Contents
Part I: Thyroid
Chapter 1: Iodine Deficiency and Thyroid Function
1.1 Introduction
1.2 Iodine Absorption and Metabolism
1.2.1 Iodine Requirements and Tolerable Upper Levels
1.2.2 Thyroidal Adaptation to Iodine Deficiency
1.3 Iodine Deficiency in Pregnancy and Fetal Brain
1.3.1 Maternal Thyroid Adaptation to Iodine Deficiency
1.3.2 Fetal Consequences of Maternal Iodine Deficiency
1.3.3 Iodine Supplementation During Pregnancy
1.3.4 Iodine and Lactating Mothers
1.4 Iodine Deficiency in Infancy and Childhood
1.5 Iodine Deficiency in Adults and Elderly
1.6 Prevention of Iodine Deficiency Disorders
1.6.1 Monitoring of Iodine Prophylaxis Programs
References
Chapter 2: Classification of Thyroid Diseases
2.1 Introduction
2.2 Hypothyroidism
2.2.1 Autoimmune Thyroiditis
2.2.2 Subclinical Hypothyroidism
2.2.3 Iodine-Induced Hypothyroidism
2.2.4 Drug-Induced Hypothyroidism
2.2.5 Congenital Hypothyroidism
2.2.6 Central Hypothyroidism
2.3 Hyperthyroidism
2.3.1 Graves’ Disease
2.3.2 Toxic Nodular Disease
2.3.3 Thyroiditis
2.3.4 Drug-Induced Hyperthyroidism
2.3.5 Iodine-Induced Hyperthyroidism
2.3.6 Subclinical Hyperthyroidism
2.4 Thyroid Nodular Diseases
2.4.1 Follicular-Derived Thyroid Cancers
2.4.1.1 Differentiated Thyroid Cancers
2.4.1.2 Anaplastic Thyroid Cancers
2.4.2 Neuroendocrine C-Cell-Derived Thyroid Cancer
2.4.2.1 Medullary Thyroid Cancers
References
Chapter 3: Techniques to Study Thyroid Function and Morphology
3.1 The Role of Ultrasound
3.2 Normal Anatomy
3.3 Diffuse Thyroid Pathology
3.4 Nodular Thyroid Pathology
3.4.1 Hyperplastic Adenomatous Nodule
3.5 Sonoelastography
3.6 CEUS
3.7 Parathyroid Glands and Lymphnodes
Bibliography
Chapter 4: Overt Hyperthyroidism and Subclinical Hyperthyroidism: Who and How to Treat
4.1 Hyperthyroidism
4.1.1 Diagnosis
4.1.2 Treatment
4.1.2.1 GD
ATD
ATD and Side Effects
4.1.2.2 Choice of Treatment
ATD
Radioiodine
Surgery
Overview
4.2 Multinodular Toxic Goiter (MTG): Toxic Adenoma
4.3 Thyrotoxic Storm
4.4 Hyperthyroidism and GO
4.5 Amiodarone-Induced Thyrotoxicosis (AIT)
4.6 Hyperthyroidism and Pregnancy
4.6.1 Subclinical Hyperthyroidism (SH)
Bibliography
Chapter 5: Minimally Invasive Treatments of Benign Thyroid Nodules: Techniques and Results
5.1 Background
5.2 Indications
5.3 Techniques
5.4 Clinical Applications
References
Part II: Obesity
Chapter 6: Obesity: Classification and Diagnosis
6.1 Introduction
6.2 Definition and Diagnosis of Obesity
6.2.1 Body Mass Index
6.2.2 Adiposity
6.3 Classification of Obesity
6.3.1 The Metabolically Unhealthy Obesity (MUO)
6.3.2 The Metabolically Healthy Obesity (MHO)
6.3.3 The Metabolically Obese Normal Weight (MONW) Phenotype
6.3.4 Normal Weight Obese (NWO) Syndrome
6.3.5 Sarcopenic Obesity (SO)
6.4 Secondary Causes of Obesity
6.4.1 Endocrine Causes
6.4.1.1 Cushing’s Syndrome
6.4.1.2 Hypothyroidism
6.4.1.3 Polycystic Ovaries Syndrome (PCOS)
6.4.1.4 Growth Hormone Deficiency
6.4.1.5 Hypogonadism
6.4.1.6 Pseudohypoparathyroidism
6.4.1.7 Hypothalamic Disorders
6.4.2 Genetic Causes
6.4.2.1 Leptin and Leptin Receptor Deficiency
6.4.2.2 POMC Deficiency
6.4.2.3 MCR4 Deficiency
6.4.2.4 Prader–Willi Syndrome
6.4.3 Iatrogenic Causes
6.4.3.1 Medication
6.4.4 Eating Disorders
References
Chapter 7: Complications of Obesity
7.1 Introduction
7.2 Metabolic Syndrome
7.2.1 Altered Glucose and Lipid Metabolism
7.2.2 Metabolic Dysfunction-Associated Fatty Liver Disease
7.2.3 Elevated Blood Pressure
7.2.4 Metabolically Healthy and Unhealthy Obesity
7.3 Vascular System
7.3.1 Cardiovascular and Cerebrovascular Disease
7.3.2 Prothrombotic State
7.4 Respiratory System
7.5 Gastrointestinal System
7.6 Kidney and Urinary System Disorders
7.6.1 Chronic Kidney Disease
7.6.2 Other Disorders
7.7 Musculoskeletal System
7.7.1 Bone and Joint Diseases
7.7.2 Sarcopenic Obesity
7.8 Reproductive System
7.9 Neurological and Psychological Disorders
7.10 Nutritional Deficiencies
7.11 Cancer
7.12 Immunity and Infections
7.13 Conclusions
References
Chapter 8: Techniques to Study Metabolism
8.1 Introduction
8.2 Direct Calorimetry
8.3 Indirect Calorimetry
8.4 Doubly Labelled Water
8.5 Accelerometer/Metabolic Holter
8.6 In Vivo Magnetic Resonance Spectroscopy (MRS)
8.6.1 1H-MRS
8.6.2 13C-MRS
8.6.3 31P-MRS
References
Chapter 9: Obesity: Medical and Surgical Treatment
9.1 Introduction
9.2 Medical Treatment
9.2.1 Pharmacological Treatment Options for Obesity Care
9.2.1.1 FDA-Approved Medications for Weight Management in the Short-Term
9.2.1.2 FDA-Approved Medications for Weight Management in the Long Term
Orlistat
Efficacy
Effect on Body Weight
Effect on Metabolism
Safety and Adverse Effects
Phentermine/Topiramate
Efficacy
Effect on Body Weight
Effect on Metabolism
Safety and Adverse Effects
Lorcaserin
Efficacy
Effect on Body Weight
Effect on Metabolism
Safety and Adverse Effects
Bupropion/Naltrexone
Efficacy
Effect on Body Weight
Effect on Metabolism
Safety and Adverse Effects
Liraglutide 3.0
Efficacy
Effect on Body Weight
Effect on Metabolism
Safety and Adverse Effects
9.2.2 Off-Label Medications for Weight Control
9.2.2.1 Metformin
9.2.2.2 Topiramate
9.2.2.3 Zonisamide
9.2.2.4 Bupropion
9.2.2.5 Pramlintide
9.2.3 Future Anti-Obesity Targets for Obesity Pharmacotherapy
9.2.4 Conclusion
9.3 Surgical Treatment
9.3.1 Bariatric and Metabolic Surgery (BMS)
9.3.2 Patient Selection
9.3.3 Surgical Procedures
9.3.3.1 Sleeve Gastrectomy (SG) (Fig. 9.1)
9.3.3.2 Roux-En-Y Gastric Bypass (RYGB) (Fig. 9.2)
9.3.3.3 Adjustable Gastric Band (AGB) (Fig. 9.3)
9.3.3.4 Biliopancreatic Diversion with Duodenal Switch (BPD-DS) (Fig. 9.4)
9.3.3.5 One Anastomosis Gastric Bypass (OAGB) (Fig. 9.6)
9.3.4 Metabolic Surgery: The Manipulation of the Gastrointestinal Tract to Condition the Brain
References
Part III: Thyroid, Obesity and Metabolism
Chapter 10: Thyroid and Obesity
10.1 Obesity and Autoimmune Thyroid Disease
10.2 Obesity and Thyroid Cancer
10.3 Thyroid Ultrasound Examination in Obese Patients
10.4 Adipocytes and Thyroid Function
10.5 Thermogenesis and Thyroid Hormones
10.6 Thyroid and Ghrelin
References
Chapter 11: Thyroid Dysfunction and Metabolism: Diagnosis and Follow-Up
11.1 Background
11.2 Measurement of Resting Energy Expenditure (REE)
11.3 The Role of Indirect Calorimetry (IC) in Weight-Reduction Interventions
11.4 Thyroid Hormones and Energy Expenditure
11.5 The Role of Indirect Calorimetry (IC) in the Treatment of Overt Thyroid Dysfunction
11.6 The Role of Indirect Calorimetry (IC) in the Treatment of Subclinical Thyroid Disease
References
Chapter 12: Muscle Tissue in Hypothyroidism and Hyperthyroidism
12.1 Skeletal Muscle Physiology
12.2 Thyroid Hormones and Muscle Tissue
12.3 Hypothyroidism and Muscle Tissue
12.4 Hyperthyroidism and Muscle Tissue
References
Chapter 13: Thyroid Function and Effects on Cardiovascular System
13.1 Introduction
13.2 TH and Hyperlipidemia
13.2.1 TH, Vasculature, and Blood Pressure
13.2.2 TH and Thrombogenesis
13.3 Molecular and Cellular Mechanisms of Thyroid Hormone Action
13.3.1 Responses Dependent on T3 Binding to Thyroid Receptors (TRs) Localized in the Nucleus (Genomic Effects)
13.3.2 Signaling through TRs Localized in the Cytoplasm or Associated with the Plasma Membrane (Non-genomic Effects Impacting on Transmembrane and Intracellular Ion Flux)
13.4 Cardiovascular Consequences of Overt Hyperthyroidism (OHyper) and Subclinical Hyperthyroidism (SHyper)
13.4.1 SHyper
13.4.2 Treatment of OHyper and SHyper
13.5 Cardiovascular Consequences of Overt Hypothyroidism (OHypo) and Subclinical Hypothyroidism (SHypo)
13.5.1 SHypo
13.5.2 Treatment of OHypo and SHypo
13.6 TH and Cardiovascular Consequences of Heart Failure (Low T3 Syndrome)
References
Chapter 14: Obesity, Adipokines and Thyroid Dysfunction
14.1 Obesity and Adipose Tissue
14.2 Adipokines
14.2.1 Leptin
14.2.2 Adiponectin
14.2.3 Resistin
14.2.4 Vaspin
14.2.5 Visfatin
14.3 Adipokines and Thyroid Dysfunction in Humans
14.3.1 Thyroiditis
14.3.2 Hypothyroidism
14.3.3 Hyperthyroidism
14.4 Conclusions
References
Chapter 15: Adipokines and Thyroid Malignancies
15.1 Thyroid Cancer
15.1.1 Epidemiology, Histological Classification, and Molecular Alterations
15.1.2 Diagnosis, Treatments, and Follow-Up
15.2 Thyroid Cancer: Association with Adipokines and Metabolism
15.2.1 Insulin
15.2.2 Adipokines
References
Part IV: Clinical Cases
Chapter 16: Clinical Cases
16.1 Clinical Case 1
16.2 Clinical Case 2
16.3 Clinical Case 3
References