Thyroid hormones status during pregnancy in normal Iranian women

Pregnancy is associated with significant, but reversible changes in thyroid function studies, which are among the most profound seen as a result of a normal physiologic state. The present study was carried out to find out alterations in thyroid function tests in each trimester in normal pregnant women as compared to non-pregnant women in Tabriz-Iran. A case-control study designed with 229 normal pregnant women that randomly selected from the first (64 samples), the second (92 samples), and the third (73 samples) trimesters and 250 randomly selected non-pregnant healthy female controls. Age range in both groups was 16–40 years. Thyroid function tests carried out by measuring serum levels of thyroid stimulating hormone (TSH), free and total thyroxin (FT₄, TT₄), and free and total triiodothyronine (FT₃, TT₃) by commercially available radio immunoassay kits. We found that mean TT₄ increased progressively during pregnancy. Our study showed increasing in serum levels of TT₃ in the second trimester and then declining during the third trimester compared with non-pregnant women. We showed that FT₄ strongly decreased during the third trimester. Free T₃ showed declining in the second and third trimesters. Mean TSH did not show significant difference in each trimester compared with non-pregnant women. The thyroid function tests in pregnancy should be interpreted against gestational age-related reference intervals to avoid mis-interpretation of thyroid function during pregnancy.     

Session - 5 December 18, 2007 AACC Symposium

The prevalence of abnormal thyroid hormone levels in diabetes mellitus in Nigeria is not well described. To determine the incidence of abnormal thyroid hormone levels in diabetics in Calabar, Nigeria, fasting blood samples from 161 diabetic subjects and 105 non-diabetic controls were analysed. Free thyroxine (FT), thyroid stimulating hormone (TSH), total triiodothyronine (T₃) and total thyroxine (T₄) kits obtained from Biomerica Inc. of USA were used for the analysis. TSH levels (1.80±1.62) in diabetics were significantly lower (p=0.016) than the level in non-diabetic controls (2.34±1.24). Male diabetics had lower (p<0.05) levels of TSH (1.192±0.68 miu/ml) than diabetic females (1.90±1.70 mlu/mt). The level of T₃ in diabetic males (125±97ng/ml) was higher than the level in females (98±75ng/dl). TSH (F=2.74, p=0.049), T₄(F=56.87, p=0.001), T₃(F=56.44, P=0.001) in diabetics and FT₄ (F=5.74, p=0.002) in controls showed significant variation with the ages of the subjects. Out of 161 diabetics subjects studies 26.6% had low plasma thyroid hormone levels (FT₄>2.01 ng/dl). This study has shown a high incidence (46.5%) of abnormal thyroid hormone levels among the diabetics in Nigeria (hypothyroidism 26.6%, hyperthyroidism, 19.9%). The prevalence of hypothyroidism was higher in women (16.8%) than in men (9.9%), while hyperthyroidism was higher in males (11%) than in females (8%). This study has defined thyroid function status of diabetics in Calabar, Nigeria probably the first of such work in Africa.     

Impact of iodine deficiency on thyroid function in pregnant African women — A possible factor in the genesis of ‘small for dates’ babies

The effect of iodine deficiency (ID) on thyroid function in African women during pregnancy and postnatal period was examined, for which very limited information is available. Serum T₄, T₃, TSH, TBG, thyroxine binding capacity (TBK), free thyroxine index (FT₄I=T₄/TBK) and T₄/TBG were determined by ELISA technique in 32 pregnant women (resident of Plateau state, Nigeria- an ID zone) through pregnancy upto term delivery, and in 5 women up to 6 weeks post delivery. Urinary iodide level was measured at delivery to determine the degree of iodine deficiency. Results were matched with a non pregnant control comprising 44 subjects. 5555 birth weights (BW) of term babies in the region were analysed to determine the prevalence of ‘small for dates’ (SFD) babies in the population. Results show that the level of serum FT₄I was elevated very significantly at late gestation (P<.001) but the women were not hyperthyroid, suggesting a marked disturbance in binding of T₄ with TBG during pregnancy. Five women with SFD babies were found in ‘compensated hypothyroid state’ and showed a significant depression (p<.01) in serum T₄/TBG, T₄, FT₄I and T₃ levels to a low normal range, with a concurrent significant rise (p.<.001) in TSH level (above normal range) throughout pregnancy. Incidence of SFD babies was higher (p.<.001) in ID zone (Bassa 15.2%) compared to control zone (Jos 9.8%). It is concluded that a state of maternal ‘subclinical (compensated) hypothyroidism’ during pregnancy possibly plays an important role in the aetiopathogenesis of SFD babies in Africans. A normal reference range for thyroid parameters at various stages of pregnancy in healthy African women is established for the first time.     

Establishment of Trimester-Specific Reference Intervals of Serum TSH & fT4 in a Pregnant Indian Population at North Kolkata

Reference intervals (RIs) of serum thyroid stimulating hormone (TSH) and free thyroxine (fT₄) were determined in 402 healthy pregnant women by enzyme-linked immunosorbent assay (ELISA) technique after partitioning them into three trimesters. The reference population was chosen from a study population of 610 pregnant females by applying strict inclusion and exclusion criteria. The assays were done using proper quality control measures. RIs were calculated from the central 95 % of the distribution of TSH and fT₄ values located between the lower reference limit of 2.5 percentile and upper reference limit of 97.5 percentile value 0.90 confidence intervals for the upper and lower reference limits were also determined. The reference intervals for TSH were 0.25–3.35 μIU/ml for the first trimester; 0.78–4.96 μIU/ml for the second trimester and 0.89–4.6 μIU/ml for the third trimester. Similarly, the reference intervals for fT₄ for first, second and third trimesters were 0.64–2.0, 0.53–2.12 and 0.64–1.98 ng/dl respectively. The values thus obtained varied from those provided by the kit literature. In comparison to our derived reference intervals, the reference data from kit manufacturer under-diagnosed both subclinical hypo- and hyper-thyroidism within our pregnant reference population.     

An audit of total and free thyroxine measurements in screening for hypo and hyperthyroidism in patients using chemiluminescence immunoassay

An audit of 2509 patient specimens analyzed for both total thyroxine (TT4) and free thyroxine (FT4) by the ACS-180 automated chemiluminescence immunoassay analyzer revealed that there were 219 discrepancies (8.7% of the total). A discrepancy was defined as one analyte within its reference range and the other outside. The discrepant results were divided into 4 groups: group A: normal TT4, but decreased FT4, 101 patients (4.0%); group B: increased TT4, normal FT4, 78 patients (3.1%); group C: decreased TT4, normal FT4, 34 patients (1.4%); and group D: normal TT4, increased FT4, 6 patients (0.2%). TSH measurements were available, by a 3^rd generation chemiluminescent assay, in 142 of these patients, and were consistent with the FT4 result in 72 patients, with TT4 in 61 cases and with neither in 9 patients. The clinical diagnosis was investigated in a subgroup of 43 endocrine patients. Thirteen of the 20 endocrine patients in group A were diagnosed as hypothyroid, with a measured serum TSH, in 11 of them, of median 14.6, range 1.2 to 46.2 μlU/ml. Eleven of the 19 endocrine patients in group B were on thyroid replacement, with a measured serum TSH, in 7 of them of <0.01 μlU/ml. The audit of current laboratory practice led to a suggestion to replace the current thyroid function screening strategy of measuring both TT4 and FT4 by the combination of FT4 and TSH. The reasons for the discrepancies and the alternative strategies for screening of thyroid function are discussed.     

A Study on the Level of T<Subscript>3</Subscript>, T<Subscript>4</Subscript>, TSH and the Association of A/G Polymorphism with CTLA-4 Gene in Graves’ Hyperthyroidism among South Indian Population

Graves’ disease (GD) is an organ-specific heterogenous autoimmune disorder associated with T-lymphocyte abnormality affecting the thyroid, eyes and skin. GD is a multifactorial disease that develops as a result of complex interaction between genetic susceptibility genes and environmental factors. It has been suggested that the Cytotoxic T lymphocytes associated molecule-4 (CTLA-4) is a genetic susceptibility candidate for GD. The present study was focused on A/G polymorphism at position 49 in exon-1 of the CTLA-4 gene in 80 GD patients (GP) and 80 sex and age matched healthy individuals among South Indian (Madurai) population. Serum concentrations of thyroid hormone (T₄, T₃ and TSH) were determined by using automated analyzer. The genomic DNA was isolated from the patient and control groups and genotyping was performed using the polymerase chain reaction followed by restriction enzyme analysis using Bbv1. Significant difference (P < 0.001) was observed in the level of T₃, T₄ and TSH in GD patients and healthy individuals. The results revealed the CTLA-4 gene G/G genotype to be 32 (40%) in patients and 26 (32.50%) in healthy individuals, A/G genotype to be 37 (46.25%) in patients and 25 (31.25%) in healthy individuals and A/A genotype to be 11 (13.75%) in patients and 29 (36.25%) in healthy individuals. The calculated odds ratio (OR) in individuals with mutant genotype (GG/AG) reveal 3.6 fold risk for GD (95% confidence interval = 1.6–7.8). The mutant “G” allele frequency was observed to be 0.63 in GD patients and 0.48 in healthy individuals. Thus the present study demonstrates an association between the CTLA-4 gene polymorphism and Graves’ disease.     

A study of thyroid status in hyperemesis gravidarum

Study was undertaken to assess thyroid status in hyperemesis gravidarum. 150 women pregnant with <20 weeks of gestation were selected randomly and out of these 100 women presenting with hyperemesis formed study group while 50 normal pregnant women served as controls. 53% of hyperemetic pregnant women were primigravidae and 82% of pregnant women presented with vomiting at less than 12 weeks of gestation. Statistically significant, 22% of hyperemetic women had increased serum T₃ levels while T₄ levels were increased in 67% of women in study group as compared to 8% and 16% respectively in control group. TSH levels were decreased in 18% of hyperemetic women as compared to 8% in control group with decrease in mean TSH level statistically significant. 22% of hyperemetic women had electrolyte disturbances and 7% were ketonuric. In clinically euthyroid women, biochemically altered thyroid function can attribute to vomiting and its prolongation to second trimester     

Diagnostic strategies for subclinical hypothyroidism

The aim of this study is to delineate laboratory diagnostic strategies for subclinical hypothyroidism in patients who are clinically symptomatic but may have a normal thyroid profile. Tri — iodothyronine (T₃), thyroxine (T₄), thyroid stimulating hormone (TSH) and anti thyroid peroxidase antibodies (anti-TPO) were estimated on fasting blood samples from 99 patients using electrochemiluminescence methods on ELECSYS 1010 (Roche). 74% of study subjects had elevated anti-TPO levels.61% patients had subclinical hypothyroidism. 45 of the 61 subclinical hypothyroid patients had elevated anti-TPO levels (73%). This is an important finding suggesting an autoimmune etiology for subclinical thyroid dysfunction with a higher risk of developing overt hypothyroidism.     

Serum lipids in hypothyroidism: Our experience

In order to determine whether the screening of lipid profile is justified in patients with hypothyroidism we estimated serum lipids in cases having different levels of serum TSH. 60 patients of hypothyroidism in the age group of 20 to 60 yrs were studied for thyroid profile over a period of one year. On the basis of serum TSH level the cases were divided into three groups: In the first group TSH concentration was 8.8±2.99 μlU/ml, 95% confidence interval (Cl) 8.8±1.07, whereas serum total cholesterol and LDL-chol levels were 196±37.22 and 126±29.17 mg/dl respectively. The statistical analysis of these two groups showed a significant correlation between raised TSH levels and serum total cholesterol and LDL-chol (P<0.05 & P<0.01) respectively. We conclude that hypothyrodism is associated with changes in lipid profile.     

Effect of some antitubercular drugs on the calmodulin content ofMycobacterium tuberculosis

The effect of the antitubercular drugs isoniazid (10 μg/ml), ethambutol (10 μg/ml), rifampicin (0.5 μg/ml) and streptomycin (1 μg/ml) on the calmodulin like protein (CAMLP) content ofMycobacterium tuberculosis H₃₇R_v andM. tuberculosis H₃₇R_a was investigated. The drugs were added to actively growing cells at their mid log phase of growth (14 days) and after 12 more hours of incubation, CAMLP was estimated. In both the mycobacteria, all the four antitubercular drugs CAMLP.     

Plasma Fibronectin Concentration in Obese/Overweight Pregnant Women: A Possible Risk Factor for Preeclampsia

Plasma fibronectin (FN) levels in obese/overweight and non-obese pregnant women were evaluated as a possible risk factor for preeclampsia. A total of one hundred and sixty three pregnant women attending antenatal clinic at University of Calabar Teaching Hospital participated in the study and sixty non-pregnant women served as control. About 77 (47.24%) of the pregnant women were followed up for any subsequent development of preeclampsia during the pregnancy. Fibronectin levels in plasma were measured by ELISA assay and serum total protein, urea and creatinine were determined spectrophotometrically. The mean plasma FN concentration of non-obese pregnant women in first trimester was lower than those of the non-pregnant women by 24%, but however, increased to the non-pregnant level in second and third trimesters. Obese/overweight pregnant women had significantly (P < 0.05) higher values than non-obese pregnant women in second and third trimesters. FN in obese/overweight pregnant women correlated positively with mean arterial blood pressure (MAP: r = 0.414, P = 0.04). About 28.57% of the pregnant women with FN above cut off point of 330 μg/ml at 18–24 weeks of gestation developed preeclampsia. This value increased to 40.0% when only the obese/overweight women were considered. On analysis of both fibronectin >330 μg/ml and MAP > 90, the predictive value increased to 66.7%. We therefore conclude that elevated FN may be regarded as a risk factor of preeclampsia especially among the obese women.     

Are we using Thyroid Function Tests Appropriately?

Thyroid function tests are very important for the diagnosis and monitoring of patients with thyroid dysfunction. The guidelines recommend serum thyroid stimulating hormone (TSH) as the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism. The aim of this study was to analyze the ordering pattern for thyroid function tests by physicians and the analysis of results based on the clinical history. The mean age of the patients was 32.5 ± 6.5 years. Majority of samples (87.7% of total) were received from the departments of Medicine and Gynae. Thyroid profiles (47.5%) were ordered more frequently as compared to TSH only (46%). There was no significant difference in the percentage of normal reports for both types of tests. 77.8% of TFT and 76.6% of TSH samples had results within the reference range. The percentage of abnormal results was 13.7% in the patients who were screened for thyroid disorders. There is a need to redefine the case definition for thyroid dysfunction and order the appropriate test in a rational and cost effective manner.     

A Microarray Immunoassay for Serum Thyrotropin and Thyroglobulin Using Antibodies Immobilized on Track-Etched Membranes

Serum thyroglobulin (Tg) and thyroid stimulating hormone (TSH) measurements have evolved as important analytes for monitoring the prognosis of patients with differentiated thyroid cancer, post-thyroidectomy. Individual analyte immunoassay is the current practice in clinical pathology, but the simultaneous assay for all relevant analytes for a given disease, can reduce assay costs, improve patient compliance and give the clinician more information for an unequivocal diagnosis. Microarray immunoassay (MI) can achieve this goal and, hence, we have developed and validated a immuno-radiometric MI for quantitation of serum TSH and Tg by using highly micro-porous polycarbonate (PC) track-etched membranes (TEM) to immobilize the monoclonal anti-TSH and polyclonal anti-Tg antibodies in ~1 mm diameter spots. Non-competitive immunoassays were performed using mixture of ¹²⁵I labeled monoclonal anti-TSH and anti-Tg antibodies. Phosphorimager was used to quantify the bound radioactivity. TSH and Tg were detected with detection limit of 0.07 µIU/ml and 0.13 ng/ml respectively, which is lower than the clinically required cut-off level. The assay showed: acceptable intra-assay precision within 20 % and recovery in the range of 76–111.2 %. MI compared well with the established immunoradiometric assay (IRMA) with r = 0.98, p < 0.01 (n = 41). No cross-reactivity was seen between the immobilized antibodies. Although two hormones are addressed in this report, MI using PC TEM and isotopic/non-isotopic tracers has the potential for highly automated multiplexed analysis.     

Antihyperglycemic and antilipidperoxidative effects of<Emphasis Type="Italic">Tephrosia purpurea</Emphasis> seed extract in streptozotocin induced diabetic rats

The aim of the present study was to evaluate the antihyperglycemic and antilipidperoxidative effects of ethanolic seed extract ofTephrosia purpurea (TpEt) in streptozotocin induced diabetic rats. Hyperglycemia associated with an altered hexokinase and glucose 6 phosphatase activities, elevated lipid peroxidation, disturbed enzymatic and non-enzymatic antioxidants status were observed in streptozotocin induced diabetic rats. Oral administration of “TpEt” at a dose of 300mg/kg bw showed significant antihyperglcemic and antilipidperoxidative effects as well as increased the activities of enzymatic antioxidants and levels of non enzymatic antioxidants. We also noticed that the antihyperglycemic effect of plant drug (TpEt) was comparable to that of the reference drug glibenclamide. Our results clearly indicate that “TpEt” has potent antihyperglycemic and antilipidperoxidative effects in streptozotocin induced diabetic rats and therefore further studies are warranted to isolate and characterize the bioactive antidiabetic principles from “TpEt”.     

Establishing paediatric reference intervals for thyroid function tests in Croatian population on the Abbott Architect i2000

IntroductionEvaluation of thyroid function is often requested and therefore defining paediatric reference intervals (RIs) is of vital importance. Currently, there is a distinct lack of paediatric RIs for thyroid function tests in Croatia. Thus, we established RIs for thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) in the Croatian paediatric population.Materials and methodsReference intervals were calculated from 397 apparently healthy children, aged from 2 days to < 19 years. Serum samples were analysed for thyroid function tests on the Abbott Architect i2000. Age- and sex-specific 95% RIs with 90% confidence intervals were established according to Clinical and Laboratory Standards Institute guidelines. To express the magnitude of sex and age variation, standard deviation ratio (SDR) was calculated using two-level nested ANOVA. The criterion for considering partitioning reference values was set to SDR > 0.3.ResultsAll thyroid function tests required age partitioning, confirmed by SDR above 0.3. There was no need for sex partitioning, confirmed by SDR below 0.3. Still, FT3 was partitioned due to visually noticeable sex related difference for the oldest group (12 years to < 19 years).ConclusionThis is the first study to establish RIs for thyroid function tests in the Croatian paediatric population. We propose RIs for widely used Abbott platform, thus giving laboratories method- and population-specific paediatric RIs for thyroid function tests that should improve clinical test interpretation.     

The freedoms of software and its ethical uses

The “free” in “free software” refers to a cluster of four specific freedoms identified by the Free Software Definition. The first freedom, termed “Freedom Zero,” intends to protect the right of the user to deploy software in whatever fashion, towards whatever end, he or she sees fit. But software may be used to achieve ethically questionable ends. This highlights a tension in the provision of software freedoms: while the definition explicitly forbids direct restrictions on users’ freedoms, it does not address other means by which software may indirectly restrict freedoms. In particular, ethically-inflected debate has featured prominently in the discussion of restrictions on digital rights management and privacy-violating code in version 3 of the GPL (GPLv3). The discussion of this proposed language revealed the spectrum of ethical positions and valuations held by members of the free software community. In our analysis, we will provide arguments for upholding Freedom Zero; we embed the problem of possible uses of software in the broader context of the uses of scientific knowledge, and go on to argue that the provision of Freedom Zero mitigates against too great a moral burden—of anticipating possible uses of software—being placed on the programmer and that, most importantly, it facilitates deliberative discourse in the free software community.     

Kinetics of Inhibition of Monoamine Oxidase Using <Emphasis Type="Italic">Cymbopogon martinii</Emphasis> (Roxb.) Wats.: A Potential Antidepressant Herbal Ingredient with Antioxidant Activity

The study was designed to evaluate the antioxidant activity and effect of Cymbopogon martinii (Roxb.) Wats. (Poaceae) leaves on the activity of monoamine oxidase and kinetics of enzyme inhibition. Ethanol extract of C. martinii and rat brain mitochondrial monoamine oxidase preparation ware used to study the kinetics of enzyme inhibition using double reciprocal Lineweaver–Burk plot. The DPPH was used as a source of free radical to evaluate antioxidant potential. It is observed that, the ethanolic extract of C. martinii inhibits the monoamine oxidase activity with competitive mode of inhibition. The V _max (0.01 mM/min) remained constant while, K _m varied from 21.00 ± 1.1, 43.33 ± 1.5 and 83.33 ± 1.4 mM for 100–500 μg/ml concentration of C. martinii. The K _i values were calculated to be 90.00 ± 0.87, 75.00 ± 0.69, 68.18 ± 0.68 μg for 100–500 μg/ml concentration of C. martini. It also shows a significant DPPH (1,1-diphenyl-2-picryl hydrazine) radical scavenging (IC₅₀ = 0.34 ± 0.05 mg/ml) and reducing activity (IC₅₀ = 0.70 ± 0.22 mg/ml). The C. martini can be considered as a possible source of MAO inhibitor used in the treatment of depression and other neurological disorders.     

Separation of serum LD isoenzymes by capillary electrophoresis

Separation and quantitative estimation of the isoenzymes of lactate dehydrogenase(LD) in serum were accomplished with capillary electrophoresis system. An uncoated fused silica capillary column 50 cm long, 75μm I.D. and substrate containing running buffer including L-lactic acid and NAD⁺ were used for the separation of serum LD isoenzymes. The resulting product of “NADH” was detected at 340 nm. Injection of 10 nL of five fold diluted serum sample were performed by pressure injection within 2 seconds. The isoenzymes were separated at 10 kV of voltage for 5 min, by turning off the voltage applied for 30 min incubation at 24°C for reaction between substrate and isoenzymes, and applying voltage of 30 min. Under these conditions, the isoenzymes of LD were detected by a NADH generated as isoenzyme of LD-5 emerged at 20 min, LD-1 peak at 23.5 min with close to baseline separation of the other isoenzymes which emerge between LD-5 to LD-1, after the emergence to LD-1 peak, followed another peak, termed “sample shock”: The results obtained by the proposed method correlated well with those by gel electrophoresis systemes (r=0.92∼0.98) for each five LD isoenzymes, respectively. Within-run precision CVs for 5 replicate analysis were 3.01 (LD-3, mean 14.6%)%∼7.82% (LD-4, mean 4.22%.), respectively.     

External quality assessment of RIA for thyroid related hormones

An external quality assessment was conducted for RIA of thyroid related hormones. Thirtyfive laboratories (35 for T₄, 34 for T₃ and 23 for TSH) from different parts of country participated in the programme. Twentyfour samples (16 pools: 5 simple and 11 manipulated pools) in 8 batches, 3 per batch per month were sent for analysis of T₄, T₃ and TSH. Some of the samples were repeated 3 times at different occasions to assess the imprecision of the laboratory. The overall mean percent CV obtained for T₄, T₃ and TSH were 22.7, 36.32 and 52.38 respectively. The recovery for added T₄ was 86.73% while that for T₃ was 117.4%. A large variation was obtained for recovery of TSH. For T₄ estimations, 13 laboratories had a desirable performance i. e. bias less than ±10.0% and variability of bias (VB) and imprecision (IP) less than 15.0%. None of the laboratories had a desirable performance for T₃ or TSH. The number of laboratories with acceptable performance i. e. bias between ±10.0–15.0%, VB and IP between 20.0–25.0% for T₄, T₃ and TSH were 4, 3 and 0 respectively. The number of laboratories which required attention (bias between ±15.0–20.0%; VB and IP between 20.0–25.0%) were 5,7 and 1 respectively. The unacceptable results with larger bias, VB and IP for T₄, T₃ and TSH were 6, 18 and 17 respectively. Our results are in general agreement that the performance of T₄ assay is better than T₃ and both in turn are much better than TSH. Quantitation of circulating thyroid hormones (TH) viz. tri-iodothyronine (T₃), thyroxine (T₄) and thyroid stimulating hormone (TSH), which form the largest percentage of hormones estimated in a clinical laboratory is mainly done by radio-immunoassay (RIA) procedures. The reliability and reproducibility of these assays are generally monitored by using internal quality control (IQC) samples in every assay batch. Thus, the IQC provides information whether the assay results are satisfactory and can be released. However, external quality assessment (EQA) is a procedure whereby an external agency undertakes evaluation of the quality of an analytical service by providing samples for analysis to individual laboratories performing the assay. The data gathered is analysed collectively. EQA therefore provides a means by which performance of a laboratory is assessed in relation to other laboratories and matching the assay unbiased by removing systematic error, if present. This is important since RIA procedure involves several steps (collection and storage of samples, quality of the reagents, procedure followed for performance of an assay, counting equipment used and the mode of the data analysis) and therefore prone to systematic errors. We therefore undertook the EQA programme for assessment of thyroid related hormones as a joint collaborative project of Bhabha Atomic Research Centre, India and International Atomic Energy Agency.     

Thyroid hormone status in protein energy malnutrition in Indian children

Thyroid hormonal status was measured in 80 malnourished children of different grades (I–IV) of protein energy malnutrition (PEM). Serum levels of tri-iodo thyronine (T₃), thyroxine (T₄) and thyroid stimulating hormone (TSH) were measured by radioimmunoassay. The results were compared with 20 healthy, age and sex matched controls. Levels of T₃ and T₄ were significantly low in PEM cases whereas TSH levels were similar in PEM cases when compared to controls.