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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Avaliação da radioidoterapia com doses de 10 e 15 mCi em pacientes com doenças de graves

MOTA, Viviane Canadas da January 2006 (has links)
Made available in DSpace on 2014-06-12T18:28:00Z (GMT). No. of bitstreams: 2 arquivo7904_1.pdf: 1266782 bytes, checksum: ae430a4a9cbd5ba3771d8e14df2fa3a1 (MD5) license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) Previous issue date: 2006 / O hipertireoidismo da Doença de Graves, a forma mais comum de hipertireoidismo, é causado por auto-anticorpos que ativam o receptor do TSH. Associa-se com aumento da mortalidade cardiovascular e fraturas de colo de fêmur em idosas. As opções terapêuticas atualmente disponíveis são as drogas antitireoidianas, a cirurgia e o radioiodo, sendo nenhuma delas considerada ideal pois não atuam diretamente na etiopatogênese da doença. O radioiodo vem sendo cada vez mais utilizado como primeira escolha, sendo um tratamento definitivo, seguro e de fácil administração. A utilização de doses calculadas não traz nenhum benefício, comparando com às doses fixas. Há autores que preferem doses mais altas para induzir deliberadamente o hipotireoidismo, e outros doses mais baixas, com menor incidência de hipotireoidismo e maior de eutireoidismo. Não há consenso sobre o melhor esquema de doses fixas a ser utilizado, sendo esse o principal enfoque deste trabalho. Foram avaliados, pacientes com hipertireoidismo por Doença de Graves atendidos no Serviço de Endocrinologia do Hospital das Clínicas da Universidade Federal de Pernambuco, submetidos ao radioiodo com doses de 10 e 15 mCi no Serviço de Medicina Nuclear do referido hospital, no período de janeiro de 2000 a dezembro de 2002. Foi analisada a função tireoidiana e a associação entre idade, procedência e uso prévio de drogas antitireoidianas com 6, 12 e 24 meses após o radioiodo. Os resultados finais foram expressos pela média dos valores obtidos, quando então, foram os grupos comparados entre si. Dos 164 pacientes analisados, 61 (37,2%) foram submetidos a 10 mCi e 103 (62,8%) a 15 mCi. Na análise longitudinal observou-se que a remissão do hipertireoidismo foi estatisticamente diferente no 6º mês (p<0,001), sendo maior no grupo que foi empregada a dose de 15 mCi; mas, foi semelhante nos grupos nos 12º e 24º meses. É possível concluir que doses fixas de 10 e 15 mCi, promovem semelhante remissão do hipertireoidismo após 12 meses de tratamento. A remissão do hipertireoidismo não teve associação com a idade, sexo e uso prévio de drogas antitireoidianos
2

Avaliação dos efeitos agudos e em longo prazo do hormônio tireoidiano sobre o eixo hipotálamo-hipófise-adrenal e sua importância fisiológica. / Acute and long therm effects of thyroid hormones on the hypothalamicpituitary-adrenal axys and its physiological importance.

Prévide, Rafael Maso 25 November 2016 (has links)
Os hormônios tireoidianos (HTs) participam de diversos processos biológicos por meio de ações que exercem na expressão de genes que codificam proteínas envolvidas no metabolismo, crescimento e desenvolvimento. O objetivo desse trabalho foi caracterizar ações genômicas e não genômicas dos HT no eixo hipotálamo-hipófise-adrenal. Detectamos nos ratos tireoidectomizados (Tx) uma redução do conteúdo de mRNA da POMC, em paralelo a um aumento de sua cauda poli(A) e de sua taxa de tradução. T3 em dose suprafisiológica por 30 minutos ou 5 dias promoveu aumento na expressão desse mRNA e o conteúdo proteico de POMC/ACTH permaneceu inalterado. A enzima PC1 teve sua expressão aumentada em ratos Tx, fato revertido pelo tratamento com T3. As enzimas esteroidogênicas e a corticosterona sérica não apresentaram diferenças nos grupos estudados in vivo, apesar da redução sérica de ACTH em animais Tx, porém SF1 teve sua expressão aumentada in vitro após tratamento com T3. Na cultura de hipófises, o TSH se mostrou capaz de aumentar AMPc e Ca2+ citosólico promovendo a secreção de ACTH. / Thyroid hormones (TH) participate in many biological processes promoting the expression of genes that encode proteins involved in the metabolism, growth and development. The aim of this study was to characterize genomic and non genomic actions of TH in the hypothalamic-pituitary-adrenal axis. We detected in thyroidectomized (Tx) rats a reduction of POMC mRNA content in parallel to an increase of its poli(A) tail and its translation rate. Supraphysiological doses of T3 for 30 minutes or 5 days injections increased the expression of this mRNA, although POMC/ACTH protein content remained unchanged. PC1 enzyme had its expression increased in Tx rats, which was reversed back to control levels after T3 treatment. Steroidogenic enzymes and serum corticosterone did not show any differences in the groups studied in vivo, despite the reduction of serum ACTH in Tx animals, but SF-1 had its in vitro expression increased after treatment with T3. In pituitary primary culture, TSH promoted increase in cAMP and cytosolic Ca2+ concentration stimulating ACTH secretion.
3

Mise en oeuvre de dosages pour le diagnostic précoce de l'hypothyroïdie / Implementation of immuno-assays for the early diagnosis of hypothyroidism

Iss, Chloé 19 January 2015 (has links)
Le diagnostic précoce de l'hypothyroïdie permet d'initier le traitement au plus tôt et ainsi de préserver la santé du patient. Le bénéfice du traitement de l'hypothyroïdie franche a été depuis longtemps établi, mais les critères de prise en charge des patients en hypothyroïdie fruste sont encore difficiles à définir. En effet, les symptômes ne sont pas toujours présents et leur appréciation est subjective. Afin d'établir le diagnostic et la prise en charge, le médecin s'appuie sur le dosage de la thyréostimuline (TSH) dans le sang, qui peut éventuellement être complété par le dosage des hormones thyroïdiennes. Le dosage de la TSH, très sensible, peut présenter sur un même échantillon sanguin d'importantes variations qui rendent d'autant plus difficiles la décision du médecin et le suivi du patient. Le polymorphisme naturel de la TSH peut expliquer en partie ces variations. La TSH appartient en effet à la famille des hormones glycoprotéiques et sa glycosylation peut constituer jusqu'à 30% de son poids. Dans le cas de l'hypothyroïdie en particulier, ces glycanes sont modifiés et présentent une plus grande quantité d'acides sialiques terminaux. Ainsi, certaines variations entre les dosages de la TSH, qui freinent actuellement leur harmonisation, peuvent être dues à des différences de reconnaissance de glycoformes par les anticorps utilisés dans les dosages. Dans ce contexte, l'objectif de de ces travaux était de contribuer à la construction de dosages plus performants que ceux actuellement utilisés dans le diagnostic de l'hypothyroïdie. Un nouveau calibrateur recombinant sialylé plus proche de la TSH circulante dans l'hypothyroïdie a alors été produit. De nouvelles associations d'anticorps monoclonaux ont été utilisées pour construire des dosages. Les nouveaux dosages sélectionnés ont ensuite été calibrés avec la TSH sialylée produite et le calibrateur de référence international. Ils ont alors servi à doser plusieurs séries de sérums de patients. Ces travaux ont donc validé l'utilisation d'un nouveau calibrateur d'origine recombinante pour les dosages de la TSH, ce qui devrait à l'harmonisation des dosages existants. / If iodine deficiency is the first cause of low thyroid hormone levels in the world, there are also other etiologies to thyroid disorders. Diagnosis of those allow an early treatment to preserve patient's health. Although there is a general agreement concerning treatment of overt hypothyroidism, treatment of subclinical hypothyroidism is still under debate. In these cases, symptoms are, by definition, not always present. In order to establish diagnosis, the clinicians rely on the measurement of circulating thyroid stimulating hormone (TSH, potentially completed with thyroid hormones measurement). TSH assays are now very sensitive, but can present important between assays variations. The diagnosis and follow up of the patient are consequently complicated. Natural polymorphism of TSH can explain a part of this variability. TSH belongs to the glycoprotein hormones family and its glycans can count for more than 30% of its weight. In hypothyroidism, these glycans are subject of modulation and present higher levels of terminal sialylation. Variation in immuno-assays can be explained by these modifications of sialylation if recognition by antibodies used in immuno-assays is glycosylation dependent. In this context, the aim of this work was to contribute to the construction of new immuno-assays, more reliable in the early diagnosis of subclinical hypothyroidism. During this thesis a new recombinant standard closer to circulating TSH was produced. The total level of sialylation was higher and better mimic the circulating forms in hypothyroidism. In order to select the best antibodies associations in immuno-assays, new antibodies were obtained and associated with commercially available antibodies. New immuno assays improvement is based on the following two approaches: the first one is the use of a new standard which presents glycoformes closer to the circulating TSH and the second one consists in an appropriate selection of antibodies involved in the assays. The new assays were used to measure TSH concentration in blood samples. These studies associated with validation steps allow us to select four assays and constitute a proof of concept for the use of a new sialylated recombinant standard for TSH assays. This can contribute to the needed harmonization of TSH assays.
4

Mise en oeuvre de dosages pour le diagnostic précoce de l'hypothyroïdie / Implementation of immuno-assays for the early diagnosis of hypothyroidism

Iss, Chloé 19 January 2015 (has links)
Le diagnostic précoce de l'hypothyroïdie permet d'initier le traitement au plus tôt et ainsi de préserver la santé du patient. Le bénéfice du traitement de l'hypothyroïdie franche a été depuis longtemps établi, mais les critères de prise en charge des patients en hypothyroïdie fruste sont encore difficiles à définir. En effet, les symptômes ne sont pas toujours présents et leur appréciation est subjective. Afin d'établir le diagnostic et la prise en charge, le médecin s'appuie sur le dosage de la thyréostimuline (TSH) dans le sang, qui peut éventuellement être complété par le dosage des hormones thyroïdiennes. Le dosage de la TSH, très sensible, peut présenter sur un même échantillon sanguin d'importantes variations qui rendent d'autant plus difficiles la décision du médecin et le suivi du patient. Le polymorphisme naturel de la TSH peut expliquer en partie ces variations. La TSH appartient en effet à la famille des hormones glycoprotéiques et sa glycosylation peut constituer jusqu'à 30% de son poids. Dans le cas de l'hypothyroïdie en particulier, ces glycanes sont modifiés et présentent une plus grande quantité d'acides sialiques terminaux. Ainsi, certaines variations entre les dosages de la TSH, qui freinent actuellement leur harmonisation, peuvent être dues à des différences de reconnaissance de glycoformes par les anticorps utilisés dans les dosages. Dans ce contexte, l'objectif de de ces travaux était de contribuer à la construction de dosages plus performants que ceux actuellement utilisés dans le diagnostic de l'hypothyroïdie. Un nouveau calibrateur recombinant sialylé plus proche de la TSH circulante dans l'hypothyroïdie a alors été produit. De nouvelles associations d'anticorps monoclonaux ont été utilisées pour construire des dosages. Les nouveaux dosages sélectionnés ont ensuite été calibrés avec la TSH sialylée produite et le calibrateur de référence international. Ils ont alors servi à doser plusieurs séries de sérums de patients. Ces travaux ont donc validé l'utilisation d'un nouveau calibrateur d'origine recombinante pour les dosages de la TSH, ce qui devrait à l'harmonisation des dosages existants. / If iodine deficiency is the first cause of low thyroid hormone levels in the world, there are also other etiologies to thyroid disorders. Diagnosis of those allow an early treatment to preserve patient's health. Although there is a general agreement concerning treatment of overt hypothyroidism, treatment of subclinical hypothyroidism is still under debate. In these cases, symptoms are, by definition, not always present. In order to establish diagnosis, the clinicians rely on the measurement of circulating thyroid stimulating hormone (TSH, potentially completed with thyroid hormones measurement). TSH assays are now very sensitive, but can present important between assays variations. The diagnosis and follow up of the patient are consequently complicated. Natural polymorphism of TSH can explain a part of this variability. TSH belongs to the glycoprotein hormones family and its glycans can count for more than 30% of its weight. In hypothyroidism, these glycans are subject of modulation and present higher levels of terminal sialylation. Variation in immuno-assays can be explained by these modifications of sialylation if recognition by antibodies used in immuno-assays is glycosylation dependent. In this context, the aim of this work was to contribute to the construction of new immuno-assays, more reliable in the early diagnosis of subclinical hypothyroidism. During this thesis a new recombinant standard closer to circulating TSH was produced. The total level of sialylation was higher and better mimic the circulating forms in hypothyroidism. In order to select the best antibodies associations in immuno-assays, new antibodies were obtained and associated with commercially available antibodies. New immuno assays improvement is based on the following two approaches: the first one is the use of a new standard which presents glycoformes closer to the circulating TSH and the second one consists in an appropriate selection of antibodies involved in the assays. The new assays were used to measure TSH concentration in blood samples. These studies associated with validation steps allow us to select four assays and constitute a proof of concept for the use of a new sialylated recombinant standard for TSH assays. This can contribute to the needed harmonization of TSH assays.
5

Ensaio imunoradiometrico ultra-sensivel de tireotrofina humana (hTsH) obtido mediante a identificacao e minimizacao de ligacoes inespecificas

PERONI, CIBELE N. 09 October 2014 (has links)
Made available in DSpace on 2014-10-09T12:38:00Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:04:41Z (GMT). No. of bitstreams: 1 05581.pdf: 1858679 bytes, checksum: 40e224a27b1e68838662dfa34b14949f (MD5) / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP
6

Ensaio imunoradiometrico ultra-sensivel de tireotrofina humana (hTsH) obtido mediante a identificacao e minimizacao de ligacoes inespecificas

PERONI, CIBELE N. 09 October 2014 (has links)
Made available in DSpace on 2014-10-09T12:38:00Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:04:41Z (GMT). No. of bitstreams: 1 05581.pdf: 1858679 bytes, checksum: 40e224a27b1e68838662dfa34b14949f (MD5) / Dissertacao (Mestrado) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP
7

The Role of PRAJA2 in TSH- or Isoproterenol- Stimulated Lipolysis in Human Adipocytes

McBride, Arran January 2014 (has links)
Thyrotropin (TSH) binds to TSH receptors on thyrocytes to regulate development and growth of the thyroid gland, and to stimulate thyroid hormone production. Thyrotropin has also been shown to act in an extra-thyroidal fashion, and to engage TSH receptors on adipocytes to induce lipolysis, similar to the response seen by stimulation with β-adrenergic receptor agonists (i.e. isoproterenol). In both cell types, cAMP-dependent kinase (PKA) is activated. Recently, PRAJA2, a novel AKAP and E3 ubiquitin ligase that targets the regulatory subunits of PKA was identified. The ubiquitin-dependent proteasomal degradation of the PKA regulatory subunits, due to PKA- phosphorylated PRAJA2, prolongs the catalytic activity of PKA, as shown in neuroblastoma cells by Lignitto et al., 2011. In adipocytes, stimulated PKA activity is required for lipolysis. Additionally, PRAJA2 has been described to have increased expression in TSH-responsive, differentiated thyroid cancer cells when compared to anaplastic thyroid tumor (Cantara et al., 2012) The aim of this study was to characterize PRAJA2 and its potential influence on adipocyte lipolysis. These data confirm that TSH and isoproterenol stimulate lipolysis in primary human differentiated adipocytes. PRAJA2 is expressed at the mRNA and protein level in differentiated adipocytes, with no change following stimulation with TSH or isoproterenol. Stimulation with isoproterenol, but not TSH, increases PKA-dependent phosphorylation of a 122kDa (potentially PRAJA2) and 69kDa protein identified in PRAJA2 immunoprecipitates. These proteins may prove important for lipolytic signaling or other PRAJA2-dependent process in adipocytes. Experimentation was unable to identify interactions between PRAJA2 and PKAR2 in differentiated adipocytes; however further investigations are required before discounting this interaction. An attempt was made to knockdown PRAJA2 in this model, and measure effects on lipolytic response; however, this was unsuccessful. Taken together, PRAJA2 appears to be phosphorylated following β-adrenergic stimulation in human adipocytes; however, further studies are needed to delineate the specific role of PRAJA2 in this human differentiated adipocyte model.
8

Hormone events in human lactogenesis

Sun, Jiangping January 1996 (has links)
No description available.
9

Efectos secundarios a corto y mediano plazo del tratamiento con 131I en pacientes con cáncer diferenciado de tiroides

Paillahueque Velásquez, Gabriela January 2018 (has links)
Residente de 3º año de Medicina Nuclear, Hospital Clínico de la Universidad de Chile, Servicio de Medicina Nuclear, Departamento de Medicina / INTRODUCCIÓN: El cáncer diferenciado de tiroides (CDT) es la neoplasia maligna más frecuente del sistema endocrino. Su tratamiento incluye frecuentemente yodo radiactivo, el cual puede producir efectos secundarios indeseados. Actualmente existe controversia respecto a la indicación y actividad de radioyodo a administrar. OBJETIVO: Evaluar los efectos secundarios a corto y mediano plazo del tratamiento con 131I en pacientes con CDT y su relación con la actividad administrada; además, determinar la concordancia de las dosis indicadas localmente versus lo recomendado por la Guía ATA 2015. MATERIALES Y MÉTODOS: Estudio prospectivo, que incluyó pacientes con CDT que ingresaron al Servicio de Medicina Nuclear del Hospital Clínico de la Universidad de Chile para tratamiento con radioyodoterapia posterior a tiroidectomía total. Se valoró la aparición de efectos secundarios a corto y mediano plazo a través de una encuesta, en 2 oportunidades: dentro de los 10 primeros días post radioyodo y a los 6 meses post terapia. Además, se catalogó a cada paciente según riesgo de recurrencia y se estableció la concordancia de la indicación de 131I con la Guía ATA 2015. RESULTADOS: Los síntomas secundarios más frecuentes a corto plazo fueron las náuseas (59 pacientes), dolor cervical (44 pacientes) y disgeusia (43 pacientes); mientras que a corto plazo fue la disgeusia (16 pacientes) xerostomía (9 pacientes) y sialoadenitis (7 pacientes). Existe una relación directamente proporcional entre la ocurrencia de efectos secundarios y la actividad administrada de yodo radiactivo. Hubo buena concordancia de riesgo de recurrencia vs indicación de 131I en los pacientes de riesgo intermedio y alto, a diferencia de los pacientes de bajo riesgo, en que se observó frecuentemente indicación de mayor actividad a la recomendada. CONCLUSIONES: Los efectos secundarios a la radioyodoterapia en los pacientes con CDT son frecuentes, habitualmente de corta duración y autolimitados. Existe cierta heterogeneidad en los criterios de indicación de 131I, especialmente en los casos de bajo riesgo.
10

RelaÃÃo entre os elementos definidores da sÃndrome metabÃlica e a funÃÃo tireoidiana em indivÃduos com eutireoidismo da populaÃÃo de Fortaleza-CE. / Relationship between the defining elements of the metabolic syndrome and thyroid function in subjects with euthyroid in population of Fortaleza.

Maria Helane Costa Gurgel Castelo 08 September 2010 (has links)
Conselho Nacional de Desenvolvimento CientÃfico e TecnolÃgico / A associaÃÃo entre disfunÃÃes tireoideanas clinicamente manifestas e o desenvolvimento de distÃrbios metabÃlicos està bem determinada. Entretanto, nos Ãltimos anos, o debate acerca da relaÃÃo entre alteraÃÃes na funÃÃo tireoideana (FT) e a sÃndrome metabÃlica (SM), ou seus componentes, tem ganhado especial atenÃÃo. Sendo o hormÃnio tireoestimulante (TSH) o teste de rastreamento mais sensÃvel para a detecÃÃo de alteraÃÃes da FT, tem se discutido critÃrios mais rigorosos de normalidade em indivÃduos sadios, a partir do achado de associaÃÃo de desfechos clÃnicos desfavorÃveis com valores anteriormente considerados normais. No entanto, torna-se difÃcil a definiÃÃo de âsaÃdeâ, em especial no Ãmbito relacionado à adiposidade corporal, considerando ser a obesidade uma condiÃÃo de elevada prevalÃncia e per si relacionada a inÃmeras morbidades. Assim, este trabalho objetivou avaliar a relaÃÃo entre os elementos definidores da SM e a FT e determinar o valor de referÃncia (VR) do TSH em uma amostra de indivÃduos saudÃveis, do ponto de vista tireoideano, residentes na cidade de Fortaleza-CE, Brasil. Trata-se de um estudo transversal conduzido no perÃodo de marÃo de 2009 a janeiro de 2010 onde foram incluÃdos 267 indivÃduos eutireoideanos, selecionados a partir de critÃrios clÃnicos e laboratoriais. Esta seleÃÃo compreendeu quatro etapas incluindo o preenchimento de um questionÃrio auto-administrado, avaliaÃÃo mÃdica e laboratorial, com antropometria, medida da circunferÃncia abdominal (CA), da pressÃo arterial sistÃlica (PAS) e diastÃlica (PAD), determinaÃÃo sÃrica de TSH, tiroxina livre (T4l), triiodotironina (T3), anticorpo anti-tireoperoxidase (ATPO), anticorpo anti-tireoglobulina (ATG), glicose em jejum (GJ), insulina, colesterol total (CT), LDL, HDL e triglicerÃdeos (TG), cÃlculo da resistÃncia à insulina, atravÃs do modelo de avaliaÃÃo da homeostase (HOMA-IR), e a realizaÃÃo de ultrassonografia tireoideana (UST). Dentre os 267, foram selecionados 125 participantes, denominados indivÃduos-referÃncia, caracterizados por T4l e T3 normais, anticorpos anti-tireoideanos negativos e UST normal. Este grupo compÃs o banco de registros individuais necessÃrios para a determinaÃÃo do VR do TSH de acordo com as recomendaÃÃes do NCCLS e NACB guidelines. Os dados foram submetidos à anÃlise estatÃstica, atravÃs do software Statistical Package for the Social Sciences (SPSS), versÃo 14.0 para Windows&#61666;, sendo usados o teste t de Student, teste de Mann-Whitney para comparaÃÃo das variÃveis contÃnuas, o teste do qui-quadrado para variÃveis categÃricas e o teste de Spearman para anÃlise de correlaÃÃes, sendo adotado o nÃvel de significÃncia estatÃstica de 5% (p<0,05). Modelos de regressÃo linear mÃltipla foram aplicados na avaliaÃÃo das associaÃÃes entre a FT com as concentraÃÃes de lipÃdeos sÃricos e com vÃrios traÃos da SM, com e sem ajuste para idade, sexo e HOMA-IR. Para determinaÃÃo do intervalo de referÃncia do TSH foram adotados os percentis 2,5% e 97,5% da curva de distribuiÃÃo deste analito, como sendo os correspondentes dos limites inferior e superior do VR do TSH. ApÃs a anÃlise, observou-se que 77,2% dos indivÃduos eutireoideanos apresentaram pelo menos um elemento definidor da SM. Quanto Ãs relaÃÃes entre os parÃmetros metabÃlicos e a FT, observou-se correlaÃÃo positiva do TSH apenas com CA e PAD, enquanto o T4l correlacionou-se inversamente com quatro (CA, GJ, TG, PAD) dos cinco elementos definidores da SM. Ainda foi demonstrada uma clara correlaÃÃo inversa entre o status de FT e o HOMA-IR. A partir destes achados, especula-se que de fato exista uma associaÃÃo entre a FT e a SM, e que os nÃveis sÃricos de hormÃnios tireoideanos (HTs), mais do que TSH, estÃo relacionados com fatores de risco cardiovascular. Na determinaÃÃo do intervalo de referÃncia do TSH, os valores obtidos se encontram entre 0,56 a 4,45mUI/l, o que està em consonÃncia com os pontos previamente estabelecidos em estudos de base populacional. / The association between clinically overt thyroid dysfunction and the development of metabolic disorders is well established. However, in recent years, the debate about the relationship between changes in thyroid function (TF), the metabolic syndrome (MS) or its components has gained special attention. Since the thyroid stimulating hormone (TSH) screening test more sensitive for detecting changes in TF, has been discussed more stringent criteria of normality in healthy individuals, from the finding of an association of adverse clinical outcomes with values previously considered normal. However, it is difficult to define "health", particularly in relation to body adiposity, whereas obesity is a condition of high prevalence itself linked to numerous illnesses. This study aimed to evaluate the relationship between the defining elements of MS and changes in the TF and determine the reference value (RV) of TSH in a sample of healthy subjects, from the stand point of thyroid, in the city of Fortaleza, Brazil. This is a cross-sectional study conducted from March 2009 to January 2010 which included 267 euthyroid subjects were selected from clinical and laboratory criteria. This team comprised four stages including the completion of a self-administered questionnaire, laboratorial and medical evaluation, with anthropometry, measurement of waist circumference (WC), systolic blood pressure (SBP) and diastolic (DBP), determination of serum TSH, free thyroxine ( FT4), triiodothyronine (T3), anti-thyroperoxidase (ATPO), thyroglobulin antibody (ATG), fasting glucose (FG), insulin, total cholesterol (TC), LDL, HDL and triglycerides (TG), insulin resistance calculated by homeostasis model assessment (HOMA-IR ), and the realization of thyroid ultrasound (TUS). Among the 267, 125 participants were selected, named individuals-reference, characterized by normal FT4, anti-thyroid antibody negative and normal TUS normal. This group composed the database of individual records necessary for determining the VR TSH according to the NCCLS and NACB guidelines. Data were subjected to statistical analysis (software Statistical Package for the Social Sciences (SPSS), versÃo 14.0 para Windows&#61666;) being used the Student t test, Mann-Whitney test to compare continuous variables, the chi-square test for categorical variables and Spearman test for correlation analysis, adopting the statistical significance level of 5% (p < 0.05). Multiple linear regression models were applied to evaluate the associations between the FT with the concentrations of serum lipids and various traits of MS, with and without adjustment for age, sex, and HOMA-IR. To determine the reference range of TSH were adopted percentiles 2.5% and 97.5% of the distribution curve of the analyte, as the correspondents of the lower and upper limits of TSH RV. After the analysis, we observed that 77.2% of euthyroid subjects had at least one defining element of MS. Regarding the relationships between metabolic parameters and FT, there was positive correlation of TSH with only WC and DBP, while the FT4 correlated inversely with four (WC, FG, TG, DBP) in the five defining elements of MS. Yet been demonstrated a clear inverse correlation between the status of TF and HOMA-IR. From these findings, we speculate that in fact there is an association between the TF and MS, and that serum levels of thyroid hormones (THs) more than TSH, are related to cardiovascular risk factors. In determining the reference range of TSH, the values are between 0.56 to 4.45 mIU / l, which is in line with the points previously established in population-based studies.

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