Postoperative Radioiodine not beneficial in Low-Risk Thyroid Cancer patients: ESTIMABL2 Trial

France: A recent study has found that a non-radioiodine follow-up strategy is non-inferior to postoperative radioactive iodine (131I) treatment in patients with low-risk differentiated thyroid cancer. The study was published online in The Lancet Diabetes & Endocrinology on November 22, 2024.

“The group that did not receive radioactive iodine had a 93.2% event-free rate, while the 131I group had a slightly higher rate of 94.8%. These results demonstrate that withholding radioactive iodine after surgery did not negatively affect patient outcomes, offering a less invasive approach that enhances overall management,” the researchers reported.

The ESTIMABL2 trial, a multicenter randomized phase 3 study involving patients with low-risk differentiated thyroid cancer (pT1am or pT1b, N0 or Nx), demonstrated the non-inferiority of a follow-up strategy that excluded radioactive iodine (131I) administration compared to postoperative 131I treatment after 3 years of follow-up. The study author Prof Sophie Leboulleux, University Paris-Saclay, Paris, France, and colleagues present the results of a pre-specified analysis conducted after 5 years of follow-up.

For this purpose, the researchers randomly assigned patients who underwent total thyroidectomy with or without prophylactic neck lymph node dissection and had no postoperative suspicious findings on neck ultrasonography to either the no-radioiodine group or the radioiodine group (1.1 GBq-30 mCi of radioactive iodine after recombinant human thyrotropin-stimulating hormone). Follow-up included annual thyroglobulin and thyroglobulin antibody measurements during levothyroxine treatment, along with neck ultrasonography in odd-numbered years.

An event was defined as abnormal 131I uptake on a post-treatment whole-body scan requiring additional treatment, abnormal neck ultrasonography, elevated thyroglobulin levels, rising thyroglobulin antibody titres, or a combination. Non-inferiority was established if the proportion of patients without an event in one group compared to the other at 5 years post-randomization differed by no more than -5%, and the confidence interval did not overlap this threshold.

Key findings:

  • A total of 776 patients were enrolled in the study, with 642 (82.7%) female and 134 (17.3%) male participants. The median age was 52.9 years.
  • Of the enrolled patients, 698 were evaluable at 5 years.
  • The proportion of patients without events was 93.2% in the no-radioiodine group and 94.8% in the radioiodine group, resulting in a difference of –1.6%.
  • Events included 11 cases of structural or functional abnormalities and 31 cases of biological abnormalities.

“The non-inferiority of a follow-up strategy, compared to postoperative 131I administration, in low-risk thyroid cancer, previously demonstrated at 3 years, was reaffirmed at 5 years. This confirms that there is no disadvantage in managing these patients without postoperative ablation,” the researchers concluded.

Reference:

Leboulleux S, Bournaud C, Chougnet CN, Lamartina L, Zerdoud S, Do Cao C, Catargi B, Dygai I, Kelly A, Barge ML, Vera P, Rusu D, Schneegans O, Roux J, Raymond P, Benisvy D, Eberle MC, Bidault S, Nascimento C, Bastie D, Giraudet AL, Bardet S, Le Moullec N, Roudaut N, Drui D, Godbert Y, Zalzali M, Drutel A, Morel O, Velayoudom FL, Al Ghuzlan A, Schlumberger M, Buffet C, Borget I. Thyroidectomy without radioiodine in patients with low-risk thyroid cancer: 5 years of follow-up of the prospective randomised ESTIMABL2 trial. Lancet Diabetes Endocrinol. 2024 Nov 22:S2213-8587(24)00276-6. doi: 10.1016/S2213-8587(24)00276-6. Epub ahead of print. PMID: 39586309.

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Levothyroxine use linked to bone loss, reveals study

According to a study to be presented at next week’s RSNA meeting in Chicago, Levothyroxine use  may be associated over time with bone loss,

Levothyroxine is the second most commonly prescribed medication among older adults in the U.S. It is marketed under multiple brand names including Synthroid and is a synthetic version of a hormone called thyroxine and is commonly prescribed to treat the condition hypothyroidism, or underactive thyroid. In people with hypothyroidism, the thyroid gland does not produce enough thyroxine on its own, often resulting in fatigue, weight gain, hair loss and other symptoms. If left untreated, hypothyroidism can lead to serious and potentially fatal complications.

Approximately 23 million Americans-about 7% of the U.S. population-take levothyroxine daily. Sometimes, patients have been taking levothyroxine for many years, but it is not clear why it was initially prescribed or if it is still required.

“Data indicates that a significant proportion of thyroid hormone prescriptions may be given to older adults without hypothyroidism, raising concerns about subsequent relative excess of thyroid hormone even when treatment is targeted to reference range goals,” said the study’s lead author Elena Ghotbi, M.D., postdoctoral research fellow at Johns Hopkins University School of Medicine in Baltimore, Maryland.

Though there are some variables, a normal reference range for thyroid-stimulating hormone (TSH) is typically around 0.4 – 5.0 microunits per milliliter. Excess thyroid hormone has been associated with increased bone fracture risk.

For this study-a multidisciplinary collaboration between the Russell H. Morgan Department of Radiology and Radiological Science and Endocrinology Department at Johns Hopkins Medical Institutions, Dr. Ghotbi and colleagues aimed to determine whether levothyroxine use and higher thyroid hormone levels within the reference range are associated with higher bone loss over time in older “euthyroid” adults, meaning adults with normal thyroid function.

The researchers used the Baltimore Longitudinal Study of Aging (BLSA), a prospective observational cohort study of community-dwelling older adults. Participants aged 65 and older who had at least two visits and thyroid function tests consistently within the reference ranges were included in Dr. Ghotbi’s study.

“This research is a collaboration between Johns Hopkins and the BLSA, the longest-running study on aging conducted by the Intramural Research Program of the National Institute on Aging,” said co-author Eleanor Simonsick, Ph.D., epidemiologist and BLSA co-director. “The BLSA’s extensive data include repeated DEXA measurements at each study visit, which provides valuable insight into the progression of bone density and bone mass changes over time, offering a more comprehensive understanding of aging-related osteoporosis.”

The study group included 81 euthyroid levothyroxine users (32 men, 49 women) and 364 non-users (148 men, 216 women), with a median age of 73 and TSH levels of 2.35 at the initial visit. Other risk factors like age, gender, height, weight, race, medications, smoking history and alcohol use were considered in propensity score matching of levothyroxine users versus non-users.

The results showed that levothyroxine use was associated with greater loss of total body bone mass and bone density-even in participants whose TSH levels were within the normal range-over a median follow-up of 6.3 years. This remained true when taking into account baseline TSH and other risk factors.

“Our study suggests that even when following current guidelines, levothyroxine use appears to be associated with greater bone loss in older adults,” said Shadpour Demehri, M.D., co-senior author and professor of radiology at Johns Hopkins.

Jennifer Mammen, M.D., Ph.D., co-senior author and associate professor of endocrinology at Johns Hopkins, advises that adults taking levothyroxine should discuss their treatment with their health care provider and regularly monitor their thyroid function tests. “A risk-benefit assessment should be conducted, weighing the strength of the indications for treatment against the potential adverse effects of levothyroxine in this population,” she said.

Reference:

Common thyroid medicine linked to bone loss, Radiological Society of North America, Meeting: 110th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

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Study Reveals Connection Between Thyroid Hormones and Brain Changes in Violent Schizophrenia

China: New data reveals that schizophrenia patients exhibiting violent behavior had reduced gray matter volume in the left frontal pole and elevated thyroid-stimulating hormone (TSH) levels compared to non-violent patients. The findings were published online in Neuropsychiatric Disease and Treatment on November 18, 2024.

Schizophrenia (SCZ), affecting about 1% of the population, is linked to a higher prevalence of violence, with studies reporting up to 33.3% of individuals exhibiting violent behavior. Research indicates that thyroid dysfunction, which is common in SCZ due to genetic variations and antipsychotic treatments, may contribute to neuropsychiatric symptoms such as delusions and cognitive changes, increasing the risk of violence. The frontal lobe, critical for emotional regulation and cognition, often shows reduced gray matter volume (GMV) in violent SCZ patients. Thyroid hormones, essential for brain development and function, may influence these GMV alterations, suggesting a potential mechanism for violence in SCZ.

Against the above background, Tao Yu, Anhui Mental Health Center; Affiliated Psychological Hospital of Anhui Medical University; Hefei Fourth People’s Hospital, People’s Republic of China, and colleagues aimed to assess whether thyroid hormone levels are linked to frontal lobe gray matter volume (GMV) in male schizophrenia patients with violent behavior.

For this purpose, the researchers conducted thyroid function tests, including triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4), on 55 male patients with schizophrenia. Structural magnetic resonance imaging (sMRI) scans were performed, and the data were processed using FreeSurfer version 5.0.

The researchers applied multiple linear stepwise regression analysis to explore the relationship between frontal lobe gray matter volume and thyroid hormone levels.

Key findings:

  • Patients with schizophrenia and violent behavior had reduced gray matter volume (GMV) in the left frontal pole and higher TSH levels compared to those without violent behavior.
  • After controlling for potential covariates, a negative association was found between frontal pole GMV and TSH levels in all participants.

“Our results showed that schizophrenia patients with violent behavior had reduced gray matter volume in the frontal pole and elevated TSH levels compared to those without violence. Additionally, we found a negative association between frontal pole GMV and TSH levels. These findings highlight the potential role of decreased frontal GMV in violence among SCZ patients,” the researchers wrote.

“The results suggest that factors contributing to increased TSH levels should be considered to reduce the risk of violence in schizophrenia. Therefore, monitoring and addressing thyroid hormone alterations in SCZ patients is crucial,” they concluded.

Reference:

Yu T, Pei W, Zhang X, Deng C. Associations Between Thyroid Hormones Levels and Gray Matter Volume of Frontal Lobe Involved into Violence in Male Schizophrenia Patients. Neuropsychiatr Dis Treat. 2024;20:2169-2175

https://doi.org/10.2147/NDT.S481875

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Neither medication nor procedural abortions increases risk of mental health disorders in short or long term: Study

Since the introduction of mifepristone, a progesterone blocker, the rate of medication-based abortions has consistently increased in both the United States and worldwide. In 2020, 53% of abortions in the United States were medication-based, and in most Western European countries, more than half of the abortions were also medication-based according to the most recent data. Recent study examined whether mental health disorders increased in the shorter and longer-term after a medication or procedural abortion using Danish population data.

The researchers followed 72,424 females who had a first-trimester abortion between 2000 and 2018, analyzing the risk of any first psychiatric diagnosis, mood disorder diagnosis, and anxiety/stress disorder diagnosis. They compared the risk in the year after the abortion to the year before, as well as over longer time periods. The key findings were: 1. Females having medication (n=37,155) and procedural abortions (n=35,269) had the same risk of any first psychiatric diagnosis in the year after their abortion relative to the year before (medication abortion adjusted incidence rate ratio=1.02; procedural abortion adjusted incidence rate ratio=0.94). 2. As more time passed after the abortion, the risk of psychiatric diagnoses actually decreased relative to the year before the abortion for each method. For example, 5+ years after the abortion, the adjusted incidence rate ratios were 0.58 for medication abortions and 0.54 for procedural abortions. 3. These findings were consistent when examining specific diagnoses like mood disorders and anxiety/stress disorders, as well as in sensitivity analyses.

Conclusion

The researchers conclude that neither medication nor procedural abortions increase the risk of mental health disorders in the shorter or longer-term. These findings provide evidence that abortions do not negatively impact mental health. The results suggest policies or practices based on the idea that abortion methods increase psychological problems are not supported by the data.

Key Points

1. The study examined whether mental health disorders increased in the shorter and longer-term after a medication or procedural abortion using Danish population data.

2. The researchers followed 72,424 females who had a first-trimester abortion between 2000 and 2018, analyzing the risk of any first psychiatric diagnosis, mood disorder diagnosis, and anxiety/stress disorder diagnosis.

3. Females having medication (n=37,155) and procedural abortions (n=35,269) had the same risk of any first psychiatric diagnosis in the year after their abortion relative to the year before.

4. As more time passed after the abortion, the risk of psychiatric diagnoses actually decreased relative to the year before the abortion for both medication and procedural abortions. For example, 5+ years after the abortion, the adjusted incidence rate ratios were 0.58 for medication abortions and 0.54 for procedural abortions.

5. The findings were consistent when examining specific diagnoses like mood disorders and anxiety/stress disorders, as well as in sensitivity analyses.

6. The researchers conclude that neither medication nor procedural abortions increase the risk of mental health disorders in the shorter or longer-term, and that policies or practices based on the idea that abortion methods increase psychological problems are not supported by the data.

Reference –

Steinberg JR, Laursen TM, Lidegaard Ø, Munk-Olsen T. Medication and procedural abortions before 13 weeks gestation and risk of psychiatric disorders. Am J Obstet Gynecol 2024;231:437.e1-18

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New blood test may accurately predict preterm birth risk, suggests study

A new blood test developed at The Ohio State University College of Nursing – in collaboration with The Ohio State University Wexner Medical Center – is the first of its kind to potentially predict the risk for preterm birth in early pregnancy, one of the leading causes of childhood death worldwide.

The test was developed after a team led by Shannon Gillespie, PhD, RN, FAAN, assistant professor at Ohio State’s College of Nursing, studied risk factors for preterm birth, including stressors such as early life adversity and experiences with racial discrimination. They learned that key risk factors for preterm birth such as persistent stress, poor sleep, depression and anxiety can subtly change how the immune system works over time. Those dangerous changes to immune function can be measured with a simple blood test, using less than a teaspoon of blood.

“We’re essentially trying to create this ‘crystal ball’ of future events,” said Gillespie. “We are truly producing a future likely scenario early in pregnancy. And so, if the body’s not responding in the right way, we can see that.”

“We don’t want anyone to have to get sick; we don’t want anyone to have to have contractions. We want to say, ‘How will you handle these things?’ If it’s a way that we know is linked to the risk, then let’s do something about it,” said Gillespie.

The World Health Organization reports that more than 15 million babies are born prematurely every year, and more than a million of them do not survive. Approximately 70% of cases of preterm birth happen spontaneously without a medical need. Black mothers are also twice as likely to give birth early compared to White mothers for unknown reasons.

Ebony Wilson understands the power of knowledge and understanding potential risks during pregnancy. When she first got pregnant, she figured she did not have any complications. But Wilson and her husband lost their son when she unexpectedly went into labor at just 20 weeks. She said knowing their risks can help women take action and seek proper care and support.

“If a blood test is going to report whether I’m a high-risk pregnancy, low-risk pregnancy or anything in between, that is just a great nugget for me to know so that I can process in my pregnancy the proper supports that I need to stay pregnant and be happy in my pregnancy and enjoy this,” said Wilson. “Because giving life is to be enjoyed as best as possible.”

Preventative measures helped Wilson in her second pregnancy; although her daughter Ava was born early at 23 weeks, she survived and is thriving today.

Preliminary tests of the blood test show the potential to predict preterm birth risk with considerable accuracy – up to 97.5 percent. Gillespie said this test can be used in what is known as the “prenatal battery,” which is designed to help clinicians identify what appears to be increasing a patient’s risk for preterm birth, setting the stage for prevention before a patient experiences a single sign or symptom.

“It should feel as simple as a test for anemia,” said Gillespie. “So things that can be available for everyone that’s interested.”

Gillespie and her team are working on a $2.3 million grant from the National Institutes of Health/National Institute of Child Health and Human Development to put the new blood test through an expanded and comprehensive study to make sure it works just as accurately in large groups of patients. They are also working to identify ideal treatments to “reset” the body’s immune responses to normal levels.

“It’s all about the patients and their families. They are my inspiration, my reason for persevering and staying committed to this pursuit of knowledge,” said Gillespie. “I’m hopeful that this study will lead to a future where all moms are cared for with great thought and consideration and all babies have more time with mom – including that precious time in the tummy.”

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Severe Hyperglycemia Linked to Poor Outcomes in Patients with Large Ischemic Stroke, finds study

A recent analysis of the RESCUE-Japan LIMIT trial revealed that severe hyperglycemia significantly worsens outcomes for patients with large ischemic region strokes, even when treated with effective interventions like endovascular therapy (EVT). The study published in the Journal of the American Heart Association highlighted the impact of elevated blood sugar levels on recovery and complications in stroke patients by focusing the critical aspect of stroke management.

The trial focused a total of 200 patients with a median age of 76.5 years and an average blood glucose level of 131 mg/dL. Participants were randomly assigned to either EVT or standard medical management. Blood glucose levels on admission were categorized into 3 groups as normoglycemia (<140 mg/dL), moderate hyperglycemia (140–179 mg/dL), and severe hyperglycemia (≥180 mg/dL). Each group was analyzed for functional recovery and complications, particularly symptomatic intracranial hemorrhage (ICH), within 90 days.

The major findings indicate that severe hyperglycemia was strongly associated with poor functional recovery. The proportion of patients achieving a modified Rankin Scale score of 0–3, signifying minimal disability, was only 6.5% in the severe hyperglycemia group when compared to 25% in the normoglycemia group and 24.5% in the moderate hyperglycemia group. Adjusted odds ratios (aORs) highlighted the stark difference, with severe hyperglycemia showed an aOR of 0.17 when compared to normoglycemia.

The risk of symptomatic ICH was markedly higher in patients with severe hyperglycemia (25.8%) when compared to the ones with normoglycemia (2.5%) or moderate hyperglycemia (6.1%). Also, the incidence of ICH varied based on treatment and glycemic status. In normoglycemic and moderately hyperglycemic patients, ICH rates were similar between EVT and medical management. However, in severely hyperglycemic patients, EVT carried a disproportionately higher risk of symptomatic ICH (36.8%) when compared to medical management (8.3%).

When compared to 18.4% in the moderate group and 10% in the normoglycemic group, this study also underlined the prevalence of diabetes among hyperglycemic patients, with 71% of the severe hyperglycemia group having pre-existing diabetes. This highlighted the potential role of diabetes as a contributing factor in poor stroke outcomes. Overall, these findings illuminate the importance of glucose management in acute stroke care.

Source:

Tanaka, K., Yoshimoto, T., Koge, J., Yamagami, H., Imamura, H., Sakai, N., Uchida, K., Beppu, M., Matsumaru, Y., Matsumoto, Y., Kimura, K., Ishikura, R., Inoue, M., Sakakibara, F., Morimoto, T., Yoshimura, S., & Toyoda, K. (2024). Detrimental Effect of Acute Hyperglycemia on the Outcomes of Large Ischemic Region Stroke. In Journal of the American Heart Association. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/jaha.124.034556

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Granulocyte Concentrate reduces mortality and benefits neutropenic children with severe infections: Study

Granulocyte Concentrate reduces mortality and benefits neutropenic children with severe infections suggests a study published in the Journal of Personalized Medicine.

Infections remain the leading cause of mortality among neutropenic patients with haematologic malignancies, making effective infection management crucial. Achieving a sufficient neutrophil count is essential for the elimination of pathogens. Granulocyte concentrate (GC) can be a treatment option for neutropenic patients with severe infections. This study aimed to evaluate the efficacy, safety, and impact on survival of Granulocyte Concentrate transfusions in neutropenic children with severe infections treated over the past 13 years in a single centre. Methods: The retrospective study analysed clinical data from 60 children (median age 9.5 years) who received Granulocyte concentration transfusions at our centre. Granulocytes were collected by apheresis from donors stimulated with granulocyte colony-stimulating factor. The majority of the patients (70%) were diagnosed with acute leukaemia. The main indications for Granulocyte Concentrate were severe pneumonia (45%) and bacterial sepsis (38.33%). Results: The patients received 1 to 29 Granulocyte Concentrate transfusions for 1 to 70 days, with a median time of administration of 3 days. Neutrophil counts increased to >1000/µL within a median of 5 days. Granulocyte concentrations were well tolerated by most patients. One patient presented symptoms of anaphylaxis, the other acute lung injury related to transfusions, and alloimmunisation was reported in one patient. Of the patients analysed, 78.33% survived the infection that justified Granulocyte Concentrate administration. They did not observe significant differences in survival depending on the aetiology of the infection. Conclusions: Based on our research, Granulocyte Concentrate appears to be a beneficiary for neutropenic children with severe infections and reduces infection mortality rates. However, further well-designed randomised trials are needed to define its role in this setting.

Reference:

Mielecka-Jarmocik, Gabriela, et al. “Use of Granulocyte Transfusions in the Management of Severe Infections Among Children With Neutropenia.” Journal of Personalized Medicine, vol. 14, no. 11, 2024.

Keywords:

Granulocyte, Concentrate, reduces, mortality, benefits, neutropenic, children, severe, infections, study, Mielecka-Jarmocik, Gabriela

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C-Section Deliveries Linked to Higher Child Undernutrition and Mortality: NFHS-5 Study

India: Data from the National Family Health Survey in India indicate higher risks of stunting, wasting, and underweight among children born via C-section compared to those delivered vaginally. The analysis, which included 200,794 births, also found an increased likelihood of neonatal mortality in C-section births.

Additionally, children born to mothers with third or higher-order pregnancies faced greater risks of both neonatal and infant mortality. These findings, published in BMC Pediatrics, highlight the need to address delivery methods and maternal factors in improving child health outcomes.

Child undernutrition and mortality remain critical health challenges in low- and middle-income countries like India. A 2017 global report found that 22% of children were stunted, and 45% of child deaths occurred in those under five. Undernutrition, infectious diseases, and delivery methods (C-section vs. vaginal) are major contributors to these issues. C-sections, especially when overused, are linked to negative maternal and child health outcomes. Excessive C-section rates can increase risks of mortality, financial burden, and clinical complications.

Against the above background, Ujjwal Das & Nihar Ranjan Rout from Fakir Mohan University, Balasore, Odisha, India, examined the impact of delivery methods on child health in children aged 0–59 months in India.

For this purpose, the researchers used 200,794 samples in the study. Of these, 45,784 births were delivered by C-section, while the remaining 150,010 were delivered through normal vaginal delivery.

To assess the association between child health and mode of delivery, life table estimation of mortality and bivariate and multivariate logistic regression were applied to data from the fifth round of the National Family Health Survey conducted in 2019-21.

The study led to the following findings:

  • Children born via normal delivery had significantly lower rates of stunting, wasting, and underweight compared to those born by C-section.
  • The likelihood of neonatal death was higher for newborns delivered by C-section than for those delivered vaginally, across various background characteristics.
  • Mothers with a third or higher-order birth who deliver via C-section face a higher risk of neonatal and infant mortality compared to those with a second-order birth.

The study highlights that C-section deliveries are linked to delayed breastfeeding, higher financial burdens, and shorter breastfeeding durations compared to vaginal births. Additionally, C-sections increase the risk of child undernutrition, mortality, and complications, especially in emergency C-sections and those with previous C-sections. Neonatal and infant mortality rates are higher among C-section births.

“These findings stress the importance of antenatal and postnatal care visits. Low maternal healthcare coverage in rural areas exacerbates these issues. Health policies should focus on improving obstetric care quality and promoting vaginal deliveries to reduce mortality and improve child health outcomes,” the researchers concluded.

Reference:

Das, U., Rout, N.R. Impact of normal vs. caesarean deliveries on child nutritional status and mortality in India: insights from NFHS-5 data. BMC Pediatr 24, 781 (2024). https://doi.org/10.1186/s12887-024-05149-4

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Alopecia Areata linked to Increased Risk of Celiac Disease, reports study

Researchers have found that alopecia areata (AA) (an autoimmune disease leading to hair loss), increases patients chances of developing celiac disease. A large cohort study was carried out, where it was determined that nearly twice the prevalence rate of celiac disease was found among AA patients compared to healthy controls. This study was conducted by Yonit W. and colleagues and was published in Clinical and Experimental Dermatology journal.

This study clarifies the association of AA with celiac disease by studying a large cohort. Data was collected from patients from 2005 to 2019. The report used medical records of 33,401 AA patients for screening on celiac disease and matched it with healthy controls of 66,802 patients across age and gender. Specifically, results looked into the incidence of celiac disease in AA patients, ascertaining if it was higher or lower compared to a control group.

  • Among the AA group, the prevalence of celiac disease was observed in 1.1% of the patients, compared to 0.6% of the control group.

  • This difference represented a nearly twofold increase, with an Odds Ratio (OR) of 1.95 and a 95% Confidence Interval (CI) of 1.69-2.25, indicating a statistically significant association between AA and celiac disease.

  • Among the total of 754 the patients analyzed, 754 (0.85%) had a diagnosed case of celiac disease.

  • The highest rate of celiac disease prevalence in AA patients was reported among those aged above 40.

In conclusion, the study suggests an association of AA with significantly increased risk for celiac disease. Early diagnostic measures in patients with AA over the age of 40 may play a significant role in preventing complications from undiagnosed celiac disease. These results identify a potential need for cross-screening strategies in clinical practice, which improves patient outcomes.

Reference:

Wohl, Y., Mashiah, J., Drutin, Y., & Ben-Tov, A. (2024). Celiac risk doubles in patients with alopecia areata: a nationwide case -control study. Clinical and Experimental Dermatology. https://doi.org/10.1093/ced/llae489

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People With Abdominal Obesity may have Higher Prevalence of Tooth Loss, reveals research

People With Abdominal Obesity may have Higher Prevalence of Tooth Loss, suggests study published in the Clinical and Experimental Dental Research.

Previous research has shown that people with obesity are at a higher risk of tooth loss; however, it is unclear whether abdominal obesity (e.g., high waist circumference) is associated with tooth loss among individuals without obesity. This study aims to investigate the association between abdominal obesity and tooth loss among people who are not obese.

Two cross‐sectional surveys were used: the United States’ National Health and Nutrition Examination Survey (NHANES) 1999–2012 (n = 19,436) and the Scottish Health Survey (SHeS) 2008–2014 (n = 4243). Tooth loss was measured by the number of remaining teeth: 20 and over, 1–19, and edentulous. Abdominal obesity was defined by categorizing waist circumference into three levels: normal, high, and very high. Ordinal logistic regression was used to model the association between tooth loss and abdominal obesity.

Results: For people living without obesity, abdominal obesity is associated with a higher prevalence of tooth loss, and the effect is different between women and men. For women, abdominal obesity increased the chance of tooth loss by 64% (odds ratio [OR]: 1.64, 95% confidence interval [CI]: 1.16–2.34) in the NHANES and 196% (OR: 2.96, 95% CI: 1.47–5.97) in the SHeS. For men, abdominal obesity increased the chance of tooth loss by 41% (OR: 1.41, 95% CI: 1.06–1.87) in the NHANES and 65% (OR: 1.65, 95% CI: 1.02–2.73) in the SHeS. This study indicated that the prevalence of tooth loss is substantially higher in people with abdominal obesity, and this association is distinctively different between men and women. These findings suggest that those who are not obese but have abdominal obesity may be an important target population for oral health prevention strategies.

Reference:

Kang J, Larvin H, Pavitt S, Wu J. Higher Prevalence of Tooth Loss in People With Abdominal Obesity but Normal Weight: Findings From the United States and Scottish Populations. Clin Exp Dent Res. 2024 Dec;10(6):e70047. doi: 10.1002/cre2.70047. PMID: 39563168; PMCID: PMC11576517.

Keywords:

People, Abdominal, Obesity, Higher, Prevalence, Tooth Loss, suggests, study, Clinical and Experimental Dental Research, body mass index, gender difference, obesity, periodontal disease, tooth loss, Kang J, Larvin H, Pavitt S, Wu J.

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