Edible mushrooms as a potent therapeutics of subclinical thyroid dysfunction among adults,especially in obese individuals:a prospective cohort study

Background:Mushrooms are a good source of many nutrients which are potentially beneficial for chronic diseases.We speculated that due to its abundant nutrients edible mushrooms might have a beneficial effect on the prevention of subclinical thyroid dysfunction(SCTD).Therefore,we designed a large-scale cohort study to examine whether mushrooms consumption is a protective factor for SCTD in adults.Methods:This prospective cohort study investigated 6631 participants(mean age:(45.0±10.2)years;55.1%men).Edible mushrooms consumption was measured at baseline using a validated food frequency questionnaire.SCTD was defined as abnormal serum thyroid-stimulating hormone levels and normal free thyroxine.Cox proportional hazards regression models were used to examine the association of edible mushrooms consumption with incident SCTD.Results:During follow-up period,a total of 262 new cases of SCTD were identified,the incidence rate of subclinical hypothyroidism was 8.9/1000 person-years and subclinical hyperthyroidism was 7.2/1000 person-years.After adjusting potential confounding factors,the multivariable hazard ratios(95%confidence intervals)for subclinical hypothyroidism were 1.00(reference)for almost never,0.53(0.29,0.97)for 1-3 times/week and 0.30(0.10,0.87)for≥4 times/week(P for trend=0.02).It also showed edible mushrooms consumption was inversely associated with subclinical hypothyroidism in obese individuals but not non-obese individuals,the final hazard ratios(95%confidence intervals)were 0.14(0.03,0.73)(P for trend<0.01).Conclusions:This population-based prospective cohort study has firstly demonstrated that higher edible mushrooms consumption was significantly associated with lower incidence of subclinical hypothyroidism among general adult population,especially in obese individuals.

Non-alcoholic fatty liver disease and thyroid dysfunction:A systematic review

Thyroid hormones are totally involved in the regulation of body weight, lipid metabolism, and insulin resistance. Therefore it is anticipated that thyroid hormones may have a role in the pathogenesis of non alcoholic fatty liver disease(NAFLD) and non alcoholic steatohepatitis(NASH). In this study, we reviewed the current literature on the association between thyroid dysfunction and NAFLD/NASH. A search for English language medical literature reporting an association between thyroid dysfunction and NAFLD/NASH in humans was conducted across PubMed, ISI Web of Science, and Scopus in August, 2013. Out of 140 studies initially identified through the search, 11 relevant articles were included in the final review. Thyroid dysfunctions in the form of overt or subclinical hypothyroidism are prevalent among patients with NAFLD/NASH. Hypothyroidism appears to be an independent risk factor for NAFLD/NASH in some studies; however, other newly published studies failed to find such anassociation. The results of the studies on the role of thyroid abnormalities in NAFLD/NASH are inconsistent, and further research is recommended to determine the relationship between hypothyroidism and NAFLD/NASH and the underlying mechanisms.

Burden, Type, and Associated Factors of Thyroid Dysfunction in Patients with Heart Failure in Sub-Saharan Africa: A Cross-Sectional Study

Background: Various thyroid abnormalities have been reported during heart failure (HF). The present study aimed to evaluate the burden, type, and associated factors of thyroid disorders in Cameroonian patients with heart failure. Materials and Methods: We conducted a cross-sectional study from January to May 2020, involving volunteer adults followed for heart failure at the Yaoundé Central Hospital. Those receiving treatment that could cause thyroid dysfunction were excluded. Thyroid hormone levels (TSH, free T3, and free T4) were measured by enzyme-linked immunosorbent assay. Results: A total of 63 patients (30 women;47.6%) were included. The median age was 65 (IQR: 56 - 70) years. The main etiology of heart failure was hypertension (52.4%) followed by valvular heart disease (14.3%). Thyroid dysfunction was seen in 38 (60.3%, [95% CI: 47.2 - 72.4]) patients, of which 30 (79%) had hypothyroidism and 8 (21%) had hyperthyroidism. The most frequent thyroid dysfunction was Low T3 syndrome in 27% (95% CI: 16.6 - 39.7) of the study population followed sub-clinical hypothyroidism in 19.1% (95% CI: 10.3 - 30.9) of patients. Patients with HF and reduced ejection fraction (HFrEF) were more likely to have hypothyroidism than those with preserved ejection fraction (OR: 3.5, [95% CI: 1.2 - 9.9], p = 0.016). Also, patients with more than one hospital admission in the past 12 months were more likely to have hypothyroidism (OR: 5.3, [95% CI: 1.3 - 21.5], p = 0.013). Conclusion: The burden of thyroid dysfunction was high in this group of patients with HF. These were mainly low T3 syndrome and sub-clinical hypothyroidism. These were associated with heart failure with reduced ejection fraction and those with more than one hospitalization within the past 12-months.

Thyroid Dysfunction in Children Exposed to Iodinated Contrast Media:A Meta-Analysis and Systematic Review

Iodinated contrast media(ICM)has the potential to cause thyroid dysfunction in some patients.However,it is unclear whether this relationship exists in children.We conducted a systematic review and meta-analysis aim to obtain a general overview of the relationship between ICM exposure and the risk of thyroid dysfunction in children.Methods:Computer search of Web of Science,EMbase,PubMed,Cochrane Library,collection of relevant literature on ICM and thyroid dysfunction in children,the search period was from the establishment of the database to July 2021.Meta-analysis was performed using Stata 14.0 software.Results:A total of 8 literatures with 3497 children.The incidence of hypothyroidism in children with ICM exposure was 0.05(95%CI:0.05,0.12),P<0.0001.Subgroup analysis showed that the incidence of hypothyroidism in ICM exposed children in the European region was 0.21(95%CI:0.13,0.30),P<0.0001,a statistically significant difference.Conclusion:The current evidence shows that children exposed to ICM are at risk for hypothyroidism,with a higher risk in neonates,especially children with congenital heart disease.

Long-term effect of a large dose of iodinated contrast in patients with mild thyroid dysfunction:a prospective cohort study

Background:More than 75 million procedures with intravascular iodine-based contrast media(ICM)are performed worldwide every year,and some patients undergoing these procedures do not have normal thyroid function.The long-term effects of ICM in patients with mild thyroid dysfunction(TD)are unclear.Methods:This prospective cohort study was conducted in China.Patients with stable angina pectoris with total triiodothyronine(TT3)reduction,normal thyroid-stimulating hormone,and reverse triiodothyronine(rT3)were enrolled and divided into high-dose(≥100 mL ICM)and low-dose groups(<100 mL ICM).We dynamically investigated the trends in thyroid function,rT3,and thyroid antibodies one year after ICM exposure.Results:A total of 154 patients completed 6 months of follow-up and 149 completed 1 year of follow-up.Thyroglobulin antibody(TGAB)levels were elevated in 41(26.6%)patients before ICM exposure,11(7.1%)of whom also had elevated thyroid peroxidase antibody levels.Transient subclinical TD occurred 6 months after ICM exposure;75.5%(34/45)of post-operative TD occurred in the high-dose group.One patient developed severe hypothyroidism with myxedema,requiring drug intervention 1 year after ICM exposure.The level of rT3 showed no statistically significant changes during post-operative follow-up(P=0.848).The TGAB level decreased at 6th month(P<0.001),but increased at 1 year after ICM exposure(P=0.002).Conclusions:Patients with T3 reduction are at a risk of transient subclinical TD and hypothyroidism after a single large dose of ICM.Follow-up of this population at 9-12 months after ICM exposure is warranted.

Ningbo thyroid dysfunction prevalence study： a cross-sectional survey in an employees-cohort

Background The prevalence and the spectrum of thyroid dysfunction in the mainland of China are not adequately understood. We performed a population-based study to determine the prevalence of major thyroid dysfunctions including overt and subclinical hyper- and hypothyroidism in a stable cohort. Methods All active and retired employees aged 20 years and older （11 067） of Sinopec Zhenhai Refining ＆ Chemical Company in Ningbo participated in the cross-sectional survey with a questionnaire and blood samples. Results A total of 10 405 individuals attended for screening. Using biochemical definitions 95.5% were euthyroid. The prevalence of former diagnosed hyperthyroidism was 1.1% in females and 0.4% in males, hypothyroidism 1.7% and 0.3%, and thyroid surgery 1.2% and 0.3%, respectively. In both sex the prevalence increased with age. Twenty-four percent of individuals with thyroid surgery or medications had abnormal thyroid-stimulating hormone （TSH） levels. In individuals without a history of thyroid disease, the prevalence of pathological TSH values in females and males were TSH 〉10 mU/L 0.60% and 0.29%; TSH 4.8-9.9 mU/L 5.71% and 2.25%; TSH 〈0.3 mU/L 0.87% and 0.41%, respectively. Overt hyper- and hypothyroidism were uncommon （0.2%, 0.3%, respectively）. The prevalence of subclinical hyper- and hypothyroidism was 0.4% and 3.4%, respectively. Subclinical hypothyroidism was more common in females （male 2.4% vs. female 5.8%, P 〈0.001） and with increasing age （P 〈0.001）. Conclusions The prevalence of thyroid dysfunction is 4.5% in the cohort. Among individuals with thyroid medications or surgery, only 75.7% were within the normal range of TSH. These results indicate that thyroid dysfunction is common in Chinese adults.

Analysis of thyroid dysfunction in patients with sudden sensorineural hearing loss

Background:Sudden sensorineural hearing loss(SSHL)refers to the sudden occurrence of unexplained sensorineural hearing loss.The present study showed that different systemic diseases had different influence on the occurrence and hearing outcome of SSHL.Thyroid hormone is one of the important factors for the development of fetal ear and auditory function.However,the distribution of thyroid dysfunction in SSHL patients and the effect of thyroid dysfunction on the occurrence and hearing outcome of SSHL has not been studied.Methods:In this study,a retrospective analysis had been done in 676 patients with SSHL.We had described the distribution of thyroid function in patients with SSHL in detail,and by the statistical method,analyzed the relationship between the hearing outcome and thyroid dysfunction,respectively.Results:In all patients,24.41%(165/676)had abnormal thyroid function testing results.The onset age of SSHL in FT3 abnormal group(including low and high group)was younger than that in normal FT3 group.Recovery group had more patients with lower-than-normal T3 level as compared to non-recovery patients.Significant associations between T3 levels and hearing outcome were observed in the subgroup with longer time elapse between symptom onset and treatment(≥14 d).Conclusion:The incidence of thyroid dysfunction in SSHL is significantly higher than in the general population.There was obvious relationship between T3 and FT3 item of thyroid dysfunction and the onset time and hearing outcome of SSHL,which indicated that T3 or FT3 indicator may be one of the affecting factors for the SSHL.Early screening and diagnosis of thyroid dysfunction,especial T3 level,may help to evaluate the prognosis in SSHL patients.

Comparison of Thyroglobulin and Thyroid Function in Pregnant Women between Counties with a Median Urinary Iodine Concentration of 100-149 μg/L and 150-249 μg/L

Objective This study explored whether thyroglobulin and thyroid disease prevalence rates were higher in pregnant Chinese women with a median urinary iodine concentration of 100-149μg/L,compared with those with a median urinary iodine concentration of 150-249μg/L maintained through sustainable universal salt iodization.Methods This was a cross-sectional study in which 812 healthy pregnant women were enrolled to collect samples of their household edible salt,urine,and blood during their routine antenatal care in the18 counties in Fujian Province,China.The levels of salt iodine concentration,urinary iodine concentration(UIC),free triiodothyronine(FT3),free thyroid hormone(FT4),thyroid-stimulating hormone(TSH),thyroglobulin(Tg),thyroid peroxidase antibody and thyroglobulin antibody were assessed during the routine antenatal care visits.Results The median UIC(m UIC)in pregnant women was 130.8μg/L(interquartile range=91.5-198.1μg/L)in the counties with an m UIC of 100-149μg/L(Group I),and 172.0μg/L(interquartile range=123.5-244.4μg/L)in the counties with an m UIC of 150-249μg/L(Group II).Goiter prevalence and thyroid nodule detection rates showed no difference between Group I and Group II(P>0.05).Except for FT4 values,the TSH,FT4,FT3,Tg and Tg values>40(μg/L)and the thyroid diseases prevalence rate(TDR)showed no significant differences between Group I and Group II(P>0.05),whether or not iodine supplementation measures were taken.Conclusion Compared with an m UIC of 150-249μg/L,not only there was no difference in thyroid morphology,but also the Tg value,rate of Tg values>40μg/L,and TDR were not higher in pregnant women in the counties with an m UIC of 100-149μg/L achieved through sustainable universal salt iodization in Fujian Province,China.

Maternal hyperthyroidism increases the synthesis activity and the osteogenic markers expression of calvarial osteoblasts from offspring in a murine model

To evaluate the characteristics and synthesis activity of osteoblasts extracted from the calvaria of offspring of rats exposed to maternal hyperthyroidism.Twelve adult Wistar rats were divided into two groups,one control and one treated with daily administration of L-thyroxine by an orogastric tube(50μg/animal/day)during pregnancy.Three days after delivery and confirmation of the mothers’hyperthyroidism,the offspring were euthanized for the extraction of osteoblasts from the calvaria.At 7,14,and 21 days,proliferation activity was assessed using MTT assay,while alkaline phosphatase(ALP)activity was assessed by the BCIP/NBT method.At 21 days,the total area of the mineralized matrix stained by von Kossa was evaluated by morphometry.The expression of gene transcripts for Runx2,Bmp2,Fgfr1,collagen type 1(Col1),osteocalcin(Oc),and osteopontin(Op)were evaluated by real-time RT-PCR.Means were compared using the Student’s t-test.FA activity was significantly higher at 14 and 21 days in cultures of osteoblasts extracted from offspring exposed to maternal hyperthyroidism,while MTT conversion was significantly lower at 21 days in this group.Osteoblast cultures of neonates exposed to maternal hyperthyroidism also showed a larger total area of mineralized matrix and greater expression of gene transcripts for Oc and Op.Maternal hyperthyroidism increases the activity of matrix synthesis,alkaline phosphatase activity,and expression of gene transcripts for osteocalcin and osteopontin in the osteoblasts,extracted from the calvaria of the offspring,which may be one of the mechanisms of premature fusion of cranial sutures.

Up-regulation of visfatin expression in subjects with hyperthyroidism and hypothyroidism is partially relevant to a nonlinear regulation mechanism between visfatin and tri-iodothyronine with various concentrations

Background Visfatin, a visceral fat-derived adipocytokine, plays a significant physiological function in lipid metabolism. However, the precise function of visfatin and its regulation by thyroid hormones are still unknown. This study observed the plasma visfatin concentrations in subjects with hyperthyroidism and hypothyroidism in vivo, and investigated the possible reaulation mechanism between visfatin and tri-iodothvronine （T3） in vitro as a further interpretation.

Application of adaptive pressure-driven microfluidic chip in thyroid function measurement

The improvement in accuracy of in vitro diagnosis has always been the focus of early screening of thyroid dysfunction.We constructed a microfluidic chip based on a polystyrene polymer substrate.Total triiodothyronine(TT3),total thyroxine(TT4),free triiodothyronine(FT3),free thyroxine(FT4),and thyrotropin(TSH) in human whole blood samples were analysed by fluorescence immunoassay to evaluate thyroid function.The results indicate that the microfluidic chip shows a good linear relationship in the detection of TT3,TT4,FT3,FT4,and TS H standards,and the correlation coefficient(r) is not less than0.9900.In addition,the chip also has strong anti-interference(RSD%≤5%) and good repeatability(CV≤8%),and its inter-batch differences are small(CV ≤15%).The results of practical application in clinical thyroid function mea surement indicated its high accuracy(r≥0.9900).It provides a new method for the determination of thyroid function and lays a foundation for subsequent clinical application.