scholarly journals Association between Thyroid-Stimulating Hormone Level after Total Thyroidectomy and Hypercholesterolemia in Female Patients with Differentiated Thyroid Cancer: A Retrospective Study

2019 ◽  
Vol 8 (8) ◽  
pp. 1106 ◽  
Author(s):  
Young Ki Lee ◽  
Hokyou Lee ◽  
Seunghee Han ◽  
Hyein Jung ◽  
Dong Yeob Shin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Differentiated Thyroid Cancer ◽  
Ldl Cholesterol ◽  
Density Lipoprotein ◽  
Recurrence Risk ◽  
Thyroid Stimulating Hormone ◽  
Metabolic Derangement ◽  
Tsh Suppression ◽  
Tsh Levels

Less-intense TSH suppression strategies can be used for differentiated thyroid cancer (DTC) patients with a low recurrence risk, but their metabolic outcomes are not well known. We aimed to evaluate changes in the serum cholesterol levels and the risk of hypercholesterolemia according to postoperative TSH levels in 1092 female DTC patients receiving levothyroxine after total thyroidectomy. The preoperative-to-follow-up change in total cholesterol (TC) levels in the TSH level <0.03, 0.03–0.3, 0.3–2, and 2–5 mIU/L groups was −3.69 mg/dL (p = 0.006), +0.13 mg/dL (p = 0.926), +12.46 mg/dL (p < 0.001), and +16.46 mg/dL (p < 0.001), respectively. When compared with TSH levels of 0.03–0.3 mIU/L, those of 0.3–2 mIU/L were found to be associated with hypercholesterolemia (adjusted odds ratio (AOR) = 1.86 and 5.08 for TC 200–240 and ≥240 vs. <200 mg/dL) and hyper-low-density lipoprotein (LDL)-cholesterolemia (AOR = 2.76 for LDL-cholesterol ≥160 vs. <130 mg/dL). Additionally, TSH levels of 2–5 mIU/dL were associated with hypercholesterolemia (AOR = 2.85 and 6.95 for TC 200–240 and ≥240 vs. <200 mg/dL) and hyper-LDL-cholesterolemia (AOR = 2.08 and 4.17 for LDL-cholesterol 130–159 and ≥160 mg/dL vs. <130 mg/dL). In patients with normal TSH level maintenance following thyroidectomy, TC levels markedly increased, resulting in an increased hypercholesterolemia prevalence. Metabolic derangement risk due to insufficient levothyroxine replacement should be considered in the adoption of less-intense TSH suppression strategies, postoperatively, in DTC patients.

Effects of Chronic Suppression or Oversuppression of Thyroid-Stimulating Hormone on Psychological Symptoms and Sleep Quality in Patients with Differentiated Thyroid Cancer

2021 ◽  
Vol 53 (10) ◽  
pp. 683-691
Author(s):  
Seher Çetinkaya Altuntaş ◽  
Çiçek Hocaoğlu
Keyword(s):  
Thyroid Cancer ◽  
Sleep Quality ◽  
Differentiated Thyroid Cancer ◽  
Sleep Problems ◽  
Psychological Symptoms ◽  
Thyroid Stimulating Hormone ◽  
Sensitivity Index ◽  
Significant Difference ◽  
The Mean ◽  
Tsh Levels

AbstractIn differentiated thyroid cancer (DTC), the standard treatment includes total thyroidectomy and lifetime levothyroxine (LT4) replacement. However, long-term exogenous LT4 has become controversial due to the adverse effects of oversuppression. The study included 191 patients (aged 18–76 years) with a prospective diagnosis of non-metastatic DTC and 79 healthy individuals. The patients with DTC were stratified into three groups according to their TSH levels: suppressed thyrotropin if TSH was below 0.1 μIU/ml, mildly suppressed thyrotropin if TSH was between 0.11 and 0.49 μIU/ml, and low-normal thyrotropin if THS was between 0.5 and 2 μIU/ml. The Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Anxiety Sensitivity Index (ASI), Short Symptom Inventory (SSI), and Pittsburgh Sleep Quality Index (PSQI) were administered to all participants. It was found that the BDI, BAI, SSI and PSQI scores were worse in patients with DTC (p=0.024, p=0.014, p=0.012, and p=0.001, respectively). According to theTSH levels, the mean ASI was found to be higher in the suppressed and mildly suppressed thyrotropin groups (19±14.4 vs. 10.6±11.1; 16.4±14.9 vs. 10.6±11.1, p=0.024, respectively), the mean SSI was found higher in the suppressed group (61.0±55.5 vs. 35.1±37.0, p=0.046), and the mean PSQI was higher in all three groups (7.94±3.97 vs. 5.35±4.13; 7.21±4.59 vs. 5.35±4.13; 7.13±4.62 vs. 5.35±4.13, p=0.006) when compared with the controls. No significant difference was found between the groups. A positive correlation was detected in the duration of LT4 use and BDI and SSI, and a weak, negative correlation was detected between TSH levels and ASI and PSQI. Based on our study, it was found that depression, anxiety disorders, and sleep problems were more prevalent in patients with DTC, being more prominent in the suppressed TSH group. These results were inversely correlated with TSH values and positively correlated with the duration of LT4 use. Unnecessary LT4 oversuppression should be avoided in patients with DTC.

scholarly journals Preoperative thyroid-stimulating hormone associated risk of differentiated thyroid cancer in patients with thyroid nodules

2021 ◽  
Vol 67 (3) ◽  
pp. 85-91
Author(s):  
Al Essa M
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Thyroid Nodules ◽  
Conditional Logistic Regression ◽  
Care Center ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Normal Range ◽  
Tsh Levels ◽  
Stimulating Hormone

In an assessment of risk for differentiated thyroid cancer (DTC) in individuals with human papillary thyroid cancer (PTC) and thyroid nodules a cohort prospective study was undertaken to establish the significance of preoperative thyroid-stimulating hormone (TSH) levels. Confirmed histologically PTC cases in one tertiary care center, and matched healthy individuals were tested for TSH, T3, T4 and T4 free total. The ORs and 95% confidence intervals have been calculated using conditional logistic regression models (CI). The blood TSH levels were related to the higher risk of PTC for men (OR,0,09; 95% Ci, 04–0,21, 95% CI and women) compared with the middle tertile of the TSH levels in the normal range (OR,0,07; 95 percent CI, 0,04–0,1). Over the normal range of TSH levels, an elevated PTC risks were connected amongst women (OR 0,09; 95% CI, 0,04–0,21) but not amongst men (OR,0,07; 95% CI, 0,04–0,1). With an increase in TSH level in the normal range between men and women, the risk for PTC reduced (Ptrend=0.041 and 0.0001). The risk of PTC related to TSH levels has been dramatically elevated above  the normal range for men  and TSH values below the normal range for women.

Relationship between Thyroglobulin and Tumor Detectabilily with Thallium-201 in Differentiated Thyroid Cancer

2000 ◽  
Vol 39 (01) ◽  
pp. 10-15 ◽  
Author(s):  
S. P. Müller ◽  
Ch. Reiners ◽  
A. Bockisch ◽  
Katja Brandt-Mainz
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Roc Analysis ◽  
Tsh Suppression ◽  
Significant Difference ◽  
Test Specificity ◽  
The Relationship ◽  
Tumor Scintigraphy ◽  
Tsh Stimulation

Summary Aim: Tumor scintigraphy with 201-TICI is an established diagnostic method in the follow-up of differentiated thyroid cancer. We investigated the relationship between thyroglobulin (Tg) level and tumor detectability. Subject and methods: We analyzed the scans of 122 patients (66 patients with proven tumor). The patient population was divided into groups with Tg above (N = 33) and below (N = 33) 5 ng/ml under TSH suppression or above (N = 33) and below (N = 33) 50 ng/ml under TSH stimulation. Tumor detectability was compared by ROC-analysis (True-Positive-Fraction test, specificity 90%). Results: There was no significant difference (sensitivity 75% versus 64%; p = 0.55) for patients above and below 5 ng/ml under TSH suppression and a just significant difference (sensitivity 80% versus 58%; p = 0.04) for patients above and below 50 ng/ml under TSH stimulation. In 18 patients from our sample with tumor, Tg under TSH suppression was negative, but 201-TICI-scan was able to detect tumor in 12 patients. Conclusion: Our results demonstrate only a moderate dependence of tumor detectability on Tg level, probably without significant clinical relevance. Even in patients with slight Tg elevation 201-TICI scintigraphy is justified.

scholarly journals Utility of recombinant human TSH stimulation test in the follow-up of patients with differentiated thyroid cancer depending on basal thyroglobulin results

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Amaia Sandúa ◽  
Monica Macias ◽  
Carolina Perdomo ◽  
Juan Carlos Galofre ◽  
Roser Ferrer ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Differentiated Thyroid Cancer ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Thyroid Stimulating Hormone ◽  
Stimulation Test ◽  
Human Thyroid ◽  
Antithyroglobulin Antibodies ◽  
Structural Disease

AbstractBackgroundThyroglobulin (Tg) is fundamental for differentiated thyroid cancer (DTC) monitoring. Tg detection can be enhanced using recombinant human thyroid-stimulating hormone (TSH) (rhTSH). This study is aimed to evaluate the use of the rhTSH stimulation test when using a high-sensitivity Tg assay.MethodsWe retrospectively studied 181 rhTSH tests from 114 patients with DTC and negative for antithyroglobulin antibodies (anti-TgAb). Image studies were performed in all cases. Serum Tg and anti-TgAb were measured using specific immunoassays.ResultsrhTSH stimulation in patients with basal serum Tg (b-Tg) concentrations lower than 0.2 ng/mL always resulted in rhTSH-stimulated serum Tg (s-Tg) concentrations lower than 1.0 ng/mL and negative structural disease. In patients with b-Tg concentration between 0.2 and 1.0 ng/mL, s-Tg detected one patient (1/30) who showed biochemical incomplete response. Patients with negative images had lower s-Tg than those with nonspecific or abnormal findings (p<0.05). Receiver operating characteristic curve analysis of the s-Tg to detect altered images showed an area under the curve of 0.763 (p<0.05). With an s-Tg cutoff of 0.85 ng/mL, the sensitivity was 100%, decreasing to 96.15% with an s-Tg cutoff of 2 ng/mL.ConclusionsPatients with DTC with b-Tg concentrations equal or higher than 0.2 ng/mL can benefit from the rhTSH stimulation test.

Central cooling effects in patients with hypercholesterolaemia

1998 ◽  
Vol 95 (2) ◽  
pp. 213-217 ◽  
Author(s):  
F. DE LORENZO ◽  
M. MUKHERJEE ◽  
Z. KADZIOLA ◽  
R. SHERWOOD ◽  
V. V. KAKKAR
Keyword(s):  
Total Cholesterol ◽  
Ldl Cholesterol ◽  
Cold Water ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Thyroid Stimulating Hormone ◽  
Tympanic Temperature ◽  
Whole Body ◽  
Cooling Effects ◽  
Stimulating Hormone

1.A prospective study has been carried out, and 68 patients with hypercholesterolaemia have been investigated to study the effects of central cooling on serum lipid levels. 2.Central cooling was obtained by the exposure of the whole body to cold water. All patients were trained to gradually reduce the water temperature from 22 to 14 ;°C and to increase the time of exposure from 5 to 20 ;min over a period of 90 days. The 33 male and 35 female patients were aged between 40 and 60 years at entry with total cholesterol of 6.0 ;mmol/l or greater and low-density lipoprotein (LDL)-cholesterol of 4.0 ;mmol/l or greater. Thyroid-stimulating hormone, free thyroxine (FT4), total T3, total cholesterol, LDL-cholesterol, high-density lipoprotein (HDL)-cholesterol, triacylglycerols and total fat mass (determined by dual-energy X-ray absorptiometry scan) were obtained at baseline and after 3 months treatment with hydrotherapy. 3.Central cooling obtained by hydrotherapy results in a median fall in tympanic temperature from 0.2 ;°C (P< 0.001) to 0.8 ;°C (P< 0.001). We have observed in these patients a significant reduction in total cholesterol (-0.2 ;mmol/l, P = 0.006) and LDL-cholesterol (-0.2 ;mmol/l, P = 0.004). Serum FT4 level was higher than baseline results in 30 of these hypercholesterolaemic patients (15.5 ;pmol/l to 17.3 ;pmol/l) and there was no significant change in serum thyroid-stimulating hormone and total T3. 4.In conclusion, in our patients with hypercholesterolaemia we have observed a significant reduction of total cholesterol and LDL-cholesterol after body temperature regulation.

Reconsideration of tumor size threshold for total thyroidectomy in differentiated thyroid cancer

Surgery ◽  
2018 ◽  
Vol 164 (3) ◽  
pp. 504-510 ◽  
Author(s):  
Shih-Ping Cheng ◽  
Ming-Nan Chien ◽  
Tao-Yeuan Wang ◽  
Jie-Jen Lee ◽  
Chun-Chuan Lee ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Total Thyroidectomy ◽  
Tumor Size ◽  
Differentiated Thyroid Cancer ◽  
Size Threshold
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