Nano-TiO2 is widely used in various fields such as industry, daily necessities, food and medicine. Previous studies have shown that it can enter mammalian tissues through the digestive tract or respiratory tract and have effects on various organs and systems. However, the effect of nano-TiO2 on the mammalian thyroid gland has not been reported. In this study, we fed SD rats with rutile nano-TiO2 at a dose of 5 mg/kg body weight for 3 weeks, and then examined the thyroid histology and thyroid function of the rats. In vitro experiments were conducted to determine the effects of nano-TiO2 on the viability, apoptosis, inflammatory factors, antioxidant enzymes, and oxidative stress of human thyroid follicular epithelial cells. Histological evidence showed abnormal morphology of rat thyroid follicles and organelle damage in follicular epithelial cells. Nano-TiO2 caused a decrease in the level of sodium/iodide symporter (NIS), an increase in the level of apoptotic protein cleaved-caspase 3, and an increase in the levels of pro-inflammatory factors IL-1β and TNF-α in rat thyroid tissue. Nano-TiO2 also resulted in increased serum FT4 and TPO-Ab levels. In in vitro experiments, nano-TiO2 reduced the viability of human thyroid follicular cells, downregulated the levels and activities of antioxidant enzymes CAT, GPX1 and SOD, and increased the levels of ROS and MDA caused by oxidative stress. These results indicate that nano-TiO2 damages the structure and function of thyroid follicular epithelial cells through oxidative stress. Long-term exposure to nano-TiO2 could be a potential risk factor for thyroid dysfunction.

The prevalence of thyroid dysfunction is increasing, often leading to unfavorable alterations in lipid profiles. Dyslipidemia is a risk factor for cardiovascular disease. The present study aimed to assess the prevalence of thyroid dysfunction and examine its effects on serum lipid profiles among Jordanians. A total of 228 subjects were recruited and divided into two groups: patients with thyroid dysfunction (n=178, mean age=52.6±9.8 years) and a control group (n=50, mean age=51.7±9.2 years). Serum thyroid-stimulating hormone, free thyroxine 4, free triiodothyronine 3, total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein and triglycerides (TG) were measured. Results showed that thyroid dysfunction was diagnosed in 75% of participants, with an increased frequency among females. The prevalence of overt hypothyroidism was 17.4%, subclinical hypothyroidism was 43.8%, overt hyperthyroidism was 18.4% and subclinical hyperthyroidism was 20.4%. There was a significant association between hypothyroidism and elevated TC (>200 mg/dl), LDL (>130 mg/dl) and TG (>200 mg/dl; P<0.05). Among the hypothyroid patients, 48.4% had hypercholesterolemia and 32.3% had hypertriglyceridemia. In conclusion, public screening and education are necessary to combat thyroid dysfunction. There is a notable link between thyroid dysfunction and lipid abnormalities, necessitating regular monitoring for dyslipidemia and cardiovascular disease in affected patients.

OBJECTIVE: Increased frequency of autoimmune thyroid disease, particularly Hashimoto\'s thyroiditis (HT) was reported several studies in the literature, in individuals with childhood-onset systemic lupus erythematosus (cSLE). Our study aimed to investigate the prevalence and contributing factors of thyroid dysfunction and HT among cSLE patients.
METHODS: Thyroid function tests were obtained cross-sectionally from cSLE patients. Demographic, clinical, and laboratory characteristics and activity scores were collected from medical records. Patients diagnosed with cSLE were compared to the healthy control group for the frequency of thyroid dysfunction. The Mann-Whitney U, independent samples t test, and the Chi-square or Fisher\'s exact test were used to compare study groups. A p-value below 0.05 was considered statistically significant.
RESULTS: Out of 73 cSLE patients, 14 (19.1%) had subclinical hypothyroidism, 9 (12.3%) had clinical hypothyroidism, 12 (16.4%) were diagnosed with HT, and 12 (16.4%) had a family history of HT. Thyroid USG was performed in 5 euthyroid patients and 1 borderline subclinical hypothyroid patient with positive thyroid autoantibody and reported as diffuse heterogeneous echogenicity enlargement in the thyroid gland. There were no significant differences in clinical and laboratory data or medication used between the groups with and without HT; however, patients with HT had a higher frequency of clinical hypothyroidism and family history of HT. Cumulative prednisolone dose was significantly lower in patients diagnosed with HT. The frequency of HT was considerably higher in patients with cSLE compared to the healthy control group.
CONCLUSIONS: The results demonstrate an increased incidence of HT in cSLE patients, even if they are euthyroid, and recommend that cSLE patients be screened more frequently.

UNASSIGNED: SARS-CoV-2 can invade the thyroid gland. This study was to delineate the risk of thyroid dysfunction amidst the prevalence of the Omicron variant, and to investigate the correlation between thyroid function and Coronavirus disease 2019 (COVID-19) outcomes. The study also aimed to ascertain whether thyroid dysfunction persisted during COVID-19 recovery phase.
UNASSIGNED: This was a retrospective cohort study. COVID-19 patients from the Renmin Hospital of Wuhan University, China during the epidemic of Omicron variants were included, and their thyroid function were analyzed in groups.
UNASSIGNED: A history of thyroid disease was not associated with COVID-19 outcomes. COVID-19 can lead to a bimodal distribution of thyroid dysfunction. The severity of COVID-19 was inversely proportional to the levels of thyroid- stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4), leading to a higher prevalence of thyroid dysfunction. Severe COVID-19 was a risk factor for euthyroid sick syndrome (ESS) (OR=22.5, 95% CI, 12.1 - 45.6). Neutrophil to lymphocyte ratio mediated the association between severe COVID-19 and ESS (mediation effect ratio = 41.3%, p < 0.001). ESS and decreased indicators of thyroid function were associated with COVID-19 mortality, while high levels of FT3 and FT4 exhibited a protective effect against death. This effect was more significant in women (p < 0.05). During the recovery period, hyperthyroidism was quite uncommon, while a small percentage of individuals (7.7%) continued to exhibit hypothyroidism.
UNASSIGNED: COVID-19 severity was linked to thyroid dysfunction. Severe COVID-19 increased the risk of ESS, which was associated with COVID-19 mortality. Post-recovery, hyperthyroidism was rare, but some individuals continued to have hypothyroidism.

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BACKGROUND: This study was designed to evaluate the frequency and type of menstrual disorders in thyroid dysfunction. The relationship between thyroid dysfunction and menstrual disorders has been known for a long time. The menstrual cycle should be checked in women with thyroid dysfunction. On the contrary, women with menstrual irregularities should be investigated for thyroid dysfunction.
METHODS: Women who presented to our hospital\'s internal medicine and endocrinology clinics that recently diagnosed thyroid dysfunction were included. The patients were divided into five groups (subclinical hypothyroidism, overt hypothyroidism, subclinical hyperthyroidism, overt hyperthyroidism, and euthyroid) according to thyroid functions. They were questioned regarding the amount, frequency, and duration of menstrual bleeding. The prevalence of menstrual disturbances, including secondary amenorrhea, hypomenorrhea, oligomenorrhea, hypermenorrhea, polymenorrhea, menorrhagia, metrorrhagia, and menometrorrhagia, was examined in 485 patients and 108 healthy controls.
RESULTS: Hypermenorrhea was significantly more common in patients with overt hypothyroidism (33%) than in controls (6%) (p<0.05). The types and frequencies of menstrual disorders in patients with hyperthyroidism and those with normal thyroid function were not significantly different from those in controls.
CONCLUSIONS: Menstrual abnormalities frequently occur in women with thyroid dysfunction. Therefore, menstrual dysfunction should be considered when treating patients with thyroid abnormalities.

UNASSIGNED: Pregnancy serves as a physiological stress test for the thyroid which often leads to dysfunction in women with limited thyroid reserves. The occurrence of gestational thyroid dysfunction is linked to unfavourable obstetric and foetal outcomes. Globally, iodine deficiency is a prominent causative factor for thyroid dysfunction. The study aimed to determine the prevalence and pattern of thyroid dysfunction among pregnant women in Enugu, South-east Nigeria.
UNASSIGNED: This hospital-based descriptive cross-sectional and observational study was conducted over six months on selected participants from pregnant women attending antenatal clinics at the study sites. Maternal clinical and demographic risk factors for thyroid dysfunction were evaluated in a cohort of 318 pregnant women. An analysis of variance (ANOVA) was performed to compare participants\' thyroid status across different trimesters of pregnancy, and different thyroid and nutritional iodine states.
UNASSIGNED: The prevalence of thyroid dysfunction in the study population is 6.6%. Hypothyroidism was detected in 5.3% of the participants, consisting of 3.8% sub-clinical hypothyroidism and 1.6% overt hypothyroidism. Sub-clinical hyperthyroidism accounted for 1.3% of all participants; no overt hyperthyroidism was detected in this study.
UNASSIGNED: There is a relatively high prevalence of gestational thyroid dysfunction in the study population with hypothyroidism being the predominant disorder. This highlights the need for region-specific considerations in antenatal care to facilitate early detection and effective management of gestational thyroid dysfunction, thereby mitigating potential adverse maternal and foetal outcomes.

Thyroid dysfunction and diabetes mellitus are prevalent endocrine disorders that often coexist and influence each other. The role of spexin (SPX) in diabetes and obesity is well-documented, but its connection to thyroid function is less understood. This study investigates the influence of exercise (EX) and SPX on thyroid hypofunction in obese type 2 diabetic rats. Rats were divided into normal control, obese diabetic sedentary, obese diabetic EX, and obese diabetic SPX groups, with subdivisions for M871, and HT-2157 treatment in the later 2 groups. High-fat diet together with streptozotocin injection induced obesity and diabetes. The EX-group underwent swimming, while the SPX-group received SPX injections for eight weeks. Results showed significant improvements in thyroid function, metabolic, oxidative, and inflammatory states with EX and SPX-treatment. The study also explored the involvement of galanin receptor isoforms (GALR) 2/3 in SPX effects on thyroid function. Blocking GALR2/3 receptors partially attenuated the beneficial effects, indicating their interaction. These findings underscore the importance of EX and SPX in modulating thyroid function in obesity and diabetes. Comprehending this interplay could enable the development of new treatment approaches for thyroid disorders associated with obese type 2 diabetes. Additional research is necessary to clarify the exact mechanisms connecting SPX, EX activity, and thyroid function.

A common immune-related adverse event (irAE) with immune checkpoint inhibitors (ICIs) is thyroid dysfunction (TD-irAEs). The clinical presentation can be varied, and its association with prognosis remains unclear. We investigated the characteristics of TD-irAEs and their association with clinical outcomes among cancer patients treated with ICIs in a real-life setting. Response to treatment was assessed using RECIST v1.1. We calculated the probability of recurrence and survival associated with TD-irAEs using multivariable-adjusted regression and Cox proportional hazards models. In this single-center retrospective analysis, we included 238 patients (72% male) with a median age of 69.5 years. Primary tumors were melanoma (23.1%), lung (60.5%), or urothelial cancer (16.4%), treated with atezolizumab (23.1%), pembrolizumab (44.5%), ipilimumab (0.4%), and/or nivolumab (25.6%). Seventy (29%) patients developed TD-irAEs in a median time of 69 days (41-181). The incidence of TD-irAEs with combination therapy was higher than with monotherapy (67% vs 6.3%, P = 0.011). TD-irAE patients showed a higher objective response rate (ORR) than those without TD-irAEs (60% vs 42.3%, P = 0.013) and longer overall survival (OS) 45 vs 16 months, P < 0.006. Patients who developed TD-irAEs had a relative reduction of 77% (OR 0.23, 95% CI 0.11-0.47) in the risk of progression and of 47% in the risk of mortality (HR 0.53, 95% CI 0.36-0.80), independent of age, sex, primary tumor, or ICI regimen. TD-irAEs occur in nearly 30% of our patients receiving ICIs. In our analysis, TD-irAEs appeared to be associated with higher ORR and longer OS and showed a reduction in the risk of progression and mortality.

OBJECTIVE: This study was designed to develop and validate a predictive model for assessing the risk of thyroid toxicity following treatment with immune checkpoint inhibitors.
METHODS: A retrospective analysis was conducted on a cohort of 586 patients diagnosed with malignant tumors who received programmed cell death 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. Logistic regression analyses were performed on the training set to identify risk factors of thyroid dysfunction, and a nomogram was developed based on these findings. Internal validation was performed using K-fold cross-validation on the validation set. The performance of the nomogram was assessed in terms of discrimination and calibration. Additionally, decision curve analysis was utilized to demonstrate the decision efficiency of the model.
RESULTS: Our clinical prediction model consisted of 4 independent predictors of thyroid immune-related adverse events, namely baseline thyrotropin (TSH, OR = 1.427, 95%CI:1.163-1.876), baseline thyroglobulin antibody (TgAb, OR = 1.105, 95%CI:1.035-1.180), baseline thyroid peroxidase antibody (TPOAb, OR = 1.172, 95%CI:1.110-1.237), and baseline platelet count (platelet, OR = 1.004, 95%CI:1.000-1.007). The developed nomogram achieved excellent discrimination with an area under the curve of 0.863 (95%CI: 0.817-0.909) and 0.885 (95%CI: 0.827-0.944) in the training and internal validation cohorts respectively. Calibration curves exhibited a good fit, and the decision curve indicated favorable clinical benefits.
CONCLUSIONS: The proposed nomogram serves as an effective and intuitive tool for predicting the risk of thyroid immune-related adverse events, facilitating clinicians making individualized decisions based on patient-specific information.