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Thyroid
Big Data Articles (National Health Insurance Service Database)
Risk of Subsequent Primary Cancers in Thyroid Cancer Survivors according to the Dose of Levothyroxine: A Nationwide Cohort Study
Min-Su Kim, Jang Won Lee, Min Kyung Hyun, Young Shin Song
Endocrinol Metab. 2024;39(2):288-299.   Published online March 4, 2024
DOI: https://doi.org/10.3803/EnM.2023.1815
  • 2,399 View
  • 97 Download
  • 1 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Current research has not investigated the effect of thyroid-stimulating hormone suppression therapy with levothyroxine on the risk for developing subsequent primary cancers (SPCs). This study aimed to investigate the association between levothyroxine dosage and the risk for SPCs in thyroid cancer patients.
Methods
We conducted a nationwide population-based retrospective cohort study form Korean National Health Insurance database. This cohort included 342,920 thyroid cancer patients between 2004 and 2018. Patients were divided into the non-levothyroxine and the levothyroxine groups, the latter consisting of four dosage subgroups according to quartiles. Cox proportional hazard models were performed to evaluate the risk for SPCs by adjusting for variables including cumulative doses of radioactive iodine (RAI) therapy.
Results
A total of 17,410 SPC cases were observed over a median 7.3 years of follow-up. The high-dose levothyroxine subgroups (Q3 and Q4) had a higher risk for SPC (adjusted hazard ratio [HR], 1.14 and 1.27; 95% confidence interval [CI], 1.05–1.24 and 1.17– 1.37; respectively) compared to the non-levothyroxine group. In particular, the adjusted HR of stomach (1.31), colorectal (1.60), liver and biliary tract (1.95), and pancreatic (2.48) cancers were increased in the Q4 subgroup. We consistently observed a positive association between high levothyroxine dosage per body weight and risk of SPCs, even after adjusting for various confounding variables. Moreover, similar results were identified in the stratified analyses according to thyroidectomy type and RAI therapy, as well as in a subgroup analysis of patients with good adherence.
Conclusion
High-dose levothyroxine use was associated with increased risk of SPCs among thyroid cancer patients regardless of RAI therapy.

Citations

Citations to this article as recorded by  
  • The Levothyroxine Odyssey: Navigating the Path of Survivorship in Thyroid Cancer
    Jin Hwa Kim
    Endocrinology and Metabolism.2024; 39(2): 283.     CrossRef
  • Levothyroxine Dosage and the Increased Risk of Second Primary Malignancy in Thyroid Cancer Survivors
    Young Joo Park
    Clinical Thyroidology®.2024; 36(7): 258.     CrossRef
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Thyroid
Thyroid Hormone Reference Intervals among Healthy Individuals In Lanzhou, China
Yan Lu, Wen-Xia Zhang, De-Hong Li, Lian-Hua Wei, Yu-Jun Zhang, Fu-Na Shi, Shen Zhou
Endocrinol Metab. 2023;38(3):347-356.   Published online June 14, 2023
DOI: https://doi.org/10.3803/EnM.2023.1638
  • 2,490 View
  • 136 Download
  • 1 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
The common reference intervals (RIs) for thyroid hormones currently used in China are provided by equipment manufacturers. This study aimed to establish thyroid hormone RIs in the population of Lanzhou, a city in the subplateau region of northwest China, and compare them with previous reports and manufacturer-provided values.
Methods
In total, 3,123 individuals (1,680 men, 1,443 women) from Lanzhou, an iodine-adequate area of China, perceived as healthy were selected. The Abbott Architect analyzer was used to determine the serum concentration of thyroid hormones. The 95% RI was estimated using the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively.
Results
The serum levels of thyroid-stimulating hormone (TSH), total triiodothyronine (TT3), antithyroglobulin (ATG) antibody, and antithyroid peroxidase (ATPO) antibody levels were significantly correlated with sex (P<0.05). TSH, total thyroxine (TT4), and ATPO levels were significantly correlated with age (P<0.05). The serum levels of TSH, ATG, and ATPO in men were significantly lower than in women; in contrast, the serum TT3 level was significantly higher in men than in women (P<0.05). Serum TSH, TT3, TT4, and ATG levels differed across age groups (P<0.05), but no such variation was observed for ATG levels (P>0.05). The established RIs of TSH, ATG, and ATPO in this study differed between sexes (P<0.05). The thyroid hormone RIs established herein were inconsistent with the manufacturer-provided values.
Conclusion
The RIs of thyroid hormones in the healthy population of Lanzhou were inconsistent with those in the manufacturer’s manual. Validated sex-specific values are required for diagnosing thyroid diseases.

Citations

Citations to this article as recorded by  
  • Burden of non-alcoholic fatty liver disease in subclinical hypothyroidism
    Mahmood Dhahir Al-Mendalawi
    Journal of Clinical and Scientific Research.2024; 13(1): 68.     CrossRef
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Review Articles
Thyroid
Evaluation and Management of Bone Health in Patients with Thyroid Diseases: A Position Statement of the Korean Thyroid Association
A Ram Hong, Ho-Cheol Kang
Endocrinol Metab. 2023;38(2):175-189.   Published online April 27, 2023
DOI: https://doi.org/10.3803/EnM.2023.1701
  • 4,854 View
  • 275 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDFPubReader   ePub   
Thyroid hormones play an important physiological role in maintaining adult bone structure and strength. Consequently, thyroid dysfunction is related to skeletal outcomes. Overt hyperthyroidism is an established cause of high bone turnover with accelerated bone loss, leading to osteoporosis and increased fracture risk. Hyperthyroidism induced by thyroid-stimulating hormone-suppressive therapy in patients with differentiated thyroid cancer is a cause of secondary osteoporosis. In contrast, there is a lack of evidence on the negative impact of hypothyroidism on bone health. Considering the clinical updates on the importance of bone health in thyroid dysfunction, the Task Force from the Clinical Practice Guidelines Development Committee of the Korean Thyroid Association recently developed a position statement on the evaluation and management of bone health of patients with thyroid diseases, particularly focused on endogenous hyperthyroidism and thyroid-stimulating hormone-suppressive therapy-associated hyperthyroidism in patients with differentiated thyroid cancer. Herein, we review the Korean Thyroid Association’s position statement on the evaluation and management of bone health associated with thyroid diseases.

Citations

Citations to this article as recorded by  
  • Diagnosis and therapeutic approach to bone health in patients with hypopituitarism
    Justyna Kuliczkowska-Płaksej, Aleksandra Zdrojowy-Wełna, Aleksandra Jawiarczyk-Przybyłowska, Łukasz Gojny, Marek Bolanowski
    Reviews in Endocrine and Metabolic Disorders.2024; 25(3): 513.     CrossRef
  • Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights
    Shunichi Yokota, Hotaka Ishizu, Takuji Miyazaki, Daisuke Takahashi, Norimasa Iwasaki, Tomohiro Shimizu
    Biomedicines.2024; 12(4): 843.     CrossRef
  • Acute hypercalcemic crisis: A narrative review with a focus on pregnancy
    Nadia Sabbah
    Annales d'Endocrinologie.2024;[Epub]     CrossRef
  • Review on the protective activity of osthole against the pathogenesis of osteoporosis
    Jincai Chen, Xiaofei Liao, Juwen Gan
    Frontiers in Pharmacology.2023;[Epub]     CrossRef
  • Estudio comparativo tras la cirugía tiroidea y otras variables asociadas al desarrollo de osteoporosis en una cohorte latinoamericana
    María Paula Ciliberti Artavia, Juan Sebastián Theran León, Jaime Alberto Gómez Ayala, Valentina Cabrera Peña, Rafael Guillermo Parales Strauch, Edgar Camilo Blanco Pimiento, Luis Andres Dulcey Sarmiento, Juan Camilo Martínez, Juan Camilo Mayorca, María Al
    Revista Salud y Desarrollo.2023; 7(2): e605.     CrossRef
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Thyroid
Thyroid Function across the Lifespan: Do Age-Related Changes Matter?
John P. Walsh
Endocrinol Metab. 2022;37(2):208-219.   Published online April 14, 2022
DOI: https://doi.org/10.3803/EnM.2022.1463
  • 7,039 View
  • 373 Download
  • 14 Web of Science
  • 16 Crossref
AbstractAbstract PDFPubReader   ePub   
Circulating concentrations of thyrotropin (TSH) and thyroxine (T4) are tightly regulated. Each individual has setpoints for TSH and free T4 which are genetically determined, and subject to environmental and epigenetic influence. Pituitary-thyroid axis setpoints are probably established in utero, with maturation of thyroid function continuing until late gestation. From neonatal life (characterized by a surge of TSH and T4 secretion) through childhood and adolescence (when free triiodothyronine levels are higher than in adults), thyroid function tests display complex, dynamic patterns which are sexually dimorphic. In later life, TSH increases with age in healthy older adults without an accompanying fall in free T4, indicating alteration in TSH setpoint. In view of this, and evidence that mild subclinical hypothyroidism in older people has no health impact, a strong case can be made for implementation of age-related TSH reference ranges in adults, as is routine in children.

Citations

Citations to this article as recorded by  
  • The ageing thyroid: implications for longevity and patient care
    Diana van Heemst
    Nature Reviews Endocrinology.2024; 20(1): 5.     CrossRef
  • Incidence and Determinants of Spontaneous Normalization of Subclinical Hypothyroidism in Older Adults
    Evie van der Spoel, Nicolien A van Vliet, Rosalinde K E Poortvliet, Robert S Du Puy, Wendy P J den Elzen, Terence J Quinn, David J Stott, Naveed Sattar, Patricia M Kearney, Manuel R Blum, Heba Alwan, Nicolas Rodondi, Tinh-Hai Collet, Rudi G J Westendorp,
    The Journal of Clinical Endocrinology & Metabolism.2024; 109(3): e1167.     CrossRef
  • Multi-trait analysis characterizes the genetics of thyroid function and identifies causal associations with clinical implications
    Rosalie B. T. M. Sterenborg, Inga Steinbrenner, Yong Li, Melissa N. Bujnis, Tatsuhiko Naito, Eirini Marouli, Tessel E. Galesloot, Oladapo Babajide, Laura Andreasen, Arne Astrup, Bjørn Olav Åsvold, Stefania Bandinelli, Marian Beekman, John P. Beilby, Jette
    Nature Communications.2024;[Epub]     CrossRef
  • Evaluation of multiple organophosphate insecticide exposure in relation to altered thyroid hormones in NHANES 2007‐2008 adult population
    Massira Ousseni Diawara, Songtao Li, Mingzhi Zhang, Francis Manyori Bigambo, Xu Yang, Xu Wang, Tianyu Dong, Di Wu, Chenghao Yan, Yankai Xia
    Ecotoxicology and Environmental Safety.2024; 273: 116139.     CrossRef
  • Thyroid-function reference ranges in the diagnosis of thyroid dysfunction in adults
    Salman Razvi
    Nature Reviews Endocrinology.2024; 20(5): 253.     CrossRef
  • Association between exposure to chemical mixtures and epigenetic ageing biomarkers: Modifying effects of thyroid hormones and physical activity
    Wanying Shi, Jianlong Fang, Huimin Ren, Peijie Sun, Juan Liu, Fuchang Deng, Shuyi Zhang, Qiong Wang, Jiaonan Wang, Shilu Tong, Song Tang, Xiaoming Shi
    Journal of Hazardous Materials.2024; 469: 134009.     CrossRef
  • Biochemical pattern and prevalence of thyroid disorders among adults in a tertiary hospital in North-East Nigeria
    Bawa Ibrahim Abubkar, Longwap Abdulazis Saleh, Dauda E. Suleiman, Sanni Musa, Bosede Oluwasayo Adegoke, Ibrahim Naziru, Abbas Hamisu, Harisu Salisu, Rabi’atu Ahmad Bichi, Mansur Ramalan Aliyu, Christian Isichei
    Annals of African Medical Research.2024;[Epub]     CrossRef
  • DNA Methylation in Autoimmune Thyroid Disease
    Nicole Lafontaine, Scott G Wilson, John P Walsh
    The Journal of Clinical Endocrinology & Metabolism.2023; 108(3): 604.     CrossRef
  • A Causality between Thyroid Function and Bone Mineral Density in Childhood: Abnormal Thyrotropin May Be Another Pediatric Predictor of Bone Fragility
    Dongjin Lee, Moon Ahn
    Metabolites.2023; 13(3): 372.     CrossRef
  • Serum Lipidomic Analysis Reveals Biomarkers and Metabolic Pathways of Thyroid Dysfunction
    Hua Dong, Wenjie Zhou, Xingxu Yan, Huan Zhao, Honggang Zhao, Yan Jiao, Guijiang Sun, Yubo Li, Zuncheng Zhang
    ACS Omega.2023; 8(11): 10355.     CrossRef
  • Developmental and environmental modulation of fecal thyroid hormone levels in wild Assamese macaques (Macaca assamensis)
    Verena Behringer, Michael Heistermann, Suchinda Malaivijitnond, Oliver Schülke, Julia Ostner
    American Journal of Primatology.2023;[Epub]     CrossRef
  • Prevalence of Functional Alterations and the Effects of Thyroid Autoimmunity on the Levels of TSH in an Urban Population of Colombia: A Population-Based Study
    Hernando Vargas-Uricoechea, Valentina Agredo-Delgado, Hernando David Vargas-Sierra, María V. Pinzón-Fernández
    Endocrine, Metabolic & Immune Disorders - Drug Targets.2023; 23(6): 857.     CrossRef
  • Genetic determinants of thyroid function in children
    Tessa A Mulder, Purdey J Campbell, Peter N Taylor, Robin P Peeters, Scott G Wilson, Marco Medici, Colin Dayan, Vincent V W Jaddoe, John P Walsh, Nicholas G Martin, Henning Tiemeier, Tim I M Korevaar
    European Journal of Endocrinology.2023; 189(2): 164.     CrossRef
  • Relationship between Thyroid CT Density, Volume, and Future TSH Elevation: A 5-Year Follow-Up Study
    Tomohiro Kikuchi, Shouhei Hanaoka, Takahiro Nakao, Yukihiro Nomura, Takeharu Yoshikawa, Md Ashraful Alam, Harushi Mori, Naoto Hayashi
    Life.2023; 13(12): 2303.     CrossRef
  • Thyroid Stimulating Hormone and Thyroid Hormones (Triiodothyronine and Thyroxine): An American Thyroid Association-Commissioned Review of Current Clinical and Laboratory Status
    Katleen Van Uytfanghe, Joel Ehrenkranz, David Halsall, Kelly Hoff, Tze Ping Loh, Carole A. Spencer, Josef Köhrle
    Thyroid®.2023; 33(9): 1013.     CrossRef
  • Blood hormones and suicidal behaviour: A systematic review and meta-analysis
    Xue-Lei Fu, Xia Li, Jia-Mei Ji, Hua Wu, Hong-Lin Chen
    Neuroscience & Biobehavioral Reviews.2022; 139: 104725.     CrossRef
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Diabetes, Obesity and Metabolism
Effects of Intermittent Fasting on the Circulating Levels and Circadian Rhythms of Hormones
Bo Hye Kim, Yena Joo, Min-Seon Kim, Han Kyoung Choe, Qingchun Tong, Obin Kwon
Endocrinol Metab. 2021;36(4):745-756.   Published online August 27, 2021
DOI: https://doi.org/10.3803/EnM.2021.405
  • 29,505 View
  • 1,082 Download
  • 36 Web of Science
  • 35 Crossref
AbstractAbstract PDFPubReader   ePub   
Intermittent fasting has become an increasingly popular strategy in losing weight and associated reduction in obesity-related medical complications. Overwhelming studies support metabolic improvements from intermittent fasting in blood glucose levels, cardiac and brain function, and other health benefits, in addition to weight loss. However, concerns have also been raised on side effects including muscle loss, ketosis, and electrolyte imbalance. Of particular concern, the effect of intermittent fasting on hormonal circadian rhythms has received little attention. Given the known importance of circadian hormonal changes to normal physiology, potential detrimental effects by dysregulation of hormonal changes deserve careful discussions. In this review, we describe the changes in circadian rhythms of hormones caused by intermittent fasting. We covered major hormones commonly pathophysiologically involved in clinical endocrinology, including insulin, thyroid hormones, and glucocorticoids. Given that intermittent fasting could alter both the level and frequency of hormone secretion, decisions on practicing intermittent fasting should take more considerations on potential detrimental consequences versus beneficial effects pertaining to individual health conditions.

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    Reza Karimi, Alina Yanovich, Fawzy Elbarbry, Anita Cleven
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Original Article
Thyroid
Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients
Jiyeon Ahn, Min Kyung Lee, Jae Hyuk Lee, Seo Young Sohn
Endocrinol Metab. 2021;36(4):769-777.   Published online August 27, 2021
DOI: https://doi.org/10.3803/EnM.2021.1109
  • 4,878 View
  • 187 Download
  • 18 Web of Science
  • 18 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients.
Methods
The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones.
Results
Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile.
Conclusion
Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.

Citations

Citations to this article as recorded by  
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Review Articles
Thyroid
The Role of Thyroid Hormone in the Regulation of Cerebellar Development
Sumiyasu Ishii, Izuki Amano, Noriyuki Koibuchi
Endocrinol Metab. 2021;36(4):703-716.   Published online August 9, 2021
DOI: https://doi.org/10.3803/EnM.2021.1150
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AbstractAbstract PDFPubReader   ePub   
The proper organized expression of specific genes in time and space is responsible for the organogenesis of the central nervous system including the cerebellum. The epigenetic regulation of gene expression is tightly regulated by an intrinsic intracellular genetic program, local stimuli such as synaptic inputs and trophic factors, and peripheral stimuli from outside of the brain including hormones. Some hormone receptors are expressed in the cerebellum. Thyroid hormones (THs), among numerous circulating hormones, are well-known major regulators of cerebellar development. In both rodents and human, hypothyroidism during the postnatal developmental period results in abnormal morphogenesis or altered function. THs bind to the thyroid hormone receptors (TRs) in the nuclei and with the help of transcriptional cofactors regulate the transcription of target genes. Gene regulation by TR induces cell proliferation, migration, and differentiation, which are necessary for brain development and plasticity. Thus, the lack of TH action mediators may directly cause aberrant cerebellar development. Various kinds of animal models have been established in a bid to study the mechanism of TH action in the cerebellum. Interestingly, the phenotypes differ greatly depending on the models. Herein we summarize the actions of TH and TR particularly in the developing cerebellum.

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Thyroid
Bisphenols and Thyroid Hormone
Min Joo Kim, Young Joo Park
Endocrinol Metab. 2019;34(4):340-348.   Published online December 23, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.4.340
  • 9,960 View
  • 242 Download
  • 63 Web of Science
  • 66 Crossref
AbstractAbstract PDFPubReader   ePub   

In recent decades, attention has been directed toward the effects of bisphenol A (BPA) on human health. BPA has estrogenic activity and is regarded as a representative endocrine disruptor. In addition, mounting evidence indicates that BPA can disrupt thyroid hormone and its action. This review examined human epidemiological studies to investigate the association between BPA exposure and thyroid hormone levels, and analyzed in vivo and in vitro experiments to identify the causal relationship and its mechanism of action. BPA is involved in thyroid hormone action not only as a thyroid hormone receptor antagonist, but also through several other mechanisms. Since the use of bisphenols other than BPA has recently increased, we also reviewed the effects of other bisphenols on thyroid hormone action.

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Thyroid
Evaluation of Thyroid Hormone Levels and Urinary Iodine Concentrations in Koreans Based on the Data from Korea National Health and Nutrition Examination Survey VI (2013 to 2015)
Jae Hoon Chung
Endocrinol Metab. 2018;33(2):160-163.   Published online May 4, 2018
DOI: https://doi.org/10.3803/EnM.2018.33.2.160
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AbstractAbstract PDFPubReader   ePub   

No nationwide data have been published about thyroid hormone levels and urinary iodine concentrations (UICs) in Korea. The Korea Centers for Disease Control and Prevention and the Korean Thyroid Association established a project to evaluate the nationwide thyroid hormone profile and UICs in healthy Koreans as part of the Korea National Health and Nutrition Examination Survey (KNHANES) VI (2013 to 2015), a nationwide, cross-sectional survey of the Korean population that enrolled 7,061 individuals who were weighted to represent the entire Korean population. Based on the KNHANES VI, the geometric mean value of serum thyroid stimulating hormone was 2.16 mIU/L, and its reference interval was 0.59 to 7.03 mIU/L. The mean value of serum free thyroxine was 1.25 ng/dL, and its reference interval was 0.92 to 1.60 ng/dL. The median UIC in the Korean population was reported to be 294 μg/L, corresponding to ‘above requirements’ iodine intake according to the World Health Organization recommendations. A U-shaped relationship of UIC with age was found. The prevalence of overt hyperthyroidism and overt hypothyroidism in the Korean population based on the KNHANES VI was 0.54% and 0.73%, respectively.

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Original Articles
Clinical Study
Triiodothyronine Levels Are Independently Associated with Metabolic Syndrome in Euthyroid Middle-Aged Subjects
Hye Jeong Kim, Ji Cheol Bae, Hyeong Kyu Park, Dong Won Byun, Kyoil Suh, Myung Hi Yoo, Jae Hyeon Kim, Yong-Ki Min, Sun Wook Kim, Jae Hoon Chung
Endocrinol Metab. 2016;31(2):311-319.   Published online May 13, 2016
DOI: https://doi.org/10.3803/EnM.2016.31.2.311
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AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Recent studies have shown an association between thyroid hormone levels and metabolic syndrome (MetS) among euthyroid individuals; however, there have been some inconsistencies between studies. Here, we evaluated the relationship between thyroid hormone levels and MetS in euthyroid middle-aged subjects in a large cohort.

Methods

A retrospective analysis of 13,496 euthyroid middle-aged subjects who participated in comprehensive health examinations was performed. Subjects were grouped according to thyroid stimulating hormone, total triiodothyronine (T3), total thyroxine (T4), and T3-to-T4 ratio quartile categories. We estimated the odds ratios (ORs) for MetS according to thyroid hormone quartiles using logistic regression models, adjusted for potential confounders.

Results

Of the study patients, 12% (n=1,664) had MetS. A higher T3 level and T3-to-T4 ratio were associated with unfavourable metabolic profiles, such as higher body mass index, systolic and diastolic blood pressure, triglycerides, fasting glucose and glycated hemoglobin, and lower high density lipoprotein cholesterol levels. The proportion of participants with MetS increased across the T3 quartile categories (P for trend <0.001) and the T3-to-T4 ratio quartile categories (P for trend <0.001). The multi-variate-adjusted OR (95% confidence interval) for MetS in the highest T3 quartile group was 1.249 (1.020 to 1.529) compared to the lowest T3 quartile group, and that in the highest T3-to-T4 ratio quartile group was 1.458 (1.141 to 1.863) compared to the lowest T3-to-T4 ratio quartile group, even after adjustment for potential confounders.

Conclusion

Serum T3 levels and T3-to-T4 ratio are independently associated with MetS in euthyroid middle-aged subjects. Longitudinal studies are needed to define this association and its potential health implications.

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Endocrine Research
Thyroid Hormone Regulates the mRNA Expression of Small Heterodimer Partner through Liver Receptor Homolog-1
Hwa Young Ahn, Hwan Hee Kim, Ye An Kim, Min Kim, Jung Hun Ohn, Sung Soo Chung, Yoon-Kwang Lee, Do Joon Park, Kyong Soo Park, David D. Moore, Young Joo Park
Endocrinol Metab. 2015;30(4):584-592.   Published online December 31, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.4.584
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AbstractAbstract PDFPubReader   
Background

Expression of hepatic cholesterol 7α-hydroxylase (CYP7A1) is negatively regulated by orphan nuclear receptor small heterodimer partner (SHP). In this study, we aimed to find whether thyroid hormone regulates SHP expression by modulating the transcriptional activities of liver receptor homolog-1 (LRH-1).

Methods

We injected thyroid hormone (triiodothyronine, T3) to C57BL/6J wild type. RNA was isolated from mouse liver and used for microarray analysis and quantitative real-time polymerase chain reaction (PCR). Human hepatoma cell and primary hepatocytes from mouse liver were used to confirm the effect of T3 in vitro. Promoter assay and electrophoretic mobility-shift assay (EMSA) were also performed using human hepatoma cell line

Results

Initial microarray results indicated that SHP expression is markedly decreased in livers of T3 treated mice. We confirmed that T3 repressed SHP expression in the liver of mice as well as in mouse primary hepatocytes and human hepatoma cells by real-time PCR analysis. LRH-1 increased the promoter activity of SHP; however, this increased activity was markedly decreased after thyroid hormone receptor β/retinoid X receptor α/T3 administration. EMSA revealed that T3 inhibits specific LRH-1 DNA binding.

Conclusion

We found that thyroid hormone regulates the expression of SHP mRNA through interference with the transcription factor, LRH-1.

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    Piero Portincasa, Mohamad Khalil, Laura Mahdi, Valeria Perniola, Valeria Idone, Annarita Graziani, Gyorgy Baffy, Agostino Di Ciaula
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    Giuseppe Ferrandino, Rachel R. Kaspari, Olga Spadaro, Andrea Reyna-Neyra, Rachel J. Perry, Rebecca Cardone, Richard G. Kibbey, Gerald I. Shulman, Vishwa Deep Dixit, Nancy Carrasco
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Thyroid
Weight Changes in Patients with Differentiated Thyroid Carcinoma during Postoperative Long-Term Follow-up under Thyroid Stimulating Hormone Suppression
Seo Young Sohn, Ji Young Joung, Yoon Young Cho, Sun Mi Park, Sang Man Jin, Jae Hoon Chung, Sun Wook Kim
Endocrinol Metab. 2015;30(3):343-351.   Published online August 4, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.3.343
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AbstractAbstract PDFPubReader   
Background

There are limited data about whether patients who receive initial treatment for differentiated thyroid cancer (DTC) gain or lose weight during long-term follow-up under thyroid stimulating hormone (TSH) suppression. This study was aimed to evaluate whether DTC patients under TSH suppression experience long-term weight gain after initial treatment. We also examined the impact of the radioactive iodine ablation therapy (RAIT) preparation method on changes of weight, comparing thyroid hormone withdrawal (THW) and recombinant human TSH (rhTSH).

Methods

We retrospectively reviewed 700 DTC patients who underwent a total thyroidectomy followed by either RAIT and levothyroxine (T4) replacement or T4 replacement alone. The control group included 350 age-matched patients with benign thyroid nodules followed during same period. Anthropometric data were measured at baseline, 1 to 2 years, and 3 to 4 years after thyroidectomy. Comparisons were made between weight and body mass index (BMI) at baseline and follow-up.

Results

Significant gains in weight and BMI were observed 3 to 4 years after initial treatment for female DTC but not in male patients. These gains among female DTC patients were also significant compared to age-matched control. Women in the THW group gained a significant amount of weight and BMI compared to baseline, while there was no increase in weight or BMI in the rhTSH group. There were no changes in weight and BMI in men according to RAIT preparation methods.

Conclusion

Female DTC patients showed significant gains in weight and BMI during long-term follow-up after initial treatment. These changes were seen only in patients who underwent THW for RAIT.

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    Naykky Singh Ospina, Ana Castaneda-Guarderas, Oksana Hamidi, Oscar J. Ponce, Wang Zhen, Larry Prokop, Victor M. Montori, Juan P. Brito
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Obesity and Metabolism
Serum Concentrations of Ghrelin and Leptin according to Thyroid Hormone Condition, and Their Correlations with Insulin Resistance
Kyu-Jin Kim, Bo-Yeon Kim, Ji-Oh Mok, Chul-Hee Kim, Sung-Koo Kang, Chan-Hee Jung
Endocrinol Metab. 2015;30(3):318-325.   Published online May 18, 2015
DOI: https://doi.org/10.3803/EnM.2015.30.3.318
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AbstractAbstract PDFPubReader   
Background

Thyroid hormones can influence energy metabolism and insulin sensitivity via their interaction with adipocytokines and gut hormones. The aims of this study were to evaluate differences in serum ghrelin and leptin concentrations according to thyroid hormone levels, and to investigate the correlation of insulin resistance.

Methods

A total of 154 patients (57 hyperthyroid patients, 61 euthyroid patients, and 36 hypothyroid patients; mean age, 47.9 years) were enrolled. Serum leptin, ghrelin, and insulin levels were measured and insulin resistance was calculated using the formula of the homeostasis model assessment of insulin resistance (HOMA-IR).

Results

There were no differences in mean concentrations of ghrelin or leptin among the three groups. There were no significant differences in insulin levels between the groups (P=0.06), although hyperthyroid patients had borderline statistically significantly higher levels of insulin than did euthyroid subjects by post hoc test (26.4 µIU/mL vs. 16.1 µIU/mL, P=0.057). Regarding HOMA-IR index, the mean levels were highest in the hyperthyroid group among those of the three groups (hyperthyroid vs. euthyroid vs. hypothyroid, 6.7 vs. 3.8 vs. 4.4, P=0.068). Plasma levels of ghrelin were significantly negatively correlated with age, insulin, glucose, body mass index (BMI), and HOMA-IR. Plasma levels of leptin showed significant positive correlation with BMI and triglyceride. There were no significant correlations among thyroid hormone, thyrotropin, ghrelin, leptin, or insulin.

Conclusion

The present study found that serum ghrelin, leptin, and insulin levels didn't differ according to thyroid function conditions. Further studies with larger numbers of patients are required to establish a direct relationship between plasma ghrelin, leptin, and thyroid hormone.

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