Evidence map›Paper›PMID 32154116›Full record

ArticleJournal of clinical & translational endocrinology2020

Low CSF/serum ratio of free T4 is associated with decreased quality of life in mild hypothyroidism - A pilot study.

Anders Funkquist, Anders Bengtsson, P M Johansson, Johan Svensson, Per Bjellerup, Kaj Blennow, Birger Wandt, Stefan Sjöberg

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In one paragraph

Article in Journal of clinical & translational endocrinology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Anders FunkquistDpt. of Medicine, Halland Central Hospital, Halmstad, Sweden.
Anders BengtssonDpt. of Medicine, Halland Central Hospital, Halmstad, Sweden.
P M JohanssonDpt. of Clinical Sciences Helsingborg, Lund University, Sweden.
Johan SvenssonDpt. of Internal Medicine at Institute of Medicine, Sahlgrenska Academy, University of Göteborg, Sweden.
Per BjellerupDpt. of Laboratory Medicine, Central Hospital Västmanland, Västerås, Sweden.
Kaj BlennowDpt. of Psychiatry and Neurochemistry at Institute of Neuroscience and Physiology, Sahlgrenska Academy, Mölndal, Sweden.
Birger WandtDpt. of Research and Education, Örebro University Hospital and School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
Stefan SjöbergDpt. of Medicine, Halland Central Hospital, Halmstad, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND &

objectivePatients with mild hypothyroidism often are depressed and have impaired quality of life despite serum free-T4 and T3 within reference values. Therefore, we investigated whether their symptoms were dependent on the concentrations of free -T4 and T3 in the circulation and cerebrospinal fluid (CSF).

methodsTwenty-five newly diagnosed, untreated hypothyroid subjects and as many age- and sex-matched healthy controls were investigated. Blood and CSF sampling was performed in the morning after an overnight fast. Quality of life (QoL) was assessed by a Likert scale. In the hypothyroid subjects, the MADRS rating scale was also used to evaluate symptoms of depression. Furthermore, the results obtained by the questionnaires were related to serum and CSF levels of free- T4 and T3 as well as the ratios between them in CSF and in serum.

resultsSelf-reported health was considerably lower in hypothyroid subjects. MADRS was considerably higher than the normal range for healthy individuals. Low CSF/serum free-T4 ratio was correlated with an increased depressed state according to MADRS (p < 0.01), and in addition, CSF/serum free-T4 ratio correlated positively with the self-reported general health Likert scale (p < 0.05). Concentrations of TSH, or free-T3 in serum or CSF, were not associated with an increased depressed state or self-reported general health.

conclusionsLow CSF/serum ratio of free-T4 was correlated with impaired general health and mood, in contrast to serum measurements not showing any correlations. These findings might partly explain why some patients with hypothyroidism suffer from mental symptoms, despite adequate serum levels of free-T4. However, the findings need to be confirmed in further and larger studies.

Indexed as

AHDS, Allan-Herndon-Dudley syndromeBBB, blood brain barrierBSA, body surface areaCON, healthy control group in our studyCRP, C reactive proteinCSF, cerebrospinal fluidDIO2, type II iodothyronine deiodinase-enzymef-T3 and f-T4, free unbound thyroid hormoneGHLS, General Health Likert ScaleHb, hemoglobulinHYP, hypothyroid subjects in our studyMADRSMADRS, Montgomery Asberg Depression Rating ScaleMCT8, monocarboxylate transporter 8Md, median valueMild hypothyroidismM, mean valueNS, non-significantOATP1C1, organic anion transporter polypeptide 1C1PH, primary hypothyroidism in generalQ1, first quartileQ3, third quartileQoL, quality of lifeQuality of lifes-, serumSubclinical hypothyroidismT3, triiodothyronineT4, thyroxineThyroxineTPO, thyroid peroxidase antibodyTriiodothyronineTSH, thyroid stimulating hormone

Identifiers

PMID32154116
PMCPMC7052503

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.