The association between hypoechogenicity or irregular echo pattern at thyroid ultrasonography and thyroid function in the general population

Objective: Patients with overt hypothyroidism show decreased echogenicity of the thyroid at ultrasonography (US). The aim of this study was to investigate the association between echogenicity of the thyroid/irregular echo pattern, and thyroid function in the general population, i.e. subjects without overt thyroid disease. Design: A cross-sectional investigation of 4649 randomly selected adult subjects. Methods: Blood samples were analysed for serum TSH, thyroid hormones and thyroid autoantibodies. US of the thyroid was performed. Results: Participants with decreased echogenicity (n=379) had a higher mean TSH (1.65 mU/l) compared with subjects with normal echogenicity (1.21 mU/l, P<0.0001). The association was stronger in subjects with markedly decreased echogenicity (4.20 mU/l, P<0.0001). A similar association was seen when the subjects were divided into subgroups according to the level of TSH; more subjects with high levels of TSH had decreased echogenicity (P<0.0001). Likewise, more subjects with high levels of TSH had an irregular echo pattern (P<0.0001). Subjects with decreased echogenicity had a higher risk of having thyroid autoantibodies than subjects without decreased echogenicity (P<0.0001). This association was stronger when echogenicity was markedly decreased. Conclusions: We demonstrated an association between hypoechogenicity at thyroid US and higher levels of serum TSH even in subjects without overt thyroid disease, suggesting decreased echogenicity as an early sign of thyroid dysfunction. Irregular echo pattern, whether accompanied by hypoechogenicity or not, was another possible marker of thyroid failure. This indicates a possible use of thyroid US in detecting early and subclinical thyroid dysfunction.

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Thyroid dysfunction in preeclampsia and related fetomaternal outcomes

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191944 ◽

2019 ◽

Vol 8 (5) ◽

pp. 1928

Author(s):

Puja Banik ◽

R. K. Praneshwari Devi ◽

Aheibam Bidya ◽

Akoijam Tamphasana ◽

M. Agalya ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Birth Asphyxia ◽

Normal Pregnancy ◽

Thyroid Stimulating Hormone ◽

Severe Preeclampsia ◽

Intrauterine Fetal Death ◽

Overt Hypothyroidism ◽

Thyroid Function Tests ◽

Cross Sectional

Background: Changes in thyroid function in normal pregnancy are well-documented but in complicated pregnancy like preeclampsia, very little is known. Studies have shown evidences of hypothyroidism in preeclampsia necessitating thyroid function tests to be done in preeclampsia. The study was done to analyze the fetomaternal outcome of preeclampsia with coexisting thyroid dysfunction.Methods: A cross-sectional analytical study was done over 18 months on 95 preeclamptic patients admitted at the antenatal ward and fetomaternal outcomes were analyzed according to thyroid status.Results: Out of 95 patients with preeclampsia, 42 (44.2%) had thyroid dysfunction. Among these 42 patients, 37 (38.9%) patients had subclinical hypothyroidism, 4 (4.2%) had overt hypothyroidism and 1 (1%) had hyperthyroidism. Severe preeclampsia was seen in 64.3% of the patients with thyroid dysfunction compared with 39.6% in euthyroid patients. The mean thyroid stimulating hormone (TSH) level was significantly higher and means free thyroxine (fT4) level was significantly lower in severe preeclampsia compared with non-severe preeclampsia. Complications like abruption, intrauterine fetal death (IUD), intrauterine growth restriction (IUGR), oligohydramnios, preterm deliveries, postpartum hemorrhage (PPH), low birth weight babies, birth asphyxia in babies and subsequent neonatal intensive care unit (NICU) admissions were significantly higher (p <0.05) in the preeclampsia patients with thyroid dysfunction in comparison with euthyroid ones.Conclusions: Hypothyroidism may be a modifiable risk factor for preeclampsia. Thyroid screening early in pregnancy may be helpful in predicting the occurrence of preeclampsia and timely thyroid hormone administration can reduce the maternal and perinatal morbidity and mortality associated with preeclampsia.

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Frequency of subclinical thyroid dysfunction and risk factors for cardiovascular disease among women at a workplace

Sao Paulo Medical Journal ◽

10.1590/s1516-31802010000100005 ◽

2010 ◽

Vol 128 (1) ◽

pp. 18-23 ◽

Cited By ~ 11

Author(s):

Rodrigo Diaz-Olmos ◽

Antônio-Carlos Nogueira ◽

Daniele Queirós Fucciolo Penalva ◽

Paulo Andrade Lotufo ◽

Isabela Martins Benseñor

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Thyroid Disease ◽

Thyroid Dysfunction ◽

Free T4 ◽

Cross Sectional

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.

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The Prevalence of Thyroid Dysfunction and Autoimmunity in Women With History of Miscarriage or Subfertility

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa302 ◽

2020 ◽

Vol 105 (8) ◽

pp. 2667-2677 ◽

Cited By ~ 1

Author(s):

Rima K Dhillon-Smith ◽

Aurelio Tobias ◽

Paul P Smith ◽

Lee J Middleton ◽

Kirandeep K Sunner ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Disease ◽

Thyroid Dysfunction ◽

Significant Proportion ◽

Thyroid Stimulating Hormone ◽

Overt Hypothyroidism ◽

Thyroid Peroxidase ◽

Regression Analyses ◽

Asian Ethnicity ◽

History Of

Abstract Objective To describe the prevalence of and factors associated with different thyroid dysfunction phenotypes in women who are asymptomatic preconception. Design Observational cohort study. Setting A total of 49 hospitals across the United Kingdom between 2011 and 2016. Participants Women aged 16 to 41years with history of miscarriage or subfertility trying for a pregnancy. Methods Prevalences and 95% confidence intervals (CIs) were estimated using the binomial exact method. Multivariate logistic regression analyses were conducted to identify risk factors for thyroid disease. Intervention None. Main Outcome Measure Rates of thyroid dysfunction. Results Thyroid function and thyroid peroxidase antibody (TPOAb) data were available for 19213 and 19237 women, respectively. The prevalence of abnormal thyroid function was 4.8% (95% CI, 4.5-5.1); euthyroidism was defined as levels of thyroid-stimulating hormone (TSH) of 0.44 to 4.50 mIU/L and free thyroxine (fT4) of 10 to 21 pmol/L. Overt hypothyroidism (TSH > 4.50 mIU/L, fT4 < 10 pmol/L) was present in 0.2% of women (95% CI, 0.1-0.3) and overt hyperthyroidism (TSH < 0.44 mIU/L, fT4 > 21 pmol/L) was present in 0.3% (95% CI, 0.2-0.3). The prevalence of subclinical hypothyroidism (SCH) using an upper TSH concentration of 4.50 mIU/L was 2.4% (95% CI, 2.1-2.6). Lowering the upper TSH to 2.50 mIU/L resulted in higher rates of SCH, 19.9% (95% CI, 19.3-20.5). Multiple regression analyses showed increased odds of SCH (TSH > 4.50 mIU/L) with body mass index (BMI) ≥ 35.0 kg/m2 (adjusted odds ratio [aOR] 1.71; 95% CI, 1.13-2.57; P = 0.01) and Asian ethnicity (aOR 1.76; 95% CI, 1.31-2.37; P < 0.001), and increased odds of SCH (TSH ≥ 2.50 mIU/L) with subfertility (aOR 1.16; 95% CI, 1.04-1.29; P = 0.008). TPOAb positivity was prevalent in 9.5% of women (95% CI, 9.1-9.9). Conclusions The prevalence of undiagnosed overt thyroid disease is low. SCH and TPOAb are common, particularly in women with higher BMI or of Asian ethnicity. A TSH cutoff of 2.50 mIU/L to define SCH results in a significant proportion of women potentially requiring levothyroxine treatment.

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Thyroid function after resection for non-toxic goitre with special reference to thyroid lymphocytic aggregation and circulating thyroid autoantibodies

Acta Endocrinologica ◽

10.1530/acta.0.1090214 ◽

1985 ◽

Vol 109 (2) ◽

pp. 214-219 ◽

Cited By ~ 8

Author(s):

Ulla Bang ◽

M. Blichert-Toft ◽

P. Hyltoft Petersen ◽

B. B. Nielsen ◽

H. Diederichsen ◽

...

Keyword(s):

Thyroid Function ◽

Lymphocytic Infiltration ◽

Thyroid Stimulating Hormone ◽

Overt Hypothyroidism ◽

Thyroid Autoantibodies ◽

Thyroglobulin Antibodies ◽

Free Thyroxine Index ◽

Total Triiodothyronine ◽

Bilateral Surgery ◽

Serum Tsh

Abstract. A series of 91 patients operated on for nontoxic goitre was followed systematically during 24 months post-operatively with regard to thyroid function. A thyroid remnant of at least 5 to 8 g was left in the majority of cases, and thyroid replacement was not given. Histopathological grading was performed on goitrous specimens with reference to lymphocytic infiltration. Thyroglobulin antibodies and thyroid microsomal antibodies were determined pre-operatively. Goitre resection provoked a high, but transient increase in serum thyroid stimulating hormone (TSH) levels with peak values 3 to 6 months after operation. Twenty-four months after surgery serum TSH values had normalized, but were still slightly elevated in patients with bilateral surgery and high lymphocytic infiltration, 9% of the patients. The concentration of serum free thyroxine index (FT4I) and serum total triiodothyronine (TT3) decreased after operation, but within reference range. Twenty-four months after surgery, serum FT4I was back to baseline values, while serum TT3 was still lowered compared to the pre-operative level. None of the patients developed overt hypothyroidism. Occurrence of circulating thyroid autoantibodies was not related to post-operative changes in thyroid parameters. We conclude that thyroid replacement therapy seems not to be indicated routinely following resection for non-toxic goitre, but precaution should be taken in case of bilateral resection and high lymphocytic infiltration of goitrous specimens.

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Thyroid Diseases in Omani Type 2 Diabetics: A Retrospective Cross-Sectional Study

Advances in Endocrinology ◽

10.1155/2015/353121 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6

Author(s):

Sanaa Al-Sumry ◽

Thuraya Al-Ghelani ◽

Huda Al-Badi ◽

Mohammed Al-Azri ◽

Kawther Elshafie

Keyword(s):

Diabetes Mellitus ◽

General Population ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Thyroid Diseases ◽

Control Group ◽

Diabetic Patients ◽

Cross Sectional ◽

Type 2 Diabetics

Background. Diabetes mellitus and thyroid diseases are common endocrine disorders in the general population and found to exist simultaneously. This study aimed to establish the prevalence of thyroid dysfunction among Omani type 2 diabetics and its association with glycemic control. Methodology. A retrospective cross-sectional randomized primary and secondary care based study of 285 Omani type 2 diabetics, ≥ 30 years of age with known thyroid function. The following parameters were examined: age, sex, duration of diabetes, duration of thyroid disease, thyroid morphology, thyroid function, thyroid antibodies, and the mean glycated hemoglobin (mean HbA1C). The prevalence of thyroid dysfunction was compared to an independent control group of randomly selected healthy individuals with known thyroid function. Results. Thyroid dysfunction was found in 12.6% of the diabetic patients compared to 4.9% in the control group. The prevalence was higher among the diabetic females (86%) compared to diabetic males (14%). The commonest thyroid dysfunction among diabetics was overt hypothyroidism (4.6%). Subclinical hypothyroidism was the commonest thyroid dysfunction seen in less controlled diabetics at a mean HbA1c of 7.8 (± 0.7). Conclusion. Screening for thyroid dysfunction in patients with type 2 diabetes mellitus should be routinely performed considering the higher prevalence of thyroid diseases in this group compared to the general population.

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Occurrence of subclinical and overt hypothyroidism among chronic kidney disease patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20203679 ◽

2020 ◽

Vol 8 (9) ◽

pp. 3284

Author(s):

Dilip Kumar Jha ◽

Gregory Minj ◽

Umesh Prasad ◽

Yuvraj Lahre ◽

Diljeet Bodra

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Cross Sectional Study ◽

Overt Hypothyroidism ◽

Sectional Study ◽

Medical Sciences ◽

Cross Sectional ◽

Serum T3

Background: Chronic kidney disease (CKD) is one of the vital health problems worldwide leading to increased global morbidity and mortality. Thyroid dysfunction including hypothyroidism, hyperthyroidism and non-thyroidal illness has been reported in CKD patients. This study was conducted to determine the prevalence of subclinical and overt hypothyroidism among chronic kidney disease patients. This study also tried to correlate thyroid function abnormalities with severity of renal failure.Method: In this observational and cross sectional study, 100 patients of CKD who were admitted in Department of Medicine, Rajendra institute of medical sciences, Ranchi were studied for thyroid function abnormalities. Result: This study found that glomerular filtration rate (GFR) is positively correlated with serum T3 and T4 level (i.e. with decreasing renal function both T3 and T4 levels decreased). Serum creatinine levels were negatively correlated with serum T3 and T4 level.Conclusions: From this study it was established that CKD is associated with thyroid dysfunction characterized by low serum fT3 and fT4 with high TSH in some cases.

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Association between Thyroid Function and Erythrocyte Indices in General Population from the Asir Region of Saudi Arabia: A Cross-Sectional Study

Current Topics in Nutraceutical Research ◽

10.37290/ctnr2641-452x.20:200-206 ◽

2021 ◽

Vol 20 (1) ◽

pp. 200-206

Author(s):

Alqahtani Saif Aboud M

Keyword(s):

Saudi Arabia ◽

General Population ◽

Thyroid Function ◽

Subclinical Hypothyroidism ◽

Thyroid Dysfunction ◽

Cross Sectional Study ◽

Sectional Study ◽

Male Population ◽

Cross Sectional ◽

Erythrocyte Indices

The purpose of the current investigation is to evaluate the relationship between erythrocyte indices and thyroid function in a general population from the southern region of Saudi Arabia. In a cross-sectional study conducted on 3,007 subjects examined associations among erythrocyte indices, thyroid-stimulating hormone, and free thyroxine. The average age of the population was 48.40±0.261 years, ranging from 13 years to 90 years, and the most represented age group was <50 years. Thyroid dysfunction was observed in 8.41% of the study population, and the most common thyroid dysfunction was subclinical hypothyroidism followed by clinical hyperthyroidism. Most erythrocyte indices were significantly lower in the hypothyroidism group (both primary and subclinical) in comparison to the euthyroid group stratified by gender. According to our investigation, microcytic hypochromic anemia and normocytic normochromic anemia were detected in patients with hypothyroidism. Furthermore, females with subclinical hypothyroidism had a significantly higher prevalence of anemia than male population.

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Serum Thyrotropin Concentrations Are Not Associated with the Ankle-Brachial Index: Results from Three Population-Based Studies

European Thyroid Journal ◽

10.1159/000381309 ◽

2015 ◽

Vol 4 (Suppl. 1) ◽

pp. 101-107

Author(s):

Till Ittermann ◽

Roberto Lorbeer ◽

Daniel Tiller ◽

Ina Lehmphul ◽

Alexander Kluttig ◽

...

Keyword(s):

Thyroid Function ◽

Thyroid Dysfunction ◽

Reference Range ◽

Ankle Brachial Index ◽

Arterial Disease ◽

Population Based ◽

Thyroid Stimulating Hormone ◽

Cross Sectional ◽

Potential Association ◽

Serum Tsh

Background: There is only limited data on the potential association between thyroid dysfunction and peripheral arterial disease (PAD). Objective: The aim of our study was to investigate the potential association of thyroid function, as defined by serum concentrations of the clinically used primary thyroid function marker thyrotropin [i.e. thyroid-stimulating hormone (TSH)] and 3,5-diiodothyronine (3,5-T2), with the ankle-brachial index (ABI) as a marker of PAD. Methods: We used data from 5,818 individuals from three cross-sectional population-based studies conducted in Northeast (SHIP-2 and SHIP-TREND) and Central Germany (CARLA). Measurement of serum TSH concentrations was conducted in one central laboratory for all three studies. In a randomly selected subpopulation of 750 individuals of SHIP-TREND, serum 3,5-T2 concentrations were measured with a recently developed immunoassay. ABI was measured either by a hand-held Doppler ultrasound using the Huntleigh Dopplex D900 or palpatorily by the OMRON HEM-705CP device. Results: Serum TSH concentrations were not significantly associated with ABI values in any of the three studies. Likewise, groups of individuals with a TSH <0.3 mIU/l or with a TSH ≥3.0 mIU/l had no significantly different ABI values in comparison with individuals with a TSH in the reference range. Analyses regarding TSH within the reference range or serum 3,5-T2 concentrations did not reveal consistent significant associations with the ABI. No sex-specific associations were detected. Conclusions: The results of our study do not substantiate evidence for an association between thyroid function and PAD, but further studies are needed to investigate the associations of overt forms of thyroid dysfunction with PAD.

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EFFECTS OF THYROID DYSFUNCTION ON LIPID PROFILE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i6.301 ◽

2019 ◽

Vol 3 (6) ◽

Author(s):

Dr. Vinod Kumar ◽

Dr. S.L. Mathur ◽

Dr. Rajat Kumar Tuteja

Keyword(s):

Lipid Profile ◽

Thyroid Function ◽

Thyroid Dysfunction ◽

Hdl Cholesterol ◽

Overt Hypothyroidism ◽

Cvd Risk ◽

Cross Sectional ◽

Vldl Cholesterol ◽

Group A ◽

Group B

Background: Thyroid function regulates a wide array of metabolic parameters. Thyroid function significantly affects lipoprotein metabolism as well as some cardiovascular disease (CVD) risk factors, thus influencing overall CDV risk. Methods: A cross sectional study has been conducted to assess the association of subclinical hypothyroidism and overt hypothyroidism with lipid abnormalities. Results: Serum HDL cholesterol in group A was 37.97±7.97 mg/dl, that in group B was 37.62±6.67 mg/dl, while in group C it was 36.27±5.79 mg/dl. Serum LDL cholesterol in group A was 150.9±29.70 mg/dl, that in group B was 115.2±22.02 mg/dl, while in group C it was 93.07±19.88 mg/dl. Serum total cholesterol in group A was 223±32.69 mg/dl, that in group B was 179.67±27.50 mg/dl, while in group C it was 152.4±21.47 mg/dl. Serum VLDL cholesterol in group A was 34.12±11.06 mg/dl, that in group B was 26.85±4.01 mg/dl, while in group C it was 23.05±3.09 mg/dl. Serum VLDL cholesterol in group A was 167.42±47.83 mg/dl, that in group B was 134.37±20.22 mg/dl, while in group C it was 115.17±15.66 mg/dl. Conclusion: Thyroid dysfunction can have an important effect on lipid profile. Biochemical screening for thyroid dysfunction is critical in all dyslipidemic patients, as well as in all patients with unexpected improvement or worsening of their lipid profile. Keywords: LDL,HDL,Cholesterol.

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Management of thyroid disease in pregnancy – Room for improvement in the first trimester

Obstetric Medicine ◽

10.1177/1753495x16629773 ◽

2016 ◽

Vol 9 (3) ◽

pp. 126-129 ◽

Cited By ~ 1

Author(s):

Helen Robinson ◽

Philip Robinson ◽

Michael D’Emden ◽

Kassam Mahomed

Keyword(s):

General Practitioner ◽

Thyroid Function ◽

Thyroid Disease ◽

Thyroid Dysfunction ◽

First Trimester ◽

Antenatal Clinic ◽

Thyroid Stimulating Hormone ◽

Thyroid Function Tests ◽

In Pregnancy ◽

Stimulating Hormone

Background First-trimester care of maternal thyroid dysfunction has previously been shown to be poor. This study evaluates early management of thyroid dysfunction in pregnancy in Australia. Methods Patients reviewed by the Obstetric Medicine team for thyroid dysfunction from 1 January 2012 to 30 June 2013 were included. Data were collected on gestation at referral from the patient’s general practitioner to the antenatal clinic, information provided in the referral letter, thyroid function tests and thyroid medications. Results Eighty-five women were included in the study. At the time of general practitioner referral to antenatal services, 19% of women with preexisting thyroid disease had no thyroid function tested. Forty-three percent had an abnormal thyroid-stimulating hormone defined as being outside the laboratory-specific pregnancy reference range if available, or outside the level of 0.1–2.5 mIu/L in the first trimester, 0.2–3.0 mIu/L in the second trimester and 0.3–3.0 mIu/L in the third trimester. Only 21% of women increased their thyroxine dose prior to their first antenatal clinic review. Conclusion This study highlights that a significant proportion of women with known thyroid disease either have untested thyroid function in the first trimester or a thyroid-stimulating hormone outside of levels recommended by guidelines.

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