P1536Does free thyroxine (fT4) predict risk of atherosclerotic cardiovascular disease (ASCVD)?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J L Anderson ◽  
V Jacobs ◽  
H T May ◽  
T L Bair ◽  
B A Benowitz ◽  
...  
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Atherosclerotic Cardiovascular Disease ◽  
Reference Ranges ◽  
Rotterdam Study ◽  
Normal Range ◽  
Hormone Levels ◽  
Prevalent Disease ◽  
Artery Disease ◽  
Intermountain Healthcare ◽  
Tsh Levels

Abstract Background Thyroid hormones are associated with arrhythmic risk, but their relationship to ASCVD is unclear. The Rotterdam Study* reported associations of higher fT4 and lower thyroid stimulating hormone (TSH) levels with ASCVD, including within the euthyroid range. Free T3 (fT3) was not assessed. Methods We tested whether fT4, fT3, and TSH levels were associated with ASCVD in Intermountain Healthcare. All patients >18 y old with an fT4 level in the electronic medical record database were included. The hormone reference ranges were divided into quartiles (Q), and associations with prevalent and incident ASCVD were assessed by multivariable regression and trend tests. Results A total of 212,202 patients (age = 64.4±11.2 y; 66.6% women) were included and followed for 6.1±4.4 y. Of these, 8.3%, 86.6%, and 5.1% had fT4 levels below, within, and above the reference range. CAD was prevalent in 18.9% of fT4 Q1 patients. The adjusted odds ratio (OR) for coronary artery disease (CAD) increased through (Q4/Q1 OR=1.36) and beyond (High/Q1 OR=1.71) the normal range, p-trend<0.001 (Table). Smaller incremental risks were noted for fT3 (Q4/Q1 OR=1.13; High/Q1 OR=1.25). The frequencies of incident MI (Q1=2.5%) and stroke (Q1=5.4%) were low and did not show a concentration-related risk gradient. Incident all-cause death (Q1=24.3%) increased slightly for Q4 and high fT4 (OR=1.05, 1.06) but not fT3; death also increased with low fT4 (OR=1.28). TSH showed no consistent gradient within the normal range for prevalent or incident events; however, mortality increased with both high and low TSH. Thyroid Hormone Levels and Prevalent CAD Prevalent CAD (adjusted OR) Low Normal Q1 Normal Q2 Normal Q3 Normal Q4 High fT4 (n=212,202) OR=1.08, p=0.02 OR=1.00 referent OR=1.11, p<0.001 OR=1.21, p<0.001 OR=1.36, p<0.001 OR=1.71, p<0.001 fT3 (n=30,200) OR=1.12, p<0.001 OR=1.00 referent OR=0.98, p=0.61 OR=1.02, p=0.53 OR=1.13, p<0.001 OR=1.25, p<0.001 TSH (n=183,227) OR=1.39, p<0.001 OR=1.00 referent OR=0.93, p=0.42 OR=0.88, p=0.15 OR=0.92, p=0.35 OR=1.73, p<0.001 Reference Q 1–4 are: fT4: 0.75–0.90; 0.91–1.01; 2.02–1.14; 1.15–1.50 ng/dL; TSH: 0.54–1.30; 1.31–2.04; 2.05–3.68; 3.69–6.80 uIU/mL; fT3: 2.40–2.60; 2.70–2.80; 2.90–3.10; 3.20–4.20 pg/dL. Conclusions Consistent with the Rotterdam Study, we found an increase in prevalent CAD with increasing fT4 levels within and beyond the normal range and, uniquely, a more modest relationship with fT3. We could not confirm a normal-range relationship between hormone levels and incident events or between TSH and prevalent disease. The relationship of fT4 levels to ASCVD is intriguing, is deserving of further study, and may have important implications for ASCVD prevention. *A Bano, et-al. Circ Res 2017; 121:1397–1400

scholarly journals Comparison Study Between Local TSH IRMA Kit (CRRT) and Imported TSH IRMA Kit (Riakey, Korea)

2019 ◽  
Vol 4 (2) ◽  
pp. 77
Author(s):  
Gina Mondrida ◽  
Triningsih Triningsih ◽  
Kristina Dwi Purwanti ◽  
Sutari Sutari ◽  
Sri Setyowati ◽  
...  
Keyword(s):  
False Negative ◽  
Thyroid Stimulating Hormone ◽  
The Body ◽  
True Positive ◽  
Comparison Study ◽  
Complex Matrix ◽  
Normal Range ◽  
True Negative ◽  
Immunoassay Technique ◽  
Tsh Levels

<p><em>Thyroid Stimulating Hormone</em> (TSH) is one of hormones that our body need for growth of brains, bones and other tissues and regulate the metabolism in the body. Normal range of TSH for adult is from 0.3 to 5.5 µIU/ml, whereas for baby ranged from 3 to 18 µIU/ml. An Immunoradiometricassay (IRMA) is one of immunoassay technique using radionuclide as the tracer to detect low quantity of analyte. This technique is suitable for determine TSH levels in human blood serum which has complex matrix and various concentration. The Center for Radioisotope and Radiopharmaceutical Technology (CRRT)-BATAN has developed a reagent of TSH IRMA kit. The aim of this research is to compare between local TSH IRMA kit (CRRT-BATAN) and imported TSH IRMA kit (Riakey, Korea) toward 110 adult samples obtained from PTKMR - BATAN. The results showed 97 samples as true negative, 5 samples as true positive, 1 sample as false negative and 7 samples false positive. The comparison study gave diagnostic sensitivity as much as 83.33 %, diagnostic spesificity as much as 93.27 % and accuracy as much as 92.72 %.</p>

Normal-range thyroid-stimulating hormone levels and cardiovascular events and mortality in type 2 diabetes

2019 ◽  
Vol 157 ◽  
pp. 107880
Author(s):  
Tamar I. de Vries ◽  
Harold W. de Valk ◽  
Yolanda van der Graaf ◽  
Gert J. de Borst ◽  
Maarten J.M. Cramer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Events ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Hormone Levels ◽  
Stimulating Hormone

Relation between thyroid-stimulating hormone and the occurrence of cardiovascular events and mortality in patients with manifest vascular diseases

2011 ◽  
Vol 19 (4) ◽  
pp. 864-873 ◽  
Author(s):  
Jan Westerink ◽  
Yolanda van der Graaf ◽  
Daniël R Faber ◽  
Wilko Spiering ◽  
Frank LJ Visseren
Keyword(s):  
Myocardial Infarction ◽  
Vascular Disease ◽  
Vascular Diseases ◽  
Thyroid Stimulating Hormone ◽  
Tissue Thickness ◽  
Normal Range ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Visceral Adipose ◽  
Tsh Levels

Aims: To investigate whether levels of thyroid-stimulating hormone (TSH) within the normal range are associated with an increased risk of new vascular events and mortality in patients with clinical manifest vascular diseases and whether this relation is influenced by adiposity. Methods and results: Prospective cohort study in 2443 patients (1790 men and 653 women) with clinical manifest vascular disease and TSH levels in the normal range. Median follow up was 2.7 (interquartile range 1.4–3.9) years. Clinical endpoints of interest were: myocardial infarction, stroke, vascular death, and all-cause mortality. In patients with manifest vascular disease, the prevalence of (subclinical) hypothyroidism was 5.7%, while 3.6% had (subclinical) hyperthyroidism. An increase in 1 unit of TSH was associated with a 33% higher risk (HR 1.33; 95% CI 1.03–1.73) for the occurrence of myocardial infarction, adjusted for age, gender, renal function, and smoking. In patients with a body mass index (BMI) below the median of 26.7 kg/m2 the HR per unit TSH for myocardial infarction was 1.55 (95% CI 1.08–2.21) compared to 1.18 (95% CI 0.81–1.71) in patients with a BMI ≥26.7 kg/m2. Visceral adipose tissue thickness below the median (≤8.8 cm) was associated with higher HR per unit TSH for myocardial infarction (HR 1.69; 95% CI 1.21–2.35) compared to visceral adipose tissue thickness >8.9 cm (HR 1.00; 95% CI 0.66–1.49). There was no relation between TSH and risk of stroke, vascular death, the combined endpoint, or all-cause mortality. Conclusion: Higher TSH levels within the normal range are associated with an increased risk of myocardial infarction, in patients with clinical manifest vascular disease. This relation is most prominent in patients without visceral obesity.

scholarly journals Reference Intervals Generated by Electronic Medical Record Data Mining with Clinical Exclusions: Age-Specific Intervals for Thyroid-Stimulating Hormone from 33038 Euthyroid Patients

2018 ◽  
Vol 3 (2) ◽  
pp. 231-239 ◽  
Author(s):  
Julia C Drees ◽  
Karl Huang ◽  
Matthew S Petrie ◽  
Thomas S Lorey ◽  
Richard S Dlott
Keyword(s):  
Data Mining ◽  
African American ◽  
Older Patients ◽  
Reference Population ◽  
Reference Intervals ◽  
Thyroid Stimulating Hormone ◽  
Reference Ranges ◽  
A Posteriori ◽  
Black African ◽  
Tsh Levels

Abstract Background Serum thyroid-stimulating hormone (TSH) reference intervals are dependent on population characteristics, including prevalent thyroid disease and iodine status. Studies in the US have demonstrated increasing TSH levels with age, and the American Thyroid Association recommends higher TSH goals for older patients taking thyroid supplementation, but few laboratories offer age-specific reference intervals for TSH. Our objective was to establish TSH reference ranges in our racially diverse population in northern California. Methods Data mining of electronic medical records was used with the a posteriori approach to select a euthyroid reference population for TSH reference intervals. A report gathered all TSH results from 2 weeks from &gt;1 year in the past, excluding results from patients with thyroid-related disease or medication use at any time before or after the TSH test. Results The reference population numbered 33038 and consisted of approximately 44% of the total TSH results reported in the selected time periods. The population identified as 46.5% white, 18.3% Asian, 17.0% Hispanic/Latino, 8.0% black/African American, and 10.3% other or unknown. These data demonstrate an increase in the median and 97.5 percentile of TSH levels with increasing age in adults. No clinically significant difference was seen between female and male individuals or between the self-identified races, except for lower TSH levels in the black/African American population. Conclusions The a posteriori approach using data mining for disease-specific criteria proved to be an efficient method for obtaining a large healthy reference population. Age-specific TSH reference ranges could prevent inappropriate diagnoses of subclinical hypothyroidism in older patients.

Is There Compensated Hypothyroidism in Infancy?

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 207-211
Author(s):  
Ramin Alemzadeh ◽  
Silvia Friedman ◽  
Pavel Fort ◽  
Bridget Recker ◽  
Fima Lifshitz
Keyword(s):  
Screening Program ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Close Monitoring ◽  
Normal Range ◽  
Thyroid Screening ◽  
Serum T4 ◽  
Hypometabolic State ◽  
Serum Tsh ◽  
Tsh Levels

The state-mandated newborn thyroid screening program may uncover infants who exhibit normal thyoxine (T4) levels with various degrees of hyperthyrotropinemia. To elucidate further the thyroid status, the basal metabolic rate (BMR) of 10 infants (7 boys, 3 girls; aged 9 to 63 days) was studied by indirect calorimetry. They were clinically euthyroid and healthy with no evidence of overt biochemical hypothyroidism (low T4, high thyroid-stimulating hormone [TSH]). Confirmatory testing indicated that all infants had normal serum T4 levels for age (mean ± SD: 10.3 ± 3.2 µg/dL). However, serum TSH levels varied from 2.3 to 99.2 µU/mL In 4 infants (2 boys, 2 girls) the BMR was low (38.1 ± 4.1 kcal/kg per day), while the other 6 patients (5 boys, 1 girl) demonstrated BMRs within the normal range (49.6 ± 1.9 kcal/kg per day, P &lt; .001). The serum TSH levels were above 7.0 µU/mL among those infants with a low BMR, whereas the serum TSH levels were always below 6.0 µU/mL among the normometabolic infants. All infants who had a low BMR received thyroid therapy and promptly became normometabolic (BMR: 48.7 ± 1.0 kcal/kg per day) with suppression of TSH levels (3.2 ± 1.3 µU/mL) within 3 weeks of therapy, while their serum T4 levels remained within the normal range. The observed normalization of BMR In parallel to reduction of TSH levels following thyroid replacement therapy strongly suggests that these patients demonstrated a hypometabolic state, despite normal serum T4 levels. Therefore, the assessment of BMR may help define subclinical hypothyroidism in infancy in conjunction with a close monitoring of TSH concentration.

scholarly journals Yagya Therapy for Sub-Clinical Hypothyroidism: A Case Study

2018 ◽  
Vol 1 (2) ◽  
pp. 31-36 ◽  
Author(s):  
Shilpi Verma ◽  
Pawan Kumar ◽  
Alka Mishra ◽  
Vandana Shrivastava
Keyword(s):  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Hormonal Balance ◽  
Effective Option ◽  
Low Levels ◽  
Traditional Approaches ◽  
In Fire ◽  
Very High ◽  
Tsh Levels

Sub-clinical hypothyroidism (SCH) is a condition in which Thyroid Stimulating Hormone (TSH) levels are increased, Thyroxine (T4) level is normal to low, and Triiodothyronine (T3) level is normal. Daily use of the synthetic thyroid hormone such as levothyroxine has been a standard approach to SCH. However, most modern approaches are unable to revert the condition to its normal level. Traditional approaches such as Yagya-Therapy can be an effective option in this regard. Yagya-Therapy provides pulmonary inhalation of medicinal-smoke of multiple herbs (generated through oblation in fire along with chanting of Vedic hymns), which have the potential for hormonal balance A case study is being reported wherein a patient (Male/60 years), who had been suffering from SCH since past 2 years and 4 months (pre-data), had been continuously taking allopathic medication for SCH, B12 complex and high blood pressure, and all this time TSH never became normal. The patient continued with the aforesaid medication, and took Yagya-Therapy for 3 months as an add-on therapy. Subsequently, after 4 months of completing Yagya-Therapy, post-data was recorded. Before Yagya-Therapy, TSH levels were very high, i.e. 4.79-11.82 µ/ml, which became normal (3.0 µ/ml) after the Yagya-Therapy. The earlier low levels of B12 (238-326 pg/ml) also increased to the upper side of the normal range (1034 pg/ml). Patient's other complaints such as tiredness, weakness, sleep issues were also resolved completely. Thus, the present study indicates the effectiveness of Yagya-Therapy in the treatment of SCH.

scholarly journals Association of High Vitamin D Status with Low Circulating Thyroid-Stimulating Hormone Independent of Thyroid Hormone Levels in Middle-Aged and Elderly Males

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Qingqing Zhang ◽  
Zhixiao Wang ◽  
Min Sun ◽  
Mengdie Cao ◽  
Zhenxin Zhu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Thyroid Hormone ◽  
Smoking Status ◽  
Thyroid Stimulating Hormone ◽  
Vitamin D Status ◽  
Middle Aged ◽  
Hormone Levels ◽  
Elderly Males ◽  
Thyroid Hormone Levels ◽  
Tsh Levels

Background. A recent study has reported that high circulating 25-hydroxyvitamin D [25(OH)D] is associated with low circulating thyroid-stimulating hormone (TSH) levels, but only in younger individuals. The goal of the present study was to explore the relationship between vitamin D status and circulating TSH levels with thyroid autoimmunity and thyroid hormone levels taken into consideration in a population-based health survey of middle-aged and elderly individuals.Methods. A total of 1,424 Chinese adults, aged 41–78 years, were enrolled in this cross-sectional study. Serum levels of 25(OH)D, TSH, thyroid hormones, and thyroid autoantibodies were measured.Results. The prevalence of vitamin D insufficiency was 94.29% in males and 97.22% in females, and the prevalence of vitamin D deficiency was 55.61% in males and 69.64% in females. Vitamin D status was not associated with positive thyroid autoantibodies after controlling for age, gender, body mass index, and smoking status. Higher 25(OH)D levels were associated with lower TSH levels after controlling for age, FT4 and FT3 levels, thyroid volume, the presence of thyroid nodule(s), and smoking status in males.Conclusion. High vitamin D status in middle-aged and elderly males was associated with low circulating TSH levels independent of thyroid hormone levels.

scholarly journals Thyroid-stimulating hormone levels in the normal range and incident type 2 diabetes mellitus

2018 ◽  
Vol 56 (4) ◽  
pp. 431-440 ◽  
Author(s):  
T. I. de Vries ◽  
◽  
L. J. Kappelle ◽  
Y. van der Graaf ◽  
H. W. de Valk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Hormone Levels ◽  
Incident Type ◽  
Incident Type 2 Diabetes ◽  
Stimulating Hormone

scholarly journals Low TSH levels are not associated with osteoporosis in childhood

2007 ◽  
Vol 157 (2) ◽  
pp. 221-223 ◽  
Author(s):  
Anastasios Papadimitriou ◽  
Dimitrios T Papadimitriou ◽  
Anna Papadopoulou ◽  
Polyxeni Nicolaidou ◽  
Andreas Fretzayas
Keyword(s):  
Thyroid Hormone ◽  
Calcium Phosphate ◽  
Bone Metabolism ◽  
Serum Calcium ◽  
Type I ◽  
Normal Range ◽  
Hormone Levels ◽  
Amino Terminal ◽  
Thyroid Hormone Levels ◽  
Tsh Levels

Introduction: A recent study on TSH receptor (TSHR) null mice suggested that skeletal loss occurring in hyperthyroidism is caused by the low TSH rather than high thyroid hormone levels. The aim of this study was to examine whether low TSH results in osteoporosis in the human. Subjects and methods: We determined bone mineral density (BMD) and markers of bone metabolism in two male siblings aged 9.8 and 6.8 years with isolated TSH deficiency, due to a mutation of the TSH β-subunit gene. BMD was measured in the lumbar spine (L1–L4) by dual-energy X-ray absorptiometry. Laboratory investigation included the determination of serum calcium, phosphate, 25-hydroxy-vitamin D, parathyroid hormone concentrations, and urine calcium (Ca)/creatinine (Cr) ratio. Osteoblast activity was measured by serum bone alkaline phosphatase and osteocalcin levels, and osteoclast activity by urine cross-linked amino-terminal, carboxy-terminal telopeptides of type I collagen and deoxypyridinoline concentrations. Results: BMD of both patients was within the normal range for age and sex; z-scores were −0.55 and −0.23 for patients 1 and 2 respectively. Serum calcium, phosphate, urine Ca/Cr ratio, and specific markers of bone metabolism were also within normal range. Conclusion: In childhood, chronic extremely low TSH levels, in the face of normal thyroid hormone levels, are not related to bone loss.

scholarly journals Seizure duration may increase thyroid-stimulating hormone levels in children experiencing a seizure

2019 ◽  
Vol 48 (5) ◽  
pp. 030006051988840
Author(s):  
Ji Yoon Han ◽  
In Goo Lee ◽  
Soyoung Shin ◽  
Joonhong Park
Keyword(s):  
Thyroid Hormones ◽  
Neuronal Excitability ◽  
Thyroid Stimulating Hormone ◽  
Seizure Type ◽  
Hormonal Changes ◽  
Seizure Duration ◽  
Hormone Levels ◽  
Logistic Regression Models ◽  
Tsh Levels ◽  
Stimulating Hormone

Objective Variations in hormone levels are a direct effect of epileptic discharges in both animals and humans, and seizure can affect the hypothalamus–pituitary–thyroid axis. The purpose of this study was to determine which parameters could affect the alternation of thyroid hormones in children experiencing seizure. Methods We retrospectively reviewed the medical records of 181 pediatric patients with seizure and compared three thyroid hormones (serum thyroid-stimulating hormone [TSH], free thyroxine [fT4], and triiodothyronine [T3]) between initial (admission to hospital) and follow-up (2 weeks later) testing. Results Multivariable logistic regression models were used to determine which six parameters (gender, age, seizure accompanying with fever, seizure type, seizure duration, and anti-epileptic drug medication) could help to explain the higher initial TSH levels in pediatric seizure. Only seizure duration in patients with an increase in TSH levels was significantly longer compared with patients with normal TSH at the time of initial testing. Conclusion Neuronal excitability by seizure can cause thyroid hormonal changes, which likely reflects changes in hypothalamic function.

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