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Thyroid
Exploring the Association between Thyroid Function and Frailty: Insights from Representative Korean Data
Youn-Ju Lee, Min-Hee Kim, Dong-Jun Lim, Jung-Min Lee, Sang Ah Chang, Jeongmin Lee
Endocrinol Metab. 2023;38(6):729-738.   Published online November 2, 2023
DOI: https://doi.org/10.3803/EnM.2023.1769
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  • 73 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
This study investigates the association between thyroid function and frailty in the old patients using representative data.
Methods
The study was conducted using data from the Korea National Health and Nutrition Examination Survey conducted from 2013 to 2015. The study population included 2,416 participants aged 50 years and older with available thyroid function test data. Frailty assessment was performed using the Fried frailty phenotype. The prevalence of frailty was analyzed across different thyroid diseases and thyroid function parameters.
Results
The significant association between thyroid dysfunction and frailty was observed in overt hyperthyroidism and subclinical hyperthyroidism. After adjusting for various factors, the association between thyroid dysfunction and frailty remained significant. On the other hand, overt hypothyroidism did not show a significant association with frailty in the adjusted analysis. For individuals with overt hyperthyroidism and subclinical hyperthyroidism, higher levels of free thyroxine (FT4) were significantly associated with an increased risk of frailty (aOR >999; 95% CI, >999 to 999). Among individuals with overt hypothyroidism, lower level of FT4 levels and high thyrotropin (TSH) levels showed a significant association with frailty risk (FT4: aOR, <0.01; TSH: aOR, 999). In participants with subclinical hypothyroidism, there were no significant associations between parameters for thyroid and frailty risk.
Conclusion
These findings suggest that thyroid dysfunction, particularly overt hyperthyroidism and subclinical hyperthyroidism, may be associated with an increased risk of frailty in the old patients.

Citations

Citations to this article as recorded by  
  • Associations of thyroid feedback quantile-based index with diabetes in euthyroid adults in the United States and China
    Heng Wan, Genfeng Yu, Yajun He, Siyang Liu, Xingying Chen, Yuqi Jiang, Hualin Duan, Xu Lin, Lan Liu, Jie Shen
    Annals of Medicine.2024;[Epub]     CrossRef
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Thyroid
Association between Iodine Intake, Thyroid Function, and Papillary Thyroid Cancer: A Case-Control Study
Kyungsik Kim, Sun Wook Cho, Young Joo Park, Kyu Eun Lee, Dong-Wook Lee, Sue K. Park
Endocrinol Metab. 2021;36(4):790-799.   Published online August 11, 2021
DOI: https://doi.org/10.3803/EnM.2021.1034
  • 4,793 View
  • 237 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to assess the effects of iodine intake, thyroid function, and their combined effect on the risk of papillary thyroid cancer (PTC) and papillary thyroid microcarcinoma (PTMC).
Methods
A case-control study was conducted including 500 community-based controls who had undergone a health check-up, and 446 overall PTC cases (209 PTC and 237 PTMC) from the Thyroid Cancer Longitudinal Study. Urinary iodine concentration (UIC), was used as an indicator of iodine intake, and serum for thyroid function. The risk of PTC and PTMC was estimated using unconditional logistic regression.
Results
Excessive iodine intake (UIC ≥220 μg/gCr) was associated with both PTC (odds ratio [OR], 18.13 95% confidence interval [CI], 8.87 to 37.04) and PTMC (OR, 8.02; 95% CI, 4.64 to 13.87), compared to adequate iodine intake (UIC, 85 to 219 μg/gCr). Free thyroxine (T4) levels ≥1.25 ng/dL were associated with PTC (OR, 1.97; 95% CI, 1.36 to 2.87) and PTMC (OR, 2.98; 95% CI, 2.01 to 4.41), compared to free T4 levels of 0.7 to 1.24 ng/dL. Individuals with excessive iodine intake and high free T4 levels had a greatly increased OR of PTC (OR, 43.48; 95% CI, 12.63 to 149.62), and PTMC (OR, 26.96; 95% CI, 10.26 to 70.89), compared to individuals with adequate iodine intake and low free T4 levels.
Conclusion
Excessive iodine intake using creatinine-adjusted UIC and high free T4 levels may have a synergistic effect on PTC and PTMC. Considering both iodine intake and thyroid function is important to assess PTC and PTMC risk.

Citations

Citations to this article as recorded by  
  • Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study
    Yerin Hwang, Hyun-Kyung Oh, Jae Hoon Chung, Sun Wook Kim, Jung-Han Kim, Jee Soo Kim, Myung-Hee Shin
    Scientific Reports.2023;[Epub]     CrossRef
  • Association between iodine nutrition and cervical lymph node metastasis of papillary thyroid microcarcinoma
    Hengqiang Zhao, Jin Hu, Le Cui, Yiping Gong, Tao Huang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Sex-specific Associations between Body Mass Index and Thyroid Cancer Incidence among Korean Adults
    Kyoung-Nam Kim, Kyungsik Kim, Sangjun Lee, Sue K. Park
    Cancer Epidemiology, Biomarkers & Prevention.2023; 32(9): 1227.     CrossRef
  • Nomogram Model Based on Iodine Nutrition and Clinical Characteristics of Papillary Thyroid Carcinoma to Predict Lateral Lymph Node Metastasis
    Junrong Wang, Yuzhang Gao, Yuxuan Zong, Weitong Gao, Xueying Wang, Ji Sun, Susheng Miao
    Cancer Control.2023;[Epub]     CrossRef
  • Content of Copper, Iron, Iodine, Rubidium, Strontium and Zinc in Thyroid Malignant Nodules and Thyroid Tissue adjacent to Nodules
    Vladimir Zaichick, Qiping Dong
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 7.     CrossRef
  • Distinguish Thyroid Malignant from Benign Alterations using Trace Element Contents in Nodular Tissue determined by Neutron Activation and Inductively Coupled Plasma Mass Spectrometry
    Vladimir Zaichick
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 18.     CrossRef
  • Seaweed and Iodine Intakes and SLC5A5 rs77277498 in Relation to Thyroid Cancer
    Tung Hoang, Eun Kyung Lee, Jeonghee Lee, Yul Hwangbo, Jeongseon Kim
    Endocrinology and Metabolism.2022; 37(3): 513.     CrossRef
  • Iodine nutrition and papillary thyroid cancer
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Chuyao Feng, Weiping Teng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • The relationship between urinary iodine concentration and papillary thyroid cancer: A systematic review and meta-analysis
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Renaguli Aihaiti, Chuyao Feng, Deshi Chen, Xu Zhao, Weiping Teng
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Screening and validation of lymph node metastasis risk-factor genes in papillary thyroid carcinoma
    Qiaoyue Zhang, Jing Li, Hengyan Shen, Xinyu Bai, Tao Zhang, Ping Liu
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Diagnosis of Thyroid Malignancy using Levels of Chemical Element Contents in Nodular Tissue
    Vladimir Zaichick
    Journal of Health Care and Research.2022; 3(1): 16.     CrossRef
  • Associations of Habitual Mineral Intake with New-Onset Prediabetes/Diabetes after Acute Pancreatitis
    Claire F. Norbitt, Wandia Kimita, Juyeon Ko, Sakina H. Bharmal, Maxim S. Petrov
    Nutrients.2021; 13(11): 3978.     CrossRef
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Thyroid
Insights from a Prospective Follow-up of Thyroid Function and Autoimmunity among COVID-19 Survivors
David Tak Wai Lui, Chi Ho Lee, Wing Sun Chow, Alan Chun Hong Lee, Anthony Raymond Tam, Carol Ho Yi Fong, Chun Yiu Law, Eunice Ka Hong Leung, Kelvin Kai Wang To, Kathryn Choon Beng Tan, Yu Cho Woo, Ching Wan Lam, Ivan Fan Ngai Hung, Karen Siu Ling Lam
Endocrinol Metab. 2021;36(3):582-589.   Published online June 8, 2021
DOI: https://doi.org/10.3803/EnM.2021.983
  • 10,972 View
  • 267 Download
  • 32 Web of Science
  • 34 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The occurrence of Graves’ disease and Hashimoto thyroiditis after coronavirus disease 2019 (COVID-19) raised concerns that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger thyroid autoimmunity. We aimed to address the current uncertainties regarding incident thyroid dysfunction and autoimmunity among COVID-19 survivors.
Methods
We included consecutive adult COVID-19 patients without known thyroid disorders, who were admitted to Queen Mary Hospital from July 21 to September 21, 2020 and had serum levels of thyroid-stimulating hormone, free thyroxine, free triiodothyronine (fT3), and anti-thyroid antibodies measured both on admission and at 3 months.
Results
In total, 122 patients were included. Among 20 patients with abnormal thyroid function tests (TFTs) on admission (mostly low fT3), 15 recovered. Among 102 patients with initial normal TFTs, two had new-onset abnormalities that could represent different phases of thyroiditis. Among 104 patients whose anti-thyroid antibody titers were reassessed, we observed increases in anti-thyroid peroxidase (TPO) (P<0.001) and anti-thyroglobulin (P<0.001), but not anti-thyroid stimulating hormone receptor titers (P=0.486). Of 82 patients with negative anti-TPO findings at baseline, 16 had a significant interval increase in anti-TPO titer by >12 U, and four became anti-TPO-positive. Worse baseline clinical severity (P=0.018), elevated C-reactive protein during hospitalization (P=0.033), and higher baseline anti-TPO titer (P=0.005) were associated with a significant increase in anti-TPO titer.
Conclusion
Most patients with thyroid dysfunction on admission recovered during convalescence. Abnormal TFTs suggestive of thyroiditis occurred during convalescence, but infrequently. Importantly, our novel observation of an increase in anti-thyroid antibody titers post-COVID-19 warrants further follow-up for incident thyroid dysfunction among COVID-19 survivors.

Citations

Citations to this article as recorded by  
  • The prevalence of thyroid disorders in COVID-19 patients: a systematic review and meta-analysis
    Sadra Ashrafi, Hossein Hatami, Razieh Bidhendi-Yarandi, Mohammad Hossein Panahi
    BMC Endocrine Disorders.2024;[Epub]     CrossRef
  • Does COVID-19 affect thyroid more than non-COVID-19 infections? A retrospective study
    Yasemin Ucal, Muhittin Serdar, Hande Karpuzoğlu, Neval Yurttutan Uyar, Meltem Kilercik, Mustafa Serteser, Aysel Ozpinar
    Turkish Journal of Biochemistry.2024;[Epub]     CrossRef
  • Thyroiditis and COVID-19: focus on pediatric age. A narrative review
    F. d’Aniello, M. E. Amodeo, A. Grossi, G. Ubertini
    Journal of Endocrinological Investigation.2024;[Epub]     CrossRef
  • The most common persistent symptoms in patients with COVID-19 who were evaluated in the Internal Medicine polyclinic
    Zeynep KOÇ, Seydahmet AKIN
    The European Research Journal.2023; 9(1): 97.     CrossRef
  • Clinical assessment of children with long COVID syndrome
    Réka Garai, Péter Krivácsy, Vivien Herczeg, Fanni Kovács, Bálint Tél, Judit Kelemen, Anna Máthé, Eszter Zsáry, Johanna Takács, Dániel Sándor Veres, Attila J. Szabó
    Pediatric Research.2023; 93(6): 1616.     CrossRef
  • T Cell Receptor Sequences Amplified during Severe COVID-19 and Multisystem Inflammatory Syndrome in Children Mimic SARS-CoV-2, Its Bacterial Co-Infections and Host Autoantigens
    Robert Root-Bernstein, Elizabeth Churchill, Shelby Oliverio
    International Journal of Molecular Sciences.2023; 24(2): 1335.     CrossRef
  • A Literature Review on SARS-CoV-2 and Other Viruses in Thyroid Disorders: Environmental Triggers or No-Guilty Bystanders?
    Francesca Gorini, Cristina Vassalle
    International Journal of Environmental Research and Public Health.2023; 20(3): 2389.     CrossRef
  • Thyroid dysfunction as a long-term post-COVID-19 complication in mild-to-moderate COVID-19
    Vesselina Yanachkova, Teodora Stankova, Radiana Staynova
    Biotechnology & Biotechnological Equipment.2023; 37(1): 194.     CrossRef
  • The Influence of SARS-CoV-2 Infection on the Thyroid Gland
    Aleksandra Piekarska, Marta Góral, Marta Kozula, Aleksandra Jawiarczyk-Przybyłowska, Katarzyna Zawadzka, Marek Bolanowski
    Biomedicines.2023; 11(2): 614.     CrossRef
  • Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study
    Deepika Patel, Dukhabandhu Naik, Sadishkumar Kamalanathan, Kadhiravan Tamilarasu, Jayaprakash Sahoo, Ayan Roy, Chandhana Merugu, Varun Suryadevara
    Hormone and Metabolic Research.2023; 55(03): 169.     CrossRef
  • The Spectrum of Thyroid Function Tests and Autoantibodies During Hospitalization and After Six Months of Discharge in COVID-19 Patients: Does COVID-19 Trigger Autoimmunity?
    Ziynet Alphan Uc, Pinar Yagcı, Zelal Adibelli, Cevdet Duran
    Endocrine Research.2023; 48(2-3): 44.     CrossRef
  • Increased prevalence of autoimmune thyroid disease after COVID-19: A single-center, prospective study
    Alessandro Rossini, Sara Cassibba, Francesca Perticone, Simone Vasilij Benatti, Serena Venturelli, Greta Carioli, Arianna Ghirardi, Marco Rizzi, Tiziano Barbui, Roberto Trevisan, Silvia Ippolito
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • A prospective follow-up of thyroid volume and thyroiditis features on ultrasonography among survivors of predominantly mild to moderate COVID-19
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    Endocrinology and Metabolism.2023; 38(4): 455.     CrossRef
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    Journal of Medical Virology.2022; 94(1): 54.     CrossRef
  • The Independent Association of TSH and Free Triiodothyronine Levels With Lymphocyte Counts Among COVID-19 Patients
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  • Thyrotropin Levels in Patients with Coronavirus Disease 2019: Assessment during Hospitalization and in the Medium Term after Discharge
    Abdallah Al-Salameh, Noémie Scherman, Imane Adda, Juliette André, Yoann Zerbib, Julien Maizel, Jean-Daniel Lalau, Etienne Brochot, Claire Andrejak, Rachel Desailloud
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  • Higher SARS-CoV-2 viral loads correlated with smaller thyroid volumes on ultrasound among male COVID-19 survivors
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  • POST-COVID ENDOCRINOPATHY :ABOUT A CASE ENDOCRINOPATHIE POST- COVID :À PROPOS D’UN CAS
    S. Rafi, G. Elmghari, N, Elansari
    INDIAN JOURNAL OF APPLIED RESEARCH.2021; : 13.     CrossRef
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Clinical Study
Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study
Mijin Kim, Bo Hyun Kim, Hyungi Lee, Min Hee Jang, Jeong Mi Kim, Eun Heui Kim, Yun Kyung Jeon, Sang Soo Kim, In Joo Kim
Endocrinol Metab. 2020;35(1):106-114.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.106
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  • 121 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background

Studies on the relationship between thyroid function and anemia in the euthyroid range are scarce. We aimed to evaluate the association between anemia and serum free thyroxine (fT4) and thyrotropin (TSH) in euthyroid adults.

Methods

Data on 5,352 participants aged ≥19 years were obtained from the Korea National Health and Nutrition Examination Survey VI (2013 to 2015). Anemia was defined as hemoglobin (Hb) <13 and <12 g/dL for men and women, respectively.

Results

Overall, 6.1% of participants had anemia, and more women (9.9%) had anemia than men (2.8%, P<0.001). In multivariate analysis, serum fT4 levels, but not TSH, were positively associated with serum Hb levels in both sexes (P<0.001, each). Serum Hb levels linearly reduced across decreasing serum fT4 quartile groups in both sexes (P<0.001, each). After adjusting for potential confounding factors, participants with low-normal fT4 had 4.4 (P=0.003) and 2.8 times (P<0.001) higher risk for anemia than those with high-normal fT4 among men and women, respectively. When participants were divided into two groups at 50 years of age, in younger participants, men and women with the first quartile were at higher risk of anemia than men with the second quartile (odds ratio [OR], 3.3; P=0.029) and women with the forth quartile (OR, 3.2; P<0.001), respectively. This association was not observed in older participants.

Conclusion

These results suggest that a low-normal level of serum fT4 was associated with a lower serum Hb level and a higher risk of anemia in euthyroid adults, especially in younger participants.

Citations

Citations to this article as recorded by  
  • Thyroid Function and Risk of Anemia: A Multivariable-Adjusted and Mendelian Randomization Analysis in the UK Biobank
    Nicolien A van Vliet, Annelies E P Kamphuis, Wendy P J den Elzen, Gerard J Blauw, Jacobijn Gussekloo, Raymond Noordam, Diana van Heemst
    The Journal of Clinical Endocrinology & Metabolism.2022; 107(2): e643.     CrossRef
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    Alisa D Kjaergaard, Alexander Teumer, Eirini Marouli, Panos Deloukas, Aleksander Kuś, Rosalie Sterenborg, Bjørn O Åsvold, Marco Medici, Christina Ellervik
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    Zheng Feei Ma
    Endocrinology and Metabolism.2020; 35(2): 484.     CrossRef
  • Association between Serum Free Thyroxine and Anemia in Euthyroid Adults: A Nationwide Study (Endocrinol Metab 2020;35:106-14, Mijin Kim et al.)
    Mijin Kim, Bo Hyun Kim
    Endocrinology and Metabolism.2020; 35(3): 669.     CrossRef
Close layer
Review Article
Thyroid
Genome-Wide Association Studies of Autoimmune Thyroid Diseases, Thyroid Function, and Thyroid Cancer
Yul Hwangbo, Young Joo Park
Endocrinol Metab. 2018;33(2):175-184.   Published online June 21, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.2.175
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  • 59 Web of Science
  • 58 Crossref
AbstractAbstract PDFPubReader   ePub   

Thyroid diseases, including autoimmune thyroid diseases and thyroid cancer, are known to have high heritability. Family and twin studies have indicated that genetics plays a major role in the development of thyroid diseases. Thyroid function, represented by thyroid stimulating hormone (TSH) and free thyroxine (T4), is also known to be partly genetically determined. Before the era of genome-wide association studies (GWAS), the ability to identify genes responsible for susceptibility to thyroid disease was limited. Over the past decade, GWAS have been used to identify genes involved in many complex diseases, including various phenotypes of the thyroid gland. In GWAS of autoimmune thyroid diseases, many susceptibility loci associated with autoimmunity (human leukocyte antigen [HLA], protein tyrosine phosphatase, non-receptor type 22 [PTPN22], cytotoxic T-lymphocyte associated protein 4 [CTLA4], and interleukin 2 receptor subunit alpha [IL2RA]) or thyroid-specific genes (thyroid stimulating hormone receptor [TSHR] and forkhead box E1 [FOXE1]) have been identified. Regarding thyroid function, many susceptibility loci for levels of TSH and free T4 have been identified through genome-wide analyses. In GWAS of differentiated thyroid cancer, associations at FOXE1, MAP3K12 binding inhibitory protein 1 (MBIP)-NK2 homeobox 1 (NKX2-1), disrupted in renal carcinoma 3 (DIRC3), neuregulin 1 (NRG1), and pecanex-like 2 (PCNXL2) have been commonly identified in people of European and Korean ancestry, and many other susceptibility loci have been found in specific populations. Through GWAS of various thyroid-related phenotypes, many susceptibility loci have been found, providing insights into the pathogenesis of thyroid diseases and disease co-clustering within families and individuals.

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    Piet C. de Groen
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