[SPINA] SPINA Thyr - looking backward to 2017

[Johannes W. Dietrich]

Dear subscribers of the SPNA list,

thank you for your continued interest in the SPINA methodology! At the end of the year I would like to provide a small review of the developments in the previous 12 months.

In 2017, SPINA Thyr was used for at least* five research papers with more than 4000 participants in sum, and for one review article (*I may have missed some third-party papers. Please contributes additional publications from 2017 you may be aware of).

A working group from Istanbul compared patients suffering from subclinical hypothyroidism with healthy controls. The trial covering 56 participants [1] showed that thyroid's secretory capacity (SPINA-GT) correlates to Tp-e interval, Tp-e/QT ratio and Tp-e/QTC ratio in ECG recordings. The results demonstrate that structural thyroid diseases (including "sublatent" disorders) may be associated with myocardial remodeling. This may have significant consequences for future thyrocardiac research.

A large population-based study showed in 3649 subjects in Australia that SPINA-GT predicts the incidence of prostate cancer [2]. The mechanism behind this correlation is still unknown.

A small study investigated the influence of Metformin on thyroid function in 37 female patients. The study, which was performed at the University of Katowice, showed that SPINA-GT rises under Metformin therapy [3]. The known TSH-lowering effect of Metformin may therefore result from a direct effect on the thyroid rather than from an influence via the pituitary.

In 319 patients with thyroid cancer we assessed the relation between TSH and peripheral thyroid hormones [4]. We could show that step-up deiodination capacity (SPINA-GD) depends on the levothyroxine dose and that it affects the feedback of T4 on TSH. The study delivered evidence for a dual feedback via T4 and T3.

In another project we simulated patterns of individual set points of thyroid homeostasis and compared the results with clinical data of 502 subjects [5]. What we observed was that SPINA-GD correlated in healthy subjects with TSH concentration and that this effect is suspended under therapy with L-T4. Here, SPINA-GD correlates to substitution dose. This study is another hint for the under-recognised TSH-T3 shunt.

A comprehensive review article of an international working group has systematically summarised allostatic responses of thyroid function in certain physiological situations and diseases (including but not limited to NTIS / TACITUS, starvation, obesity, pregnancy, embryonal and fetal period, exercise and psychiatric diseases). It also went into details of the utility of SPINA-GT and SPINA-GD for differential diagnosis. If confirmed by future studies, the results of the present studies suggest a potential for significant improvements of diagnostic methodology.

With this small overview I want to say goodbye for 2017. I don't want to conceal that additional studies are in the pipeline and that the year 2018 will probably see a new version of SPINA Thyr (version 4.1.0 Bonfire), which will provide additional functionality and bug fixes.

Best regards and a Happy New Year,
JWD


Reference:

1. Gürdal A, Eroğlu H, Helvaci F, Sümerkan MÇ, Kasali K, Çetin Ş, Aksan G, Kiliçkesmez K. Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with subclinical hypothyroidism. Ther Adv Endocrinol Metab. 2017 Mar;8(3):25-32. doi 10.1177/2042018816684423. PMID 28377800. http://dx.doi.org/10.1177/2042018816684423 https://www.ncbi.nlm.nih.gov/pubmed/28377800

2. Chan YX, Knuiman MW, Divitini ML, Brown SJ, Walsh J, Yeap BB. Lower TSH and higher free thyroxine predict incidence of prostate but not breast, colorectal or lung cancer. Eur J Endocrinol. 2017 Oct;177(4):297-308. doi 10.1530/EJE-17-0197. PMID 28684452. http://dx.doi.org/10.1530/EJE-17-0197 https://www.ncbi.nlm.nih.gov/pubmed/28684452

3. Krysiak R, Szkróbka W, Okopień B. Sex-Dependent Effect of Metformin on Serum Prolactin Levels In Hyperprolactinemic Patients With Type 2 Diabetes: A Pilot Study. Exp Clin Endocrinol Diabetes. 2017 Nov 23. doi 10.1055/s-0043-122224. PMID 29169197. http://dx.doi.org/10.1055/s-0043-122224 https://www.ncbi.nlm.nih.gov/pubmed/29169197

4. Hoermann R, Midgley JEM, Dietrich JW, Larisch R. Dual control of pituitary thyroid stimulating hormone secretion by thyroxine and triiodothyronine in athyreotic patients. Ther Adv Endocrinol Metab. 2017 Jun;8(6):83-95. doi: 10.1177/2042018817716401. PMID: 28794850. http://dx.doi.org/10.1177/2042018817716401 http://www.ncbi.nlm.nih.gov/pubmed/28794850

5. Hoermann R, Midgley JEM, Larisch R, Dietrich JWC. Advances in applied homeostatic modelling of the relationship between thyrotropin and free thyroxine. PLoS One. 2017 Nov 20;12(11):e0187232. doi10.1371/journal.pone.0187232. PMID 29155897. http://dx.doi.org/10.1371/journal.pone.0187232 https://www.ncbi.nlm.nih.gov/pubmed/29155897

6. Chatzitomaris A, Hoermann R, Midgley JE, Hering S, Urban A, Dietrich B, Abood A, Klein HH, Dietrich JW. Thyroid Allostasis-Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming. Front Endocrinol (Lausanne). 2017 Jul 20;8:163. doi: 10.3389/fendo.2017.00163. PMID 28775711; PMCID PMC5517413. http://dx.doi.org/10.3389/fendo.2017.00163 https://www.ncbi.nlm.nih.gov/pubmed/28775711


-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --
-- PD Dr. med. Johannes W. Dietrich
-- Laboratory XU44, Endocrine Research
-- Medical Hospital I, Bergmannsheil University Hospitals
-- Ruhr University of Bochum
-- Buerkle-de-la-Camp-Platz 1, D-44789 Bochum, NRW, Germany
-- Phone: +49:234:302-6400, Fax: +49:234:302-6403
-- eMail: "johannes.dietrich at ruhr-uni-bochum.de"
-- http://www.thyreologie.com.de
-- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- --






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