Endocrine Abstracts

We conducted a prospective study of 5784 subjects aged 65 or over, screened and identified in primary care. The cohort comprised 2934 women, 2850 men, mean age 73.5 years (range 63.5-98.6). All had TSH measured in a sensitive assay (normal range 0.4-5.5 mU/l), as well as free T4 (normal range 9-20 pmol/l), and resting 12-lead ECG. Atrial fibrillation (AF) was present in 4.81% of the cohort. The prevalence of AF showed significant variation with serum TSH concentrations, being ...

Thyroid dysfunction is common, particularly in the elderly, and has an important impact on morbidity and mortality, especially in this age group.Aim: We have investigated associations between thyroid function, presence of atrial fibrillation and cognitive function in a large general practice-based study conducted from December 2002-November 2004. Subjects with a previous history of thyroid disease or currently taking thyroxine or anti-thyroid drugs were ...

Thyroid disease - hyper- and hypothyroidism, together with goitre and thyroid cancer - is extremely common. The familial clustering of autoimmune diseases such as Graves' hyperthyroidism illustrates the genetic contribution to susceptibility; we have described advances in understanding of the role of the CTLA4, HLA and other immune response genes in this susceptibility. We have shown that hyperthyroidism results in increased mortality, especially from vascular disease. Develop...

Thyroid nodules and goitre are a common problem, with a very high prevalence evident from screening studies of the general population. In contrast, thyroid cancer is rare accounting for <1% of all new malignancies diagnosed in England and Wales each year. The challenge to the clinician is therefore to identify, amongst the large number of patients referred because of thyroid enlargement, the small proportion thyroid neoplasia. This differentiation is critical since most wit...

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Thyroid cancer is the commonest endocrine malignancy but there is much debate about the role of specific treatment modalities, including the extent of surgery, post-operative ablation with iodine-131, need for TSH-suppressive doses of thyroxine, role of serum thyroglobulin measurements and imaging during follow-up. Recent data have suggested poorer outcome for thyroid cancer in the UK than other countries and recent audits have highlighted shortcomings in patient management. T...

Hyperthyroidism is common affecting up to 2% of the UK population and the prevalence is highest in young and middle-aged women. Although patients may have clinical symptoms suggestive of hyperthyroidism, rates of undiagnosed hyperthyroidism range from 0.5 to 1.5%, especially in the elderly. We investigated 3563 UK patients to (i) assess the influence of ageing on clinical signs and symptoms and (ii) identify symptoms and signs indicating hyperthyroidism in different age groups...

We have previously shown Pituitary Tumor Transforming Gene (PTTG) and basic Fibroblast Growth Factor (FGF-2) to be upregulated in thyroid cancer. PTTG requires interaction with the protein PBF (PTTG Binding Factor) to stimulate FGF-2 secretion, and hence promote tumour angiogenesis and growth. We now report that PBF is also upregulated in hyperplastic and neoplastic thyroid tissues compared with normal thyroid (N=11) (2.6-fold in multinodular goitre (N=25, P=0.002), and 3.3-fo...

Graves' disease (GD) is an autoimmune disorder of the thyroid gland, of which the aetiology is unknown, but susceptibility to disease is thought to result from both genetic and environmental factors. Familial clustering data suggests that GD is a polygenic disorder, with laboratory studies identifying the HLA gene region and the CTLA-4 gene region as susceptibility loci. However, together the HLA region and the CTLA-4 gene regions only contribute about 50% towards the genetic ...

The transplacental passage of thyroid hormones (TH) from the maternal to fetal circulations is important for normal fetal development, particularly the fetal central nervous system. This is particularly so before the onset of endogenous fetal TH production from the second trimester of pregnancy. The human hemochorial placenta regulates the quantity of TH passing through and the complement of the different forms of TH to ensure requisite levels are present in the fetus for each...