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相关概念视频

Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
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Functions of Thyroid Hormones01:18

Functions of Thyroid Hormones

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
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Target Cell Response to Hormones01:22

Target Cell Response to Hormones

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Hormones intricately bind to receptors on the surface or within target cells, initiating a cascade of cellular responses.
Notably, the cellular response can be regulated by altering the number of receptors expressed in the cell. For example, prolonged exposure to elevated hormone levels results in a gradual decline or down-regulation in the number of receptors for that specific hormone on the cell surface. Conversely, in response to low hormone levels, cells may use up-regulation, producing an...
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Bioequivalence: Overview01:16

Bioequivalence: Overview

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Pharmaceutical equivalents, by definition, are drug products with the same active ingredient in the same quantities, encapsulated in identical dosage forms, and intended for the same administration routes. These pharmaceutical equivalents are deemed bioequivalent if the bioavailability of the active entity in the drug preparations is similar. Moreover, pharmaceutical equivalents demonstrating bioequivalence are also regarded as therapeutically equivalent. This means that when used as directed,...
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Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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甲状腺激素简介在替代治疗中和替代治疗后有什么不同?

Adrian H Heald1,2, Lakdasa D Premawardhana3, Peter N Taylor3

  • 1The School of Medicine and Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK.

Clinical endocrinology
|December 20, 2024
PubMed
概括

甲状腺功能低下症的Levothyroxine治疗通常会导致甲状腺刺激激素 (TSH) 和自由T4 (FT4) 水平高于预期. 这表明目前的治疗方案可能无法优化甲状腺激素状况,特别是在女性中.

关键词:
甲状腺激素特征 甲状腺激素特征治疗过的甲状腺功能低下症没有治疗的和euthyroid个体.

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科学领域:

  • 内分泌学 在内分泌学.
  • 甲状腺学 甲状腺学
  • 临床化学 临床化学

背景情况:

  • 在甲状腺功能低下患者中优化甲状腺激素状况仍然是一个临床挑战.
  • 了解自由T4 (FT4) 和甲状腺刺激激素 (TSH) 之间的关系对于有效的甲状腺功能低下症管理至关重要.

研究的目的:

  • 在接受甲状腺功能测试的大量实验室样本中分析FT4和TSH之间的关系.
  • 为了比较服用莱沃西替代疗法的患者与未接受治疗的患者的FT4和TSH水平.

主要方法:

  • 对来自13万个人的29万个甲状腺功能测试 (TFT) 的回顾性分析 (2009-2012).
  • 数据分为接受治疗 (利沃西) 和未接受治疗的组,针对并发症和单个与中位数测试结果进行特定过.
  • 集群分析用于定义未治疗个体的预期FT4/TSH范围 (第5至第95个百分位),并评估治疗患者的偏差.

主要成果:

  • 与未接受治疗的人 (TSH: 1.8 mU/L, FT4: 15.5 pmol/L) 相比,接受治疗的患者的TSH和FT4水平中位数较高 (TSH: 2.3 mU/L, FT4: 18.9 pmol/L).
  • 在接受治疗的患者中,很大一部分 (68%) 的结果超出了未接受治疗的患者所确定的参考范围,TSH和FT4值较高.
  • 这种不一致性在女性 (70%) 比男性 (63%) 更明显.

结论:

  • 目前的levothyroxine剂量策略并不总是达到最佳的实验室甲状腺功能测试配置文件.
  • 在接受治疗的甲状腺功能低下患者中,很大一部分患者的TSH和FT4水平超出预期范围,这表明潜在的治疗不足或低于最佳的治疗方案.
  • 在女性中更高的患病率表明了可能存在的levothyroxine代谢或反应的性别特异性差异.