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  • 1
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    The impact of metabolic syndrome on chronic kidney disease development. Insights from a big prospective study
    Wiley ; 2023
    In:  European Journal of Clinical Investigation Vol. 53, No. 4 ( 2023-04)
    Details
    In: European Journal of Clinical Investigation, Wiley, Vol. 53, No. 4 ( 2023-04)
    Abstract: Chronic kidney disease (CKD) can progress over time and cause renal replacement therapy. Studies showed the association between metabolic syndrome (MetS) and CKD. Current evidence is from cross‐sectional studies. There is a need for the robust data from big prospective cohort studies with long‐term follow‐up. This study investigated the association between CKD and MetS after 18 years of follow‐up. Material and Method Among 15,255 participants aged ≥20 years at baseline (1999–2005), after exclusion of CKD, cancer, and use of corticosteroids, 8987 participants entered the study and followed at a three‐year cycle up to 2018. All participants were divided into five subgroups: (1) MetS‐free, (2) MetS (DM+, HTN−), (3) MetS+ (DM−, HTN+), (4) MetS+ (DM+, HTN+) and (5) MetS+ (DM−, HTN−). Result At baseline, the mean age of the participants was 39.8 ± 13.3 years; 4996 (55.6%) were females. CKD was developed in 2038 (22.7%) subjects during 18 years of follow‐up, of whom 1107 had MetS. After adjusting for the confounding variables, MetS (DM+, HTN+) subgroup had the highest risk of CKD (HR = 1.51, 95% CI = 1.32–1.71). MetS subjects with five components had a higher incidence rate of CKD (HR = 1.43, 95% CI = 1.22–1.68). There was no association between high waist circumference (WC) (HR = 1.08, 95% CI = 0.99–1.19) and high‐density lipoprotein (HDL) (HR = 1.07, 95% CI = 0.98–1.18) with CKD. Conclusion CKD significantly develops in patients with MetS. Metabolic syndrome was associated with the development of chronic kidney disease incidence. Hypertension, diabetes, and age were strong indicators, while abdominal obesity and reduced HDL were not associated with the incidence of CKD.
    Type of Medium: Online Resource
    ISSN: 0014-2972 , 1365-2362
    URL: Issue
    URL: Article
    DOI: 10.1111/eci.v53.4
    DOI: 10.1111/eci.13945
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2004971-7
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  • 2
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    Prevalence of Subclinical Hypothyroidism in Chronic Kidney Disease in a Population-based Study: Tehran Thyroid Study
    Briefland ; 2021
    In:  International Journal of Endocrinology and Metabolism Vol. 19, No. 2 ( 2021-03-17)
    Details
    In: International Journal of Endocrinology and Metabolism, Briefland, Vol. 19, No. 2 ( 2021-03-17)
    Abstract: Background: Chronic kidney disease (CKD) is a rising public health concern that has detrimental effects on cardiovascular health and overall survival. Subclinical hypothyroidism (SCH) has been associated with poor outcomes in the general population. It is thought to be more prevalent in CKD subjects, and their coexistence may contribute to poor outcomes in these patients. We aimed to determine the prevalence of SCH in CKD. Methods: Using data from the Tehran thyroid study, which is a prospective population-based cohort study, adult subjects with an estimated Glomerular Filtration Rate (eGFR) of 60 mL/min/1.73 m2 or less were selected for studying the prevalence of thyroid abnormalities, as well as other known cardiovascular risk factors. Results: Of 5,626 subjects recruited, 823 (14.6%) individuals had CKD. Individuals with CKD were older, heavier, had a higher prevalence of diabetes, higher serum thyrotropin, and thyroid peroxidase anti-body levels, but lower free thyroxine levels. The prevalence of SCH was 7.3% and 5.2% (P 〈 0.001) in kidney disease and non-kidney disease subjects, respectively. However, there was no difference in the risk of SCH between CKD and non-CKD subjects after adjustment for age, sex, BMI, smoking, and TPOAb (OR: 1.28; 95%CI, 0.89 - 1.83). None of the metabolic markers compared between the CKD subgroups of those with and without SCH remained statistically significantly different after adjusting for age and gender. Conclusions: The prevalence of SCH was not higher in CKD after controlling for confounding factors. Besides, CKD subjects with and without SCH had no different metabolic parameters.
    Type of Medium: Online Resource
    ISSN: 1726-913X , 1726-9148
    URL: Journal
    URL: Article
    DOI: 10.5812/ijem
    DOI: 10.5812/ijem.103750
    Language: Unknown
    Publisher: Briefland
    Publication Date: 2021
    detail.hit.zdb_id: 2744447-8
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  • 3
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    The association of parathyroid hormone with serum 25-hydroxyvitamin during pregnancy
    Cambridge University Press (CUP) ; 2023
    In:  Journal of Nutritional Science Vol. 12 ( 2023)
    Details
    In: Journal of Nutritional Science, Cambridge University Press (CUP), Vol. 12 ( 2023)
    Abstract: It is currently debated whether vitamin D requirements during pregnancy differ from those during non-gravid states. In current analyses, we aimed to determine the best model for the association between PTH and serum 25-hydroxyvitamin D (25(OH)D) and the threshold for circulating 25(OH)D at which serum parathyroid hormone (PTH) is suppressed. This multicenter prospective cross-sectional study was conducted on 227 Iranian pregnant women aged 15–45 years in their third trimester of pregnancy. The locally weighted smoothing scatter plot (LOWESS) was used to determine the curvilinear shape of the 25(OH)D/PTH relationship. Linear and non-linear methods were employed to determine the best fit and cut-point for serum 25(OH)D concentration. The median serum 25(OH)D and corresponding serum PTH concentration were 17⋅26 (13⋅44–23⋅08) ng/ml and 19⋅46 (15⋅08–25⋅04) pg/ml in our study population, respectively. The LOWESS curve suggested a non-linear and monotonic with a negative slope relation between PTH (pg/ml) and serum 25(OH)D (ng/ml). The optimal model for the association between PTH and serum 25(OH)D was a one-term fractional polynomial (FP1) (AIC = 1640⋅463). The FP1 analysis identified the 25(OH)D threshold of 12⋅48 ng/ml at which serum PTH rapidly rose. The expected degree of PTH stimulation seems to have a linear trend as 25(OH)D falls below 40 ng/ml. 25(OH)D (ng/ml) and PTH (pg/ml) had a non-linear and monotonic relationship with a negative slope. Our data suggest that a 25(OH)D threshold of 12⋅48 ng/ml is sufficient for parathyroid hormone suppression, which could be used to screen for deficient individuals.
    Type of Medium: Online Resource
    ISSN: 2048-6790
    URL: Article
    DOI: 10.1017/jns.2022.110
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2656288-1
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  • 4
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    Incidence of Thyroid Dysfunction Facing Metabolic Syndrome: A Prospective Comparative Study with 9 Years of Follow-Up
    Bioscientifica ; 2021
    In:  European Thyroid Journal Vol. 10, No. 5 ( 2021), p. 390-398
    Details
    In: European Thyroid Journal, Bioscientifica, Vol. 10, No. 5 ( 2021), p. 390-398
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Studies assessing thyroid hormones in metabolic syndrome (MetS) patients are contradictory. Also, the effect of MetS on thyroid function over time is not yet evaluated. This study investigated the prevalence and incidence of thyroid dysfunction (TD) as well as time trends of thyroid hormones in subjects with and without MetS, during a 10-year follow-up in Tehranian adult population. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This is a prospective cohort study conducted in the framework of Tehran Thyroid Study on 5,786 subjects aged ≥20 years: 4,905 eligible participants entered the study after excluding those with corticosteroid or radioactive iodine use, pregnancy, thyrotropin (TSH) & #x3c;0.1 and & #x3e;10 mU/L, and missing data. Physical examinations were performed and serum concentrations of TSH, free thyroxine (FT4), thyroid peroxidase antibody (TPOAb), fasting plasma glucose, insulin, and lipid profile were assessed at baseline and 3-year intervals during the follow-up. MetS was defined according to the Joint Interim Statement Definition. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 At baseline, there were no difference in median serum concentrations of FT4 and TSH between MetS and non-MetS group after adjusting for age, sex, BMI, smoking, and TPOAb positivity. Although there was higher risk of overt (42%) and subclinical hypothyroidism (16%) in MetS compared with non-MetS subjects, no significant difference was observed in adjusted ORs for any TD between 2 groups. There were also no significant differences in time trends of TSH, FT4, TPOAb positivity, and incidence rates of TDs between MetS and non-MetS groups during 10 years, after adjustment for age, sex, BMI, smoking status, and TPOAb positivity. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 MetS is not associated with thyroid hypofunction considering other important confounders such as age, sex, smoking, BMI, and TPOAb positivity. There is also no difference in the trend of thyroid hormones and incidence of TD between MetS and non-MetS subjects during a 10-year follow-up.
    Type of Medium: Online Resource
    ISSN: 2235-0640 , 2235-0802
    URL: Article
    DOI: 10.1159/000512665
    Language: English
    Publisher: Bioscientifica
    Publication Date: 2021
    detail.hit.zdb_id: 2659767-6
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  • 5
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    The Effect of Maternal Vitamin D Supplementation on Vitamin D Status of Exclusively Breastfeeding Mothers and Their Nursing Infants: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
    Elsevier BV ; 2022
    In:  Advances in Nutrition Vol. 13, No. 2 ( 2022-03), p. 568-585
    Details
    In: Advances in Nutrition, Elsevier BV, Vol. 13, No. 2 ( 2022-03), p. 568-585
    Type of Medium: Online Resource
    ISSN: 2161-8313
    URL: Article
    DOI: 10.1093/advances/nmab126
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2583634-1
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  • 6
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    Trimester-Specific Reference Ranges for Thyroid Hormones in Iranian Pregnant Women
    Hindawi Limited ; 2013
    In:  Journal of Thyroid Research Vol. 2013 ( 2013), p. 1-6
    Details
    In: Journal of Thyroid Research, Hindawi Limited, Vol. 2013 ( 2013), p. 1-6
    Abstract: Background . Due to many physiological changes during pregnancy, interpretation of thyroid function tests needs trimester-specific reference intervals for a specific population. There is no normative data documented for thyroid hormones on healthy pregnant women in Iran. The present survey was conducted to determine trimester-specific reference ranges for serum TSH, thyroxine (TT4), and triiodothyronine (TT3). Methods . The serum of 215 cases was analyzed for measurement of thyroid function tests by immunoassay method of which 152 iodine-sufficient pregnant women without thyroid autoantibodies and history of thyroid disorder or goiter were selected for final analysis. Reference intervals were defined as 5th and 95th percentiles. Results . Reference intervals in the first, second, and third trimesters were as follows: TSH (0.2–3.9, 0.5–4.1, and 0.6–4.1 mIU/l), TT4 (8.2–18.5, 10.1–20.6, and 9–19.4  μ g/dl), and TT3 (137.8–278.3, 154.8–327.6, and 137–323.6 ng/dl), respectively. No correlation was found between TSH and TT4 or TT3. Significant correlation was found between TT4 and TT3 in all trimesters ( r = 0.35 , P 〈 0.001 ). Conclusion . The reference intervals of thyroid function tests in pregnant women differ among trimesters. Applying trimester-specific reference ranges of thyroid hormones is warranted in order to avoid misclassification of thyroid dysfunction during pregnancy.
    Type of Medium: Online Resource
    ISSN: 2090-8067 , 2042-0072
    URL: Article
    DOI: 10.1155/2013/651517
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2013
    detail.hit.zdb_id: 2549014-X
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  • 7
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    Management of Hyperthyroidism in Pregnancy: Comparison of Recommendations of American Thyroid Association and Endocrine Society
    Hindawi Limited ; 2013
    In:  Journal of Thyroid Research Vol. 2013 ( 2013), p. 1-6
    Details
    In: Journal of Thyroid Research, Hindawi Limited, Vol. 2013 ( 2013), p. 1-6
    Abstract: Appropriate diagnosis and treatment of hyperthyroidism during pregnancy are of outmost importance, because hyperthyroidism has major adverse impact on both mother and fetus. Since data on the management of thyroid dysfunction during pregnancy is rapidly evolving, two guidelines have been developed by the American Thyroid Association and the Endocrine society in the last 2 years. We compare here the recommendations of these two guidelines regarding management of hyperthyroidism during pregnancy. The comparison reveals no disagreement or controversy on the various aspects of diagnosis and treatment of hyperthyroidism during pregnancy between the two guidelines. Propylthiouracil has been considered as the first-line drug for treatment of hyperthyroidism in the first trimester of pregnancy. In the second trimester, consideration should be given to switching to methimazole for the rest of pregnancy. Methimazole is also the drug of choice in lactating hyperthyroid women.
    Type of Medium: Online Resource
    ISSN: 2090-8067 , 2042-0072
    URL: Article
    DOI: 10.1155/2013/878467
    Language: English
    Publisher: Hindawi Limited
    Publication Date: 2013
    detail.hit.zdb_id: 2549014-X
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  • 8
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    Serum Thyroid Peroxidase Antibody Level and Incident Hypertension in Iranian Men: A Suggestion for the Role of Thyroid Autoimmunity
    Bentham Science Publishers Ltd. ; 2020
    In:  Endocrine, Metabolic & Immune Disorders - Drug Targets Vol. 20, No. 10 ( 2020-12-02), p. 1711-1718
    Details
    In: Endocrine, Metabolic & Immune Disorders - Drug Targets, Bentham Science Publishers Ltd., Vol. 20, No. 10 ( 2020-12-02), p. 1711-1718
    Abstract: Dysfunction of the thyroid gland has profound effects on the cardiovascular system. Objective: We aimed to explore the relation of serum thyroid peroxidase antibody (TPO-Ab), as a marker of thyroid autoimmunity with incident hypertension among a euthyroid population. Methods: A total of 3681 participants (1647 men) entered the study. Multivariate Cox proportional hazard models were conducted to estimate the association between TPO-Ab and incident hypertension. Results: The mean age (standard deviation) of the participants was 37.5 (12.8) years. During a median follow-up of 12.2 years, 511 men and 519 women developed hypertension. The multivariable hazard ratios (HRs) and related 95% confidence intervals (CIs) of 1-unit increase in natural logarithm (ln) of TPO-Ab for incident hypertension were 1.09 (1.00-1.19), 1.03 (0.97-1.10), and 1.05 (1.00-1.11) for men, women, and total population, respectively. Moreover, considering the TPO-Ab status as a categorical variable (i.e. TPO-Ab positive or TPO-Ab negative), the multivariate-adjusted HRs (95% CIs) of TPO-Ab positivity for incident hypertension, were 1.33 (0.95-1.85), 1.12 (0.86-1.45) and 1.19 (0.97- 1.46) for men, women, and total population, respectively. Conclusion: Elevated serum TPO-Ab level can contribute to the development of hypertension among euthyroid men during a long follow-up; suggesting a role for thyroid autoimmunity.
    Type of Medium: Online Resource
    ISSN: 1871-5303
    URL: Article
    DOI: 10.2174/1871530320666200624163035
    Language: English
    Publisher: Bentham Science Publishers Ltd.
    Publication Date: 2020
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  • 9
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    Online Resource
    Does Motivational Interviewing Improve the Weight Management Process in Adolescents? A Systematic Review and Meta-analysis
    Springer Science and Business Media LLC ; 2022
    In:  International Journal of Behavioral Medicine Vol. 29, No. 1 ( 2022-02), p. 78-103
    Details
    In: International Journal of Behavioral Medicine, Springer Science and Business Media LLC, Vol. 29, No. 1 ( 2022-02), p. 78-103
    Type of Medium: Online Resource
    ISSN: 1070-5503 , 1532-7558
    URL: Article
    DOI: 10.1007/s12529-021-09994-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2027575-4
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  • 10
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    Subclinical thyroid dysfunction and incident diabetes: a systematic review and an individual participant data analysis of prospective cohort studies
    Oxford University Press (OUP) ; 2022
    In:  European Journal of Endocrinology Vol. 187, No. 5 ( 2022-11-01), p. S35-S46
    Details
    In: European Journal of Endocrinology, Oxford University Press (OUP), Vol. 187, No. 5 ( 2022-11-01), p. S35-S46
    Abstract: Few prospective studies have assessed whether individuals with subclinical thyroid dysfunction are more likely to develop diabetes, with conflicting results. In this study, we conducted a systematic review of the literature and an individual participant data analysis of multiple prospective cohorts to investigate the association between subclinical thyroid dysfunction and incident diabetes. Methods We performed a systematic review of the literature in Medline, Embase, and the Cochrane Library from inception to February 11, 2022. A two-stage individual participant data analysis was conducted to compare participants with subclinical hypothyroidism and subclinical hyperthyroidism vs euthyroidism at baseline and the adjusted risk of developing diabetes at follow-up. Results Among 61 178 adults from 18 studies, 49% were females, mean age was 58 years, and mean follow-up time was 8.2 years. At the last available follow-up, there was no association between subclinical hypothyroidism and incidence of diabetes (odds ratio (OR) = 1.02, 95% CI: 0.88–1.17, I2 = 0%) or subclinical hyperthyroidism and incidence of diabetes (OR = 1.03, 95% CI: 0.82–1.30, I2 = 0%), in age- and sex-adjusted analyses. Time-to-event analysis showed similar results (hazard ratio for subclinical hypothyroidism: 0.98, 95% CI: 0.87–1.11; hazard ratio for subclinical hyperthyroidism: 1.07, 95% CI: 0.88–1.29). The results were robust in all sub-group and sensitivity analyses. Conclusions This is the largest systematic review and individual participant data analysis to date investigating the prospective association between subclinical thyroid dysfunction and diabetes. We did not find an association between subclinical thyroid dysfunction and incident diabetes. Our results do not support screening patients with subclinical thyroid dysfunction for diabetes. Significance statement Evidence is conflicting regarding whether an association exists between subclinical thyroid dysfunction and incident diabetes. We therefore aimed to investigate whether individuals with subclinical thyroid dysfunction are more prone to develop diabetes in the long run as compared to euthyroid individuals. We included data from 18 international cohort studies with 61 178 adults and a mean follow-up time of 8.2 years. We did not find an association between subclinical hypothyroidism or subclinical hyperthyroidism at baseline and incident diabetes at follow-up. Our results have clinical implications as they neither support screening patients with subclinical thyroid dysfunction for diabetes nor treating them in the hope of preventing diabetes in the future.
    Type of Medium: Online Resource
    ISSN: 0804-4643 , 1479-683X
    URL: Article
    DOI: 10.1530/EJE-22-0523
    RVK:
    WA 15000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1485160-X
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