The Experts below are selected from a list of 45681 Experts worldwide ranked by ideXlab platform
Alan P. Farwell - One of the best experts on this subject based on the ideXlab platform.
-
Comprehensive Physiology - Euthyroid Sick Syndrome.
Comprehensive Physiology, 2016Co-Authors: Sun Y. Lee, Alan P. FarwellAbstract:In this review, we discuss the characteristics, pathophysiology, and therapeutic implications of the Euthyroid sick syndrome. Multiple mechanisms have been identified to contribute to the development of Euthyroid sick syndrome, including alterations in the iodothyronine deiodinases, thyroid-stimulating hormone secretion, thyroid hormone binding to plasma protein, transport of thyroid hormone in peripheral tissues, and thyroid hormone receptor activity. The Euthyroid sick syndrome appears to be a complex mix of physiologic adaptation and pathologic response to acute illness. The underlying cause for these alterations has not yet been elucidated. Treatment of the Euthyroid sick syndrome with thyroid hormone to restore normal serum thyroid hormone levels in an effort to improve disease prognosis and outcomes continues to be a focus of many clinical studies, although currently available data do not provide evidence of a clear benefit of treatment.
-
Euthyroid sick syndrome
Comprehensive Physiology, 2016Co-Authors: Sun Y. Lee, Alan P. FarwellAbstract:In this review, we discuss the characteristics, pathophysiology, and therapeutic implications of the Euthyroid sick syndrome. Multiple mechanisms have been identified to contribute to the development of Euthyroid sick syndrome, including alterations in the iodothyronine deiodinases, thyroid-stimulating hormone secretion, thyroid hormone binding to plasma protein, transport of thyroid hormone in peripheral tissues, and thyroid hormone receptor activity. The Euthyroid sick syndrome appears to be a complex mix of physiologic adaptation and pathologic response to acute illness. The underlying cause for these alterations has not yet been elucidated. Treatment of the Euthyroid sick syndrome with thyroid hormone to restore normal serum thyroid hormone levels in an effort to improve disease prognosis and outcomes continues to be a focus of many clinical studies, although currently available data do not provide evidence of a clear benefit of treatment.
-
Comprehensive Physiology - Euthyroid Sick Syndrome
Comprehensive Physiology, 2016Co-Authors: Alan P. FarwellAbstract:In this review, we discuss the characteristics, pathophysiology, and therapeutic implications of the Euthyroid sick syndrome. Multiple mechanisms have been identified to contribute to the development of Euthyroid sick syndrome, including alterations in the iodothyronine deiodinases, thyroid-stimulating hormone secretion, thyroid hormone binding to plasma protein, transport of thyroid hormone in peripheral tissues, and thyroid hormone receptor activity. The Euthyroid sick syndrome appears to be a complex mix of physiologic adaptation and pathologic response to acute illness. The underlying cause for these alterations has not yet been elucidated. Treatment of the Euthyroid sick syndrome with thyroid hormone to restore normal serum thyroid hormone levels in an effort to improve disease prognosis and outcomes continues to be a focus of many clinical studies, although currently available data do not provide evidence of a clear benefit of treatment. © 2016 American Physiological Society. Compr Physiol 6:1071-1080, 2016.
-
Sick Euthyroid Syndrome
Journal of Intensive Care Medicine, 1997Co-Authors: Alan P. FarwellAbstract:Critical illness causes multiple alterations in thyroid hormone concentrations in patients who have no intrinsic thyroid disease. These effects are nonspecific, and they relate to the severity of illness. Because a wide variety of illnesses tend to result in the same changes in serum thyroid hormone levels, such alterations in thyroid hormone indexes has been termed the sick Euthyroid syndrome. These changes are rarely isolated, and they are often associated with alterations in other endocrine systems. Similar changes in endocrine function has been shown experimentally by administration of cytokines from the interleukin and interferon families, as well as tumor necrosis factor-α. Thus, the sick Euthyroid syndrome should not be viewed as an isolated pathological event, but as part of a coordinated systemic reaction to illness that involves both the immune and the endocrine systems. Recovery from the illness usually results in resolution of the alterations in thyroid hormone parameters. Supplemental thyroid...
Robin P F Dullaart - One of the best experts on this subject based on the ideXlab platform.
-
the relationship of the anti oxidant bilirubin with free thyroxine is modified by insulin resistance in Euthyroid subjects
PLOS ONE, 2014Co-Authors: Petronella E Deetman, Stephan J L Bakker, Arjan J Kwakernaak, Gerjan Navis, Robin P F DullaartAbstract:Background: The strong anti-oxidative properties of bilirubin largely explain its cardioprotective effects. Insulin resistance is featured by low circulating bilirubin. Thyroid hormone affects both bilirubin generation and its biliary transport, but it is unknown whether circulating bilirubin is associated with thyroid function in Euthyroid subjects. Aim is to determine relationships of bilirubin with TSH, free T-4 and free T-3 in Euthyroid subjects without type 2 diabetes mellitus (T2DM), and to assess whether such a relationship would be modified by the degree of insulin resistance. Methods: Total bilirubin, TSH, free T-4, free T-3, glucose, insulin, lipids and transaminases were measured in 1854 fasting Euthyroid subjects without T2DM, recruited from the general population (PREVEND cohort). Insulin resistance was assessed by homeostasis model assessment. Results: Bilirubin was positively related to free T-4 (beta = 0.116, P Conclusions: Low bilirubin relates to low free T-4 in Euthyroid non-diabetic subjects. Low normal free T-4 may particularly confer low bilirubin in more insulin resistant individuals.
-
adiposity blunts the positive relationship of thyrotropin with proprotein convertase subtilisin kexin type 9 levels in Euthyroid subjects
Thyroid, 2013Co-Authors: Arjan J Kwakernaak, Anneke Muller C Kobold, Gilles Lambert, Robin P F DullaartAbstract:Background: Effects of thyroid function status on lipoprotein metabolism may extend into the Euthyroid range. Low-density lipoprotein (LDL) metabolism is governed by proprotein convertase subtilisin-kexin type 9 (PCSK9), which down-regulates LDL receptor expression, resulting in higher LDL cholesterol (LDL-C). Here, we tested whether plasma PCSK9 correlates with thyroid function in nonobese and obese Euthyroid subjects. Methods: We assessed the extent to which plasma PCSK9 is determined by thyrotropin (TSH) in 74 Euthyroid subjects (31 women; TSH between 0.5 and 4.0 mU/L and free thyroxine [FT4] between 11.0 and 19.5 pM) with varying degrees of obesity (body mass index [BMI] ranging from 20.2 to 40.4 kg/m2). Results: TSH, FT4, PCSK9, non–high-density lipoprotein cholesterol (non-HDL-C), LDL-C, and apolipoprotein B (apoB) levels were not different between 64 nonobese subjects (BMI 0.20 for each). PCSK9 correlated positively with TSH in nonobese subjects (r=0...
-
carotid artery intima media thickness is inversely related to serum free thyroxine in Euthyroid subjects
Clinical Endocrinology, 2007Co-Authors: Robin P F Dullaart, Rindert De Vries, Carolien Roozendaal, Anneke Muller C Kobold, Wim J SluiterAbstract:Objective The effect of thyroid function on cardiovascular risk may extend to the Euthyroid range. In Euthyroid subjects, we determined whether carotid artery intima media thickness (IMT), a measure of subclinical atherosclerosis, is related to thyroid function. Design and subjects Cross-sectional study in a cohort of 78 nonsmoking, predominantly middle-aged, Euthyroid subjects (44 men and 34 women, mean age 56 years, TSH between 0.5 mU/l and 4.0 mU/l and FT4 between 11.0 pmol/l and 19.5 pmol/l). Measurements IMT (mean of three segments in both carotid arteries by ultrasonography), clinical factors, insulin resistance (HOMA(ir)), plasma lipids, C-reactive protein (CRP), serum FT4, TSH and thyroid autoantibodies. Results In several multiple linear regression models, age- and sex-adjusted IMT was found to be independently related to either pulse pressure and body mass index (BMI), to high density lipoprotein (HDL) cholesterol or to FT4, but not to TSH, thyroid autoantibodies, HOMA(ir), CRP, non-HDL cholesterol and triglycerides. In a subsequent model which included age, sex, pulse pressure, body mass index (BMI), HDL cholesterol and FT4, IMT was independently and positively related to age (beta = 0.43, P <0.001), male sex (beta = 0.34, P = 0.014), pulse pressure (beta = 0.29, P = 0.002), BMI (beta = 0.24, P = 0.007) and inversely related to FT4 (beta = -0.19, P = 0.046). IMT was also inversely related to FT4 in a model which included HDL cholesterol, non-HDL cholesterol and triglycerides. Conclusions In Euthyroid subjects, IMT is associated with FT4, after controlling for clinical factors, lipid levels and thyroid autoantibodies. These findings raise the possibility that, even within the Euthyroid range, low normal thyroid function may adversely affect cardiovascular risk.
Joon Park - One of the best experts on this subject based on the ideXlab platform.
-
Effect of Seasonal Changes on the Transition Between Subclinical Hypothyroid and Euthyroid Status
The Journal of clinical endocrinology and metabolism, 2013Co-Authors: Tae Hyuk Kim, Kyung Won Kim, Hwa Young Ahn, Hoon Choi, Hojeong Won, Yunhee Choi, Sun Wook Cho, Jae Hoon Moon, Joon ParkAbstract:Context: The widespread use of thyroid tests in asymptomatic individuals identifies many patients with transient subclinical hypothyroidism. Objective: Our objective was to determine the effect of seasonal change on serum TSH levels and the transition between subclinical hypothyroid and Euthyroid status. Design, Setting, and Subjects: This was a retrospective longitudinal study of 1751 subclinical hypothyroid and 28 096 Euthyroid subjects aged over 18 years who underwent serial thyroid function tests at a health screening center between October 2003 and May 2011. Main Outcome Measures: Age-adjusted geometric mean values of the TSH level by month were calculated using linear mixed models. Adjusted odds ratios of test season and multiple baseline clinical factors were determined using generalized estimating equations. Results: During a median 36 months of follow-up, 57.9% of subclinical hypothyroid subjects reverted to Euthyroidism, and 4.3% of Euthyroid subjects developed subclinical hypothyroidism. The mo...
Fereidoun Azizi - One of the best experts on this subject based on the ideXlab platform.
-
serum free thyroxine concentration is associated with metabolic syndrome in Euthyroid subjects
Thyroid, 2014Co-Authors: Ladan Mehran, Atieh Amouzegar, Maryam Tohidi, Maryam Moayedi, Fereidoun AziziAbstract:Context: The association between thyroid hormones within the Euthyroid range and metabolic syndrome is not clear. Aim: This study evaluated the relationship between thyroid hormones and metabolic syndrome and its components in Euthyroid subjects. Design and setting: This is a cross-sectional population based study conducted within the framework of the cohort of the Tehran Thyroid Study. Participants: Out of 5786 subjects aged ≥20 years, 3755 Euthyroid subjects without a history of thyroid disorders, diabetes, or use of steroids or lipid-lowering agents were investigated. Outcome measures: Body weight, waist circumference (WC), and blood pressure (BP) were measured. Serum concentrations of lipids and lipoproteins, fasting blood glucose (FBG), insulin, free T4 (FT4), and thyrotropin (TSH) were assayed. Metabolic syndrome was determined by definition of the Joint Interim Statement adjusted for the Iranian population. Results: After adjustment for age, sex, and smoking, serum FT4 was significantly associated ...
G. Tsapas - One of the best experts on this subject based on the ideXlab platform.
-
Heart failure accompanied by sick Euthyroid syndrome and exercise training
Current Opinion in Cardiology, 2002Co-Authors: D. Psirropoulos, N. Lefkos, G. Boudonas, A. Efthimiadis, V. Vogas, C. Keskilidis, G. TsapasAbstract:Sick Euthyroid syndrome is defined as the decrease of serum free triiodothyronine with normal free L-thyroxin and thyrotropin. Its appearance in patients with chronic heart failure is an indicator of severity. Exercise training through a wide variety of mechanisms reverses sick Euthyroid syndrome (normalization of free triiodothyronine levels) and improves the ability to exercise. There is a connection during exercise among dyspnea, hyperventilation, fatigue, catecholamines, a decrease in the number and function of β-blocker receptors, and elevation of serum free triiodothyronine. It is not known whether sick Euthyroid syndrome contributes to the development of heart failure or is only an attendant syndrome.
-
Heart failure accompanied by sick Euthyroid syndrome and exercise training.
Current opinion in cardiology, 2002Co-Authors: D. Psirropoulos, N. Lefkos, G. Boudonas, A. Efthimiadis, V. Vogas, C. Keskilidis, G. TsapasAbstract:Sick Euthyroid syndrome is defined as the decrease of serum free triiodothyronine with normal free L-thyroxin and thyrotropin. Its appearance in patients with chronic heart failure is an indicator of severity. Exercise training through a wide variety of mechanisms reverses sick Euthyroid syndrome (normalization of free triiodothyronine levels) and improves the ability to exercise. There is a connection during exercise among dyspnea, hyperventilation, fatigue, catecholamines, a decrease in the number and function of beta-blocker receptors, and elevation of serum free triiodothyronine. It is not known whether sick Euthyroid syndrome contributes to the development of heart failure or is only an attendant syndrome.
