MECHANISMS IN ENDOCRINOLOGY: Impact of isolated TSH levels in and out of normal range on different tissues

Frőhlich, Eleonore; Wahl, Richard L.

doi:10.1530/eje-15-0713

Cited by 17 publications

(11 citation statements)

References 135 publications

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“…Finally, TSH level is intensively related to iodine status, and iodine deficiency can result in increased TSH level (17,73). Some studies found that TSH have an important role in regulating both the function of the immune system and immune response (74,75,76,77,78,79,80,81). Therefore, the increased TSH level among hypothyroidism individuals caused by iodine deficiency may induce aberrant immune response and further promote the development of TAI.…”

Section: Discussionmentioning

confidence: 99%

U-shaped relationship between iodine status and thyroid autoimmunity risk in adults

Wang

et al. 2019

European Journal of Endocrinology

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Background Iodine status has long been regarded as an environmental determinant for thyroid dysfunction, but its relationship with thyroid autoimmunity (TAI) is still controversial. Our study aimed to elucidate the relationship between iodine status and TAI through both a population-based study and a dose–response meta-analysis of eligible epidemiological studies. Methods A population-based, cross-sectional study was firstly carried out, which enrolled a total of 2808 Chinese adults. Odds ratio (OR) with 95% confidence interval (95% CI) was calculated through logistic regression analysis. A dose–response meta-analysis of eligible epidemiological studies was also carried out. Results The cross-sectional study showed an U-shaped relationship between iodine intake and TAI in adults. Compared with those with more than adequate iodine status, individuals with iodine deficiency, adequate iodine status and iodine excess all had higher risk of TAI, and the adjusted ORs were 1.50 (95% CI 1.03–2.17, P = 0.032), 1.50 (95% CI 1.09–2.07, P = 0.013) and 1.68 (95% CI 1.11–2.53, P = 0.014), respectively. The dose–response meta-analysis included 22 epidemiological studies with a total of 69,987 participants and further validated the U-shaped relationship between iodine intake and TAI in adults, which proved the significantly increased risk of TAI among individuals with either iodine deficiency or iodine excess. Stratified analysis of studies with low risk of confounding bias also identified similar findings. Conclusion The study suggests an U-shaped relationship between iodine intake and TAI in adults, and both iodine deficiency and iodine excess are risk factors of TAI in adults. The underlying mechanisms need to be elucidated in future studies.

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Section: Discussionmentioning

confidence: 99%

U-shaped relationship between iodine status and thyroid autoimmunity risk in adults

Wang

et al. 2019

European Journal of Endocrinology

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“…Moreover, thyrotropin‐releasing hormone (TRH), thyroid‐stimulating hormone (TSH) and thyroid hormone receptors were shown to be present in monkey uterus . Another study described a smooth muscle cells proliferation after stimulation by TSH …”

Section: Discussionmentioning

confidence: 99%

“…Moreover, thyrotropin-releasing hormone (TRH), thyroid-stimulating hormone (TSH) and thyroid hormone receptors were shown to be present in monkey uterus 38. Another study described a smooth muscle cells proliferation after stimulation by TSH 39. Somatic genetic mutations play a part in the molecular pathogenesis of both fibroids (MED12 mutations)12 and differentiated thyroid cancer (eg, BRAF mutations) 1.…”

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confidence: 99%

Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort

Guenego

Mesrine

Dartois

et al. 2018

Clinical Endocrinology

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Summary Background Thyroid cancers are threefold more frequent in women than in men. A role of reproductive or hormonal factors has been suggested but with contradictory results. We investigated potential associations between history of hysterectomy, with or without oophorectomy, and history of benign gynaecological disease (uterine fibroids, endometriosis) and the incidence of differentiated thyroid cancer, in a large French prospective cohort. Methods A total of 89 340 women from the E3N cohort were followed up between 1990 and 2012. Gynaecological diseases treated by surgery were self‐reported. Thyroid cancers were validated by histological reports. Time‐dependent covariates included smoking status, BMI and history of benign thyroid disease. Cox proportional hazard models with age as timescale were used to estimate Hazard Ratios (HR) and 95% confidence intervals (CI). Results A total of 412 cases of thyroid cancer were diagnosed during follow‐up. A history of hysterectomy was associated with an increased risk of differentiated thyroid cancer (adjusted HR=2.05; 95%CI: 1.65‐2.55). The association was not altered after further adjustment for reproductive factors. Endometriosis, uterine polyps, ovarian cysts and oophorectomy without hysterectomy were not associated with the risk of thyroid cancer. A history of fibroids was also significantly related to the risk of thyroid cancer over the follow‐up period (adjusted HR=1.91; 95%CI: 1.50‐2.44) and the increased risk persisted after adjustment for history of hysterectomy. Conclusions Women who had either a history of fibroids or hysterectomy had an increased risk of differentiated thyroid cancer. These findings suggest shared biological mechanisms between fibroids and thyroid cancer, which deserve to be further dissected.

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“…Smooth muscle cell proliferation has been reported after TSH stimulation. 36 It was found that thyroid hormone receptor in rat uterus, 37 thyrotropin-releasing hormone, TSH, thyroid hormone receptor in monkey uterus, 38 and binding site presumed to be T3 receptor in human myometrium. 39 Elevated TSH, as with hypothyroidism, might increase the likelihood of developing uterine broids.…”

Section: Third What Can Explain the Relationship Between Uterine Broids And Hypothyroidism?mentioning

confidence: 99%

Association between Uterine Fibroid and Benign Thyroid Disease: Nationwide Population-Based Cohort Study

Yuk

Kim

2021

Preprint

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Background Uterine fibroid and benign thyroid disease are common diseases in women. Objective This study aims to evaluate both diseases are related. Study Design: We established the uterine fibroid group according to diagnosis codes and surgery codes using the Korea National Health Insurance data from 2007 to 2020. All women from 20 to 50 years old with uterine myomectomy from 2007 to 2020 were identified (uterine fibroids group). For controls, 1:1 propensity score matching was performed on age at 5-year intervals, socio-economic status (SES), region, Charlson comorbidity index (CCI), and menopause (control group). Thyroid disease cases were selected using the thyroid disease diagnosis code and thyroid-associated laboratory examination. Results A total of 21,246 patients were extracted from the uterine fibroid and control groups, respectively. The median ages of each group were 40 (range, 35 ~ 44) years and 40 (range, 35 ~ 44) years old. Benign thyroid disease was 469 (2.2%) in the uterine fibroid group and 246 (1.2%) in the control group. Among benign thyroid diseases, hypothyroidism was the largest in both groups. A non-toxic single thyroid nodule followed it. The uterine fibroid group had a higher incidence of hypothyroidism {relative risk (RR) 1.943, 95% CI 1.5-2.516), autoimmune thyroid disease (RR 1.59, 95% CI 1.065–2.373), goiter (RR 1.773, 95% CI 1.051–2.99), nontoxic single thyroid nodule (RR 2.213, 95% CI 1.685–2.907), other thyroid disease (RR 2.31, 95% CI 1.608–3.317), and total thyroid disease (RR 1.905, 95% CI 1.63–2.226) in logistic regression analysis adjusted for age, SES, region, CCI, and menopause compared than the control group. The uterine fibroid group had a higher risk of hypothyroidism (HR 1.431, 95% CI 1.023–2.001) and nontoxic single thyroid nodule (HR 1.511, 95% CI) in cox regression adjusted for age, SES, region, CCI, and menopause. Conclusions Uterine fibroid might be associated with hypothyroidism and thyroid nodule.

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MECHANISMS IN ENDOCRINOLOGY: Impact of isolated TSH levels in and out of normal range on different tissues

Cited by 17 publications

References 135 publications

U-shaped relationship between iodine status and thyroid autoimmunity risk in adults

U-shaped relationship between iodine status and thyroid autoimmunity risk in adults

Relation between hysterectomy, oophorectomy and the risk of incident differentiated thyroid cancer: The E3N cohort

Association between Uterine Fibroid and Benign Thyroid Disease: Nationwide Population-Based Cohort Study

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