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Background: Any abnormal change in thyroid hormone levels leads to thyroid disorders, including hyperthyroidism, hypothyroidism, goiter, and so on. Recent studies have reported an increasing prevalence and incidence of thyroid disorders worldwide. This study aims to determine the hypothyroid prevalence, incidence, and risk factors related to this disorder. Methods: Data from a comprehensive prospective cohort study, collected from a population of 10,000 Yazd (Iran) individuals over a period of 6 years (2015-2021) was analyzed. Physicians diagnosed hypothyroidism and reported it. Data processing and preparation were performed using SQL18 and Excel, while STATA17 and SPSS22 software were employed for data analysis. Descriptive statistics, logistic regression, and Chi-square tests were conducted at a significance level of 0.05. Results: The prevalence of hypothyroidism was found to be 93/1000, and the incidence was 15/1000 of the population, respectively. Women had five folds more chance of hypothyroidism (adjusted OR=5.31, 95% CI=3.06-9.19 vs. unadjusted OR=6.28, 95% CI=3.90-10.12), and they usually developed it between the ages of 30 and 39. Eating less (iodized) salt also increased the risk of hypothyroidism (unadjusted OR=1.47, 95% CI=1.02-2.11). Iron supplementation (unadjusted OR=2.09, 95% CI=1.26-3.48) was identified as one of the significant risk factors. Based on our findings in the unadjusted model, tooth brushing once or twice a day increases the chance of hypothyroidism (OR=1.89, P=0.008, and OR=2.12, P=0.016, respectively). Tobacco smoking (unadjusted OR=0.29, 95% CI=0.107-0.786) was also among the factors that need further investigation. Conclusion: The increasing trend of hypothyroidism is concerning in our population. The high prevalence, particularly among women of childbearing age, is notable. [ABSTRACT FROM AUTHOR]

Background & Objective: This study aimed to assess maternal and neonatal outcomes in cases of Intrauterine Growth Restriction (IUGR). Understanding these outcomes is vital for early identification of potential adverse effects and facilitating prompt intervention and management. Materials & Methods: This retrospective cohort study focused on mothers whose fetuses experienced IUGR at Imam Khomeini Hospital in Ahvaz, Iran, between March 2021 and 2022. Data on neurodevelopmental and clinical aspects were collected periodically up to 24 months’ post-birth, encompassing various parameters such as infant age, gender, developmental and motor coordination disorders, neurodevelopmental status, medical and speech disorders, and maternal health during pregnancy. Results: Over a one-year period, 80 breastfed infants were studied. At 6, 12, and 24 months after birth, 30% of children showed growth disorders. Boys had a slightly higher percentage of growth arrest (76.4% vs. 63.2%, P>0.05). Growth retardation was present in 13.16% of girls, compared to none of the boys. The most common medical outcomes were asthma and orthopedic disorders (5% each). Developmental disorders and motor disorders were the most common neurological and developmental outcomes, each affecting 11.25% of children. During pregnancy, 16.25% had gestational diabetes, 17.5% had hypertension, and 10% had hypothyroidism, which decreased to 6.25%, 11.25%, and 3.75%, respectively, after childbirth. Conclusion: The present study indicates a significant prevalence of growth and developmental disorders, as well as medical outcomes such as asthma and orthopedic issues at the age of two in infants with IUGR. Mothers of these infants also faced significant postpartum issues, such as diabetes and hypertension. [ABSTRACT FROM AUTHOR]

Background & Objective: Occurrence of maternal or fetal complications during pregnancy may be related to development of postpartum thyroid dysfunction based on the underlying thyroid autoimmune status. The purpose of this study was to investigate the incidence of thyroid dysfunction after delivery in euthyroid mothers who have experienced adverse pregnancy outcomes. Materials & Methods: Among 387 euthyroid pregnant women, 118 experienced adverse pregnancy outcomes out of which only 96 subjects completed the study. The level of thyroperoxidase antibody in the first week after delivery and thyroid function tests including Total T4, T3RU and TSH three months after delivery were measured by electrochemiluminescence immunoassay method. SPSS version 22 was used to analyze the data and the significance level was defined as p<0.05. Results: Thyroperoxidase antibody was positive in 14 participants (14.6%). Overall maternal and fetal complications in the group with positive thyroperoxidase antibody were more than the group without this antibody (p<0.001). Total T4 level was significantly (p=0.02) higher in the group with negative thyroperoxidase antibody (8.03±1.91) comparing with the positive antibody group (6.72±1.96). Overt hypothyroidism was the only thyroid dysfunction that had a significant relationship with thyroid autoimmune status three months after delivery (p=0.02). Conclusion: This study indicates the possible occurrence of thyroid dysfunction after delivery in euthyroid mothers who have experienced maternal or fetal pregnancy complications. [ABSTRACT FROM AUTHOR]

Background & Aims Some studies have reported a high risk of metabolic syndrome among women and night shift workers. This study aims to determine the status of metabolic syndrome laboratory indicators and thyroid function tests in nurses working in Rajaei Cardiovascular, Medical, & Research Center (RCMRC) in Tehran, Iran, in 2020-2021. Materials & Methods This is a descriptive cross-sectional study on the health records of nurses working in RCMRC. The sampling was done using a census method. Records with incomplete information were excluded. A form containing demographic characteristics, thyroid function indicators, and metabolic syndrome laboratory indicators was used to collect data from the health records. Data analysis was performed in SPSS software, version 26. Results Out of 401 reviewed records, 339 cases (84.5%) were for female nurses. The mean age of nurses was 37.47±8.68 years, and their mean work experience was 13.17±8.07 years. According to the criteria of the American Heart Association and the National Heart, Lung, and Blood Institute, the prevalence of abnormalities in metabolic syndrome laboratory tests was 5.21%, while according to the National Cholesterol Education Program III criteria, it was 2.99%. The prevalence of clinical hypothyroidism was 0.2%; subclinical hypothyroidism, 12.0%; and subclinical hyperthyroidism, 1.5%. Conclusion The prevalence of metabolic syndrome and thyroid disorders among nurses working in RCMRC is not considerable. Further large-scale studies (cohort or longitudinal) are recommended. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism (especially subclinical hypothyroidism) and Metabolic Syndrome (MetS) association have been controversial. Aim and Objectives: This study was aimed to examine the MetS components in patients with Clinical and Subclinical Hypothyroidism (CH & SCH) in northeast Iran. Material and Methods: In this cross-sectional study, 186 hypothyroid patients were evaluated for MetS using NCEP-ATP III criteria. Thyroid function and lipid profile parameters were measured using ELISA and enzymatic photometric methods. Results: MetS was common in 53.2% of hypothyroid patients. The odds of MetS in 50 years and above were about 3.2 times higher than those under 50 (p = 0.001). Simple logistic regression analysis showed decreasing one mg/dl High-Density Lipoprotein Cholesterol (HDL-C) increased nearly 10% odds of MetS (OR = 0.916; 95% CI: 0.882-0.951; p = 0.001). In addition, rising one unit Waist Circumference (WC) increased about 14% odds of MetS (OR = 1.137; 95% CI: 1.092-1.183; p = 0.001). As well as, multiple logistic regression analysis showed low HDL-C (p = 0.0001), high SBP (p = 0.0001), and high WC (p = 0.009) had the most significant effect on developing MetS, respectively. Conclusion: This study determined that CH and SCH are significantly associated with MetS. In addition, MetS significantly increased in reduced HDL-C, increased SBP, and age more than 50. [ABSTRACT FROM AUTHOR]

Background: Addiction increases the risk of different lifelong disorders. However, there are limited studies evaluating the effects of opioid use disorder (OUD) on thyroid function. The present study aimed to compare the thyroid function of individuals with and without OUD. Methods: This cross-sectional study was conducted on 700 eligible participants of the Persian Cohort of Fasa, Iran. Pregnant women and participants with false or missing data were excluded from the study. Remained participants were divided into case and control groups based on the recorded history of OUD. Frozen plasma samples of the cohort bank were used to determine the levels of T3, T4, and thyroid-stimulating hormone (TSH). The thyroid function was compared between the two groups using the Mann-Whitney test (P < 0.05). Results: The mean age of the final studied population (n = 648) was 54.0 ± 9.8 years, including 336 men (49.1%) and 197 participants with OUD (28.8%). The median levels of TSH, T4, and T3 were 2.91 ± 4.61, 9.26 ± 3.65, and 1.22 ± 0.49, respectively. The case group had significantly higher TSH (3.72 ± 6.2 vs. 2.58 ± 3.75, P < 0.001) and lower T4 (8 ± 3.6 vs. 9.8 ± 3.5, P < 0.001). Also, T3 was slightly lower in the case group (1.1 ± 0.5 vs. 1.3 ± 0.5; P = 0.369), although this association was only significant in female opium users (P < 0.001). Conclusions: The present findings revealed that OUD caused a reduction in T4 while increasing TSH. Therefore, OUD may lead to the development of primary hypothyroidism, which needs to be investigated in future studies. [ABSTRACT FROM AUTHOR]

Background & Aim: Menstrual disorders are one of the most common complaints among women, ranging from delayed menstrual cycles to cycles with hypermenorrhea, hypomenorehea and dysmenorrhea, which can reduce the quality of life of women during their reproductive years. The aim of this study was to determine the prevalence of menstrual disorders and their related causes in women referring to health centers in Bojnurd. Materials & Methods: This descriptive cross-sectional study was conducted in 2022. The random sampling method was used, and the study population consisted of 220 women aged 14- 49 years referring to medical centers. To collect data, medical records of patients with menstrual disorders were reviewed in women's health clinics and specialists' offices. SPSS 23 software was used for data analysis, and descriptive statistics were used to describe the data. Results: The mean age of the participants was 29.545± 9.21 years, 42.7 percent were single and 57.3 percent were married. The most common causes of menstrual disorders were related to polycystic ovary syndrome 30.9%, cysts 18.6%, hypothyroidism 16.1%, respectively. Oligo menorrhea was the most prevalent menstrual disorder, while dysmenorrhea had the lowest prevalence among women. Conclusion: Considering the high prevalence of polycystic ovary syndrome among the causes of menstrual disorders, by checking on time and treatment can improve the quality of life of affected individuals. [ABSTRACT FROM AUTHOR]

Background and Objectives Blood transfusion in thalassemia patients has side effects such as endocrine iron overload. It is necessary to use iron chelators. The aim is to investigate the prevalence of hypothyroidism and its relationship with the level of iron overload and the results of the heart and liver MRI as a new method for diagnosing iron deposition, and iron removal treatment. Determining the factors affecting this complication can help prevent or improve it. Materials and Methods This cross-sectional study was conducted on 232 beta-thalassemia major and intermedia patients of Tehran adult thalassemia clinic in the year 1400 who were selected by convenient sampling method. The comparison of the level of thyroid hormones and ferritin was done with Chi-squared, independent t, Mann-Whitney and Kruskal-Wallis tests by SPSS 26. Results The prevalence of hypothyroidism in patients with an average age of 40.79 ± 9.02 year was 27.6% There was no significant relationship between hypothyroidism with ferritin levels or heart and liver iron deposition. TSH level was significantly (p= 0.01) higher in men than women. Most of patients used combined iron chelators, but the type of drug was not significantly different. Conclusions It seems that iron overload may be effective in hypothyroidism, but it does not necessarily lead to it. Despite the treatment of iron deficiency, this complication is still one of the main problems. It is suggested to consider the amount of iron load and iron removal treatment before and after the onset of hypothyroidism in future studies. [ABSTRACT FROM AUTHOR]

Background: Recent investigations have highlighted autoimmune origins and abnormal immune responses; particularly those related to T cell-mediated immunity and elevated T lymphocyte cells in the oral mucosa. Therefore, we investigated the relationship between recurrent aphthous stomatitis (RAS) and autoimmune thyroid diseases (ATDs) in an Iranian population. Methods: A cross-sectional study was performed on 102 patients diagnosed with ATD (cases) and 102 healthy patients (controls) who had been referred for the routine dental treatment. All participants were asked for the history of RAS and their age, gender, other systemic diseases, medications, and frequency of RAS in a year. Matching was performed based on the propensity scores for age and sex. In addition, the number of lesions in each recurrence in both groups was assessed and compared. The type of thyroid disease has been assessed for case participants and has been confirmed by the endocrinologist. The chi-square test, t-test, and Mann-Whitney U test were used to analyze the data using SPSS 18. Results: Patients with ATD had higher RAS than healthy controls (P = 0.040). ATD patients had 1.93 times more risk for RAS, and the frequency of RAS in a year was 3.15times higher in these patients (P = 0.011). Moreover, the frequency of RAS was higher in patients with hypothyroidism than in those with hyperthyroidism. However, there were no significant differences in the size and the number of lesions between the groups. Conclusion: The risk and frequency of RAS were significantly higher in patients with ATDs. This would provide valuable insights into the underlying mechanisms and potential treatment strategies for both conditions. [ABSTRACT FROM AUTHOR]

Background: Understanding pharmacokinetics (PK) and pharmacodynamics (PD) of the sustained-release liothyronine (SR-T3) is of paramount importance to design therapeutic regimens that are able to simulate normal thyroid hormone secretion while avoiding excursions in the T3 serum concentration. Here, we designed a parallel randomized clinical trial to characterize the PK and PD of the combined preparations of LT4 + SR-T3 in hypothyroid patients. Methods: Radioiodine-treated hypothyroid patients over 20 years of age, who attained euthyroidism with LT4 monotherapy were recruited from the Endocrine Clinic in Tehran. The patients were allocated to two intervention groups of group A: 9 µg SR-T3 plus 68.5 μg LT4 (ratio 1:7.5) and group B: 12 µg SR-T3 plus 60 µg LT4 (ratio 1:5), and a control group with LT4 monotherapy. For PD study, thyroid hormone profile was evaluated at 8 and 12 weeks intervals after intervention. To assess PK properties of SR-T3, T3-Cmax, T3-Tmax and AUC0 − 24 were calculated at the last visit. Results: Serum T4 and FT4 concentrations decreased in the intervention groups after 3 months. No significant difference was observed in serum T3 and FT3 concentrations before and after intervention. Serum T3/T4 ratio increased significantly in the intervention groups after intervention, with the highest increase in group B from 8.6 ± 2.03 at baseline to 12.2 ± 1.6. Comparison of trial groups at follow-up showed no differences in serum TSH, T4, T3 and T3/T4 concentrations among different groups. During 24 h, minimal variation in serum T3 concentration was observed in group B with mean ∆T3 of 15.4 ± 10.5 ng/dl. T3-Tmax, T3-Cmax and AUC0 − 24 in the combined sustained-release preparation were 4.38 ± 1.1 h., 101.0 ± 5.7 ng/dl and 2257 ± 110 ng.h/L, respectively which were significantly different from the control group. Conclusion: Combined treatment with a single dose of SR-T3 plus LT4 is associated with increased serum T3/T4 ratio and minimal excursions in serum T3 concentration during 24 h; however, it was not significantly different from the control group. To incorporate sustained-release T3 in the management of hypothyroidism, a higher ratio of SR-T3 to LT4 than that of the previously recommended by the international organizations is suggested. IRCT registration number: IRCT20100922004794N13. https://www.irct.ir/search/result?query=IRCT20100922004794N13. Registration date: 08/12/2021. [ABSTRACT FROM AUTHOR]

Introduction: Childhood cancers are usually treated with chemotherapy and radiation. Therefore, understanding the late side effects of such treatments is important to improve the quality of life in childhood cancer survivors. The present study aimed to investigate the late complications of treatments in childhood cancer survivors. Methods: This study is a retrospective descriptive study. A total number of 93 cases were enrolled in this study. These cases had a history of childhood cancer documented in their medical records at the Shafa Hospital, Ahvaz, Iran. The age range was 5.9–21.3 years and included 62 males and 31 female patients. Results: Many of the patients at this hospital with childhood cancer had experienced chemotherapy side effects as well as late effects of cancer therapy. Hypothyroidism is a late complication of therapy in thoracic cancers and head/neck tumors with relative frequencies of 23.1% and 12.5%, respectively. Scoliosis was observed in the patients undergoing the ABVD + COPP and 8/1 regimens with relative frequencies of 4% and 50%, respectively. Lower growth percentiles were also late side effects of cancer therapy. The highest relative frequency of growth retardation was observed in the <5 age group (46.7%). Restrictive lung changes had an overall relative frequency of 6.5% in male patients with all types of tumors. Sensorineural hearing loss was observed in patients with leukemia and Hodgkin lymphoma with relative frequencies of 8.7% and 24.0, respectively. Conclusion: The occurrence of most side effects could be decreased through early diagnosis, dose adjustment of some drugs, and preventative measures. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism is the most common clinical disorder of the thyroid gland which is associated with an increased prevalence of sexual dysfunction even if treated with medication. Objective: The aim of this study was to determine the effect of cognitive-behavioral therapy (CBT) on sexual function in reproductive-aged women with hypothyroidism. Materials and methods: This randomized clinical trial was performed on 66 reproductive-aged women with hypothyroidism referring to selected health centers in Izeh, Iran. Data collection tools included demographic information form and Female Sexual Function Index (FSFI). Eligible individuals were randomly assigned to case (n = 33) and control (n = 33) groups using block randomization with the block size of 4. In addition to standard hypothyroidism treatment, the case group received 8 sessions of cognitive-behavioral group therapy, while the control group received only standard treatment. Results: Before of treatment, there was no significant difference between the mean score of sexual function and its dimensions between the case and control groups (p < 0.05). However, immediately and 4 weeks after completion of treatment, the mean total score of sexual function and its dimensions in the case group increased significantly compared to the control group (p < 0.001). Conclusion: According to the results of this study, CBT can be effective in improving sexual dysfunction in reproductive-aged women with hypothyroidism. However, before recommending this therapy to women suffering from hypothyroidism, more detailed studies are needed to prove the effectiveness of this intervention, as an adjuvant treatment to the standard pharmacotherapy. [ABSTRACT FROM AUTHOR]

Background: Primary hypothyroidism is a common endocrine disorder caused by impaired production of thyroid hormones. Recent studies have shown that dietary habits, oxidative stress, and inflammation may play roles in thyroid hypofunction. Thus, the present article aimed to determine the relationship between major dietary patterns and oxidative stress and inflammation in primary hypothyroid patients and healthy people in Iranian adults. Methods: This matched case-control study was conducted on 200 participants (100 cases and 100 controls). The presence of primary hypothyroidism was determined by endocrinologists based on American Thyroid Association (ATA) criteria. Dietary intake was assessed using a validated 168-item, semi-quantitative food frequency questionnaire (FFQ). The principal component analysis (PCA) method was used to derive major dietary patterns. Statistical analysis was performed using logistic regression analysis, and the findings were reported using odds ratios (ORs) with 95% CIs. Results: We identified 2 major dietary patterns (i.e., healthy and Western dietary patterns). After adjusting for confounding variables, participants in the highest tertile of the healthy eating pattern had lower odds of primary hypothyroidism. Also, there was a significant relationship between total antioxidant capacity (TAC) levels and thyroid hypofunction; however, no significant correlation was seen between the Western dietary pattern and malondialdehyde (MDA) and C-reactive protein (CRP) with hypothyroidism. Conclusions: There were statistically direct associations between healthy dietary patterns (loaded with vegetables, nuts and seeds, fruits, dried fruits, olives, garlic, black pepper, starchy vegetables, low-fat dairy, and legumes) and increased TAC levels with a decreased risk of thyroid hypofunction. However, Western dietary patterns and MDA and CRP levels did not associate with an underactive thyroid. [ABSTRACT FROM AUTHOR]

Background: Cardiac surgery plays a vital role in human health. Hypothyroidism is a common disorder that affects 4 - 10% of the world's population. One of the important challenges of cardiac surgery in hypothyroid patients is their perioperative management. Objectives: In this study, we determined the effects of hypothyroidism on complications after cardiac surgery. Methods: In this retrospective cohort study, patients who underwent cardiac surgery in Birjand, Iran, during 2016 - 2021 and had TSH > 5 μU/mL in adults ≤ 50 and TSH > 10 μU/mL in adults > 50 years old were included as the case group. Also, adults ≤ 50 with TSH 0.3 -- 5 μU/mL and adults > 50 years old with TSH 0.3 -- 10 μU/mL were included as the control group. The complications and outcomes of cardiac surgery were extracted from the patient files. Results: This study involved 30 patients with hypothyroidism and 90 controls. The two study groups were comparable regarding gender, type of cardiac surgery, history of diabetes, hypertension, heart failure, myocardial infarction (MI), and dyslipidemia (P > 0.05). The frequency distribution of cardiac and pulmonary complications, delirium, acute kidney injury (AKI), sepsis, and mortality ratio was not significantly different between the two groups (P > 0.05); the mean systolic and diastolic blood pressure before and after the surgery, duration of mechanical ventilation, cardiopulmonary bypass time, aortic clamp time, duration of ICU hospitalization, and amount of use of dopamine, epinephrine, and norepinephrine were also similar (P > 0.05). Conclusions: Hypothyroidism did not affect the frequency of complications and outcomes after cardiac surgery. Thus, achieving a euthyroid status in hypothyroid patients is unnecessary before cardiac surgery, and there is no need to postpone elective cardiac surgery until hypothyroidism is corrected. [ABSTRACT FROM AUTHOR]

Introduction: There is inconsistent data regarding COVID-19 prognosis in patients with background hypothyroid disorder. The present study aimed to evaluate the severity of symptoms and blood parameters in COVID-19 patients with hypothyroidism. Material & Methods: This study investigated 100 COVID-19 patients (50 individuals with a history of hypothyroidism and 50 patients without thyroid disorder [euthyroid]). Demographic and clinical characteristics were collected from the COVID-19 registry database in Shahid Mustafa Khomeini Hospital. All patients were admitted and treated between March and December 2020. Hospitalization duration, the ICU admissions rate, and blood laboratory tests were evaluated in this study. Findings: Hospitalization period was significantly longer in the hypothyroid group, compared to the euthyroid group (P=0.009). The number of red blood cells (RBCs), hemoglobin level, and hematocrit percentage were lower in the hypothyroid group (P=0.001, P=0.003, and P=0.003, respectively). Nevertheless, the number of white blood cells (WBCs) and inflammatory indicators, including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were the same in both groups. (Ethic code: IR.MEDILAM.REC.1401.186) Discussion & Conclusion: Although background hypothyroidism had no significant effect on inflammation severity caused by COVID-19; however; it extended hospital stay in these patients. Anemia, a common problem in hypothyroidism, may explain longer hospitalization in hypothyroid COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is a multifactorial hypertensive disorder of pregnancy with multisystem involvement. Recent studies have demonstrated that preeclampsia is associated with increased placental oxidative stress at the cellular level. The nuclear factor erythroid-2-like 2 (Nrf2)/Kelch-like ECH-associated protein 1 (Keap1) signaling is an antioxidant pathway that plays an important role in protecting cells against oxidative stress. Here, we aimed to determine the possible association between the Keap1 variants and genetic susceptibility to preeclampsia. Methods: In a case-control study, 150 preeclampsia patients and 150 women with normal pregnancy from Northern Iran were selected to evaluate the genotypes of Keap1 (rs11085735) using the polymerase chain reaction (PCR)-restriction length polymorphism (RFLP) method. Results: A significant association between genotypes of Keap1 rs11085735 polymorphism with the renal function biomarkers and the risk of preeclampsia was not found. However, the aspartate aminotransferase (AST) level was higher in the presence of the Keap1 AA genotype compared to AC and CC genotypes. We found a significantly higher prevalence of gestational diabetes mellitus (GDM) in mild- and severe- preeclampsia and also hypothyroidism in severe preeclampsia compared to controls. Conclusions: We found an association between preeclampsia with GDM and hypothyroidism. Our findings suggest that the Keap1rs11085735 polymorphism may not be a risk factor for susceptibility to preeclampsia in our studied population; however, this polymorphism could affect the activity of AST. [ABSTRACT FROM AUTHOR]

The present study was carried out, for the first time, to evaluate the association of rs2268458 polymorphism, biochemical and environmental factors on hypothyroid and hyperthyroid disorders in thyroid patients and healthy individuals in Yazd province, Iran. In this study, blood samples were collected from a total of 100 cases, including 60 hypothyroid, 20 hyperthyroid and 20 normal individuals. DNA was extracted from blood samples and the rs2268458 single nucleotide intronic polymorphism was evaluated using Restriction Fragment Length Polymorphism PCR (RFLP-PCR). The results have shown that 59 individuals were homozygote (TT), 40 cases were heterozygote (TC) and one homozygote (CC) case. Of 59 TT homozygote cases, 25 cases were hypothyroid females and 7 hypothyroid male patients. While, heterozygote TC group consisted of 20 hypothyroid females and 7 hypothyroid male cases. Furthermore, only 1 (CC) homozygote male hypothyroid patient was observed in this study. The hyperthyroid population consisted of 7 (TT) homozygote hyperthyroid female cases, 8 (TC) heterozygote hyperthyroid female cases, 3 (TT) homozygote hyperthyroid male cases and 2 (TC) heterozygote hyperthyroid male cases. According to our study, heterozygote cases (TC) showed less severe symptoms, while homozygote cases (TT) showed no serious symptoms and the (CC) homozygote case showed severe thyroid abnormalities. So, it can be concluded that the TSHR-related rs2268458 polymorphism is associated with hypothyroidism and hyperthyroidism in the male and female populations of Yazd Province, Iran and C allele can be a risk factor for some physio-biochemical and hormonal imbalance in the thyroid disorder patients. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism is the most common hormonal deficiency worldwide; however, there is limited data about its prevalence in the children and adolescents of the Middle East. Methods: The prevalence of hypothyroidism were calculated by dividing the number of patients purchasing levothyroxine in 1397 Solar-Hijri year (Correlate with March 2018-February 2019) by the population at risk (per 10 000 persons). Data were collected from the Iran health insurance organization registration records and family physician databases of health vice-chancellor of Shiraz University of Medical Sciences. Results: The present study shows that the prevalence of levothyroxine treated population aged under 18 years is 13 in 10 000 in the Fars province and it is more common in females (17 in 10 000 in females versus 9 in 10 000 in males). This study also revealed that the prevalence of hypothyroidism was different in various age groups and increased in older children and adolescents after pubertal ages. Also, an increase in the female: male ratio of prevalence was more obvious during and after puberty. Conclusion: Our study showed that the prevalence of congenital hypothyroidism was 3/10 000 in southern Iran. Also, the prevalence of hypothyroidism in children and adolescents was totally 13/10 000 population, and this prevalence increased in older age and female gender. This prevalence was close to the data from iodine sufficient areas in Europe and the United States. [ABSTRACT FROM AUTHOR]

Introduction: Today diabetes is one of the most common endocrine diseases today and a leading cause of death across the globe. There is evidence of thyroid dysfunction in people with type II diabetes, leading to a poorer prognosis in diabetics. The present study aimed to assess thyroid function in patients with type II diabetes. Methods: This cross-sectional study was conducted on 800 patients with type 2 diabetes in Hamada, Iran, during 2018-1400. All patients under treatment with type II diabetes confirmed by the census method were included in the study. A checklist with two sections of demographic and clinical information was used to collect data. After data collection, they were analyzed in SPSS software (version 22) using descriptive and analytical methods. Results: The patients included 36.6% males and 63.4% females with a mean age of 58.09±10.95 years. The result of the thyroid examination was abnormal in 10.5% of diabetic patients. Thyroid disorder was detected in 31.4% of patients, including clinical hypothyroidism (17.8%), subclinical hypothyroidism (10.5%), and hyperthyroid (3.1%). The prevalence of thyroid disorder in patients with type 2 diabetes in females and those over 35 years of age was significantly higher than in males and those under 35 years of age (P<0.05). Conclusion: About one-third of participants with diabetes had thyroid dysfunction. Both hypothyroidism and subclinical hypothyroidism were more common in type II diabetic patients. The findings of this study indicated that further research is needed in the future on measures to evaluate thyroid function in patients with type II diabetes. [ABSTRACT FROM AUTHOR]

Introduction. Subclinical hypothyroidism during pregnancy can be associated with numerous adverse outcomes. The purpose of this study was to compare short-term adverse pregnancy outcomes in treated versus nontreated patients who fall within the numerical range of thyroid-stimulating hormone (TSH) between the Iranian and American reference ranges. Materials and Methods. Eighty pregnant women with a known level of antithyroid peroxidase (anti-TPO) and TSH levels of 2.5–3.9 mIu/L in the first trimester and 3–4.1 mIu/L in the second and third trimesters were enrolled in the study and randomly assigned into two groups including 41 patients in the intervention group and 39 in the control group. The intervention group was treated with levothyroxine at least 50 μg/day and the control group received no treatment. The data were analyzed by SPSS software version 23. Results. The only significant findings were a correlation between pregnancy loss frequency (p − 0.011) and/or increased TSH level in the follow-up period (p = 0.008) with anti-TPO antibody positivity. Forty-four percent of mothers with positive anti-TPO Ab needed treatment initiation with levothyroxine, based on Iranian guidelines, due to increased TSH level during the follow-up period. Conclusion. Untreated pregnant women with subclinical hypothyroidism, who were placed in the intermediate range of TSH, recommended by Iranian and American guidelines, did not show any significant difference in short-term adverse pregnancy outcomes compared to the treated patients. Positive anti-TPO Ab may play a role in the development of short-term complications in mothers with subclinical hypothyroidism or it may increase the likelihood of an increase in TSH level during pregnancy. [ABSTRACT FROM AUTHOR]

Background: The prevalence of celiac disease (CD) and hypothyroidism exhibit significant variation in different studies among patients with congenital heart disease (CHD). This study evaluated the frequency of laboratory test abnormalities in children and adolescents with CHD in Shiraz, Iran., Methods: This prospective case-control study was conducted on 223 children and adolescents with CHD and healthy individuals referred to the heart clinic affiliated with Shiraz University of Medical Sciences between February 2019 and December 2021. They were classified into case and control groups. Blood tests were performed for total IgA antibody, anti-tissue transglutaminase IgA antibody (anti-TTG Ab), T4, and thyroid stimulating hormone (TSH) and anti-thyroid peroxidase antibodies in serum, along with transthoracic echocardiography. Likewise, demographic characteristics of patients, including age, sex, weight, height, and body mass index (BMI), were recorded. Also, anti-TTG Ab levels were compared among CHD patients according to cyanosis status, gender, age (above and below five years), and BMI (under and over 18.5)., Results: Ninety-eight CHD patients and 100 healthy individuals with an average age of 5.32 ± 4.05 years (1-18 years) were examined. In children with CHD, atrial septal defect (27%), ventricular septal defect (20%), and tetralogy of Fallot (13%) were the most prevalent disorders. Only one CHD patient had an anti-TTG Ab level of 16.6 unit/mL, considered borderline for seropositive CD diagnosis. There was no difference in anti-TTG Ab levels between age (above and below five years), BMI (under and over 18.5), cyanosis status, and gender groups. Seven CHD patients had high TSH levels, three had cyanotic CHD, and one had Down syndrome. The TSH levels and non-autoimmune hypothyroidism were significantly higher in CHD patients than in normal subjects (p < 0.05)., Conclusions: According to the results of this study, the serum level of TSH and prevalence of non-autoimmune hypothyroidism were higher in patients with CHD than in normal subjects, but the serum level of anti-TTG Ab was not different between the two groups., (© 2024. The Author(s).)

Background: The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status. Methods: This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020-2021. Results: The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%-90%), overt hypothyroidism (2.8%, 95% CI: 2%-3%), subclinical hypothyroidism (5.8%, 95% CI: 4%-6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%-1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%-1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6-3.7), subclinical hypothyroidism (20.6, 95% CI: 18-23), overt hyperthyroidism (1.9, 95% CI: 1-2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6-3.7) per 1000 (person-year). Conclusion: We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection. [ABSTRACT FROM AUTHOR]

Background: Familial hypercholesterolemia (FH) leads to elevated low-density lipoprotein cholesterol (LDL-C) levels in plasma. Mutations of its related gene; apolipoprotein B (APOB) is seen in about two percent of the patient with FH. Thyroid disease is usually part of the exclusion criteria for the detection of FH which alters the lipid profile. We evaluated mutations in the APOB gene in patients with high LDL-C levels. Materials and Methods: Patients aged between 2 and 80 years with at least one LDL-C level of more than 190 mg/dl were selected (120 patients) from Isfahan Laboratories. Blood samples were obtained from all patients. Genomic DNA was extracted. Primer sequences were designed by Oligo 7.60 to amplify the desired 844 bp region of exon 26 of the APOB gene containing R3500Q and R3500W variants associated with FH. Results: Overall, two patients showed a heterozygous form of a common pathogenic variant in exon 26 named c. 10579 C > T (R3500W, cDNA.10707), and one patient was hypothyroidism. We also recognized another nonpathognomonic variant c. 10913G > A (rs1801701, cDNA.11041) in 13 patients, two of them were hypothyroidism. Conclusion: This study for the first time shows the coexistence of APOB mutation in hypothyroidism, which emphasis screening of patients with hypothyroid for FH detection. [ABSTRACT FROM AUTHOR]

Introduction: Gestational diabetes is a degree of glucose intolerance that is first diagnosed or developed during pregnancy due to the inability of the pancreas to secrete more insulin to respond to increased insulin resistance or decreased insulin sensitivity. Many studies have shown that gestational diabetes mellitus (GDM) and thyroid dysfunction can have a variety of adverse effects on the outcomes of pregnancy and offspring. In the present study, the relationship between gestational diabetes and thyroid hormone levels was investigated in pregnant women in Zabol. Materials and Methods: In this case-control study, 252 pregnant women (87 with and 165 without GDM) were randomly admitted during 2020. The serum levels of FBS, free thyroxine (FT4), and thyroid-stimulating hormone (TSH) were compared between the two groups. Data were analyzed using SPSS statistical software (version 22). Results: The mean TSH levels in the case and control groups were 2.75 ± 1.56 and 1.78 ± 1.07 μIU/mL, respectively, which was significantly higher in the case group (P < 0.00). Mean FT4 levels were 1.5 ± 0.61 and 1.4 ± 0.68 ng/ in case and control groups, respectively which were not statistically different in both groups (P = 0.25). Among patients with GDM, 16 (12.48%) had subclinical hypothyroidism and 6 (7.69%) had clinical hypothyroidism, while among non-GDM patients, 7 (4.24%) had subclinical hypothyroidism and 4 (2.42%) had clinical hypothyroidism. Conclusion: These findings indicate a significant association between hypothyroidism and gestational diabetes. Therefore, accurate measurement and evaluation of thyroid hormones during pregnancy, especially in diabetic mothers, is recommended for better management and its prognosis. [ABSTRACT FROM AUTHOR]

Objective: Toxoplasma gondii is an important agent responsible for many hormonal and behavioral disorders in humans. The main objective of this study was to evaluate the hypothesis that 'T. gondii infection interferes with thyroid hormones secretion or thyroid drug treatment'. Methods: This is a cross-sectional study that involved 249 patients suffering from thyroid dysfunctions, divided into 3 groups: hypothyroidism (n=107), hyperthyroidism (n=96), and drug-controlled thyroid disorders (n=91), referred to Seyedoshohada Kerman private clinic. Serum samples were tested for thyroid-stimulating hormone (TSH), triiodothyronine (T3), and thyroxine (T4) along with Toxoplasma anti-IgG using ELISA technique. Demographic information was collected using a demographic sheet. Results: The seroprevalence of Toxoplasma gondii IgG antibodies among patients with hypothyroidism, hyperthyroidism, and drug-controlled thyroid disorders was 22.4%, 19.8%, and 22% respectively. The mean value of thyroid hormones of positive T. gondii samples in hypothyroidism, hyperthyroidism, and drug-controlled thyroid disorders was TSH=7.95, T3=1.12, T4=2.36; TSH=0.14, T3=1.42, T4=7.85; and TSH=2.75, T3=1.12, T4=1.45 respectively. The seropositivity of Toxoplasma gondii infection was 40.4% among individuals with a history of contact with pets and 26.3% among the rural dwellers. Conclusion: There was no significant difference between T. gondii infection among the three study groups. A comparison of serum levels of thyroid hormones between infected and non-infected individuals in the above-mentioned groups illustrated that latent toxoplasmosis wasn't significantly associated with thyroid hormones secretion. Also, contact with pets and the rural lifestyle has a positive association with T. gondii seroprevalence. [ABSTRACT FROM AUTHOR]

Background: Although selenium is one of the nutrients that has an important role in the metabolism of thyroid hormones, it has been investigated in rare studies. This study aimed to evaluate role of selenium deficiency in children and adolescents with acquired hypothyroidism. Methods: This case and control study was conducted on 60 acquired hypothyroidism and 60 healthy children who had been referred to the pediatrics endocrine clinic in Shiraz, Iran, from November 2018 to April 2019. Some information such as age, gender, weight, height, duration of disease, and level of plasma selenium were recorded. Plasma selenium level was measured by atomic absorption spectrophotometer. Data were analyzed using SPSS software 21.0. Results: The mean of selenium level in the case and control groups were 93.77 ± 24.90 µg/dl and 85.96 ± 25.20 µg/dl, respectively. There was no significant difference between the two groups in the mean levels of selenium. Independent t-test showed no significant difference in the mean levels of selenium in male and female samples in the case group, but this difference was significant in the control group. Conclusion: Selenium deficiency may not have significant role as a cause of acquired hypothyroidism in pediatric and adolescent age group, in south of Iran. Thus, it does not seem necessary to routinely check the level of selenium for patients with thyroid dysfunction. [ABSTRACT FROM AUTHOR]

Background: Congenital hypothyroidism (CH) is the most important cause of mental and physical retardation in newborns. The prevalence of CH has been reported high in East Azerbaijan province of Iran. However, the risk factors for CH are poorly understood. This study aimed to determine and compare risk factors for permanent and transient CH in East Azerbaijan, Iran. Methods: A case-control study was conducted in the Iranian national screening program for CH. This study included 680 neonates: 340 neonates with confirmed CH and 340 matched healthy controls born at the same period and from the same residential area as the cases. Multiple logistic regression analyses were used to estimate the crude and adjusted odds ratios and 95% confidence intervals for the association between different risk factors and transient and permanent CH. Results: Out of the 680 participants, 364 (53.53%) were male. Family history of CH (OR = 5.09, 95% CI: 1.66–15.63), neonatal jaundice (OR = 3.89, 95% CI: 2.36–6.43) and parental consanguineous relation (OR = 2.19, 95% CI: 1.51–3.17) were associated with an increased risk of permanent CH. Likewise, the use of Betadine in pregnancy (OR = 4.87, 95% CI: 1.45–16.28), family history of CH (OR = 5.98, 95% CI: 2.04–17.48), neonatal jaundice (OR = 2.81, 95% CI: 1.75–4.52), parental consanguineous relation (OR = 3.86, 95% CI: 1.92–5.74), and gestational age at birth (OR = 3.2, 95% CI: 1.90–5.41) were identified as risk factors for transient CH. Conclusion: Family history, neonatal jaundice, gestational age at birth, and Betadine usage in pregnancy are associated with CH. [ABSTRACT FROM AUTHOR]

Background: Due to the increasing worldwide prevalence of obesity, it is essential to determine the prevalence of obesity-related thyroid dysfunctions. The purpose of this study was to investigate the prevalence of thyroid dysfunctions, namely hypothyroidism and hyperthyroidism, and their association with BMI among adult Iranian overweight and obese individuals. Method: This cross-sectional study was carried out within the framework of the Tehran Thyroid Study (TTS); 5353 participants (57.5% female) entered our study. Anthropometric measurements were performed. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and thyroid peroxidase antibody (TPOAb) were assayed. We categorized individuals into 3 BMI groups (normal-weight, overweight and obese), then calculated prevalence rate, odds ratio (OR), and 95% confidence interval (CI) for outcomes in overweight and obese groups. The normal-weight group was used as the control group. Results: We found a higher prevalence of hypothyroidism (11.6% vs 8.2% Total, 4.0% vs 1.1% overt and 7.6% vs 7.1% subclinical, P < 0.001) and TPOAb positivity (17.3% vs 11.6%, P < 0.001) in obese participants compared with normal-weight participants. Hyperthyroidism's overall prevalence was 4.2, 5.7, and 4.9% in obese, overweight, and normal-weight groups, respectively. Obesity was associated with higher odds of overt hypothyroidism (OR: 2.0, 95% CI: 1.15–3.49, P < 0.05) and TPOAb positivity (OR: 1.29, 95% CI: 1.04–1.60, P < 0.05) after adjusting for confounding variables. In contrast, no association was observed between the overweight group and the odds of hypothyroidism and TPOAb positivity in the adjusted results. Conclusions: Obesity was associated with an increased risk of overt hypothyroidism and TPOAb positivity. [ABSTRACT FROM AUTHOR]

Aim: The current study aimed to investigate the risk factors, endoscopic findings, and treatments of upper gastrointestinal bezoars. Background: Bezoars are compact masses formed by the accumulation of dietary fiber, undigested food, hair, or medications. The majority of bezoars are asymptomatic, but they may cause serious symptoms or even life-threatening events such as bleeding, obstruction, or perforation Methods: This retrospective study was conducted in three gastroenterology clinics between January 2016 and December 2019. Bezoars were detected in 109 of 15,830 endoscopy records (0.68%). Results A total of 103 patients (52.4% male) were enrolled in this study. Mean patient age was 60.5±11.3 years. The most frequent risk factors were history of gastric surgery (25.2%), diabetes mellitus (21.3%), hypothyroidism (15.5%), trichophagia (5.8%), and anxiety disorders (2.9%), respectively. The most common endoscopic findings were peptic ulcers (34.9%), erosive gastritis/duodenitis (12.6%), and reflux esophagitis (10.6%). While bezoars were most commonly observed in the stomach (84.4%), the majority of them were phytobezoars (92.2%). The mean number of endoscopic interventions for each patient was 1.5 (range, 1-4). Endoscopy was successful in removing bezoars in 85.4%. Conclusion: The synergistic effect of multiple factors for a long time, such as gastrointestinal surgery, diabetes mellitus or psychiatric disorders, may lead to bezoar formation. These risk factors should be avoided or treated in order to prevent bezoar formation and subsequent life-threatening complications. [ABSTRACT FROM AUTHOR]

Congenital goiter (CG) is one of the rarest disorders observed in a newborn at birth diagnosed with hypothyroidism. Considering the simultaneity of pregnancy and baby's hypothyroidism at birth, the goiter can be caused by diabetes during pregnancy and hypothyroidism emergence in the baby. [ABSTRACT FROM AUTHOR]

Objectives: Nephrotic syndrome is a glomerular disease characterised by a loss of albumin and high-molecular-weight proteins such as thyroxine-binding globulin and thyroid hormones, potentially resulting in subclinical or even overt hypothyroidism. This study aimed to compare thyroid hormone levels between nephrotic children and healthy controls as well as between nephrotic children in the active phase of the disease and those in remission. Methods: This case-control study was conducted between March 2016 and 2018 at a paediatric hospital in Qazvin, Iran. A total of 73 nephrotic children comprised the case group--including 49 with active disease and 24 in remission--while the control group included 74 healthy children. Thyroid function was assessed according to levels of thyroid-stimulating hormone (TSH), free triiodothyronine (T3), free thyroxine (T4), total T4, total T3 and anti-thyroid peroxidase. Results: All of the controls had normal total T4 levels. Elevated TSH levels were more frequent in nephrotic children compared to controls (34.2% versus 10.8%; P = 0.001). A significantly lower number of patients with active disease were euthyroid compared to those in remission (51% versus 95.8%; P = 0.001). Moreover, 7 (9.5%) of patients in the active and no patient in remission phase had abnormal total T4 levels (P <0.001), while 14.3% and 0% had highly elevated TSH levels (P = 0.002). Conclusion: Due to the prevalence of subclinical and even overt hypothyroidism, thyroid screening tests may be required for nephrotic children. However, further research is needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Background: Subclinical hypothyroidism is defined as elevated TSH levels while T4 or FT4 levels are normal. Elevated TSH levels are linked with obesity in adults. In a recent meta-analysis in Iran, 6.1% of children below 18 had obesity. Due to the low number of studies on the subject in children we, designed the study to assess the relation between BMI Z-score and TSH levels in children and adolescence. Method: This cross-sectional study was performed in a pediatric endocrinology clinic in Shiraz. Children aged between 2 to 18 years that came to the clinic for routine growth assessment follow up from January till April 2018 were considered. 850 children including 365 boys and 485 girls were included. Results: Prevalence of subclinical hypothyroidism is increased in higher BMI groups. 9.9, 13.8, 17.2 and 20.5% of underweight, healthy weight, overweight and obese had subclinical hypothyroidism respectively. Obese and overweight participants had higher odds of subclinical hypothyroidism than those who were not (OR:1.649, P = 0.010, CI95% 1.126–2.413). On the other hand, Subclinical hypothyroid participants had higher odds of overweight or obesity than those who were euthyroid (OR:1.650, P = 0.010, CI95% 1.128–2.413). When TSH is set as a dependent value, TSH level is increased (β = 0.126, r = 0.125, P = 0.001) with an increase in BMI Z-score. When BMI Z-score is set as a dependent value, BMI Z-score is increased (β = 0.113, r = 0.243, P = 0.001) with an increase in TSH level. Conclusion: BMI Z-score and elevated TSH levels are positively correlated however studies should be performed on establishing the causality. [ABSTRACT FROM AUTHOR]

Background: Although in many studies, the relationship between autoimmune hypothyroidism (Hashimoto) and Vitamin D deficiency was shown, no research has been performed on the role of vitamin D in non-autoimmune hypothyroidism. Methods: This was a case-control study in Endocrinology clinic of Jahrom (south of Iran). The patients with Hashimoto (n = 633) and non-Hashimoto hypothyroidism (n = 305), along with a control group (n = 200) were evaluated. 25(OH) D level, T3 and T4 levels were studied and Anti TPO and Anti TG tests were performed. The results of vitamin D level were analyzed and interpreted using SPSS in terms of the cause of hypothyroidism (immune and non-immune). Results: The results of the study showed a significantly lower level of vitamin D in both immune and non-immune Hashimoto's thyroiditis (HT) in comparison to healthy controls (P < 0.05). We observed a significant inverse correlation between the vitamin D and TGAb level (p = 0.001, r = − 0.261) and a direct correlation of vitamin D with TSH level (p = 0.008, r = 0.108) in Hashimoto thyroiditis patients. Conclusion: Finally, the results indicated that non-autoimmune hypothyroidism, as well as HT, is associated with vitamin D deficiency. The role of vitamin D deficiency in Hashimoto thyroiditis was thought to be in the association of higher autoantibody (TGAb) level; while, there should be further studies determining vitamin D deficiency's role in non-immune hypothyroidism. [ABSTRACT FROM AUTHOR]

Background: Thyroid disorders such as subclinical hypothyroidism and isolated maternal hypothyroxinemia are understudied in pregnant women, despite their possible adverse effects on the health of mother and child. Also, the role of iodine deficiency in developing such disorders has not yet been fully understood. Methods: The present national population-based cross-sectional study was conducted on 1080 randomly recruited pregnant women, aged 20–40 from 12 provinces of Iran from 2013 to 2014. Serum concentrations of thyrotropin, T4, thyroid peroxidase antibody (TPOAb), and triiodothyronine (T3) resin uptake values were measured in fasting blood samples, and urinary iodine concentration (UIC) was measured in three separate urine samples. Multinomial logistic regression was run to analyze the possible risk factors regarding thyroid disorders. To clarify the role of iodine in thyroid status specifically, the determinants of UIC and its correlations with thyroid function tests were investigated independently and through subgroup analysis. Results: Isolated hypothyroxinemia was the most common thyroid disorder (9.9%), followed by subclinical hypothyroidism (8%). In comparison to euthyroid pregnant women, isolated hypothyroxinemia was more likely in pregnant women older than 30 years (odds ratio [OR] = 1.6), in the second and the third trimesters (OR = 2.62 and 2.12 respectively), with history of multiparity (OR = 1.72), residing in rural areas (OR = 1.57) and in the capital province of the country (OR = 3.3). Subclinical hypothyroidism was more likely in TPOAb positive pregnant women (OR = 2.56). All the mentioned ORs were statistically significant (p < 0.05). The UIC did not correlate significantly with any of the thyroid function tests in the study population. Subgroup analysis showed a significant correlation between UIC and T4 in pregnant women with subclinical hypothyroidism (p < 0.05). Conclusion: Isolated maternal hypothyroxinemia was the most prevalent thyroid disorder in Iranian pregnant women and its associated risk factors were identified. Although the calculated prevalence of thyroid disorders was expected in a moderately iodine deficient setting, no correlations between UICs and thyroid function tests were found at the individual level. The contribution of iodine deficiency to thyroid condition for each pregnant woman may be more evident in pregnant women with certain thyroid disorders or those with long-term iodine deficiency. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the levels of trace metals Fe, Cr, Co, Cd, Cu, Ni, Hg, Zn, and Pb in healthy individuals and patients with thyroid disease (hyperthyroidism, hypothyroidism, and cancerous). The serum levels of 110 participants living in Birjand City, east of Iran, were collected and analyzed using ICP-MS (Agilent 7900). Results showed that the concentration levels of Cr, Co, Zn, Cd, and Pb were significantly higher at case-patients (p < 0.05), but the levels of Fe, Ni, and Hg were similar between healthy and patient subjects (p > 0.05). In patients with high or low thyroid activity, strong mutual correlations between Cr, Ni, and Fe were noticeable (p < 0.05). In hypothyroid patients, no significant correlation between Zn and Hg, Co, and Cd was found, but Zn was moderately and positively correlated with other trace metals. The moderate negative correlations between Cd-Cr (p = − 0.46) and Cd-Fe (p = − 0.43) were also observed. Logistic regression analysis showed that the effect of Cr, Co, Pb, Cu, Zn, and Cd was significant in developing hyperthyroidism and hypothyroidism; whereas, in patients with thyroid cancer, the effect of Cr, Cd, and Pb was found to be significant. In conclusion, our findings suggest that toxic metals such as Pb, Cd, and Cr can increase the risk of developing hypothyroidism and thyroid cancer, but more research is needed to evaluate the potential toxicity mechanisms of Pb, Cd, and Cr. [ABSTRACT FROM AUTHOR]

Background: Little is known about the association of dietary patterns with thyroid function. Since thyroid function and cardiometabolic variables are inter-related, we investigated whether cardiometabolic-related dietary patterns are associated with thyroid function., Methods: This cross-sectional study included 3520 Tehran Lipid and Glucose Study participants. Reduced rank regression was used to find dietary patterns with body mass index, serum fasting glucose, triglycerides, HDL-C, and systolic and diastolic blood pressures as response variables. Two patterns were retained, one based on 35 food groups (native-based pattern) and the other based on the European Prospective Investigation into Cancer and Nutrition Germany (EPIC) food grouping (n = 33). A confirmatory cardio-metabolic dietary pattern was also created according to the weight of food groups proposed by the Framingham Offspring Study (FOS). The association of each pattern with thyroid-stimulating hormone (TSH), free thyroxine, and thyroid peroxidase antibody (TPOAb) and the odds of thyroid dysfunction was examined by linear and logistic regression, respectively., Results: The two exploratory dietary patterns were highly correlated and associated with greater TSH levels in euthyroid participants. The adjusted odds ratio (95% CI) of subclinical hypothyroidism per one standard deviation was 1.14 (1.01, 1.28) for the native-based pattern and 1.16 (1.03, 1.31) for the EPIC-based pattern. The odds of subclinical hypothyroidism was significantly greater in the second and third tertiles of the native-based pattern compared to the first tertile in the adjusted model (p-trend = 0.005). The odds of subclinical hypothyroidism increased across the tertiles of the EPIC-based pattern, but the odds was significantly higher only in tertile 3 compared to tertile 1, with an OR (95% CI) of 1.44 (1.07, 1.94) in the adjusted model. The adjusted odds of clinical hypothyroidism were greater in tertile 3 of the native-based pattern compared with tertile 1 (OR = 1.65, 95% CI 1.04, 2.62). The patterns were unrelated to hyperthyroidism or TPOAb positivity. The FOS-based confirmatory score was unrelated to thyroid function., Conclusions: A diet high in fast foods, soft drinks, and legumes and low in confectionery, potatoes, butter, and jam and honey was associated with higher TSH levels in euthyroidism and higher odds of subclinical hypothyroidism., (© 2023. The Author(s).)

Background: The aim of the current study is to assess the prevalence of different categories of thyroid dysfunction and their associated risk factors among the modern urban population of Tehran, the capital of Iran., Methods: The present investigation is a sub-study of the HAMRAH study, a population-based prospective study designed to assess the prevalence of traditional cardiovascular risk factors and their changes through a 10-year follow-up. 2228 (61% female) adults aged between 30 and 75 years old and with no overt cardiovascular diseases were selected through a multistage cluster randomized sampling. Blood levels of thyroid-stimulating hormone (TSH), thyroxin (T4), and triiodothyronine (T3) were measured with the aim of assessing the prevalence of abnormal thyroid function status among the modern urban Iranian population, and in order to report the total prevalence of participants with clinical hypo- or hyperthyroidism, the number of individuals taking thyroid-related drugs were added to the ones with overt thyroid dysfunction. A subgroup analysis was also performed to determine the associated risk factors of thyroid dysfunction., Results: The prevalence of thyroid dysfunction among the total population was 7% (95%CI: 5.9 - 8%) and 0.4% (95% CI: 0.1 - 0.6%) for subclinical and overt hypothyroidism, and 1.6% (95% CI: 1 - 2%) and 0.2% (95% CI: 0 - 0.3%) for subclinical and overt hyperthyroidism, respectively. Clinical thyroid dysfunction was detected in 10.3% of the study population (9.4% had clinical hypo- and 0.9% had clinical hyperthyroidism). In the subgroup analysis, thyroid dysfunction was significantly more prevalent among the female participants (P-value = 0.029)., Conclusions: In the current study, the prevalence of different categories of abnormal thyroid status, and also the rate of clinical hypo- and hyperthyroidism was assessed using the data collected from the first phase of the HAMRAH Study. In this study, we detected a higher prevalence of clinical and subclinical hypothyroidism among the Iranian population compared to the previous studies., (© 2023. The Author(s).)

Background: Thyroid gland involvement and invasion during larynx and hypopharynx cancers is rare, but due to the anatomical closeness of the thyroid gland and the larynx, it could occur through local invasion. Thyroidectomy is usually performed in patients with thyroid gland involvement having larynx and hypopharyngeal cancers. A lot of controversies exist regarding the thyroid gland involvement and efficiency of a different kind of thyroidectomy intraoperatively in these types of cancers. Objectives: Thus, elucidating the exact role of thyroidectomy, its efficiency, and parameters associated with thyroid gland involvement is critical in treating the patients with the larynx and hypopharyngeal cancers. Methods: In this retrospective study, the medical records of 117 patients admitted to Loghman Hakim Hospital from 2001 to 2015 with laryngeal and hypopharyngeal carcinoma, who underwent laryngectomy with or without thyroidectomy as a primary treatment of cancer, were evaluated. Several parameters, including gender, prevalence, location of the thyroid gland and lymph node involvement, the exact type of malignancy, differentiation stage of the tumor cells, the exact method of thyroidectomy, thyroid function, and its post-surgical cancer recurrence were assessed. Results: The prevalence of laryngeal cancers was significantly higher in males than females and most of the malignancies were squamous cell carcinoma (SCC). The location of the malignancy was mostly at supraglottis, glottis, transglottis, and subglottis, respectively. The rate of thyroid gland involvement was approximately 11.96%. Lobectomy was performed in 57.14 %, total thyroidectomy was performed in 35.71 %, and in 7.14% of the patients, and thyroidectomy was not performed. After the initial surgery, out of 11.96% of all patients with thyroid gland involvement, 28.5% had a recurrence of the thyroid gland. Only 21% of the patients with thyroid gland involvement had hypothyroidism after the surgery. Conclusions: The rate of thyroid gland involvement in the pathology report after surgery was approximately 3.41% of the thyroid gland involvement, which is low. We concluded that thyroidectomy is a very efficient way, but it should be limited to cases of subglottic or transglobic involvement or in cases of bilateral tumors, high staging, post-cricoid involvement, and clear radiological evidence or in the event of muscle involvement. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Burning sensation in Hashimoto patient's oral cavity is an unknown prevalent problem. Purpose: This study aimed to evaluate the prevalence and intensity of burning mouth syndrome (BMS) in patients suffering from Hashimoto's thyroiditis in all public hospitals in Shiraz, 2016. Materials and Method: A total of 153 patients with Hashimoto's thyroiditis were selected based on simple random sampling. The initial level of thyroid stimulating hormone (TSH), Anti-TPO (thyroperoxidase), Anti-TG (thyroglobulin), Free T3 (triiodothyronine) and Free T4 (thyroxine) serum as the indices of Hashimoto's thyroiditis was assessed. The BMS intensity was measured according to each patient's verbal or nonverbal expression about the pain experience based on visual analog scale (VAS). Results: Based on the clinical evaluation and interview, only 19out of 153 cases (12%) reported BMS. The mean BMS was 3 based on VAS. Statistically significant association was detected between the level of TSH (p= 0.0001), Anti-TPO (p= 0.035), Anti-TG (p= 0.0001), Free T3 (p= 0.0001), Free T4 (p= 0.0001) indices in patients with BMS. Significant association was also observed between the level of Anti-TPO (p= 0.0001), Anti-TG (p= 0.0001), Free T3 (p= 0.0001) and TSH (p= 0.0001) indices and BMS intensity. However, no significant association was found between the BMS severity and Free T4 (p= 0.056). Conclusion: The level of TSH, Anti-TPO, and Anti-TG, Free T3, and TSH indices of Hashimoto's patients were associated with the presence and severity of BSM. However, Free T4 level was only associated with the presence of BMS and not the intensity. [ABSTRACT FROM AUTHOR]

In patients with COVID‐19, certain medical conditions could result in poorer clinical outcomes. However, the prognostic role of hypothyroidism in COVID‐19 is still unknown. In the present retrospective study, we estimated the prevalence of hypothyroidism in COVID‐19 admitted patients in Tehran, Iran. Among 390 COVID‐19 admitted patients, 21 hypothyroid cases (5.4%) were found, in which nearly 90% were aged 50 years and older. Regarding the effect of hypothyroidism on COVID‐19 mortality, 60 (15.3%) of total patients and 4 (19%) of hypothyroid patients died, and no significant difference was found between the two groups. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the effects of levothyroxine replacement therapy on insulin resistance, lipid profile, and thyroid function in patients with untreated primary hypothyroidism. 105 patients with hypothyroidism with indication for levothyroxine replacement were enrolled in the present study. Insulin, fasting blood glucose and lipid profile were assessed at the beginning of diagnosis and three months after levothyroxine replacement. Insulin resistance was calculated by hemostasis model assessment of insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI)., Results: Our data revealed a significant reduction in body mass index (27.18 ± 4.27 versus 26.81 ± 4.18 kg/m2, p = 0.028), cholesterol (199.79 ± 37.61 versus 178.10 ± 32.25 mg/dl, p < 0.001), triglyceride (160.41 ± 71.86 versus 146 ± 61.11 mg/dl, p = 0.012), low density lipoprotein-cholesterol (123.54 ± 30.7 versus 107.08 ± 26.98 mg/dl, p < 0.001), fasting insulin (8.91 ± 3.92 versus 8.05 ± 2.65 mIU/l, p < 0.001), and thyroid stimulating hormone (47.47 ± 3.4 versus 2.22 ± 1.84 µIU/ml, p < 0.001) levels before and after drug intervention. However, no statistical differences were observed in HOMA-IR, QUICKI, and high density lipoprotein-cholesterol. In conclusion, in patients with untreated primary hypothyroidism, levothyroxine replacement therapy based on HOMA-IR and QUICKI did not improve insulin resistance; however, lipid profile was significantly improved following levothyroxine administration., Trial Registration: This study was registered in the Iranian Registry of Clinical Trials (IRCT) with ID number: IRCT20130610013612N10 on the date 2019-09-02., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Juvenile Idiopathic Arthritis (JIA) is accompanied by growth failure, mostly occurring due to chronic inflammation and use of corticosteroids for treatment. The aim of our study was to determine the prevalence of short stature in JIA patients and possible systemic disorders which may affect the growth pattern in this group of patients. Methods: In this cross-sectional study erformed from June 2014 to May 2015, JIA patients with a history of more than one-year treatment were examined by an endocrinologist and based on their height standard deviation score (SDS) two groups were determined: Group A > -2SD and group B < -2SD. Complete blood count, thyroid function tests and 25OHD3 level were assessed in both groups, but other laboratory tests, including liver and renal function tests, growth hormone stimulation test, urine analysis and culture, as well as left hand and wrist X-ray for bone age determination, were done in group B. Results: Of 117 JIA patients who were enrolled, 41 patients were under -2SD (19% of pauciarticular, 62% of poly articular and 33% of systemic onset). The mean height SDS in group B was-3.48±1.28 (compared to -0.9±0.8 in their parents). We found hypovitaminosis D in 73% of our patients. The prevalence of subclinical hypothyroidism was 7.4% (5% of group A and 9.7% of group B). Twenty-four percent (10 patients) of group B did not respond to growth hormone (GH) stimulation test and 14.6% of them (6 patients) were possibly GH resistant. Liver function tests and renal function tests were normal in all the patients. There was no difference between 2 groups in hypothyroidism and hypovitaminosis D but polyarticular type of the disease was associated with short stature (P Value < 0.000). Conclusions: Growth failure is common in JIA patients. So they, especially those with polyarticular type, need to be visited periodically by an endocrinologist. [ABSTRACT FROM AUTHOR]

Background and Objectives Major beta-thalassemia is a hereditary hemoglobinopaty that is characterized by a genetic deficiency in the synthesis hemoglobin polypeptide chain. The aim is to determine endocrine disorders such as diabetes, hypothyroid, hypo-parathyroid, low growth hormone, hypogonadism and deranged glucose tolerance test and their relation with sexuality, age, ferritin measure and Desferal beginning age in Kurdistan province in 2013. Materials and Methods In this descriptive study, all patients with major thalassemia over 3 year of age with treatment record in Sanandaj Besat Hospital were enrolled. For all patients, tests of GTT, LH, FSH, FSH.T3, T4, TSH, PTH, Ferritin were conducted. The demographic information together with the beginning age of Desferal use were added to the questionnaire. Data were then analyzed by T-test, Kscore, linear regression and logistic regression in STATA-11 software. Results Out of 43 patients, 20 had hypogonadism, 17 had low growth hormone, 2 diabetes, 4 hypoparathyroid, 3 hypothyroid, and 4 deranged glucose tolerance test result. We also found a significant corrrelation between hypogonadism with age, ferritin measure and the beginning age of the Desferal use. The correlation between deranged glucose tolerance test with ferritin measure was significant. There were no significant correlations between other variables. Conclusions This study showed that the prevalence rate of endocrine disorder in patients with thalassemia being more than healthy people. Therefore, all patients with major beta thalassemia over 15 years of age should undergo considerable clinical and laboratory evaluation for endocrine gland. [ABSTRACT FROM AUTHOR]

Background: Research interest in the impact of comorbidities in MS has been expanding. Based on studies, certain comorbidities are more prevalent in MS population such as depression, anxiety, hypertension and hypercholesterolemia, diabetes, and hypothyroidism., Objective: This study aims to describe the prevalence of comorbidities in MS population based on the health insurance claims data., Method: This retrospective database analysis was conducted using patient-level medicinal and pharmacy claims data from a leading insurance group (Iranian health insurance) in 2007-2016. MS population was identified based on their Disease Modifying Therapies prescribed by a neurologist (qualified to diagnose MS). Comorbidities in MS and non-MS population were assessed by their prescriptions. Crude and age-standardized prevalence rate (ASPR) of coverage of comorbidities in different age and sex groups and their odds ratio versus non-MS population were assessed., Results: The most common comorbidities were depression (15.50%) and anxiety (10.1%). Hypercholesterolemia, diabetes, hypertension, and hypothyroidism were prevalent in 6%, 3.6%, 3.5%, and 2.7% respectively. Anxiety and depression were more prevalent in middle age group (45-65 years old). But other comorbidities were more prevalent in older age groups. All comorbidities were more prevalent in female except hypertension in patients ≥45 years old. The odds of all comorbidities were higher for male patients with MS rather than their parallel age group in non-MS patients. These also applied for female patients with MS 18-44 years old (except hypertension)., Conclusion: Using claims data, the prevalence of taking treatment for selected comorbidities in MS population and their association with sex and age, can guide patients, healthcare providers, and policy makers to help improve MS patients' wellbeing., Competing Interests: Declaration of Competing Interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: The association between metabolic phenotypes and thyroid function has not yet been established; therefore, this study examined whether different metabolic phenotypes are associated with the development of hypothyroidism., Methods: Study participants were selected from the Tehran Thyroid Study (TTS). A total of 3338 euthyroid adults were included and categorized into four obesity phenotype groups: metabolically healthy normal weight (MHNW), metabolically healthy obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy obese (MUO). The participants were assessed at baseline and during three follow-up studies at three-year intervals. Multiple logistic regression analysis was used to examine the relationship between metabolic phenotypes and the development of hypothyroidism., Results: In the total population, the chi-square test was only significant (P=0.008) in 3 rd year with a higher prevalence of hypothyroidism in the MUNW phenotype, followed by MHO, MUO, and MHNW. Moreover, in the 3 rd and 9 th years of follow-up, hypothyroidism was more prevalent in MUO only in male subjects (P=0.002 and 0.035, respectively). In the unadjusted model, the MHO phenotype increased the odds of hypothyroidism compared with the MHNW phenotype (OR=1.51; 95% CI=1.04, 2.18; P-value=0.031). After adjusting for confounding factors, the odds of hypothyroidism were higher in the MUNW (OR=1.86; 95% CI=1.17, 2.96; P-value=0.008), MHO (OR=1.71; 95% CI=1.09, 2.67; P-value=0.018), and MUO (OR=1.64; 95% CI=1.03, 2.62; P-value=0.036) phenotypes than in the MHNW group. The MUNW phenotype increased the risk of hypothyroidism compared to MHNW, only in males. However, in females, the MHO phenotype increased the risk of hypothyroidism compared to MHNW., Conclusion: Both obesity and metabolic abnormalities are associated with hyperthyroidism. Healthy metabolic and weight maintenance were associated with a lower risk of hypothyroidism in males and females., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Abiri, Ahmadi, Mahdavi, Hosseinpanah, Amouzegar and Valizadeh.)

Introduction: Risk factors associated with Carpal Tunnel Syndrome include repetitive use of hand and wrist, advanced age, obesity, pregnancy, diabetes mellitus and thyroid disease. Decompression of the median nerve is the last treatment of choice usually indicated when negative results to conservative treatments remain for three months. In this study, we aimed to find out whether hypothyroid patients would respond to CTS surgical decompression differently in comparison to healthy individuals. Methods: This case control study was conducted on patients with CTS in need of surgical release who were refered to Shahid Faghihi hospital, International Branch of Shiraz University of Medical Sciences, Shiraz, Iran from January 2013 to January 2015. Twenty-five hypothyroid and 22 euthyroid patients were recruited. Hypothyroidism was diagnosed based on clinical symptoms and serum TSH level. All patients were followed for three weeks after surgery and a Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was completed for them pre and post operation. An electrophysiological study was performed during the same follow up period. Statistical analysis was performed using SPSS version 16. Results: The CTS grade reported by electrophysiological study, decreased significantly 3 weeks after operation in comparison with preoperative grades (p<0.001). A significant decrease was observed in the immediate postoperative BCTQ scores compared to preoperative (p<0.001). Also a decrease was detected in the three weeks of postoperative follow up compared to immediate postoperative BCTQ scores (p<0.001) and preoperative BCTQ scores (p<0.001). Postoperative BCTQ scores of euthyroid patients decreased more in comparison to hypothyroid patients (p<0.001). Conclusion: It seems that, hypothyroidism has an effect on postoperative outcome of carpal tunnel release. [ABSTRACT FROM AUTHOR]