Higher TSH Is Not Associated With Thyroid Cancer Risk in the Presence of Thyroid Autoimmunity

2020 ◽  
Vol 105 (7) ◽  
pp. e2389-e2397 ◽  
Author(s):  
Rodis D Paparodis ◽  
Dimitra Bantouna ◽  
Evangelos Karvounis ◽  
Shahnawaz Imam ◽  
Juan Carlos Jaume
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Autoimmunity ◽  
Tertiary Care ◽  
The United States ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Clinical Observations ◽  
Thyroid Cancer Risk ◽  
Benign Histology

Abstract Background Higher-but-within-normal thyrotropin (thyroid-stimulating hormone, TSH) is associated with higher risk for differentiated thyroid cancer (DTC) in surgical series. Our recent clinical observations suggest that this is not the case in the presence of autoimmune thyroid disease (AITD). We designed the present study to clarify this controversy. Methods We analyzed our prospectively collected database of patients referred for thyroid surgery at 2 tertiary care referral centers in Greece and the United States. We collected data for preoperative TSH, postoperative pathology, and thyroid peroxidase (TPO) antibodies titers. Subjects were subdivided into 2 groups, those with AITD (i.e., lymphocytic thyroiditis) and non-AITD. We excluded subjects with Graves disease, abnormal TSH (< 0.40 or > 4.50 mIU/mL), or recent use of levothyroxine. We compared the serum TSH among different groups using the Mann-Whitney test. Results A total of 3973 subjects were screened; 1357 met exclusion criteria. After all exclusions, data from 1731 non-AITD subjects and 329 AITD subjects were included in the analysis. AITD subjects had higher TSH than non-AITD subjects (2.09 vs 1.48; P < 0.0001). TSH values were higher in DTC compared with benign histology only in non-AITD subjects (1.65 vs 1.40; P < 0.0001). Progressively higher TSH was associated with higher incidence of DTC only in non-AITD subjects (P < 0.0001). In AITD subjects, TSH was similar between groups with or without DTC (2.02 vs 2.14; P = 0.21). Conclusions TSH concentrations are not associated with the risk of developing DTC in the presence of thyroid autoimmunity, even though this seems to be the case for all other patients.

Role of the Specialized Pro-resolving Mediator Resolvin D1 in Hashimotoʼs Thyroiditis

2021 ◽  
Author(s):  
Jing Song ◽  
Rongxin Sun ◽  
Yuanyuan Zhang ◽  
Ying Fu ◽  
Dong Zhao
Keyword(s):  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Inflammatory Factors ◽  
Thyroid Peroxidase ◽  
Sensitivity Index ◽  
Resolvin D1 ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody ◽  
Inflammation Resolution

Abstract Objective Resolvins are produced by the catabolism of polyunsaturated fatty acids (PUFAs) and play vital roles in inflammation resolution. Resolvins have been associated with autoimmune disorders. This study aimed to measure the level of Resolvin D1 (RVD1) in the serum of Hashimoto's thyroiditis (HT) patients and healthy controls (HCs) and to further analyse its correlation with thyroid autoantibodies and inflammatory factors. Methods Sixty-three participants were recruited, namely, 30 untreated HT patients and 33 sex- and age-matched HCs. Serum RVD1 and inflammatory chemokine (MCP-1 and IP-10) levels were measured by ELISA according to the manufacturer’s protocol. Serum total T3 (TT3), TT4, free T3 (FT3), FT4, thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone (TSH) levels were measured using an electrochemiluminescence immunoassay. Thyroid homeostasis parameters, including the thyroid secretory capacity (SPINA-GT), the total deiodinase activity (SPINA-GD), Jostel’s TSH index (TSHI) and the thyrotroph thyroid hormone sensitivity index (TTSI), were calculated. Results Serum RVD1 levels in HT patients (134.76, 85.35–201.36 pg/mL) were significantly lower than those in HCs (187.64, 131.01–326.85 pg/mL) (P=0.004). As the TPOAb level increased, the RVD1 level showed a decreasing trend (P for trend=0.002). Both multinomial and ordinal logistics analyses revealed that serum RVD1 levels were negatively correlated with TPOAb levels in the adjusted models. Moreover, RVD1 showed a negative correlation with the inflammatory chemokine IP-1 0 (r=–0.276, P=0.034), TSHI (r=–0.269, P=0.036) and TTSI (r=–0.277, P=0.031). Conclusions Thyroid autoimmunity may be associated with low levels of RVD1. Decreased RVD1 levels indicate impaired resolution of inflammation in HT patients.

IRON DEFICIENCY, A RISK FACTOR FOR THYROID AUTOIMMUNITY DURING SECOND TRIMESTER OF PREGNANCY IN CHINA

2020 ◽  
Vol 26 (6) ◽  
pp. 595-603
Author(s):  
Yanan Zhang ◽  
Xinmei Huang ◽  
Zaoping Chen ◽  
Qian Yang ◽  
Xiaoying Li ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Iron Deficiency ◽  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Second Trimester ◽  
Thyroid Peroxidase Antibody ◽  
Thyroglobulin Antibody

Objective: Previous studies have reported an association between iron deficiency (ID) and increased thyroid peroxidase antibody (TPO-Ab) during early pregnancy. The objective of this study was to explore the relationship between ID and thyroid dysfunction, as well as thyroid autoantibodies, during the second trimester of pregnancy. Methods: A total of 1,592 pregnant women (13 to 28 weeks gestation) were enrolled in this cross-sectional study. According to serum ferritin (SF) concentrations, they were divided into ID (SF <20 μg/L) or non-ID (SF ≥20 μg/L) groups. Logistic regression analysis was used to evaluate the association between ID and subclinical hypothyroidism (thyroid-stimulating hormone [TSH] >4.0 mIU/L and free thyroxine [FT4] within the reference range) and thyroid autoimmunity. Results: The prevalence of ID was 23.43% (373/1,592). Compared with the non-ID group, the ID group had lower FT4 levels (13.94 pmol/L [8.91 to 29.82 pmol/L] versus 14.63 pmol/L [8.22 to 47.24 pmol/L]; P<.001]) and higher TSH levels (1.85 mIU/L [0.01 to 7.84 mIU/L] versus 1.69 mIU/L [0.01 to 10.2 mIU/L]; P<.05). Logistic regression analysis confirmed ID as a risk factor for increased thyroglobulin antibody (TG-Ab) (odds ratio 1.974; 95% confidence interval 1.065, 3.657; P<.05), but not for subclinical hypothyroidism or increased TPO-Ab. Conclusion: ID is associated with increased TG-Ab during the second trimester of pregnancy. Abbreviations: BMI = body mass index; CV = coefficient of variation; FT4 = free thyroxine; Hb = hemoglobin; ID = iron deficiency; IDA = iron deficiency anemia; SF = serum ferritin; T3 = triiodothyronine; T4 = thyroxine; TAI = thyroid autoimmunity; TG = thyroglobulin; TG-Ab = thyroglobulin antibody; TPO = thyroid peroxidase; TPO-Ab = thyroid peroxidase antibody; TSH = thyroid-stimulating hormone

scholarly journals Prospective Study of Ultraviolet Radiation Exposure and Thyroid Cancer Risk in the United States

2016 ◽  
Vol 26 (5) ◽  
pp. 684-691 ◽  
Author(s):  
Rachel D. Zamoiski ◽  
Elizabeth K. Cahoon ◽  
D. Michal Freedman ◽  
Martha S. Linet ◽  
Cari M. Kitahara
Keyword(s):  
United States ◽  
Thyroid Cancer ◽  
Cancer Risk ◽  
Ultraviolet Radiation ◽  
Prospective Study ◽  
Radiation Exposure ◽  
The United States ◽  
Ultraviolet Radiation Exposure ◽  
Thyroid Cancer Risk

The Antibody Response in Human Autoimmune Thyroid Disease

1997 ◽  
Vol 92 (6) ◽  
pp. 529-541 ◽  
Author(s):  
Richard S. McIntosh ◽  
M. Suhail Asghar ◽  
Anthony P. Weetman
Keyword(s):  
Antibody Response ◽  
Thyroid Disease ◽  
Hormone Receptor ◽  
Autoimmune Thyroid Disease ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Thyroid Autoantigens ◽  
Reactive Antibody ◽  
Stimulating Hormone

1. The analysis of the antibody response in autoimmune thyroid disease has followed several historical trends. It was the investigation of thyroid-reactive antibody that allowed the initial characterization of the three principle thyroid autoantigens, thyroglobulin, thyroid peroxidase and the thyroid stimulating hormone receptor. 2. Analysis can be grouped under two broad areas: analysis of the physiological and pathological effects of the antibody, and analysis of the structure of the antibodies themselves. This review will focus on the latter. 3. Within recent years there has been a great increase in knowledge of thyroid-reactive antibody structure, principally through the adoption of phage display combinatorial library methodologies. While this latter technique has established some general principles for antibodies to thyroglobin and especially thyroid peroxidase, there is still a substantial gap in our knowledge of the antibody response to the thyroid stimulating hormone receptor. 4. Thyroid peroxidase antibodies have a relatively restricted V-region usage, and there is a correlation between the V-regions used and the epitope on thyroid peroxidase bound. In particular the Vκ light chain, Vκl(O12), is associated with reactivity to one epitope. 5. The purpose of this review is to bring together the latest results concerning the molecular analysis of the antibody response in autoimmune thyroid disease, to highlight areas of ignorance and conflict, and to discuss the methods adopted to circumvent the problems associated with analysis of the antibody response.

scholarly journals Increase of Circulating CXCL9 and CXCL11 Associated with Euthyroid or Subclinically Hypothyroid Autoimmune Thyroiditis

2011 ◽  
Vol 96 (6) ◽  
pp. 1859-1863 ◽  
Author(s):  
Alessandro Antonelli ◽  
Silvia Martina Ferrari ◽  
Silvia Frascerra ◽  
Andrea Di Domenicantonio ◽  
Andrea Nicolini ◽  
...  
Keyword(s):  
Linear Regression ◽  
Regression Model ◽  
Multiple Linear Regression ◽  
Autoimmune Thyroiditis ◽  
Linear Regression Model ◽  
Thyroid Autoimmunity ◽  
Thyroid Volume ◽  
Multiple Linear Regression Model ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid

Context: Recently, CXCL9 and CXCL11 have been shown to be involved in autoimmune thyroid disorders; however, no data are present about CXCL9 and CXCL11 circulating levels in thyroid autoimmunity. Objective: Our objective was to evaluate circulating CXCL9 and CXCL11 in autoimmune thyroiditis (AIT). Design and Patients or Other Participants: Serum CXCL9 and CXCL11 have been measured in 141 consecutive patients with newly diagnosed AIT (AIT-p), 70 euthyroid controls, and 35 patients with nontoxic multinodular thyroid. The three groups were similar in gender distribution and age; among the AIT-p, 26% had subclinical hypothyroidism. Results: Serum CXCL9 and CXCL11 levels were significantly (P &lt; 0.0001 for both) higher in AIT-p (143 ± 164 and 121 ± 63 pg/ml, respectively) than in controls (68 ± 37 and 65 ± 19 pg/ml, respectively) or patients with multinodular thyroid (87 ± 43 and 71 ± 20 pg/ml, respectively). Among AIT-p, CXCL9 and CXCL11 levels were significantly higher in patients older than 50 yr or those with a hypoechoic ultrasonographic pattern or with hypothyroidism. In a multiple linear regression model including age, thyroid volume, hypoechogenicity, hypervascularity, TSH, anti-thyroglobulin, and anti-thyroid peroxidase, only age and TSH were significantly (P &lt; 0.05) related to serum CXCL9 or CXCL11 levels. In a multiple linear regression model of CXCL9 vs. age, TSH, and CXCL11, TSH (P = 0.032) and CXCL11 (P = 0.001) were significantly and independently related to CXCL9. Conclusions: We first show that circulating CXCL9 and CXCL11 are increased in patients with thyroiditis and hypothyroidism and are related to each other. These results underline the importance of a Th1 immune attack in the initiation of AIT.

scholarly journals Postpartum Thyroiditis and Autoimmune Thyroiditis in Women of Childbearing Age: Recent Insights and Consequences for Antenatal and Postnatal Care

2001 ◽  
Vol 22 (5) ◽  
pp. 605-630 ◽  
Author(s):  
Alex F. Muller ◽  
Hemmo A. Drexhage ◽  
Arie Berghout
Keyword(s):  
Autoimmune Thyroiditis ◽  
Thyroid Autoimmunity ◽  
Fetal Loss ◽  
First Year ◽  
Thyroid Peroxidase ◽  
Childbearing Age ◽  
Activated T Cells ◽  
Postpartum Thyroiditis ◽  
Autoimmune Thyroid ◽  
Significant Impairment

Abstract Postpartum thyroiditis is a syndrome of transient or permanent thyroid dysfunction occurring in the first year after delivery and based on an autoimmune inflammation of the thyroid. The prevalence ranges from 5–7%. We discuss the role of antibodies (especially thyroid peroxidase antibodies), complement, activated T cells, and apoptosis in the outbreak of postpartum thyroiditis. Postpartum thyroiditis is conceptualized as an acute phase of autoimmune thyroid destruction in the context of an existing and ongoing process of thyroid autosensitization. From pregnancy an enhanced state of immune tolerance ensues. A rebound reaction to this pregnancy-associated immune suppression after delivery explains the aggravation of autoimmune syndromes in the puerperal period, e.g., the occurrence of clinically overt postpartum thyroiditis. Low thyroid reserve due to autoimmune thyroiditis is increasingly recognized as a serious health problem. 1) Thyroid autoimmunity increases the probability of spontaneous fetal loss. 2) Thyroid failure due to autoimmune thyroiditis—often mild and subclinical—can lead to permanent and significant impairment in neuropsychological performance of the offspring. 3) Evidence is emerging that as women age subclinical hypothyroidism—as a sequel of postpartum thyroiditis—predisposes them to cardiovascular disease. Hence, postpartum thyroiditis is no longer considered a mild and transient disorder. Screening is considered.

scholarly journals Trimester-specific reference ranges for thyroid hormones of pregnant females at tertiary care hospitals in Lahore, Pakistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Asim Mumtaz ◽  
Fauzia Sadiq ◽  
Saima Zaki ◽  
Hijab Batool ◽  
Muhammad Ibrahim ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Thyroid Function Test ◽  
Cross Sectional Study ◽  
Thyroid Stimulating Hormone ◽  
Specific Reference ◽  
Thyroid Peroxidase ◽  
Reference Ranges ◽  
Cross Sectional ◽  
Pregnant Females ◽  
Tertiary Care Hospitals

Abstract Background The significance of investigation for diagnosing and managing thyroid dysfunction in pregnant females has been extensively documented in the medical literature. This study aimed to determine trimester-specific reference ranges for thyroid-stimulating hormones (TSH), free T3 (FT3), and free T4 (FT4) in apparently healthy pregnant women attending tertiary care hospitals in Lahore. Methods This cross-sectional study was conducted at two tertiary care Hospitals in Lahore, Pakistan. In this multi-centric study, 500 pregnant females were initially enrolled from September 2019 to December 2019 who fulfilled the inclusion criteria. For measurement of serum FT3, FT4, thyroid stimulating hormone (TSH), anti-thyroid peroxidase (anti-TPO), and thyroglobulin antibodies, 5 ml of the blood sample was drawn, under aseptic conditions, from each subject using Maglumi 800 chemiluminescence immunoassay (CLIA) system. Results Out of 500 subjects, 23 subjects with positive anti-TPO, 19 subjects with anti-TG antibodies, and 12 subjects due to less volume of serum yielded from whole blood (serum less than 3 ml) were excluded from the analysis. Ten samples were hemolyzed and not included in the analysis. A total of 436 samples were examined for analysis. Of the remaining 436 subjects, 133 (30.5%) were from 1st trimester, 153 (35.1%) from 2nd trimester, and 150 (34.4%) from 3rd trimester. As the data were non-normal, the 2.5th, 50th, and 97.5th percentiles were calculated to express each group's results. Trimester specific range of TSH 0.168-4.294, 0.258-4.584 and 0.341-4.625 mIU/mL, FT31.857-4.408, 1.958-4.621 and 2.025-4.821 pmol/L and FT4 8.815-18.006, 8.306-17.341 and 7.402-17.292 pmol/L. Conclusion In this study, we established a trimester-specific reference range for our local population's thyroid function test. The results of this study have complemented the results of previous studies.

scholarly journals Total Thyroidectomy Versus Lobectomy for Thyroid Cancer: Single-Center Data and Literature Review

2021 ◽  
Author(s):  
Carla Colombo ◽  
Simone De Leo ◽  
Marta Di Stefano ◽  
Matteo Trevisan ◽  
Claudia Moneta ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Risk Group ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Low Risk ◽  
The Other ◽  
Intermediate Risk ◽  
Other Hand

Abstract Background Controversies remain about the ideal risk-based surgical approach for differentiated thyroid cancer (DTC). Methods At a single tertiary care institution, 370 consecutive patients with low- or intermediate-risk DTC were submitted to either lobectomy (LT) or total thyroidectomy (TT) and were followed up. Results Event-free survival by Kaplan–Meier curves was significantly higher after TT than after LT for the patients with either low-risk (P = 0.004) or intermediate-risk (P = 0.032) tumors. At the last follow-up visit, the prevalence of event-free patients was higher in the TT group than in the LT low-risk group (95% and 87.5%, respectively; P = 0.067) or intermediate-risk group (89% and 50%; P = 0.008). No differences in persistence prevalence were found among microcarcinomas treated by LT or TT (low risk, P = 0.938 vs. intermediate-risk, P = 0.553). Nevertheless, 15% of the low-risk and 50% of the intermediate-risk microcarcinomas treated by LT were submitted to additional treatments. On the other hand, macrocarcinomas were significantly more persistent if treated with LT than with TT (low-risk, P = 0.036 vs. intermediate-risk, P = 0.004). Permanent hypoparathyroidism was more frequent after TT (P = 0.01). After LT, thyroglobulin (Tg)/thyroid-stimulating hormone (TSH) had shown decreasing trend in 68% of the event-free patients and an increasing trend in the persistent cases. Conclusions Lobectomy can be proposed for low-risk microcarcinomas, although in a minority of cases, additional treatments are needed, and a longer follow-up period usually is required to confirm an event-free outcome compared with that for patients treated with TT. On the other hand, to achieve an excellent response, TT should be favored for intermediate-risk micro- and macro-DTCs despite the higher frequency of postsurgical complications.

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