scholarly journals PREVALENCE OF SUBCLINICAL AND UNDIAGNOSED OVERT HYPOTHYROIDISMIN HABITUAL ABORTION

2021 ◽  
Vol 9 (08) ◽  
pp. 150-156
Author(s):  
Mostafa Abdulla ◽  
Elsayed Mahmoud
Keyword(s):  
Subclinical Hypothyroidism ◽  
Hormone Level ◽  
Recurrent Miscarriage ◽  
Free Thyroxine ◽  
University Hospital ◽  
Overt Hypothyroidism ◽  
Childbearing Age ◽  
Population Prevalence ◽  
Risk Pregnancy ◽  
Increased Risk

Background:Hypothyroidism is the second most common endocrine disorder in women of childbearing age with an increased risk of pregnancy loss.Pregnancy loss associated with subclinical hypothyroidism (SCH), defined as elevatedthyroid-stimulating-hormone level, with normal free thyroxine. In overt hypothyroidism (OH), the free thyroxine is low. Materials and methods:Cases recruited from those attending high risk pregnancy unit of obstetrics and gynecology department of Benha university hospital Egypt from 2019 till 2020. We examined theprevalence of subclinical and undiagnosed overt hypothyroidism in women with recurrent miscarriage, late miscarriageand stillbirth.Cases with sporadic miscarriages, autoimmune disorders, thrombophilias and known hypothyroidism were excluded. Sample size: Two-hundredwomen were included. Median maternal age was 35 years (range 18-47). Subclinical andundiagnosed overt hypothyroidism was found in 24 cases (12%) of women. Sixteen women (8%) had subclinical hypothyroidism,eight (4%) had undiagnosed overt hypothyroidism. Results were compared to women with ongoing pregnancies. Results: The prevalence of subclinical and undiagnosed overt hypothyroidism in the pregnancy loss population was 12% (24 /200), where 8 %( 16/200) were subclinical, and 4% (8/200) were undiagnosed overt. In the control population, prevalence of hypothyroidism was 1.5% (3/200).

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 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 Implantation failure in rats with subclinical hypothyroidism is associated with LIF/STAT3 signaling

2019 ◽  
Vol 8 (6) ◽  
pp. 718-727 ◽  
Author(s):  
Ling Shan ◽  
Yingying Zhou ◽  
Shiqiao Peng ◽  
Xinyi Wang ◽  
Zhongyan Shan ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Subclinical Hypothyroidism ◽  
Overt Hypothyroidism ◽  
Implantation Failure ◽  
Oh Groups ◽  
Stat3 Signaling ◽  
Stat3 Signaling Pathway ◽  
Increased Risk ◽  
Implantation Sites ◽  
Adverse Pregnancy

Background Pregnant women with subclinical hypothyroidism are associated with an increased risk of spontaneous abortion. This study aims to investigate the mechanisms underlying the effects of maternal subclinical hypothyroidism during early pregnancy on abortion in the uterus, focusing upon the LIF/STAT3 signaling pathway. Methods One hundred five Wistar rats were randomly divided into three groups (35 rats in each group): control (CON) group, subclinical hypothyroidism (SCH) group and overt hypothyroidism (OH) group. We examined the weight of rat uteri, rat placenta and embryos. We also determined the number of implantation sites and the embryo absorption rates. The protein and mRNA expressions of TSHR, TR-α, TR-β, LIFR, gp130, JAK1, p-STAT3 and STAT3 were measured by immunohistochemical staining, real-time PCR and Western blotting. Results The weights of rat uteri, rat placenta and embryos were significantly reduced in the SCH and OH groups. The number of implantation sites was significantly decreased in the SCH and OH groups, while embryo absorption rates were significantly increased. The mRNA and protein expressions of TSHR were upregulated in the SCH and OH groups, while TR-α and TR-β showed no difference when compared between the three groups. The expression levels of LIFR, gp130, JAK1 and p-STAT3 were significantly higher in the SCH and OH groups. Conclusions Clinical and subclinical hypothyroidism during early pregnancy might cause adverse pregnancy outcomes. Implantation failure in rats with subclinical hypothyroidism was associated with abnormal LIF/STAT3 signaling.

scholarly journals Lack of Association between Angiotensin Converting Enzyme I/D Polymorphism and Unexplained Recurrent Miscarriage in Saudi Arabia

2016 ◽  
Vol 35 (2) ◽  
pp. 166-174 ◽  
Author(s):  
Fatimah Basil Al-Mukaynizi ◽  
Afrah AlKhuriji ◽  
Zaineb Babay ◽  
Mohammad Addar ◽  
Sooad AlDaihan ◽  
...  
Keyword(s):  
Angiotensin Converting Enzyme ◽  
Recurrent Miscarriage ◽  
University Hospital ◽  
Control Group ◽  
Converting Enzyme ◽  
Chi Square ◽  
Ace Gene ◽  
Increased Risk ◽  
Unexplained Recurrent Miscarriage ◽  
Meta Analyses

Summary Background: An insertion/deletion (I/D) polymorphism in the angiotensin converting enzyme (ACE) gene has been associated with recurrent miscarriage (RM) in several populations. We initiated this study to determine the association, if any, between the I/D polymorphism of ACE gene and RM in Saudi females. Method: This study was conducted on 61 Saudi females suffering from RM (mean age: 34.1±6.2 years; range 15–45) attending clinics at King Khalid University Hospital, and 59 age matched females who had at least 2 children, as controls. Blood samples were drawn in EDTA tubes by venipuncture. DNA was extracted using the Puregene DNA purification kits. Insertion/Deletion (I/D) polymorphism of ACE gene was investigated by amplifying the genomic DNA by PCR using gene-specific primers. A single 190 bp or 490 bp band was obtained in the homozygous cases for the D allele or I allele, respectively, while the presence of both 190 and 490 bp bands indicated heterozygosity (ID). Statistical analysis: Deviation from Hardy-Weinberg equilibrium was determined (http://ihg.gsf.de/cgi-bin/hw/hwa1.pl). A standard chi-square (χ2) test was used for comparing the genotype and allele frequencies in the two groups and Students‘t’ test and χ2 test were employed to compare values between the two groups. P<0.05 was considered statistically significant. Results: The frequencies of DD, ID, and II genotypes were 56.7%, 29.5% and 4.9%, respectively, in females with RM and 54.2%, 42.3% and 3.3% respectively in the control group, but the difference was not statistically significant. Conclusion: In some populations, meta-analyses showed an association between I/D polymorphism and RM risk, and the D allele was implicated as an increased risk factor for RM. However, this association was not apparent in the Saudi females.

Thyroid disease during pregnancy

2011 ◽  
pp. 547-552 ◽  
Author(s):  
John H. Lazarus ◽  
L.D. Kuvera ◽  
E. Premawardhana
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Thyroid Disease ◽  
Overt Hypothyroidism ◽  
Thyroid Disorders ◽  
Childbearing Age ◽  
Thyroid Function Testing ◽  
Appropriate Therapy ◽  
Function Testing ◽  
In Pregnancy

Thyroid disorders are common. The prevalence of hyperthyroidism is around 5/1000 in women and overt hypothyroidism about 3/1000 in women. Subclinical hypothyroidism has a prevalence in women of childbearing age in iodine-sufficient areas of between 4% and 8%. As these conditions are generally much more common in females, it is to be expected that they will appear during pregnancy. Developments in our understanding of thyroid physiology (1) and immunology (2) in pregnancy, as well as improvements in thyroid function testing (3), have highlighted the importance of recognizing and providing appropriate therapy to women with gestational thyroid disorders. Before considering the clinical entities occurring during and after pregnancy it is useful to briefly review thyroid physiology and immunology in relation to pregnancy.

Contraception in patients with kidney disease

2018 ◽  
Author(s):  
Kate Wiles ◽  
Catherine Nelson-Piercy
Keyword(s):  
Kidney Disease ◽  
Unplanned Pregnancy ◽  
Contraceptive Methods ◽  
Childbearing Age ◽  
Vascular Events ◽  
Barrier Methods ◽  
Fertility Awareness ◽  
Risk Pregnancy ◽  
Increased Risk ◽  
End Stage

Three per cent of women of childbearing age have chronic kidney disease, and although end-stage renal failure impacts on fertility, conception and high-risk pregnancy do occur. Following renal transplantation, the patient should understand the potential impact of a pregnancy on transplant function and vice versa. Surveys show that a large proportion of pregnancies in female renal patients are unplanned. The effectiveness of a particular contraceptive method is dependent upon acceptability to the patient and compliance. Contraceptive decision-making needs to balance acceptability and safety with the risk of an unplanned pregnancy. Oestrogen-containing contraceptive methods are considered unacceptable for many renal patients because of their association with increased blood pressure and thrombotic and vascular events. Progesterone-only methods have an advantageous safety profile. The progesterone-only pill (desogestrel preparations), intrauterine system (Mirena®), and implant (Nexplanon®) are safe and effective in women with CKD. Concerns regarding the intrauterine system (Mirena®) in women taking immunosuppression are unfounded and observational evidence does not demonstrate an increased risk of infection. Sterilization is effective and should be considered to be irreversible. The effectiveness of barrier methods is reduced when ‘typical use’ is compared to ‘perfect use’. Unplanned pregnancy rates are high with fertility awareness methods and reliance on lactational amenorrhoea is not advocated.Interactions between drugs which are commonly prescribed in the renal population and different contraceptive methods are outlined in this chapter.

scholarly journals The Relation Between Thyroid Function and Anemia: A Pooled Analysis of Individual Participant Data

2018 ◽  
Vol 103 (10) ◽  
pp. 3658-3667 ◽  
Author(s):  
Daisy M Wopereis ◽  
Robert S Du Puy ◽  
Diana van Heemst ◽  
John P Walsh ◽  
Alexandra Bremner ◽  
...  
Keyword(s):  
Thyroid Function ◽  
Subclinical Hypothyroidism ◽  
Sensitivity Analyses ◽  
Overt Hypothyroidism ◽  
Individual Participant Data ◽  
Subclinical Hyperthyroidism ◽  
Thyroid Status ◽  
Increased Risk ◽  
Individual Participant ◽  
Overt Hyperthyroidism

Abstract Context Anemia and thyroid dysfunction often co-occur, and both increase with age. Human data on relationships between thyroid disease and anemia are scarce. Objective To investigate the cross-sectional and longitudinal associations between clinical thyroid status and anemia. Design Individual participant data meta-analysis. Setting Sixteen cohorts participating in the Thyroid Studies Collaboration (n = 42,162). Main Outcome Measures Primary outcome measure was anemia (hemoglobin &lt;130 g/L in men and &lt;120 g/L in women). Results Cross-sectionally, participants with abnormal thyroid status had an increased risk of having anemia compared with euthyroid participants [overt hypothyroidism, pooled OR 1.84 (95% CI 1.35 to 2.50), subclinical hypothyroidism 1.21 (1.02 to 1.43), subclinical hyperthyroidism 1.27 (1.03 to 1.57), and overt hyperthyroidism 1.69 (1.00 to 2.87)]. Hemoglobin levels were lower in all groups compared with participants with euthyroidism. In the longitudinal analyses (n = 25,466 from 14 cohorts), the pooled hazard ratio for the risk of development of anemia was 1.38 (95% CI 0.86 to 2.20) for overt hypothyroidism, 1.18 (1.00 to 1.38) for subclinical hypothyroidism, 1.15 (0.94 to 1.42) for subclinical hyperthyroidism, and 1.47 (0.91 to 2.38) for overt hyperthyroidism. Sensitivity analyses excluding thyroid medication or high levels of C-reactive protein yielded similar results. No differences in mean annual change in hemoglobin levels were observed between the thyroid hormone status groups. Conclusion Higher odds of having anemia were observed in participants with both hypothyroid function and hyperthyroid function. In addition, reduced thyroid function at baseline showed a trend of increased risk of developing anemia during follow-up. It remains to be assessed in a randomized controlled trial whether treatment is effective in reducing anemia.

Relation between Obesity and Maternal Hypothyroxenemia during Early Pregnancy

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
HMA Amer ◽  
MM Abdelsalam ◽  
CA Girgis ◽  
MM Algamal
Keyword(s):  
Thyroid Function ◽  
Early Pregnancy ◽  
Subclinical Hypothyroidism ◽  
Maternal Obesity ◽  
Obese Group ◽  
University Hospital ◽  
P Value ◽  
Overt Hypothyroidism ◽  
Thyroid Peroxidase ◽  
Pregnant Females

Abstract Aim of the Work To study the relation between maternal obesity (indicated by BMI), maternal hypothyroidism, thyroid peroxidase antibodies and anti-thyroglobulin positivity during early pregnancy. Patients and Methods The study was conducted in Ain shams University Hospital and National Institute of Diabetes and Endocrinology. The study included women aged 19–40 who were pregnant at the 4th –8th weeks of gestation. Results obese group had the highest prevalence of overt (5.33%) and subclinical hypothyroidism (2.6%), highest mean TSH value, p value (0.007*). And the lowest mean FT4 with p value (0.017*) .Also obesity was associated with the highest prevalence of anti TPO (16%) and anti TG Abs (12%). Conclusion we concluded that maternal obesity may be associated with TPO anti TG positivity, subclinical hypothyroidism and overt hypothyroidism. Screening of thyroid function in obese pregnant females can detect maternal hypothyroidism and prevention of its hazard’s effects for both mother and fetus.

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.

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.

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