Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigen...Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.展开更多
Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigen...Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.展开更多
Background: Hypothyroidism has multiple etiologies and manifestation where accurate diagnosis and appropriate treatment is required and is in?uenced by coexisting medical conditions. This paper describes evidence-base...Background: Hypothyroidism has multiple etiologies and manifestation where accurate diagnosis and appropriate treatment is required and is in?uenced by coexisting medical conditions. This paper describes evidence-based clinical causes and indications. Objective: The objective is to review the clinical effect of hypothyroidism in different selected aspects and summarize the potential evidence about relationship between subclinical hypothyroidism with cardiovascular disease, diabetes mellitus, insulin resistance and mortality. Data Sources: A systematic review was conducted by searching English-language articles identified from 23 databases and search engines, yielding over 1000 documents. Study Selection: They are reports on the effects of hypothyroidism versus euthyroidism on obesity, insulin resistance, cardiovascular disease, coronary heart disease and mortality. Data Extraction: Data from research articles on hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism, insulin resistance including diabetes mellitus and risk for coronary heart disease (CHD) including metabolic syndrome were independently assessed and summarized. Data Synthesis: Twelve of twenty-nine identified studies involved population-based cohorts, case controls and retrospective studies that included 4306 subjects. All 13 studies examined risks associated with subclinical hypothyroidism with type 2 diabetes mellitus (T2DM) and prevalence rates of SCH in T2DM patients ranged from 4.69% to 64.28% in the 12 included studies. Moreover, 4 studies out of the above 12 studies have revealed insulin resistance in the participants. Another population-based 12 studies have been carried out to assess hypothyroidism-related cardiac manifestation and according to the given data, average prevalence of CHD in hypothyroid participants is 25.20 (vary from 3.73 to 47.14) and it is 13.90 in euthyroid participants (vary from 1.17 to 38.49). Conclusions: Type 2 diabetes mellitus people are more likely to get subclinical hypothyroidism and展开更多
Objective To study whether free triiodothyronine （FT3） within normal range has effects on the presence and severity of coronary ar- tery disease （CAD） in different gender and age groups. Methods A total of 4206 eu...Objective To study whether free triiodothyronine （FT3） within normal range has effects on the presence and severity of coronary ar- tery disease （CAD） in different gender and age groups. Methods A total of 4206 euthyroid patients were consecutively enrolled and di- vided into CAD group （n = 3306） and non-CAD group （n = 900）. All patients underwent coronary angiography （CAG）. Gensini score （GS） was used to determine the severity of coronary artery stenosis. Severe CAD was defined as GS 〉 32 and mild CAD was defined as GS 〈 32. Logistic regression analysis and linear regression analysis were conducted to determine the association of FT3 with CAD in patients with different gender and ages. Results Concentration of FT3 was lower in patients with CAD than that in angiography-normal control group （P 〈 0.05）. In addition, concentration of FT3 was lower in severe CAD than that in mild CAD. After adjusting for traditional cardiovascular risk factors and potential confounders, FT3 was negatively correlated with the presence of CAD, but not in the old patients （〉 65 years old）. Mul- tivariable linear regression analysis showed that FT3 was negatively associated with GS in male and young patients with stable CAD, but not in the old patients. Conclusions Low FT3 within normal range was negatively associated with the presence and severity of CAD in young patients, but not in the old ones. Further studies are needed to confirm our findings.展开更多
Thyroid eye disease(also known as Graves’ophthalmopathy)is a complex orbital inflammatory disease,which can be sight threatening,debilitating and disfiguring.This overview discusses the epidemiology,risk factors,path...Thyroid eye disease(also known as Graves’ophthalmopathy)is a complex orbital inflammatory disease,which can be sight threatening,debilitating and disfiguring.This overview discusses the epidemiology,risk factors,pathogenesis,presentation,ophthalmic clinical features,investigations and treatment of thyroid eye disease.展开更多
Background Growing evidence links alternation of the thyroid function to the pathogenesis and progression of Alzheimer disease （AD）. However, only a few studies evaluate the association between thyroid hormone level...Background Growing evidence links alternation of the thyroid function to the pathogenesis and progression of Alzheimer disease （AD）. However, only a few studies evaluate the association between thyroid hormone levels and neuropsychiatric manifestations in patients with AD. This study aimed to investigate the relationship of thyroid hormone levels and neuropsychiatric symptoms in euthyroid patients with AD. Methods Forty patients with AD （26 women and 14 men）, with no prior AD treatment within 4 weeks before study entry, were evaluated on their thyroid status （total triiodothyronine （TT3）,total thyroxine （TT4）, and thyroid-stimulating hormone （TSH）, cognition （Mini-Mental State Examination （MMSE） and Alzheimer＇s disease Assessment Scale-Cognitive Subscale （ADAS-cog）, neuropsychiatric symptoms （Neuropsychiatric Inventory （NPI） and depression （Hamilton Rating Scale for Depression （HAMD17）. The unique relationship between thyroid hormones and cognitive function and mood was examined with multivariate linear regression analyses. The thyroid status between the neuropsychiatric symptoms group and the non-neuropsychiatric symptoms group was examined with independent-samples t-test. Results In euthyroid AD patients with agitation and irritability has lower TSH serum level than those without these symptoms （t=-2.130, P 〈0.05; t=-2.657, P 〈0.05）; and core score of HAMD is significantly associated with the serum level of TSH （β=0.395, P 〈0.01）. There is no significant association between thyroid hormone levels and cognition （MMSE, ADAS-cog and its subscale score）.展开更多
This study investigated whether high-normal thyrotropin（TSH） levels are associated with metabolic syndrome in euthyroid Chinese people≥40 years old.Clinical and metabolic factors were assessed in 2,356 subjects（40...This study investigated whether high-normal thyrotropin（TSH） levels are associated with metabolic syndrome in euthyroid Chinese people≥40 years old.Clinical and metabolic factors were assessed in 2,356 subjects（40-77 years old） with TSH levels in the normal range（0.35-5.00 mU/L）.Using 2.50 mU/L as the cut-off point of TSH level within the normal range,we divided subjects into the high-TSH（2.50-5.00 mU/L;n= 1,064） and low-TSH（0.35-2.50mU/L;n= 1,292） group.The results showed that the mean levels of body mass index（BMI）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,and fasting plasma glucose（FPG） were higher in the high-TSH group and TSH levels were significantly positively con-elated with BMI,LDL-C,TC,and FPG.The prevalence of central obesity,hypertriglyceridemia,low high density lipoprotein cholesterol（HDL-C）,and high FPG（〉5.60 mmol/L） was significantly higher in females and subjects with high-TSH levels.Metabolic syndrome was also more prevalent in the high-TSH group.People over the age of 40 years with high-normal TSH levels had a 1.2-fold increased risk of metabolic syndrome,compared with those with low-normal TSII levels,after adjusting for age and gender.In conclusion,high normal TSH is a risk factor for metabolic syndrome in people ≥40 years old.展开更多
The aim of this study was to determine the association between thyroid-stimulating hormone (TSH) level and pregnancy outcomes in euthyroid women undergoing in vitro fertilization (IVF)/intra-cytoplasmic sperm injectio...The aim of this study was to determine the association between thyroid-stimulating hormone (TSH) level and pregnancy outcomes in euthyroid women undergoing in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI).A total of 1185 women were enrolled in the retrospective study,and 12 studies with a total of 6624 women were included in the meta-analysis (including the data of the present retrospective study).Participants in the retrospective study were divided into two groups in terms of their serum TSH levels:TSH <2.5 mIU/L group (w=830) and TSH >2.5 mIU/L group (h=355).They were monitored for the status of clinical pregnancy or miscarriage.In the TSH <2.5 mIU/L group,441 (53.1%) women achieved clinical pregnancy,while 48 (5.8%) had early pregnancy loss and 12 (1.4%) had ectopic pregnancy.In the TSH >2.5 mIU/ L group,175 (49.3%) women achieved clinical pregnancy,while 21 (5.9%) had early pregnancy loss and 3 (0.8%) had ectopic pregnancy.No significant differences were observed between the two groups in pregnancy outcomes (P=0.126,P=0.512,P=0.297).The meta-analysis also revealed no significant difference in the clinical pregnancy rate and the miscarriage rate between women with serum TSH <2.5 mIU/L and those with serum TSH >2.5 mIU/L.In conclusion,high TSH levels (TSH level >2.5 mIU/L) did not affect clinical pregnancy rate or increase miscarriage rate in euthyroid women undergoing IVF/ICSI.展开更多
This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine ...This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine （FT3）, free thyroxin （FT4）, thyroid-stimulating hormone （TSH）, and thyroid antibodies were measured.展开更多
文摘Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.
文摘Basedowian orbitopathy is an autoimmune disease representing the most frequent extra-thyroidal manifestation. Its pathophysiology is imperfectly elucidated and is the result of cross-reactivity between thyroid antigens and orbital tissue. It is most frequently seen in the context of hyperthyroidism (basedow’s disease or Graves’ disease), sometimes hypothyroidism (Hashimoto’s thyroiditis), or euthyroidism. Diagnosis is often straightforward, but management remains difficult. The introduction of simple medical treatment exposes the patient to the risk of recurrence. In Sikasso, there have been few studies of Graves’ disease. The aim of this study was to describe the clinical, therapeutic and evolutionary features of Graves’ disease in Sikasso Hospital. The patient was a 35-year-old woman with no previous history of Graves’ disease and no history of alcohol or tobacco intoxication, consulting for bilateral exophthalmos with moderate pain for 1 year. Endocrine tests were normal (euthyroidism), as was orbital-cerebral MRI, which revealed stage II exophthalmos with no sellar or supra-saltar abnormalities. The main complication was exposure to keratitis. Our patient was treated with corticosteroids. The evolution was favorable under treatment, with no recurrence after one year’s follow-up. Graves’ disease is the most common cause of hyperthyroidism, but this should not obscure the diagnosis of euthyroidism, as demonstrated in this case report. Exophthalmos remains the main ophthalmological clinical manifestation.
文摘Background: Hypothyroidism has multiple etiologies and manifestation where accurate diagnosis and appropriate treatment is required and is in?uenced by coexisting medical conditions. This paper describes evidence-based clinical causes and indications. Objective: The objective is to review the clinical effect of hypothyroidism in different selected aspects and summarize the potential evidence about relationship between subclinical hypothyroidism with cardiovascular disease, diabetes mellitus, insulin resistance and mortality. Data Sources: A systematic review was conducted by searching English-language articles identified from 23 databases and search engines, yielding over 1000 documents. Study Selection: They are reports on the effects of hypothyroidism versus euthyroidism on obesity, insulin resistance, cardiovascular disease, coronary heart disease and mortality. Data Extraction: Data from research articles on hypothyroidism including subclinical hypothyroidism (SCH) and overt hypothyroidism, insulin resistance including diabetes mellitus and risk for coronary heart disease (CHD) including metabolic syndrome were independently assessed and summarized. Data Synthesis: Twelve of twenty-nine identified studies involved population-based cohorts, case controls and retrospective studies that included 4306 subjects. All 13 studies examined risks associated with subclinical hypothyroidism with type 2 diabetes mellitus (T2DM) and prevalence rates of SCH in T2DM patients ranged from 4.69% to 64.28% in the 12 included studies. Moreover, 4 studies out of the above 12 studies have revealed insulin resistance in the participants. Another population-based 12 studies have been carried out to assess hypothyroidism-related cardiac manifestation and according to the given data, average prevalence of CHD in hypothyroid participants is 25.20 (vary from 3.73 to 47.14) and it is 13.90 in euthyroid participants (vary from 1.17 to 38.49). Conclusions: Type 2 diabetes mellitus people are more likely to get subclinical hypothyroidism and
文摘Objective To study whether free triiodothyronine （FT3） within normal range has effects on the presence and severity of coronary ar- tery disease （CAD） in different gender and age groups. Methods A total of 4206 euthyroid patients were consecutively enrolled and di- vided into CAD group （n = 3306） and non-CAD group （n = 900）. All patients underwent coronary angiography （CAG）. Gensini score （GS） was used to determine the severity of coronary artery stenosis. Severe CAD was defined as GS 〉 32 and mild CAD was defined as GS 〈 32. Logistic regression analysis and linear regression analysis were conducted to determine the association of FT3 with CAD in patients with different gender and ages. Results Concentration of FT3 was lower in patients with CAD than that in angiography-normal control group （P 〈 0.05）. In addition, concentration of FT3 was lower in severe CAD than that in mild CAD. After adjusting for traditional cardiovascular risk factors and potential confounders, FT3 was negatively correlated with the presence of CAD, but not in the old patients （〉 65 years old）. Mul- tivariable linear regression analysis showed that FT3 was negatively associated with GS in male and young patients with stable CAD, but not in the old patients. Conclusions Low FT3 within normal range was negatively associated with the presence and severity of CAD in young patients, but not in the old ones. Further studies are needed to confirm our findings.
文摘Thyroid eye disease(also known as Graves’ophthalmopathy)is a complex orbital inflammatory disease,which can be sight threatening,debilitating and disfiguring.This overview discusses the epidemiology,risk factors,pathogenesis,presentation,ophthalmic clinical features,investigations and treatment of thyroid eye disease.
文摘Background Growing evidence links alternation of the thyroid function to the pathogenesis and progression of Alzheimer disease （AD）. However, only a few studies evaluate the association between thyroid hormone levels and neuropsychiatric manifestations in patients with AD. This study aimed to investigate the relationship of thyroid hormone levels and neuropsychiatric symptoms in euthyroid patients with AD. Methods Forty patients with AD （26 women and 14 men）, with no prior AD treatment within 4 weeks before study entry, were evaluated on their thyroid status （total triiodothyronine （TT3）,total thyroxine （TT4）, and thyroid-stimulating hormone （TSH）, cognition （Mini-Mental State Examination （MMSE） and Alzheimer＇s disease Assessment Scale-Cognitive Subscale （ADAS-cog）, neuropsychiatric symptoms （Neuropsychiatric Inventory （NPI） and depression （Hamilton Rating Scale for Depression （HAMD17）. The unique relationship between thyroid hormones and cognitive function and mood was examined with multivariate linear regression analyses. The thyroid status between the neuropsychiatric symptoms group and the non-neuropsychiatric symptoms group was examined with independent-samples t-test. Results In euthyroid AD patients with agitation and irritability has lower TSH serum level than those without these symptoms （t=-2.130, P 〈0.05; t=-2.657, P 〈0.05）; and core score of HAMD is significantly associated with the serum level of TSH （β=0.395, P 〈0.01）. There is no significant association between thyroid hormone levels and cognition （MMSE, ADAS-cog and its subscale score）.
基金supported by the grants from the Chinese Society of Endocrinology and National Clinical Research Center for Metabolic Diseases(81170726)
文摘This study investigated whether high-normal thyrotropin（TSH） levels are associated with metabolic syndrome in euthyroid Chinese people≥40 years old.Clinical and metabolic factors were assessed in 2,356 subjects（40-77 years old） with TSH levels in the normal range（0.35-5.00 mU/L）.Using 2.50 mU/L as the cut-off point of TSH level within the normal range,we divided subjects into the high-TSH（2.50-5.00 mU/L;n= 1,064） and low-TSH（0.35-2.50mU/L;n= 1,292） group.The results showed that the mean levels of body mass index（BMI）,total cholesterol（TC）,low density lipoprotein cholesterol（LDL-C）,and fasting plasma glucose（FPG） were higher in the high-TSH group and TSH levels were significantly positively con-elated with BMI,LDL-C,TC,and FPG.The prevalence of central obesity,hypertriglyceridemia,low high density lipoprotein cholesterol（HDL-C）,and high FPG（〉5.60 mmol/L） was significantly higher in females and subjects with high-TSH levels.Metabolic syndrome was also more prevalent in the high-TSH group.People over the age of 40 years with high-normal TSH levels had a 1.2-fold increased risk of metabolic syndrome,compared with those with low-normal TSII levels,after adjusting for age and gender.In conclusion,high normal TSH is a risk factor for metabolic syndrome in people ≥40 years old.
基金This work was supported by grants from the National Key Research and Development Program of China (No.2018YFC1002103)the National Natural Science Foundation of China (No.81601348).
文摘The aim of this study was to determine the association between thyroid-stimulating hormone (TSH) level and pregnancy outcomes in euthyroid women undergoing in vitro fertilization (IVF)/intra-cytoplasmic sperm injection (ICSI).A total of 1185 women were enrolled in the retrospective study,and 12 studies with a total of 6624 women were included in the meta-analysis (including the data of the present retrospective study).Participants in the retrospective study were divided into two groups in terms of their serum TSH levels:TSH <2.5 mIU/L group (w=830) and TSH >2.5 mIU/L group (h=355).They were monitored for the status of clinical pregnancy or miscarriage.In the TSH <2.5 mIU/L group,441 (53.1%) women achieved clinical pregnancy,while 48 (5.8%) had early pregnancy loss and 12 (1.4%) had ectopic pregnancy.In the TSH >2.5 mIU/ L group,175 (49.3%) women achieved clinical pregnancy,while 21 (5.9%) had early pregnancy loss and 3 (0.8%) had ectopic pregnancy.No significant differences were observed between the two groups in pregnancy outcomes (P=0.126,P=0.512,P=0.297).The meta-analysis also revealed no significant difference in the clinical pregnancy rate and the miscarriage rate between women with serum TSH <2.5 mIU/L and those with serum TSH >2.5 mIU/L.In conclusion,high TSH levels (TSH level >2.5 mIU/L) did not affect clinical pregnancy rate or increase miscarriage rate in euthyroid women undergoing IVF/ICSI.
基金supported by the National Natural Science Foundation of China(No.81370960 and 81670795)the Ministry of Science and Technology(No.2015BAI12B14,2015BAI12B02,2016YFC0901200,and 2016YFC1305202)
文摘This current cross-sectional study investigates the relationship between thyroid hormones and peripheral artery disease （PAD） among euthyroid Chinese population aged 40 years and above. Serum free triiodothyronine （FT3）, free thyroxin （FT4）, thyroid-stimulating hormone （TSH）, and thyroid antibodies were measured.
