Thyroid Dysfunction and Nodular Goiter in Hemodialysis and Peritoneal Dialysis Patients

1998 ◽  
Vol 18 (5) ◽  
pp. 516-521 ◽  
Author(s):  
Chih Ching Lin ◽  
Tzen Wen Chen ◽  
Yee Yung Ng ◽  
Yi Hong Chou ◽  
Wu Chang Yang

Objective To investigate the prevalence of nodular goiter and thyroid dysfunction in uremic patients undergoing hemodialysis (HD) and peritoneal dialysis. Design Cross-sectional study. Setting Single dialysis unit and outpatient clinic. Patients The study included 221 patients [143 HD and 78 continuous ambulatory peritoneal dialysis (CAPD) patients] along with 135 consecutively selected outpatients as controls. Main Outcome Measures Ultrasonography was used to detect patients’ thyroid function and nodular goiter. Results Nodular goiter was detected in 54.8% of the uremic patients and in 21.5% of the controls. Uremic patients had higher prevalence of thyroid dysfunction, which included reduced serum concentration of total T3, total T4, and free T4, and increased serum level of TSH. Hypothyroidism was also observed more frequently in uremic patients than in the control group (5.4% vs 0.7%, p < 0.05). Nodular goiter was more frequently found in females than in males (63.5% vs 48%, p < 0.05). Moreover, the prevalence of nodular goiter increased with age (p < 0.02) in uremic patients. Hemodialysis patients had a higher frequency of reduced total T3 level (46.9% vs 29.5%, p < 0.02). However, CAPD patients had lower T4 levels (6.23 ± 1.82μg/dL vs 7.15± 1.99μg/dL, p < 0.05). Conclusion Because of the high incidence of hypothyroidism and nodular goiter in uremic patients, screening of thyroid function and goiter detection with ultrasound should be considered in evaluation of end-stage renal disease patients.

2002 ◽  
Vol 22 (3) ◽  
pp. 394-399 ◽  
Author(s):  
Chih Ching Lin ◽  
Wu Chang Yang ◽  
Yee Yung Ng ◽  
Yi Hong Chou ◽  
Cherng Tarng Der ◽  
...  

Objective To investigate the association of clinical parameters and serum anion gap with thyroid dysfunction and nodular goiter in continuous ambulatory peritoneal dialysis (CAPD) patients. Design Cross-sectional study. Setting Single dialysis unit and outpatient clinic. Patients This study included 89 uremic patients on CAPD. Gender ratio was 50 males to 39 females (M/F = 1.28); mean age was 54.8 years. Main Outcome Measures We investigated the prevalence of nodular goiter and thyroid dysfunction with a 10-MHz high-frequency ultrasound scanner and immunoassay kits. Results Nodular goiter was detected in 52.8% (47/89) of the CAPD patients. Patients with nodular goiter were older than those without goiter (57.7 vs 51.5 years, p < 0.05). Nodular goiter was found more frequently in females than in males (66.7% vs 44.0%, p < 0.05). Patients with nodular goiter had longer duration of CAPD than patients without goiter (51.6 ± 42.9 vs 31.0 ± 28.1 months, p < 0.02). In addition, CAPD patients with goiter had a higher serum anion gap (AG) (16.8 ± 3.3 vs 14.0 ± 4.5 mEq/L, p < 0.02) and a lower weekly creatinine clearance (55.9 ± 12.6 vs 64.6 ± 21.1 L/week/1.73 m2, p < 0.05) than patients without goiter. As serum AG gradually increased, significant alteration of thyroid parameters developed in the following sequence: ( 1 ) reduction of total T3 level at an AG level of 15, ( 2 ) elevation of thyrotropin (TSH) and increased prevalence of goiter at an AG of 18, and ( 3 ) reduction of free T4 and total T4 levels and elevation of TSH, with further increased frequency of goiter at an AG of 20 mEq/L. Conclusion According to this study, age, gender, dialysis duration, serum AG, and weekly creatinine clearance are correlated with prevalence of goiter in CAPD patients. Sequential alteration of thyroid function and increasing frequency of nodular goiter correlated with higher serum AG. There are two explanations for this correlation: the level of serum AG may be an indirect index of the level of serum goitrogens, and higher serum AG and increased frequency of nodular goiters might be a reflection of loss of residual renal function. Therefore, thyroid function screening and goiter detection using ultrasound should be considered when examining CAPD patients with progressively elevating serum anion gap.


2021 ◽  
Author(s):  
Celia Neder Kalil Mangabeira ◽  
Rafael Kalil Mangabeira ◽  
Luis Jesuino de Oliveira Andrade

Individuals with Down syndrome (DS) present increased risk for thyroid dysfunction, especially hypothyroidism, due in increased expression of the DYRK1A gene. Objective: The aim of this study was to make a morphological functional thyroid assessment in individuals with DS. Materials and Methods: This is a descriptive cross-sectional study, consisting of 29 individuals with DS, with a mean age of 12,3 (0.66 / 36.00) years, 16 women (55.2%) and 13 men (44.8%), with a morphological/functional thyroid assessment being made comprising hormonal dose (Free T4, TSH), antithyroid antibody (TPOAb and TgAb) and ultrasonography of the thyroid. Results: Twenty-three (79.3%) individuals presented normal thyroid function while 6 (20.7%) presented with thyroid dysfunction, 4 with hypothyroidism and 2 with hyperthyroidism. Autoimmune thyroiditis and goiter were present in 27.6% of the individuals. Conclusion: Thyroid function should be assessed periodically in individuals with DS, in view of the high prevalence of thyroid dysfunction, especially autoimmune thyroiditis with consequent hypothyroidism. Key Words: Down Syndrome, thyroid, ultrasonography, thyroid dysfunction.


Author(s):  
Kashish Narula ◽  
Narendra Kumar Dara ◽  
Shyam Lal Meena

Background: Thyroid hormones influence nearly all major metabolic pathways. Their most obvious and well-known action is the increase in basal energy expenditure obtained by acting on protein, carbohydrate and lipid metabolism. The lipid metabolism is more influenced by the thyroid hormone. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results: The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: Dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Thyroid profile, Total cholesterol, Triglycerides and LDL


2021 ◽  
Vol 12 (10) ◽  
pp. 47-50
Author(s):  
Ritu Gupta ◽  
Akhil K Vijayan ◽  
Sushma Choudhary

Background: Metabolic syndrome is characterized by hypertension, dyslipidemia, central obesity, glucose intolerance, insulin resistance. Thyroid hormone acts as general pacemaker, accelerating metabolic process and may be associated with metabolic syndrome. There is no information available in literature regarding the prevalence and association of thyroid dysfunction in metabolic syndrome in this central region of the country. Aims and Objective: To estimate the prevalence of thyroid dysfunction in patients of metabolic syndrome. Materials and Methods: It is a duration based prospective cross sectional study including 200 patients of metabolic syndrome. A detailed history, clinical examination and relevant investigations including serum Free T4 (FT4), Free T3 (FT3), Thyroid Stimulating Hormone (TSH) were done. Range, frequencies, percentage, mean, standard deviation and P value were calculated. P value of < 0.05 was taken as significant. Results: Prevalence of thyroid dysfunction in metabolic syndrome patients was 28.5%. Prevalence of subclinical and overt hypothyroidism was 18.5% and 8.5% respectively. In patients with both metabolic syndrome and thyroid dysfunction, most common components associated are diabetes mellitus and hypertriglyceridemia. Conclusion: Thyroid dysfunction is significantly common in metabolic syndrome patients. It should be aggressively detected and treated in these patients for better outcome.


Author(s):  
Daulat Meena ◽  
Ramavatar Bairwa

Background: Thyroid hormones have profound metabolic effects, the most striking action being an increase in energy expenditure. Thyroid hormones play an important role in regulating lipid metabolism; and thyroid dysfunctions can result in lipid abnormalities which increase the risk of endothelial dysfunction, hypertension and cardiovascular disease. Methods: A cross-sectional study was conducted on 100 patients with suspicion of thyroid disorders were taken as cases. One hundred patients with normal thyroid profile and no history of other chronic diseases were taken as control group. Results- The serum TC, TG and LDL levels in hypothyroid individuals (both overt and subclinical) were significantly higher than euthyroid subjects but the levels were comparable between hyperthyroid and euthyroid group. Conclusion: We conclude that, dyslipidemias are associated with thyroid disorders, so biochemical screening for thyroid dysfunction in all dyslipidemic patients. Therefore, patients presenting with dyslipidemia are recommended for investigation to explore thyroid dysfunction. Keywords: Total cholesterol, Triglycerides and LDL.


KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 95-98
Author(s):  
Kamrunnahar Alo ◽  
Shyamal Chandra Banik ◽  
Safayet Ahammed ◽  
Ayesha Yasmin ◽  
Tania Rahman

Background: Thyroid dysfunction specially hypothyroidism may occur in type 2 diabetic patients. Objective: To observe thyroid function status in type 2 diabetic patients Materials and Methods: This cross sectional study was carried out in the Department of Physiology, Sir Salimullah Medical College, Dhaka from July 2016 to June 2017. Total 60 subjects including male and female, age ranged from 40 to 60 years were included in this study, among them 30 were non-diabetic subjects and 30 were type 2 diabetic patients. Results: In this study, mean serum TSH level was significantly (p<0.001) higher and serum FT4 level was significantly (p<0.01) lower in diabetic patients than that of apparently healthy non-diabetic subjects. Serum FT3 level was lower in type 2 diabetic patients in comparison to that of non-diabetic subjects but the difference was not statistically significant. However, among the diabetic patients 10% were subclinical hypothyroid and 6.67% were hypothyroid Conclusion: The present study reveals that hypothyroidism occurs in type 2 diabetic patients. So type 2 diabetic patients should measure thyroid hormone levels routinely to detect thyroid dysfunction. KYAMC Journal Vol. 10, No.-2, July 2019, Page 95-98


2010 ◽  
Vol 128 (1) ◽  
pp. 18-23 ◽  
Author(s):  
Rodrigo Diaz-Olmos ◽  
Antônio-Carlos Nogueira ◽  
Daniele Queirós Fucciolo Penalva ◽  
Paulo Andrade Lotufo ◽  
Isabela Martins Benseñor

CONTEXT AND OBJECTIVE: Subclinical thyroid dysfunction is very common in clinical practice and there is some evidence that it may be associated with cardiovascular disease. The aim here was to evaluate the frequencies of subclinical thyroid disease and risk factors for cardiovascular disease among women at a workplace, and to evaluate the association between subclinical thyroid disease and cardiovascular risk factors among them. DESIGN AND SETTING: Cross-sectional study on 314 women aged 40 years or over who were working at Universidade de São Paulo (USP). METHODS: All the women answered a questionnaire on sociodemographic characteristics and risk factors for cardiovascular disease and the Rose angina questionnaire. Anthropometric variables were measured and blood samples were analyzed for blood glucose, total cholesterol and fractions, high-sensitivity C-reactive protein, thyroid-stimulating hormone (TSH), free thyroxine (free-T4) and anti-thyroperoxidase antibodies (anti-TPO). RESULTS: The frequencies of subclinical hypothyroidism and hyperthyroidism were, respectively, 7.3% and 5.1%. Women with subclinical thyroid disease presented higher levels of anti-TPO than did women with normal thyroid function (P = 0.01). There were no differences in sociodemographic factors and cardiovascular risk factors according to thyroid function status, except for greater sedentarism among the women with subclinical hypothyroidism. Restricting the comparison to women with subclinical hypothyroidism (TSH > 10 mIU/l) did not change the results. CONCLUSION: In this sample of women, there was no association between poor profile of cardiovascular risk factors and presence of subclinical thyroid disease that would justify screening at the workplace.


Author(s):  
Jyotsana Gupta ◽  
Charu Lata Bansal ◽  
Sangita Nangia Ajmani ◽  
Ajay Kumar Ajmani

Background: the aim was to study the prevalence of abnormal thyroid function and thyroid autoimmunity in infertile women and in general population (control group) and to correlate the thyroid dysfunction with presence of anti-thyroid antibodies. It was a case control study. The study was carried out at Department of obstetrics and gynaecology, Kasturba Hospital, Delhi. Population of the study was fifty infertile women in whom other causes of infertility are excluded and fifty fertile women attending out- patient department with other complaints.Methods: All the women enrolled in the study were non pregnant, clinically euthyroid (with no signs and symptoms of thyroid disorders and no documented abnormal thyroid function test) and no known autoimmune disorder. Detailed history and a thorough general physical examination, including thyroid examination was done. Haemogram, blood group, fasting and post prandial blood sugar, VDRL, transabdominal ultrasound, TSH, free T3, free T4, and antithyroid per-oxidase antibody assay was done using the ELISA technique.Results: The mean age of the study group was found 28.38±2.45 years, 22% had abnormal thyroid function, 20% had antithyroid antibodies positive and the mean TSH of the study group was 4.61±1.72µIU/ml. The mean age of the control group was found to be 29.10±2.01 years, 12% had abnormal thyroid function, 10% had antithyroid antibodies positive and the mean TSH of the control group was 3.89±1.56µIU/ml.Conclusions: Thyroid dysfunction and anti-thyroid antibodies were more prevalent in patients with infertility. A statistically significant correlation was established between thyroid autoimmunity and thyroid dysfunction in infertile women in the study.


2021 ◽  
Vol 59 (234) ◽  
Author(s):  
Manoranjan Shrestha ◽  
Reshmi Shrestha

Introduction: Thyroid dysfunction prevalence is high in females worldwide which increases with age. Postmenopausal and elderly women are particularly at risk of developing comorbidities and mortality related to thyroid dysfunction. We aimed to study the prevalence of thyroid dysfunction in postmenopausal women in the National Reference Laboratory of Nepal. Methods: A descriptive cross-sectional study was conducted in National Reference Laboratory from January 2019 to June 2019 including postmenopausal females, ≥49 years. The database of thyroid function test result was used for statistical analysis and proportion of thyroid dysfunction was calculated. The data was collected after approval from the institutional review committee. Statistical Package for Social Sciences version 21 was used to study descriptive data. Results: Out of a total of 160 postmenopausal females with thyroid function tests, 71 (44.4%) had thyroid dysfunction. Subclinical hypothyroidism was the frequently occurring thyroid dysfunction 51 (32%) followed by subclinical hyperthyroidism 13 (8%), hypothyroidism 3 (2%) and hyperthyroidism 3 (2%). In our study population, thyroid dysfunction peaked at 49 to 58 years of age interval 53 (33.1%) and subclinical hypothyroidism was the most frequent form 38 (23.7%). Conclusions: Subclinical hypothyroidism was the common thyroid dysfunction in postmenopausal age which peaked at 49 to 58 years of age group. Early postmenopausal females are predisposed to increased risk of comorbidities (cardiovascular disease, osteoporosis with high fracture, depression) which could be exacerbated with thyroid dysfunction; therefore awareness of thyroid dysfunction prevalence and thyroid screening for early management seems appropriate in Nepalese postmenopausal women.


Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3330
Author(s):  
Nuozhou Liu ◽  
Fang Ma ◽  
Ying Feng ◽  
Xue Ma

Thyroid function has a close link with inflammation. However, it is still unknown whether the dietary inflammatory potential is associated with thyroid function. We aimed to assess the relationship among them using the data from the National Health and Nutrition Examination Survey (NHANES). This study was a cross-sectional study, where weighted multivariable linear regression, subgroup analyses, and interaction terms were employed. Thyroid function was assessed by eight indexes, including total and free T4 and T3, Tg, TgAb, TPOAb, and TSH. A total of 2346 male participants aged ≥20 years with an average age of 50.74 ± 17.68 years were enrolled. The mean DII score among participants was −0.46 ± 1.73, ranging from −4.12 to 4.41, and mean total thyroxine (T4) was 7.61 ± 1.51 μg/dL. We found a positive association between DII and total T4 (β = 0.07; p = 0.0044). Using subgroup analysis, this association became stronger in both the iodine-deficient and obese group (iodine-deficient group: β = 0.15, p < 0.0001; obese group: β = 0.14, p < 0.0001). In conclusion, men adhering to a more pro-inflammatory diet appeared to have higher total T4 levels. However, these hormone variations were still within the normal clinical range and more well-designed studies are still needed to validate the causal relationship between DII and thyroid function.


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