scholarly journals EVALUATION OF SERUM CREATININE LEVEL IN SUBCLINICAL HYPOTHYROIDISM

2021 ◽  
pp. 29-32
Author(s):  
Deepa Thadani ◽  
Manna Lal Kumawat ◽  
Sarla Mahawar ◽  
Ajay Jain
Keyword(s):  
Serum Creatinine ◽  
Subclinical Hypothyroidism ◽  
Waste Product ◽  
Muscle Metabolism ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Normal Serum ◽  
Renal Physiology ◽  
Healthy Controls ◽  
Chemical Waste

Background: Hypothyroidism is a common endocrinal disorder caused by insufcient production of thyroid hormones. Subclinical hypothyroidism (SCH) can be dened as a state of high serum thyroid stimulating hormone (TSH) levels (less than 10µIU/ml) with normal serum free thyroxine (fT ) and triiodothyronine (fT ) levels in 4 3 the presence or absence of symptoms. Creatinine is a chemical waste product that is produced by muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Thyroid dysfunction can affect renal physiology and development, and on the other hand, kidney disorders can inuence thyroid function. This study was aimed to nd out the status of serum fT , fT ,TSH and serum creatinine levels in subclinical hypothyroid cases and 3 4 healthy controls. Materials and Methods: The present study is descriptive case control study, was conducted in the Department of Biochemistry, J.L.N. Medical College and Associated group of Hospitals, Ajmer (Raj.). 130 cases of subclinical hypothyroidism attending Medical OPD of J.L.N. Hospitals were included and 50 age-sex matched euthyroid controls were selected. Results: The mean serum creatinine levels were found to be signicantly high in subclinical hypothyroid cases(0.99 + 0.19 mg%) as compared to healthy controls (0.75 + 0.15 mg%), (p<0.0001). Conclusion: Serum creatinine can be used as a biomarker for early detection of subclinical hypothyroidism in general population to prevent the morbidity and mortality which are associated with hypothyroidism. Early diagnosis and intervention of subclinical hypothyroid and their cluster of risk factor can prevent the renal dysfunction.

scholarly journals Evaluation of renal function in subclinical hypothyroidism

2018 ◽  
Vol 10 (01) ◽  
pp. 050-055 ◽  
Author(s):  
Vijayetha P. Patil ◽  
Alagilwada S. Shilpasree ◽  
Vidya S. Patil ◽  
Kangokar R. Pravinchandra ◽  
Deepti G. Ingleshwar ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Subclinical Hypothyroidism ◽  
Linear Regression Analysis ◽  
Laboratory Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Function Parameter ◽  
Overt Hypothyroidism ◽  
Free Triiodothyronine ◽  
Cross Sectional

Abstract INTRODUCTION: Patients with subclinical hypothyroidism (SCH) have a few or no symptoms or signs of thyroid dysfunction and thus by its very nature, SCH is a laboratory diagnosis. Serum creatinine is elevated and glomerular filtration rate (GFR) values are reversibly reduced in overt hypothyroid patients. We hypothesize that SCH also may be associated with low GFR. AIMS AND OBJECTIVES: The objective of this study was (1) to know the effect of SCH on kidney function, (2) to find the correlation between the renal function parameter creatinine, estimated GFR (eGFR), and thyroid-stimulating hormone (TSH), and (3) to know if creatinine values can be predicted by TSH values in SCH cases. MATERIALS AND METHODS: This is a hospital-based cross-sectional study for 1 year. A total of 608 subjects of either sex were included in the study and were divided into 3 groups: (1) SCH, (2) overt hypothyroidism (OHT), and (3) euthyroidism (ET). TSH, free triiodothyronine, free thyroxine, and serum creatinine were estimated and eGFR was calculated using modification of diet in renal disease study equation and the chronic kidney disease epidemiology collaboration equations. RESULTS: Serum creatinine levels were higher and eGFR was lower significantly in the subclinical hypothyroid group when compared to the control ET group (P < 0.001). The overtly hypothyroid group had significantly higher levels of serum creatinine and lower eGFR when compared to both the groups (P < 0.001). Significant correlation between TSH, creatinine, and eGFR was found in OHT group only. Linear regression analysis showed the regression in creatinine upon TSH is attributable to 44.5% among OHT group, 48.2% in SCH group. CONCLUSION: It can be concluded that the SCH group behaves biochemically similar to OHT group and changes in serum creatinine reflect tissue hypothyroidism in SCH cases.

Atopy as a risk factor for subclinical hypothyroidism development in children

2017 ◽  
Vol 30 (8) ◽  
Author(s):  
Marcella Pedullà ◽  
Giuseppina Rosaria Umano ◽  
Vincenzo Fierro ◽  
Francesco Capuano ◽  
Anna Di Sessa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Serum Concentration ◽  
Subclinical Hypothyroidism ◽  
Significant Risk ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Low Grade ◽  
Work Up ◽  
Low Grade Inflammation ◽  
Serum Tsh

AbstractBackground:Increased thyroid stimulating hormone (TSH) serum concentration can be a marker of subclinical hypothyroidism (SCH) or transient hyperthyrotropinemia. The aim of our study was to evaluate whether high serum TSH concentrations in allergic children could represent true SCH or isolated and transient hyperthyrotropinemia.Methods:We enrolled 620 allergic children (1.11–12.8 years) consecutively attending to our department. They were classified as atopics and non-atopics on the basis of the atopy work-up and, at baseline, they were investigated for thyroid function and low-grade inflammation state. Further, TSH was evaluated after 6 (T1) and 12 (T2) months.Results:Both atopics and non-atopics showed higher SCH prevalence compared to controls (p=0.0055 and p=0.02, respectively), and a significant association between atopy and SCH (OR 10.11, 95% CI 1.36–75.12) was found. Both at T1 and T2, atopics had a significant risk of developing severe SCH compared to non-atopics (RR 1.8, 95% CI 1.39–2.34 and 1.61, 95% CI 1.21–2.14; respectively).Conclusions:Our data may suggest that hyperthyrotropinemia in atopic children could be used as a marker of true SCH.

Starting lithium in patients with compromised renal function – is it wise?

2020 ◽  
pp. 026988112093654
Author(s):  
Mihaela Golic ◽  
Harald Aiff ◽  
Per-Ola Attman ◽  
Bernd Ramsauer ◽  
Staffan Schön ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Impairment ◽  
Serum Creatinine ◽  
Severe Renal Impairment ◽  
Lithium Treatment ◽  
Observation Time ◽  
High Serum ◽  
Normal Serum ◽  
Somatic Comorbidity ◽  
Matching Criteria

Background: Little is known of the risks involved for patients who, at the start of lithium treatment, already have compromised renal function. Aims: To assess the risk of developing severe renal impairment (chronic kidney disease (CKD) 4–5) among those patients and to explore predictors for the progression. Methods: A retrospective longitudinal cohort study using data from Sahlgrenska University Hospital’s laboratory database 1981–2017. We compared the risk of developing CKD 4–5 in two patient cohorts: an exposed cohort of 83 patients who had high serum creatinine prior to start of lithium and a reference cohort of 83 patients with normal serum creatinine, matched by gender, duration of lithium treatment and age at the start of lithium treatment. The patients’ medical charts were reviewed and the Swedish Renal Registry was used to identify patients with renal replacement therapy. Results: There were no significant differences between the exposed and reference cohorts with respect to our matching criteria. Almost half the patients in the exposed cohort versus only 10% of the reference patients progressed to CKD 4–5 (HR 6.7, 95%CI 3.1–14.3, p < 0.001) during a mean observation time of more than 10 years. The progressors were older at the start of lithium treatment and were characterised by a higher burden of comorbid somatic diseases, in particular cardiovascular diseases. Conclusions: Compromised renal function prior to initiating lithium treatment increases the risk of developing severe renal impairment. Monitoring of renal function should include somatic comorbidity among older 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 Subclinical hypothyroidism & infertility: a review

2015 ◽  
Vol 8 (1) ◽  
pp. 17-24
Author(s):  
HS Ferdous ◽  
Faria Afsana ◽  
Nazmul Kabir Qureshi ◽  
Rushda SB Rouf ◽  
Irfan N Noor ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Clinical Importance ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Trh Stimulation ◽  
Risk Of Progression ◽  
Potential Benefits ◽  
Potential Risks ◽  
Thyroxine Replacement Therapy ◽  
Current Guidelines

Subclinical hypothyroidism (SCH) may be of greater clinical importance in women with “unexplained” infertility, especially when the luteal phase is inadequate, and such patients should be investigated for thyroid dysfunction in detail. To date, studies investigating the association between SCH and infertility are still based on the high serum thyroid stimulating hormone (TSH) levels while some older studies are based on the presence of an abnormal serum TSH after a thyrotropin releasing hormone (TRH) stimulation test. The recommendation in the current guidelines to treat subclinical hypothyroidism is based on minimal evidence and it is thought that with treatment the potential benefits outweigh the potential risks. Thyroxine-replacement therapy should be started in patients with SCH caused by conditions which are at high risk of progression to overt hypothyroidism.Ibrahim Med. Coll. J. 2014; 8(1): 17-24

Estimation of Serum Ferritin Levels in Patients with Acute Coronary Syndrome in Amritsar, India

2021 ◽  
Vol 8 (26) ◽  
pp. 2260-2264
Author(s):  
Shaina Gakhar ◽  
Manish Chandey ◽  
Gurinder Mohan
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Stay ◽  
Serum Ferritin ◽  
Systolic Function ◽  
High Serum ◽  
Normal Serum ◽  
Healthy Controls ◽  
Coronary Syndrome ◽  
Developing Heart ◽  
The Difference

BACKGROUND India is leading the world in incidence, prevalence, complications and mortality due to coronary artery disease (CAD). Various risk factors for acute coronary syndrome (ACS) are diabetes, hypertension, dyslipidaemia, smoking and obesity. It has been proposed that high serum ferritin levels are associated with enhancement in myocardial ischaemic response along with decreased ischaemic threshold in the setting up of acute ischaemic conditions. In this study, we wanted to measure and compare serum ferritin levels in patients of acute coronary syndrome and healthy controls to know the association between serum ferritin levels and risk of acute coronary syndrome. METHODS 60 patients of acute coronary syndrome admitted at Sri Guru Ram Das Hospital, Vallah Sri Amritsar were taken as cases and 60 age and sex matched healthy controls were taken. Serum ferritin levels were measured in both the cases and controls and were compared. RESULTS Most of the patients of ACS were in the age group of 51 - 60 years. Hypertension was the most common risk factor observed followed by diabetes mellitus (DM). Mean serum cholesterol levels were higher in cases. The most common vessel involved in ACS was left anterior descending artery (LAD). The difference in mean serum ferritin levels of cases and controls was statistically significant with higher levels in cases as compared to controls. These patients also had higher risk of developing heart failure and had a longer hospital stay. CONCLUSIONS The difference between serum ferritin levels in cases of ACS and controls was statistically significant. People with raised serum ferritin levels are at a greater risk of developing ACS as compared to those with normal serum ferritin levels. KEYWORDS Acute Coronary Syndrome, Serum Ferritin, Systolic Function, Diastolic Function, Mortality, Hospital Stay

scholarly journals Cholesterol Synthesis Increased in the MMI-Induced Subclinical Hypothyroidism Mice Model

2017 ◽  
Vol 2017 ◽  
pp. 1-6
Author(s):  
Yongfeng Song ◽  
Xiujuan Zhang ◽  
Wenbin Chen ◽  
Ling Gao
Keyword(s):  
Subclinical Hypothyroidism ◽  
Cholesterol Synthesis ◽  
Cholesterol Metabolism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Control Group ◽  
Mice Model

Subclinical hypothyroidism (SCH) is defined as increased serum thyroid-stimulating hormone (TSH) concentrations and normal serum thyroid hormone (TH) levels as well as an increased serum cholesterol level, which is an important cause of secondary hypercholesterolemia and cardiovascular diseases. Some studies have demonstrated a direct effect of TSH on cholesterol metabolism via in vivo and in vitro experiments. However, because no suitable SCH model has been established until now, the changes in cholesterol synthesis that occur in SCH patients remain unknown. Here, we establish an SCH mouse model by using long-term low-dose MMI administered in drinking water. Compared with the control group, the MMI-treated mice had elevated circulating TSH levels, but the serum FT3 levels in these mice did not change. Additionally, the TC levels increased in both the serum and liver of the experimental mice. Both the protein expression and activity of hepatic HMGCR, the rate-limiting enzyme for cholesterol synthesis in the liver, increased in these mice. We also found that the SCH mice had decreased phospho-HMGCR and phospho-AMPK expression, while the expression of AMPK showed no change. In conclusion, we established a suitable SCH model in which cholesterol synthesis is increased.

scholarly journals Specific impact of cardiovascular risk factors on coronary microcirculation in patients with subclinical hypothyroidism

2021 ◽  
Author(s):  
Mirjana Stojković ◽  
Biljana Nedeljković-Beleslin ◽  
Milorad Tesic ◽  
Zoran Bukumiric ◽  
Jasmina Ciric ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Thyroid Hormones ◽  
Cardiovascular Risk Factors ◽  
Subclinical Hypothyroidism ◽  
Thyroid Stimulating Hormone ◽  
Normal Serum ◽  
Free Triiodothyronine ◽  
Flow Reserve ◽  
The Impact

Background: Although thyroid hormones have significant effect on cardiovascular system, the impact of subtle thyroid dysfunction such as subclinical hypothyroidism (SCH) remains to be determined. We investigated coronary flow reserve (CFR) in patients with subclinical hypothyroidism. Methods: Thirty-two subjects with SCH and eighteen control subjects with normal serum thyroid hormones and thyroid-stimulating hormone (TSH) levels were included in the study. TSH, free thyroxine, free triiodothyronine, glucose, insulin, HbA1c, cholesterol, triglyceride and plasma levels of C-reactive protein were measured. Coronary diastolic peak flow velocities in left anterior descending coronary artery were measured at baseline and after adenosine infusion. CFR was calculated as the ratio of hyperemic to baseline diastolic peak velocity. Results: CFR values were not significantly different between the two groups (SCH 2.76 ± 0.35 vs controls 2.76 ± 0.42). There was a significant correlation of CFR with waist to hip ratio, hypertension, smoking habits, markers of glucose status (glucose level, HbA1c, insulin level, HOMA IR), cholesterol, LDL-cholesterol and triglyceride levels in SCH group, whereas only cholesterol level showed significant correlation with CFR in controls. There was no correlation between CFR and thyroid hormones. Conclusion: We concluded that there is a different impact of cardiovascular risk factors on CFR in SCH patients compared to healthy control and that these two groups behave differently in the same circumstances under the same risk factors. The basis for this difference could be that the altered thyroid axis “set point” changes the sensitivity of the microvasculature in patients with SCH to known risk factors.

scholarly journals A study of levothyroxine substitution therapy on subclinical hypothyroid patients and its effects on lipid profile in the department of medicine at tertiary care hospital

2020 ◽  
Vol 4 (2) ◽  
pp. 4-11
Author(s):  
Binod Raut ◽  
N Paudel ◽  
N Bhosekar
Keyword(s):  
Lipid Profile ◽  
Subclinical Hypothyroidism ◽  
Tertiary Care ◽  
Serum Triglyceride ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Slight Reduction ◽  
Care Hospital ◽  
Free T4

Background: Subclinical hypothyroidism is represented by high serum thyroid stimulating hormone (TSH) and normal serum free T4 and T3, Recent studies on subclinical hypothyroidism and lipid profile indicates that the serum total cholesterol, LDL-C, and total triglycerides were significantly increased. Clinical evidence suggests that thyroid replacement therapy with levothyroxine has beneficial effect. Methods: It is a hospital based prospective observational study involving 122 patients based on non probability sampling conducted in the Department of Internal Medicine. The study involved patients who have been diagnosed with subclinical hypothyroidism with normal level of free T4, T3 and elevated levels of TSH with positive Thyroperoxidase (TPO) antibodies. Patients were advised to investigate lipid profile before and after prescribing levothyroxine. Follow up was done after 6-9 wks. Results: In this study 122 patients diagnosed with Subclinical hypothyroidism were prescribed with levothyroxine in which 112 came for follow up. The mean age of the patient was 46.81. There was significant reduction in mean TSH from 12.09 (±1.89)mIU/L to 7.97(±1.59)mIU/L,TC from 217.12( ±20.87)mg/dl to 198.47( ±17.34)mg/dl and LDL from 137.16(±14.57)mg/dl to 124.62( ±12.89)mg/dl was found along with significant reduction in VLDL was found after levothyroxine therapy, There was slight reduction in serum triglyceride was found with no significant alteration in HDL and BMI levels. Conclusion: The study showed significant reduction in the lipid profile including TC, LDL and VLDL after levothyroxine therapy. There was significant reduction in the level of TSH was also found whereas the level of free T4 and T3 were not much altered. There was no significant change found in the level of HDL and BMI.  

scholarly journals Reproductive Outcomes in Cases of Subclinical Hypothyroidism and Thyroid Autoimmunity: A Narrative Review

2020 ◽  
Vol 42 (12) ◽  
pp. 829-833
Author(s):  
Bruno Ramalho de Carvalho ◽  
Andrea Prestes Nácul ◽  
Cristina Laguna Benetti-Pinto ◽  
Ana Carolina Japur de Sá Rosa-e-Silva ◽  
José Maria Soares Júnior ◽  
...  
Keyword(s):  
Subclinical Hypothyroidism ◽  
Thyroid Autoimmunity ◽  
Serum Levels ◽  
Thyroid Stimulating Hormone ◽  
High Serum ◽  
Reproductive Period ◽  
Current Data ◽  
Thyroid Disorders ◽  
Reproductive Outcomes ◽  
Comprehensive Review

AbstractThyroid diseases are relatively common in women in the reproductive period. It is currently understood that clinically-evident thyroid disorders may impair ovulation and, consequently, fertility. However, to date it has not been proven that high serum levels of thyroid-stimulating hormone and/or positivity for antithyroid antibodies are associated to a reduction in fertility, mainly in the absence of altered thyroxine levels. The present comprehensive review aims to present current data on the association between subclinical hypothyroidism and/or thyroid autoimmunity and reproductive outcomes.

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