نتائج البحث - "Subclinical hypothyroidism"

1

Lifestyle is associated with thyroid function in subclinical hypothyroidism: a cross-sectional study

المؤلفون: Junjun Xu, Xuelin Gao, Linxi Wang, Sujie Ke, Xiaoying Lin, Kejun Wu, Chengwen Xie, Li Ma, Yanping Wang, Xiaohong Liu, Jingze Huang, Lijuan Wu, Xiao-Ying Liu, Yu Zhou, Libin Liu, Li Wu, Beibei Li

المصدر: BMC Endocrine Disorders, Vol 21, Iss 1, Pp 1-11 (2021)
BMC Endocrine Disorders

مصطلحات موضوعية: Adult, Male, 0301 basic medicine, Thyroid function, China, Thyroid Hormones, endocrine system, endocrine system diseases, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Physiology, 030209 endocrinology & metabolism, Diseases of the endocrine glands. Clinical endocrinology, Pittsburgh Sleep Quality Index, 03 medical and health sciences, 0302 clinical medicine, Hypothyroidism, Thyroid-stimulating hormone, Thyroid peroxidase, Subclinical hypothyroidism, Humans, Medicine, Euthyroid, Life Style, Subclinical infection, biology, business.industry, Research, Thyroid, General Medicine, Prognosis, Lifestyle, RC648-665, Cross-Sectional Studies, 030104 developmental biology, medicine.anatomical_structure, biology.protein, Female, business, Follow-Up Studies

الوصف: Background Few studies have focused on the association between lifestyle and subclinical hypothyroidism (SCH). The purpose of this study was to investigate the association between lifestyle and thyroid function in SCH. Methods This study was a part of a community-based and cross-sectional study, the Epidemiological Survey of Thyroid Diseases in Fujian Province, China. A total of 159 participants with SCH (81 males and 78 females) and 159 euthyroid (87 males and 72 females) participants without any missing data were included in the analysis. General information and lifestyle information including sleep, exercise, diet and smoking habits of the participants was collected by questionnaire and Pittsburgh sleep quality index scale (PSQI) was collected. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TgAb) and urine iodine concentration (UIC) were tested. Thyroid homeostasis parameter thyroid’ s secretory capacity (SPINA-GT), Jostel’s TSH index (TSHI), thyrotroph T4 sensitivity index (TTSI) were calculated. Logistic regression and multiple linear regression were performed to assess associations. Results Compared with euthyroid subjects, patients with SCH were more likely to have poor overall sleep quality (15.1 vs.25.8 %, P = 0.018) and l less likely to stay up late on weekdays (54.7 vs. 23.9 % P β= -0.224, P = 0.004), thyroid secretory capacity (β = 0.244, P = 0.006) and thyrotropin resistance (β = 0.206, P = 0.009). Iodine excess was the influencing factor of thyroid secretory capacity (β = 0.209, P = 0.001) and pituitary thyroid stimulating function (β = 0.167, P = 0.034). Smoking was the influencing factor of pituitary thyroid stimulating function (β = 0.161, P = 0.040). Staying up late on weekends was the influencing factor of thyroid secretory capacity (β = 0.151, P = 0.047). After adjusting for possible confounders, logistic regression showed that those with poor overall sleep quality assessed by PSQI and iodine excess had an increased risk of SCH (OR 2.159, 95 %CI 1.186–3.928, P = 0.012 and OR 2.119, 95 %CI 1.008–4.456, P = 0.048, respectively). Conclusions Lifestyle including sleep, smoking, diet and exercise was closely related to thyroid function especially thyroid homeostasis in SCH.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e77619f6783efac86665f7e2a595847aTest
https://doaj.org/article/dbc3efd2ad2c4c5fb2f5201ea8e6e427Test

2

Subclinical hypothyroidism: treat or watch?

المؤلفون: S. V. Bulgakova, A. V. Melikova, I. A. Tsanava

المصدر: Вестник медицинского института «Реавиз»: Реабилитация, врач и здоровье, Vol 0, Iss 6, Pp 98-108 (2021)

الوصف: Manifest hypothyroidism occurs in more than 5 % of the population, while prevalence of subclinical hypothyroidism is much higher and reaches 15 %. In the practice of an endocrinologist, in most cases, the diagnosis and treatment of manifest hypothyroidism does not raise questions, while subclinical changes in thyroid hormones quite often generate a lot of discussions. The generally accepted reference range for TSH up to 4.50 μIU / ml is in conflict with data showing that more than 95 % of healthy people with euthyroidism have serum TSH levels up to 2.5 μIU / ml. At the same time, a lot of data has been accumulated on the effect of even slightly altered levels of thyroid hormones and TSH on various tissues, organs and systems of the body, especially on the cardiovascular, nervous and reproductive systems. This review analyzes the results of studies aimed at studying the relationship of subclinical hypothyroidism with cardiovascular and metabolic disorders, cognitive disorders, pathology of pregnant women.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7019a1571b47be90879f9b6c59931083Test
https://vestnik.reaviz.ru/jour/article/view/108Test

3

Levothyroxine and the risk of adverse pregnancy outcomes in women with subclinical hypothyroidism: a systematic review and meta-analysis

المؤلفون: Kristian B. Filion, Oriana Hoi Yun Yu, Sonia Marzia Grandi, Francesca Y E Frati, Ihab Kandil, Magnus Bein

المصدر: BMC Endocrine Disorders, Vol 21, Iss 1, Pp 1-17 (2021)
BMC Endocrine Disorders

مصطلحات موضوعية: Pediatrics, medicine.medical_specialty, Blinding, Endocrinology, Diabetes and Metabolism, Levothyroxine, Thyrotropin, 030209 endocrinology & metabolism, Cochrane Library, lcsh:Diseases of the endocrine glands. Clinical endocrinology, 03 medical and health sciences, 0302 clinical medicine, Hypothyroidism, Pregnancy, Risk Factors, Subclinical hypothyroidism, medicine, Humans, 030212 general & internal medicine, Subclinical infection, Randomized Controlled Trials as Topic, Pregnancy outcomes, lcsh:RC648-665, business.industry, Confounding, Pregnancy Outcome, General Medicine, medicine.disease, Pregnancy Complications, Observational Studies as Topic, Thyroxine, Meta-analysis, Observational study, Female, business, medicine.drug, Research Article

الوصف: BackgroundLevothyroxine replacement therapy may decrease the risk of adverse pregnancy outcomes among women with subclinical hypothyroidism (SCH). The aim of this study is to conduct a systematic review and meta-analysis to examine the risk of adverse pregnancy, perinatal, and early childhood outcomes among women with SCH treated with levothyroxine.MethodsA systematic literature search was conducted using Ovid-Medline, Ovid-EMBASE, Pubmed (non-Medline), Ebsco-CINAHL Plus with full text and Cochrane Library databases. Randomized controlled studies (RCTs) and observational studies examining the association between treatment of SCH during pregnancy and our outcomes of interest were included. Studies that compared levothyroxine treatment versus no treatment were eligible for inclusion. Data from included studies were extracted and quality assessment was performed by two independent reviewers.ResultsSeven RCTs and six observational studies met our inclusion criteria. A total of 7342 individuals were included in these studies. RCTs demonstrated several sources of bias, with lack of blinding of the participants or research personnel; only one study was fully blinded. In the observational studies, there was moderate to serious risk of bias due to lack of adjustment for certain confounding variables, participant selection, and selective reporting of results. Pooled analyses showed decreased risk of pregnancy loss (RR: 0.79; 95% CI: 0.67 to 0.93) and neonatal death (RR: 0.35; 95% CI: 0.17 to 0.72) associated with levothyroxine treatment during pregnancy among women with SCH. There were no associations between levothyroxine treatment and outcomes during labour and delivery, or cognitive status in children at 3 or 5 years of age.ConclusionTreatment of SCH with levothyroxine during pregnancy is associated with decreased risks of pregnancy loss and neonatal death. Given the paucity of available data and heterogeneity of included studies, additional studies are needed to address the benefits of levothyroxine use among pregnant women with SCH.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::5c5b757436182b00605f147fcb73bde8Test
https://doaj.org/article/387d59ca25e54e8bb52ab8f2d4562826Test

4

Thyroid Function and Mood Disorders: A Mendelian Randomization Study

المؤلفون: Fabiola Del Greco M, Tomasz Bednarczuk, Alisa D. Kjaergaard, Panos Deloukas, Christina Ellervik, Layal Chaker, Stephen Burgess, Robin P. Peeters, Rosalie B T M Sterenborg, Marco Medici, Aleksander Kuś, Eirini Marouli, Alexander Teumer, Bjørn Olav Åsvold

المساهمون: Kuś, Aleksander [0000-0001-5422-6900], Kjaergaard, Alisa D [0000-0003-3899-1324], Åsvold, Bjørn O [0000-0003-3837-2101], Teumer, Alexander [0000-0002-8309-094X], Ellervik, Christina [0000-0002-3088-4375], Apollo - University of Cambridge Repository, Internal Medicine, Epidemiology

المصدر: Kuś, A, Kjærgaard, A D, Marouli, E, Del Greco M, F, Sterenborg, R B T M, Chaker, L, Peeters, R P, Bednarczuk, T, Åsvold, B O, Burgess, S, Deloukas, P, Teumer, A, Ellervik, C & Medici, M 2021, ' Thyroid function and mood disorders: a Mendelian Randomization study ', Thyroid : official journal of the American Thyroid Association, vol. 31, no. 8, pp. 1171-1181 . https://doi.org/10.1089/thy.2020.0884Test
Thyroid, 31, 8, pp. 1171-1181
Kuś, A, Kjaergaard, A D, Marouli, E, Del Greco M., F, Sterenborg, R B T M, Chaker, L, Peeters, R P, Bednarczuk, T, Åsvold, B O, Burgess, S, Deloukas, P, Teumer, A, Ellervik, C & Medici, M 2021, ' Thyroid Function and Mood Disorders : A Mendelian Randomization Study ', Thyroid, vol. 31, no. 8, pp. 1171-1181 . https://doi.org/10.1089/thy.2020.0884Test
Thyroid, 31(8), 1171-1181. Mary Ann Liebert Inc.
Thyroid, 31, 1171-1181

مصطلحات موضوعية: Male, Bipolar Disorder, Endocrinology, Diabetes and Metabolism, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Thyroid Gland, Thyrotropin, Thyroid Function Tests, thyroid, 0302 clinical medicine, Endocrinology, SUBCLINICAL HYPOTHYROIDISM, EPIDEMIOLOGY, AXIS, Mendelian randomization study, Depression (differential diagnoses), bipolar disorder, RISK, Thyroid, mood disorders, TRIIODOTHYRONINE, medicine.anatomical_structure, 030220 oncology & carcinogenesis, depression, AUGMENTATION, Major depressive disorder, Thyroid function, hormones, hormone substitutes, and hormone antagonists, Adult, Risk, medicine.medical_specialty, 030209 endocrinology & metabolism, METABOLISM, behavioral disciplines and activities, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Mendelian randomization, mental disorders, medicine, Humans, Bipolar disorder, GENOME-WIDE ASSOCIATION, Psychiatry, Depressive Disorder, Major, business.industry, Mood Disorders, MAJOR DEPRESSION, Mendelian Randomization Analysis, medicine.disease, normal-range thyroid function, Thyroxine, Mood disorders, Observational study, business, Genome-Wide Association Study

الوصف: Item does not contain fulltext Background: Observational studies suggest that even minor variations in thyroid function are associated with the risk of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). However, it is unknown whether these associations are causal or not. We used a Mendelian randomization (MR) approach to investigate causal effects of minor variations in thyrotropin (TSH) and free thyroxine (fT4) levels on MDD and BD risk. Materials and Methods: We performed two-sample MR analyses using data from the largest publicly available genome-wide association studies on normal-range TSH (n = 54,288) and fT4 (n = 49,269) levels, MDD (170,756 cases, 329,443 controls) and BD (20,352 cases, 31,358 controls). Secondary MR analyses investigated the effects of TSH and fT4 levels on specific MDD and BD subtypes. Reverse MR was also performed to assess the effects of MDD and BD on TSH and fT4 levels. Results: There were no associations between genetically predicted TSH and fT4 levels and MDD risk, nor MDD subtypes and minor depressive symptoms. A one standard deviation increase in fT4 levels was nominally associated with an 11% decrease in the overall BD risk (odds ratio [OR] = 0.89, 95% confidence interval [CI] = 0.80-0.98, p = 0.022) and a 13% decrease in the BD type 1 risk (OR = 0.87, CI = 0.75-1.00, p = 0.047). In the reverse direction, genetic predisposition to MDD and BD was not associated with TSH nor fT4 levels. Conclusions: Variations in normal-range TSH and fT4 levels have no effects on the risk of MDD and its subtypes, and neither on minor depressive symptoms. This indicates that depressive symptoms should not be attributed to minor variations in thyroid function. Borderline associations with BD and BD type 1 risks suggest that further clinical studies should investigate the effect of thyroid hormone treatment in BD.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cd9177b5db621b8fc4975affe8c31540Test
https://hdl.handle.net/2066/238103Test

5

Study of Subclinical Thyroid Disorders in Type 2 Diabetes Mellitus

المؤلفون: Salim Javeedh, T A Vidya

المصدر: Journal of Evidence Based Medicine and Healthcare, Vol 8, Iss 02, Pp 103-107 (2021)

الوصف: BACKGROUND Thyroid disease is more common in people with diabetes mellitus than in general population. Among thyroid disorders, subclinical hypothyroidism is more common than the overt form. Hypothyroidism is associated with dyslipidaemia, hypertension and cardiac disease. Subclinical hypothyroidism has also been reported to have these features. With this background, we aimed to determine the prevalence of subclinical thyroid disorder and its influence on the metabolic profile of patients with type 2 diabetes mellitus (DM). METHODS 234 type 2 diabetes patients, 117 males and 117 females, who were previously not known to have thyroid disease, were screened for thyroid dysfunction using serum free T3, free T4, and thyroid stimulating hormone (TSH) levels. Patients were evaluated for clinical features of thyroid disease and investigated for microvascular complications of DM, dyslipidaemia and cardiac disease. Individuals with subclinical hypothyroidism were further screened for anti-thyroid peroxidase (TPO) antibodies. RESULTS In this study, subclinical hypothyroidism was present in 29 (12.4 %) of 234 type 2 diabetics; no case of subclinical hyperthyroidism was detected. 25 of these 29 patients with subclinical hypothyroidism were females. Elevated TPO antibody levels were present in 82.8 % (24 out of 29) subclinical hypothyroidism (SCH) patients. SCH was found to be associated with higher body mass index (BMI) and patients aged more than 50 years. No significant difference was found in glycaemic profile or lipid profile between patients with SCH and euthyroid subjects. There was no significant difference among SCH patients with and without microvascular complications. Left Ventricle (LV) diastolic dysfunction was present in 34.4 % of SCH patients. CONCLUSIONS SCH is common among type 2 diabetics, especially in females and most commonly due to autoimmune thyroid disease. SCH in type 2 DM is associated with a higher BMI and an older age group, but it does not seem to have an influence on glycaemic profile, lipid profile or microvascular complications of diabetes. KEYWORDS Thyroid Stimulating Hormone (TSH), Type 2 Diabetes Mellitus (T2DM), Subclinical Hypothyroidism (SCH), BMI, Anti–TPO (Thyroid Peroxidase) Antibody

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ea3c5593629d9434a7a4313797567244Test
https://jebmh.com/assets/data_pdf/T.A.Vidya-Sadiya--Rathna.pdfTest

6

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

المؤلفون: Payal Choudhary, Kalpana Mahadik, Prasun Kumar Roy

المصدر: BMC Pregnancy and Childbirth, Vol 20, Iss 1, Pp 1-7 (2020)
BMC Pregnancy and Childbirth

مصطلحات موضوعية: medicine.medical_specialty, endocrine system, endocrine system diseases, India, Thyrotropin, 030209 endocrinology & metabolism, Thyroid Function Tests, Thyroid dysfunction in pregnancy, Hyperthyroidism, lcsh:Gynecology and obstetrics, 03 medical and health sciences, 0302 clinical medicine, Hypothyroidism, Pre-Eclampsia, Pregnancy, Subclinical hypothyroidism, Prevalence, medicine, Humans, Euthyroid, Prospective Studies, Hypothyroidism and anemia, lcsh:RG1-991, Subclinical infection, Pregnancy and hypothyroidism, Cesarean Section, Obstetrics, business.industry, Thyroid disease, Infant, Newborn, Pregnancy Outcome, Obstetrics and Gynecology, medicine.disease, Thyroid disorder, Pregnancy Complications, Low birth weight, 030220 oncology & carcinogenesis, Female, Apgar score, Thyroid function, medicine.symptom, business, Research Article

الوصف: 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.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::985ea650157d2114a4fa114092753a7dTest
https://doaj.org/article/ba43d1bc6f2e46328c23b61ab752fec6Test

7

Prevalence, predictors and outcomes of thyroid dysfunction in patients with acute myocardial infarction: the ThyrAMI-1 study

المؤلفون: Lorna Ingoe, J. Vernazza, Avais Jabbar, Azfar Zaman, Peter Carey, Shahid Junejo, Honey Thomas, Salman Razvi, John P Greenwood, Caroline Addison, David Austin

المصدر: Journal of Endocrinological Investigation

مصطلحات موضوعية: Male, medicine.medical_specialty, Low T3 syndrome, Endocrinology, Diabetes and Metabolism, Myocardial Infarction, 030209 endocrinology & metabolism, Acute myocardial infarction, 030204 cardiovascular system & hematology, Hyperthyroidism, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Hypothyroidism, Thinness, Thyroid peroxidase, Subclinical hypothyroidism, Predictive Value of Tests, Internal medicine, medicine, Prevalence, Humans, Euthyroid, Myocardial infarction, Mortality, Correlation of Data, Autoantibodies, biology, Proportional hazards model, business.industry, Thyroid disease, Hazard ratio, Thyroid, Thyroid dysfunction, Middle Aged, medicine.disease, Euthyroid Sick Syndromes, Causality, Thyroxine, medicine.anatomical_structure, England, Creatinine, biology.protein, Original Article, Subclinical hyperthyroidism, Prevalence and predictors, Female, business, Cohort study

الوصف: Purpose Thyroid dysfunction in patients with cardiac disease is associated with worse outcomes. This study aimed to evaluate the prevalence and analyse predictors and outcomes of thyroid dysfunction in patients presenting with an acute myocardial infarction (AMI). Methods A prospective multicentre observational study of patients recruited from six acute hospitals within the North of England. Consecutive patients without previous thyroid disease presenting with both ST-elevation AMI (STEMI) and non-ST-elevation AMI (NSTEMI) were recruited to the Thyroxine in Acute Myocardial Infarction 1 (ThyrAMI-1) cohort study between December 2014 and 2016. Thyroid profile, standard biochemistry measurements and demographic information were obtained within 12 h of admission to hospital. Multivariable logistic regression analyses were performed to assess the predictors of thyroid dysfunction and Cox proportional hazards analyses were utilised to compare all-cause mortality by categories of thyroid dysfunction up to June 2019. Results Of the 1802 participants analysed, 1440 (79.9%) were euthyroid, 312 (17.3%) had subclinical hypothyroidism (SCH), 22 (1.2%) had subclinical hyperthyroidism (SHyper) and 25 (1.3%) had low T3 syndrome (LT3S). Predictors for SCH were increasing age, female sex, higher thyroid peroxidase antibody (TPOAb) levels, higher serum creatinine levels and early morning sampling time (between 00:01–06:00 h). The predictors of SHyper were lower body mass index and afternoon sampling time (between 12:01 and 18:00 h). Predictors of LT3S were increasing age, higher creatinine levels and presence of previous ischaemic heart disease. Compared to the euthyroid group, patients with LT3S had higher all-cause mortality; adjusted hazard ratio (95% CI) of 2.02 (1.03–3.95), p = 0.04, whereas those with SCH and SHyper did not exhibit significantly increased mortality; adjusted hazard ratios (95% CI) of 1.05 (0.74–1.49), p = 0.79 and 0.27 (0.04–1.95), p = 0.19, respectively. Conclusions Thyroid dysfunction is common in AMI patients on admission to hospital and our data provide an understanding regarding which factors might influence thyroid dysfunction in these patients. Furthermore, the negative association between LT3S and increased mortality post-AMI has once again been highlighted by this study. More research is required to assess if treatment of thyroid dysfunction improves clinical outcomes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b4036c66ccae50d83ed88d8a47ad4c1aTest
http://europepmc.org/articles/PMC8124048Test

8

MANAGEMENT OF ENDOCRINE DISEASE Subclinical hypothyroidism in children

المؤلفون: Nicola Improda, Mariacarolina Salerno, Donatella Capalbo

المساهمون: Salerno, Mariacarolina, Improda, Nicola, Capalbo, Donatella

المصدر: European Journal of Endocrinology. 183:R13-R28

مصطلحات موضوعية: Pediatric Obesity, PubMed, medicine.medical_specialty, Pediatrics, Adolescent, Endocrinology, Diabetes and Metabolism, Levothyroxine, Thyrotropin, 030209 endocrinology & metabolism, Reference range, Hashimoto Disease, Bone health, 03 medical and health sciences, Neonatal Screening, 0302 clinical medicine, Endocrinology, Hypothyroidism, Normal linear growth, Thyroid dysfunction, Internal medicine, medicine, Humans, False Positive Reactions, Endocrine Disease, Subclinical Hypothyroidism, Children, Child, Subclinical infection, Endocrine disease, business.industry, Infant, Newborn, Infant, General Medicine, Nutrition Surveys, medicine.disease, Thyroid Diseases, Iodine deficiency, Thyroxine, Child, Preschool, 030220 oncology & carcinogenesis, business, Iodine, medicine.drug

الوصف: Subclinical hypothyroidism (SH) is biochemically defined as serum TSH levels above the upper limit of the reference range in the presence of normal free T4 (FT4) concentrations. While there is a general agreement to treat subjects with serum TSH levels above 10 mU/L, the management of mild form (TSH concentrations between 4.5 and 10 mU/L) is still a matter of debate. In children, mild SH is often a benign and remitting condition and the risk of progression to overt thyroid dysfunction depends on the underlying condition, being higher in the autoimmune forms. The major concern is to establish whether SH in children should always be considered an expression of mild thyroid dysfunction and may deserve treatment. Current data indicate that children with mild SH have normal linear growth, bone health and intellectual outcome. However, slight metabolic abnormalities and subtle deficits in specific cognitive domains have been reported in children with modest elevation of TSH concentration. Although these findings are not sufficient to recommend levothyroxine treatment for all children with mild SH, they indicate the need for regular monitoring to ensure early identification of children who may benefit from treatment. In the meanwhile, the decision to initiate therapy in children with mild SH should be based on individual factors.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::da4c76210b546f76ed40cbedbd793b26Test
https://doi.org/10.1530/eje-20-0051Test

9

Pregnancy and Neonatal Outcomes With Levothyroxine Treatment in Women With Subclinical Hypothyroidism Based on New Diagnostic Criteria: A Systematic Review and Meta-Analysis

المؤلفون: Zheng Ding, Yindi Liu, Spyridoula Maraka, Nadia Abdelouahab, He-Feng Huang, William D. Fraser, Jianxia Fan

المصدر: Frontiers in Endocrinology
Frontiers in Endocrinology, Vol 12 (2021)

الوصف: BackgroundSubclinical hypothyroidism (SCH) during pregnancy has been associated with multiple adverse maternal and neonatal outcomes. However, the potential benefits of levothyroxine (LT4) supplementation remain controversial. Variations across studies in diagnostic criteria for SCH may, in part, explain the divergent findings on the subject. This study aimed to assess the effect of LT4 treatment on pregnancy and neonatal outcomes among pregnant women who were diagnosed as SCH based on the most recent diagnostic criteria.MethodsWe conducted a systematic review and meta-analysis of the literature published from inception to January 2020. The search strategy targeted the studies on pregnancy and neonatal outcomes following LT4 treatment in women with SCH based on 2017 American Thyroid Association diagnostic criteria. Pooled effect sizes were estimated using fixed and random effect models, according to the absence or presence of heterogeneity which was assessed using the I-squared statistic. Sources of heterogeneity and the stability of results were evaluated through sensitivity analysis.ResultsOf the 2781 identified references, 306 full-text articles were screened for eligibility. Finally, 6 studies including a total of 7955 participants were retained for analysis. Summary effect estimates indicated that pregnant women with SCH treated with LT4 had a lower risk of pregnancy loss [odds ratio (OR) = 0.55, 95% confidence interval (CI): 0.43-0.71], preterm birth (OR=0.63, 95% CI: 0.41-0.98) and gestational hypertension (OR = 0.78, 95% CI: 0.63-0.97) than those in control group.ConclusionLT4 treatment in pregnant women with SCH may reduce the risk of pregnancy loss, preterm delivery and gestational hypertension.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b2b4cd7a999a5b007b7b5e9cee9027e3Test
http://europepmc.org/articles/PMC8703220Test

10

Subclinical hypothyroidism in childhood, treatment or only follow-up?

المؤلفون: Murillo-Vallés, Marta, Martinez, Santiago, Aguilar-Riera, Cristina, Garcia-Martin, Miguel Angel, Bel, Joan, Granada, Maria Luisa, Universitat Autònoma de Barcelona

المصدر: BMC Pediatrics, Vol 20, Iss 1, Pp 1-6 (2020)
Dipòsit Digital de Documents de la UAB
Universitat Autònoma de Barcelona
BMC Pediatrics
Recercat. Dipósit de la Recerca de Catalunya
instname
Recercat: Dipósit de la Recerca de Catalunya
Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)

مصطلحات موضوعية: medicine.medical_specialty, endocrine system, Adolescent, endocrine system diseases, Thyrotropin, 030209 endocrinology & metabolism, Thyroid Function Tests, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Hypothyroidism, Subclinical hypothyroidism, Internal medicine, medicine, Humans, In patient, Child, Subclinical infection, Retrospective Studies, business.industry, Clinical course, lcsh:RJ1-570, Female sex, Cut-off, lcsh:Pediatrics, Thyroxine, 030220 oncology & carcinogenesis, Child, Preschool, Pediatrics, Perinatology and Child Health, Thyroid autoimmunity, Screening, Female, business, hormones, hormone substitutes, and hormone antagonists, Hormone, Follow-Up Studies, Research Article

الوصف: Background Subclinical hypothyroidism (SH) is defined as serum levels of thyroid-stimulating hormone (TSH) above the upper limit with normal concentrations of free T4 (fT4). Its management remains challenging. The aim of the study was to evaluate clinical and laboratory findings as well as the clinical course of children with SH followed in a third level hospital. Sixty-five patients aged between 2 and 18 years old were retrospectively studied. Methods The patients were followed for a median period of 9 months (range 6 months to 24 months). Those who normalized TSH levels were discharged (Group 1). If TSH persisted mildly elevated (5-10μUI/mL) with normal fT4 and negative TPOAb/TgAb, they were classified as Group 2 and followed semi-annually without treatment. Those patients whose TSH raised ≥10μUI/mL or who maintained TSH 5-10μUI/mL and positive TPOAb/TgAb were considered suitable for thyroxin therapy (Group 3, G3). Results In 89% of our patients, TSH concentrations spontaneously reverted to normality or remained stable without treatment (Groups 1 and 2), whereas less than 11% progressed to clinical hypothyroidism (Group 3). Baseline TSH was significantly lower in group 1 than in group 3. In group 3 the prevalence of female sex (71%) was higher and TPO antibodies were present in 85% of patients. The risk of developing overt hypothyroidism in patients with positive anti-thyroid antibodies respect to those who normalized TSH was 45 (95%CI 6.5–312.5). Conclusion Baseline TSH, female sex and the presence of thyroid autoimmunity were the best predictors of the evolution to SH over time.

وصف الملف: application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a56047165c8e2e51460fb7bbf0019675Test
http://link.springer.com/article/10.1186/s12887-020-02177-8Test

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