scholarly journals Cardiac autonomic modulation and anti-TPO antibodies in Subclinical Hypothyroidism – Does any correlation exit?

2021 ◽  
Author(s):  
Manisha Mavai ◽  
Bharti Bhandari ◽  
Anish Singhal ◽  
Sandeep K Mathur ◽  
R C Gupta
Keyword(s):  
Subclinical Hypothyroidism ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Thyroglobulin Antibodies ◽  
Increased Risk ◽  
Biochemical Evaluation ◽  
Thyroid Profile ◽  
And Control ◽  
Nonlinear Geometric ◽  
Cardiac Autonomic Activity

Abstract Background Heart rate variability (HRV) reflects the balance of activities of sympathetic and parasympathetic components of the autonomic nervous system. Anti-thyroid antibodies have long been associated with thyroid dysfunction and influence thyroid profile testing, the most common being anti-Thyroid Peroxidase (TPO) and anti-Thyroglobulin antibodies. Subclinical hypothyroidism (SCHypo) is characterized by elevated TSH with normal thyroid hormones.We hypothesized that autonomic function may be deranged in anti-TPO positive sub-clinical hypothyroid cases even before the onset of overt hypothyroidism. Objectives To investigate the association between anti-TPO antibodies (anti-TPOAb) positive SCHypo and sympathovagal imbalance (SVI). Methodology: The study was conducted on age and BMI matched subclinical hypothyroid patients (n = 52) and healthy controls (n = 20). Cardiac autonomic activity was assessed by short term HRV in the time (SDNN, RMSSD, pNN50) and frequency domain (LFms2, HFms2, LFnu, HFnu, TP and LF/HF ratio). Nonlinear geometric measures (SD1, SD2, SD1/SD2, TINN, HRV triangular index) were also evaluated. Biochemical evaluation of serum thyroid profile, anti-TPOAb was done in all the subjects. Results Decreased HRV was observed in anti-TPOAb positive group when compared to negative and control groups. Significant positive correlation of anti-TPOAb with TSH, LF nu, LF/HF and negative correlation with SDNN, RMSSD, pNN50, SD1, SD1/SD2, HFnu and TP of HRV was observed. Conclusion Anti-TPOAb positive SCHypo group exhibited modifications in HRV characterized by decreased parasympathetic modulation, as compared to controls. The findings were also suggestive of increased risk of autonomic dysfunction in TPOAb- positive patients than negative. Anti-TPO antibody was significantly correlated with TSH and SVI in SCHypo patients.

Subclinical hypothyroidism

2019 ◽  
Vol 12 (3) ◽  
pp. 131-135
Author(s):  
Adam Grice
Keyword(s):  
Cardiovascular Disease ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Autoimmune Thyroid ◽  
Thyroid Peroxidase Antibodies ◽  
Increased Risk ◽  
Stimulating Hormone

Subclinical hypothyroidism is a common condition associated with a raised thyroid-stimulating hormone and a normal serum free thyroxine that affects about 10% of females over 55 years in age. The most common cause is autoimmune thyroid disease, with 2.5% of patients with subclinical hypothyroidism progressing to clinically overt hypothyroidism each year. The rate of progression is higher in patients with anti-thyroid peroxidase antibodies and higher levels of thyroid-stimulating hormone. Only a small proportion of patients with subclinical hypothyroidism have symptoms, and although there is some debate in the literature about which patients should be treated, the National Institute for Health and Care Excellence clinical knowledge summaries give clear recommendations. There is an increased risk of cardiovascular disease in patients with subclinical hypothyroidism; it is uncertain whether treatment with levothyroxine reduces this risk. When deciding whether to treat subclinical hypothyroidism consider the patient’s age, symptoms, presence of anti-thyroid peroxidase antibodies, thyroid-stimulating hormone levels and risk factors such as cardiovascular disease.

scholarly journals Thyroid Antibody Status, Subclinical Hypothyroidism, and the Risk of Coronary Heart Disease: An Individual Participant Data Analysis

2014 ◽  
Vol 99 (9) ◽  
pp. 3353-3362 ◽  
Author(s):  
Tinh-Hai Collet ◽  
Douglas C. Bauer ◽  
Anne R. Cappola ◽  
Bjørn O. Åsvold ◽  
Stefan Weiler ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Subclinical Hypothyroidism ◽  
Data Extraction ◽  
Thyroid Autoimmunity ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Prognostic Information ◽  
Chd Risk ◽  
Increased Risk

Context: Subclinical hypothyroidism has been associated with increased risk of coronary heart disease (CHD), particularly with thyrotropin levels of 10.0 mIU/L or greater. The measurement of thyroid antibodies helps predict the progression to overt hypothyroidism, but it is unclear whether thyroid autoimmunity independently affects CHD risk. Objective: The objective of the study was to compare the CHD risk of subclinical hypothyroidism with and without thyroid peroxidase antibodies (TPOAbs). Data Sources and Study Selection: A MEDLINE and EMBASE search from 1950 to 2011 was conducted for prospective cohorts, reporting baseline thyroid function, antibodies, and CHD outcomes. Data Extraction: Individual data of 38 274 participants from six cohorts for CHD mortality followed up for 460 333 person-years and 33 394 participants from four cohorts for CHD events. Data Synthesis: Among 38 274 adults (median age 55 y, 63% women), 1691 (4.4%) had subclinical hypothyroidism, of whom 775 (45.8%) had positive TPOAbs. During follow-up, 1436 participants died of CHD and 3285 had CHD events. Compared with euthyroid individuals, age- and gender-adjusted risks of CHD mortality in subclinical hypothyroidism were similar among individuals with and without TPOAbs [hazard ratio (HR) 1.15, 95% confidence interval (CI) 0.87–1.53 vs HR 1.26, CI 1.01–1.58, P for interaction = .62], as were risks of CHD events (HR 1.16, CI 0.87–1.56 vs HR 1.26, CI 1.02–1.56, P for interaction = .65). Risks of CHD mortality and events increased with higher thyrotropin, but within each stratum, risks did not differ by TPOAb status. Conclusions: CHD risk associated with subclinical hypothyroidism did not differ by TPOAb status, suggesting that biomarkers of thyroid autoimmunity do not add independent prognostic information for CHD outcomes.

The effect of levothyroxine in comparison with placebo on serum osteocalcin levels in patients with subclinical hypothyroidism

2021 ◽  
Vol 16 ◽  
Author(s):  
Reihaneh Rezaee ◽  
Masoud Mohebbi ◽  
Mozhgan Afkhamizadeh ◽  
Mohammad Ali Yaghoubi ◽  
Mona Najaf Najafi ◽  
...  
Keyword(s):  
Thyroid Hormones ◽  
Subclinical Hypothyroidism ◽  
Intervention Group ◽  
Serum Levels ◽  
Overt Hypothyroidism ◽  
Serum Osteocalcin ◽  
Significant Difference ◽  
Before And After ◽  
Metabolic Conditions ◽  
And Control

Background and Objective: Subclinical hypothyroidism can potentially develop to overt hypothyroidism. Thyroid hormones have substantial roles in metabolism and glucose homeostasis and thus are closely related to determinant factors of metabolic syndromes, such as obesity and insulin resistance. Osteocalcin is considered a predictor of metabolic conditions in thyroid diseases. This study aimed to investigate the effect of levothyroxine vs. placebo on serum osteocalcin levels in patients with subclinical hypothyroidism. Methods: This randomized clinical trial was performed on 30 patients with subclinical hypothyroidism who were referred to the endocrine clinics of Ghaem and Imam Reza hospitals in Mashhad, Iran. After giving informed consent, patients were randomly divided into intervention (50 µg/day levothyroxine for 2 months) and control (placebo) groups. Serum levels of osteocalcin, thyroid hormones, lipid profile, insulin, and fasting glucose, as well as other clinical and anthropometric data, were measured at baseline and at the end of the study. SPSS was used to analyze the data and P<0.05 was considered significant. Results: Mean age in the intervention and control groups was 35.07 ± 9.94 and 31.30 ± 4.30, respectively (P=0.20). There was no significant difference between osteocalcin levels before and after the intervention in either of the groups (P=0.54). TSH level was significantly decreased in the levothyroxine group after the intervention (P<0.01). T4 level was significantly increased in the intervention group (P=0.02). Conclusion: Levothyroxine had no significant effect on increasing the levels of serum osteocalcin in patients with subclinical hypothyroidism. We have registered the trial in the Iranian registry of clinical trials (IRCT) with the registration code IRCT20171129037677N1.

scholarly journals Prevalence of Non-autoimmune Hypothyroidism in Steroid Resistant Nephrotic Syndrome in Paediatric Age Group

2020 ◽  
Author(s):  
Seema Rani Sinha ◽  
Rekha Kumari ◽  
Rakesh Kumar ◽  
Ravi Shekhar ◽  
Pritam Prakash ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Rational Approach ◽  
Control Group ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Normal Range ◽  
Steroid Resistant ◽  
Autoimmune Hypothyroidism ◽  
Thyroid Profile ◽  
Serum Tsh

Introduction: It was observed that approximately 10% of children with Nephrotic Syndrome (NS) are found as Steroid Resistant NS (SRNS). The data on the prevalence of non-autoimmune hypothyroidism among the SRNS in India is limited. Aim: To assess the prevalence of non-autoimmune hypothyroidism in the case of SRNS. Materials and Methods: A case control cross-sectional study was conducted in which 52 cases of SRNS and 52 healthy controls were enrolled. Thyroid profile like serum Thyroid Stimulating Hormone (TSH), Free Triiodothyronine (T3), Free Thyroxine (T4) done in the all cases and controls but anti-Thyroid Peroxidase (TPO), and anti-thyroglobulin antibody test was done in the case and control group with deranged thyroid function test. Low Free T4 (normal: 0.7-2 ng/mL) and elevated serum TSH above the upper limit of the reference range (>4.5 mIU/L) was defined as overt hypothyroidism, whereas elevation in serum TSH with a normal serum FT4 concentration was defined as sub clinical hypothyroidism. MedCalc statistical software Version 19.2.6 was used to do statistical analysis. Results: Prevalence of Non-autoimmune hypothyroidism was 38.46% (20 out of 52), 16 (30.76%) had subclinical and 4 (7.69%) had overt hypothyroidism in case of SRNS in comparison to 1.96% (1 out of 52) in control group. Out of 16 subclinical hypothyroid patients, two cases with grade 1, 12 cases with grade 2, and two cases with grade 3 found. Patients with SRNS had a mean (SD) TSH value of 4.5±4.7 mlU/L which was significantly higher than control (1.8±1.1 mlU/L). Serum levels of FT4 were within normal range. Anti-TPO and anti-thyroglobulin titre were in normal range in children with hypothyroidism. Conclusion: The prevalence of non-autoimmune hypothyroidism was high in cases of idiopathic SRNS. So, on the basis of this study estimation of thyroid profile in children with SRNS seems to be the rational approach which will lead to early diagnosis and timely management of hypothyroidism in SRNS.

Thyroid evaluation of children and adolescents with Williams syndrome in Zhejiang Province

2017 ◽  
Vol 30 (12) ◽  
Author(s):  
Wei-Jun Chen ◽  
Chai Ji ◽  
Dan Yao ◽  
Zheng-Yan Zhao
Keyword(s):  
Children And Adolescents ◽  
Thyroid Function ◽  
Williams Syndrome ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Zhejiang Province ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Thyroid Antibodies ◽  
Free Triiodothyronine

AbstractBackground:The objective of the study was to describe the prevalence of abnormal thyroid function and volume in children and adolescents with Williams syndrome (WS) in Zhejiang Province, China.Methods:Thyroid function, including thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid antibodies (thyroid peroxidase and thyroglobulin) were measured in 83 patients with WS, aged 0.2–16.5 years. Twenty-three patients were followed for an average of 1.7 years (0.4–4.1), and multiple TSH determinations were considered. Thyroid ultrasonography was performed on 49 patients.Results:One patient was diagnosed with overt hypothyroidism, and 23 patients (27%) had subclinical hypothyroidism (SH). Thyroid antibodies were absent in all patients. In five age groups (0–1 years, 1–3 years, 3–6 years, 6–9 years, 9–18 years), the prevalence of patients with subclinical hypothyroidism was 25%, 28.5%, 44.4%, 16.7% and 4.7%, respectively. Through ultrasound examination, 21 patients (42%) were observed to have thyroid hypoplasia (TH), and there were no cases of thyroid haemiagenesis. The incidence rate of TH increased with age, rising from 20% in the youngest group to 66% in the oldest.Conclusions:SH and TH is common in children and adolescents with WS. Yearly evaluation of thyroid must be performed in all patients in this population, regardless of the result of the neonatal screening. Age under 6 years and existing thyroid abnormalities are risk factors for developing SH, and a shorter follow-up interval is needed for screening in these individuals, SH is often self-limiting, and clinicians should be alert to overt hypothyroidism.

scholarly journals Investigating the prevalence of primary thyroid dysfunction in obese and overweight individuals: Tehran thyroid study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahdi Mahdavi ◽  
Atieh Amouzegar ◽  
Ladan Mehran ◽  
Elham Madreseh ◽  
Maryam Tohidi ◽  
...  
Keyword(s):  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
Normal Weight ◽  
Control Group ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Cross Sectional ◽  
Increased Risk ◽  
Prevalence Of Obesity ◽  
Thyroid Dysfunctions

Abstract Background Due to the increasing worldwide prevalence of obesity, it is essential to determine the prevalence of obesity-related thyroid dysfunctions. The purpose of this study was to investigate the prevalence of thyroid dysfunctions, namely hypothyroidism and hyperthyroidism, and their association with BMI among adult Iranian overweight and obese individuals. Method This cross-sectional study was carried out within the framework of the Tehran Thyroid Study (TTS); 5353 participants (57.5% female) entered our study. Anthropometric measurements were performed. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb) were assayed. We categorized individuals into 3 BMI groups (normal-weight, overweight and obese), then calculated prevalence rate, odds ratio (OR), and 95% confidence interval (CI) for outcomes in overweight and obese groups. The normal-weight group was used as the control group. Results We found a higher prevalence of hypothyroidism (11.6% vs 8.2% Total, 4.0% vs 1.1% overt and 7.6% vs 7.1% subclinical, P < 0.001) and TPOAb positivity (17.3% vs 11.6%, P < 0.001) in obese participants compared with normal-weight participants. Hyperthyroidism’s overall prevalence was 4.2, 5.7, and 4.9% in obese, overweight, and normal-weight groups, respectively. Obesity was associated with higher odds of overt hypothyroidism (OR: 2.0, 95% CI: 1.15–3.49, P < 0.05) and TPOAb positivity (OR: 1.29, 95% CI: 1.04–1.60, P < 0.05) after adjusting for confounding variables. In contrast, no association was observed between the overweight group and the odds of hypothyroidism and TPOAb positivity in the adjusted results. Conclusions Obesity was associated with an increased risk of overt hypothyroidism and TPOAb positivity.

scholarly journals Study of thyroid function in pregnancy, its feto-maternal outcome; a prospective observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kalpana Mahadik ◽  
Payal Choudhary ◽  
P. K. Roy
Keyword(s):  
Birth Weight ◽  
Observational Study ◽  
Subclinical Hypothyroidism ◽  
Prospective Observational Study ◽  
Fetal Outcome ◽  
Overt Hypothyroidism ◽  
Thyroid Disorder ◽  
History Of ◽  
Thyroid Profile ◽  
In Pregnancy

Abstract Background Pregnancy is a stress test of maternal thyroid function. The prevalence of thyroid dysfunction in pregnant women is high. Subclinical hypothyroidism occurs in 10% of all pregnancies. Effects of hypothyroidism in pregnancy are anemia, low birth weight and mental retardation in neonate. This study is aimed to evaluate maternal and fetal outcomes in pregnant women with deranged thyroid profile. The relevance of this study is to document the association of hypothyroidism and its adverse effects on mother and fetus. Methods This prospective observational study was carried out at R.D. Gardi Medical College, Ujjain, India. Subjects of this study were 198 antenatal women in third trimester with singleton pregnancy admitted in the obstetric ward, and informed consent was obtained. Women were chosen irrespective of age, parity, residence and socioeconomic status. Women with multiple pregnancy, a known case of thyroid disorder, or any pre-existing medical disorder were excluded. Routine hematological parameters and estimation of T3, T4 and TSH was conducted. Patients with deranged thyroid profile were subsequently assessed for maternal and fetal complications. History of infertility, family history of thyroid disease, menstrual pattern, recurrent abortion, hemoglobin level and fetal outcome were the main study variables. Data was analysed in SPSS software for statistical co-relation. Results Prevalence of thyroid disorder is 11%; with subclinical hypothyroidism, overt hypothyroidism and subclinical hyperthyroidism occurring in 5.6, 3.5 and 1.5% of subjects respectively. In women with subclinical and overt hypothyroidism, anemia was present in 26.3% being significantly associated with hypothyroidism (p = 0.008). With respect to fetal outcome, LBW 31.6% (p = 0.001), NICU admission 42.1%, (p = 0.000) and low APGAR Score (21.1%, p = 0.042) were statistically associated with hypothyroidism. Risk of anemia, Low Birth weight, NICU admissions, and low APGAR score was 4.8, 6.3, 0.14 and 3.64 times higher respectively in women with hypothyroidism than in women who are euthyroid. Conclusion Prevalence of subclinical hypothyroidism is 5.6% in 3rd trimester of pregnancy. Anemia, pre-eclampsia, high caesarean rates and neonatal morbidities is significantly associated with hypothyroidism.

scholarly journals Prevalence of Metabolic Syndrome in Patients with Subclinical and Overt Hypothyroidism Visiting Tertiary Care Centre of Western Nepal

2020 ◽  
Vol 8 (1) ◽  
pp. 33-37
Author(s):  
Amit Chandra Jha ◽  
Kedar Nath Koirala ◽  
Archana Jayan ◽  
Narayan Gautam ◽  
Raju Kumar Dubey ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Colorimetric Method ◽  
Hormone Deficiency ◽  
Overt Hypothyroidism ◽  
Atherosclerotic Cardiovascular Disease ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Increased Risk

INTRODUCTION: Hypothyroidism is a syndrome resulting from thyroid hormone deficiency. Metabolic syndrome (MetS) is a cluster of metabolic abnormalities is associated with increased risk for atherosclerotic cardiovascular disease (CVS) and type 2 diabetes mellitus. Thyroid hormones are major regulatory hormones that control the rate of metabolic function; thus, alteration in the levels of these hormones may be associated with MetS. The objective of our study was to find out the prevalence of MetS in subclinical and overt hypothyroidism. MATERIAL AND METHODS: A hospital-based cross sectional study was conducted at Universal College of Medical Sciences Teaching Hospital (UCMS-TH) Bhairahawa from March to September 2019. A total of 222 hypothyroid patients were enrolled in this study. MetS was diagnosed by National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III; 2005) revision criteria. The anthropometric indices were recorded. fT3, fT4  and TSH were measured by chemiluminescence immunoassay (CLIA) method and other biochemical parameters were estimated by colorimetric method. Data were analyzed by using SPSS 16.0. RESULTS: Patients were aged between 10 and 60 years, with a mean age of 38.89 years. The prevalence of MetS was 44.1% of which 80.6% were females. Furthermore, the prevalence of MetS was found to be 43.7% in subclinical hypothyroidism and 46.6% in overt hypothyroidism. CONCLUSION: The prevalence of MetS is high in both overt and subclinical hypothyroidism. Screening for MetS in patients with hypothyroidism can reduce the risk for CVD, as well as the mortality rate and mortality associated with it.

scholarly journals Circulating Betatrophin Is Increased in Patients with Overt and Subclinical Hypothyroidism

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Cheng Han ◽  
Xinghai Xia ◽  
Aihua Liu ◽  
Xiaowen Zhang ◽  
Mi Zhou ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Dysfunction ◽  
Metabolic Diseases ◽  
Thyroid Autoimmunity ◽  
Thyroid Stimulating Hormone ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Thyroid Peroxidase Antibody ◽  
Antibody Positivity ◽  
Healthy Control

Thyroid hormone (TH) affects many metabolic processes such as promoting oxidation of sugar, fat, and protein in many tissues. Thyroid dysfunction is associated with metabolic disorders. The newly discovered adipocyte- and hepatocyte-derived cytokine, betatrophin, has been reported to be involved in metabolic diseases, but its influence on thyroid dysfunction is uncertain. Therefore, the present study aims to evaluate circulating betatrophin levels in subjects with different thyroid function status and to predict the factors associated with betatrophin levels, especially whether thyroid stimulating hormone (TSH), TH, or thyroid autoantibodies are associated with betatrophin levels. In the study, serum betatrophin was measured in the subjects grouped as overt hypothyroidism (OH), subclinical hypothyroidism (SCH), euthyroid with isolated thyroid peroxidase antibody positivity (isolated Ab), and healthy control (HC), according to their thyroid functions. From our results, we found that betatrophin may be associated with thyroid insufficiency but not thyroid autoimmunity. Thus, when interpreting the results of betatrophin, thyroid functions should also be taken into consideration.

scholarly journals Evaluation of Thyroid Dysfunction in Adult Patients of Celiac Disease

2021 ◽  
Vol 8 (4) ◽  
pp. 3-8
Author(s):  
Nauman Wazir ◽  
Shafqat Ur Rehman
Keyword(s):  
Celiac Disease ◽  
Thyroid Dysfunction ◽  
Adult Patients ◽  
Control Group ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Serological Evidence ◽  
Adult Celiac Disease ◽  
Significant Difference ◽  
And Control

OBJECTIVES: To assess free thyroxine (fT4), thyroid stimulating hormone (TSH), and anti thyroid peroxidase antibodies (anti TPO abs) in adult Celiac disease patients and non-celiac controls and to find out any statistically significant difference in their corresponding means between the two groups. METHODOLOGY: The study design was analytical cross sectional. Sixty adult patients of celiac disease (CD) and 30 apparently healthy non-celiac adults were included in the study. CD patients had earlier been diagnosed by elevated levels of serological evidence of elevated (greater than 15X ULN) anti tissue transglutaminase (TTG) (IgA class) antibodies. CD was ruled out in the control group by normal levels of the antibodies. TSH, fT4 and anti TPO abs were obtained from all individuals of CD patient and control groups. RESULTS: Mean age of Celiac disease in patients was 23.85±5.43 years. Mean age of individuals in the control group was 24.26±5.55 years. Statistically significant difference in mean TSH and anti-TPO abs levels between the CD patient group and control group (p values of 0.03 and 0.038, respectively) was present. No statistically significant difference was seen between mean fT4 of patients and control group (p=0.74). Subclinical and overt hypothyroidism was present in 10% and 5% of CD patients, while anti TPO abs was positive in 16.6% of CD patients. CONCLUSION: There is a considerably high prevalence of subclinical and overt hypothyroidism as well as serological evidence of thyroid dysfunction in adult patients of CD.

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