Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A Linhaça (Linum Usitatissimum) apresenta diversas substâncias com alegados efeitos benéficos que diminuem a obesidade, glicemia e corrigem a dislipidemia, protegendo o sistema cardiovascular. Neste trabalho objetivamos avaliar o efeito da suplementação materna com linhaça durante a lactação sobre a composição corporal, a homeostase glicêmica, lipídica e protéica, a leptinemia, adiponectinemia e insulinemia, a função tireoideana e a via de sinalização da leptina no eixo hipotálamo-hipófise-tireóide da prole aos 21 e 180 dias de vida. As ratas lactantes foram separadas em dois grupos: controle (C) - recebendo ração a base de caseína (20%) e linhaça (L) recebendo ração suplementada com 25% de linhaça, contendo 18,9% de proteína (sendo 13,9% de caseína e 5% de linhaça) durante a lactação. O sacrifício das proles ocorreu aos 21 e 180 dias de idade, para determinação de: glicemia, albuminemia, proteínas totais, hematócrito, hemoglobina, colesterol total e triglicerídeos, insulina, leptina, adiponectina, TSH, T4 livre e T3 total. Os animais foram completamente eviscerados para obtenção da carcaça e análise da composição corporal. O consumo alimentar e a massa corporal (MC) foram aferidos diariamente durante a lactação e de 4 em 4 dias após a lactação até a idade adulta. As ratas lactantes do grupo L não apresentaram diferença na massa corporal e consumo alimentar. Durante a lactação a prole L apresentou maior ganho de peso corporal e após ao desmame observamos um aumento transitório de massa corporal até a idade adulta. Aos 21 dias, observamos na prole do grupo L menor gordura total e subcutanea, colesterol total, triglicerideo, albumina, insulina, T3 total e atividade de D1 no fígado; e aumento da área dos adipocitos no tecido subcutaneo, leptina, TSH e expressão de Ob-R, STAT3 e p-STAT3 na hipofise (p<0,05). Aos 180 dias, o grupo L apresentou menor glicemia, adiponectina, T4 livre, atividade de D1 e D2 na tireóide; e aumento da área dos adipocitos no tecido adiposo visceral e subcutâneo, insulinemia, expressão de Ob-R na tireóide e atividade de D2 no tecido adiposo marrom (p<0,05). Concluímos, a partir destes dados, que o uso de linhaça durante a lactação afeta a composição corporal, perfil lipídico, a homeostase glicêmica e a função tireóidea. Esta impressão metabólica e hormonal, na lactação, programa para alterações na adiposidade, possível resistência insulínica e disfunção tireóidea. Desta forma, seu uso deve ser visto com cautela durante o período de amamentação. / Flaxseed (Linum usitatissimum) presents high number of substances with beneficial effects that reduce obsesity, blood glucose and dyslipidemia, protecting the cardiovascular system. We aimed to evaluate the maternal flaxseed diet during lactating upon body composition, glucose homeostase, lipid and protein, leptinemia, adiponectinemia and insulinemia, thyroid function, and leptin signaling pathway in the hypothalamus-pituitary-thyroid axis in the offspring at 21 and 180 days old. Lactating rats were divided into: (1) Controls (C), diet containing 20% casein; (2) Flaxseed (F), diet with additional 25% of flaxseed, containing 18.9% protein (13.9% from casein and 5% from flaxseed). The offspring were sacrificed at 21 and 180 days of age to determinate: glycemia, albumin, leptin, adiponectin, TSH, free T4 and total T3. The animals were completely eviscerated to obtain the carcass by body composition analysis. The maternal food intake and body mass were measured daily during the lactation, and after weaning were monitored once every 4 days until they were 180 days old. The dams of F group presented no changes in body mass and food intake. During the lactation the F offspring showed higher body mass and after weaning they presented a higher transitory body mass until 180 days old. At 21 days old, F group showed lower total and subcutaneous fat mass, total cholesterol, triacylglycerol, albumin, insulin, total T3 and D1 liver activity; and higher subcutaneous adipocytes area, leptin, TSH and Ob-R, STAT3 and p-STAT expression in pituitary (p<0,05). At 180 days old, F group presented lower glycemia, adiponectin, free T4 and D1 and D2 activity in thyroid; and higher visceral and subcutaneous adipocytes area, insulin, Ob-R expression in thyroid and D2 activity in brown adipose tissue (p<0,05). In conclusion, maternal flaxseed diet during lactation affects body composition, lipid profile, glucose homeostasis and thyroid function. The metabolic and hormonal impression in lactation programs for changes in adiposity, insulin resistance and possible thyroid dysfunction. Thus, flaxseed use should be viewed with caution during breastfeeding.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A Linhaça (Linum Usitatissimum) apresenta diversas substâncias com alegados efeitos benéficos que diminuem a obesidade, glicemia e corrigem a dislipidemia, protegendo o sistema cardiovascular. Neste trabalho objetivamos avaliar o efeito da suplementação materna com linhaça durante a lactação sobre a composição corporal, a homeostase glicêmica, lipídica e protéica, a leptinemia, adiponectinemia e insulinemia, a função tireoideana e a via de sinalização da leptina no eixo hipotálamo-hipófise-tireóide da prole aos 21 e 180 dias de vida. As ratas lactantes foram separadas em dois grupos: controle (C) - recebendo ração a base de caseína (20%) e linhaça (L) recebendo ração suplementada com 25% de linhaça, contendo 18,9% de proteína (sendo 13,9% de caseína e 5% de linhaça) durante a lactação. O sacrifício das proles ocorreu aos 21 e 180 dias de idade, para determinação de: glicemia, albuminemia, proteínas totais, hematócrito, hemoglobina, colesterol total e triglicerídeos, insulina, leptina, adiponectina, TSH, T4 livre e T3 total. Os animais foram completamente eviscerados para obtenção da carcaça e análise da composição corporal. O consumo alimentar e a massa corporal (MC) foram aferidos diariamente durante a lactação e de 4 em 4 dias após a lactação até a idade adulta. As ratas lactantes do grupo L não apresentaram diferença na massa corporal e consumo alimentar. Durante a lactação a prole L apresentou maior ganho de peso corporal e após ao desmame observamos um aumento transitório de massa corporal até a idade adulta. Aos 21 dias, observamos na prole do grupo L menor gordura total e subcutanea, colesterol total, triglicerideo, albumina, insulina, T3 total e atividade de D1 no fígado; e aumento da área dos adipocitos no tecido subcutaneo, leptina, TSH e expressão de Ob-R, STAT3 e p-STAT3 na hipofise (p<0,05). Aos 180 dias, o grupo L apresentou menor glicemia, adiponectina, T4 livre, atividade de D1 e D2 na tireóide; e aumento da área dos adipocitos no tecido adiposo visceral e subcutâneo, insulinemia, expressão de Ob-R na tireóide e atividade de D2 no tecido adiposo marrom (p<0,05). Concluímos, a partir destes dados, que o uso de linhaça durante a lactação afeta a composição corporal, perfil lipídico, a homeostase glicêmica e a função tireóidea. Esta impressão metabólica e hormonal, na lactação, programa para alterações na adiposidade, possível resistência insulínica e disfunção tireóidea. Desta forma, seu uso deve ser visto com cautela durante o período de amamentação. / Flaxseed (Linum usitatissimum) presents high number of substances with beneficial effects that reduce obsesity, blood glucose and dyslipidemia, protecting the cardiovascular system. We aimed to evaluate the maternal flaxseed diet during lactating upon body composition, glucose homeostase, lipid and protein, leptinemia, adiponectinemia and insulinemia, thyroid function, and leptin signaling pathway in the hypothalamus-pituitary-thyroid axis in the offspring at 21 and 180 days old. Lactating rats were divided into: (1) Controls (C), diet containing 20% casein; (2) Flaxseed (F), diet with additional 25% of flaxseed, containing 18.9% protein (13.9% from casein and 5% from flaxseed). The offspring were sacrificed at 21 and 180 days of age to determinate: glycemia, albumin, leptin, adiponectin, TSH, free T4 and total T3. The animals were completely eviscerated to obtain the carcass by body composition analysis. The maternal food intake and body mass were measured daily during the lactation, and after weaning were monitored once every 4 days until they were 180 days old. The dams of F group presented no changes in body mass and food intake. During the lactation the F offspring showed higher body mass and after weaning they presented a higher transitory body mass until 180 days old. At 21 days old, F group showed lower total and subcutaneous fat mass, total cholesterol, triacylglycerol, albumin, insulin, total T3 and D1 liver activity; and higher subcutaneous adipocytes area, leptin, TSH and Ob-R, STAT3 and p-STAT expression in pituitary (p<0,05). At 180 days old, F group presented lower glycemia, adiponectin, free T4 and D1 and D2 activity in thyroid; and higher visceral and subcutaneous adipocytes area, insulin, Ob-R expression in thyroid and D2 activity in brown adipose tissue (p<0,05). In conclusion, maternal flaxseed diet during lactation affects body composition, lipid profile, glucose homeostasis and thyroid function. The metabolic and hormonal impression in lactation programs for changes in adiposity, insulin resistance and possible thyroid dysfunction. Thus, flaxseed use should be viewed with caution during breastfeeding.

To ιχνοστοιχείο Ιώδιο είναι απαραίτητο συστατικό των θυρεοειδικών ορμονών. Οι θυρεοειδικές ορμόνες συντίθενται και εκκρίνονται στην κυκλοφορία από το θυρεοειδή αδένα και είναι απαραίτητες για τη διαφοροποίηση, την ανάπτυξη και το πολλαπλασιασμό των ανθρώπινων (και όχι μόνο) κυττάρων. Η αναγκαία ποσότητα Ιωδίου για τον οργανισμό προσλαμβάνεται από τη τροφή. Είναι γνωστό ότι οι κάτοικοι των παραθαλάσσιων περιοχών προσλαμβάνουν διαιτητικώς μεγαλύτερα ποσά Ιωδίου, σε σύγκριση με τους κατοίκους ορεινών περιοχών. Παρόλα αυτά ανεπάρκεια ημερήσιας πρόσληψης Ιωδίου έχει αναφερθεί και σε κατοίκους παραθαλάσσιων περιοχών. Οι διαφορές αποδίδονται σε αυξημένες ποσότητες σε μερικές παράλιες περιοχές εισπνεόμενου αέριου Ιωδίου που προκύπτει από την έντονη παρουσία παράλιων φυκιών πλούσιων σε Ιώδιο. Η ανεπαρκής ή εξεζητημένη διαθεσιμότητα και πρόσληψη Ιωδίου από τον ανθρώπινο οργανισμό μπορεί να οδηγήσει σε διαταραχές της θυρεοειδικής λειτουργίας. Το Ιώδιο εμφανίζει το φαινόμενο της εξάχνωσης και μπορεί να μεταβεί από την στερεή στην αέρια κατάσταση, χωρίς να μεσολαβήσει η υγρή. Χρησιμοποιείται ιδιαίτερα στη φαρμακολογία ως απολυμαντικό και αντισηπτικό μέσο, κυρίως αυτούσιο, με τη μορφή διαλύματος σε αιθυλική αλκοόλη και νερό. Διάλυμα 10% σε νερό ιωδιούχου ποβιδόνης (Betadine) χρησιμοποιείται ως αντισηπτικό στα χειρουργεία. / Our Letter to the Editor entitled "Absence of differences in urinary iodine excretion and thyroid function tests in operating room staff members using or not using iodine-containing antiseptic solutions" refered to a recently published article to Thyroid by Erdogan et al (Vol 23 (3) page 342-345, March 2013).

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A morbidade e mortalidade por doenças cardiovasculares demonstram tendência geral de declínio, mas, em países em desenvolvimento como o Brasil a ocorrência destes eventos é crescente. A obesidade e principalmente a localização intra-abdominal de gordura, relaciona-se com a ocorrência de doença crônica e diferentes tipos de dietas tem sido testados na busca pela efetiva redução da adiposidade. Fatores biológicos como a resistência à insulina pode interferir na resposta obtida com intervenções nutricionais. O objetivo deste estudo foi avaliar se a perda de peso e as mudanças ocorridas na composição corporal de mulheres saudáveis, eutróficas ou com sobrepeso, submetidas a um programa de prevenção de ganho de peso foram influenciadas pela resistência à insulina no inicio da intervenção. Trata-se de um estudo observacional prospectivo. 203 mulheres foram alocadas randomicamente para dieta de baixo e alto índice glicêmico. Destas, 185, foram avaliadas quanto a presença de resistência a insulina na linha de base, 34,6% foram classificadas como resistentes a insulina segundo o índice HOMA-IR, no ponto de corte 2,71. As medidas antropométricas de localização de gordura, circunferência da cintura (CC) e relação cintura quadril (RCQ) associaram-se com a resistência a insulina do inicio do estudo, sendo a RCQ a mais fortemente associada (razão de prevalência: 2,28; p=0,0005, enquanto que para CC o valor foi 1,53; p=0,04). A análise da modificação do peso e das medidas antropométricas de composição corporal ao longo dos 6 meses de acompanhamento não demonstrou diferença estatisticamente significante entre os grupos com e sem resistência a insulina. Em conclusão, embora a resistência à insulina tenha se correlacionado com a localização de gordura avaliada principalmente pela relação cintura quadril no inicio do estudo, ela não foi capaz de explicar mudanças na composição corporal e de peso em resposta a uma intervenção nutricional. / Pups leptin injection on the first 10 days of lactation programmes for higher food intake (FI), body mass (BM), lean mass, thyroid function, hyperleptinemia and resistance to its action and lower leptin receptor (ObRb) expression on 150 days-old rats. When mothers were leptin-treated on the last 3 days of lactation, it seems to reproduce partially this programming effect, except for higher visceral fat mass (VFM). So, we evaluated the offspring metabolic phenotype when the mothers were treated with leptin in the first 10 days of lactation. On birth, the lactating Wistar rats were divided into: Leptin (LEP) treated with recombinant leptin (8mg/100g, PC, sc) for the first 10 days of lactation and Control (C) saline-treated in the same conditions. The mothers BM and FI were monitored daily and they were milked at the 21st day of lactation. LEP mothers had lower BM during lactation (~6%, p <0.05) and normal FI. The mothers sacrifice occurred to the end of lactation. The leptin concentration of LEP mothers was normal in serum and milk, while T3 was normal in serum and higher in milk (+30%, p <0.05). The offspring BM and FI was monitored daily and accompanied by 4 on 4 days after weaning until 180 days of age. The LEP offspring had lower BM during lactation (~5%, p<0.05) and from the day 69 onward higher BM (+10%, p<0.05), while the FI was higher (+17%, p<0.05) at day 145 onward. The leptin resistance test was performed at 30 and 180 days. Both group was subdivided into: CLEP and LEPLEP treated with leptin (0.5 mg / kg / ip PC); CSAL and LEPSAL treated with saline. The animals were sacrificed at 21, 30 and 180 days. We collected the VFM, carcass, blood (glycemia, leptin, total T3 and T4, TSH, insulin) and liver (GPDm activity). LEP offspring had higher T3 at 21 days, but not significant (p = 0.06) and when they were 30 days-old they already present leptin resistance and lower serum T3 (-20%,p<0.05). At 180 days they had higher VFM (+57%, p<0.05), total body fat (+40%, p<0.05), leptin resistance, hyperleptinemia (+1,35x, p<0.05) with normal 125I thyroid uptake, serum T4 and TSH and lower GPDm activity at 30 and 180 day (-42% and -57%,p< 0.05 respectively). So, the mother's hyperleptinaemia in the beginning of lactation programs as early as the 30 days-old offspring: leptin resistance and hypothyroidism, probably by a higher leptin transfer through the milk. We suggested that the levels of leptin in early lactation are determinants of the physiological regulation of energy balance in adulthood. We suggest that the programming effects are dependent on the way that leptin reaches the offspring. The present study seems more physiological and reproduces almost completely the programming effect in the adulthood when the mothers were leptin-injected at the end of lactation and, partially reproduces the effects when leptin was directally injected in the pups.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A morbidade e mortalidade por doenças cardiovasculares demonstram tendência geral de declínio, mas, em países em desenvolvimento como o Brasil a ocorrência destes eventos é crescente. A obesidade e principalmente a localização intra-abdominal de gordura, relaciona-se com a ocorrência de doença crônica e diferentes tipos de dietas tem sido testados na busca pela efetiva redução da adiposidade. Fatores biológicos como a resistência à insulina pode interferir na resposta obtida com intervenções nutricionais. O objetivo deste estudo foi avaliar se a perda de peso e as mudanças ocorridas na composição corporal de mulheres saudáveis, eutróficas ou com sobrepeso, submetidas a um programa de prevenção de ganho de peso foram influenciadas pela resistência à insulina no inicio da intervenção. Trata-se de um estudo observacional prospectivo. 203 mulheres foram alocadas randomicamente para dieta de baixo e alto índice glicêmico. Destas, 185, foram avaliadas quanto a presença de resistência a insulina na linha de base, 34,6% foram classificadas como resistentes a insulina segundo o índice HOMA-IR, no ponto de corte 2,71. As medidas antropométricas de localização de gordura, circunferência da cintura (CC) e relação cintura quadril (RCQ) associaram-se com a resistência a insulina do inicio do estudo, sendo a RCQ a mais fortemente associada (razão de prevalência: 2,28; p=0,0005, enquanto que para CC o valor foi 1,53; p=0,04). A análise da modificação do peso e das medidas antropométricas de composição corporal ao longo dos 6 meses de acompanhamento não demonstrou diferença estatisticamente significante entre os grupos com e sem resistência a insulina. Em conclusão, embora a resistência à insulina tenha se correlacionado com a localização de gordura avaliada principalmente pela relação cintura quadril no inicio do estudo, ela não foi capaz de explicar mudanças na composição corporal e de peso em resposta a uma intervenção nutricional. / Pups leptin injection on the first 10 days of lactation programmes for higher food intake (FI), body mass (BM), lean mass, thyroid function, hyperleptinemia and resistance to its action and lower leptin receptor (ObRb) expression on 150 days-old rats. When mothers were leptin-treated on the last 3 days of lactation, it seems to reproduce partially this programming effect, except for higher visceral fat mass (VFM). So, we evaluated the offspring metabolic phenotype when the mothers were treated with leptin in the first 10 days of lactation. On birth, the lactating Wistar rats were divided into: Leptin (LEP) treated with recombinant leptin (8mg/100g, PC, sc) for the first 10 days of lactation and Control (C) saline-treated in the same conditions. The mothers BM and FI were monitored daily and they were milked at the 21st day of lactation. LEP mothers had lower BM during lactation (~6%, p <0.05) and normal FI. The mothers sacrifice occurred to the end of lactation. The leptin concentration of LEP mothers was normal in serum and milk, while T3 was normal in serum and higher in milk (+30%, p <0.05). The offspring BM and FI was monitored daily and accompanied by 4 on 4 days after weaning until 180 days of age. The LEP offspring had lower BM during lactation (~5%, p<0.05) and from the day 69 onward higher BM (+10%, p<0.05), while the FI was higher (+17%, p<0.05) at day 145 onward. The leptin resistance test was performed at 30 and 180 days. Both group was subdivided into: CLEP and LEPLEP treated with leptin (0.5 mg / kg / ip PC); CSAL and LEPSAL treated with saline. The animals were sacrificed at 21, 30 and 180 days. We collected the VFM, carcass, blood (glycemia, leptin, total T3 and T4, TSH, insulin) and liver (GPDm activity). LEP offspring had higher T3 at 21 days, but not significant (p = 0.06) and when they were 30 days-old they already present leptin resistance and lower serum T3 (-20%,p<0.05). At 180 days they had higher VFM (+57%, p<0.05), total body fat (+40%, p<0.05), leptin resistance, hyperleptinemia (+1,35x, p<0.05) with normal 125I thyroid uptake, serum T4 and TSH and lower GPDm activity at 30 and 180 day (-42% and -57%,p< 0.05 respectively). So, the mother's hyperleptinaemia in the beginning of lactation programs as early as the 30 days-old offspring: leptin resistance and hypothyroidism, probably by a higher leptin transfer through the milk. We suggested that the levels of leptin in early lactation are determinants of the physiological regulation of energy balance in adulthood. We suggest that the programming effects are dependent on the way that leptin reaches the offspring. The present study seems more physiological and reproduces almost completely the programming effect in the adulthood when the mothers were leptin-injected at the end of lactation and, partially reproduces the effects when leptin was directally injected in the pups.

Thesis (M.Med. (Radiation Oncology)) -- University of Limpopo, 2022 / Background Hypothyroidism in head and neck cancer patients after radiotherapy is known to occur, yet thyroid function tests are not routinely monitored in all patients post radiation therapy. Routine post radiation therapy thyroid function testing is currently not part of the follow-up protocol in these patients at Pietersburg Hospital. The aim of this study is to evaluate post radiation therapy hypothyroidism among head and neck cancer patients treated with radiotherapy at Pietersburg Hospital Methods A prospective (cohort) observational study was carried out among head and neck cancer patients receiving radiotherapy at the radiation oncology department in Pietersburg Hospital. Sample size of n=37 was calculated using Statistica V13.0. Thyroid function tests were performed at the start of radiation therapy and repeated on the first day of follow up, 6 weeks after completing radiation therapy. During follow up, participants were also interviewed for the presence of symptoms of hypothyroidism such as dry skin, dry hair, fatigue, cold intolerance, or weight gain. Data analysis was done with STATA version 16. Descriptive statistics were used to characterise variables, and summarised in tables, graphs and charts. Changes in thyroid function tests and other variables were analysed. A p-value of 0.05 was deemed statistically significant. Results Thirty-seven patients were enrolled in the study, 26 males and 11 females. The mean age of the patients was 53.1 ±12.3 standard deviation [SD]) with a range of 40.8 to 65.4 years. The most common diagnoses were cancer of the larynx and hypopharynx, forming 29.7% and oral cavity cancer, 29.7%. Only three patients (8%) had an early stage cancer (Stages 1 and 2), 11 patients (29.7%) moderately advanced cancer (Stage 3) while the majority (62%; n =23) had locally advanced cancer (Stage 4). Majority of the patients received 70Gy in 35 daily fractions, five fractions per week via 3-D conformal radiotherapy. Only 29 patients who had complete pre- and post radiotherapy thyroid function tests were included in the final analysis. Of these, none had clinical hypothyroidism at 3 months. Two patients (6.8%) had sub-clinical hypothyroidism, with post radiation therapy TSH values greater than 3.5mIU/ml. The mean post radiation therapy TSH values increased by 8.3% and the mean fT4 values decreased by 2.05% compared to the pre-radiation therapy values. Both changes were not statistically significant (p=0.99 and p=0.82 respectively). There was no statistically significant correlation between changes in TSH and fT4 versus age (p=0.88 and p=0.92 respectively), sex (p=0.55 and p=0.15 respectively), cancer stage (p=0.21 and p=0.78 respectively), and cancer site (p=0.17 and p=0.74 respectively). The most common post radiotherapy symptom was fatigue (62%) followed by cold intolerance (54%), weight gain (43%) and dry skin or dry hair (43% each). Conclusion The results of the study suggest that sub-clinical hypothyroidism is detectable early post radiation therapy presenting as clinical symptoms.

Le fipronil, insecticide largement utilisé, est un perturbateur thyroïdien chez le rat modulant le catabolisme hépatique des hormones thyroïdiennes. Ses effets chez le mouton, considéré comme un modèle plus pertinent que le rat pour étudier une régulation de la fonction thyroïdienne chez l'Homme, sont plus limités. Le but de cette thèse était de caractériser au niveau hépatique le mode d'action du fipronil sur la fonction thyroïdienne en s'intéressant 1) au rôle potentiel du principal métabolite du fipronil formé in vivo, le fipronil sulfone, et 2) aux différences interspécifiques de métabolisme du fipronil et/ou de sensibilité à la perturbation thyroïdienne qui peuvent préjuger de la pertinence des différents modèles animaux pour l'analyse du risque du fipronil pour la santé humaine. L'efficacité du fipronil sulfone à induire l'expression et/ou l'activité d'enzymes responsables du métabolisme hépatique des hormones thyroïdiennes ou du fipronil était la même que celle du fipronil autant in vivo chez le rat que in vitro sur hépatocytes. L'utilisation d'un modèle de souris déficientes pour des récepteurs nucléaires xénosenseurs suggérait fortement une implication des récepteurs nucléaires Constitutive Androstane Receptor et/ou Pregnane X Receptor dans la perturbation thyroïdienne induite par le fipronil / The widely used insecticide fipronil is a thyroid disruptor in rat acting on thyroid hormone hepatic metabolism. In sheep, a more relevant species for the human thyroid regulation, fipronil-induced thyroid-disruption is much more limited. The goal of this thesis was to characterize the mode of action of fipronil on thyroid function at the hepatic level focusing on 1) the potential role of fipronil sulfone, the main fipronil metabolite formed in vivo, and on 2) interspecific differences in terms of fipronil metabolism and/or sensitivity to thyroid disruption that can prejudge of the relevance of the different animal models for the risk assessment of fipronil for human health. Fipronil sulfone was as efficient as fipronil to induce the expression and/or activity of enzymes involved in thyroid hormone or fipronil hepatic metabolism both in vivo in rat and in vitro on hepatocytes. The use of knock-out mice for xenosensors nuclear receptors strongly suggested an implication of the nuclear receptor Constitutive Androstane Receptor and/or Pregnane X Receptor on fipronil-induced thyroid disruption

Down syndrome (DS) is associated with psychomotor retardation, short stature and endocrine dysfunction. Statural growth is a well-known indicator of health. The growth in DS differs markedly from that of other children and there is a 20 cm reduction of final height as compared to target height. We developed growth charts specific for Swedish children with DS, in order to facilitate early diagnosis of concomitant diseases that influence growth. The growth charts are available for paediatricians and child health care professionals in Sweden. The mechanism underlying the impaired growth in DS is unknown. Height is influenced by parental factors, energy intake, hormone balance and general health. In DS, genetic factors deriving from the extra chromosome 21 further affect growth. Children with DS seem to have reasonable levels of growth hormone (GH), even though GH treatment for limited periods of time improves growth velocity. Within the present project, the subjects of a previous study on early GH therapy in DS were followed up regarding late effects. We found a larger adult head circumference and better psychomotor abilities in the previously treated subjects despite a lack of effect on final height. In adult life, GH has effects on psychological well-being and metabolism. The clinical features in adults with DS might indicate impaired GH secretion. Ten young adults with DS were studied and compared with ten healthy controls. The GH secretion in the DS subjects did not differ from that in the controls. The fat body mass percentage was increased in DS, in line with the high prevalence of overweight/obesity. The finding of an increased HOMA index as well as a high relative rate of hepatic glucose production in DS indicates reduced insulin sensitivity both peripherally and in the liver. Thyroid dysfunction is common in DS. There is a 30-fold increase in congenital hypothyroidism, and acquired hypothyroidism has been reported to be present in up to 50% of adults with DS. We collected neonatal screening results and hospital records for the first ten years of life of 68 children with DS. The mean TSH concentration was increased neonatally, indicating marginal hypothyroidism early in life in DS. However, the neonatal TSH level did not predict development of manifest hypothyroidism later in life. / Downs syndrom (DS) är en vanlig kromosomavvikelse. Kortvuxenhet och psykomotorisk utvecklingsstörning är kardinaltecken vid DS. Endokrina avvikelser är också frekvent förekommande. Tillväxt är en bra indikator på barns hälsa. Nyfödda barn med DS är kortare än andra nyfödda, och skillnaden i längd ökar under barndomen. Sjukdomar som påverkar tillväxten upptäcks ofta via ett förändrat tillväxtmönster. Detta kan lätt förbises vid DS eftersom tillväxten redan är avvikande. Användning av syndromspecifika tillväxtkurvor ökar möjligheterna till diagnostik av sjukdomar som stör längdtillväxten. Vi har framställt tillväxtkurvor för barn med DS, vilka finns tillgängliga inom svensk barnsjukvård och barnhälsovård. Längdtillväxt styrs av nedärvda faktorer från föräldrarna liksom av nutrition, hälsa och hormoner. Genetiska faktorer, kopplade till kromosom 21, kan påverka tillväxten vid DS, men tillväxtstörningens exakta bakgrund är inte känd. I vuxen ålder är personer med DS ungefär 20 cm kortare än förväntat med hänsyn till föräldralängder. Trots att barn med DS har relativt normala nivåer av tillväxthormon (STH eller GH) förbättras deras tillväxt vid STH-behandling. Inom avhandlingsarbetet följde vi upp ungdomar med DS, vilka behandlats med STH i tidig barndom. Vi kunde påvisa större huvudomfång samt förbättrad kognitiv och motorisk förmåga, trots avsaknad av effekt på slutlängden. Tillväxthormon har i vuxen ålder effekt både på ämnesomsättning och psykologiskt välbefinnande. Vuxna individer med DS uppvisar flera tecken förenliga med STH-brist. Vi jämförde tio unga vuxna med DS med tio friska kontrollindivider avseende förmågan att insöndra STH. STH-insöndringen hos individerna med DS skiljde sig inte från den hos kontrollerna. Vid samtidig undersökning av kroppssammansättning påvisades en ökad andel kroppsfett hos individerna med DS, resultat i linje med den frekventa förekomsten av övervikt/fetma. Individerna med DS hade en förhöjd glukosproduktion, som tillsammans med ett ökat HOMA-index talar för förekomst av minskad insulinkänslighet både på levernivå och perifert. Brist på sköldkörtelhormon är mycket vanligt vid DS och upp till hälften av vuxna med DS kan ha hypotyreos. Vi studerade 68 barn med DS avseende nivåer av tyroideastimulerande hormon (TSH) vid PKU-provtagning. Vi följde också barnens journalhandlingar från de tio första levnadsåren i syfte att undersöka om den neonatala TSH-nivån kan prediktera framtida underfunktion av sköldkörteln. Resultaten visade att barn med DS har en förhöjd nivå av TSH neonatalt, vilket indikerar en brist på sköldkörtelhormon redan i nyföddhetsperioden, men nivån förutsäger inte utveckling av manifest hypotyreos senare under barndomen.

Reports of endocrine disrupting potential of common environmental chemicals and the effects on reproductive health are well documented in literature. It has been suggested that deteriorating male reproductive health could be due to in utero exposures to these chemicals. The effects mediated through endocrine disrupting chemicals (EDCs) are on the fetus and may therefore be trans-generational. Ultimately, these chemicals land up in aquatic systems and affect wildlife and humans. Humans are exposed to these chemicals through multiple routes including atmosphere, water, occupational, domestic and food consumption. South Africa (SA) is an important livestock producer with about 13.8 million cattle within the feedlot industry contributing up to 80% of the total beef production. Veterinary growth stimulants (VGS) are used by beef producers to enhance growth in cattle. In SA, the following five VGS have been approved for use in beef products under the Register Act 36 of 1947, estradiol, progesterone and testosterone (natural), α'-zearalanol and trenbolone (synthetic). These VGS and their metabolites are environmentally stable compounds. The excretions from the animals are not treated and land up in the local aquatic systems, indirectly posing a health risk. In SA no research has been done on VGS associated with feedlot activities. The aim of this study was to investigate the effects of a mixture of VGS, as possible EDCs on the reproductive health and thyroid function in male rats in utero, during lactation and life-time exposure. The (anti)estrogenic and (anti)androgenic activity in water from specific feedlots was determined by using a battery of screening bio-assays. Water samples were collected over a period of a year and assessed for EDC activity in the recombinant yeast screen (YES), the T47D-KBluc (estrogenic) and the MDA-Kb2 (androgenic) bioassays. The OECD (Organization for Economic Co-operation and Development) 415 protocol, (1983) for a one-generation reproduction toxicity study, was modified to accommodate one control and three experimental groups. The experimental groups were orally gavaged with mixtures of: zilpaterol, diethylstilbestrol (DES) and α-zearalanol (Group 2; estogenic); with β'-trenbolone and methyltestosterone (MT) (Group 3; androgenic); a combination of compounds (Group 4; estrogenic and androgenic) and the Control group received cottonseed oil only. The bio-assay results indicated that water samples analysed from selected feedlots contained compounds with estrogenic activity. The shorter anogenital distance (AGD) (Group 3), decreased seminal vesicle mass (Group 4), decreased prostate mass (Group 4), increased lumen diameter (Group 3 and 4), lowered sperm concentration (Group 3), and increased T4 (Group 2 and 3) differed significantly from the control. The body weight of the males in Group 2 in the F2 generation was significantly lower than the control. The F2 females in Group 2, 3 and 4 were also significantly lower than the control. The reduced AGD, decreased seminal vesicle and increased T4 (thyroxine) might be the result of an estrogenic effect. The reduced sperm concentration might be the result of in utero and lactation exposure to these VGS. The bio-assays confirmed estrogenic activity in the feedlot water sources. The reproductive toxicology study findings confirm the hypothesis that VGS can act as EDCs and could therefore be responsible for negative reproductive effects and thyroid function. More research is needed to investigate the effects of VGS mixtures at different concentrations on male reproductive health, thyroid function and their offspring. AFRIKAANS : Goed gedokumenteerde literatuur dui aan dat chemikalieë wat algemeen in die omgewing gevind word, die potensiaal het om die manlike voortplantingstelsel aan te tas. Dit word gespekuleer dat in utero blootstelling verantwoordelik kan wees vir hierdie agteruitgang. Die fetus en daarop- volgende geslagte se gesondheid kan ook beÏnvloed word deur chemikalieë. Hierdie chemikalieë het die potensiaal om die watersisteme te bereik en gevolglik dier en menslike gesondheid te beÏnvloed. Blootstelling kan plaasvind deur verskeie roetes wat die atmosfeer, water, werksomstandighede, huishoudelike produkte en gekontamineerde voedsel insluit. Suid-Afrika (SA) is 'n belangrike produsent van vleisprodukte met omtrent 13.8 miljoen beeste wat bydra tot 80% van die vleisproduksie. Veterinêre-groei-stimulante (VGS) word gebruik om die vleisproduksie te verbeter. Vyf groei stimulante naamlik estradiol, progesteroon, testosteroon (natuurlike), α-zearalanol en trenboloon (sinteties) is goedgekeur onder die Wet 36 van 1947, vir groei produksie van beeste. Hierdie VGS en hul metaboliete is stabiel in die natuur. Die fekale en urinere uitskeidingsprodukte van die diere word nie behandel nie en eindig op in ons waterstelsels. Geen navorsing is nog in SA gedoen om die potensiële bydraes wat voerkrale tot die besoedeling van water lewer, te bestudeer nie. Die doel van die studie was om die gesamentlike effekte van mengsels VGS as moontlike endokrien-ontwrigtende chemicalieë (EOC) op die manlike voortplantingstelsel en tiroïdhormone van mannetjiesrotte na in utero-, gedurende laktasie- en na 'n leeftyd-blootstelling te bepaal. Die (anti)estrogeniese en (anti)androgeniese aktiwiteit in water vanaf spesifieke voerkrale is met behulp van 'n reeks biologiese seltoetse bepaal. Watermonsters is geanaliseer met die gisseltoets (YES)(estrogenies), die T47D-KBluc (estrogenies) en die MDA-Kb2 (androgenies). Die OECD 415 protokol (1983) vir een generasie reproduktiewe toksologie toets was aangepas om een kontrole en drie eksperimentele groepe te huisves. Die eksperimentele groepe rotte is oraal gedoseer met 'n mengsel van zilpaterol, dietielstilbestrol (DES) en α-zearalanol (Groep 2); β-trenboloon en metieltestosteroon (Groep 3); 'n kombinasie van al bogenoemde (Groep 4); en 'n kontrole groep wat katoensaad olie VGS ontvang het nie. Estrogeniese aktiwiteit en sitotoksisiteit was teenwoordig in die water vanaf die voerkrale. Die verkorte anogenitale afstand (AGD) (Groep 3), kleiner seminale vesikel (SV) massa (Groep 4), kleiner prostaat massa (Groep 4), groter lumen deursneë (Groep 3 en 4), laer spermtelling (Groep 3), verhoogde T4 (Groep 2 en 3), het almal statisties-betekenisvol van die kontrole groep verskil. In die F2 generasie het die liggaamsmassas van die mannetjies in Groep 2 en liggaamsmassas van die wyfies in Groepe 2, 3 , 4, almal statisties-betekenisvol laer as die kontrole Groep. Die verkorte AGD, kleiner SV en verhoogde T4 kan moonlik wees as gevolg van 'n estrogeniese effek en die verlaagde sperm konsentrasie weens 'n in utero en laktasie blootstelling. Die biologiese seltoetse het die teenwoordigheid van estrogeniese aktiwiteit in voerkrale se water bevestig. Die gevolge van die blootstelling van EOC mengsels op voortplantings-parameters bevestig die moontlikheid van EOC effek geassosieer met VGS. Verdere navorsing is nodig om die dosisresponsverhoudings van verskillende VGS te ondersoek. Copyright / Dissertation (MSc)--University of Pretoria, 2011. / School of Health Systems and Public Health (SHSPH) / Unrestricted

<p>Uvod: Poslednjih godina u fokusu istraživača je efekat sintetskih jednjenja na endokrini sistem. Estri ftalne kiseline se koriste u procesu plastifikacije, kao industrijski rastvarači, lubrikanti, aditivi u tekstilnoj industriji, u pesticidima, kozmetičkim proizvodima. Raste broj dokaza da je tiroidna žlezda podložna dejstvu endokrinih disruptora. Tiroidni hormoni imaju važnu ulogu u regulaciji rasta, tkivne diferencijacije, energetskog metabolizma, reprodukcije i formiranja centralnog nervnog sistema. Brojna istraživanja ukazala su da ftalati deluju kao EDs. Ciljevi istraživanja: 1. Procena izloženosti populacije mono-etilheksil-ftalatu (MEHP) i mono-etil-ftalatu (MEP). 2. Evaluacija razlika u nivou pokazatelja tirodine funkcije između ftalat pozitivnih i ftalat negativnih ispitanika i između gojaznih i normalno uhranjenih ftalat pozitivnih ispitanika. 3.Utvrđivanje razlika u serumskom nivou leptina gojaznih ispitanika sa i bez pozitivnih ftalatnih metabolita i procena povezanosti leptina sa MEP i MEHP i pokazateljima tiroidne funkcije. Izbor ispitanika i metod rada: Istraživanje je sprovedeno kao studija preseka, obuhvatilo je 201 ispitanika. Ispitanici su podeljeni u grupu MEP/MEHP pozitivnih i negativnih i na podgupe normalno uhranjenih i gojaznih. Od antropometrijskih mera određena je telesna visina, telesna masa, obim struka i indeks telesne mase. Laboratorijske analize: jutarnji uzorak urina za određivanje MEP i MEHP; na&scaron;te uzet uzorka venske krvi za FT4, FT3, TSH i leptin. Statististička analiza sprovedena je na softverskom paketu SPSS. Rezultati: Polovina stanovni&scaron;tva je izložena ftalatima. MEP dovodi do povi&scaron;enja FT4 samo u subpopulaciji gojaznih. Nije utvrđen statistički značajan uticaj MEP na FT3. Kod gojaznih MEP pozitivnih osoba ženskog pola povi&scaron;en je TSH. MEHP uzrokuje sniženje FT4 kod normalno uhranjenih ispitanika, a kod normalno uhranjenih mu&scaron;karaca snižava FT3. Nije utvrđen uticaj MEHP na tirotropin. U gojaznih nije ustanovljen uticaj DEHP i DEP na leptinsku sekreciju.Uočena je tendencija negativne korelacije leptina i FT4 kod gojaznih, dok uticaja na FT3 i TSH nema. Zaključak: Na&scaron;a populacija je u velikoj meri izložena ftalatima. Potvrđeno je da MEP i MEHP imaju uticaj na pojedine indikatore tiroidne funkcije. Ftalati u na&scaron;em istraživanju ne uzrokuju poremećaj leptinske skrecije, a leptin ima blag uticaj jedino na FT4.</p> / <p>Introduction: Effects of synthesized chemicals on endocrine system has been in the focus in the last years. Phthalates are used in plasticization, as industrial solvents, lubricants, textile industry additives, in pesticides and cosmetic products. Evidence for thyroid disruption is growing. Thyroid hormones (TH) have an important role in regulation of growth, tissue differentiation, energy metabolism, reproduction and central nervous system formation. Studies show phthalates can cause endocrine disruption. Aims: 1. Estimation of burden of mono-ethyl phthalate (MEP) and di-2-ethylheksyl phthalate(MEHP) in the population. 2. Evaluation of differences in TH and TSH in MEP/MEHP positive and negative participants, as in obese and lean MEP/MEHP positive participants. 3. Evaluation of differences in leptin in obese MEP/MEHP positive and negative subjects and evaluation of the connection between leptin, MEP, MEHP and thyroid indicators. Patients and methods: This was a cross-sectional study that comprised 201 subjects divided into MEP/MEHP positive and negative group, further subdivided in obese and lean. Anthropometric parameters done: body height, body weight, waist and body mass index. Laboratory tests done: morning urine sample analysis for MEP/MEHP and venous sample analysis for free thyroxine (FT4), free tri-iodothyronine (FT3), thyroid stimulating hormone (TSH) and leptin. Statistical analysis was done in SPSS. Results: Half of subjects were exposed to phthalates. MEP induced an increase in FT4 in obese participants and had no influence on FT3. TSH was increased in obese MEP positive female subjects. MEHP induced a decrease in FT4 in lean participants and a decrease of FT3 in lean males. There was no correlation between MEHP and TSH. Influence of MEP/MEHP on leptin secretion. A tendency for negative correlation between leptin and FT4 was seen. There was no influence of leptin on FT3 and TSH. Conclusion: Our population is greatly exposed to phthalates. MEP and MEHP influence certain thyroid indicators i.e. cause thyroid disruption. Phthalates do not influence leptin secretion in our study. There is a mild effect of leptin on FT4.</p>