Nonthyroidal Illness Syndrome in Ischaemic Stroke Patients is Associated with Increased Mortality

2019 ◽  
Vol 128 (12) ◽  
pp. 811-818 ◽  
Author(s):  
Saulius Taroza ◽  
Daiva Rastenytė ◽  
Aurelija Podlipskytė ◽  
Henrikas Kazlauskas ◽  
Narseta Mickuvienė
Keyword(s):  
Venous Blood ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
First Year ◽  
Free Triiodothyronine ◽  
Kaplan Meier ◽  
Index Stroke ◽  
Thyroid Axis ◽  
Changes Over Time ◽  
Overall Mortality

Abstract Background Results of studies on associations between triiodothyronine serum levels and mortality after acute ischemic stroke (AIS) are inconsistent. Therefore, the aim of this prospective study was to evaluate links between serum levels of thyroid axis associated hormones and all-cause mortality during 1 year after AIS. Methods and results This study involved 255 patients with AIS. Patients were divided into two groups: those who survived 1 year after their index stroke and those who not, and by quartiles of free triiodothyronine (FT3) and ΔFT3 (difference between basal FT3 and repeated FT3 on discharge) hormone serum concentrations. To assess serum levels of thyroid stimulating hormone (TSH), FT3 and free tetraiodothyronine (FT4), venous blood was taken from all included patients on admission to hospital. On discharge, blood tests were repeated for 178 (69.8%) patients. Study endpoints were overall mortality within 30, 90 and 365 days after AIS. Results Compared with the survivals, those who died had significantly lower mean FT3, FT3/FT4 ratio in all periods and lower median TSH within 30 days. Higher FT3 serum levels versus lower, even after adjustment for included important variables, remained significant for lower odds of death within 365 days after AIS (OR=0.57; 95% CI: 0.33–0.97, p=0.04), but added insignificant additional predictive value to the NIHSS score or age. Kaplan–Meier survival curves demonstrated that the first FT3 quartile was significantly associated with increased mortality compared with all other quartiles within 365 days after AIS. With ΔFT3 quartiles no such association was found. Conclusions. Higher FT3 levels on admission versus lower are significantly associated with lower mortality within 365 days after AIS. FT3 serum levels changes over time didn’t show any association with mortality within first year.

Hypothalamus-pituitary-thyroid axis interactions with pineal gland in the rat.

1979 ◽  
Vol 236 (4) ◽  
pp. E416 ◽  
Author(s):  
G L Brammer ◽  
J E Morley ◽  
E Geller ◽  
A Yuwiler ◽  
J M Hershman
Keyword(s):  
Pineal Gland ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Prolactin Release ◽  
Free Thyroxine Index ◽  
Pituitary Thyroid Axis ◽  
Thyroid Axis ◽  
Melatonin Production

We examined in the rat several possible relationships between the pineal gland and the hypothalamus-pituitary-thyroid axis. The pineal gland, the retina, and the hypothalamus exhibited a diurnal rhythm in thyrotropin-releasing hormone (TRH) content with peak values occurring around 1200 h. This rhythm in the hypothalamus was abolished by constant light but was not affected by pinealectomy. Nor did pinealectomy affect hypothalamic TRH content, pituitary content of thyroid-stimulating hormone (TSH) or prolactin; serum levels of (TSH), triiodothyronine (T3), or thyroxine (T4), or serum free-thyroxine index; or free-triiodothyronine index. Melatonin did not affect TSH or prolactin release from the anterior pituitary or TRH release from the hypothalamus in vitro. Isoproterenol did not affect the TRH content of pineal glands in vitro; nor did TRH or T3 affect basal or stimulated activities of serotonin N-acetyltransferase, the presumed controlling enzyme in melatonin production. We found no evidence for significant interactions between the pineal gland and the hypothalamus-pituitary-thyroid axis.

scholarly journals P198 Long-term outcomes after mitraclip implantation

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
J P Dias Ferreira Reis ◽  
L Moura Branco ◽  
L Almeida Morais ◽  
R Ilhao Moreira ◽  
P Rio ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Univariate Analysis ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
First Year ◽  
Exclusion Criteria ◽  
Kaplan Meier ◽  
Cox Analysis ◽  
Overall Mortality

Abstract Background Mitraclip implantation (MI) is a well-established option for patients (P) with severe mitral regurgitation (MR) noneligible to surgery. Its impact on long term prognosis is being addressed by several recent studies. Purpose To identify predictors of morbidity and mortality in P undergoing MI and evaluate if the COAPT, Everest and MITRAFR exclusion criteria (EC) had any impact on the outcome of our population. Methods prospective study of P who underwent MI between 2013 and 2018 in one medical center. EC: COAPT: LVEF < 20%, LV end-diastolic diameter > 70mm or pulmonary artery systolic pressure > 70mmHg; Everest: LVEF < 25% or LV end-systolic diameter (LVESD)>55mm; MITRA-FR: LVEF < 15% or >40% or primary MR. An univariate analysis was performed followed by a multivariate Cox analysis to evaluate overall mortality (M), overall mortality/ heart failure hospitalization (MH) and mortality in the first year post-MI(M1). Survival analysis using Kaplan-Meier plots. p < 0.05 were considered significant. Results 40P, 60% male, mean age 66 ± 12 years (Y) and mean follow-up time of 18 ± 15 months. 67.5% presented with MR grade IV and 75% had functional MR. Successful implantation in 97.5%, with 55% presenting mild MR post-procedure. Overall mortality was 30% (12P), mostly due to cardiovascular causes, with 9P dying in the first year (30%). There was no difference between pts with functional and primary MR: M- 33%vs20% (p = 0.6); MH– 53.3%vs30% (p = 0.5). P who met the COAPT exclusion criteria (N-22) presented an inferior 1Ysurvival (64.5%vs86.7%, p = 0.046). The overall outcome was comparable between P who matched and didn"t match Everest and MITRA-FR exclusion criteria. Basal BNP value (p = 0.037), mean preprocedural MAGGIC score (p = 0.040) and EROA (p = 0.039) were associated to M1. Multivariate Cox analysis revealed that basal BNP was an independent predictor of M (p = 0.017), whereas a higher distance in the pre-procedural 6 minute walk test (p = 0.008) and the "reduction in the MR severity and PASP" (p = 0.008) presented a protective effect. LVESD > 55mm was an independent predictor of MH (p = 0.017), but MR of grade 2 or less after procedure was protective (p = 0.006). Conclusion There was no M difference between P with functional and primary MR. P with COAPT exclusion criteria had worse 1Ysurvival. A higher distance in 6MWT and a reduction in MR severity and PASP were protective. An LVESD > 55 mm had a worse prognosis. Careful P selection may be crucial to improve MI"s results Abstract P198 Figure. Kaplan-Meier Plots

Haematological profile in foals during the first year of life

2019 ◽  
Vol 184 (16) ◽  
pp. 503-503 ◽  
Author(s):  
Babak Faramarzi ◽  
Lon Rich
Keyword(s):  
Venous Blood ◽  
Reference Intervals ◽  
First Year ◽  
Cell Counts ◽  
Haematological Values ◽  
Haematological Profile ◽  
White Blood Cell Counts ◽  
First Year Of Life ◽  
Changes Over Time ◽  
Over Time

Foals’ haematological values change constantly during their first year of life. The use of updated age-based reference intervals (RIs) is imperative for providing accurate diagnosis and optimum care for sick foals. The authors' objective was to provide updated RIs for 13 haematological values in 2, 7, 14, 30, 90, 180 and 365-day-old foals and to investigate the changes over time in each measured value. Venous blood was collected at those ages from clinically healthy foals. Thirteen haematological values were analysed. The 95% RIs were reported using a bootstrapping method. Differences over time were examined using Friedman test. RIs for each of the measured values were calculated. Results showed noticeable trends in changes over time in several values. Nevertheless, white blood cell counts significantly increased between day 2 and day 90 (P=0.011) while lymphocyte counts increased from day 2 up to day 180 (P=0.033). The mean corpuscular haemoglobin and mean corpuscular volume (P=0.011) significantly decreased between day 2 and day 90. Normal haematological values in foals not only differ from those in adult horses but also change throughout the first year of life; thus, it is critical that clinicians use age-based RIs when treating sick foals.

scholarly journals Study of thyroid hormones free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) in subjects with dental fluorosis

2012 ◽  
Vol 06 (02) ◽  
pp. 184-190 ◽  
Author(s):  
Mahadevi B Hosur ◽  
S R Puranik ◽  
Shrinivas Vanaki ◽  
Surekha R Puranik
Keyword(s):  
Thyroid Hormones ◽  
Dental Fluorosis ◽  
Statistical Significance ◽  
Serum Levels ◽  
Iodine Intake ◽  
Thyroid Stimulating Hormone ◽  
Control Group ◽  
Endemic Fluorosis ◽  
Free Triiodothyronine ◽  
Thyroid Gland Function

ABSTRACTObjective: Apart from its well-known deleterious dental and skeletal effects, fluoride excess can have toxic effects on many other tissues. Fluoride, when in excess, is known to interfere with thyroid gland function. Fluoride-induced thyroid disturbances similar to those observed in iodine deficiency state in spite of adequate iodine intake have been documented. Similar thyroid disturbances in individuals with dental fluorosis have not been well studied in populations with endemic fluorosis. This work was undertaken to study the effects of fluoride-induced thyroid disturbances in individuals with dental fluorosis.Methods: The study group included 65 subjects with dental fluorosis from endemic fluorosis populations. An additional control group was comprised of 10 subjects without dental fluorosis. The drinking water fluoride levels of the study populations were analyzed. Serum free FT3, FT4, and TSH levels of both groups were assessed.Results: All subjects with dental fluorosis had serum levels of thyroid hormones (FT3, FT4, and TSH) within the normal range, with the exception of 1 individual, who had elevated levels of TSH. Statistical significance was found when FT3 and TSH values were compared with different Dean’s index groups by a 1-way ANOVA test: FT3 (F = 3.4572; P=.0377) and TSH (F = 3.2649 and P=.0449).Conclusions: Findings of this study did not show any significant alterations in the levels of the thyroid hormones FT3, FT4, and TSH in subjects with dental fluorosis. Our observations suggest that thyroid hormone levels were not altered in subjects with dental fluorosis. Hence, future studies of this kind, along with more detailed investigations are needed. (Eur J Dent 2012;6:184-190)

scholarly journals The Association Between COVID-19 and Thyroxine Levels: A Meta-Analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Yiru Chen ◽  
Xiuneng Li ◽  
Yu Dai ◽  
Jingjing Zhang
Keyword(s):  
Meta Analysis ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Cochrane Library ◽  
Free Triiodothyronine ◽  
Time Restrictions ◽  
Literature Search Strategy ◽  
The Difference ◽  
Set Up ◽  
The Cochrane Library

ObjectivesRecently, a number of reports have described the potential relationship between COVID-19 and thyroid hormones, but the results were conflicting. We performed a meta-analysis to evaluate the effect of the severity of COVID-19 on thyroid-related hormones and the effect of thyroid-related hormones on the outcome of COVID-19 in order to try to confirm the association between the serum levels of free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) and the severity or mortality of coronavirus-19 patients.MethodsThe methodology was already registered in the International Prospective Register of Systematic Reviews (PROSPERO) database, and the protocol number is CRD42021269246. Systematic searches were carried out on the Cochrane Library, Embase, PubMed and Web of Science databases on November 15, 2021. We set up the literature search strategy based on the following keywords: [(T3 OR FT3 OR triiodothyronine) or (T4 OR FT4 OR thyroxine) or (TSH or thyrotropin)] and (COVID-19 OR SARS-CoV-2), without time restrictions.ResultsTwenty studies satisfied the inclusion/exclusion criteria and were included in the meta-analysis. A total of 3609 patients were enrolled in the study. From the analysis of the included studies, the incidence of thyroid-related hormone abnormalities was higher in patients with severe COVID-19, and the serum levels of FT3 and TSH were lower than those of patients with nonsevere COVID-19. However, the difference in the FT4 levels was not significant. Similar characteristics were shown between survivors and nonsurvivors. In addition, the outcomes of the meta-analysis showed that patients with abnormal thyroid-related hormones had greater mortality.ConclusionsLow FT3 serum levels, low FT4 serum levels and low TSH serum levels may increase the mortality of COVID-19 patients during admission. On the other hand, the higher the severity level of COVID-19, the higher the probability of decreases in the FT3, FT4, TSH levels.

scholarly journals Development of Graves’ disease during drug-free remission of juvenile dermatomyositis

2021 ◽  
Author(s):  
Ichiro Kobayashi ◽  
Masaki Shimomura ◽  
Masahiro Ueki ◽  
Shunichiro Takezaki ◽  
Yuka Okura ◽  
...  
Keyword(s):  
Juvenile Dermatomyositis ◽  
English Literature ◽  
Interleukin 2 ◽  
Elevated Serum ◽  
Oral Prednisolone ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Graves Disease ◽  
Free Triiodothyronine ◽  
Drug Free

ABSTRACT We report a Japanese boy with Graves’ disease (GD) which developed during drug-free remission of juvenile dermatomyositis (JDM). He had been diagnosed with JDM at the age of 6 years by typical skin rashes, muscle weakness, elevated serum transaminase levels, and typical findings of both magnetic resonance imaging and muscle biopsy. Although anti-melanoma differentiation antigen 5 autoantibody was positive, there was no complication of interstitial lung disease. He showed good response to methylprednisolone pulse therapy followed by oral prednisolone in combination with weekly methotrexate (MTX) and achieved drug-free remission after 3.5 years of treatment. Nevertheless, serum levels of soluble interleukin-2 receptor (sIL-2R) gradually elevated to 3185 U/ml despite no signs of relapse or malignancy. Hyperactivity and attention deficit was also noted. One year and 3 months after the cessation of MTX, he presented with abdominal pain, tachycardia, and apparent goitre. Laboratory tests showed elevated free triiodothyronine, undetectable thyroid stimulating hormone (TSH), and positive anti-TSH receptor antibodies. 99mTc scintigraphy showed high levels of thyroid uptake. He was diagnosed with GD and treated with 15 mg/day of thiamazole. Although transient drug eruption was observed, his thyroid functions are currently well-controlled on 5 mg/day of thiamazole. In conclusion, to our knowledge, this is the first report in English literature describing complication of GD with JDM. Unexpected elevation of sIL-2R could be a clue to the diagnosis of GD during the follow-up of JDM.

scholarly journals Neuroprotection of reduced thyroid hormone with increased estrogen and progestogen in postpartum depression

2019 ◽  
Vol 39 (9) ◽  
Author(s):  
Dan Li ◽  
Yangyao Li ◽  
Yun Chen ◽  
Haiyan Li ◽  
Yuqi She ◽  
...  
Keyword(s):  
Body Weight ◽  
Thyroid Hormone ◽  
Postpartum Depression ◽  
Cell Structure ◽  
Elevated Serum ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
Free Triiodothyronine ◽  
Promising Therapeutic Approach

Abstract Background: Postpartum depression (PPD) is a common serious mental health problem. Recent studies have demonstrated that hormone therapy serves as a promising therapeutic approach in managing PPD. The present study aims at exploring the role of thyroid hormone (TH), estrogen and progestogen in patients with PPD. Methods: Initially, PPD patients were enrolled and a PPD mouse model was established. The serum levels of estradiol (E2), progesterone (P), triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were subsequently measured. Next, in order to identify the effects of TH, estrogen and progestogen on PPD progression, mice were administrated with E2, P, contraceptives (CA), Euthyrox and methimazole (MMI). Besides, the body weight, activities, basolateral amygdala (BLA) neuron cell structure and the related gene expression of mice were analyzed. Results: The PPD patients and the mice showed elevated serum levels of T3, T4, FT3 and FT4 along with diminished E2, P and TSH levels. In the mice administered with a combination of E2, P, and MMI, decreased TH and increased estrogen and progestogen were detected, which resulted in increased body weight, normal activities, and BLA neuron cell structure. Moreover, brain-derived neurotrophic factor (BDNF) and cAMP-responsive element-binding protein (CREB) were both up-regulated in PPD mice administrated with a combination of E2, P, and MMI, which was accompanied by decreased TH and elevated estrogen and progestogen. Conclusion: Taken together, reduced TH combined with enhanced estrogen and progestogen confers neuroprotection in PPD, highlighting a potential target in prevention and treatment of PPD.

scholarly journals Thyroid Dysfunction in Relation to Immune Profile, Disease Status, and Outcome in 191 Patients with COVID-19

2020 ◽  
Author(s):  
David Tak Wai Lui ◽  
Chi Ho Lee ◽  
Wing Sun Chow ◽  
Alan Chun Hong Lee ◽  
Anthony Raymond Tam ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Thyroid Dysfunction ◽  
Thyroid Autoimmunity ◽  
Prognostic Significance ◽  
Disease Status ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Free Triiodothyronine ◽  
Autoimmune Thyroid ◽  
Reactive Protein

Abstract Objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related thyroiditis is increasingly recognized. The role of thyroid autoimmunity and SARS-CoV-2 viral load in SARS-CoV-2–related thyroid dysfunction is unclear. We evaluated the thyroid function of a cohort of coronavirus disease 2019 (COVID-19) patients, in relation to their clinical features, and biochemical, immunological, and inflammatory markers. Methods Consecutive adult patients, without known thyroid disorders, admitted to Queen Mary Hospital for COVID-19 from July 21 to August 21, 2020, were included. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine, free triiodothyronine (fT3), and antithyroid antibodies were measured on admission. Results Among 191 patients with COVID-19 (mean age 53.5 ± 17.2 years; 51.8% male), 84.3% were mild, 12.6% were moderate, and 3.1% were severe. Abnormal thyroid function was seen in 13.1%. Ten patients had isolated low TSH, suggestive of subclinical thyrotoxicosis due to thyroiditis, although the contribution of autoimmunity was likely in 2 of them. Autoimmune thyroiditis probably also contributed to subclinical hypothyroidism in another patient. Ten patients had isolated low fT3, likely representing nonthyroidal illness syndrome. Lower SARS-Cov-2 polymerase chain reaction cycle threshold values and elevated C-reactive protein were independently associated with occurrence of low TSH (P = .030) and low fT3 (P = .007), respectively. A decreasing trend of fT3 with increasing COVID-19 severity (P = .032) was found. Patients with low fT3 had more adverse COVID-19-related outcomes. Conclusion Around 15% of patients with mild to moderate COVID-19 had thyroid dysfunction. There may be a direct effect of SARS-CoV-2 on thyroid function, potentially leading to exacerbation of pre-existing autoimmune thyroid disease. Low fT3, associated with systemic inflammation, may have a prognostic significance.

scholarly journals Thyroid autoimmunity in patients with hyperprolactinemia: an observational study

2014 ◽  
Vol 58 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Eda Demir Onal ◽  
Fatma Saglam ◽  
Muhammed Sacikara ◽  
Reyhan Ersoy ◽  
Bekir Cakir
Keyword(s):  
Thyroid Function ◽  
Thyroid Autoimmunity ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Thyroid Disorder ◽  
Free Triiodothyronine ◽  
Thyroid Autoantibody ◽  
Median Serum ◽  
And Gender

Objective : To establish whether there is a relationship between hyperprolactinemia and primary thyroid disorders, focusing on patients with autoimmune features. Materials and methods : The medical records of 100 patients with hyperprolactinemia (HPRL) were retrospectively examined. Records of thyroid ultrasonography (USG), basal serum levels of thyroid stimulating hormone, circulating free thyroxine, free triiodothyronine, antithyroglobulin (anti-Tg), and antithyroperoxidase (anti-TPO) antibodies were analyzed. In 100 control subjects, matched by age and gender with HPRL patients, thyroid USG, thyroid function tests (TFTs), and autoantibody panel were obtained. Results : The median PRL in patients was 93 ng/mL (range: 37-470). Twenty-five patients (25%) and 22 controls (22%) had positive anti-Tg and/or anti-TPO titers (P = 0.739). The median serum PRL was 98 (37-470) ng/mL in patients with positive thyroid autoantibodies, and 92 (40-470) ng/mL in patients who were negative (P = 0.975). Among the individuals with autoantibody positivity TFTs abnormalities were more frequent in HPRL patients (60%, out of 25 patients, 14 with subclinical hypothyroidism and one with hyperthyroidism) than in controls (9.1%, out of 22 patients, 2 with subclinical hyperthyroidism) (P < 0.001). Twenty-seven patients with HPRL and 31 controls had goiter (27 vs. 31%, P = 0.437). Forty-six patients (46%) and 50 (50%) controls had one or more of the features of thyroid disorder, which were goiter, positive thyroid autoantibody, and thyroid function abnormality (P = 0.888). Conclusion : HPRL may be associated with more severe thyroid dysfunction in patients with thyroid autoimmunity.

scholarly journals Thyroid endocrine status and biochemical stress responses in adult male Wistar rats chronically exposed to pristine polystyrene nanoplastics

2019 ◽  
Vol 8 (6) ◽  
pp. 953-963 ◽  
Author(s):  
Fatemeh Amereh ◽  
Akbar Eslami ◽  
Simin Fazelipour ◽  
Mohammad Rafiee ◽  
Mohammad Ismail Zibaii ◽  
...  
Keyword(s):  
Adult Male ◽  
Stress Responses ◽  
Density Lipoprotein ◽  
Kidney Injury ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Male Rats ◽  
Future Research ◽  
Free Triiodothyronine ◽  
Endocrine Status

Abstract Toxicity evaluations of micro- or nano-sized plastics in rodent species commonly employed for toxicity analyses based on which risk assessment for humans could be performed are still largely lacking. Given this knowledge gap, the present work was aimed at determining the potential impact of chronic exposure to polystyrene nanoplastics (PS NPs) on the thyroid endocrine status and biochemical stress in a rat model. Young adult male rats were orally administered with PS NPs (1, 3, 6 and 10 mg kg−1 day−1) for five weeks. Thyroid hormones (THs) l-thyroxine (T4), l-triiodothyronine (T3), l-free triiodothyronine (FT3), and l-free thyroxine (FT4) as well as thyroid stimulating hormone (TSH) serum levels of normal rats and those exposed to PS NPs were compared. Serum levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL), cholesterol, and creatinine, as well as glutamic oxaloacetic transaminase (GOT) and glutamic pyruvic transaminase (GPT) enzymes were also measured. Exposure to PS NPs suppressed the serum levels of T3 and circulating levels of THs, whereas TSH increased significantly. Though exposure to PS NPs did not affect the molar ratios of T3/T4, it induced a slight, but significant, increase in FT3/FT4. In addition, exposure to plastic nanoparticles showed signs of nephrotoxicity induction and kidney injury in exposed organisms as can be inferred from the significantly higher serum levels of creatinine in exposed groups. Our results provide clear evidence of an association between exposure to plastic NPs and thyroid endocrine disruption as well as metabolic deficit, and generate new leads for future research efforts.

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