Day 2 :
- Thyroid Disorders | Advancements in Treatment and Prevention | Thyroid Cancer | Endocrinology and Diabetes
Session Introduction
Shaheena Banu
Aspire2 International, New Zealand
Title: Genetic and epigenetic markers of low density lipoprotein-cholesterol receptors in management of Type 2 diabetes mellitus and newer treatment options
Biography:
Dr Shaheena Banu has completed his PhD in 2005 from Rajiv Gandhi University of Health Sciences,India and postdoctoral studies at Jayadeva Institute of Cardiovascular Sciences and Research Bangalore. She is currently Senior Lecturer at Aspire2 International, a category-1 PTE of New Zealand. She has published more than 25 papers in reputed journals and has been serving as Guest editor for special issue of Bentham Publications “Endocrine, Metabolic & Immune Disorders-Drug Targets with Impact Factor 1.897).
Abstract:
The global rise of Type-2 Diabetes Mellitus(T2DM) and its complications, primarily Coronary Artery Disease (CAD) are enormous. Application of genetic knowledge of T2DM polymorphisms to clinical use is limited. Genetic markers of T2DM based on genome-wide association scan (GWAS) findings yield inconclusive results. The burden of CAD in T2DM is high, increased levels of Low-Density Lipoprotein cholesterol remains prevalent. This paper evaluates the genetic variants of Low-Density Lipoprotein receptor(LDLR), review inheritable changes in gene expression caused by epigenetic regulations and discuss newer therapeutic options. For the purpose of literature review, the systematic search was conducted with the use of Medline and Cochrane library. Data collected from 2013 through to 2018 published in English alone was analyzed. The role of LDLR polymorphisms in T2DM is discussed. Analysis of LDLRrs688 TT genotype and T alleles associated are compared with similar studies and linked to dyslipidemia in T2DM. Epigenetic changes that are reported, following diet and exercise. are reviewed. Further, the diabetogenic effect of statins on T2DM and emerging treatment options are reviewed2. The research identifies uncommon variants, structural variation and gene-environment interactions of LDLR that contribute to CAD in T2DM. LDLR rs688 TT genotype and T alleles indicate susceptibility to CAD in Indians within a small study. Individual statins differ with respect to their diabetogenic property. Underlying genetic mutation of LDLR can be used as a predictor of response. LDLR polymorphism can be approached in a holistic manner, considering newer treatments for dyslipidemia of T2DM, applying genetically guided personalized therapies.
Hyun-Chul Kim
E & M Psychiatry Clinic, Republic of Korea
Title: Dysthyroidism : Is this one of suicide squads
Biography:
HyunChul Kim is Graduated from Gyeong Buk Medical University (1999) Degree of Master/Post Graduate diploma/School of psychiatry, Hallym University (2004) A doctor for compulsory military service (2004-2007) Director of Mental Health Promotion Center, Daegu Suseong District (2007-2011) EMDR therapist course completed (2011). Member of the International Association of Self Psychology (IASP) (2011) International Member of American Psychiatric Association (2018) Corresponding Member of the European Congress of Neuropharmacology (2018).
Abstract:
Biography:
Born in Germany in 1972. She completed her specialist education at Ege University. During his professional life, she worked as a psychiatric specialist in a general medical hospital, as a associate professor of psychiatry in the second largest mental health hospital in the Turkey. Since 2014, as a professor of psychiatry she has taught at Üsküdar University and has been worked with bipolar disorder in NPIstanbul Brain Hospital. Another area of interest is psychoanalytic psychotherapies.
Abstract:
According to Vancampfort et al.’s meta-analysis, antipsychotic use significantly explained higher MetS prevalence estimates in major depressive disorder (MDD), (2013b). Differences in MetS prevalences were not mediated by age, gender, geographical area, smoking, antidepressant use, presence of psychiatric co-morbidity. In another study, there was some mediating role for tricyclic and non-selective serotonin-reuptake inhibitor antidepressant use but overall, the mediating role of clinical differences were limited (Luppino et al. 2014). When Margary et al. evaluated 83 psychiatric inpatients diagnosed with schizophrenia, bipolar disoreder and MDD they found a positive association between antidepressant drug treatment with triglycerides, and triglycerides/HDL ratio levels and antipsychotics drugs with the HOMA and Framingham index (2013). In Perugi et al.’s study, duration of pharmacological treatment and age at onset of first major episode were associated with the presence of comorbid MetS (2015). Time of onset for affective disorders and medical conditions were relatively concurrent. When comorbidity of medical conditions were evaluated in terms of phases of bipolar disorder, possibly they are more prevalent at onset and earlier episodes. This is because early mortality is observed more in patients with earlier onset (Goldstein et al. 2009). Comorbid medical conditions that emerge in middle stages of bipolar disorder would possibly be related to the effect of treatment and effects of patient’s habits and lifestyle. However it was showed that even in these circumstances they emerge one decade earlier than the age-matched subjects without bipolar disorder. When all these findings are taken together, it seems that MetS is one of the variables which is in a position as both an initiator and an outcome of bipolar disorder.
Neda Seyedsadjadi
University of New South Wales, Australia
Title: Visceral fat mass: Is it the link between uric acid and diabetes risk?
Biography:
Neda Seyedsadjadi has her expertise in evaluation and passion in improving the health and wellbeing. She is a PhD student at University of New South Wales working on how lifestyle behaviors are associated with subclinical changes in biomarkers associated with non-Communicable Diseases (NCDs) such as diabetes. This will assist in on time and appropriate prevention of this prevalent disease.
Abstract:
Uric Acid (UA) has been suggested as a novel risk factor for diabetes. However, as it is also accompanied with other major risk factors such as obesity and high visceral adiposity, its definite role in this area is still the subject of discussion. Therefore, in this study we aimed to investigate the associations between plasma UA and fasting plasma glucose, HbA1c, lipid profile and inflammatory markers after accounting for the contribution of other diabetes risk factors such as BMI and VAT fat mass. In a cross-sectional study, 100 non-diabetic middle-aged males and females were recruited. Central fat distribution measures including android to gynoid fat ratio, VAT and Subcutaneous Adipose Tissue (SAT) fat mass were determined using Dualenergy X-ray Absorptiometry (DXA). Biochemical analysis was done using methods well established for clinical and research laboratories. Multiple linear regression analysis was performed to do statistical analysis. UA was positively associated with body mass index (BMI) (r(98)=0.42, P≤0.001), android to gynoid fat ratio (r(98)=0.62, P≤0.001) and VAT fat mass (r(96)=0.55, P≤0.001). UA was also positively associated with plasma glucose (r(98)=0.33, P≤0.001), HbA1c (r(93) =0.25, P=0.014), triglyceride (rs(95)=0.40, P≤0.001), HDL-cholesterol (r(98)=−0.61, P≤0.001) and CRP (rs(98)=0.23, P=0.026). However, these associations were no longer significant after accounting for BMI or/and VAT f vat mass. No significant association was observed between UA and SAT fat mass (r(97)=0.02, P≥0.05), Total cholesterol (r(98)=0.03, P≥0.05), LDL-cholesterol (r(98)=0.13, P≥0.05), TNF-α (r(97)=0.12, P≥0.05) and IL-6 (r(96)=−0.02, P≥0.05). Our results suggest, for the first time, that VAT fat mass plays a major role in linking plasma UA and glucose in a non-diabetic population.
Biography:
Mennatallah A. Ali is currently a Lecturer at Pharmacology & Therapeutics Department, Faculty of Pharmacy & Drug Manufacturing, Pharos University in Alexandria since 2008. He obtained my Ph.D. degree in Pharmacology from Faculty of Pharmacy, Cairo University in 2015. The Master degree of Pharmacology and Experimental Therapeutics was obtained from Medical Research Institute, Alexandria University in 2012. Bachelor degree in Pharmaceutical Sciences was from Faculty of Pharmacy, Ain Shams University in 2007. He worked as a community pharmacist since her graduation as he was keen on patient counseling and advising. My research motivation is to explore the underlying molecular mechanisms that potentiate the therapeutic beneficial effects of any antidiabetic agent and to discover any new compounds that can be used as adjuvants to treat diabetes mellitus
Abstract:
There has been a recent explosion of interest in the notion that metaflammation and activation of the innate immune system are closely involved in the pathogenesis of type 2 diabetes mellitus (T2DM). Hence, we assessed the potential antidiabetic effect of leflunomide (10 mg/kg every other day) and sulfasalazine (100 mg/kg/day), in a comparison with pioglitazone (5 mg/ kg/day) as a reference drug, using neonatal STZ animal model. All treatments were gavaged for 8 weeks. Leflunomide and sulfasalazine lowered significantly the n5-STZ-induced elevation in body weight, blood glucose, and HOMA index. Moreover, they amended successfully serum lipid profile and increased serum insulin level. Additionally, leflunomide and sulfasalazine showed antioxidant (Nrf2, keap1), anti-inflammatory (NF-κB, TNF-α) and anti-apoptotic (caspase-3, cytochrome c) capabilities. Both drugs showed comparable effects on almost all the parameters, however, pioglitazone effect was superior to both. On the molecular level, drugs have improved the hepatic insulin (glucokinase, p-insulin receptor, p-Akt, IRS-1), lipogenic (SREBP-1c, PGC-1α) and Wnt/β-catenin (p-GSK-3β, β-catenin, FOXO) signaling pathways. All treatments also showed decreases in the hepatic 8-oxoguanine content. The present results clearly proved that altered immune responses play a key role in T2DM and that the immunomodulatory drugs can gain insights as prospective antidiabetic agents.
Getachew Seid
Ethiopian public health institute, Ethiopia
Title: Status of Vitamin B12 deficiency among type 2 diabetes mellitus patients on metformin treatment
Biography:
Abstract:
Background: Metformin is a standard therapy, most commonly prescribed oral hypoglycemic agent for individuals with type2 diabetes (T2DM). Many studies also documented the association between long-term metformin use and low vitamin B12 levels among individuals with T2DM.To the best of our knowledge, studies on the association between long term metformin use and low vitamin B12 levels among individuals with T2DM are scarcely found in Ethiopia.
Objective: To determine the status of vitamin B12 deficiency and associated risk factors in type 2 diabetes mellitus patients taking metformin treatment attending diabetic clinic of the Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia.
Methods: Institutional based cross-sectional study was conducted from March 01/ 2017 to June 30/2017 at diabetic clinic of TASH. The study participants were all patients with a diagnosis of T2DM on follow up at the clinic during the study period and having a baseline data. Blood samples were collected and Vitamin B12 levels were determined by cobas e411 analyzer by electro chemiluminescence immunoassay. Neuropathy Total Symptom Score-6 questionnaire (NTSS-6 scores) was used to compare severity of PN in both groups. Finally data was entered and analyzed through SPSS version 20 computer software packages. Results: Serum B12 levels were low in 15 patients (21.1%) on metformin as compared to 2 patients (4.0%) without metformin treatment. Mean B12 level on metformin were found to be 331.58 pg/ml(± 134.48) as compare to those without metformin 482.23pg/ml(± 235.24), the difference was statistically significant with p value 0.000. A strong negative correlation between serum B12 levels and the duration of metformin use (r = -0.608; P = 0.000) was seen.
Conclusion: Among patients with T2DM treated with metformin had low serum B12 levels than patients not treated by metformin with significant effect of metformin dose and duration on B12 levels. The deficiency was not associated with peripheral neuropathy.
Getachew Seid
Ethiopian public health institute, Ethiopia
Title: Status of Vitamin B12 Deficiency Among Type 2 Diabetes Mellitus Patients on Metformin Treatment
Biography:
Abstract:
Laksmi M L
Rajiv Gandhi Center for Biotechnology, India
Title: Estrogen mediated regulatory role of Ezrin in the invasion of thyroid cancer cells
Biography:
Lakshmi M L is currently employed in Cancer Research Program Lab at Rajiv Gandhi Center for Biotechnology, India. She is a Senior Research Fellow of University Grants Commission (UGC), Government of India. She is having 4 years of research experience and is currently working on the elucidation of mechanistic regulation of ezrin in in Estrogen Receptor (ER) positive thyroid carcinoma cells
Abstract:
Thyroid carcinoma is 3-4 times more prevalent in women than in men and this preponderance can be linked to age, sex, iodine deficiency, and diet and radiation exposure. Certain factors like genetics, sex hormones and environment are reckoned to predispose a person to thyroid carcinoma. These data suggests the role of the sex steroid estrogen in the pathogenesis of thyroid carcinoma. It is clearly demonstrated that like breast and ovary, thyroid is also an estrogen responsive tissue. So in this study we checked the effect of 17-β Estradiol in the invasion of thyroid carcinoma. Cancer cell metastasis involves the formation of lamellipodia and filopodia. The formation of these structures is related to rapid activation of Ezrin/Radixin/Moesin (ERM) family of proteins. It is reported that ezrin was highly overexpressed in metastatic cancer cell lines when compared to poorly metastatic counterparts. We investigated influence of genomic and nongenomic actions of 17-β estradiol on ezrin. Genomic pathway is a long delayed process. Beyond the conventional genomic pathway, the nongenomic pathway of 17-β Estradiol is a transient process which lasts for few minutes. The phosphorylated ezrin can interacts and activates many signaling molecules which are important for cancer cell proliferation, invasion and metastasis. Further we have to investigate the upstream kinase causing the phosphorylation of ezrin and various expression patterns of ezrin and phosphoezrin ex vivo. Genomic pathway which is a long delayed process through ER alpha increased the expression of ezrin in a time dependent and dose dependent manner we observed a transient phosphorylation of ezrin by17-β Estradiol which lasts only for a few minutes. This process was sensitive to inhibitors. We observed that 17-β Estradiol can cause both the increased expression and activation of ezrin which occurs through the estrogen receptors suggesting that thyroid is also a target for estrogenic action. Such studies may lead to a new understanding of the pathogenesis of thyroid cancer and its female bias.
- Hypothyroidism
Session Introduction
Ismael Kalayu Sitotaw
Arsi University, Ethiopia
Title: Comparison of nutritional status and associated factors of lactating women between lowland and highland communities of district Raya, Alamata, Southern Tigiray, Ethiopia
Biography:
Abstract:
The Ethiopian regions have a relatively higher prevalence of under-nutrition are found in the lowlands of the country, with the exception of the highlands of Tigiray, where under-nutrition is also prevalent. A community based comparative cross-sectional study design was conducted from January 27- March 7, 2014. Sample size was determined by two population estimation formula. The total calculated sample size was 456. A stratified sampling technique was used to stratify the study area to highland and lowland. Study participants were selected by simple random sampling technique. Data were collected using anthropometric measurements and structured questionnaire. The raw data were entered and analyzed using SPSS version 20.0. Multivariable Logistic regression was done to determine the association between explanatory variable with chronic energy deficiency (CED) using body mass index (BMI), by computing odds ratio at 95% confidence level. A P – value < 0.05 was considered as statistically significant. The prevalence of CED of lactating mothers from lowland and highland was 17.5% and 24.6% respectively: age, husband occupation, taking vitamin A immediately after delivery or within the first eight weeks after delivery and consumption of extra food during lactation time were factors associated with chronic energy deficiency for lowland lactating women whereas parity, number of meals per day and household consumption of iodized salt were factors associated with CED for highland lactating women. CED in both comparative studies was a serious public health problem. As it is known food security does not mean nutritionally secured, Therefore, the need to develop nutrition intervention such as nutrition security programs to address under-nutrition in the study area is significant, as it was found food secured participants were slightly vulnerable than food insecure. The dietary diversity score of the participants were very low so that encourage the community about nutrition diversification is substantial for adequate nutrient intake.
Tika Ram Lamichhane
Tribhuvan University (TU), Nepal
Title: Status of hypothyroidism and its impact on molecular level
Biography:
Abstract:
Statement of the Problem: Routine assesment of thyroid status basically relies on ultrasonographic (USG) examinations and thyroid function tests (TFT) determining the serum concentrations of FT3, FT4 and TSH. Along with finding the prevalence of hypothyroidism, it is required to explore the biophsical insights in the molecular levels behind such disorders. Methodology & Theoretical Orientation: USG and TFT measurements of the patients were performed at Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal. The mutational and overt hypothyroidal impacts on thyroid hormone receptors (THRs) were studied by nanoscale molecular dynamics simulations in a high performance computer at Central Department of Physics, TU, Nepal. Findings: The prevalences of subclinical and overt hypothyroidism are 64.58% and 11.73% of 963 hypothyroid subjects based on TFT results under the study of 4438 subjects. In a total of 140 patients (mean age: 38.94±13.60 years) perfroming both USG and TFT observations, 22.86 % have hypothyroidism (mean TSH: 25.86 mIU/L) with mean size of left and right lobe, 4.92±3.24 mL and 5.66±3.93 mL, respectively finding multinodular goiters, hypoechoic lesions, chronic thyroiditis, benign/malignant nodules, and colloid cysts in some patients. Negative correlation between FT3/FT4 and TSH verifies the negative feedback mechanism of thyroid cycle. At overt hypothyroidism, THRs become free of T3 or T4 in their binding sites that reduce the gene transcription rate. By the molecular dynamics study of native stateTHRs, the heat capacity of T3 liganded THR-β is 9.76±0.38 kcal/mol/K and that of unliganded THR-β is 9.08±0.34 kcal/mol/K at 310 K. It makes change in heat transfer properties. Conclusion & Significance: In menarche and menopause periods, thyroid size of females is higer than that of males. Females are more vulnerable towards hypothyroidism. The mutated, T3-liganded and unliganded-THRs have the different structuaral and thermophysical properties like interaction energies, heat capacity, heat coduction and normal modes of vibrations.
Ramchandra Sargar
RUDN-University, Russia
Title: Radiological diagnostic method in subclinical hypothyroidism
Biography:
Sargar R.V is working in RUDN-University, Moscow, Russia. His wide range of publications in various national and international journals.
Abstract:
Purpose of study- To study the diagnostic capabilities of X-ray computed tomography (CT) for the evaluation of intra-thyroid hormone formation in diseases of the thyroid gland.
Material and Methods- Total number of patients were 236 women with thyroid disease, which caused disorders of the thyroid gland function. The control group consisted of individuals of 2 groups; first group who denied contact with iodine; 2) had contact with iodine. All patients were examined in accordance with the standards of care to conduct the evaluation of thyroid CT density in HU.
Results: In primary hypothyroidism (= 87), hyperthyroidism (â„– = 35), carriers of antibody (â„– = 28) thyroid HU density was significantly (p <0.05) reduced compared with the control group and was respectively (M ± m) 53 ± 2; 85 Ä… 9; 84 ± 6 units. With iodine induced hyperthyroidism ( = 8) and hypothyroidism (RL = 11), thyroid density in HU was significantly increased to 182 ± 7 and 181 ± 6 units compared to control group «1» »(CH = 36). In the control group "2" (CHO = 31) who consumed iodized sodium chloride, the thyroid density in HU was significantly increased to 162 ± 7 vs. 104 ± 8 in the control group «1) ».
It should be emphasized that the thyroid density in HU, determined at CT, is directly proportional to the concentration of intra thyroid stable iodine. In turn, 80% of the element iodine is in the phenyl ring of thyroid hormones. Consequently, the thyroid density index in HU reflects the level of hormone formation and the reserves of iodinated thyroid hormones directly into the thyroid gland. In this regard, it should be noted that the thyroid gland is the only endocrine organ that, after the synthesis of hormones lasting 50 days, stores them in the thyroid structure (colloid of thyroglobulin) and secretes thyroid hormones into the blood at the request of the body. Based on the literature data and the results of our own research, for all regions of Russia we have proposed the following fluctuations in thyroid density in HU, reflecting the euthyroid status and favorable future of the thyroid function: from 85 to 140 units. In those cases when there is an iodine- induced dysfunction of thyroid function, the thyroid density index in HU is increased above 140. If the synthesis of thyroid hormones (primary hypothyroidism) or synthesis is impossible, but pathological secretion with a lack of fixation in thyroid globulin collagen (diffuse toxic goiter with thyrotoxicosis), the thyroid density in HU decreases less than 85 units. It is important to note that in the determination of TSH in the blood, fasting, the use of a number of drugs, stress, sleep deprivation, severe illnesses of the subject can lead to errors in determining the concentration of TSH and thyroid hormones (due to so-called non thyroidal factors) in the direction of their change as in hypothyroidism with the presence of euthyroidism in fact. In this case, normal thyroid density in HU indicates euthyroidism.
Conclusions: One time assessment of thyroid density in HU with CT and blood serum TSH level makes it possible to perform differential diagnosis between iodine induced and true thyroid dysfunction and also to correct for the error in determination of TSH concentration as a result of the influence of non thyroidal factors. Evaluation of thyroid density in HU in CT should be used for screening the risk of thyroid dysfunction and for determining the need for individual and population iodine prophylaxis and monitoring its effectiveness in order to prevent iodine induced transient disorders of thyroid function.
Ramchandra Sargar
RUDN-University, Russia
Title: Radiological diagnostic method in subclinical hypothyroidism
Biography:
Sargar R.V is working in RUDN-University, Moscow, Russia. His wide range of publications in various national and international journals.
Abstract:
Purpose of study- To study the diagnostic capabilities of X-ray computed tomography (CT) for the evaluation of intra-thyroid hormone formation in diseases of the thyroid gland.
Material and Methods- Total number of patients were 236 women with thyroid disease, which caused disorders of the thyroid gland function. The control group consisted of individuals of 2 groups; first group who denied contact with iodine; 2) had contact with iodine. All patients were examined in accordance with the standards of care to conduct the evaluation of thyroid CT density in HU.
Results: In primary hypothyroidism (= 87), hyperthyroidism (â„– = 35), carriers of antibody (â„– = 28) thyroid HU density was significantly (p <0.05) reduced compared with the control group and was respectively (M ± m) 53 ± 2; 85 Ä… 9; 84 ± 6 units. With iodine induced hyperthyroidism ( = 8) and hypothyroidism (RL = 11), thyroid density in HU was significantly increased to 182 ± 7 and 181 ± 6 units compared to control group «1» »(CH = 36). In the control group "2" (CHO = 31) who consumed iodized sodium chloride, the thyroid density in HU was significantly increased to 162 ± 7 vs. 104 ± 8 in the control group «1) ».
It should be emphasized that the thyroid density in HU, determined at CT, is directly proportional to the concentration of intra thyroid stable iodine. In turn, 80% of the element iodine is in the phenyl ring of thyroid hormones. Consequently, the thyroid density index in HU reflects the level of hormone formation and the reserves of iodinated thyroid hormones directly into the thyroid gland. In this regard, it should be noted that the thyroid gland is the only endocrine organ that, after the synthesis of hormones lasting 50 days, stores them in the thyroid structure (colloid of thyroglobulin) and secretes thyroid hormones into the blood at the request of the body. Based on the literature data and the results of our own research, for all regions of Russia we have proposed the following fluctuations in thyroid density in HU, reflecting the euthyroid status and favorable future of the thyroid function: from 85 to 140 units. In those cases when there is an iodine- induced dysfunction of thyroid function, the thyroid density index in HU is increased above 140. If the synthesis of thyroid hormones (primary hypothyroidism) or synthesis is impossible, but pathological secretion with a lack of fixation in thyroid globulin collagen (diffuse toxic goiter with thyrotoxicosis), the thyroid density in HU decreases less than 85 units. It is important to note that in the determination of TSH in the blood, fasting, the use of a number of drugs, stress, sleep deprivation, severe illnesses of the subject can lead to errors in determining the concentration of TSH and thyroid hormones (due to so-called non thyroidal factors) in the direction of their change as in hypothyroidism with the presence of euthyroidism in fact. In this case, normal thyroid density in HU indicates euthyroidism.
Conclusions: One time assessment of thyroid density in HU with CT and blood serum TSH level makes it possible to perform differential diagnosis between iodine induced and true thyroid dysfunction and also to correct for the error in determination of TSH concentration as a result of the influence of non thyroidal factors. Evaluation of thyroid density in HU in CT should be used for screening the risk of thyroid dysfunction and for determining the need for individual and population iodine prophylaxis and monitoring its effectiveness in order to prevent iodine induced transient disorders of thyroid function.