{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:34:26Z","timestamp":1784306066047,"version":"3.55.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>GlycA is a novel glycoprotein biomarker of systemic inflammation and cardiovascular risk. Our objective was to assess the levels of GlycA in individuals with hypothyroidism. We also explored whether levothyroxine (LT4)-treated patients had different levels of GlycA, with attention to thyrotropin (TSH) levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We performed a cross-sectional analysis, using baseline data from the ELSA-Brasil cohort study. We included only participants with serum TSH and GlycA levels measurements, using magnetic resonance spectroscopy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094745). We excluded individuals with endogenous hyperthyroidism and those using drugs impacting thyroid function. Participants not taking LT4 and whose serum TSH was 0.4\u20134.0 mIU\/L were classified as euthyroid (EU) and those with elevated TSH as undiagnosed hypothyroidism (UH). For those on LT4 (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009345), adequacy of treatment was defined as TSH within the reference range. Those with TSH &lt;0.4 mIU\/L were considered over-treated (OT), and those &gt;4.0 mIU\/L, under-treated (UT). Both (UT+OT) were considered inadequately treated (IT). Group comparisons were performed by Kruskal-Wallis, adjusted Chi-square, and the\n                      <jats:italic toggle=\"yes\">post hoc<\/jats:italic>\n                      Dunn test. Additional subgroup analysis were performed in patients with circulating thyroperoxidase antibodies (TPO-Ab+). Respective multivariable analyses were performed to evaluate the relationship between thyroid-related variables and GlycA levels (Generalized Linear Model), as well as an abnormal GlycA (&gt;400\u2009\u03bcmol\/L; Logistic Binary Regression).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The prevalence rate of UH was 9.8% (467\/4745) and, among those on LT4, only 61.7% (213\/345) were adequately treated (AT). GlycA levels were higher in IT in comparison to EU (429 vs. 410\u2009\u03bcmol\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.01) but did not differ between UH (413\u2009\u03bcmol\/L) and euthyroidism. However, the subgroup analysis of those TPO-Ab+ showed that not only those with IT, but also those with UH, had higher levels of GlycA in comparison to euthyroidism (423 and 424 vs. 402\u2009\u03bcmol\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04). This association between higher levels of GlycA and IT was maintained even in multivariable analysis (odds ratio 1.53, confidence interval 1.03 to 2.31) Lower levels of GlycA were detected in AT (405\u2009\u03bcmol\/L,) compared with OT (432\u2009\u03bcmol\/L, 0.04) and UT (423\u2009\u03bcmol\/L,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Patients with IT, both OT and UT, had higher GlycA levels, which may be associated with low-grade systemic inflammation and, possibly, increased cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/thy.2023.0070","type":"journal-article","created":{"date-parts":[[2023,8,3]],"date-time":"2023-08-03T08:28:50Z","timestamp":1691051330000},"page":"1171-1181","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["GlycA as a Novel Biomarker of Systemic Inflammation in Hypothyroidism"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4181-5567","authenticated-orcid":false,"given":"Sarah","family":"Galvao","sequence":"first","affiliation":[{"name":"Post-Graduate Program in Endocrinology, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabela M.","family":"Bensenor","sequence":"additional","affiliation":[{"name":"Center for Clinical and Epidemiological Research, Faculdade de Medicina, Universidade de S\u00e3o Paulo, S\u00e3o Paulo, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Jones","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter P.","family":"Toth","sequence":"additional","affiliation":[{"name":"Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, Maryland, USA."},{"name":"Department of Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul D.","family":"Santos","sequence":"additional","affiliation":[{"name":"Lipid Clinic Heart 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