Evaluation of the Thyroid Status and Types of Thyroid Dysfunction in Beta-Thalassemia Major Patients More Than 9 Years of Age in Wassit, Iraq 2020

Background: Hypothyroidism is one of the commonest endocrine complications that can happen in patients with Beta-Thalassemia Major (BTM) above nine years old which may pass hidden and untreated for years. Aim: To evaluate the thyroid status and types of thyroid dysfunction in Beta-Thalassemia Major Patients above 9 years of age. Method: A Cross-Sectional study was performed on sixty-six randomly selected patients above 12 years of age with BTM in Al-Kut Heriditory Blood Disease Center at Wassit province from March to August 2020. Thyroid function tests were done (TSH, T3, and T4) to detect the thyroid status and identify patients with thyroid dysfunction and determine the type of hypothyroidism (Primary, central, Subclinical). Data collected include Age, Sex, weight, height, Serum ferritin and mean hemoglobin level, Type of chelation therapy, dose, compliance, and frequency of blood transfusion, other diseases such as Diabetes Mellitus, HCV, HBV, HIV, and Heart Failure were evaluated statistically. Results: In the studied patients, Thirty-one patients (46.96%) were found to have hypothyroidism;( Seven of them (10.6%) had primary hypothyroidism, Sixteen(24.2%) had subclinical hypothyroidism and eight (12.1%) had central hypothyroidism). Twenty-one (67.74 %) patients with Hypothyroidism were found to have stunted height or short stature (with significant p.value 0.03) from the 13 (41.9%) who had subclinical hypothyroidism. By Pearson correlation, increasing serum ferritin levels significantly affect decreasing thyroxin (T4) levels with inverse correlation (P value 0.0001), (r)= -0.45. Conclusion: in this study, there was a high prevalence of hypothyroidism in BTM and subclinical hypothyroidism is the most common type, which signifies the importance of regular screening and close supervision especially when high ferritin and or short stature are present.

Thyroid-Mediated Metabolic Differences Underlie Ecological Specialization of Extremophile Salmonids in the Arctic Lake El’gygytgyn

El’gygytgyn, the only “ancient lake” in the Arctic (3.6 MY), is a deep (176 m) and extremely cold (always ≤ 4°C) waterbody inhabited by unique salmonids, which colonized the ecosystem stepwise during the global fluctuations of the Quaternary climate. The descendant of the first-wave-invaders (long-finned charr) dwells in the deep waters and feeds on amphipods. The second-wave-invaders (smallmouth charr) consume copepods in the mid-waters. Recent third-wave-invaders (Boganida charr) are spread throughout the ecosystem and feed on insects when they are young shifting to piscivory at an older age. Here, we present the data on the charrs’ thyroid status and metabolic characteristics, confirming their ecological specialization. The long-finned charr exhibits an extremely low thyroid content, the substitution of carbohydrates for lipids in the cellular respiration, an increased hemoglobin level and a high antioxidant blood capacity. These traits are likely to be the legacy of anaerobic survival under perennial ice cover during several Quaternary glaciations. Moderate thyroid status and reduced metabolic rate of the smallmouth charr, along with an inactive lifestyle, could be regarded as a specialization to saving energy under the low food supply in the water column. The piscivorous Boganida charr could be sub-divided into shallow-water and deep-water groups. The former demonstrates a significantly elevated thyroid status and increased metabolism. The latter is characterized by a reduced thyroid level, metabolic rate, and lipid accumulation. Thus, the endemic El’gygytgyn charrs represent a wide spectrum of contrast physiological adaptation patterns essential to survive in sympatry under extremely cold conditions.

Higher thyrotropin leads to unfavorable lipid profile and somewhat higher cardiovascular disease risk: evidence from multi-cohort Mendelian randomization and metabolomic profiling

Background Observational studies suggest interconnections between thyroid status, metabolism, and risk of coronary artery disease (CAD), but causality remains to be proven. The present study aimed to investigate the potential causal relationship between thyroid status and cardiovascular disease and to characterize the metabolomic profile associated with thyroid status. Methods Multi-cohort two-sample Mendelian randomization (MR) was performed utilizing genome-wide significant variants as instruments for standardized thyrotropin (TSH) and free thyroxine (fT4) within the reference range. Associations between TSH and fT4 and metabolic profile were investigated in a two-stage manner: associations between TSH and fT4 and the full panel of 161 metabolomic markers were first assessed hypothesis-free, then directional consistency was assessed through Mendelian randomization, another metabolic profile platform, and in individuals with biochemically defined thyroid dysfunction. Results Circulating TSH was associated with 52/161 metabolomic markers, and fT4 levels were associated with 21/161 metabolomic markers among 9432 euthyroid individuals (median age varied from 23.0 to 75.4 years, 54.5% women). Positive associations between circulating TSH levels and concentrations of very low-density lipoprotein subclasses and components, triglycerides, and triglyceride content of lipoproteins were directionally consistent across the multivariable regression, MR, metabolomic platforms, and for individuals with hypo- and hyperthyroidism. Associations with fT4 levels inversely reflected those observed with TSH. Among 91,810 CAD cases and 656,091 controls of European ancestry, per 1-SD increase of genetically determined TSH concentration risk of CAD increased slightly, but not significantly, with an OR of 1.03 (95% CI 0.99–1.07; p value 0.16), whereas higher genetically determined fT4 levels were not associated with CAD risk (OR 1.00 per SD increase of fT4; 95% CI 0.96–1.04; p value 0.59). Conclusions Lower thyroid status leads to an unfavorable lipid profile and a somewhat increased cardiovascular disease risk.

Thyroid dysfunction in pregnancy: practical perspective

Pregnancy is a complex endocrine and metabolic status in life of women, therefore role of the thyroid physiology during this period will be profoundly affected, this has been attributed to the complex interplay of Human chorionic gonadotrophin that acts as TSH receptors’ stimulant, more estrogen is produced by placenta will lead to rise in the serum level of Thyrogublin binding protein, change in iodine homeostasis, and hemodynamic changes. From 12th -16th week of pregnancy, the fetus is entirely dependent on the thyroid status of the mother, therefore any disruption in this metabolic milieu will lead to negative outcomes on both the fetus and the mother. Therefore, the current guidelines have stressed on appropriate management of thyroid dysfunction in pregnancy with particular interest on early pregnancy, a critical period for neurocognitive development, then throughout the pregnancy and postpartum period (Figure 1).

Selected Essential and Toxic Chemical Elements in Hypothyroidism—A Literature Review (2001–2021)

Thyroid hormones are known for controlling metabolism of lipids, carbohydrates, proteins, minerals, and electrolytes and for regulating body temperature. Normal thyroid status depends on the chemical/elemental composition of body fluids and tissues, which changes depending on physiological state, lifestyle and environment. A deficiency or excess of certain essential chemical elements (selenium, zinc, copper, iron or fluorine) or exposure to toxic (cadmium or lead) or potentially toxic elements (manganese or chromium) interacts with thyroid hormone synthesis and may disturb thyroid homeostasis. In our review, accessible databases (Scopus, PubMed and Web of Science) were searched for articles from 2001–2021 on the influence of selected chemical elements on the development of hypothyroidism. Our review adopted some of the strengths of a systematic review. After non-eligible reports were rejected, 29 remaining articles were reviewed. The review found that disruption of the physiological levels of elements in the body adversely affects the functioning of cells and tissues, which can lead to the development of disease.

Analysis of the thyroid status of pregnant women in the region of mild iodine deficiency

Introduction. Thyroid hormones play an important role during pregnancy, providing organogenesis, growth and development of the fetus, participate in the formation and development of the brain and its structures, affecting cognitive abilities. Thyroid dysfunction is associated with the pathological course of pregnancy and childbirth, as well as a negative effect on the fetus. Iodine deficiency, which persists throughout Russia, creates the preconditions for the more frequent development of subclinical hypothyroidism and hypothyroxinemia in pregnant women. Therefore, early detection of thyroid dysfunction during gestation in the region of iodine deficiency is relevant.Aim. To assess the thyroid status in pregnant women in the region of iodine deficiency.Materials and methods. A single-center, prospective, one-sample study was performed in a population of pregnant women registered from June 2019 to December 2019 to the antenatal clinic in Tyumen.Results. According to the results of biomedical monitoring of iodine deficiency in the population of pregnant women in Tyumen, iodine supply improved, as evidenced by the median concentration of ioduria 154.4 μg / l, the frequency of endemic goiter was 0.37%. Continuous screening of women in the 1st trimester of pregnancy without thyroid pathology revealed subclinical hypothyroidism in 21.5% of pregnant women, carriage of antibodies to thyroperoxidase was found in 10.5% of women.Conclusions. Given the persisting problem of iodine deficiency, the widespread occurrence of subclinical hypothyroidism in the population of pregnant women, it is necessary to include the study of thyroid status in the standard of examination of pregnant women when registering in an antenatal clinic for early diagnosis and timely treatment of hypothyroidism. It is also recommended to continue preventive measures aimed at replenishing the iodine deficiency starting from the stage of pregravid preparation.

Vitamin D, Testosterone, and Thyroid Status in Young Men at Different Seasons

There are evidences that seasonal fluctuations in vitamin D levels coincide with annual rhythms of testosterone levels, and hypothyroidism may be a predictor of hypoandrogenism. The aim of the study was to establish the levels of vitamin D (vit. D), testosterone (T), thyroid stimulating hormone (TSH) and free thyroxine (T4f) in young people with pathospermia and normospermia in the spring-summer and autumn-winter periods. Materials and methods. The data of 58 men aged 23-44 years, who are in a sterile marriage, were analyzed: 24 were examined in the spring-summer period, 34 - in the autumn-winter period. BMI, levels of T, TSH, T4fandvit. Dwere investigated. Results. In the general group of men, the frequency of D - hypovitaminosis was higher in those examined in the autumn-winter period. Vit D levels were significantly lower with pathospermia than with normospermia. BMI did not significantly affect the level of vit.D in the blood.A direct correlation between vit. D and T in men with patho- and normospermiahas not been established, although such a correlation took place in the general group of the surveyed. The average TSH values ​​in the group examined in the spring-summer period did not significantly differ in the group with patho- and normospermia, and in those examined in the autumn-winter period, against the background of pathospermia, there was a decrease in T4f values ​​and an increase in TSH. 13.6% of this subgroup had laboratory signs of subclinical hypothyroidism. Conclusions: In men of the general group, without taking into account the state of the spermatogenic function of the testicles, examined in the autumn-winter period, there is a significant increase in the frequency of D-hypovitaminosis compared with a similar group of men in whom the level of vitamin D blood was determined in the spring-summer period. Regardless of the examination period, patients with pathospermia show a decrease in the average levels of vitamin D and testosterone compared to men with normal semen parameters. The frequency of vitamin D deficiency in patients with pathospermia significantly increases in the autumn-winter period. Disorders of spermatogenesis in men can be associated with the hypofunctional state of the thyroid gland against the background of the existing deficiency of vitamin D in the autumn-winter period.