Thyroid最新文献

{"title":"A Phase 2 Study of XP-8121: Once-Weekly Subcutaneous Levothyroxine Sodium for the Treatment of Hypothyroidism in Adults.","authors":"Valentina Conoscenti, Robbie Huang, Diane Rudisill, Richard Fitch, Frances Broyles, Matthew David Ettleson, Antonio C Bianco","doi":"10.1177/10507256261454211","DOIUrl":"10.1177/10507256261454211","url":null,"abstract":"<p><strong>Background: </strong>The standard of care for hypothyroidism treatment worldwide is daily oral levothyroxine (LT4) sodium. Limitations associated with daily oral administration highlight the need for alternative formulations to address challenges in maintaining euthyroidism. XP-8121 (LT4 sodium for subcutaneous [SC] administration) is a ready-to-use, liquid formulation of LT4 intended for once-weekly administration, offering an alternative hormone replacement approach by bypassing the gastrointestinal tract. This study assessed the safety, tolerability, and target dose conversion factor from oral LT4 to XP-8121 SC in adult participants.</p><p><strong>Participants and methods: </strong>This Phase 2, multicenter, nonrandomized, open-label, single-arm, self-controlled study (NCT05823012) evaluated XP-8121 SC in 46 adults with hypothyroidism receiving a consistent dose of oral LT4 for at least 3 months prior to screening, with documented normal thyrotropin (TSH) levels at least 3 months prior to screening and normal free thyroxine (fT4) at screening. The weekly XP-8121 SC dose was initiated at 50% of the target dose and titrated every 2 weeks for up to 8 weeks based on individual response using fT4 trough concentrations. Following titration, participants continued the established dose during a 4-week maintenance period.</p><p><strong>Results: </strong>Of the 46 participants enrolled, 39 completed the study. The majority were female (37; 80.4%) and identified as White (44; 95.7%). The final dose conversion factor point estimate ranged from 4.02 (90% confidence interval [CI]: 3.79-4.27) to 4.24 (90% CI: 4.06-4.42), supporting a conversion factor of approximately four times the daily oral LT4 dose when transitioning to XP-8121 SC. Although participants were initially underdosed during titration, TSH normalization was observed in 79.5% and fT4 normalization in 100% among those who completed the study on a consistent dose (unchanged for 6 weeks) at the end of maintenance. Overall, 78 treatment-emergent adverse events (TEAEs) were reported in 30 participants (65.2%) who received at least one dose of XP-8121 SC; fatigue (21.7%) and injection-site pain (10.9%) were the most common TEAEs. A majority of participants who completed the study reported higher satisfaction, convenience, and perceived effectiveness with once-weekly XP-8121 SC and expressed preference over daily oral LT4.</p><p><strong>Conclusions: </strong>Once-weekly XP-8121 SC was generally well-tolerated in all treated participants and supported a dose conversion factor of four times the daily oral LT4 dose.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"853-861"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Hormones Exhibit Promising Prognostic and Therapeutic Potential in Autosomal Dominant Polycystic Kidney Disease.","authors":"Angelo Michele Lavecchia, Laura Locatelli, Matias Trillini, Alice Del Vecchio, Domenico Cerullo, Alessandro Villa, Tobia Peracchi, Valerio Brizi, Sara Buttò, Daniela Corna, Laura Brunelli, Chiara Guarinoni, Nadia Rubis, Giuseppe Remuzzi, Christodoulos Xinaris","doi":"10.1177/10507256261460200","DOIUrl":"10.1177/10507256261460200","url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disorder characterized by progressive cyst development and renal dysfunction. While thyroid hormones (THs) are known to regulate key pathways in various kidney diseases, their role in ADPKD pathobiology and therapeutic potential remains unexplored. Here, we aimed to elucidate the role of THs in ADPKD and evaluate whether their pharmacological modulation could serve as a therapeutic strategy.</p><p><strong>Methods: </strong>Patient-derived renal epithelial cells were used to engineer 3D polycystic tubules and to test the anti-cystogenic effects of THs and their analogs. The therapeutic efficacy of thyroxine (T4) in reducing cyst formation and delaying disease progression was assessed <i>in vivo</i> using PCK rats, an animal model of ADPKD. Lastly, serum THs levels were measured in 90 ADPKD patients enrolled in the REORIENTED clinical study and correlated with estimated glomerular filtration rate to explore their clinical relevance (Clinical Trial Gov NCT05646420).</p><p><strong>Results: </strong>Mechanistically, thyroxine inhibits cyst growth by modulating proliferative, metabolic and ferroptotic pathways through αvβ3 integrin binding. In PCK rats, an animal model of ADPKD, T4 administration decreased kidney weight and significantly reduced macrocystic area (%, Vehicle 9.255 ± 2.654 vs. T4 1.945 ± 0.850, <i>p</i> < 0.05). Clinical data from ADPKD patients showed that altered TH serum levels correlate with disease severity: in the overall population of the study reverse triiodothyronine (rT3, a T3's metabolite) levels inversely correlate with renal function (<i>R</i>² = 0.159, <i>r</i> = -0.397, <i>p</i> < 0.001), while free triiodothyronine (fT3) levels show a positive correlation (<i>R</i>² = 0.110, <i>r</i> = 0.332, <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>This study reveals that THs contribute to ADPKD progression and identifies them as potential prognostic and therapeutic agents. By modulating multiple pathogenic pathways, THs may offer a novel, multi-targeted approach to reduce cyst growth and preserve renal function. These findings further support the development of personalized, hormone-based treatments and more refined stratification in the clinical management of ADPKD.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"840-852"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148259723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Hypothyroidism on Short-Term and Long-Term Outcomes of Coronary Artery Bypass Graft Surgery.","authors":"Vandrize Meneghini, Fabyan Esberard de Lima Beltrão, Anis Ismail, Salim Hayek, George Golovko, Kamil Khanipov, Matthew D Ettleson, Isabela M Bensenor, Antonio C Bianco","doi":"10.1177/10507256261460759","DOIUrl":"10.1177/10507256261460759","url":null,"abstract":"<p><strong>Background: </strong>Thyroid dysfunction has been associated with adverse postoperative outcomes, but little is known about its effects on patients undergoing coronary artery bypass grafting (CABG). Here, our goals were (1) to evaluate the incidence of CABG in patients with hypothyroidism receiving thyroid hormone replacement therapy, and (2) to assess short-term and long-term outcomes in patients with hypothyroidism undergoing CABG compared with controls without thyroid disease, and (3) to determine whether abnormal preoperative thyroid-stimulating hormone (TSH) levels modify postoperative surgical risk in this patient population.</p><p><strong>Methods: </strong>Retrospective longitudinal study using the TriNetX Global Collaborative Network database. The incidence of CABG was evaluated in about 1.23 million patients with hypothyroidism during a 20-year observation period (median of 4.4 ± 5.9). Post-CABG outcomes, including mortality, cardiovascular events, and postsurgical complications, were evaluated in 6557 patients with hypothyroidism over 10 years after 1:1 propensity score-matching.</p><p><strong>Results: </strong>Over 20 years, patients with a diagnosis of hypothyroidism had a higher incidence of CABG compared with controls (0.27% vs. 0.22%; hazard ratio [HR] 1.08; confidence interval [CI]: 1.03-1.14). Among patients who underwent CABG, the diagnosis of hypothyroidism was associated with mild increased risk of short-term postsurgical infections (HR:1.10, CI:1.01-1.20), CABG-specific complications (HR: 1.24, CI: 1.08-1.42), and critical care utilization (HR:1.14, CI:1.07-1.21). During long-term follow-up, these patients were at increased risk of incident heart failure (HR:1.15, CI:1.04-1.28), stroke (HR:1.18, CI:1.01-1.39), and major adverse cardiovascular events (MACE) (HR:1.15, CI:1.01-1.29). Sensitivity analysis, including only patients with hypothyroidism diagnosis, showed that abnormal preoperative TSH levels, particularly those with elevated TSH, had a higher risk of short-term mortality and long-term embolic events.</p><p><strong>Conclusions: </strong>Hypothyroidism is associated with a higher incidence of coronary disease requiring CABG and increased risks of postoperative complications, heart failure, stroke, and MACE. These findings support the potential value of preoperative thyroid function assessment and optimization to mitigate postoperative complications and improve surgical outcomes in this high-risk group.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"862-871"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild Thyroid Eye Disease-The Most Common yet the Least Studied Presentation of Thyroid Eye Disease.","authors":"Maria-Cristina Burlacu, Tomasz Bednarczuk, Vickie Lee, Petros Perros","doi":"10.1177/10507256261464556","DOIUrl":"10.1177/10507256261464556","url":null,"abstract":"<p><strong>Background: </strong>Mild thyroid eye disease (TED) is the most common form of TED, yet it is the least studied. Uncertainties about the natural history and prevention, and underfunding for clinical research, are an obstacle to improving the management of this important group of patients.</p><p><strong>Summary: </strong>The available evidence suggests that the prevalence of mild TED can reach up to two-thirds of all cases, depending on the expertise of the assessor and the criteria used for diagnosis. Prevalent symptoms and signs of mild TED predominantly arise from lid changes, soft tissue involvement and ocular surface disease, but disease presentation is heterogeneous and in some patients proptosis and eye motility changes may be underrated with the current classification. Little is known about the impact of the various manifestations of mild disease on patients' risk of progression and quality of life (QoL). Although in most patients with mild TED the disease remits spontaneously, some patients progress, and a significant proportion evolve to persistent, inactive TED. Current therapeutic options for these patients are based on scarce, low-to-moderate quality and sometimes conflicting evidence, resulting in significant differences in the management of mild TED in different countries and by different specialists. Among the most recommended therapeutic interventions, selenium supplementation was mainly studied in selenium-insufficient populations with active mild TED and it lacks efficacy in longstanding, inactive disease. The use of immunosuppressive drugs and targeted therapies for mild TED are commonly reported by surveys of medical professionals in a clinical setting, but the indication and efficacy of these agents in mild TED remain unclear.</p><p><strong>Conclusions: </strong>Mild TED has a significant psychosocial and functional burden that should be reconsidered and addressed by local, systemic or surgical treatments in an individualized manner. Given the overall effect on QoL and the socioeconomic impact, it is of immediate importance to highlight the knowledge gaps and the need for research in mild TED.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"817-826"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148346327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulating Thyrotropin Receptor Antibodies Enhance the Expression of Both Thyrotropin Receptors and Insulin-Like Growth Factor 1 Receptors in Fibroblasts.","authors":"Pingping Xiang, Mihaly Mezei, Rauf Latif, Terry F Davies","doi":"10.1177/10507256261463222","DOIUrl":"10.1177/10507256261463222","url":null,"abstract":"<p><strong>Background: </strong>Thyrotropin (TSH) and insulin-like growth factor 1 (IGF-1) signals have been shown to be additive in their action on thyroid cells and fibroblasts, and this coordination emphasizes the role of TSH receptor (TSHR) and IGF-1 receptor (IGF-1R) signaling exerted by stimulating TSHR antibodies in patients with thyroid eye disease (TED). Here, we have reanalyzed the influence of TSHR autoantibodies on TSHR and IGF-1R expression in a fibroblast model.</p><p><strong>Methods: </strong>We developed a new method to assess TSHR expression using a hinge-region monoclonal antibody (MC-1) that does not interfere with TSH or TSHR antibodies. Using molecular dynamic simulations, we first assessed access to the binding sites for TSH and TSHR antibodies within the leucine-rich repeat region of the TSHR ectodomain in the presence of MC-1 binding. 3T3-L1 fibroblasts and human orbital fibroblasts were treated with increasing doses of TSH or the stimulating TSHR antibody M22. TSHR and IGF-1R expressions were measured by flow cytometry and real-time quantitative polymerase chain reaction (RT-qPCR), with 3T3-L1 cell differentiation confirmed by Oil Red O staining. To explore mechanisms of TSH- and M22-induced receptor upregulation, we assessed the effects of inhibiting protein synthesis and endocytosis.</p><p><strong>Results: </strong>TSH ligand induced a dose-dependent increase in detectable expression of the TSHR as measured using MC-1 binding. Furthermore, parallel assessment of IGF-1R expression showed a similar dose-dependent increase in expression induced by TSH. Studies with stimulating TSHR antibody (M22) also demonstrated a similar increase in TSHR and IGF-1R expression peaking at 48 hours. These data could not be explained by transcriptional changes as measured by RT-qPCR. In addition, analysis of the effect of protein synthesis inhibition failed to reduce TSHR and IGF-1R induction. However, inhibition of endocytosis markedly reduced enhancement of TSHR and IGF-1R expression.</p><p><strong>Conclusions: </strong>These data strengthen the role of TSHR antibodies in TED by showing that they enhance TSHR and IGF-1R expression in fibroblasts, helping to explain their additive retroorbital signaling. This enhancement is largely driven by receptor recycling, which can be blocked by inhibiting endocytosis and may be therapeutically targeted. The dual increase in both receptors also supports prior evidence of TSHR/IGF-1R complex formation.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"903-911"},"PeriodicalIF":6.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148353600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sneak Peek of the 2026 American Thyroid Association Annual Meeting, November 4-7 in Philadelphia.","authors":"Michael W Yeh, Sara Ahmadi","doi":"10.1177/10507256261471380","DOIUrl":"https://doi.org/10.1177/10507256261471380","url":null,"abstract":"","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"10507256261471380"},"PeriodicalIF":6.6,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148472954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Evaluation of Follow-Up De-Escalation to Primary Care in Differentiated Thyroid Cancer with Excellent Response to Therapy.","authors":"Pablo Fernández Velasco, Beatriz Torres, Lucia Estévez Asensio, Alfonso Cocho Cuesta, Maria de la O Nieto de la Marca, Ana Ortolá Buigues, Emilia Gómez Hoyos, Daniel de Luis Román, Gonzalo Díaz Soto","doi":"10.1177/10507256261454209","DOIUrl":"10.1177/10507256261454209","url":null,"abstract":"<p><strong>Background: </strong>Dynamic risk stratification (DRS) enables response-adapted follow-up in differentiated thyroid carcinoma (DTC). However, prospective data supporting surveillance de-escalation and discharge to primary care (PC) after an excellent response (ER) is lacking.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study with a prospectively conducted postdischarge reassessment, including 154 patients with DTC treated with total thyroidectomy, with or without radioiodine ablation, who completed ≥5 years of specialist follow-up and were discharged to PC after achieving ER. A small subset (<i>n</i> = 9) of clinically stable patients was also discharged despite a persistent indeterminate response (IR), based on clinical judgment. Patients underwent a standardized reassessment ≥5 years after discharge to PC. DRS was assessed at three predefined time points 6 months after initial therapy, final predischarge specialist visit, and postdischarge reassessment. Outcomes included recurrence, additional interventions, real-world PC follow-up practices, referrals back to specialist care, and patient-reported outcomes collected at reassessment using a study-specific 5-point Likert-type questionnaire.</p><p><strong>Results: </strong>Baseline American Thyroid Association-2025 recurrence risk was low 78/154 (50.6%), intermediate-low 44/154 (28.6%), intermediate-high 23/154 (14.9%), and high 9/154 (5.8%). ER increased from 118/154 (76.6%) at 6 months to 145/154 (94.2%) at predischarge and to 148/154 (96.1%) at postdischarge reassessment (<i>p</i> < 0.001). At last predischarge visit, 9/154 (5.8%) had an IR, decreasing to 6/154 (3.9%) at postdischarge reassessment. No biochemical or structural recurrences were observed over a mean postdischarge follow-up of 70.3 ± 10.6 months. All non-ER findings at reassessment occurred exclusively in patients already classified as IR at discharge, with no deterioration from ER. During specialist follow-up, 8/154 (5.2%) required additional interventions. PC surveillance was characterized by low-intensity follow-up, with thyroglobulin testing in 11/154 (7.1%), no routine neck ultrasound, and stable levothyroxine dosing. Premature re-referral to specialist care occurred in 13/154 (8.4%) without evidence of recurrence. Despite favorable outcomes, 66/154 (42.9%) reported high fear of recurrence and 141/154 (91.6%) preferred specialist follow-up.</p><p><strong>Conclusions: </strong>Our findings suggest that patients with DTC who complete ≥5 years of specialist follow-up and achieve ER may be safely transitioned to PC. ER represents a stable clinical state, with minimal risk of clinically meaningful recurrence even with markedly reduced biochemical and imaging surveillance. These findings support a response-adapted long-term care model centered in PC, focused on thyroid hormone replacement and TSH monitoring. Further studies are warranted to confirm these findings.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"729-739"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148017409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Predictors of Poor Emotional Functioning in Patients with Differentiated Thyroid Carcinoma.","authors":"Gerasimos P Sykiotis, Athina Mageiropoulou, Akram Al-Ibraheem, Monica Pinto, Ioannis Iakovou, Arild Andre Østhus, Eva Gamper, Eva Hammerlid, Laura Deborah Locati, Ricardo Ribeiro Gama, Giuseppe Fanetti, Naomi Kiyota, Juan Ignacio Arraras, Johanna Inhestern, Georgios Ioannidis, Rita Canotilho, Olga Husson, Guy Andry, Harald Rimmele, Matthias Buettner, Katherine J Taylor, Susanne Singer","doi":"10.1177/10507256261442504","DOIUrl":"10.1177/10507256261442504","url":null,"abstract":"<p><strong>Background: </strong>The health-related quality of life (HRQoL) of patients with differentiated thyroid carcinoma (DTC), especially their mental health, can be compromised by various factors beyond disease prognosis and treatment stage. However, predictors of poor emotional functioning (EF) in DTC patients have not been thoroughly studied. To inform targeted interventions that could improve or preserve HRQoL in patients with DTC, this study aimed to identify predictors of impaired EF, and particularly modifiable factors.</p><p><strong>Methods: </strong>Data analyzed were from the phase IV international validation study of the European Organization for Research and Treatment of Cancer thyroid cancer-specific HRQoL questionnaire (QLQ-THY34). Patients (<i>n</i> = 196) were assessed at three timepoints before treatment (t1), 6 weeks after the start of treatment (t2), and 6 months after t2 (t3). Multilevel, multivariable logistic regression models were used to assess the likelihood of impaired EF at t3 according to predefined potential predictors at t1 and t2.</p><p><strong>Results: </strong>Impaired EF at t1 or t2 predicted impaired EF at t3. Exhaustion, head and neck discomfort and body image issues were significantly associated with poor EF at t3. More specifically, temporal changes of these three variables from t1 to t2 were independent predictors of poor EF at t3 with an odds ratio of 1.04 (<i>p</i> < 0.001), 1.01 (<i>p</i> = 0.04), and 1.01 (<i>p</i> = 0.001) per score point, respectively. There was no evidence that worry about important others, lacking social support, sex, stage, or Karnofsky performance score are associated with EF at t3.</p><p><strong>Conclusions: </strong>Exhaustion, head and neck discomfort, and body image concerns emerged as modifiable factors that predict future impaired EF in patients with DTC undergoing treatment. These factors could be targeted in prehabilitation, rehabilitation or other interventional programs to potentially improve or preserve patients' EF.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"740-749"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sexual Function and Depressive Symptoms in Premenopausal Women with Differentiated Thyroid Cancer: A Cross-Sectional Study.","authors":"Ahmet Numan Demir, Serdar Sahin, Didem Gulhan, Ali Kaan Ozcelik, Ali Tunc, Mehmet Umut Capar, Cem Sulu, Dildar Konukoglu, Mustafa Sait Gonen, Pinar Kadioglu","doi":"10.1177/10507256261427804","DOIUrl":"10.1177/10507256261427804","url":null,"abstract":"<p><strong>Background: </strong>Differentiated thyroid carcinoma (DTC) is the most common endocrine malignancy, disproportionately affecting women. Despite excellent survival outcomes, DTC treatment, particularly long-term thyrotropin (TSH) suppression therapy, has been associated with differences in psychological well-being and sexual function. Although the association between thyroid dysfunction and female sexual dysfunction (FSD) is well-established, limited data exist regarding FSD in premenopausal women with DTC.</p><p><strong>Objective: </strong>To investigate the presence and severity of depressive symptoms and FSD in premenopausal women with DTC and examine their association with thyroid hormone levels and thyroid autoimmunity.</p><p><strong>Methods: </strong>This cross-sectional study included 110 premenopausal women with DTC on stable TSH suppression therapy, stratified into three groups by TSH level (<0.1, 0.1-0.5, and 0.5-2.5 mIU/mL), and 40 healthy controls. Sexual function and depressive symptoms were assessed using the Female Sexual Function Index (FSFI) and Beck Depression Inventory-II (BDI-II), respectively. Thyroid function tests, thyroid antibodies, and sex hormones were evaluated. Correlation and logistic regression analyses were performed.</p><p><strong>Results: </strong>Women with DTC showed higher rates of sexual dysfunction and depressive symptoms than controls (FSD 53.6% vs. 10%; depressive symptoms 65.5% vs. 15%), with the greatest impairment under stronger TSH suppression. Increased BDI-II scores were inversely correlated with FSFI total and subdomain scores (desire, satisfaction, pain). TSH levels were positively associated with FSFI scores, while free thyroxine and free triiodothyronine showed inverse correlations with satisfaction and lubrication. Elevated thyroglobulin antibody levels were associated with higher depression scores. Multivariable models were adjusted for age. Covariates included body mass index, risk of recurrence, disease duration, TSH, free thyroxine, free triiodothyronine, thyroglobulin antibody, total testosterone, prolactin, and BDI-II. Logistic regression analysis showed that suppressed TSH and higher BDI-II scores were independently associated with higher odds of FSD.</p><p><strong>Conclusions: </strong>Sexual dysfunction and depressive symptoms were more frequent in women with DTC than in healthy controls; moreover, among women with DTC, the greatest deterioration was seen in those receiving stronger TSH suppression. These findings highlighted the need for comprehensive care that includes psychological and sexual health assessment in the long-term management of women with DTC.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"750-759"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Conventional Smears with Liquid Preparations and Their Combined Use in Thyroid Cytopathology: A Multi-Institutional Study.","authors":"Wenke Chen, Yuanyuan Zheng, Ping Mei, Gang Chen, Peng Sun, Wei Du, Yonghua Bai, Yinghui Wu, Zheng Yang, Yue Liang, Jiehua Xu, Daping Yang, Yongqin Wen, Ying Li, Changming Chen, Ke Gao, Liting Wu, Dandan Xiong, Yuyan Pang, Xinyi Deng, Zhenbang Ke, Wenxin Chen, Yufei He, Fenghua Lai, Chubo Qi, Athanasios Bikas, Lili Chen, Yihao Liu","doi":"10.1177/10507256261457010","DOIUrl":"10.1177/10507256261457010","url":null,"abstract":"<p><strong>Background: </strong>Processing methods for fine-needle aspiration biopsy (FNA) samples mainly include conventional smears (CS) and liquid-based preparations (LBP). There is still debate as to which method is better and the diagnostic value and necessity of combining the two methods remains unclear. The objective of the current study was to compare the diagnostic performance of the two methods and their combined use in thyroid nodules.</p><p><strong>Methods: </strong>We analyzed thyroid cytopathology data from 16 medical centers between June 2010 and November 2025, comparing nondiagnostic and indeterminate nodules rates across preparation methods. For histologically confirmed samples, diagnostic performance metrics were calculated. Cases with separate CS and LBP descriptions (multi-diagnoses group) were analyzed for diagnostic consistency and performance.</p><p><strong>Results: </strong>In total, 89,392 thyroid FNA cases were included (49,309 CS, 13,161 LBP, and 26,922 combined). The rate of indeterminate nodules was 10.3% (CS), 10.9% (LBP), and 14.8% (combined), while nondiagnostic rate was lowest in the combined group (7.3% vs. 10.5% for CS and 17.9% for LBP). LBP demonstrated higher sensitivity (98.1% vs. 95.0%) and accuracy (97.0% vs. 93.7%) than CS, while combined use provided no significant advantage over LBP alone. In the multi-diagnoses group, CS-LBP concordance among diagnostic samples was 92.9%, with comparable diagnostic performance across all methods.</p><p><strong>Conclusions: </strong>LBP demonstrated superior diagnostic performance compared with CS, but combined use of both methods provided no significant advantage over LBP alone.</p>","PeriodicalId":23016,"journal":{"name":"Thyroid","volume":" ","pages":"804-809"},"PeriodicalIF":6.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148144690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}