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Frontiers in Endocrinology 2023Previous observational studies have reported a positive correlation between obesity and susceptibility to hypothyroidism; however, there is limited evidence from...
INTRODUCTION
Previous observational studies have reported a positive correlation between obesity and susceptibility to hypothyroidism; however, there is limited evidence from alternative methodologies to establish a causal link.
METHODS
We investigated the causal relationship between obesity and hypothyroidism using a two-sample bidirectional Mendelian randomization (MR) analysis. Single-nucleotide polymorphisms (SNPs) associated with obesity-related traits were extracted from a published genome-wide association study (GWAS) of European individuals. Summarized diagnostic data of hypothyroidism were obtained from the UK Biobank. Primary analyses were conducted using the inverse variance-weighted (IVW) method with a random-effects model as well as three complementary approaches. Sensitivity analyses were performed to ascertain the correlation between obesity and hypothyroidism.
RESULTS
MR analyses of the IVW method and the analyses of hypothyroidism/myxedema indicated that body mass index (BMI) and waist circumference (WC) were significantly associated with higher odds and risk of hypothyroidism. Reverse MR analysis demonstrated that a genetic predisposition to hypothyroidism was associated with an increased risk of elevated BMI and WC, which was not observed between WC adjusted for BMI (WCadjBMI) and hypothyroidism.
DISCUSSION
Our current study indicates that obesity is a risk factor for hypothyroidism, suggesting that individuals with higher BMI/WC have an increased risk of developing hypothyroidism and indicating the importance of weight loss in reducing the risk of hypothyroidism.
Topics: Humans; Genome-Wide Association Study; Mendelian Randomization Analysis; Hypothyroidism; Causality; Obesity
PubMed: 38260160
DOI: 10.3389/fendo.2023.1287463 -
Advances in Therapy Jul 2020Hypothyroidism is one of the most common chronic endocrine conditions. However, as symptoms of hypothyroidism are non-specific, up to 60% of those with thyroid... (Review)
Review
Hypothyroidism is one of the most common chronic endocrine conditions. However, as symptoms of hypothyroidism are non-specific, up to 60% of those with thyroid dysfunction are unaware of their condition. Left untreated, hypothyroidism may contribute to other chronic health conditions. In the Arabian Gulf States, hypothyroidism is thought to be common, but is underdiagnosed, and management approaches vary. An advisory board of leading Saudi endocrinologists and policy advisers was convened to discuss and formulate recommendations for the diagnosis and management of hypothyroidism in Saudi Arabia based on their clinical expertise. The final document was shared with leading endocrinologists from the other Gulf Cooperation Council (GCC) and aconsensus report was generated and summerized in this article. While there is no consensus regarding population screening of hypothyroidism, current recommendations suggest screening patients with risk factors, including those with a history of head or neck irradiation, a family history of thyroid disease or pharmacological treatment that may affect thyroid function. Evidence from a cross-sectional study in Saudi Arabia suggests screening the elderly (> 60 years), at least in the primary care setting. In Saudi Arabia, the incidence of congenital hypothyroidism is approximately 1 in every 3450 newborns. Saudi nationwide population prevalence data are lacking, but a single-centre study estimated that the prevalence of subclinical hypothyroidism in the primary care setting was 10%. Prevalence rates were higher in other cross-sectional studies exclusively in women (13-35%). The recommendations included in this article aim to streamline the diagnosis and clinical management of hypothyroidism in the GCC, especially in the primary care setting, with the intention of improving treatment outcomes. Further study on the incidence, prevalence and risk factors for, and clinical features of, hypothyroidism in the GCC countries is required.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Cross-Sectional Studies; Diagnostic Techniques and Procedures; Female; Humans; Hypothyroidism; Incidence; Infant; Infant, Newborn; Male; Middle Aged; Practice Guidelines as Topic; Prevalence; Saudi Arabia; Symptom Assessment; Thyroxine; Young Adult
PubMed: 32488658
DOI: 10.1007/s12325-020-01382-2 -
Annales D'endocrinologie Dec 2023Hypothyroidism is the most common complication of hemithyroidectomy for thyroid nodules. This retrospective cohort study investigated the prognostic factors for...
OBJECTIVE
Hypothyroidism is the most common complication of hemithyroidectomy for thyroid nodules. This retrospective cohort study investigated the prognostic factors for hypothyroidism following hemithyroidectomy.
METHODS
We included patients who underwent hemithyroidectomy between 2016 and 2017, excluding those with history of preoperative hypothyroidism or malignancy on histopathological examination. The primary endpoint was development of hypothyroidism during follow-up (TSH≥2 above normal).
RESULTS
Twenty-six of the 128 included patients (20%) developed postoperative hypothyroidism. The following independent prognostic factors were found: preoperative TSH level>1.5 mIU/L (OR 2.11; P=0.013), and remaining thyroid volume adjusted for body surface area<4.0mL/m (OR 1.77; P=0.015). Twenty-one patients (81%) had first TSH values above the upper limit of normal. Postoperatively, first TSH level correlated significantly with the preoperative value (R=0.5779, P<0.001). Levothyroxine was prescribed to 16% of patients, with a mean dose of 0.92μg/kg/day.
CONCLUSION
Patients with TSH>1.5 mIU/or remaining thyroid volume adjusted for body surface area<4.0mL/m should have intensified clinical and biological follow-up in the first year after surgery.
Topics: Humans; Retrospective Studies; Hypothyroidism; Thyroidectomy; Thyroxine; Risk Factors; Thyrotropin
PubMed: 37517518
DOI: 10.1016/j.ando.2023.06.004 -
Medicina Oral, Patologia Oral Y Cirugia... Jan 2023Burning mouth syndrome is an idiopathic condition characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. In the case of... (Review)
Review
BACKGROUND
Burning mouth syndrome is an idiopathic condition characterized by burning pain in a normal-appearing oral mucosa lasting at least four to six months. In the case of secondary burning mouth syndrome is associated with local or systemic factors (such as thyroid disorders) that can cause these symptoms. The aim of this review was to study the relationship between thyroid disorders and burning mouth syndrome.
MATERIAL AND METHODS
The present study followed the PRISMA guidelines. An electronic search strategy was developed for PubMed/Medline, Scopus and Cochrane. The following combination of keywords and Boolean operators were used: Thyroid AND burning mouth; Thyroid AND burning mouth syndrome; Hypothyroidism AND burning mouth; Hypothyroidism AND burning mouth syndrome; Hyperthyroidism AND burning mouth; Hyperthyroidism AND burning mouth syndrome. The results were processed by existing free software in https://www.graphpad.com/. To evaluate the association of the categorical variables we used the Fisher test at a level of significance of p-value ≤ 0,05. As a primary summary measure the Odds Ratio (OR) has been used. To analyze the risk of bias the guidelines of the GRADE guide were used and the grade of evidence was analyzed by the guide of Joanna Briggs Institute: Levels of Evidence and Grades of Recommendations.
RESULTS
After applying the inclusion and exclusion criteria, 5 studies were selected for review. The Chi-square was 10.92 and the Odds Ratio was 3.31 with respect to TSH values with p <0.0001 (Fisher's test). The population of patients with TSH alterations is increased in 80.49% and decreased in 19.51%.
CONCLUSIONS
It can be concluded that thyroid hormone abnormalities are a factor in secondary burning mouth syndrome; specially in patients with hypothyroidism.
Topics: Humans; Burning Mouth Syndrome; Hypothyroidism; Thyroid Hormones; Hyperthyroidism; Thyrotropin
PubMed: 36173716
DOI: 10.4317/medoral.25596 -
Radiotherapy and Oncology : Journal of... Dec 2022Post-radiation primary hypothyroidism is a common late complication in head and neck cancer (HNC) survivors. No radiation dose-volume constraint of the thyroid gland has...
Post-radiation primary hypothyroidism in patients with head and neck cancer: External validation of thyroid gland dose-volume constraints with long-term endocrine outcomes.
BACKGROUND
Post-radiation primary hypothyroidism is a common late complication in head and neck cancer (HNC) survivors. No radiation dose-volume constraint of the thyroid gland has been externally validated for predicting long-term thyroid function outcomes.
MATERIALS AND METHODS
This external validation study evaluated the diagnostic properties of 22 radiation dose-volume constraints of the thyroid gland proposed in the literature. Radiation dosimetric data from 488 HNC patients who underwent neck irradiation from January 2013 to December 2015 at two tertiary oncology centers were reviewed. The diagnostic metrics of candidate constraints were computed by inverse probability of censoring weighting and compared using time-dependent receiver operating characteristic (ROC) curves with death designated as a competing event. Multivariable regression analyses were performed using the Fine-Gray sub-distribution hazard model.
RESULTS
Over a median follow-up period of 6.8 years, 205 (42.0 %) patients developed post-radiation primary hypothyroidism. The thyroid volume spared from 60 Gy (VS60) had the largest area under ROC curve of 0.698 at 5 years after radiotherapy. Of all evaluated constraints, VS60 at a cutoff value of 10 cc had the highest F-score of 0.53. The 5-year hypothyroidism risks of patients with thyroid VS60 ≥ 10 cc and < 10 cc were 14.7 % and 38.2 %, respectively (p < 0.001). The adjusted sub-hazard ratio for post-radiation primary hypothyroidism for VS60 < 10 cc was 1.87 (95 % confidence interval, 1.22-2.87; p < 0.001).
CONCLUSION
Thyroid VS60 is the best radiation dose-volume parameter to predict the long-term risk of primary hypothyroidism in patients with HNC who underwent neck irradiation. VS60 ≥ 10 cc is a robust constraint that limits the 5-year primary hypothyroidism risk to less than 15 % and should be routinely employed during radiotherapy optimization.
Topics: Humans; Radiotherapy, Intensity-Modulated; Radiation Injuries; Head and Neck Neoplasms; Hypothyroidism; Radiotherapy Dosage
PubMed: 36336109
DOI: 10.1016/j.radonc.2022.10.034 -
Hormone Molecular Biology and Clinical... Jan 2016Hypothyroidism is a condition in which the serum levels of thyroid hormones are below that necessary to carry out physiological functions in the body. Hypothyroidism is... (Review)
Review
Hypothyroidism is a condition in which the serum levels of thyroid hormones are below that necessary to carry out physiological functions in the body. Hypothyroidism is related to obesity as an increase in body weight gain is seen in hypothyroid patients. Moreover, an inverse correlation between free thyroxine values and body mass index has been reported. Leptin, a polypeptide hormone produced by adipocytes, was originally thought to be an antiobesity hormone due its anorexic effects on hypothalamic appetite regulation. However, nowadays it is known that leptin conveys information about the nutritional status to the brain being considered a crucial endocrine factor for regulating several physiological processes including reproduction. Since the identification of thyroid hormone and leptin receptors on the testes, these hormones are being recognized as having important roles in male reproductive functions. A clear link exists among thyroid hormones, leptin and reproduction. Both hormones can negatively affect spermatogenesis and consequently may cause male infertility. The World Health Organization (WHO) estimates the overall prevalence of primary infertility ranging from 8 to 15%. The fact that 30% of couples' inability to conceive is related to a male factor and that the longer hypothyroidism persisted, the greater the damage to the testes, strongly suggest that more studies attempting to clarify both hormones actions directly in the testes need to be conducted specially in cases of congenital hypothyroidism. Therefore, the goal of this review is to highlight the relationship of such hormones in the reproductive system.
Topics: Animals; Humans; Hypothyroidism; Infertility, Male; Leptin; Male; Obesity; Reproduction; Thyroid Hormones
PubMed: 26953711
DOI: 10.1515/hmbci-2015-0054 -
Ethiopian Journal of Health Sciences Nov 2023Children with sickle cell anaemia have been reported to have potential risk of hypothyroidism from chronic blood transfusions and probable thyroid tissue ischaemia....
BACKGROUND
Children with sickle cell anaemia have been reported to have potential risk of hypothyroidism from chronic blood transfusions and probable thyroid tissue ischaemia. However, few studies on hypothyroidism status of children with sickle cell anaemia in Nigeria are available. The objective of this study was to determine the prevalence of hypothyroidism among children with sickle cell anaemia.
METHODS
A cross sectional study that assayed the thyroid hormones and thyroid stimulating hormone (TSH) of 71 children with sickle cell anaemia was conducted at Olabisi Onabanjo University Teaching Hospital Sagamu. Using age appropriate hormonal reference values, the subjects were classified into subclinical, primary and secondary hypothyroidism.
RESULTS
The mean serum TSH, Free T3, and Free T4 were comparable irrespective of age category (p > 0.05). No subject was identified to have low TSH value while 7.0% had high TSH value. Low free T3 was identified in 1.4% and 8.5% had high free T3 values. Low free T3 and free T4 were seen in 11.3% each of the subjects. The overall prevalence of primary, secondary and subclinical hypothyroidism was 0%, 0% and 4.2%, respectively.
CONCLUSION
Sub-clinical hypothyroidism does occur in Nigerian children with sickle cell anaemia. Routine screening for hypothyroidism is advocated in all children with sickle cell anaemia.
Topics: Humans; Anemia, Sickle Cell; Hypothyroidism; Child; Male; Cross-Sectional Studies; Female; Nigeria; Thyrotropin; Child, Preschool; Prevalence; Adolescent; Thyroxine; Triiodothyronine; Thyroid Hormones; Infant
PubMed: 38784480
DOI: 10.4314/ejhs.v33i6.6 -
Endocrine Regulations Oct 2022Cardiovascular diseases (CVD) and thyroid dysfunction are two of the most prevailing disorders in the world that are closely interlinked. Actions of thyroid hormones are... (Review)
Review
Cardiovascular diseases (CVD) and thyroid dysfunction are two of the most prevailing disorders in the world that are closely interlinked. Actions of thyroid hormones are mediated via thyroid receptors present in the myocardium and the vascular tissue. Primary mechanism that links thyroid dysfunction with CVD is the modification of cardiovascular risk factors (dyslipidemia, blood pressure, coagulation parameters, etc.) resulting in endothelial and left ventricular systolic and diastolic dysfunction. Both overt and subclinical hyperthyroidism and hypothyroidism may cause adverse alterations in cardiac function. Hyperthyroidism gives rise to palpitation, atrial fibrillation, systolic hypertension, and heart failure, whereas hypothyroidism increases diastolic hypertension, pericardial effusion, and the risk of ischemic heart disease via altering lipid and coagulation parameters. Early recognition and treatment of thyroid dysfunction may prevent adverse cardiovascular events in patients with or without pre-existing CVD. Certain cardiac conditions and medications can cause alterations in thyroid function that may predispose an individual to higher morbidity and mortality. In certain situations, thyroid dysfunction treatment may have cardiovascular benefits. This study deals with the interplay between cardiovascular and thyroid dysfunctions associated with clinical implications and management strategies.
Topics: Humans; Hyperthyroidism; Hypothyroidism; Thyroid Diseases; Thyroid Hormones; Cardiovascular Diseases; Hypertension; Lipids
PubMed: 36270343
DOI: 10.2478/enr-2022-0033 -
The Annals of Pharmacotherapy Oct 2022Immune checkpoint inhibitors (ICIs) used in cancer treatment cause immune-related adverse effects (irAEs), including thyroiditis leading to hypothyroidism. The...
BACKGROUND
Immune checkpoint inhibitors (ICIs) used in cancer treatment cause immune-related adverse effects (irAEs), including thyroiditis leading to hypothyroidism. The management and outcomes of this irAE are not well established.
OBJECTIVE
The purpose of this analysis is to describe the onset, management, and outcomes of patients experiencing hypothyroidism from ICI.
METHODS
A retrospective study was conducted of adults receiving ICI therapy at a community cancer center between January 1, 2017, and February 1, 2020. The primary endpoint was to describe onset (timing) of hypothyroidism (thyroid-stimulating hormone [TSH] > 10 µIU/mL). Secondary outcomes included describing hypothyroidism symptoms and levothyroxine use, time to documented disease progression, and occurrence of additional adverse effects (AEs).
RESULTS
Of the 200 patients included in the study, 19% developed clinical hypothyroidism (TSH > 10 µIU/mL, or required initiation of or dose increase in levothyroxine). Median time to TSH higher than 10 µIU/mL was 13.3 weeks and symptoms of hypothyroidism occurred in 34% of patients developing clinical hypothyroidism. The median final daily levothyroxine dose was 88 mcg (0.88 mcg/kg). Time to disease progression was longer in those with clinical hypothyroidism (27.4 months vs. 6.8 months, respectively, = .015). Additional AEs occurred in 68% of those developing hypothyroidism versus 49% without hypothyroidism ( = .029).
CONCLUSION AND RELEVANCE
Patients with clinical hypothyroidism during ICI treatment may have improved cancer outcomes, but they also are more likely to develop other AEs. Patients requiring thyroid replacement therapy with levothyroxine may benefit from a starting dose between 50 and 100 mcg/day, approximately 0.88 mcg/kg/day.
Topics: Adult; Disease Progression; Drug-Related Side Effects and Adverse Reactions; Humans; Hypothyroidism; Immune Checkpoint Inhibitors; Retrospective Studies; Thyrotropin; Thyroxine
PubMed: 35168406
DOI: 10.1177/10600280211073323 -
Pediatric Research Feb 2023A rise in the incidence of congenital hypothyroidism (CH) has been reported worldwide. This nationwide study aimed to describe the secular trends and current incidence...
BACKGROUND
A rise in the incidence of congenital hypothyroidism (CH) has been reported worldwide. This nationwide study aimed to describe the secular trends and current incidence of CH in Finland.
METHODS
Two independent study cohorts, a national and a regional, were collected from national registers and patient records. The national cohort represents all CH cases born in Finland between 1994 and 2017. Birth data, results of the screening test, and the incidence of CH were reviewed.
RESULTS
Between 1994 and 2017, 1,400,028 children were born in Finland. Of these children, 503 were diagnosed with primary CH (incidence 1:2783). Male-to-female sex ratio was 1:2.0. The nationwide incidence was 33 cases per 100,000 live births between 1994 and 1999, 38 cases per 100,000 live births between 2000 and 2005, 40 cases per 100,000 live births between 2006 and 2011, and 33 cases per 100,000 live births between 2012 and 2017. In the regional cohort (n = 139), the incidence of transient CH was 3.6%. The incidence of mild, moderate, and severe CH remained constant.
CONCLUSIONS
In Finland, the incidence of CH has not changed during the 24-year study period.
IMPACT
As opposed to recent reports worldwide, the incidence of congenital hypothyroidism has not changed between 1994 and 2017 in Finland. The proportions of mild, moderate, and severe congenital hypothyroidism did not change significantly over the study period. Lowering the TSH cut-off limit or increasing immigration did not affect the incidence rate of primary congenital hypothyroidism in Finland.
Topics: Child; Humans; Male; Female; Infant, Newborn; Congenital Hypothyroidism; Incidence; Finland; Thyrotropin; Neonatal Screening
PubMed: 35661828
DOI: 10.1038/s41390-022-02118-4