scholarly journals Screening for congenital hypothyroidism: results of screening 5600 Ardabil province infants

Author(s):  
Mehrdad Mirzarahimi ◽  
Manouchehr Barak ◽  
Ali Mardi ◽  
Afsaneh Enteshari-Moghaddam

<p class="abstract"><strong>Background:</strong> Congenital hypothyroidism (CH) is a condition of thyroid hormone deficiency which varies more by geographic areas and affecting 1 in 3000 to 4000 of newborns. The aim of this study was to investigate the screening of CH results in in Ardabil Province, Iran.</p><p class="abstract"><strong>Methods:</strong> This descriptive study was conducted on 158624 neonates during 2007 to 2013 which were screened for CH by measuring serum TSH obtained by heel prick. Of all neonates 5600 neonates who had a TSH ≥5 mU/L were recalled for measurement of serum T4 and thyroid stimulating hormone (TSH) in venous samples. Collected data analyzed by statistical methods in SPSS.16.  </p><p class="abstract"><strong>Results:</strong> The incidence of congenital hypothyroidism was found to be 1:916 with a female to male ratio of 0.76:1. In 220 patients with CH, 40 patients were diagnosed with permanent CH (18.2%) and 140 with transient hypothyroidism (81.8%). The frequency of transient hypothyroidism was 4.5 times more than permanent hypothyroidism and was significant. In newborns with permanent hypothyroidism the average of TSH levels in the first and second times was 37.15 and 31.56 μIU/ml, respectively.</p><p><strong>Conclusions:</strong> Results showed that the prevalence of CH in Ardabil province was significantly high and comparing the results of this study with other studies in other countries suggests the proper efficacy of congenital hypothyroidism screening in Ardabil's health system. Also we should be attention to other environmental factors especially during pregnancy which affect the performance of the mother’s thyroid. </p>

PEDIATRICS ◽  
1992 ◽  
Vol 90 (2) ◽  
pp. 207-211
Author(s):  
Ramin Alemzadeh ◽  
Silvia Friedman ◽  
Pavel Fort ◽  
Bridget Recker ◽  
Fima Lifshitz

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.


Author(s):  
Lakshmi Venugopalan ◽  
Aishwarya Rajan ◽  
Hemchand. K. Prasad ◽  
Anupama Sankaran ◽  
Gnanabalan Murugesan ◽  
...  

AbstractObjectivesPrevalence of Maternal and congenital hypothyroidism is on the rise. To present the thyroid stimulating hormone screening results in babies born to hypothyroid mothers and assess the burden, aetiology of hypothyroidism in these babiesMethodsAll antenatal mothers attending our hospital during the study period were enrolled into the study. Group I includes 249 term babies born to hypothyroid mothers and group II comprises 2154 newborns born to mothers who are euthyroid. Heel prick thyroid stimulating hormone was done for all newborns on day 3 for both groups. Confirmatory venous testing was done for all for babies in group I and screen positives belonging to group II. Evaluation and therapy done as per standard guidelines.ResultsThyroid stimulating hormone values in the two groups are presented. There was significant correlation between peak maternal thyroid stimulating hormone and neonatal day 3 heel prick in group I (r=0.7, P<0.05). The prevalence of positive screening test in groups I and II was 3.8 and 1.03% (p<0.05) whereas corresponding values for confirmed disease was 4.3 and 0.6%, respectively (p<0.05). Aetiological evaluation revealed both transient hypothyroidism (33.3%) and permanent hypothyroidism (66.6%).Conclusion4.3% of babies born to hypothyroid mothers develop congenital hypothyroidism; aetiology being both transient and permanent. A venous test by 3 weeks is helpful in these babies to improve case identification.


2005 ◽  
Vol 153 (3) ◽  
pp. 429-434 ◽  
Author(s):  
P Cettour-Rose ◽  
T J Visser ◽  
A G Burger ◽  
F Rohner-Jeanrenaud

Objectives: Intrapituitary triiodothyronine (T3) production plays a pivotal role in the control of TSH secretion. Its production is increased in the presence of decreased serum thyroxine (T4) concentrations and the enzyme responsible, deiodinase type 2 (D2), is highest in hypothyroidism. In order to document the role of this enzyme in adult rats we developed an experimental model that inhibited this enzyme using the specific inhibitor, reverse T3 (rT3). Methods: Hypothyroidism was induced with propylthiouracil (PTU; 0.025 g/l in drinking water) which in addition blocked deiodinase type 1 (D1) activity, responsible for the rapid clearance of rT3 in vivo. During the last 7 days of the experiment, the hypothyroid rats were injected (s.c.) for 4 days with 0.4 or 0.8 nmol T4 per 100 g body weight (bw) per day. For the last 3 days, the same amount of T4 was infused via s.c. minipumps. In additional groups, 25 nmol rT3/100 g bw per day were added to the 3-day infusion of T4. Results: Infusion of 0.4 nmol T4/100 g bw per day did not affect the high serum TSH levels, 0.8 nmol T4/100 g bw per day decreased them to 57% of the hypothyroid values. The infusions of rT3 inhibited D2 activity in all organs where it was measured: the pituitary, brain cortex and brown adipose tissue (BAT). In the pituitary, the activity was 27%, to less than 15% of the activity in hypothyroidism. Despite that, serum TSH levels did not increase, serum T4 concentrations did not change and the changes in serum T3 were minimal. Conclusions: We conclude that in partly hypothyroid rats, a 3-day inhibition of D2 activity, without concomitant change in serum T4 and minimal changes in serum T3 levels, is not able to upregulate TSH secretion and we postulate that this may be a reflection of absent or only minimal changes in circulating T3 concentrations.


Homeopathy ◽  
2021 ◽  
Author(s):  
Luiz Carlos Esteves Grelle ◽  
Luiz Antonio Bastos Camacho

Abstract Background Subclinical hypothyroidism (SCH) is a common clinical problem. Controversy surrounds the definition, clinical importance, and need for prompt diagnosis and treatment of the mild form of SCH. Aim The aim of the study was to analyze the evolution of serum thyroid stimulating hormone (TSH) levels after a therapeutic homeopathic intervention in women older than 40 years with SCH. Methods This study is a retrospective series of 19 cases of SCH, with serum TSH levels between 5 and 10 mIU/L, treated exclusively with homeopathic medicines prescribed on an individualized basis. Results Nineteen patients were included according to the inclusion and exclusion criteria. Their mean age was 56 years, they were followed for a mean duration of 69 months, the mean number of serum TSH level measurements was 18, and the intervention was successful for 13 patients. Conclusion The homeopathic therapeutic intervention was successful in 68% of the patients, with serum TSH levels back within the normal range (0.5–5.0 mIU/L).


2019 ◽  
Vol 47 (7) ◽  
pp. 3040-3049 ◽  
Author(s):  
Fu-Man Du ◽  
Hong-Yu Kuang ◽  
Bin-Hong Duan ◽  
Da-Na Liu ◽  
Xin-Yang Yu

Objective We investigated the prevalence of abnormal thyroid function and depression in centrally obese participants, and to analyze the relationship of thyroid hormones and depression with components of central obesity. Methods We randomly selected 858 centrally obese participants and 500 non-obese controls in this study. For all participants, we measured serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), body mass index (BMI), waist–hip ratio (WHR), fasting blood glucose and insulin, homeostasis model assessment of insulin resistance (HOMA-IR), lipid concentrations, and blood pressure. Depression was assessed using the Center for Epidemiological Studies-Depression (CES-D) scale. Results Centrally obese participants had a higher prevalence of hypothyroidism and depression than non-obese controls. Serum FT4 levels negatively correlated with BMI and serum TSH levels and positively correlated with BMI, WHR, total triglycerides (TG), total cholesterol (TC), and low density lipoprotein cholesterol (LDL-C). After excluding participants with hypothyroidism and hyperthyroidism, serum FT4 levels showed negative correlation and serum TSH levels showed positive correlation with BMI in the remaining centrally obese participants. CES-D scores positively correlated with BMI. Conclusion We found high prevalences of hypothyroidism and depression among centrally obese participants. FT4 and TSH are important in weight regulation. Depression positively correlated with obesity.


1971 ◽  
Vol 49 (4) ◽  
pp. 569-572
Author(s):  
J. R. BOURKE ◽  
S. W. MANLEY ◽  
R. W. HAWKER

SUMMARY The effect of methallibure (ICI 33,828), a non-steroidal pituitary inhibitor, on serum and pituitary thyroid-stimulating hormone (TSH) levels has been investigated. A biphasic action of the drug on serum TSH levels was observed, the greatest falls occurring with the lowest doses (2mg/day). Increasing dose and period of administration induced progressive decreases in pituitary TSH content. These results are interpreted in terms of three actions on the thyroid—pituitary system: (1) inhibition of the release of TSH from the pituitary, (2) inhibition of TSH synthesis evident only at higher doses, and (3) a thyroid-blocking action, which is also only observed at the higher dose levels, with consequent pituitary stimulation via the thyroid—pituitary feedback mechanism. Effects upon body weight and weight of endocrine organs are reported, that upon the seminal vesicles being the most marked.


1981 ◽  
Vol 97 (3) ◽  
pp. 361-368 ◽  
Author(s):  
J. Salmerón De Diego ◽  
C. Alonso Rodriguez ◽  
A. Salazar Orlando ◽  
P. Sanchez Garcia Cervigon ◽  
E. Caviola Mutazzi ◽  
...  

Abstract. A 74 year old woman was found to have elevated serum thyroid-stimulating hormone (TSH) levels and elevated serum thyroid hormone levels, with clinical euthyroidism. There was no evidence of a pituitary tumour. TSH levels increased substantially during methimazole therapy. Administration of dexamethasone was followed by a prompt fall in serum TSH levels. Triiodothyronine (T3) was administered over a period of 20 days in doses from 25 μg to as much as 100 μg daily causing a rise in serum T3 above 700 ng/100 ml, a decline of T4 and a blunting of the response to thyrotrophinreleasing hormone (TRH), with normal metabolic responses (pulse rate, photomotogram, cholesterol). These results suggest that the patient's disorder is due to partial target organ resistance to thyroid hormones.


2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Abdul Rehman Khokhar ◽  
Abdul Majeed Cheema

Objectives: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism. Methods: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied. Results: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group. Conclusions: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan. doi: https://doi.org/10.12669/pjms.37.5.4086 How to cite this:Khokhar AR, Cheema AM. Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4086 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2014 ◽  
Vol 7 ◽  
pp. CMED.S15466 ◽  
Author(s):  
Alexander D. Shinkov ◽  
Anna-Maria I. Borissova ◽  
Roussanka D. Kovatcheva ◽  
lliana B. Atanassova ◽  
Jordan D. Vlahov ◽  
...  

Osteoprotegerin (OPG) and osteocalcin (OC) are essential bone proteins. Recent studies have demonstrated that they are not secreted solely by bone cells; they play roles in the vascular function and energy metabolism, and they are influenced by multiple factors. The aim of the current study was to investigate the influence of menopause and age on OPG and OC in women with different thyroid-stimulating hormone (TSH) levels. Material and Methods We studied 49 women with elevated TSH, 26 with suppressed TSH, and 67 age-matched euthyroid controls. Of them 64 were menstruating and 78 postmenopausal. Body weight, height, waist circumference (WC), body mass index (BMI), serum TSH, free thyroxin (FT4), OPG, and OC were measured. Results Generally, both OPG and OC were higher in the postmenopausal women than in the menstruating subjects (OPG 3.85 ± 1.49 pmol/L vs. 5.84 ± 2.42 pmol/L, P < 0.001; OC 8.84 ± 3.70 ng/dL vs. 12.87 ± 6.45 ng/dL, P < 0.001), and within the two thyroid dysfunction subgroups and the controls (all P < 0.05). OPG correlated with age (postmenopausal rho = 0.57, P < 0.001; premenopausal rho = 0.31, P = 0.015). Among the premenopausal subjects, OPG was higher in those with low TSH than in the controls ( P = 0.048). OC correlated negatively with BMI and WC in the postmenopausal group (Spearman rho = –-0.25, P = 0.03 and rho = –-0.42, P < 0.001 respectively). OC was higher in the postmenopausal subjects with low TSH than in those with elevated TSH ( P = 0.024), and correlated positively with FT4 (rho = 0.40, P = 0.002) and negatively with TSH (rho = -0.29, P = 0.013). CONCLUSIONS In women, OPG and OC depended differently on age and menopause and, to a lesser extent, on the thyroid function and body composition.


Author(s):  
Niranjan Gopal ◽  
Akash Shivaji Pune ◽  
Roshan Takhelmayum ◽  
Ashok Kumar Ahirwar

Abstract Objectives The incidence of metabolic syndrome is increasing even at younger ages. Metabolic syndrome constitutes a group of cardiovascular risk factors that include high cholesterol, triacylglycerol, hyperglycemia, central obesity, etc., which increases the risk of cardiovascular disease, diabetes mellitus, may be even cancer. Indian students enter colleges just after crossing their adolescent age and will be exposed to greater academic stress. Psychological stress or depression is associated with transient change in thyroid hormones level or dysfunction. To explore an association among serum Thyroid Stimulating Hormone (TSH) levels, fT3:fT4 ratio, psychological stress scores, and selected known cardio-metabolic risk markers. Methods Forty first year MBBS students were included. Their demographic, anthropometric variables, and the blood pressure were documented. Serum TSH, fT3, fT4, and salivary cortisol level was quantified. The stress level was assessed using Cohen Perceived Stress Scale Scoring. Data were expressed in mean ± standard deviation. Data (parametric/non-parametric) were compared by Independent unpaired ANOVA or Kruskal Wallis test whichever is appropriate. Spearmen correlation analysis was performed. Results Serum TSH and Cohen stress score are negatively correlated (r=−0.152), but serum cortisol showed (r=0.763) a positive correlation. TSH levels and the marks obtained in the summative assessments were negatively correlated and the correlation was not statistically significant. Conclusions The psychological stress is associated with low serum TSH, high cortisol, and poor academic performance in first year MBBS students. Blood pressure, plasma glucose, and anthropometric measures were not associated with the psychological stress.


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