Less known aspects of central hypothyroidism: Part 1 – Acquired etiologies

Benvenga, Salvatore; Klose, Marianne; Vita, Roberto; Feldt‐Rasmussen, Ulla

doi:10.1016/j.jcte.2018.09.003

Cited by 12 publications

(12 citation statements)

References 109 publications

(188 reference statements)

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“…After a mean follow-up of 51.9 months [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , long-term control of hyperprolactinemia (92% vs. 72%) and hypogandism (78% vs. 83%) was attained in the majority of patients, independent of the primary treatment (TSS vs. DAs, respectively). The prevalence of secondary hypothyroidism and secondary adrenal insufficiency was not significantly altered compared to baseline, independent of the primary treatment strategy (i.e.…”

Section: Resultsmentioning

confidence: 99%

Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term

Andereggen

Frey

Andres

et al. 2021

Journal of Clinical & Translational Endocrinology

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Highlights High prolactin (PRL) levels are associated with weight gain and impaired metabolic profiles. Long-term control of hyperprolactinemia can be attained by first-line surgery and medical therapy. Normalization of PRL improves patients’ BMI and fasting glucose levels. Marginal changes in patients’ metabolic profiles are noted regardless of the primary therapy. Not dopamine agonists per se, but rather the control of hyperprolactinemia plays a role in metabolic profile alterations.

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Section: Resultsmentioning

confidence: 99%

Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term

Andereggen

Frey

Andres

et al. 2021

Journal of Clinical & Translational Endocrinology

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“…In conclusion, the prevalence of thyroid disease tended to be higher in our study than in previous general population studies, and the prevalence varied according to the type of pituitary disease. We should be aware that pituitary disease sometimes accompanies thyroid disease, and this accompanied thyroid disease may have a different underlying cause than what was originally suspected [33]. Pituitary diseases may mask thyroid disorders, and focusing on the pituitary problem can neglect the thyroid disease.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease

Kim

Cho

et al. 2019

JCM

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Thyroid disease mainly has a thyroid origin but can occasionally have a pituitary origin. Clinicians face several challenges when these conditions occur together. We aimed to determine the prevalence of thyroid disorders in patients undergoing trans-sphenoidal adenomectomy (TSA) for pituitary disease. We reviewed the medical records of patients undergoing TSA for pituitary disease between 2008 and 2017 at Severance Hospital. Thyroid disorders were categorized using blood test results and medical histories at the time of preoperative evaluation. Among 2202 patients, 44 (2%), 218 (9.9%), and 74 (3.4%) had hyperthyroidism, hypothyroidism, and post-thyroidectomy status before TSA, respectively. Among the 44 patients with hyperthyroidism, 30 (68.2%) had central hyperthyroidism. Among the 218 patients with hypothyroidism, 165 (75.7%) had central hypothyroidism. Central hypothyroidism was more common in patients with adrenocorticotropic hormone-secreting pituitary adenomas (aOR (adjusted odds ratio) 1.85), Rathke’s cleft cysts (aOR 2.34), and craniopharyngiomas (aOR 2.58) (all p < 0.05) than in those with nonfunctioning pituitary adenomas. Contrastingly, thyroid cancer had an increased prevalence in patients with growth hormone- (aOR 3.17), prolactin- (aOR 3.66), and thyroid-stimulating hormone-secreting (aOR 6.28) pituitary adenomas (all p < 0.05). Pituitary disease sometimes accompanies thyroid disorders; their characteristics vary according to the type of pituitary disease.

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“…Defects or damage to brain regions results in insufficient stimulation of the normal thyroid gland. Approximately 99.9% of cases of hypothyroidism are caused by primary hypothyroidism, but it depends on age 63,64 .…”

Section: Hypothyroidismmentioning

confidence: 99%

Interconnection between circadian clocks and thyroid function

et al. 2019

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Circadian rhythmicity is an approximately 24h cell-autonomous period driven by transcriptiontranslation feedback loops of specific genes, which are referred to as 'circadian clock genes'. In mammals, the central circadian pacemaker, which is located in the hypothalamic suprachiasmatic nucleus, controls peripheral circadian clocks. The circadian system regulates virtually all physiological processes, which are further modulated by changes in external environment, such as light exposure and timing of food intake. Chronic circadian disruption caused by shift work, travel across time zones or irregular sleep-wake cycles has long-term consequences on our health and is an important lifestyle factor that contributes to the risk of obesity, type 2 diabetes mellitus and cancer. Although the hypothalamic-pituitary-thyroid axis is under the control of the circadian clock via the suprachiasmatic nucleus pacemaker, daily TSH secretion profiles are disrupted in some patients with hypothyroidism and hyperthyroidism. Disruption of circadian rhythms has been recognized as a perturbation of the endocrine system and of cell cycle progression. Expression profiles of circadian clock genes are abnormal in well-differentiated thyroid cancer but not in the benign nodules or a healthy thyroid. Therefore, the characterization of the thyroid clock machinery might improve the preoperative diagnosis of thyroid cancer.

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Less known aspects of central hypothyroidism: Part 1 – Acquired etiologies

Cited by 12 publications

References 109 publications

Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term

Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term

Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease

Interconnection between circadian clocks and thyroid function

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