INTRODUCTION: Insulin resistance (IR) is a key and early pathogenetic mechanism of cardiometabolic diseases with huge potential if detected early and mitigated, for lowering the burden of the disease. Available data are conflicting to what extent adult thyroid dysfunction is associated with IR. Therefore, we aimed to investigate the association and to identify which thyroid parameters are predictors of IR. MATERIAL AND METHODS: After undergoing basic anthropometric and biochemical studies including thyroid hormones, oral glucose tolerance test (OGTT), and insulin, 1425 middle-aged individuals were divided into three groups according to thyroid parameters: overt hypothyroidism (OH), subclinical hypothyroidism (SH), and euthyroidism (EU). RESULTS: The homeostasis model assessment of IR (HOMA-IR), fasting insulin, and two-hour glucose levels of OGTT showed a steady, yet insignificant, increase from EU through SH to OH. The strongest noted correlations were those of insulin levels with free triiodothyronine/free thyroxine (FT3/FT4) ratio (r = 0.206, p < 0.001) and FT3 (r = 0.205, p < 0.001). Also in the case of HOMA-IR, the only statistically significant correlations were observed for FT3 (r = 0.181, p < 0.001) and the FT3/FT4 ratio (r = 0.165, p < 0.001). Among other thyroid hormones, linear logistic regression proved the FT3/FT4 ratio as the only significant predictor of HOMA-IR (linear coefficient = 5.26, p = 0.027) and insulin levels (linear coefficient = 18.01, p = 0.023), respectively. Thyroid-stimulating hormone was not associated with IR in either correlation or regression analysis. CONCLUSIONS: The FT3/FT4 ratio should be more emphasised in the diagnosis and treatment of thyroid disorders. Patients could benefit from a pharmacological reduction of the FT3/FT4 ratio, potentially leading to a decrease in insulin resistance, and thus a corresponding decrease in the risk of the cardiometabolic diseases.

• Klíčová slova
• FT3/FT4 ratio, euthyroidism, hypothyroidism, insulin resistance, thyroid disorder,
• MeSH
• hypotyreóza metabolismus   MeSH
• inzulinová rezistence fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• průřezové studie MeSH
• rizikové faktory MeSH
• testy funkce štítné žlázy MeSH
• thyroxin krev   MeSH
• trijodthyronin krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• thyroxin MeSH
• trijodthyronin MeSH

Mammals usually possess a majority of medium-wavelength sensitive (M-) and a minority of short-wavelength sensitive (S-) opsins in the retina, enabling dichromatic vision. Unexpectedly, subterranean rodents from the genus Fukomys exhibit an S-opsin majority, which is exceptional among mammals, albeit with no apparent adaptive value. Because thyroid hormones (THs) are pivotal for M-opsin expression and metabolic rate regulation, we have, for the first time, manipulated TH levels in the Ansell's mole-rat (Fukomys anselli) using osmotic pumps. In Ansell's mole-rats, the TH thyroxine (T4) is naturally low, likely as an adaptation to the harsh subterranean ecological conditions by keeping resting metabolic rate (RMR) low. We measured gene expression levels in the eye, RMR, and body mass (BM) in TH-treated animals. T4 treatment increased both, S- and M-opsin expression, albeit M-opsin expression at a higher degree. However, this plasticity was only given in animals up to approximately 2.5 years. Mass-specific RMR was not affected following T4 treatment, although BM decreased. Furthermore, the T4 inactivation rate is naturally higher in F. anselli compared to laboratory rodents. This is the first experimental evidence that the S-opsin majority in Ansell's mole-rats is a side effect of low T4, which is downregulated to keep RMR low.

• MeSH
• bazální metabolismus účinky léků   MeSH
• čípky retiny - opsiny genetika   metabolismus   MeSH
• mikroftalmičtí podzemní hlodavci krev   metabolismus   MeSH
• retina metabolismus   MeSH
• thyroxin krev   nedostatek   MeSH
• zvířata MeSH
• Check Tag
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• čípky retiny - opsiny MeSH
• thyroxin MeSH

OBJECTIVE: The article aimed to assess the benefit of incorporating maternal serum thyroid disease marker levels (thyroid-stimulating hormone and free thyroxine) into first trimester Down syndrome screening protocols. METHODS: Statistical modelling was used to predict performance with and without the thyroid markers. Two protocols were considered: the combined test and the contingent cell-free DNA (cfDNA) test, where 15-40% women are selected for cfDNA because of increased risk based on combined test results. Published parameters were used for the combined test, cfDNA and the Down syndrome means for thyroid-stimulating hormone and free thyroxine; other parameters were derived from a series of 5230 women screened for both thyroid disease and Down syndrome. RESULTS: Combined test: For a fixed 85% detection rate, the predicted false positive rate was reduced from 5.3% to 3.6% with the addition of the thyroid markers. Contingent cfDNA test: For a fixed 95% detection rate, the proportion of women selected for cfDNA was reduced from 25.6% to 20.2%. CONCLUSIONS: When screening simultaneously for maternal thyroid disease and Down syndrome, thyroid marker levels should be used in the calculation of Down syndrome risk. The benefit is modest but can be achieved with no additional cost. © 2017 John Wiley & Sons, Ltd.

• MeSH
• biologické markery krev   MeSH
• dospělí MeSH
• Downův syndrom krev   komplikace   diagnóza   patofyziologie   MeSH
• lidé MeSH
• nemoci štítné žlázy krev   diagnóza   MeSH
• plošný screening metody   MeSH
• prediktivní hodnota testů MeSH
• prenatální diagnóza metody   MeSH
• první trimestr těhotenství krev   MeSH
• senzitivita a specificita MeSH
• štítná žláza patofyziologie   MeSH
• těhotenství MeSH
• testy funkce štítné žlázy metody   MeSH
• thyreotropin analýza   krev   MeSH
• thyroxin analýza   krev   MeSH
• volné cirkulující nukleové kyseliny analýza   krev   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• hodnotící studie MeSH
• Názvy látek
• biologické markery MeSH
• thyreotropin MeSH
• thyroxin MeSH
• volné cirkulující nukleové kyseliny MeSH

Importance of subclinical thyroid disease (STh) is now a matter of discussion. Definition of this unit is laboratory: in presence of normal level of thyroxine (T4) TSH value is changed: in lower TSH level the subclinical hyperthyroidism (STx) in increase TSH levels subclinical hypothyroidism (SH) is present. Risk of clinical manifestation is two three times highter in comparison with persons with normal TSH level. Clinical importance STh is still not evaluated definitively. SH caused disturbance of lipid metabolism, elasticity of vessels and endothelial function and therefore increases risk of atherosclerosis. STx causes electrical instability of myocardium with increased risk of arythmias, increases risk of osteoporosis and other changes. Most important are effects of STh in cardiology, reproductive medicine and gynecology. Clinical significance of these effects is not definitively evaluated.

• MeSH
• hypertyreóza krev   komplikace   diagnóza   etiologie   MeSH
• hypotyreóza krev   komplikace   diagnóza   etiologie   MeSH
• komplikace těhotenství krev   diagnóza   etiologie   MeSH
• lidé MeSH
• nemoci štítné žlázy krev   komplikace   diagnóza   etiologie   MeSH
• referenční hodnoty MeSH
• těhotenství MeSH
• thyreotropin krev   MeSH
• thyroxin krev   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• thyreotropin MeSH
• thyroxin MeSH

Thyroid hormones play fundamental role in conception and pregnancy and are essential for normal adult health, fetus and childhood development. Many studies have shown an association between maternal thyroid diseases esp. hypothyroidism with obstetric problems and/or psychomotoric impairment in the offspring. The prevalence of undiagnosed lower thyroid function in pregnancy is present in about 4-8 % of pregnant women, and euthyroid women with thyroid autoimmunity (6-8 %) are further candidates for thyroid disorders in pregnancy. The thyroid gland needs to produce 50 % more thyroxine in pregnancy to maintain an euthyroid state to keep TSH ideally 2.5 mIU/l in the first trimester of pregnancy and TSH 3.0 mIU/l in the second and third trimester. Consequently, there is a need to start the substitution therapy as soon as diagnosis of subclinical and /or overt hypotyroidism is established, and in majority of euthyroid women with autoimmune thyroid disease there is a need to start therapy as well. Most women on levothyroxine therapy before pregnancy require an increase in dose when pregnant. As maternal thyroid disease is a quite prevalent condition and often asymptomatic, but easily diagnosed and for which an effective, safe and cheap treatment is available, endocrinological societies including ČES ČLS JEP worldwide are suggesting the need of thyroid dysfunction screening as a simple prevention attitude. Hormone determination of TSH and TPOab antibodies should be performed early during the first trimester, using trimester-specific reference values. Furthermore, adequate iodine supplementation during pregnancy is critical and if feasible it should be initiated before the woman attempts to conceive.

• MeSH
• autoimunitní tyreoiditida krev   diagnóza   farmakoterapie   MeSH
• dítě MeSH
• dospělí MeSH
• komplikace těhotenství krev   diagnóza   farmakoterapie   MeSH
• lidé MeSH
• nemoci štítné žlázy krev   diagnóza   farmakoterapie   MeSH
• novorozenec MeSH
• prenatální diagnóza MeSH
• první trimestr těhotenství MeSH
• referenční hodnoty MeSH
• těhotenství MeSH
• testy funkce štítné žlázy MeSH
• thyreotropin krev   MeSH
• thyroxin krev   terapeutické užití   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• novorozenec MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• thyreotropin MeSH
• thyroxin MeSH

BACKGROUND: Hypothyroidism and/or autoimmune thyroid disorders (AITD) may contribute to spontaneous abortions (SpA). Cost-effectiveness analyses of thyroid screening in women after SpA are lacking. Our aim was to evaluate the cost-effectiveness of screening for AITD and/or hypothyroidism and their treatment in women after SpA with regard to their reproductive health. METHODS: We performed a cross-sectional non-randomized study with follow-up in 2008-2011 in the settings of Departments of Endocrinology and Obstetrics/Gynecology of a university hospital. We enrolled 258 women after SpA before the 12th gestational week and followed them for a median of 3 years. At enrollment, serum concentrations of thyroid stimulatory hormone (TSH), antibodies to thyroid peroxidase (TPOAb) and free thyroxine (FT4) were measured and thyroid ultrasound performed. Women with overt hypothyroidism were treated with levothyroxine (n = 45; 61.6%) and women with subclinical hypothyroidism or euthyroid AITD were treated (n = 28; 38.4%) or left untreated (n = 38; 14.7%). Euthyroid women without signs of AITD served as controls (n = 147; 57.0%). RESULTS: Of the 38 untreated women with AITD and/or subclinical hypothyroidism, 8 (21.1%) reported secondary infertility as compared to 16/147 (10.9%) controls and 3/73 (4.1%) treated women (p = 0.021). Treatment was associated with an increased rate of successfully completed subsequent pregnancies (increment of 6 newborns/100 women) and a savings of €19,539/100 women. Total costs per successfully completed pregnancy were €1,189 in controls, €1,564 in the treated, and €2,488 in the untreated women. CONCLUSIONS: Screening for thyroid disorders in women after SpA and treatment with levothyroxine is cost-saving and it improves the subsequent pregnancy rate.

• MeSH
• analýza nákladů a výnosů MeSH
• autoimunitní nemoci komplikace   diagnóza   farmakoterapie   MeSH
• autoprotilátky krev   MeSH
• dospělí MeSH
• hypotyreóza komplikace   diagnóza   farmakoterapie   MeSH
• jodidperoxidasa imunologie   MeSH
• lidé MeSH
• následné studie MeSH
• plošný screening ekonomika   MeSH
• průřezové studie MeSH
• samovolný potrat etiologie   MeSH
• těhotenství MeSH
• thyreotropin krev   MeSH
• thyroxin krev   ekonomika   terapeutické užití   MeSH
• úhrn těhotenství na počet žen v reprodukčním věku MeSH
• ženská infertilita etiologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• práce podpořená grantem MeSH
• Názvy látek
• autoprotilátky MeSH
• jodidperoxidasa MeSH
• thyreotropin MeSH
• thyroxin MeSH

OBJECTIVES: To investigate the associations of serum lipid profile with disease progression in high-risk clinically isolated syndromes (CIS) after the first demyelinating event. METHODS: High density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and total cholesterol (TC) were obtained in pretreatment serum from 135 high risk patients with CIS (≥ 2 brain MRI lesions and ≥ 2 oligoclonal bands) enrolled in the Observational Study of Early Interferon β-1a Treatment in High Risk Subjects after CIS study (SET study), which prospectively evaluated the effect of intramuscular interferon β-1a treatment following the first demyelinating event. Thyroid stimulating hormone, free thyroxine, 25-hydroxy vitamin D3, active smoking status and body mass index were also obtained. Clinical and MRI assessments were obtained within 4 months of the initial demyelinating event and at 6, 12 and 24 months. RESULTS: The time to first relapse and number of relapses were not associated with any of the lipid profile variables. Higher LDL-C (p=0.006) and TC (p=0.001) levels were associated with increased cumulative number of new T2 lesions over 2 years. Higher free thyroxine levels were associated with lower cumulative number of contrast-enhancing lesions (p=0.008). Higher TC was associated as a trend with lower baseline whole brain volume (p=0.020). Higher high density lipoprotein was associated with higher deseasonalised 1,25-dihydroxy vitamin D3 (p=0.003) levels and a trend was found for deseasonalised 25-hydroxy vitamin D3 (p=0.014). CONCLUSIONS: In early multiple sclerosis, lipid profile variables particularly LDL-C and TC levels are associated with inflammatory MRI activity measures.

• Klíčová slova
• Clinical Neurology, Mri, Multiple Sclerosis, Neurobiology, Neuroradiology,
• MeSH
• adjuvancia imunologická terapeutické užití   MeSH
• časná lékařská intervence MeSH
• cholesterol krev   MeSH
• demyelinizační nemoci krev   farmakoterapie   MeSH
• dospělí MeSH
• HDL-cholesterol krev   MeSH
• index tělesné hmotnosti MeSH
• injekce intramuskulární MeSH
• interferon beta 1a MeSH
• interferon beta terapeutické užití   MeSH
• kalcifediol krev   MeSH
• kohortové studie MeSH
• kouření škodlivé účinky   krev   MeSH
• LDL-cholesterol krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• longitudinální studie MeSH
• magnetická rezonanční tomografie MeSH
• mladý dospělý MeSH
• mozek účinky léků   patologie   MeSH
• prospektivní studie MeSH
• roztroušená skleróza krev   diagnóza   farmakoterapie   MeSH
• thyreotropin krev   MeSH
• thyroxin krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• adjuvancia imunologická MeSH
• cholesterol MeSH
• HDL-cholesterol MeSH
• interferon beta 1a MeSH
• interferon beta MeSH
• kalcifediol MeSH
• LDL-cholesterol MeSH
• thyreotropin MeSH
• thyroxin MeSH

Antithyroid drugs are relatively simple molecules known as thionamides, which contain a sulfhydryl group and a thiourea moiety within a heterocyclic structure. Propylthiouracil (6- propyl 2- sulfanylidene 1,2,3,4- tetrahydropyrimidin4- one) and methimazole (1- metyl 2,3- dihydro1H imidazole 2- thione) are the antithyroid drugs used in the United States. Methimazole is used in most of Europe and Asia, and carbimazole - methimazole analogue, is used in the United Kingdom and parts of the former British Commonwealth. Their primary effect is to inhibit thyroid hormone synthesis by interfering with thyroid peroxidase mediated iodination of tyrosine residues in thyroglobulin and is an important step in the synthesis of thyroxine and triiodothyronine. Propylthiouracil (but not methimazole or carbimazole), can block the conversion of thyroxine to triiodothyronine within the thyroid and in peripheral tissues. Antithyroid drugs may have clinically important immunosuppressive effects. Side effects of thionamides are usually mild, serious untoward effects are observed in < 5% of cases, more frequently during the initial phases of treatment, when the drug daily dose is higher.

• MeSH
• hormony štítné žlázy krev   MeSH
• hypertyreóza krev   farmakoterapie   MeSH
• karbimazol škodlivé účinky   terapeutické užití   MeSH
• lidé MeSH
• methimazol škodlivé účinky   terapeutické užití   MeSH
• propylthiouracil škodlivé účinky   terapeutické užití   MeSH
• thyreoglobulin krev   MeSH
• thyreostatika škodlivé účinky   chemie   terapeutické užití   MeSH
• thyroxin krev   MeSH
• trijodthyronin krev   MeSH
• vztahy mezi strukturou a aktivitou MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• hormony štítné žlázy MeSH
• karbimazol MeSH
• methimazol MeSH
• propylthiouracil MeSH
• thyreoglobulin MeSH
• thyreostatika MeSH
• thyroxin MeSH
• trijodthyronin MeSH

This article discusses the conditions that may lead to a phenomenon called dysthyronemia. Here, the thyroid gland has concentration of thyrotropin in circulation within the reference range, but the concentrations of free or total fractions of thyroid hormones are outside the reference range. Normal values of thyrotropin (TSH) and increased values of THs are referred to as hyperthyroxinemia, while normal values of thyrotropin and decreased values of thyroid hormone are hypothyroxinemia. As shown by our observations, it is a relatively frequent situation in the parallel determinations of TSH and free thyroxine, when results verging on hyperthyroxinemia were found in 7% of cases (6.74%, n=259,590), and also in the parallel sets of TSH and total triiodothyronine when hypotriiodothyroninemia reached 8.5% (8.48%, n=73,143). We are assuming that the main cause of hyperthyroxinemia in the free thyroxine and TSH system is the presence of autoantibodies against thyroxine in patients with autoimmune thyroid disease. The reason of hypotriiodothyroninemia in the system of triiodothyronine and TSH is a decreased concentration of thyroid binding globulin in postmenopausal women. Manufacturers of immunoanalytical kits should take into account the potential adverse effects of autoantibodies against thyroid hormones when measuring the results of immunoassay determination of the free fraction of these hormones.

• MeSH
• dospělí MeSH
• hormony štítné žlázy krev   MeSH
• hypertyroxinemie krev   diagnóza   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• proteiny vázající thyroxin metabolismus   MeSH
• referenční hodnoty MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• štítná žláza metabolismus   patologie   MeSH
• thyreotropin krev   MeSH
• thyroxin krev   MeSH
• trijodthyronin krev   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• hormony štítné žlázy MeSH
• proteiny vázající thyroxin MeSH
• thyreotropin MeSH
• thyroxin MeSH
• trijodthyronin MeSH

OBJECTIVES: The objective of the study was to assess the metabolic risk of excessive dietary iodine intake in ewes and neonatal lambs. DESIGN: Pregnant Šumava ewes received an experimental diet containing 3.1 mg iodine per kg of dietary dry matter in Group A (control, n=13, 6 ewes and 7 lambs) and 5.1 mg iodine per kg of dietary dry matter in Group B (experimental, n=12, 6 ewes, 6 lambs) for eight months. Iodine was administered to ewes as calcium iodate. TSH in blood serum; TT3, TT4, fT3, and fT4 in blood plasma were examined in both groups of ewes and lambs to assess the risks of iodine intake above the permitted limit, as it applies to thyroid gland activity. RESULTS: Group B ewes showed a significant increase in TSH and TT4 only on day 1 after parturition. The highest values of TT4, TT3, and fT3 in lambs were recorded on day 1 after birth. The lowest values of fT3 and fT4 in lambs were measured on day 60 after birth with no differences observed between the groups. In lambs of Group B the lower concentration of TSH until day 3 after birth was followed by a significant increase from day 10 after birth. CONCLUSION: Our results indicate a risk of postnatal hypothyroidism among lambs from pregnant and lactating ewes having a high iodine intake.

• MeSH
• hypotyreóza krev   chemicky indukované   MeSH
• jod toxicita   MeSH
• laktace MeSH
• náhodné rozdělení MeSH
• novorozená zvířata MeSH
• ovce MeSH
• štítná žláza účinky léků   fyziologie   MeSH
• stopové prvky toxicita   MeSH
• těhotenství MeSH
• thyreotropin krev   MeSH
• thyroxin krev   MeSH
• trijodthyronin krev   MeSH
• zpožděný efekt prenatální expozice krev   chemicky indukované   MeSH
• zvířata MeSH
• Check Tag
• těhotenství MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• jod MeSH
• stopové prvky MeSH
• thyreotropin MeSH
• thyroxin MeSH
• trijodthyronin MeSH