Novel frameshift mutation causes early termination of the thyroxine-binding globulin protein and complete thyroxine-binding globulin deficiency in a Chinese family: A case report

BACKGROUND Thyroxine-binding globulin(TBG;the gene product of SERPINA7)is the main transporter of thyroid hormones in humans.Mutations in the TBG gene may lead to inherited TBG deficiency.There have been 28 reported mutations that associate with complete TBG deficiency(TBG-CD).Here we identified a novel frameshift mutation causing early termination of the TBG protein and TBG-CD in a Chinese family.CASE SUMMARY A 46-year-old Chinese man was referred to our hospital with normal free thyroxine,free triiodothyronine,thyrotropin,but lower total thyroxine and total triiodothyronine,and undetectable serum TBG,indicative of TBG-CD.Blood samples were obtained from the patient’s family members and thyroid function and serum TBG were evaluated.Genomic DNA from peripheral blood was sequenced to detect possible TBG mutation(s).Quantitative PCR high-resolution melting curve analysis was used to screen TBG-Poly(L283F)among 117 Chinese men.A novel mutation of TBG(p.Phe135Alafs*21),a 19-nucleotide insertion in exon 1,was identified,which resulted in a truncated TBG protein product and caused TBG-CD.The other mutation,identified in the proband’s father,is a known polymorphism,TBG-Poly(L283F).The frequency of the TBG-Poly allele among 117 unrelated Han Chinese men from northeast China was 21.37%.CONCLUSION A novel mutation in the TBG gene associated with the TBG-CD phenotype was identified in a Chinese family.Additionally,it was found that 21.37%of Chinese males had TBG-Poly(L283F).

Settlement and metamorphosis of Styela canopus Savigny larvae in response to some neurotransmitters and thyroxin

The larvae of ascidian Styela canopus Savigny were treated with epinephrine, norepinephrine, L-DOPA, GABA and thyroxin to test the ability of these compounds to induce or inhibit larval settlement and metamorphosis. The results showed that epinephrine, norepinephrine and L-DOPA at the concentration of 1 μmol/dm^3 induced larval settlement and metamorphosis in S. canopus, with short exposure （ 1 h） to 1 μmol/dm^3 of L-DOPA inducing rapid settlement. In contrast, GABA at the concentrations of 0.1 ～1130.0 μmol/dm^3 significantly inhibited the settlement and metamorphosis of S. canopus larvae. In addition, thyroxin at 1 -50 μg/dm^3 had no effect on larval settlement and metamorphosis in S. canopus. These results suggest the importance of neurotransmitters in the settlement and metamorphosis of S. canopus larvae.

Relationship between Free Thyroxine and Islet Beta-cell Function in Euthyroid Subjects

Thyroid hormones have a specific effect on glucose-induced insulin secretion from the pancreas.We aimed to investigate the association between euthyroid hormones and islet betacell function in general population and non-treated type 2 diabetes mellitus(T2DM)patients.A total of 5089 euthyroid participants(including 4601 general population and 488 non-treated T2DM patients)were identified from a cross-sectional survey on the prevalence of metabolic diseases and risk factors in East China from February 2014 to June 2016.Anthropometric indices,biochemical parameters,and thyroid hormones were measured.Compared with general population,non-treated T2DM patients exhibited higher total thyroxine(TT4)and free thyroxine(FT4)levels but lower ratio of free triiodothyronine(T3):T4(P<0.01).HOMA-βhad prominently negative correlation with FT4 and positive relationship with free T3:T4 in both groups even after adjusting for age,body mass index(BMI)and smoking.When analyzed by quartiles of FT4 or free T3:T4,there were significantly decreased trend of HOMA-β going with the higher FT4 and lower free T3:T4 in both groups.Linear regression analysis showed that FT4 but not FT3 and free T3:T4 was negatively associated with HOMA-β no matter in general population or T2DM patients,which was independent of age,BMI,smoking,hypertension and lipid profiles.FT4 is independently and negatively associated with islet beta-cell function in euthyroid subjects.Thyroid hormone even in reference range could play an important role in the function of pancreatic islets.

Thyroxine treatment for elderly patients with heart failure and sick euthyroid syndrome

Objectives To evaluate the effect of thyroid hormone therapy with low dose of thyroxin on cardiac function in elderly patients with heart failure and sick euthyroid syndrome.Methods Forty-seven patients(33 males and 14 females,mean age 85.9+4.6 years,ranging from 80 to 99 years)with chronic heart failure(NYHAⅡ-Ⅳ)and low triiodothyronine(T_(3))state were randomly allocated to the treatment group or control group.The treatment group patients received oral administration of levothyroxine sodium(Euthyrox)25-50mg/d in addition to conventional therapy of heart failure,whereas patients in control group were given conventional therapy only.Serum level of total T_(3)(TT_(3)),free T_(3)(FT_(3)),total thyroxine(TT_(4)),free thyroxine(FT_(4)),and thyroid-stimulating hormone(TSH)were determined.For both groups,left ventricular ejection fraction(LVEF)and stroke volume(SV)were assessed by two-dimensional echocardiography before and at 8 weeks after treatment.The changes of these parameters after the treatment were evaluated by adjusting heart rate in the two groups.Results The reduced serum T_(3) level in the treatment group was corrected after thyroid hormone therapy,and these patients had a significant improvement in cardiac function after treatment.By contrast,in the control group only changes of serum TT_(3) and TT_(4) levels and SV and LVEF after treatment were statistically significant.The heart rate-adjusted mean SV and LVEF in both groups were also increased,which was significantly greater in the treatment group than in the control group.Conclusion In the elderly patients with heart failure and sick euthyroid syndrome,addition of thyroxine at a low dosage to the conventional treatment could effectively improve the low T_(3) state and cardiac function independent of changes of heart rate.

Determination of Thyroxine with Capillary Electrophoretic Enzyme Immunoassay

A Capillary electrophortic enzyme linked immunoassay with electrochemical detection (CE-EIA-ED) has been developed. The method can be used to determine thyroxine with a limit of 3.8×10-9 mol/L.

Ameliorating Effects of Thyroxine and Atropine in Phosphamidon Intoxicated Chick Embryos

The effects of thyroxine and atropine in ameliorating phosphamidon intoxication in chick embryos was studied. Treatment of phosphamidon significantly enhanced the moriality and abnormalityrates, decreased the average body weights, and cholinesterase activity in chick embryos. When thyroxine was administered to the phosphamidon intoxicated embryos, the above parameters changedsignificantly, indicating an ameliorating effect of thyroxine against phosphamidon intoxication in chick embryos. The combined thyroxine and atropine therapy did not further improve the ameliorating effect. Since in many respects chick embryo development parallels that of mammalian embryos,a short-term use of thyroxine as a protective agent against organophosphate toxicity might be useful

The effectiveness and safety of thyroxine replacement therapy for children with down syndrome and subclinical or congenital hypothyroidism—A systematic review

Introduction: Down syndrome (DS) is the most common chromosomal abnormality causing mental handicap in humans. Children with DS have significant medical problems and developmental delay which are further impaired by hypothyroidism. Those clinical features are potentially improved by using thyroxine replacement therapy. Objectives: To examine the evidence of effectiveness (motor & mental development) and safety of thyroxine supplementation in the treatment of SH and CH in children with DS. Methods: Several medical data bases (MEDLINE, EMBASE, CINAHL, Cochrane, Clinical Trials Gov, Essential Evidence and Google) were searched until 20 October, 2011, for randomized control trials (RCTs) that had examined thyroxine’s effectiveness and safety in the treatment of SH or CH in children with DS. Results: There were two high quality RCTs that examined thyroxine in the treatment of CH in children with DS, and no RCTs were found to have examined the effectiveness of thyroxine for SH in children with DS. Conclusion: The RCT which met our inclusion criteria provides the reliable evidence in recommending thyroxine for the treatment of CH in children with DS which is similar to the guidelines for general population. The absence of RCTs examining the treatment of SH in Children with DS indicates the need to conduct such trials.

The effect of maternal thyroxine injection on growth, survival and development of the digestive system of Nile tilapia, <i>Oreochromis niloticus</i>, larvae

The present study deals with the effect of exogenous treatment of O. niloticus females with L-thyroxine (T4) on the development of the digestive system during larval rearing, and its subsequent effect on larval growth and survival. The development of the digestive tract and accessory glands was investigated histologically and histochemically in the developing O. niloticus larvae, from control and T4-treated spawners. During yolk-sac absorption, the digestive system of the fish underwent further differentiation and the rudimentary alimentary canal became segmented into four different histological regions: the buccopharynx, oesophagus, stomach and intestine. The injection of females O. niloticus with thyroxine (1 or 10 μg T4/g BW) greatly enhanced the development of the digestive tract and accessory glands of larvae as indicated by the quantitative and qualitative changes of the mucus composition from predominantly neutral to a mixture of neutral and acid mucosubstances, or acid mucosubstances occurred during the rearing period for the larvae produced from T4-treated females. This may be due to the direct effect of exogenous thyroxine, which might have been transferred from maternal circulation into the oocytes and larvae, on the synthesis of proteins, which increased with larval development. Thus, thyroxine directly or indirectly improved O. niloticus larval growth, since a marked increase in both, length and weight of larvae occurred during the experimental period. In addition, larvae from treated females also gave a significantly higher survival rate than that of control. It could be concluded that exogenous T4 in maternal circulation might have been transferred into oocytes and larvae. The transferred thyroid hormone appears to play some role in the early development of larvae and may confer a distinct advantage for the growth of the offspring of the Nile tilapia, O. niloticus.

THE EFFECTS OF RECOMBINANT EEL GROWTH HORMONE,METHYLTESTOSTERONE AND L-THYROXINE ON THE GROWTH OF REDSEABREAM,PAGROSOMUSMAJOR

The effects of recombinant eel growth hormone (reGH).methyltestosterone (MT)and L-thyroxine (T4)on the growth of red sea bream. Pagrosomus major.were investigated.Administration of reGH to fry by immersion at 2 mg 1 for 2 hevery 5 dsys resulted in significant increase in both weight and length.but the condition factor (CF) diminished relative to that of similarly treated controls over the 37day treatment period.Immersion in 0.1 mg:1 T4 also resulted in significant increase in both weight and length and higher survival rate of test fry compared to the controls. Immersion in MT had less effect on growth and high-dose resulted in high mortality.In the second study.injection of 2 μg reGH(gwk)caused a significant increase in the specific growth rate (SGR) of test red sea bream fingerlings relative to that of the controls during the 4-week treatment period and maintained the increasing trend over the post-treatment period (weeks 4-6).Injection of MT at a dosage of 1μg (gwk) resulted in a significant

Hormonal （Thyroxin, Cortisol） and Immunological （Leucocytes） Responses to Cistern Size and Heat Stress in Tunisia

This study was designed to determine the effects of heat stress on plasma leucocytes, Thyroxin （T4） and cortisol concentrations in dairy cows with small and large cistern under hot climate. This experiment was carried out in 2006, in North Tunisia, using a randomized block design per udder cistern size, using 60 Holstein cows. Cows were classified according to udder cistern size by ultrasonography as large-cisterned （44 ±13 cm2; LC） and small-cisterned （21 ± 8 cm2; SC）. The experiment was carried out in two different periods： spring （Apr. 5 （D1）） and summer （July 19 （D2）, Aug. 19 （D3） and Sept. 19 （D4））. On each test day, temperature and relative humidity data were registered hourly and cows＇ blood was sampled from the jugular vein to determine serum concentrates of cortisol and T4. Leucocytes （lyrnphocytes, eosinophils, neutrophils and monocytes） were counted differentially, and percentages of lymphocytes relative to total counted cells were calculated. Mean temperature-humidity index （THI） values were 62 ±2, 79 ±2, 84 ±2, and 77 ±1 in DI, D2, D3, and D4, respectively. Lymphocyte incidence relative to total cell counts and T4 concentrations were affected by test day （P 〈 0.001）. Lymphocytes （%） were significantly less in hotter months. During summer, T4 concentration at D2 （87.4 nmol/L） was higher relative to concentrations at D3 （42.8 nmol/L） and D4 （53.5 nmol/L）. T4 concentrations were higher （P 〈 0.01） in SC cows （67.7 ±0.1 nmol/L） compared to LC cows （52.7 ±0.1 nmol/L）. Cortisol concentration was effected neither by test day nor by cistern size. However, the decrease of lymphocyte concentration during summer compared to spring could be considered as an evidence of the suppression of cows＇ immune system under heat stress.

甲状腺功能亢进症患者血清神经调节蛋白4水平及其临床意义

目的 探讨甲状腺功能亢进症(甲亢)患者血清神经调节蛋白4(NRG4)水平及其临床意义。方法 选取2019年8月至2021年8月该院收治的69例甲亢患者作为甲亢组,同期收治的57例亚临床甲亢患者作为亚临床甲亢组,同期健康体检者63例为健康对照组。对甲亢患者均给予硫酰胺类药物甲巯咪唑治疗3个月。比较3组促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT3)、游离甲状腺素(FT4)水平;分析甲亢患者治疗前后的TSH、FT3、FT4、NRG4水平变化;评估治疗前血清NRG4辅助诊断甲亢的价值;分析治疗前血清NRG4水平与TSH、FT3、FT4水平的相关性。结果 甲亢组治疗前TSH水平[(0.14±0.03)mU/L]低于亚临床甲亢组[(0.25±0.04)mU/L]、健康对照组[(2.61±0.45)mU/L],甲亢组治疗前FT3、FT4、NRG4水平[(15.54±2.68)pmol/L、(41.36±10.02)pmol/L、(3.42±1.12)ng/mL]高于亚临床甲亢组[(6.25±0.27)pmol/L、(20.34±3.45)pmol/L、(2.61±0.52)ng/mL]、健康对照组[(3.74±0.39)pmol/L、(12.03±2.16)pmol/L、(1.89±0.49)ng/mL],差异均有统计学意义(P<0.05)。甲亢患者FT3、FT4、NRG4水平在治疗1个月[(12.04±2.41)pmol/L、(30.25±7.84)pmol/L、(2.84±0.87)ng/mL]、3个月[(7.65±2.23)pmol/L、(19.63±4.25)pmol/L、(2.37±0.61)ng/mL]时相比治疗前降低(P<0.05),TSH水平在治疗1个月[(0.87±0.21)mU/L]、3个月[(1.42±0.32)mU/L]相比治疗前升高(P<0.05)。受试者工作特征曲线分析结果显示:血清NRG4诊断甲亢的曲线下面积为0.859(95%CI=0.799~0.919,P<0.05),灵敏度为66.7%,特异度为88.9%,最佳临界值为2.39 ng/mL,约登指数为0.556。Pearson相关分析结果显示:NRG4水平与TSH水平呈负相关(r=-0.494,P<0.05),与FT3、FT4水平均呈正相关(r=0.502、0.644,P<0.05)。结论 甲亢患者血清NRG4呈相对高水平,硫酰胺类药物治疗后其水平下降;甲亢患者NRG4水平与甲状腺激素指标水平具有相关性,对甲亢的临床诊治具有辅助评估价值。

疏肝消瘿方联合穴位敷贴治疗甲状腺结节的临床观察

目的:探讨疏肝消瘿方联合穴位敷贴治疗甲状腺结节的效果及对甲状腺激素、血流阻力指数(RI)、搏动指数(PI)、微血管密度(MVD)影响。方法:选取2022年1月至2023年6月上海交通大学医学院附属第六人民医院收治的甲状腺结节患者80例作为研究对象,按照随机数字表法随机分为对照组与观察组,每组40例。对照组患者给予西医治疗,观察组在对照组基础上,采用疏肝消瘿方联合穴位敷贴治疗。比较2组治疗效果,包括游离三碘甲状腺素(FT3)、游离甲状腺素(FT4)及促甲状腺激素水平(TSH),以及超声指标(RI、PI、MVD)的变化情况。结果:观察组患者治疗有效率为92.50%,显著高于对照组的75.00%(P<0.05),其中医证候积分也明显低于对照组(P<0.05);2组患者治疗前后,FT3和FT4水平差异无统计学意义(P>0.05),TSH水平比治疗前下降,且观察组治疗后TSH水平降低更多(P<0.05);治疗后2组患者RI、PI、MVD值明显低于治疗前(P<0.05),且观察组RI、PI、MVD明显低于对照组(P<0.05)。结论:疏肝消瘿方联合穴位敷贴可以改善甲状腺结节患者中医证候积分,降低TSH表达水平,减少RI、PI、MVD值,效果明显。

甲状腺功能异常对凝血系统的影响及治疗药物相互作用研究进展

甲状腺功能异常患者的凝血指标可出现异常,存在潜在发生血栓或出血的风险。甲状腺功能亢进患者存在显著的血管内皮功能紊乱并引起血栓风险,但关于甲状腺功能减退对凝血功能的影响仍存在争议。甲状腺功能异常对凝血系统的潜在风险可能干扰抗凝药物治疗安全性,同时甲状腺疾病治疗药物与抗凝药物之间的相互作用也对患者的用药安全造成影响。该文基于既往研究文献分析甲状腺功能异常与凝血功能相关性,评估和探讨甲状腺功能异常对凝血系统的影响及相关治疗药物相互作用,以期为甲状腺功能紊乱合并凝血功能异常患者的诊治提供参考。

妊娠早期甲状腺功能指标与妊娠期糖尿病的相关性研究

目的:探讨妊娠早期甲状腺功能指标与妊娠期糖尿病(GDM)的相关性。方法:回顾性选取2019年1月至2022年12月在上海市长宁区妇幼保健院产科门诊建卡的孕妇800例,收集妊娠早期促甲状腺激素(TSH)、游离甲状腺素(FT4)、游离三碘甲状腺原氨酸(FT3)、甲状腺过氧化物酶抗体(TPOAB)、甲状腺球蛋白(TGAB)、24~28周行口服葡萄糖耐量试验(OGTT)等检测指标。按GDM诊断标准分为GDM组(136例)和非GDM组(664例),分析妊娠早期甲状腺功能指标与GDM的相关性。结果:GDM组的年龄、孕次、TSH、FT3/FT4比值均高于非GDM组(P<0.05)。GDM孕妇妊娠早期FT4水平明显低于非GDM组孕妇(P<0.05)。Spearman分析显示,FT4与OGTT各时段血糖值呈负相关(r<0,P<0.05)。FT3/FT4与OGTT各时段血糖值呈正相关(r>0,P<0.05)。多因素逻辑回归分析显示,FT3、FT3/FT4是GDM发生的危险因素。FT4是GDM的保护因子。结论:FT3值越高,后续发生GDM风险高;FT4值越高,后续发生GDM风险越低;FT3/FT4比值越高,后续发生GDM风险越大。

Incubation temperature induced developmental plasticity of cold responsive physiological phenotypes in Japanese Quails

Embryonic development is a critical period for phenotype formation.Environmental variation during embryonic development can induce changes in postnatal phenotypes of animals.The thyroxine secretion and aerobic metabolic activity of small birds are important phenotypes closely related to their winter survival.In the context of climate change,it is necessary to determine whether temperature variation during incubation in birds leads to developmental plasticity of these cold responsive phenotypes.We incubated Japanese Quail(Coturnix japonica)eggs at 36.8℃,37.8℃,and 38.8℃,and raised the chicks to 35-day old at 22℃with same raising conditions,then all the quails were exposed to gradually temperature dropping environment(from 15℃to 0℃).After cold treatment,serum T3 level,resting metabolic rate,skeletal muscle and liver metabolomes of the birds were measured.The serum T3 levels were significantly lower in the 38.8℃group and significantly higher in the 36.8℃group compared to the 37.8℃group.The metabolic rate in the 38.8℃group was significantly lower compared to the 37.8℃group.Compared with the 37.8℃group,metabolites involved in the tricarboxylic acid cycle in the liver were significantly lower in the 38.8℃group,and metabolites related to lipid oxidation metabolism and fatty acid biosynthesis were significantly lower in the skeletal muscles in the 38.8℃group but significantly higher in the 36.8℃group.These results indicate that incubation temperature variation can lead to developmental plasticity in cold responsive physiological phenotypes.Higher incubation temperature may impair the capacity of birds coping with cold challenge.

Cardiovascular mechanisms of thyroid hormones and heart failure:Current knowledge and perspectives

A multiple hormonal imbalance that accompanies heart failure(HF)may have a significant impact on the clinical course in such patients.The non-thyroidal illness syndrome(NTIS),also referred to as euthyroid sick syndrome or low triiodothyronine syndrome,can be found in about 30%of patients with HF.NTIS represents a systemic adaptation to chronic illness that is associated with increased cardiac and overall mortality in patients with HF.While conclusions on thyroid-stimulating hormone,free triiodothyronine,total and free thyroxine are currently unresolved,serum total triiodothyronine levels and the ratio of free triiodothyronine to free thyroxine seem to provide the best correlates to the echocardiographic,laboratory and clinical parameters of disease severity.HF patients with either hyper-or hypothyroidism should be treated according to the appropriate guidelines,but the therapeutic approach to NTIS,with or without HF,is still a matter of debate.Possible treatment options include better individual titration of levothyroxine therapy,combined triiodothyronine plus thyroxine therapy and natural measures to increase triiodothyronine.Future research should further examine the cellular and tissue mechanisms of NTIS as well as new therapeutic avenues in patients with HF.

FT3/FT4、hs-CRP/PA、NT-proBNP水平对预测老年急性心力衰竭患者预后的价值

目的 探究游离三碘甲状腺原氨酸/甲状腺素(FT3/FT4)、超敏C反应蛋白/前清蛋白(hs-CRP/PA),及氨基末端脑钠肽前体(NT-proBNP)对老年急性心力衰竭(AHF)预后不良的预测价值。方法 选取2022年3月—2023年3月首都医科大学附属北京潞河医院收治的72例老年AHF患者作为研究组,收集患者FT3/FT4、hs-CRP/PA,及NT-proBNP等临床资料及入院随访一年预后情况,根据预后情况分为预后不良组(n=23)和预后良好组(n=49);另随机抽取72例健康志愿者作为对照组,分析其临床资料及NT-proBNP、FT3/FT4、hs-CRP/PA水平差异,分析其对老年AHF的预测价值。结果 研究组患者的FT3/FT4低于对照组患者,hs-CRP/PA及NT-proBNP高于对照组患者(P<0.05);预后不良组患者FT3/FT4低于预后良好组患者,hs-CRP/PA及NT-proBNP水平高于预后良好组患者(P<0.05)。多因素Logistic回归分析结果显示NT-proBNP、FT3/FT4、hs-CRP/PA水平均为患者预后不良的影响因素(P<0.05)。受试者操作特征曲线分析结果显示,NT-proBNP、FT3/FT4、hs-CRP/PA水平预测老年AHF患者的曲线下面积分别为0.816、0.862、0.713。结论 NT-proBNP、FT3/FT4、hs-CRP/PA与老年AHF患者不良预后有关,3项指标共同使用预测患者预后效能良好。

Association between sensitivity to thyroid hormones and non-highdensity lipoprotein cholesterol levels in patients with type 2 diabetes mellitus

BACKGROUND Dyslipidemia and type 2 diabetes mellitus(T2DM)are chronic conditions with substantial public health implications.Effective management of lipid metabolism in patients with T2DM is critical.However,there has been insufficient attention given to the relationship between thyroid hormone sensitivity and dyslipidemia in the T2DM population,particularly concerning non-high-density lipoprotein cholesterol(non-HDL-C).AIM To clarify the association between thyroid hormone sensitivity and dyslipidemia in patients with T2DM.METHODS In this cross-sectional study,thyroid hormone sensitivity indices,the thyroid feedback quantile-based index(TFQI),the thyroid-stimulating hormone index(TSHI),the thyrotrophic T4 resistance index(TT4RI),and the free triiodothyronine(FT3)/free thyroxine(FT4)ratio were calculated.Logistic regression analysis was performed to determine the associations between those composite indices and non-HDL-C levels.Random forest variable importance and Shapley Additive Explanations(SHAP)summary plots were used to identify the strength and direction of the association between hyper-non-HDL-C and its major predictor.RESULTS Among the 994 participants,389(39.13%)had high non-HDL-C levels.Logistic regression analysis revealed that the risk of hyper-non-HDL-C was positively correlated with the TFQI(OR:1.584;95%CI:1.088-2.304;P=0.016),TSHI(OR:1.238;95%CI:1.034-1.482;P=0.02),and TT4RI(OR:1.075;95%CI:1.006-1.149;P=0.032)but was not significantly correlated with the FT3/FT4 ratio.The relationships between composite indices of the thyroid system and non-HDL-C levels differed according to sex.An increased risk of hyper-non-HDL-C was associated with elevated TSHI levels in men(OR:1.331;95%CI:1.003-1.766;P=0.048)but elevated TFQI levels in women(OR:2.337;95%CI:1.4-3.901;P=0.001).Among the analyzed variables,the average SHAP values were highest for TSHI,followed by TT4RI.CONCLUSION Impaired sensitivity to thyroid hormones was associated with high non-HDL-C levels in patients with T2DM.

血清β-hCG、甲状腺激素水平与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的关系

目的:探究剖宫产瘢痕妊娠患者血清β-人绒毛膜促性腺激素(β-hCG)、三碘甲状腺原氨酸(T)、甲状腺素(T)水平与子宫动脉栓塞术后再妊娠的关系。方法:选取2019年11月-2020年11月本院143例剖宫产瘢痕妊娠患者作为研究对象,依据术后3年再妊娠情况分为再妊娠组86例和未妊娠组57例,记录患者临床资料,采用化学发光法测定术前、术后第1、第3个月经周期血清β-hCG水平,采用ELISA法检测T_(3)、T_(4)水平。血清β-hCG、甲状腺激素水平与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的关系行logistic回归分析;绘制ROC曲线分析血清β-hCG、甲状腺激素水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的价值。结果:血清β-hCG、T_(3)、T_(4)水平在未妊娠组和再妊娠组及术后不同时间点存在交互效应(均P<0.05);术后血清β-hCG水平呈下降趋势,血清T_(3)、T_(4)水平呈上升趋势。术后第1、第3个月经周期再妊娠组的血清β-hCG水平均低于未妊娠组,血清T_(3)、T_(4)水平均高于未妊娠组(均P<0.05)。术后第1个月经周期血清β-hCG、T_(3)、T_(4)水平预测剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠的AUC分别为0.827、0.816、0.830,低于三者联合预测的AUC为0.933(Z=2.543、2.807、2.471,均P<0.05)。术后第1、第3个月经周期的血清β-hCG、T_(3)、T_(4)水平均与剖宫产瘢痕妊娠子宫动脉栓塞术后再妊娠有关,其中术后第1、第3个月经周期β-hCG为独立危险因素,T_(3)、T_(4)为保护因素(均P<0.05)。结论:子宫动脉栓塞术后第1个月经周期血清β-hCG、Ts、T4水平联合检测可一定程度预测再妊娠情况,进而指导临床治疗。

新外来中药紫锥菊对虚热证虚寒证小鼠甲状腺激素和物质能量代谢的影响

目的:考察紫锥菊水提物对虚寒、虚热证小鼠内分泌激素、物质能量代谢水平的影响,探讨紫锥菊水提物的药性。方法:将KM雄性小鼠随机分为空白组、虚热模型组、虚热西洋参组、虚热紫锥菊水提物低剂量组、虚热紫锥菊水提物高剂量组、虚寒模型组、虚寒人参组、虚寒紫锥菊水提物低剂量组、虚寒紫锥菊水提物高剂量组;虚热模型组小鼠每天灌胃甲状腺片水溶液(160 mg/kg),虚寒模型组小鼠灌胃氢化可的松溶液(25 mg/kg),1次/d,连续14 d制备虚热、虚寒模型,各给药组灌胃相应药物。检测各组小鼠血清三碘甲状腺原氨酸(T_(3))、甲状腺素(T_(4))、总胆固醇(TC)、三酰甘油(TG)、总蛋白(TP)、白蛋白(ALB)以及血糖(GLU)等指标变化,比色法检测小鼠肝脏乳酸脱氢酶(LDH)、琥珀酸脱氢酶(SDH)、Na^(+)-K^(+)-ATP酶活力,采用实时聚合酶链反应法检测小鼠肝组织细胞色素c氧化酶7A2(COX7A2)、琥珀酸脱氢酶复合体D亚基(SDHD)mRNA表达情况。结果:与虚热模型组比较,紫锥菊水提物对虚热小鼠整体状态有一定程度改善,体质量和脾脏指数有所改善(P<0.05),T_(3)、T_(4)水平显著降低(P<0.05,P<0.01),TP、ALB、GLU、LDH的水平显著升高(P<0.01),SDH、Na^(+)-K^(+)-ATP酶、COX7A2、SDHD mRNA的表达水平显著降低(P<0.05,P<0.01),紫锥菊水提物与寒凉性质的西洋参表现出相似的作用;与虚寒模型组比较,紫锥菊水提物对虚寒小鼠整体状态、胸腺指数以及脾脏指数无明显改善,紫锥菊水提物高剂量显著升高SDH、Na^(+)-K^(+)-ATP酶水平(P<0.01),而紫锥菊水提物对虚寒小鼠T_(3)、T_(4)、TP、ALB、TC、TG、GLU、COX7A2 mRNA、SDHD mRNA表达水平的调节不明显,差异无统计学意义(P>0.05),紫锥菊水提物与温热性质的人参作用趋于相反。结论:紫锥菊水提物性凉,可能是紫锥菊寒凉药性的物质基础。