Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 6 Articles
Background: The present study aimed to study the relationship between serum 25 hydroxyvitamin D3(25(OH)D3) and insulin-like growth factor-1 (IGF-1) and thyroid nodules.\nMethods: Two hundred eighty-nine cases with thyroid nodules and 109 health subjects (control group) whoadmitted to the Hebei General Hospital during June 2016 to December 2016 were included in the study.Basic clinical information (age, sex, thyroid function, liver and kidney function, hypertension history, etc.) of patients were collected. Serum 25(OH) D3 and Serum IGF-1 were detected by electrochemiluminescence and radioimmunoassay methods, respectively. The relationship between the above-mentioned factors and thyroid nodules was statistically analyzed.\nResults: Serum 25(OH)D3, IGF-1, fasting blood glucose (FBG), total cholesterol (TC), waist circumference (WC), total triiodothyronine (TT3), total thyroxine (TT4), hypertension history, and drinking history were significantly different between the nodules group and the control group (P < 0.05). Logistic regression analysis showed that there was a negative correlation between thyroid nodules and levels of 25(OH)D3, IGF-1, TT3, as well as a positive correlation with FBG, TC, TT4, and hypertension. There was a positive correlation between IGF-1 and serum 25(OH)D3 in thyroid nodules (P < 0.05). After correcting the aforementioned factors, high-level of serum 25(OH) D3 was significantly correlated with the decreased incidence of thyroid nodules.\nConclusions: The incidence of thyroid nodules is relatively lower in a high-level of serum 25(OH)D3, and serum 25(OH) D3 may be a direct protective factor for thyroid nodules. Serum IGF-1 can be one of the indirect protective factors for thyroid nodules as well....
Background: On average, patients in Japan with type 2 diabetes mellitus have a clinical consultation every month,\nalthough evidence for a favorable follow-up interval is lacking. This study investigated whether the follow-up\ninterval can be extended by comparing the clinical outcomes and cost for monthly versus bimonthly follow-up of\npatients with well-controlled diabetes mellitus.\nMethods: We combined administrative claims data from the National Health Insurance and the Health Checkups\nProgram data of Tsu city, Japan between 2011 and 2014 to conduct a retrospective cohort study of patients with\nwell-controlled type 2 diabetes mellitus. Propensity scores were used to assemble a matched-pairs cohort from\npatients who had monthly and bimonthly follow-up. Equivalence between two groups was assessed by\ndesignating the proportion of patients who maintained good control of their diabetes in the subsequent year as a\nprimary outcome. The proportion achieving target blood pressure and lipid levels, favorable lifestyle, and annual\ncost were compared as secondary outcomes.\nResults: Of 12,145 participants, 693 with monthly follow-up and 693 with bimonthly follow-up were matched using\npropensity scores. In the monthly follow-up group 654 (94.4%) remained under good diabetic control, versus 658\n(95.0%) in the bimonthly group (difference: 0.6%; 95% confidence interval: - 1.8 to 2.9%). All secondary outcomes\nwere equivalent for the monthly and bimonthly follow-up groups except the proportion achieving target blood\npressure, the proportion engaging in regular exercise, and annual cost.\nConclusions: For patients with well-controlled diabetes mellitus, although frequent follow-up by a physician does\nnot affect the control of blood glucose level in the subsequent year, the annual treatment cost becomes much\nhigher. We suggest that patients with well-controlled diabetes can be followed up less often....
Background: Older diabetic patients are more likely to be frail than those\nwho do not have diabetes. Frailty is an important risk factor for both mortality\nand disability in older patients with type 2 diabetes. However, the\nmechanism of frailty in diabetes mellitus is not fully understood. Aims: The\naim of this study was to identify the prevalence of frailty and associated\nfactors in older patients with type 2 diabetes in Japan. Methods: A\ncross-sectional study was conducted with a total of 178 outpatients who\nwere over 65 years old with type 2 diabetes. We used the Obu Study Health\nPromotion for the Elderly definition of frailty to divided subjects into a\nnon-frail and a frail group. We investigated the association between frailty\nand various patient characteristics. Results: In the study, 21.4% of the older\npatients with type 2 diabetes were considered frail. There were no significant\ndifferences in the duration of diabetes, BMI, proportion of microvascular\ncomplications, or HbA1c values between the frail and non-frail group.\nHowever, serum albumin and IGF-1 levels were lower in the frail group\nthan the non-frail group as were the Mini-Mental State Examination scores.\nThe frail group had a higher number of medications than the non-frail\ngroup. In a multivariable analysis, frailty was positively associated with the\nnumber of medications and, lower levels of both serum albumin and IGF-1.\nConclusion: Our study suggests that diabetes accelerates the aging process\nand frailty is associated with low albumin, polypharmacy and low levels of\nIGF-1....
Background: Ovarian reserve, vital for reproductive function, can be adversely affected by thyroid diseases. Despite\nalternations of thyroid hormones with ageing, data on interactions between the overtime trend of thyroid functions\nand ovarian reserve status has rarely been reported. We aimed to examine the overtime trend of thyroid hormones,\nthyroid peroxidase antibody (TPO Ab) and their associations with ovarian reserve status, identified by levels of age\nspecific anti-mullerian hormone (AMH) in reproductive aged women, who participated in 12-year cohort of Tehran\nThyroid Study (TTS).\nMethods: Reproductive age women(n = 775) without any thyroid disease or ovarian dysfunction were selected\nfrom the Tehran Thyroid Study cohort. Participants were divided into four age specific AMH quartiles (Q1-Q4), Q1,\nthe lowest and Q4, the highest. AMH was measured at the initiation of study and thyroid stimulating hormone\n(TSH), free T4 (FT4), and TPO Ab were measured at baseline and at three follow up visits.\nResults: At baseline, there was no statistically significant difference in thyroid hormones between women of the\nfour quartiles, although TPO Ab levels were higher in women of Q1. During the follow ups, FT4 was decreased in\nall quartiles (p < 0.05), whereas TPO Ab increased in Q1 (p = 0.02). Odds ratio of overall TPO Ab positivity in women\nof Q1 was 2.08 fold higher than those in Q4. (OR: 2.08, 95%CI: 1.16, 3.72; p = 0.01).\nConclusion: Women with the lowest ovarian reserves had higher levels of TPO Ab, with a positive trend of this\nantibody overtime in comparison to other quartiles, indicating that this group may be at a higher risk of\nhypothyroidism over time....
Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder in pregnancy, and it is associated with\nincreased risk of morbidity in maternal-fetal outcomes. GDM is also associated with a higher risk to develop\ndiabetes in the future. Diabetes-related autoantibodies (AABs) have been detected in a small percentage (usually\nless than 10%) of women with gestational diabetes. The prevalence in gestational diabetes of these autoimmune\nmarkers of type 1 diabetes (T1D) has been assessed in many studies, together with the risk of progression of AABspositive\nGDM towards impaired glucose regulation (IFG or IGT) and overt diabetes after pregancy. The question\nwhether it is necessary to test for T1D autoantibodies in all pregnancies with GDM is still debated. Here we\nexamine the epidemiology of T1D autoantibodies in GDM, their clinical relevance in term of future risk of diabetes\nor impaired glucose regulation and in term of maternal-fetal outcomes, and discuss when it may be the most\nappropriate time to search for T1D autoantibodies in women with gestational diabetes....
Background: Hypothyroidism, one of the prevalent endocrine disorders worldwide, has a broad spectrum of\nclinical manifestations, from an asymptomatic condition to myxedema coma. Although the majority of patients\nwith hypothyroidism have minor clinical symptoms, which are recovered with levothyroxine treatment, some\npatients occasionally do experience fatal complications. Here we report, for the first time, the case of a patient who\nhad hypothyroidism with simultaneous occurrence of rhabdomyolysis with acute kidney injury, moderate pericardial\neffusion, and sudden sensorineural hearing loss.\nCase presentation: A 57-year-old man with a previous history of dyslipidemia and untreated hypothyroidism was\nadmitted to the hospital due to shortness of breath, lethargy, lower extremity discomfort, and unilateral hearing\nloss. Laboratory results revealed rhabdomyolysis with acute kidney injury and severe hypothyroidism. We detected\ncardiomegaly without lung parenchymal infiltration on chest radiography and moderate pericardial effusion on\ntransthoracic echocardiography. We performed pure tone audiometry and identified profound unilateral\nsensorineural hearing loss. Aggressive fluid resuscitation, levothyroxine treatment, and systemic and intratympanic\nsteroid therapy alleviated the patientâ??s severe hypothyroidism, rhabdomyolysis, and pericardial effusion; however,\nsensorineural hearing loss was not fully recovered.\nConclusions: Early recognition of life-threatening complications is important in patients with severe\nhypothyroidism to prevent adverse outcomes. This case suggests that hypothyroidism should be considered in\npatients who have rhabdomyolysis with acute kidney disease and pericardial effusion. Moreover, sudden\nsensorineural hearing loss should be kept in mind as a rare complication of hypothyroidism....
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