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1.
The effect of iodine deficiency (ID) on thyroid function in African women during pregnancy and postnatal period was examined, for which very limited information is available. Serum T4, T3, TSH, TBG, thyroxine binding capacity (TBK), free thyroxine index (FT4I=T4/TBK) and T4/TBG were determined by ELISA technique in 32 pregnant women (resident of Plateau state, Nigeria- an ID zone) through pregnancy upto term delivery, and in 5 women up to 6 weeks post delivery. Urinary iodide level was measured at delivery to determine the degree of iodine deficiency. Results were matched with a non pregnant control comprising 44 subjects. 5555 birth weights (BW) of term babies in the region were analysed to determine the prevalence of ‘small for dates’ (SFD) babies in the population. Results show that the level of serum FT4I was elevated very significantly at late gestation (P<.001) but the women were not hyperthyroid, suggesting a marked disturbance in binding of T4 with TBG during pregnancy. Five women with SFD babies were found in ‘compensated hypothyroid state’ and showed a significant depression (p<.01) in serum T4/TBG, T4, FT4I and T3 levels to a low normal range, with a concurrent significant rise (p.<.001) in TSH level (above normal range) throughout pregnancy. Incidence of SFD babies was higher (p.<.001) in ID zone (Bassa 15.2%) compared to control zone (Jos 9.8%). It is concluded that a state of maternal ‘subclinical (compensated) hypothyroidism’ during pregnancy possibly plays an important role in the aetiopathogenesis of SFD babies in Africans. A normal reference range for thyroid parameters at various stages of pregnancy in healthy African women is established for the first time.  相似文献   

2.
The prevalence of abnormal thyroid hormone levels in diabetes mellitus in Nigeria is not well described. To determine the incidence of abnormal thyroid hormone levels in diabetics in Calabar, Nigeria, fasting blood samples from 161 diabetic subjects and 105 non-diabetic controls were analysed. Free thyroxine (FT), thyroid stimulating hormone (TSH), total triiodothyronine (T3) and total thyroxine (T4) kits obtained from Biomerica Inc. of USA were used for the analysis. TSH levels (1.80±1.62) in diabetics were significantly lower (p=0.016) than the level in non-diabetic controls (2.34±1.24). Male diabetics had lower (p<0.05) levels of TSH (1.192±0.68 miu/ml) than diabetic females (1.90±1.70 mlu/mt). The level of T3 in diabetic males (125±97ng/ml) was higher than the level in females (98±75ng/dl). TSH (F=2.74, p=0.049), T4(F=56.87, p=0.001), T3(F=56.44, P=0.001) in diabetics and FT4 (F=5.74, p=0.002) in controls showed significant variation with the ages of the subjects. Out of 161 diabetics subjects studies 26.6% had low plasma thyroid hormone levels (FT4>2.01 ng/dl). This study has shown a high incidence (46.5%) of abnormal thyroid hormone levels among the diabetics in Nigeria (hypothyroidism 26.6%, hyperthyroidism, 19.9%). The prevalence of hypothyroidism was higher in women (16.8%) than in men (9.9%), while hyperthyroidism was higher in males (11%) than in females (8%). This study has defined thyroid function status of diabetics in Calabar, Nigeria probably the first of such work in Africa.  相似文献   

3.
Pregnancy is associated with significant, but reversible changes in thyroid function studies, which are among the most profound seen as a result of a normal physiologic state. The present study was carried out to find out alterations in thyroid function tests in each trimester in normal pregnant women as compared to non-pregnant women in Tabriz-Iran. A case-control study designed with 229 normal pregnant women that randomly selected from the first (64 samples), the second (92 samples), and the third (73 samples) trimesters and 250 randomly selected non-pregnant healthy female controls. Age range in both groups was 16–40 years. Thyroid function tests carried out by measuring serum levels of thyroid stimulating hormone (TSH), free and total thyroxin (FT4, TT4), and free and total triiodothyronine (FT3, TT3) by commercially available radio immunoassay kits. We found that mean TT4 increased progressively during pregnancy. Our study showed increasing in serum levels of TT3 in the second trimester and then declining during the third trimester compared with non-pregnant women. We showed that FT4 strongly decreased during the third trimester. Free T3 showed declining in the second and third trimesters. Mean TSH did not show significant difference in each trimester compared with non-pregnant women. The thyroid function tests in pregnancy should be interpreted against gestational age-related reference intervals to avoid mis-interpretation of thyroid function during pregnancy.  相似文献   

4.
Thyroid stimulating hormone (TSH), Free Thyroxine (FT4) and Free Triiodothyronine (FT3) were assayed in 505 women of this region. 60 women had previous history of thyroid disease. The remaining 445 women formed the “Disease free group”. A “Reference group” was obtained by excluding women with previous and present history of thyroid dysfunction. Of the total 505 women examined 15.8% had thyroid dysfunction and 84.2% were euthyroid. 11.5% were hypothyroid (9.5% sub-clinical) and 1.8% hyperthyroid (1.2% clinical). The geometric mean TSH for the total population was 2.65 μIU/ml. It was significantly (p=0.025) lower in the reference population 2.17 μIU/ml. There was no significant difference in the FT3 and FT4 values between groups. 19% of women over 60 years had elevated TSH above 4.5 μIU/ml. The 2.5 and 97.5 percentiles of the reference population was 1.1–5.2 μIU/ml. 6.1% of women in the reference group had TSH levels above the reference intervals. Hypothyroidism particularly sub-clinical hypothyroidism is predominantly present amongst women in this iodine sufficient region. Evaluation of thyroid status could help in early detection and treatment.  相似文献   

5.
An external quality assessment was conducted for RIA of thyroid related hormones. Thirtyfive laboratories (35 for T4, 34 for T3 and 23 for TSH) from different parts of country participated in the programme. Twentyfour samples (16 pools: 5 simple and 11 manipulated pools) in 8 batches, 3 per batch per month were sent for analysis of T4, T3 and TSH. Some of the samples were repeated 3 times at different occasions to assess the imprecision of the laboratory. The overall mean percent CV obtained for T4, T3 and TSH were 22.7, 36.32 and 52.38 respectively. The recovery for added T4 was 86.73% while that for T3 was 117.4%. A large variation was obtained for recovery of TSH. For T4 estimations, 13 laboratories had a desirable performance i. e. bias less than ±10.0% and variability of bias (VB) and imprecision (IP) less than 15.0%. None of the laboratories had a desirable performance for T3 or TSH. The number of laboratories with acceptable performance i. e. bias between ±10.0–15.0%, VB and IP between 20.0–25.0% for T4, T3 and TSH were 4, 3 and 0 respectively. The number of laboratories which required attention (bias between ±15.0–20.0%; VB and IP between 20.0–25.0%) were 5,7 and 1 respectively. The unacceptable results with larger bias, VB and IP for T4, T3 and TSH were 6, 18 and 17 respectively. Our results are in general agreement that the performance of T4 assay is better than T3 and both in turn are much better than TSH. Quantitation of circulating thyroid hormones (TH) viz. tri-iodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH), which form the largest percentage of hormones estimated in a clinical laboratory is mainly done by radio-immunoassay (RIA) procedures. The reliability and reproducibility of these assays are generally monitored by using internal quality control (IQC) samples in every assay batch. Thus, the IQC provides information whether the assay results are satisfactory and can be released. However, external quality assessment (EQA) is a procedure whereby an external agency undertakes evaluation of the quality of an analytical service by providing samples for analysis to individual laboratories performing the assay. The data gathered is analysed collectively. EQA therefore provides a means by which performance of a laboratory is assessed in relation to other laboratories and matching the assay unbiased by removing systematic error, if present. This is important since RIA procedure involves several steps (collection and storage of samples, quality of the reagents, procedure followed for performance of an assay, counting equipment used and the mode of the data analysis) and therefore prone to systematic errors. We therefore undertook the EQA programme for assessment of thyroid related hormones as a joint collaborative project of Bhabha Atomic Research Centre, India and International Atomic Energy Agency.  相似文献   

6.
Thyroid hormonal status was measured in 80 malnourished children of different grades (I–IV) of protein energy malnutrition (PEM). Serum levels of tri-iodo thyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) were measured by radioimmunoassay. The results were compared with 20 healthy, age and sex matched controls. Levels of T3 and T4 were significantly low in PEM cases whereas TSH levels were similar in PEM cases when compared to controls.  相似文献   

7.
The aim of this study is to delineate laboratory diagnostic strategies for subclinical hypothyroidism in patients who are clinically symptomatic but may have a normal thyroid profile. Tri — iodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH) and anti thyroid peroxidase antibodies (anti-TPO) were estimated on fasting blood samples from 99 patients using electrochemiluminescence methods on ELECSYS 1010 (Roche). 74% of study subjects had elevated anti-TPO levels.61% patients had subclinical hypothyroidism. 45 of the 61 subclinical hypothyroid patients had elevated anti-TPO levels (73%). This is an important finding suggesting an autoimmune etiology for subclinical thyroid dysfunction with a higher risk of developing overt hypothyroidism.  相似文献   

8.
Thyroid hormones regulate the renal hemodynamics and basal metabolic rate of most cells. This hospital-based case-control study was done to evaluate the changes in biochemical markers of liver and kidney function in hypothyroid subjects before and after treatment. The study included 176 subjects randomly selected from Thyroid clinics. Serum T3, T4, TSH, Liver and Kidney Function tests were analysed using standard kits. Forty-six hypothyroid patients were re-evaluated 6 weeks after thyroxine substitution therapy. Hypothyroid subjects (n=80) showed significantly raised serum creatinine and uric acid levels as compared to euthyroid subjects (n=96). After 6 weeks of thyroxine replacement, serum creatinine and uric acid decreased significantly and were comparable to euthyroid group. A positive correlation of ALT, AST, uric acid, protein and albumin with TSH levels (p<0.05) and negative correlation of serum T4 levels with ALT, AST, proteins (p<0.05) was observed in the hypothyroid group. Hypothyroidism results in reversible impairment of hepatorenal function.  相似文献   

9.
Blood samples of 40 pregnant women were analysed for glycosylated haemoglobin (HbA1c) and blood sugar. The patients were followed up till delivery and their obstetric outcome was analysed in conjunction with the glycaemic profile and the level of glycosylated haemoglobin. Group I comprising the normal pregnant women showed a mean HbA1c of 6.23% at 20–40 weeks of gestation. In contrast the diabetic pregnant women (group II) at the same gestation demonstrated an HbA1c of 9.4%. Further group IIA of gestational diabetic women showed an HbA1c of 8.97% and group IIB comprising the overt diabetics had HbA1c of 9.86%. The mother who delivered a congenitally malformed child had an elevated HbA1c of 10.4% during pregnancy. Seven cases of macrosomia were reported and the mean HbA1c of their mothers at 20–40 weeks of gestation was found to be 9.91%. Six mothers delivered infants who developed respiratory distress syndrome (RDS) soon after birth and all these six had elevated HbA1c with a mean of 8.9%. Abortions were also associated with elevated HbA1c of 10.3% antenatally. One case of still birth was reported and the mother demonstrated an elevated glycosylated haemoglobin during pregnancy. An HbA1c of 10% or more was associated with abortion, still-birth, or congenitally malformed babies.  相似文献   

10.
Reference intervals (RIs) of serum thyroid stimulating hormone (TSH) and free thyroxine (fT4) were determined in 402 healthy pregnant women by enzyme-linked immunosorbent assay (ELISA) technique after partitioning them into three trimesters. The reference population was chosen from a study population of 610 pregnant females by applying strict inclusion and exclusion criteria. The assays were done using proper quality control measures. RIs were calculated from the central 95 % of the distribution of TSH and fT4 values located between the lower reference limit of 2.5 percentile and upper reference limit of 97.5 percentile value 0.90 confidence intervals for the upper and lower reference limits were also determined. The reference intervals for TSH were 0.25–3.35 μIU/ml for the first trimester; 0.78–4.96 μIU/ml for the second trimester and 0.89–4.6 μIU/ml for the third trimester. Similarly, the reference intervals for fT4 for first, second and third trimesters were 0.64–2.0, 0.53–2.12 and 0.64–1.98 ng/dl respectively. The values thus obtained varied from those provided by the kit literature. In comparison to our derived reference intervals, the reference data from kit manufacturer under-diagnosed both subclinical hypo- and hyper-thyroidism within our pregnant reference population.  相似文献   

11.
In order to see the pattern of changes in differential serum lipid and lipoprotein fractions as a risk marker of coronary complication in paired ‘maternal—neonate’ blood samples in an iodine deficient zone, 26 pregnant women and their corresponding new born infants at term delivery from the iodine deficient Bassa region of Plateau state, Nigeria were assessed and the results were compared with those seen in a similar 44 group of women and their newborns assessed in non lodine deficient region of Jos. The serum thyroid function and lipid and lipoprotein profiles were determined by ‘ELISA’ and ‘enzymatic’ methods respectively. Urinary iodide excretion level was also measured in 14 pregnant women in Bassa, 23 pregnant women in Jos and 16 non pregnant control from Jos. Results indicate that the pregnant women assessed in Bassa were iodine deficient (P<0.01) and their thyroid status was strikingly reduced as reflected by a drop in serum level of T4/TBG ratio (P<0.01) and a rise in TSH (P<0.005) in comparison to that seen in Jos. There was marked hypertriglyceridaemia and total hypercholesterolaemia (P<0.005), with differential significant rise in LDL cholestotol fraction (P<0.005) in the women assessed in Bassa as compared to Jos. The HDL cholesterol however dropped less significantly in the group (P<0.05) with a concurrent marked rise (P<0.001) in the serum ratio of LDL cholesterol/HDL cholesterol, total cholesterol/HDL cholesterol and triglycerides/HDL cholesterol in the lodine deficient group. A similar pattern of changes were seen in the corresponding neonates in the Bassa group as compared to Jos group. It is concluded that the pregnant women and their newborn offsprings living in a longstanding environmental iodine deficiency run a higher risk of developing coronary complications than those living in non endemic region. It is striking that such newborns surrounded by a continued state of lodine deficient may at a later adult-period of life develop marked risk of coronary complication and other features of hyperlipidaemias associated with varying thyroid insufficiency and accompanied iodine deficiency disorders. Prophylaxis measures as intervention has been highlighted.  相似文献   

12.
Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 μg/ml at 18–24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 μg/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women.  相似文献   

13.
The implications of subclinical hypothyroidism (SCH) are many amongst which the most important is progression to overt hypothyroidism. Other debatable aspects are its association with cardiovascular risk, neuromuscular and psychiatric dysfunction, increased predisposition to developing metabolic syndrome and an underlying pro-inflammatory state. We aimed to study the lipid profile, lipoprotein(a) [Lp(a)] and hsCRP levels and insulin resistance in a group of patients with SCH in a referral hospital and see if any significant differences exist between them and euthyroids. This is a case–control study where the selection of controls and cases was based on the thyroid profile. Subjects were selected on their visit to clinical biochemistry lab for thyroid function tests. 33 euthyroids were taken as controls (Group I) and 38 patients comprising of subclinical hypothyroids were grouped as cases (Group II). Serum thyroid stimulating hormone (TSH) was in the range of 0.5–5.0 mIU/L for euthyroids and for subclinical hypothyroids the concentration of TSH was more than 5 mIU/L. The concentration of tri-iodothyronine (T3) and thyroxine (T4) were in normal reference range in both the groups. Individual lipid profile parameters failed to show a significant p value between cases and controls. The LDL/HDL ratio was highly significant (p value < 0.0001) and hsCRP was also statistically between the two groups (p value = 0.0054). Lp(a) and insulin resistance did not differ significantly. SCH is a common disorder that frequently progresses to overt hypothyroidism. This study underlines the importance of LDL/HDL ratio rather than measurement of individual lipid profile parameters in bringing to light the dyslipidemic state associated with SCH. Moreover the use of hsCRP to detect an underlying pro-inflammatory state in SCH can also be emphasized.  相似文献   

14.
The role of triodothyronine (T3 in regulating thyroid function is paramount in that at cellular level it interacts with receptors in the nucleus and thereby modulates gene expression. The multiple steps in the processing of lodide by the thyroid gland is under the influence of the thyroid stimulating hormone (TSH). In terms of laboratory evaluation of thyroid function the primary test is TSH. To discriminate between hypothalamic and pitutary dysfunction, the thyroid releasing hormone (TRH) stimulation test is useful. Currently used 2-site Immunometric procedures that employ mouse monoclonal antibodies can be subject to Interference by heterophlle antibodies in patient's serum. Drugs and other extraneous substances can influence the results obtained in some thyroid function tests. Thyroid dysfunction could also be due to autoimmune disease. The limitations of the usefulness of thyroid function tests in non-thyroidal illness should be kept in perspective. In conclusion, the proper interpretation of results of thyroid function tests depends on the sound understanding of concepts of thyroid function and variables affecting laboratory testing.  相似文献   

15.
Graves’ disease (GD) is an organ-specific heterogenous autoimmune disorder associated with T-lymphocyte abnormality affecting the thyroid, eyes and skin. GD is a multifactorial disease that develops as a result of complex interaction between genetic susceptibility genes and environmental factors. It has been suggested that the Cytotoxic T lymphocytes associated molecule-4 (CTLA-4) is a genetic susceptibility candidate for GD. The present study was focused on A/G polymorphism at position 49 in exon-1 of the CTLA-4 gene in 80 GD patients (GP) and 80 sex and age matched healthy individuals among South Indian (Madurai) population. Serum concentrations of thyroid hormone (T4, T3 and TSH) were determined by using automated analyzer. The genomic DNA was isolated from the patient and control groups and genotyping was performed using the polymerase chain reaction followed by restriction enzyme analysis using Bbv1. Significant difference (P < 0.001) was observed in the level of T3, T4 and TSH in GD patients and healthy individuals. The results revealed the CTLA-4 gene G/G genotype to be 32 (40%) in patients and 26 (32.50%) in healthy individuals, A/G genotype to be 37 (46.25%) in patients and 25 (31.25%) in healthy individuals and A/A genotype to be 11 (13.75%) in patients and 29 (36.25%) in healthy individuals. The calculated odds ratio (OR) in individuals with mutant genotype (GG/AG) reveal 3.6 fold risk for GD (95% confidence interval = 1.6–7.8). The mutant “G” allele frequency was observed to be 0.63 in GD patients and 0.48 in healthy individuals. Thus the present study demonstrates an association between the CTLA-4 gene polymorphism and Graves’ disease.  相似文献   

16.
In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (P<0.05 & P<0.01) respectively. We conclude that hypothyrodism is associated with changes in lipid profile.  相似文献   

17.
Epilepsy raises special concern in women during pregnancy. Antiepileptic drugs are known to induce major and minor malformations in the foetus. Aim of the study was to find an association between maternal serum alpha fetoprotein levels, foetal abnormalities and antiepileptic drugs mediated teratogenicity. Maternal serum alpha feto protein levels, kidney and liver function tests in age matched normal pregnant women and seizure free epileptic pregnant women during 12–14 weeks of gestation were estimated. Cases were subjected to ultrasonography at 11th–14th week of pregnancy and again at 20th week of pregnancy. maternal serum alfa feto protein was assayed by a specific Electro Chemiluminescence Immuno Assay test. There was no significant difference in kidney and liver function tests in cases as compared to controls. There were elevated levels of alpha feto protein in cases as compared to controls but this was not statistically significant. No anomalies were detected in ultrasound reports. Most women had normal full term delivery with healthy children but of low birth weight. No correlation was seen between maternal serum alfa feto protein levels and antiepileptic drug leading to teratogenesis.  相似文献   

18.
This study was carried out to estimate the levels of glutathione peroxidase and selenium in blood of abortion cases. Glutathione peroxidase and selenium were determined in 52 abortion cases (22 in 1st trimester, 30 in second trimester), 45 normal pregnant cases and 25 nonpregnant control cases. The selenium concentration in whole blood and plasma in abortion cases was almost the same as in normal pregnant women but significantly low when compared with the control non-pregnant group. The glutathione levels was higher in abortion cases when compared with normal pregnant and non-pregnant control groups. Red cell and plasma glutathione peroxidase activities of women who had abortion were significantly lower compared with both non-pregnant control group and normal pregnancies.  相似文献   

19.
An external quality assessment was conducted to assess the performance of various laboratories for RIA of thhyroid related hormones in two phases. In the first phase thirty five laboratories participated. At the end of first phase a meeting cum workshop was organised to discuss the results of first phase, difficultires faced by the participants and pinpoint the short oming. A second phase was then initiated with an objective of improvement in the performance, if any, where twelve samples from four pools were distributed to twenty four laboratories who participated for the second phase. The overall return of the results increased significantly from 71.8% (1586/2208) for the first phase to 92.4% (732/792) for the second phase. The inter laboratory %CV for T3, T4 and TSH were lower during the second phase (30.6%, 19.0% and 31.6% respectively) as compared to those observed during first phase (36.3%, 22.7% and 52.8% respectively). Similarly, there was an improvement in reproducibility of ALTM as %CV for T3, T4 and TSH decreased from 6.0%, 9.8% and 13.4% respectively to 4.5%, 4.6% and 8.5% respectively. The individual performances of the participating laboratories viz. bias, variability of bias and imprecision also showed a trend towards improvement as percent laboratories having desirable or acceptable results for T3, T4 and TSH increased from 10.7%, 60.7% and 0.0% respectively to 20.8%, 66.7% and 22.2% respectively. External quality assessment thus appears to be beneficial in assessing the performane of a laboratory in comfparison with other laboratories and indeed helps in improving the performance.  相似文献   

20.
Hormones play an important role in the digestive system. The main hormones that control digestion are gastrin, secretin, and cholecystokinin. Herein, the current study is concerned with assessing the effect of spasmo canulase and librax drugs on the human hormones profile. Blood samples were withdrawn from adult patients to measure serum FSH, E2, LH, prolactin, progesterone, DHEAS, testosterone, TSH, T3, T4, fasting insulin, and cortisol. All hormone concentrations were determined quantitatively using ELISA procedure. Intriguingly, the present study showed putative changes including thyroid and sex hormonal profiles. Eventually, we concluded that the prospective study could be important in drug dose optimization and providing new medical guidelines to avoid side effects that could harm patients.  相似文献   

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