#Thyroid Function and #Sudden Cardiac Death

http://circ.ahajournals.org/content/134/10/713

Conclusions: Higher FT4 levels are associated with an increased risk of SCD, even in euthyroid participants.

Worldwide #Thyroid-Cancer Epidemic? The Increasing Impact of #Overdiagnosis

http://www.nejm.org/doi/full/10.1056/NEJMp1604412#article

Dramatic increases have been seen over recent decades in the reported incidence of thyroid cancer, but owing to new modes of screening, hundreds of thousands of cases may be overdiagnoses — diagnosis of tumors that would not, if left alone, result in symptoms or death.

Low #Thyroid Hormone in Early Pregnancy Is Associated with an Increased Risk of Gestational #Diabetes Mellitus

http://press.endocrine.org/doi/10.1210/jc.2016-1506

Conclusions:
Low thyroid hormone levels in early pregnancy are a risk factor for GDM incidence.

#Thyroid Function and #Cancer Risk: The Rotterdam Study

http://press.endocrine.org/doi/abs/10.1210/jc.2016-2104

Conclusions:
Higher FT4 levels are significantly associated with an increased risk of any solid, lung and breast cancer. Further research should elucidate the underlying pathophysiological mechanisms.

People with higher #thyroid hormone levels may be at greater risk for #atherosclerosis

https://www.endocrine.org/news-room/current-press-releases/people-with-higher-thyroid-hormone-levels-may-be-at-greater-risk-for-atherosclerosis

Over a median followup of 8.8 years, 1,130 atherosclerotic events and 580 atherosclerotic deaths occurred in the population. Higher free thyroxine (FT4) levels in these patients were associated with elevated risk of atherosclerotic morbidity and mortality independent of cardiovascular risk factors.
The authors also found that higher FT4 levels were associated with greater risk of subclinical atherosclerosis.
These results suggest that the link between thyroid function and atherosclerosis is mediated through yet unexplored cardiovascular risk factors or alternative pathways, the authors wrote in their abstract.

#Vitiligo and overt #thyroid diseases: A nationwide population-based study in Korea

http://www.jaad.org/article/S0190-9622(16)31295-6/fulltext

The study enrolled 73,336 vitiligo patients and 146,672 controls. Patients with vitiligo were at increased risks of Graves disease (odds ratio [OR] 2.610 [95% confidence interval {CI} 2.319-02.938]), Hashimoto thyroiditis (OR 1.609 [95% CI 1.437-1.802]), and thyroid cancer (OR 1.127 [95% CI 1.022-1.242]), compared with the controls. The associations were consistently stronger in males and younger patients. Vitiligo was significantly associated with overt autoimmune thyroid diseases and overt thyroid cancer.

Screening for #Thyroid #Cancer
US Preventive Services Task Force Recommendation Statement
http://jamanetwork.com/journals/jama/fullarticle/2625325#159892429

The USPSTF found inadequate direct evidence on the harms of screening but determined that the overall magnitude of the harms of screening and treatment can be bounded as at least moderate, given adequate evidence of harms of treatment and indirect evidence that overdiagnosis and overtreatment are likely to be substantial with population-based screening. The USPSTF therefore determined that the net benefit of screening for thyroid cancer is negative.

Conclusions and Recommendation The USPSTF recommends against screening for thyroid cancer in asymptomatic adults. (D recommendation)

Natural History and Tumor Volume Kinetics of #Papillary #Thyroid Cancers During Active Surveillance
http://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2650803

During a median (range) active surveillance of 25 (6-166) months, growth in tumor diameter of 3 mm or more was observed in 11 of 291 (3.8%) patients, with a cumulative incidence of 2.5% (2 years) and 12.1% (5 years). No regional or distant metastases developed during active surveillance. In all cases, 3-dimensional measurements of tumor volume allowed for earlier identification of growth (median, 8.2 months; range, 3-46 months before increase in tumor diameter).

In multivariable analysis, both younger age at diagnosis (hazard ratio per year, 0.92; 95% CI, 0.87-0.98; P = .006) and risk category at presentation (hazard ratio for inappropriate, 55.17; 95% CI, 9.4-323.19; P < .001) were independently associated with the likelihood of tumor growth. Of the tumors experiencing volume growth, kinetics demonstrated a classic exponential growth pattern, with a median doubling time of 2.2 years

Conclusions and Relevance The rates of tumor growth during active surveillance in a US cohort with PTCs measuring 1.5 cm or less were low. Serial measurement of tumor volumes may facilitate early identification of tumors that will continue to grow and thereby inform the timing of surveillance imaging and therapeutic interventions

#Thyroid Function and the Risk of #Atherosclerotic Cardiovascular Morbidity and Mortality: The Rotterdam Study
http://circres.ahajournals.org/content/early/2017/09/28/CIRCRESAHA.117.311603

Thyroid hormones have been linked with various proatherogenic and antiatherogenic processes. However, the relationship of thyroid function with manifestations of atherosclerosis remains unclear

During a median follow-up of 8.8 years (interquartile range:4.5-11.8 years), 934 incident ASCV events and 612 ASCV deaths occurred. FT4 levels were positively associated with high CAC score (odds ratio OR; 95% confidence interval CI: 2.28; 1.30-4.02) and incident ASCV events (hazard ratio HR; CI: 1.87; 1.34-2.59). The risk of ASCV mortality increased in a linear manner with higher FT4 levels (HR; CI: 2.41; 1.68-3.47 per 1 ng/dl) and lower TSH levels (HR; CI: 0.92; 0.84-1.00 per 1 logTSH). Results remained similar or became stronger among euthyroid participants.

Conclusions: FT4 levels in middle-aged and elderly subjects were positively associated with atherosclerosis throughout the whole disease spectrum, independently of cardiovascular risk factors

#Thyroid Function and the Risk of #Atherosclerotic Cardiovascular Morbidity and Mortality: The Rotterdam Study
http://circres.ahajournals.org/content/early/2017/09/28/CIRCRESAHA.117.311603

Thyroid hormones have been linked with various proatherogenic and antiatherogenic processes. However, the relationship of thyroid function with manifestations of atherosclerosis remains unclear A total of 9420 community-dwelling participants (mean age±SD, 64.8±9.7 years) were included. During a median follow-up of 8.8 years (interquartile range:4.5-11.8 years), 934 incident ASCV events and 612 ASCV deaths occurred. FT4 levels were positively associated with high CAC score (odds ratio OR; 95% confidence interval CI: 2.28; 1.30-4.02) and incident ASCV events (hazard ratio HR; CI: 1.87; 1.34-2.59). The risk of ASCV mortality increased in a linear manner with higher FT4 levels (HR; CI: 2.41; 1.68-3.47 per 1 ng/dl) and lower TSH levels (HR; CI: 0.92; 0.84-1.00 per 1 logTSH). Results remained similar or became stronger among euthyroid participants.

Conclusions: FT4 levels in middle-aged and elderly subjects were positively associated with atherosclerosis throughout the whole disease spectrum, independently of cardiovascular risk factors.

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Quantitative Analysis of the Benefits and Risk of #Thyroid #Nodule Evaluation in Patients ≥70 Years Old

https://www.liebertpub.com/doi/10.1089/thy.2017.0655

A total of 1129 patients ≥70 years old with 2527 nodules ≥1 cm were evaluated. FNA was safe in all, and cytology proved benign in 67.3% of patients. However, FNA led to surgery in 208 patients, of whom 93 (44.7%) had benign histopathology. Among all patients who underwent FNA, only 17 (1.5%) SRTC were identified, all of which were preoperatively identifiable by imaging and/or cytology. These SRTC were responsible for all (n = 10; 0.9%) thyroid cancer deaths. Among all other patients (n = 1112), 160 deaths (14.4%) were confirmed during a median follow-up of four years. None of these were thyroid cancer related. Survival analysis for these 1112 patients demonstrated that a separate non-thyroidal malignancy or coronary artery disease at the time of nodule evaluation was associated with increased mortality compared to those without these diagnoses (hazard ratio = 2.32 confidence interval 1.66–3.26; p < 0.01), confirming these are important variables to identify prior to thyroid nodule evaluation.

Conclusions: For patients ≥70 years old, US and FNA are safe and prove helpful in identifying SRTC and benign cytology. However, the surgical management of patients ≥70 years old presenting without high-risk findings should be tempered, especially when comorbid illness is identified

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#Thyroid hormones treatment for subclinical #hypothyroidism: a clinical practice guideline

https://www.bmj.com/content/365/bmj.l2006

Clinical question What are the benefits and harms of thyroid hormones for adults with subclinical hypothyroidism (SCH)? This guideline was triggered by a recent systematic review of randomised controlled trials, which could alter practice.

Current practice Current guidelines tend to recommend thyroid hormones for adults with thyroid stimulating hormone (TSH) levels >10 mIU/L and for people with lower TSH values who are young, symptomatic, or have specific indications for prescribing.

Recommendation

The guideline panel issues a strong recommendation against thyroid hormones in adults with SCH (elevated TSH levels and normal free T4 (thyroxine) levels). It does not apply to women who are trying to become pregnant or patients with TSH >20 mIU/L. It may not apply to patients with severe symptoms or young adults (such as those ≤30 years old).

#Thyroid dysfunction and #breast cancer risk among women in the UK Biobank cohort

https://2medical.news/2021/05/29/thyroid-dysfunction-and-breast-cancer-risk-among-women-in-the-uk-biobank-cohort/

#Thyroid Hormone Therapy and Incident #Stroke

https://2medical.news/2021/06/19/thyroid-hormone-therapy-and-incident-stroke/

Evidence of a Causal Relationship between Serum #Thyroid-Stimulating Hormone and #Osteoporotic Bone Fractures

https://2medical.news/2021/08/24/evidence-of-a-causal-relationship-between-serum-thyroid-stimulating-hormone-and-osteoporotic-bone-fractures/

Associations of #sex-related and #thyroid-related #hormones with risk of metabolic dysfunction-associated fatty #liver disease in T2DM patients

https://2medical.news/2024/07/16/associations-of-sex-related-and-thyroid-related-hormones-with-risk-of-metabolic-dysfunction-associated-fatty-liver-disease-in-t2dm-patients/