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In this case-control study, 58 transfusion-dependent Thalassemic patients compared with 46 normal healthy persons on study of their thyroid size & function. In this study, thalassemia patients divided in two groups: Group one 31 patients with (Ferritin<1500) and group two 27 patients with (Ferritin>1500) and 3rd one was named control group (46 healthy persons). These groups were compared to achieve the best possible results and conclusion out of 31 patients. From first group 26 people had normal thyroid function test only 5 patients (16%) had goiter. From 27 patients in second group, 5 people (19%) had normal thyroid and 22 patients had goiter, in 3rd group 29% had normal thyroid, the difference between second and third groups were significant (P<0.01). In second group T4 level were lower than control, instead the TSH level were more than control group. The difference in second and third group were significant. The mean of T3 and T4 in group one and three don’t have significant differences. Conclusion: The goiter incidence and hypothyroidism in major Thalassemia with poor control (Ferritin>1500) are high.

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Diabetes commonly is associated with CAD risk factors, in addition sub-optimal metabolic control of diabetes is associated with increased incidence of thyroid function disorders. In this study patients with diabetes type II who were referred to 5th Azar Hospital in Gorgan were assessed to find out the relationship between thyroid dysfunction and NIDDM in such patients in Gorgan. We studied 210 diabetic patients in hospital outpatient department. The blood pressure, height, weight, serum total Cholesterol, Triglycerides, fasting blood sugar, and glycosylated hemoglobin (HbA1c) were determined. The obesity (BMI>30) were seen in 35% of the subjects. Hypertension and hyperlipidemia were seen in 38 and 65 of our patients respectively. The observed disorders included goiter (30%), sub-clinical hypothyroidism (13%), clinical hypothyroidism (4%), and clinical hyperthyroidism (0.5%). The patients were divided into two groups according to HbA1c: Group 1 with HbA1c<8 and group II with HbA1c?8. A significant difference was observed in TSH serum concentration between group I and II (1.5±1.2 vs. 3.7±11.3 mu/l, P<0.05), whereas the concentration of T4 (10±11 vs. 11±8) and T3 (2.4±3.7 vs. 1.9±3.2) were not significantly different between the two groups. The mean concentration of HbA1c in patients with hypothyroidism was significantly higher than those that of non-hypothyroid subjects (11±2.5 vs. 9±2.5, P<0.005). A significant positive correlation was observed between HbA1c concentration and TSH levels (R=0.2, P<0.01). Our results confirm the association between thyroid dysfunction and uncontrolled diabetes mellitus. It has been recommended that the final diagnosis of thyroid function disorder in diabetic patients should be made after optimal metabolic status has been archived.

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Background&Objective: The presence of single or multiple nodules within the thyroid gland is a common clinical problem. It is immposible to differentiate benign and malignant follicular neoplasms in cytologic examinations.Estimation of risk of malignancy in thyroid nodules who are cytologically assumped to be follicular neoplasm has a critical importance.The aim of this research is evaluation of diagnostic value of thyroid FNA in follicular neoplasm. Materials&Methods: This survey was done on 476 patients with thyroid nodule whome were biopsied in a 7 years period (in 5th Azar hospital, Gorgan). Standard aspirations and biopsies techniques performed and nessassary smears prepared. Wet-fixed smear glass slides are placed immediately in alcohol (70%) 7-10 slides from the aspiration. The patients with cytologic report whome considered follicular neoplasm followed total thyroidectomy or lobectomy. Results: From 476 patients for thyroid nodules 412 cases(86.5%) are suitable for cytologic evaluation which 312 cases(77.9%) of them were benign and 14 cases(3.3%) were malignant.The rest(77 cases)reported to have follicular neoplsm, this patients also undergone thyroid surgery.The result of histological findings appeared in 32 cases(57.1%) follicular adenoma,15 cases(26.7%) non-neoplastic nodules,5 cases(8.9%) follicular carcinoma and 4 cases(7.1%)follicular type of papillary carcinoma. Conclusion: 9 cases (16%) found malignant among cases which cytologic reports considered as “follicular neoplasms” and subsequently undergone thyroid surgery (consist of follicular carcinoma and follicular type of papillary carcinoma), confirme the importance of histopathologic study of follicular lesions for differentiation between malignant and benign lesions.

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Background and Objective: Many factors are known to be involved in a number of human pathologies of obesity including serum leptin and thyroid hormones levels. The purpose of this study was to compare the serum levels of leptin and thyroid hormones in obese and non-obese women, in Shiraz-Iran during 2006. Materials and Methods: In this case- control study, 35 women with BMI≥30 Kg/m2 recruited as an obese group (Case group) and 35 women with healthy BMI (BMI<25 Kg/m2) were selected as a control group. General information data were gathered from each sample using questionnaires and face-to-face interviews. Body weight, height, waist and hip circumferences were measured and BMI, WHR and percent of body fat (%TBF) were calculated for each subject. Venous blood samples were drawn from subjects and serum was separated to determine the concentrations of serum leptin and thyroid hormones (T4, T3 and TSH) levels. Results: Mean serum concentration of leptin was significantly higher in obese group than control group (p<0.001). Serum leptin levels positively correlated to anthropometric indices (BMI, WHR, %TBF). No significant difference was observed between obese and non-obese groups in serum thyroid hormones concentration. Serum leptin levels positively related to serum T3 levels (P<0.05). Conclusion: This study indicated that obese women had higher leptin levels compared to non-obese. The interaction between thyroid hormone in particular T3 and leptin can be one of the reason for increasing the serum leptin level among obse women.

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Background and Objective: The thalassemic syndromes are geneticaly structural disturbance of Alfa and Beta globin chains. In major Beta-thalassemia the life expectancy depended on frequent blood transfusions that lead to over storage and deposition of Iron in different body-organs (Hemochromatosis) including parathyroid glands, which may cause hupoparathyroidism. This study was done to evaluate the frequency of hypoparathyroidism in thalassemic patients referred to teaching hospitals in Hamedan – Iran. Materials and Methods: This descriptive, cross-sectional study was done on 56 thalassemic patients, which received blood transfusion. Serum Ca , P , PTH , total protein , albumin , Ferritin and BUN cratinine were checked two weeks after last transfusion. The hypoparathyroidism was defined when calcium was less than 8mg/dl and phosphorus more than 5.5mg/dl and PTH less than 10 ng/dl. Results: In this study, 14.2% of patients had hypoparathyroidism. 37.5% of hypoparathyroid ones had clinical manifestation of hypocalcemia. There were statistically meaningful association (P<0.05) between The hypoparathyroidism with desferal administration, splenectomy and diabetes. Conclusion: This study showed that the frequency of hypoparathyroidism in Beta-thalassemic patients receiving blood transfusion was relatively high, so clinical and labratory evaluation for endocrine glands specially parathyroid is recommended since early second decay of life.

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Background and Objective: Unsaturated fatty acids such as turpentine oil can decrease serum leptin level. In regard to this effect and the key role of thyroid hormones and leptin in metabolism. This study was designed to investigate the impact of dietary wild pistachio oil on serum leptin concentration and its relationship with thyroid hormones in experimental hyperthyroidism in male rat. Materials and Methods: In this experimental study thirty white Sprague Dawely adult male rats were divided randomly into the five groups with six rats in each. The first group as a natural control I received only ordinary diet and water during the study period. The second group as a control II received ordinary diet in addition to administration of 12mg Sigma levothyroxine in one liter of water daily for one month. Third, fourth and fifth groups with administration of considered dosage of levothyroxine were received respectively 5%, 10% and 20% concentrations of wild pistachio oil for one month. Blood samples were obtained at 10-day intervals. T4, T3, fT4, fT3 and leptin were measured by RIA and ELISA methods. Serum lipid profiles were measured by enzymatic method. Results: Thyroidal hormones, lipids and leptin level did not show any statistically significant differences between experimental days in the rats of control group I.The serum concentrations of T4, T3, fT4, fT3 in third, T4 in fourth and fifth groups showed significant differences(P<0.05). The serum leptin concentration decreased significantly during the experiment in the third, fourth and fifth groups (P<0.05), but serum lipids did not show any significant differences between various days of experiment. Conclusion: This study showed that the level of T4, T3, fT4, fT3 and HDLc / LDLc ratio at 30th day of study in case groups compaing to controls were decreased and increased, respectively.

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Background and Objective: Destructive effects of thyroid diseases in pregnancy and fetal frowth is well established subclinical autoimmune thyroid diseases can double the rate of preterm labor, abortion and postpartum thyroiditis. This study was done to compare thyroid function and autoimmunity derangment in goiterous and non-goiterous pregnant women. Materials and Methods: This case – control study was done on 100 healthy and 100 goiterous pregnant women in Dezyani hospital located in Gorgan, Northern Iran during 2005. Five mililiter of blood sample was obtained from each subject to measure thyroid hormones concentration including T3/ T4/ TSH/ T3 RUP and thyroid autoantibodies (Anti Tg/Anti TPO). Thyroid hormone and auto antibodies were measured using IRMA and ELISA techniques. Results: Thyroid volume was enlargel twice and tripl of its orginal size in 34% and 66% goitrious pregnant women respectively. Mean serum TSH in cases and controls were 1.81+/-1.33 microU/ml and 1.84+/-1.4 microU/ml respectively. The mean of Anti TPO and Anti Tg in cases were 373.91+-197.36 U/ml and 248.80+-70.59 U/ml respectively. The same indecs for controls were 79.52+-63.99 U/ml and 248.80+-70.59 U/ml respectively. In pregnant women with goiter 36% had high Anti TPO and 9% had high Anti Tg, but in control group 16% and 4% of controls had elevated Anti TPO and Anti Tg, respectively. Conclusion: According to thyroid function tests there were elevation of antibody in 20% of the healthy subjects and 45% of the goiterous subjects, therefore it is advisable to measure thyriod function tests accompanied with thyriod antibodies in all pergnant women either with or without goiter in order to prevent feto-maternal disorders.

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Background and Objective: Menstrual disorders are including of metruragy, oligomenorrhea, polymenorrhea, dysmenorrheal and amenorrhea. Hormonal disorders can be the cause of such abnormalities. This study was designed to evaluate, the correlation between serum thyroid and sex hormones level,with menstrual disorders.

Materials and Methods: This descriptive - analytical study carried out on 110 women with menstrual disorders without anatomical disorders referred to private clinic during 2007-08. In third day of menstrual cycle, sample blood was taken for determination of LH, FSH, PRL, TSH, T3, T4 and Testosterone. Laboratory tests were performed by ELISA method.

Results: The 42.7% of women with menstrual disorders were in age group lower than 25 years. Oligomenorrhea with 42.7% was the major menstrual disorder and amenorrhea was the lowest with 4.5%. The most hormonal disorders was related to T3 (46.3%), LH (44.5%) and testosterone was the lowest with 5.4%. 11 cases (10.0%) have presented with hirsutism.

Conclusion: According to findings of this study T3 and LH are the common hormonal disorders in menstrual abnormalities.

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Background and Objective: Parathyroid proteins involved in calcium homeostasis. With increasing age and other relevant factors, this hormone is not able to perform its role. Using recombinant parathyroid hormone prevent disease progression and effective in improvement of disease. This study was done to design and build the desired construct genes, cloning process and synthesis of soluble parathyroid hormone in E. coli. Methods: In this laboratory study, design and optimization sequence of the gene parathyroid hormone (PTH) was carried out for expression of soluble proteins in bacteria. The construct contining PTH gene (puc 57) transformed into bacteria and cultivation was done in SOB medium then Plasmid extraction was performed. Fragment encoding the PTH was isolated by digestion of the cloning vector and ligate to expression vector (PET-32a). Subcloning process followed by induction with IPTG 1mM. The recombinant parathyroid hormon was expressed in bacteria, subsequently. Results: After enzymatic digestion, the fragment encoding the protein of interest was properly localized. The process was confirmed by polymerase chain reaction (PCR). Following performing a transformation, induction process performed by IPTG with final concentration 1mM that caused the soluble parathyroid proteins to be expressed in bacteria and the process was confirmed by Western blot technique. Conclusion: Protein expression in bacteria due to its rapid growth and the need to inexpensive medium is cost-effective. Soluble recombinant protein expression reduces downstream of recombinant protein production.

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Background and Objective: Vitiligo is one of the most frequent skin disorders with a prevalence of 1-2% in different populations. Although many theories have been suggested for its pathogenesis, but the most popular hypotheses is the role of autoimmunity in Vitiligo. This study was done to evaluate the thyroid dysfunction and thyroid autoantibodies in patients with Vitiligo.

Methods: This case-control study was carried out on 45 patients with Vitiligo and 45 age- and sex-matched healthy individuals as control group. Age, gender, duration of the disease and type of Vitiligo were collected through a standard questionnaire. Thyroid autoantibodies including thyroglobulin antibody, anti- thyroglobulin and thyroid peroxidase antibody, and anti-TPO thyroid hormones Tetraiodothyronine (T4), Triiodothyronine (T3) and thyroid stimulating hormone (TSH) in Vitiligo patients and healthy volunteers were measeared.

Results: Serum level of T4 was significantly reduced in Vitiligo patient compared to controls (P<0.05). Serum level of T4 in 20% of Vitiligo patient and 2.2% of control cases was less the normal level. Anti-TPO in 14 (31.1%) of Vitiligo patient and 6 (13.3%) of controls were higher than normal range (<60 IU/m) (P<0.05). Serum level of anti- thyroglobulin was significantly higher in those with Vitiligo in compared to controls (P<0.05).

Conclusion: This study showed that the thyroid dysfunction particularly hypothyroidism and anti-TPO is more common in Vitiligo patients.

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Background and Objective: Hyperlipidemia can be considered as one of the main risk factor, involved in cardiovascular disease and it is a major cause of death. This study was done to determine the effect of air part of Echinophora platyloba extract on Pituitary - thyroid axis hormones and lipid profile in hypercholesterolemic rats.

Methods: In this experimental study, 40 male Wistar rats were randomly allocated into 5 groups (n=8) including control group with normal diet, hypercholesterolemic group along with high cholesterol diet, and the three treatment groups with hypercholesterolemia which animals were received daily doses of 100, 200 and 300 mg/kg/bw of the hydroalcoholic extract of Echinophora platyloba, respectively by gavage during 42 days. At the end of this period, blood sample was obtained. Lipid profile, including total cholesterol, triglycerides (TG), low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), high density lipoprotein (HDL), triiodothyronine (T3), thyroxine (T4) and thyroid hormone stimulation (TSH) were measeared using Radioimnoassay method.

Results: The level of LDL and cholesterol and TG, significantly reduced in treated group receiving the lowest dose of the extract (100 mg/kg/bw) in compare to hypercholesterolemic group (P<0.05). The level of HDL, TSH and T4 significantly increased in the treated group receiving the highest doses of the extract (300 mg/kg/bw) in compare to hypercholesterolemic group (P<0.05).

Conclusion: Echinophora platyloba extract dose dependly can alter Pituitary- thyroid axis hormones and lipid profile in hypercholesterolemic rats.

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Background and Objective: Insulin resistance (IR) is common in hypothyroidism. IR is one of risk factors for cardiovascular disease. Insulin clamp is the gold standard method for evaluation of IR but it is not routine in clinical usage. The triglyceride- glucose (TyG) and homeostasis model assessment (HOMA) indices are non-invasive surrogate of IR. This study was done to determine the IR using the TyG and HOMA indices in hypothyroid patients.
Methods: This descriptive-analytic study was done on 23 hypothyroid patients including 15 overt and 8 subclinical hypothyroid patients. All patients were new cases and were matched for age, sex, and high. TSH, FT4, TG, LDL, FBS and fasting plasma insulin level were measured twice at time of diagnosis and after treatment and the changes of TyG and HOMA indices were recorded.
Results: In two groups IR based on HOMA was more than TyG index. IR in overt hypothyroidism based on HOMA index was more than two times in comparison with TyG index at the first time and more than three times (10:3) at the second time. IR in subclinical hypothyroidism based on HOMA index was more than four times in comparison with TyG index at the first time and more than three times (7:2) at the second time. A significant difference was found in IR based on HOMA before and after treatment (P<0.05). There were not any significant differences in IR indices of overt hypothyroidism group.
Conclusion: The eight weeks treatment of hypothyroidism and reducing TSH level is probably having no effect on HOMA and TyG in overt and subclinical hypothyroidism.

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Background and Objective: Sodium levothyroxine is one of the common medicines used for treatment of hypothyroidism and thyroid cancer. The study was done to determine the effect of sodium levothyroxine on knee articular cartilage tidemark integrity, plateau tibia cartilage thickness (calcified and non-calcified) and liver enzymes in induced hypothyroidism rats.
Methods: In this experimental study, 50 adult female BALB/c mice, weighting 25-30 grams were randomly allocated into one control and four experimental groups. Animals in control did not receive any medicine. Animals in the second group were received different increasing doses of sodium levothyroxine daily for 8 weeks. Animals in the third group were received constantly high dose of levothyroxine daily for 8 weeks. In the fourth group, the animals became hypothyroid with propylthiouracil (PTU). In the fifth group, animals with hypothyroidism were received sodium levothyroxine by gavage same as group 2. After 8 weeks serum samples were taken to determine ALT, AST and ALP. The plateau tibia cartilage stained with hematoxylin-eosin. Histologic changes evaluated by light microscopy. Using a light microscope equipped with camera, the samples were photographed and using a computer equipped with axiovision software. Cartilage (calcified and non-calcified) thickness measured in micrometer. The integrity of tidemark line on hematoxylin-eosin staining also evaluated.
Results: The results of the present study showed separation, disruption and destruction in tidemark line in group 3 (the group with high dosage of sodium levothyroxine from the beginning of the treatment). The total cartilage and non-calcified part thickness in groups 3, 4, 5 were reduced and in group 3 showed significant reduction (P<0.05). Calcified cartilage thickness in all groups were reduced and in group 3 showed significant reduction (P<0.05). ALT level decreased in all groups compared to control group but only in the second and third groups, the decrease of ALT was significant (P<0.05). AST serum level in all groups significantly increased in compared to control group (P<0.05). ALP serum level in all groups increased compared to the control group, but this increase was significant only in the groups 4, 5.
Conclusion: Consumption of sodium levothyroxine with constantly high dose can cause severe alteration in knee joint cartilage in hypothyroidism rats.

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Background and Objective: Thyroid nodules are common among the general population and they increase the risk of thyroid malignancies. This study was done to evaluate the correlation of findings of ultrasound based on Thyroid Imaging and Reporting Data System (TIRADS) and cytology of fine needle aspiration (FNA) based on Bethesda system to evaluate of thyroid nodules.
Methods: This descriptive-analytical study, was performed on 165 patients (152 females and 13 males) referred to the sonography center of Sayyad Shirazi Educational Hospital, Gorgan, northern Iran during 2018. Ultralosonographic features of nodules were recorded in the pre-filled checklist. According to TIRADS and endocrinologist clinical suspicion, couple of patients was eligible for FNA under the ultrasound guidance. The cytology of FNAs was reported based on the Bethesda system classification.
Results: The mean age was significantly lower in patients with malignant nodules (35.4 vs 44.8; P<0.05). Frequency of malignancy was 8 times higher among females than males (16 vs. 2). TIRADS 3 and 4 were the most common categories among the others with the prevalence of 44.4% and 32.3%, respectively. Bethesda 2 and 4 were the most prevalent categories with prevalence of 58.8% and 20.6%, respectively. The strongest agreement was observed between TIRADS 2 and Bethesda 2 that showed benign findings. Kappa index was 0.061 between TIRADS and Bethesda (P<0.05). Echogenicity, echogenic foci, shape, and margin of nodules were seen significantly more in malignancy.
Conclusion: The most accurate prediction of TIRADS belongs to benign nodules. The correlation between TIRADS and Bethesda was evaluated to be significant overall and the maximum level of correlation was at benign findings. Therefore, these two systems can efficiently be used in order to rule out malignancies and reduce the rate of invasive interventions.

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Background and Objective: Thyroid cancer is a common cancer of the endocrine system, and knowing the etiology can be effective in its treating. On the other hand, the FNA technique is not accurate enough, so finding a biomarker for thyroid cancer is of importance. This study was done to evaluate the NKX2-1 gene as indicator of differentiation of papillary thyroid carcinoma (PTC).
Methods: In this case-control study, 17 fresh PTC tissue samples and 20 adjacent-healthy tissues were collected during thyroidectomy in Isfahan, Iran. RNA extraction was followed by cDNA synthesis. The expression of the NKX2-1 gene was performed using specific primers (exon-junction and intron spanning) using the RT-qPCR method.
Results: An examination of the quality and quantity of extracted RNAs showed that they were intact and suitable for making cDNA. Examination of the melting curve showed a specific amplification of the NKX2-1 gene. The difference in expression of the NKX2-1 gene between PTC and healthy-adjacent tissues was 0.947.
Conclusion: No difference in the expression of the NKX2-1 gene between the healthy tissue adjacent to the tumor and the tissue of the PTC tumor indicates that the PTC tumors were differentiated.

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Background and Objective: Thyroid masses are one of the most common reasons for patients to visit endocrinology clinics. Fine needle aspiration (FNA) is used to reduce thyroid surgery for benign lesions. This study was done to determine the diagnostic accuracy of FNA of thyroid mass(s) compared with histological results in Medical Centers, Gorgan, Iran.
Methods: In this descriptive-analytical study, 102 patients (12 males and 90 females) were diagnosed with a thyroid mass and referred for surgery to Medical Centers, Gorgan, Iran during 2020-21. FNA was performed, and the samples were sent to the pathology department for examination. The result of cytology was recorded in the checklist. According to cytology results, some patients were referred for surgery. Then, the surgical pathology results were compared with the cytology findings. In addition, the sensitivity and specificity of the results of the cytology of thyroid masses were calculated compared to the results of pathology.
Results: FNA, mass size, and the patient’s main complaint had a significant relationship with histological results (P<0.05). According to FNA findings compared to pathology, sensitivity was 74%, specificity was 88.1%, positive predictive value was 88.1%, negative predictive value was 74%, false positive rate was 12%, false negative rate was 26%, and accuracy was 80.4%.
Conclusion: FNA remains a key tool in evaluating thyroid nodule(s). Improving FNA techniques is necessary to increase the accuracy of FNA.

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Background and Objective: Obesity is a well-known public health problem that affects people of all ages. It has myriad effects on several body tissues, including the thyroid, in both human and animal models. Some treatments, such as dietary modification and physical activity, may be effective or ineffective in reducing obesity. Accordingly, the present research investigated the effects of obesity on thyroid tissue and the impact of diet modification and aerobic exercises on histopathological and hormonal changes in the thyroid tissue of obese male rats.
Methods: In this experimental study, for obesity induction, 50 three-week-old male Wistar rats were exposed to a high-fat diet (including 40% fat, 40% protein, and 20% carbohydrate) for 12 weeks. Then, 25 rats were randomly divided into 5 groups: healthy control, obese + high-fat diet, obese + normal diet, obese + high-fat diet + aerobic, obese + normal diet + aerobic. After the induction of obesity, 2 groups were given a standard diet (including 20% fat, 10% protein, and 70% carbohydrates). Aerobic exercises for 8 weeks included 30 minutes per day, 8 m/min, and 5 days per week. After anesthesia, an autopsy was performed, and the thyroid tissue was sent to the laboratory for histopathological studies. Also, 5 cc of blood was taken to study TSH, T3, and T4 using a radioimmunoassay kit.
Results: The serum levels of TSH hormone increased slightly in the high-fat diet groups compared to the control group and the normal diet with/without aerobic activity group. Also, the amount of T3 hormone in the group receiving a normal diet along with aerobic activity was significantly lower than in the control, high-fat diet, and high-fat diet along with aerobic activity groups (P<0.05). The T4 hormone increased significantly in all obesity groups compared to the control group (P<0.05), and these values were at the level of the control group (P<0.05) only in the group receiving the normal diet along with aerobic activity. Regarding the histopathological results, many changes were found in the follicular, parafollicular, and follicle cells of the thyroid tissue in the obesity group continuing the high-fat diet; these changes were significantly reduced in the groups for which the diet was changed to the normal diet alone and with aerobic activity.
Conclusion: Induction of obesity causes significant structural and biochemical changes in the thyroid, and the combination of diet modification and aerobic activity is more effective in alleviating these changes.