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Serum TSH Levels (serum tsh + level)
Selected AbstractsMaternal hypothyroidism in early and late gestation: effects on neonatal and obstetric outcomeCLINICAL ENDOCRINOLOGY, Issue 5 2005Iskandar Idris Summary Background, Maternal hypothyroidism may be associated with a variety of adverse neonatal and obstetric outcomes. Whether these outcomes are affected by maternal thyroid status at initial presentation or in late gestation specifically within a dedicated antenatal endocrine clinic remains unclear. The effects of thyroxine dose requirement during pregnancy and serum concentrations of TSH within such clinic settings are still not known. Objectives, We investigated these outcomes in patients with hypothyroidism during early and late gestation. TSH levels and thyroxine dose requirement during early and late gestation were also evaluated. Methods, We performed a retrospective study of data from 167 pregnancies managed in the antenatal endocrine clinic. Analysis of outcomes was linked to TSH at first presentation and in the third trimester. Outcome variables included: rate of caesarean section, pre-eclampsia, neonatal unit admission, neonatal weight and gestational age. Controlled TSH was defined as mothers with TSH between 0·1 and 2 with normal free thyroid hormone levels. Results, The caesarean section (CS) rates were higher in the study cohort (H) compared with the local (C) rate (H = 28·7%, C = 18%). The higher rate in our patient cohort was not due to a higher rate of emergency section nor to a lower threshold for performing elective caesarean section. The infant birthweight (IBW) from mothers with TSH > 5·5 (H1) and mothers with TSH between 0·1 and 5·5 at presentation (H2) was [median (range)] 3·38 (1·73,4·70) vs. 3·45 (1·36,4·76); P = ns. The prevalence of low-birthweight (LBW) infants (< 2·5 g) in groups H1 and H2 was 15% and 4·8%, respectively [odds ratio (OR) = 3·55, 95% confidence interval (95% CI) = 0·96,10·31]. IBW from mothers with TSH > 2 (H3) and mothers with controlled TSH in the third trimester (H4) were similar [3·38 (1·78,4·4) vs. 3·46 (1·36,4·76); P = ns]. The prevalence of LBW in groups H3 and H4 was 9% and 4·9%, respectively (OR = 1·95, 95% CI = 0·52,7·26). The median thyroxine dose (µg) increased significantly during pregnancy (first trimester: 100; second trimester: 125, P < 0·001; and third trimester: 150, P < 0·001) associated with appropriate suppression of TSH levels in the second and third trimesters. Rates of pre-eclampsia or admissions to neonatal units were negligible. Conclusion, Thyroxine dose requirement increases during pregnancy and thus close monitoring of thyroid function with appropriate adjustment of thyroxine dose to maintain a normal serum TSH level is necessary throughout gestation. Within a joint endocrine,obstetric clinic, maternal hypothyroidism at presentation and in the third trimester may increase the risk of low birthweight and the likelihood for caesarean section. The latter observation was not due to a higher rate of emergency caesarean section nor to a lower threshold for performing elective caesarean section. A larger study with adjustments made for the various confounders is required to confirm this observation. [source] Cord blood thyroid-stimulating hormone and free T4 levels in Turkish neonates: Is iodine deficiency still a continuing problem?PEDIATRICS INTERNATIONAL, Issue 5 2010Fatih K Abstract Background:, The objectives of this study were to determine the cord blood thyroid-stimulating hormone (TSH) and free T4 (FT4) levels in Turkish neonates and to determine whether these variables reveal iodine deficiency. Methods:, We collected 818 cords from healthy mothers at parturition and measured levels of FT4 and TSH. We also measured cord blood FT4 and TSH levels in different stages of gestation and gender. We grouped the neonates according to cord serum TSH levels, either being less (Group A) or greater (Group B) than 10 mIU/L. Group A included 589 neonates (300 girls [51%] and 289 boys [49%]) and Group B included 229 neonates (105 girls [45%] and 124 boys [55%]). Results:, The percentage of subjects with cord blood TSH < 10 mIU/L and >10 mIU/L was 72% and 28%, respectively. Although cord TSH levels in Group B were greater than those in Group A (P < 0.001), cord blood FT4 levels in Group B were lower than those in Group A (P < 0.05). There was no difference between both sex in terms of birthweight and maternal age. TSH and FT4 levels did not vary according to neonate sex during gestation, except for from week 37 to 41. TSH levels of male neonates at the 41st week of gestation were higher than those of female neonates (P < 0.05). There were no effects of birthweight on TSH and FT4 levels if the neonate was lighter than 2500 g at birth. TSH levels of male neonates were higher than those of female neonates when their birthweights were <2500 g (P < 0.05). There was no significant difference in TSH levels according to birthweights in male neonates. Conclusion:, Our data provide the normative data for cord blood TSH and FT4 levels in Turkish neonates and show that iodine deficiency is a still a public health problem in Turkey. These measurements can be useful for detection and verification of hypothyroidism in a screening program for congenital hypothyroidism as well as evaluation of the success of the iodination program. [source] Menopause Leading to Increased Vaginal Wall Thickness in Women with Genital Prolapse: Impact on Sexual ResponseTHE JOURNAL OF SEXUAL MEDICINE, Issue 11 2009Lúcia Alves Da Silva Lara MD ABSTRACT Introduction., Hypoestrogenism causes structural changes in the vaginal wall that can lead to sexual dysfunction. A reduction in vaginal wall thickness has been reported to occur after menopause, although without precise morphometry. Aim., To measure vaginal wall thickness in women with genital prolapse in normal and hypoestrogenic conditions and to correlate sexual dysfunction with vaginal wall thickness and estradiol levels. Methods., Surgical vaginal specimens from 18 normoestrogenic and 13 postmenopausal women submitted to surgery for genital prolapse grades I and II were examined. Patients were evaluated for FSH, estradiol, prolactin, glycemia, and serum TSH levels. For histological analysis, samples were stained with Masson's trichrome and hematoxylin-eosin. Sexual function was assessed by the Golombok-Rust Inventory of Sexual Satisfaction (GRISS). Main Outcome Measures., GRISS questionnaire, histological analysis, morphometric methods, Masson's trichrome. Results., The vaginal wall was thicker in the postmenopausal than premenopausal group (2.72 ± 0.72 mm and 2.16 ± 0.43, P = 0.01, and 2.63 ± 0.71 mm and 2.07 ± 0.49 mm, P = 0.01, for the anterior and posterior walls, respectively). These thicknesses seem to be due to the muscular layer, which was also thicker in the postmenopausal group (1.54 ± 0.44 and 1.09 ± 0.3 mm, P = 0.02, and 1.45 ± 0.47 and 1.07 ± 0.44 mm, P = 0.03, for the anterior and posterior wall, respectively). The vaginal epithelium was thinner in the middle segment than in the proximal one in the posterior wall (0.17 ± 0.07 mm, 0.15 ± 0.05 mm, 0.24 ± 0.09 mm, P = 0.02). There was no correlation between coital pain, vaginal wall thickness, and estradiol levels in either group. Conclusion., The vaginal wall is thicker after menopause in women with genital prolapse. In this study, vaginal thickness and estrogen levels were not related to sexual dysfunction. da Silva Lara LA, Ribeiro-Silva A, Rosa-e-Silva JC, Chaud F, Silva-de-Sá MF, Meireles e Silva AR, and Rosa-e-Silva ACJS. Menopause leading to increased vaginal wall thickness in women with genital prolapse: impact on sexual response. J Sex Med 2009;6:3097,3110. [source] The impact of a TSH receptor gene polymorphism on thyroid-related phenotypes in a healthy Danish twin populationCLINICAL ENDOCRINOLOGY, Issue 6 2007Pia Skov Hansen Summary Objectives, The Asp727Glu polymorphism in the TSH receptor (TSHR) gene is associated with serum TSH levels. However, the proportion of genetic variation accounted for by this polymorphism is unknown. In this study, we (1) examined the association of the Asp727Glu polymorphism with thyroid size, serum levels of TSH, thyroid hormones, and thyroid antibodies in 1241 healthy Danish twin individuals and (2) assessed the contribution of the polymorphism to the trait variation and the genetic variance. Measurements, The effect of the genotype on the traits (mean ± SD) was established; associations between the TSHR-Asp727Glu polymorphism and measures of thyroid homeostasis were assessed and the effect of the polymorphism on the trait's phenotypic variability was quantified by incorporating the genotype information in structural equation modelling. Results, The genotype distribution was Asp/Asp 84·9%; Asp/Glu 14·5% and Glu/Glu 0·6%. Carriers of the TSHR-Glu727 allele had lower TSH levels (noncarriers vs. carriers: 1·78 ± 0·93 vs. 1·60 ± 0·84 mU/l, P = 0·04). Regression analysis showed an association between the TSHR-Asp727Glu polymorphism and serum TSH (P = 0·007). The polymorphism accounted for 0·91% of the total phenotypic variance in serum TSH levels. Including the genotype in quantitative genetic modelling improved the model fit (P = 0·001); however, the genetic influence on serum TSH not attributable to this specific genetic variant was only reduced from 68·2% to 67·8%. The polymorphism was not significantly associated with thyroid size, thyroid hormones or thyroid antibody levels. Conclusions, The TSHR-727Glu allele was associated with decreasing TSH levels; however, the contribution to the genetic variance was very small. No association was found with other thyroid-related measures. [source] | ||||||||||