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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wencai Ke Department of Clinical Laboratory Medicine, Fifth People's Hospital of Shanghai Fudan University, Shanghai, China

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Fanfan Pan Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xinmei Huang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Objective

Neutropenia is a complication of Graves' disease (GD), but there is currently no means by which to predict its occurrence. This study aimed to investigate the risk factors for the development of neutropenia in untreated GD.

Methods

This was a retrospective cohort study. Between January 1, 2010, and July 31, 2020, 1000 patients with new-onset or relapsing GD without treatment were enrolled in the study and divided into two groups: neutropenia group (neutrophil count < 2 × 109/L) and non-neutropenia group (neutrophil count ≥ 2 × 109/L). Clinical characteristics of subjects were compared between the two groups, and logistic regression analysis was applied to determine risk factors for neutropenia. To further explore the correlation of radioactive iodine uptake (RAIU) with neutropenia, subjects were first classified according to quartile of 3 h RAIU and 24 h RAIU prior to logistic regression analysis.

Results

Of all patients recruited, 293 (29.6%) were diagnosed with neutropenia. Compared with non-neutropenic patients, those with neutropenia had a higher level of free thyroxine (FT4) (56.64 ± 31.80 vs 47.64 ± 39.64, P = 0.001), 3 h RAIU (55.64 ± 17.04 vs 49.80 ± 17.21, P < 0.001) and 24 h RAIU (67.38 ± 12.54 vs 64.38 ± 13.58, P < 0.001). Univariate logistic regression analysis revealed that FT4, 3 h RAIU, 24 h RAIU, creatinine, and low-density lipoprotein were risk factors for development of neutropenia in GD. After adjusting for confounding factors of age, BMI, and sex, we determined that 3 h RAIU and 24 h RAIU (Model 1: OR = 1.021, 95% CI: 1.008–1.033, P = 0.001; Model 2: OR = 1.023, 95% CI: 1.007–1.039, P = 0.004), but not FT4, were associated with the development of neutropenia.

Conclusions

RAIU is associated with neutropenia in patients with untreated GD.

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Rui Zhang Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Xinmei Huang Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Yue Li Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Zhiyan Yu Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Yueyue Wu Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Bingbing Zha Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Heyuan Ding Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Shufei Zang Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Jun Liu Department of Endocrinology, Shanghai Fifth People’s Hospital affiliated to Fudan University, Minhang District, Shanghai, People’s Republic of China

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Objective

The aim of this study was to evaluate the effect of TFR2 on iron storage in type 2 diabetes.

Methods

A cross-sectional study was conducted among 1938 participants from the Jiangchuan Community of Shanghai. A total of 784 participants with T2DM and 1154 normal participants (non-T2DM) were enrolled in this study. Serum ferritin, fasting blood glucose, postprandial blood glucose, and HbA1C (glycated hemoglobin A1c) levels were determined. Eighteen Wistar male rats were randomly assigned into three groups (n = 6/group): rats in a high-fat diet streptozotocin (HFD+STZ) group were fed with HFD for 4 weeks and intraperitoneally injected with streptozotocin (STZ); rats in a control group were fed with a standard diet for 4 weeks and intraperitoneally injected with buffer; rats in an STZ group were fed with a standard diet for 4 weeks and intraperitoneally injected with streptozotocin. Glucose tolerance test was performed at the end of the study. Blood samples and liver tissues were assessed for liver TFR2, blood glucose, serum ferritin, and iron levels.

Results

The mean serum ferritin level of T2DM participants was significantly higher than that of the control group (227 (140–352) vs 203.5 (130.5–312) ng/mL, P < 0.05). Serum ferritin level was an independent risk factor for T2DM (high ferritin group vs low ferritin group, 1.304 (1.03–1.651), P < 0.05). Diabetic rats showed reduced liver TFR2 levels, with increased serum ferritin levels.

Conclusion

T2DM participants exhibited iron disorder with elevated serum ferritin levels. Elevated serum ferritin levels in diabetic rats were accompanied by reduced liver TFR2 levels.

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Xuechao Jiang Scientific Research Center, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
Department of Pediatric Cardiology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Yonghui Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xiaoying Li Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Leqi He Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wei Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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B lymphocytes are the source of autoantibodies against the thyroid-stimulating hormone receptor (TSHR) in Graves’ disease (GD). Characterization of autoimmune B-cell expression profiles might enable a better understanding of GD pathogenesis. To reveal this, the expression levels of long noncoding RNAs (lncRNAs) and mRNAs (genes) in purified B cells from patients with newly diagnosed GD and healthy individuals were compared using microarrays, which elucidated 604 differentially expressed lncRNAs (DE-lncRNAs) and 410 differentially expressed genes (DEGs). GO and pathway analyses revealed that the DEGs are mainly involved in immune response. A protein–protein interaction network presented experimentally validated interactions among the DEGs. Two independent algorithms were used to identify the DE-lncRNAs that regulate the DEGs. Functional annotation of the deregulated lncRNA–mRNA pairs identified 14 pairs with mRNAs involved in cell proliferation. The lncRNAs TCONS_00022357-XLOC_010919 and n335641 were predicted to regulate TCL1 family AKT coactivator A (TCL1A), and the lncRNA n337845 was predicted to regulate SH2 domain containing 1A (SH2D1A). TCL1A and SH2D1A are highly involved in B-cell proliferation. The differential expression of both genes was validated by qRT-PCR. In conclusion, lncRNA and mRNA expression profiles of B cells from patients with GD indicated that the lncRNA–mRNA pairs n335641–TCL1A, TCONS_00022357-XLOC_010919–TCL1A, and n337845–SH2D1A may participate in GD pathogenesis by modulating B-cell proliferation and survival. Therefore, the identified lncRNA and mRNA may represent novel biomarkers and therapeutic targets for GD.

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Leqi He Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xiaoying Li Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Zaoping Chen Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wei Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Kai Wang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Xinmei Huang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Qian Yang Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Wencai Ke Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Jun Liu Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Bingbing Zha Department of Endocrinology, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China

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Objective

To explore the relationship between estradiol (E2) and thyroid function during the second trimester of pregnancy and the effect of E2 on sodium iodide transporter (NIS) expression in cultured thyroid cells.

Materials and methods

We analyzed relationships between E2 and thyroid function in 196 pregnant women during the second trimester. Multiple linear regression analysis was performed between E2 and thyroid function. The human thyroid Nthy-ori3-1 cells were cultured in different E2 concentrations, and the mRNA levels of NIS, estrogen receptor (ER)-α, and ER-β were measured by quantitative real-time PCR. Their protein levels were assessed by western blot.

Results

E2 was positively correlated with thyroid-stimulating hormone (TSH) and negatively correlated with free thyroxine (FT4) (P < 0.05). When we corrected for age, BMI, alanine aminotransferase, and serum creatinine, E2 was still negatively correlated with FT4 (P < 0.5) during the second trimester. In Nthy-ori3-1 cells treated with 10 nM E2, NIS and ER-β mRNA levels were significantly reduced, while ER-α mRNA level was not altered (P > 0.5). Moreover, 10 nM E2 significantly decreased protein levels of ER-β, phosphorylated versions of protein kinase A (p-PKA), phosphorylated versions of cAMP response element-binding protein (p-CREB), and NIS, while treatment with the ER-β inhibitor restored the expression of p-PKA, p-CREB, and NIS (P < 0.05).

Conclusion

High concentration of E2 has a negative correlation with FT4. High concentration of E2 can inhibit the NIS expression through the ER-β-mediated pathway, which may cause thyroid hormone fluctuations during pregnancy.

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