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Objectives: Thyroid dysfunction is commonly associated with the risk of infertility in both females and males. However, recent randomized controlled trials have demonstrated that thyroid function levels in females are not significantly related to infertility, and evidence on the association between male thyroid function and infertility is limited. We aim to investigate the association between thyroid function levels and infertility in both females and males. Method: A two-sample Mendelian randomization study was conducted using four methods, with the inverse variance weighted method (IVW) as the primary approach. Data on thyroid function as the exposure were obtained from the ThyroidOmics Consortium and UK Biobank, including over 700,000 individuals from a large meta-analysis of genome-wide association studies for thyroid function and dysfunction. The outcome data for infertility in both sex encompassed more than 70,000 individuals from the FinnGen Consortium. All participants were adults of European ancestry. The MR Egger regression intercept and Cochran's Q test were employed to evaluate directional pleiotropy and heterogeneity. Results: The results indicated no causal effect of thyroid-stimulating hormone (TSH) and free tetraiodothyronine (fT4) on female and male infertility. Furthermore, no causal association between hypo- and hyperthyroidism and infertility were identified. Notably, we observed a causal relationship between high TSH and endometriosis-related infertility (OR=0.82, 95% CI: 0.74-0.91, P = 1.49E-04). Conclusions: This study did not find evidence for casual relationship between thyroid function levels and risk of infertility. The findings suggest that overall thyroid function levels may not be a significant predictor of infertility risk. [ABSTRACT FROM AUTHOR]

This study investigates the impact of Hashimoto’s thyroiditis (HT), an autoimmune disorder, on the papillary thyroid cancer (PTC) microenvironment using a dataset of 140,456 cells from 11 patients. By comparing PTC cases with and without HT, we identify HT-specific cell populations (HASCs) and their role in creating a TSH-suppressive environment via mTE3, nTE0, and nTE2 thyroid cells. These cells facilitate intricate immune–stromal communication through the MIF–(CD74+CXCR4) axis, emphasizing immune regulation in the TSH context. In the realm of personalized medicine, our HASC-focused analysis within the TCGA-THCA dataset validates the utility of HASC profiling for guiding tailored therapies. Moreover, we introduce a novel, objective method to determine K- means clustering coefficients in copy number variation inference from bulk RNA- seq data, mitigating the arbitrariness in conventional coefficient selection. Collectively, our research presents a detailed single-cell atlas illustrating HT– PTC interactions, deepening our understanding of HT’s modulatory effects on PTC microenvironments. It contributes to our understanding of autoimmunity– carcinogenesis dynamics and charts a course for discovering new therapeutic targets in PTC, advancing cancer genomics and immunotherapy research. [ABSTRACT FROM AUTHOR]

Simple Summary: Hyperthyroidism is the most common endocrinopathy in older cats and radioiodine therapy (RAIT) is the gold standard for its treatment. Nevertheless, information about changes in thyroid and kidney values after RAIT over a period longer than six months and the effect of the presence of uni- or bilateral thyroid adenoma on these values is scarce or unreported. In our study, we evaluated thyroid and kidney values over a period of 6 to 12 months following RAIT. Total thyroxine (TT4) normalised within a month of treatment in most cats, but hypothyroidism or an increase in creatinine concentration indicating kidney disease could be diagnosed at any timepoint between 1 and 12 months post RAIT, although in most cats, these conditions were diagnosed within 6 months of treatment. Furthermore, cats with bilateral adenoma had significantly higher thyroid-stimulating hormone (TSH) concentrations after RAIT compared to those with unilateral adenoma. Our study highlights the importance of the ongoing revaluation of cats post RAIT in order to screen for patients in which treatment resulted in iatrogenic hypothyroidism or unmasked chronic kidney disease, with both conditions necessitating treatment to improve outcomes. Radioiodine therapy (RAIT) is the gold standard for treatment of hyperthyroidism in cats. The aim of this study was to evaluate the effect of the presence of uni- or bilateral thyroid adenoma on changes in total thyroxine (TT4), thyroid-stimulating hormone (TSH), and creatinine concentration over a period of 6 to 12 months following RAIT. Fifty-one hyperthyroid cats presented for RAIT between April 2021 and April 2022 were prospectively enrolled. Cats with an increased creatinine concentration (creatinine ≥ 140 µmol/L), renal morphology abnormalities, and suspected thyroid carcinoma were excluded. TT4, TSH, and creatinine were determined before and one week and one, three, six, and twelve months following RAIT. The effects of the re-examination timepoint following RAIT and the presence of uni- or bilateral thyroid adenoma based on technetium-99m scintigraphy on TT4, TSH, and creatinine were analysed by mixed effects modelling. Cats with bilateral adenoma had significantly higher TSH concentrations after RAIT compared to those with unilateral adenoma. TT4 concentration significantly decreased one week (p < 0.001) and again one month following RAIT (p < 0.001). TSH and creatinine concentration significantly increased one month post RAIT (both p < 0.001). As indicated by an increase in TSH concentration, the pituitary–thyroid axis needs a minimum of one month post RAIT to recover from hyperthyroidism-induced suppression, but hypothyroidism necessitating levothyroxine supplementation might not be diagnosed before 6 or even 12 months post RAIT. Although creatinine did not increase significantly after one month post RAIT in this cohort, an increased creatinine concentration was detected at later timepoints in individual cats. [ABSTRACT FROM AUTHOR]

Background: Thyroid cancer is the most common endocrine carcinoma, accounting for 3.26% of all cancers. The most histologically, well-differentiated thyroid cancer is papillary thyroid carcinoma (PTC). Although PTC is regarded as an indolent tumor, a portion of the cancer cells metastasize to lymph nodes around the thyroid gland. Lymph node metastasis (LNM) is a critical risk factor for tumor recurrence in PTC, which strongly affects disease prognosis and the quality of life. Methods: This study aims to examine how differences in the level of the thyroid profile and other risk factors may influence LNM incidence in patients with PTC in Taiwan. We carried out a single-center retrospective study. These PTC patients were retrospectively reviewed by the Department of Endocrinology from 2016 to 2019. A total of 165 patients were included in our research. Results: The findings revealed a close relationship with the level of free thyroxine (FT4), the level of the thyroid-stimulating hormone (TSH), and lymph node metastases. The correlation in terms of FT4 (p = 0.005) and TSH (p = 0.417) with LNM was found as a result of the univariate regression analysis. In the multiple regression analysis, the findings revealed a close relationship between LNM, FT4 (p < 0.001), and TSH (p = 0.008). Conclusions: Although the predictability of the TSH should be examined further, the association between LNM and FT4 or TSH should not be ignored. The results could help guide decision-making and patient counseling, using the level of serum FT4 or the TSH as a possible predictive factor of the LNM in PTC. [ABSTRACT FROM AUTHOR]

Background: To evaluate whether thyroid-stimulating hormone (TSH) measured during newborn screening (NBS) at birth and at discharge can be surrogate markers for neurodevelopmental impairment (NDI) in extremely preterm infants. Methods: The population cohort enrolled infants born <29 weeks' gestation in 2008-2020 in southern Taiwan. Infants with a maternal history of thyroid disorders and infants who required thyroxine supplementation during hospitalization were excluded. TSH levels measured during NBS at birth and at term-equivalent age (TEA)/discharge were respectively categorized into the lowest quartile, the interquartile range, and the highest quartile, which were correlated to NDI outcomes. Results: Among 392 patients with paired TSH data, 358 (91%) were prospectively followed until a corrected age of 24 months. At birth, infants with lowest-quartile TSH had higher NDI risks (odds ratio [OR] 2.3; 95% confidence interval [CI], 1.3-4.1, P = 0.004) compared to infants with interquartile-range TSH. Conversely, by TEA/discharge, infants with highest-quartile TSH had increased NDI (OR 1.9; 95% CI, 1.0-3.4, P = 0.03). By paired TSH categories, infants persistently in the lowest TSH quartile (48%; aOR 4.4; 95% CI, 1.4-14.5, P = 0.01) and those with a shift from interquartile range to the highest quartile (32%; aOR 2.7; 95% CI, 1.0-7.4, P = 0.046) had increased NDI risks compared with the reference with consistent interquartile-range TSH. Conclusion: Extremely preterm infants persistently in the lowest-quartile TSH level at birth and at discharge had the highest NDI risk. TSH quartile levels measured during NBS may serve as a population surrogate biomarker for assessing NDI risks in infants born extremely preterm. [ABSTRACT FROM AUTHOR]

Background Previous studies have found associations between monocyte count, high-density lipoprotein cholesterol (HDL-C), and thyroid-stimulating hormone (TSH) with acute coronary syndrome (ACS). However, research on the correlation between the monocyte count to high-density lipoprotein cholesterol ratio (MHR) and the onset of ACS is limited. The association between MHR, TSH, and the onset of ACS in postmenopausal women remains unclear. Objective To explore the predictive value of MHR and TSH for the onset of ACS in postmenopausal women and to investigate the correlation between these indicators and the degree of coronary artery stenosis in patients. Methods A total of 325 postmenopausal women hospitalized in the Department of Cardiology at Northern Jiangsu People's Hospital, from 2020 to 2021 and who underwent coronary angiography were selected as the study subjects. Patient general information was collected through the electronic medical record system. Venous blood was collected upon admission to measure monocyte count, total cholesterol (TC), triglycerides (TG), HDL-C, low-density lipoprotein cholesterol (LDL-C), and TSH. Left ventricular ejection fraction (LVEF) was measured using the biplane Simpson method, and coronary artery lesions were observed through coronary angiography. The Gensini scoring system was used to uniformly measure the extent of coronary artery lesions. Patients meeting the diagnostic criteria for ACS were classified as the ACS group (n=184), and non-ACS patients as the control group (n=141). The ACS group was further divided into subgroups based on the tertiles of the Gensini score: ≤36.5 as the low-risk subgroup (n=59), 36.6-66.5 as the moderate-risk subgroup (n=64), and >66.5 as the high-risk subgroup (n=61). Univariate and multivariate Logistic regression analyses were used to explore the influencing factors of ACS. The receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of TSH, MHR, and combined detection for ACS and to calculate the area under the curve (AUC). Spearman's rank correlation analysis was used to explore the correlation between TSH, MHR, and combined detection indicators with the Gensini score. Results The baseline data of patients in the ACS and control groups showed that BMI, smoking rate, hypertension, diabetes, LDL-C, monocytes, TSH, and MHR in the ACS group were higher than in the control group, while LVEF and HDL-C were lower (P

Shangyu Luo,1 Xueqin Hu,2 Yunjun Hong,1 Yunchun Gao,1 Xianglin Liu,1 Yu Peng,1 Xueqing Tong,3 Xiaobo Zhang,1 Jun Wen1 1Department of Neurology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde City, Hunan Province, People’s Republic of China; 2Department of Neurosurgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People’s Hospital of Changde City), Changde City, Hunan Province, People’s Republic of China; 3Department of Brain Electrophysiology, Changde Hospital, Xiangya School of Medicine, Central South University (The first People’s hospital of Changde city), Changde City, Hunan Province, People’s Republic of ChinaCorrespondence: Xiaobo Zhang; Jun Wen, Fax +86 0736 7788009 ; +86 0736 7788010, Email 285058041@qq.com; cdwenjun1973@163.comPurpose: Research on post-stroke depression (PSD) following the lifting of coronavirus disease 2019 (COVID-19) restrictions remains sparse. This study aimed to investigate the factors associated with PSD after the easing of COVID-19 restriction measures.Patients and Methods: This cross-sectional study was conducted with 947 stroke patients (cerebral hemorrhage and cerebral infarction) meeting the inclusion criteria. Participants completed a demographic questionnaire and the Patient Health Questionnaire-9 (PHQ-9). Additionally, data were collected on C-reactive protein (CRP), homocysteine (Hcy), modified Rankin Scale (mRS), stroke site, National Institutes of Health Stroke Scale (NIHSS), thyroid-stimulating hormone (TSH), and the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. This study assessed correlations between these indices and PSD.Results: Stroke patients with a PHQ-9 score ≥ 5 were identified as having PSD, with a prevalence rate of 14.15%. No significant correlation was found between previous COVID-19 infection and PSD. However, multiple regression analysis revealed associations between PSD and the following factors: TSH (OR: 0.87, 95% CI: 0.76– 1), CRP levels (OR: 1.01, 95% CI: 1– 1.02), family history of stroke (OR: 4.25, 95% CI: 1.66– 10.88), migraine history (OR: 8.63, 95% CI: 2.49– 29.85), and shorter sleep duration (OR: 0.6, 95% CI: 0.51– 0.71) (all P

Abstract Purpose This study aims to investigate the association of serum TSH with BMD in Chinese adults with normal thyroid function. Methods These participants were divided into tertiles based on serum TSH levels. Linear regression model and multinomial logistic regression models were used to analyze the associations of continuous BMD and categorical BMD with serum TSH, respectively. Results In women younger than 60 years, BMD decreased with the increase of TSH at normal level, while in women older than 60 years, BMD increased with the increase of TSH at normal level; besides, the BMD of women younger than 60 years old was significantly higher than that of women over 60 years old (156.05 ± 39.34 mg/cm3 vs. 86.95 ± 29.51 mg/cm3, P

Abstract Background Altered thyroid hormone levels have been associated with increased risk of Alzheimer's disease (AD) dementia and related cognitive decline. However, the neuropathological substrates underlying the link between thyroid hormones and AD dementia are not yet fully understood. We first investigated the association between serum thyroid hormone levels and in vivo AD pathologies including both beta-amyloid (Aβ) and tau deposition measured by positron emission tomography (PET). Given the well-known relationship between Aβ and tau pathology in AD, we additionally examined the moderating effects of thyroid hormone levels on the association between Aβ and tau deposition. Methods This cross-sectional study was conducted as part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) cohort. This study included a total of 291 cognitively normal adults aged 55 to 90. All participants received comprehensive clinical assessments, measurements for serum total triiodothyronine (T3), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH), and brain imaging evaluations including [11C]-Pittsburgh compound B (PiB)- PET and [18F] AV-1451 PET. Results No associations were found between either thyroid hormones or TSH and Aβ and tau deposition on PET. However, fT4 (p = 0.002) and fT3 (p = 0.001) exhibited significant interactions with Aβ on tau deposition: The sensitivity analyses conducted after the removal of an outlier showed that the interaction effect between fT4 and Aβ deposition was not significant, whereas the interaction between fT3 and Aβ deposition remained significant. However, further subgroup analyses demonstrated a more pronounced positive relationship between Aβ and tau in both the higher fT4 and fT3 groups compared to the lower group, irrespective of outlier removal. Meanwhile, neither T3 nor TSH had any interaction with Aβ on tau deposition. Conclusion Our findings suggest that serum thyroid hormones may moderate the relationship between cerebral Aβ and tau pathology. Higher levels of serum thyroid hormones could potentially accelerate the Aβ-dependent tau deposition in the brain. Further replication studies in independent samples are needed to verify the current results.

Subclinical hypothyroidism (SCH) is closely related to insulin resistance, and thyroid-stimulating hormone (TSH) level is an independent factor for insulin resistance associated with subclinical hypothyroidism. This study aims to explore the effects of TSH levels on insulin signal transduction in adipocytes and to establish the role of endoplasmic reticulum (ER) stress in this process. In this study, the SCH mouse model was established, and 3T3-L1 adipocytes were treated with TSH or tunicamycin (TM), with or without 4-phenylbutyric acid (4-PBA), an inhibitor of ER stress. Subclinical hypothyroidism mice exhibited impaired glucose tolerance, inactivation of the IRS-1/AKT pathway, and activation of the IRE1/JNK pathway in adipose tissue, which can all be alleviated by 4-PBA. Supplementation with levothyroxine restored the TSH to normal, alongside alleviated ER stress and insulin resistance in SCH mice, which is characterized by improved glucose tolerance, decreased mRNA expression of IRE1, and decreased phosphorylation of JNK in adipose tissue. In 3T3-L1 adipocytes, TSH induces insulin resistance, leading to a decrease in glucose uptake. This effect is mediated by the downregulation of IRS-1 tyrosine phosphorylation, reduced AKT phosphorylation, and inhibited GLUT4 protein expression. Notably, all these effects can be effectively reversed by 4-PBA. Moreover, TSH induced TNF-α and IL-6 production and upregulated the expression of ER stress markers. Similarly, these changes can be recovered by 4-PBA. These findings indicate that TSH has the capability to induce insulin resistance in adipocytes. The mechanism through which TSH disrupts insulin signal transduction appears to involve the ER stress–JNK pathway.

Background: Thyroid disease is one of the most common illnesses in the UAE, which could be linked to vast numbers of people suffering from vitamin D deficiency. This study aimed to explore the association between serum 25(OH)D levels and thyroid function parameters in men and women with diagnosed hypothyroidism. Methods and Results: This cross-sectional observational study included 86 patients (78[90.7%] women and 8[9.3%] men) with diagnosed hypothyroidism. The patients were divided into two groups, male and female. These two groups were compared in terms of age, TSH, free-T4 (FT4), vitamin D, free-T3 (FT3), and body mass index (BMI). In addition, the correlation between levels of vitamin D and TSH was also examined in these two groups. The mean age of the patients was 27.5 years, and BMI was 28.00 kg/m2, indicating overweight. Vitamin D deficiency was found in 61(70.9%) patients and severe vitamin D deficiency in 10(11.6%) patients with hypothyroidism. 25(OH)D levels were significantly low in patients with high TSH levels, showing a weak negative correlation (r=-0.132, P=0.043). A negligible positive correlation was identified between 25(OH)D levels and FT4 r=0.089, P>0.05) and FT3 (r=0.071, P>0.05), and a negligible negative correlation with BMI (r=-0.059, P>0.05). Conclusion: There is a clear indication that vitamin D deficiency is prevalent in hypothyroid patients and that these subjects have lower levels of serum 25(OH)D. Suggesting that lower serum 25(OH)D is related to hypothyroidism and the deficiency in vitamin D plays a role in the development of the disease.

Purpose: This study aims to investigate the association of serum TSH with BMD in Chinese adults with normal thyroid function. Methods: These participants were divided into tertiles based on serum TSH levels. Linear regression model and multinomial logistic regression models were used to analyze the associations of continuous BMD and categorical BMD with serum TSH, respectively. Results: In women younger than 60 years, BMD decreased with the increase of TSH at normal level, while in women older than 60 years, BMD increased with the increase of TSH at normal level; besides, the BMD of women younger than 60 years old was significantly higher than that of women over 60 years old (156.05 ± 39.34 mg/cm3 vs. 86.95 ± 29.51 mg/cm3, P < 0.001). Linear regression results showed negative associations of BMD and normal TSH level in women with age younger than 60 years (β=-4.34, P < 0.001), but this inverse trend was observed in women over 60 years old (β = 2.04, P = 0.041). Both in men younger than 60 years and over 60 years old, BMD decreased with the increase of TSH at normal levels; besides, the BMD of men younger than 60 years was significantly higher than those over 60 years old (143.08 ± 32.76 mg/cm3 vs. 108.13 ± 31.99 mg/cm3, P < 0.001). Conclusions: The results demonstrated an opposite trend in BMD at normal TSH levels in younger and elder females, that is, in females younger than 60 years, BMD decreased with the increase of TSH, which indicated that TSH might play a different role in younger and elder females. However, this trend was not significant in males. Summary: This study demonstrated an opposite trend in BMD at normal TSH levels in younger and elder females, that is, in females younger than 60 years, BMD decreased with the increase of TSH, which indicated that TSH might play a different role in younger and elder females. [ABSTRACT FROM AUTHOR]

This study investigated the potential associations between hepatitis virus antibody status and thyroid and inflammatory function. The C-reactive protein (CRP), thyroid-stimulating hormone (TSH), and free thyroxine (FT4) levels were measured in individuals with and without antibodies to the hepatitis A virus (HAV) and hepatitis B virus (HBV). Participants were stratified by age, sex, and HAV/HBV antibody status. Participants with and without antibodies to HAV and HBV had normal CRP, TSH, and FT4 levels. However, notable discrepancies were observed in FT4 levels among participants with HAV antibodies and in CRP and FT4 levels among those with both HAV and HBV antibodies, suggesting potential associations between viral immunity and thyroid function, especially in younger participants. Significant variations in thyroid hormone levels were noted when the sample was stratified by sex and HAV and HBV antibody status, indicating that the association between antibody status and thyroid hormone levels varied by sex. This study underscores the need for further research on the effect of viral immunity on inflammatory parameters and thyroid hormone levels. [ABSTRACT FROM AUTHOR]

Aim and Background. This study aims to explore alternative diagnostic methods to assess thyroid function in patients unable to undergo blood tests for thyroid-stimulating hormones (TSH) and thyroxine (T4), such as individuals with trypanophobia, severe medical conditions, or coagulopathy. Considering the impact of thyroid dysfunction on mitochondrial metabolism and the essential role of proper mitochondrial function in ciliary motility, we postulate that assessing nasal ciliary function could serve as a surrogate diagnostic approach for thyroid dysfunction. Methods. This cross-sectional study was performed on individuals with no history of thyroid diseases. The primary endpoint was the diagnostic value of the nasal mucociliary (NMC) test using Iranica Picris (Asteraceae) aqueous extract in differentiating hypo- or hyperthyroidism cases from euthyroid cases. Results. 232 individuals were recruited (71% females, 86% euthyroid). Receiver operating characteristic (ROC) analysis showed a good diagnostic value for the NMC test in differentiating overt hypothyroidism (area under the ROC curve [AUROC] = 0.82, p = 0.004) and its fair value in diagnosing subclinical hyperthyroidism (AUROC = 0.78, p = 0.01) from the euthyroid condition. The NMC test had a significant positive correlation with TSH (r = 0.47, p < 0.001) and a significant negative correlation with T4 (r = −0.32, p < 0.001). The NMC rate was significantly different in distinct thyroid function groups (p < 0.001). Compared with euthyroid cases, the post-hoc analysis showed that the NMC test is significantly higher in overt hypothyroidism (15.06 vs. 21.07 min, p = 0.003) and significantly lower in subclinical hyperthyroidism (15.05 vs. 10.9 min, p = 0.02). Conclusions. The Iranica Picris-based NMC test might serve as a diagnostic method to distinguish overt hypothyroidism and subclinical hyperthyroidism. [ABSTRACT FROM AUTHOR]

Background: Altered thyroid hormone levels have been associated with increased risk of Alzheimer's disease (AD) dementia and related cognitive decline. However, the neuropathological substrates underlying the link between thyroid hormones and AD dementia are not yet fully understood. We first investigated the association between serum thyroid hormone levels and in vivo AD pathologies including both beta-amyloid (Aβ) and tau deposition measured by positron emission tomography (PET). Given the well-known relationship between Aβ and tau pathology in AD, we additionally examined the moderating effects of thyroid hormone levels on the association between Aβ and tau deposition. Methods: This cross-sectional study was conducted as part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE) cohort. This study included a total of 291 cognitively normal adults aged 55 to 90. All participants received comprehensive clinical assessments, measurements for serum total triiodothyronine (T3), free triiodothyronine (fT3), free thyroxine (fT4), and thyroid-stimulating hormone (TSH), and brain imaging evaluations including [11C]-Pittsburgh compound B (PiB)- PET and [18F] AV-1451 PET. Results: No associations were found between either thyroid hormones or TSH and Aβ and tau deposition on PET. However, fT4 (p = 0.002) and fT3 (p = 0.001) exhibited significant interactions with Aβ on tau deposition: The sensitivity analyses conducted after the removal of an outlier showed that the interaction effect between fT4 and Aβ deposition was not significant, whereas the interaction between fT3 and Aβ deposition remained significant. However, further subgroup analyses demonstrated a more pronounced positive relationship between Aβ and tau in both the higher fT4 and fT3 groups compared to the lower group, irrespective of outlier removal. Meanwhile, neither T3 nor TSH had any interaction with Aβ on tau deposition. Conclusion: Our findings suggest that serum thyroid hormones may moderate the relationship between cerebral Aβ and tau pathology. Higher levels of serum thyroid hormones could potentially accelerate the Aβ-dependent tau deposition in the brain. Further replication studies in independent samples are needed to verify the current results. [ABSTRACT FROM AUTHOR]

Background. In December 2019, the World Health Organization was notified about cases of pneumonia of unknown etiology originating in Wuhan, Hubei province, China. Hashimoto’s thyroiditis and other thyroid disorders including Graves’ disease affects almost 5 % of the general population. Hashimoto’s thyroiditis is a chronic disease in which the body interprets the thyroid gland and its hormone products as threats, therefore producing special antibodies that target thyroid cells, thereby destroying them. It may present with hypothyroidism or hyperthyroidism and with or without goiter. Basic questions in the consideration of a clinical case: what is COVID-19, and health complications? What concerns are related to pain in the front of the neck? How much has COVID-19 affected the occurrence of thyroid problems? Сase report. A 40-year-old man presented to the infectious disease clinic with a fever (37.9 °C), sore throat, body aches, and lethargy for 3 days on January 25, 2021. Due to the clinical features and the COVID-19 pandemic, a nasopharyngeal swab was used for sampling, and SARS-CoV-2 test was positive (mRNA in real time RT-PCR). On the 13th day, the patient’s general condition improved, but he complained of sore throat. On re-examination, we noticed a slight tenderness in the neck in the thyroid area. On thyroid ultrasound, a heterogeneous thyroid gland with ill-defined bilateral hypoechoic areas revealed subacute thyroiditis. The same patient presented to the infectious clinic with a fever (37.1 °C), sore throat, body aches and fatigue on June 28, 2022. After 5 days, the test for SARS-CoV-2 was negative, but, after one month of recovery, blood samples were analyzed to identify the functional state of the thyroid gland, and we obtained results with high values of thyroid-stimulating hormone. Conclusions. COVID-19 is a new disease for which larger-scale research is still ongoing, potential complications of COVID-19 and organ involvement are still being elucidated in the literature. Pain in the front of the neck, which can be combined with the upper part of the respiratory tract, especially in the conditions of COVID-19, should not be overlooked and requires further examinations. Subacute thyroiditis is a rare complication of COVID-19 that should be considered, especially in the progression of COVID-19 and the appearance of Hashimoto’s thyroiditis. [ABSTRACT FROM AUTHOR]

Background: Despite a good prognosis, survivors of differentiated thyroid cancer (DTC) may have reduced health-related quality of life (HRQOL) many years after treatment, and it is unclear how suppression of thyroid-stimulating hormone (TSH) may contribute to HRQOL. This study investigated changes in HRQOL in the 5 years following DTC treatment, the association between HRQOL and TSH suppression, and how HRQOL compares to the general population. Methods: In this nationwide prospective cohort study, 487 patients with DTC were identified between 2012 and 2017 from all Swedish hospitals treating patients with DTC. Patients treated with total thyroidectomy and planned for radioiodine answered the Swedish version of the Short Form-36 Health Survey (SF-36) and a study specific questionnaire at treatment and after 1, 3, and 5 years. Summary measures for physical and mental QOL were derived from the SF-36, and TSH values were collected from patient records. To study changes in HRQOL over time, linear mixed models were fitted on multiply imputed data, with all patients and measurement points included in the model. Results: In total, 351 patients consented to participate in the study. In the 5 years following DTC treatment, physical QOL did not change significantly with time, while mental QOL improved by on average 0.61 (p < 0.001) per year. TSH levels were not predictive of either physical or mental QOL, or their change over time. At 5 years, there was a significant difference in physical and mental QOL compared with the Swedish general population, but effect sizes were small (Cohen's d = 0.29 and −0.21, respectively). The SF-36 domains general health, vitality, social functioning, and mental health were lower at 5 years compared with the general population (difference 8.7–13.3), and these differences were clinically significant. Conclusions: The mental component of HRQOL improves over time following DTC treatment. HRQOL in patients with DTC is not explained by TSH suppression. Although overall differences in physical and mental HRQOL compared with the general population were small 5 years after treatment, several specific psychosocial HRQOL domains were clinically meaningfully reduced. Psychosocial health issues should be screened for during DTC follow-up. [ABSTRACT FROM AUTHOR]

Transient hyperthyrotropinemia/transient hypothyroxinaemia and congenital hypothyroidism (CH) have completely different treatment and clinical outcomes. However, a powerful, highly sensitive and cost-effective marker for the differentiation of these clinical entities in the early postnatal period is not available. Therefore, we aimed to test the potential, early predictive, diagnostic power of the thyroid-stimulating hormone (TSH)/free thyroxine (fT4) ratio for differentiation of the two clinical entities in the early period of life. TSH and fT4 levels were recorded on the postnatal day 7 of premature infants<32 weeks of gestational age. TSH/fT4 ratio was calculated. The significance degree of TSH/fT4 ratio was analyzed for the differentiation of transient hyperthyrotropinemia or transient hypothyroxinaemia and CH. The study included 1,204 preterm infants<32 weeks of gestational age. Of the 1,204 infants, 978 (81.2 %) had normal thyroid function. Eighty-eight infants (7.3 %) were diagnosed with CH and 138 (11.5 %) with transient hyperthyrotropinemia or transient hypothyroxinemia. Initial TSH/fT4 ratio>4.8 was found to be an early diagnostic warning sign with high power in favor of transient hyperthyrotropinemia or transient hypothyroxinemia (AUC value: 0.947) and TSH/fT4 ratio>12.5 (AUC value: 0.999) was found to be an early diagnostic warning sign with high power in favor of CH (p=0.0001). We found for the first time that the TSH/fT4 ratio can be used for the early differentiation of transient hyperthyrotropinemia/transient hypothyroxinaemia and CH in preterm infants without additional cost and with high power. [ABSTRACT FROM AUTHOR]

BackgroundThe characteristics of blood lipid and metabolic indicators were analyzed in patients with subclinical hypothyroidism (SCH), and the effect of type 2 diabetes mellitus (T2DM) on SCH patients was determined.MethodsThe physical examination data of 2,119 residents in a university community were retrospectively divided into 2 groups (SCH and non-SCH groups). Furthermore, the SCH group was divided into SCH-T2DM and SCH–non-T2DM subgroups, and the data between the groups were analyzed.ResultsThe SCH group had significantly higher levels of triglycerides (p = 0.044), total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.019), very low-density lipoprotein cholesterol (p = 0.044), 2-h plasma glucose (p = 0.023), and globulin (p = 0.000) compared to the non-SCH group. The SCH–T2DM group was older (p

Background: The thyroid hormone’s significant impact on the treatment of depressive and other mood disorders is well documented. Even minor hypothyroidism can modify the progression and treatment results of major depressive disorder. This research aims to explore the correlation between initial thyroid levels and the treatment outcome in bipolar mood disorder using lithium, a well-established treatment method. Methodology: The study involved 45 bipolar mood disorder patients diagnosed according to the Diagnostic and Statistical Manual 5 criteria and admitted to a tertiary care teaching institute in Northeast India. The patients received lithium treatment, with injectable lorazepam used for immediate agitation control when necessary. On the 1st day, a semi-structured questionnaire and Brief Psychiatric Rating Scale (BPRS) 24-item scale were used to evaluate symptoms, and samples were collected for a thyroid profile, including T3, T4, FT3, FT4, and thyroid-stimulating hormone (TSH). The BPRS scale was used again on the 30th day to assess treatment response. Results: The BPRS subscale showed the highest treatment response for grandiosity and the lowest for depression. Factors such as age, illness duration, substance use, and family history of mood disorder were inversely correlated with the BPRS score’s decrease. Initial thyroid levels were identified as a predictor of treatment response, with baseline T4 levels showing a significant positive correlation with treatment response, while baseline TSH levels showed a negative correlation. Conclusion: Lithium proved to be an effective treatment for bipolar mood disorder, particularly for the manic subtype. Initial T4 and TSH levels were found to significantly predict treatment response, with T4 showing a positive correlation and TSH showing a negative correlation.

Aim. To evaluate the levels of soluble growth stimulator gene 2 (sST2) protein and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with acute coronary syndrome (ACS) depending on the presence of concomitant subclinical hypothyroidism (SH). Materials and methods. 125 patients with ACS aged 36 to 81 years (mean age – 60.98 ± 0.81 years) were included in the study. All the patients were divided into two groups according to the state of thyroid function. Group I consisted of 51 patients (40.8 %) with SH (thyroid-stimulating hormone (TSH) level >4 μIU/mL), mean age – 62.51 ± 1.18 years; Group II – 74 patients (59.2 %) with normal thyroid function (TSH level 0.4–4.0 μIU/mL), mean age – 59.93 ± 1.08 years. The state of SH was diagnosed at a TSH level of >4.0 μIU/mL and a serum free thyroxine (FT4) level within the normal range. Results. In the group of patients with ACS and SH (I), significantly higher mean levels of sST2 and NT-proBNP have been found compared to patients without thyroid dysfunction (II), 46.6 (27.9; 57.7) ng/ml (I) vs. 29.9 (22.0; 38.5) ng/ml (II), p = 0.001 and 173.0 (103.4; 1005.1) ng/l (I) vs. 95.9 (71.8; 178.6) ng/l (II), p = 0.0001, respectively. Among patients with ACS and SH (I), the sST2 level of 35–70 ng/ml was 1.94 times more often, and sST2 >70 ng/ml was 2.28 times more often as compared to those in patients with ACS without thyroid dysfunction (II), 22.74 % (47.06 ± 6.99 % (I) vs. 24.32 ± 4.99 % (II), p = 0.008) and 15.81 % (21.57 ± 5.76 % (I) vs. 9.46 ± 3.40 % (II), p < 0.05), respectively. The study on NT-proBNP levels in ACS patients with SH (I) has revealed a 75.67 % significantly higher proportion of individuals with NT-proBNP levels > 600 ng/L (33.33 ± 6.60 % (I)) as compared to ACS patients with normal thyroid function (II) (8.11 ± 3.17 % (II), p = 0.001). The level of NT-proBNP 600 ng/L have been detected compared to the group of ACS patients with normal thyroid function. These results may indicate a higher risk of development, progression and complications of heart failure due to a higher probability of myocardial fibrosis and subsequent left ventricular remodeling in ACS patients with SH. The significant strong positive correlation has been found between the mean levels of sST2 and NT-proBNP in the group of ACS patients with SH (I) (r = 0.775, p < 0.001). In the group of ACS patients with normal thyroid function (II), the correlation between the mean levels of sST2 and NT-proBNP was less pronounced (r = 0.678, p < 0.001). Combined assessment of these biomarkers may be more informative for the diagnosis and prognosis of heart failure in ACS patients with concomitant thyroid dysfunction than measurements of individual biomarkers. In particular, the simultaneous increase in sST2 and NT-proBNP above reference values allows to identify a very high-risk group for heart failure occurrence and progression in ACS patients.

Abstract Background Acute illness can result in changes in serum total thyroxine (tT4), total triiodothyronine (tT3), and thyrotropin (TSH) concentrations in euthyroid dogs defined as nonthyroidal illness syndrome, but longitudinal evaluation of these hormones during the recovery phase is lacking. Objectives To longitudinally evaluate serum tT4, tT3, and TSH concentrations during the acute phase and recovery from acute illness in dogs. Animals Nineteen euthyroid client‐owned dogs hospitalized for acute illness at a veterinary teaching hospital. Methods Prospective longitudinal study. Serum tT4, tT3, and TSH concentrations were measured at the admission (T0), at last day of hospitalization (T1), and during the recovery phase at 3, 7, 14, and 21 days after the discharge (T2, T3, T4, and T5), respectively. Results tT4 and tT3 were below the reference interval (RI) at T0 in 3 (16%) and 18 (95%) dogs, respectively; tT4 normalized in all dogs early in the recovery phase, while low tT3 persisted at the end of the study in 16 (83%) dogs. Median TSH concentrations were increased at T5 compared with T1 (0.19 ng/mL [range 0.03‐0.65] vs 0.11 ng/mL [range (0.05‐0.26)], mean difference = 0.09 ng/mL; P = .03). Five (26%) dogs had TSH above the RI at least at 1 time point during the recovery phase. None of the dogs had concurrent low tT4 and high TSH during the study. Conclusions and Clinical Relevance In euthyroid dogs acute illness can interfere with evaluation of thyroid function up to 21 days during the recovery phase. Thyroid testing should be avoided or postponed in these dogs.

Mei Xiao,1 Guangwen Luo,1 Zhaowei Zhang,1 Yanfen Liu,2 Rui Gong,3 Jianghuan Ke1 1Department of Pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China; 2Department of Endocrinology and Metabolism, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of China; 3Department of Clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, People’s Republic of ChinaCorrespondence: Guangwen Luo, Department of pharmacy, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, Zhejiang, 321000, People’s Republic of China, Tel +86-0579-82552760, Email lgw2018@126.comPurpose: To investigate the correlation between thyroid-related hormones and diabetic retinopathy (DR) in euthyroid patients with type 2 diabetes mellitus (T2DM).Patients and Methods: Patients with T2DM admitted to our hospital between January 2023 and June 2023 were retrospectively analyzed. The patients were divided into DR and non-diabetic retinopathy (NDR) groups according to whether DR occurred. Thyroid function-related hormones (TSH, FT3, and FT4), blood glucose indices (FBG and HbA1c), and blood lipid indices (HDL-C, LDL-C, TC, and TG) of the two groups were analyzed by univariate and multivariate logistic regression to explore the risk factors for DR. Pearson correlation analysis and multiple stepwise regression analysis were used to investigate the correlation of TSH or FT3 with FBG, HbA1c, and TG in DR patients.Results: Of the 286 patients with T2DM included in this study, 101 (35.31%) developed DR and 185 (64.69%) did not. High TG, FBG, HbA1c, and TSH and low FT3 levels were independent risk factors for DR in T2DM patients. TSH positively correlated with TG, whereas FT3 negatively correlated with TG and HbA1c in T2DM patients with DR.Conclusion: Higher TSH and lower FT3 in T2DM patients with normal thyroid function may affect glucose and lipid metabolism, thereby increasing the risk of DR.Keywords: type 2 diabetes mellitus, diabetic retinopathy, thyroid-stimulating hormone, free triiodothyronine, glucose and lipid metabolism

Roxadustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor, has proven efficacy in the treatment of renal anemia; however, evidence indicates that it may cause central hypothyroidism. The prevalence and reversibility of roxadustat-induced central hypothyroidism in patients undergoing hemodialysis remain unclear. Here, we retrospectively analyzed thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels in 51 patients (mean age: 72.3 ± 10.7 years; 58.8% male) undergoing hemodialysis before, during, and after halting roxadustat treatment. TSH levels were significantly decreased from a median of 2.46 (interquartile range:1.60–4.51) mU/L before roxadustat treatment to 1.36 (0.72–2.41) mU/L during treatment (p 0.1 mU/L to

Background: Acute illness can result in changes in serum total thyroxine (tT4), total triiodothyronine (tT3), and thyrotropin (TSH) concentrations in euthyroid dogs defined as nonthyroidal illness syndrome, but longitudinal evaluation of these hormones during the recovery phase is lacking. Objective s : To longitudinally evaluate serum tT4, tT3, and TSH concentrations during the acute phase and recovery from acute illness in dogs. Animals: Nineteen euthyroid client‐owned dogs hospitalized for acute illness at a veterinary teaching hospital. Methods: Prospective longitudinal study. Serum tT4, tT3, and TSH concentrations were measured at the admission (T0), at last day of hospitalization (T1), and during the recovery phase at 3, 7, 14, and 21 days after the discharge (T2, T3, T4, and T5), respectively. Results: tT4 and tT3 were below the reference interval (RI) at T0 in 3 (16%) and 18 (95%) dogs, respectively; tT4 normalized in all dogs early in the recovery phase, while low tT3 persisted at the end of the study in 16 (83%) dogs. Median TSH concentrations were increased at T5 compared with T1 (0.19 ng/mL [range 0.03‐0.65] vs 0.11 ng/mL [range (0.05‐0.26)], mean difference = 0.09 ng/mL; P =.03). Five (26%) dogs had TSH above the RI at least at 1 time point during the recovery phase. None of the dogs had concurrent low tT4 and high TSH during the study. Conclusions and Clinical Relevance: In euthyroid dogs acute illness can interfere with evaluation of thyroid function up to 21 days during the recovery phase. Thyroid testing should be avoided or postponed in these dogs. [ABSTRACT FROM AUTHOR]

There is controversy regarding whether to treat subtle abnormalities of thyroid function in infertile female patients. This guideline document reviews the risks and benefits of treating subclinical hypothyroidism in female patients with a history of infertility and miscarriage, as well as obstetric and neonatal outcomes in this population. [ABSTRACT FROM AUTHOR]

Background & Objective: Thyroid-related adverse pregnancy outcomes can be analyzed by Anti-thyroid peroxidase antibody (Anti-TPO Ab). However, whether women with anti-thyroid peroxidase antibody (Anti- TPO Ab) positivity have a higher risk of poor pregnancy outcomes is debatable. The aim of the present study was to compare the pregnancy outcomes in pregnant women with positive and negative TPO-Ab. Materials & Methods: This cross-sectional study was conducted on pregnant women with positive anti-TPO Ab (n= 108) and negative anti-TPO Ab (n=340) referring to Imam Khomeini Hospital and Ahvaz clinics from January 2020 to December 2020. The pregnancy outcomes, including gestational diabetes mellitus (GDM), preeclampsia, miscarriage, preterm birth, placental abruption, IUFD, IUGR, and TSH level, were compared between the two groups by SPSS software using student t-test and Chi-square test. Results: The mean TSH level was significantly different in women with negative TPO-Ab than those with positive TPO-Ab (Mean (SD): 2.25(1.47) vs. 4.82(9.38), P<0.0001). In addition, 81 (75.00%) women in the positive anti-TPO group and 104 (30.58%) in the negative anti-TPO group had high TSH (P<0.001). The frequency of GDM in positive anti-TPO Ab pregnant women was significantly higher than that in the negative anti-TPO Ab group (46.29% vs. 34.11%, P=0.029). The results also indicated an enhancement in the rate of miscarriage (15.74% vs. 4.11%, P<0.001) and preterm parturition (13.88% vs. 3.52%, P<0.001) in positive anti-TPO Ab women. Conclusion: Presence of positive anti-TPO Ab was significantly associated with preterm delivery, abortion and GDM in pregnancy. Treatment with Levothyroxine can reduce the risk of adverse pregnancy outcomes in women who are positive for TPOAb. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the levels of soluble growth stimulator gene 2 (sST2) protein and N-terminal pro-brain natriuretic peptide (NTproBNP) in patients with acute coronary syndrome (ACS) depending on the presence of concomitant subclinical hypothyroidism (SH). Materials and methods. 125 patients with ACS aged 36 to 81 years (mean age - 60.98 ± 0.81 years) were included in the study. All the patients were divided into two groups according to the state of thyroid function. Group I consisted of 51 patients (40.8 %) with SH (thyroid-stimulating hormone (TSH) level >4 μIU/mL), mean age - 62.51 ± 1.18 years; Group II - 74 patients (59.2 %) with normal thyroid function (TSH level 0.4-4.0 μIU/mL), mean age - 59.93 ± 1.08 years. The state of SH was diagnosed at a TSH level of >4.0 μIU/mL and a serum free thyroxine (FT4) level within the normal range. Results. In the group of patients with ACS and SH (I), significantly higher mean levels of sST2 and NT-proBNP have been found compared to patients without thyroid dysfunction (II), 46.6 (27.9; 57.7) ng/ml (I) vs. 29.9 (22.0; 38.5) ng/ml (II), p = 0.001 and 173.0 (103.4; 1005.1) ng/l (I) vs. 95.9 (71.8; 178.6) ng/l (II), p = 0.0001, respectively. Among patients with ACS and SH (I), the sST2 level of 35-70 ng/ml was 1.94 times more often, and sST2 >70 ng/ml was 2.28 times more often as compared to those in patients with ACS without thyroid dysfunction (II), 22.74 % (47.06 ± 6.99 % (I) vs. 24.32 ± 4.99 % (II), p = 0.008) and 15.81 % (21.57 ± 5.76 % (I) vs. 9.46 ± 3.40 % (II), p < 0.05), respectively. The study on NT-proBNP levels in ACS patients with SH (I) has revealed a 75.67 % significantly higher proportion of individuals with NT-proBNP levels > 600 ng/L (33.33 ± 6.60 % (I)) as compared to ACS patients with normal thyroid function (II) (8.11 ± 3.17 % (II), p = 0.001). The level of NT-proBNP <125 ng/l has been detected 2.31 times more often in the group of ACS patients with normal thyroid function (II) compared to that in ACS patients with SH (I), by 36.06 % (63.51 ± 5.60 % (II) vs. 27.45 ± 6.25 % (I), p = 0.00002). A significant strong positive correlation has been found in the group of ACS patients with SH (I) (correlation coefficient (r) = 0.775, p < 0.001) in assessing the relationship between the mean levels of sST2 and NT-proBNP. In the group of ACS patients with normal thyroid function (II), a moderate correlation has been found between the mean levels of sST2 and NT-proBNP (r = 0.678, p < 0.001). Conclusions. In the group of ACS patients with moderately reduced thyroid function (SH), significantly higher mean levels of sST2 and NT-proBNP and significantly higher percentage of individuals with sST2 levels ≥ 35 ng/mL, NT-proBNP >600 ng/L have been detected compared to the group of ACS patients with normal thyroid function. These results may indicate a higher risk of development, progression and complications of heart failure due to a higher probability of myocardial fibrosis and subsequent left ventricular remodeling in ACS patients with SH. The significant strong positive correlation has been found between the mean levels of sST2 and NT-proBNP in the group of ACS patients with SH (I) (r = 0.775, p < 0.001). In the group of ACS patients with normal thyroid function (II), the correlation between the mean levels of sST2 and NT-proBNP was less pronounced (r = 0.678, p < 0.001). Combined assessment of these biomarkers may be more informative for the diagnosis and prognosis of heart failure in ACS patients with concomitant thyroid dysfunction than measurements of individual biomarkers. In particular, the simultaneous increase in sST2 and NT-proBNP above reference values allows to identify a very high-risk group for heart failure occurrence and progression in ACS patients. [ABSTRACT FROM AUTHOR]

Background and Objectives: Pregnancy introduces various interfering factors that, alongside individual variations, impact the assessment of thyroid function tests. This underscores the necessity of defining trimester-specific reference intervals for thyroid-stimulating hormone (TSH) levels. Differences in population characteristics, including ethnicity, socio-economic factors, iodine prophylaxis, and obesity, emphasize the need to establish trimester-specific TSH ranges for women of reproductive age in the respective region or center. The aim of the present study was to establish first- and second-trimester-specific reference intervals for TSH and free thyroxine (FT4) in a relevant pregnant population. Materials and Methods: A retrospective monocenter analysis utilized the electronic database of Ob/Gyn Hospital "Dr. Shterev", Sofia, Bulgaria. The analysis involved data from 497 pregnant and 250 non-pregnant women, all without evidence of thyroid dysfunction or a family history thereof, no indication of taking medication interfering with thyroid function, no evidence of levothyroxine treatment, and no history of sterility treatment. To establish the limits of the TSH reference range, the percentile method was applied using a bootstrapping procedure following the recommendations of the International Federation of Clinical Chemistry (IFCC). Results: Trimester-specific reference intervals for TSH and FT4 in our center were established as follows: first trimester—0.38–2.91 mU/L, FT4-12.18–19.48 pmol/L; second trimester—0.72–4.22 mIU/L and 9.64–17.39 pmol/L, respectively. We also established the normal reference range for the non-pregnant control group, which is similar to that applicable in our laboratory. Conclusions: Our results differ from the fixed limits recommended by the American Thyroid Association, European Thyroid Association, and Endocrine Society Guidelines. Following the relevant established intervals would significantly impact timely diagnosis and therapy requirements for a substantial proportion of pregnant women. [ABSTRACT FROM AUTHOR]

Background: The study of thyroid status and its influence on neonatal and postneonatal development of newborns from mothers with endemic goiter (EG) is one of the topical areas of modern endocrinology. Objective: The study of thyroid hormone levels in newborns born to women with endemic goiter. Materials and Methods: The design of the study is based on a randomized controlled method, taking into account the requirements of CONSORT, with distribution into mutually comparable study groups. A study was carried out on 68 newborns born to women with EG. Methods included the collection of history and study of thyroid hormone levels in neonates and women in labor. Results: In newborns born from women with EG, thyroid‑stimulating hormone (TSH) in cord blood averaged 15.6 ± 0.87 mIU/l, which is 22.38% higher compared to the control group (P = 0.038). The difference between free triiodothyronine (T3) and thyroxine (T4) in newborns from mothers with EG in comparison to the control group was below 8.57% and 4.29%, respectively. In the 1st month of life, a lag in weight gain was noted by an average of 9.57% concerning practically healthy newborns. Conclusions: In newborns from women with EG, there was a decrease in T4 – 4.29% and T3 – 8.57%, against the background of an increase in the level of TSH to 22.38% in the cord blood relative to children from the control group. These fluctuations may persist in the 1st month of life and manifest as a delay in weight gain. [ABSTRACT FROM AUTHOR]

Background: The thyroid hormone's significant impact on the treatment of depressive and other mood disorders is well documented. Even minor hypothyroidism can modify the progression and treatment results of major depressive disorder. This research aims to explore the correlation between initial thyroid levels and the treatment outcome in bipolar mood disorder using lithium, a well-established treatment method. Methodology: The study involved 45 bipolar mood disorder patients diagnosed according to the Diagnostic and Statistical Manual 5 criteria and admitted to a tertiary care teaching institute in Northeast India. The patients received lithium treatment, with injectable lorazepam used for immediate agitation control when necessary. On the 1st day, a semi-structured questionnaire and Brief Psychiatric Rating Scale (BPRS) 24-item scale were used to evaluate symptoms, and samples were collected for a thyroid profile, including T3, T4, FT3, FT4, and thyroid-stimulating hormone (TSH). The BPRS scale was used again on the 30th day to assess treatment response. Results: The BPRS subscale showed the highest treatment response for grandiosity and the lowest for depression. Factors such as age, illness duration, substance use, and family history of mood disorder were inversely correlated with the BPRS score's decrease. Initial thyroid levels were identified as a predictor of treatment response, with baseline T4 levels showing a significant positive correlation with treatment response, while baseline TSH levels showed a negative correlation. Conclusion: Lithium proved to be an effective treatment for bipolar mood disorder, particularly for the manic subtype. Initial T4 and TSH levels were found to significantly predict treatment response, with T4 showing a positive correlation and TSH showing a negative correlation. [ABSTRACT FROM AUTHOR]

Thyroid-stimulating hormone (TSH) is an important clinical marker in the diagnosis and management of thyroid disease. TSH measurements are reported in milli-International Units per Litre (mIU/L), traceable to a World Health Organisation (WHO) reference material. There is a wide variety of commercial immunoassays for TSH measurements available, which have historically been poorly harmonised due to a lack of commutability of the WHO reference materials with patient samples. This led to the recent development of a serum-based reference panel for TSH, traceable to the WHO reference material, available via the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC), aimed at harmonisation of TSH immunoassays. This report describes recent developments in the TSH reference system, including establishment of the 4th WHO International Standard for TSH, and aims to clarify the relationship between the available reference materials and their intended uses. This 4th WHO IS is widely available and defines the unit of TSH activity, therefore its continued existence is of paramount importance, however it continues to show a lack of commutability with patient in many TSH immunoassays. This makes the C-STFT TSH panel, albeit available in restricted numbers, a critical resource to ensure better TSH assay harmonisation. [ABSTRACT FROM AUTHOR]

Studies on the relationship between iodine, vitamin A (VA), and vitamin D (VD) and thyroid function are limited. This study aimed to analyze iodine and thyroid-stimulating hormone (TSH) status and their possible relationships with VA, VD, and other factors in postpartum women. A total of 1,311 mothers (896 lactating and 415 non-lactating) from Hebei, Zhejiang, and Guangxi provinces were included in this study. The urinary iodine concentration (UIC), TSH, VA, and VD were measured. The median UIC of total and lactating participants were 142.00 µg/L and 139.95 µg/L, respectively. The median TSH, VA, and VD levels in all the participants were 1.89 mIU/L, 0.44 µg/mL, and 24.04 ng/mL, respectively. No differences in the UIC were found between lactating and non-lactating mothers. UIC and TSH levels were significantly different among the three provinces. The rural UIC was higher than the urban UIC. Obese mothers had a higher UIC and a higher prevalence of excessive TSH. Higher UICs and TSHs levels were observed in both the VD deficiency and insufficiency groups than in the VD-sufficient group. After adjustment, no linear correlation was observed between UIC and VA/VD. No interaction was found between vitamins A/D and UIC on TSH levels. The mothers in the present study had no iodine deficiency. Region, area type, BMI, and VD may be related to the iodine status or TSH levels. [ABSTRACT FROM AUTHOR]

Background: Multiple evidence suggests that thyroid function is associated with polycystic ovary syndrome (PCOS), but whether thyroid function is causally related to PCOS is unclear. To investigate whether the association reflect causality, a Mendelian randomization (MR) analysis was conducted. Methods: Single nucleotide polymorphisms (SNPs) involved in this study were acquired from The ThyroidOmics Consortium and the IEU Open Genome-wide association study (GWAS) database, respectively. In forward MR analysis, we included normal free thyroxine (FT4, n=49,269), normal thyroid-stimulating hormone (TSH, n=54,288), hypothyroidism (n=53,423) and hyperthyroidism (n=51,823) as exposure. The outcome was defined as PCOS in a sample size of 16,380,318 individuals. The exposure in the reverse MR analyses was chosen as PCOS, while the outcome consisted of the four phenotypes of thyroid function. The inverse-variance weighted (IVW) method was performed as the major analysis, supplemented by sensitivity analyses. Results: The occurrence of PCOS was associated with increased risk of hyperthyroidism (IVW, OR=1.08, 95%CI=1.02-1.13, P=0.004). No evidence suggested that other phenotypes of thyroid function were related to PCOS. Conclusions: Our findings demonstrate a cause-and-effect connection between PCOS and hyperthyroidism. The study established foundation for further investigation for interaction between thyroid function and PCOS. [ABSTRACT FROM AUTHOR]

This article presents a comparative study on the effectiveness of acupuncture in treating hypothyroidism. The study involved 80 patients who were randomly assigned to two groups and received acupuncture treatment for three months. The results showed significant improvement in thyroid function in both groups, with no significant difference between the two acupuncture points used. The study suggests that acupuncture can effectively improve thyroid function in hypothyroidism patients, but further research is needed to validate these findings. Overall, acupuncture shows promise as a complementary treatment for hypothyroidism. [Extracted from the article]

Objective: Although several studies have examined the relationship between thyroid function and muscle strength, their population primarily derived from Asian areas, and their results were controversial. Thus, this study aimed to explore the association between thyroid function and handgrip strength (HGS) in the U.S. population. Methods: A total of 1,067 participants from NHANES were categorized into three different age groups including young (<45 years), middle (45~64 years), and old (≥65 years) age groups. Thyroid function was measured by the competitive binding immune-enzymatic assays, while HGS was examined by a trained evaluator using a dynamometer. The weighted multiple linear regression models were used to examine the association between thyroid function and handgrip strength. The restricted cubic splines were employed to explore the non-linear relationship between these two variables. All statistical analyses were performed using the SPSS version 20.0 and R software. Results: After adjustment for potential covariates, FT3/FT4, but not TSH was positively associated with HGS in middle age group (b=0.091, t=2.428, P=0.016). The subgroup analysis by sex revealed that the positive association between FT3/ FT4 and HGS was observed in the middle age group for both male and female participants (b=0.163, t=2.121, P=0.035; b=0.157, t=2.180, P=0.031). The RCS analysis showed a statistically significant non-linear association between FT3/FT4 and HGS in overall population (P for non-linear=0.026). After adjustment for covariates, men with low HGS had a significant lower FT3/FT4 than those without low HGS in old age group (P=0.013). There was a significant increase in TSH level for female participants with low HGS in old age group compared to those with normal HGS (P=0.048). Conclusions: This study demonstrated FT3/FT4, but not TSH, was positively associated with HGS in middle age group, and the different association was observed in men in middle age group when participants were stratified by sex. Future longitudinal cohort study should be conducted to reveal the causal relationship between thyroid function and muscle strength. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the association between mild elevation of thyroid-stimulating hormone (TSH) levels and pregnancy outcomes of in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) treatments in women with the first fresh embryo transfer. Methods: Large single-center retrospective cohort study of 15,728 patients from January 2018 to December 2022 were enrolled in the analyses. Clinical pregnancy rates, live birth rates, miscarriage rates, and ectopic pregnancy rates were compared between the TSH levels < 2.5 mIU/L group (N = 10,932) and TSH levels ≥ 2.5 mIU/L group (N = 4796). Subgroup analysis was performed for patients with TSH levels ≥ 2.5 mIU/L, dividing them into the thyroid peroxidase antibody (TPO)–negative group (N = 4524) and the TPO-positive group (N = 272). Results: There were no significant differences in the aforementioned pregnancy outcomes between the TSH levels < 2.5 mIU/L group and TSH levels ≥ 2.5 mIU/L group. Similarly, no significant differences were observed in the pregnancy outcomes between the TPO-negative group and the TPO-positive group. Conclusion: Mildly elevated pre-conception TSH levels in thyroid-normal infertile patients did not have an impact on pregnancy outcomes of IVF/ICSI treatments. [ABSTRACT FROM AUTHOR]

The so-called cafeteria diet (CD), rich in saturated fats and light fast-digesting carbohydrates, leads to obesity and is a risk factor for type 2 diabetes. Metformin (MF) is often used to correct diet-induced obesity, but in some patients, it elicits serious side effects, which requires dose reduction, including through its co-application with drugs potentiating MF effects. Intranasally administered insulin (INI), which per se has a restorative potential in the treatment of metabolic disorders, is a candidate for the role of such a drug. This work was aimed to study the efficacy of a 3-week combined course of MF (100 mg/kg/day, perorally) and INI (1.5 or 6.0 IU/kg/day) to correct metabolic and hormonal disorders in male rats with CD-induced obesity (CDIO). It was shown that in CDIO rats, the MF + INI combination normalized body weight and abdominal fat, as well as restored glucose homeostasis, lipid metabolism, basal and glucose-stimulated insulin and leptin levels. Compared to MF monotherapy, a combined course of MF + INI application more effectively restored insulin sensitivity, as assessed by a decrease in the insulin resistance index, and normalized glucose tolerance, as assessed by a decrease in AUC0–120, the integrated area under glucose concentration curves in the glucose tolerance test. The combination of MF with INI at a dose of 1.5 IU/kg/day normalized thyroidal status, disturbed in CDIO, while the combination of MF with INI at a dose of 6 IU/kg/day exacerbated the hypothyroid state, mainly due to hyperactivation of thyroid-stimulating hormone secretion and the development of thyroid resistance to this hormone. Thus, a combined course of MF with relatively low-dose INI, which has no negative effects on the thyroid axis, appears promising for correcting metabolic and hormonal indices in CDIO, including functional restoration of the thyroid system. [ABSTRACT FROM AUTHOR]

SUMMARY: Alzheimer's disease and vascular dementia are the two most common types of dementia. It becomes difficult to distinguish between the two, especially when there are no specific genetic causes or vascular changes apparent. The aim of this review was to identify specific biomarkers supporting the diagnosis of vascular dementia by conducting a literature search for systematic reviews and observational studies. We found seven studies meeting our inclusion/exclusion criteria, and from these we identified four specific biomarkers supporting the diagnosis of vascular dementia: high levels of thyroid-stimulating hormone, lipoprotein(a), homocysteine and N-terminal prosomatostatin. However, the studies were small and a well-conducted study with larger populations is recommended to strengthen the evidence base. [ABSTRACT FROM AUTHOR]

Marzena Ratajczak,1 Monika Krzywicka,2 Monika Szuli&nacute;ska,3 Dominika Musia&lstrok;owska,4 Krzysztof Kusy,5 Joanna Karolkiewicz6 1Department of Medical Biology, Poznan University of Physical Education, Poznan, 61-871, Poland; 2Department of Cardiological and Rheumatological Rehabilitation, Poznan University of Physical Education, Poznan, 61-871, Poland; 3Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences, Poznan, 61-701, Poland; 4Insulin Resistance Foundation – Healthy Diet and Healthy Life, Poznan, 61-379, Poland; 5Department of Athletics Strength and Conditioning, Poznan University of Physical Education, Poznan, 61-871, Poland; 6Department of Food and Nutrition, Poznan University of Physical Education, Poznan, 61-871, PolandCorrespondence: Marzena Ratajczak, Department of Medical Biology, Poznan University of Physical Education, Poznan, 61-871, Poland, Email mratajczak@awf.poznan.plBackground: Circuit training is an exercise mode, that may include both endurance and resistance components. There are premises that a combination of these two modalities brings additional benefits, particularly in improving insulin sensitivity. The retinol-binding protein 4 (RBP4) may inhibit signaling from insulin metabolic pathways in skeletal muscles, thus developing insulin resistance. This study aimed to evaluate whether moderate intensity circuit training combining strength and endurance exercise induces changes in tissue insulin sensitivity, carbohydrate and lipid metabolism, and serum RBP4 levels in insulin-resistant women.Methods: In this clinical controlled trial women diagnosed with insulin-resistance were randomly divided into two groups. The training group (T) performed circuit training combining strength (50%-80%1RM) and endurance (50%-75%HRR) exercise on five weight and two cardio machines, for 33 minutes, three times per week, for 3 months. Women from the control non-training group (NT) did not change their previous physical activity. At the beginning of the study and after the intervention period, a one-repetition maximum, body mass, and composition, resting heart rate (HR), blood pressure, glucose, insulin, blood lipids, thyroid-stimulating hormone (TSH), insulin-like growth factor-1 (IGF-1), RBP4, and insulin resistance (HOMA-IR) were measured. The results of 27 patients were analyzed using a two-way repeated measures ANOVA.Results: Significant differences in the pattern of change over time between the groups for resting HR (p < 0.010) and total lean mass (p < 0.039) were found. No differences in HOMA-IR, and RBP4 were observed post-study compared to pre-study in the T group. A significant correlation between RBP4 and TSH concentration was found.Conclusion: Twelve-week circuit training combining strength and endurance exercise has minor effects on HOMA-IR, glucose and lipid metabolism, IGF-1, TSH, and RBP4. Although moderate-intensity circuit training is considered safe, its effectiveness in patients with overweight and mild obesity may be insufficient to reduce insulin resistance.Trial Registration: ClinicalTrials.gov: NCT04528693, registered August 23, 2020.Keywords: insulin resistance, exercise program, retinol-binding protein 4, insulin-like growth factors-1, thyroid-stimulating hormone

Background: The study of thyroid status and its influence on neonatal and postneonatal development of newborns from mothers with endemic goiter (EG) is one of the topical areas of modern endocrinology. Objective: The study of thyroid hormone levels in newborns born to women with endemic goiter. Materials and Methods: The design of the study is based on a randomized controlled method, taking into account the requirements of CONSORT, with distribution into mutually comparable study groups. A study was carried out on 68 newborns born to women with EG. Methods included the collection of history and study of thyroid hormone levels in neonates and women in labor. Results: In newborns born from women with EG, thyroid-stimulating hormone (TSH) in cord blood averaged 15.6 ± 0.87 mIU/l, which is 22.38% higher compared to the control group (P = 0.038). The difference between free triiodothyronine (T3) and thyroxine (T4) in newborns from mothers with EG in comparison to the control group was below 8.57% and 4.29%, respectively. In the 1st month of life, a lag in weight gain was noted by an average of 9.57% concerning practically healthy newborns. Conclusions: In newborns from women with EG, there was a decrease in T4 – 4.29% and T3 – 8.57%, against the background of an increase in the level of TSH to 22.38% in the cord blood relative to children from the control group. These fluctuations may persist in the 1st month of life and manifest as a delay in weight gain.

Background: Endocrine disorders, such as hypothyroidism, can impact fetal growth and development. The significance and necessity of fetal screening before birth are critical for the prevention of congenital disabilities. The present study aimed to evaluate the association between thyroid hormones, specifically T3, T4, FT3, FT4, TSH, Anti TPO, Free BhCG, B-MOM, P-MOM, and NT-MOM, and the risk of screening tests conducted during the first trimester of pregnancy in women diagnosed with hypothyroidism.Methods: This retrospective, case-control study included 82 pregnant women in their first trimester who were referred for fetal screening tests between 2022 and 2023 at Imam Reza and Motazadi hospitals in Kermanshah, Iran. The case group consisted of 41 pregnant women diagnosed with hypothyroidism and treated with levothyroxine, and the control group comprised 41 pregnant women with normal thyroid function. The assessment of serum levels of T3, free T3, T4, free T4, TSH, and Anti TPO was carried out using the ELISA method, while the first-stage fetal screening tests, including Free BhCG, B-MOM, P-MOM, and NT-MOM, were conducted using the Electro-chemiluminescent (ECL) method. Subsequently, data analysis was conducted using SPSS.Results: In the case group, the average levels of TSH (P=0.001), TPO (P=0.006), trisomy 21 (P=0.001), and trisomy 13/18 (P=0.001) were significantly higher as compared with the control group. Conversely, in the case group, PAPP-A was significantly lower (P=0.001). However, there was no statistically significant difference between the two groups in terms of mean levels of beta-hCG (P=0.297), B-MoM (P=0.202), and NT-MoM (P=0.221). Furthermore, in the case group treated with levothyroxine, mean serum TSH level was significantly higher in the screen positive and medium risk groups of Down syndrome (DS) as compared with the negative screen group (P=0.014).Conclusion: Our results indicated that it is important to promptly identify pregnant women with hypothyroidism and ensure that timely screening tests for fetal health are carried out as a mandatory practice.

Abstract 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.

Thyroid dysfunctions (TDs) are the most common endocrine diseases, especially in women. Phrase "thyroid dysfunction" refers to a variety of diseases affecting the thyroid gland and its hormones. This study aims to compare serum neudesin levels and lipid profiles between people with and without thyroid dysfunction. Study involved 56 TDs patients from a medical laboratory and 28 healthy controls (HCs). Neudesin concentration in serum was assessed using an enzyme-linked immunosorbent test (ELISA), whilst triglycerides (TGs), total cholesterol (T. Cho), High-density lipoprotein cholesterol (HDL-C) and total cholesterol levels were measured using enzyme colorimetry. Serum level of neudesin was lower in thyroid dysfunction patients than in HCs (P< 0.000l), neudesin has an important negative correlation with TGs, HDL, and very low-density lipoprotein (VLDL) (mg/dL) (P< 0.000l), while it showed a positive correlation with low-density lipoprotein (LDL) (mg/dL) (P < 0.000l). Studied parameters showed of the areas under the receiver operating characteristic (AUROC) curve hypothyroidism and hyperthyroidism, respectively: Neudesin (0.8017 and 0.9043 ng/mL), HDL (0.677 and 0.5708 mg/dL), triiodothyronine (T3) (0.8578 and 1 nmol/L), thyroxine (T4) (0.9872 and 1 nmol/L), thyroid-stimulating hormone (TSH) (0.9847 and 0.757 mIU/mL), T. Cho. (0.909 and 0.6645 mg/dL), TGs (0.944 and 0.669 mg/dL), VLDL (0.942 and 0.669 mg/dL), and LDL (0.872 and 0.7526 mg/dL). Present study found serum levels of neudesin showed a negative correlation with T.Cho, and LDL in hyperthyroidism patients while showing a negative correlation with triglycerides and VLDL in hypothyroidism patients.

Introduction: Thyroid disorders, particularly hypothyroidism, are the most common thyroid disorders in India, affecting one in ten adults. Autoimmunity may play a significant role in the progression of hyperlipidaemia, which is one of the recurrent issues associated with thyroid disorders. Although serum lipids have been proven to control immunological and inflammatory responses, little is known about their relationship to thyroid autoimmunity. Aim: To investigate the association between Thyroid Peroxidase Antibody (anti-TPO) and serum lipid parameters among patients diagnosed with hypothyroidism. Materials and Methods: A hospital-based cross-sectional study was conducted at Parul Sevashram Hospital in Vadodara, Gujarat from November 2022 to May 2023. A total of 103 patients with hypothyroidism were included in the study. All patients underwent estimation of thyroid function parameters such as triiodothyronine (T3), thyroxine (T4), and ThyroidStimulating Hormone (TSH), as well as anti-TPO levels and selected lipid profile parameters such as Total Cholesterol (TC), Triglycerides (TG), High-Density Lipoproteins (HDL), and LowDensity Lipoproteins (LDL). The association between anti-TPO and lipid levels was further analysed. Statistical analysis was performed using the Chi-square test. Results: Among the 103 hypothyroid patients, 83 (80.6%) were females, while only 20 (19.4%) were males. Positive serum antiTPO antibodies were found in 79 (76.7%) patients, whereas negative Anti-TPO cases accounted for 24 (23.3%). The total serum cholesterol, with a mean of 226.88±37.44 mg/dL, and serum LDL, with 145.31±34.60 mg/dL, were significantly increased (p-value0.05). Conclusion: Hypothyroid patients positive for anti-TPO antibodies are at risk of experiencing disrupted lipid levels. There was a significant association between positive anti-TPO status and TC and LDL in the present study.

Xing Li, Zhuyuan Zhang, Wen Cai, Xuexin Zhou, Yan Zhang, Cailiang Wu, Xianming Xu, Hao Wu Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200080, People’s Republic of ChinaCorrespondence: Hao Wu; Xianming Xu, Email zhuwy2007@126.com; xuxm11@163.comBackground: The relationship of iron deficiency and thyroid hormone has been researched a lot among pregnant or other healthy population. However, invisible iron deficiency, namely shortage of serum ferritin (sFer) level, has been barely investigated among Chinese pregnant women. This study aimed to explore the effects of sFer status on thyroid function and pregnancy outcomes in a population-based upper first-class hospital.Methods: A total of 781 singleton pregnant women of gestation in Shanghai General Hospital took part in this retrospective cohort study. The participants were divided into four groups by quartiles of serum ferritin levels (Q1– 4). Binary logistic regressions were used to examine the strength of association between the different traits and the serum ferritin (sFer) quartiles separately, where Q1 (lowest ferritin quartile) was taken as the base reference. One-way ANOVA was adopted to compare the averages of the different variables across sFer quartiles. Categorical measures were compared by Fisher exact test or chi-square test.Results: As the sFer concentration rises, incidence of premature birth (15.8%vs 12.3% vs 9.20% vs 6.20% p = 0.016) as well as threatened miscarriage (14.8% vs 7.2% vs 8.70% vs 6.70% p = 0.021) presented a downward trend. Compared with the other sFer group, subjects of the low sFer group were older, more often to be found to have lower serum γT3 and FT4 levels in early pregnancy but not in middle pregnancy.Conclusion: sFer concentration in the first trimester can affect thyroid function. The correction of invisible iron deficiency with inadequate sFer status prior to pregnancy or during early pregnancy is imperative, not only to prevent anemia, but also for maintaining optimum thyroid function and normal fetal development. For clinicians, sFer status of pregnant women should be attached great importance apart from attention to iron level.Keywords: serum ferritin, thyroid hormone, subclinical hypothyroidism, thyroid-stimulating hormone, pregnant women

Background: Thyroid cancer is the most common endocrine carcinoma, accounting for 3.26% of all cancers. The most histologically, well-differentiated thyroid cancer is papillary thyroid carcinoma (PTC). Although PTC is regarded as an indolent tumor, a portion of the cancer cells metastasize to lymph nodes around the thyroid gland. Lymph node metastasis (LNM) is a critical risk factor for tumor recurrence in PTC, which strongly affects disease prognosis and the quality of life. Methods: This study aims to examine how differences in the level of the thyroid profile and other risk factors may influence LNM incidence in patients with PTC in Taiwan. We carried out a single-center retrospective study. These PTC patients were retrospectively reviewed by the Department of Endocrinology from 2016 to 2019. A total of 165 patients were included in our research. Results: The findings revealed a close relationship with the level of free thyroxine (FT4), the level of the thyroid-stimulating hormone (TSH), and lymph node metastases. The correlation in terms of FT4 (p = 0.005) and TSH (p = 0.417) with LNM was found as a result of the univariate regression analysis. In the multiple regression analysis, the findings revealed a close relationship between LNM, FT4 (p < 0.001), and TSH (p = 0.008). Conclusions: Although the predictability of the TSH should be examined further, the association between LNM and FT4 or TSH should not be ignored. The results could help guide decision-making and patient counseling, using the level of serum FT4 or the TSH as a possible predictive factor of the LNM in PTC.