Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis

Wiersinga, Wilmar M.; Poppe, Kris; Effraimidis, Grigoris

doi:10.1016/s2213-8587(23)00005-0

Cited by 67 publications

(38 citation statements)

References 142 publications

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“…ATDs such as MMI and PTU inhibit TPO activity (36, 37). Our results reinforce a conventional theory that ATDs decrease thyroid hormone secretion by inhibiting TPO (38).…”

Section: Discussionsupporting

confidence: 89%

Transcriptomic Landscape of Hyperthyroidism in Mice Overexpressing Thyroid Stimulating Hormone

Yamauchi,

Sugawa,

Hakata

et al. 2023

Preprint

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Hyperthyroidism is a condition with excessive thyroid hormone secretion. Activation of thyroid stimulating hormone receptor (TSHR) fundamentally leads to hyperthyroidism. The details of TSHR signaling remain to be elucidated. We conducted transcriptome analyses for hyperthyroid mice that we generated by overexpressing TSH. TSH overexpression via hydrodynamic gene delivery with pLIVE-TSHBand pLIVE-CGAvectors consistently caused hyperthyroidism and goiters for at least 4 weeks in C57BL/6J mice. RNA sequencing analysis of their thyroid glands revealed that thiamazole slightly changed the thyroid transcriptome, which reinforces a conventional theory that thiamazole decreases thyroid hormone secretion via inhibition of thyroid peroxidase activity. Meanwhile, TSH overexpression drastically changed the thyroid transcriptome. In particular, enrichment analyses identified the cell cycle, phosphatidylinositol-3 kinase/Akt pathway, and Ras-related protein 1 pathway as possibly associated with goiter development. Regarding the role of TSHR signaling in hyperthyroidism, it is noteworthy thatSlc26a4was exclusively upregulated among genes crucial to thyroid hormone secretion at both 1 and 4 weeks after hydrodynamic gene delivery. To verify the relationship between this upregulation and hyperthyroidism, we overexpressed TSH inSlc26a4knockout mice. TSH overexpression caused hyperthyroidism inSlc26a4knockout mice, equivalent to that in control mice. To summarize, we analyzed hyperthyroid mice generated by TSH overexpression. We did not observe significant changes in known genes and pathways involved in thyroid hormone secretion. Thus, our datasets might include candidate genes that have not yet been identified as regulators of thyroid function. Our transcriptome datasets regarding hyperthyroidism can contribute to future research on TSHR signaling.

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“…ATDs such as MMI and PTU inhibit TPO activity (36, 37). Our results reinforce a conventional theory that ATDs decrease thyroid hormone secretion by inhibiting TPO (38).…”

Section: Discussionsupporting

confidence: 89%

Transcriptomic Landscape of Hyperthyroidism in Mice Overexpressing Thyroid Stimulating Hormone

Yamauchi,

Sugawa,

Hakata

et al. 2023

Preprint

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“…GD is an organ-specific autoimmune condition that results in hyperthyroidism, which accounts for 70% of cases presenting with hyperthyroidism. 20 SLE and GD frequently cooccur, with elevated incidence for both GD among SLE individuals and subsequent SLE development in GD patients. [21][22][23] This study confirmed a significant correlation between genetic variations strongly associated with SLE in the East Asian population and an elevated risk of GD occurrence through univariable MR analysis (OR 1.12).…”

Section: Discussionmentioning

confidence: 99%

The potential causal association between systemic lupus erythematosus and endocrine and metabolic disorders in the East Asian population: A bidirectional two-sample Mendelian randomization study

Wang,

Zhang,

Chen

et al. 2024

Lupus

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Objectives Observational studies indicate a significant correlation between systemic lupus erythematosus (SLE) and endocrine and metabolic disorders, but the causal association between SLE and endocrine and metabolic disorders remains unclear due to the reverse causality and confounding biases commonly presented in conventional observational research. This study endeavors to uncover the causal association between SLE and three common endocrine and metabolic disorders, including Graves’ disease (GD), type 2 diabetes mellitus (T2DM), and osteoporosis (OP). Methods We used genome-wide association study data for SLE and three endocrine and metabolic disorders in an East Asian population, employing bidirectional two-sample Mendelian randomization (MR) analysis and sensitivity analysis to ascertain the causal association between SLE and endocrine and metabolic disorders. Results A multiplicative random-effect inverse-variance weighted approach revealed a significant positive correlation between SLE and an elevated risk of GD with an odds ratio (OR) of 1.12 (95% CI: 1.04–1.22, p < .01), and inverse-variance weighted (IVW) analysis also indicated that SLE increased the risk of OP with an OR of 1.035 (95% CI: 1.003–1.068, p < .05). Additionally, GD causally affected SLE in an IVW analysis after Bonferroni correction, with an OR of 1.33 (95% CI: 1.19–1.49, p < .05/3), but the application of multivariable MR analysis resulted in the absence of a causal association of GD on SLE (OR 1.047, 95% CI: 0.952–1.151, p > .05). Lastly, the robustness and validity of the findings were verified through a sensitivity analysis. Conclusions We confirmed that SLE has a causal effect on GD as well as OP, but no evidence exists to substantiate a causal link between SLE and T2DM. Our study offers valuable contributions for uncovering the etiology of SLE and endocrine and metabolic disorders and furthering disease risk research while providing potential targets for disease monitoring and therapeutic intervention.

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“…The dysfunction is also implicated in increasing the cardiovascular risk of the patient, specifically for atrial fibrillation [2]. For these reasons, treatment is indicated, and radioiodine treatment (RIT) and surgery offer two well established modalities of definite treatment [3]. Both options have a high success rate, in both relieving the hyperthyroid symptoms and preventing adverse cardiovascular risks associated with untreated hyperthyroidism [4].…”

Section: Introductionmentioning

confidence: 99%

Effect of Radioiodine Treatment on Quality of Life in Patients with Subclinical Hyperthyroidism: A Prospective Controlled Study

Larisch,

Midgley,

Dietrich

et al. 2024

Nuklearmedizin

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Radioiodine treatment (RIT) has a high success rate in both the treatment of hyperthyroidism and improving the quality of life (QoL) of symptomatic patients. In asymptomatic patients with subclinical hyperthyroidism thyroid related QoL outcomes are less well known. Methods Study aim was to evaluate thyroid-related QoL in patients with subclinical hyperthyroidism mostly due to toxic nodular goitre undergoing RIT, compared to a control group of euthyroid subjects. Study design was monocentric, prospective, controlled. Fifty control subjects were enrolled and 51 RIT patients. Most subjects were examined at least twice at an interval of 6 months, with visits immediately before and 6 months after treatment in the RIT group. QoL was estimated with the ThyPRO questionnaire, using its composite scale as primary outcome. Treatment effect was the mean adjusted difference (MAD) between groups over time, using repeated? measures mixed? effects models. Results TSH concentrations were lower in the RIT group prior to treatment and recovered thereafter slightly above the level of the control group. Correspondingly, QoL improved significantly after 6 months from a worse level in the RIT group, compared to controls (MAD –10.3 [95% CI –14.9, –5.7], p<0.001). QoL improvements were strong for general items, but less pronounced for the hyperthyroid domain. Compared to controls, thyroid volume, thyroid functional capacity (SPINA-GT) and deiodinase activity (SPINA-GD) were significantly reduced in the RIT group. Conclusion Patients with subclinical hyperthyroidism improve both biochemically and in their QoL after RIT, compared to controls. QoL assessment should have a wider role in clinical practice to complement biochemical tests and help with treatment decisions.

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Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis

Cited by 67 publications

References 142 publications

Transcriptomic Landscape of Hyperthyroidism in Mice Overexpressing Thyroid Stimulating Hormone

Transcriptomic Landscape of Hyperthyroidism in Mice Overexpressing Thyroid Stimulating Hormone

The potential causal association between systemic lupus erythematosus and endocrine and metabolic disorders in the East Asian population: A bidirectional two-sample Mendelian randomization study

Effect of Radioiodine Treatment on Quality of Life in Patients with Subclinical Hyperthyroidism: A Prospective Controlled Study

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