomethionine treatment on patients affected by subclinical hypothyroidism, likely due to the presence of autoantibody (TPOAb and TgAb, are further improved by cotreatment with Myo-Inositol. Conclusions. Indeed, due to its action as TSH second messenger, Myo-Inositol treatment reduces TSH levels closer to physiological concentrations.

  2. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial.

    Science.gov (United States)

    Sharma, Ashok Kumar; Basu, Indraneel; Singh, Siddarth

    2017-08-22

    Subclinical hypothyroidism, a thyroid disorder without obvious symptoms of thyroid deficiency, occurs in 3%-8% of the global population. Ashwagandha [Withania somnifera (L.) Dunal], a traditional medicine in Ayurveda, is often prescribed for thyroid dysfunctions. This pilot study was designed to evaluate the efficacy and safety of ashwagandha root extract in subclinical hypothyroid patients. A prospective, randomized, double-blind, single-center placebo-controlled study was performed at Sudbhawana Hospital, Varanasi, India between May 2016 and September 2016. Fifty subjects with elevated serum thyroid stimulating hormone (TSH) levels (4.5-10 μIU/L) aged between 18 and 50 were randomized in either treatment (n = 25) or placebo (n = 25) groups for an 8-week treatment period. Ashwagandha root extract (600 mg daily) or starch as placebo. Efficacy Variables: Serum TSH, serum triiodothyronine (T3), and thyroxine (T4) levels. A total of four subjects (two from each group) withdrew their consent before the second visit. Eight weeks of treatment with ashwagandha improved serum TSH (p Ashwagandha treatment effectively normalized the serum thyroid indices during the 8-week treatment period in a significant manner (time-effects: TSH [p ashwagandha: 1[4%]; Placebo: 3[12%]) out of 50 reported few mild and temporary adverse effects during this study. Treatment with ashwagandha may be beneficial for normalizing thyroid indices in subclinical hypothyroid patients.

  3. Subclinical hypothyroidism after vascular complicated pregnancy.

    Science.gov (United States)

    van der Zanden, Moniek; Hop-de Groot, Rianne J; Sweep, Fred C G J; Ross, H Alec; den Heijer, Martin; Spaanderman, Marc E A

    2013-01-01

    Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions. In 372 women with a history of vascular complicated pregnancy, we assessed thyroid function. Subclinical hypothyroidism was diagnosed in 73/372 women (19.6%). It occurred more often when pregnancy ended before 32 weeks of gestation (p = 0.008). In this cohort, subclinical hypothyroidism is more common after very preterm delivery. It may contribute to the elevated risk of remote cardiovascular disease.

  4. Unresolved Subclinical Hypothyroidism is Independently Associated with Progression of Chronic Kidney Disease

    Science.gov (United States)

    Kim, Eun Oh; Lee, Ihn Suk; Choi, Yoo A; Lee, Sang Ju; Chang, Yoon Kyung; Yoon, Hye Eun; Jang, Yi Sun; Lee, Jong Min; Kim, Hye Soo; Yang, Chul Woo; Kim, Suk Young; Hwang, Hyeon Seok

    2014-01-01

    Background and Aim: Patients with chronic kidney disease (CKD) often have subclinical hypothyroidism. However, few reports have investigated changes in the status of subclinical hypothyroidism in CKD patients and its clinical significance in CKD progression. Methods: We included 168 patients with nondialysis-dependent CKD stages 2-4. The normalization of subclinical hypothyroidism during follow-up was assessed, and the association between transitions in subclinical hypothyroid status and the rate of decline of the estimated glomerular filtration rate (eGFR) was investigated. Results: At baseline, 127 patients were euthyroid and 41 (24.4%) patients were diagnosed with subclinical hypothyroidism. Of these 41 patients, 21 (51.2%) spontaneously resolved to euthyroid during follow-up. The rate of eGFR decline of patients with resolved subclinical hypothyroidism was similar to that of euthyroid patients. The patients with unresolved subclinical hypothyroidism showed a steeper renal function decline than patients with euthyroidism or resolved subclinical hypothyroidism (all p hypothyroidism than in those who were euthyroid (p = 0.006). In multivariate linear regression for rate of eGFR decrease, unresolved subclinical hypothyroidism (β = -5.77, p = 0.001), baseline renal function (β = -0.12, p hypothyroidism did not resolve to euthyroidism, and this lack of resolution was independently associated with rapid renal function decline. PMID:24396286

  5. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions.

  6. Expression profiles of six circulating microRNAs critical to atherosclerosis in patients with subclinical hypothyroidism: a clinical study.

    Science.gov (United States)

    Zhang, Xinhuan; Shao, Shanshan; Geng, Houfa; Yu, Yong; Wang, Chenggang; Liu, Zhanfeng; Yu, Chunxiao; Jiang, Xiuyun; Deng, Yangxin; Gao, Ling; Zhao, Jiajun

    2014-05-01

    Increasing evidence shows that subclinical hypothyroidism (SCH) is associated with atherosclerosis (ATH), but the association remains controversial. MicroRNAs (miRNAs) have been proved to be involved in atherosclerosis and dyslipidemia as gene regulators. The objective of the study was to determine the expression profiles of six serum miRNAs critical to atherosclerosis in SCH patients and reanalyze the association between atherosclerosis and SCH from a new perspective. OUTCOMES, DESIGN, AND PARTICIPANTS: MicroRNA profiling analysis was performed by real-time PCR in normal control subjects (NC; n = 22); patients with subclinical hypothyroidism alone (SCH; n = 20); SCH patients plus atherosclerosis (SCH+ATH; n = 21); and patients with atherosclerosis but without subclinical hypothyroidism (ATH; n = 22). MiR-21-5p was up-regulated in SCH, SCH+ATH, and ATH groups than in the NC group. In addition, expression levels of miR-21-5p in SCH+ATH group were higher than in SCH alone and ATH alone groups, respectively. Both miR-125a-5p and miR-126-3p showed a decreased trend from NC to SCH and then to SCH+ATH or ATH subjects. MiR-221-3p and miR-222-3p were decreased in the SCH+ATH and ATH groups compared with either the NC or SCH groups. No differences were found in the levels of miR125a-5p, miR126-3p, miR221-3p, and miR222-3p between the ATH and SCH+ATH group. MiR-21-5p showed the most specific expression patterns in all patients with subclinical hypothyroidism (SCH and SCH+ATH groups). Down-regulation of miR-125a-5p, miR-126-3p, miR-221-3p, and miR-222-3p may be a manifestation of atherosclerosis either in SCH+ATH or in ATH-alone patients. MiR-126-3p has the most specific expression patterns in all atherosclerosis patients (SCH+ATH and ATH groups).

  7. Subclinical hypothyroidism: Controversies to consensus

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    Syed Abbas Raza

    2013-01-01

    Full Text Available Diagnoses of subclinicaal hypothyroidism (SCH is biochemically made, when serum thyroid stimulating hormone (TSH levels is elevated while free thyroid hormone levels are within normal reference range. SCH is diagnosed after excluding all other causes of elevated TSH levels. Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms. The risk of progression to overt hypothyroidism is related to number of factors including initial serum TSH concentration, presence of auto antibodies, family history and presence goiter. Various screening recommendations for thyroid function assessment are in practice. There are still controversies surrounding SCH and associated risk of various cardiovascular diseases (CVDs, pregnancy outcomes, neuropsychiatric issues, metabolic syndrome, and dyslipidemia. Consensus will require more large randomized clinical studies involving various age groups and medical condition, especially in developing countries. All these efforts will definitely improve our understanding of disease and ultimately patient outcomes.

  8. Circulating Betatrophin Is Increased in Patients with Overt and Subclinical Hypothyroidism

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    Cheng Han

    2016-01-01

    Full Text Available Thyroid hormone (TH affects many metabolic processes such as promoting oxidation of sugar, fat, and protein in many tissues. Thyroid dysfunction is associated with metabolic disorders. The newly discovered adipocyte- and hepatocyte-derived cytokine, betatrophin, has been reported to be involved in metabolic diseases, but its influence on thyroid dysfunction is uncertain. Therefore, the present study aims to evaluate circulating betatrophin levels in subjects with different thyroid function status and to predict the factors associated with betatrophin levels, especially whether thyroid stimulating hormone (TSH, TH, or thyroid autoantibodies are associated with betatrophin levels. In the study, serum betatrophin was measured in the subjects grouped as overt hypothyroidism (OH, subclinical hypothyroidism (SCH, euthyroid with isolated thyroid peroxidase antibody positivity (isolated Ab, and healthy control (HC, according to their thyroid functions. From our results, we found that betatrophin may be associated with thyroid insufficiency but not thyroid autoimmunity. Thus, when interpreting the results of betatrophin, thyroid functions should also be taken into consideration.

  9. Subclinical Hypothyroidism and Its Association with Increased Cardiovascular Mortality

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    Alvaro Altamirano Ufion

    2017-01-01

    Full Text Available Thyroid hormones play an important role in regulating different metabolism functions and multiple organs’ performance. Changes in the thyroid hormone axis can lead to profound effects on the stability of vital organs and systems, especially the cardiovascular system. Hypothyroidism is classified according to the clinical presentation as overt and subclinical. There is some evidence supporting the benefits of thyroxine hormone replacement for subclinical hypothyroidism on cardiovascular mortality outcomes. However, the clinical relevance of measuring and treating high thyroid-stimulating hormone (TSH levels in newly diagnosed heart failure patients with preserved ejection fraction requires further study. In this report, we review the current evidence regarding the prognostic significance of subclinical hypothyroidism in heart failure patients with preserved ejection fraction.

  10. Clinical aspects of endogenous hypothyroidism and subclinical hyperthyroidism in patients with differentiated thyroid carcinoma

    NARCIS (Netherlands)

    Heemstra, Karen Anne

    2009-01-01

    Patients with DTC are initially treated with a total thyroidectomy and radioiodine therapy. Hereafter, all patients are treated with high doses of thyroxin aiming at significantly suppressing thyrotropin (TSH) levels, resulting in a subclinical hyperthyroid state. The rationale of this approach is

  11. BENEFICIAL EFFECTS OF LEVOTHYROXINE IN THE TREATMENT OF SUBCLINICAL HYPOTHYROIDISM

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    Mulic Mersudin

    2016-12-01

    Full Text Available Introduction:Increased cardiovascular risk in thyroid dysfunction is associated with disorders of lipid and lipoproteins, endothelial dysfunction, metabolic, hormonal, hemodynamic changes and coagulation disorders. Subclinical hypothyroidism is characterized by a suprarnormal level of TSH with normal levels of thyroid hormones. The correlation between subclinical hypothyroidism of the lipid profile and cardiovascular outcomes remains unclear. Several intervention studies assessed the effect of levothyroxine therapy on the lipid profile of patients with subclinical hypothyroidism and obtained conflicting results. The aim of the research is to determine whether subclinical hypothyroidism is associated with the atherogenic lipid profile and whether these changes are reversible after the introduction of the L-thyroxine replacement therapy. Method: The study included 51 patients over 50 years of age with subclinical hypothyroidism. All the participants were subjected to an examination programme which included a detailed anamnesis and physical examination, laboratory tests (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, T3, T4, TSH. After eight weeks of levothyroxine therapy, the same laboratory parameters were determined in the patients. Results: Subjects with subclinical hypothyroidism had high average values: TSH (12.77 + 2.78 mIU / ml, total cholesterol (7.55 ± 0.79 mmol / l, LDL cholesterol (5.03 ± 0.61 mmol / l, triglycerides (2.48 ± 1.01 mmol / l; and the average value of HDL cholesterol was within reference values (1.12 ± 0.21 mmol / l. After eight weeks of levothyroxine replacement therapy, there was a statistically significant reduction of average values (p <0.0001: TSH (3.83 ± 1.33 mIU / ml, total cholesterol (6.28 ± 0.96 mmol / l, LDL cholesterol ( 4.03 ± 0.70 mmol / mmol / l l, triglycerides (1.98 ± 0.87 mmol / l; and the average value of HDL cholesterol increased significantly (p <0.0001 (1.32 ± 0.22 mmol

  12. SUBCLINICAL HYPOTHYROIDISM CURRENT CONCEPTS & M ANAGEMENT STRATEGEIES

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    Radha Krishnan

    2015-05-01

    Full Text Available Subclinical hypothyroidism is a biochemical diagnosis characterized by raised thyroid stimulating hormone ( TSH and normal free T3 & T4 , without clinical features of hypothyroidism . Clinical significance of SCH remains uncertain and controversial . Symptoms of SCH may vary from being asymptomatic to having mild nonspecific symptoms . There are still controversies surrounding SCH and associated risk of various cardiovascular diseases ( CVDs , pregnancy outcomes , neuropsychiatric issues , metabolic syndrome , and dyslipidemia . This review will summarize the current data related to the effects of SCH on cardiovascular risk , SCH in pregnancy , in dyslipedemia and clinical guidelines on management of this condition . The evidence has been updated by a Pub med search on the risks and treatment of subclinical hypothyroidism of most recent articles published until March 2015

  13. Subclinical hypothyroidism in childhood and adolescense.

    Science.gov (United States)

    Catli, Gonul; Abaci, Ayhan; Büyükgebiz, Atilla; Bober, Ece

    2014-11-01

    Subclinical hypothyroidism (SH) is defined as a serum thyroid-stimulating hormone (TSH) level above the reference range with normal serum free thyroxin (sT4) and free triiodothyronine (sT3) levels. The prevalence of SH in children and adolescents is reported between 1.7% and 9.5%. Hashimoto's thyroiditis is the most prevalent cause of SH in children. Although it has been suggested that SH is entirely an asymptomatic laboratory diagnosis, typical hypothyroid symptoms as well have been reported in some patients. Results of the adult studies on SH revealed that SH had unfavorable effects on cardiovascular system (atherosclerosis); metabolic parameters (dyslipidemia, insulin resistance, etc.); neuromuscular system; and cognitive functions in the long term. The number of studies investigating the effect of childhood SH on growth, bone maturation, lipid parameters, carbohydrate metabolism, neuromuscular system, and cognitive and cardiac function is limited. Knowledge about the natural history of SH is unclear even though there are numerous studies upon this subject. In children and adults, treatment of SH with L-T₄ is still a matter of debate, and there is no consensus on this issue yet.

  14. The debate on treating subclinical hypothyroidism.

    Science.gov (United States)

    Tng, Eng Loon

    2016-10-01

    Subclinical hypothyroidism (SCH) represents a mild or compensated form of primary hypothyroidism. The diagnosis of SCH is controversial, as its symptoms are non-specific and its biochemical diagnosis is arbitrary. The treatment of SCH was examined among non-pregnant adults, pregnant adults and children. In non-pregnant adults, treatment of SCH may prevent its progression to overt hypothyroidism, reduce the occurrence of coronary heart disease, and improve neuropsychiatric and musculoskeletal symptoms associated with hypothyroidism. These benefits are counteracted by cardiovascular, neuropsychiatric and musculoskeletal side effects. SCH is associated with adverse maternal and fetal outcomes that may improve with treatment. Treating SCH in children is safe and may improve growth. Importantly, the evidence in this field is largely from retrospective and prospective studies with design limitations, which precludes a conclusive recommendation for the treatment of SCH. Copyright: © Singapore Medical Association.

  15. Cardiovascular risk with subclinical hyperthyroidism and hypothyroidism: pathophysiology and management.

    Science.gov (United States)

    Duggal, Jasleen; Singh, Sarabjeet; Barsano, Charles P; Arora, Rohit

    2007-01-01

    Previous studies have suggested that subclinical thyroid dysfunction, as manifested by abnormalities in thyroid-stimulating hormone (TSH) levels, are associated with detrimental effects on the cardiovascular system. Subclinical hypothyroidism is characterized by abnormal lipid metabolism, cardiac dysfunction, diastolic hypertension conferring an elevated risk of atherosclerosis, and ischemic heart disease. Similarly, patients with subclinical hyperthyroidism have nearly 3 times the likelihood of atrial fibrillation over a 10-year follow-up interval, raising the question of whether patients with subclinical hyperthyroidism should be treated to prevent atrial fibrillation. A single measurement of low serum TSH in individuals aged 60 years or older has been reported to be associated with increased mortality from all causes and in particular from circulatory and cardiovascular disease in a 10-year follow-up study. Subclinical thyroid dysfunction is currently the subject of numerous studies and remains controversial, particularly as it relates to cardiovascular morbidity and mortality and clinical applications.

  16. Subclinical hypothyroidism ups the risk of vascular complications in ...

    African Journals Online (AJOL)

    Ghada A. Mohamed

    hypothyroidism was 3.4% in males and 5.8% in females.14 Perros et al. found that the occurrence of subclinical hypothyroidism was 3.3% in men and 4.6% in women with Type 2 diabetes.15 The incidence of subclinical hypothyroidism in our study was greater than those of both these studies and revealed a dominance of.

  17. Subclinical hypothyroidism: Is it important in intracytoplasmic sperm injection cycles?

    Science.gov (United States)

    Çalışkan, Eray; Ergin, Rahime Nida; Öztekin, Deniz Can; Kars, Bülent; Çakır, Seda; Sofuoğlu, Kenan

    2017-06-01

    To compare intracytoplasmic sperm injection (ICSI) outcomes of women with subclinical hypothyroidism with those of euthyroid women. A retrospective case-control study was conducted. Out of 2529 ICSI cycles evaluated, 41 women with hypothyroidism, 28 women with hyperthyroidism, and 128 women with subclinical hyperthyroidism were excluded, and 2336 cycles were analyzed. Women were identified as having subclinical hypothyroidism (case group, n=105) in the presence of a thyroid-stimulating hormone level >4.5 mU/L and normal free T4 and compared with euthyroid controls (n=2231). The mean age, body mass index, day 3 follicle-stimulating hormone level, and antral follicle count of the study patients were similar to the control group (p>0.5). The cycle cancellation rate of the study group was similar to the control group (13.3% vs. 7.6%, p=0.1). The clinical pregnancy rate was 21.2% in the study group, which was significantly lower than the 35.8% in the control group (p=0.04). The take-home baby rate was also significantly lower in the study group compared with the control groups (13.5% vs. 31.4% respectively, p=0.01). Both the clinical pregnancy rate and the take-home baby rate is lower in women with subclinical hypothyroidism at the time of ICSI cycle.

  18. Thyroid Hormone Therapy for Older Adults with Subclinical Hypothyroidism

    DEFF Research Database (Denmark)

    Stott, David J.; Rodondi, Nicolas; Kearney, Patricia M.

    2017-01-01

    BACKGROUND: The use of levothyroxine to treat subclinical hypothyroidism is controversial. We aimed to determine whether levothyroxine provided clinical benefits in older personswith this condition. METHODS: We conducted a double-blind, randomized, placebo-controlled, parallel-group trial involving...... 737 adults who were at least 65 years of age and who had persisting subclinical hypothyroidism (thyrotropin level, 4.60 to 19.99 mIU per liter; free thyroxine level within the reference range). A total of 368 patients were assigned to receive levothyroxine (at a starting dose of 50 μg daily, or 25 μg...... if the body weight was Hypothyroid Symptomsscore and Tiredness score on a thyroid...

  19. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH...

  20. Subclinical hypothyroidism and its relation to obesity in patients before and after Roux-en-Y gastric bypass.

    Science.gov (United States)

    Janssen, Ignace M C; Homan, Jens; Schijns, Wendy; Betzel, Bark; Aarts, Edo O; Berends, Frits J; de Boer, Hans

    2015-01-01

    Subclinical hypothyroidism (SH), defined as a raised serum thyroid-stimulating hormone (TSH) with a normal free thyroxine (FT4), is occasionally observed in morbidly obese patients. It is currently not known whether thyroid hormone treatment is indicated. The aim of the present study was to assess the changes in thyroid hormone levels in thyroxine-naïve patients with SH in response to weight loss induced by Roux-en-Y gastric bypass (RYGB). General hospital specialized in bariatric surgery. Serum levels of TSH and FT4 were measured at baseline in 503 patients presenting for RYGB. In patients diagnosed with SH, these measurements were repeated 12 months postoperatively. SH de novo was present in 71 out of 503 patients (14.1%). One-year follow-up was available in 61 out of 71 patients (86%). TSH level >10 mU/L was observed in 3 patients (.5%). RYGB induced a decrease in BMI from 47±8 kg/m(2) to 33±6 kg/m(2) at 12-month follow-up (Pobese patients. After RYGB it resolves in about 90% of patients. This high degree of spontaneous recovery suggests that follow-up alone is sufficient in the majority of patients. Copyright © 2015 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  1. Epicardial Adipose Tissue Thickness in Patients With Subclinical Hypothyroidism and the Relationship Thereof With Visceral Adipose Tissue Thickness.

    Science.gov (United States)

    Arpaci, Dilek; Gurkan Tocoglu, Aysel; Yilmaz, Sabiye; Korkmaz, Sumeyye; Ergenc, Hasan; Gunduz, Huseyin; Keser, Nurgul; Tamer, Ali

    2016-03-01

    Subclinical hypothyroidism (SH) is associated with cardiovascular metabolic syndromes, especially dislipidemia and abdominal obesity. Visceral abdominal adipose tissue (VAAT) and epicardial adipose tissue (EAT) have the same ontogenic origin and produce many proinflammatory and proatherogenic cytokines. We evaluated EAT and VAAT thickness in patients with SH. Forty-one patients with SH and 35 controls were included in the study. Demographical and anthropometric features of both patients and controls were recorded. Thyroid and metabolic parameters were measured. EAT was measured using 2D-transthoracic echocardiography. The age and gender distributions were similar in the two groups (P = 0.998 and P = 0.121, respectively). Body mass index (BMI), fat mass, waist circumference (WC), hip circumference (HC), the WC/HC ratio, and the thicknesses of VAAT and abdominal subcutaneous adipose tissue were higher in the case group than the control group (all P values 0.05). We found no difference between the two groups in fasting plasma glucose (FPG) level (P = 0.780), but the levels of LDL-C and TG differed significantly (P = 0.002 and P = 0.026, respectively). The serum TSH level was higher and the FT4 level was lower in the case than the control group (both P values <0.01). Increased abdominal adipose tissue thickness in patients with SH is associated with atherosclerosis. To detemine the risk of atherosclerosis in such patients, EAT measurements are valuable; such assessment is simple to perform.

  2. Overt and subclinical hypothyroidism among Bangladeshi pregnant women and its effect on fetomaternal outcome.

    Science.gov (United States)

    Sharmeen, M; Shamsunnahar, P A; Laita, T R; Chowdhury, S B

    2014-08-01

    Thyroid disorders are among the common endocrine problems in pregnant women. It is now well established that not only overt but subclinical thyroid dysfunction also has adverse effects on maternal and fetal outcome. There are few data from Bangladesh about the prevalence of thyroid dysfunction in pregnancy. With this background, this study aims to find out thyroid dysfunction (both overt and subclinical hypothyroidism) in pregnancy and its impact on obstetrical outcome. We studied the evaluation of 50 admitted pregnancies corresponding to 29 women with subclinical hypothyroidism and rest 21 was overt hypothyroidism. Detailed history and examination were performed. Apart from routine obstetrical investigations, Thyroid Stimulating Hormone (TSH) estimation was done. Their obstetrical and perinatal outcomes were noted. Overt hypothyroidism was significantly (p hypothyroidism patients. In sub clinical hypothyroidism 86.2% conceived firstly within 2 years and 66.7% in overt hypothyroidism patients conceived firstly in between 3 to 5 years after marriage. Overt hypothyroids were prone to have pregnancy-induced hypertension 42.9%, intrauterine growth restriction (P = 0.001) and gestational diabetes (38.1%) as compared to subclinical cases. Neonatal complications were significantly more in overt hypothyroidism group. Mean TSH level was significantly (p hypothyroidism patients but mean FT4 level was almost similar in both groups. Majority of the patient underwent caesarean section in both groups due to associated medical and obstetrical complications. None of the babies showed hypothyroidism by cord blood tests. In this analysis our results showed that overt hypothyroidism among Bangladeshi pregnant women are associated with more maternal complication & adverse parental outcome than subclinical hypothyroidism. The adequate treatment of hypothyroidism during gestation minimizes risks and generally, makes it possible for pregnancies to be carried to term without complications

  3. Evolution of subclinical hypothyroidism and its relation with glucose and triglycerides levels in morbidly obese patients after undergoing sleeve gastrectomy as bariatric procedure.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Boix, Evangelina; Galindo, Isabel; Zubiaga, Lorea; Diez, María; Arroyo, Antonio; Calpena, Rafael

    2014-05-01

    There is an increased prevalence of subclinical hypothyroidism (SCH) in patients with obesity. It is unclear if this biochemical abnormality may be a secondary phenomenon of obesity or a real hypothyroid state. A retrospective study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy as bariatric procedure between October 2007 and November 2012 was performed. Weight loss, body mass index (BMI) and excess weight loss, baseline glucose, lipid profiles, and TSH levels were obtained before operation and postoperative determinations at 3, 6, and 12 months after surgery. Sixty patients were included. Prevalence of subclinical hypothyroidism was 16.7% preoperatively, 10% at 3 months, 3.3% at 6 months, and 1.7% at 12 months. A significant correlation could be established between TSH decrease and weight loss at 12 months (Pearson 0.603; p = 0.007). TSH decrease showed a significant correlation with glucose and glycated hemoglobin decrease from 6th month onwards. Referring to lipid profile, an association of TSH decrease with total cholesterol, LDL cholesterol, or HDL cholesterol could not be determined. A significant association between TSH decrease and triglycerides and cardiovascular risk index triglycerides/HDL cholesterol reductions could also be established 12 months after surgery. SCH is usually corrected after bariatric surgery, while there are no significant changes in total or LDL cholesterol. This suggests that, in morbidly obese subjects, SCH is, in most patients, just a consequence of the abnormal fat accumulation and not a real hypothyroid state.

  4. MANAGEMENT OF ENDOCRINE DISEASE: The impact of subclinical hypothyroidism on anthropometric characteristics, lipid, glucose and hormonal profile of PCOS patients: a systematic review and meta-analysis.

    Science.gov (United States)

    Pergialiotis, Vasilios; Konstantopoulos, Panagiotis; Prodromidou, Anastasia; Florou, Venetia; Papantoniou, Nikolaos; Perrea, Despina N

    2017-03-01

    Subclinical hypothyroidism (SCH) is encountered in 10-25% of women with PCOS. To date, it remains unclear whether this coexistence influences the severity of metabolic and hormonal profile of these patients. The purpose of our systematic review is to investigate this potential relation. We systematically searched Medline, Scopus, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases together with reference lists from included studies. All prospective and retrospective observational cohort studies that investigated the impact of subclinical hypothyroidism on hormonal and metabolic parameters of PCOS patients were included. The methodological quality of studies was assessed with the Ottawa-Newcastle criteria. Statistical meta-analysis was performed with the RevMan 5.3 software. Twelve studies were finally included in the present review, which enrolled 2341 PCOS patients. Among them, 577 had subclinical hypothyroidism, whereas the remaining 2077 were PCOS women with normal thyroid function. The presence of SCH significantly affected HDL (MD -3.92 mg/dL 95% CI: -6.56, -1.29) and triglycerides levels (26.91 mg/dL 95% CI: -3.79, 50.02). HOMA-IR was also affected (MD 0.82 95% CI: 0.15, 1.50). On the other hand, LDL, fasting glucose and 2-h OGTT were not influenced. Similarly, prolactin, FSH, LH, LH/FSH ratio and sex hormone-binding globulin remained unaffected. Subclinical hypothyroidism does not influence the hormonal profile of women with PCOS. On the other hand, it results in mild metabolic abnormalities, which are not clinically important in a short-term setting. © 2017 European Society of Endocrinology.

  5. Subclinical hypothyroidism in obese children

    Directory of Open Access Journals (Sweden)

    Emel Torun

    2013-01-01

    Full Text Available Objective: Thyroid functions in obese children and adolescentswere evaluated in order to determine subclinicaland clinical hypothyroidism.Materials and methods: In this study, 85 obese (Bodymass index >97th percentile children, aged 2-14 years, aswell as 47 healthy controls were enrolled. Levels of serumfree triiodothyronine (fT3, free thyroxine (fT4 and thyroidstimulatinghormone (TSH of the two groups were compared.Obese children with TSH level above 5.4 IU/mlwere also analyzed for thyroid autoantibodies and thyroidultrasounds were performed.Results: Obese children showed higher serum concentrationsof TSH and fT3 than the controls but no significantdifference in serum fT4 levels was found between the twogroups (P=0.001. One child had high auto antibodiesand 32 had high TSH levels. Of 28 children with TSH >5,4IU/ml, 25 children had normal thyroid ultrasound findingsand three had nodules or thyroiditis but no enlargementof the thyroid gland.Conclusion: TSH and fT3 levels were found to be higherin obese children compared with non-obese children withno difference of fT4 levels between two groups.Key words: Body mass index, obesity, thyroid functions

  6. [Should subclinical hypothyroidism in older persons be treated?

    NARCIS (Netherlands)

    Elzen, W.P. den; Smit, J.W.A.; Mooijaart, S.P.; Gussekloo, J.

    2012-01-01

    Subclinical hypothyroidism is a common finding in older persons. Clinical guidelines are inconsistent in providing recommendations for the treatment of subclinical hypothyroidism, especially in older persons. To date, there is no high-quality evidence from randomized controlled trials about the

  7. Sub-clinical hypothyroidism in infertile Nigerian women with ...

    African Journals Online (AJOL)

    Studies on the impact of subclinical hypothyroidism in infertility are scarce and this seeks to determine the proportion of infertile Nigerian women with hyperprolactinaemia that had subclinical hypothyroidism. Serum prolactin and thyroid stimulating hormone were determined using ELECSYS 1010 auto analyzer.

  8. The Biochemical Prognostic Factors of Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Myung Won Lee

    2014-06-01

    Full Text Available BackgroundPatients with subclinical hypothyroidism (SHT are common in clinical practice. However, the clinical significance of SHT, including prognosis, has not been established. Further clarifying SHT will be critical in devising a management plan and treatment guidelines for SHT patients. Thus, the aim of this study was to investigate the prognostic factors of SHT.MethodsWe reviewed the medical records of Korean patients who visited the endocrinology outpatient clinic of Severance Hospital from January 2008 to September 2012. Newly-diagnosed patients with SHT were selected and reviewed retrospectively. We compared two groups: the SHT maintenance group and the spontaneous improvement group.ResultsThe SHT maintenance group and the spontaneous improvement group had initial thyroid-stimulating hormone (TSH levels that were significantly different (P=0.035. In subanalysis for subjects with TSH levels between 5 to 10 µIU/mL, the spontaneous improvement group showed significantly lower antithyroid peroxidase antibody (anti-TPO-Ab titer than the SHT maintenance group (P=0.039. Regarding lipid profiles, only triglyceride level, unlike total cholesterol and low density lipoprotein cholesterol, was related to TSH level, which is correlated with the severity of SHT. Diffuse thyroiditis on ultrasonography only contributed to the severity of SHT, not to the prognosis. High sensitivity C-reactive protein and urine iodine excretion, generally regarded as possible prognostic factors, did not show any significant relation with the prognosis and severity of SHT.ConclusionOnly initial TSH level was a definite prognostic factor of SHT. TPO-Ab titer was also a helpful prognostic factor for SHT in cases with mildly elevated TSH. Other than TSH and TPO-Ab, we were unable to validate biochemical prognostic factors in this retrospective study for Korean SHT patients.

  9. Incidence of Subclinical Hypothyroidism and Hypothyroidism in Early Pregnancy.

    Science.gov (United States)

    Akram, Frida Hosseini; Johansson, Bengt; Möllerström, Gunnar; Landgren, Britt-Marie; Stavreus-Evers, Anneli; Skjöldebrand-Sparre, Lottie

    2017-11-01

    Untreated and subclinical hypothyroidism (SCH) has been associated with adverse pregnancy complications such as increased risk of miscarriage, hypertension, preeclampsia, and preterm delivery. However, in Sweden, screening for thyroid dysfunction during pregnancy is only recommended for women with a high risk of thyroid disease. Therefore, the aim of this study was to determine the incidence of clinical and SCH in women in the first trimester of pregnancy. In this prospective study, 1298 pregnant women were divided into three groups: one unselected general screening group (n = 611), one low-risk group comprising women without risk factors for thyroid disorder (n = 511), and one high-risk group comprising women with an inheritance or suspicion of thyroid disease or undergoing treatment for thyroid disease (n = 88). Serum was obtained up to gestational week 13, and thyrotropin (TSH) was analyzed. The incidences of thyroid dysfunction in the three screening groups were 9.8% in the general screening group, 9.6% in the low-risk group, and 10.2%, p = 0.948, in the high-risk group. In the women with known hypothyroidism on levothyroxine treatment, 50.6% had serum TSH levels above 2.0 mIU/L. High-risk screening is not useful in predicting which women are at risk of thyroid disease in early pregnancy since ∼10% of women with SCH or hypothyroidism could not be diagnosed in this way.

  10. Non-Autoimmune Subclinical and Overt Hypothyroidism in Idiopathic Steroid-resistant Nephrotic Syndrome in Children.

    Science.gov (United States)

    Marimuthu, Vidhya; Krishnamurthy, Sriram; Rajappa, Medha

    2017-11-15

    To evaluate the frequency of non-autoimmune subclinical and overt hypothyroidism in children with idiopathic steroid-resistant nephrotic syndrome (SRNS). This cross-sectional study recruited 30 children (age 1-18 y) with idiopathic SRNS; and 30 healthy controls. Serum T3, T4 and TSH were performed in cases as well as controls. Anti-thyroid peroxidase and anti-thyroglobulin antibody tests were performed in all cases. Non-autoimmune subclinical or overt hypothyroidism was detected in 10 out of 30 children with idiopathic SRNS; 2 had overt hypothyroidism, while 8 patients had subclinical hypothyroidism. Children with SRNS had a mean (SD) TSH value 4.55 (4.64) mIU/L that was higher as compared to controls (1.88 (1.04) mIU/L) (Phypothyroidism (2 cases) and grade III subclinical hypothyroidism (1 case) were subsequently started on levothyroxine therapy. The prevalence of subclinical and overt hypothyroidism seems to be high in idiopathic SRNS, with almost one-third of children having overt or subclinical non-autoimmune hypothyroidism.

  11. Prevalence and predictors of hyperprolactinemia in subclinical hypothyroidism.

    Science.gov (United States)

    Sharma, Lokesh Kumar; Sharma, Neera; Gadpayle, Adesh Kisanji; Dutta, Deep

    2016-11-01

    Hyperprolactinemia has been reported in 0-57% of primary hypothyroidism. Data on hyperprolactinemia in subclinical hypothyroidism (ScH) is scant and inconsistent. This study aimed to determine the prevalence and predictors of hyperprolactinemia in ScH. Consecutive patients diagnosed to have normal thyroid function, ScH or overt primary hypothyroidism underwent serum prolactin, gonadotropins, testosterone and estradiol estimation. Patients with pregnancy, pituitary adenomas, secondary hypothyroidism, hyperthyroidism, comorbid states and drug-induced hyperprolactinemia were excluded. From initially screened 4950 patients, hormonal data from 2848 individuals who fulfilled all criteria were analyzed. The occurrence of hyperprolactinemia (females:males) was highest in primary hypothyroidism (42.95%:39.53%) (n=192), followed by ScH (35.65%:31.61%) (n=770) and euthyroid individuals (2.32%:2.02%) (n=1886) (P10mIU/L (females: males) was 25.56%:20.73%, 49.07%:50% and 61.43%:35.71% respectively (Phypothyroidism. In females, testosterone was lowest in patients with primary hypothyroidism. In males, serum estradiol was significantly higher, and testosterone significantly lower in men with ScH and primary hypothyroidism. Regression analysis revealed serum TSH followed by free T4, to be best predictors of serum prolactin in both sexes. Hyperprolactinemia is common in ScH, especially in those with TSH>7.5mIU/L. ROC analysis confirmed that TSH≥7.51mIU/L in females and ≥8.33mIU/L in males had a sensitivity of ≈50% with a very high specificity of >90% in detecting hyperprolactinemia. Prolactin screening may be warranted in ScH with TSH>7.5mIU/L, and may form an indication for treating ScH. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity

    DEFF Research Database (Denmark)

    Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob

    2015-01-01

    INTRODUCTION: The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number...... with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous...... of spontaneous abortions. METHODS: Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. RESULTS: 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism...

  13. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity

    DEFF Research Database (Denmark)

    Feldthusen, Anne-Dorthe; Pedersen, Palle L; Larsen, Jacob

    2015-01-01

    INTRODUCTION: The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number...... of spontaneous abortions. METHODS: Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. RESULTS: 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism...... with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous...

  14. The relationship between serum thyroid hormone levels, subclinical hypothyroidism, and coronary collateral circulation in patients with stable coronary artery disease.

    Science.gov (United States)

    Ballı, Mehmet; Çetin, Mustafa; Taşolar, Hakan; Uysal, Onur Kadir; Yılmaz, Mahmut; Durukan, Mine; Elbasan, Zafer; Çaylı, Murat

    2016-03-01

    Thyroid disease is a common endocrine disease with important effects on the cardiovascular system. As an adaptive response to myocardial ischemia, coronary collateral circulation (CCC) plays an important role in obstructive coronary artery disease (CAD). The association between serum thyroid hormone levels and development of CCC was investigated in the present study. In total, 430 consecutive patients who underwent coronary angiography procedure and had documented total occlusion in at least 1 major coronary artery were investigated retrospectively. Degree of CCC was classified according to Cohen-Rentrop method. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were assessed by the chemiluminescence immunoassay technique. In spite of diabetes mellitus (p=0.019), smoking (p<0.001), and TSH (p<0.001), FT3 (p<0.001), FT4 (p=0.015), and subclinical hypothyroidism (SCH) (p<0.001) ratios were significantly different between groups. In regression analysis, SCH (p=0.024), DM (p=0.021), smoking (p<0.001), and heart failure (p=0.029) were independent predictors of poor CCC development in multivariate model 1. When regression analyses were performed based on multivariate model 2, TSH (p<0.001), FT3 (p<0.001), heart failure (p=0.022), smoking (p<0.001), and hyperlipidemia (HPL) (p=0.046) were independent predictors of poor CCC development. In addition to traditional risk factors, SCH, higher serum TSH, and lower FT3 levels were associated with development of poor CCC in patients with obstructive CA.

  15. Evaluation of LDL-Cholesterol / HDL-Cholesterol Ratio as Predictor of Dyslipidemia in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Smita S. Kottagi

    2014-01-01

    Full Text Available Background: Subclinical hypothyroidism is defined as a serum TSH concentration above the upper limit of the reference range when serum T3 and T4 concentrations are within reference ranges. Subclinical thyroid disease is a laboratory diagnosis. Patients with subclinical disease have few or no definitive clinical signs or symptoms of thyroid dysfunction. It has been associated with higher levels of some cardiovascular risk factors. Despite some conflicting results, many studies have found that subjects with subclinical hypothyroidism have total cholesterol and low density lipoprotein cholesterol levels higher than euthyroid subjects. The association between subclinical hypothyroidism and dyslipidemia is well known. Aims and Objectives: This study is an attempt to find the importance of Low Density Lipoprotein – Cholesterol / Higher Density Lipoprotein - Cholesterol (LDL-C/HDL-C ratio rather than measurement of individual lipid profile parameters in bringing to light the dyslipidemic state associated with subclinical hypothyroidism. Materials and Methods: We studied 30 subclinical hypothyroid cases with age above 35 yrs and 30 age matched euthyroid controls. Serum T3, T4, TSH were estimated by ELISA method, serum total cholesterol, HDL Cholesterol by enzymatic CHOD-PAP method, and LDL cholesterol using Friedewald formula. Results: We found the significant increase in the serum levels of TSH (p < 0.001, Total cholesterol (p<0.001, LDL cholesterol (p<0.001, and LDL-C/HDL-C (p<0.001, Systolic blood pressure and diastolic blood pressure (p<0.001. There was no significant change in the levels of serum T3, T4, HDL- cholesterol. Conclusion: Increased levels of total cholesterol, LDL cholesterol and increased LDL-C/HDL-C ratio are seen in patients with subclinical hypothyroidism. LDL-C/HDLC ratio is a better indicator for dyslipidemia in subclinical hypothyroid cases.

  16. Patients with subclinical hypothyroidism before 20 weeks of pregnancy have a higher risk of miscarriage: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Yibing; Wang, Haoyu; Pan, Xifeng; Teng, Weiping; Shan, Zhongyan

    2017-01-01

    To evaluate the relationship between subclinical hypothyroidism (SCH) and the risk of miscarriage before 20 weeks of pregnancy. Literature databases were searched, including the PubMed, Web of Science, Embase and Cochrane databases, from January 1, 1980, to December 31, 2015. The following search terms were used: subclinical hypothyroidism, hypothyroidism, thyroid dysfunction, thyroid hypofunction, subclinical thyroid disease, thyroid dysfunction, pregnancy loss, abortion and miscarriage. Studies comparing the prevalence of miscarriage in pregnant women with SCH with those who were euthyroid were selected. From the studies matched, the relative risk (RR) and corresponding 95% confidence interval (95% CI) were calculated to yield outcomes. All the statistical analyses were performed using Review Manager (Revman) Version 5.3 and Stata Version 12.0 software. The publication bias of the studies was assessed by forest plot and Begg's test, while the stability of the results was evaluated by sensitivity analysis. Nine articles satisfying the inclusion criteria were analysed. Compared to euthyroid pregnant women, patients with non-treated SCH had a higher prevalence of miscarriage (RR = 1.90, 95% CI1.59-2.27, Ppregnancy, and early treatments can reduce the miscarriage rate. Regardless of the diagnostic criteria used, the miscarriage rate increased as long as a pregnant woman was confirmed to have SCH. The results show that the omission diagnostic rate may increase when the ATA diagnostic criteria are used. In addition, SCH patients with TAI have a higher prevalence of miscarriage, while isolated SCH patients also have a higher miscarriage rate than euthyroid women. Thus, we recommend early treatments to avoid adverse pregnancy outcomes and complications.

  17. Subclinical hypothyroidism among Egyptian children with systemic ...

    African Journals Online (AJOL)

    EL-HAKIM

    (SLEDAI), symptoms suggestive of hypothyroidism (pubertal delay, puffy features, swelling in neck, cold intolerance, etc….) or hyperthyroidism (emotional lability, weight loss, and restless sleep, some degree of exophthalmos, etc….). Patients with overt thyroid disease were excluded. B- The laboratory work up of the study:.

  18. Is subclinical hypothyroidism increasing exogen obesity in children?

    Directory of Open Access Journals (Sweden)

    Ceyda Tuna Kirsaclioglu

    2015-03-01

    Conclusion:.Thyrotropin releasing hormone stimulation test may be helpful to determine subclinical hypothyroidism in exogen obese children, if basal TSH levels were elevated. [J Contemp Med 2015; 5(1.000: 1-7

  19. Hyperprolactinemia in Children with Subclinical Hypothyroidism.

    Science.gov (United States)

    Sharma, Neera; Dutta, Deep; Sharma, Lokesh Kumar

    2017-12-15

    Prevalence of hyperprolactinemia in children with subclinical hypothyroidism (ScH) is not known. This study aimed to determine the occurrence and predictors of hyperprolactinemia in euthyroid children and in children with ScH and overt primary hypothyroidism (OPH). Serum prolactin levels were estimated in consecutive children hypothyroidism, multiple pituitary hormone deficiency, comorbid states, and drug-induced hyperprolactinemia were excluded. From the initially screened 791 children, hormonal data from 602 children who fulfilled all criteria were analyzed. Seventy-one (11.79%) of these had ScH, and 33 (5.48%) had OPH. Occurrence of hyperprolactinemia was highest in the OPH group (51.51%), followed by ScH (30.98%) and euthyroid children (4.41%) (p<0.001). Median (25 th -75 th percentiles) levels for prolactin in euthyroid, ScH, and OPH children were 13.3 (9.4-17.95), 19.15 (15.97-30.12), and 28.86 (17.05-51.9) ng/mL, respectively (p<0.001). In children, prolactin levels were comparable in males and females. An age-related increase in serum prolactin was noted in euthyroid children, which was statistically significant in post-pubertal (16-18 years) children. Area under the curve for thyroid stimulating hormone (TSH) in predicting hyperprolactinemia in children was 0.758 (95% confidence interval: 0.673-0.829; p<0.001). TSH ≥4.00 mIU/L had a sensitivity of 69.4% and specificity of 77.6% in detecting hyperprolactinemia. Hyperprolactinemia is common in children with ScH and OPH. TSH ≥4.00 mIU/L has a good sensitivity and specificity in predicting hyperprolactinemia in children. More studies are needed to establish if hyperprolactinemia should be an indication for treating ScH in children.

  20. Subclinical hypothyroidism in children with Down syndrome: To treat ...

    African Journals Online (AJOL)

    Solaf M. Elsayed

    2014-09-16

    Sep 16, 2014 ... Subclinical hypothyroidism in children with Down syndrome: To treat or not to treat??? Congenital hypothyroidism is 30 times more frequent in newborns with Down syndrome (DS) than in the population of healthy children [1]. Mild isolated plasma thyrotropin. (TSH) elevation with normal thyroxine (T4) ...

  1. Submental thyroid ectopy might cause subclinical hypothyroidism in early childhood

    Directory of Open Access Journals (Sweden)

    Mirjana Kocova

    2016-12-01

    Full Text Available Objective: Thyroid ectopy is a rare condition resulting from abnormal embryologic development and migration of the gland. Sublingual is the most common thyroid ectopy; all other ectopic thyroid locations occur very rare. There are no reports in the literature that describe the clinical course of patients with congenital hypothyroidism due to thyroid ectopy. Methods and Results: We present a child with congenital hypothyroidism detected on neonatal screening which had a subclinical course during follow-up. Scintigraphy revealed submental thyroid ectopy, a rare ectopic location and no orthotopic thyroid gland. Conclusion: Our case is unique because of the rare ectopic thyroid location but also of the unexpected clinical course; however, further thyroid monitoring is required for the therapy adjustment and detection of any changes in the ectopic tissue.

  2. Endocan, TGF-beta, and ADMA as Risk Factors for Endothelial Dysfunction and Possible Vascular Disease in Patients with Subclinical Hypothyroidism.

    Science.gov (United States)

    Arpaci, Dilek; Karakece, Engin; Tocoglu, Aysel Gurkan; Ergenc, Hasan; Gurol, Gonul; Ciftci, Ihsan Hakki; Tamer, Ali

    2016-12-01

    Although the relationship between atherosclerosis and overt hypothyroidism has been confirmed, it remains controversial in cases of subclinical hypothyroidism. Higher TSH and similar T4 suggest differences in set-points or differences due to diagnostic limitations regarding subclinical hypothyroidism. Endothelial dysfunction (ED) is a marker rather than a precursor of cardiovascular disease. Asymmetric dimethylarginine (ADMA) and endocan are known as novel markers of ED in various diseases. Transforming growth factor-beta (TGF-β) has a protective role against autoimmune diseases such as thyroiditis. This study aimed to determine the relationships between serum ADMA, endocan, TGF-β, and the high-sensitivity C-reactive protein (hs-CRP) levels, a proven indicator of ED, in patients with SH. Thirty-five patients with SH and 21 age- and sex-matched euthyroid subjects were included in the study. The levels of TSH, FT4, lipid parameters, endocan, ADMA, TGF-β, and hs-CRP were measured. No significant differences in age or sex were found between the patient and control groups (p=0.294 and 0.881, respectively). Mean TSH level was higher in the patient group (p=0.005), whereas mean fT4 level was similar in two groups (p=0.455). The average hs-CRP, endocan, TGF-β l level in the patient group was higher than control group (p=0.001; P=0.012; P=0.025; Phypothyroidism is associated with increased levels of serum endocan, ADMA, and TGF-β, which are new markers for ED. In particular, ADMA was correlated with both endocan and hs-CRP levels. These findings are suggestive for increased risk of ED and subsequent development of atherosclerosis in patients with SH. © 2016 by the Association of Clinical Scientists, Inc.

  3. Subclinical hypothyroidism in childhood - current knowledge and open issues.

    Science.gov (United States)

    Salerno, Mariacarolina; Capalbo, Donatella; Cerbone, Manuela; De Luca, Filippo

    2016-12-01

    Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T4 or free T4. This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals.

  4. Association between TPO Asn698Thr and Thr725Pro gene polymorphisms and serum anti-TPO levels in Iranian patients with subclinical hypothyroidism.

    Science.gov (United States)

    Khoshi, Amirhosein; Sirghani, Alireza; Ghazisaeedi, Mehran; Mahmudabadi, Ali Zare; Azimian, Amir

    2017-01-01

    Subclinical hypothyroidism (SCH) is defined as high levels of TSH in the presence of normal levels of serum FT4. Since thyroid peroxidase (TPO) plays a key role in thyroid hormone synthesis, variations in the TPO gene can change the enzyme structure and result in the production of anti-TPO antibodies. The aim of this study was to examine the relationship between the Asn698Thr (A2095C) and Thr725Pro (A2173C) polymorphisms of the TPO gene and anti-TPO levels in patients with SCH. In this study, 150 individuals (75 cases and 75 controls), aged 19-75 years, were selected randomly by a clinician. The thyroid function tests included were FT3, FT4, TSH and anti-TPO antibodies using ELISA. The TPO gene polymorphisms were examined by PCR-RFLP. Anti-TPO levels in the experimental group was significantly increased (P=0.020). The A2095C genotype frequency in the experimental and control groups were 37.3% vs 34.7% for the AA healthy genotype, 20% vs 46.7% for AC and 42.7% vs 18.6% for CC, respectively (P=0.001). The A2173C genotype frequency in the experimental and control groups were 22.6% vs 68% for healthy AA, 40% vs 25.3% for AC and 37.4% vs 6.7% for CC, respectively (P TPO antibodies were significantly associated with the A2173C polymorphism (P=0.035). The findings showed that the chance (odds ratio) of developing subclinical hypothyroidism in individuals who had C alleles was 1.5 and 5.6-fold higher than in individuals without these alleles in the A2095C and A2173C regions, respectively. Determination of anti-TPO antibody levels and exon 12 TPO gene polymorphisms in patients with SCH can be helpful for prediction of overt hypothyroidism.

  5. Hypothyroidism Complicating Nephropathy in a Diabetes Patient

    OpenAIRE

    Jayaprakash Sahoo; Ilangovan Veerappan; Anila Abraham; Somasundaram Hariharan

    2012-01-01

    We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus a...

  6. Hemodynamic changes after levothyroxine treatment in subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Faber, J; Petersen, L; Wiinberg, N

    2002-01-01

    In hypothyroidism, lack of thyroid hormones results in reduced cardiac function (cardiac output [CO]), and an increase of systemic vascular resistance (SVR). We speculated whether hemodynamic regulation in subjects with subclinical hypothyroidism (SH) (defined as mildly elevated thyrotropin [TSH.......05). These changes were qualitatively similar but quantitatively less pronounced than in 15 women with overt hypothyroidism, also studied. Taking the two groups together (n = 31), pretreatment thyroid function (expressed as either TSH or free T(4) estimate) correlated to CO and SVR as well as the changes induced...... by LT(4) (p hypothyroidism should...

  7. Cardiac changes with subclinical hypothyroidism in obese women.

    Science.gov (United States)

    Kılıçaslan, Barış; Tigen, Mustafa Kürşat; Tekin, Ahmet Selami; Ciftçi, Hilmi

    2013-09-01

    Obesity has been linked to a spectrum of minor cardiovascular changes. The aim of this study was to determine the effect of obesity on cardiac functions and its relations with subclinical hypothyroidism in healthy women. Eighty-eight consecutive "healthy" females (mean age: 31.2±6.6 years) were included in the study. Thyroid function tests and echocardiography studies were performed in all patients. Height, weight, and waist and hip circumference were also measured. A body mass index (BMI) above 30 kg/m2 was considered obese. Left ventricular mass (LVM) was higher in obese subjects (pobese subjects with higher E/e' (p=0.001) and larger left atrial volume (LAV) (pobese subjects (p=0.033). Thyroid-stimulating hormone (TSH) levels were significantly higher in obese subjects (p=0.011) and were positively correlated with BMI, waist circumference, LAV, and LVM. The prevalence of abnormal systolic and diastolic functions showed stepwise increases with higher TSH levels in obese subjects. Multiple regression analysis was used to evaluate the association of E/e' with anthromorphometric and biochemical parameters, and waist circumference was found to be the strongest independent variable correlated with the E/e' ratio. Cardiac structural and functional deteriorations may be related with subclinical hypothyroidism in obese subjects.

  8. Diagnosis and management of subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Negro, Roberto; Stagnaro-Green, Alex

    2014-10-06

    In prospective studies, the prevalence of undiagnosed subclinical hypothyroidism in pregnant women ranges from 3% to 15%. Subclinical hypothyroidism is associated with multiple adverse outcomes in the mother and fetus, including spontaneous abortion, pre-eclampsia, gestational hypertension, gestational diabetes, preterm delivery, and decreased IQ in the offspring. Only two prospective studies have evaluated the impact of levothyroxine therapy in pregnant women with subclinical hypothyroidism, and the results were mixed. Subclinical hypothyroidism is defined as raised thyrotropin combined with a normal serum free thyroxine level. The normal range of thyrotropin varies according to geographic region and ethnic background. In the absence of local normative data, the recommended upper limit of thyrotropin in the first trimester of pregnancy is 2.5 mIU/L, and 3.0 mIU/L in the second and third trimester. The thyroid gland needs to produce 50% more thyroid hormone during pregnancy to maintain a euthyroid state. Consequently, most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant to maintain euthyroidism. Ongoing prospective trials that are evaluating the impact of levothyroxine therapy on adverse outcomes in the mother and fetus in women with subclinical hypothyroidism will provide crucial data on the role of thyroid hormone replacement in pregnancy. © BMJ Publishing Group Ltd 2014.

  9. Subclinical hypothyroidism and cognitive function in people over 60 years

    DEFF Research Database (Denmark)

    Akintola, Abimbola A; Jansen, Steffy W; van Bodegom, David

    2015-01-01

    Subclinical hypothyroidism (SCH), defined as elevated thyroid stimulating hormone (TSH) and normal thyroid hormone levels, and cognitive impairment are both common in older people. While the relation between overt hypothyroidism and cognitive impairment is well established, data on the association...... criteria for eligibility and methodological quality, and data were extracted using standardized forms. Of the 844 reports initially identified, 270 remained after exclusion of duplicates. Of the 270, 15 studies comprising 19,944 subjects, of whom 1,199 had subclinical hypothyroidism were included. Data...... hypothyroidism was not significantly associated with accelerated cognitive decline. This systematic review and meta-analysis provides no evidence that supports an association between SCH and cognitive impairment in relatively healthy older adults....

  10. Hypothyroidism Complicating Nephropathy in a Diabetes Patient

    Directory of Open Access Journals (Sweden)

    Jayaprakash Sahoo

    2012-01-01

    Full Text Available We describe a patient with type 2 diabetes mellitus and autoimmune hypothyroidism who presented with elevated serum creatinine possibly due to subclinical rhabdomyolysis induced by hypolipidemic drug therapy in the background of diabetic nephropathy. Both hypothyroidism and rhabdomyolysis were asymptomatic in this case as evidenced by lack of classical clinical features of hypothyroidism despite elevated serum TSH and absent pigment cast in renal biopsy. The combination of diabetes mellitus and hypothyroidism is common in the general population and should not be forgotten in patients with diabetes and kidney disease.

  11. Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients

    African Journals Online (AJOL)

    Effect of levothyroxine therapy on dyslipidemia in hypothyroid patients. ... Internet Journal of Medical Update - EJOURNAL ... (both subclinical and overt hypothyroidism), its association with dyslipidemia and whether replacement therapy with thyroid hormone has an effect on plasma lipid profile of hypothyroid patients.

  12. Is there an association between subclinical hypothyroidism and preterm uterine contractions? A prospective observational study.

    Science.gov (United States)

    Nassie, Daniel I; Ashwal, Eran; Raban, Oded; Ben-Haroush, Avi; Wiznitzer, Arnon; Yogev, Yariv; Aviram, Amir

    2017-04-01

    To investigate the association between subclinical hypothyroidism and preterm contractions. Prospective observational study among women at 23 + 0/7 and 34 + 6/7 weeks of gestation, with no known thyroid function abnormality, and preterm uterine contractions (PTC). All patients underwent laboratory evaluation of Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4). Patients with and without PTC were compared. No association was found between PTC and subclinical hypothyroidism. Rate of spontaneous preterm delivery (PTD) was comparable between women with abnormal and normal thyroid function tests. Excluding indicated PTD, patients in the study group had a higher rate of spontaneous PTD (24.7% versus 9.6%, p = 0.03). Patients with past PTD and preterm contractions had higher rates of hypothyroxinemia compared with patients without past PTD (54.6% versus 19.0% and 31.2%, p = 0.001), and patients with past PTD (regardless of the presence or absence of PTC) had higher rate of subclinical hypothyroidism compared with patients with PTC and without PTD (59.1% and 66.7% versus 31.6%, p = 0.017). No association was found between PTC and subclinical hypothyroidism in the entire cohort, except for patients with preterm contractions and a history of past PTD. This specific group of patients might benefit from thyroid function evaluation.

  13. [Hypothyroidism in patients with heart disease].

    Science.gov (United States)

    Jiskra, Jan

    Hypothyroidism is frequently found in patients with heart disease. It is a risk factor for atherosclerosis and ischemic heart disease and has a direct negative effect on both the left and right ventricular functions (hypothyroidism-induced cardiomyopathy). The confirmed manifest hypothyroidism is always a reason for replacement therapy with levothyroxine; regarding patients with heart disease, we always begin treatment with a small dose and increase it gradually. The treatment of subclinical hypothyroidism in patients with heart disease is disputable and its benefits probably depend on age. At a higher age, the therapy-related risks often outweigh its benefits, so we make do with the target levels of the thyroid stimulating hormone being within the upper band of the normal range, or even slightly above it, rather than overdosing the patient. To summarize in a simplified way, the treatment of subclinical hypothyroidism in patients with heart disease is the most effective in younger individuals, mainly those aged below 65, while at a higher age > 80 years the risk usually outweighs the benefit.Key words: cardiovascular risk - hypothyroidism - ischemic heart disease - left ventricular dysfunction - right ventricular dysfunction - subclinical hypothyroidism - thyroid peroxidase antibodies.

  14. Coronary artery calcium scoring is a better predictor of cardiac risk in subclinical hypothyroidism patients with low-risk Framingham score

    Directory of Open Access Journals (Sweden)

    Rajesh Verma

    2016-01-01

    Full Text Available Context: Overt hypothyroidism accelerates the cardiovascular disease. Subclinical hypothyroidism (SCH, being considered as a preclinical state, impacts on cardiovascular status is not clear. Aims: This study was aimed at assessing cardiac risk stratification by Framingham risk scoring (FRS and coronary coronary artery calcium score (CACS by noncontrast cardiac computed tomography in SCH. Study Design: Observational study. Subjects and Methods: We enrolled thirty treatment-naive SCH patients (aged 30–60 years with no serious concurrent medical conditions, thirty euthyroid (age, sex, and body mass index-matched controls, and ten healthy controls. All cases were evaluated for coronary artery calcium scoring and Framingham risk score. Statistical Analysis: Qualitative data were analyzed using the Chi-square test. In addition, demographics and CACS are summarized graphically or in a table. Results: SCH cases had higher thyroglobulin, while there was a trend toward an increase in total cholesterol, low-density lipoprotein (LDL, very LDL, and decrease in HDL levels. All participants had low-risk FRS (10-year FRS < 10%. The mean CACS in SCH was significantly higher than simple obese and healthy controls (47.17 vs. 2.67 vs. 0.00. Conclusion: This study suggests that SCH is an independent risk factor for coronary artery disease in apparently healthy controls. The risk of occult coronary artery disease is increased in SCH cases.

  15. Management of subclinical hypothyroidism in pregnancy: are we too simplistic?

    Science.gov (United States)

    Brabant, Georg; Peeters, Robin P; Chan, Shiao Y; Bernal, Juan; Bouchard, Philippe; Salvatore, Domenico; Boelaert, Kristien; Laurberg, Peter

    2015-07-01

    Guideline advice of many societies on the management of subclinical hypothyroidism in pregnancy suggests treatment when TSH serum levels exceed 2.5 mU/l. Justification of this procedure is based on limited experience, mainly from studies carried out in patients with positive thyroid-specific antibodies and higher TSH levels that classically define the condition in the non-pregnant state. Taking into account a lack of clear understanding of the regulation of thyroid hormone transport through the utero-placental unit and in the absence of foetal markers to monitor the adequacy of thyroxine treatment, this review attempts to discuss currently available data and suggests a more cautious approach. © 2015 European Society of Endocrinology.

  16. How selective are the new guidelines for treatment of subclinical hypothyroidism for patients with thyrotropin levels at or below 10 mIU/L?

    Science.gov (United States)

    Rosario, Pedro Weslley; Calsolari, Maria Regina

    2013-05-01

    By consensus, a thyrotropin (TSH) level persistently >10 mIU/L is an indication for the treatment of subclinical hypothyroidism (SCH). Controversy exists regarding patients whose TSH level is elevated but AACE) published their position about factors that should be considered in the decision on treating SCH. This study evaluated the frequency of these factors among adult (non-pregnant) women with SCH whose TSH levels are ≤10 mIU/L. The presence of the conditions that should be considered for the treatment of SCH according to ATA and AACE was evaluated in 252 women who were diagnosed with SCH and had TSH levels ≤10 mIU/L. Pregnant women were excluded. Antithyroperoxidase antibodies (TPOAbs) were detected in 137 (54.3%) women. A high cardiovascular risk was observed in 43 (17%) women. Eighty (31.7%) women who were not at high cardiovascular risk presented at least one classical risk factor (arterial hypertension, elevated level of low-density lipoprotein-cholesterol or low level of high-density lipoprotein-cholesterol, smoking, or first-degree family history of premature coronary artery disease). At least one symptom or sign of hypothyroidism that could not be explained by another condition was observed in 180 (71.4%) women. Two hundred thirty-two (92%) women had positive TPOAbs, or at least one classical cardiovascular risk factor, or at least one symptom or sign of hypothyroidism. According to the new ATA and AACE guidelines, L-T4 therapy would be considered for 92% of women with SCH and TSH ≤10 mIU/L.

  17. Subclinical hypothyroidism in childhood obesity and its correlation with lipoproteins.

    Science.gov (United States)

    Emokpae, M A; Adeleke, S I; Uwumarongie, H O

    2011-12-01

    There is an ongoing debate regarding the influence of subclinical hypothyroidism on body mass index. The objectives of the study were (i) to determine whether levels of thyroid stimulating hormone (TSH) are elevated in obese children, (ii) to compare the serum levels of triiodothyronine (T3) and thyroxine (T4) in obese with non-obese and (iii) to examine the association of subclinical hypothyroidism with lipoproteins and body mass index. Fifty six obese children/adolescent girls aged 10.5 +/- 4.3 years, BMI 31.2 +/- 2.2 kg/m2 and apparently healthy children aged 11.2 +/- 5.2 years, BMI 21.0 +/- 2.1 kg/m2 were evaluated. Serum T3, T4 and TSH were measured using ELECSYS 1010 autoanalyzer while serum triglyceride, total cholesterol, LDL cholesterol, HDL cholesterol and glucose were measured using enzyme catalyzed colorimetric techniques. Subclinical hypothyroidism was observed in 10.7% of obese subjects. Significantly increase levels of T3 (p obese than control subjects. TSH and triglyceride correlated positively with body mass index. Subclinical hypothyroidism was present in 10.7% of obese children. TSH and triglyceride correlated positively with body mass index in childhood/adolescent obesity. There is need for this group ofsubjects to be evaluated for thyroid hormones so that those requiring therapy can be diagnosed and treated.

  18. High prevalence of subclinical hypothyroidism during first trimester of pregnancy in North India

    Directory of Open Access Journals (Sweden)

    Dinesh K Dhanwal

    2013-01-01

    Full Text Available Background: Thyroid dysfunction is a common occurrence in pregnancy and affects both maternal and fetal outcomes. There are limited data on prevalence of hypothyroidism during pregnancy from India. Therefore, this study was designed to evaluate the prevalence of thyroid dysfunction especially hypothyroidism during first trimester in a large public hospital in North India. Materials and Methods: All the consecutive first trimester pregnant women attending Lok Nayak and Kasturba Hospitals were enrolled in the study after institutional ethics approval and consent from the study subjects. The pregnant women with diagnosed thyroid disease and on thyroid medications were excluded from the study. Morning samples of study participants were analyzed for thyroid hormone profile which included free T3, free T4, TSH, and TPO Ab. In addition, all study participants were tested for CBC, LFT, KFT, and lipid profile. Results: A total of 1000 women were enrolled for this prospective observational study. The mean (SD age of study subjects was 25.6 (11.1 years, and mean (SD gestational age was 10.3 (3.4 weeks. One hundred and forty-three (14.3% subjects had TSH values more than 4.5 mIU/L above the cutoff used for definition of hypothyroidism. Out of these, 135 had normal free T4 and therefore labeled as subclinical hypothyroidism and 7 had low free T4 suggestive of overt hypothyroidism. TPO Ab was positive in 68 (6.82% of total, 25 (18.5% of subclinical and 5 (71% of overt hypothyroid patients. Conclusion: Hypothyroidism, especially subclinical, is common in North Indian women during first trimester. Further countrywide studies are needed to evaluate the prevalence and etiology of hypothyroidism to prevent maternal and fetal adverse effects of hypothyroidism in India.

  19. Interventions for clinical and subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Reid, Sally M; Middleton, Philippa; Cossich, Mary C; Crowther, Caroline A

    2010-07-07

    Over the last decade there has been enhanced awareness of the appreciable morbidity of thyroid dysfunction, particularly thyroid deficiency. Since treating clinical and subclinical hypothyroidism may reduce adverse obstetric outcomes, it is crucial to identify which interventions are safe and effective. To identify interventions used in the management of hypothyroidism and subclinical hypothyroidism in pregnancy and to ascertain the impact of these interventions on important maternal, fetal, neonatal and childhood outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (November 2009). Randomised controlled trials (RCTs) that compared a pharmacological intervention for hypothyroidism and subclinical hypothyroidism in pregnancy with another intervention or placebo. Two review authors assessed trial eligibility and quality and extracted the data. We included three RCTs of moderate risk of bias involving 314 women. In one trial of 115 women, levothyroxine therapy to treat pregnant euthyroid women with thyroid peroxidase antibodies was not shown to reduce pre-eclampsia significantly (risk ratio (RR) 0.61; 95% confidence interval (CI) 0.11 to 3.48) but did significantly reduce preterm birth by 72% (RR 0.28; 95% CI 0.10 to 0.80). One trial of 30 hypothyroid women compared levothyroxine doses, but only reported biochemical outcomes. A trial of 169 women compared the trace element selenomethionine (selenium) with placebo and no significant differences were seen for either pre-eclampsia (RR 1.44; 95% CI 0.25 to 8.38) or preterm birth (RR 0.96; 95% CI 0.20 to 4.61). None of the three trials reported on childhood neurodevelopmental delay.There was a non-significant trend towards fewer miscarriages with levothyroxine, and selenium showed some favourable impact on postpartum thyroid function and decreased incidence of moderate to advanced postpartum thyroiditis. Levothyroxine treatment of clinical hypothyroidism in pregnancy is already standard

  20. Cardiovascular Risk Factors in Subclinical Hypothyroidism: A Case Control Study in Nepalese Population

    Directory of Open Access Journals (Sweden)

    Rajendra KC

    2015-01-01

    Full Text Available Objectives. To assess cardiovascular risk factors in Nepalese population with subclinical hypothyroidism as compared to age and sex matched controls. Materials and Methods. A case control study was conducted among 200 subjects (100 subclinical hypothyroid and 100 euthyroid at B.P. Koirala Institute of Health Sciences, Dharan, Nepal. Demographic and anthropometric variables including systolic and diastolic blood pressure (BP were taken. Blood samples were assayed for serum free triiodothyronine (fT3, free thyroxine (fT4, thyroid stimulating hormone (TSH, total cholesterol (TC, high density lipoprotein cholesterol (HDL-C, low density lipoprotein cholesterol (LDL-C, and high sensitivity C reactive protein (hs-CRP. Results. Subclinical hypothyroid patients had significantly higher diastolic BP, total cholesterol, LDL cholesterol, and hs-CRP than controls. The odds ratio of having hypercholesterolemia (>200 mg/dL, low HDL cholesterol (100 mg/dL, high hs-CRP (>1 mg/L, and high diastolic BP (>80 mmHg and being overweight (BMI ≥ 23 Kg/m2 in subclinical hypothyroidism was 2.29 (95% CI; 1.2–4.38, p=0.011, 1.73 (95% CI; 0.82–3.62, p=0.141, 3.04 (95% CI; 1.66–5.56, p<0.001, 2.02 (95% CI; 1.12–3.64, p=0.018, 3.35 (95% CI; 1.72–6.55, p<0.001, and 0.9 (95% CI; 0.48–1.67, p=0.753, respectively, as compared to controls. Conclusion. Subclinical hypothyroid patients are associated with higher risk for cardiovascular disease than euthyroid subjects.

  1. Delaying Thyroxine Until Positive Beta-Human Chorionic Gonadotropin is Safe for Patients Receiving Fertility Therapy: Applying New ATA Guidelines to Subclinical Hypothyroidism.

    Science.gov (United States)

    Goldberg, Alyse S; Sujana Kumar, Shoba; Greenblatt, Ellen; Lega, Iliana C; Shapiro, Heather

    2017-09-08

    This study sought to examine the effect of changing TSH threshold recommendations from 2.5 to 4 mIU/L before fertility therapy on the prevalence of early gestational subclinical hypothyroidism (SCH) (TSH2 >2.5 mIU/L) and to evaluate implications on progression to clinical pregnancy (defined as detection of cardiac activity on ultrasound). A retrospective chart review was performed in an academic fertility clinic on all patients with a measured pre-treatment TSH (TSH1) and positive beta-human chorionic gonadotropin following fertility treatment. The study assessed the effect of TSH2 on ongoing pregnancy, both in patients newly diagnosed with SCH and in patients previously receiving LT4, stratified by initial TSH. Of 482 women included in the study, baseline TSH (TSH1) was pregnancy (TSH2) was clinical pregnancy between women with a TSH2 of 2.5-4 mIU/L compared with women with a TSH2 clinical pregnancy (OR 0.90; 95% CI 0.28-2.86). Rate of progression to clinical pregnancy was equivalent between women with an early pregnancy TSH (TSH2) pregnancy, as opposed to pre-pregnancy if the TSH remains above cut-off because there does not appear to be a difference in in early pregnancy outcomes if treatment is delayed. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  2. Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

    DEFF Research Database (Denmark)

    Dahl, Maria; Ohrt, Johanne Dam; Fonvig, Cilius Esman

    2017-01-01

    OBJECTIVE: Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children and adolesc......OBJECTIVE: Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children...... and adolescents. METHODS: In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1.......28. The control group (n=1210) comprised lean children with a BMI SDS hormone (TSH), free triiodothyronine, and free thyroxine (fT4) at baseline. RESULTS...

  3. Improvements in insulin sensitivity are blunted by subclinical hypothyroidism.

    Science.gov (United States)

    Amati, Francesca; Dubé, John J; Stefanovic-Racic, Maja; Toledo, Frederico G; Goodpaster, Bret H

    2009-02-01

    Exercise- and weight loss-induced improvements in insulin resistance (IR) are variable; some individuals experience robust enhancements in insulin sensitivity, whereas others do not. Thyroid hormone status is related to IR, but it is not clear whether subclinical hypothyroidism may help to explain the variability in improvements in IR with diet and exercise. The purpose of this study was to examine whether thyroid hormone status is related to the improvement in insulin sensitivity and physical fitness after weight loss and exercise training. By retrospective nested case-control analysis, eight subclinical hypothyroid (sHT) subjects and eight matched euthyroid controls underwent a euglycemic hyperinsulinemic clamp and peak oxygen uptake test, before and after a 16-wk program of moderate aerobic exercise combined with diet-induced weight loss. All subjects were middle-aged (57.3 +/- 3.3 yr), were overweight to obese (body mass index = 33.1 +/- 0.8 kg m(-2)), and had impaired glucose tolerance. The improvement in insulin sensitivity was significantly lower (P hypothyroidism may interfere with beneficial adaptations on muscle metabolism and physical fitness that typically occur with weight loss and increased physical activity. These results may have significant clinical implications because of the high prevalence of both hypothyroidism and insulin resistance in the aging population.

  4. Prevalence of subclinical and undiagnosed overt hypothyroidism in a pregnancy loss clinic

    National Research Council Canada - National Science Library

    Khalid, A S; Joyce, C; O'Donoghue, K

    2013-01-01

    ...% of pregnancies respectively. We examined the prevalence of subclinical and undiagnosed overt hypothyroidism in women with recurrent miscarriage, late miscarriage and stillbirth attending the Pregnancy Loss Clinic...

  5. Is There Any Effect on Smell and Taste Functions with Levothyroxine Treatment in Subclinical Hypothyroidism?

    Science.gov (United States)

    Baskoy, Kamil; Ay, Seyid Ahmet; Altundag, Aytug; Kurt, Onuralp; Salihoglu, Murat; Deniz, Ferhat; Tekeli, Hakan; Yonem, Arif; Hummel, Thomas

    2016-01-01

    Subclinical hypothyroidism has been accused for coronary heart disease, lipid metabolism disorders, neuropsychiatric disorders, infertility or pregnancy related problems with various strength of evidence. Currently there is insufficient knowledge about olfaction and taste functions in subclinical hypothyroidism. Aim of the present study is to investigate the degree of smell and taste dysfunction in patients with subclinical hypothyroidism. 28 subclinical hypothyroid patients, and 31 controls enrolled in the prospective study in Istanbul, Turkey. Subclinical hypothyroid patients were treated with L-thyroxine for 3 months. Psychophysiological olfactory testing was performed using odor dispensers similar to felt-tip pens ("Sniffin' Sticks", Burghart, Wedel, Germany). Taste function tests were made using "Taste Strips" (Burghart, Wedel, Germany) which are basically tastant adsorbed filter paper strip. Patients scored lower on psychophysical olfactory tests than controls (odor thresholds:8.1±1.0 vs 8.9±1.1, p = 0.007; odor discrimination:12.4±1.3 vs 13.1±0.9, p = 0.016; odor identification:13.1±0.9 vs 14.0±1.1, p = 0.001; TDI score: 33.8±2.4 vs 36.9±2.1, p = 0.001). In contrast, results from psychophysical gustatory tests showed only a decreased score for "bitter" in patients, but not for other tastes (5.9±1.8 vs 6.6±1.0, p = 0.045). Three month after onset of treatment olfactory test scores already indicated improvement (odor thresholds:8.1±1.0 vs 8.6±0.6, psmell and taste, with thyroid function test were also evaluated. TSH, fT4 were found have no correlation with smell and taste changes with treatment. However bitter taste found positively correlated with T3 with treatment(r: 0.445, p: 0.018). Subclinical hypothyroid patients exhibited a significantly decreased olfactory sensitivity; in addition, bitter taste was significantly affected. Most importantly, these deficits can be remedied on average within 3 months with adequate treatment.

  6. Treatment of Subclinical Hypothyroidism or Hypothyroxinemia in Pregnancy.

    Science.gov (United States)

    Casey, Brian M; Thom, Elizabeth A; Peaceman, Alan M; Varner, Michael W; Sorokin, Yoram; Hirtz, Deborah G; Reddy, Uma M; Wapner, Ronald J; Thorp, John M; Saade, George; Tita, Alan T N; Rouse, Dwight J; Sibai, Baha; Iams, Jay D; Mercer, Brian M; Tolosa, Jorge; Caritis, Steve N; VanDorsten, J Peter

    2017-03-02

    Subclinical thyroid disease during pregnancy may be associated with adverse outcomes, including a lower-than-normal IQ in offspring. It is unknown whether levothyroxine treatment of women who are identified as having subclinical hypothyroidism or hypothyroxinemia during pregnancy improves cognitive function in their children. We screened women with a singleton pregnancy before 20 weeks of gestation for subclinical hypothyroidism, defined as a thyrotropin level of 4.00 mU or more per liter and a normal free thyroxine (T4) level (0.86 to 1.90 ng per deciliter [11 to 24 pmol per liter]), and for hypothyroxinemia, defined as a normal thyrotropin level (0.08 to 3.99 mU per liter) and a low free T4 level (hypothyroidism underwent randomization at a mean of 16.7 weeks of gestation, and 526 with hypothyroxinemia at a mean of 17.8 weeks of gestation. In the subclinical hypothyroidism trial, the median IQ score of the children was 97 (95% confidence interval [CI], 94 to 99) in the levothyroxine group and 94 (95% CI, 92 to 96) in the placebo group (P=0.71). In the hypothyroxinemia trial, the median IQ score was 94 (95% CI, 91 to 95) in the levothyroxine group and 91 (95% CI, 89 to 93) in the placebo group (P=0.30). In each trial, IQ scores were missing for 4% of the children. There were no significant between-group differences in either trial in any other neurocognitive or pregnancy outcomes or in the incidence of adverse events, which was low in both groups. Treatment for subclinical hypothyroidism or hypothyroxinemia beginning between 8 and 20 weeks of gestation did not result in significantly better cognitive outcomes in children through 5 years of age than no treatment for those conditions. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke; ClinicalTrials.gov number, NCT00388297 .).

  7. Clinical efficacy of therapeutic intervention for subclinical hypothyroidism during pregnancy.

    Science.gov (United States)

    Ju, R; Lin, L; Long, Y; Zhang, J; Huang, J

    2016-11-21

    This study explored the effects of levothyroxine (L-T4) replacement therapy on pregnancy outcomes in patients with subclinical hypothyroidism (SCH). We analyzed the effects on pregnancy outcomes with respect to gestational week when the desired thyroid-stimulating hormone (TSH) level was reached as well as the length of time required to reach the target level during L-T4 treatment. This study enrolled 457 patients diagnosed with SCH upon initial thyroid function screening. Subjects were assigned to the treatment group (N = 184), and the control group (N = 273). Two variables were analyzed in the treatment group: the gestational week when the target TSH level was achieved and the length of time required to reach the target level during treatment. Based on these criteria, the treatment group was further divided into subgroups, including three subgroups based on the time required to reach target levels (8 weeks) and gestational week when the target TSH level was achieved (before the 12th, between the 12th-28th, and after the 28th gestational week). The overall risk of complications in the control group was significantly higher than in the treatment group (P 8 weeks treatment duration (P pregnancy outcomes in pregnant women with SCH. The shorter the treatment duration required to reach the target TSH level and the earlier the gestational week when the target TSH level is achieved through treatment, the lower the incidence of complications.

  8. [Subclinical and manifested hypothyroidism as a consequence of thyroid autoimmune disease].

    Science.gov (United States)

    Milosević, Dragoslav P; Djurica, Snezana; Davidović, Mladen; Stević, Radmila; Rajić, Miodrag; Marković, Natasa

    2005-10-01

    Chronic thyroiditis (Hashimoto's disease) is a slowly developing persistent inflamation of the thyroid gland, which frequently leads to hypothyroidism. Some of the up-to-date knowledge about hypothyroidism, both subclinical and manifested, caused by autoimmune disease, was presented. Autoimmune thyroid gland disease can occur at any age, but predominantly affects women after periods of high emotional and physical stress or accidents, as well as during periods of hormonal changes. It can also develop in families, and having an autoimmune disease slightly increases the risk of developing another. This paper showed an increasing incidence of subclinical hypothyroidism (4.17%) in elderly, and, at the same time, the incidence of primary hypothyroidism accounting for 1%. It is very usefull to estimate the stimulated thyrotropin (TSH) response, as well as the value of fast, short time thyroid gland reserves, analyzed by T3 and T4 serum level at 60th minute after TRH stimulation. Treatment of choice for HT (hypothyroidism of any cause) is thyroid hormone replacement. Drug of choice is orally administered levothyroxine sodium, usually for life-time. The standard dose is 1.6-1.8 mcg/kg body weight per day, but is in most cases patient dependent. Elderly patients usually require smaller replacement dose of levothyroxine, sometimes less than 1 mcg/kg body weight per day with coronary dilatator at the same time.

  9. Prevalence of Subclinical Hypothyroidism in Pregnant Women in Tehran-Iran

    Directory of Open Access Journals (Sweden)

    Fakhrolmolouk Yassaee

    2014-07-01

    Full Text Available Background: Maternal subclinical hypothyroidism during pregnancy is associated with various adverse outcomes. Recent consensus guidelines advocate universal thyroid function screening during pregnancy. There are no data from Iran about the prevalence of thyroid hypofunction in pregnancy. This study aims to find the prevalence of thyroid dysfunction. Materials and Methods: In this descriptive cross sectional study, thyrotropin (TSH was measured in 3158 pregnant women irrespective of gestational age from October 2008-March 2012. If TSH was more than 2.5 mIU/L in the first trimester or more than 3 mIU/L in the second or third trimester, free T4 was measured to diagnose subclinical / overt hypothyroidism. If serum free T4 was in the normal range (0.7-1.8 ng/dl the diagnosis was subclinical hypothyroidism and if below the normal range, overt hypothyroidism was diagnosed. Results: A total of 3158 pregnant women were evaluated. One hundred forty seven of them were diagnosed as hypothyroidism. Subclinical hypothyroidism and overt hypothyroidism were present in 131 (89.1% and 16 (10.9% women respectively. Prevalence of subclinical hypothyroidism was 4.15%. Most of the subclinical and overt hypothyroidism cases were diagnosed in the first trimester. Conclusion: It appears logical to check TSH during pregnancy due to the observed prevalence of subclinical hypothyroidism.

  10. Subclinical hypothyroidism and myocardial function in obese children.

    Science.gov (United States)

    Brienza, C; Grandone, A; Di Salvo, G; Corona, A M; Di Sessa, A; Pascotto, C; Calabrò, R; Toraldo, R; Perrone, L; del Giudice, E Miraglia

    2013-09-01

    Pediatric obesity is an important health problem representing a major public health concern worldwide in the last decades. An isolated elevation of Thyroid Stimulating Hormone (TSH) with normal levels of thyroid hormones is frequently found in obese children. It has been named Isolated Hyperthyreotropinemia or Subclinical Hypothyroidism (SCH) and may be considered a consequence of obesity. Evidence exists that SCH is related to impairment of both systolic and diastolic myocardial function in the adult population. The aim of our study is to establish if obesity-related SCH influences myocardial function in children. We examined 34 obese children and adolescents with SCH and 60 obese children with normal TSH levels who underwent Doppler echocardiographic to evaluate myocardial function. Global systolic function as assessed by Ejection Fraction (EF) was comparable between groups, however Right Ventricle pressure global systolic function and pressure were significantly reduced in SCH group. Mitral annulus peak systolic (MAPSE) excursion lateral and MAPSE septum resulted significantly reduced in SCH group. Tissue Doppler imaging peak systolic motion (TDI-S) was reduced in SCH group. Diastolic function also showed significant modifications in SCH group. These results suggest possible involvement of cardiac function in obese children with SCH resulting in both abnormal diastolic function and reduced longitudinal systolic function. This new insight into cardiovascular consequences of obesity-related SCH in children could influence clinical approach to such patients by pediatric endocrinologists. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Should Subclinical Hypothyroidism Be an Exclusion Criterion for the Diagnosis of Polycystic Ovary Syndrome?

    Science.gov (United States)

    de-Medeiros, Sebastião Freitas; Yamamoto, Márcia Marly Winck; de-Medeiros, Matheus Antônio Souto; Barbosa, Jacklyne Silva; Norman, Robert John

    2017-01-01

    The purpose of the study was to examine whether patients with subclinical hypothyroidism (SCH) should be excluded before making a diagnosis of polycystic ovary syndrome (PCOS). Seven hundred sixteen patients, 462 with true PCOS, 31 with PCOS-SCH, and 223 normal cycling women were enrolled. Clinical, metabolic, and hormonal parameters among the groups were investigated. Continuous variables were compared by one-way analysis of variance. Proportions were compared using Z test. Fisher test was used to compare categorical variables. Simple correlation was performed using Spearman's coefficient. Correlation between thyroid stimulating hormone (TSH) and dependent variables were performed using backward multiple regression. The significance level was set at 0.05. True polycystic ovary and polycystic ovary with subclinical hypothyroidism patients presented similar anthropometrical parameters. C-peptide was higher in polycystic ovary patients than in the other groups (p=0.014). Prevalence of glucose intolerance (p=0.186) and insulin resistance (p=0.293) was not statistically different in polycystic ovary and polycystic ovary with subclinical hypothyroidism. TSH levels showed positive correlation with lean body mass (p=0.032), total cholesterol (p=0.046, insulin (p=0.048) and prolactin (p=0.047). Backward multiple regression model retained TC, insulin, and PRL as predictors of TSH levels (p=0.011). Anthropometric parameters and ovary morphology were similar in both PCOS and PCOS-with-SCH patients. Regarding hormones, only C-peptide was higher in PCOS group. TSH correlated with total cholesterol, insulin, and prolactin. Before PCOS diagnosis, the exclusion criterion thyroid dysfunction should be standardized and subclinical hypothyroidism should not exclude a diagnosis of PCOS.

  12. [Clinical or subclinical hypothyroidism and thyroid autoantibody before 20 weeks pregnancy and risk of preterm birth: a systematic review].

    Science.gov (United States)

    Wang, Shaowei; Li, Min; Chu, Defa; Liang, Lin; Zhao, Xiaodong; Zhang, Junrong

    2014-11-01

    To evaluate the relationship between clinical or subclinical hypothyroidism and positive thyroid autoantibody before 20 weeks pregnancy and risk of preterm birth. Literature search was done in PubMed, EMBASE, Wanfang Medical Database, China Academic Journal Network Publishing Database and China Biology Medicine disc databases from January 1st, 1980 to December 31th, 2013. The following search terms were used:hypothyroidism, subclinical hypothyroidism, hypothyroxinnism, thyroid antibody, preterm labor, preterm birth, etc. (1) Criteria for inclusion:cohort studies and clinical studies were included; only articles that described at least 10 patients were eligible;the exposure was clinical or subclinical hypothyroidism and positive thyroid autoantihody, and outcome was preterm birth. (2) The excluded subjects were articles that described less than 10 patients; controls were pregnant women without eurothyrodisim. Meta-analysis was performed by RevMan 5. The relationship between clinical or subclinical hypothyroidism and positive thyroid autoantibody and risk of preterm birth was evaluated by OR or RR. (1) Twenty cohort studies were enrolled. A total of 39 596 cases of preterm birth occurred among 498 418 pregnant women. The controls in these studies were pregnant women with eurothyrodisim. (2) Clinical hypothyroidism in pregnancy: eight studies were included, reported data on 478 418 pregnant women (5 473 women with clinical hypothyroidism and 472 945 euthyroid pregnant women). The risk of preterm birth in pregnant women with clinical hypothyroidism was higher than those eurothyroid pregnant women in control group (OR = 1.25, 95% CI:1.15-1.36, P hypothyroidism in pregnancy: ten studies were included, reported data on 277 531 pregnant women (5 257 women with subclinical hypothyroidism and 272 274 euthyroid pregnant women). The risk of preterm birth in pregnant women with subclinical hypothyroidism was higher than those in control group by random effects analysis (OR = 1

  13. The value of P300 event related potentials in the assessment of cognitive function in subclinical hypothyroidism.

    Science.gov (United States)

    Dejanović, Mirjana; Ivetić, Vesna; Nestorović, Vojkan; Milanović, Zvezdan; Erić, Mirela

    2017-03-01

    Mild hypothyroidism (thyroid stimulating hormone [TSH] less than 10 mIU/L) induces reversible cognitive dysfunction, which can be evaluated by event related potentials (ERP). So far, only little is known about the impact of subclinical hypothyroidism on ERP as electrophysiological markers of cognitive activity. The aim of this study was to follow-up P300 latencies and amplitudes in patients with subclinical hypothyroidism and to evaluate the influence of thyroxine treatment which led to the normalization of TSH level in serum. We recorded the P300 wave using an auditory oddball paradigm in 60 patients (mean age 51.1±6.2 years, range 40-62 years), with subclinical hypothyroidism (normal mean value of FT4, with elevated TSH levels) at baseline, after 3 months, after 6 months and in 30 healthy control subjects. 30 patients treated six months with L-thyroxine until the normalization of TSH and 30 patients received placebo. The P300 latencies in patients with subclinical hypothyroidism were significantly longer, and the P300 amplitudes were significantly smaller than those of the control group. In the thyroxine treated patients P300 latency continuously decreased over the observation period with a significant difference after 6 months compared to baseline (Phypothyroidism. The P300 latency stands out as a marker for cognitive function recovery during treatment with thyroxine.

  14. Hypothyroidism and Mortality among Dialysis Patients

    Science.gov (United States)

    Rhee, Connie M.; Alexander, Erik K.; Bhan, Ishir

    2013-01-01

    Summary Background and objectives Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear. Design, setting, participants, & measurements This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time. Results Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4–2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death. Conclusions These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement

  15. Dyslipidemia in subclinical hypothyroidism requires assessment of small dense low density lipoprotein cholesterol (sdLDL-C

    Directory of Open Access Journals (Sweden)

    Saric Maida Seferovic

    2017-09-01

    Full Text Available Background. Usually both hypothyroidism and hyperthyroidism are related to the cardiovascular and cerebrovascular disease development. The relationship between subclinical hypothyroidism has been widely investigated but the findings remain controversial. The aim of the present study was to evaluate the lipid profile in patients with subclinical hypothyroidism (SHypo in comparison to controls and to determine the association of SHypo and dyslipidemia in attempt to find importance of small dense low-density lipoprotein cholesterol (sdLDL-C in atherosclerosis. Material and methods. In this study we included 100 women, aged 30 to 70 years that were divided into subgroups according to their age. According to the values of levels of thyroid hormones they were divided into euthyroid (control group (n = 64 and (newly discovered subclinical hypothyroidism (SHypo group (n = 36. A high-sensitivity C-reactive protein (hs-CRP and lipid profile, including small dense low-density lipoprotein cholesterol (sdLDL-C were determined. Body weight and height were measured and BMI calculated. History of the current illness, medication, alcohol consumption and cigarettes smoking were noted. Results. Changed lipid profile as well as elevated triglycerides and sdLDL-C were observed in the group with subclinical hypothyroidism compared to the control group. Conclusions. It is important to determine serum lipid levels, especially serum sdLDL-C levels at an early stage of subclinical hypothyroidism, since they represent atherogenic LDL particles and are better indicators for dyslipidaemia in subclinical hypothyroidism and the development of atherosclerosis with potential complications such as cardiovascular and cerebrovascular diseases.

  16. Thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus: a case report

    Directory of Open Access Journals (Sweden)

    Kunii Yasuto

    2011-09-01

    Full Text Available Abstract Introduction Non-convulsive status epilepticus is a form of epileptic seizure that occurs without convulsions. Recent reviews suggest that the diagnosis of non-convulsive status epilepticus remains difficult. Here, we report the case of a patient with thyroid-stimulating hormone elevation misdiagnosed as subclinical hypothyroidism following non-convulsive status epilepticus. Case presentation Our patient was a 68-year-old Japanese woman. The results of endocrine testing after her first episode of non-convulsive status epilepticus suggested latent subclinical hypothyroidism: she had elevated thyroid-stimulating hormone with normal levels of free tri-iodothyronine and free thyroxine. On examination, a diagnosis of thyroid disorder was not supported by other test results and our patient remained untreated. A follow-up examination revealed that her thyroid-stimulating hormone levels had spontaneously normalized. When she consulted another doctor for confusion, the transient increase in thyroid-stimulating hormone levels following non-convulsive status epilepticus was mistaken for subclinical hypothyroidism, and unfortunately treated with levothyroxine. Our patient then experienced levothyroxine-induced non-convulsive status epilepticus. Conclusions In this report, we suggested possible mechanisms for latent hypothyroid-like hormone abnormality following epileptic seizures and the possibility of provoking epileptic seizures by administering levothyroxine for misdiagnosed subclinical hypothyroidism.

  17. Efficacy of Levothyroxine in Migraine Headaches in Children with Subclinical Hypothyroidism

    OpenAIRE

    MIROULIAEI, Mehrdad; FALLAH, Razieh; BASHARDOOST, Nasrollah; PARTOVEE, Mina; ORDOOEI, Mahtab

    2012-01-01

    How to Cite this article: Mirouliaie M, Fallah R, Partovee M, Ordooei M. Efficacy of Levothyroxine in Migraine Headaches in Children with Subclinical Hypothyroidism. Iran J Child Neurol Autumn 2012;6(4):23-26. AbstractObjectiveHypothyroidism may be an exacerbating factor for  primary headaches and migraine is one of the most common primary headaches in childhood. Thepurpose of this study was to evaluate the effect of treatment of subclinical hypothyroidism on children with migraine headache.M...

  18. Study protocol; Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism

    DEFF Research Database (Denmark)

    Stott, David J.; Gussekloo, Jacobijn; Kearney, Patricia M.

    2017-01-01

    BACKGROUND: Subclinical hypothyroidism (SCH) is a common condition in elderly people, defined as elevated serum thyroid-stimulating hormone (TSH) with normal circulating free thyroxine (fT4). Evidence is lacking about the effect of thyroid hormone treatment. We describe the protocol of a large...... in the placebo group. The primary outcomes are changes in two domains (hypothyroid symptoms and fatigue / vitality) on the thyroid-related quality of life questionnaire (ThyPRO) at one year. The study has 80% power (at p = 0.025, 2-tailed) to detect a change with levothyroxine treatment of 3.......0% on the hypothyroid scale and 4.1% on the fatigue / vitality scale with a total target sample size of 750 patients. Secondary outcomes include general health-related quality of life (EuroQol), fatal and non-fatal cardiovascular events, handgrip strength, executive cognitive function (Letter Digit Coding Test), basic...

  19. Prevalence of subclinical and undiagnosed overt hypothyroidism in a pregnancy loss clinic.

    Science.gov (United States)

    Khalid, A S; Joyce, C; O'Donoghue, K

    2013-04-01

    Recent studies have associated pregnancy loss with subclinical hypothyroidism, defined as elevated thyroid-stimulating-hormone level, with normal free thyroxine. In overt hypothyroidism, the free thyroxine is low. Subclinical and overt hypothyroidism occurs in 0.25-2.5% and 0.2-0.3% of pregnancies respectively. We examined the prevalence of subclinical and undiagnosed overt hypothyroidism in women with recurrent miscarriage, late miscarriage and stillbirth attending the Pregnancy Loss Clinic. Data was collected from the Pregnancy Loss Clinic records. Women with sporadic miscarriages, autoimmune disorders, thrombophilias and known hypothyroidism were excluded. Two-hundred-and-sixty-two women were included. Median maternal age was 35 years (range 18-47). Subclinical and undiagnosed overt hypothyroidism was found in 11.45% of women. Twenty-two women (8.39%) had subclinical hypothyroidism, eight (3.05%) had undiagnosed overt hypothyroidism. Results were compared to women with ongoing pregnancies. A proportion of women attending the clinic had subclinical or undiagnosed overt hypothyroidism, raising the suspicion of causation in unexplained pregnancy loss.

  20. Subclinical hypothyroidism as an independent risk factor for colorectal neoplasm.

    Science.gov (United States)

    Mu, Guifang; Mu, Xuefeng; Xing, Huizhi; Xu, Ruibiao; Sun, Guangxi; Dong, Chonghai; Pan, Qichuan; Xu, Chao

    2015-04-01

    Recently, the prevalence of colorectal neoplasm is increasing sharply. It has been reported that both colorectal neoplasm and cardiovascular disease share similar common risk factors. Subclinical hypothyroidism (SCH) occurs in 4-20% of the adult population and is an independent risk factor for cardiovascular disease. However, no study has yet explored the relationship between SCH and colorectal neoplasm. Our objectives were to clarify the association between the two conditions. This is a case-control study. A total of 273 cases of colorectal neoplasm were first identified, and a 1:3 matched random sample of 819 controls was then collected using strata according to age, and gender. The medical records of all these patients were retrieved. Blood pressure, body mass index, and thyroid function were determined. Colonoscopies were performed by experienced gastroenterologists. A logistic regression analysis was carried out to explore the relationship between SCH and colorectal neoplasm. Remarkably, the prevalence rate of SCH was significantly higher in colorectal neoplasm (+) group, compared with colorectal neoplasm (-) group (Pneoplasm was found in 67 (34.9%) subjects in SCH group, which was more than that in euthyroid group (P=0.002). Moreover, patients with SCH were more likely to have advanced colonic lesion and colorectal cancer compared with euthyroid subjects (P=0.028 and 0.036, respectively). After adjusting for the factors of blood pressure, body mass index, history of hypertension and smoking, an association still existed between colorectal neoplasm and SCH (OR=1.689, 95% CI: 1.207-2.362, P=0.002). A strong association between SCH and colorectal neoplasm was firstly identified. SCH was found to be an independent risk factor for colorectal neoplasm. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  1. Subclinical hypothyroidism in pregnancy: intellectual development of offspring.

    Science.gov (United States)

    Behrooz, Hossein Ghorbani; Tohidi, Maryam; Mehrabi, Yadollah; Behrooz, Ebrahim Ghorbani; Tehranidoost, Mehdi; Azizi, Fereidoun

    2011-10-01

    The effects of maternal subclinical hypothyroidism (M-SCH) on the neuropsychological development of the offspring are not clear. We evaluated the intellectual development of children of mothers who had M-SCH during the pregnancy for these children. Sixty-two children were recruited. After excluding those age 15, 44 were enrolled. The mothers of these children were part of a sub-pool of 90, of 441 hypothyroid women of reproductive age seen in Tehran endocrine clinics between 1991 and 2003 and who were observed during gestation. Mothers were receiving levothyroxine (LT4) before gestation. Mothers of 19 children (control group) had normal serum thyrotropin (TSH) during the pregnancy that produced these children. Mothers of the other 25 children had increased TSH during the comparable pregnancy. Nineteen mothers had M-SCH (case group) and six had overt hypothyroidism. Serum TSH and free T4 (FT4) and urine iodine were measured, and seven cognitive performance and intelligence quotient (IQ) tests were performed. Case children were similar to control children with respect to gender, age, parental education, maternal age at time of pregnancy and at the time of their hypothyroidism, percent mothers having thyroid peroxidase antibodies, LT4 dose of mothers during pregnancy, gestational age at delivery, birth weight, and duration of breast feeding. Maternal TSH (mean ± standard deviation) in the case group during their mother's pregnancies was 11.3 ± 5.3 and 1.4 ± 1.0 mU/L in the controls (p hypothyroid mothers is similar in those whose mothers have M-SCH during pregnancy compared with those whose mothers have normal serum TSH concentrations during pregnancy.

  2. Pregnancy outcomes with thyroxine replacement for subclinical hypothyroidism: Role of thyroid autoimmunity

    Directory of Open Access Journals (Sweden)

    Muthukrishnan Jayaraman

    2013-01-01

    Full Text Available Objective: To study pregnancy outcomes in relation to thyroid peroxidase antibody (TPOAb status with optimum thyroxine replacement for subclinical hypothyroidism. Materials and Methods: Ninety-eight women with subclinical hypothyroidism were followed up until the end of their pregnancy. TPO antibody status was performed for 59 women (positive 20, negative 39. Levothyroxine was supplemented to maintain TSH between 0.3-3 mIU/l in all patients, irrespective of TPOAb status. Pregnancy outcomes were noted as pregnancy-induced hypertension (PIH, antepartum or postpartum hemorrhage, preterm delivery, and spontaneous abortion. Outcomes were compared between 3 groups as per TPO antibody status (positive, negative, and undetermined, which were matched for age and gestational period. Results: Thyroid autoimmunity was noted in 34% of women screened for TPO antibody. A total of 11 adverse pregnancy outcomes were recorded (4 spontaneous abortions, 4 preterm deliveries, 3 PIH with no significant difference between the groups. Conclusion: Adverse pregnancy outcomes were not different in the 3 groups with adequate thyroxine replacement for pregnant women with subclinical hypothyroidism targeting TSH in euthyroid range, irrespective of thyroid autoimmunity status.

  3. Subclinical Hypothyroidism: Impact on Fertility, Obstetric and Neonatal Outcomes.

    Science.gov (United States)

    Usadi, Rebecca S; Merriam, Kathryn S

    2016-11-01

    The incidence of subclinical hypothyroidism (SCH) in pregnancy was classically thought to be low; however, with new definition of normal TSH range in pregnancy, there has been an increase in the percentage of women who meet classification for SCH. The diagnosis of SCH is important not only for monitoring for maternal conversion to overt hypothyroidism, but also for identifying obstetric and neonatal outcomes related to SCH. Although there have been proven associations between maternal overt hypothyroidism and adverse obstetric and neonatal outcomes, there has been conflicting data on the correlation between SCH and these outcomes. Recent data from a meta-analysis found an increased risk of pregnancy loss, placental abruption, premature rupture of membranes, and neonatal death for women with SCH compared to euthyroidism in pregnancy. Research studies have not demonstrated a distinct benefit from treatment of SCH, and the professional societies are divided on their recommendations for treating SCH. Additionally, universal screening of SCH is controversial at present. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Evidence for a specific defect in hippocampal memory in overt and subclinical hypothyroidism.

    LENUS (Irish Health Repository)

    Correia, Neuman

    2012-02-01

    CONTEXT: Declarative memory largely depends upon normal functioning temporal lobes (hippocampal complex) and prefrontal cortex. Animal studies suggest abnormal hippocampal function in hypothyroidism. OBJECTIVE: The aim of the study was to assess declarative memory in overt and subclinical (SCH) hypothyroid patients before and after l-T(4) (LT4) replacement and in matched normal subjects. DESIGN AND SETTING: A prospective, open-labeled interventional study was conducted at a teaching hospital. PARTICIPANTS AND INTERVENTION: Hypothyroid (n = 21) and SCH (n = 17) patients underwent neuropsychological tests at baseline and 3 and 6 months after LT4 replacement. Normal subjects were studied at the same time-points. MAIN OUTCOME: Tests of spatial, verbal, associative, and working memory; attention; and response inhibition and the Hospital Anxiety and Depression Scale were administered. RESULTS: Baseline deficits in spatial, associative, and verbal memory, which rely upon the integrity of the hippocampal and frontal areas, were identified in patients with overt hypothyroidism. Spatial and verbal memory were impaired in SCH patients (P < 0.05). TSH levels correlated negatively (P < 0.05) with these deficits. After LT4 replacement, verbal memory normalized. Spatial memory normalized in the SCH group but remained impaired in the hypothyroid group. Associative memory deficits persisted in the overt hypothyroid group. Hospital Anxiety and Depression Scale scores did not correlate with cognitive function. Measures of attention and response inhibition did not differ from control subjects. CONCLUSION: Cognitive impairment occurs in SCH and more markedly in overt hypothyroidism. These impairments appear predominantly mnemonic in nature, suggesting that the etiology is not indicative of general cognitive slowing. We propose that these deficits may reflect an underlying disruption of normal hippocampal function and\\/or connectivity.

  5. Subclinical hypothyroidism : A 'laboratory-induced' condition?

    NARCIS (Netherlands)

    Coene, Karlien L M; Demir, Ayse Y; Broeren, Maarten A. C.; Verschuure, Pauline; Lentjes, Eef G W M; Boer, Arjen Kars

    2015-01-01

    Objective: In current literature and guidelines, there is a tendency to define absolute TSH concentrations at which patient follow-up or even pharmaceutical intervention should be initiated. As TSH concentrations depend on the analytical method/platform used for TSH quantification, absolute cut-off

  6. Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with subclinical hypothyroidism.

    Science.gov (United States)

    Gürdal, Ahmet; Eroğlu, Hatice; Helvaci, Füsun; Sümerkan, Mutlu Çağan; Kasali, Kamber; Çetin, Şükrü; Aksan, Gökhan; Kiliçkesmez, Kadriye

    2017-03-01

    Prolongation of the peak-to-end interval of the T wave (Tp-e) has been reported as associated with ventricular arrhythmias. The aim of this study was to investigate the ventricular repolarization by using the Tp-e interval, Tp-e/QT ratio and Tp-e/ QTc ratio in patients with subclinical hypothyroidism (SH). We studied 56 volunteers: These were 28 patients with SH (mean age 45 ± 11 years) and 28 healthy subjects (mean age 34 ± 8 years). All basic biochemical parameters were analyzed and electrocardiograms (ECGs) were recorded. RR and QT intervals, QTc, Tp-e intervals and the Tp-e/QT and Tp-e/QTc ratios were calculated. The categorical and numerical variables were compared using the chi-square test and independent t test, respectively. Correlations were analyzed using the Spearman and Pearson correlation tests. We found no difference between QT and QTc intervals between groups. In the subjects with SH, the Tp-e intervals (87 ± 5 ms, 66 ± 5 ms, p< 0.01), Tp-e/ QT ratio (0.23 ± 0.03, 0.18 ± 0.01, p< 0.01) and Tp-e/QTc ratio (0.21 ± 0.02, 0.16 ± 0.01, p< 0.01) were increased compared with healthy subjects. We also found positive correlations between levels of thyroid stimulating hormone (TSH) and Tp-e (r = 0.72, p< 0.01), Tp-e/ QT ratio (r = 0.67 p< 0.01), Tp-e/ QTc ratio (r = 0.68, p< 0.01). In the subjects with SH, Left Ventricular Myocardial Performance Index (LV-MPI) was increased compared with the healthy subjects (0.64 ± 0.08, 0.59 ± 0.09, p = 0.066) although it was not significant. Compared with healthy subjects, patients with SH demonstrated longer Tp-e intervals, and higher Tp-e/QT and Tp-e/QTc ratios. TSH levels were positively correlated with Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.

  7. Prospective Observation of 5-Year Clinical Course of Subclinical Hypothyroidism in Korean Population

    Science.gov (United States)

    Park, Woo Ri; Oh, Tae Keun

    2013-01-01

    Subclinical hypothyroidism (SCH) is a common clinical condition, whereas it's natural course has not been identified distinctly. We evaluated the natural history of 169 SCH patients over 5-yr and the prognostic factors including thyroid autoantibodies and thyroid ultrasonographic (USG) findings related to develop overt hypothyroidism. After 5 yr, 47.3% of patients showed normalization of TSH, while 36.7% of patients remained persistence of high level of TSH, and overt hypothyroidism developed in 11.2% of patients. There were painless thyroiditis (2.9%) and hyperthyroidism (1.7%) during 5 yr follow-up. The thyroid nodule was seen in 48.6% of patients. Most of patients had 1 to 2 nodules whereas only 3% of patients with thyroid nodule had more than 6 nodules. Overt hypothyroidism patients had more heterogenous echogenecity in USG compared to patients with normalization or persistent SCH (76.5% vs 50.0% vs 35.0%, P = 0.048) and higher prevalence positive anti-thyroid peroxidase (anti-TPO Ab) and anti-thyroglobulin antibody (anti-Tg Ab) and titer of anti-TPO Ab than other two groups. The cut off values for prediction of overt hypothyroidism were TSH > 7.45 µIU/mL, free T4 560 IU/mL. SCH has various courses and initial TSH, free T4, presence of thyroid autoantibody, titer of thyroid autoantibody; and thyroid USG findings can serve as a prognostic factor for progression of overt hypothyroidism. These parameters suggest consideration to initiate thyroid hormone treatment in SCH. PMID:24265525

  8. Subclinical Hypothyroidism and Survival: The Effects of Heart Failure and Race

    Science.gov (United States)

    Curhan, Gary C.; Alexander, Erik K.; Bhan, Ishir; Brunelli, Steven M.

    2013-01-01

    Context: Studies examining the association between subclinical hypothyroidism and mortality have yielded conflicting results. Emerging data suggest these associations may depend upon underlying congestive heart failure (CHF) and/or race, but this has not been empirically determined. Objective: Our objective was to examine the association between subclinical hypothyroidism and hypothyroidism overall with mortality according to pre-existing CHF and race. Design and Participants: We examined the associations of subclinical hypothyroidism (TSH higher than assay upper limit of normal; total T4 within reference) and hypothyroidism overall (TSH higher than assay upper limit of normal; total T4 below lower limit of normal or within reference) with all-cause mortality among Third National Health and Nutrition Examination Survey participants stratified by CHF and race using multivariable Cox models. To confirm whether differences between strata were statistically significant, we tested for interaction on the basis of CHF (separately) and race by likelihood ratio testing. Results: There were 14 130 (95.0%) euthyroid controls and 749 (5.0%) participants with hypothyroidism, 691 (4.6%) of whom had subclinical disease. Subclinical hypothyroidism vs euthyroidism was associated with greater mortality in those with CHF but not in those without: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) = 1.44 (1.01–2.06) and 0.97 (0.85–1.11), respectively (P interaction = .03). Similar findings were observed for hypothyroidism overall. Hypothyroidism overall vs euthyroidism was associated with greater mortality in Black participants (HR = 1.44 [95% CI = 1.03–2.03]) but not in non-Blacks (HR = 0.95 [95% CI = 0.83–1.08]) (P interaction = .03). Conclusion: Among participants with CHF, subclinical hypothyroidism and hypothyroidism overall are associated with greater death risk. Additional studies are needed to confirm findings and explore possible mechanisms for the

  9. [Prevalence of clinical and subclinical hypothyroidism during pregnancy in a pregnant women population].

    Science.gov (United States)

    Cruz-Cruz, Edgar Alonso; Ramírez-Torres, Aurora; Pimentel-Nieto, Diana; Roque Sánchez, Armando Miguel

    2014-11-01

    To determine the prevalence of hypothyroidism during pregnancy in a group of pregnant patients attending antenatal care at the National Institute of Perinatology and to meet cases not detected by universal screening. Was conducted from October 2012 to March 2013, in a group of pregnant patients attending to National Institute of Perinatology, thyroid profile was performed according to the recom- mendations of the American Thyroid Association. Patients were referred to endocrinology consultation and treatment was started in case of abnormal thyroid profile. We used central tendency and non-parametric measures for description of the sample. The prevalence of thyroid disease in pregnancy was 33.9% (n = 37), 12.8% (n = 14) with clinical hypothyroidism and 21.1% (n = 23) subclinical hypothyroidism. The 87.1% (n = 95) of patients reported at least one symptom or risk factor history for thyroid disease, only 12.8% (n = 14), had no history or symptoms related to thyroid disease. There is no relationship between a history or symptoms reported and the presence of thyroid disease. The prevalence of thyroid clinical and subclinical disease is greater than that reported in the literature. There is not relationship with each risk factor for thyroid disease. Perform universal screening detects almost twice thyroid disease during pregnancy.

  10. Relationship between subclinical hypothyroidism and serum homocysteine concentration in premenopausal women

    Directory of Open Access Journals (Sweden)

    Ayfer Aydoğdu Çolak

    2013-09-01

    Full Text Available Objective: In our study we aimed to examine serum homocysteinelevels of patients without thyroid dysfunctionswho have high serum anti thyroid peroxidase (anti-TPOlevels and patients with subclinical hypothyroidism whohave high serum thyroid stimulating hormone (TSH andanti-TPO levels.Methods: One hundred and seven premenopause femaleoutpatients who referred to endocrine clinic of our hospitalwere included in our study. We generated 3 groups. Firstgroup (Control consists of 53 (50% patients between theages of 30-40 years. Second group (Euthyroid consistsof 31 (29% patients between the ages of 26-49. Thirdgroup (Subclinical Hypothyroidism consists of 23 (21%patients between the ages of 33-53 years. Serum totalcholesterol, triglycerides, high density lipoprotein (HDLlevels were measured by Olympus 2700 autoanalyzer.Serum TSH, free T4, anti-TPO and homocysteine levelswere measured by Siemens Immulite 2000 autoanalyzer.Results: In our study, total cholesterol, triglycerides, lowdensity lipoprotein (LDL and very low density lipoprotein(VLDL levels were not statistically significantly differentamong the groups. Although serum homocysteine levelsof the third group were higher than the other groups it wasnot statistically significantly different among the groups.Conclusion: Serum homocysteine and lipid levels of patientswith euthyroidism and subclinical hypothyroidismwho have positive anti-TPO levels may be inadequate inassessing the risk of cardiovascular diseases. J Clin ExpInvest 2013; 4 (3: 293-297Key words: Hypothyroidsm, homocysteine, premenopause

  11. Five-year follow-up for women with subclinical hypothyroidism in pregnancy.

    Science.gov (United States)

    Shields, Beverley M; Knight, Bridget A; Hill, Anita V; Hattersley, Andrew T; Vaidya, Bijay

    2013-12-01

    Increasing numbers of women are being treated with l-thyroxine in pregnancy for mild thyroid dysfunction because of its association with impaired neuropsychological development in their offspring and other adverse obstetric outcomes. However, there are limited data to indicate whether treatment should be continued outside of pregnancy. We aimed to determine whether subclinical hypothyroidism and maternal hypothyroxinemia resolve postdelivery. A total of 523 pregnant healthy women with no known thyroid disorders were recruited during routine antenatal care and provided blood samples at 28 weeks of pregnancy and at a mean of 4.9 years postpregnancy. TSH, free T₄, free T₃, and thyroid peroxidase antibody levels were measured in serum taken in pregnancy and at follow-up. Subclinical hypothyroidism in pregnancy (TSH >3 mIU/L) was present in 65 of 523 (12.4%) women. Of these, 49 (75.4%) women had normal thyroid function postpregnancy; 16 of 65 (24.6%) had persistent high TSH (TSH >4.5 mIU/L postpregnancy) with 3 women receiving l-thyroxine treatment. A total of 44 of 523 (8.4%) women had isolated maternal hypothyroxinemia in pregnancy (free T₄ 4.5 mIU/L outside pregnancy. Of the women with subclinical hypothyroidism in pregnancy with antibody measurements available, those with thyroid peroxidase antibodies in pregnancy were more likely to have persistently elevated TSH or be receiving l-thyroxine replacement after pregnancy (6 of 7 [86%] vs 10 of 57 [18%], P hypothyroidism in pregnancy are transient, so treatment with l-thyroxine in these patients should be reviewed because it may not be warranted after pregnancy.

  12. The Natural History of Subclinical Hypothyroidism in the Elderly: The Cardiovascular Health Study

    Science.gov (United States)

    Somwaru, Lily L.; Rariy, Chevon M.; Arnold, Alice M.

    2012-01-01

    Context: Studies of long-term outcomes of subclinical hypothyroidism have assessed only baseline thyroid function, despite natural transitions to euthyroidism and overt hypothyroidism over time. Objective: We provide estimates of persistence, resolution, and progression of subclinical hypothyroidism over 4 yr, stratified by baseline TSH, anti-thyroid peroxidase antibody (TPOAb) status, age, and sex. Design, Setting, and Participants: Participants were 3996 U.S. individuals at least 65 yr old enrolled in the Cardiovascular Health Study. Subclinical hypothyroidism was detected at baseline in 459 individuals not taking thyroid medication. Main Outcome Measure: Thyroid function was evaluated at 2 and 4 yr and initiation of thyroid medication annually. Results were stratified by baseline TSH, TPOAb status, age, and sex. Results: Persistence of subclinical hypothyroidism was 56% at 2 and 4 yr. At 2 yr, resolution was more common with a TSH of 4.5–6.9 mU/liter (46 vs. 10% with TSH 7–9.9 mU/liter and 7% with TSH ≥10 mU/liter; P hypothyroidism (P hypothyroidism were common between 2 and 4 yr. Age and sex did not affect transitions. Conclusions: Subclinical hypothyroidism persists for 4 yr in just over half of older individuals, with high rates of reversion to euthyroidism in individuals with lower TSH concentrations and TPOAb negativity. Future studies should examine the impact of transitions in thyroid status on clinical outcomes. PMID:22438233

  13. [Prevalence of cardiovascular diseases in patients with hypothyroidism].

    Science.gov (United States)

    Mitu, F; Cojocaru, Elena; Tamba, B; Leon, Maria-Magdalena

    2012-01-01

    The cardiovascular risk in patients with hypothyroidism is related to an increased risk of functional cardiovascular abnormalities and atherosclerosis. AIMS--The purpose of the present study was to examine a possible association between subclinical and clinical hypothyroidism and cardiovascular disease (CVD). The retrospective study, which covered a 12 months period, had the purpose to establish the prevalence of various risk factors for CVD, within subclinical and clinical hypothyroidism. We have studied 64 subjects with subclinical and clinical hypothyroidism admitted to the Rehabilitation Hospital, in the Cardiovascular Clinic. They were divided by sex, age, living environment (urban, rural), value of cholesterol, heart rate, BMI, blood pressure. CONCLUSIONS--The study revealed an increased risk of cardiovascular abnormalities and an increased risk of atherosclerosis: 65,61% subjects were obese, 90,6% with high blood pressure, 62,5% had dyslipidaemia. Subclinical thyroid dysfunction is common in older people. The identification of subclinical and clinical hypothyroidism earlier, pursuit of markers for subclinical atherosclerosis and deployment of lifestyle changes, are elements that can also be the key in improving clinical and paraclinical parameters.

  14. Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

    DEFF Research Database (Denmark)

    Dahl, Maria; Ohrt, Johanne Dam; Fonvig, Cilius Esman

    2017-01-01

    and adolescents. METHODS: In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1...... overweight/obese study participants. The positive correlations of circulating TSH and fT4 with WHtR suggest that central obesity, independent of the overall degree of obesity, augments the risk of concurrent thyroid abnormalities in children and adolescents with obesity.......OBJECTIVE: Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children...

  15. Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents

    DEFF Research Database (Denmark)

    Dahl, Maria; Ohrt, Johanne Dam; Fonvig, Cilius Esman

    2017-01-01

    OBJECTIVE: Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children...... and adolescents. METHODS: In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1...... overweight/obese study participants. The positive correlations of circulating TSH and fT4 with WHtR suggest that central obesity, independent of the overall degree of obesity, augments the risk of concurrent thyroid abnormalities in children and adolescents with obesity....

  16. Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke : An Individual Participant Data Analysis

    NARCIS (Netherlands)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P. J.; Ikram, M. Arfan; Blum, Manuel R.; Collet, Tinh-Hai; Bakker, Stephan J. L.; Dehghan, Abbas; Drechsler, Christiane; Luben, Robert N.; Hofman, Albert; Portegies, Marileen L. P.; Medici, Marco; Iervasi, Giorgio; Stott, David J.; Ford, Ian; Bremner, Alexandra; Wanner, Christoph; Ferrucci, Luigi; Newman, Anne B.; Dullaart, Robin P.; Sgarbi, Jose A.; Ceresini, Graziano; Maciel, Rui M. B.; Westendorp, Rudi G.; Jukema, J. Wouter; Imaizumi, Misa; Franklyn, Jayne A.; Bauer, Douglas C.; Walsh, John P.; Razvi, Salman; Khaw, Kay-Tee; Cappola, Anne R.; Voelzke, Henry; Franco, Oscar H.; Gussekloo, Jacobijn; Rodondi, Nicolas; Peeters, Robin P.

    Objective: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. Data Sources and Study Selection: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished

  17. A Genomic Analysis of Subclinical Hypothyroidism in Hippocampus and Neocortex of the Developing Brain -- JN

    Science.gov (United States)

    Hypothyroidism during pregnancy and the early postnatal period has severe neurological consequences for the developing offspring. The impact of milder degrees of perturbation of the thyroid axis, typically considered subclinical, however, has not been established. Thyroid hormo...

  18. Postpartum follow-up in women diagnosed with subclinical hypothyroidism during pregnancy

    Directory of Open Access Journals (Sweden)

    K Neelaveni

    2017-01-01

    Full Text Available Background: Management guidelines about the thyroid disease in pregnancy are silent about the postpartum course of new onset subclinical hypothyroidism (SCH. Hence, we analyzed the 2 years outcome of SCH diagnosed during pregnancy. Materials and Methods: We conducted this retrospective study using the medical records of patients with new onset SCH during pregnancy between 2010 and 2013 (n = 718. Patients who stopped their levothyroxine after delivery with a 2-year follow-up record were included. We excluded patients with known thyroid disorders and continuous use of drugs that affect the thyroid results. The patients were divided into two groups (Group 1 – euthyroid and Group 2 – hypothyroid based on the final outcome after 2 years. The data were analyzed using appropriate statistical methods and a P < 0.05 was considered statically significant. Results: A total of 559 (77.8% women stopped levothyroxine after delivery, and the final follow-up data were available for 467 patients only. At the end of 2 years, 384 (82.2% remained euthyroid, and the remaining 83 (17.8% developed hypothyroidism. SCH and overt hypothyroidism were seen in 22 and 61 patients, respectively. Group 2 patients had higher mean age (25.5 vs. 23.6 years, goiter (51 vs. 2%, initial thyroid stimulating hormone (7.9 vs. 5.1 μIU/mL, and thyroid antibody positivity (76 vs. 13% (P < 0.001. Conclusion: The majority of patients with SCH during pregnancy remain euthyroid after delivery. Advanced age, goiter, positive family history, and thyroid autoimmunity increase the future risk of hypothyroidism in patients with SCH diagnosed during pregnancy.

  19. Subclinical hypothyroidism ups the risk of vascular complications in ...

    African Journals Online (AJOL)

    The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical ...

  20. Subclinical hypothyroidism is an independent risk factor for atherosclerosis and myocardial infarction in elderly women: the Rotterdam Study

    NARCIS (Netherlands)

    A.E. Hak (Liesbeth); H.A.P. Pols (Huib); T.J. Visser (Theo); H.A. Drexhage (Hemmo); J.C.M. Witteman (Jacqueline); A. Hofman (Albert)

    2000-01-01

    textabstractBACKGROUND: Overt hypothyroidism has been found to be associated with cardiovascular disease. Whether subclinical hypothyroidism and thyroid autoimmunity are also risk factors for cardiovascular disease is controversial. OBJECTIVE: To investigate whether

  1. The Effects of Altered Membrane Cholesterol Levels on Sodium Pump Activity in Subclinical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Suparna Roy

    2017-02-01

    Full Text Available BackgroundMetabolic dysfunctions characteristic of overt hypothyroidism (OH start at the early stage of subclinical hypothyroidism (SCH. Na+/K+-ATPase (the sodium pump is a transmembrane enzyme that plays a vital role in cellular activities in combination with membrane lipids. We evaluated the effects of early changes in thyroid hormone and membrane cholesterol on sodium pump activity in SCH and OH patients.MethodsIn 32 SCH patients, 35 OH patients, and 34 euthyroid patients, sodium pump activity and cholesterol levels in red blood cell membranes were measured. Serum thyroxine (T4 and thyroid stimulating hormone (TSH levels were measured using enzyme-linked immunosorbent assays. Differences in their mean values were analysed using post hoc analysis of variance. We assessed the dependence of the sodium pump on other metabolites by multiple regression analysis.ResultsSodium pump activity and membrane cholesterol were lower in both hypothyroid groups than in control group, OH group exhibiting lower values than SCH group. In SCH group, sodium pump activity showed a significant direct dependence on membrane cholesterol with an inverse relationship with serum TSH levels. In OH group, sodium pump activity depended directly on membrane cholesterol and serum T4 levels. No dependence on serum cholesterol was observed in either case.ConclusionDespite the presence of elevated serum cholesterol in hypothyroidism, membrane cholesterol contributed significantly to maintain sodium pump activity in the cells. A critical reduction in membrane cholesterol levels heralds compromised enzyme activity, even in the early stage of hypothyroidism, and this can be predicted by elevated TSH levels alone, without any evident clinical manifestations.

  2. The Effects of Altered Membrane Cholesterol Levels on Sodium Pump Activity in Subclinical Hypothyroidism.

    Science.gov (United States)

    Roy, Suparna; Dasgupta, Anindya

    2017-03-01

    Metabolic dysfunctions characteristic of overt hypothyroidism (OH) start at the early stage of subclinical hypothyroidism (SCH). Na⁺/K⁺-ATPase (the sodium pump) is a transmembrane enzyme that plays a vital role in cellular activities in combination with membrane lipids. We evaluated the effects of early changes in thyroid hormone and membrane cholesterol on sodium pump activity in SCH and OH patients. In 32 SCH patients, 35 OH patients, and 34 euthyroid patients, sodium pump activity and cholesterol levels in red blood cell membranes were measured. Serum thyroxine (T₄) and thyroid stimulating hormone (TSH) levels were measured using enzyme-linked immunosorbent assays. Differences in their mean values were analysed using post hoc analysis of variance. We assessed the dependence of the sodium pump on other metabolites by multiple regression analysis. Sodium pump activity and membrane cholesterol were lower in both hypothyroid groups than in control group, OH group exhibiting lower values than SCH group. In SCH group, sodium pump activity showed a significant direct dependence on membrane cholesterol with an inverse relationship with serum TSH levels. In OH group, sodium pump activity depended directly on membrane cholesterol and serum T₄ levels. No dependence on serum cholesterol was observed in either case. Despite the presence of elevated serum cholesterol in hypothyroidism, membrane cholesterol contributed significantly to maintain sodium pump activity in the cells. A critical reduction in membrane cholesterol levels heralds compromised enzyme activity, even in the early stage of hypothyroidism, and this can be predicted by elevated TSH levels alone, without any evident clinical manifestations.

  3. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

    Directory of Open Access Journals (Sweden)

    Anne-Dorthe Feldthusen

    2015-01-01

    Full Text Available Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb, and mild (subclinical hypothyroidism in women from The Danish General Suburban Population Study (GESUS on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical hypothyroidism in a Danish population of women.

  4. Impaired Fertility Associated with Subclinical Hypothyroidism and Thyroid Autoimmunity: The Danish General Suburban Population Study

    Science.gov (United States)

    Pedersen, Palle L.; Larsen, Jacob

    2015-01-01

    Introduction. The aim of this study was to estimate the significance of TSH, thyroid peroxidase antibody (TPOAb), and mild (subclinical) hypothyroidism in women from The Danish General Suburban Population Study (GESUS) on the number of children born, the number of pregnancies, and the number of spontaneous abortions. Methods. Retrospective cross sectional study of 11254 women participating in GESUS. Data included biochemical measurements and a self-administrated questionnaire. Results. 6.7% had mild (subclinical) hypothyroidism and 9.4% prevalent hypothyroidism. In women with mild hypothyroidism TPOAb was significantly elevated and age at first child was older compared to controls. TSH and TPOAb were negatively linearly associated with the number of children born and the number of pregnancies in the full cohort in age-adjusted and multiadjusted models. TSH or TPOAb was not associated with spontaneous abortions. Mild (subclinical) hypothyroidism was associated with a risk of not having children and a risk of not getting pregnant in age-adjusted and multiadjusted models. Prevalent hypothyroidism was not associated with the number of children born, the number of pregnancies, or spontaneous abortions. Conclusion. Impaired fertility is associated with TSH, TPOAb, and mild (subclinical) hypothyroidism in a Danish population of women. PMID:26351582

  5. Thyroid hormone treatment among pregnant women with subclinical hypothyroidism: US national assessment.

    Science.gov (United States)

    Maraka, Spyridoula; Mwangi, Raphael; McCoy, Rozalina G; Yao, Xiaoxi; Sangaralingham, Lindsey R; Singh Ospina, Naykky M; O'Keeffe, Derek T; De Ycaza, Ana E Espinosa; Rodriguez-Gutierrez, Rene; Coddington, Charles C; Stan, Marius N; Brito, Juan P; Montori, Victor M

    2017-01-25

     To estimate the effectiveness and safety of thyroid hormone treatment among pregnant women with subclinical hypothyroidism.  Retrospective cohort study.  Large US administrative database between 1 January 2010 and 31 December 2014.  5405 pregnant women with subclinical hypothyroidism, defined as untreated thyroid stimulating hormone (TSH) concentration 2.5-10 mIU/L.  Thyroid hormone therapy.  Pregnancy loss and other pre-specified maternal and fetal pregnancy related adverse outcomes.  Among 5405 pregnant women with subclinical hypothyroidism, 843 with a mean pre-treatment TSH concentration of 4.8 (SD 1.7) mIU/L were treated with thyroid hormone and 4562 with a mean baseline TSH concentration of 3.3 (SD 0.9) mIU/L were not treated (PPregnancy loss was significantly less common among treated women (n=89; 10.6%) than among untreated women (n=614; 13.5%) (Ppregnancy loss (odds ratio 0.62, 95% confidence interval 0.48 to 0.82) but higher odds of preterm delivery (1.60, 1.14 to 2.24), gestational diabetes (1.37, 1.05 to 1.79), and pre-eclampsia (1.61, 1.10 to 2.37); other pregnancy related adverse outcomes were similar between the two groups. The adjusted odds of pregnancy loss were lower in treated women than in untreated women if their pre-treatment TSH concentration was 4.1-10 mIU/L (odds ratio 0.45, 0.30 to 0.65) but not if it was 2.5-4.0 mIU/L (0.91, 0.65 to 1.23) (Ppregnancy loss among women with subclinical hypothyroidism, especially those with pre-treatment TSH concentrations of 4.1-10 mIU/L. However, the increased risk of other pregnancy related adverse outcomes calls for additional studies evaluating the safety of thyroid hormone treatment in this patient population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Subclinical Hypothyroidism in Danish Lean and Obese Children and Adolescents.

    Science.gov (United States)

    Dahl, Maria; Ohrt, Johanne Dam; Fonvig, Cilius Esmann; Kloppenborg, Julie Tonsgaard; Pedersen, Oluf; Hansen, Torben; Holm, Jens Christian

    2017-03-01

    Thyroid abnormalities are common in obese children. The aim of the present study was to examine the prevalence of subclinical hypothyroidism (SH) and to determine how circulating thyroid hormone concentrations correlate with anthropometrics in Danish lean and obese children and adolescents. In this cross-sectional study, we included 3006 children and adolescents, aged 6-18 years, from the Registry of the Danish Childhood Obesity Biobank. The overweight/obese group (n=1796) consisted of study participants with a body mass index (BMI) standard deviation score (SDS) ≥1.28. The control group (n=1210) comprised lean children with a BMI SDS obese compared to lean study participants (10.4% vs. 6.4%, p=0.0001). In the overweight/obese group, fasting serum TSH concentrations were associated positively with BMI SDS (pobese compared with lean (p=0.0007) and 1.8 when presenting with a WHtR >0.5 (p=0.0003). The prevalence of SH was higher among overweight/obese study participants. The positive correlations of circulating TSH and fT4 with WHtR suggest that central obesity, independent of the overall degree of obesity, augments the risk of concurrent thyroid abnormalities in children and adolescents with obesity.

  7. Subsequent pregnancy outcomes in women previously diagnosed with subclinical hypothyroidism.

    Science.gov (United States)

    Nelson, David B; Casey, Brian M; McIntire, Donald D; Cunningham, F Gary

    2014-01-01

    To evaluate subsequent pregnancy outcomes in women previously identified during an index pregnancy to have subclinical hypothyroidism (SCH). From 2000 to 2003, thyroid analytes were measured in 17,298 women. Using their index pregnancy thyroid-analyte classification, pregnancy outcomes were compared between the returning cohorts. There were 6,985 women previously screened and subsequently delivered at our hospital though 2011 with 230 (3.3%) designated to have SCH and 6,645 (95.1%) euthyroid. Significant differences between the two cohorts included risk for diabetes (odds ratio [OR] 1.8, 95% confidence interval [CI] 1.2 to 2.7, p = 0.005), gestational diabetes (OR 1.74, 95% CI 1.13 to 2.69, p = 0.015), and stillbirth (OR 3.5, 95% CI 1.05 to 11.68, p = 0.042). After adjustment, the increased likelihood of diabetes (adjusted OR 1.58, 95% CI 1.04 to 2.40, p = 0.032) and stillbirth (adjusted OR 3.41, 95% CI 1.01 to 11.49, p = 0.048) persisted. Women identified during a previous pregnancy with SCH are at increased risk for some adverse perinatal outcomes during a subsequent pregnancy. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Beneficial Effects on Pregnancy Outcomes of Thyroid Hormone Replacement for Subclinical Hypothyroidism

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    Norman J. Blumenthal

    2017-01-01

    Full Text Available Background. Hypothyroidism and raised thyroid antibody levels have been associated with adverse obstetrical outcomes. Several studies have investigated causal associations, but results have been inconsistent and few studies have reported the effects of thyroxine replacement therapy on pregnancy outcomes in hypothyroid patients. Objective. The primary study objective was to determine the outcome of pregnancies in women diagnosed with overt and subclinical hypothyroidism (SCH (serum TSH > 2.5 mIU/L and those with elevated circulating thyroid autoantibody levels in the first trimester of pregnancy and after the institution of appropriate thyroxine replacement therapy to maintain the serum TSH ≤ 2.5 mIU/L. Study Design. This prospective observational study was undertaken between 2013 and 2016. Blood samples were taken from 1025 women at presentation for thyroid stimulating hormone (TSH, anti-thyroglobulin antibodies (TGAb, and thyroid peroxidase antibodies (TPOAb. Those with a TSH > 2.5 mIU/L were treated with thyroxine and managed appropriately to ensure that the TSH was maintained ≤2.5 mIU/L. Outcomes in these patients were compared to those in euthyroid patients. Maternal antenatal complications and perinatal outcomes were recorded. Results. There were a total of 1025 patients of whom 382 (37.5% were nulliparous. 10.1% had a TSH level > 2.5 mIU/L and 18.2% had at least one raised thyroid antibody level. No differences in adverse outcomes of pregnancy were evident in women treated for SCH or overt hypothyroidism compared to the euthyroid group. There was also no association between raised thyroid antibodies and adverse pregnancy outcomes in either group. Conclusion. There were no adverse outcomes of pregnancy found in pregnant women who had been diagnosed and treated with thyroxine for SCH at the time of presentation when compared to euthyroid patients. There was also no relationship with thyroid antibodies and adverse pregnancy

  9. Subclinical hypothyroidism in children and adolescents after hematopoietic stem cells transplantation without irradiation

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    Milenković Tatjana

    2014-01-01

    Full Text Available Background/Aim. Although total body irradiation (TBI was considered to be the primary cause of thyroid dysfunction following hematopoietic stem cells transplantation (HSCT, a significant prevalence of subclinical hypothyroidism after HSCT with chemotherapy-only conditioning regimens has been observed in several studies. The aim of this study was to assess changes in thyroid stimulating hormone (TSH levels in children after HSCT, without the use of irradiation at any time in the course of the treatment. Methods. Our cohort consisted of 41 children and adolescents who underwent autologous or allogeneic HSCT and were available for follow-up for at least one year after transplantation. Irradiation was not performed in any of the subjects, neither during pretransplatation therapy, nor during conditioning. The median duration of follow-up was 2.9 years. The indications for HSCT were hematologic malignancy (41.5%, solid malignant tumor (34.1%, and other disorders (24.4%. The thyroid status of all the subjects was assessed prior to HSCT and after follow-up period. Results. Thyroid dysfunction after HSCT was present in 27 (65.8% subjects. Subclinical hypothyroidism was the most common abnormality, presenting in 23 (56.1% patients, primary hypothyroidism was present in one (2.4% patient, while 3 (7.3% subjects had low free T4 with normal TSH values. Significantly (p < 0.01 higher elevations in TSH levels were present in the patients who received chemotherapy for the underlying disease prior to HSCT. Conclusion. Our findings emphasize the need for long-term monitoring of thyroid function following HSCT, regardless of whether or not irradiation was used.

  10. Replacement therapy with levothyroxine modulates platelet activation in recent-onset post-thyroidectomy subclinical hypothyroidism.

    Science.gov (United States)

    Desideri, G; Bocale, R; D'Amore, A; Necozione, S; Boscherini, M; Carnassale, G; Barini, A; Barini, A; Bellantone, R; Lombardi, C P

    2017-10-01

    Subclinical hypothyroidism has been linked to increased risk of atherosclerotic disease. Soluble CD40 ligand (sCD40L), mainly derived from activated platelets, and the lipid peroxidation product 8-iso-prostaglandin F 2α (8-iso-PGF 2α ) are known to play a relevant pathophysiological role in atherogenesis. In this study, we analyzed the relationship between thyroid hormones and circulating levels of sCD40L and 8-iso-PGF 2α in patient with recent-onset post-thyroidectomy subclinical hypothyroidism under replacement therapy. Circulating levels of thyroid hormones, sCD40L, and 8-iso-PGF 2α were assessed in 40 recently thyroidectomized patients (33 females, mean age 52.0 ± 11.7 years) at baseline (5-7 day after surgery) and after 2 months under replacement therapy with levothyroxine (LT-4). At baseline, circulating levels of thyroid hormones were indicative of a subclinical hypothyroidism (TSH 7.7 ± 3.9 μU/mL, FT3 1.8 ± 0.6 pg/mL, and FT3 8.9 ± 3.0 pg/mL). Circulating levels of sCD40L and 8-iso-PGF 2α were directly correlated with each other (r = 0.360, p = 0.023) and with TSH levels (r = 0.322, p = 0.043 and r = 0.329 p = 0.038, respectively). After 2 months under the replacement therapy with LT-4 circulating levels of TSH (from 7.7 ± 3.9 to 2.7 ± 2.8 μU/mL, p hypothyroidism to develop atherosclerotic disease. Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  11. Effect of levothyroxine therapy on hypertension in hypothyroid patients

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    A K Kapoor

    2012-01-01

    Full Text Available The aim of this study was to observe whether levothyroxine replacement therapy has an effect on hypertension in patients of hypothyroidism. This prospective study included all newly diagnosed cases of hypothyroidism (overt or subclinical with hypertension, of either sex between 21-70 years of age. Levothyroxine replacement therapy was administered continuously during study period. Patients were clinically assessed for blood pressure before and every 3-4 monthly on levothyroxine therapy. Statistical analysis was carried out using a paired Student’s t-test. During one year study period, out of 180 newly diagnosed hypothyroid cases enrolled, 88 had overt hypothyroidism (OH and 92 subclinical hypothyroidism (SH. Male: female ratio was 1: 6.5. Of these, hypertension was present in 51 (28.33% patients (33 OH and 18 SH. Only diastolic blood pressure was raised in 28(54.9% cases, systolic in 12 (23.53% and both systolic and diastolic in 11 (21.57% cases. Incidence of only diastolic hypertension was comparatively more in overt hypothyroidism (57.57% than subclinical hypothyroidism (50%. Complete reversal of hypertension was observed in 8 out of 17 SH and 18 out of 29 OH cases while partial reversal was noted in one case in each category. A statistically significant decrease in mean values of both systolic and diastolic blood pressure was observed in patients of SH as well as OH. Hypertension is fairly common in patients of hypothyroidism. Replacement therapy with levothyroxine is quite helpful in reversing hypertension, a potential cardiovascular risk factor.

  12. Subclinical hypothyroidism in the first trimester of pregnancy in North India

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    Jubbin Jagan Jacob

    2013-01-01

    Full Text Available Subclinical hypothyroidism based on population and trimester specific cut-offs is reported to complicate 1-2% of all pregnancies. Using the recent Endocrine Society guidelines of 2.5 mIU/L of Thyroid Stimulating Hormone as the upper level of normal in the first trimester the reported prevalence of subclinical hypothyroidism is much higher. Recent publications have also emphasized that there is considerable racial variation in the prevalence of thyroid disorders in pregnancy. Among published literature North Indian women appear to have the highest rates of subclinical hypothyroidism in the first trimester of pregnancy. More widespread use of universal screening and trimester specific ranges in pregnancy for thyroid hormonal assays will lead to a large number of North Indian women requiring treatment for thyroid disorders in pregnancy.

  13. Thyroid Function Within the Normal Range, Subclinical Hypothyroidism and the Risk of Atrial Fibrillation

    DEFF Research Database (Denmark)

    Baumgartner, Christine; da Costa, Bruno R.; Collet, Tinh-Hai

    2017-01-01

    variations in thyroid function within the normal range or subclinical hypothyroidism are also associated with AF. Methods -We conducted a systematic review and obtained individual participant data from prospective cohort studies that measured thyroid function at baseline and assessed incident AF. Studies...... were identified from MEDLINE and EMBASE databases from inception to July 27, 2016. The euthyroid state was defined as thyroid-stimulating hormone (TSH) 0.45 to 4.49 mIU/L, and subclinical hypothyroidism as TSH 4.5 to 19.9 mIU/L with free thyroxine (fT4) levels within reference range. The association...... of TSH levels in the euthyroid and subclinical hypothyroid range with incident AF was examined by using Cox proportional hazards models. In euthyroid participants, we additionally examined the association between fT4 levels and incident AF. Results -Of 30 085 participants from 11 cohorts (278 955 person...

  14. Subclinical Hypothyroidism after 131I-Treatment of Graves' Disease: A Risk Factor for Depression?

    Science.gov (United States)

    Yu, Jing; Tian, Ai-Juan; Yuan, Xin; Cheng, Xiao-Xin

    2016-01-01

    Although it is well accepted that there is a close relationship between hypothyroidism and depression, previous studies provided inconsistent or even opposite results in whether subclinical hypothyroidism (SCH) increased the risk of depression. One possible reason is that the etiology of SCH in these studies was not clearly distinguished. We therefore investigated the relationship between SCH resulting from 131I treatment of Graves' disease and depression. The incidence of depression among 95 patients with SCH and 121 euthyroid patients following 131I treatment of Graves' disease was studied. The risk factors of depression were determined with multivariate logistic regression analysis. Thyroid hormone replacement therapy was performed in patients with thyroid-stimulating hormone (TSH) levels exceeding 10 mIU/L. Patients with SCH had significantly higher Hamilton Depression Scale scores, serum TSH and thyroid peroxidase antibody (TPOAb) levels compared with euthyroid patients. Multivariate logistic regression analysis revealed SCH, Graves' eye syndrome and high serum TPO antibody level as risk factors for depression. L-thyroxine treatment is beneficial for SCH patients with serum TSH levels exceeding 10 mIU/L. The results of the present study demonstrated that SCH is prevalent among 131I treated Graves' patients. SCH might increase the risk of developing depression. L-thyroxine replacement therapy helps to resolve depressive disorders in SCH patients with TSH > 10mIU/L. These data provide insight into the relationship between SCH and depression.

  15. Adipokine expression and endothelial function in subclinical hypothyroidism rats

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    Ningning Gong

    2018-02-01

    Full Text Available The purpose of our study was to observe adipokine expression and endothelial function in subclinical hypothyroidism (sHT rats and to determine whether levothyroxine (LT4 treatment affects these changes. Sixty-five male Wistar rats were randomly divided into five groups: the control group; sHT A, B and C groups and the sHT + T4 group. The sHT rats were induced by methimazole (MMI and the sHT + T4 rats were administered LT4 treatment after 8 weeks of MMI administration. Thyroid function and lipid levels were measured using radioimmunoassays and enzymatic colorimetric methods, respectively. Serum adiponectin (APN, chemerin, TNF-α, endothelin (ET-1 and nitric oxide (NO levels were measured using ELISA kits and a nitric-reductive assay. The expression of APN, chemerin and TNF-α in visceral adipose tissue (VAT was measured in experimental rats using RT-PCR and Western blotting. Hematoxylin–eosin (HE staining was used to observe changes in adipose tissue. The sHT rats had significantly higher levels of thyroid-stimulating hormone (TSH, TNF-α, chemerin, ET-1, total cholesterol (TC and low-density lipoprotein cholesterol (LDL-C and lower levels of APN and NO than those in control and sHT + T4 rats. Based on Pearson correlation analysis, the levels of chemerin, TNF-α, ET-1, LDL-C, TC and triglyceride (TG were positively correlated with TSH, but APN and NO levels were negatively correlated with TSH. These findings demonstrated that high TSH levels contribute to the changes of adipokines and endothelial dysfunction in sHT, but LT4 treatment ameliorates those changes.

  16. Cardiovascular risk factors in children and adolescents with subclinical hypothyroidism

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    Yogesh Yadav

    2017-01-01

    Full Text Available Background: Subclinical hypothyroidism (SCH is a commonly encountered entity in day-to-day clinical practice and has been associated with adverse cardiovascular risk profile in adults and children. Data on children and adolescents with SCH, from India, are limited. Materials and Methods: This study was a cross-sectional case–control study, conducted at a tertiary care center in Northeast India. Twenty-seven children and adolescents aged 11 ± 2.4 years with SCH and thyroid-stimulating hormone >7.5 mIU/L were included in the study along with 20 age-, gender-, and height-matched controls. Multiple clinical, biochemical, and radiological cardiovascular risk factors were assessed and compared between the two groups. Results: Body mass index (BMI (P = 0.048, waist circumference (P = 0.008, waist to height ratio (P = 0.007, low-density lipoprotein cholesterol (P = 0.04, triglycerides (TGs (P = 0.038, TGs to high-density lipoprotein (HDL cholesterol ratio (P = 0.005, non-HDL cholesterol (P = 0.019, fasting insulin (P = 0.006, and homeostasis model assessment of insulin resistance (P = 0.007 were found to be significantly higher while free T4 (P = 0.002 and HDL cholesterol (P = 0.019 were found to be significantly lower in SCH subjects compared to controls. On multiple regression analysis, BMI was found to have significant association with multiple cardiovascular risk factors. Conclusion: Children and adolescents with SCH were found to have adverse cardiovascular risk profile. Long-term follow-up studies are required to assess the clinical significance of these findings and requirement for therapy.

  17. Hypothyroidism in diabetes mellitus patients in Eastern Nepal

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    Robin Maskey

    2015-01-01

    Full Text Available Context: The coexistence of diabetes mellitus (DM with hypothyroidism is a known clinical observation. Aims: To estimate prevalence and co-relate that of hypothyroidism in patients with DM in relation to the age and sex, the lipid profile, body mass index visiting diabetes clinic and inpatients in B. P. Koirala Institute of Health Sciences. Settings and Design: The hospital-based descriptive study. Materials and Methods: Two hundred and seventy-one known or newly detected cases of DM aged more than 15 years were selected randomly from September 2012 to September 2013 and subjected to evaluation for thyroid function - clinically and biochemically and other relevant investigations were done. Statistical Analysis Used: For descriptive statistics mean, standard deviation, percentage, proportion were calculated. For inferential statistics following test were carried out at the level of significant 0.05 where confidence interval is 95%. The statistical operations were done through Statistical Package for the Social Sciences version 10. Results: Of 271 subjects, the prevalence of hypothyroidism (clinical and subclinical in diabetics was, 4.05% (11/271 with females preponderance, of which 7 (30.4% were clinically hypothyroid and 4 (17.4% were subclinical hypothyroid. One (4.3% patient had subclinical hyperthyroidism. The mean age at diagnosis of type 2 DM was 51-60 years. 8.69% of diabetics with primary hypothyroids were having morbid obesity. High-density lipoprotein among different thyroid status were statistically significant (P = 0.042. Conclusions: Hypothyroidism is not uncommon in diabetes, and we found body mass index, mean triglyceride and cholesterol levels were more in those diabetic patients having coexisting hypothyroidism.

  18. PREVALENCE OF OVERT AND SUBCLINICAL HYPOTHYROIDISM AMONG INDIAN PREGNANT WOMEN AND ITS EFFECT ON FOETOMATERNAL OUTCOME

    OpenAIRE

    Deeksha; Ruchika; Anchal; Rekha; Manjula

    2016-01-01

    BACKGROUND Thyroid disorders are amongst the commonest endocrinological disorders encountered in pregnancy. It is now well established that not only overt (OH), but Subclinical Hypothyroidism (SCH) also has adverse effects on maternal and foetal outcomes. Most of the studies are from the western population and only a few studies have analysed pregnancy outcome in hypothyroid Indian pregnant women. Presently, there is a paucity of Indian data on the prevalence and effect of hypot...

  19. The effect of maternal subclinical hypothyroidism during pregnancy on brain development in rat offspring.

    Science.gov (United States)

    Liu, Dijie; Teng, Weiping; Shan, Zhongyan; Yu, Xiaohui; Gao, Yun; Wang, Sen; Fan, Chenling; Wang, Hong; Zhang, Hongmei

    2010-08-01

    Maternal thyroid hormones (THs), especially thyroxine (T(4)), are crucial to early brain development in the mammalian embryo. Epidemiological studies and case reports have shown that maternal subclinical hypothyroidism may result in significant negative effects on pregnancy and neurodevelopment of the fetus. To understand the mechanism responsible for these neurological alterations, we induced maternal subclinical hypothyroidism in pregnant rats. Behavior and several genes that are under the control of THs were evaluated in the offspring of TH-deficient rats. A total of 60 female rats were divided into three groups: (i) maternal subclinical hypothyroidism (total thyroidectomy with T(4) infusion), (ii) maternal hypothyroidism (total thyroidectomy without T(4) infusion), and (iii) control (sham operated). All rats were mated 10 days after the start of infusion. The infusion continued until 10 days postpartum. Pups were sacrificed at postnatal day 3 (PND 3), PND 7, and PND 21. The hippocampus was collected and tested for brain-derived neurotrophic factor (BDNF) and Rap1 protein expression by Western blotting and for BDNF and neural cell adhesion molecule mRNA expression by real-time polymerase chain reaction. On PND 41-PND 49, rat pups explored the Morris water maze. Time spent in the quadrant previously containing the platform was recorded. This study found decreases in BDNF mRNA expression (on PND 3) and protein level (on PND 3 and PND 7) in hippocampi of pups from subclinical hypothyroidism dams (p hypothyroidism offspring than in control offspring at PND 7 and PND 21. No change was observed in neural cell adhesion molecule mRNA expression in the maternal subclinical hypothyroidism offspring. In addition, results from the Morris water maze revealed that pups from the subclinical hypothyroidism dams showed deficits in long-term memory, spending less time in the platform quadrant (p 0.05) in this group as well. The long-term memory deficits of pups born to maternal

  20. Effect of subclinical hypothyroidism and obesity on whole-body and regional bone mineral content.

    Science.gov (United States)

    Bertoli, A; Fusco, A; Andreoli, A; Magnani, A; Tulli, A; Lauro, D; De Lorenzo, A

    2002-01-01

    The present investigation was aimed to evaluate the effect of subclinical hypothyroidism and obesity on bone mineral content (BMC) in different body segments. Thirty-two premenopausal women (age: 37 +/- 9.9 years), with a wide range in body mass index (BMI), were studied. Subclinical hypothyroidism was defined by a basal TSH > or = 4 microU/l and/or a TRH-stimulated peak > or = 30 microU/l. For each subject, weight, height, BMI (weight/height(2)) and the waist/hip ratio were measured. Total BMC, total bone mineral density (BMD), leg BMC, leg BMD, trunk BMC, trunk BMD, arm BMC and arm BMD were determined using dual-energy X-ray absorptiometry. Thyroid function (basal and TRH-stimulated TSH, free T(3) and free T(4)) were determined from fasting blood samples for all subjects. Anova was conducted within all the groups to observe the effect of thyroid status and/or obesity on BMC and BMD. There was no statistical difference for age. Total BMC was affected by obesity (p obesity (p hypothyroid status (p obesity seem to affect BMD differently in the body segments. An influence of gravitational force seems necessary in order to make evident the effect of subclinical hypothyroidism on bone. A condition of subclinical hypothyroidism should be considered when evaluating subjects for osteoporosis, since a BMD measured at the femoral neck may induce underestimation of initial osteoporosis. Copyright 2002 S. Karger AG, Basel

  1. Evaluation of Subclinical Hypothyroidism in Children and Adolescents: A Single-Center Study

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    Kamila Such

    2016-01-01

    Full Text Available The main purpose of our retrospective study was to evaluate the medical care of the patients with subclinical hypothyroidism (sHT and to investigate the rationale for administering L-thyroxine (LT-4 to young sHT patients. Patients and Methods. Based on a retrospective review of the charts of 261 patients referred to the Endocrinology Outpatient Clinic between 2009 and 2014 with suspicion of sHT, 55 patients were enrolled for further analysis. Data collected was baseline age, anthropometric measurements, serum TSH, fT4, fT3, anti-thyroid autoantibodies, positive family history, absence/presence of clinical symptoms, length of follow-up, and data concerning LT-4 therapy (therapy: T1; no therapy: T0. Results. T1 encompassed 33 (60.0% patients. There were no differences between T1 and T0 (p>0.05 with regard to age, TSH concentrations, BMI Z-score, and hSDS values, though follow-up was longer in T1 (p<0.01. Four (11.8% children in T1 and none in T0 had a positive family history of thyroid disorders. Fifteen (68.2% patients in group T0 became euthyroid. One (1.8% girl (T1 developed overt hypothyroidism. Conclusions. A small percentage of patients can proceed to overt hypothyroidism. Only positive family history seemed to influence the decision to initiate LT-4 therapy. Further prospective studies are warranted in order to establish treatment indications, if any, and the mean recommended dosage of LT-4.

  2. Is subclinical hypothyroidism associated with lower live birth rates in women who have experienced unexplained recurrent miscarriage?

    Science.gov (United States)

    van Dijk, Myrthe M; Vissenberg, Rosa; Bisschop, Peter H; Dawood, Feroza; van Wely, Madelon; Goddijn, Mariëtte; Farquharson, Roy G

    2016-12-01

    Thyroid disorders have been associated with recurrent miscarriage. Little evidence is available on the influence of subclinical hypothyroidism on live birth rates. In this cohort study, women who had experienced miscarriage and subclinical hypothyroidism (defined as thyroid-stimulating hormone >97.5th percentile mU/l with a normal thyroxine level) were investigated; the control group included women who had experienced recurrent miscarriage and normal thyroid function. Multivariable logistic regression was used to investigate the association of subclinical hypothyroidism. Data were available for 848 women; 20 (2.4%) had subclinical hypothyroidism; 818 women (96%) had euthyroidism; and 10 (1.2%) had overt hypothyroidism. The live birth rate was 45% in women with subclinical hypothyroidism and 52% in euthyroid women (OR 0.69, 95% CI 0.28 to 1.71). The ongoing pregnancy rate was 65% versus 69% (OR 0.82, 95% CI 0.32 to 2.10) and the miscarriage rate was 35% versus 28% (OR 1.43, 95% CI 0.56 to 3.68), respectively. No differences were found when thyroid stimulating hormone 2.5 mU/l was used as cut-off level to define subclinical hypothyroidism. In women with unexplained miscarriage, no differences were found in live birth, ongoing pregnancy and miscarriage rates between women with subclinical hypothyroidism and euthyroid women. Copyright © 2016. Published by Elsevier Ltd.

  3. [Hematological disturbances in subclinical hypothyroidism and their dynamics during substitution therapy].

    Science.gov (United States)

    Nekrasova, T A; Strongin, L G; Ledentsova, O V

    2013-01-01

    The aim of the study was to estimate dynamics of hematological disturbances in autoimmune thyroiditis and subclinical hypothyroidism (SH) during substitution therapy and without it and to elucidate factors promoting successful correction. The control group included 36 women, 60 others had SH. They were matched for age, BMI, free T3 level but differed in TSH (1.8 +/- 0.81 vs 7.0 +/- 3.41 mcunits/ml, p 0.05). The best effect of therapy and highest rise in ferritin level were documented in younger patients (p = 0.06), in the absence of obesity (p = 0.003) and at the low initial ferritin level (p obese patients. Sideropenic syndrome suggests potential benefits of levothyroxin therapy and may be regarded as an additional indication for its prescription.

  4. Association of Hypothyroidism with Body Mass Index, Systolic Blood Pressure and Proteinuria in Diabetic Patients: Does treated Hypothyroidism with Thyroxine Replacement Therapy Prevent Nephropathy/Chronic Renal Disease?

    Science.gov (United States)

    Aziz, Kamran M A

    2016-01-01

    Untreated or sub-clinical hypothyroidism is associated with insulin resistance, obesity, adverse effects on cardiovascular system, hypertension and in turn risk of nephropathy. However, these changes are reversible with thyroxine replacement therapy (TRT). Current research studied 4235 diabetic patients, divided into two groups, those with clinical hypothyroidism /on TRT, compared to those without thyroid disease or undiagnosed. BMI, blood pressure, creatinine, urine microalbumin and spot urine protein levels were compared between these two groups. Study finding demonstrated that for hypothyroid cases, BMI was higher (32.2 ± 7.44 versus 29.4 ± 5.7; p hypothyroidism (on TRT) was strongly associated with obesity (p hypothyroidism.

  5. Levothyroxine treatment restored the decreased circulating fibroblast growth factor 21 levels in patients with hypothyroidism.

    Science.gov (United States)

    Wang, Guang; Liu, Jia; Yang, Ning; Hu, Yanjin; Zhang, Heng; Miao, Li; Yao, Zhi; Xu, Yuan

    2016-06-01

    Fibroblast growth factor 21 (FGF21) is an important endogenous regulator of energy metabolism. Thyroid hormone has been shown to regulate hepatic FGF21 expression in rodents. The goal of this study was to evaluate the plasma FGF21 levels in participants with normal thyroid function, subclinical hypothyroidism, or overt hypothyroidism and to investigate the change of plasma FGF21 levels in patients with overt hypothyroidism after levothyroxine treatment. A total of 473 drug-naive participants were recruited, including 250 healthy control subjects, 116 patients with subclinical hypothyroidism, and 107 patients with overt hypothyroidism. Thirty-eight patients with overt hypothyroidism were assigned to receive levothyroxine treatment. The overt hypothyroidism group had decreased FGF21 levels compared with the control and subclinical hypothyroidism groups (Phypothyroidism. A significant increase in plasma FGF21 levels was observed after levothyroxine treatment (Phypothyroidism. The increase in FGF21 levels after levothyroxine treatment might be partly associated with the amelioration of metabolic disorders in patients with hypothyroidism. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  6. Subclinical Hypothyroidism and Thyroid Autoimmunity Are Not Associated With Fecundity, Pregnancy Loss, or Live Birth.

    Science.gov (United States)

    Plowden, Torie C; Schisterman, Enrique F; Sjaarda, Lindsey A; Zarek, Shvetha M; Perkins, Neil J; Silver, Robert; Galai, Noya; DeCherney, Alan H; Mumford, Sunni L

    2016-06-01

    Prior studies examining associations between subclinical hypothyroidism and antithyroid antibodies with early pregnancy loss and live birth suggest mixed results and time to pregnancy (TTP) has not been studied in this patient population. This study sought to examine associations of prepregnancy TSH concentrations and thyroid autoimmunity with TTP, pregnancy loss, and live birth among women with proven fecundity and a history of pregnancy loss. This was a prospective cohort study from a large, randomized controlled trial that took place at four medical centers in the United States. Healthy women, ages 18-40 y, who were actively attempting to conceive and had one or two prior pregnancy losses and no history of infertility were eligible for the study. There were no interventions. TTP, pregnancy loss, and live birth. Women with TSH ≥ 2.5 mIU/L did not have an increased risk of pregnancy loss (risk ratio, 1.07; 95% confidence interval [CI], 0.81-1.41) or a decrease in live birth rate (risk ratio, 0.97; 95% CI, 0.88-1.07) or TTP (fecundability odds ratio, 1.09; 95% CI, 0.90-1.31) compared with women with TSH pregnancy loss, TSH levels ≥ 2.5 mIU/L or the presence of antithyroid antibodies were not associated with fecundity, pregnancy loss, or live birth. Thus, women with subclinical hypothyroidism or thyroid autoimmunity can be reassured that their chances of conceiving and achieving a live birth are likely unaffected by marginal thyroid dysfunction.

  7. Impact of positive thyroid autoimmunity on pregnant women with subclinical hypothyroidism.

    Science.gov (United States)

    López-Tinoco, Cristina; Rodríguez-Mengual, Amparo; Lara-Barea, Almudena; Barcala, Julia; Larrán, Laura; Saez-Benito, Ana; Aguilar-Diosdado, Manuel

    2018-03-01

    The impact of subclinical hypothyroidism (SH) and thyroid autoimmunity on obstetric and perinatal complications continues to be a matter of interest and highly controversial. To assess the impact of SH and autoimmunity in early pregnancy on the obstetric and perinatal complications in our population. A retrospective cohort study in 435 women with SH (TSH ranging from 3.86 and 10 μIU/mL and normal FT4 values) in the first trimester of pregnancy. Epidemiological and clinical parameters were analyzed and were related to obstetric and perinatal complications based on the presence of autoimmunity (thyroid peroxidase antibodies [TPO] > 34 IU/mL). Mean age was 31.3 years (SD 5.2). Seventeen percent of patients had positive TPO antibodies. Presence of positive autoimmunity was associated to a family history of hypothyroidism (P=.04) and a higher chance of miscarriage (P=.009). In the multivariate analysis, positive TPO antibodies were associated to a 10.25-fold higher risk of miscarriage. No statistically significant associations were found with all other obstetric and perinatal complications. In our region, pregnant women with SH and thyroid autoimmunity had a higher risk of miscarriage but not of other obstetric and perinatal complications. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. [Prevalence and clinical characteristics of subclinical hypothyroidism in an opportunistic sample in the population of Castile-León (Spain)].

    Science.gov (United States)

    Mariscal Hidalgo, Ana Isabel; Lozano Alonso, José E; Vega Alonso, Tomás

    2015-01-01

    To describe the distribution of thyroid-stimulating hormone (TSH) values and to estimate the prevalence of subclinical hypothyroidism in the adult population of Castile and León (Spain). An observational study was conducted in an opportunistic sample of 45 primary care centers in Castile and León. TSH was determined in people aged ≥35 years that attended a primary care physician and had a blood test for any reason. Confirmatory analysis included free thyroxine and anti-thyroid peroxidase antibody determination. A total of 3957 analyses were carried out, 63% in women. The mean age was 61.5 years. The median TSH value was 2.3 μIU/mL (2.5 μIU/mL in women and 2.1 μIU/mL in men), with a rising trend with age. TSH values were higher in undiagnosed or untreated subclinical hypothyroidism than in patients under treatment. The lowest levels were found in euthyroidism. The prevalence of subclinical hypothyroidism was 9.2% (95%CI: 8.3-10.2), and hypothyroidism was three times higher in women than in men (12.4% versus 3.7%). Hypothyroidism increased with age, reaching a peak of 16.9% in women aged 45 to 64 years. The prevalence of subclinical hypothyroidism in our sample was high and in the upper limits of values found in previous studies. Proper diagnosis and treatment are important because of the risk of progression to hypothyroidism and the association with multiple diseases and other risk factors. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  9. Lipids in newly discovered subclinical and clinical hypothyroidism

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    Marinković Snežana

    2016-01-01

    Full Text Available There is a positive correlation between the levels of TSH and cholesterol levels, while levels between TSH levels triglicrerida negative correlation with the clinical and subclinical form of reduced thyroid function.

  10. Hipotiroidismo subclínico: Actualización Updating on subclinical hypothyroidism

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    Julieta García Sáez

    2005-12-01

    Full Text Available La utilización de técnicas ultrasensibles para la determinación de tirotropina (TSH han posibilitado un incremento notable del diagnóstico de hipotiroidismo subclínico (HSC, trastorno que se presenta en cualquier etapa de la vida (con mayor frecuencia en la tercera edad con predominio del sexo femenino y relacionado frecuentemente con la presencia de anticuerpos antitiroperoxidasa (antiTPO. Aunque por definición el HSC es asintomático, la mayoría de los pacientes refieren, al menos, un síntoma que podría ser expresión del HSC. El tratamiento medicamentoso o el expectante son las terapéuticas recomendadas, aunque no existe consenso internacional respecto a decidir una u otra. Los diferentes aspectos que giran alrededor de este trastorno, la controversia sobre la conducta terapéutica, así como lo disperso de las publicaciones sobre el tema y la utilización en la práctica clínica en Cuba de métodos ultrasensibles para precisar los niveles de TSH, motivaron la realización de esta revisión.The use of ultrasensitive techniques for determination of thyrotropine (TSH has made it possible to substantially raise the possibilities of diagnosis of subclinical hypothyroidism (SCH. This is a disorder that may occur in any life stage (more frequently in the older age mainly in females and mostly related to the presence of anti-thyroid peroxidase antibodies (antiTPO. By definition, subclinical hypothyroidism is asymptomatic but the majority of patients report at least a symptom that might be expression of hypothyroidism. Drug and expectant therapies are the most recommended types of treatment, although there is no international consensus on deciding the use of one or the other. The different aspects of this disorder, the controversy about the therapeutic behavior to be adopted as well as the scattered publications about this topic and the use of ultrasensitive methods in Cuban clinical practice to establish the levels of TSH motivated this

  11. The Effect of Early Substitution of Subclinical Hypothyroidism on Biochemical Blood Parameters and the Quality of Life

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    Pandrc Milena S.

    2017-04-01

    Full Text Available Background: Subclinical hypothyroidism (SCH is defined as high TSH and normal thyroxine. Data on the effects of early substitution by levothyroxine on psychophysical health in SCH are still not consistent enough to support its introduction.

  12. Final diagnosis in children with subclinical hypothyroidism and mutation analysis of the thyroid peroxidase gene (TPO).

    Science.gov (United States)

    Turkkahraman, Doga; Alper, Ozgul M; Aydin, Funda; Yildiz, Akin; Pehlivanoglu, Suray; Luleci, Guven; Akcurin, Sema; Bircan, Iffet

    2009-09-01

    To determine the final diagnosis of patients with subclinical hypothyroidism (SCH), and to perform mutation screening of the thyroid peroxidase gene (TPO). Infants with SCH without an identified etiology were included in the study. Patients with thyroid dysgenesis were excluded. Children > or = 2 years of age, and still on L-thyroxine (LT4) treatment underwent a diagnostic algorithm. After LT4 was discontinued for 4 weeks, thyroid function tests (TFT) were obtained. A perchlorate discharge test (PDT) was performed in patients with normal thyroid ultrasound but abnormal TFT. Sequence analysis of TPO was studied in all children who underwent a PDT. Forty-eight patients (23 males and 25 females) completed the trial. Among these children, 19 (39.5%) had transient SCH, and 29 (60.5%) had permanent SCH. Among patients with permanent SCH, 19 had thyroid hypoplasia, six had partial iodide organification defect with positive PDT, and four had other dyshormonogenesis with negative PDT. Mean LT4 dose before the medication ceased was 1.2 +/- 0.5 microg/kg/day in transient cases, and 1.7 +/- 0.4 in those with permanent SCH (p TPO mutation was detected. However, in five patients, seven different previously known TPO polymorphisms were detected: c.102C > G, L4L; > A, A576A; c.2088C > T, D666D; c.2263A > C, T725P; c.2630 T >C, V847A. LT4 treatment should be stopped after the age of 2 years in infants with SCH without a definite pathology of the thyroid gland to exclude cases with transient hypothyroidism. Additionally, we should consider particularly thyroid gland hypoplasia, and also partial defects in iodide organification in infants with SCH.

  13. Early levothyroxine treatment on maternal subclinical hypothyroidism improves spatial learning of offspring in rats.

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    Wang, S; Teng, W; Gao, Y; Fan, C; Zhang, H; Shan, Z

    2012-05-01

    Maternal hypothyroidism has adverse effects on neural development in the offspring. The present study aimed to investigate whether maternal subclinical hypothyroidism impairs spatial learning in the offspring, as well as the efficacy and optimal time of levothyroxine (L-T(4)) treatment in pregnancy. Female adult Wistar rats were randomly divided into six groups (n = 10 per group): control, hypothyroid (H), subclinical hypothyroid (SCH) and SCH treated with L-T(4), starting from the tenth, thirteenth and seventeenth gestational day (GD10, GD13 and GD17), respectively, to restore normal thyroid hormone levels. Spatial learning was assessed on progenies by a water maze test, a field excitatory postsynaptic potential (fEPSP) recording, and an long-term potentiation induction assay. Protein levels of early growth response protein 1 (Egr1), activity-regulated cytoskeleton-associated protein (Arc), Ras-proximate-1 (Rap1), p-extracellular signal-regulated kinase (p-ERK) and brain-derived neurotrophic factor (BDNF) were determined by western blotting. Progenies from the SCH and H groups demonstrated significantly longer mean latency in the water maze test and a lower amplification percentage of the amplitude and slope of the fEPSPs compared to offspring of the control group. L-T(4) treatment for the GD10 and GD13 groups significantly shortened mean latency and increased the amplification percentage of the amplitude and slope of the fEPSPs of the progeny of rats with subclinical hypothyroidism. However, L-T(4) treatment for the GD17 group showed only minimal effects on spatial learning in the offspring. Progenies of SCH and H groups had lower levels of Egr1, Arc, p-ERK and BDNF but higher levels of Rap1 compared to those of the controls. L-T(4) treatment ameliorated these protein expression changes in the progeny of rats with subclinical hypothyroidism. Maternal subclinical hypothyroidism impaired spatial learning in the offspring; L-T(4) treatment in early pregnancy

  14. Carotis Intima Media Thickness in Female Patiens with Subclinical Hypothyroidism - Orijinal Article

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    Hayriye

    2010-12-01

    Full Text Available Objective: Recent studies have shown that subclinical hypothyroidism (SCH has similar cardiovascular risks with clinical hypothyroidism (CH. We evaluated carotis intima media thickness (CIMT-indicator of early changes in atherosclerotic process- in female patients, who have either CH or SCH, with similar age and demographic features. Materials and Methods: In this study, we included 81 female patients admitted to internal medicine and endocrinology outpatient clinic, diagnosed with CH (30 or SCH (51 according to their laboratory findings and who have not previously received treatment and 38 healthy women. BMI (body mass index, sistolic and diastolic blood pressure, triglycerides (TG, total cholesterol (TC, LDL cholesterol (LDL-C, HDL cholesterol (HDL-C, vitamin B-12, folate, homocysteine, high-sensitive C-reactive protein (Hs CRP, and CIMT were measured in all participants Results: There was not a statistical difference between the groups in TG, TC, HDL-C, LDL-C, vitamin B-12, and folate levels (p>0.05. On the other hand, SCH and CH groups differed statistically significantly from the control group for Hs CRP (p=0.011, homocysteine (p<0.001, and CIMT values. Additionally, age was found to be the most important factor for increase in CIMT when multiple linear regression analysis was performed.Conclusions: Lack of difference between CH patients and SCH patients in respect to Hs CRP, homocystein, and CIMT shows that inflammation and increase in CIMT starts during SCH period. Hence, we think that the increase in CIMT in SCH patients when TSH levels are higher than the normal range is a clinically important sign of early cardiovascular diseases. Turk Jem 2010; 14: 89-94

  15. The debate on the link between subclinical hypothyroidism and childhood migraine: is initial endocrinological evaluation necessary for children with migraine?

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    Ekici, Bariş; Cebeci, Ayşe Nurcan

    2015-06-01

    Subclinical hypothyroidism (SH) is characterized by mildly elevated thyroid stimulating hormone (TSH) levels with normal serum-free thyroxine (fT4). While the prevalence of SH is 2 % in pediatric population, it has been reported much higher in children with migraine headache. In this study, the presence of subclinical hypothyroidism and associated endocrinological abnormalities in children with migraine naïve to treatment was investigated. Children with migraine who were diagnosed in Pediatric Neurology Clinic based on the second edition of the International Classification of Headache Disorders and who did not receive any medication were recruited in this cross-sectional study. All patients were examined by the same pediatric endocrinologist and anthropometric measurements, systemic blood pressure, pubertal stages were recorded. Fasting serum levels of thyroid function tests, lipids, glucose and insulin were obtained. Ninety-eight children (55 female) with a mean age of 11.45 ± 3.1 years were evaluated. Of those, 39 were prepubertal and 59 were pubertal. Subclinical hypothyroidism (TSH ≥ 5.0 mIU/L with normal fT4) was detected in five patients (5.1 %); none had positive thyroid antibodies. Other conditions were obesity (n = 6), hirsutism (n = 4), short stature (n = 3), polycystic ovaries (PCO, n = 3), precocious puberty (n = 2) and gynecomastia (n = 1). Of five patients with SH, only one had obesity. Our results revealed that the prevalence of SH in children with migraine is not as high as previously reported. Since no significant endocrinologic disturbance was found in those children, we suggest that the initial endocrinological evaluation or screening for SH is unnecessary.

  16. Subclinical hypothyroidism: Comparison of adhesion molecule levels before and after levothyroxine therapy.

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    Bilgir, Ferda; Bilgir, Oktay; Calan, Mehmet; Calan, Ozlem; Isikyakar, Tolgay

    2014-06-01

    Adhesion molecules are involved in inflammation, atherosclerosis and malignancy. This study measured levels of adhesion molecules before and after levothyroxine therapy in patients with subclinical hypothyroidism (SHO). Levels of soluble (s) intracellular adhesion molecule (ICAM)-1, s vascular cell adhesion molecule (sVCAM) VCAM-1 and sE-selectin were analysed in patients diagnosed with SHO, prior to administration of 50 µg/day levothyroxine orally for 3 months. Subsequently, levels of sICAM-1, sVCAM-1 and sE-selectin were reanalysed then compared with the pretreatment levels. In 30 patients with SHO, levels of sICAM-1 were found to be significantly higher than those in healthy controls, (P = 0.001). Post-treatment sICAM-1 levels were significantly lower than pretreatment levels (P = 0.001). No significant differences were found in sVCAM-1 or sE-selectin levels between healthy controls and patients with SHO before treatment, or between patients with SHO pre- and post-treatment. Patients with SHO had significantly higher levels of sICAM-1 compared with controls. Levels became normal after treatment with levothyroxine. These findings emphasize the need for levothyroxine therapy in cases of SHO to normalize sICAM-1 levels. Such treatment helps to prevent the future development of atherosclerosis or cancer. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Subclinical hypothyroidism does not influence the metabolic and hormonal profile of women with PCOS.

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    Trakakis, Eftihios; Pergialiotis, Vasilios; Hatziagelaki, Erifili; Panagopoulos, Periklis; Salloum, Ioannis; Papantoniou, Nikolaos

    2017-06-23

    Background Subclinical hypothyroidism (SCH) is present in 5%-10% of polycystic ovary syndrome (PCOS) patients. To date, its impact on the metabolic and hormonal profile of those women remains controversial. The purpose of our study is to evaluate the impact of SCH on the glycemic, lipid and hormonal profile of PCOS patients. Materials and methods We conducted a prospective case control study of patients that attended the Department of Gynecological Endocrinology of our hospital. Results Overall, 280 women with PCOS were enrolled during a time period of 7 years (2009-2015). Twenty-one patients (7.5%) suffered from SCH. The anthropometric characteristics were comparable among women with PCOS and those with SCH + PCOS. The prevalence of acne, hirsutism and anovulation did not differ. Significant differences were observed in the 2-h oral glucose tolerance test (OGTT) (p = 0.003 for glucose and p = 0.046 for insulin). The QUICKI, Matsuda and homeostatic model assessment-insulin resistance (HOMA-IR) indices where, however, similar. No difference in serum lipids was observed. Slightly elevated levels of follicle stimulating hormone (FSH) and testosterone were noted. The remaining hormonal parameters remained similar among groups. Similarly, the ovarian volume and the endometrial thickness did not differ. Conclusions The impact of SCH on the metabolic and hormonal profile of PCOS patients seems to be negligible. Future studies are needed in the field and their conduct in a multi-institutional basis seems to be required, given the small prevalence of SCH among women with PCOS.

  18. Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation.

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    Baumgartner, Christine; da Costa, Bruno R; Collet, Tinh-Hai; Feller, Martin; Floriani, Carmen; Bauer, Douglas C; Cappola, Anne R; Heckbert, Susan R; Ceresini, Graziano; Gussekloo, Jacobijn; den Elzen, Wendy P J; Peeters, Robin P; Luben, Robert; Völzke, Henry; Dörr, Marcus; Walsh, John P; Bremner, Alexandra; Iacoviello, Massimo; Macfarlane, Peter; Heeringa, Jan; Stott, David J; Westendorp, Rudi G J; Khaw, Kay-Tee; Magnani, Jared W; Aujesky, Drahomir; Rodondi, Nicolas

    2017-11-28

    Atrial fibrillation (AF) is a highly prevalent disorder leading to heart failure, stroke, and death. Enhanced understanding of modifiable risk factors may yield opportunities for prevention. The risk of AF is increased in subclinical hyperthyroidism, but it is uncertain whether variations in thyroid function within the normal range or subclinical hypothyroidism are also associated with AF. We conducted a systematic review and obtained individual participant data from prospective cohort studies that measured thyroid function at baseline and assessed incident AF. Studies were identified from MEDLINE and EMBASE databases from inception to July 27, 2016. The euthyroid state was defined as thyroid-stimulating hormone (TSH) 0.45 to 4.49 mIU/L, and subclinical hypothyroidism as TSH 4.5 to 19.9 mIU/L with free thyroxine (fT4) levels within reference range. The association of TSH levels in the euthyroid and subclinical hypothyroid range with incident AF was examined by using Cox proportional hazards models. In euthyroid participants, we additionally examined the association between fT4 levels and incident AF. Of 30 085 participants from 11 cohorts (278 955 person-years of follow-up), 1958 (6.5%) had subclinical hypothyroidism and 2574 individuals (8.6%) developed AF during follow-up. TSH at baseline was not significantly associated with incident AF in euthyroid participants or those with subclinical hypothyroidism. Higher fT4 levels at baseline in euthyroid individuals were associated with increased AF risk in age- and sex-adjusted analyses (hazard ratio, 1.45; 95% confidence interval, 1.26-1.66, for the highest quartile versus the lowest quartile of fT4; P for trend ≤0.001 across quartiles). Estimates did not substantially differ after further adjustment for preexisting cardiovascular disease. In euthyroid individuals, higher circulating fT4 levels, but not TSH levels, are associated with increased risk of incident AF. © 2017 American Heart Association, Inc.

  19. Phosphodiesterase 8B gene polymorphism is associated with subclinical hypothyroidism in pregnancy.

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    Shields, Beverley M; Freathy, Rachel M; Knight, Bridget A; Hill, Anita; Weedon, Michael N; Frayling, Timothy M; Hattersley, Andrew T; Vaidya, Bijay

    2009-11-01

    Maternal subclinical hypothyroidism is associated with a number of adverse outcomes in pregnancy. The Endocrine Society's recent consensus guidelines have recommended treatment with T(4) for this condition in pregnancy. The single nucleotide polymorphism rs4704397 in the phosphodiesterase 8B (PDE8B) gene has been found to be associated with altered serum TSH concentrations in the general population. We aimed to assess whether genetic variation in TSH due to the rs4704397 genotype affects the number of individuals classified as having subclinical hypothyroidism in pregnancy. Serum TSH, FT4, FT3, and thyroid peroxidase antibodies (TPOAbs) were measured in 970 pregnant women at 28 wk gestation. rs4704397 genotype was available on 877 subjects. Reference range calculations were based on the TPOAb-negative women. TSH, but not FT4, FT3, or TPOAbs, varied with genotype and was highest in those with the AA genotype (median, 2.16, 1.84, and 1.73 mIU/liter for AA, AG, and GG genotypes, respectively; P = 0.0004). A greater proportion of women with the AA genotype had TSH concentrations above 4.21 mIU/liter, the upper limit of the reference range, compared with the AG and GG genotypes (9.6 vs. 3.5%, respectively; P = 0.004). Maternal PDE8B genotype was not associated with offspring birthweight or gestational age at delivery. Genetic variation in TSH levels in pregnancy associated with the PDE8B rs4704397 genotype has implications for the number of women treated for subclinical hypothyroidism under current guidelines. Consideration should be made to individualization of normal ranges, potential effects on pregnancy outcome, and intention to treat for subclinical hypothyroidism in pregnancy.

  20. Prevalence of hypertension and other cardiovascular risk factors in subjects with subclinical hypothyroidism.

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    Gonzalez Gil, Lidia; de la Sierra, Alejandro

    2017-04-21

    To assess the prevalence of hypertension, diabetes, and dyslipidaemia in subjects with subclinical hypothyroidism (SH) in comparison with an age- and sex-matched control group. Case-control study with 240 subjects with SH and 480 controls carried out on patients aged 35-75 years admitted to a Primary Care Centre. The prevalence of hypertension, diabetes and dyslipidaemia, as well as blood pressure, plasma glucose, and lipid profilses, were evaluated in both groups. No differences were observed neither in the prevalence of hypertension (34.2% vs. 29.6%) or diabetes (12.1% vs. 10%) nor in mean values of blood pressure or plasma fasting glucose. Subjects with SH had an increased prevalence of lipid abnormalities (72.1% vs. 57.7%; P<.001), and increased mean values of total cholesterol (205±34 vs. 193±35mg/dL; P<.001), compared to the control group. Patients with SH have an increased prevalence of lipid abnormalities. This can be responsible for an increased cardiovascular risk in such patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  1. Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke: An Individual Participant Data Analysis

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    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P. J.; Ikram, M. Arfan; Blum, Manuel R.; Collet, Tinh-Hai; Bakker, Stephan J. L.; Dehghan, Abbas; Drechsler, Christiane; Luben, Robert N.; Hofman, Albert; Portegies, Marileen L. P.; Medici, Marco; Iervasi, Giorgio; Stott, David J.; Ford, Ian; Bremner, Alexandra; Wanner, Christoph; Ferrucci, Luigi; Newman, Anne B.; Dullaart, Robin P.; Sgarbi, José A.; Ceresini, Graziano; Maciel, Rui M. B.; Westendorp, Rudi G.; Jukema, J. Wouter; Imaizumi, Misa; Franklyn, Jayne A.; Bauer, Douglas C.; Walsh, John P.; Razvi, Salman; Khaw, Kay-Tee; Cappola, Anne R.; Völzke, Henry; Franco, Oscar H.; Gussekloo, Jacobijn; Rodondi, Nicolas

    2015-01-01

    Objective: The objective was to determine the risk of stroke associated with subclinical hypothyroidism. Data Sources and Study Selection: Published prospective cohort studies were identified through a systematic search through November 2013 without restrictions in several databases. Unpublished studies were identified through the Thyroid Studies Collaboration. We collected individual participant data on thyroid function and stroke outcome. Euthyroidism was defined as TSH levels of 0.45–4.49 mIU/L, and subclinical hypothyroidism was defined as TSH levels of 4.5–19.9 mIU/L with normal T4 levels. Data Extraction and Synthesis: We collected individual participant data on 47 573 adults (3451 subclinical hypothyroidism) from 17 cohorts and followed up from 1972–2014 (489 192 person-years). Age- and sex-adjusted pooled hazard ratios (HRs) for participants with subclinical hypothyroidism compared to euthyroidism were 1.05 (95% confidence interval [CI], 0.91–1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80–1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25–8.80) for individuals aged 18–49 years. There was an increased risk of fatal stroke in the age groups 18–49 and 50–64 years, with a HR of 4.22 (95% CI, 1.08–16.55) and 2.86 (95% CI, 1.31–6.26), respectively (p trend 0.04). We found no increased risk for those 65–79 years old (HR, 1.00; 95% CI, 0.86–1.18) or ≥80 years old (HR, 1.31; 95% CI, 0.79–2.18). There was a pattern of increased risk of fatal stroke with higher TSH concentrations. Conclusions: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed. PMID:25856213

  2. Impact of Overt and Subclinical Hypothyroidism on Exercise Tolerance: A Systematic Review

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    Lankhaar, Jeannette A. C.; de Vries, Wouter R.; Jansen, Jaap A. C. G.; Zelissen, Pierre M. J.; Backx, Frank J. G.

    2014-01-01

    Purpose: This systematic review describes the state of the art of the impact of hypothyroidism on exercise tolerance and physical performance capacity in untreated and treated patients with hypothyroidism. Method: A systematic computer-aided search was conducted using biomedical databases. Relevant studies in English, German, and Dutch, published…

  3. SCREENING OR AGGRESSIVE CASE FINDING FOR HYPOTHYROID PATIENTS. WHAT IS THE EVIDENCE??

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    Anand Rawat

    2010-06-01

    Full Text Available Backgound: Hypothyroidism enhances atherosclerosis in multiple ways. Carotid intima media thickness(C’IMI as measured by B-Mode ultrasound and color Doppler is a risk determinant of atheroscierosis. hsC’RP is a marker of inflammation and has been incriminated as a risk Jiictorforfuture cardiovascular events. Our study aims at generating evidence Jbr increased risk of cardiovascular risk factors in hypothyroid patients and thus needfor population- based screening for hypothyroidism. Methods: We included 25 consecutive patients in to each of two groups of our study (n=50, Hypothyroid group had patients with Thyroid stimulating hormone (TSH, > I0miu/l, subclinical hjpothyroid (SCH group patients with TSH 6-1 0miu/l. We compared CIMT and hsCRP in 2 groups along with other atherosclerotic risk factors. Results : We found that in the subclinical hypothyroid patients the mean value of total cholesterol (TC(208.8,84±6.14. LDL-C levels (157.88±33.51, total cholesterol/ LDL cholesterol ratio(5.29±131, LDL cholesterol ratio” HDL cholesterol ratio (3.93±l.25 and plasma hsCRP (2.13±0. 69 levels were higher than the normal values. In hypothyroid patients we found that these values and the CIMT values were statistically signficantly higher than the subclinical hypothyroid patients, in addition diastolic hypertension (95.84±11.06 and higher than normal waist-hip ratio (1.03±0.19 was also seen in hypothyroid group. CIMT and hsCRP also showed positive correlation with other atherosclerotic risk factors. (Waist-hip ratio, diastolic hypertension andLDL cholesterol Conclusion : Cardiovascular risk factors were increased in sub clinical as well as in clinical hypothyroidism so efforts should be made to detect andtreat hypothyroidism at an early stage by aggressive casefinding in high risk population.

  4. Subclinical hypothyroidism ups the risk of vascular complications in type 2 diabetes

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    Ghada A. Mohamed

    2017-08-01

    Full Text Available The incidence of thyroid dysfunction in diabetic patients is higher than that of the general population. Undiagnosed thyroid dysfunction may affect the metabolic control and enhance cardiovascular, and other chronic complication risks in diabetic patients. Few studies have examined the relationship between subclinical hypothyroidism (SCH and vascular complications of type 2 diabetes. Objectives: To find out the relationship between SCH and vascular complications in patients with Type 2 diabetes. Subjects and Methods: Our cross sectional study included 110 patients with type 2 DM (45 males and 65 females who were followed at the Diabetes outpatient Clinics in the state of Kuwait during 6 months period. All patients subjected to complete clinical and laboratory data, including thyroid function tests, total cholesterol (TC, triglyceride (TG, HDL-C, LDL-C, urinary albumin, fundus examination, ECG, and Glycosylated hemoglobin. Results: Among 110 patients, 21 (19.1% Patients had SCH. Patients with SCH were more significantly older, with longer duration of diabetes, higher HbA1c, total cholesterol and LDL-C than euthyroid group. However, gender (p = 0.076, BMI (p = 0.092, and smoking (P = 0.715 were not significantly different between the SCH and euthyroid groups. The SCH group had a higher prevalence of dyslipidemia (p = 0.017, diabetic nephropathy (p = 0.003 diabetic retinopathy (p = 0.004 and IHD (p = 0.011 than the euthyroid group while no significant difference in the prevalence of diabetic neuropathy (p = 0.420. Conclusions: SCH is a common endocrine disorder in patients with Type 2 diabetes. It could be associated with a higher prevalence of vascular complications in type 2 diabetes. We could not prove a relation between SCH and diabetic neuropathy.

  5. Subclinical Hypothyroidism in Pregnancy: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Maraka, Spyridoula; Ospina, Naykky M Singh; O'Keeffe, Derek T; Espinosa De Ycaza, Ana E; Gionfriddo, Michael R; Erwin, Patricia J; Coddington, Charles C; Stan, Marius N; Murad, M Hassan; Montori, Victor M

    2016-04-01

    The impact of subclinical hypothyroidism (SCH) and of levothyroxine replacement in pregnant women with SCH is unclear. The aims of this study were to assess (i) the impact of SCH during pregnancy on maternal and neonatal outcomes, and (ii) the effect of levothyroxine replacement therapy in these patients. Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, the Cochrane Controlled Trials Register, Ovid EMBASE, Web of Science, and Scopus were searched from inception to January 2015. Randomized trials and cohort studies of pregnant women with SCH that examined adverse pregnancy and neonatal outcomes were included. Reviewers extracted data and assessed methodological quality in duplicate. Eighteen cohort studies at low-to-moderate risk of bias were included. Compared with euthyroid pregnant women, pregnant women with SCH were at higher risk for pregnancy loss (relative risk [RR] 2.01 [confidence interval (CI) 1.66-2.44]), placental abruption (RR 2.14 [CI 1.23-3.70]), premature rupture of membranes (RR 1.43 [CI 1.04-1.95]), and neonatal death (RR 2.58 [CI 1.41-4.73]). One study at high risk of bias compared pregnant women with SCH who received levothyroxine to those who did not and found no significant decrease in the rate of pregnancy loss, preterm delivery, gestational hypertension, low birth weight, or low Apgar score. SCH during pregnancy is associated with multiple adverse maternal and neonatal outcomes. The value of levothyroxine therapy in preventing these adverse outcomes remains uncertain.

  6. Monitorização ambulatorial da pressão arterial em pacientes normotensos com hipotireoidismo subclínico Ambulatory blood pressure monitoring in normotensive patients with subclinical hypothyroidism

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    Marcia Martins Ferreira

    2010-06-01

    (ABPM, over 24 hours, in normotensive patients with SH in comparison to euthyroid (EU normotensive individuals. METHODS: A cross-sectional study was performed with 50 participants (SH = 30 and EU = 20 that did not differ regarding risk factors for hypertension. The ABPM was carried out with a DINAMAPA TM monitor, using the oscillometric method validated by AAMI (Association for the Advancement of Medical Instrumentation and by the BHS (British Hypertension Society. RESULTS: The mean serum TSH and FT4 were respectively 6.9 ± 2.2 µUI/ml and 1.1 ± 0.2 ng/dl in SH patients. Although there was no difference in the mean values of systolic and diastolic blood pressure between the two groups, there was a positive correlation between the mean values of diastolic blood pressure (DBP and serum TSH levels in SH patients (r:0.477; p = 0.004. These correlations were detected at daytime (r:0.498; p = 0.002 and sleep-time (r:0.322; p = 0.032 measurements. CONCLUSION: The blood pressure was not different between patients with or without SH; however, the results suggest that the progression of subclinical hypothyroidism to higher levels of TSH may increase the cardiovascular risk by increasing diastolic blood pressure.

  7. The prevalence and determinants of hypothyroidism in hospitalized patients with type 2 diabetes mellitus.

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    Song, Fei; Bao, Cuiping; Deng, Meiyu; Xu, Hui; Fan, Meijuan; Paillard-Borg, Stéphanie; Xu, Weili; Qi, Xiuying

    2017-01-01

    The purpose of this study was to investigate the prevalence of hypothyroidism among hospitalized patients with type 2 diabetes mellitus and its related factors, and to assess the prevalence of macrovascular and microvascular diseases among type 2 diabetes mellitus inpatients with hypothyroidism and euthyroidism. A total of 1662 type 2 diabetes mellitus inpatients hospitalized at the Metabolic Diseases Hospital, Tianjin Medical University from 1 January 2008 to 1 March 2013 were included in this study. Information on demographic and anthropometric factors and additional variables related to hypothyroidism were collected from medical records. Prevalence rates were calculated and standardized using direct method based on the age-specific and sex-specific structure of all participants. Data were analyzed using binary logistic regression with adjustment for potential confounders. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and 77.0 % of the patients with hypothyroidism had subclinical hypothyroidism. The prevalence of hypothyroidism increased with age, and was higher in women (10.8 %) than in men (3.4 %). Older age (odds ratio, 1.74; 95 % confidence interval, 1. 05 to 2.89), female gender (odds ratio, 2.02; 95 % confidence interval, 1.05 to 3.87), and positive thyroid peroxidase antibody (odds ratio, 4.99; 95 % confidence interval, 2.83 to 8.79) were associated with higher odds of hypothyroidism among type 2 diabetes mellitus inpatients. The type 2 diabetes mellitus inpatients with hypothyroidism had higher prevalence of cerebrovascular diseases than those with euthyroidism after adjustment for age and gender. The prevalence of hypothyroidism among type 2 diabetes mellitus inpatients was 6.8 %, and most patients had subclinical hypothyroidism. Older age, female gender, and positive thyroid peroxidase antibody could be indicators for detecting hypothyroidism in type 2 diabetes mellitus inpatients.

  8. Subclinical hypothyroidism in children and adolescents: a wide range of clinical, biochemical, and genetic factors involved.

    Science.gov (United States)

    Rapa, Anna; Monzani, Alice; Moia, Stefania; Vivenza, Daniela; Bellone, Simonetta; Petri, Antonella; Teofoli, Francesca; Cassio, Alessandra; Cesaretti, Graziano; Corrias, Andrea; de Sanctis, Vincenzo; Di Maio, Salvatore; Volta, Cecilia; Wasniewska, Malgorzata; Tatò, Luciano; Bona, Gianni

    2009-07-01

    The aim of the study was to examine clinical characteristics, biochemical parameters, and TSH-R gene variations in children and adolescents with subclinical hypothyroidism (SH) in order to evaluate their pattern of distribution in SH. We enrolled 88 patients, each having at least two TSH measurements above the upper limit of the reference range with normal free thyroid hormones and negative thyroid autoantibodies. Clinical characteristics included height, weight, family history of thyroid diseases, thyroid volume, and echogenicity at ultrasonography. Biochemical parameters included TSH, free thyroid hormones, thyroid autoantibodies, and adjusted daily urinary iodine excretion (UIE). Genetic variations in the TSH-R gene were assessed. The prevalence of overweight/obesity, positive family history of thyroid diseases, and thyroid hypoechogenicity was 28.4, 45.5, and 22.7%, respectively. Median TSH was higher in overweight/obese patients than in normal-weight ones (7.4 vs. 5.7 muIU/ml; P = 0.04) and in overweight/obese patients with hypoechogenicity than in those with normal ultrasound pattern (8.5 vs. 6.8 muIU/ml; P = 0.04). Adjusted daily UIE was lower in subjects without than in those with a positive family history of thyroid diseases (81 vs. 120 mug/d; P = 0.001). The prevalence of a positive family history of thyroid diseases was 1.9-fold higher in patients with nonsynonymous mutations in the TSH-R gene than in patients without any mutation (80 vs. 42%; P = 0.03). A novel mutation at position 1559 in exon 10 (W520X) was detected in one child. Overweight/obesity, thyroid hypoechogenicity, and nonsynonymous mutations in the TSH-R gene are characterizing features of a large portion of SH children.

  9. Live birth rates following in vitro fertilization in women with thyroid autoimmunity and/or subclinical hypothyroidism.

    Science.gov (United States)

    Chai, Joyce; Yeung, Wing-Yee T; Lee, Chi-Yan V; Li, Hang-Wun R; Ho, Pak-Chung; Ng, Hung-Yu E

    2014-01-01

    To investigate whether the live birth rate following in vitro fertilization (IVF) is affected by thyroid autoimmunity (TAI) and/or subclinical hypothyroidism in subfertile women. Retrospective study in a university infertility clinic. A total of 627 women without past or current history of thyroid disorder undergoing their first IVF cycle. Pre-IVF archived blood serum samples were tested for TAI and thyroid function tests. Live birth rate. The clinical pregnancy rate, live birth rate and miscarriage rate were similar among women with or without TAI and/or subclinical hypothyroidism using a TSH threshold 4·5 mIU/l. Thyroid autoantibody level did not affect these IVF outcomes. The live birth rate and miscarriage rate of women with TAI and/or subclinical hypothyroidism following IVF were not impaired. © 2013 John Wiley & Sons Ltd.

  10. Dyslipidemia in subclinical hypothyroidism and the effect of thyroxine on lipid profile

    Directory of Open Access Journals (Sweden)

    Ajay Asranna

    2012-01-01

    Full Text Available Introduction: Subclinical hypothyroidism (SH has a prevalence between 4% and 10.5% in various studies. The burden of SH in India is expected to increase with increasing iodine sufficiency. Studies have shown conflicting results concerning not only the degree of lipid changes in SH but also the effect of thyroxine substitution therapy. Indian studies on dyslipidemia in SH and the effect of thyroxine on lipid profile are currently lacking. Aims and Objectives: (1 To assess the association of SH and lipid profile. (2 To quantify the effect of thyroxine treatment on lipid profile. Materials and Methods: About 54 patients who were detected to have SH were compared with 56 healthy controls. Thyroid stimulating hormone (TSH, free T3, free T4, anti thyroperoxidase (TPO antibodies, total cholesterol, high density lipoprotein (HDL cholesterol, low density lipoprotein (LDL cholesterol, Very low density lipoprotein (VLDL cholesterol, serum triglycerides were measured in all the patients after an overnight fast. Selected patients were started on thyroxine replacement. Twenty-one patients were followed up after 3 months with a repeat lipid profile. Results: Mean total cholesterol and mean LDL levels were significantly higher in SH compared to controls, but there was no statistically significant difference in the mean HDL, VLDL, and triglyceride levels. There was a significant reduction in mean T. cholesterol, mean LDL, mean VLDL, and mean triglyceride levels after treatment with thyroxine, while there was no significant difference among the mean HDL levels. Conclusion: Dyslipidemia is more common in SH compared to controls. There is a TSH dependent increase in cholesterol, LDL, VLDL, and triglyceride levels. Achieving euthyroid status with thyroxine has a favourable effect on lipid profile.

  11. Subclinical Hypothyroidism and the Risk of Stroke Events and Fatal Stroke

    DEFF Research Database (Denmark)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J

    2015-01-01

    to euthyroidism were 1.05 (95% confidence interval [CI], 0.91-1.21) for stroke events (combined fatal and nonfatal stroke) and 1.07 (95% CI, 0.80-1.42) for fatal stroke. Stratified by age, the HR for stroke events was 3.32 (95% CI, 1.25-8.80) for individuals aged 18-49 years. There was an increased risk of fatal...... of increased risk of fatal stroke with higher TSH concentrations. CONCLUSIONS: Although no overall effect of subclinical hypothyroidism on stroke could be demonstrated, an increased risk in subjects younger than 65 years and those with higher TSH concentrations was observed....

  12. Interventions for clinical and subclinical hypothyroidism pre-pregnancy and during pregnancy.

    Science.gov (United States)

    Reid, Sally M; Middleton, Philippa; Cossich, Mary C; Crowther, Caroline A; Bain, Emily

    2013-05-31

    Over the last decade there has been enhanced awareness of the appreciable morbidity of thyroid dysfunction, particularly thyroid deficiency. Since treating clinical and subclinical hypothyroidism may reduce adverse obstetric outcomes, it is crucial to identify which interventions are safe and effective. To identify interventions used in the management of hypothyroidism and subclinical hypothyroidism pre-pregnancy or during pregnancy and to ascertain the impact of these interventions on important maternal, fetal, neonatal and childhood outcomes. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 March 2013). Randomised controlled trials (RCTs) and quasi-randomised controlled trials that compared a pharmacological intervention for hypothyroidism and subclinical hypothyroidism pre-pregnancy or during pregnancy with another intervention or placebo. Two review authors assessed trial eligibility and quality and extracted the data. We included four RCTs of moderate risk of bias involving 362 women. In one trial of 115 women, levothyroxine therapy to treat pregnant euthyroid (normal thyroid function) women with thyroid peroxidase antibodies was not shown to reduce pre-eclampsia significantly (risk ratio (RR) 0.61; 95% confidence interval (CI) 0.11 to 3.48) but did significantly reduce preterm birth by 72% (RR 0.28; 95% CI 0.10 to 0.80). Two trials of 30 and 48 hypothyroid women respectively compared levothyroxine doses, but both trials reported only biochemical outcomes. A trial of 169 women compared the trace element selenomethionine (selenium) with placebo and no significant differences were seen for either pre-eclampsia (RR 1.44; 95% CI 0.25 to 8.38) or preterm birth (RR 0.96; 95% CI 0.20 to 4.61). None of the four trials reported on childhood neurodevelopmental delay.There was a non-significant trend towards fewer miscarriages with levothyroxine, and selenium showed some favourable impact on postpartum thyroid function and a decreased

  13. Burden of illness attributable to subclinical hypothyroidism in the Spanish population.

    Science.gov (United States)

    Donnay, S; Balsa, J A; Álvarez, Julia; Crespo, C; Pérez-Alcántara, F; Polanco, C

    2013-11-01

    Subclinical hypothyroidism (SH) has been associated recently to cardiovascular diseases. However, the loss of health it entails remains unknown. This study has assessed the burden of illness attributable to SH in Spain. Based on the Spanish prevalence data found in international studies, a theoretical model was developed to estimate the Disability Adjusted Life Years (DALYs), Years of Life Lost (YLL) and Years Lost due to Disability (YLD) associated with SH. Prevalence of risk factors, coronary mortality risk and coronary event risk associated with SH were obtained from a review of the literature. An analysis was conducted according to the World Health Organization methodology approach for these studies, using official Spanish sources (hospital discharge records, minimum basic data set [MBDS], inpatient mortality records, etc. In Spain, approximately 2,767,124 people have SH, specifically 1,949,820 with levels of TSH between 4.5 and 6.9mIU/l (70.5%), 538,988 with levels between 7 and 9.9mIU/l (19.5%), and 278,317 between 10 and 19.9mIU/l (10%). These subjects suffer approximately 12,608 cardiac events and 1,388 deaths a year attributed to their SH. This represents 30,550 DALYs (13,124 YLL and 17,426 YLD). Between 1.6 and 7.3% of cardiovascular DALYs can be attributed to SH. SH is a silent disease which considerably increases the burden of disease. Evaluation of SH, at least in patients belonging to risk groups, could be cost-effective. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  14. 2014 European Thyroid Association Guidelines for the Management of Subclinical Hypothyroidism in Pregnancy and in Children

    Science.gov (United States)

    Lazarus, John; Brown, Rosalind S.; Daumerie, Chantal; Hubalewska-Dydejczyk, Alicja; Negro, Roberto; Vaidya, Bijay

    2014-01-01

    This guideline has been produced as the official statement of the European Thyroid Association guideline committee. Subclinical hypothyroidism (SCH) in pregnancy is defined as a thyroid-stimulating hormone (TSH) level above the pregnancy-related reference range with a normal serum thyroxine concentration. Isolated hypothyroxinaemia (defined as a thyroxine level below the 2.5th centile of the pregnancy-related reference range with a normal TSH level) is also recognized in pregnancy. In the majority of SCH the cause is autoimmune thyroiditis but may also be due to iodine deficiency. The cause of isolated hypothyroxinaemia is usually not apparent, but iodine deficiency may be a factor. SCH and isolated hypothyroxinaemia are both associated with adverse obstetric outcomes. Levothyroxine therapy may ameliorate some of these with SCH but not in isolated hypothyroxinaemia. SCH and isolated hypothyroxinaemia are both associated with neuro-intellectual impairment of the child, but there is no evidence that maternal levothyroxine therapy improves this outcome. Targeted antenatal screening for thyroid function will miss a substantial percentage of women with thyroid dysfunction. In children SCH (serum TSH concentration >5.5-10 mU/l) normalizes in >70% and persists in the majority of the remaining patients over the subsequent 5 years, but rarely worsens. There is a lack of studies examining the impact of SCH on the neuropsychological development of children under the age of 3 years. In older children, the evidence for an association between SCH and impaired neuropsychological development is inconsistent. Good quality studies examining the effect of treatment of SCH in children are lacking. PMID:25114871

  15. Subclinical Hypothyroidism in PCOS: Impact on Presentation, Insulin Resistance, and Cardiovascular Risk

    Directory of Open Access Journals (Sweden)

    Qun Yu

    2016-01-01

    Full Text Available Aim of Study. To assess status of thyroid function and thyroid disorders particularly subclinical hypothyroidism (SCH in subjects with polycystic ovarian syndrome (PCOS and impact of SCH on various clinical and biochemical parameters and cardiovascular risk in PCOS. Methods. Hundred females diagnosed with PCOS as per Rotterdam criteria and 100 normal controls were recruited and were subjected to elaborate anthropometric, clinical, and biochemical assessment. Results. Notable findings included significantly higher frequency of subjects with subclinical hypothyroidism (p=0.0002, autoimmune thyroiditis (p<0.001, and goitre (p=0.02 in polycystic ovarian syndrome subjects compared to control subjects. Further SCH PCOS subjects were found to harbor significantly higher HOMA-IR (p<0.05 and frequency of subjects with dyslipidemia (p<0.05 compared to both euthyroid PCOS and euthyroid control subjects. Though frequency of subjects with cardiovascular risk factors was higher in SCH PCOS group than euthyroid PCOS group, it failed to reach statistical significance. Conclusion. We concluded that PCOS is associated with high incidence of SCH and AIT compared to normal population and SCH poses increased risk of cardiovascular disorder in PCOS.

  16. The Association Between Subclinical Hypothyroidism and Metabolic Syndrome as Defined by the ATP III Criteria.

    Science.gov (United States)

    Eftekharzadeh, Anita; Khamseh, Mohammad Ebrahim; Farshchi, Amir; Malek, Mojtaba

    2016-04-01

    The association between subclinical hypothyroidism (SCH) and metabolic syndrome (MetS) is a matter of debate. In this study, we aimed to examine the risk of MetS in SCH through a systematic review and meta-analysis. A systematic search of published literature up to September 2015 was conducted. General population studies were included if they had considered SCH as the independent variable. After data extraction, a meta-analysis was run to assess the odds ratio (OR) of MetS and its components between subclinical hypothyroid and euthyroid groups. Only studies employing Adult Treatment Panel III (ATP III) criteria for MetS were included in the meta-analysis. In the SCH group, female gender was more prevalent [OR = 1.65, 95% confidence interval (95% CI) 1.29-2.13]. Meta-analysis showed no significant difference in MetS prevalence between SCH and euthyroid individuals (OR = 1.13, 95% CI 0.95-1.34). However, the prevalence of central obesity (OR = 1.43, 95% CI 1.04-1.96) was significantly higher in the SCH group. On the other hand, hypertriglyceridemia was more prevalent in the female-only SCH subgroup. In conclusion, although we found some MetS components to be more prevalent in SCH, the prevalence of MetS as defined by ATP III criteria was not increased in SCH. Considerable heterogeneity observed may have influenced the results on MetS components.

  17. Subclinical hypothyroidism in pregnancy: An emerging problem in Southern West Bengal: A cross-sectional study.

    Science.gov (United States)

    Mandal, Ratan Chandra; Bhar, Debasish; Das, Anjan; Basunia, Sandip Roy; Kundu, Sudeshna Bhar; Mahapatra, Chinmay

    2016-01-01

    Prevalence of subclinical hypothyroidism (SCH) in pregnancy varies widely in different parts of our country, but it has multiple adverse outcomes in both the mother and fetus. This study was conducted to evaluate the prevalence of SCH in pregnant women during the first trimester and to identify the prevalence of thyroid autoimmunity in pregnant women. This cross-sectional study (March 2014 to February 2015) was conducted among the pregnant women attending antenatal clinic in their first trimester at a tertiary care center. Morning samples of study participants were analyzed for free thyroxin (FT4), thyroid stimulating hormone (TSH), and thyroid peroxidase antibody (TPO Ab). Data expressed as mean ± standard deviation and percentage (%) as applicable. Of the 510 subjects, 168 had TSH value >2.5 μIU/ml (32.94%) with normal FT4 and they were diagnosed as SCH. TSH level >4.5 μIU/ml was estimated in 13.92% (71) of the subjects. TPO Ab was positive in 57 (33.93%) of subclinical hypothyroid and 5 (1.47%) of normal subjects. 70.42% (50) of the subjects with TSH >4.5 μIU/ml had positive TPO Ab. Prevalence of SCH is high in South Bengal and routine thyroid screening at the first antenatal visit should be done to reduce the social and financial burden caused by SCH.

  18. Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis

    Science.gov (United States)

    Collet, Tinh-Hai; Bauer, Douglas C.; Cappola, Anne R.; Åsvold, Bjørn O.; Weiler, Stefan; Vittinghoff, Eric; Gussekloo, Jacobijn; Bremner, Alexandra; den Elzen, Wendy P. J.; Maciel, Rui M. B.; Vanderpump, Mark P. J.; Cornuz, Jacques; Dörr, Marcus; Wallaschofski, Henri; Newman, Anne B.; Sgarbi, José A.; Razvi, Salman; Völzke, Henry; Walsh, John P.; Aujesky, Drahomir

    2014-01-01

    Context: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk. Objective: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs). Data Sources and Study Selection: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes. Data Extraction: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events. Data Synthesis: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87–1.53 vs HR 1.26, CI 1.01–1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87–1.56 vs HR 1.26, CI 1.02–1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status. Conclusions: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes. PMID:24915118

  19. Subclinical hypothyroidism in children with Down syndrome: To treat ...

    African Journals Online (AJOL)

    Mohamed El Kholy

    2014-12-01

    Dec 1, 2014 ... ing could be considered adequate and may be the preferred strategy, thus avoiding chronic hormonal therapy at least in. Down syndrome patients in whom TSH levels tend to sponta- neously normalize. A positive anti-TPO antibody test is a key factor in the follow-up of these patients because of its potential.

  20. Effects of maternal subclinical hypothyroidism on obstetrical outcomes during early pregnancy.

    Science.gov (United States)

    Wang, S; Teng, W P; Li, J X; Wang, W W; Shan, Z Y

    2012-03-01

    Maternal hypothyroidism [overt hypothyroidism and subclinical hypothyroidism (SCH)] during early pregnancy is suspected to associate with adverse obstetrical outcomes. The aim of the present study was to investigate whether maternal SCH during the early stage of pregnancy increase obstetrical complications and whether treatment results in an improvement in these outcomes. A total of 756 women in the 1st trimester (≤12 weeks) of pregnancy were enrolled through 10 hospitals in Shenyang from 2007 to 2009. All participants underwent thyroid function testing in early pregnancy and their obstetrical outcomes were studied following delivery. The incidence of spontaneous abortions in the SCH group was higher than the normal TSH group (15.48% vs 8.86%, p=0.03). No significant association was observed between SCH and other obstetrical complications including gestational hypertension, premature delivery, anemia, post-partum hemorrhage, low neonatal Apgar scores and low birth weight. Although levo-T4 (L-T4) treatment decreased the incidence of spontaneous abortions in women with SCH, it was not statistically significant when compared to women who did not receive treatment in the SCH group. None of the 28 women who received L-T4 treatment had premature delivery, low birth weight, hemorrhage, and low Apgar score. The incidence of spontaneous abortion in pregnant women with SCH increases in early pregnancy. © 2012, Editrice Kurtis.

  1. Hypothyroidism in pregnancy.

    Science.gov (United States)

    Teng, Weiping; Shan, Zhongyan; Patil-Sisodia, Komal; Cooper, David S

    2013-11-01

    Hypothyroidism is the most common pregnancy-related thyroid disorder, affecting 3-5% of all pregnant women. Subclinical hypothyroidism is more common than is overt hypothyroidism, and is usually defined as a serum thyroid-stimulating hormone (TSH) concentration greater than the pregnancy-specific reference range for each laboratory value, or by serum TSH concentrations greater than 2·5 mIU/L in the first trimester and greater than 3 mIU/L in the second and third trimesters. Some authors have defined subclinical hypothyroidism as a serum TSH between 5 and 10 mIU/L, and overt hypothyroidism as a serum TSH greater than 10 mIU/L, but this is not the commonly accepted definition. Once overt hypothyroidism is diagnosed, treatment with levothyroxine should be started to achieve serum TSH concentrations within the reference ranges for pregnancy as soon as possible. For patients with subclinical hypothyroidism, recommendations for therapy differ between various professional groups as a result of inconsistent data from both observational studies and clinical trials regarding the benefits for the mother or the child. Similarly, because benefits of therapy are still uncertain, universal screening of all pregnant women for subclinical hypothyroidism or thyroid autoimmunity is not recommended by most professional groups. During gestation, an increase in levothyroxine dose is required in more than 50% of women with previously diagnosed hypothyroidism, and can be managed by increasing the levothyroxine dose by 30% when pregnancy is confirmed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Effect of levothyroxine treatment on in vitro fertilization and pregnancy outcome in infertile women with subclinical hypothyroidism undergoing in vitro fertilization/intracytoplasmic sperm injection.

    Science.gov (United States)

    Kim, Chung-Hoon; Ahn, Jun-Woo; Kang, Sunjung Park; Kim, Sung-Hoon; Chae, Hee-Dong; Kang, Byung-Moon

    2011-04-01

    To investigate whether levothyroxine (LT4) treatment has beneficial effects on IVF results and pregnancy outcome in infertile patients with subclinical hypothyroidism undergoing IVF/intracytoplasmic sperm injection (ICSI). Prospective, randomized trial. University-affiliated infertility clinic. A total of 64 infertile patients with subclinical hypothyroidism, defined as an elevated serum TSH level associated with a normal free T4 level and without frank symptoms of hypothyroidism. Patients were randomized into an LT4 treatment group or control group. For the LT4 treatment group, 50 μg LT4 was administered from the first day of controlled ovarian stimulation for IVF/ICSI. Results of IVF and pregnancy outcome. There were no differences in patient characteristics between the two groups. Total dose and days of recombinant human FSH used for controlled ovarian stimulation were also similar. The number of grade I or II embryos was significantly higher in the LT4 treatment group than in the control group. There was no significant difference in the clinical pregnancy rate per cycle between the two groups. However, the miscarriage rate was significantly lower in the LT4 treatment group than in the control group. Embryo implantation rate and live birth rate were significantly higher in the LT4 treatment group. In the control group, both thyroid peroxidase antibody and thyroglobulin antibody levels were significantly higher in the miscarried subgroup than in the delivered subgroup. LT4 treatment can improve embryo quality and pregnancy outcome in subclinical hypothyroid women undergoing IVF/ICSI. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Peculiarities of biochemical blood parameters and cytokine profile in patients with non-alcoholic fatty liver disease depending on the form of hypothyroidism

    Directory of Open Access Journals (Sweden)

    V.P. Prysyazhnyuk

    2017-04-01

    to NAFLD patients with normal functional activity of the thyroid gland. A significant increase in liver vertical size measured by midclavicular line was observed in NAFLD patients with manifest hypothyroidism as compared to the patients with normal thyroid function or subclinical hypothyroidism.

  4. Evaluation of Selected Atherosclerosis Risk Factors in Women with Subclinical Hypothyroidism Treated with L-Thyroxine.

    Science.gov (United States)

    Adamarczuk-Janczyszyn, Maria; Zdrojowy-Wełna, Aleksandra; Rogala, Natalia; Zatońska, Katarzyna; Bednarek-Tupikowska, Grażyna

    2016-01-01

    Subclinical hypothyroidism (SCH) is a common endocrine disorder, probably increasing cardiovascular (CV) risk. However, the relation between SCH and atherosclerosis risk factors remains unclear. The aim of the study was to evaluate selected atherosclerosis risk factors in women with SCH in comparison to a group of healthy women and women with overt hypothyroidism, as well as to investigate the influence of L-thyroxine replacement on those risk factors. The study group consisted of 187 obese women aged between 50 and 70 years: 100 women with SCH, 45 women with overt hypothyroidism and 42 women with TSH level in reference ranges. Anthropometric parameters were evaluated. Laboratory tests included thyroid hormones concentrations, lipid profile with apolipoproteins, CRP, homocysteine. Atherosclerotic indexes were calculated: LDL C/HDL C ratio, apoA1/apoB ratio and Castelli risk index. Women with hypothyroidism were given L-thyroxine treatment and after 6 months in euthyroidism the evaluation was repeated. Total cholesterol, LDL-cholesterol and triglycerides concentrations as well as LDL-C/HDL-C ratio and Castelli index were higher in SCH than in controls and decreased after L-thyroxin substitution. All of the calculated atherosclerosis indexes showed significant positive correlations with TSH concentration in SCH group. Also in this group the systolic and diastolic blood pressure decreased significantly after treatment. Dyslipidemia in obese SCH women is not severe, but if untreated for many years, it may lead to atherosclerosis. Substitution therapy improves the lipid profile, changing the relations between protective and proatherogenic fractions of serum lipids, and optimises blood pressure.

  5. Bone health in children with long–term idiopathic subclinical hypothyroidism

    Directory of Open Access Journals (Sweden)

    Di Mase Raffaella

    2012-10-01

    Full Text Available Abstract Background Subclinical hypothyroidism (SH is a relatively common condition characterized by a mild persistent thyroid failure. The management of children with SH is still a controversial issue and the decision to treat with L-thyroxine represents a clinical dilemma. Thyroid hormone and TSH play an important role in skeletal growth and bone mineral homeostasis. Aim To evaluate whether untreated idiopathic SH may affect bone health in childhood and to compare two different diagnostic tools such as dual-energy X-ray densitometry (DXA and quantitative ultrasound (QUS. Patients and Methods Twenty-five children and adolescents (11 males aged 9.8 ± 3.5 years (range 4.2-18.7 with untreated idiopathic SH were enrolled in the study. SH was diagnosed on the basis of normal FT4 levels with TSH concentrations between 4.2 and 10 mU/l. Children have been followed for 3.3 ± 0.3 years from the time of SH diagnosis. Twenty-five healthy children, age- and sex-matched, were enrolled as controls. Patients and controls underwent DXA to evaluate lumbar spine bone mineral density (BMD and QUS at proximal phalanges of the non-dominant hand to assess bone quality, measured as amplitude-dependent speed of sound (Ad-SoS and bone transmission time (BTT. Results Mean BMD Z-score was −0.4 ± 1.36 in patients and −0.2 ± 1.2 in controls. Mean Ad-SoS Z-score was 0.01 ± 1.0 in patients and 0.1 ± 1.2 in controls and mean BTT Z-score was −0.03 ± 0.8 and 0.04 ± 1.1 respectively. All values were within the normal range, both in patients and in controls. There were no statistically significant differences between the two groups. Conclusion Bone health, evaluated by lumbar spine DXA and phalangeal QUS, is not impaired in our children, despite long-term duration of idiopathic SH. Data about bone status provided by QUS are comparable to those provided by DXA. Therefore, QUS may represent a good, cheaper and safe screening test for bone evaluation in children with SH.

  6. Quality of life in patients with hypothyroidism

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    T Morgunova

    2010-06-01

    Full Text Available To assess the quality of life of patients with hypothyroidism and to compare with the QoL of patients with nodular goiter and people without thyroid disease. Thirty patients with compensated primary hypothyroidism (aged from 25 to 55 years, 28 patients with nodular (multinodular euthyroid goiter of the same age not receiving levothyroxine, and 30 healthy people. The scores for the Short-Form 36 (SF-36 and Beck Depression Inventory Scale were analyzed. Almost all scales of the questionnaire SF-36 (except for general health and role emotional functioning in patients with compensated hypothyroidism were significantly lower (p < 0.05, than in healthy people. While comparing QoL in patients with hypothyroidism with QoL in patients with nodular goiter the rates of role physical functioning (p = 0.042, vitality (p = 0.015, social functioning (p = 0.0 and psychological health (p = 0.021 of patients with hypothyroidism were significantly less compared with patients with euthyroid goiter. In assessing the severity of depression revealed that the value on a scale of depression in patients with compensated hypothyroidism was significantly higher compared with the results of patients with nodular goiter and healthy individuals (p = 0.014. Conclusion: In patients with compensated hypothyroidism in almost all parameters the quality of life worse than in people without thyroid disease, and on many scales (role physical functioning, vitality, social functioning and psychological health is worse than in patients with euthy-roid goiter. Severity of depression in patients with compensated hypothyroidism is higher compared to patients with nodular goiter and healthy people, which may be one of the reasons for the decrease of quality of life of these patients.

  7. Subclinical Hypothyroidism and Type 2 Diabetes: A Systematic Review and Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Cheng Han

    Full Text Available Abundant evidence suggests an association between subclinical hypothyroidism (SCH and type 2 diabetes mellitus (T2DM, but small sample sizes and inconclusive data in the literature complicate this assertion.We measured the prevalence of SCH in T2DM population, and investigated whether T2DM increase the risk of SCH and whether SCH was associated with diabetic complications.We conducted a meta-analysis using PubMed, EMBASE, Web of Science, Wan Fang, CNKI and VIP databases for literature search. We obtained studies published between January 1, 1980 to December 1, 2014. The studies were selected to evaluate the prevalence of SCH in T2DM subjects, compare the prevalence of SCH in T2DM subjects with those non-diabetics, and investigate whether diabetic complications were more prevalent in SCH than those who were euthyroid. Fixed and random effects meta-analysis models were used, and the outcome was presented as a pooled prevalence with 95% confidence interval (95% CI or a summary odds ratio (OR with 95% CI.Through literature search, 36 articles met the inclusion criteria and these articles contained a total of 61 studies. Funnel plots and Egger's tests showed no publication bias in our studies, except for the pooled prevalence of SCH in T2DM (P = 0.08 and OR for SCH in T2DM (P = 0.04. Trim and fill method was used to correct the results and five potential missing data were replaced respectively. The adjusted pooled prevalence of SCH in T2DM patients was 10.2%, meanwhile, T2DM was associated with a 1.93-fold increase in risk of SCH (95% CI: 1.66, 2.24. Furthermore, SCH might affect the development of diabetic complications with an overall OR of 1.74 (95% CI: 1.34, 2.28 for diabetic nephropathy, 1.42 (95% CI: 1.21, 1.67 for diabetic retinopathy, 1.85 (95% CI: 1.35, 2.54 for peripheral arterial disease, and 1.87 (95% CI: 1.06, 3.28 for diabetic peripheral neuropathy.T2DM patients are more likely to have SCH when compared with healthy population and SCH

  8. Hypothyroidism

    Science.gov (United States)

    ... to normal, as do some patients with thyroiditis after pregnancy. Hypothyroidism may become more or less severe, and your dose of thyroxine may need to change over time. You have to make a lifetime commitment to treatment. But if you take your pills every day and work with your doctor to get and ...

  9. Rhabdomyolysis in a Patient with Severe Hypothyroidism.

    Science.gov (United States)

    Salehi, Nooshin; Agoston, Endre; Munir, Iqbal; Thompson, Gary J

    2017-08-22

    BACKGROUND Muscular symptoms, including stiffness, myalgia, cramps, and fatigue, are present in the majority of the patients with symptomatic hypothyroidism, but rhabdomyolysis, the rapid breakdown of skeletal muscle, is a rare manifestation. In most patients with hypothyroidism who develop rhabdomyolysis, precipitating factors, such as strenuous exercise or use of lipid-lowering drugs, can be identified. CASE REPORT We report a case of a 52-year-old Hispanic woman with a history of hypothyroidism, hypertension, and type 2 diabetes mellitus who presented with fatigue, severe generalized weakness, bilateral leg pain, and recurrent falls. She reported poor medication compliance for the preceding month. Initial laboratory testing showed elevated thyroid stimulating hormone (TSH) and creatine kinase (CK) levels, indicating uncontrolled hypothyroidism with associated rhabdomyolysis. Supportive treatment with intravenous fluids and intravenous levothyroxine were initiated and resulted in dramatic clinical improvement. CONCLUSIONS We report a case of rhabdomyolysis, which is a rare but potentially serious complication of hypothyroidism. Screening for hypothyroidism in patients with elevated muscle enzymes should be considered, since an early diagnosis and prompt treatment of hypothyroidism is essential to prevent rhabdomyolysis and its consequences.

  10. The association between maternal subclinical hypothyroidism and growth, development, and childhood intelligence: a meta-analysis.

    Science.gov (United States)

    Liu, Yahong; Chen, Hui; Chen, Jing; Li, Fupin

    2017-09-29

    To explore the association between maternal subclinical hypothyroidism (SCH) in pregnancy and the development of their children. Using RevMan 5.3 software, we performed a meta-analysis of cohort studies published from inception to May 2017, focusing on the association between maternal SCH in pregnancy and childhood growth, development and intelligence. Sources included the Cochrane Library, Pub-Med, Web of Science, CNKI, and Wan Fang Data. We included a total of 15 cohort studies involving 1,896 pregnant women with SCH. SCH in pregnancy was significantly associated with child's intelligence (P = 0.0007) and motor development (P development, low birth weight, premature delivery, fetal distress and fetal growth restriction. .

  11. Hypothyroidism

    Science.gov (United States)

    ... to meet your body's needs. This condition is hypothyroidism. Hypothyroidism is more common in women, people with other ... cause. Other causes include thyroid nodules, thyroiditis, congenital hypothyroidism, surgical removal of part or all of the ...

  12. Subclinical Hypothyroidism in Children: Normal Variation or Sign of a Failing Thyroid Gland?

    Directory of Open Access Journals (Sweden)

    Kaplowitz PaulB

    2010-05-01

    Full Text Available Subclinical hypothyroidism (SCH, defined by a normal total or free T4 level and a mildly elevated TSH (typically 5–10 mU/L, is common in children, but there is currently no consensus on management. Several recent pediatric studies indicate that progression of SCH to overt hypothyroidism (OH is uncommon and that over a period of several years, elevated TSH usually either normalizes or persists but does not increase. The etiology appears to be multifactorial, with some cases representing minor developmental abnormalities, some related to obesity, some to mild autoimmune thyroiditis, and some associated with mutations in the gene for the TSH-receptor. There are no pediatric studies showing clinical benefit of treating these children with thyroid hormone, but additional studies in this area are needed. Since few cases of pediatric SCH progress to OH, treatment can be deferred, and periodic follow-up testing may be the preferred strategy, with elevated thyroid antibodies or a goiter being considered risk factors for eventual OH.

  13. Subclinical Hypothyroidism in Children: Normal Variation or Sign of a Failing Thyroid Gland?

    Directory of Open Access Journals (Sweden)

    Paul B. Kaplowitz

    2010-01-01

    Full Text Available Subclinical hypothyroidism (SCH, defined by a normal total or free T4 level and a mildly elevated TSH (typically 5–10 mU/L, is common in children, but there is currently no consensus on management. Several recent pediatric studies indicate that progression of SCH to overt hypothyroidism (OH is uncommon and that over a period of several years, elevated TSH usually either normalizes or persists but does not increase. The etiology appears to be multifactorial, with some cases representing minor developmental abnormalities, some related to obesity, some to mild autoimmune thyroiditis, and some associated with mutations in the gene for the TSH-receptor. There are no pediatric studies showing clinical benefit of treating these children with thyroid hormone, but additional studies in this area are needed. Since few cases of pediatric SCH progress to OH, treatment can be deferred, and periodic follow-up testing may be the preferred strategy, with elevated thyroid antibodies or a goiter being considered risk factors for eventual OH.

  14. Subclinical Hypothyroidism and the Effect of Autoimmunity on the Echocardiography Indices of Left Ventricular Function, Lipid Profile, and Inflammatory Markers

    Directory of Open Access Journals (Sweden)

    Zohreh Moossavi

    2015-03-01

    Full Text Available Background: Subclinical hypothyroidism (Sch is the most frequent thyroid disease. The relationship between overt hypothyroidism and cardiovascular diseases has been well documented, but conflicting data have remained regarding Sch. Objectives: The present study aimed to assess the effect of Sch on increasing the risk of cardiovascular involvement considering the autoimmune subset. Patients and Methods: This case-control study was conducted on thirty patients with Sch and 30 healthy controls. Serum levels of thyroperoxidase antibody (TPOab, lipids, hsCRP, homocysteine, and ferritin were measured. Besides, conventional echocardiographic study and tissue Doppler imaging (including strain rate indices was done to evaluate Left Ventricular (LV systolic function. Results: The results showed a significant difference between the Sch patients and the controls regarding the serum level of triglyceride (117.43 ± 63.51 mg/dL vs. 86.86 ± 41.57, P = 0.031, echocardiographic parameters (longitudinal systolic strain rate [SRs: -1.006 ± 0.4 vs. -1.26 ± 0.16, P = 0.002; SRl: -1.43 ± 0.27 vs. -1.68 ± 0.29, P = 0.001], and Sm of septal mitral annulus (6.90 ± 0.6 vs. 7.43 ± 0.8, P = 0.006]. However, no significant difference was observed between the two groups regarding the serum levels of the inflammatory markers. Moreover, a significant correlation was found between TSH and Sm (r = -0.36, P = 0.005 and longitudinal systolic strain rate (SRs: r = 0.42, P < 0.001; SRl: r = 0.40, P = 0.001. Systolic strain rate was significantly lower in the TPOab positive patients (-0.99 ± 0.18 vs. -1.15 ± 0.25, P = 0.047. Conclusions: The clear association between Sch and subclinical LV systolic dysfunction which was more evident in the subgroup of patients with circulating anti-thyroid antibodies would remind a greater emphasis for considering the subgroup of TPOab positive patients for directing toward hormone replacement.

  15. Hypothyroidism and obesity: An intriguing link.

    Science.gov (United States)

    Sanyal, Debmalya; Raychaudhuri, Moutusi

    2016-01-01

    According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH) could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity. High leptin levels may play a role in the hyperthyrotropinemia of obesity and also increase susceptibility to thyroid autoimmunity and subsequent hypothyroidism. There is at most a modest effect of L-T4 treatment in overt hypothyroidism in inducing weight loss; benefit in subclinical hypothyroidism is not established with no data supporting thyroid hormone use in euthyroid obese patients.

  16. Hypothyroidism and obesity: An intriguing link

    Directory of Open Access Journals (Sweden)

    Debmalya Sanyal

    2016-01-01

    Full Text Available According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody status may help in establishing the diagnosis of subclinical hypothyroidism in obesity. High leptin levels may play a role in the hyperthyrotropinemia of obesity and also increase susceptibility to thyroid autoimmunity and subsequent hypothyroidism. There is at most a modest effect of L-T4 treatment in overt hypothyroidism in inducing weight loss; benefit in subclinical hypothyroidism is not established with no data supporting thyroid hormone use in euthyroid obese patients.

  17. Subclinical hypothyroidism as a risk factor for the development of cardiovascular disease in obese adolescents with nonalcoholic fatty liver disease.

    Science.gov (United States)

    Sert, Ahmet; Pirgon, Ozgur; Aypar, Ebru; Yilmaz, Hakan; Odabas, Dursun

    2013-06-01

    No data are available on the relationship between subclinical hypothyroidism and risk factors for the development of cardiovascular disease in obese adolescents with nonalcoholic fatty liver disease (NAFLD). This study aimed to determine whether an association exists between subclinical hypothyroidism and risk factors for the development of cardiovascular disease in obese adolescents with NAFLD. The study enrolled 111 obese adolescents and 42 lean subjects. The obese subjects were divided into two subgroups based on the presence or absence of fatty liver with high transaminases: a NAFLD group and a non-NAFLD group. Subclinical hypothyroidism was defined as a thyroid-stimulating hormone (TSH) level higher than 4 mIU/l and a normal free-thyroxine level (0.6-1.8 ng/dl). Insulin resistance was calculated by the homeostasis model assessment (HOMA-IR). Left ventricular mass (LVM), LVM index measurements, carotid intima media thickness (IMT), and HOMA-IR values were higher in the NAFLD obese group with TSH levels higher than 4 mIU/l than in the NAFLD obese group with TSH levels lower than 4 mIU/l. Elevated TSH values in the NAFLD obese group were positively correlated with most of the metabolic and cardiovascular risk parameters such as total cholesterol (r = 0.606, p = 0.001), triglycerides (r = 0.476, p = 0.016), low-density lipoprotein cholesterol (r = 0.461, p = 0.004), insulin (r = 0.607, p = 0.001), HOMA-IR (r = 0.596, p = 0.002), carotid IMT (r = 0.894, p obese adolescents with NAFLD and subclinical hypothyroidism had a more adverse cardiovascular risk profile and a higher carotid IMT and LVM.

  18. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy.

    Science.gov (United States)

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won; Lee, Seung Mi

    2015-09-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, Phypothyroidism.

  19. Treatment of subclinical hypothyroidism in pregnancy using fixed thyroxine daily doses of 75 μg.

    Science.gov (United States)

    Penin, Manuel; Trigo, Cristina; López, Yolanda; Barragáns, María

    2014-01-01

    Treatment of hypothyroid pregnant women is usually calculated based on weight (1 μg/kg/day) and TSH levels. This study assessed the usefulness of treating these women with a fixed dose of 75 μg/day. All women with pregnancy diagnosed from January to August 2012 in the Vigo Health Area (Spain) without previous diagnosis of thyroid disease or thyroxine treatment and with TSH levels over 4,5 mUI/ml were enrolled by consecutive sampling. All 116 women in the sample were treated with a fixed daily dose of thyroxine 75 μg-thyroxine levels were measured at two, four, and six months, and thyroxine dose was modified if TSH level was lower than 0.3 or higher than 4.5 mUI/ml. A woman had a TSH level less than 0.3 mUI/ml in a test; reduction of thyroxine dose to 50 μg/day allowed for maintaining TSH level within the desired range until delivery. Six women had TSH levels over 4.5 mUI/ml in one test; in all of them, increase in thyroxine dose to 100 μg/day allowed for maintaining the level within the desired range until delivery. Fixed daily doses of thyroxine 75 μg allowed for achieving goal TSH levels in most of our pregnant women with subclinical hypothyroidism, irrespective of their weight and baseline TSH level. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  20. Impact of subclinical hypothyroidism in women with recurrent early pregnancy loss.

    Science.gov (United States)

    Bernardi, Lia A; Cohen, Ronald N; Stephenson, Mary D

    2013-11-01

    To assess the impact of subclinical hypothyroidism (SCH) in women with recurrent early pregnancy loss (REPL). Observational cohort study. REPL program in an academic medical center. 286 women with a history of ≥2 pregnancy losses 2.5 mIU/L with a normal free thyroxine or free thyroxine index); from 2008 onward, levothyroxine treatment prepregnancy to maintain TSH ≤2.5 mIU/L. Live-birth rate (LBR). The prevalence of SCH was 55 (19%) of 286 in this REPL cohort. The cumulative LBR was 27 (69%) of 39 for women with SCH versus 104 (74%) of 141 for euthyroid women. The per-pregnancy LBR was 34 (49%) of 69 for SCH versus 129 (58%) of 221 for euthyroid women. When the LBR was compared between treated and untreated SCH, the cumulative LBR was 17 (71%) of 24 versus 10 (67%) of 15, respectively. The per-pregnancy LBR for SCH treated versus untreated women was 22 (48%) of 46 versus 12 (52%) of 23, respectively. Although there was a high prevalence of SCH in the REPL cohort, there was no statistically significant difference in the subsequent live-birth rate when comparing women with SCH and euthyroid women, or treated and untreated SCH. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  1. Hypothyroidism and obesity. Cause or effect?

    Science.gov (United States)

    Verma, Abhyuday; Jayaraman, Muthukrishnan; Kumar, Hari K V S; Modi, Kirtikumar D

    2008-08-01

    To establish relationship between obesity and hypothyroidism and to analyze the frequency the frequency of primary hypothyroidism in obese patients and frequency of obesity in primary hypothyroidism patients. We conducted this retrospective, observational study in the Department of Endocrinology and Obesity Clinic, Medwin Hospital, Hyderabad, India in Mar 2008. In the last 18 months (between September 2006 to February 2008), data on 625 consecutive primary hypothyroidism patients (Group I) and 450 patients from obesity clinic (Group II) were analyzed. Frequency difference between the 2 groups was assessed by Chi-square test. In Group I, 278/625 (44%) had body mass index (BMI) >25 kg/m2. Obesity was higher (46% versus 34%) in overt hypothyroidism than in subclinical hypothyroidism (p=0.21). More patients were overweight in overt hypothyroidism group than in subclinical hypothyroidism group (p=0.02). In obesity patients, overt hypothyroidism was present in 33% and subclinical hypothyroidism in 11% patients. Overall thyroid dysfunction was found more in obese individuals with varying degree of significance. Detailed studies are required to assess the cause and effect relation between obesity and hypothyroidism.

  2. Linear growth and intellectual outcome in children with long-term idiopathic subclinical hypothyroidism.

    Science.gov (United States)

    Cerbone, Manuela; Bravaccio, Carmela; Capalbo, Donatella; Polizzi, Miriam; Wasniewska, Malgorazata; Cioffi, Daniela; Improda, Nicola; Valenzise, Mariella; Bruzzese, Dario; De Luca, Filippo; Salerno, Mariacarolina

    2011-04-01

    The treatment of children with subclinical hypothyroidism (SH) is controversial for TSH values between 4.5 and 10 mU/l. The aim of this cross-sectional, controlled study was to evaluate growth and intellectual outcome in children with persistent SH who have never been treated with levothyroxine. Clinical and auxological parameters, thyroid function, and intellectual outcome were evaluated in 36 children with persistent SH at the age of 9.7±0.6 (range 4-18.0) years. Children had been followed longitudinally for 3.3±0.3 (range 2.0-9.3) years, from first diagnosis of SH until enrollment in the study. Thirty-six age- and sex-matched children were enrolled in the study as controls. At study entry, height (-0.8±0.2 SDS), bone age/chronological age (BA/CA ratio 0.92±0.6), and body mass index (BMI -0.1±0.2 SDS) in SH children were normal. Despite long-term duration of SH, none of these parameters showed a worsening with respect to height (-0.7±0.2 SDS), BA/CA (0.97±0.03), and BMI (-0.1±0.2) at the time of first SH detection. None of the children showed overt signs or symptoms of hypothyroidism during the follow-up. Verbal (99.1±2.2), performance (100.4±1.9), and full-scale (99.7±1.9) intelligence quotient (IQ) scores in SH children were normal and comparable to those of controls. No relationship was detected between IQ scores and the degree or duration of SH. Persistent SH in children is not associated with alterations in growth, bone maturation, BMI, and cognitive function or other complaints that could be ascribed to SH even after several years without therapeutic intervention.

  3. Effects of 18 months of L-T4 replacement in women with subclinical hypothyroidism.

    LENUS (Irish Health Repository)

    Adrees, M

    2012-02-01

    CONTEXT: Some of the cardiovascular and renal abnormalities seen in overt hypothyroidism have also been reported in subclinical hypothyroidism (SCH). Short-term L-T4 replacement in SCH improves cardiovascular risk markers and reduces carotid intima-media thickness (CIMT), a surrogate marker of atherosclerosis. The haemodynamic and renal effects of L-T4 replacement in SCH are poorly understood. OBJECTIVES: To compare cardiovascular risk factors and renal variables in women with SCH and normal women. To study the effects of L-T4 replacement in SCH subjects on these variables and on structural and functional changes in common carotid and brachial arteries. DESIGN: Fifty-six women with SCH before and after L-T4 replacement for 18 months and 56 normal women of similar age distribution were studied. Blood Pressure (BP), plasma lipids and homocysteine were measured and renal function evaluated [estimation of glomerular filtration rate (eGFR) using standard equations and measurement of serum Cystatin-C] in women with SCH before and after 18 months of l-T4, and in healthy women. CIMT and endothelial function (using brachial artery ultrasound) were studied before and after L-T4 in a subgroup of women with SCH. RESULTS: Systolic and diastolic BP, total cholesterol, triglyceride, LDL-cholesterol, lipoprotein(a) and homocysteine were greater in SCH (P < 0.05), and following L-T4 replacement decreased (P < 0.05) to levels that no longer differed from normal subjects. Estimated GFR was reduced and serum Cystatin-C increased (P < 0.05) in SCH. These variables also normalized following L-T4. Following L-T4 replacement the carotid artery baseline diameter increased by 7.1% and CIMT decreased by a mean value of 13%, while brachial artery diameter increased basally by 12.5% and following endothelium-dependent vasodilatation by 17.5% (P < 0.05). However, the increment following reactive hyperaemia did not differ before or following L-T4 replacement. CONCLUSION: Normalization of

  4. Health information-seeking behavior among hypothyroid patients at ...

    African Journals Online (AJOL)

    BACKGROUND: Hypothyroidism causes considerable morbidity. Low knowledge coupled with inadequate health literacy may lead to poor prevention and management. This study aimed to assess health information-seeking behavior and hypothyroid knowledge among South Indian hypothyroid patients. METHODS: This ...

  5. Endothelial Functioning and Hemodynamic Parameters in Rats with Subclinical Hypothyroid and the Effects of Thyroxine Replacement.

    Directory of Open Access Journals (Sweden)

    Cuixia Gao

    Full Text Available Subclinical hypothyroidism (SCH and its associations with atherosclerosis (AS and cardiovascular disease remain controversial. The purpose of our study was to observe changes in endothelial functioning and hemodynamics in rats with SCH and to determine whether L-thyroxine (L-T4 administration affects these changes.In total, sixty male Wistar rats were randomly divided into the following three groups with 20 rats each: control euthyroid rats, SCH rats and SCH rats that had been treated with thyroxine (SCH+T4. The SCH rats were induced by administration of 10 mg x kg(-1 x d(-1 methimazole (MMI once daily by gavage for 3 months. The SCH+T4 rats were administered the same dose of MMI for three months in addition to 2 μg x kg(-1 x d(-1 L-T4 once daily by gavage after 45 days of MMI administration. The control rats received physiological saline via gavage.The SCH group had significantly higher thyroid-stimulating hormone (TSH, total cholesterol (TC, low-density lipoprotein cholesterol (LDL-C, and endothelin (ET levels and a lower nitric oxide (NO level than the control and SCH+T4 groups. The tail and carotid artery blood pressures, left ventricular systolic pressure, heart rate and aorta ventralis blood flow were significantly lower in the SCH group than in the control and SCH+T4 groups. ACH treatment caused concentration-dependent relaxation, which was reduced in the SCH arteries compared with the control and SCH+T4 arteries. Histopathological examination revealed the absence of pathological changes in the SCH rat arteries.These findings demonstrate that L-T4 treatment ameliorates endothelial dysfunction and hemodynamic changes in SCH rats.

  6. Endothelial Functioning and Hemodynamic Parameters in Rats with Subclinical Hypothyroid and the Effects of Thyroxine Replacement

    Science.gov (United States)

    Liu, Jing; Guo, Qian; Tian, Limin

    2015-01-01

    Objective Subclinical hypothyroidism (SCH) and its associations with atherosclerosis (AS) and cardiovascular disease remain controversial. The purpose of our study was to observe changes in endothelial functioning and hemodynamics in rats with SCH and to determine whether L-thyroxine (L-T4) administration affects these changes. Methods In total, sixty male Wistar rats were randomly divided into the following three groups with 20 rats each: control euthyroid rats, SCH rats and SCH rats that had been treated with thyroxine (SCH+T4). The SCH rats were induced by administration of 10 mg.kg-1.d-1 methimazole (MMI) once daily by gavage for 3 months. The SCH+T4 rats were administered the same dose of MMI for three months in addition to 2 μg.kg-1.d-1 L-T4 once daily by gavage after 45 days of MMI administration. The control rats received physiological saline via gavage. Results The SCH group had significantly higher thyroid-stimulating hormone (TSH), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and endothelin (ET) levels and a lower nitric oxide (NO) level than the control and SCH+T4 groups. The tail and carotid artery blood pressures, left ventricular systolic pressure, heart rate and aorta ventralis blood flow were significantly lower in the SCH group than in the control and SCH+T4 groups. ACH treatment caused concentration-dependent relaxation, which was reduced in the SCH arteries compared with the control and SCH+T4 arteries. Histopathological examination revealed the absence of pathological changes in the SCH rat arteries. Conclusions These findings demonstrate that L-T4 treatment ameliorates endothelial dysfunction and hemodynamic changes in SCH rats. PMID:26158620

  7. Urinary iodine in early pregnancy is associated with subclinical hypothyroidism in Tianjin, China: an observational study.

    Science.gov (United States)

    Wang, Kunling; Zhang, Jie; Li, Fengao; Zhang, Wanqi; Wang, Hao; Ding, Li; Liu, Yaxin; Lin, Laixiang; Zhang, Shuang; Zhu, Mei

    2017-02-17

    Subclinical hypothyroidism (SH) is associated with adverse obstetric outcomes and neurodevelopment disorders. Both iodine deficiency and excess are associated with SH; however, few data regarding iodine nutrition status of pregnant women with SH are available. This study aimed to clarify whether iodine deficiency or excess is associated with SH, especially, when test results for anti-thyroid autoantibodies are negative. A total of 115 women with SH and 104 women with euthyroidism (EH) in early pregnancy in Tianjin, China were investigated, and their serum thyroid-stimulating hormone, free thyroxine, free triiodothyronine, anti-thyroid peroxidase antibody (TPOAb), anti-thyroid globulin antibody (TGAb), urinary iodine (UIC), and urinary creatinine (UCr) concentrations were measured. Thyroid ultrasonography was performed to determine thyroid echogenicity and volume. The UIC, UIC/UCr ratio, prevalence of TPOAb and TGAb positivity, and thyroid gland volume were compared between the EH and SH groups. UIC and ultrasonographic features were analysed in subjects in the SH group who were negative for TPOAb and TGAb. Median UIC of SH (154.0 μg/L) and EH (150.1 μg/L) met the World Health Organization criterion for iodine sufficiency in pregnant women. Neither UIC nor the UIC/UCr ratio differed significantly between groups. The prevalence of TPOAb and TGAb positivity in the SH group was significantly higher than that in the EH group (P pregnancy with SH in Tianjin were iodine sufficient, but still at risk of iodine deficiency as pregnancy progressed. UIC ≥ 250 μg/L was associated with increased risk of SH. Serological negative autoimmune thyroiditis and UIC ≥ 250 μg/L may play a role in pathogenesis of SH cases with negative results for autoantibodies.

  8. Minimal changes of thyroid axis activity influence brain functions in young females affected by subclinical hypothyroidism.

    Science.gov (United States)

    Menicucci, D; Sebastiani, L; Comparini, A; Pingitore, A; Ghelarducci, B; L'Abbate, A; Iervasi, G; Gemignani, A

    2013-03-01

    There is evidence of an association between thyroid hormones (TH) alterations and mental dysfunctions related to procedural and working memory functions, but the physiological link between these domains is still under debate, also for the presence of age as a confounding factor. Thus, we investigated the TH tuning of cerebral functions in young females affected by the borderline condition of subclinical hypothyroidism (SH) and in euthyroid females of the same age. The experiment consisted in the characterization of the affective state and cognitive abilities of the subjects by means of specific neuropsychological questionnaires, and of brain activity (EEG) in resting state and during the passive viewing of emotional video-clips. We found that SH had i) increased anxiety for Physical Danger; ii) better scores for both Mental Control and no-working-memory-related functions; iii) association between anxiety for Physical Danger and fT4 levels. Thus, in young adults, SH increases inward attention and paradoxically improves some cognitive functions. In addition, self-assessed questionnaires showed that SH had a greater susceptibility to unpleasant emotional stimulation. As for EEG data, SH compared to controls showed: i) reduction of alpha activity and of gamma left lateralization in resting state; ii) increased, and lateralized to the right, beta2 activity during stimulations. Both results indicated that SH have higher levels of arousal and greater susceptibility to negative emotion than controls. In conclusion, our study indicates that minimal changes in TH levels produce subtle but well-defined mental changes, thus encouraging further studies for the prediction of pathology evolution.

  9. Hypothyroidism in the elderly: diagnosis and management

    Science.gov (United States)

    Bensenor, Isabela M; Olmos, Rodrigo D; Lotufo, Paulo A

    2012-01-01

    Thyroid disorders are highly prevalent, occurring most frequently in aging women. Thyroid-associated symptoms are very similar to symptoms of the aging process; thus, improved methods for diagnosing overt and subclinical hypothyroidism in elderly people are crucial. Thyrotropin measurement is considered to be the main test for detecting hypothyroidism. Combined evaluations of thyroid stimulating hormone (TSH) and free-thyroxine can detect overt hypothyroidism (high TSH with low free-thyroxine levels) and subclinical hypothyroidism (high TSH with normal free-thyroxine levels). It is difficult to confirm the diagnosis of thyroid diseases based only on symptoms, but presence of symptoms could be an indicator of who should be evaluated for thyroid function. The most important reasons to treat overt hypothyroidism are to relieve symptoms and avoid progression to myxedema. Overt hypothyroidism is classically treated using L-thyroxine; elderly patients require a low initial dose that is increased every 4 to 6 weeks until normalization of TSH levels. After stabilization, TSH levels are monitored yearly. There is no doubt about the indication for treatment of overt hypothyroidism, but indications for treatment of subclinical disease are controversial. Although treatment of subclinical hypothyroidism may result in lipid profile improvement, there is no evidence that this improvement is associated with decreased cardiovascular or all-cause mortality in elderly patients. In patients with a high risk of progression from subclinical to overt disease, close monitoring of thyroid function could be the best option. PMID:22573936

  10. Vascular Endothelial Growth Factor Levels in Patients with Hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.M. Didushko

    2016-01-01

    Full Text Available The objective of the investigation was to determine the levels of vascular endothelial growth factor in patients with primary hypothyroidism. Having examined 133 patients with manifested hypothyroidism, we discovered that levels of vascular endothelial growth factor significantly increased in blood plasma of both obese and non-obese patients, but the highest indices have been found in patients with hypothyroidism resulting from autoimmune thyroiditis and with obesity. The obtained correlations indicate mutually aggravating effect of thyroid hypofunction, obesity and hypercholesterolemia on the development of endothelial dysfunction in patients with primary hypothyroidism, in particular on the increase of vascular endothelial growth factor levels.

  11. Impact of borderline-subclinical hypothyroidism on subsequent pregnancy outcome in women with unexplained recurrent pregnancy loss.

    Science.gov (United States)

    Uchida, Sayaka; Maruyama, Tetsuo; Kagami, Maki; Miki, Fumie; Hihara, Hanako; Katakura, Satomi; Yoshimasa, Yushi; Masuda, Hirotaka; Uchida, Hiroshi; Tanaka, Mamoru

    2017-06-01

    Because subclinical hypothyroidism (thyroid-stimulating hormone [TSH] > 4.5 IU/mL) is associated with adverse pregnancy outcome, including early pregnancy loss, TSH is recommended to be titrated to ≤2.5 mIU/L in levothyroxine-treated women before pregnancy. The purpose of this study was to determine whether borderline-subclinical hypothyroidism (borderline-SCH; 2.5 borderline-SCH, and euthyroidism (0.3 ≤ TSH ≤ 2.5 IU/mL). All women had normal serum free thyroxine (T4) and did not receive levothyroxine before or during the subsequent pregnancy. There were no significant differences in age, number of previous pregnancy losses, number of live births, or body mass index between the borderline-SCH (n = 56) and the euthyroid (n = 261) groups, but the rate of ANA positivity differed significantly (53.6% vs 33.7%, respectively; P = 0.005). The subsequent pregnancy rate did not differ between the two groups (55.4%, 31/56 vs 51.3%, 134/261, respectively). The pregnancy loss rate (borderline-SCH than the euthyroid group (29.0%, 9/31 vs 17.9%, 24/134), although not significantly so (P = 0.16). Although some subset of uRPL is though to be due to as-yet-unidentified cause(s), borderline-SCH is unlikely to be involved in uRPL. © 2017 Japan Society of Obstetrics and Gynecology.

  12. Hypothyroidism

    Science.gov (United States)

    ... on the National Agricultural Library website at www. nutrition. gov. Dietary Supplements Iodine is an essential mineral for the thyroid. ... in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. American Journal of ... Hypothyroidism Points ...

  13. Infantile mitochondrial disorder associated with subclinical hypothyroidism is caused by a rare mitochondrial DNA 8691A>G mutation: a case report.

    Science.gov (United States)

    Hao, Xiaosheng; Liu, Songyan; Wu, Xuemei; Hao, Yunpeng; Chen, Yinbo

    2015-07-08

    Mitochondrial diseases, ~15% of cases, are because of mitochondrial DNA mutations. This study reported a case of an 11-month-old male infant with mitochondrial disease characteristics and subclinical hypothyroidism (a high thyrotropin level). Laboratory tests were all normal and the enzymatic activities of mitochondrial respiratory chain enzyme complexes I-IV were normal. However, thyroid tests showed abnormal results, and complex V showed a deficiency activity of 52.8% of the low limit of healthy individuals (normal activity is >60.7%). The patient experienced convulsions, and the 24-h ambulatory electroencephalography results showed abnormalities, but the electromyography results were normal. Axial brain MRI showed abnormal dysplasia over the white matter myelination in the bilateral horn of the lateral ventricle. Furthermore, DNA sequencing data showed a novel mutation at 8691A>G of the mitochondrial ATPase 6 gene. This case adds to the growing literature of mitochondrial disorders caused by mitochondrial ATPase 6 mutations.

  14. Prevalence, associated risk factors and effects of hypothyroidism in pregnancy: a study from north India.

    Science.gov (United States)

    Goel, Poonam; Kaur, Jasbinder; Saha, Pradip Kumar; Tandon, Rimpy; Devi, Lajjya

    2012-01-01

    There is a controversy regarding universal versus targeted screening for hypothyroidism during pregnancy. We studied the prevalence and the associated risk factors of hypothyroidism. The secondary objective of the study was to compare the maternal and perinatal outcomes in overt and subclinical hypothyroidism. We screened 1,005 antenatal patients for hypothyroidism with a thyrotropin assay. Patients diagnosed with hypothyroidism were further tested for anti-thyroid peroxidase antibodies and free thyroxin to determine the cause and type (overt or subclinical) of hypothyroidism. Maternal and perinatal outcomes were compared in the overt, subclinical and euthyroid groups. The overall prevalence of hypothyroidism was 6.3% (overt 2.9% and subclinical 3.4%). Thirty-four (3.4%) new hypothyroid cases could be detected by universal screening. The risk factors for thyroid dysfunction were not significantly different in the screen-positive versus screen-negative patients except for excessive weight gain (p = 0.00). Targeted screening could have missed one third of subclinical hypothyroid cases. Gestational hypertension was significantly greater in the overt hypothyroid group (p = 0.007), and more patients required induction in this group (p = 0.013) but other maternal complications and perinatal outcomes were similar. We recommend universal screening for hypothyroidism in pregnancy in our population, as the prevalence of hypothyroidism is high. Copyright © 2012 S. Karger AG, Basel.

  15. Iodine Treatment in Children with Subclinical Hypothyroidism Due to Chronic Iodine Deficiency Decreases Thyrotropin and C-Peptide Concentrations and Improves the Lipid Profile

    NARCIS (Netherlands)

    Zimmermann, M.B.; Aeberli, I.; Boonstra, A.; Grimci, L.; Bridson, J.; Chaouki, N.; Mbhenyane, X.; Jooste, P.L.

    2009-01-01

    Background: Chronic iodine deficiency (ID) increases thyrotropin (TSH) concentrations and produces a thyroid hormone pattern consistent with subclinical hypothyroidism (ScH). ScH may be associated with cardiovascular disease risk factors. Thus, the study aim was to determine if iodine treatment of

  16. Longitudinal study on thyroid function in patients with thalassemia major: High incidence of central hypothyroidism by 18 years

    Directory of Open Access Journals (Sweden)

    Ashraf T Soliman

    2013-01-01

    Full Text Available Introduction: Primary hypothyroidism is one of the most frequent complications observed in-patients suffering from thalassemia. We investigated and reviewed the thyroid function in all thalassemic patients attending the Pediatric Endocrine Clinic of Hamad Medical Center, Doha, Qatar during the last 10 years of follow-up. Patients and Methods: A total of 48 patients with ί-thalassemia major between 5 years and 18 years of age. Thyroid dysfunction was defined as follows: Overt hypothyroidism (low Free thyroxine [FT4] and increased thyroid-stimulating hormone [TSH] levels >5 μIU/ml; subclinical hypothyroidism (normal FT4, TSH between 5 μIU/ml and 10 μIU/ml and central (secondary hypothyroidism (low FT4 and normal or decreased TSH. Results: A total of 48 patients (22 males and 26 females completed a 12 year-period of follow-up. During this period, hypothyroidism was diagnosed in 17/48 (35% of patients. There was no significant difference in the prevalence in males 7/22 (32% versus females 10/26 (38%. Sixteen of the patients had hypothyroidism after the age of 10 years (94%. The prevalence of overt hypothyroidism had risen from 0% at the age of 7 years to 35% at the age of 18 years. None of the patients had high anti-thyroperoxidase antibody titers. Out of 17 patients, 13 patients with hypothyroidism had normal or low TSH level (not appropriately elevated indicative of defective hypothalamic pituitary response to low FT4 (central hypothyroidism. Three patients (6.3% had subclinical hypothyroidism (TSH between 5 uIU/ml and 10 uIU/ml and normal FT4. The general trend of FT4 level showed progressive decrease over the 12 years, whereas, TSH levels did not show a corresponding increase. These data suggested defective hypothalamic pituitary thyroid axis involving both TSH and FT4 sretion in patients with thalassemia major over time. There was a significant negative correlation between serum ferritin and FT4 (r = −0.39, P = 0.007, but no correlation

  17. Pseudohypoparathyroidism Type 1A-Subclinical Hypothyroidism and Rapid Weight Gain as Early Clinical Signs: A Clinical Review of 10 Cases.

    Science.gov (United States)

    Kayemba-Kay's, Simon; Tripon, Cedric; Heron, Anne; Hindmarsh, Peter

    2016-12-01

    To evaluate the clinical signs and symptoms that would help clinicians to consider pseudohypoparathyroidism (PHP) type 1A as a diagnosis in a child. A retrospective review of the medical records of children diagnosed by erythrocyte Gsα activity and/or GNAS1 gene study and followed-up for PHP type 1A. Clinical and biochemical parameters along with epidemiological data were extracted and analyzed. Weight gain during infancy and early childhood was calculated as change in weight standard deviation score (SDS), using the French growth reference values. An upward gain in weight ≥0.67 SDS during these periods was considered indicative of overweight and/or obesity. Ten cases of PHP type 1A were identified (mean age 41.1 months, range from 4 to 156 months). In children aged ≤2 years, the commonest clinical features were round lunar face, obesity (70%), and subcutaneous ossifications (60%). In older children, brachydactyly was present in 60% of cases. Seizures occurred in older children (3 cases). Short stature was common at all ages. Subclinical hypothyroidism was present in 70%, increased parathormone (PTH) in 83%, and hyperphosphatemia in 50%. Only one case presented with hypocalcemia. Erythrocyte Gsα activity tested in seven children was reduced; GNAS1 gene testing was performed in 9 children. Maternal transmission was the most common (six patients). In three other cases, the mutations were de novo, c.585delGACT in exon 8 (case 2) and c.344C>TP115L in exon 5 (cases 6&7). Based on our results, PHP type 1A should be considered in toddlers presenting with round face, rapid weight gain, subcutaneous ossifications, and subclinical hypothyroidism. In older children, moderate mental retardation, brachydactyly, afebrile seizures, short stature, and thyroid-stimulating hormone resistance are the most suggestive features.

  18. Levothyroxine treatment and pregnancy outcome in women with subclinical hypothyroidism undergoing assisted reproduction technologies: systematic review and meta-analysis of RCTs.

    Science.gov (United States)

    Velkeniers, B; Van Meerhaeghe, A; Poppe, K; Unuane, D; Tournaye, H; Haentjens, P

    2013-01-01

    BACKGROUND Previous meta-analyses of observational data indicate that pregnant women with subclinical hypothyroidism have an increased risk of adverse pregnancy outcome. Potential benefits of levothyroxine (LT4) supplementation remain unclear, and no systematic review or meta-analysis of trial findings is available in a setting of assisted reproduction technologies (ART). METHODS Relevant trials published until August 2012 were identified by searching MEDLINE, EMBASE, Web of Knowledge, the Cochrane Controlled Trials Register databases and bibliographies of retrieved publications without language restrictions. RESULTS From 630 articles retrieved, we included three trials with data on 220 patients. One of these three trials stated 'live delivery' as outcome. LT4 treatment resulted in a significantly higher delivery rate, with a pooled relative risk (RR) of 2.76 (95% confidence limits 1.20-6.44; P = 0.018; I(2) = 70%), a pooled absolute risk difference (ARD) of 36.3% (3.5-69.0%: P = 0.030) and a summary number needed to treat (NNT) of 3 (1-28) in favour of LT4 supplementation. LT4 treatment significantly lowered miscarriage rate with a pooled RR of 0.45 (0.24-0.82; P = 0.010; I(2) = 26%), a pooled ARD of -31.3% (-48.2 to -14.5%: P pregnancy (RR 1.75; 0.90-3.38; P = 0.098; I(2) = 82%). In an ART setting, no data are available on the effects of LT4 supplementation on premature delivery, arterial hypertension, placental abruption or pre-eclampsia. CONCLUSIONS Our meta-analyses provide evidence that LT4 supplementation should be recommended to improve clinical pregnancy outcome in women with subclinical hypothyroidism and/or thyroid autoimmunity undergoing ART. Further research is needed to determine pregnancy outcome after close monitoring of thyroid function to maintain thyroid-stimulating hormone and free T4 levels within the trimester-specific reference ranges for pregnancy.

  19. Frequency of other endocrine disorders in hypothyroidism

    OpenAIRE

    Bjekić-Macut, Jelica; Trbojević, Božo

    2012-01-01

    Hypothyroidism is a condition of reduced production, distribution, or absence of action of thyroid hormones. Clinical diagnosis of hypothyroidism is not easily established due to the nonspecific clinical manifestations. Determination of serum TSH is the first-line test for the diagnosis of hypothyroidism. The aim of the study was to determine the presence of other endocrine disorders in patients with subclinical (TSH levels between 5 and 10 mIU/l), or clinical (TSH above 10 mIU/l) hypothyrodi...

  20. [Risk factors for renal dysfunction in patients with hypothyroidism].

    Science.gov (United States)

    Didushko, O M

    2014-01-01

    SUMMARY In order to study the features of kidney function in patients with hypothyroidism, examined 84 patients with primary hypothyroidism. Of the patients 46 patients had postoperative hypothyroidism in 38--hypothyroidism is autoimmune thyroiditis in the background (AIT). According to our results, in patients with manifest hypothyroidism is present renal dysfunction, which is manifested by increased serum creatinine and a decrease in glomerular filtration rate (GFR),the development and progression of which contributes to the presence of risk factors in patients--hyperlipidemia, excessive body weight and abdominal obesity, which is a pronounced in patients with Hashimoto's thyroiditis. Stated that more meaningful indicators of dyslipidemia associated with major manifestations of abdominal obesity as defined by waist circumference (OT) ((96.58 ± 1.70) and (98.73 ± 3.35) cm) and higher body mass index (BMI).

  1. Frequency of other endocrine disorders in hypothyroidism

    Directory of Open Access Journals (Sweden)

    Bjekić-Macut Jelica

    2012-01-01

    Full Text Available Hypothyroidism is a condition of reduced production, distribution, or absence of action of thyroid hormones. Clinical diagnosis of hypothyroidism is not easily established due to the nonspecific clinical manifestations. Determination of serum TSH is the first-line test for the diagnosis of hypothyroidism. The aim of the study was to determine the presence of other endocrine disorders in patients with subclinical (TSH levels between 5 and 10 mIU/l, or clinical (TSH above 10 mIU/l hypothyrodism. We analyzed 50 patients (35 with clinical hypothyroidism and 15 with subclinical form. In all patients anthropometric data (age, sex, weight, height, body mass index, blood pressure and heart rate, and clinical signs of hypothyroidism (skin changes, menstrual disorders were determined. Blood was drawn in fasting state for measurement of FT4, sTSH, glucose, lipids, ionized calcium, PTH, cortisol, ACTH, prolactin, gonadotropins, estradiol in women of reproductive age, and testosterone in men. Skin lesions were rarely present. Oligomenorrhea was more frequent in subclinical hypothyroidism, and menopause in clinical hypothyroidism. Blood pressure was normal in all subjects. Patients with clinical hypothyroidism compared to those with subclinical form had higher TSH values (19.5 ± 5.7 vs. 5.9 ± 0.3 mIU/l, and higher doses of L-thyroxine (81.2 ± 4.6 vs. 21.4 ± 3.5 μg/day. Disturbance of glycemic control was present in 18% of patients. Total cholesterol and LDL were insignificantly higher in patients with hypothyroidism than in subclinical form of the disease. FT4, calcium, PTH, cortisol, ACTH, gonadotropins, estradiol and testosterone did not differ between groups. The proatherogenic relation of estradiol with triglycerides was established in women with clinical form of hypothyroidism.

  2. Focus on BMI and subclinical hypothyroidism in adolescent girls first examined for amenorrhea or oligomenorrhea. The emerging role of polycystic ovary syndrome.

    Science.gov (United States)

    Nezi, Markella; Christopoulos, Panagiotis; Paltoglou, George; Gryparis, Alexandros; Bakoulas, Vassilios; Deligeoroglou, Efthimios; Creatsas, George; Mastorakos, George

    2016-06-01

    TSH concentrations 4.5 μIU/mL (subclinical hypothyroidism), respectively. Following the definition of polycystic ovary syndrome (PCOS) according to either the National Institutes of Health (NIH) criteria or those proposed in the literature by Carmina and his team, patients presented mainly with oligomenorrhea or secondary amenorrhea. There was good agreement between patients with amenorrhea or oligomenorrhea fulfilling both of the PCOS definition criteria employed. Among adolescent patients presenting with amenorrhea or oligomenorrhea for the first time those with low and high BMI present more often with primary and secondary amenorrhea, respectively. Obesity is involved in the development of hyperandrogenemia and hyperinsulinemia, particularly in PCOS patients. In these patients, subclinical hypothyroidism may be concealed and it should be investigated. These patients should be treated for abnormally increased or decreased BMI and be investigated for autoimmune thyroiditis.

  3. Well-being and depression in individuals with subclinical hypothyroidism and thyroid autoimmunity—A general population study

    DEFF Research Database (Denmark)

    Fjaellegaard, Katrine; Kvetny, Jan; Allerup, Peter N.

    2015-01-01

    BACKGROUND: The association between subclinical hypothyroidism (SCH), with and without raised thyroid peroxidase antibodies (anti-TPO), and well-being or depression is still controversial, in spite of many studies on the topic. AIMS: In this large general population study of 8214 individuals, we...... aim to clarify the significance of elevated levels of anti-TPO as a marker of poor well-being and depression in euthyroid individuals and individuals with SCH. METHODS: In participants from the Danish General Suburban Population Study (GESUS), serum thyroid stimulating hormone (TSH), total...... triiodothyronine (tT3), free thyroxine (fT4) and anti-TPO was measured. Prevalence of poor well-being and depression was measured using the WHO-5 Well-being questionnaire and WHO MDI [Major (ICD-10) Depression Inventory] questionnaire. RESULTS: Raw score for well-being or depression overall and stratified for sex...

  4. Hipotiroidismo subclínico, ni tan asintomático, ni tan inofensivo Subclinical hypothyroidism neither so asymptomatic nor so harmless

    Directory of Open Access Journals (Sweden)

    Marelys Yanes Quesada

    2009-04-01

    Full Text Available El hipotiroidismo subclínico es la condición definida por la elevación de la hormona estimulante del tiroides, en presencia de secreción de hormonas tiroideas (T3 y T4 normales para el rango de referencia. Sus manifestaciones clínicas no son tan nulas como lo define el término subclínico. Si se hace un correcto interrogatorio y examen clínico se pueden encontrar alteraciones en diversos sistemas y órganos que perjudican la calidad de vida de los pacientes afectos e incrementan su morbimortalidad. Durante el embarazo, la entidad cobra especial atención debido a la repercusión en el feto de la alteración de su desarrollo. En los pacientes ancianos es de vital importancia su diagnóstico, debido al incremento de la prevalencia de la entidad en este grupo y la repercusión sobre la calidad de vida. El presente trabajo tiene como objetivo revisar las alteraciones clínicas que se puedan presentar en el hipotiroidismo subclínico, así como en situaciones especiales de la vida (embarazo y senectud.Subclinical hypothyroidism is the condition defined by the raise of thyroid-stimulating hormone in presence of normal thyroid hormone secretion (T3 and T4 for reference rank. Its clinical manifestations are not so nulls as defines the subclinical term. If an appropriate questioning and clinical examination is made it is possible to find alterations in many systems and organs harming the quality of life of patients affected and to increase its morbidity and mortality. During pregnancy this entity acquires a special attention due to repercussion on fetal development alteration. In elderly patients is essential its diagnosis due to entity prevalence increase on this group and the repercussion on quality of life. Aim of present paper is to review the clinical alterations that may be present in subclinical hypothyroidism, as well as in special situations of life (pregnancy and senescence.

  5. Hypothyroidism in clinical practice

    Directory of Open Access Journals (Sweden)

    Faiza Qari

    2014-01-01

    Full Text Available Background: Hypothyroidism is the most common endocrine disease that was seen in the clinical practice especially for family physicians. Methods: This review article covered the important practical clinical issues for managing overt hypothyroidism, subclinical hypothyroidism and hypothyroidism during pregnancy. Conclusions: The clinical issues were addressed by clinical scenario followed by questions and stressed on the important clinical points.

  6. Hypothyroidism and the Heart.

    Science.gov (United States)

    Udovcic, Maja; Pena, Raul Herrera; Patham, Bhargavi; Tabatabai, Laila; Kansara, Abhishek

    2017-01-01

    Hypothyroidism is a commonly encountered clinical condition with variable prevalence. It has profound effects on cardiac function that can impact cardiac contractility, vascular resistance, blood pressure, and heart rhythm. With this review, we aim to describe the effects of hypothyroidism and subclinical hypothyroidism on the heart. Additionally, we attempt to briefly describe how hypothyroid treatment affects cardiovascular parameters.

  7. [Obesity and hypothyroidism: myth or reality?].

    Science.gov (United States)

    Portmann, Luc; Giusti, Vittorio

    2007-04-04

    While obesity has been historically considered a criteria to establish the diagnosis of hypothyroidism, the association between them is seldom encountered in patients. Nowadays the main metabolic criteria is the gain of weight in the presence of other symptoms of hypothyroidism. The large differences between the thermogenesis of hypothyroid and hyperthyroid patients underline the complex relationship of thyroid hormones and metabolic pathways. The treatment of a subclinical hypothyroidism has almost no influence on the body weight, whereas in more severe dysfunctions a weight loss is expected, usually less than 10% of body weight. Thereafter severe obesity may not be secondary to a thyroid failure.

  8. Metabolic and hemostatic parameters in patients with type 2 diabetes and hypothyroidism

    OpenAIRE

    G G Petrik

    2011-01-01

    To identify hemostatic and metabolic abnormalities in patients with hypothyroidism of varying severity and duration and possible modifying effects of chronic hyperglycemia on the investigated parameters comprehensive analysis of the parameters of metabolism, platelet and plasma hemostasis in 69 patients with hypothyroidism and 36 patients having hypothyroidism and diabetes mellitus (DM) has been performed. Decompensated hypothyroidism regardless of disease duration and presence of complicatio...

  9. [Thalidomide-associated hypothyroidism in a patient with multiple myeloma].

    Science.gov (United States)

    Okamura, Ikue; Ikeda, Takashi; Sato, Ken; Kimura, Fumihiko

    2015-01-01

    Thalidomide is highly effective against multiple myeloma, but some patients must discontinue this medication due to adverse effects. We present herein an instructive case report on thalidomide-associated hypothyroidism in a patient with multiple myeloma. Thyroid hormone replacement therapy allowed us to restart administration of thalidomide, a potentially life-saving therapy. Known adverse effects of thalidomide, such as lethargy, constipation, and bradycardia, are potential symptoms of hypothyroidism, but we tend to overlook drug-associated hypothyroidism. Our case highlights the importance of routinely testing thyroid function in patients receiving thalidomide therapy.

  10. Мonocyte Chemoattractant Protein Levels in Patients with Primary Hypothyroidism

    OpenAIRE

    O.M. Didushko

    2016-01-01

    Objective of the research — to study the content of monocyte chemoattractant protein‑1 (MCP‑1) in the urine of patients with primary hypothyroidism. Materials and methods. 141 patients with overt hypothyroidism have been examined. Among them, 71 patients had postoperative hypothyroidism, 70 — hypothyroidism on the background of autoimmune thyroiditis (AIT). Patients were divided: into I A group consisted of 35 patients with hypothyroidism following AIT without obesity; I B group — 35 patie...

  11. Hypothyroidism in Patients with Psoriasis or Rosacea: A Large Population Study.

    Science.gov (United States)

    James, Sara M; Hill, Dane E; Feldman, Steven R

    2016-10-15

    Hypothyroidism is a common disease, and there may be a link between hypothyroidism and inflammatory skin disease. The purpose of this study is to assess whether hypothyroidism is more prevalent in psoriasis or rosacea patients. We utilized a large claims-based database to analyze rates of hypothyroidism in patients with psoriasis and rosacea compared to other patients with skin diseases. Participants were patients between 20-64 years of age with ICD-9 diagnosis codes for psoriasis, rosacea, and hypothyroidism. We found that rates of hypothyroidism in rosacea and psoriasis patients were similar to rates of hypothyroidism in those without rosacea or psoriasis.

  12. [Comparison of the effect of different diagnostic criteria of subclinical hypothyroidism and positive TPO-Ab on pregnancy outcomes].

    Science.gov (United States)

    He, Yiping; He, Tongqiang; Wang, Yanxia; Xu, Zhao; Xu, Yehong; Wu, Yiqing; Ji, Jing; Mi, Yang

    2014-11-01

    To explore the effect of different diagnositic criteria of subclinical hypothyroidism using thyroid stimulating hormone (TSH) and positive thyroid peroxidase antibodies (TPO-Ab) on the pregnancy outcomes. 3 244 pregnant women who had their antenatal care and delivered in Child and Maternity Health Hospital of Shannxi Province August from 2011 to February 2013 were recruited prospectively. According to the standard of American Thyroid Association (ATA), pregnant women with normal serum free thyroxine (FT4) whose serum TSH level> 2.50 mU/L were diagnosed as subclinical hypothyroidism in pregnancy (foreign standard group). According to the Guideline of Diagnosis and Therapy of Prenatal and Postpartum Thyroid Disease made by Chinese Society of Endocrinology and Chinese Society of Perinatal Medicine in 2012, pregnant women with serum TSH level> 5.76 mU/L, and normal FT4 were diagnosed as subclinical hypothyroidism in pregnancy(national standard group). Pregnant women with subclinical hypothyroidism whose serum TSH levels were between 2.50-5.76 mU/L were referred as the study observed group; and pregnant women with serum TSH levelTPO- Ab were referred as the control group. Positive TPO-Ab results and the pregnancy outcomes were analyzed. (1) There were 635 cases in the foreign standard group, with the incidence of 19.57% (635/3 244). And there were 70 cases in the national standard group, with the incidence of 2.16% (70/3 244). There were statistically significant difference between the two groups (P 0.05) when compared with the foreign standard group. (2) Among the 3 244 cases, 402 cases had positive TPO-Ab. 318 positive cases were in the foreign standard group, and the incidence of subclinical hypothyroidism was 79.10% (318/402). There were 317 negative cases in the foreign standard group, with the incidence of 11.15% (317/2 842). The difference was statistically significant (P TPO-Ab, with the incidence of 11.44% (46/402), and 24 cases had negative result, with the

  13. Excess mortality in patients diagnosed with hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Pedersen, Dorthe Almind

    2013-01-01

    Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from...... January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over...... a mean period of 5.6 years (range 0-30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1...

  14. [Subclinical hypothyroidism; the start of a clinical trial into the usefulness of treatment with radioactive iodine

    NARCIS (Netherlands)

    Hoogendoorn, E.H.; Wiersinga, W.M.; Prummel, M.F.; Heijer, M. den; Corstens, F.H.M.; Hermus, A.R.M.M.

    2004-01-01

    Subclinical hyperthyroidism is defined as the presence of serum free thyroxine (T4) and triiodothyronine (T3) levels within the reference range and a reduced serum thyrotrophin (TSH) level. Evidence is accumulating that it has important clinical effects. Randomised clinical trials are needed to

  15. Does Acquired Hypothyroidism Affect the Hearing Functions?

    Directory of Open Access Journals (Sweden)

    Ayşe Arduç

    2015-12-01

    Full Text Available Purpose: It is well known that congenital hypothyroidism can cause hearing loss. However, conflicting results were found in studies investigating hearing functions in acquired hypothyroidism. Therefore, we evaluated the audiometric findings in patients with acquired hypothyroidism. Material and Method: The study included 58 patients with hypothyroidism and age- and gender-matched 34 healthy controls. Twenty eight (48.27% patients had subclinical hypothyroidism, and 30 (51.73% had obvious hypothyroidism. All subjects had a normal otoscopic examination and tympanometry. Pure tone audiometry at 250, 500, 1000, 2000, 4000, 6000, and 8000 Hertz (Hz was performed in both groups. Blood pressure measurements and the levels of plasma electrolytes, lipids and vitamin B12 were available in all subjects. Results: Hypothyroidism group and control group were similar with respect to systolic and diastolic blood pressures and plasma glucose, lipid, vitamin B12, calcium, sodium, potassium, and chloride levels. Significantly higher audiometric thresholds (dB at 250 (10 (0-45 vs. 5 (0-15, p<0.001 and 500 Hz (10 (0-40 vs. 10 (-5-15, p=0.003 were recorded in hypothyroid patients compared to that in healthy controls. Hearing thresholds at 250 and 500 Hz correlated positively with thyroid-stimulating hormone (TSH, and negatively with free triiodothyronine and free thyroxine. Subclinical hypothyroid patients had a higher hearing threshold at 250 Hz than healthy controls (p=0.001. Discussion: Our study demonstrated that hearing ability decreases in hypothyroidism, even in subclinical hypothyroidism. The changes in TSH and thyroid hormone levels seem to be directly related to the hearing loss in this population of patients.

  16. Chronic brain ischemia in patients with arterial hypertension and hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.Ye. Kovalenko

    2017-04-01

    Full Text Available The questions of the pathogenesis of chronic brain ischemia in patients with hypertension and hypothyroidism are studied. Examples of some results of authors’ research are listed. According to the research, patients with hypertensive dyscirculatory encephalopathy and hypothyroidism have deterioration of blood supply to the brain by reducing the reactivity of the vascular wall, decrease in the functional activity of the brain, impairement of cognitive function and increase in the anxiety and depression.

  17. Psychiatric and cognitive manifestations of hypothyroidism

    Science.gov (United States)

    Samuels, Mary H

    2014-01-01

    Purpose of review Overt hypothyroidism has major effects on neuropsychiatric function, but patients with mild hypothyroidism may attribute unrelated neuropsychiatric symptoms to their thyroid condition. This review will summarize data on neuropsychiatric effects of hypothyroidism, and provide guidelines regarding the relationship between hypothyroidism and neuropsychiatric issues, and treatment indications. Recent findings Clinical investigations and functional imaging studies confirm that overt hypothyroidism is associated with affective and cognitive decrements, largely reversible with treatment. In contrast, subclinical hypothyroidism is not associated with major neuropsychiatric deficits, although studies utilizing sensitive measures show small deficits in memory and executive function. Neuropsychiatric complaints are more common when patients are aware of their thyroid disease, regardless of their thyroid function at the time of testing. Summary Neuropsychiatric dysfunction is common in overt hypothyroidism, and will improve (although perhaps not completely resolve) with therapy. On the other hand, deficits related to thyroid dysfunction are usually mild in subclinical hypothyroidism, and realistic expectations need to be set regarding symptom reversibility with treatment. Patients with mild hypothyroidism and significant distress related to neuropsychiatric symptoms most likely have independent diagnoses that should be evaluated separately. PMID:25122491

  18. Incidence of primary hypothyroidism in patients exposed to therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland

    Directory of Open Access Journals (Sweden)

    B A Laway

    2012-01-01

    Full Text Available Introduction: Hypothyroidism is a known consequence of external-beam radiotherapy to the neck encompassing a part or whole of the thyroid gland. In this non-randomized prospective study, we have tried to evaluate the response of the thyroid gland to radiation by assessing thyroid function before irradiation and at regular intervals after irradiation. Aims and Objectives: The aim of this study were to assess in the cancer patients, who were exposed to the therapeutic external beam radiation, where radiation portals include a part or whole of the thyroid gland: the incidence of primary hypothyroidism, the time required to become hypothyroid, any relation between the total dose for the development of hypothyroidism, and whether there are any patient or treatment-related factors that are predictive for the development of hypothyroidism, including the use of concurrent chemotherapy. Materials and Methods: This non-randomized, prospective study was conducted for a period of 2 years in which thyroid function was assessed in 59 patients (cases of head and neck cancer, breast cancer, lymphoma patients and other malignancies, who had received radiotherapy to the neck region. 59 euthyroid healthy patients (controls were also taken, who had not received the neck irradiation. These patients/controls were assessed periodically for 2 years. Results: The incidence of hypothyroidism after external beam radiation therapy (EBRT to neck where radiation portals include part or whole of the thyroid gland was 16.94%, seven cases had subclinical hypothyroidism (11.86% and three cases had clinical hypothyroidism (5.08%. Mean time for development of hypothyroidism was 4.5 months. There was no effect of age, gender, primary tumor site, radiation dose and chemotherapy, whether neoadjuvant or concurrent with the development of hypothyroidism. Conclusion: In summary, we found that thyroid dysfunction is a prevalent, yet easily treatable source of morbidity in patients

  19. The evaluation of diastolic dysfunction with tissue Doppler echocardiography in women with subclinical hypothyroidism and the effect of L-thyroxine treatment on diastolic dysfunction: a pilot study.

    Science.gov (United States)

    Erkan, Gulbanu; Erkan, Aycan Fahri; Cemri, Mustafa; Karaahmetoglu, Selma; Cesur, Mustafa; Cengel, Atiye

    2011-01-01

    Background. Subclinical hypothyroidism (SH) predominantly affects women. The necessity of treatment in SH is controversial. Objective. We aimed to investigate the response of diastolic dysfunction to thyroid hormone replacement therapy (THRT) in women. Methods and Results. Twenty-two female subjects with SH and 20 euthyroid female controls were enrolled. Baseline and follow-up biochemical, hormonal, and echocardiographic evaluations were performed. Repeat echocardiograms were performed three months after the achievement of a euthyroid status with THRT. Mean baseline myocardial performance index (MPI) was 0.27 ± 0.08 in the SH group, and 0.22 ± 0.06 in the control group (P = 0.03). MPI did not change significantly after THRT. Pulsed-wave Doppler findings were not different among the groups. However, tissue Doppler-derived mitral annular E' velocities were significantly lower in the SH group. A moderate but significant improvement was observed in E' velocities after THRT (13.2 ± 3.87 versus 14.53 ± 2.75, P = 0.04). We also observed left ventricular concentric remodeling in SH patients which was reversible with THRT. Conclusions. Tissue Doppler echocardiography may be a useful tool for monitoring the response of diastolic dysfunction to thyroid hormone replacement therapy in patients with SH. Our findings suggest that THRT may reverse diastolic dysfunction in women with SH.

  20. The Evaluation of Diastolic Dysfunction with Tissue Doppler Echocardiography in Women with Subclinical Hypothyroidism and the Effect of L-Thyroxine Treatment on Diastolic Dysfunction: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gulbanu Erkan

    2011-01-01

    Full Text Available Background. Subclinical hypothyroidism (SH predominantly affects women. The necessity of treatment in SH is controversial. Objective. We aimed to investigate the response of diastolic dysfunction to thyroid hormone replacement therapy (THRT in women. Methods and Results. Twenty-two female subjects with SH and 20 euthyroid female controls were enrolled. Baseline and follow-up biochemical, hormonal, and echocardiographic evaluations were performed. Repeat echocardiograms were performed three months after the achievement of a euthyroid status with THRT. Mean baseline myocardial performance index (MPI was 0.27±0.08 in the SH group, and 0.22±0.06 in the control group (P=0.03. MPI did not change significantly after THRT. Pulsed-wave Doppler findings were not different among the groups. However, tissue Doppler-derived mitral annular E’ velocities were significantly lower in the SH group. A moderate but significant improvement was observed in E’ velocities after THRT (13.2±3.87 versus 14.53±2.75, P=0.04. We also observed left ventricular concentric remodeling in SH patients which was reversible with THRT. Conclusions. Tissue Doppler echocardiography may be a useful tool for monitoring the response of diastolic dysfunction to thyroid hormone replacement therapy in patients with SH. Our findings suggest that THRT may reverse diastolic dysfunction in women with SH.

  1. The effects of subclinical hypothyroidism on serum lipid level and TLR4 expression of monocyte in peripheral blood of rats.

    Science.gov (United States)

    Yang, Shuan-suo; Tang, Lei; Li, Ruo-gu; Ge, Guang-hao; Qu, Xin-kai; Ma, Jiang-wei; Qiao, Zeng-yong; Zhang, Li; Liu, Hua-jin; Hou, Yue-mei; Cao, Hua; Hao, Zhi-min; Cheng, Wen-bo; Wang, Hong-wei

    2014-01-01

    To observe effect of subclinical hypothyroidism (SCH) on serum lipid level and expression of toll-like receptor 4 (TLR4) in rats' peripheral blood mononuclear cells (PBMC). Fifty Wistar female rats were divided into three groups: normal control (NC group; n=10), sham group (n=10), and L-T-4 (L-thyroxine) group (n=30, with thyroidectomy, fed with rich-calcium water after operation. 5 weeks later, abdominal subcutaneous injection of L-T-4: 0.95 μg/100g/d). 8 weeks later, the rats were killed then the peripheral blood was collected to determine the levels of serum thyroid-stimulating hormone (TSH), total thyroid hormone (TT4), total cholesterol (TC) and low density lipoprotein cholesterin (LDL-C). Rats in L-T-4 group were divided into normal lipid (NL) group) and high lipid (HL) group) according to lipid value of NC group. Monocytes were separated from blood to determine TLR4 expression by flow cytometry. In NL and HL groups TSH were higher than in NC and Sham groups (p0.05). TLR4, TLR4 mRNA, NF-κB (p65) were increased (p0.05). TLR4, TLR4 mRNA, NF-κB (p65) of PBMC and TNF-α, IL-6, IL-1β expression in serum were all increased in SCH rats, which was not related to serum dyslipidemia.

  2. Effect of Combination Treatment for Hypothyroidism on Renal Function in Patients with Hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.M. Didushko

    2016-03-01

    Full Text Available Objective. To improve known methods of diagnosing kidney damage in patients suffering from hypothyroidism with elements of metabolic syndrome, to study the effect of combined treatment on renal function. Materials and methods. The study included 240 patients with primary hypothyroidism (among them — 130 patients with primary hypothyroidism with components of the metabolic syndrome. All patients were divided into 2 groups: the I group included 42 patients with hypothyroidism without obesity (age 44.8 ± 5.7 years; body mass index (BMI 21.3 ± 2.6 kg/m2; group II — 45 patients with hypothyroidism and abdominal obesity (age 43.8 ± 6.1 years; BMI 33.4 ± 4.8 kg/m2. The control group included 20 healthy individuals (age 43.5 ± 5.9 years; BMI 22.0 ± 2.4 kg/m2. Kidney damage was detected in violation of glomerular filter permeability — occurrence of albuminuria and parameters of glomerular filtration rate (GFR were determined using CKD-EPI formulas. The concentration of monocyte chemoattractant protein-1 (MCP-1, leptin, insulin was determined by immunoenzyme assay. Results. During the correlation analysis, between GFR in patients of group I we have established: moderate inverse correlation between the level of GFR and thyroid stimulating hormone (TSH (r = 0.571, GFR and vascular endothelial growth factor (r = –0.616, GFR anf interleukin-6 (IL-6 (r = –0.418, total cholesterol (ChS (r = –0.311, GFR and insulin resistance index (IIR (r = –0.606 and weak inverse relationship between level of GFR and MCP-1 (r = –0.2917. In the II group of patients, a strong direct correlation between the level of GFR and IIR (r = 0.819, Caro index (r = 0.793 and a strong inverse correlation between GFR and TSH (r = –0.782, GFR and HOMA index (r = –0.875, moderate inverse correlation between the levels of GFR and ChS (r = –0.577, leptin (r = –0.476, GFR and IL-6 (r = –0.418, GFR and glucose (r = –0.436 and vascular endothelial growth factor (r

  3. Characteristics of peripheral blood NK and NKT-like cells in euthyroid and subclinical hypothyroid women with thyroid autoimmunity experiencing reproductive failure.

    Science.gov (United States)

    Miko, Eva; Meggyes, Matyas; Doba, Katalin; Farkas, Nelli; Bogar, Barbara; Barakonyi, Aliz; Szereday, Laszlo; Szekeres-Bartho, Julia; Mezosi, Emese

    2017-11-01

    Thyroid autoimmunity (TAI) appears to play a crucial role in female infertility, recurrent pregnancy loss and IVF failure. Thyroid autoantibodies against thyroid peroxidase and thyroglobulin have been shown to represent an independent risk factor for infertility and miscarriage. Moreover, thyroxin hormone administration reduces the risk of obstetrical complications in TAI positive women. The aim of our present study was to investigate the immunological background of female infertility and recurrent pregnancy loss in euthyroid and subclinical hypothyroid women with TAI focusing on innate immunity. Phenotypic and functional analysis was carried out on peripheral blood mononuclear cells from healthy donors and TAI patients by flow cytometry. Our findings show Th1 oriented changes of innate immunity in the peripheral blood of women suffering from thyroid autoimmunity. Elevated NK and NKT-like cells ratios and enhanced natural cytotoxicity of TAI positive women reveal an altered immune status with possible negative impact on pregnancy outcome. It is important to notice that immune alterations are already established in the euthyroid phase of autoimmune thyroiditis before endocrine dysfunction develops and only the presence of thyroid autoantibodies indicate TAI condition. For this reason, screening of healthy women of reproductive age for the presence of thyroid autoantibodies would be beneficial not only from the endocrinological aspect but from the reproductive point of view since, although yet unexplained, thyroid hormone administration may improve pregnancy outcome. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. Abnormal Production of Monocyte Chemoattractant Protein in Patients with Primary Hypothyroidism

    OpenAIRE

    O.M. Didushko

    2015-01-01

    The objective of the research was to study monocyte chemoattractant protein-1 (MCP-1) levels in patients with hypothyroidism.Materials and methods. 139 patients with manifested hypothyroidism were examined. Among them 69 patients had postoperative hypothyroidism and 70 – developed it on the background of autoimmune thyroiditis. All patient were divided into several groups: IA group involved 35 patients with hypothyroidism resulting from AIT without obesity; IB group included 35 patients suffe...

  5. Hypothyroidism among SLE patients: Case-control study.

    Science.gov (United States)

    Watad, Abdulla; Mahroum, Naim; Whitby, Aaron; Gertel, Smadar; Comaneshter, Doron; Cohen, Arnon D; Amital, Howard

    2016-05-01

    The prevalence of hypothyroidism in SLE patients varies considerably and early reports were mainly based on small cohorts. To investigate the association between SLE and hypothyroidism. Patients with SLE were compared with age and sex-matched controls regarding the proportion of hypothyroidism in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. The study included 5018 patients with SLE and 25,090 age and sex-matched controls. The proportion of hypothyroidism in patients with SLE was increased compared with the prevalence in controls (15.58% and 5.75%, respectively, Phypothyroidism (odds ratio 2.644, 95% confidence interval 2.405-2.908). Patients with SLE have a greater proportion of hypothyroidism than matched controls. Therefore, physicians treating patients with SLE should be aware of the possibility of thyroid dysfunction. Copyright © 2016 Elsevier B.V. All rights reserved.

  6. Metabolic and hemostatic parameters in patients with type 2 diabetes and hypothyroidism

    Directory of Open Access Journals (Sweden)

    G G Petrik

    2011-09-01

    Full Text Available To identify hemostatic and metabolic abnormalities in patients with hypothyroidism of varying severity and duration and possible modifying effects of chronic hyperglycemia on the investigated parameters comprehensive analysis of the parameters of metabolism, platelet and plasma hemostasis in 69 patients with hypothyroidism and 36 patients having hypothyroidism and diabetes mellitus (DM has been performed. Decompensated hypothyroidism regardless of disease duration and presence of complications is accompanied by platelets hyperfunction. In subcompensated hypothyroidism the aggregation activity was not changed. The combination of type 2 diabetes in patients with decompensated and subcompensated hypothyroidism is accompanied by platelets activation, hypertriglyceridemia, increased platelets average volume and shortening of APTT.

  7. A review of the evidence for and against increased mortality in hypothyroidism

    DEFF Research Database (Denmark)

    Thvilum, Marianne; Brandt, Frans; Brix, Thomas H

    2012-01-01

    The lifetime risk of overt hypothyroidism is around 5%, and this disease is usually preceded by subclinical hypothyroidism, which has an even higher prevalence (estimated to be up to 9%). Hypothyroidism has been linked with cardiac dysfunction, atherosclerosis, hypertension and coagulopathy....... Intuitively, this increased morbidity is expected to shorten patients' lifespan, but definitive data are lacking on whether either of these hypothyroid states (particularly overt hypothyroidism) increase mortality. Study findings are inconsistent and, overall, the pooled data do not demonstrate increased...... mortality in patients with either subclinical or overt hypothyroidism. However, none of the available studies was adequately designed to answer this question. This Review discusses major shortcomings in those studies, such as population dissimilarities, hypothyroid state classification and misclassification...

  8. Intrauterine Zn Deficiency Favors Thyrotropin-Releasing Hormone-Increasing Effects on Thyrotropin Serum Levels and Induces Subclinical Hypothyroidism in Weaned Rats

    Directory of Open Access Journals (Sweden)

    Viridiana Alcántara-Alonso

    2017-10-01

    Full Text Available Individuals who consume a diet deficient in zinc (Zn-deficient develop alterations in hypothalamic-pituitary-thyroid axis function, i.e., a low metabolic rate and cold insensitivity. Although those disturbances are related to primary hypothyroidism, intrauterine or postnatal Zn-deficient adults have an increased thyrotropin (TSH concentration, but unchanged thyroid hormone (TH levels and decreased body weight. This does not support the view that the hypothyroidism develops due to a low Zn intake. In addition, intrauterine or postnatal Zn-deficiency in weaned and adult rats reduces the activity of pyroglutamyl aminopeptidase II (PPII in the medial-basal hypothalamus (MBH. PPII is an enzyme that degrades thyrotropin-releasing hormone (TRH. This hypothalamic peptide stimulates its receptor in adenohypophysis, thereby increasing TSH release. We analyzed whether earlier low TH is responsible for the high TSH levels reported in adults, or if TRH release is enhanced by Zn deficiency at weaning. Dams were fed a 2 ppm Zn-deficient diet in the period from one week prior to gestation and up to three weeks after delivery. We found a high release of hypothalamic TRH, which along with reduced MBH PPII activity, increased TSH levels in Zn-deficient pups independently of changes in TH concentration. We found that primary hypothyroidism did not develop in intrauterine Zn-deficient weaned rats and we confirmed that metal deficiency enhances TSH levels since early-life, favoring subclinical hypothyroidism development which remains into adulthood.

  9. Frequent Occurrence of Faulty Practices, Misconceptions and Lack of Knowledge among Hypothyroid Patients.

    Science.gov (United States)

    Goel, A; Shivaprasad, C; Kolly, A; Pulikkal, A A; Boppana, R; Dwarakanath, C S

    2017-07-01

    Hypothyroidism is a common endocrine disorder with a reported prevalence of 4%-10%. Previous studies have reported significant gaps in the basic knowledge about the condition in hypothyroid patients. It has also been observed that faulty practices prevail among these patients. There is paucity of data on the assessment of knowledge and practices among treated hypothyroid patients. The present study was aims to assess the knowledge, awareness and practices in treated hypothyroid patients. The current cross-sectional study was conducted on 244 consecutive hypothyroid patients, attending the Endocrinology Outpatient Department (OPD). The patients were asked to fill a structured questionnaire pertaining to knowledge and practices about various aspects of hypothyroidism. Only two-thirds of the participants correctly identified thyroid as a gland and 41% were aware that hypothyroidism is caused due to decreased function of the thyroid gland. The most common symptom attributed to hypothyroidism was weight gain (139 responses). Nearly 45% of the patients believed alternative forms of medicine can be used for treatment of hypothyroidism. It was believed by 42% of the patients that hypothyroidism runs in the family and about 10% believed it could be transferred to their spouses. Only 33% of the patients gave one hour gap between levothyroxine and food intake. The study demonstrates the lack of knowledge about basic aspects of hypothyroidism among the patients. In addition, there is a high prevalence of misconceptions and faulty practices. The study highlights the need for comprehensive patient education to improve therapeutic outcomes and compliance among hypothyroid patients.

  10. The effect of hypothyroidism occurring in patients with metabolic syndrome.

    Science.gov (United States)

    Gierach, Marcin; Junik, Roman

    2015-01-01

    Metabolic syndrome involves abdominal obesity, arterial hypertension, type 2 diabetes and lipid disorders manifested as atherogenic dyslipidaemia. Abnormal thyroid function affects the severity of MetS components, since regulating metabolism is one of the most important functions of thyroid hormones. In this study, we present the influence of hypothyroidism on lipid and carbohydrate disorders in patients with MetS. The described study was a prospective, two-centre screening study of 24-month duration. The study participants were 441 patients (350 women, 91 men, aged 28-82) with metabolic syndrome diagnosed according to the 2005 IDF. By comparing the study and the control group, statistically significant differences were observed in the mean triglyceride levels (respectively 161,5 vs. 134,8 mg/dL, p = 0.047), mean fasting glycaemia (respectively 111,8 vs. 126,1 mg/dL, p = 0.044) and TG/HDL ratio (4,74 vs. 3,71, p = 0.043). Hypothyroidism shows a positive correlation with the TG levels and TG/HDL-C ratio and a negative correlation with the mean fasting glycaemia in people with MetS. A significantly higher TG/HDL-C ratio and lower mean insulin sensitivity ratio observed in men with hypothyroidism, indicated higher insulin resistance in men. In view of the above, it may be hypothesized that in patients with both MetS and hypothyroidism, especially of male gender, the risk of death of cardiovascular causes is greater due to the severity of MetS components. Moreover, we suggest that in patients recently diagnosed with MetS, active detection of hypothyroidism should be performed by determining the TSH levels, while patients diagnosed with hypothyroidism (apart from replacement therapy) should be monitored for the possible occurrence of MetS in the future.

  11. Hypothyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2014-01-01

    INTRODUCTION: Hypothyroidism is six times more common in women, affecting up to 40 in 10,000 each year (compared with 6/10,000 men). METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for clinical (overt......) hypothyroidism? What are the effects of treatments for subclinical hypothyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We...

  12. Acute hypothyroidism in a severely ill surgical patient

    DEFF Research Database (Denmark)

    Mogensen, T; Hjortsø, N C

    1988-01-01

    A case of acute postoperative hypothyroidism in a 62-year old woman is presented. One month before emergency admission because of a perforated gastric ulcer the patient had normal thyroid function, despite removal of a thyroid adenoma 20 years earlier. Following surgery the patient developed...

  13. Critique of the hyperthyroidism and hypothyroidism CPG.

    Science.gov (United States)

    Scatcherd, Julie A

    2004-10-01

    The clinical practice guideline (CPG) for the evaluation and treatment of hyperthyroidism and hypothyroidism was developed in 2002 to update the original American Association of Clinical Endocrinologists (AACE) thyroid guidelines, which were published in 1995 (AACE Thyroid Task Force). The mission of this guideline as stated by the authors was to provide a framework for managing the diagnosis and treatment of patients with hyperthyroidism and hypothyroidism. The guidelines are intended to improve outcomes and reduce costs while stressing the importance of routine continual care provided by one physician. The guidelines are also intended to enhance physicians' awareness of subclinical hyperthyroidism and subclinical hypothyroidism, which are frequently encountered in the clinical setting and often have detrimental health consequences when untreated. The organization of the guideline is clear and easy to follow. Hyperthyroidism and hypothyroidism are described in two separate sections, each of which covers clinical features, diagnosis, laboratory evaluation, differential diagnosis, treatment, and management. (See previous article in this column.).

  14. Onychomycosis is associated with subclinical atherosclerosis in patients with diabetes.

    Science.gov (United States)

    Onalan, Orhan; Adar, Adem; Keles, Hakan; Ertugrul, Goksen; Ozkan, Nurhayat; Aktas, Habibullah; Karakaya, Ekrem

    2015-01-01

    We aimed to investigate the association of toenail onychomycosis with subclinical atherosclerosis in patients with diabetes mellitus. Consecutive diabetic patients who were seen at our outpatient clinic were enrolled. The carotid intima-media thickness (CIMT) was assessed and toenail onychomycosis was diagnosed with microscopic evaluation. We investigated 127 patients with diabetes melltus type 2. Overall, the prevalence of toenail onychomycosis was 37.8 % (48 of 127). Of the 127 patients, 60 (47.2 %) had subclinical atherosclerosis (CIMT ≥ 1 mm). Prevalence of male gender (43.3 % vs. 22.4 %, p = 0.012) and onychomycosis (53.3 % vs. 23.9 %, p = 0.001) was significantly higher in patients with subclinical atherosclerosis. Among biochemical parameters, low-density lipoprotein (122 ± 38 mg/dL vs. 108 ± 36 mg/dL, p = 0.039) and glycosylated hemoglobin levels (median 8.4 %, IQR: 2.1 % vs. median 7.5 %, IQR: 1.6 %, p = 0.002) were significantly higher in patients with subclinical atherosclerosis. Study groups were similar with respect to all other demographic, clinical, and laboratory parameters. After adjustment for all potential confounders, the presence of onychomycosis was independently associated with subclinical atherosclerosis (OR 2.77, 95 % CI 1.16 to 6.30) in multivariate logistic regression analysis. Presence of onychomycosis in patients with diabetes is associated with subclinical atherosclerosis. Onychomycosis may be a marker of atherosclerotic arterial involvement.

  15. Prevalence and correction of hypothyroidism in a large cohort of patients referred for dyslipidemia

    NARCIS (Netherlands)

    Diekman, T.; Lansberg, P. J.; Kastelein, J. J.; Wiersinga, W. M.

    1995-01-01

    Treatment of hypercholesterolemia can reduce the risk of developing premature atherosclerosis. The hypercholesterolemia caused by hypothyroidism is potentially reversible by thyroid hormone replacement therapy. We determined the prevalence of hypothyroidism in patients referred to a university lipid

  16. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population.

    Science.gov (United States)

    Chen, Liang-Miao; Du, Wen-Jun; Dai, Jie; Zhang, Qian; Si, Guang-Xin; Yang, Hong; Ye, En-Ling; Chen, Qing-Shou; Yu, Le-Chu; Zhang, Chi; Lu, Xue-Mian

    2014-01-01

    Adverse maternal outcomes and perinatal complications are closely associated with overt maternal hypothyroidism, but whether these complications occur in women with subclinical hypothyroidism (SCH) during pregnancy remains controversial. The aim of this study was to evaluate the effects of SCH on maternal and perinatal outcomes during pregnancy. A prospective study of data from 8012 pregnant women (371 women with SCH, 7641 euthyroid women) was performed. Maternal serum samples were collected in different trimesters to examine thyroid hormone concentrations. SCH was defined as a thyroid stimulating hormone concentration exceeding the trimester-specific reference value with a normal free thyroxine concentration. The occurrence of maternal outcomes, including gestational hypertension (GH), gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes (PROM), and premature delivery; and perinatal outcomes, including intrauterine growth restriction (IUGR), fetal distress, low birth weight (LBW; live birth weight ≤ 2500 g), stillbirth, and malformation, was recorded. Logistic regression with adjustment for confounding demographic and medical factors was used to determine the risks of adverse outcomes in patients with SCH. Compared with euthyroid status, SCH was associated with higher rates of GH (1.819% vs. 3.504%, P = 0.020; χ2 = 7.345; odds ratio (OR), 2.243; 95% confidence interval (CI), 1.251-4.024), PROM (4.973% vs. 8.625%, P = 0.002; χ2 = 72.102; adjusted OR, 6.014; 95% CI, 3.975-9.099), IUGR (1.008% vs. 2.965%, <0.001; χ2 = 13.272; adjusted OR, 3.336; 95% CI, 1.745-6.377), and LBW (1.885% vs. 4.582%, P<0.001; χ2 = 13.558; adjusted OR, 2.919; 95% CI, 1.650-5.163). The results of this study indicate that pregnant women with SCH had increased risks of GH and PROM, and their fetuses and infants had increased risks of IUGR and LBW. Thus, routine maternal thyroid function testing is necessary to improve maternal and perinatal

  17. Effects of subclinical hypothyroidism on maternal and perinatal outcomes during pregnancy: a single-center cohort study of a Chinese population.

    Directory of Open Access Journals (Sweden)

    Liang-Miao Chen

    Full Text Available OBJECTIVE: Adverse maternal outcomes and perinatal complications are closely associated with overt maternal hypothyroidism, but whether these complications occur in women with subclinical hypothyroidism (SCH during pregnancy remains controversial. The aim of this study was to evaluate the effects of SCH on maternal and perinatal outcomes during pregnancy. METHODS: A prospective study of data from 8012 pregnant women (371 women with SCH, 7641 euthyroid women was performed. Maternal serum samples were collected in different trimesters to examine thyroid hormone concentrations. SCH was defined as a thyroid stimulating hormone concentration exceeding the trimester-specific reference value with a normal free thyroxine concentration. The occurrence of maternal outcomes, including gestational hypertension (GH, gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes (PROM, and premature delivery; and perinatal outcomes, including intrauterine growth restriction (IUGR, fetal distress, low birth weight (LBW; live birth weight ≤ 2500 g, stillbirth, and malformation, was recorded. Logistic regression with adjustment for confounding demographic and medical factors was used to determine the risks of adverse outcomes in patients with SCH. RESULTS: Compared with euthyroid status, SCH was associated with higher rates of GH (1.819% vs. 3.504%, P = 0.020; χ2 = 7.345; odds ratio (OR, 2.243; 95% confidence interval (CI, 1.251-4.024, PROM (4.973% vs. 8.625%, P = 0.002; χ2 = 72.102; adjusted OR, 6.014; 95% CI, 3.975-9.099, IUGR (1.008% vs. 2.965%, <0.001; χ2 = 13.272; adjusted OR, 3.336; 95% CI, 1.745-6.377, and LBW (1.885% vs. 4.582%, P<0.001; χ2 = 13.558; adjusted OR, 2.919; 95% CI, 1.650-5.163. CONCLUSIONS: The results of this study indicate that pregnant women with SCH had increased risks of GH and PROM, and their fetuses and infants had increased risks of IUGR and LBW. Thus, routine maternal thyroid function

  18. Prevalence of hypothyroidism in patients with frozen shoulder.

    Science.gov (United States)

    Schiefer, Marcio; Teixeira, Patricia F Santos; Fontenelle, Cesar; Carminatti, Tiago; Santos, Daniel A; Righi, Lucas D; Conceição, Flavia Lucia

    2017-01-01

    Hypothyroidism and frozen shoulder (FS) have been associated, although this relationship remains uncertain. The main objective of this study was to determine the prevalence of hypothyroidism in patients with FS. A case-control study was performed to compare FS patients (cases) with patients who visited an orthopedic service for other clinical conditions (controls). FS was diagnosed according to specific criteria based on anamnesis, physical examination, and shoulder radiographs. A specific questionnaire was applied, and measurements of serum thyroid-stimulating hormone (TSH) and free tetraiodothyronine were performed in all subjects. We evaluated 401 shoulders from 93 FS patients and 151 controls. The prevalence of hypothyroidism diagnosis was significantly higher in the FS group (27.2% vs. 10.7%; P = .001). There was also a tendency for higher prevalence of bilateral FS among patients with elevated TSH levels (P = .09). Mean serum TSH levels were higher in patients with bilateral FS compared with those with unilateral compromise (3.39 vs. 2.28; P = .05) and were higher in patients with severe FS compared with those with mild and moderate FS together (3.15 vs. 2.21; P = .03). Multivariate analysis showed that FS was independently related to a diagnosis of hypothyroidism (odds ratio, 3.1 [1.5-6.4]; P = .002). There was a trend toward independent association between high serum TSH levels and both severe (odds ratio, 3.5 [0.8-14.9]; P = .09) and bilateral (odds ratio, 11.7 [0.9-144.8]; P = .05) compromise. The prevalence of hypothyroidism was significantly higher in FS patients than in controls. The results suggest that higher serum TSH levels are associated with bilateral and severe cases of FS. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  19. High prevalence of DUOX2 mutations in Japanese patients with permanent congenital hypothyroidism or transient hypothyroidism.

    Science.gov (United States)

    Matsuo, Kumihiro; Tanahashi, Yusuke; Mukai, Tokuo; Suzuki, Shigeru; Tajima, Toshihiro; Azuma, Hiroshi; Fujieda, Kenji

    2016-07-01

    Dual oxidase 2 (DUOX2) mutations are a cause of dyshormonogenesis (DH) and have been identified in patients with permanent congenital hypothyroidism (PH) and with transient hypothyroidism (TH). We aimed to elucidate the prevalence and phenotypical variations of DUOX2 mutations. Forty-eight Japanese DH patients were enroled and analysed for sequence variants of DUOX2, DUOXA2, and TPO using polymerase chain reaction-amplified direct sequencing. Fourteen sequence variants of DUOX2, including 10 novel variants, were identified in 11 patients. DUOX2 variants were more prevalent (11/48, 22.9%) than TPO (3/48, 6.3%) (p=0.020). The prevalence of DUOX2 variants in TH was slightly, but not significantly, higher than in PH. Furthermore, one patient had digenic heterozygous sequence variants of both DUOX2 and TPO. Our results suggest that DUOX2 mutations might be the most common cause of both PH and TH, and that phenotypes of these mutations might be milder than those of other causes.

  20. Prepregnancy hypothyroidism versus gestational hypothyroidism: A comparative study

    Directory of Open Access Journals (Sweden)

    Prashant Ulhas Kaduskar

    2017-01-01

    Full Text Available Introduction: Hypothyroidism managed inadequately in pregnancy may have grave outcomes for both mother and baby. Understanding pregnancy outcomes in our country with low awareness about thyroid diseases is important. Objectives: The objectives of the study were to evaluate demographic features and biochemical parameters in patients with prepregnancy hypothyroidism versus patients diagnosed to have primary hypothyroidism during pregnancy and to assess pregnancy outcomes. Study Design: Prospective design Materials and Methods: The study was conducted in a tertiary care center in Bengaluru for 2 years. The patients were divided into two groups - Group I: Prepregnancy hypothyroidism and Group II: Hypothyroid during pregnancy. They were further staged according to ESI guidelines as subclinical or overt hypothyroidism. Statistical Analysis: Chi-square and Mann–Whitney test. Results: A total of 452 pregnant women with hypothyroidism were analyzed. The data of 371 delivered pregnancies were available. Group I and II had 196 (43.36% and 256 (56.64% patients, respectively. Age at presentation (years was 27.09 ± 4.19 in Group I versus 25.74 ± 4.29 in Group II (P = 0.003; gestational age (weeks was 9.04 ± 5.41 in Group I versus 13.81 ± 9.12 in Group II (P = 0.000. There was one case of congenital hypothyroidism in baby in each group. Mean birth weight was 2.90 ± 0.39 kg in Group I versus 2.88 ± 0.36 kg in Group II; P = 0.608. There were four abortions in Group I versus ten in Group II (P = 0.231, 104 cesarean sections in Group I compared to 133 in Group II; (P = 0.382. There was no difference in number of cesarean sections, abortions and low birth weight babies between overt and subclinical hypothyroidism subgroups. Conclusions: Group I patients presented earlier for testing suggesting awareness was good in this group. There was no difference in pregnancy outcome between the two groups. Overt versus subclinical status did not have any different

  1. Association between previously unknown connective tissue disease and subclinical hypothyroidism diagnosed during first trimester of pregnancy.

    Science.gov (United States)

    Beneventi, Fausta; Locatelli, Elena; Alpini, Claudia; Lovati, Elisabetta; Ramoni, Véronique; Simonetta, Margherita; Cavagnoli, Chiara; Spinillo, Arsenio

    2015-11-01

    To investigate the presence of autoimmune rheumatic disorders among women with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy and subsequent pregnancy outcomes. Case-control study. Tertiary obstetric and gynecologic center. Pregnant women in the first trimester of pregnancy. Clinical, laboratory, ultrasonographic evaluations. Thyroid-stimulating hormone (TSH) level; antibodies against thyroperoxidase, thyroid globulin and TSH receptor detection; screening for rheumatic symptoms and antinuclear antibodies (ANA); uterine artery pulsatility index evaluation; pregnancy complication onset. Out of 3,450 women enrolled, 106 (3%) were diagnosed with autoimmune thyroid disorders. ANA were present in 18 (16.9%) of 106 cases and 26 (12.6%) of 206 controls. Of the cases, 28 (26.4%) of 106 reported rheumatic symptoms, 5 of these were diagnosed with Sjögren syndrome or with undefined connective tissue disease. Autoimmune thyroid diseases are statistically significantly associated with a higher risk of preeclampsia, fetal growth restriction, and overall pregnancy complications compared with controls, with a higher uterine artery pulsatility index, suggesting a defective placentation in thyroid disorders. The effect of ANA-positivity on moderate/severe adverse pregnancy outcomes was statistically significant among the patients with thyroid disorders (9 of 18 as compared to 8 of 88, odds ratio 9.65; 95% confidence interval, 2.613-7.81). Connective tissue diseases are frequently associated with autoimmune thyroid disorders diagnosed during the first trimester of pregnancy. Thyroid autoimmunity and ANA positivity independently increased the risk of adverse pregnancy outcomes. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Thyroid peroxidase and thyroglobulin auto-antibodies in patients with newly diagnosed overt hypothyroidism

    DEFF Research Database (Denmark)

    Carle, A.; Laurberg, P.; Knudsen, N.

    2006-01-01

    Objectives: Thyroid autoimmunity is a major cause for hypothyroidism. We describe thyroid auto-antibodies in patients with various nosological subtypes of hypothyroidism identified in a population study. Design: Population-based follow-up study identifying all new cases of hypothyroidism in an open...... cohort. Methods: We established a monitoring system, and identified all new cases with primary overt hypothyroidism (n = 685) in a 4 year period in a well-defined population cohort (2,027,208 person-years of observation). Patients were sub-classified into: spontaneous hypothyroidism, presumably...... of autoimmune origin ( n 578); non-spontaneous hypothyroidism ( associated with medication, delivery, neck-irradiation or subacute thyroiditis, n 97); and congenital hypothyroidism ( n 10). A total of 186 adult patients (61% of those invited) underwent thyroid ultrasonography and measurements of antibodies...

  3. The Treatment of Hypothyroidism in Pregnancy

    Directory of Open Access Journals (Sweden)

    Miulescu Rucsandra Dănciulescu

    2017-06-01

    Full Text Available Hypothyroidism is a pathologic condition generated by the thyroid hormone deficiency. The American Thyroid Association advises for the screening of hypothyroidism beginning at 35 years and thereafter every 5 years in people at high risk for this condition: females older than 60 years, pregnant women, patients with other autoimmune disease or patients with a history of neck irradiation. In pregnant women, hypothyroidism can been associated with adverse effect for both mother and child. The „Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum“ recommends the treatment of maternal overt hypothyroidism: females with a thyrotropin (TSH level higher than the trimester-specific reference interval and decreased free thyroxine (FT4, and females for which TSH level is higher than 10.0 mIU/L, irrespective of the FT4 value, with administration of oral levothyroxine. The goal of treatment of maternal overt hypothyroidism is to bring back the serum TSH values to the reference range specific for the pregnancy trimester. The Guidelines of the „European Thyroid Association for the Management of Subclinical Hypothyroidism in Pregnancy and in Children“ recommends treatment of pregnancy associated subclinical hypothyroidism with the following levothyroxine doses: „1.20 μg/kg/day for TSH≤4.2 mU/l, 1.42 μg/kg/day for TSH >4.2-10 and 2.33 μg/kg/day for overt hypothyroidism“. The „Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and Postpartum“ and the „European Thyroid Association for the Management of Subclinical Hypothyroidism in Pregnancy and in Children“ do not recommend the treatment of isolated hypothyroxinemia in pregnancy.

  4. Early Cardiac Tamponade in a Patient with Postsurgical Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Archana Sinha

    2015-01-01

    Full Text Available Pericardial effusion is a common cardiac manifestation of hypothyroidism, but effusion resulting in cardiac tamponade is extremely rare. We present a case of a 56-year-old African American woman with slurred speech and altered mental status that was initially suspected to have stroke. Her chest X-ray revealed cardiomegaly and subsequent echocardiogram showed a large pericardial effusion with echocardiographic evidence of cardiac tamponade. Clinically, patient did not have pulsus paradoxus or hypotension. Further questioning revealed a history of total surgical thyroidectomy and noncompliance with thyroid replacement therapy. Pericardiocentesis was performed promptly and thyroxine replacement therapy was started. Thereafter, her mental status improved significantly. The management of pericardial effusion associated with hypothyroidism varies depending on size of effusion and hemodynamic stability of the patient. The management strategy ranges from conservative management with close monitoring and thyroxine replacement to pericardiocentesis or creation of a pericardial window.

  5. Hyperleptinemia as One of the Factors for Renal Dysfunction in Patients with Hypothyroidism

    OpenAIRE

    O.M. Didushko

    2014-01-01

    In order to study the features of renal function in patients with hypothyroidism we have examined 132 patients with primary hypothyroidism. The results showed that in patients with overt hypothyroidism there is renal dysfunction manifested by increased serum creatinine level and decreased glomerular filtration rate, the development and progression of which is facilitated by the presence of risk factors in patients — hyperleptinemia, dyslipidemia, overweight and abdominal obesity. It is stated...

  6. Clinical Features of Early and Late Postoperative Hypothyroidism After Lobectomy.

    Science.gov (United States)

    Park, Suyeon; Jeon, Min Ji; Song, Eyun; Oh, Hye-Seon; Kim, Mijin; Kwon, Hyemi; Kim, Tae Yong; Hong, Suck Joon; Shong, Young Kee; Kim, Won Bae; Sung, Tae-Yon; Kim, Won Gu

    2017-04-01

    Lobectomy is preferred in thyroid cancer to decrease surgical complications and avoid lifelong thyroid-hormone replacement. However, postoperative hypothyroidism, requiring thyroid-hormone replacement, may occur. We aimed to identify the incidence and risk factors of postoperative hypothyroidism to develop a surveillance strategy after lobectomy for papillary thyroid microcarcinoma (PTMC). This historical cohort study involved 335 patients with PTMC treated by lobectomy. Postoperative thyroid functions were measured regularly, and patients were prescribed levothyroxine according to specific criteria. Patients not satisfying hormone-replacement criteria were closely followed up. Postoperative hypothyroidism occurred in 215 patients (64.2%) including 5 (1.5%) with overt hypothyroidism and 210 (62.7%) with subclinical hypothyroidism. Forty patients (11.9%) were required thyroid hormone replacement. One hundred nineteen patients (33.5%) experienced temporary hypothyroidism and spontaneously recovered to euthyroid state. High preoperative thyroid-stimulating hormone (TSH) was the most important factor predicting postoperative hypothyroidism and failure of recover from hypothyroidism (odds ratio [OR], 2.82 and 1.77; 95% confidence interval [CI], 2.07 to 3.95 and 1.22 to 2.63; P hypothyroidism, 70 (32.6%) developed hypothyroidism after the first postoperative year. Postoperative 1-year TSH levels were able to differentiate patients developing late hypothyroidism or euthyroidism (OR, 2.29; 95% CI, 1.68 to 3.26; P hypothyroidism and identify those requiring long-term surveillance for hypothyroidism. Additionally, mild postoperative hypothyroidism cases should be followed up without immediate levothyroxine replacement with the expectation of spontaneous recovery.

  7. Laparoscopic adrenalectomy in patients with subclinical Cushing syndrome.

    Science.gov (United States)

    Perysinakis, Iraklis; Marakaki, Chrisanthi; Avlonitis, Spyridon; Katseli, Anastasia; Vassilatou, Evangeline; Papanastasiou, Lambrini; Piaditis, George; Zografos, George N

    2013-06-01

    Subclinical Cushing syndrome in patients with adrenal incidentalomas has been associated with an increased prevalence of the metabolic syndrome and cardiovascular risk. The management of these patients, be it conservative or surgical, is still debated, but there is accumulating evidence that surgery is best and that laparoscopic adrenalectomy, when possible, is the most preferred procedure. Here we present the short- and long-term results of laparoscopic adrenalectomy for subclinical Cushing syndrome and determine the effect of this procedure on components of the metabolic syndrome. Twenty-nine patients, 8 men and 21 women with adrenal incidentalomas and subclinical Cushing syndrome who underwent laparoscopic adrenalectomy, were studied retrospectively. They had undergone postoperative follow-up for improvement or worsening of their arterial blood pressure, body weight, and fasting glucose level for a mean period of 77 months. Preoperatively, 17 patients (58.6 %) had arterial hypertension, 14 (48.3 %) had a body mass index exceeding 27 kg/m(2), and 12 (41.4 %) had diabetes mellitus. Postoperatively, a decrease in mean arterial pressure was found in 12 patients (70.6 %), a decrease in body mass index in 6 patients (42.9 %), and an improvement in glycemic control in 5 patients (41.7 %). Laparoscopic adrenalectomy is beneficial in many patients with subclinical Cushing syndrome because it reduces arterial blood pressure, body weight, and fasting glucose levels. Prospective randomized studies are needed to compare laparoscopic adrenalectomy with a conservative approach and to confirm these results.

  8. Prevalence of hypothyroidism among patients with breast cancer treated with radiation to the supraclavicular field: a single-centre survey

    Science.gov (United States)

    Kikawa, Yuichiro; Kosaka, Yasuhiro; Hashimoto, Kazuki; Hohokabe, Eri; Takebe, Sayaka; Narukami, Ryo; Hattori, Takayuki; Ueki, Kazuhiro; Ogura, Kengo; Imagumbai, Toshiyuki; Kato, Hironori; Kokubo, Masaki

    2017-01-01

    Purpose We investigated the prevalence of hypothyroidism (HT) in patients with breast cancer who received radiation therapy to the supraclavicular (SC) field to evaluate the effect of radiation on thyroid. Methods Between April 2007 and May 2016, consecutive patients with invasive breast cancer who received SC radiation were recruited. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were measured between April and August 2016. On the basis of the radiation-planning CT images, thyroid volume was calculated and dose–volume parameters were estimated. The endpoints were the prevalence of HT as determined by high levels of TSH and low levels of fT4 in serum, and the prevalence of subclinical HT, determined by high-serum TSH and normal fT4. Results Among the 68 consecutive patients, 26 were excluded from evaluation (10 patients died, 6 had a history of previous thyroid disease and 10 were lost to follow-up). One (2.4%) and six (14.3%) of these patients had HT and subclinical HT, respectively, with a mean TSH level of 8.27 µU/mL. By univariate analysis, a predictive factor of HT and subclinical HT was a thyroid volume thyroid volume thyroid volume appeared to be a predictive marker of HT in this cohort, further prospective evaluation is needed. PMID:28761733

  9. Respiratory manifestations of hypothyroidism

    DEFF Research Database (Denmark)

    Sorensen, Jesper Roed; Winther, Kristian Hillert; Bonnema, Steen Joop

    2016-01-01

    BACKGROUND: Hypothyroidism has been associated with increased pulmonary morbidity and overall mortality. We conducted a systematic review to identify the prevalence and underlying mechanisms of respiratory problems among patients with thyroid insufficiency. METHODS: PubMed and EMBASE databases were...... searched for relevant literature from January 1950 through January 2015 with study eligibility criteria: English-language publications; Adult subclinical or overt hypothyroid patients; Intervention, observational or retrospective studies; and respiratory manifestations. We followed the PRISMA statement...... and used the Cochrane's risk of bias tool. RESULTS: A total of 1699 papers were screened by two independent authors for relevant titles. Of 109 relevant abstracts, 28 papers underwent full text analyses, of which 22 were included in the review. We identified possible mechanisms explaining respiratory...

  10. Subclinical hypothyroidism as a risk factor for placental abruption: evidence from a low-risk primigravid population.

    LENUS (Irish Health Repository)

    Breathnach, Fionnuala M

    2013-12-01

    Subclinical thyroid hypofunction in pregnancy has been shown to have an association with neurodevelopmental delay in the offspring. It is unclear whether obstetric factors may account for this observation.

  11. The effects of screening and intervention of subclinical hypothyroidism on pregnancy outcomes: a prospective multicenter single-blind, randomized, controlled study of thyroid function screening test during pregnancy.

    Science.gov (United States)

    Ma, Liangkun; Qi, Hong; Chai, Xiaofeng; Jiang, Fang; Mao, Su; Liu, Juntao; Zhang, Shaoqin; Lian, Xiaolan; Sun, Xiujing; Wang, Danhua; Ren, Jie; Yan, Qi

    2016-01-01

    To evaluate the effect of subclinical hypothyroidism (SCH) screening and intervention on pregnancy outcomes and explore the significance of thyroid function during early pregnancy. Pregnant women were recruited from Peking Union Medical College Hospital (screening group for measuring thyroid function and thyroid antibody in early pregnancy) and Haidian Maternal & Child Health Hospital (control group whose serum was stored and measured shortly after delivery) from July 2011 to December 2012. Thyrotropin levels 2.5-10 mIU/L and free T4 levels in normal range were considered SCH. Some of the screening group were treated with levothyroxine and adjusted. The others did not take medicine but kept a regular follow-up visit to doctors after antenatal clinic. The pregnancy outcomes and complications were compared. 1671 women (675 in screening group and 996 in control group) were recruited. 419 (167 from screening group) women was diagnosed as SCH. In screening group, 105 SCH and 4 hypothyroid women received thyroid hormone replacement therapy. The miscarriage and fetal macrosomia risks were lower, and cesarean was higher in screening group than control. Screening and intervention of SCH can significantly reduce the incidence rate of miscarriage.

  12. Sub-clinical middle ear malfunctions in elderly patients; prevalence ...

    African Journals Online (AJOL)

    Sub-clinical middle ear malfunctions in elderly patients; prevalence, pattern and predictors. ... Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM ... Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.

  13. Prevalence of anxiety and depressive symptoms among patients with hypothyroidism

    Directory of Open Access Journals (Sweden)

    Manish Bathla

    2016-01-01

    Full Text Available Context: The association between depression and thyroid function is well known. Both conditions express many similar symptoms, thus making the diagnosis and treatment difficult. Aims: To find the prevalence of anxiety and depressive symptoms among patients with hypothyroid. Settings and Design: Cross-sectional study. Materials and Methodology: A total of 100 patients diagnosed as hypothyroidism were evaluated using Hamilton depression rating scale (HDRS and Hamilton scale for anxiety (HAM-A. Statistical Analysis Used: The data were analyzed using the SPSS for Windows version 17.0 software. The quantitative data were expressed in number and percentage. The results obtained were compared using the Chi-square test. Results: Females constituted 70% of the sample. A total of 60% reported some degree of depression based on HDRS (males – 56.63% and females – 64.29% whereas about 63% out of the total patients screened showed some degree of anxiety (males –56.66% and females – 65.72% based on HAM-A. The most common depressive symptom among the males was depressed mood (73.33% and among females was gastrointestinal somatic symptoms (68.54%. The most common anxiety symptom among the males was depressed mood (70.0% and among females was anxious mood (92.85%. Conclusions: Psychiatric symptoms/disorders are common in patients with thyroid dysfunction.

  14. Overview of Hypothyroidism in Pregnancy.

    Science.gov (United States)

    Kroopnick, Jeffrey M; Kim, Caroline S

    2016-11-01

    Overt hypothyroidism in pregnancy, defined as an elevated serum thyroid-stimulating hormone (TSH) and reduced serum free thyroxine or a TSH >10 mIU/L, is known to have adverse effects on pregnancy. Subclinical hypothyroidism is typically defined as an elevated TSH and normal FT4 levels. There remains much controversy on the benefit of starting levothyroxine for mothers diagnosed with subclinical hypothyroidism. Recent studies are redefining the normal range for TSH in pregnancy, and the data on whether treatment of subclinical hypothyroidism improves outcomes for the mother and fetus are unclear. One confounding variable is the presence of thyroid peroxidase antibodies, as it may be a surrogate marker for other autoimmune disorders detrimental to pregnancy. If levothyroxine treatment is initiated, the dosing and monitoring strategy is different from nonpregnant individuals. Randomized clinical trials are underway that may better elucidate whether treatment of subclinical hypothyroidism is warranted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  15. Subclinical atherosclerosis in low Framingham risk HIV patients.

    Science.gov (United States)

    León, Rafael; Reus, Sergio; López, Nicolás; Portilla, Irene; Sánchez-Payá, José; Giner, Livia; Boix, Vicente; Merino, Esperanza; Torrús, Diego; Moreno-Pérez, Óscar; Portilla, Joaquín

    2017-08-01

    Pathogenesis of atherosclerosis is complex, and differences between HIV-infected patients and general population cannot be completely explained by the higher prevalence of traditional cardiovascular risk factors. We aimed to analyse the association between inflammation and subclinical atherosclerosis in HIV patients with low Framingham risk score. Case-control study. Outpatient Infectious Diseases clinic in a university hospital. HIV-1-infected patients aged > 35 years receiving antiretroviral treatment with viral load  5 cigarettes/day; diabetes; hypertension; vascular diseases. subclinical atherosclerosis determined by ultrasonography: common carotid intima-media thickness greater than 0·8 mm or carotid plaque presence. Explanatory variables: ribosomal bacterial DNA (rDNA), sCD14, interleukin-6 (IL-6) and TNF-α. Eighty-four patients were included, 75% male, mean age 42 years and mean CD4+ cells 657 ± 215/mm(3) . Median Framingham risk score was 1% at 10 years (percentile 25-75: 0·5-4%). Eighteen patients (21%) had subclinical atherosclerosis; the associated factors were older age (P = 0·001), waist-hip ratio (P = 0·01), time from HIV diagnosis (P = 0·02), rDNA (P = 0·04) and IL-6 (P = 0·01). In multivariate analysis, OR for subclinical atherosclerosis was 7 (95% CI, 1.3-40, P = 0.02) and 9 (95% CI, 1.0-85, P = 0.04) for patients older than 44 years and IL-6 > 6·6 pg/mL, respectively. Well-controlled HIV patients with low Framingham risk score have a high prevalence of subclinical carotid atherosclerosis, and the main risk factors are age and inflammation. These patients are not receiving primary prophylaxis for cardiovascular events according to current guidelines. © 2017 Stichting European Society for Clinical Investigation Journal Foundation.

  16. The effect of metformin on the hypothalamic-pituitary-thyroid axis in patients with type 2 diabetes and amiodarone-induced hypothyroidism.

    Science.gov (United States)

    Krysiak, Robert; Gilowska, Małgorzata; Szkróbka, Witold; Okopień, Bogusław

    2016-04-01

    Chronic metformin treatment was found to reduce elevated thyrotropin levels. Amiodarone treatment is associated with a range of effects in thyroid function from mild derangements to overt thyroid dysfunction. No previous study has investigated the effect of metformin on hypothalamic-pituitary-thyroid axis activity in patients with amiodarone-induced hypothyroidism. The study included three age-, sex- and weight-matched groups of amiodarone-treated patients with type 2 diabetes: patients with treated overt hypothyroidism (group I, n=15), patients with untreated subclinical hypothyroidism (group II, n=15), and subjects without thyroid disorders (group III, n=18). The lipid profile, fasting plasma glucose levels, the homeostatic model assessment 1 of insulin resistance ratio (HOMA1-IR), glycated hemoglobin, the estimated glomerular filtration rate, as well as serum levels of thyrotropin, thyroid hormones, prolactin, insulin and insulin-like growth factor-1 (IGF-1) were assessed at baseline and after 6 months of metformin treatment (2.55-3g daily). In all groups of patients, metformin reduced plasma glucose and triglycerides, serum insulin, glycated hemoglobin as well as HOMA1-IR. The estimated glomerular filtration rate, thyroid hormones, prolactin and IGF-1 remained at a similar level throughout the study. In patients with untreated amiodarone-induced hypothyroidism, but not in the other groups of patients, metformin reduced serum levels of thyrotropin and this effect correlated weakly with its action on insulin sensitivity. The obtained results indicate that the effect of metformin on hypothalamic-pituitary-thyroid axis activity is partially related to thyroid function. Metformin treatment may bring clinical benefits to patients with amiodarone-induced hypothyroidism and poor tolerance of exogenous L-thyroxine. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  17. The effect of metformin on the hypothalamic-pituitary-thyroid axis in patients with type 2 diabetes and subclinical hyperthyroidism.

    Science.gov (United States)

    Krysiak, R; Szkrobka, W; Okopien, B

    2015-04-01

    In hypothyroid patients, metformin was found to reduce serum levels of TSH. No previous study investigated metformin action on hypothalamic-pituitary-thyroid axis in patients with hyperthyroidism. The aim of our study was to assess the effect of metformin treatment on thyroid function tests in patients with untreated subclinical hyperthyroidism. We studied 15 patients with low but detectable TSH levels (0.1-0.4 mIU/L) (group 1), 12 patients with suppressed TSH levels (less than 0.1 mIU/L) (group 2) and 15 euthyroid patients with a history of hyperthyroidism, who because of coexisting 2 diabetes were treated with metformin (2.55-3 g daily). Glucose homeostasis markers, as well as serum levels of TSH and total and free thyroxine and triiodothyronine levels were assessed at baseline and after 3 and 6 months of therapy. As expected, metformin reduced plasma glucose, insulin resistance and glycated hemoglobin. However, with the exception of an insignificant decrease in TSH levels after 3-month therapy in group 2, metformin therapy did not affect thyroid function tests. Our results indicate that metformin has a negligible effect on hypothalamic-pituitary-thyroid axis activity in type 2 diabetic patients with subclinical hyperthyroidism. © Georg Thieme Verlag KG Stuttgart · New York.

  18. A case of a naturally conceived pregnancy associated with multiple ovarian cysts in a patient with severe untreated primary hypothyroidism.

    Science.gov (United States)

    Zhou, Yue-Di; Teng, Yin-Cheng; Jiang, Rong-Zhen; Huang, Ya-Juan

    2012-09-01

    There are few reports of multiple ovarian cysts secondary to hypothyroidism, and multiple ovarian cysts associated with pregnancy most commonly occur in association with assisted reproductive technologies. Herein, we report a case of a naturally conceived pregnancy occurring 2 years after stopping treatment for primary hypothyroidism. The patient developed multiple ovarian cysts in the first trimester, and laboratory studies and ultrasonography were consistent with hypothyroidism. Herein, we present the case and discuss the importance of prenatal screening for hypothyroidism.

  19. Subclinical atherosclerosis in patients with recurrent aphthous stomatitis.

    Science.gov (United States)

    Sereflican, M; Sereflican, B; Dagistan, E; Goksugur, N; Kizildag, B

    2016-09-01

    Recurrent aphtous stomatitis (RAS) is an inflammatory oral mucosal disease. It has been known that inflammatory cascade plays important role in the atherosclerotic process. The aim of the study was to investigate the relationship between subclinical atherosclerotic findings and a systemic inflammatory disease, RAS. In total, 32 patients with RAS were matched with 30 control subjects on the basis of age, sex, and major cardiovascular risk factors. Laboratory parameters including lipid profiles were determined for patients and controls. B-mode ultrasonography was used to assess carotid extra-medial thickness (cEMT) and carotid intima-media thickness (cIMT). Both cEMT and cIMT in the RAS group were significantly higher than in the control group (P = 0.002 and 0.013, respectively). There was a significant positive correlation between cIMT and cEMT (r = 0.381, P = 0.034). cIMT was positively correlated with age, triglyceride levels, and systolic blood pressure, while cEMT was positively correlated with age in patients with RAS. To our knowledge, this is the first reported study to evaluate cEMT and cIMT in patients with RAS. This study presents morphological evidence of subclinical atherosclerosis in patients with RAS. Further studies investigating the relationship between atherosclerosis and RAS are needed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Clinical, behavioural and pharmacogenomic factors influencing the response to levothyroxine therapy in patients with primary hypothyroidism-protocol for a systematic review.

    Science.gov (United States)

    Dew, Rosie; Okosieme, Onyebuchi; Dayan, Colin; Eligar, Vinay; Khan, Ishrat; Razvi, Salman; Pearce, Simon; Wilkes, Scott

    2017-03-21

    Suboptimal thyroid hormone therapy including under-replacement and over-replacement is common amongst patients with hypothyroidism. This is a significant health concern as affected patients are at risk of adverse cardiovascular or metabolic consequences. Despite a growing body of evidence on the effects of various factors on thyroid hormone replacement, a systematic appraisal of the evidence is lacking. This review aims to appraise and quantify the extent to which clinical, behavioural and pharmacogenomic factors affect levothyroxine therapy in patients with primary hypothyroidism. The databases Web of Science, Cochrane Library, EMBASE and PubMed will be searched. Patients must be adults over the age of 18 years, suffering from primary hypothyroidism including overt and subclinical hypothyroidism and receiving levothyroxine treatment. Studies in children, pregnant women and patients with secondary or tertiary hypothyroidism will not be included. We will also exclude studies focused on forms of thyroid hormone replacement therapy other than levothyroxine. The primary outcome is to quantify the effect of clinical, behavioural and pharmacogenomic factors on thyroid stimulating hormone (TSH) levels. Secondary outcomes are the effect these factors have on thyroxine (T4) and triiodothyronine (T3) levels, mortality, morbidity, quality of life, treatment complications, adverse effects, physical and social functioning. Studies will be screened through reading the title, abstract and then full text. Two reviewers will independently extract the data and select articles, and a third reviewer will be consulted if there is any disagreement. We will undertake a meta-analysis of studies in which there is a defined intervention or exposure, patients are receiving levothyroxine for hypothyroidism, there is an appropriate control group of levothyroxine treated patients that are not exposed to the intervention, and the primary outcome is determined by serum TSH levels. Studies will

  1. Effect of Metformin on Parameters of Insulin Resistance in Patients with Primary Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Tamara Vatseba

    2017-03-01

    Differentiated treatment of patients with primary hypothyroidism, obesity and initial carbohydrate metabolism disorders has demonstrated the priority of efficiency of combination therapy with appointed metformin and levothyroxine in comparison with the basic substitution therapy. Appointment of metformin for the treatment of the patients with proven IR contributed to the rapid compensation of hypothyroidism, normalization of carbohydrate metabolism indexes, and it is also preventing the possible development of metabolic syndrome.

  2. Subclinical hypothyroidism is associated with higher carotid intima-media thickness in cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

    Science.gov (United States)

    Peixoto de Miranda, É J F; Bittencourt, M S; Pereira, A C; Goulart, A C; Santos, I S; Lotufo, P A; Bensenor, I M

    2016-10-01

    Although subclinical hypothyroidism (SCH) is associated with cardiovascular risk, there is scarce data about subclinical atherosclerosis in subjects with SCH. We aimed to analyze the association between SCH and carotid intima-media thickness (IMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We included subjects with normal thyroid function (TSH: 0.4-4.0 mIU/l, and normal free thyroxine (FT4): 0.8-1.9 ng/dl) and SCH (TSH ≥ 4.0 mIU/l and normal FT4) evaluated for IMT in a cross-sectional analysis. We excluded individuals using medications that affect thyroid function and those with a history of cardiovascular disease. We performed logistic and linear regression models to evaluate the association with IMT (mean values and categorized at the 75th percentile) as a dependent variable and SCH as an independent variable, adjusted for other cardiovascular risk factors. From 8623 subjects (median age of 50 years; interquartile range: 44-57), 4624 (53.6%) were women, 8095 (93.9%) were euthyroid, and 528 (6.1%) had SCH. Groups varied in age, body mass index, Framingham risk score, Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), C-reactive protein, as well as, IMT, that were all higher in SCH compared to euthyroid participants. SCH is associated with IMT as a continuous variable (β = 0.010, P = 0.036) and IMT >75th percentile: OR = 1.30 (95% CI = 1.06-1.59) in logistic models. Individuals with SCH presented higher IMT compared with euthyroid subjects, even after adjustment for potential confounders. IMT was independently associated with SCH in the baseline of the ELSA-Brasil study. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  3. Influence of Insulin Resistance on the Renal Function in Patients with Primary Hypothyroidism

    Directory of Open Access Journals (Sweden)

    O.M. Didushko

    2015-07-01

    Full Text Available The article presents literature data and data of our own researches on the role of leptin in the formation of insulin resistance associated with obesity in patients with primary hypothyroidism and their effect on the renal function. The study involved 108 patients with primary hypothyroidism, including 60 women and 48 men. Between HOMA-IR indices and the level of thyroid stimulating hormone, a direct linear correlation has been established. We have detected a significantly high level of leptin in all patients with overt hypothyroidism compared with the control group. A direct correlation between HOMA-IR and leptin indices has been established in all patients with hypothyroidism, a strong direct correlation between the values of HOMA-IR and leptin has been found in the group of patients with overt hypothyroidism in combination with obesity. In addition, the level of leptin negatively correlated with glomerular filtration rate. Hyperleptinemia can be regarded as a key factor in the development of insulin resistance and impaired renal function in patients with hypothyroidism with components of metabolic syndrome.

  4. Subclinical hypothyroidism is associated with increased risk for cancer mortality in adult Taiwanese-a 10 years population-based cohort.

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    Fen-Yu Tseng

    Full Text Available The association between subclinical hypothyroidism (SCH and cancer mortality is seldom discussed.A total of 115,746 participants without thyroid disease history, aged 20 and above, were recruited from four nationwide health screening centers in Taiwan from 1998 to 1999. SCH was defined as a serum thyroid-stimulating hormone (TSH level of 5.0-19.96 mIU/L with normal total thyroxine concentrations. Euthyroidism was defined as a serum TSH level of 0.47-4.9 mIU/L. Cox proportional hazards regression analyses were used to estimate the relative risks (RRs of death from cancer for adults with SCH during a 10-year follow-up period.Among 115,746 adults, 1,841 had SCH (1.6% and 113,905 (98.4% had euthyroidism. There were 1,532 cancer deaths during the 1,034,082 person-years follow-up period. Adjusted for age, gender, body mass index, diabetes, hypertension, dyslipidemia, smoking, alcohol drinking, betel nut chewing, physical activity, income, and education level, the RRs (95% confidence interval of cancer deaths among subjects with SCH versus euthyroid subjects were 1.51 (1.06 to 2.15. Cancer site analysis revealed a significant increased risk of bone, skin and breast cancer among SCH subjects (RR 2.79, (1.01, 7.70. The risks of total cancer deaths were more prominent in the aged (RR 1.71, (1.02 to 2.87, in females (RR 1.69 (1.08 to 2.65, and in heavy smokers (RR 2.24, (1.19 to 4.21.Subjects with SCH had a significantly increased risk for cancer mortality among adult Taiwanese. This is the first report to demonstrate the association between SCH and cancer mortality.

  5. Screening For Hypothyroidism-Results Of A Study Conducted At District Headquarter Hospital, Abbottabad.

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    Gul, Nasreen; Farid, Jamila; Idris, Muhammad; Sarwar, Javed

    2016-01-01

    Sub-clinically hypo-functioning thyroid is a condition in which there is biochemical evidence of hypothyroidism but patient is clinically asymptomatic. This concept is not new. The typical picture of this condition is increased thyroid stimulating hormone and normal thyroxine levels. Subclinical hypothyroidism has been found to have variable prevalence ranging from 4-10% to 10- 26%. This cross sectional study was conducted on 378 adult patients coming to outpatient department of District Headquarter Hospital Abbottabad over a period of two years from February 2013 to February 2015. Out of the 378 individuals studied, 37 (9.78%) had subclinical hypothyroidism. Mean age of the patients was 43.5±10.5 years. Females outnumbered males, i.e., 24 out of 37 (65%). It was noted that there was no correlation between mean TSH level and gender or age of the patients. Subclinical hypothyroidism is not an uncommon condition and its diagnosis is established easily by doing thyroid hormone levels in fasting condition. Early diagnosis and therapeutic intervention may not only prevent the progression to clinical hypothyroidism but also help in preventing the wastage of resources on doing unnecessary investigations.

  6. Dyschromatopsia in Multiple Sclerosis Patients: A Marker of Subclinical Involvement?

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    Felgueiras, Helena; Parra, Joana; Cruz, Simão; Pereira, Pedro; Santos, Ana F; Rua, Adriana; Meira, Dália; Fonseca, Pedro; Pedrosa, Catarina; Cardoso, João N; Almeida, Cristina; Araújo, Maria; Santos, Ernestina

    2016-09-01

    In multiple sclerosis (MS), even in the absence of a clinical episode of optic neuritis (ON), the optic nerve and retinal nerve fiber layer (RNFL) may be damaged leading to dyschromatopsia. Subclinical dyschromatopsia has been described in MS associated with lower motor and cognitive performances. To set the prevalence of dyschromatopsia in eyes of MS patients without a history of ON, to compare its prevalence in patients with and without ON history, and to explore the association between dyschromatopsia and disease duration, average peripapillary RNFL thickness, macular volume, and cognitive and motor performances. An observational cross-sectional study was conducted at multiple medical centers. Data were collected after single neurological and ophthalmological evaluations. Dyschromatopsia was defined by the presence of at least 1 error using Hardy-Rand-Rittler plates. In our population of 125 patients, 79 patients (63.2%) never had ON and 35 (28.8%) had unilateral ON. The prevalence of dyschromatopsia in eyes of patients without ON was 25.7%. Patients with dyschromatopsia had a statistically significant lower RNFL thickness (P = 0.004 and P = 0.040, right and left eyes, respectively) and worse performance in symbol digit modalities test (P = 0.012). No differences were found in macular volume or motor function tasks. Dyschromatopsia occurs frequently in MS patients. It may be associated with a worse disease status and possibly serve as a marker for the detection of subclinical disease progression since it was detected even in the absence of ON. It correlated with thinner peripapillary RNFL thickness and inferior cognitive performance.

  7. [Hypothyroidism in adults in a basic health area].

    Science.gov (United States)

    López-Macías, I; Hidalgo-Requena, A; Pérez-Membrive, E; González-Rodríguez, M E; Bellido-Moyano, C; Pérula-de Torres, L A

    2017-08-29

    The objective of the present study is to study the prevalence, as well as the clinical and epidemiological characteristics of hypothyroid disease in adults using the computerised clinical records. Observational, descriptive and cross-sectional study. The target population was the patients of the health centres of Lucena I and II (Córdoba). Patients 14 years or older, diagnosed with hypothyroidism, born and resident in Lucena. Two hundred and fourteen patients were recruited by random sampling, who then underwent a clinical interview using a questionnaire. The mean age of the patients was 49.71 years (SD 17.03; 95% CI 47.34-51.98), with 85.5% women. A diagnosis of sub-clinical hypothyroidism was found in 74.8%, compared to 18.7% of primary hypothyroidism, and 6.5% of secondary hypothyroidism. The 53.7% (95% CI 46.81-60.59) of patients diagnosed with hypothyroidism did not have thyroid antibodies results. However, 75.2% (95% CI 68.89-80.86) were being treated with levothyroxine. The prevalence of hypothyroidism was 5.7% (95% CI 5.46-5.96). Sub-clinical hypothyroidism is very common in Primary Care clinics. Many patients are not correctly diagnosed and many are over-medicated, suggesting a need to review the diagnosis. Copyright © 2017 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Relation between Hormonal Disorders and Components of Metabolic Syndrome in Patients with Primary Hypothyroidism

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    Т.Yu. Yuzvenko

    2016-09-01

    Full Text Available During the last decade plenty of the researches dedicated to the problem of hypothyroidism were published, that radically changed views to the value of thyroid pathology on the whole. Neurohumoral changes are considered as a nosotropic factor of hypothyroidism development in persons with metabolic syndrome (MS. Aim of the research is to study the features of hormonal disorders and their correlation with the components of metabolic syndrome in patients with primary hypothyroidism. Materials and methods. The study involved 80 patients with primary hypothyroidism: 61 had metabolic syndrome and 19 did not have metabolic syndrome. Results. Statistically significant increased levels of leptin, insulin, cortisol, C-peptide were revealed in patients with hypothyroidism and metabolic syndrome while the most marked changes were found in patients with multiple metabolic abnormalities. Conclusions. The interrelations between hyperleptinemia and fasting glucose, glycated hemoglobin, insulin levels, thyroid-stimulating hormone, index HOMA were determined indicating the modulating role of chronic hyperglycemia, hormonal disorders and insulin resistance in the expression and realization of the biological action of leptin in patients with hypothyroidism and metabolic syndrome.

  9. [Effect of the treatment acceptance on the perinatal outcomes in women with subclinical hypothyroidism, positive thyroid gland peroxidase antibody in early pregnancy].

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    Yang, Junjuan; Guo, Huafeng; Ding, Shugui; Tao, Beibei; Zhang, Xinhua

    2015-09-01

    To investigate if women with subclinical hypothyroidism (SCH), positive thyroid gland peroxidase antibody (TPOAb) in early pregnancy accepted treatment or not had effect on perinatal outcomes. 15 000 pregnant women who delivered in Women and Infants Hospital of Zhengzhou from January 1, 2013 to June 30, 2014 were recruited retrospectively. Among them, 2 042 women had SCH in early pregnancy. The diagnostic standard of SCH was serum free thyroxine (FT4) between 12.91-22.35 pmol/L and TSH level between 5.22-10.00 mU/L. TPOAb level ≥ 34 U/L was defined as positive result. The 2 042 patients with SCH were divided into the treated group (1 236 cases) and the untreated group (806 cases), according to whether or not women accepted the levothyroxine treatment. Meanwhile, the 2 042 patients with SCH were divided into the TPOAb (+) treated group (1 021 cases), the TPOAb (+) untreated group (201 cases), the TPOAb (-) treated group (215 cases) and the TPOAb (-) untreated group (605 cases), according to the TPOAb result and acceptance the levothyroxine treatment. 2 000 pregnant women with normal thyroid function who delivered in the same period were selected as the control group. Perinatal outcomes were analyzed. (1) The incidence of SCH in early pregnancy was 13.61% (2 042/15 000). 60.53% (1 236/2 042) accepted levothyroxine treatment and 39.47% (806/2 042) did not. (2) The incidence of abortion (5.71%, 46/806), premature delivery (6.20%, 50/806), gestational hypertension disease (13.90%, 112/806), gestational diabetes mellitus (GDM; 6.58%, 53/806), fetal growth restriction (FGR; 12.28%, 99/806) and low birth weight infants (10.17%, 82/806) in the untreated group were higher than those in the treated group [3.96% (49/1 236), 4.21% (52/1 236), 10.76% (133/1 236), 4.13% (51/1 236), 8.90% (110/1 236), 7.52% (93/1 236), respectively] and the control group [3.60% (72/2 000), 4.00% (80/2 000), 10.70% (214/2 000), 3.80% (76/2 000), 9.60% (192/2 000), 7.50% (150/2 000), respectively

  10. A PROSPECTIVE STUDY OF HYPOTHYROIDISM IN DIAGNOSED CASE OF GALLSTONE DISEASE

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    P. Sundareswar

    2016-11-01

    Full Text Available BACKGROUND Disturbances in lipid metabolism, which occur during hypothyroidism lead to the formation of gallstones. This study aims to evaluate the thyroid function pattern in patients with gallstones. The aim of this study was to investigate the association between hypothyroidism and gallstone disease. MATERIALS AND METHODS 200 patients admitted as inpatients for management of gallstone disease in Department of General Surgery, GRH, Madurai, between September 2014 to August 2015 were evaluated with details of cases, full history, clinical examination, symptoms and signs of hypothyroidism (loss of appetite, gaining weight, tiredness, constipation, cold intolerance, menstrual disturbances, bradycardia, presence or absence of goiter, etc. and investigations (USG abdomen, USG neck, thyroid function test (T3, T4, TSH. Patients are divided according to history, clinical examination, USG neck and lab estimation of T3, T4 and TSH. 1. Subclinical Hypothyroidism: Symptom free patient with TSH concentration above upper limit of normal range and T3/T4 or both decrease below normal limit. 2. Clinical Hypothyroidism: In which, there are symptoms of hypothyroidism with TSH level above the upper limit and T3/T4 or both decrease below normal limit. 3. Euthyroid Group: Where clinical and lab tests are within normal range (all these groups may present with or without goiter. RESULTS This study included 200 gallstone patients who were studied prospectively over a period of 1 year from September 2014 to August 2015. Among them, 18 patients had subclinical hypothyroidism and 6 patients had clinical hypothyroidism. A total of 12% of gallstone patients were diagnosed to have hypothyroidism showing that there is association of hypothyroidism with gallstone disease. CONCLUSION Thyroid dysfunction is more common among patients with gallstones and it maybe a risk factor for biliary stone formation. This may be attributed to the absence of the pro-relaxing effects of

  11. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study.

    Science.gov (United States)

    Ruscitti, Piero; Cipriani, Paola; Masedu, Francesco; Romano, Silvio; Berardicurti, Onorina; Liakouli, Vasiliki; Carubbi, Francesco; Di Benedetto, Paola; Alvaro, Saverio; Penco, Maria; Valenti, Marco; Giacomelli, Roberto

    2017-01-01

    Several studies showed the close relationship between Rheumatoid Arthritis (RA) and cerebro-cardiovascular events (CVEs) and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV) and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis. We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis. We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH), type 2 diabetes mellitus and metabolic syndrome (MS), at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis. Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors.

  12. Peculiarities of myocardial diastolic function in patients with autoimmune thyroiditis divided according to the mild hypothyroidism range

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    T A Nekrasova

    2012-12-01

    Full Text Available The aim of the present study was to evaluate myocardial diastolic function in patients with autoimmune thyroiditis (AT against the TSH level within the reference range and subclinical interval as well as to determine whether it is related to the thyroid function or other metabolic and functional indices. METHODS. We studied diastolic function of left and right ventricles by the ratio of mitral and tricuspid annular early and late diastolic velocities (em/am and et/at respectively using tissue Doppler imaging; structural heart characteristics by echocardiography; lipid profile and peroxidation parameters; serum ferritin and iron concentrations in 132 middle-aged women. 36 of them were euthyroid controls, 96 had AT and were ranged according to their TSH value into 4 groups: women with “low- normal” (0.4–2.5 mU/L and “upper-normal” (2.5–4.0 mU/L TSH range; patients with subclinical hypothyroidism and TSH below and above 6 mU/L. RESULTS. The increase of TSH value within reference range and subclinical interval was associated with the parallel tendency to the em/am and et/at ratio decrease suggesting detrimental effect of the mildest thyroid failure on the left and right ventricles diastolic function. Thus, patients with TSH values >6 mU/L had significantly lower em/am and et/at ratio compared to the “low-normal” TSH group ( p < 0.05 and controls ( p < 0.01. Among them, the highest LDL cholesterol, myocardial mass index and oxidative stress rate were detected as well as lower iron and ferritin serum concentrations ( p < 0.05 compared to controls with regard to all the parameters listed above. Abnormalities in heart structure, lipid and iron metabolism correlated with alterations in ventricular relaxation suggesting that they can contribute, at least partly, to the diastolic dysfunction devel- opment CONCLUSION. The increase of TSH value within reference range and subclinical interval can affect diastolic function of the heart. Its

  13. Endothelial Dysfunction as a Factor of Renal Impairment Development in Patients with Hypothyroidism

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    O.N. Didushko

    2016-06-01

    Full Text Available Introduction. The endothelial dysfunction was found to be detected even within normal range of thyroid-stimulating hormone and it worsens while the growth of thyroid-stimulating hormone levels. The objective of the investigation was to study the condition of the endothelium and its influence on renal function in patients with primary hypothyroidism. Materials and methods. 188 patients with manifested hypothyroidism were examined. They were divided into following groups: group I involved 45 non-obese patients with hypothyroidism on the background of autoimmune thyroiditis; group II included 46 obese patients with autoimmune thyroiditis and hypothyroidism; group III consisted of 47 non-obese patients with post-operative hypothyroidism and group IV consisted of obese patients with postoperative hypothyroidism, n = 50. Results. Investigating endothelial dysfunction in all groups of patients suffering from hypothyroidism, a significant difference in its indices has been revealed, moreover, endothelial dysfunction has appeared to be more pronounced in patients from group II and group IV. Increase in the diameter of the brachial artery after compression in group II and group IV has turned out to be twice less and respectively, endothelium-dependent vasodilation (EDVD has become 46.4 % and 47.7 % less than the one in healthy people. An inverse correlation of medium strength has been established between thyroid-stimulating hormone and EDVD levels as well as between EDVD and total cholesterol and low-density lipoproteins in a joint group that involved patients with manifested hypothyroidism. The same inverse correlation of medium strength has been revealed in group I and group II; and weak, but positive inverse correlation between vasculoendothelial growth factor and glomerular filtration rate has been established in group III and group IV. Conclusions. Revealed correlations indicate mutually aggravating influence of thyroid hypofunction, obesity

  14. Pediatric Hypothyroidism: Diagnosis and Treatment.

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    Wassner, Ari J

    2017-08-01

    Thyroid hormone has important physiologic functions in nearly every organ system. The critical role of thyroid hormone in growth and in physical and neurologic development lends particular importance to the prompt diagnosis and appropriate treatment of hypothyroidism in infants and children. Congenital hypothyroidism is common and has potentially devastating neurologic consequences. While the approach to diagnosis and treatment of severe congenital hypothyroidism is well established, data continue to emerge about the genetic causes, clinical significance, and prognosis of the milder forms of congenital hypothyroidism that are increasingly being diagnosed by newborn screening. Similarly, the diagnosis and treatment of severe acquired hypothyroidism is straightforward and clearly of clinical benefit, but uncertainty remains about the optimal management of mild subclinical hypothyroidism. This review summarizes current knowledge of the causes, clinical manifestations, diagnosis, treatment, and prognosis of hypothyroidism in infants and children, with a focus on recent developments and areas of uncertainty in this field.

  15. [Influence of hypothyroidism on pregnancy outcome and fetus during pregnancy].

    Science.gov (United States)

    Hou, M Q; Wang, Z J; Hou, K Z

    2016-05-01

    To investigate the influence of hypothyroidism on pregnancy outcome and fetus in pregnant women. A total of 4 286 pregnant women, who received prenatal examination in our hospital from January 2013 to October 2015, were selected as study subjects. The incidence of hypothyroidism and the influence on pregnancy outcomes and fetus were investigated. In 4 286 pregnant women surveyed, 209 hypothyroidism cases were detected(4.9%), including 85 clinical hypothyroidism cases and 124 subclinical hypothyroidism cases. In health group, the premature delivery rate was 1.0%, significantly lower than that in clinical hypothyroidism group(10.6%)and in subclinical hypothyroidism group(6.5%), the differences were significant(χ(2)= 38.884, Phypothyroidism group(18.8%)and in subclinical hypothyroidism group(9.7%), the differences were significant(χ(2)=30.949, Phypothyroidism group(14.1%)and in subclinical hypothyroidism group(4.8%), the differences were significant(χ(2)=50.593, Phypothyroidism group(10.6%)and in subclinical hypothyroidism group(5.6%), the differences were significant(χ(2)=19.257, Phypothyroidism group(9.25 ± 0.45)and in subclinical hypothyroidism group(9.28 ± 0.44), the differences were significant(t=8.823, PHypothyroidism during pregnancy has adverse influences on pregnancy outcome and fetus, and it is necessary to strengthen the hypothyroidism detection in pregnant women for the early treatment.

  16. Resveratrol ameliorates the anxiety- and depression-like behavior of subclinical hypothyroidism rat: possible involvement of the HPT axis, HPA axis, and Wnt/β-catenin pathway

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    Jinfang eGe

    2016-05-01

    Full Text Available Metabolic disease subclinical hypothyroidism (SCH is closely associated with depression-like behavior both in human and animal studies, and our previous studies have identified the antidepressant effect of resveratrol (RES in stressed rat model. The aim of this study was to investigate whether RES would manifest an antidepressant effect in SCH rat model and explore the possible mechanism. A SCH rat model was induced by hemi-thyroid electrocauterization, after which the model rats in the RES and LT4 groups received a daily intragastric injection of RES at the dose of 15 mg/kg or LT4 at the dose of 60 μg/kg for 16 days, respectively. The rats’ plasma concentrations of thyroid hormones were measured. Behavioral performance and hypothalamic-pituitary-adrenal (HPA activity were evaluated. The protein expression levels of the Wnt/β-catenin in the hippocampus were detected by western blot. The results showed that RES treatment down-regulated the elevated plasma thyroid stimulating hormone (TSH concentration and the hypothalamic mRNA expression of thyrotropin releasing hormone (TRH in the SCH rats. RES-treated rats showed increased rearing frequency and distance in the OFT, increased sucrose preference in the SPT, and decreased immobility in the FST compared with SCH rats. The ratio of the adrenal gland weight to body weight, the plasma corticosterone levels and the hypothalamic CRH mRNA expression were reduced in the RES-treated rats. Moreover, RES treatment up-regulated the relative ratio of phosphorylated-GSK3β (p-GSK3β/GSK3β and protein levels of p-GSK3β, cyclinD1 and c-myc, while down-regulating the relative ratio of phosphorylated-β-catenin (p-β-catenin/β-catenin and expression of GSK3β in the hippocampus. These findings suggest that RES exerts anxiolytic- and antidepressant-like effect in SCH rats by down-regulating hyperactivity of the HPA axis and regulating both the HPT axis and the Wnt/β-catenin pathway.

  17. Laparoscopic sleeve gastrectomy leads to reduction in thyroxine requirement in morbidly obese patients with hypothyroidism.

    Science.gov (United States)

    Aggarwal, Sandeep; Modi, Shrey; Jose, Toney

    2014-10-01

    The impact of laparoscopic sleeve gastrectomy (LSG) on various co-morbidities including type II diabetes mellitus, hypertension, and sleep apnea is well established. However, its effect on hypothyroidism has not been given due attention evidenced by the scant literature on the subject. The purpose of this report is to assess the change in thyroxine (T4) requirement in morbidly obese patients with clinical hypothyroidism after LSG. We conducted a retrospective review of morbidly obese patients on T4 replacement therapy for clinical hypothyroidism who underwent LSG from August 2009 to July 2012 at our institution. Of the 200 patients who underwent LSG during this period, 21 (10.5 %) were on T4 replacement therapy preoperatively for clinical hypothyroidism. Two patients were lost to follow-up. The remaining 19 patients were categorized into two groups. Group 1 comprised 13 patients with decreased T4 requirements after LSG. Group 2 comprised six patients in whom the T4 dose remained unaltered. The mean change in T4 requirement in group 1 was 42.07 % (12-100 %). Group 1 patients had a significantly higher mean preoperative body mass index (48.7 vs. 43.0 kg/m(2); p = 0.03) than the group 2 patients. There was a significant correlation between the percentage excess weight loss and the percentage change in T4 requirement in group 1 (r = 0.607, p = 0.028). Sleeve gastrectomy has a favorable impact on hypothyroid status as seen by a reduction in T4 requirement in the majority of morbidly obese patients with overt hypothyroidism.

  18. Laparoscopic Roux-en-Y gastric bypass surgery on morbidly obese patients with hypothyroidism.

    Science.gov (United States)

    Fazylov, Rafael; Soto, Eliana; Cohen, Steve; Merola, Stephen

    2008-06-01

    It is well known that obesity is accompanied by changes in thyroid function. Hypothyroidism is associated with increased body weight. The aim of this study was to evaluate the operative outcomes, weight loss, and the effect of weight loss on thyroid function in morbidly obese patients with hypothyroidism who undergo laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. A retrospective review of 20 morbidly obese female patients with hypothyroidism and on thyroid replacement therapy who underwent LRYGB between January 2003 and August 2006. Mean preoperative body mass index (BMI) was 47.6 kg/m2 (range 38-58.5 kg/m2). Average patient age was 44.5 years (range 21-66 years). There was one early complication (pneumonia). Late complications included one death, three anastomotic strictures, and one small bowel obstruction. The patients were followed for a mean of 13.5 months (range 3-24 months). Their mean excess body weight loss was 13 kg (22%), 24.4 kg (39.4%), 33.2 kg (63.3%), 38.4 kg (65%), 41.7 kg (70%), and 43 kg (73%) at 1, 3, 6, 9, 12, and 24 months, respectively. Change in a mean BMI was the same regardless of the patient preoperative and postoperative thyroxine dose. Hypothyroidism resolved in 5(25%) patients, improved in 2(10%) patients, unchanged in 8(40%) patients, and worsened in 5 (25%) patients. Most of the five whose hypothyroidism worsened had thyroid autoimmune disease. Hypothyroidism appears to improve in the vast majority of morbidly obese patients who undergo LRYGB, except for those whose thyroid disease is autoimmune in nature.

  19. Clinical Usefulness of serum total cholesterol as an index of hypothyroidism in patients after cervical radiation

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    Iguma, Yoko; Iwai, Chikako; Okuyama, Masako; Futami, Takahiro; Inui, Ken-ichi [Kyoto Univ. (Japan). Hospital; Asato, Ryo [Kyoto Univ. (Japan). Graduate School of Medicine

    2003-02-01

    Cervical radiation therapy is often applied to patients with head and neck cancers because radiation has a high sensitivity to these cancers and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. We have encountered some patients who showed hypercholesterolemia resulting from cervical radiation. Therefore, we have paid close attention to the relationship between hypercholesterolemia after cervical radiation and hypothyroidism. Thyroid hormone tests in these patients with hypercholesterolemia after cervical radiation showed high thyroid stimulating hormone (TSH) and low free thyroxine (fT{sub 4}), indicating the presence of hypothyroidism. After administration of levothyroxine Na, their fT{sub 4} levels increased and both TSH levels and serum total cholesterol levels decreased. In conclusion, in patients who have received cervical radiation, we recommend monitoring serum total cholesterol periodically to detect hypothyroidism easily before the appearance of its symptoms. (author)

  20. Hyperleptinemia as One of the Factors for Renal Dysfunction in Patients with Hypothyroidism

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    O.M. Didushko

    2014-10-01

    Full Text Available In order to study the features of renal function in patients with hypothyroidism we have examined 132 patients with primary hypothyroidism. The results showed that in patients with overt hypothyroidism there is renal dysfunction manifested by increased serum creatinine level and decreased glomerular filtration rate, the development and progression of which is facilitated by the presence of risk factors in patients — hyperleptinemia, dyslipidemia, overweight and abdominal obesity. It is stated that more significant indicators of dyslipidemia were associated with the greatest manifestations of abdominal obesity in terms of waist circumference (96.58 ± 1.70 cm and 98.73 ± 3.35 cm, as well as greater body mass index.

  1. Blood Fibrinolytic Activity in Patients with Type 2 Diabetes Mellitus Associated with Hypothyroidism

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    Т.Yu. Yuzvenko

    2015-04-01

    Full Text Available The objective of the research was to study the level of plasminogen activator inhibitor type 1 (PAI-1 in the blood serum of patients with type 2 diabetes mellitus (DM in combination with hypothyroidism. We have observed 62 patients with type 2 DM, 32 of them had primary hypothyroidism. Control group consisted of 20 persons without carbohydrate metabolism disorders and thyroid pathology. In patients with type 2 DM, we have detected violations in the fibrinolytic system as an increase of PAI-1, whose level depends on the body mass index, waist circumference, level of glycated haemoglobin, indexes of insulin resistance, blood lipid spectrum, as well as on the presence of microalbuminuria. The presence of hypothyroidism has an additional negative impact on the parameters of carbohydrate, lipid metabolism and PAI-1 level in patients with type 2 DM.

  2. Investigation of Regorafenib-induced Hypothyroidism in Patients with Metastatic Colorectal Cancer.

    Science.gov (United States)

    Sugita, Kazuo; Kawakami, Kazuyoshi; Yokokawa, Takashi; Mae, Yutaro; Toya, Wataru; Hagino, Akane; Suzuki, Kenichi; Suenaga, Mitsukuni; Mizunuma, Nobuyuki; Yamaguchi, Toshiharu; Hama, Toshihiro

    2015-07-01

    Hypothyroidism is one of the side-effects caused by regorafenib. In the Japanese subset of the CORRECT study, hypothyroidism developed in 1.5% of the patients, but was not grade 3 or higher in any patient. Regorafenib is an oral multi-kinase inhibitor that has the same mechanism of action as sunitinb. However, the reported incidence of sunitinb-related hypothyroidism varies widely, ranging from 16.0% in clinical trials to 35.4% in post-marketing surveillance studies. In general, symptoms of hypothyroidism include fatigue and dysphonia. Hyperthyroidism must, therefore, be appropriately managed in order to maintain patient quality of life and avoid a critical level of hypothyroidism. During the first cycle of treatment with regorafenib, the incidence of abnormal thyroid-stimulating hormone (TSH) elevation was 31.4%. Our results suggest that thyroid function tests should be performed from day 1 of treatment with regorafenib. It would be prudent to consider routine monitoring of thyroid function in all patients who receive regorafenib and to recommend endocrinological consultation as necessary. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  3. Biomarkers of Subclinical Atherosclerosis in Patients with Autoimmune Disorders

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    Elisabetta Profumo

    2012-01-01

    Full Text Available Atherosclerosis is accelerated in rheumatoid arthritis (RA and psoriatic arthritis (PsA. We investigated a possible association of oxidized low-density lipoproteins (ox-LDLs, nitric oxide (NO, 3-nitrotyrosine, vitamin A, vitamin E, and β-carotene serum levels with subclinical atherosclerosis in RA and PsA. By the use of ELISA, we observed higher ox-LDL levels in patients with intima-media thickness (IMT > 1 than in patients with IMT ≤ 1 and a negative correlation between NO levels and IMT values. By the use of high-performance liquid chromatography, we determined higher levels of vitamin A in patients with PsA and IMT ≤ 1 than in controls and lower levels of β-carotene in patients with RA and PsA than in controls. β-carotene concentrations were negatively correlated to the duration of disease in RA. Our study confirms that ox-LDLs and NO may be markers of accelerated atherosclerosis in RA and PsA whereas vitamins seem to be associated only to the presence of the autoimmune disorders.

  4. Clinical conundrums in management of hypothyroidism in critically ill geriatric patients.

    Science.gov (United States)

    Sehgal, Vishal; Bajwa, Sukhminder Jit Singh; Sehgal, Rinku; Bajaj, Anurag

    2014-01-01

    Articles in various international and national bibliographic indices were extensively searched with an emphasis on thyroid and hypothyroid disorders, hypothyroidism in elderly hospitalized patients, hypothyroidism in critically ill geriatric population, thyroxine in elderly hypothyroid, drug interactions and thyroid hormones, and thyroid functions in elderly. Entrez (including PubMed), NIH.gov, Medscape.com, WebMD.com, MedHelp.org, Search Medica, MD consult, yahoo.com, and google.com were searched. Manual search was performed on various textbooks of medicine, critical care, pharmacology, and endocrinology. Thyroid function tests in elderly hospitalized patients must be interpreted with circumspection. The elderly are often exposed to high iodide content and critical care settings. This may occur because of either decreased iodine excretion or very high intake of iodine. This is especially true for elderly population with underlying acute or chronic kidney diseases or both. Amiodarone, with a very high iodine content, is also often used in this set of population. Moreover, other medications including iodinated contrast are often used in the critical care settings. These may affect different steps of thyroid hormone metabolism, and thereby complicate the interpretation of thyroid function tests. The current review is aimed at analyzing and managing various clinical aspects of hypothyroidism in hospitalized elderly, and critically ill geriatric patients.

  5. Hypothyroidism in Cancer Patients on Immune Checkpoint Inhibitors with anti-PD1 Agents: Insights on Underlying Mechanisms.

    Science.gov (United States)

    Alhusseini, M; Samantray, J

    2017-04-01

    Background: Immune therapy using monoclonal antibodies against cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and programmed cell death 1 receptor (PD-1) for various cancers have been reported to cause thyroid dysfunction. Little is known, however, about the underlying pathogenic mechanisms and the course of hypothyroidism that subsequently develops. In this report, we use the change in thyroglobulin and thyroid antibody levels in patients on immune therapy who develop hypothyroidism to better understand its pathogenesis as well as examine the status of hypothyroidism in the long term. Methods: We report a case series of 10 patients who developed hypothyroidism after initiation of immune therapy (either anti-PD-1 alone or in combination with anti-CTLA-4). Available thyroid antibodies including anti-thyroglobulin (anti-Tg), anti-thyroid peroxidase (anti-TPO), and thyroid stimulating immunoglobulin (TSI) were noted during the initial thyroiditis phase as well as the hypothyroid phase. Persistence or remission of hypothyroidism was noted at 6 months. Summary: During the thyroiditis phase, 50% of the patients had elevated Tg titers, 40% had elevated anti-Tg, and 40% had elevated TSI. All of these titers decreased during the hypothyroid phase. Permanent hypothyroidism was noted in 80% of the cases. Conclusion: Hypothyroidism following initiation of immune therapy has immunologic and non-immunologic mediated mechanisms and is likely to be persistent. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Sunitinib-induced hypothyroidism predicts progression-free survival in metastatic renal cell carcinoma patients.

    Science.gov (United States)

    Buda-Nowak, Anna; Kucharz, Jakub; Dumnicka, Paulina; Kuzniewski, Marek; Herman, Roman Maria; Zygulska, Aneta L; Kusnierz-Cabala, Beata

    2017-04-01

    Sunitinib is a tyrosine kinase inhibitor (TKI) used in treatment of metastatic renal cell carcinoma (mRCC), gastrointestinal stromal tumors and pancreatic neuroendocrine tumors. One of the most common side effects related to sunitinib is hypothyroidism. Recent trials suggest correlation between the incidence of hypothyroidism and treatment outcome in patients treated with TKI. This study evaluates whether development of hypothyroidism is a predictive marker of progression-free survival (PFS) in patients with mRCC treated with sunitinib. Twenty-seven patients diagnosed with clear cell mRCC, after nephrectomy and in 'good' or 'intermediate' MSKCC risk prognostic group, were included in the study. All patients received sunitinib as a first-line treatment on a standard schedule (initial dose 50 mg/day, 4 weeks on, 2 weeks off). The thyroid-stimulating hormone serum levels were obtained at the baseline and every 12 weeks of treatment. In statistic analyses, we used Kaplan-Meier method for assessment of progression-free survival; for comparison of survival, we used log-rank test. In our study, the incidence of hypothyroidism was 44%. The patients who had developed hypothyroidism had better median PFS to patients with normal thyroid function 28,3 months [95% (CI) 20.4-36.2 months] versus 9.8 months (6.4-13.1 months). In survival analysis, we perceive that thyroid dysfunction is a predictive factor of a progression-free survival (PFS). In the unified group of patients, the development of hypothyroidism during treatment with sunitinib is a positive marker for PFS. During that treatment, thyroid function should be evaluated regularly.

  7. [Subclinical sensorineural hearing loss in female patients with rheumatoid arthritis].

    Science.gov (United States)

    Treviño-González, José Luis; Villegas-González, Mario Jesús; Muñoz-Maldonado, Gerardo Enrique; Montero-Cantu, Carlos Alberto; Nava-Zavala, Arnulfo Hernán; Garza-Elizondo, Mario Alberto

    2015-01-01

    The rheumatoid arthritis is a clinical entity capable to cause hearing impairment that can be diagnosed promptly with high frequencies audiometry. To detect subclinical sensorineural hearing loss in patients with rheumatoid arthritis. Cross-sectional study on patients with rheumatoid arthritis performing high frequency audiometry 125Hz to 16,000Hz and tympanometry. The results were correlated with markers of disease activity and response to therapy. High frequency audiometry was performed in 117 female patients aged from 19 to 65 years. Sensorineural hearing loss was observed at a sensitivity of pure tones from 125 to 8,000 Hz in 43.59%, a tone threshold of 10,000 to 16,000Hz in 94.02% patients in the right ear and in 95.73% in the left ear. Hearing was normal in 8 (6.84%) patients. Hearing loss was observed in 109 (93.16%), and was asymmetric in 36 (30.77%), symmetric in 73 (62.37%), bilateral in 107 (91.45%), unilateral in 2 (1.71%), and no conduction and/or mixed hearing loss was encountered. Eight (6.83%) patients presented vertigo, 24 (20.51%) tinnitus. Tympanogram type A presented in 88.90% in the right ear and 91.46% in the left ear, with 5.98 to 10.25% type As. Stapedius reflex was present in 75.3 to 85.2%. Speech discrimination in the left ear was significantly different (p = 0.02)in the group older than 50 years. No association was found regarding markers of disease activity, but there was an association with the onset of rheumatoid arthritis disease. Patients with rheumatoid arthritis had a high prevalence of sensorineural hearing loss for high and very high frequencies. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  8. Prevalência do hipotiroidismo subclínico e repercussões sobre o perfil lipídico e massa óssea em mulheres na pós-menopausa Prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Eliana Aguiar Petri Nahas

    2005-08-01

    Full Text Available OBJETIVO: avaliar a prevalência do hipotiroidismo subclínico e suas repercussões sobre o perfil lipídico e a densidade mineral óssea (DMO em mulheres na pós-menopausa. Métodos: trata-se de estudo transversal com recuperação de dados de prontuários de pacientes acompanhadas em ambulatório de climatério. Critérios de inclusão: mulheres na pós-menopausa com dosagem do hormônio estimulador da tiróide (TSH e de tiroxina livre (T4-L. Critérios de exclusão: hipertiroidismo e carcinoma de tiróide. Considerou-se hipotiroidismo subclínico valores de TSH superiores a 5,0 mUI/mL e T4-L normal. Foram selecionadas 320 pacientes (idade 55,2±6,4 anos divididas em 3 grupos: função tiroideana normal (n=208, hipotiroidismo subclínico (n=53 e hipotiroidismo clínico sob tratamento (n=59. Foram analisados dados clínicos, uso de terapia hormonal, índice de massa corpórea (IMC=kg/m², perfil lipídico (colesterol total, HDL, LDL, triglicerídeos e DMO da coluna lombar e fêmur. Na análise estatística, as diferenças entre as médias dos grupos foram comparadas utilizando-se a análise de variância (ANOVA. Para múltipla comparação, assumindo que a variância era diferente entre os grupos, utilizou-se o método de Tukey. RESULTADOS: o hipotiroidismo subclínico foi diagnosticado em 16,1% dos casos. Os grupos foram homogêneos quanto às características clínicas, IMC e perfil lipídico e uso de terapêutica hormonal. Nas pacientes com hipotiroidismo subclínico ou clínico encontrou-se menor freqüência de osteopenia na coluna lombar e fêmur quando comparadas às eutiroidianas (pPURPOSE: to evaluate the prevalence of subclinical hypothyroidism and its effects on lipidic profile and bone mineral density (BMD in postmenopausal women. METHODS: a cross-sectional study with survey of data from medical records of patients attended at a climacteric outpatient clinic. Inclusion criteria: postmenopausal women with measured thyroid

  9. Hypothyroidism and hyponatremia: data from a series of patients with iatrogenic acute hypothyroidism undergoing radioactive iodine therapy after total thyroidectomy for thyroid cancer.

    Science.gov (United States)

    Vannucci, L; Parenti, G; Simontacchi, G; Rastrelli, G; Giuliani, C; Ognibene, A; Peri, A

    2017-01-01

    The aim of the present study was to evaluate the role of hypothyroidism as a cause of hyponatremia in a clinical model of iatrogenic acute hypothyroidism due to thyroid hormone withdrawal prior to ablative radioactive iodine (RAI) therapy after total thyroidectomy. The study group consisted of 101 differentiated thyroid cancer (DTC) patients (77 women and 24 men). Plasma concentration of thyroid-stimulating hormone ([TSH]) and sodium ([Na(+)]) was evaluated before total thyroidectomy (pre[TSH] and pre[Na(+)]) and on the day of RAI therapy (post[TSH] and post[Na(+)]). The frequency of hypothyroidism-associated hyponatremia was 4 % (4/101). Pre[Na(+)] was significantly higher than post[Na(+)] (140.7 ± 1.6 vs 138.7 ± 2.3 mEq/L, p = 0.012). Moreover, a linear correlation was identified between pre[Na(+)] and post[Na(+)]. Iatrogenic acute hypothyroidism-related hyponatremia is uncommon. However, because of the significant reduction of [Na(+)] in the transition from euthyroidism to iatrogenic hypothyroidism, the value of pre[Na(+)] should be viewed as a parameter to be considered. Since it acts as an independent risk factor for the development of hyponatremia, patients with a pre[Na(+)] close to the lower limit of normal range may deserve a closer monitoring of [Na(+)].

  10. Obstructive sleep apnea syndrome and hypothyroidism - merely concurrence or causal association?

    Science.gov (United States)

    Kuczyński, Wojciech; Gabryelska, Agata; Mokros, Łukasz; Białasiewicz, Piotr

    2016-01-01

    The prevalence of obstructive sleep apnea-hypopnea syndrome (OSAHS) ranges from 4 to 7% in men and from 2 to 5% in women. Its deleterious consequences such as traffic accidents, cardiovascular complications increasing morbidity and mortality, make it a major health problem. Apart from obesity (a major risk factor for OSAHS), hypothyroid patients are prone to reveal this phenotype. Although hypothyroidism seems an acknowledged risk factor for OSAHS, some authors report the lack of clinically relevant association. The argument partly depends on the increased prevalence of hypothyroidism in OSAHS patients, but the epidemiological data is limited and somehow inconsistent; even less is known about sub-clinical hypothyroidism in OSAHS patients. Even if frequency of overt and sub-clinical hypothyroidism in OSAHS patients is comparable to the general population, screening for it seems beneficial, as hormone replacement therapy may improve sleep disordered breathing. Unfortunately, this favorable outcome was found only in a few studies with limited number of patients with hypothyroidism. Yet, despite the lack of international guidelines and no large multicentre studies on the topic available, we think that TSH screening might prove beneficial in vast majority of OSAHS patients.

  11. Evaluating autoimmunity markers (TPO Ab, Tg Ab and TM Ab in hypothyroid patients of Bushehr province

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    Iraj Nabipour

    2005-09-01

    Full Text Available Background: Chronic autoimmune thyroiditis (Hashimoto's Thyroiditis is the common cause of primary hypothyroidism in iodine sufficient countries. Iran is named an iodine sufficient country, in this century. Methods: A total of 88 hypothyroid patients, on suppressing dose of levothyroxine who were followed in a university endocrine disorder clinic were evaluated for serum thyroid autoimmunity markers: thyroid peroxidase antibody (TPO Ab, thyroglobulin antibody (Tg Ab and thyroid microsomal antibody (TM Ab using ELISA method. Results: The prevalence of TPO Ab, Tg Ab and TM Ab were 73.9%, 45.5% and 71.6%, respectively. Among the patients with high level of TPO Ab (> 75 u/ml, 45.3% had grade 1 or 2 of goiter (P< 0.05. Conclusion: Autoimmune thyroid disease (Hashimoto's thyroiditis is the most common cause of hypothyroidism in Bushehr province.

  12. Effect of levothyroxine therapy on hypertension in hypothyroid patients

    African Journals Online (AJOL)

    overt or subclinical) with hypertension, of either sex between 21-70 years of age. ... Complete reversal of hypertension was observed in 8 out of 17 SH and 18 out of 29 OH cases while partial reversal was noted in one case in each category.

  13. Betel Nut Chewing and Subclinical Ischemic Heart Disease in Diabetic Patients

    OpenAIRE

    Chin-Hsiao Tseng

    2011-01-01

    Background. This study investigated the association between betel nut chewing and subclinical ischemic heart disease (IHD) in Taiwanese type 2 diabetic patients. Methods. A total of 394 male patients aging ≥45 years and without previous heart disease were studied. Among them 349 had no habit of chewing betel nut and 45 possessed the habit for ≥5 years. Subclinical IHD was diagnosed by a Minnesota-coded resting electrocardiogram and was present in 71 cases. Statistical analyses were perform...

  14. Mutation analysis of the NKX2.5 gene in Iranian pediatric patients with congenital hypothyroidism.

    Science.gov (United States)

    Khatami, Mehri; Heidari, Mohammad Mehdi; Tabesh, Fatemeh; Ordooei, Mahtab; Salehifar, Zohreh

    2017-08-28

    The embryonic development of the thyroid gland is regulated by the expression of several candidate genes which are related to congenital hypothyroidism. These genes include the numerous critical thyroid transcription factors such as NKX2.1, NKX2.5, FOXE1, and PAX8. The molecular analysis of these loci will be essential to the explanation of the participation of these transcription activators in the etiology of hypothyroidism. Among them, the role of NKX2.5 is important during the early thyroid morphogenesis and in controlling thyroidal cell differentiation and migration. Importantly, NKX2.5 change nucleotides are recognized to be central to the genesis of congenital hypothyroidism. A case-control study was conducted in 65 unrelated patients, diagnosed with primary congenital hypothyroidism and all of them were diagnosed according to the clinical presentations of thyroid hypoplasia and without cardiovascular defects. Mutational screening of the entire NKX2-5 coding sequence was performed in a cohort of pediatric patients by PCR-SSCP and direct sequencing. We identified two known variations 73C>T (R25C) and 63A>G (E21E) in patients with thyroid hypothyroidism. Both of them are located in conserved region of the gene and previously reported in cases with thyroid dysgenesis and congenital heart defects. There was a significance association between 63A>G variation with primary hypothyroidism (p=0.003). These SNPs are probably related to thyroid hypoplasia because the allele frequency of the 63A>G polymorphism was significantly different in patients and controls and also R25C variation not observed in healthy cases.

  15. Detection of subclinical atherosclerosis and diastolic dysfunction in patients with schizophrenia

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    Ünsal C

    2013-10-01

    Full Text Available Cüneyt Ünsal,1 Mustafa Oran,2 Hande Oktay Tureli,3 Seref Alpsoy,4 Sema Yesilyurt,5 Mehtap Arslan,6 Birol Topcu,7 Osman Karakaya,8 Erhan Kurt6 1Department of Psychiatry, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 2Department of Internal Medicine, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 3Department of Cardiology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, Istanbul, Turkey; 4Department of Cardiology, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 5Department of Psychiatry, Bağcilar Training and Research Hospital, Istanbul, Turkey; 6Department of Psychiatry, Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Istanbul, Turkey; 7Department of Biostatistics, Namik Kemal University, School of Medicine, Tekirdag, Turkey; 8Department of Social Service, Yalova University, Faculty of Economics and Administrative Sciences, Yalova, Turkey Background: Patients with schizophrenia have a higher risk for cardiovascular diseases, which is associated with early mortality compared with the nonschizophrenic population. Early diagnosis of cardiovascular diseases in asymptomatic periods in patients with schizophrenia would enhance their quality of life and reduce mortality. Echocardiography, carotid ultrasonography, and ankle brachial index (ABI measurement are known to be beneficial methods of detecting subclinical cardiovascular diseases and of risk stratification. The present study investigated carotid intima media thickness (CIMT and ABI and echocardiographic parameters measured via conventional and tissue Doppler echocardiography in patients with schizophrenia in comparison with a control group. Methods: The present case-control study included 116 patients with schizophrenia and 88 healthy patients. Participants with any current comorbid psychiatric disorder, current or lifetime neurological and medical problems, current coronary artery disease, diabetes

  16. [Pendred syndrome among patients with hypothyroidism: genetic diagnosis, phenotypic variability and occurrence of phenocopies].

    Science.gov (United States)

    Banghová, K; Al, Taji E; Novotná, D; Zapletalová, J; Hníková, O; Cáp, J; Klabochová, J; Kúseková, M; Lebl, J

    2008-01-01

    Pendred syndrome (OMIM274600) is one of the causes of congenital hypothyroidism due to thyroid dyshormonogenesis. It is an autosomal recessive disease classically characterized by dyshormonogenetic goitre and sensorineural deafness. It is caused by mutations in PDS/SLC26A4 gene encoding for pendrin--an anion transporter, mostly expressed in the thyroid gland and the inner ear. The thyroid impairment in Pendred syndrome develops only in 80% of affected individuals in form of a euthyroid or hypothyroid goitre, which is rarely present at birth, when it can be diagnosed by the neonatal screening for congenital hypothyroidism. The study was aimed to identify patients with Pendred syndrome among children with congenital or postnatal non-autoimmune hypothyroidism and subsequently confirm the diagnosis by finding mutations in the PDS/SLC26A4 gene. We examined two-hundred thirty-six Caucasians with hypothyroidism diagnosed by screening or developing later in childhood. The clinical diagnosis of Pendred syndrome was based on the laboratory and ultrasonographic signs of thyroid dyshormonogenesis (elevated TSH, low T4/fT4, goitre or normal thyroid volume) in association with sensorineural hearing loss. In subjects clinically diagnosed as Pendred syndrome, we sequenced all 21 exons of the PDS/SLC26A4 gene and their flanking intron-exon junctions. Among 236 children, nine fulfilled the diagnostic criteria of Pendred syndrome. In four, the diagnosis was confirmed by identification of mutations in the PDS/SLC26A4 gene, the remaining five patients were concluded phenocopies. Our study confirms the high phenotypic variability of thyroid impairment in Pendred syndrome and underlines the necessity of a molecular-genetic investigation for establishing the diagnosis in regard of the great number of phenocopies. However, from the endocrinologist's point of view, the genetic testing is only reasonable in patients with congenital hypothyroidism due to dyshormonogenesis in association with

  17. Prevalence of hypothyroidism in patients with chronic kidney disease: a cross-sectional study from North India

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    Abhilash Chandra

    2016-09-01

    Conclusion: There is growing evidence of increased prevalence of hypothyroidism in dialysis-independent CKD patients. A number of findings such as lower serum albumin, serum calcium, and hemoglobin levels and higher intact parathyroid hormone levels are seen in this group. Specific treatment can help improve these. Hence, there is a need to formulate guidelines to screen this population for hypothyroidism.

  18. Biological half-time of tritiated water: comparison of hyperthyroid and hypothyroid patients

    Energy Technology Data Exchange (ETDEWEB)

    Eberstadt, P.; Fernandez, M.V.G.; Gonzalez, O.

    1986-01-01

    The half-time values of tritiated water were explored in eleven hyperthyroid patients and in two hypothyroid ones. For reasons of comparability the numbers are expressed in days per square meter (d/m/sup 2/) of body surface. Against the estimated 5.4d/m/sup 2/ in normal subjects, the hyperthyroids reflected 3.9+-0.66 and the two determinations of hypothyroids were 6.42 and 7.13, respectively. During the study neither diagnostic nor therapeutic procedures were ever postponed. The half-time values are not representative of extreme conditions in hyper- or hypothyroids, but are sufficiently clear to indicate well-defined differences from normal people. The total exposure to radiation for the exploratory procedure was minimal, estimated at less than 12 mrem for the normal standard man.

  19. Increased Cardiovascular Events and Subclinical Atherosclerosis in Rheumatoid Arthritis Patients: 1 Year Prospective Single Centre Study.

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    Piero Ruscitti

    Full Text Available Several studies showed the close relationship between Rheumatoid Arthritis (RA and cerebro-cardiovascular events (CVEs and subclinical atherosclerosis. In this study, we investigated the occurrence of CVEs and subclinical atherosclerosis during the course of RA and we evaluated the possible role of both traditional cardiovascular (CV and disease related risk factors to predict the occurrence of new CVEs and the onset of subclinical atherosclerosis.We designed a single centre, bias-adjusted, prospective, observational study to investigate, in a homogeneous subset of RA patients, the occurrence of new onset of CVEs and subclinical atherosclerosis. Statistical analyses were performed to evaluate the role of traditional CV and disease-related risk factors to predict the occurrence of new CVEs and subclinical atherosclerosis.We enrolled 347 RA patients prospectively followed for 12 months. An increased percentage of patients experienced CVEs, developed subclinical atherosclerosis and was affected by systemic arterial hypertension (SAH, type 2 diabetes mellitus and metabolic syndrome (MS, at the end of follow up. Our analysis showed that the insurgence of both SAH and MS, during the follow up, the older age, the CVE familiarity and the lack of clinical response, were associated with a significantly increased risk to experience CVEs and to develop subclinical atherosclerosis.Our study quantifies the increased expected risk for CVEs in a cohort of RA patients prospectively followed for 1 year. The occurrence of both new CVEs and subclinical atherosclerosis in RA patients may be explained by inflammatory burden as well as traditional CV risk factors.

  20. Betel nut chewing and subclinical ischemic heart disease in diabetic patients.

    Science.gov (United States)

    Tseng, Chin-Hsiao

    2010-11-04

    Background. This study investigated the association between betel nut chewing and subclinical ischemic heart disease (IHD) in Taiwanese type 2 diabetic patients. Methods. A total of 394 male patients aging ≥45 years and without previous heart disease were studied. Among them 349 had no habit of chewing betel nut and 45 possessed the habit for ≥5 years. Subclinical IHD was diagnosed by a Minnesota-coded resting electrocardiogram and was present in 71 cases. Statistical analyses were performed considering confounding effects of age, diabetic duration, smoking, body mass index, blood pressure, dyslipidemia, and metabolic control status. Results. Betel nut chewers were younger and had higher prevalence of smoking (86.7% versus 60.5%), higher body mass index, poorer glycemic control, and higher prevalence of subclinical IHD (28.9% versus 16.6%). Patients with subclinical IHD were older and had higher prevalence of betel nut chewing (18.0% versus 9.9%). The multivariate-adjusted odds ratio for subclinical IHD for chewers versus nonchewers was 4.640 (1.958-10.999). The adjusted odds ratios in younger or older patients divided by the median age of 63 years were similar: 4.724 (1.346-16.581) and 4.666 (1.278-17.028), respectively. Conclusions. Betel nut chewing is significantly associated with increased risk of subclinical IHD.

  1. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

    Science.gov (United States)

    García-Peiró, Agustín; Ribas-Maynou, Jordi; Oliver-Bonet, María; Navarro, Joaquima; Checa, Miguel A.; Nikolaou, Alexandros; Amengual, María J.; Abad, Carlos; Benet, Jordi

    2014-01-01

    Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient's fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA) were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment). TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele. PMID:24967335

  2. Increased risk of developing affective disorder in patients with hypothyroidism: a register-based study.

    Science.gov (United States)

    Thomsen, Anders F; Kvist, Tine K; Andersen, Per K; Kessing, Lars V

    2005-07-01

    Links between thyroid function and depression have been noted in many contexts. We assessed whether hospitalization with hypothyroidism was a risk factor for developing affective disorder. We conducted a prospective cohort study using historical data from Danish registers. The observational period was 1977-1999. Three study cohorts were identified: all patients with a first hospital admittance with the resulting index discharge diagnoses hypothyroidism, osteoarthritis, or nontoxic goiter. A later hospitalization with a resulting discharge diagnosis of affective disorder was used as event of interest, and rates of readmission were estimated and compared using competing risk models in survival analyses. We identified 165,307 patients discharged with an index diagnosis. In the observational period, 1041 events occurred. An index diagnosis of hypothyroidism was associated with an increased risk of hospitalization with affective disorder when compared to the control diseases. The risk of hospitalization with affective disorder was greatest in the first year after index hospitalization. Patients hospitalized with hypothyroidism have a greater risk of readmission with depression or bipolar disorder than control patients. This renders epidemiologic support to theories linking thyroid dysfunction with mood disturbances.

  3. The Impact of Bariatric Surgery on Thyroid Function and Medication Use in Patients with Hypothyroidism.

    Science.gov (United States)

    Zendel, Alex; Abu-Ghanem, Yasmin; Dux, Joseph; Mor, Eyal; Zippel, Douglas; Goitein, David

    2017-08-01

    Bariatric surgery (BS) is effective in treating obesity and its associated comorbidities. However, there is a paucity of data on the effect of BS on thyroid function in hypothyroid patients, specifically in those treated with thyroid hormone replacement therapy (THR). The aim of this study was to assess the effect of BS on thyroid function and on THR dosage in patients with hypothyroidism. A retrospective analysis of prospectively collected data of all hypothyroid patients who underwent BS between 2010 and 2014 was performed. Data collected included demographic and anthropometric measurements, as well as changes in thyroid hormone levels and THR dosage up to a year from surgery. During the study period, 93 hypothyroid patients (85 females, 91%), 83 of which treated with replacement thyroid hormone, underwent BS. Laparoscopic sleeve gastrectomy was performed in 77 (82.8%) and Roux-en-Y gastric bypass in 16 patients. Average age and body mass index (BMI) were 46.6 ± 11.2 years and 43.7 ± 6.4 kg/m(2), respectively. Mean BMI and thyroid-stimulating hormone (TSH) significantly deceased after 6 and 12 months following surgery whereas mean free T4 levels remained stable. TSH decrease was directly correlated to baseline TSH but not to BMI reduction. One year after surgery, 11 patients (13.2%) did not require THR, while the rest required a significantly lower average dose (P hypothyroid bariatric population. This includes improvement of thyroid function and reduction of thyroid medication dosages. Further studies are required to evaluate an influence of THR absorption and compare different types of bariatric surgeries.

  4. Multiple Determinations of Sperm DNA Fragmentation Show That Varicocelectomy Is Not Indicated for Infertile Patients with Subclinical Varicocele

    Directory of Open Access Journals (Sweden)

    Agustín García-Peiró

    2014-01-01

    Full Text Available Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient’s fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment. TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele.

  5. A Prospective Study of Routine Screening of Hypothyroidism in Antenatal Patients and their Outcome with Levothyroxine Treatment

    Directory of Open Access Journals (Sweden)

    Manisha Sahu

    2017-10-01

    Full Text Available Introduction: Pregnancy with hypothyroidism is associated with significant maternal, fetal and neonatal complications. Early diagnosis and treatment can effectively reduce such complications. Aim: To find out the complications that can be prevented or reduced in severity in adequately treated hypothyroid pregnant women. Materials and Methods: Pregnant women attending obstetrics’ OPD upto 20 weeks were screened with serum Thyroid Stimulating Hormone (TSH and free Thyroxine FT4. Those having Subclinical Hypothyroidism (SCH, Overt Hypothyroidism (OH and pre pregnant women with hypothyroid were treated with levothyroxine as per consulting with endocrine unit. They were followed up till delivery and any adverse outcomes were documented such as Pregnancy Induced Hypertension (PIH, Pre Eclamptic Toxemia (PET, Abruption, Preterm Premature Rupture Of Membranes (PPROM, Low Birth Weight (LBW, oligohydramnios, Gestational Diabetes Mellitus (GDM, abortion, Intra Uterine Death (IUD, mode of delivery and Neonatal Intensive Care Unit (NICU admission were compared with similar complications documented among normal pregnant women excluding the treated hypothyroid during a period of one year study. Untreated or late trimester diagnosed hypothyroidism were excluded from study group. Results: Incidence of PIH, GDM, Oligohydramnios, PPROM, NICU admissions and caesarean section were higher among hypothyroid pregnant women though adequately treated than the control pregnant women. But incidence of LBW baby is less and no one had developed PET, Eclampsia or abruption among treated group. Comparing between SCH and OH incidence of PIH is almost equal in both while association of GDM is more in OH. A p-value for PIH, GDM, Oligohydramnios, PPROM developed in hypothyroid pregnant ladies which were calculated by Yates corrected Chi-Square and Fisher’s-exact test from open epic version 3.03a. A p-value is significant (<0.001 for PIH, GDM, PPROM and oligohydramnios but

  6. Transient Graves' hyperthyroidism during pregnancy in a patient with Hashimoto's hypothyroidism.

    Science.gov (United States)

    Lu, Rui; Burman, Kenneth D; Jonklaas, Jacqueline

    2005-07-01

    The course and severity of autoimmune thyroid disease are altered during pregnancy and in the postpartum period. The thyroidal response to a fluctuating immune status, combined with changes in thyroid economy during pregnancy, may result in a need to adjust the treatment regimen for thyroid disease during pregnancy. Patients with Hashimoto's hypothyroidism on thyroid hormone replacement are frequently observed to have an increased requirement for levothyroxine early in pregnancy, although this is not a universal finding. Hashimoto's hypothyroidism does not typically remit during pregnancy, although further progression of thyroiditis may be seen in the postpartum period. Graves' disease usually improves during pregnancy and flares after delivery, again necessitating monitoring of thyroid status and possible adjustments in thionamide therapy. However, spontaneous transformation from Hashimoto's hypothyroidism to Graves' disease during pregnancy is rare. We report a case of transient Graves' hyperthyroidism during the late second trimester in a patient on levothyroxine replacement for Hashimoto's hypothyroidism. This resulted in a need to discontinue the patient's thyroid hormone entirely to avoid exacerbation of her hyperthyroidism. This interesting case is presented, along with a discussion of how the expression of autoimmune thyroid disease may be altered during pregnancy.

  7. Individual plasma ghrelin changes in the same patients in hyperthyroid, hypothyroid and euthyroid state.

    Science.gov (United States)

    Ruchala, Marek; Gurgul, Edyta; Stangierski, Adam; Wrotkowska, Elzbieta; Moczko, Jerzy

    2014-01-01

    Ghrelin is a multifunctional peptide of widespread expression. Since it has been shown to influence energy homeostatis, its potential role in thyroid dysfunction may have clinical significance. In this study, plasma ghrelin changes have been analyzed in the same patients in three different thyroid states for the first time. The study group consisted of 16 patients who had been diagnosed with hyperthyroidism, were treated with radioiodine, developed hypothyroidism after treatment, and finally became euthyroid on l-thyroxine substitution. In the initial state of hyperthyroidism plasma ghrelin levels correlated negatively with fT3 and fT4. In hypothyroidism ghrelin concentration increased significantly (pghrelin tended to decrease in the euthyroid state, the individual difference between hypothyroidism and euthyroidism was not significant. Plasma ghrelin in euthyroidism was still significantly higher than in hyperthyroidism (pghrelin levels in hyperthyroidism and hypothyroidism. In our opinion, plasma ghrelin fluctuations may reflect metabolic changes in patients with thyroid dysfunction. Moreover, it cannot be excluded that in thyroid disorders ghrelin acts as a compensatory factor, helping to balance metabolic disturbances. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Erectile dysfunction in patients with hyper- and hypothyroidism: how common and should we treat?

    Science.gov (United States)

    Krassas, Gerasimos E; Tziomalos, Kostas; Papadopoulou, Fotini; Pontikides, Nikolaos; Perros, Petros

    2008-05-01

    Erectile dysfunction (ED) is associated with numerous diseases and aging. The objective of the study was to investigate the impact of hyper- and hypothyroidism on male sexual health by using the Sexual Health Inventory for Males (SHIM). Seventy-one men, 27 hyper- and 44 hypothyroid and a similar number of controls were included in the study. A validated SHIM 5-item questionnaire was administered to all participants. Patients were asked to respond before and a year after initiation of treatment for thyroid dysfunction. A score between 25 and 22 is considered normal, between 21 and 11 diagnostic of mild to moderately severe ED, and 10 or less diagnostic of severe ED. Fifty-six men with thyroid dysfunction (78.9%; 19 hyperthyroid and 37 hypothyroid) had a SHIM score of 21 or less, compared with 24 controls (33.8%) (P < 0.0001). Twenty-one patients with ED (37.5%) had SHIM scores 10 or less, indicative of severe ED, compared with six controls (25%) (P < 0.01). ED was more prevalent in patients with hyperthyroidism and hypothyroidism, compared with controls (P < 0.001 and P < 0.0001, respectively). Positive correlation was found between SHIM scores and serum free T(4) (r = 0.413, P = 0.005) and negative for TSH (r = -0.669, P < 0.001). After treatment a significant increase of SHIM scores was noted in both hyperthyroid (P < 0.0001) and hypothyroid (P < 0.0001) patients. ED is extremely common in males with dysthyroidism. Treatment of the latter restores erectile function. Screening for thyroid dysfunction in men presenting with ED is recommended, whereas specific treatment for ED should be postponed in such patients for at least 6 months after achieving euthyroidism because the latter might be responsible for ED.

  9. Serum Heart-Type Fatty Acid-Binding Protein Levels in Patients with Overt Hypothyroidism

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    Esra Tutal

    2017-03-01

    Full Text Available Purpose: Overt hypothyroidism affects mostly women with an increasing prevalence with age. Hypothyroidism is associated with accelerated atherosclerotic cardiovascular diseases possibly caused by the higher incidence of hyperlipidemia, insulin resistance, and hypertension. Heart-type fatty acid-binding protein (H-FABP is specific for cardiomyocytes and a sensitive marker of myocardial injury. The purpose of this study was examining the effect of hypothyroidism on H-FABP levels and carotid artery intima-media thickness (CIMT. Material and Method: We measured serum H-FABP levels in 33 patients with overt hypothyroidism and age, gender, and body mass index-matched 39 control subjects. The patients were newly diagnosed with Hashimoto’s thyroiditis. All participants underwent high-resolution B-mode ultrasonography for the measurement of CIMT. Results: There was no significant difference in serum levels of H-FABP between the patient group and controls (1515.87±2143.0 pg/mL vs. 953.0±416.0 pg/mL, respectively; p=0.15. CIMT level was significantly higher in the patient group than in the control group (0.53±0.08 mm vs. 0.48±0.05 mm; p=0.02. However, the homeostasis model assessment of insulin resistance and fasting insulin levels did not differ between the two groups. Discussion: Based on the results of this study, we assume that H-FABP is not a useful marker in detecting preclinical atherosclerosis in patients with overt hypothyroidism associated with Hashimoto’s thyroiditis, however, CIMT might be a useful marker in detecting early atherosclerosis.

  10. Statin-induced bilateral foot drop in a case of hypothyroidism

    Science.gov (United States)

    Chaudhary, Neera; Duggal, Ashish Kumar; Makhija, Prashant; Puri, Vinod; Khwaja, Geeta Anjum

    2015-01-01

    Muscle involvement is a common manifestation of both clinical and subclinical hypothyroidism, with serum creatine kinase (CK) elevation being probably the most common manifestation, and is seen in up to 90% of patients, but is usually mild (less than 10 times the upper limit of normal). Rhabdomyolysis is a distinctively uncommon presentation of hypothyroidism described usually in the setting of precipitating events such as strenuous exercise, alcohol, or statin use. Rarely rhabdomyolysis and myoedema seen in hypothyroidism can be complicated by the development of anterior compartment syndrome leading to neurovascular compression. We describe a case of a patient with hypothyroidism who developed acute onset bilateral foot drop on initiation of statins. This case highlights the need for cautious use of statins in patients at risk for rhabdomyolysis. PMID:26425013

  11. Statin-induced bilateral foot drop in a case of hypothyroidism

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    Neera Chaudhary

    2015-01-01

    Full Text Available Muscle involvement is a common manifestation of both clinical and subclinical hypothyroidism, with serum creatine kinase (CK elevation being probably the most common manifestation, and is seen in up to 90% of patients, but is usually mild (less than 10 times the upper limit of normal. Rhabdomyolysis is a distinctively uncommon presentation of hypothyroidism described usually in the setting of precipitating events such as strenuous exercise, alcohol, or statin use. Rarely rhabdomyolysis and myoedema seen in hypothyroidism can be complicated by the development of anterior compartment syndrome leading to neurovascular compression. We describe a case of a patient with hypothyroidism who developed acute onset bilateral foot drop on initiation of statins. This case highlights the need for cautious use of statins in patients at risk for rhabdomyolysis.

  12. Relation of subclinical serum creatinine elevation to adverse in-hospital outcomes among myocardial infarction patients.

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    Margolis, Gilad; Gal-Oz, Amir; Khoury, Shafik; Keren, Gad; Shacham, Yacov

    2017-06-01

    Acute kidney injury is associated with adverse outcomes after acute ST elevation myocardial infarction (STEMI). It remains unclear, however, whether subclinical increase in serum creatinine that does not reach the consensus criteria for acute kidney injury is also related to adverse outcomes in STEMI patients undergoing primary percutaneous coronary intervention. We conducted a retrospective study of 1897 consecutive STEMI patients between January 2008 and May 2016 who underwent primary percutaneous coronary intervention, and in whom acute kidney injury was not diagnosed throughout hospitalization. We investigated the incidence of subclinical acute kidney injury (defined as serum creatinine increase of ≥ 0.1 and < 0.3 mg/dl) and its relation to a composite end point of adverse in hospital outcomes. Subclinical acute kidney injury was detected in 321 patients (17%). Patients with subclinical acute kidney injury had increased rate of the composite end point of adverse in-hospital events (20.3% vs. 9.7%, p<0.001), a finding which was independent of baseline renal function. Individual components of this end point (occurrence of heart failure, atrial fibrillation, need for mechanical ventilation and in-hospital mortality) were all significantly higher among patients with subclinical acute kidney injury ( p< 0.05 for all). In a multivariable regression model subclinical acute kidney injury was independently associated with higher risk for adverse in-hospital events (odds ratio 1.92.6, 95% confidence interval: 1.23-2.97, p=0.004). Among STEMI patients treated with primary percutaneous coronary intervention, small, subclinical elevations of serum creatinine, while not fulfilling the consensus criteria for acute kidney injury, may serve as a significant biomarker for adverse outcomes.

  13. Prevalence of hypothyroidism during pregnancy in a highly specialised referral centre in Mexico.

    Science.gov (United States)

    López-Muñoz, Eunice; Ibarra-Avalos, Jorge Antonio; Chan-Verdugo, Rosario Guadalupe; Mateos-Sánchez, Leovigildo; Sánchez-Rodríguez, Olivia

    2016-11-01

    In order to determine the prevalence of overt and subclinical hypothyroidism, and isolated hypothyroxinemia during pregnancy, thyroid hormone reference values established by UMAE HGO4, IMSS in Mexico City and those suggested by the American Thyroid Association (ATA) were used. All pregnant patients, whose thyroid function was measured and whose pregnancy was monitored and resolved in UMAE HGO4, IMSS from 1 January to 31 December 2013, were included. Significant differences (p = .00419) were observed in the frequency of subclinical hypothyroidism, being higher when using ATA criteria (18.21% vs. 9.66%). The prevalence rate (UMAE HGO4 vs. ATA) for overt hypothyroidism was 1.11 vs. 1.63, for subclinical hypothyroidism 0.84 vs. 1.41 and for isolated hypothyroxinemia 3.17 vs. 2.79 per 1000 consults during the study period. Independently of prevalence rate, it is essential to provide information on the possible risks involved in pregnancy to all women of childbearing age at the time of hypothyroidism diagnosis.

  14. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India

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    Ambika Gopalakrishnan Unnikrishnan

    2013-01-01

    Full Text Available Background: Hypothyroidism is believed to be a common health issue in India, as it is worldwide. However, there is a paucity of data on the prevalence of hypothyroidism in adult population of India. Materials and Methods: A cross-sectional, multi-centre, epidemiological study was conducted in eight major cities (Bangalore, Chennai, Delhi, Goa, Mumbai, Hyderabad, Ahmedabad and Kolkata of India to study the prevalence of hypothyroidism among adult population. Thyroid abnormalities were diagnosed on the basis of laboratory results (serum FT3, FT4 and Thyroid Stimulating Hormone [TSH]. Patients with history of hypothyroidism and receiving levothyroxine therapy or those with serum free T4 5.50 μU/ml, were categorized as hypothyroid. The prevalence of self reported and undetected hypothyroidism, and anti-thyroid peroxidase (anti-TPO antibody positivity was assessed. Results: A total of 5376 adult male or non-pregnant female participants ³18 years of age were enrolled, of which 5360 (mean age: 46 ± 14.68 years; 53.70% females were evaluated. The overall prevalence of hypothyroidism was 10.95% (n = 587, 95% CI, 10.11-11.78 of which 7.48% (n = 401 patients self reported the condition, whereas 3.47% (n = 186 were previously undetected. Inland cities showed a higher prevalence of hypothyroidism as compared to coastal cities. A significantly higher ( P 5.50 μIU/ml. Anti - TPO antibodies suggesting autoimmunity were detected in 21.85% (n = 1171 patients. Conclusion: The prevalence of hypothyroidism was high, affecting approximately one in 10 adults in the study population. Female gender and older age were found to have significant association with hypothyroidism. Subclinical hypothyroidism and anti-TPO antibody positivity were the other common observations.

  15. Hypothyroidism and obesity: An intriguing link

    OpenAIRE

    Debmalya Sanyal; Moutusi Raychaudhuri

    2016-01-01

    According to common perception, hypothyroidism is held responsible for obesity. However, linking them causally is controversial. Overt hypothyroidism is associated with modest weight gain, but there is a lack of clarity regarding subclinical hypothyroidism. Novel view indicates that changes in thyroid-stimulating hormone (TSH) could well be secondary to obesity. The increasing prevalence of obesity further confounds definition of normal TSH range in population studies. Thyroid autoantibody st...

  16. Evaluation of subclinical atherosclerosis in migraine patients by ultrasound radiofrequency data technology: preliminary results.

    Science.gov (United States)

    Güneş Tatar, İdil; Ergun, Onur; Çeltikçi, Pınar; Kurt, Aydın; Yavaşoğlu, Neşe; Birgi, Erdem; Tatar, Tolga; Hekimoğlu, Baki

    2016-07-01

    Migraine is a headache disorder affecting approximately 12% of the population, predominantly female individuals. Migraine has been associated with vascular events such as stroke and cardiovascular disease. The close connection between these vascular disorders and atherosclerosis is well known. Carotid artery intima-media thickness (CAIMT) is a marker for detection of subclinical atherosclerosis. The present study is an analysis of the presence of subclinical atherosclerosis in migraine patients. CAIMT was evaluated in 25 female migraine patients and 27 female controls using innovative ultrasound (US) radiofrequency (RF) data technology. Mann-Whitney U test was used to compare measurements in patient and control groups. There was a statistically significant difference between mean CAIMT of migraine patients and control group (patherosclerosis compared to healthy individuals. CAIMT measurement with sonography can be utilized in follow-up to detect subclinical atherosclerosis.

  17. Correlation between vascular endothelial growth factor and subclinical atherosclerosis in patients with psoriasis.

    Science.gov (United States)

    Shahidi-Dadras, Mohammad; Haghighatkhah, Hamid Reza; Abdollahimajd, Fahimeh; Younespour, Shima; Partovi Kia, Masoud; Zargari, Omid

    2016-01-01

    Psoriasis is associated with increased risk of atherosclerotic disorders. Vascular endothelial growth factor (VEGF) is an angiogenic factor that was overexpressed in both psoriatic and atherosclerotic lesions. In a prospective controlled study, we investigated the correlation between serum levels of VEGF and subclinical atherosclerosis in patients with moderate to severe psoriasis. Sixty patients with moderate to severe psoriasis and 60 age- and gender-matched healthy controls were recruited to the study. Mean intima-media thickness of the common carotid artery (MIMT-CCA) and serum VEGF levels of all subjects were measured. Subclinical atherosclerosis was defined as having an MIMT-CCA ≥0.8 mm. Serum VEGF levels in psoriatic patients were significantly higher compared with healthy controls (P subclinical atherosclerosis (P subclinical atherosclerosis was significantly associated with serum VEGF levels, age, disease duration, and psoriasis area and severity index (PASI). This study supported the possible role of VEGF in the pathogenesis of subclinical atherosclerosis in psoriatic patients. © 2015 The International Society of Dermatology.

  18. The Association Between Endocan Levels and Subclinical Atherosclerosis in Patients With Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Lv, Yaya; Zhang, Yaqiong; Shi, Weiya; Liu, Juxiang; Li, Yonghong; Zhou, Zubang; He, Qijuan; Wei, Suhong; Liu, Jing; Quan, Jinxing

    2017-05-01

    Proinflammatory conditions induced by circulating factors in diabetes play a pivotal role in endothelial dysfunction and related vascular complications. Endothelial cell-specific molecule-1 or endocan is a dermatan sulfate proteoglycan secreted primarily by the vascular endothelium. Although endocan has been shown to be a potential biomarker in coronary heart disease, its role in the pathogenesis of atherosclerosis (AS) in diabetes remains unclear. In this study, we investigated the correlation between serum endocan levels and subclinical AS in patients with type 2 diabetes mellitus (T2DM). Patients (n = 69) with T2DM were included. All the patients were stratified based on the absence (n = 42) or presence (n = 27) of subclinical AS. Healthy subjects (n = 28) served as controls. Serum levels of endocan, fasting blood glucose, glycosylated hemoglobin A1, high-sensitivity C-reactive protein and carotid intima-media thickness (cIMT) were measured. Endocan levels were significantly elevated in both the T2DM (0.89 ± 0.28ng/mL) and T2DM with subclinical AS (1.20 ± 0.33ng/mL) groups relative to the control group (0.68 ± 0.24ng/mL) (P subclinical AS (odds ratio = 1.98, 95% CI: 1.43-2.73, P subclinical AS in patients with T2DM. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  19. Minimally invasive thyroid nodulectomy reduces post-operative hypothyroidism when compared with thyroid lobectomy.

    Science.gov (United States)

    Sarkis, Leba M; Norlen, Olov; Sywak, Mark; Delbridge, Leigh

    2017-05-01

    It has been a long-standing surgical tenet that the minimum surgical procedure for a single thyroid nodule is lobectomy. Such an approach, however, has been associated with a significant incidence of post-operative hypothyroidism with patients becoming medication dependent for life. Thermal sealing devices have enabled local nodule excision to be undertaken safely with preservation of more residual thyroid mass. The aim of this study was to determine if this approach was associated with a reduction in post-operative hypothyroidism. This is a retrospective cohort study comprising 351 patients treated between January 2010 and December 2012. Patients were assessed at 6-8-week review. Subclinical hypothyroidism was defined as a thyroid-stimulating hormone (TSH) >4.5 mIU/L, with clinical hypothyroidism defined as both an elevated TSH and presence of clinical symptoms requiring thyroxine replacement. One hundred and ninety patients underwent open thyroid lobectomy, 86 a minimally invasive thyroid lobectomy and 75 a minimally invasive nodulectomy. There was no difference in post-operative hypothyroidism after lobectomy whether by the open (22.1%) or minimally invasive (22.1%) technique. However, after minimally invasive nodulectomy, post-operative hypothyroidism was less than one quarter (5.3%) of that following lobectomy overall (22.1%, P hypothyroidism. As such, the procedure should be considered for appropriately selected patients. © 2014 Royal Australasian College of Surgeons.

  20. The relation of maternal hypothyroidism and hypothyroxinemia during pregnancy on preterm birth: An updated systematic review and meta-analysis

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    Marzieh Parizad Nasirkandy

    2017-09-01

    Conclusion: The incidence of preterm birth was higher among mothers with clinical and subclinical hypothyroidism or hypothyroxinemia during pregnancy compared to euthyroid mothers, and these relations were significant. Therefore, 83Tgynecologists and endocrinologists83T should manage these patients to control the incidence of 83Tadverse pregnancy outcomes83T such as preterm birth.

  1. Concomitância de fibromialgia em pacientes portadores de hipotireoidismo e de alterações tireoideanas em pacientes com fibromialgia Fibromyalgia concomitance in patients with hypothyroidism and thyroid disorders in patients with fibromyalgia

    Directory of Open Access Journals (Sweden)

    Marlene Freire

    2006-02-01

    : Based on this evidence, the aim of this study was to describe the concomitance of fibromyalgia in patients with hypothyroidism, the cases of hypothyroidism in patients diagnosed with fibromyalgia and determine the symptoms associated with above clinical conditions. METHODS: One hundred and sixty-six patients with fibromyalgia and 56 patients with hypothyroidism were evaluated. Volunteer patients answered a questionnaire to detect the main signs and symptoms of these diseases and then underwent serum determination of thyroid stimulating hormone (TSH, free thyroxine (FT4 and anti-thyroperoxidase (a-TPO. RESULTS: Among 166 patients with fibromyalgia, 35 (21.1% were diagnosed with clinical or sub-clinical hypothyroidism. Among 56 patients with hypothyroidism, 36 (64.3% had the diagnosis of fibromyalgia confirmed, according to the American College of Rheumatology's (ACR criteria. In patients with previously diagnosed hypothyroidism, fatigue, non-restorative sleep and chronic headache were symptoms statistically more frequent among those with the diagnosis of fibromyalgia. Morning stiffness prevailed in patients diagnosed with hypothyroidism and without fibromyalgia. CONCLUSION: We can concluded from this study that, in order to enhance the diagnostic approach and follow-up treatment, the presence of clinical or laboratorial manifestations of thyroid dysfunction in patients with fibromyalgia must be considered, as well as manifestations of fibromyalgia in patients with hypothyroidism.

  2. Cardiovascular autonomic neuropathy and subclinical cardiovascular disease in normoalbuminuric type 1 diabetic patients

    DEFF Research Database (Denmark)

    Mogensen, Ulrik Madvig; Jensen, Tonny; Køber, Lars

    2012-01-01

    Cardiovascular autonomic neuropathy (CAN) is associated with increased mortality in diabetes. Since CAN often develops in parallel with diabetic nephropathy as a confounder, we aimed to investigate the isolated impact of CAN on cardiovascular disease in normoalbuminuric patients. Fifty......-six normoalbuminuric, type 1 diabetic patients were divided into 26 with (+) and 30 without (-) CAN according to tests of their autonomic nerve function. Coronary artery plaque burden and coronary artery calcium score (CACS) were evaluated using computed tomography. Left ventricular function was evaluated using...... with increased CACS, subclinical left ventricular dysfunction, and increased pulse pressure. In conclusion, CAN in normoalbuminuric type 1 diabetic patients is associated with distinct signs of subclinical cardiovascular disease....

  3. Hemostasis in Hypothyroidism and Autoimmune Thyroid Disorders

    Science.gov (United States)

    Ordookhani, Arash; Burman, Kenneth D.

    2017-01-01

    Context There are contradictory results on the effect of hypothyroidism on the changes in hemostasis. Inadequate population-based studies limited their clinical implications, mainly on the risk of venous thromboembolism (VTE). This paper reviews the studies on laboratory and population-based findings regarding hemostatic changes and risk of VTE in hypothyroidism and autoimmune thyroid disorders. Evidence Acquisition A comprehensive literature search was conducted employing MEDLINE database. The following words were used for the search: Hypothyroidism; thyroiditis, autoimmune; blood coagulation factors; blood coagulation tests; hemostasis, blood coagulation disorders; thyroid hormones; myxedema; venous thromboembolism; fibrinolysis, receptors thyroid hormone. The papers that were related to hypothyroidism and autoimmune thyroid disorder and hemostasis are used in this review. Results Overt hypothyroidism is more associated with a hypocoagulable state. Decreased platelet count, aggregation and agglutination, von Willebrand factor antigen and activity, several coagulation factors such as factor VIII, IX, XI, VII, and plasminogen activator-1 are detected in overt hypothyrodism. Increased fibrinogen has been detected in subclinical hypothyroidism and autoimmune thyroid disease rendering a tendency towards a hypercoagulability state. Increased factor VII and its activity, and plasminogen activator inhibitor-1 are among several findings contributing to a prothrombotic state in subclinical hypothyroidism. Conclusions Overt hypothyroidism is associated with a hypocoagulable state and subclinical hypothyroidism and autoimmune thyroid disorders may induce a prothrombotic state. However, there are contradictory findings for the abovementioned thyroid disorders. Prospective studies on the risk of VTE in various levels of hypofunctioning of the thyroid and autoimmune thyroid disorders are warranted. PMID:29026409

  4. Betel Nut Chewing and Subclinical Ischemic Heart Disease in Diabetic Patients

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    Chin-Hsiao Tseng

    2011-01-01

    Methods. A total of 394 male patients aging ≥45 years and without previous heart disease were studied. Among them 349 had no habit of chewing betel nut and 45 possessed the habit for ≥5 years. Subclinical IHD was diagnosed by a Minnesota-coded resting electrocardiogram and was present in 71 cases. Statistical analyses were performed considering confounding effects of age, diabetic duration, smoking, body mass index, blood pressure, dyslipidemia, and metabolic control status. Results. Betel nut chewers were younger and had higher prevalence of smoking (86.7% versus 60.5%, higher body mass index, poorer glycemic control, and higher prevalence of subclinical IHD (28.9% versus 16.6%. Patients with subclinical IHD were older and had higher prevalence of betel nut chewing (18.0% versus 9.9%. The multivariate-adjusted odds ratio for subclinical IHD for chewers versus nonchewers was 4.640 (1.958–10.999. The adjusted odds ratios in younger or older patients divided by the median age of 63 years were similar: 4.724 (1.346–16.581 and 4.666 (1.278–17.028, respectively. Conclusions. Betel nut chewing is significantly associated with increased risk of subclinical IHD.

  5. [Prevalence of Hypothyroidism in Major Psychiatric Disorders in Hospitalised Patients in Montserrat Hospital During the period March to October 2010].

    Science.gov (United States)

    Vargas Navarro, Pedro; Ibañez Pinilla, Edgar Antonio; Galeano España, Alejandra; Noguera Bravo, Ana María; Milena Pantoja, Sandra; Suárez Acosta, Ana María

    Hypothyroidism results from inadequate production of thyroid hormone. It is known that there is a relationship between the major psychiatric disorders and hypothyroidism. To determine the prevalence of hypothyroidism in patients admitted due to major psychiatric disorders in Montserrat Hospital during the period from March to October 2010. A descriptive cross-sectional study was conducted on 105 patients admitted to Montserrat Hospital with a primary diagnosis of major psychiatric disorder (major depression, bipolar affective disorder, generalised panic disorder, panic disorder, mixed anxiety-depressive disorder, and schizophrenia) in the aforementioned period. Thyroid Stimulating Hormone (TSH) was performed to assess the evidence of hypothyroidism. The overall prevalence of hypothyroidism was found to be 10.5% (95% CI; 5%-16%). It was 12.5% in anxiety disorder, 11.1% in depressive disorder, with a lower prevalence of 10.3% for bipolar disorder, and 9.9% for schizophrenia. The overall prevalence of hypothyroidism was found to be less than in the general population, which is between 4.64% and 18.5%, and hypothyroidism was found in disorders other than depression. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  6. Risk of Hypothyroidism following Hemithyroidectomy: Systematic Review and Meta-Analysis of Prognostic Studies.

    NARCIS (Netherlands)

    Verloop, H.; Louwerens, M.; Schoones, J.W.; Kievit, J.; Smit, J.W.A.; Dekkers, O.M.

    2012-01-01

    Context: The reported risk of hypothyroidism after hemithyroidectomy shows considerable heterogeneity in literature. Objective: The aim of this systematic review and meta-analysis was to determine the overall risk of hypothyroidism, both clinical and subclinical, after hemithyroidectomy.

  7. Prevalence of hypothyroidism in nondiabetic chronic kidney disease and effect of thyroxine replacement on estimated glomerular filtration rate

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    S Bajaj

    2017-01-01

    Full Text Available Reduced T3 and free T4, elevated thyroid stimulating hormone, and hyporesponsiveness to thyrotropin releasing hormone raise questions about the presence of hypothyroidism in chronic kidney disease (CKD and raise the possibility of benefit from thyroxine supplementation. A prospective cohort study was conducted on 73 nondiabetic CKD cases. Hypothyroid patients were started on levothyroxine and were reviewed after 3 and 6 months. The mean age of study population was 42.3 ± 16.8 years. Of the total population, 32 (43.8% cases had hypothyroidism, among whom 2 (2.7% had overt hypothyroidism and 30 (41.1% had subclinical hypothyroidism. Prevalence of hypothyroidism increased with increasing severity of CKD. There were 1 (3.1% case with hypothyroidism in stage 3b, 8 (25% cases in stage 4, and 23 (71.9% cases in stage 5. The mean estimated glomerular filtration rate (ml/min/1.73 m2 at baseline was 13.7 ± 8.9 which increased to 17.5 ± 6.8 and 22.4 ± 9.3 after 3 and 6 months of thyroid hormone replacement therapy (THRT, respectively (P < 0.001. Hypothyroidism is commonly associated with nondiabetic CKD and its prevalence increases with declining renal function. THRT significantly improves renal function in nondiabetic CKD with hypothyroidism.

  8. Management of hypothyroidism in pregnancy.

    Science.gov (United States)

    Milanesi, Anna; Brent, Gregory A

    2011-10-01

    Examine recent studies on the assessment of thyroid status in pregnancy, approach to thyroid testing, the spectrum of hypothyroidism in pregnancy, and strategies for thyroid replacement in women with known hypothyroidism. Trimester-specific references range for thyroid-stimulating hormone (TSH) and free thyroxine in pregnancy must take into account iodine and thyroid autoantibody status, race, BMI, as well as other factors. Thyroid testing of only those pregnant women at increased risk for thyroid disease, case finding, will miss 30-80% of women with thyroid disease. Subclinical hypothyroidism is associated with an increasing number of adverse effects including infertility, miscarriage, preterm delivery, and breech presentation at birth. Many pregnant women with known hypothyroidism have an out-of-range TSH at the time of confirmed pregnancy. A variety of strategies are effective at keeping serum TSH normal during pregnancy including preconception increase in thyroxine, increase in thyroxine dose at the time pregnancy is confirmed, or making adjustments based on serum TSH monitoring. Evaluation of thyroid status in pregnancy requires an understanding of pregnancy-associated changes in thyroid function tests and how they vary by trimester. The spectrum of hypothyroidism in pregnancy includes isolated thyroid peroxidase antibody positivity, isolated hypothyroxinemia, subclinical and overt hypothyroidism. These patterns, in some situations, may be related to iodine status, selenium status, or underlying thyroid disease. There are a variety of approaches to management of thyroxine replacement in known hypothyroid women at the time of pregnancy that are all effective at maintaining a normal range during pregnancy.

  9. The thyroid registry: Clinical and hormonal characteristics of adult indian patients with hypothyroidism

    Directory of Open Access Journals (Sweden)

    Bipin Sethi

    2017-01-01

    Full Text Available Objectives: Appropriate treatment of hypothyroidism requires accurate diagnosis. This registry aimed to study the disease profile and treatment paradigm in hypothyroid patients in India. Materials and Methods: We registered 1500 newly diagnosed, treatment-naïve, adult hypothyroid males and nonpregnant females across 33 centers and collected relevant data from medical records. The first analysis report on baseline data is presented here. Results: The mean age of the study population was 41.1 ± 14.01 years with a female to male ratio of 7:3. The most frequently reported symptoms and signs were fatigue (60.17% and weight gain with poor appetite (36.22%. Menstrual abnormalities were reported in all women (n = 730 who had not attained menopause. Grades 1 and 2 goiter (as per the WHO were observed in 15.41% and 3.27% patients, respectively. Comorbidities were reported in 545 patients (36.36%, type 2 diabetes mellitus being the most prevalent (13.54% followed by hypertension (11.34%. Total serum thyroxine (T4 and thyroid-stimulating hormone (TSH levels were assessed in 291 (19.47% patients only. In majority of patients (81%, treatment was based on serum TSH levels alone. The dose of levothyroxine ranged from 12.5 to 375 mcg. Conclusions: Guidelines suggest a diagnosis of hypothyroidism based on TSH and T4 levels. However, most of the patients as observed in this registry received treatment with levothyroxine based on TSH levels alone, thus highlighting the need for awareness and scientific education among clinicians in India. The use of standard doses (100, 75, and 25 mcg of levothyroxine may point toward empirical management practices.

  10. The Early Diagnosis of Hypothyroidism as a Factor in the Progression of Osteoarthritis and Comorbid Processes, the Features of Phytocorrection

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    L.O. Voloshynа

    2016-10-01

    Full Text Available Objective: to study the prevalence and forms of hypothyroidism in patients with osteoarthritis (OA and to investigate the effect of phytomedication zobofit on the functional and morphological status of the thyroid gland, the manifestations of comorbid diseases, oxidative status, fibrinolytic and proteolytic activity of the blood. Materials and methods. In 312 patients with OA, we have studied the manifestations of comorbid processes, and among them — hypothyroidism phenomena. We have used clinical, biochemical, radioimmunological, ultrasound methods. Results. All patients with OA after 50 years had the increasing number and severity of comorbid processes. Among them, 4.48 % of patients has symptomatic and 13.78 % — subclinical hypothyroidism. Symptoms of hypothyroidism were marked in people over 55, especially — over 60 years. Subclinical hypothyroidism slightly worsened clinical symptoms of OA and comorbid processes, but enhanced the effects of oxidative stress, reduction of fibrinolytic and increase of proteolytic activity of the blood, impaired glomerular filtration rate of the kidneys. The above is considered as non-specific pathophysiological basis for the progression of identified ailments. Three-month application of the herbal medication zobofit in most patients has normalized thyroid homeostasis, improved overall outcomes of the treatment for underlying and comorbid illnesses, reduced the severity of metabolic disorders. Conclusions. In OA patients aged over 50 years with a high level of comorbidity, it is necessary to carry out screening for hypothyroidism. If you noticed the signs of subclinical hypothyroidism in this population of patients, it is appropriate to use multicomponental phytomedications with diverse thyroid-stimulating action.

  11. [The influence of hypothyroidism on the conversion and binding of thyroid hormones in patients with end-stage renal disease].

    Science.gov (United States)

    Dubczak, Iwanna; Niemczyk, Longin; Bartoszewicz, Zbigniew; Szamotulska, Katarzyna; Saracyn, Marek; Niemczyk, Stanisław

    2017-03-21

    Hypothyroidism in patients with renal failure (RF) causes many metabolic and clinical problems, and both these diseases can mutually exacerbate their disturbances. The aim of this study was to evaluate the effect of hypothyroidism, and end-stage renal disease (ESRD) on conversion of thyroid hormones (TH) in patients with ESRD treated with chronic hemodialysis (HD). The study was performed in 74 patients, including 41 women (K) and 33 men (M) aged 28-83 y.o. in 4 groups: G1 - 12 people with ESRD treated with HD and with newly diagnosed hypothyroidism without substitution (6 K and M 6) aged 66,83±12,90 y.o., G2 - 26 patients with ESRD treated with HD without hypothyroidism (10 F, 16 M) aged 58,85±15,52 y.o., G3 - 11 hypothyroid patients without RF (9 K, 2 M) aged 54,73±21,26 y.o., G4 - 25-persons from control group of healthy subjects (16 M, 9 M) aged 51,24±12,58 y.o. In all subjects the concentration of TSH and TH (T4, T3, fT4, TSH, FT3, rT3) were measured and values of conversion factors (T3/T4, FT3/ fT4, rT3/fT4 and rT3/fT3) and binding TH to protein factors (fT4/T4 and fT3/T3) were calculated. Lower concentration of T3 (p=0.012), fT3 (phypothyroidism than in healthy subjects. Renal failure with concomitant hypothyroidism intensify the disturbances of T4 to T3 conversion (p=0.034) and hypothyroidism with concomitant renal failure disrupts binding of T3 to proteins (p=0.001). FT3 to fT4 ratio in renal failure with concomitant hypothyroidism group was significantly lower than in each other group. rT3 concentrations were the highest in healthy subjects. Concomitance of hypothyroidism and end-stage renal disease reduces the conversion of thyroxine to triiodothyronine, but does not increase the production of rT3. Hypothyroidism significantly increases the disorders of thyroid hormones in end-stage renal disease. There is decreased tendency to bind of thyroid hormone to protein in hypothyroidism in patients with end-stage renal disease.

  12. [Management of hypothyroidism and hyperthyroidism].

    Science.gov (United States)

    Jiskra, Jan

    2015-10-01

    Functional thyropathies present significant health risks for patients. Advanced functional thyropathies are always treated while indications for therapy of subclinical thyropathies are individual and often controversial. It is widely agreed that these disorders should be diagnosed and individuals should be followed. The drug of choice in substitution therapy of hypothyroidism is levothyroxine, in the treatment of hyperthyroidism it is methimazole. Administration of propylthiouracil should be limited to the first trimester of pregnancy, because its serious hepatotoxicity has been described. Hyperthyroidism based on thyroid nodules and immunogenic hyperthyroidism not reaching long-term remission, need to be treated radically: by surgery or radioiodine treatment. When radiation protection requirements are met, radioiodine can also be administered on an outpatient basis. Exceptionally, small doses of methimazole can be administered over an extended period of time in individual cases.

  13. Increased risk of autoimmune hypothyroidism in patients affected by retinitis pigmentosa.

    Science.gov (United States)

    Scanelli, G; Dattola, L; Padovani, F

    1996-03-01

    Patients with Retinitis Pigmentosa (RP) show hemeralopia, restricted field of vision and reduced visual acuity, owing to the degeneration and proliferation of photoreceptors and a retinal pigment epithelium. The prevalence in Italy is 1:4,000. A certain number of "syndromic" associations have been described, and, in particular, also that with hypothyroidism, but very few cases have been studied. We describe a family of 40 people, spanning four generations, in which we have recorded the presence of autosomic dominant RP, associated with autoimmune hypothyroidism or with circulating antithyroid autoantibodies (ATA), currently considered as the expression of active autoimmune thyroiditis or a risk factor for this complaint. We measured, in all members, TSH, FT3, FT4, antithyroglobulin and antithyroperoxidase autoantibodies. A fundus oculi examination was performed in every subject, as well as a careful examine of the anterior region on the neck. A control population of 100 healthy people was also studied. Our data show a higher prevalence of ATA, statistically significant, in the patients with RP and in their relatives, compared with the control population and the data from the literature (13 cases over 40 = 32.5%; p distrophy reflects the need, emerging from our data, to test the thyroid function in the subjects with RP and in members of their families, since circulating ATA are considered a risk factor for the development of autoimmune hypothyroidism.

  14. Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography

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    Cheng-Hsi Chen

    2013-03-01

    Conclusion: Carotid duplex may detect subclinical vascular atherosclerosis in more than half of asymptomatic patients without coronary artery calcification detected by coronary computed tomography. These findings have important implications for early-stage atherosclerosis screening and implementation of primary preventive intervention.

  15. Factors associated with postoperative hypothyroidism after lobectomy in papillary thyroid microcarcinoma patients.

    Science.gov (United States)

    Park, Ha Kyoung; Kim, Dong Wook; Ha, Tae Kwun; Choo, Hye Jung; Park, Young Mi; Jung, Soo Jin; Kim, Do Hun; Bae, Sang Kyun

    2015-01-01

    No previous study regarding the correlation between post-operative thyroid function and underlying thyroid histopathology has been published. This study assessed the relationship between postoperative thyroid function after lobectomy and multiple factors in papillary thyroid microcarcinoma (PTMC) patients. From January 2010 to December 2010, 338 patients who had undergone thyroid lobectomy for PTMC were enrolled. Patients with pre-operative hyperthyroidism or those with hypothyroidism but no pre-operative serological data were excluded, leaving a cohort of 285 patients. The relationships between post-operative thyroid function (based on successful cessation of thyroxine replacement therapy) and multiple factors (patient age and sex, serological data, the Pre-operative anteroposterior diameter of the thyroid gland, underlying histopathology of the thyroid gland, and number of attempts to stop thyroxine replacement therapy) were analyzed. Out of 285 patients, 157 attempted to stop thyroxine replacement therapy once or twice after lobectomy; 91 successfully stopped thyroxine replacement therapy during the study period. The final histopathologic diagnoses after surgery included Hashimoto's thyroiditis (n = 5), non-Hashimoto type of lymphocytic thyroiditis (n = 17), and normal thyroid parenchyma (n = 135). Pre-operative thyroid-stimulating hormone (TSH) levels differed significantly between patients with postoperative hypothyroidism and those with postoperative euthyroidism (univariate logistic regression analysis, p = 0.0028; multivariate logistic regression analysis, p = 0.0029). No statistically significant differences were found for any other factors. The study results demonstrated that the Pre-operative TSH level was the only predictor for the development of post-operative hypothyroidism after thyroid lobectomy in PTMC patients.

  16. Hypothyroidism Side Effect in Patients Treated with Sunitinib or Sorafenib: Clinical and Structural Analyses

    Science.gov (United States)

    Shu, Mao; Zai, Xiaoli; Zhang, Beina; Wang, Rui; Lin, Zhihua

    2016-01-01

    Tyrosine kinase inhibitors (TKIs) provide more effective targeted treatments for cancer, but are subject to a variety of adverse effects, such as hypothyroidism. TKI-induced hypothyroidism is a highly complicated issue, because of not only the unrealized toxicological mechanisms, but also different incidences of individual TKI drugs. While sunitinib is suspected for causing thyroid dysfunction more often than other TKIs, sorafenib is believed to be less risky. Here we integrated clinical data and in silico drug-protein interactions to examine the pharmacological distinction between sunitinib and sorafenib. Statistical analysis on the FDA Adverse Event Reporting System (FAERS) confirmed that sunitinib is more concurrent with hypothyroidism than sorafenib, which was observed in both female and male patients. Then, we used docking method and identified 3 proteins specifically binding to sunitinib but not sorafenib, i.e., retinoid X receptor alpha, retinoic acid receptors beta and gamma. As potential off-targets of sunitinib, these proteins are well known to assemble with thyroid hormone receptors, which can explain the profound impact of sunitinib on thyroid function. Taken together, we established a strategy of integrated analysis on clinical records and drug off-targets, which can be applied to explore the molecular basis of various adverse drug reactions. PMID:26784451

  17. Risk of hypothyroidism among patients with nasopharyngeal carcinoma treated with radiation therapy: A Population-Based Cohort Study.

    Science.gov (United States)

    Fan, Chao-Yueh; Lin, Chun-Shu; Chao, Hsing-Lung; Huang, Wen-Yen; Su, Yu-Fu; Lin, Kuen-Tze; Tsai, I-Ju; Kao, Chia-Hung

    2017-06-01

    This study aimed to assess the incidence and risk of hypothyroidism among patients with nasopharyngeal carcinoma (NPC) after radiation therapy (RT). We identified 14,893 NPC patients and 16,105 other head and neck cancer (HNC) patients treated with RT without thyroidectomy from the National Health Insurance Research Database in Taiwan between 2000 and 2011. Each NPC patient was randomly frequency-matched with four individuals without NPC by age, sex, and index year. Competing-risk regression models were used to estimate hazard ratios (HRs) of hypothyroidism requiring thyroxin associated with NPC after RT. The risk of developing hypothyroidism was significantly higher in the NPC cohort than in the matched cohort (adjusted HR=14.35, 95% CI=11.85-17.37) and the HNC cohort (adjusted HR=2.06, 95% CI=1.69-2.52). Independent risk factors for hypothyroidism among NPC patients included younger age, female sex, higher urbanization level, autoimmune disease, and receipt of chemotherapy. The risk of hypothyroidism requiring thyroxin was significantly higher in NPC patients after RT than in the general Taiwanese population and HNC patients. Regular clinical and serum thyroid function tests are essential among NPC survivors after RT. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. [Hypothyroidism in pregnancy].

    Science.gov (United States)

    Krysiak, Robert; Okopień, Bogusław

    2012-06-01

    Because of its frequent occurrence during the reproductive period of a woman's life, hypothyroidism belongs to the most common endocrinopathies affecting women of childbearing age. The diagnosis of hypothyroidism in pregnant patients may be complicated by the fact that pregnancy has a considerable impact on thyroid homeostasis. Even overt hypothyroidism in these patients may be characterized by nonspecific signs or symptoms that are easily confused with complaints common to pregnancy itself. Unrecognised or untreated hypothyroidism during pregnancy is associated with adverse outcomes that can be ameliorated or prevented by adequate therapy with thyroxine. This article discusses the etiology, clinical manifestation, diagnosis, and management of hypothyroidism during pregnancy. We review the results of the current studies assessing the effect of the disease on pregnancy outcome or the offspring and provide the reader with recommendations concerning its diagnosis and treatment.

  19. Is it necessary to increase the dose of levothyroxine in patients with hypothyroidism who use omeprazole?

    Science.gov (United States)

    Abi-Abib, Raquel de Carvalho; Vaisman, Mário

    2014-10-01

    It is believed that gastric pH interferes in levothyroxine absorption. Omeprazole, which acts by blocking the secretion of gastric acid, might interfere in hypothyroidism control in patients using levothyroxine and this effect could be dose dependent. The present study aimed to investigate this possibility. Twenty-one patients with primary hypothyroidism who had been using a stabilized levothyroxine dosage for at least one year were selected and randomly assigned to take omeprazole at the dosage of 40 mg or 20 mg per day. The mean levels of thyroid-stimulating hormone (TSH) before and 3 months after omeprazole usage were compared in the entire sample and in each group. Ten patients concluded the entire treatment protocol in the 20 mg group and nine patients in the 40 mg group. There was no significant difference in TSH levels before and 3 months after omeprazole treatment in the entire patient sample (median levels: 2.28 vs. 2.30 mU/L, respectively: p = 0.56). Analysis of each subgroup (20 and 40 mg) showed no significant variation in TSH levels before and 3 months after omeprazole treatment (median levels: 2.24 vs. 2.42 mU/L, p = 0.62, and 2.28 vs. 2.30 mU/L, p = 0.82, respectively). No significant difference in the absolute (p = 0.93) or relative (p = 0.87) delta were observed between the two subgroups. Omeprazole in the dosage of 20 or 40 mg/day does not interfere in a clinically relevant manner in the treatment of patients with hypothyroidism that was previously under control.

  20. Influence of a Medium-Impact Exercise Program on Health-Related Quality of Life and Cardiorespiratory Fitness in Females with Subclinical Hypothyroidism: An Open-Label Pilot Study

    Directory of Open Access Journals (Sweden)

    Andrea Garces-Arteaga

    2013-01-01

    Full Text Available Objective. To examine the influence of a medium-impact exercise program (MIEP on health-related quality of life (HRQoL and cardiorespiratory fitness (VO2max in females with subclinical hypothyroidism (sHT. Materials and Methods. We selected 17 sedentary women with sHT (mean age: 43.1 (standard deviation: 9.7 years. Participants carried out an MIEP consisting of 3 weekly sessions of 60 minutes during 12 weeks. Before and after the exercise program HRQoL was assessed by the SF-12v2 questionnaire, and VO2max was evaluated by Rockport walk test. Results. After the 12-week intervention, the participants that performed an MIEP showed improvements in HRQoL in most domains, particularly the vitality domain by 7 points, the social functioning domain by 10 points, the mental health domain by 7 points, and the mental component summary by 7 points. One of the four domains within the physical component summary (general health domain showed significant effect of the exercise intervention: 6 points. Moreover, the participants that performed exercise showed a higher VO2max (28%; P<0.01. Conclusion. After 12 weeks of medium-impact exercise program, there were remarkable improvements in HRQoL in most domains. Moreover, this exercise program proved to have a positive influence on cardiorespiratory fitness.

  1. Influence of a medium-impact exercise program on health-related quality of life and cardiorespiratory fitness in females with subclinical hypothyroidism: an open-label pilot study.

    Science.gov (United States)

    Garces-Arteaga, Andrea; Nieto-Garcia, Nataly; Suarez-Sanchez, Freddy; Triana-Reina, Héctor Reynaldo; Ramírez-Vélez, Robinson

    2013-01-01

    Objective. To examine the influence of a medium-impact exercise program (MIEP) on health-related quality of life (HRQoL) and cardiorespiratory fitness (VO2max) in females with subclinical hypothyroidism (sHT). Materials and Methods. We selected 17 sedentary women with sHT (mean age: 43.1 (standard deviation: 9.7) years). Participants carried out an MIEP consisting of 3 weekly sessions of 60 minutes during 12 weeks. Before and after the exercise program HRQoL was assessed by the SF-12v2 questionnaire, and VO2max was evaluated by Rockport walk test. Results. After the 12-week intervention, the participants that performed an MIEP showed improvements in HRQoL in most domains, particularly the vitality domain by 7 points, the social functioning domain by 10 points, the mental health domain by 7 points, and the mental component summary by 7 points. One of the four domains within the physical component summary (general health domain) showed significant effect of the exercise intervention: 6 points. Moreover, the participants that performed exercise showed a higher VO2max (28%; P < 0.01). Conclusion. After 12 weeks of medium-impact exercise program, there were remarkable improvements in HRQoL in most domains. Moreover, this exercise program proved to have a positive influence on cardiorespiratory fitness.

  2. Congenital Hypothyroidism

    Science.gov (United States)

    ... Disease Featured Resource Find an Endocrinologist Search Congenital Hypothyroidism March 2012 Download PDFs English Espanol Editors Rosalind S. ... Resources MedlinePlus (NIH) Mayo Clinic What is congenital hypothyroidism? Newborn babies who are unable to make enough ...

  3. Hypothyroidism (image)

    Science.gov (United States)

    Hypothyroidism is a decreased activity of the thyroid gland which may affect all body functions. The rate ... and physical sluggishness. The most severe form of hypothyroidism is myxedema, which is a medical emergency.

  4. Changes in arterial stiffness, carotid intima-media thickness, and epicardial fat after L-thyroxine replacement therapy in hypothyroidism.

    Science.gov (United States)

    del Busto-Mesa, Abdel; Cabrera-Rego, Julio Oscar; Carrero-Fernández, Lisván; Hernández-Roca, Cristina Victoria; González-Valdés, Jorge Luis; de la Rosa-Pazos, José Eduardo

    2015-01-01

    To assess the relationship between primary hypothyroidism and subclinical atherosclerosis and its potential changes with L-thyroxine replacement therapy. A prospective cohort study including 101 patients with primary hypothyroidism and 101 euthyroid patients as controls was conducted from July 2011 to December 2013. Clinical, anthropometrical, biochemical, and ultrasonographic parameters were assessed at baseline and after one year of L-thyroxine replacement therapy. At baseline, hypothyroid patients had significantly greater values of blood pressure, total cholesterol, VLDL cholesterol, left ventricular mass, epicardial fat, and carotid intima-media thickness as compared to controls. Total cholesterol, VLDL cholesterol, ventricular diastolic function, epicardial fat, carotid intima-media thickness, carotid local pulse wave velocity, pressure strain elastic modulus, and β arterial stiffness index showed a significant and positive correlation with TSH levels. After one year of replacement therapy, patients with hypothyroidism showed changes in total cholesterol, VLDL cholesterol, TSH, carotid intima-media thickness, and arterial stiffness parameters. Primary hypothyroidism is characterized by an increased cardiovascular risk. In these patients, L-thyroxine replacement therapy for one year is related to decreased dyslipidemia and improvement in markers of subclinical carotid atherosclerosis. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  5. PREVALENCE OF HYPOTHYROIDISM IN PATIENTS WITH PROVISIONAL DIAGNOSIS OF DUB

    OpenAIRE

    Talasila; Shilpa Shivanna

    2014-01-01

    : OBJECTIVE: DUB accounts for 10% of all the gynecology related problems. This study is conducted to evaluate and detect the thyroid dysfunction in patients with dysfunctional uterine bleeding in all age groups especially in menorrhagic patients and to refer positive cases to the physician for the further management of thyroid disorder. METHODS: This prospective study consisted of 100 women who presented with menorrhagia to the out-patient department of OBG at Sri Adichunc...

  6. Impact of subclinical haemorrhage on the pituitary gland in patients with pituitary adenomas.

    Science.gov (United States)

    Kinoshita, Yasuyuki; Tominaga, Atsushi; Usui, Satoshi; Arita, Kazunori; Sugiyama, Kazuhiko; Kurisu, Kaoru

    2014-05-01

    Advanced magnetic resonance imaging (MRI) and optical instruments for surgery frequently demonstrate subclinical haemorrhage in pituitary adenomas; however, the effects of subclinical haemorrhage on pituitary glands remain unclear. We sought to clarify the pituitary function in patients with subclinical pituitary adenoma haemorrhage (SPAH). Between January 2006 and December 2012, we retrospectively reviewed 328 consecutive patients who underwent surgery for pituitary adenoma. SPAH was defined as an intratumoral haemorrhage based on both 3 tesla MRI and operative findings, with no clinical symptoms of acute pituitary adenoma apoplexy. The pituitary dysfunction assessed using pre- and postoperative provocative tests was investigated in patients categorized into three groups: nonapoplectic adenoma, adenoma with SPAH and adenoma with clinical apoplexy. The main outcome measure was the incidence of pituitary dysfunction. The overall incidence of nonapoplectic adenomas, adenomas with SPAH and adenomas with clinical apoplexy was 82·3%, 14·3% and 3·4%, respectively. Clinical pituitary apoplexy frequently occurred in male patients with large nonfunctioning adenomas, causing pituitary dysfunction. Contrastingly, the incidence of SPAH was significantly higher in the patients with prolactinoma (P = 0·0260), including those with relatively small adenomas (P = 0·0007). No medications, such as dopamine agonists or somatostatin analogues, were observed to affect the occurrence of SPAH. No deterioration of the pituitary function was observed in the SPAH patients in comparison with the patients with nonapoplectic adenoma, and the size of the haematoma occupying the pituitary adenoma did not exhibit any relationships with the deterioration of the pituitary function. Furthermore, SPAH caused no deterioration of the pituitary function after a surgery based on the postoperative provocation tests. Subclinical pituitary adenoma haemorrhage does not cause any added dysfunction in

  7. Radioiodine therapy in elderly patients with subclinical hyperthyroidism due to non-voluminous nodular goiter and its effect on bone metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Rosario, Pedro Weslley [Santa Casa de Belo Horizonte, MG (Brazil). Endocrinology Service

    2013-05-01

    Objective: To evaluate {sup 131}I therapy in elderly patients with subclinical hyperthyroidism (SCH) due to nodular disease and who did not receive antithyroid drugs (ATDs), and the effect of the treatment on bone metabolism. Subjects and methods: Thirty-six patients with TSH {<=} 0.1mIU/L and non-voluminous goiter (< 60 cm{sup 3} were studied. Bone mineral density (BMD) was assessed in 17 women with osteopenia. Results: Mean 24-h {sup 131}I uptake was 17.5%. Symptoms of thyrotoxicosis were reported by two (5.5%) patients in the first week after therapy. One year after radioiodine treatment, SCH was resolved in 30 (83.3%) patients, and hypothyroidism was detected in one (2.7%). In the patients in whom TSH returned to normal, femoral and lumbar spine BMD increased by 1.9% and 1.6%, respectively, in average. Conclusions: In elderly patients with SCH and non-voluminous goiter, radioiodine not preceded by ATDs is a safe and effective therapeutic alternative. Resolution of SCH has beneficial effects on BMD in postmenopausal women with osteopenia. (author)

  8. Patient's Guide to Detecting and Treating Hypothyroidism Before, During, and After Pregnancy

    Science.gov (United States)

    Detecting and Treating Hypothyroidism Before, During, and After Pregnancy A Patient’s Guide Pregnancy causes major changes in the levels of hormones made by ... thyroid hormone, doctors call this underactive thyroid or hypothyroidism . Hypothyroidism during pregnancy is not common. However, the ...

  9. Aortic Dissection and Renal Failure in a Patient with Severe Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Valerie Brooke

    2012-01-01

    Full Text Available Acute aortic dissection (AAD is a life-threatening condition associated with high morbidity and mortality. The most important recognized acquired cause that leads to dissection is chronic arterial hypertension. With respect to the anuria and renal failure, aortic dissection is not something that is always considered and is still not a very common presentation unless both renal arteries come off the false lumen of the dissection. However, when present, preoperative renal failure in patients with acute type B dissection has been noted to be an independent predictor of mortality. Early recognition and diagnosis is the key and as noted by previous studies as well, almost a third of these patients are initially worked up for other causes until later when they are diagnosed with aortic dissection. Here we present a case of a patient presenting with severe hypothyroidism, long-standing hypertension, and anuria. Through the case, we highlight the importance of having aortic dissection as an important differential in patients presenting with anuria who have a long standing history of uncontrolled hypertension. Pathophysiology relating to severe hypothyroidism-induced renal dysfunction is also discussed.

  10. Heterogeneity of peripheral blood monocytes, endothelial dysfunction and subclinical atherosclerosis in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Mikołajczyk, T P; Osmenda, G; Batko, B; Wilk, G; Krezelok, M; Skiba, D; Sliwa, T; Pryjma, J R; Guzik, T J

    2016-01-01

    Systemic lupus erythematosus (SLE) is characterized by increased cardiovascular morbidity and mortality. SLE patients have increased prevalence of subclinical atherosclerosis, although the mechanisms of this observation remain unclear. Considering the emerging role of monocytes in atherosclerosis, we aimed to investigate the relationship between subclinical atherosclerosis, endothelial dysfunction and the phenotype of peripheral blood monocytes in SLE patients. We characterized the phenotype of monocyte subsets defined by the expression of CD14 and CD16 in 42 patients with SLE and 42 non-SLE controls. Using ultrasonography, intima-media thickness (IMT) of carotid arteries and brachial artery flow-mediated dilation (FMD) as well as nitroglycerin-induced dilation (NMD) were assessed. Patients with SLE had significantly, but only modestly, increased IMT when compared with non-SLE controls (median (25th/75th percentile) 0.65 (0.60/0.71) mm vs 0.60 (0.56/0.68) mm; p subclinical atherosclerosis in SLE, although the mechanism appears to be independent of endothelial dysfunction. © The Author(s) 2015.

  11. Non-invasive imaging for subclinical coronary atherosclerosis in patients with peripheral artery disease

    DEFF Research Database (Denmark)

    Ripa, Rasmus Sejersten; Kjaer, Andreas; Hesse, Birger

    2014-01-01

    of subclinical coronary artery disease varies widely in patients with peripheral artery disease, it could include more than half of patients. No consensus exists to date on either the rationale for screening patients with peripheral artery disease for coronary atherosclerosis or the optimal algorithm and method......Patients with peripheral artery disease are at high risk of coronary artery disease. An increasing number of studies show that a large proportion of patients with peripheral artery disease have significant coronary atherosclerosis, even in the absence of symptoms. Although the reported prevalence...

  12. What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants.

    Science.gov (United States)

    Ning, Yu; Cheng, Yun J; Liu, Li J; Sara, Jaskanwal D S; Cao, Zhi Y; Zheng, Wei P; Zhang, Tian S; Han, Hui J; Yang, Zhen Y; Zhang, Yi; Wang, Fei L; Pan, Rui Y; Huang, Jie L; Wu, Ling L; Zhang, Ming; Wei, Yong X

    2017-02-02

    Whether hypothyroidism is an independent risk factor for cardiovascular events is still disputed. We aimed to assess the association between hypothyroidism and risks of cardiovascular events and mortality. We searched PubMed and Embase from inception to 29 February 2016. Cohort studies were included with no restriction of hypothyroid states. Priori main outcomes were ischemic heart disease (IHD), cardiac mortality, cardiovascular mortality, and all-cause mortality. Fifty-five cohort studies involving 1,898,314 participants were identified. Patients with hypothyroidism, compared with euthyroidism, experienced higher risks of IHD (relative risk (RR): 1.13; 95% confidence interval (CI): 1.01-1.26), myocardial infarction (MI) (RR: 1.15; 95% CI: 1.05-1.25), cardiac mortality (RR: 1.96; 95% CI: 1.38-2.80), and all-cause mortality (RR: 1.25; 95% CI: 1.13-1.39); subclinical hypothyroidism (SCH; especially with thyrotropin level ≥10 mIU/L) was also associated with higher risks of IHD and cardiac mortality. Moreover, cardiac patients with hypothyroidism, compared with those with euthyroidism, experienced higher risks of cardiac mortality (RR: 2.22; 95% CI: 1.28-3.83) and all-cause mortality (RR: 1.51; 95% CI: 1.26-1.81). Hypothyroidism is a risk factor for IHD and cardiac mortality. Hypothyroidism is associated with higher risks of cardiac mortality and all-cause mortality compared with euthyroidism in the general public or in patients with cardiac disease.

  13. Polyneuropathy in hypothyroidism.

    OpenAIRE

    Dick, D J; Lane, R.J.; Nogues, M. A.; Fawcett, P R

    1983-01-01

    A patient who developed symptoms and signs of a polyneuropathy was found to have hypothyroidism, though this diagnosis was not clinically suspected. Treatment with thyroxine resulted in resolution of his symptoms and restored his nerve conduction studies to normal.

  14. Hypothyroidism and hip pain

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2016-12-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is the most common hip disorder affecting adolescents and has multifactorial aetiology. Hypothyroidism may present as SCFE. We introduce a patient with such a presentation to highlight the association.

  15. Functional Abnormalities and Thyroid Nodules in Patients with End-stage Renal Disease.

    Science.gov (United States)

    Cuna, Vania; Menghi, Viola; Comai, Giorgia; Cappuccilli, Maria; Cianciolo, Giuseppe; Raimondi, Concettina; Grammatico, Francesco; Donati, Gabriele; Baraldi, Olga; Capelli, Irene; LA Manna, Gaetano

    2017-01-01

    Clinical and subclinical hypothyroidism is more common in patients with end-stage renal disease (ESRD) than in the general population. Patients with ESRD with hypothyroidism are more susceptible to cardiovascular disease, with an increased risk of mortality than those with normal thyroid function. Moreover, these patients have higher incidence of benign and malignant nodules. This was a retrospective study on 2,147 patients with ESRD on the renal transplant waiting list between 2000 and 2015 aimed at identifying the presence of hypothyroidism and associated variables. Hypothyroidism was detected in 437/2,147 (20.3%) patients, 289 of them having the subclinical form. Cardiovascular disease and older age were significantly associated with hypothyroidism, and autosomal polycystic kidney disease was correlated to goiter (prenal transplant to control cardiovascular complications and cancer risk. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  16. Serum gamma-glutamyltransferase is not associated with subclinical atherosclerosis in patients with type 2 diabetes.

    Science.gov (United States)

    Yoon, Hye Eun; Mo, Eun Young; Shin, Seok Joon; Moon, Sung Dae; Han, Je Ho; Kim, Eun Sook

    2016-08-05

    This study investigated the association between serum gamma-glutamyltransferase (GGT) level and subclinical atherosclerosis in patients with type 2 diabetes. This cross-sectional study involved 1024 patients with type 2 diabetes mellitus. Measurement of brachial-ankle pulse wave velocity (baPWV; as a marker of arterial stiffness) and an ultrasound assessment of carotid atherosclerosis were performed. Subclinical atherosclerosis was defined by the presence of a high baPWV (≥1720 cm/s), carotid atherosclerosis (intima-media thickness >0.8 mm or the presence of plaques), and carotid stenosis (≥50 % of luminal narrowing). The subjects were stratified into quartiles according to GGT level, and the relationship between GGT level and subclinical atherosclerosis was analysed. Serum GGT levels were closely associated with obesity, atherogenic dyslipidemia, and metabolic syndrome. However, serum GGT levels did not show a linear association with baPWV, carotid intima-media thickness, or plaque grade. The prevalence of high baPWV, carotid atherosclerosis, and carotid stenosis did not differ between the quartiles in men and women. Multivariate logistic regression analyses revealed no association between GGT level and high baPWV, carotid atherosclerosis, and carotid stenosis, either as continuous variables or quartiles. Serum GGT levels were significantly associated with obesity, atherogenic dyslipidaemia, and metabolic syndrome, but not with the early and late stages of atherosclerotic vascular changes, in patients with type 2 diabetes. Serum GGT level may not be a reliable marker of subclinical atherosclerosis in type 2 diabetes.

  17. Clinical research on keratoconus and subclinical keratoconus in patients with astigmatism examined by Pentacam

    Directory of Open Access Journals (Sweden)

    Yang An

    2016-03-01

    Full Text Available AIM: To study the keratoconus(KCNand subclinical KCN in patients with astigmatism ≥2D by Pentacam anterior segment analyzer. METHODS: Two hundred and one eyes in 107 patients with astigmatism ≥2D were included in this study. All patients underwent optometry, visual acuity, corrected visual acuity, slit lamp biomicroscopy, fundus examination, traditional corneal topography and examination with Pentacam. Changes of several parameters were observed including K1(horizontal central curvature within the scope with diameter of 3mm, K2(vertical central curvature within the scope with diameter of 3mm; Kmax(the maximum anterior corneal refractive power, corneal astigmatism(CYL, MinPachy(the thickness at the thinnest area of cornea, index of surface variation(ISV, index of vertical asymmetry(IVA, keratoconus index(KI, height of anterior corneal surface(AEand height of posterior corneal surface(PE, etc. ROC curve was made. Cutoff value and the sensitive index of each group were compared. Mann-Whitney U test was used for analysis of several parameters obtained from Pentacam. ROC curve was analyzed to determine the best diagnosis cutoff value. RESULTS: Mean age of the study population was 25.7±6.6 years old. Kmax, IVA, KI, AE and PE of the clinical and subclinical group were significantly higher than those of the astigmatism group, while the thickness at the thinnest area of cornea in clinical and subclinical group was lower than that of the astigmatism group(PCONCLUSION: The current study shows that subjects with 2D or more of astigmatism, even some of them have normal vision, should undergo corneal topography screening. Pentacam may provide more accurate information about anterior and posterior corneal anatomy especially for the height of posterior corneal surface, which plays an important role in screening of subclinical KCN.

  18. The impact of acute hypothyroidism on lipid levels in athyreotic patients

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    Rezvan Salehidoost

    2012-01-01

    Full Text Available Background: We investigated the effect of acute hypothyroidism on lipid concentrations especially on high density lipoprotein (HDL-cholesterol level in athyroatic patients. Materials and Methods: Thirty-one patients, with a history of differentiated thyroid carcinoma and total thyroidectomy, who were candidates of radioiodine therapy, enrolled in the study. Their lipid profiles and serum thyrotropin stimulating hormone (TSH levels were measured before and two-to-six weeks after thyroid hormone withdrawal. The lipid concentrations were compared with the paired t test and serum TSH using the Wilcoxon singed rank test. P values < 0.05 were considered statistically significant. Results: The median of TSH concentration was 0.06 mU / liter on thyroid hormone suppressive therapy and 102 mU / liter at the thyroid hormone withdrawal phase (P < 0.0001. The serum concentrations of all lipids were significantly increased after withdrawal (P < 0.0001. The mean (SD of the HDL-cholesterol concentration rose from 44 ± 9 mg / dL to 58 ± 17 mg / dL. The levels of total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride increased by 58, 75, 30, and 59%, respectively, during acute hypothyroidism. Conclusion: The present study showed that thyroid hormone withdrawal altered the lipid concentrations significantly, in a short period of time. The levels of both atherogenic (LDL-cholesterol and cardioprotective (HDL-cholesterol particles increased concurrently. Their clinical importance should be investigated in future.

  19. Clinical and subclinical neuropsychiatric abnormalities in rheumatoid arthritis patients

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    Eman M Khedr

    2015-01-01

    Conclusion Cognitive impairment, depression, anxiety and peripheral neuropathy are common in RA patients. Early diagnosis and management of neuropsychiatric disorders in RA patients may greatly improve the patients′ health-related quality of life.

  20. Soy isoflavones inducing overt hypothyroidism in a patient with chronic lymphocytic thyroiditis: a case report.

    Science.gov (United States)

    Nakamura, Yuya; Ohsawa, Isao; Goto, Yoshikazu; Tsuji, Mayumi; Oguchi, Tatsunori; Sato, Naoki; Kiuchi, Yuji; Fukumura, Motonori; Inagaki, Masahiro; Gotoh, Hiromichi

    2017-09-05

    Many people have thyroid conditions that make them susceptible to hypothyroidism. If the foods they eat may interfere with the production of thyroid hormone, which can lead to development of serious hypothyroidism. The danger of health drinks should always be noted. A 72-year-old Japanese woman was previously diagnosed with chronic lymphocytic thyroiditis caused by a goiter and had an elevated thyroid-stimulating hormone level (6.56 μIU/ml), a high anti-thyroid peroxidase antibody level (>600 IU/ml), and a high antithyroglobulin level (> 4000 IU/ml) but normal levels of free triiodothyronine (3.08 pg/ml) and thyroxine (1.18 ng/ml). She presented to our hospital with sudden-onset general malaise, edema, and hoarseness with an elevated thyroid-stimulating hormone (373.3 μIU/ml) level and very low triiodothyronine (powder extract. Hypothyroidism might be affected by ingredients of health drinks. She discontinued consumption of the health drink immediately and began taking 12.5 μg of levothyroxine. The amount of levothyroxine was gradually increased every 3 days up to 100 μg. At day 61, her thyroid-stimulating hormone level had decreased (6.12 μIU/ml), her free triiodothyronine (2.69 pg/ml) and thyroxine (1.56 ng/ml) levels had increased, and her general condition was improved. Among risky foods lowering thyroid function, some experimental studies have revealed that isoflavones reduce thyroid function. Therefore, we measured the presence of isoflavones in the patient's frozen serum with thin-layer chromatography. After she discontinued consumption of the health drink, two components quickly disappeared, and the other three components gradually decreased. On the basis of developing solvent composition and a positive ferric chloride reaction in thin-layer chromatography experiment, the five ingredients that disappeared or decreased were highly suspected to be soy isoflavones. This case emphasizes that consuming health drinks that include soy isoflavone

  1. Subclinical heart failure in juvenile idiopathic arthritis: a consequence of chronic inflammation and subclinical atherosclerosis

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    Hamada S Ahmad

    2016-01-01

    Conclusion Our findings indicate the presence of subclinical heart failure in these patients. JIA patients with subclinical atherosclerosis, with systemic disease, and with active disease are at greatest risk of developing subclinical heart failure.

  2. Genetic analysis of thyroid peroxidase (TPO) gene in patients whose hypothyroidism was found in adulthood in West Bengal, India.

    Science.gov (United States)

    Balmiki, Nisha; Bankura, Biswabandhu; Guria, Srikanta; Das, Tapas Kumar; Pattanayak, Arup Kumar; Sinha, Anirban; Chakrabarti, Sudipta; Chowdhury, Subhankar; Das, Madhusudan

    2014-01-01

    Recent research has revealed that genetic defects due to mutation in the Thyroid Peroxidase (TPO ) gene can lead to thyroid dysfunction in the population. We aimed to study the association between genetic defects in TPO gene and patients with hypothyroidism found in adult age. Two hundred consecutive treatment naive hypothyroid patients (age ≥ 18 years) (cases) who were negative for anti TPO antibody and their corresponding sex and age matched two hundred normal individuals (controls) were enrolled. The 17 exonic regions of the TPO gene were amplified and sequenced directly. We identified 6 different previously known single nucleotide polymorphisms (SNPs) and 2 novel deletions in TPO gene. Two of the six SNPs revealed a significant association with hypothyroidism; Thr725Pro (rs732609) and Asp666Asp (rs1126797). The c.2173C allele of the Thr725Pro in TPO showed a significant association among hypothyroid patients compared to controls (p = 0.01; Odds ratio=1.45; 95% CI: 1.09-1.92) suggesting it to be a potential risk allele toward disease predisposition. Analysis of genotype frequencies of the polymorphism between the two groups demonstrated CC as a potential risk genotype (p = 0.006; Odds ratio=1.95; 95% CI: 1.2-3.15) for the disease while another SNP Asp666Asp (c.1998T allele) showed protectiveness towards the disease (p = 0.006; Odds ratio = 0.67; 95%CI: 0.50-0.89). To our knowledge, this is first study reporting the role of TPO gene with hypothyroidism in a population of Asian Indian origin. The study threw up the possibility of TPO gene polymorphisms as a possible pathogenetic mechanism of hypothyroidism.

  3. Guidelines for Mass Screening of Congenital Hypothyroidism (2014 revision)

    Science.gov (United States)

    Nagasaki, Keisuke; Minamitani, Kanshi; Anzo, Makoto; Adachi, Masanori; Ishii, Tomohiro; Onigata, Kazumichi; Kusuda, Satoshi; Harada, Shohei; Horikawa, Reiko; Minagawa, Masanori; Mizuno, Haruo; Yamakami, Yuji; Fukushi, Masaru; Tajima, Toshihiro

    2015-01-01

    Purpose of developing the guidelines: Mass screening for congenital hypothyroidism started in 1979 in Japan, and the prognosis for intelligence has been improved by early diagnosis and treatment. The incidence was about 1/4000 of the birth population, but it has increased due to diagnosis of subclinical congenital hypothyroidism. The disease requires continuous treatment, and specialized medical facilities should make a differential diagnosis and treat subjects who are positive in mass screening to avoid unnecessary treatment. The Guidelines for Mass Screening of Congenital Hypothyroidism (1998 version) were developed by the Mass Screening Committee of the Japanese Society for Pediatric Endocrinology in 1998. Subsequently, new findings on prognosis and problems in the adult phase have emerged. Based on these new findings, the 1998 guidelines were revised in the current document (hereinafter referred to as the Guidelines). Target disease/conditions: Primary congenital hypothyroidism. Users of the Guidelines: Physician specialists in pediatric endocrinology, pediatric specialists, physicians referring patients to pediatric practitioners, general physicians, laboratory technicians in charge of mass screening, and patients. PMID:26594093

  4. High prevalence of subclinical atherosclerosis in psoriatic arthritis patients: a study based on carotid ultrasound.

    Science.gov (United States)

    Ibáñez-Bosch, Rosario; Restrepo-Velez, Juliana; Medina-Malone, Miguel; Garrido-Courel, Laura; Paniagua-Zudaire, Inmaculada; Loza-Cortina, Eduardo

    2017-01-01

    Analyse the presence of subclinical atherosclerosis in psoriatic arthritis patients (PsA). A cross-sectional study of 53 patients with PsA and 53 controls matched for age and sex was designed. Carotid intima-media thickness (IMT) and the presence of carotid plaques (CP) were assessed with carotid ultrasound. Data on cardiovascular (CV) risk factors were collected. Patients with PsA had a higher prevalence rate of obesity and tobacco smoking. CP were detected more frequently in patients with PsA than in controls with an OR of 4.15, 95% CI 1.4-12.1, which adjusted for smoking and those with history of CV disease gave an OR of 3.9, 95% CI 1.2-12.7, p = 0.026. Carotid IMT was significantly higher in patients with PsA adjusted for age and tobacco smoking. According to ultrasound data, 30.2% of patients with PsA had carotid atherosclerosis (presence of CP and/or carotid IMT > 0.90 mm) compared with 9.4% of controls. The SCORE index (Systematic Coronary Risk Evaluation) underestimated the CV risk in these patients: most patients with CP had an intermediate CV risk. According to carotid ultrasound data, PsA patients have a high prevalence of subclinical atherosclerosis. These results support the importance of screening for CV risk and to include carotid ultrasound in CV prevention strategies in these patients.

  5. Impact of Vitamin D Supplementation on the Level of Thyroid Peroxidase Antibodies in Patients with Autoimmune Hypothyroidism

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    I.V. Pan’kiv

    2016-08-01

    Full Text Available In spite of studying the relationship between the deficiency and the lack of vitamin D in autoimmune thyroid disorders, the effect of additional administration of the preparations of this vitamin has not been clear in such pathology. The aim of study was to investigate the effect of vitamin D on the content of thyroid peroxidase antibodies (TPO in patients with newly diagnosed hypothyroidism on the background of autoimmune thyroiditis (AIT. Materials and methods. The study included 52 patients with newly diagnosed hypothyroidism on the background of AIT, who were randomized into two groups. Patients of the first group additionally received cholecalciferol 2000 IU/day (14 000 IU/week and calcium preparations in a dose of 1000 mg/day for 12 weeks. Patients of the second group were administered only calcium preparations at a dose of 1000 mg/day for 12 weeks in addition to levothyroxine. A positive result of treatment was considered a reduction of antibodies to TPO of at least 25 %. Results. 94.2 % of patients with hypothyroidism had the deficiency and the lack of vitamin D. In patients with hypothyroidism, there was a significant negative correlation between the levels of 25(OHD and the titer of antibodies to TPO (r = –0.172; p = 0.046. Vitamin D supplementation resulted in a significant decrease of the level of antibodies to TPO (–48.1 % in patients with hypothyroidism. In general, lowering the level of antibodies to TPO by 25 % or more has been achieved in 73.1 % of patients. Administration of vitamin D contributed to a significant increase of the content of 25(OHD in the blood serum with a corresponding reduction in the concentration of intact parathyroid hormone in patients with hypothyroidism resulted from AIT. Conclusions. The positive effect of supplemental vitamin D has been established in terms of the level of antibodies to TPO in patients with autoimmune hypothyroidism.

  6. Residual subclinical impairment in patients who totally recovered from Guillain-Barré syndrome: impact on military performance.

    Science.gov (United States)

    Burrows, D S; Cuetter, A C

    1990-09-01

    Patients who have clinically recovered from Guillain-Barré syndrome (GBS) may exhibit a deficit during strenuous exercises that require maximal effort and muscular endurance. The Army Physical Fitness Test (APFT) is a quantitative tool that challenges neuromuscular endurance and unmasks a subclinical deficit in soldiers who have apparently recovered from GBS. The impact of this subclinical deficit on active duty soldiers and strategies for managing their poor performance on the APFT are discussed.

  7. Association between different degrees of hypothyroidism and serum ...

    African Journals Online (AJOL)

    The association between overt hypothyroidism (OH) and altered lipid profile is well known, however the significance of dyslipidemia in subclinical hypothyroidism (SCH) remain controversial. Therefore, this study was conducted to determine any association between lipid profile and different degrees of thyroid dysfunction.

  8. Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients.

    Science.gov (United States)

    Feldt-Rasmussen, Ulla; Klose, Marianne

    2016-10-01

    Hypothyroidism is characterized by hypometabolism, and may be seen as a part of secondary failure due to pituitary insufficiency or tertiary due to hypothalamic disease. Secondary and tertiary failures are also referred to as central hypothyroidism. Whereas overt primary hypothyroidism has a well-known affection on the heart and cardiovascular system, and may result in cardiac failure, cardiovascular affection is less well recognized in central hypothyroidism. Studies on central hypothyroidism and cardiovascular outcome are few and given the rarity of the diseases often small. Further, there are several limitations given vast difficulties in diagnosing the condition correctly biochemically, and difficulties monitoring the treatment because normal thyroid-pituitary feedback interrelationships are disrupted. The present review summarizes available studies of central adult hypothyroidism and its possible influence on the cardiovascular system, describe differences from primary thyroid failure and seek evidence for performing guidelines for clinical management of this particular thyroid and hypothalamo-pituitary disorder.

  9. Obesity and hypothyroidism

    OpenAIRE

    S M Zakharova; L V Savelieva; M I Fadeeva

    2013-01-01

    Obesity and hypothyroidism are common diseases, and consequently clinicians should be particularly alert to the possibility of thyroid dysfunction in obese patients. The relationship between thyroid function and obesity is likely to be bidirectional, with hypothyroidism affecting weight, but obesity also influencing thyroid function. Both serum thyroid-stimulating hormone and fT3 are typically increased in obese individuals, an effect likely mediated by leptin. Following L-T4 treatment for ov...

  10. Role of hypothyroidism in obstructive sleep apnea: a meta-analysis.

    Science.gov (United States)

    Zhang, Mingpeng; Zhang, Weisan; Tan, Jin; Zhao, Minghui; Zhang, Qiang; Lei, Ping

    2016-06-01

    This study evaluates the role of hypothyroidism in obstructive sleep apnea (OSA) by comparing the OSA indices in hypothyroid OSA (OSA-HYPOT) with euthyroid OSA (OSA-EUTHY) patients. After literature search in several electronic databases and selection of studies by following eligibility criteria, meta-analyses of mean differences/standardized mean differences were performed to compare OSA indices at the time of diagnosis between OSA-HYPOT and OSA-EUTHY patients. Metaregression analyses were carried out to examine the relationship between age, BMI, sample size, and gender vs OSA indices in OSA-HYPOT patients. Twelve studies and five case reports recruiting 192 OSA-HYPOT and 1423 OSA-EUTHY patients were included in the meta-analysis. Prevalence (mean ± SD) of clinical hypothyroidism in OSA patients was 8.12 ± 7.13% and that of subclinical hypothyroidism 11.07 ± 8.49%. Apnea-Hypopnea Index, time of sleep with oxygen desaturation Hypothyroidism is found to be associated with severity of OSA. However, obesity can be a confounder in the outcomes observed herein.

  11. Increased subclinical atherosclerosis in patients with chronic plaque psoriasis.

    Science.gov (United States)

    Evensen, Kristin; Slevolden, Ellen; Skagen, Karolina; Rønning, Ole Morten; Brunborg, Cathrine; Krogstad, Anne-Lene; Russell, David

    2014-12-01

    Psoriasis is an immune-mediated inflammatory skin condition of unknown aetiology which usually requires life-long treatment. It is regarded a systemic inflammatory disease with a possible increased risk of cardiovascular disease. The aim of this study was to assess carotid intima-media thickness (IMT), plaque prevalence and carotid stenosis as surrogate measures for cardiovascular disease in psoriasis patients and healthy controls. Sixty-two patients with psoriasis and thirty-one healthy controls were included in the study. All were examined by Colour duplex ultrasound of the carotid arteries to compare carotid IMT values, carotid plaques and carotid stenosis in the two groups. Adjustments were made for traditional cardiovascular risk factors. Patients with psoriasis had increased carotid IMT values compared to the controls: mean ± SD 0.71 ± 0.17 mm vs. 0.59 ± 0.08 mm; p = 0.001. When adjusted for known atherosclerotic risk factors this difference remained significant (p = 0.04). Carotid plaques were also more common (p = 0.03) in patients with psoriasis 13 (21%) compared to controls 1 (3%). There was no difference with regard to the number of carotid stenoses in patients and controls. The results of this study support previous evidence which suggests that psoriasis is associated with an increased risk for atherosclerosis and subsequent cardiovascular disease. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Excess Mortality in Patients Diagnosed With Hypothyroidism: A Nationwide Cohort Study of Singletons and Twins

    Science.gov (United States)

    Thvilum, Marianne; Brandt, Frans; Almind, Dorthe; Christensen, Kaare; Brix, Thomas Heiberg

    2013-01-01

    Background: Although hypothyroidism is associated with increased morbidity, an association with increased mortality is still debated. Our objective was to investigate, at a nationwide level, whether a diagnosis of hypothyroidism influences mortality. Methods: In an observational cohort study from January 1, 1978 until December 31, 2008 using record-linkage data from nationwide Danish health registers, 3587 singletons and 682 twins diagnosed with hypothyroidism were identified. Hypothyroid individuals were matched 1:4 with nonhypothyroid controls with respect to age and gender and followed over a mean period of 5.6 years (range 0–30 years). The hazard ratio (HR) for mortality was calculated using Cox regression analyses. Comorbidity was evaluated using the Charlson score (CS). Results: In singletons with hypothyroidism, the mortality risk was increased (HR 1.52; 95% confidence interval [CI]: 1.41–1.65). Although the effect attenuated, hypothyroidism remained associated with increased mortality when evaluating subjects with a CS = 0 (HR 1.23; 95% CI: 1.05–1.44). In twin pairs discordant for hypothyroidism, the hypothyroid twin had excess mortality compared with the corresponding euthyroid cotwin (HR 1.40; 95% CI 0.95–2.05). However, after stratifying for zygosity, hypothyroidism was associated with excess mortality in dizygotic twin pairs (HR 1.61; 95% CI 1.00–2.58), whereas the association attenuated in monozygotic pairs (HR 1.06; 95% CI 0.55–2.05). Conclusions: Hypothyroidism is associated with an excess mortality of around 50%, which to some degree is explained by comorbidity. In addition, the finding of an association between hypothyroidism and mortality within disease discordant dizygotic but not monozygotic twin pairs indicates that the association between hypothyroidism and mortality is also influenced by genetic confounding. PMID:23365121

  13. AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS MEDICAL GUIDELINES FOR CLINICAL PRACTICE FOR THE EVALUATION AND TREATMENT OF HYPERTHYROIDISM AND HYPOTHYROIDISM.

    Science.gov (United States)

    Baskin, H Jack; Cobin, Rhoda H; Duick, Daniel S; Gharib, Hossein; Guttler, Richard B; Kaplan, Michael M; Segal, Robert L; Garber, Jeffrey R; Hamilton, Carlos R; Handelsman, Yehuda; Hellman, Richard; Kukora, John S; Levy, Philip; Palumbo, Pasquale J; Petak, Steven M; Rettinger, Herbert I; Rodbard, Helena W; Service, F John; Shankar, Talla P; Stoffer, Sheldon S; Tourtelot, John B

    2002-11-01

    These clinical practice guidelines summarize the recommendations of the American Association of Clinical Endocrinologists for the diagnostic evaluation of hyperthyroidism and hypothyroidism and for treatment strategies in patients with these disorders. The sensitive thyroid-stimulating hormone (TSH or thyrotropin) assay has become the single best screening test for hyperthyroidism and hypothyroidism, and in most outpatient clinical situations, the serum TSH is the most sensitive test for detecting mild thyroid hormone excess or deficiency. Therapeutic options for patients with Graves' disease include thyroidectomy (rarely used now in the United States), antithyroid drugs (frequently associated with relapses), and radioactive iodine (currently the treatment of choice). In clinical hypothyroidism, the standard treatment is levothyroxine replacement, which must be tailored to the individual patient. Awareness of subclinical thyroid disease, which often remains undiagnosed, is emphasized, as is a system of care that incorporates regular follow-up surveillance by one physician as well as education and involvement of the patient.

  14. Relationship between mean platelet volume levels and subclinical target organ damage in newly diagnosed hypertensive patients.

    Science.gov (United States)

    Yarlioglues, Mikail; Kaya, Mehmet Gungor; Ardic, Idris; Dogdu, Orhan; Kasapkara, Haci Ahmet; Gunturk, Ertugrul; Akpek, Mahmut; Kalay, Nihat; Dogan, Ali; Ozdogru, Ibrahim; Oguzhan, Abdurrahman

    2011-04-01

    Significant numbers of asymptomatic hypertensive patients are attacked by subclinical target organ damage (TOD) such as proteinuria, left ventricular hypertrophy and carotid atherosclerosis. Platelets become activated in uncontrolled hypertension and play a crucial role in increased thrombotic tendency. Mean platelet volume (MPV) is one of the markers that correlate closely with platelet activity. We aimed to investigate the relationship between MPV levels and subclinical TOD in newly diagnosed hypertensive patients. 80 newly diagnosed hypertensive patients were enrolled to this cross-sectional study. Ambulatory blood pressure monitoring was performed for all patients. Left ventricular mass index (LVMI), carotid intima-media thickness (IMT) and urine albumin/creatinine ratio (UACR) were measured as indices of cardiac, vascular and renal damage, respectively. MPV was measured from blood samples collected in EDTA tubes and high-sensitivity C reactive protein (hs-CRP) was measured by using nephlometer. MPV was significantly correlated with 24-h systolic-diastolic blood pressure (r = 0.52 and r = 0.55, respectively). Correlation analysis indicated that MPV was moderately related with UACR, LVMI, carotid IMT and hs-CRP (r = 0.50, r = 0.55, r = 0.60 and r = 0.69, respectively, p = 0.0001). Multivariable analysis identified that MPV levels were independently associated with severity of proteinuria, carotid IMT and LVMI (p = 0.001). Our findings suggested that MPV levels were associated with severity of subclinical TOD including; carotid atherosclerosis, left ventricular hypertrophy and renal damage, in hypertensive patients. In addition to this, MPV levels were significantly correlated with hs-CRP levels and 24-h ambulatory blood pressure measurements.

  15. Clinical practice guidelines for hypothyroidism in adults: cosponsored by the American Association of Clinical Endocrinologists and the American Thyroid Association.

    Science.gov (United States)

    Garber, Jeffrey R; Cobin, Rhoda H; Gharib, Hossein; Hennessey, James V; Klein, Irwin; Mechanick, Jeffrey I; Pessah-Pollack, Rachel; Singer, Peter A; Woeber, Kenneth A

    2012-12-01

    Hypothyroidism has multiple etiologies and manifestations. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions. This paper describes evidence-based clinical guidelines for the clinical management of hypothyroidism in ambulatory patients. The development of these guidelines was commissioned by the American Association of Clinical Endocrinologists (AACE) in association with American Thyroid Association (ATA). AACE and the ATA assembled a task force of expert clinicians who authored this article. The authors examined relevant literature and took an evidence-based medicine approach that incorporated their knowledge and experience to develop a series of specific recommendations and the rationale for these recommendations. The strength of the recommendations and the quality of evidence supporting each was rated according to the approach outlined in the American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Guidelines-2010 update. Topics addressed include the etiology, epidemiology, clinical and laboratory evaluation, management, and consequences of hypothyroidism. Screening, treatment of subclinical hypothyroidism, pregnancy, and areas for future research are also covered. Fifty-two evidence-based recommendations and subrecommendations were developed to aid in the care of patients with hypothyroidism and to share what the authors believe is current, rational, and optimal medical practice for the diagnosis and care of hypothyroidism. A serum thyrotropin is the single best screening test for primary thyroid dysfunction for the vast majority of outpatient clinical situations. The standard treatment is replacement with L-thyroxine. The decision to treat subclinical hypothyroidism when the serum thyrotropin is less than 10 mIU/L should be tailored to the individual patient.

  16. Pellagroid Dermatitis in an Alcoholic and Hypothyroid Patient. A Case Report

    Directory of Open Access Journals (Sweden)

    Graciela Cabrera Acea

    2015-06-01

    Full Text Available Pellagroid dermatitis is a condition resulting from the deficiency of niacin and/or tryptophan that causes dermatological, gastrointestinal and neurological symptoms. It is very rare in our country, a fact that motivated us to present this case. The patient was a 49-year-old white man diagnosed with pellagroid dermatitis. He also suffered from hypothyroidism, alcohol dependence and had poor eating habits due to his frequent drinking. He had a medical history of hypertension and presented cutaneous manifestations of pellagroid dermatitis. The erythematous and scaly manifestations were located on the back of both arms. They resembled scalded skin; some had an ulcerated and blistered center and were similar to those in the neck, deltoid region and other sites exposed to sunlight. The lesions were permanently cured after vitamin therapy and skin protection from solar radiation.

  17. Congenital hypothyroidism in association with Caroli's disease and autosomal recessive polycystic kidney disease: patient report.

    Science.gov (United States)

    Jeha, George S; Tatevian, Nina; Heptulla, Rubina A

    2005-03-01

    Autosomal recessive polycystic kidney disease (ARPKD) is an important renal disease of childhood. Congenital hypothyroidism has been associated with glomerulocystic kidney disease, but to date no association has been made with ARPKD. To our knowledge this is the first reported case of congenital hypothyroidism in an infant with ARPKD.

  18. Electrophysiological Evaluation of Dysphagia in the Mild or Moderate Patients with Multiple Sclerosis: A Concept of Subclinical Dysphagia.

    Science.gov (United States)

    Beckmann, Yesim; Gürgör, Nevin; Çakır, Ahmet; Arıcı, Şehnaz; İncesu, Tülay Kurt; Seçil, Yaprak; Ertekin, Cumhur

    2015-06-01

    Swallowing mechanism and neurogenic dysphagia in MS have been rarely studied by electromyographical (EMG) methods. This study aims to evaluate the presence of subclinical dysphagia in patients with mild multiple sclerosis (MS) using electrophysiological methods. A prospective study of 51 patients with relapsing remitting multiple sclerosis and 18 age-matched healthy adults was investigated. We used electromyography to measure the activity of the submental muscles during swallowing. Electrophysiological recordings of patients were obtained during relapse, after relapse, and at any time in remission period. Clinical dysphagia was found in 12% of MS patients, while electrophysiological swallowing abnormalities were encountered in 33% of patients. Subclinical dysphagia was determined in 35% of patients during an MS relapse, in 20% of patients after a relapse, and in 25% of all 51 patients in the remission period based on EMG findings. Duration of swallowing signal of submental muscles in all MS patients was found to be longer than in normal subjects (p = 0.001). During swallowing of 50 ml of sequential water, the compensatory respiratory cycles occurred more often in MS patients than normal subjects, especially during a relapse (p = 0.005). This is the first study investigating swallowing abnormalities and subclinical dysphagia from the electrophysiological aspect in MS patients with mild disability. The electrophysiological tests described in this study are useful to uncover subclinical dysphagia since they have the advantage of being rapid, easy to apply, non-invasive, and without risk for the patients.

  19. Screening for subclinical atherosclerosis by noninvasive methods in asymptomatic patients with risk factors

    Directory of Open Access Journals (Sweden)

    Castellon X

    2013-05-01

    Full Text Available Xavier Castellon, Vera BogdanovaDepartment of Cardiology, Private Hospital Athis Mons, Paris, FranceAbstract: Atherosclerosis is a leading cause of cardiovascular death due to the increasing prevalence of the disease and the impact of risk factors such as diabetes, obesity or smoking. Sudden cardiac death is the primary consequence of coronary artery disease in 50% of men and 64% of women. Currently the only available strategy to reduce mortality in the at-risk population is primary prevention; the target population must receive screening for atherosclerosis. The value of screening for subclinical atherosclerosis is still relevant, it has become standard clinical practice with the emergence of new noninvasive techniques (radio frequency [RF] measurement of intima-media thickness [RFQIMT] and arterial stiffness [RFQAS], and flow-mediated vasodilatation [FMV], which have been used by our team since 2007 and are based on detection marker integrators which reflect the deleterious effect of risk factors on arterial remodeling before the onset of clinical events. These techniques allow the study of values according to age and diagnosis of the pathological value, the thickness of the intima media (RFQIMT, the speed of the pulse wave (RFQAS, and the degree of endothelial dysfunction (FMV. This screening is justified in asymptomatic patients with cardiovascular risk factors (hypertension, diabetes, obesity, dyslipidemia, and tobacco smoking. Studies conducted by RF coupled with two-dimensional echo since 2007 have led to a more detailed analysis of the state of the arterial wall. The various examinations allow an assessment of the degree of subclinical atherosclerosis and its impact on arterial remodeling and endothelial function. The use of noninvasive imaging in screening and early detection of subclinical atherosclerosis is reliable and reproducible and allows us to assess the susceptibility of our patients with risk factors and ensures better

  20. HDL cholesterol efflux capacity in rheumatoid arthritis patients: contributing factors and relationship with subclinical atherosclerosis.

    Science.gov (United States)

    Tejera-Segura, Beatriz; Macía-Díaz, María; Machado, José David; de Vera-González, Antonia; García-Dopico, Jose A; Olmos, José M; Hernández, José L; Díaz-González, Federico; González-Gay, Miguel A; Ferraz-Amaro, Iván

    2017-05-31

    Lipid profiles appear to be altered in rheumatoid arthritis (RA) patients because of disease activity and inflammation. Cholesterol efflux capacity (CEC), which is the ability of high-density lipoprotein cholesterol to accept cholesterol from macrophages, has been linked not only to cardiovascular events in the general population but also to being impaired in patients with RA. The aim of this study was to establish whether CEC is related to subclinical carotid atherosclerosis in patients with RA. We conducted a cross-sectional study that encompassed 401 individuals, including 178 patients with RA and 223 sex-matched control subjects. CEC, using an in vitro assay, lipoprotein serum concentrations, and standard lipid profile, was assessed in patients and control subjects. Carotid intima-media thickness (CIMT) and carotid plaques were assessed in patients with RA. A multivariable analysis was performed to evaluate the relationship of CEC with RA-related data, lipid profile, and subclinical carotid atherosclerosis. Mean (SD) CEC was not significantly different between patients with RA (18.9 ± 9.0%) and control subjects (16.9 ± 10.4%) (p = 0.11). Patients with RA with low (β coefficient -5.2 [-10.0 to 0.3]%, p = 0.039) and moderate disease activity (β coefficient -4.6 [-8.5 to 0.7]%, p = 0.020) were associated with lower levels of CEC than patients in remission. Although no association with CIMT was found, higher CEC was independently associated with a lower risk for the presence of carotid plaque in patients with RA (odds ratio 0.94 [95% CI 0.89-0.98], p = 0.015). CEC is independently associated with carotid plaque in patients with RA.

  1. Comparing Survival between peritoneal dialysis and hemodialysis patients with subclinical peripheral artery disease: a 6-year follow-up.

    Science.gov (United States)

    Liu, Jiung-Hsiun; Chen, Jan-Yow; Lin, Shih-Yi; Lin, Hsin-Hung; Ting, I-Wen; Liang, Chih-Chia; Wang, I-Kuan; Kuo, Huey-Liang; Chang, Chiz-Tzung; Huang, Chiu-Ching; Sung, Fung-Chang

    2013-01-01

    Peripheral artery disease (PAD) is known to be an increased mortality risk in patients with end-stage renal disease (ESRD). The aim of this study was to compare patient survival between patients with subclinical PAD undergoing peritoneal dialysis (PD) and hemodialysis (HD). Subclinical peripheral artery was defined as an ankle-brachial index of less than 0.9. This study was conducted from April 2005, and the observation period ended on 30 June 2011. At the end of the follow-up, the status of all patients was assessed and data on mortality were obtained for the entire cohort. A total of 91 patients (61 HD and 30 PD) were included for analyses in this study. Mortality rate was 60.0% (18/30) for PD and 52.5% (32/61) for HD. Kaplan-Meier estimate demonstrate that PD patients had a higher mortality rate than those underwent HD (log-rank p = 0.0039). Cox regression model demonstrated that PD was an independent predictor for further mortality in ESRD patients with subclinical peripheral artery disease.(p = 0.012, HR: 1.776, 95% CI: 1.136-2.775). In multivariate analysis, the HD group still had a greater survival than PD group (p = 0.005, HR:1.916, 95% CI: 1.218-3.015). In patients with subclinical peripheral artery disease, the patient survival is better in HD patients as compared with PD patients.

  2. Clinical aspects of hyperthyroidism, hypothyroidism, and thyroid screening in pregnancy.

    Science.gov (United States)

    Negro, Roberto; Stagnaro-Green, Alex

    2014-06-01

    To evaluate the peer-reviewed literature on hypothyroidism, hyperthyroidism, and thyroid autoimmunity in pregnancy. We review published studies on thyroid autoimmunity and dysfunction in pregnancy, the impact of thyroid disease on pregnancy, and discuss implications for screening. Overt hyperthyroidism and hypothyroidism are responsible for adverse obstetric and neonatal events. Several studies of association suggest that either subclinical hypothyroidism or thyroid autoimmunity increase the risk of complications. One randomized controlled trial showed that pregnant women with subclinical hypothyroidism benefit from treatment in terms of obstetric and neonatal complications, whereas another study demonstrated no benefit in the intelligence quotient of babies born to women with subclinical hypothyroidism. Thyroid autoimmunity has been associated with increased rate of pregnancy loss, recurrent miscarriage, and preterm delivery. Current guidelines agree that overt hyperthyroidism and hypothyroidism need to be promptly treated and that as potential benefits outweigh potential harm, subclinical hypothyroidism also requires substitutive treatment. The chance that women with thyroid autoimmunity may benefit from levothyroxine treatment to improve obstetric outcome is intriguing, but adequately powered randomized controlled trials are needed. The issue of universal thyroid screening at the beginning of pregnancy is still a matter of debate, and aggressive case-finding is supported.

  3. Celiac-Associated Autoimmune Thyroid Disease: A Study of 16 Patients with Overt Hypothyroidism

    Directory of Open Access Journals (Sweden)

    Hugh J Freeman

    1995-01-01

    Full Text Available Previous reports have suggested that autoimmune thyroid disorders (including Hashimoto’s or lymphocytic thyroiditis may occur in patients with celiac disease. In this study, the prevalence of thyroid disease was explored in a series of 96 consecutive patients seen with biopsy-defined adult celiac disease (average age 47.3 years. Sixteen celiac patients (average age 58.1 years were detected with hypothyroidism, including four treated with radio-iodine ablation or thyroidectomy for Grave’s disease. In addition to celiac disease, almost half had dermatitis herpetiformis, a small intestinal neoplasm (particularly lymphoma or both. Diagnosis of thyroid disease preceded diagnosis of celiac disease in 13 patients or was made concurrently in two patients. In only one patient was thyroid disease detected after celiac disease was diagnosed. This indicates that thyroid diseases occur more commonly in celiac disease than is currently appreciated, possibly due to shared embryological origins or common immunopathological features, and may be the presenting clinical manifestation in adults especially if there is coexistent dermatitis herpetiformis. Careful monitoring of this subgroup may be warranted because of the frequency of neoplastic intestinal diseases, particularly lymphoma.

  4. Serum cystatin C is associated with subclinical atherosclerosis in patients with type 2 diabetes: A retrospective study.

    Science.gov (United States)

    Chung, Yu Kyung; Lee, Young Ju; Kim, Kye Whon; Cho, Ryu Kyoung; Chung, Seung Min; Moon, Jun Sung; Yoon, Ji Sung; Won, Kyu Chang; Lee, Hyoung Woo

    2018-01-01

    The aim of this study was to investigate the association between the serum cystatin C level and cardiovascular disease risk in patients with type 2 diabetes mellitus. We studied 523 patients with type 2 diabetes mellitus and calculated estimated 10-year risk of atherosclerotic cardiovascular disease (%). Subclinical atherosclerosis was defined as brachial-ankle pulse wave velocity ⩾1700 ms, indicating the presence of arterial stiffness. Cystatin C level was significantly higher in the subclinical atherosclerosis group (brachial-ankle pulse wave velocity ⩾ 1700 ms) than in the non-subclinical atherosclerosis group (brachial-ankle pulse wave velocity diabetes and cystatin C level, but not by serum creatinine, 10-year risk of atherosclerotic cardiovascular disease score and estimated glomerular filtration rate in the multiple linear regression analysis. In addition, an increase in cystatin C level was independently associated with the risk of subclinical atherosclerosis after adjusting for age, sex, duration of diabetes, smoking, hypertension, 10-year risk of atherosclerotic cardiovascular disease risk score, serum creatinine level, total cholesterol, high-density lipoprotein cholesterol and haemoglobin A1c (odds ratio = 1.200, 95% confidence interval: 1.04-1.38, p = 0.011). Serum cystatin C level was significantly associated with subclinical atherosclerosis. This result suggests that an increase in cystatin C level could be a valuable surrogate marker for the risk of cardiovascular disease in patients with type 2 diabetes mellitus.

  5. Subclinical carotid atherosclerosis in patients with chronic obstructive pulmonary disease: a meta-analysis of literature studies.

    Science.gov (United States)

    Ambrosino, Pasquale; Lupoli, Roberta; Cafaro, Giovanni; Iervolino, Salvatore; Carone, Mauro; Pappone, Nicola; Di Minno, Matteo Nicola Dario

    2017-09-01

    Chronic obstructive pulmonary disease (COPD) patients have an increased cardiovascular (CV) morbidity and mortality. Common carotid intima-media thickness (CCA-IMT) and carotid plaques are surrogate markers of subclinical atherosclerosis and predictors of CV events. We performed a meta-analysis to evaluate the association between COPD and subclinical atherosclerosis. Studies evaluating the impact of COPD on CCA-IMT and on the prevalence of carotid plaques were systematically searched. Twenty studies (2082 COPD patients and 4844 controls) were included, 12 studies with data on CCA-IMT (13 data-sets on 1180 COPD patients and 2312 controls) and 12 studies reporting on the prevalence of carotid plaques (1231 COPD patients and 4222 controls). Compared to controls, COPD patients showed a significantly higher CCA-IMT (mean difference [MD]: 0.201 mm; 95%CI: 0.142, 0.260; p prevalence of carotid plaques (Odds Ratio [OR]: 2.503; 95%CI: 1.333, 2.175; p COPD patients and controls. COPD is significantly associated with subclinical atherosclerosis. These findings may be useful to plan adequate CV prevention strategies. Key messages COPD patients show a higher CCA-IMT and an increased prevalence of carotid plaques compared with controls. A more severe pulmonary disease is associated with a higher prevalence of carotid plaques in COPD patients. Screening for subclinical atherosclerosis may be worthy in COPD patients to plan specific prevention strategies.

  6. Subclinical Cardiovascular System Changes in Obese Patients with Juvenile Idiopathic Arthritis

    Directory of Open Access Journals (Sweden)

    Barbara Głowińska-Olszewska

    2013-01-01

    Full Text Available Objective. We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. Methods. Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNFα, adiponectin were studied together with IMT (intima-media thickness, FMD (flow mediated dilation, and LVMi (left ventricle mass index as surrogate markers of subclinical atherosclerosis. Results. Thirteen JIA children (22% were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNFα, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. Conclusions. Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.

  7. Subclinical cardiovascular system changes in obese patients with juvenile idiopathic arthritis.

    Science.gov (United States)

    Głowińska-Olszewska, Barbara; Bossowski, Artur; Dobreńko, Elżbieta; Hryniewicz, Andrzej; Konstantynowicz, Jerzy; Milewski, Robert; Łuczyński, Włodzimierz; Piotrowska-Jastrzębska, Janina; Kowal-Bielecka, Otylia

    2013-01-01

    We aimed to determine the prevalence of excess body mass in juvenile idiopathic arthritis (JIA) children and to investigate the influence of obesity into the early, subclinical changes in cardiovascular system in these patients. Fifty-eight JIA patients, aged median 13 years, were compared to 36 healthy controls. Traditional cardiovascular risk factors and inflammatory markers (hsCRP, IL-6, TNF α, adiponectin) were studied together with IMT (intima-media thickness), FMD (flow mediated dilation), and LVMi (left ventricle mass index) as surrogate markers of subclinical atherosclerosis. Thirteen JIA children (22%) were obese and had increased systolic blood pressure, cholesterol, triglycerides, insulin, HOMA, hsCRP, and IL-6 compared to nonobese JIA and controls. FMD was decreased compared to nonobese JIA and controls, whereas IMT and LVMi were increased. In multivariate regression analysis, TNF α, SDS-BMI, and systolic blood pressure were independent predictors of early CV changes in JIA. Coincident obesity is common in JIA children and is associated with insulin resistance, dyslipidemia, and increased levels of inflammatory markers leading to early changes in cardiovascular system. Thus, medical care of children with JIA should include strategies preventing cardiovascular disease by maintenance of adequate body weight.

  8. Prediction of post-treatment hypothyroidism using changes in thyroid volume after radioactive iodine therapy in adolescent patients with Graves' disease

    Directory of Open Access Journals (Sweden)

    Fukata Shuji

    2011-11-01

    Full Text Available Abstract Background The goal of iodine-131 therapy for pediatric Graves' disease is to induce hypothyroidism. However, changes in post-treatment thyroid volume have not been investigated in pediatric and/or adolescent patients. Objective The aim of this retrospective study was to examine whether changes in thyroid volume predict post-treatment hypothyroidism in adolescent Graves' disease patients. Patients and Methods We used ultrasonography to examine changes in thyroid volume, and also assessed thyroid functions, at 0, 1, 3, 5, 8 and 12 months after iodine-131 treatment in 49 adolescents ranging in age from 12 to 19 years retrospectively. Based on thyroid function outcome at 12 months, patients were divided into two groups: 29 patients with overt hypothyroidism requiring levothyroxine replacement and 20 without overt hypothyroidism. We compared changes in post-radioiodine thyroid volume between the two groups. Results About 90% of patients whose thyroid volume at 3 months after iodine-131 administration was less than 50% of the original volume were hypothyroid by one year after treatment (positive predictive value 88%, sensitivity 75.9%, specificity 85.0%. Conclusions We believe ultrasonographic measurement of thyroid volume at 3 months after iodine-131 to be clinically useful for predicting post-treatment hypothyroidism in adolescent Graves' disease patients.

  9. Subclinical thyroid disorders and cognitive performance among adolescents in the United States

    Directory of Open Access Journals (Sweden)

    Wilson Jim L

    2006-04-01

    Full Text Available Abstract Background Thyroid hormone plays a crucial role in the growth and function of the central nervous system. The purpose of the study was to examine the relationships between the status of subclinical thyroid conditions and cognition among adolescents in the United States. Methods Study sample included 1,327 adolescents 13 to 16 years old who participated in the Third National Health and Nutrition Examination Survey (NHANES III. Serum thyroxine (T4 and thyroid stimulating hormone (TSH were measured and subclinical hypothyroidism, subclinical hyperthyroidism, and euthyroid groups were defined. Cognitive performance was assessed using the subscales of the Wide Range Achievement Test-Revised (WRAT-R and the Wechsler Intelligence Scale for Children-Revised (WISC-R. The age-corrected scaled scores for arithmetic, reading, block design, and digit span were derived from the cognitive assessments. Results Subclinical hypothyroidism was found in 1.7% and subclinical hyperthyroidism was found in 2.3% of the adolescents. Cognitive assessment scores on average tended to be lower in adolescents with subclinical hyperthyroidism and higher in those with subclinical hypothyroidism than the score for the euthyroid group. Adolescents with subclinical hypothyroidism had significantly better scores in block design and reading than the euthyroid subjects even after adjustment for a number of variables including sex, age, and family income level. Conclusion Subclinical hypothyroidism was associated with better performance in some areas of cognitive functions while subclinical hyperthyroidism could be a potential risk factor.

  10. Hypothyroidism following allogeneic hematopoietic stem cell transplantation for acute myeloid leukemia.

    Science.gov (United States)

    Medinger, Michael; Zeiter, Deborah; Heim, Dominik; Halter, Jörg; Gerull, Sabine; Tichelli, André; Passweg, Jakob; Nigro, Nicole

    2017-07-01

    Hypothyroidism may complicate allogeneic hematopoietic stem cell transplantation (allo-HSCT); we therefore analyzed risk factors in this study. We studied 229 patients with acute myeloid leukemia (AML) who underwent an allo-HSCT between 2003 and 2013 with different conditioning regimens (myeloablative, reduced-intensity, chemotherapy-based, or total body irradiation-based). Thyroid-stimulating hormone (TSH) and free thyroxine levels (fT4) were available in 104 patients before and after allo-HSCT. The median age at transplantation (n=104) was 47 (IQR 40-59)], 37 (35.6%) patients were female, and the overall mortality was 34.6% (n=36). After a median follow-up period of 47 (IQR 25-84) months, overt hypothyroidism (basal TSH>4.49mIU/l, FT4hypothyroidism (basal TSH>4.49mIU/l, normal fT4) was observed in 20 patients (19.2%). Positive thyroperoxidase (TPO) antibodies were found in 5 (4.8%) patients. A total of 13 patients (12.5%) were treated with thyroid hormone replacement. Acute graft-versus-host disease (aGvHD) ≥grade 2 occurred in 55 (52.9%) and chronic GvHD (cGvHD) in 74 (71.2%) of the patients. The risk of developing hypothyroidism was higher in the patients with repeated allo-HSCTs (P=0.024) and with positive TPO antibodies (P=0.045). Furthermore, the development of overt hypothyroidism was inversely proportional to age (P=0.043). No correlation was found with GvHD, HLA-mismatch, total body irradiation, and gender. After allo-HSCT, a significant number of patients experience thyroid dysfunction, including subclinical and overt hypothyroidism. Long-term and continuous follow-up for thyroid function after HSCT is important to provide timely and appropriate treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Medicines for Hypothyroidism

    Science.gov (United States)

    ... f y o ro r idism What is hypothyroidism? Hypothyroidism, also called underactive thyroid, occurs when the thyroid ... by your body. What is the treatment for hypothyroidism? People who have hypothyroidism must take a pill ...

  12. A combined form of hypothyroidism in pubertal patients with non-mosaic Klinefelter syndrome.

    Science.gov (United States)

    Tahani, Natascia; Ruga, Gilda; Granato, Simona; Spaziani, Matteo; Panimolle, Francesca; Anzuini, Antonella; Lenzi, Andrea; Radicioni, Antonio Francesco

    2017-02-01

    Klinefelter syndrome has been associated with thyroid abnormalities, the genesis of which is not yet fully clear. The aim of this study was to evaluate thyroid function in Klinefelter syndrome subjects during the pubertal period. Chemiluminescent microparticle immunoassay was used to analyze Thyroid-Stimulating Hormone, fT3 and fT4 concentration in serum samples from 40 Klinefelter syndrome pubertal boys with classic 47,XXY karyotype and 157 healthy age-matched controls. 13 Klinefelter syndrome patients also underwent Thyrotropin-Releasing Hormone testing to evaluate hypothalamic-pituitary function. fT3 levels were significantly lower in Klinefelter syndrome patients than in age-matched controls (p first time that pubertal Klinefelter syndrome patients have significantly lower fT3 serum levels than do healthy age-matched boys, whereas Thyroid-Stimulating Hormone and fT4 are normal, albeit at the lower end of the reference range. Most patients showed an inadequate/prolonged response to pituitary stimulation with Thyrotropin-Releasing Hormone. These findings suggest a combined form of both central and peripheral hypothyroidism in Klinefelter syndrome boys during pubertal development.

  13. Thyroid V50 Highly Predictive of Hypothyroidism in Head-and-Neck Cancer Patients Treated With Intensity-modulated Radiotherapy (IMRT).

    Science.gov (United States)

    Sachdev, Sean; Refaat, Tamer; Bacchus, Ian D; Sathiaseelan, Vythialinga; Mittal, Bharat B

    2017-08-01

    Radiation-induced hypothyroidism affects a significant number of patients with head-and-neck squamous cell cancer (HNSCC). We examined detailed dosimetric and clinical parameters to better determine the risk of hypothyroidism in euthyroid HNSCC patients treated with intensity-modulated radiation therapy (IMRT). From 2006 to 2010, 75 clinically euthyroid patients with HNSCC were treated with sequential IMRT. The cohort included 59 men and 16 females with a median age of 55 years (range, 30 to 89 y) who were treated to a median dose of 70 Gy (range, 60 to 75 Gy) with concurrent chemotherapy in nearly all (95%) cases. Detailed thyroid dosimetric parameters including maximum dose, mean dose, and other parameters (eg, V50-percent volume receiving at least 50 Gy) were obtained. Freedom from hypothyroidism was evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were conducted using Cox regression. After a median follow-up period of 50 months, 25 patients (33%) became hypothyroid. On univariate analysis, thyroid V50 was highly correlated with developing hypothyroidism (P=0.035). Other dosimetric paramaters including mean thyroid dose (P=0.11) and maximum thyroid dose (P=0.39) did not reach statistical significance. On multivariate analysis incorporating patient, tumor, and treatment variables, V50 remained highly statistically significant (P=0.037). Regardless of other factors, for V50>60%, the odds ratio of developing hypothyroidism was 6.76 (P=0.002). In HNSCC patients treated with IMRT, thyroid V50 highly predicts the risk of developing hypothyroidism. V50>60% puts patients at a significantly higher risk of becoming hypothyroid. This can be a useful dose constraint to consider during treatment planning.

  14. Subclinical Coronary Plaque Burden in Asymptomatic Relatives of Patients With Documented Premature Coronary Artery Disease

    DEFF Research Database (Denmark)

    Christiansen, Morten Krogh; Jensen, Jesper Møller; Bøtker, Hans Erik

    Introduction: A family history of premature coronary artery disease (CAD) is a well-known risk factor for adverse coronary events with age of onset being inversely related to the degree of heritability. Hypothesis: We hypothesized that asymptomatic first degree relatives, of patients with premature...... CAD, suffer a high burden of subclinical coronary atherosclerosis. Methods: First degree relatives, aged 30-65 years, of patients with a documented coronary revascularization procedure before the age of 40 years, were invited to participate in the study. Participants were matched by age, sex...... and absence of a family history, with patients referred for coronary CT angiography (CTA) because of atypical angina or non-anginal chest pain. A pooled blinded analysis was performed. The main outcome measure was the number of plaque-affected coronary segments. Results: 88 relatives and 88 symptomatic...

  15. Dynamics of Carbohydrate and Lipid Metabolic Parameters under Complex Therapy in Patients with Type 2 Diabetes Mellitus Combined with Primary Hypothyroidism

    Directory of Open Access Journals (Sweden)

    T.Yu. Yuzvenko

    2015-07-01

    Full Text Available The aim of work was to study dynamics of carbohydrate and lipid metabolic parameters under complex therapy in patients with the type 2 diabetes mellitus (DM combined with primary hypothyroidism. 173 persons (26 men and 147 women were examined. The first (basic group consisted of 52 patients with  type 2 DM combined with primary hypothyroidism. The second group was formed with 55 patients with type 2 DM without thyroid pathology, the third group included 48 patients with primary hypothyroidism without DM (groups of comparison. In the group of type 2 DM patients with primary hypothyroidism in 4 and 12 weeks of complex therapy there were found the improvement of indexes of fasting glucose, postprandial glycemia and glycated haemoglobin, and there was compensation of hypothyroidism in 12 weeks. In patients with the combined pathology there were registered more severe violations of lipid metabolism as an increased values of triglycerides, total holesterol, declined high density lipoproteins, than in the groups of comparison. Under a complex therapy the positive dynamics of lipid spectrum is educed as a declined level of total holesterol, low density lipoproteins, atherogenic coefficient. Levels of total holesterol, triglycerides, atherogenic coefficient positively correlate with the level of thyreotrophin in primary hypothyroidism.

  16. Subclinical atherogenesis in patients with mild psoriasis: A role for IL-6?

    Directory of Open Access Journals (Sweden)

    Michelle Larissa Zini Lise

    Full Text Available Summary Introduction: A link of psoriasis with subclinical atherosclerosis has been postulated and cytokine network might intermediate this association. Few data are available in patients with mild psoriasis. We evaluated carotid intima-media thickness (cIMT in drug-free psoriatic individuals and controls. In parallel, we searched for associations of cIMT with disease activity indexes and serum interleukins (IL in psoriatic patients. Method: An experienced radiologist performed the cIMT analyses. Cytokine concentrations were assessed by flow cytometry. Disease activity was evaluated based on psoriasis area and severity index (PASI as well as body surface area (BSA. Results: Sixty-five (65 patients and 64 controls were studied. Mean age of patients (50.9 years did not differ from controls (p=0.362. A low PASI and BSA (0.05. Smoking habit and diabetes mellitus predominated in cases (p=0.002. An altered cIMT (≥ 0.9 mm was more frequent in cases than in controls (23.8% versus 8.5%, adjusted p=0.045. Mean cIMT was higher in cases with a borderline significance (p=0.057. cIMT scores did not correlate to PASI (rs=0.066; p=0.250 or BSA (rs=0.175; p=0.185, but did correlate significantly with serum IL-6 (rs=0.26; p=0.005. Conclusion: Subclinical atherosclerosis was more frequent in patients with mild psoriasis than controls. cIMT in psoriatic individuals correlated with serum IL-6, pointing to an eventual proatherogenic role of IL-6 in these patients. Newer studies should clarify the connection of atherogenesis with cytokines in psoriasis.

  17. The effect of obstructive sleep apnea syndrome and hypothyroidism to intima-media thickness of carotid artery.

    Science.gov (United States)

    Bozkus, Fulsen; Dikmen, Nursel; Güngör, Gülay; Samur, Anıl

    2017-03-01

    Obstructive sleep apnea syndrome (OSAS) is a common disorder and in subjects with OSAS the prevalence of hypothyroidism is approximately 1.2-11 %. The episodes of hypoxia/reoxygenation associated with the respiratory disturbances observed in subjects with OSAS increases the risk of cardiovascular diseases. Hypothyroidism; primary or subclinical, has several effects on cardiovascular system. In our study, we investigated carotid artery intima-media thickness (IMT) which is an early sign of atherosclerosis, in OSAS subjects with hypothyroidism. Subjects who admitted to Kahramanmaras Necip Fazıl City State Hospital Chest Diseases out-patient clinic between May 2014 and January 2016 for snoring and had polysomnographic evaluation at the sleep laboratory were included in this study. Each subject was evaluated for serum thyroid function tests and carotid artery IMT was measured by a Doppler ultrasound. Mean carotid artery IMT values in the isolated OSAS, OSAS plus hypothyroidism, and control groups were 0.67 ± 0.12, 0.8 ± 0.12, and 0.54 ± 0.08 mm, respectively; difference between groups was statistically significant (p hypothyroidism comorbidity in OSAS, and suspected subjects with OSAS should be screened for hypothyroidism considering the potential cardiovascular complications.

  18. The heart and hypothyroidism | Bennett | South African Medical ...

    African Journals Online (AJOL)

    The association of hypothyroidism with heart disease is reviewed. The. relative rarity of cardiac failure due to hypothyroidism is stressed, and structural abnormalities of the heart due to hypothyroidism are discussed. The clinical management of hypothyroid patients with heart disease is described.

  19. The Effect of Maternal Hypothyroidism on Fetal Umbilical Cord Brain-Derived Neurotrophic Factor Levels

    Directory of Open Access Journals (Sweden)

    Hüsnü Alptekin

    2016-03-01

    Full Text Available Objective: Brain derived neurotrophic factor (BDNF is the most important neurotrophin, which helps the differen­tiation and growth of central and peripheral neurons, and facilitates synaptic transmission. In this study we aimed to investigate fetal cord BDNF levels of infants born from subclinical and clinical maternal hypothyroidism. Methods: This study was conducted on a total of 67 preg­nant women who were followed up in Obstetrics and Gy­necology outpatient clinics, 27 with maternal hypothyroid­ism and 40 age-parity matched healthy pregnants without hypothyroidism. Immediately after vaginal or cesarean delivery fetal cord blood samples were taken from these patients and BDNF levels were measured. Results: BDNF levels of infants born from pregnants with maternal hypothyroidism were significantly lower than the control group (23.3 ± 17.4 ng/dl and 50.7 ± 28.3 ng/dl respectively; p<0.001. In multiple linear regression analysis, while BDNF level was related with maternal hy­pothyroidism and infant sex, it was not associated with mode of delivery, maternal age, total weight gain during pregnancy, gestational age at birth, thyroid stimulating hormone (TSH levels and other neonatal data. Conclusion: This study showed that fetal cord BDNF lev­els significantly decreased in infants of the pregnants with hypothyroidism.

  20. Central hypothyroidism and its role for cardiovascular risk factors in hypopituitary patients

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, Ulla; Klose, Marianne

    2016-01-01

    -known affection on the heart and cardiovascular system, and may result in cardiac failure, cardiovascular affection is less well recognized in central hypothyroidism. Studies on central hypothyroidism and cardiovascular outcome are few and given the rarity of the diseases often small. Further, there are several...... influence on the cardiovascular system, describe differences from primary thyroid failure and seek evidence for performing guidelines for clinical management of this particular thyroid and hypothalamo-pituitary disorder....

  1. Serum fibroblast growth factor 21 levels are related to subclinical atherosclerosis in patients with type 2 diabetes.

    Science.gov (United States)

    Xiao, Yang; Liu, Lingjiao; Xu, Aimin; Zhou, Pengcheng; Long, Zhaofeng; Tu, Yiting; Chen, Xiaoyan; Tang, Weili; Huang, Gan; Zhou, Zhiguang

    2015-06-06

    Fibroblast growth factor 21 (FGF21), a glucose and lipid metabolic regulator, has recently been demonstrated to be associated with cardiovascular diseases (CVD) such as carotid atherosclerosis, coronary heart disease and carotid artery plaques. However, the relationship between circulating FGF21 and subclinical atherosclerosis or atherosclerosis of other arteries such as the femoral and iliac artery remains unclear. In this study, we evaluated the association of serum FGF21 with intima-media thickness (IMT) and subclinical atherosclerosis in type 2 diabetic patients. Serum FGF21 levels were detected by enzyme-linked immunosorbent assay in 212 newly diagnosed type 2 diabetic patients without clinical symptoms of atherosclerosis or cardiovascular diseases. IMT of the carotid, femoral, and iliac arteries were measured by high-resolution B-mode ultrasound to determine the presence of subclinical atherosclerosis, which was defined as having an IMT > 1.0 mm and/or plaque on one or more of the three arteries without any clinical manifestations. The relationship between serum FGF21 levels and subclinical atherosclerosis was analyzed. Serum FGF21 levels were significantly higher in patients with subclinical atherosclerosis compared to those without [261.3 (135.1-396.4) versus 144.9 (95.9-223.0) ng/L, P subclinical atherosclerosis compared to their respective groups without [men: 243.2 (107.6-337.0) versus 136.8 (83.6-212.8) ng/L, P = 0.048; women: 292.4 (174.2-419.9) versus 160.4 (115.3-258.5) ng/L, P = 0.001]. Moreover, serum FGF21 levels showed a significantly positive correlation with carotid IMT in women (r = 0.23, P = 0.018) and with iliac IMT in both genders (women: r = 0.27, P = 0.005; men: r = 0.22, P = 0.024). Multiple logistic regression analysis further showed that serum FGF21 was an independent impact factor for subclinical atherosclerosis in patients with type 2 diabetes. Serum FGF21 is elevated in newly diagnosed type 2 diabetes, and positively correlates with

  2. Serum levels of glucagon-like peptide (GLP-1 and GLP-2 in patients with Hashimoto′s thyroiditis

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    Yue Jin

    2015-01-01

    Full Text Available Background: The influence of Hashimoto′s thyroiditis (HT with subclinical hypothyroidism or euthyroid status on the alteration of glucagon-like peptide (GLP-1 and GLP-2 levels remains uncertain. Materials and Methods: Twenty-four untreated HT patients with subclinical hypothyroidism, 24 euthyroid HT patients, and 24 age- and gender-matched controls were enrolled in the study. The levels of GLP-1, GLP-2, glucose, glycated albumin, insulin, thyroid hormone, and thyroid autoantibodies were measured and evaluated. Results: The levels of GLP-1, blood glucose, and triglyceride were higher in HT patients with subclinical hypothyroidism than in controls (all P < 0.05, respectively. However, the above variables, including GLP-2, were similar in euthyroid patients and controls. Neither GLP-1 nor GLP-2 was correlated with thyroid hormone, thyroid autoantibodies or metabolic parameters. Conclusion: The serum levels of GLP-1, not GLP-2, were increased in patients with subclinical hypothyroidism. Our data suggest that subclinical hypothyroidism affects circulating GLP-1 levels.

  3. Influence of Hypothyroidism on Separate Links of Metabolism, Structure and Function of the Heart in Insulin Resistance

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    T.Yu. Yuzvenko

    2014-07-01

    Full Text Available The article presents research findings of reduced thyroid function impact on the background of insulin resistance on the specific links of metabolism, structure and function of the heart. It is found that in thyroid dysfunction, the main nosological form of myocardial lesion in female patients without concomitant cardiovascular disease is the development of metabolic endocrine cardiomyopathy. Feature of cardiac lesion is the absence of cardiosclerotic, myocardial and ischemic processes in hypothyroidism. Obscure clinical symptoms of the heart both in apparent and subclinical hypothyroidism are detected. Features of clinical, instrumental and laboratory changes in female patients with impaired thyroid function are a trend to systolic blood pressure increase, the absence of significant dyslipidemia, dysglycemia, and cardiocytolysis and hepatocytolysis. Thyroid hormone deficiency is associated with increased myocardial repolarization heterogeneity: subclinical hypothyroidism is accompanied by violation of repolarization processes and the development of electrical heterogeneity of ventricular myocardium, and in the apparent hypothyroidism changes are more linked with the violation of the homogeneity of the electrical impulse to the atria.

  4. Obesity and hypothyroidism

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    S M Zakharova

    2013-06-01

    Full Text Available Obesity and hypothyroidism are common diseases, and consequently clinicians should be particularly alert to the possibility of thyroid dysfunction in obese patients. The relationship between thyroid function and obesity is likely to be bidirectional, with hypothyroidism affecting weight, but obesity also influencing thyroid function. Both serum thyroid-stimulating hormone and fT3 are typically increased in obese individuals, an effect likely mediated by leptin. Following L-T4 treatment for overt hypothyroidism, weight loss appears to be modest and mediated primarily by loss of water weight rather than fat. Selected thyroid analogs might be a means by which to improve weight loss by increasing energy expenditure in obese patients during continued caloric deprivation

  5. Mild hypothyroidism improves glucose tolerance in experimental type 2 diabetes.

    Science.gov (United States)

    Ashwini, S; Bobby, Zachariah; Joseph, Manoj

    2015-06-25

    obtained with parameters of oxidative stress. Oxidative stress was observed in overt hypothyroidism+diabetes, diabetes, overt hypothyroidism groups with severity decreasing in that order. Coexistence of mild hypothyroidism with diabetes decreased oxidative stress in comparison with isolated diabetes group. There was no statistical difference in lipid profile between mild hypothyroidism+diabetes and isolated diabetes group. Presence of mild hypothyroidism in type 2 diabetes confers a protective effect with respect to glucose tolerance and redox balance whereas presence of overt hypothyroidism in type 2 diabetes has a deleterious effect. The increased incidence of hypothyroidism in diabetes, especially subclinical hypothyroidism, could be a reflection of a physiological attempt by the body to mitigate damage wrought by diabetes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  6. Complement system and small HDL particles are associated with subclinical atherosclerosis in SLE patients.

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    Parra, Sandra; Vives, Gloria; Ferré, Raimon; González, Marta; Guardiola, Montse; Ribalta, Josep; Castro, Antoni

    2012-11-01

    The complement system is involved in the pathogenic course of SLE. These patients exhibit metabolic disturbances in lipoprotein metabolism characterized by a pro-inflammatory status and an accelerated atherosclerosis. The aim of this study is to investigate whether levels of the complement are associated to the presence of subclinical atherosclerosis, lipid and glucose metabolism and inflammatory markers in SLE patients. Sixty-nine consecutive patients with SLE were recruited for the study. Fasting venous blood samples were collected on the same day as the measurements of cIMT were performed. Total plasma lipids and the distribution of subclasses of lipoproteins were analyzed by nuclear magnetic resonance spectroscopy. We found direct correlations between cIMT values and the levels of C3, C4 and CH50. In multivariate analyses, the mean cIMT from the three territories were predicted by age (β = 0.005, 95% CI: 0.002-0.007, P < 0.001) and the functional hemolytic assay of the complement activity CH50 (β = 0.003, 95% CI: 0.001-0.006, P < 0.0013). The complement components were associated with BMI, SBP and levels of glucose. Small, dense HDL particles also correlated with the three complement components C3, C4 and CH50 in bivariate analyses. In multivariate analyses small HDL particles predicted levels of C3: β = 0.024, 95% CI: 0.013-0.035, P < 0.001; and C4: β = 0.005, 95% CI: 0.002-0.008, P = 0.006. Activation of the complement system measured by functional assay CH50 is related to subclinical atherosclerosis in quiescent lupus patients and is activated by the small dense HDL particles. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  7. Subclinical atherosclerosis in young patients with rheumatoid arthritis and low disease activity

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    F. Ragni Alunni

    2011-09-01

    Full Text Available Background: There is an increasing body of evidence suggesting that subjects with rheumatoid arthritis (RA are characterized by acceleration of atherosclerotic process of arterial wall. However, all investigations performed so far to evaluate subclinical atherosclerosis in RA included subjects without selection for age and degree of disease activity that may represent confounding factors in such an evaluation. Objectives: To verify signs of accelerated subclinical atherosclerosis in young subject suffering from RA but with low disease activity. Methods: Thirty-two patients with RA and 28 age- and sex-matched control subjects with non-inflammatory rheumatic diseases were enrolled. Inclusion criteria were age less than 60 and low disease activity with score £3.2 according to DAS28, while subjects with traditional risk factors for and/or overt cardiovascular disease were ruled out from the study. Both patients and controls underwent evaluation of carotid and femoral artery intima-media thickness by ultrasounds. Results: Patients had higher intima-media thickness than controls of all the sites evaluated at carodit artery level, whereas there were no differences at the comparison of the superficial and common femoral artery wall. At the univariate analysis, a positive correlation between LDL cholesterol levels and intima-media thickness at the carotid bifurcation was found. Conclusions: Young patients with RA and low disease activity have acceleration of atherosclerosis development as shown by increased intima-media thickness of carotid artery with respect to subjects without inflammatory rheumatic disease. It is conceivable that the organic damage of arterial wall could be the result of persistent endothelial dysfunction induced by chronic inflammation and immune dysregulation which characterize RA.

  8. PREVALENCE OF SUB CLINICAL HYPOTHYROIDISM IN FIRST TRIMESTER OF PREGNANCY

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    Nataraj

    2015-04-01

    Full Text Available Thyroid disorder is s econd most common endocrine disorder in pregnancy . Hypothyroidism is more common in women in their reproductive age. Subclinical hypothyroidism is one of the type of thyroid disorders with incidence of 2 - 5% . The present study is to know the prevalence of subclinical hypothyroidism in pregnancy . METHODS : A prospective study conducted in Department of Obstetrics and Gynecology , ESIMC PGI MSR Bangalore , Karnataka . Data collected from One Hundred Fifty pregnant women attending antenatal checkup in our hospital in first trimester . According to Endocrinology society thyroid function test is done , if TSH is high then FT3 , FT4 values are estimated . Normal value for TSH is 0.1 - 2.5IU/ml in 1 st trimester . RESULT: In our study out of 150 women , Primi are 85 in number and Multie are 65 in number , Women with subclinical hypothyroidism is 20 . Prevalence of hypothyroidism in our study is 13% . CONCLUSION: Universal screening of thyroid disorder is necessary during pregnancy to prevent fetal and maternal morbidity associated with subclinical hypothyroidism

  9. Potential Association of Hypothyroidism and Cardiovascular Disorders among Type II Diabetes Mellitus Patients Visiting for Dental Treatment

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    Shantala Arunkumar

    2017-04-01

    Full Text Available Background: Diabetes is a group of etiologically different metabolic defects characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Aim and Objectives: The study intended to estimate prevalence of hypothyroidism among Type 2 Diabetes Mellitus (T2DM patients and to substantiate the association of these two disorders with cardiovascular diseases. Material and Methods: The study included 208 T2DM patients; all were evaluated for diabetes mellitus, hypothyroidism and cardiovascular disorders by history, clinical examination and investigations. They were divided as Diabetes Mellitus (DM and Diabetes Mellitus Hypothyroidic (DMH categories. DM category was further divided as: Diabetic (D and Diabetic Cardiovascular (DC groups, DMH category as Diabetic Hypothyroidic (DH and Diabetic Hypothyroid Cardiovascular (DHC groups. Intra and inter category comparison of biochemical and clinical parameters were done. Results: Out of 208 T2DM patients, DM category had 102 patients and DMH category 106 patients, On intracategory comparison of various biochemical parameters between the two categories, in DM category, Fasting Blood Sugar (FBS (p=0.00, Postprandial Blood Sugar (PPBS (p=0.34 and p=0.02, Low Density Lipoprotein (LDL (p=0.00 and p=0.20 were significantly higher and High Density Lipoprotein (HDL was lower in both D and DC groups, total cholesterol in DC (p=0.23 group was significantly higher and triglycerides were within normal. In DMH category, FBS (p=0.01 and p=0.00, serum Thyroid Stimulating Hormone (TSH (p=0.00, LDL, total cholesterol (p=0.00, LDL (p=0.02 and p=0.00 and triglycerides (p=0.00 and p=0.01 were significantly higher in both DH and DHC groups, the HDL was significantly lower in DHC group. There was no association between DM category with blood pressure and electrocardiogram parameters, but in DMH category there was significant association seen, as p=0.02 and p=0.06 respectively. On inter group

  10. Association between the clinical classification of hypothyroidism and reduced TSH in LT4 supplemental replacement treatment for pregnancy in China.

    Science.gov (United States)

    Zhang, Lyu; Zhang, Zhaoyun; Ye, Hongying; Zhu, Xiaoming; Li, Yiming

    2016-01-01

    The study was aimed to evaluate the effects of levothyroxine (LT4) supplemental replacement treatment for pregnancy and analyze the associations between the clinical classification of hypothyroidism and reduced thyroid-stimulating hormone (TSH) in LT4 therapy. Totally, 195 pregnant women with hypothyroidism receiving routine prenatal care were enrolled. They were categorized into three groups: overt hypothyroidism (OH), subclinical hypothyroidism (SCH) with negative thyroperoxidase antibody (TPOAb), and SCH with positive TPOAb. The association between the clinical classification and reduced TSH in LT4 supplemental replacement treatment was assessed. The results indicated that reduced TSH was significantly different among the groups according to the clinical classifications (p = 0.043). The result was also significantly different between patients with OH and patients with SCH and negative TPOAb (p = 0.036). Similar result was reported for the comparison between patients with OH and patients with SCH and positive TPOAb (p = 0.016). Multiple variable analyses showed that LT4 supplementation, gestational age and the variable of clinical classifications were associated with reduced TSH independently. Our data suggested that the therapeutic effect of substitutive treatment with LT4 was significantly associated with different clinical classifications of hypothyroidism in pregnancy and the treatment should begin as soon as possible after diagnosis.

  11. Correlation of degree of hypothyroidism with survival outcomes in patients with metastatic renal cell carcinoma receiving vascular endothelial growth factor receptor tyrosine kinase inhibitors.

    Science.gov (United States)

    Bailey, Erin B; Tantravahi, Srinivas K; Poole, Austin; Agarwal, Archana M; Straubhar, Alli M; Batten, Julia A; Patel, Shiven B; Wells, Chesley E; Stenehjem, David D; Agarwal, Neeraj

    2015-06-01

    Hypothyroidism is a common adverse effect of vascular endothelial growth factor receptor tyrosine kinase inhibitor (VEGFR-TKI) therapy in patients with metastatic renal cell carcinoma (mRCC). Some studies have shown an association with improved survival. However, hypothyroidism severity has not been correlated with survival outcomes. We report the incidence and severity of VEGFR-TKI therapy-associated hypothyroidism in correlation with the survival outcomes of patients with mRCC. A retrospective analysis of patients with mRCC who received VEGFR-TKIs (2004 through 2013) was conducted from a single institutional database. Hypothyroidism, progression-free survival (PFS), and overall survival (OS) were assessed. Univariate and multivariate analyses were performed using the Kaplan-Meier method and Cox proportional hazard models. Of 125 patients with mRCC, 65 were eligible. Their median age was 59 years (range, 45-79 years), and 46 (70.8%) were male. Hypothyroidism occurred in 25 patients (38.5%), of whom 13 had a peak thyroid-stimulating hormone (TSH) level > 10 mIU/L during treatment. The median OS was significantly longer in patients with a peak TSH > 10 mIU/L than in patients with a peak TSH of ≤ 10 mIU/L (not reached vs. 21.4 months, P = .005). On multivariate analysis, risk criteria, number of previous therapies, and severe hypothyroidism (TSH > 10 mIU/L) during VEGFR-TKI therapy remained significant for improvements in PFS and OS. The severity of VEGFR-TKI therapy-associated hypothyroidism (TSH > 10 mIU/L) was associated with improved survival outcomes in patients with mRCC and should not necessitate a dose reduction or therapy discontinuation. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Hypothyroidism risk compared among nine common bipolar disorder therapies in a large US cohort.

    Science.gov (United States)

    Lambert, Christophe G; Mazurie, Aurélien J; Lauve, Nicolas R; Hurwitz, Nathaniel G; Young, S Stanley; Obenchain, Robert L; Hengartner, Nicolas W; Perkins, Douglas J; Tohen, Mauricio; Kerner, Berit

    2016-05-01

    Thyroid abnormalities in patients with bipolar disorder (BD) have been linked to lithium treatment for decades, yet other drugs have been less well studied. Our objective was to compare hypothyroidism risk for lithium versus the anticonvulsants and second-generation antipsychotics commonly prescribed for BD. Administrative claims data on 24,574 patients with BD were analyzed with competing risk survival analysis. Inclusion criteria were (i) one year of no prior hypothyroid diagnosis nor BD drug treatment, (ii) followed by at least one thyroid test during BD monotherapy on lithium carbonate, mood-stabilizing anticonvulsants (lamotrigine, valproate, oxcarbazepine, or carbamazepine) or antipsychotics (aripiprazole, olanzapine, risperidone, or quetiapine). The outcome was cumulative incidence of hypothyroidism per drug, in the presence of the competing risk of ending monotherapy, adjusted for age, sex, physician visits, and thyroid tests. Adjusting for covariates, the four-year cumulative risk of hypothyroidism for lithium (8.8%) was 1.39-fold that of the lowest risk therapy, oxcarbazepine (6.3%). Lithium was non-statistically significantly different from quetiapine. While lithium conferred a higher risk when compared to all other treatments combined as a group, hypothyroidism risk error bars overlapped for all drugs. Treatment (p = 3.86e-3), age (p = 6.91e-10), sex (p = 3.93e-7), and thyroid testing (p = 2.79e-87) affected risk. Patients taking lithium were tested for hypothyroidism 2.26-3.05 times more frequently than those on other treatments. Thyroid abnormalities occur frequently in patients with BD regardless of treatment. Therefore, patients should be regularly tested for clinical or subclinical thyroid abnormalities on all therapies and treated as indicated to prevent adverse effects of hormone imbalances on mood. © 2016 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

  13. Is Thyroid Autoimmunity per se a Determinant of Quality of Life in Patients with Autoimmune Hypothyroidism?

    DEFF Research Database (Denmark)

    Watt, Torquil; Hegedüs, Laszlo; Bjorner, Jakob Bue

    2012-01-01

    .001), and Anxiety (r = 0.23, p = 0.002), but no longer to Emotional Susceptibility or Impaired Social Life, indicating that the effect on these were mediated through an effect on the symptom scales (i.e. Goitre Symptoms, Depressivity and Anxiety). CONCLUSION: Health-related QoL, evaluated with state-of-the-art Qo...... with several QoL outcomes: Goitre Symptoms (p = 0.024), Depressivity (p = 0.004), Anxiety (p = 0.004), Emotional Susceptibility (p = 0.005) and Impaired Social Life (p = 0.047). In the multivariate model, the TPOAb level was related to Goitre Symptoms (r = 0.17, p = 0.019), Depressivity (r = 0.24, p = 0......PURPOSE: To evaluate the relationship between thyroid variables and health-related quality of life (QoL) in patients with autoimmune hypothyroidism, using the thyroid-specific QoL questionnaire ThyPRO. METHODS: In a cross-sectional study, responses to the ThyPRO from 199 outpatients with autoimmune...

  14. Subclinical hypothyroidism and cardiovascular risk factors

    OpenAIRE

    Frías López, M. C.; Tárraga López, P. J.; Rodríguez Montes, José Antonio; J. Solera Albero; Celada Rodríguez, A.; M. A. López Cara; Gálvez, A.

    2011-01-01

    Objetivo: Conocer la prevalencia del hipotiroidismo subclínico en la población general de un centro de salud urbano y describir las características clínicas y factores de riesgo cardiovascular de los pacientes con hipotiroidismo subclínico. Métodos: Se realizó un estudio observacional descriptivo, transversal, retrospectivo, revisando las historias clínicas de los pacientes incluidos en la muestra desde junio de 2005 hasta julio de 2007. Se analizaron las siguientes va...

  15. Erythrocyte glutathione levels in lithium-induced hypothyroidism.

    Science.gov (United States)

    Engin, Atilla; Altan, Nilgun; Isik, Erdal

    2005-01-01

    significant difference in the thyroid-stimulating hormone values as well as the red blood cell glutathione contents or superoxide dismutase activities between healthy controls and lithium-treated euthyroid subjects. It is most likely that lithium primarily inhibited hormone production in the thyroid and that this led to a compensatory increase in thyroid-stimulating hormone secretion with a significant decrease in the red blood cell glutathione content. While the red blood cell glutathione content of hypothyroid patients was reduced to 40% of the post-thyroxine level, unchanged superoxide dismutase activity might render the erythrocytes vulnerable to oxidative stress and ultimately haemolysis. Thyroxine replacement during lithium prophylaxis of psychiatric patients is advisable in order to prevent subclinical hypothyroidism and related defects of erythrocyte antioxidant capacity.

  16. Acute Pancreatitis Induced by Methimazole in a Patient With Subclinical Hyperthyroidism

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    Katrina Agito MD

    2015-06-01

    Full Text Available We report here a unique case of methimazole (MMI-induced pancreatitis. To our knowledge, this is the sixth case reported in the literature and the first diagnosed in a patient with toxic multinodular goiter. A 51-year-old Caucasian female with a history of benign multinodular goiter and subclinical hyperthyroidism was started on MMI 10 mg orally daily. Three weeks later, she developed sharp epigastric pain, diarrhea, lack of appetite, and fever. Her lipase was elevated 5 times the upper limit of normal, consistent with acute pancreatitis. There was no history of hypertriglyceridemia, or alcohol abuse. Abdominal computed tomography was consistent with acute uncomplicated pancreatitis, without evidence of gallstones or tumors. MMI was discontinued, and her hyperthyroid symptoms were managed with propranolol. Her acute episode of pancreatitis quickly resolved clinically and biochemically. One year later, she redeveloped mild clinical symptoms of hyperthyroidism with biochemical evidence of subclinical hyperthyroidism. MMI 10 mg orally daily was restarted. Five days later, she experienced progressive abdominal discomfort. Her lipase was elevated 12 times the upper limit of normal, and the abdominal computed tomography was again compatible with acute uncomplicated pancreatitis. MMI was again discontinued, which was followed by rapid resolution of her pancreatitis. The patient is currently considering undergoing definitive therapy with radioactive iodine ablation. Our case as well as previous case reports in the literature should raise awareness about the possibility of pancreatitis in subjects treated with MMI in the presence of suggestive symptoms. If the diagnosis is confirmed by elevated pancreatic enzymes, the drug should be discontinued.

  17. Thyroid Dysfunction in Non-Interferon Treated Hepatitis C Patients Residing in Hepatitis Endemic Area

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    Nayab Batool

    2017-01-01

    Full Text Available Background. Association of thyroid dysfunction (TD