Research areas
- Tumour markers and immunoassays
- Improved molecular diagnostic of thyroid cancer
- Late effects in cancer survivors (endocrine dysfunction)
- Thyroid epidemiology (HUNT)
Teaching
Medical students in Medical Biochemistry
Background
- Senior Consultant and Section leader, Department of Medical Biochemistry, Oslo University Hospital, since 2010
- Professor II in Medical Biochemistry, Intitute of Clinical Medicine, UIO, since 2007
- Group leader Thyroid Research Group, since 2012
- Group Leader Cancer Marker Research Group, to 2012 and associate member since.
- Specialist in Medical Biochemistry 1990
- Dr med (PhD) in 1988 UiO
- Cand med in 1980 UiO
Tags:
Thyroid,
Endocrinology,
Tumour Markers
Publications
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Åsvold, Bjørn Olav; Dénos, Marion Nicole Marie; Taylor, Peter N.; Razvi, Salman; Bjøro, Trine & Brumpton, Ben Michael
[Show all 7 contributors for this article]
(2026).
Changes in serum TSH across the adult lifespan: 22-year follow-up of the HUNT Study.
European Journal of Endocrinology (EJE).
ISSN 0804-4643.
194(6),
p. 819–826.
doi:
10.1093/ejendo/lvag097.
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Frich, Pål Stefan; Sigstad, Eva; Berstad, Audun Elnæs; Opsahl, Else Marie; Fagerlid, Kristin Holgersen & Kotanska-Grøholt, Krystyna
[Show all 9 contributors for this article]
(2025).
Ethanol Ablation of Metastatic Lymph Nodes in Patients With Papillary Thyroid Carcinoma—Predictors of Clinical Outcome.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
doi:
10.1210/clinem/dgaf298.
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Context
Ethanol ablation (EA) is a treatment option in recurrent or persistent metastatic lymph nodes (MLNs) from papillary thyroid carcinoma.
Objective
This work aimed to assess whether ultrasonographic characteristics of the MLN, history of lymph node surgery, aggressive histological subtype, or BRAFV600E mutation in the primary tumor predict long-term response from EA.
Methods
Seventy-five patients who received EA at a tertiary referral center were included. We evaluated treatment response from the most recent clinically indicated examination, or a study-specific examination. BRAFV600E analysis and review of histological subtypes in the primary tumor were conducted.
Results
Median interval from initial surgery to follow-up was 119 months (range, 39-471 months). Pure cystic MLN had a better outcome than the solid and partially cystic MLN (13/13, 100% vs 90/121, 74%; P = .039). Small MLNs (≤0.5 mL) had a higher response rate compared to larger lesions (71/92, 77% vs 10/19, 53%; P = .045). We observed no difference in EA response between patients with or without the BRAFV600E mutation (80/99, 81% vs 17/25, 68%; P = .181) or an aggressive subtype (22/24, 92% vs 75/100, 75%; P = .099) in their primary tumors. EA achieved similar rates of locoregional disease control in neck regions with or without previous lymph node surgery (66% vs 63%, P = .825).
Conclusion
EA was highly effective in pure cystic MLNs. Partially cystic or noncystic MLNs over 0.5 mL were less responsive, though many of these MLNs still showed a lasting response. BRAFV600E mutation, aggressive histological subtype, or absence of prior lymph node surgery did not negatively affect EA response.
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Nome, Ragnhild Veline; Paus, Elisabeth; Gehin, Johanna; Bolstad, Nils & Bjøro, Trine
(2024).
Managing hemolysis in serum neuron-specific enolase measurements–an automated algorithm for routine practice.
Scandinavian Journal of Clinical and Laboratory Investigation.
ISSN 0036-5513.
84(4),
p. 225–229.
doi:
10.1080/00365513.2024.2359091.
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Neuron-specific enolase (NSE) derived from neurons and peripheral neuroendocrine cells is a biomarker for neuroendocrine tumors and for prognostication in comatose cardiac arrest survivors. However, as platelets and erythrocytes contain NSE, hemolysis causes falsely elevated NSE. We used native serum and hemolysate derived from the same patients to make serial dilutions, and subsequently measured NSE (mNSE) and hemolytic index (HI) in each dilution. An algorithm suitable for the laboratory information system was developed based on the mNSE, HI and the estimated gradient of hemolytic interference from 30 patients. We estimated the associated uncertainty of the corrected NSE (cNSE) results based on the observed range of the gradient and derived an equation for cNSE for samples with limited hemolysis (i.e. 5 < HI ≤ 30): cNSE = mNSE − HI × (0.34 ± 0.23) µg/L. By semi-quantitatively grading the contribution from limited hemolysis, a texted result noting the hemolysis-associated degree of uncertainty can accompany the cNSE result. The major challenge of hemolysis when using serum NSE as a biomarker can be managed using an automated algorithm for correction of NSE results based on degree of hemolysis. However, laboratorians and clinicians should be aware of the limitations associated with in vivo hemolysis.
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Frich, Pål Stefan; Sigstad, Eva; Berstad, Audun Elnæs; Fagerlid, Kristin Holgersen; Paulsen, Trond Harder & Bjøro, Trine
[Show all 7 contributors for this article]
(2022).
Long-Term Efficacy of Ethanol Ablation as Treatment of Metastatic Lymph Nodes From Papillary Thyroid Carcinoma.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
107(5),
p. e2141–e2147.
doi:
10.1210/clinem/dgab907.
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Context
Ethanol ablation (EA) is considered an alternative to surgery for metastatic lymph nodes from papillary thyroid carcinoma (PTC) in selected patients.
Objective
The aim of this study was to evaluate the long-term efficacy and safety of this treatment.
Design and Setting
Adult patients with PTC who had received EA in lymph node metastasis at a tertiary referral center, and were included in a published study from 2011, were invited to participate in this follow-up study.
Methods
Radiologic and medical history were reviewed. Ultrasound examination of the neck was performed by radiologists, and clinical examination was performed by an endocrine surgeon. Response was reported according to predefined criteria for satisfactory EA treatment. Adverse events associated with EA were evaluated. Cause of death was reported for deceased patients.
Results
From the 2011 study, 51 of 63 patients were included. Forty-four patients were reexamined (67/109 lesions) and 7 patients were deceased. Median follow-up time from primary surgery was 14.5 years. Median follow-up from the latest performed EA in the 2011 study was 11.3 years. Local control was permanently achieved in most patients (80%). Recurrence within an ablated node was registered in 13 metastases in 10 patients. Seven of these patients also had recurrent disease elsewhere in the neck. No major side effects were reported.
Conclusion
EA is a minimally invasive procedure with a low risk of complications. Our data suggest that EA is a safe and efficient treatment, providing excellent results for a large group of patients in the long term.
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Huynh, Thuy-Tien Maria; Aass, Hans Christian Dalsbotten; Falk, Ragnhild Sørum; Astrup, Guro Lindviksmoen; Helland, Åslaug & Bjøro, Trine
[Show all 14 contributors for this article]
(2022).
Associations between patient-reported late effects and systemic cytokines in long-term survivors of head and neck cancer treated with radiotherapy.
Journal of cancer survivorship.
ISSN 1932-2259.
doi:
10.1007/s11764-022-01273-1.
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Purpose
Head and neck cancer (HNC) treatment may lead to late effects and impaired health-related quality of life of survivors. Knowledge on long-term late effects after radiotherapy (RT) and potential underlying biological mechanisms is lacking. We assessed the prevalence of xerostomia, dysphagia, and chronic fatigue (CF) in HNC survivors ≥ 5 years post-RT, and examined associations between pro-inflammatory cytokines and late effects.
Methods
In a cross-sectional study, 263 HNC survivors treated between 2007 and 2013 were enrolled. They completed validated questionnaires assessing xerostomia and dysphagia (the EORTC QLQ-H&N35), and CF (the Fatigue Questionnaire), and underwent blood sampling and clinical examination. Pro-inflammatory cytokines were analyzed in 262 survivors and 100 healthy age- and gender-matched controls.
Results
Median time since treatment was 8.5 years. The proportions of survivors reporting xerostomia, dysphagia, and CF were 58%, 31%, and 33%, respectively, with a preponderance of females. We found no significant associations between IL-6, IL-8, IP-10, TARC, TNF, or ENA-78 and the three late effects. The odds of having elevated levels of IL-6 and IP-10 were significantly higher in the survivors compared to the controls.
Conclusions
More than one-third of long-term HNC survivors experienced xerostomia, dysphagia, and CF. Persistent inflammation, with elevated systemic cytokines, was not associated with these late effects, although HNC survivors had higher levels of some cytokines than the controls.
Implications for Cancer Survivors
This study provides new knowledge on late effects that can serve as grounds for informing patients with HNC about risk of late effects more than 5 years after RT.
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Gehin, Johanna Elin; Warren, David; Syversen, Silje Watterdal; Lie, Elisabeth; Sexton, Joseph & Loli, Liz Paucar
[Show all 11 contributors for this article]
(2021).
Serum golimumab concentration and anti-drug antibodies are associated with treatment response and drug survival in patients with inflammatory joint diseases: data from the NOR-DMARD study.
Scandinavian Journal of Rheumatology.
ISSN 0300-9742.
50(6),
p. 445–454.
doi:
10.1080/03009742.2021.1875040.
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Objectives: This study aimed to identify the therapeutic target concentration and frequency of anti-drug antibodies (ADAbs) in golimumab-treated patients with inflammatory joint disease (IJD). Method: Associations between golimumab concentration, ADAbs, and treatment response were examined in 91 patients with IJD [41 axial spondyloarthritis (axSpA), 20 rheumatoid arthritis (RA), and 30 psoriatic arthritis (PsA)] included in the NOR-DMARD study. Treatment response was defined by Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement in axSpA, European League Against Rheumatism (EULAR) good/moderate response in RA, and improvement of ≥ 50% in modified Disease Activity index for PSoriatic Arthritis (DAPSA) (28 swollen/tender joint counts) in PsA. Serum drug concentrations and ADAbs were analysed using automated in-house assays. Results: At inclusion, 42% were biological disease-modifying anti-rheumatic drug naïve and 42% used concomitant synthetic disease-modifying anti-rheumatic drug. The median golimumab concentration was 2.2 (interquartile range 1.0–3.5) mg/L. The proportions of responders after 3 months among patients with golimumab concentration < 1.0, 1.0–3.9, and ≥ 4.0 mg/L were 19%, 49%, and 74%, respectively. A higher rate of treatment discontinuation was seen in patients with serum golimumab concentration < 1.0 compared to ≥ 1.0 mg/L (hazard ratio 3.3, 95% confidence interval 1.8–6.0, p < 0.05). ADAbs were detected in 6%, and were associated with lower drug concentrations and both reduced treatment response and drug survival. Conclusions: Golimumab concentrations ≥ 1.0 mg/L were associated with improved treatment response and better drug survival, although some patients may benefit from higher concentrations. This study suggests a rationale for dosing guided by therapeutic drug monitoring in golimumab-treated patients with IJD. The results should be confirmed in larger studies including trough samples, and the efficacy of such a strategy must be examined in randomized controlled trials.
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Gehin, Johanna Elin; Klaasen, Rolf; NORLI, ELLEN SAUAR; Warren, David; Syversen, Silje Watterdal & Goll, Guro Løvik
[Show all 10 contributors for this article]
(2021).
Rheumatoid factor and falsely elevated results in commercial immunoassays: data from an early arthritis cohort.
Rheumatology International.
ISSN 0172-8172.
41,
p. 1657–1665.
doi:
10.1007/s00296-021-04865-9.
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The aim of the study was to assess RF cross-reactivity to animal antibodies used in immunoassays, and to test if selected commercial immunoassays are vulnerable to interference from RF, causing false test results. Our study included samples from patients with RF-positive rheumatoid arthritis (RA) and controls (patients with RF-negative RA and psoriatic arthritis), included in an early arthritis-cohort. Reactivity to mouse IgG1, mouse IgG2a, rabbit IgG, bovine IgG, sheep/goat IgG and human IgG was analysed using in-house interference assays. RF-positive sera with strong reactivity to mouse IgG1 were analysed in three commercial immunoassays. To reveal interference, results before and after addition of blocking aggregated murine IgG1 were compared. Samples from 124 RF-positive RA patients and 66 controls were tested. We found considerably stronger reactivity toward animal antibodies, particularly mouse IgG1 (73% vs. 12%) and rabbit IgG (81% vs. 6%), in sera from RF-positive RA-patients compared to controls (p < 0.001). After selecting samples for testing in commercial assays, interference was revealed in 6/30 sera in the Architect β-hCG assay, 7/10 sera in the 27-plex cytokine assays, and in 2/33 samples in the Elecsys Soluble Transferrin Receptor assay. Our study revealed considerable RF reactivity to animal antibodies used in immunoassays and RF was associated with falsely elevated results in immunoassays used in clinical care and research. Clinicians, laboratorians, researchers and assay manufacturers must be alert to the risk of falsely elevated test results in RF-positive RA patients.
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Nome, Ragnhild V.; Småstuen, Milada Cvancarova; Fosså, Sophie D.; Kiserud, Cecilie E.; Åsvold, Bjørn Olav & Bjøro, Trine
(2021).
Thyroid hypofunction in aging testicular cancer survivors.
Acta Oncologica.
ISSN 0284-186X.
p. 1–8.
doi:
10.1080/0284186X.2021.1958004.
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Purpose
Thyroid hypofunction is a late effect observed in several groups of cancer survivors, but has to date not been evaluated in-depth in testicular cancer survivors (TCSs). We investigated the prevalence of thyroid hypofunction in long-term TCSs and compared the findings with those of a comparison group from the general population.
Patients and Methods
Norwegian TCSs diagnosed with unilateral testicular cancer in the period 1980–1994 (N = 1,436) were grouped according to their cancer treatment (Surgery only; Radiotherapy only; Cisplatin-based chemotherapy, eventually combined with radiotherapy). They were invited to participate in three surveys covering up to three decades post-diagnosis. Serum thyrotropin (s-TSH) from samples collected from the last survey were analyzed. S-TSH results were also available from a health survey of the general population performed in a county in mid-Norway (the HUNT3 Survey [comparison group]). Data on the prescription of thyroid hormone replacement therapy (levothyroxine) from the Norwegian Prescription Database were obtained for the TCSs and the comparison group’s participants. Thyroid hypofunction was defined as ‘untreated’ (overt or subclinical) hypothyroidism (with s-TSH ≥3.5 mIU/L and no regular prescription of levothyroxine) or ‘treated’ hypothyroidism with regular prescription of levothyroxine.
Results
Three decades after diagnosis the prevalence of thyroid hypofunction (i.e., both treated and untreated) was 11% in the TCSs and the prevalence ratio was 1.9 indicating an almost doubled prevalence in the TCSs compared to the comparison group (prevalence ratio 1.91, 95% CI [1.54; 2.38]). However, there were no significant differences in the risk of thyroid hypofunction related to the TCSs’ treatment modality.
Conclusion
TCSs may have an increased prevalence of thyroid hypofunction compared to the general population. Hypothyroidism has negative consequences related both to primary hypogonadism and to cardiovascular disease. As both conditions are overrepresented in TCSs, regular monitoring of thyroid hormones may be advisable.
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Nome, Ragnhild Veline; Småstuen, Milada Cvancarova; Bjøro, Trine; Kiserud, Cecilie E. & Fosså, Sophie Dorothea
(2020).
Longitudinal kidney function outcome in aging testicular cancer survivors.
Acta Oncologica.
ISSN 0284-186X.
59:4,
p. 467–474.
doi:
10.1080/0284186X.2020.1724328.
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Purpose: Testicular cancer survivors (TCSs) have increased risk of reduced kidney function related to treatment burden, but longitudinal studies of renal outcome in aging TCSs have been lacking. This longitudinal study describes age- and treatment-related kidney function changes in TCSs compared to a comparison group from the general population. Patients and methods: Estimated glomerular filtration rate (eGFR) was determined in blood samples from Norwegian TCSs (diagnosed 1980–1994) and surveyed median 11, 19 and 26 years since diagnosis (Survey1 [N ¼ 1273], 2 [N ¼ 849] and 3 [N ¼ 670]) defining four treatment groups; Surgery only, Radiotherapy (RT) only, Cisplatin-based chemotherapy (CBCT) 850 mg and High CBCT/RT >850 mg cisplatin or any combination of CBCT with RT. A comparison group was constructed from similarly aged men who participated in a population-based health survey. By multiple linear regressions and generalized mixed models for repeated measurements, we studied difference in eGFR between TCSs and the comparison group for all TCSs combined and stratified by treatment modality. Results: At Survey 1, the kidney function for the youngest TCSs combined versus the comparison group was significantly reduced by mean six units (mL/min/1.73 m2 ) with further decline to mean 12 units at Survey 3. The kidney function was significantly reduced in all treatment groups with the largest differences emerging for TCSs from the High CBCT/RT Group, thus indicating a deteriorating impact of high cumulative doses of cisplatin. Conclusion: Collated to the comparison group, the kidney function in TCSs became increasingly impaired during nearly three post-treatment decades, related to the treatment modality. Early detection and intervention of kidney dysfunction is important to reduce the risk of TCSs’ long-term morbidity and mortality related to nephrotoxicity, such as cardio-vascular diseases.
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Meuwese, Christiaan L.; Diepen, Merel van; Cappola, Anne R.; Sarnak, Mark J.; Shlipak, Michael G. & Bauer, Douglas C.
[Show all 39 contributors for this article]
(2019).
Low thyroid function is not associated with an accelerated deterioration in renal function.
Nephrology, Dialysis and Transplantation.
ISSN 0931-0509.
34(4),
p. 650–659.
doi:
10.1093/ndt/gfy071.
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Background Chronic kidney disease (CKD) is frequently accompanied by thyroid hormone dysfunction. It is currently unclear whether these alterations are the cause or consequence of CKD. This study aimed at studying the effect of thyroid hormone alterations on renal function in cross-sectional and longitudinal analyses in individuals from all adult age groups. Methods Individual participant data (IPD) from 16 independent cohorts having measured thyroid stimulating hormone, free thyroxine levels and creatinine levels were included. Thyroid hormone status was defined using clinical cut-off values. Estimated glomerular filtration rates (eGFR) were calculated by means of the four-variable Modification of Diet in Renal Disease (MDRD) formula. For this IPD meta-analysis, eGFR at baseline and eGFR change during follow-up were computed by fitting linear regression models and linear mixed models in each cohort separately. Effect estimates were pooled using random effects models. Results A total of 72 856 individuals from 16 different cohorts were included. At baseline, individuals with overt hypothyroidism (n = 704) and subclinical hypothyroidism (n = 3356) had a average (95% confidence interval) −4.07 (−6.37 to −1.78) and −2.40 (−3.78 to −1.02) mL/min/1.73 m2 lower eGFR as compared with euthyroid subjects (n = 66 542). In (subclinical) hyperthyroid subjects (n = 2254), average eGFR was 3.01 (1.50–4.52) mL/min/1.73 m2 higher. During 329 713 patient years of follow-up, eGFR did not decline more rapidly in individuals with low thyroid function compared with individuals with normal thyroid function. Conclusions Low thyroid function is not associated with a deterioration of renal function. The cross-sectional association may be explained by renal dysfunction causing thyroid hormone alterations.
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Celestino, Ricardo; Nome, Torfinn; Pestana, Ana; Hoff, Andreas Midbøe; Gonçalves, A. Pedro & Pereira, Luísa
[Show all 12 contributors for this article]
(2018).
CRABP1, C1QL1 and LCN2 are biomarkers of differentiated thyroid carcinoma, and predict extrathyroidal extension.
BMC Cancer.
18:68,
p. 1–16.
doi:
10.1186/s12885-017-3948-3.
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Background: The prognostic variability of thyroid carcinomas has led to the search for accurate biomarkers at the molecular level. Follicular thyroid carcinoma (FTC) is a typical example of differentiated thyroid carcinomas (DTC) in which challenges are faced in the differential diagnosis. Methods: We used high-throughput paired-end RNA sequencing technology to study four cases of FTC with different degree of capsular invasion: two minimally invasive (mFTC) and two widely invasive FTC (wFTC). We searched by genes differentially expressed between mFTC and wFTC, in an attempt to find biomarkers of thyroid cancer diagnosis and/or progression. Selected biomarkers were validated by real-time quantitative PCR in 137 frozen thyroid samples and in an independent dataset (TCGA), evaluating the diagnostic and the prognostic performance of the candidate biomarkers. Results: We identified 17 genes significantly differentially expressed between mFTC and wFTC. C1QL1, LCN2, CRABP1 and CILP were differentially expressed in DTC in comparison with normal thyroid tissues. LCN2 and CRABP1 were also differentially expressed in DTC when compared with follicular thyroid adenoma. Additionally, overexpression of LCN2 and C1QL1 were found to be independent predictors of extrathyroidal extension in DTC. Conclusions: We conclude that the underexpression of CRABP1 and the overexpression of LCN2 may be useful diagnostic biomarkers in thyroid tumours with questionable malignity, and the overexpression of LCN2 and C1QL1 may be useful for prognostic purposes.
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Opsahl, Else Marie; Akslen, Lars A.; Schlichting, Ellen; Aas, Turid; Brauckhoff, Katrin & Hagen, Anne Irene
[Show all 14 contributors for this article]
(2018).
Trends in diagnostics, surgical treatment, and prognostic factors for outcomes in medullary thyroid carcinoma in Norway: A nationwide population-based study.
European Thyroid Journal.
ISSN 2235-0640.
8,
p. 31–40.
doi:
10.1159/000493977.
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Background: Medullary thyroid carcinoma (MTC) is rare. Nationwide population-based studies are important to evaluate
its clinical course. Objectives: To describe all patients
with MTC in Norway during 1994–2016 and compare timerelated
trends in diagnostics and surgical treatment, including
prognostic factors for biochemical cure and diseasespecific
survival (DSS).
Methods: This retrospective population-based cohort study includes data for 228 out of 237 patients (96%) with MTC; 201 patients were surgically treated. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway. Data were collected from patients’ files. Trends were compared over 2 study periods.
Results: MTC accounted for 4.2% of thyroid
carcinomas. During the study periods, the incidence increased
from 0.18 to 0.25: 100,000 per year, preoperative diagnostics
improved with increased use of calcitonin, ultrasound,
and fine-needle cytology (p = 0.010, p < 0,001, and
Jan Erik Varhaug died on December 14, 2017.
Downloaded by:
UIO - Universitetsbibl., i. Oslo
91.186.70.23 - 3/25/2019 12:12:34 PM
32 Eur Thyroid J 2019;8:31–40 Opsahl et al.
DOI: 10.1159/000493977
p = 0.001), patients were diagnosed at an earlier tumor stage
(p = 0.004), and more patients were cured (p = 0.002). Via
multivariate analysis of patients with metastatic lymph
nodes, independent prognostic factors for cure were: a low
ratio of metastatic and total number of dissected lymph
nodes (p = 0.021) and no extrathyroidal extension (p =
0.030). Independent prognostic factors for DSS were: no
distant metastasis, a younger age, and a low ratio of metastatic and dissected lymph nodes (p = 0.005, p = 0.020, p = 0.022).
Conclusions: Preoperative diagnostics have improved
over time with increased therapeutic control. A low
ratio of metastatic and dissected lymph nodes predicts better
outcomes in patients with metastatic lymph nodes.
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Reinertsen, Kristin Valborg; Engebråten, Olav; Loge, Jon Håvard; Småstuen, Milada Cvancarova; Naume, Bjørn & Wist, Erik
[Show all 10 contributors for this article]
(2017).
Fatigue During and After Breast Cancer Therapy—A Prospective Study.
Journal of Pain and Symptom Management.
ISSN 0885-3924.
53(3),
p. 551–560.
doi:
10.1016/j.jpainsymman.2016.09.011.
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Context Chronic fatigue (CF) in breast cancer (BC) survivors is multifactorial and may be caused by immune activation triggered by BC or its treatment. In the Neoadjuvant Avastin in Breast Cancer study, BC patients received neoadjuvant chemotherapy (FEC100→taxane) ± bevacizumab, a monoclonal antibody with fatigue as a potential side effect. Objectives To examine fatigue levels and prevalence of CF before and during chemotherapy and at follow-up, and their associations with C-reactive protein (CRP) and clinical variables. Methods Eighty-four HER2-negative patients with cT2-4N0-3M0 BC responded to questionnaires and had CRP measured before treatment (T0), after FEC100 (T1), after taxanes before surgery (T2), and at two-year follow-up (T3). Results The prevalence of CF increased from 8% at T0 to 36% at T3, P < 0.0001. Fatigue levels peaked during chemotherapy from 12.0 at T0 to 20.0 at T2, and declined to 16.7 at T3, P < 0.001. Women with CF at T3 had higher fatigue levels at T0, T2, and T3 than those without CF (P ≤ 0.01). Psychological distress (P = 0.03) and pain (P = 0.04) at T3 were associated with CF at T3. Only psychological distress remained a significant predictor in multivariate analysis. CRP increased from T0 to T1 (P < 0.01) and declined to baseline values at T3, but changes were not associated with bevacizumab treatment. No association was found between bevacizumab or CRP, and fatigue levels or CF. Conclusion Neither bevacizumab treatment nor low-grade systemic inflammation as measured by CRP was associated with the increased fatigue levels and raised prevalence of CF, observed during and after BC therapy. Increased fatigue levels at baseline and psychological distress at T3 were associated with CF at T3.
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Nordlund, Marianne Sparby; Westgaard, Arne; Paus, Elisabeth; Øijordsbakken, Miriam; Henanger, Karoline Johansen & Naume, Bjørn
[Show all 7 contributors for this article]
(2017).
Specific antibodies and sensitive immunoassays for the human epidermal growth factor receptors (HER2, HER3, and HER4).
Tumour Biology.
ISSN 1010-4283.
39(6).
doi:
10.1177/1010428317707436.
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The use of trastuzumab in patients with breast cancer that overexpresses human epidermal growth factor receptor 2 has significantly improved treatment outcomes. However, a substantial proportion of this patient group still experiences progression of the disease after receiving the drug. Evaluation of the changes in expression of the human epidermal growth factor receptors could be of interest. Monoclonal antibodies against the extracellular domain of the human growth factor receptors, 2, 3, and 4, have been raised, and specific and sensitive immunoassays have been established. Sera from healthy individuals (Nordic Reference Interval Project and Database) were analyzed in the human epidermal growth factor receptor 2 assay (N = 805) and the human epidermal growth factor receptor 3 and 4 assays (N = 114), and reference limits were calculated. In addition, sera from 208 individual patients with breast cancer were tested in all three assays. Finally, the human epidermal growth factor receptor 2 assay was compared with a chemiluminescent immunoassay for serum human epidermal growth factor receptor 2/neu. Reference values were as follows: human epidermal growth factor receptor 2, <2.5 µg/L; human epidermal growth factor receptor 3, <2.8 µg/L; and human epidermal growth factor receptor 4, <1.8 µg/L. There were significant differences in human epidermal growth factor receptor 2 and human epidermal growth factor receptor 3 serum levels between the patients with tissue human epidermal growth factor receptor 2–positive and tissue human epidermal growth factor receptor 2–negative (p = 0.0026, p = 0.000011) tumors, but not in the serum levels of human epidermal growth factor receptor 4 (p = 0.054). There was good agreement between the in-house human epidermal growth factor receptor 2 assay and the chemiluminescent immunoassay. Our new specific antibodies for all the three human epidermal growth factor receptors may prove valuable in the development of novel anti-human epidermal growth factor receptor targeted therapies with sensitive immunoassays for measuring serum levels of the respective targets and in monitoring established treatment.
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Fleiner, Hanne Fiskvik; Bjøro, Trine; Midthjell, Kristian; Grill, Valdemar Erik Robert & Åsvold, Bjørn Olav
(2016).
Prevalence of thyroid dysfunction in autoimmune and type 2 diabetes: The population-based HUNT Study in Norway.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
101(2),
p. 669–677.
doi:
10.1210/jc.2015-3235.
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Paur, Ingvild; Lilleby, Wolfgang; Bøhn, Siv Kjølsrud; Hulander, Erik; Klein, Willibrord & Vlatkovic, Ljiljana
[Show all 19 contributors for this article]
(2016).
Tomato-based randomized controlled trial in prostate cancer patients: Effect on PSA.
Clinical Nutrition.
ISSN 0261-5614.
36(3),
p. 672–679.
doi:
10.1016/j.clnu.2016.06.014.
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Background & aims: The effect of lycopene-containing foods in prostate cancer development remains undetermined. We tested whether a lycopene-rich tomato intervention could reduce the levels of prostate specific antigen (PSA) in prostate cancer patients. Methods: Prior to their curative treatment, 79 patients with prostate cancer were randomized to a nutritional intervention with either 1) tomato products containing 30 mg lycopene per day; 2) tomato products plus selenium, omega-3 fatty acids, soy isoflavones, grape/pomegranate juice, and green/black tea (tomato-plus); or 3) control diet for 3 weeks. Results: The main analysis, which included patients in all risk categories, did not reveal differences in changes of PSA-values between the intervention and control groups. Post-hoc, exploratory analyses within intermediate risk (n = 41) patients based on tumor classification and Gleason score post-surgery, revealed that median PSA decreased significantly in the tomato group as compared to controls (−2.9% and +6.5% respectively, p = 0.016). In separate post-hoc analyses, we observed that median PSA-values decreased by 1% in patients with the highest increases in plasma lycopene, selenium and C20:5 n-3 fatty acid, compared to an 8.5% increase in the patients with the lowest increase in lycopene, selenium and C20:5 n-3 fatty acid (p = 0.003). Also, PSA decreased in patients with the highest increase in lycopene alone (p = 0.009). Conclusions: Three week nutritional interventions with tomato-products alone or in combination with selenium and n-3 fatty acids lower PSA in patients with non-metastatic prostate cancer. Our observation suggests that the effect may depend on both aggressiveness of the disease and the blood levels of lycopene, selenium and omega-3 fatty acids.
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Aakre, Inger; Strand, Tor A; Bjøro, Trine; Nordheim, Ingrid; Barikmo, Ingrid & Ares, Susana
[Show all 8 contributors for this article]
(2016).
Thyroid function among breastfed children with chronically excessive iodine intakes.
Nutrients.
8:398(7).
doi:
10.3390/nu8070398.
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Iodine excess may impair thyroid function and trigger adverse health consequences for children. This study aims to describe iodine status among breastfed infants with high iodine exposure in the Saharawi refugee camps Algeria, and further assess thyroid function and iodine status among the children three years later. In 2010, a cross-sectional study among 111 breastfed children aged 0–6 months was performed (baseline study). In 2013, a second cross-sectional study (follow-up study) was conducted among 289 children; 213 newly selected and 76 children retrieved from baseline. Urinary iodine concentration (UIC) and breast milk iodine concentration (BMIC) were measured at baseline. UIC, thyroid hormones and serum thyroglobulin (Tg) were measured at follow-up. At baseline and follow-up, 88% and 72% had excessive iodine intakes (UIC ≥ 300 µg/L), respectively. At follow-up, 24% had a thyroid hormone disturbance and/or elevated serum Tg, including 9% with subclinical hypothyroidism (SCH), 4% with elevated fT3 and 14% with elevated Tg. Children with SCH had poorer linear growth and were more likely to be underweight than the children without SCH. Excessive iodine intakes and thyroid disturbances were common among children below four years of age in our study. Further, SCH seemed to be associated with poor growth and weight.
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Aakre, Inger; Bjøro, Trine; Nordheim, Ingrid; Strand, Tor; Barikmo, Ingrid & Henjum, Sigrun
(2015).
Excessive iodine intake and thyroid dysfunction among lactating Saharawi women.
Journal of Trace Elements in Medicine and Biology.
ISSN 0946-672X.
31,
p. 279–284.
doi:
10.1016/j.jtemb.2014.09.009.
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Abstract
Objectives: Excessive iodine intake may lead to thyroid dysfunction, which may be particularly harmful during pregnancy and lactation. The main objective was to describe iodine status and the prevalence of thyroid dysfunction among lactating women in areas with high iodine (HI) and very high iodine (VHI) concentrations in drinking water.
Design and methods: A cross-sectional survey was performed among 111 lactating women in the Saharawi refugee camps, Algeria. Breast milk iodine concentration (BMIC), urinary iodine concentration (UIC) and the iodine concentration in the most commonly consumed foods/ drinks were measured. A 24-hour dietary recall was used to estimate iodine intake. Thyroid hormones and antibodies were measured in serum.
Results: Median UIC, BMIC and iodine intake across both areas was 350 µg/L, 479 µg/L and 407 µg/day, respectively. In multiple regression analyses, we discovered that being from VHI area was associated with higher UIC and BMIC. BMIC was also positively associated with iodine intake. Thyroid dysfunction and/or positive thyroid antibodies were found in 33.3% of the women, of which 18.9% had hypothyroidism and 8.1% had hyperthyroidism and 6.3% had positive antibodies with normal thyroid function. Elevated thyroid antibodies were in total found in 17.1%. We found no difference in distribution of thyroid dysfunction or positive antibodies between HI and VHI areas. BMI, BMIC and elevated thyroglobulin (Tg) predicted abnormal thyroid function tests.
Conclusions: The high prevalence of thyroid dysfunction may be caused by excessive iodine intake over several years.
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Selland, Mette; Holte, Harald; Bjøro, Trine; Schreiner, Thomas; Bollerslev, Jens & Loge, Jon Håvard
[Show all 8 contributors for this article]
(2015).
Chronic fatigue is prevalent and associated with hormonal dysfunction in
long-term non-Hodgkin lymphoma survivors treated with radiotherapy
to the head and neck region.
Leukemia and Lymphoma.
ISSN 1042-8194.
56(12),
p. 3306–3314.
doi:
10.3109/10428194.2015.1036258.
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The purposes of this study were to assess the prevalence of chronic fatigue (CF) in irradiated survivors of non-Hodgkin lymphoma, analyze for associations between hormonal dysfunction and CF, and to investigate the associations between CF and functioning. Invited survivors were all treated with radiation to the head and neck region, with or without additional chemotherapy. The participants (n =98) responded to questionnaires measuring CF, mental distress (HADS), and functioning (SF-36), and had blood drawn for analyses of four hormonal axes. Hormonal status was categorized as normal, hormone dysfunction in one or more axes, or hormone replacement therapy. A total of 29% of the survivors had CF. In multivariate analyses there was an increased risk of CF among survivors with untreated hormone dysfunction (OR 3.87, 95% CI: 1.20–12.51, P 0.02). Survivors on hormone substitution did not have increased risk for CF compared to survivors with normal hormonal status. CF was significantly associated with reduced functioning.
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Nome, Ragnhild; Hernes, Eivor; Bogsrud, Trond; Bjøro, Trine & Fosså, Sophie Dorothea
(2015).
Changes in prostate-specific antigen, markers of bone metabolism and bone scans after treatment with radium-223.
Scandinavian Journal of Urology.
ISSN 2168-1805.
49(3),
p. 211–217.
doi:
10.3109/21681805.2014.982169.
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Nordlund, Marianne Sparby; Nome, Ragnhild Veline; Sandven, Ingvill Bærøe; Paus, Elisabeth & Bjøro, Trine
(2015).
Characterization of a new highly sensitive immunometric assay for thyroglobulin with reduced interference from autoantibodies.
Tumour Biology.
ISSN 1010-4283.
p. 1–11.
doi:
10.1007/s13277-015-4597-2.
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Aakre, Inger; Bjøro, Trine; Nordheim, Ingrid; Strand, Tor; Barikmo, Ingrid & Henjum, Sigrun
(2015).
Development of thyroid dysfunction among women with excessive iodine intake - A 3-year follow-up.
Journal of Trace Elements in Medicine and Biology.
ISSN 0946-672X.
31,
p. 61–66.
doi:
10.1016/j.jtemb.2015.03.004.
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Objectives
Thyroid dysfunction can be a result of excessive iodine intake, which may have adverse health consequences, particularly for women in fertile age. In 2010, we conducted a cross-sectional study among lactating women with excessive iodine intake in the Saharawi refugee camps in Algeria and found a high prevalence of thyroid dysfunction. Three years later, we conducted a follow-up study to monitor the iodine situation and explore whether thyroid dysfunction still was highly prevalent when the women no longer were post-partum. None of the women were treated for hyper- or hypothyroidism between baseline and follow-up.
Methods
In 2013, we were able to recapture 78 of the 111 women from the baseline. Thyroid hormones and antibodies were measured in serum and thyroid size was assessed by palpation. Urinary iodine concentration (UIC) and drinking water iodine concentration were measured.
Results
The overall prevalence of thyroid dysfunction and/or positive antibodies was 34.3% and was not significantly changed from baseline. Of the non-pregnant women we reexamined, 17 had hypo- or hyperthyroidism in 2010; among these, 12 women still had abnormal thyroid function at follow-up. In addition, we found 9 new cases with marginally abnormal thyroid function. Women with thyroid dysfunction and/or positive antibodies had significantly higher BMI and thyroglobulin than women with normal thyroid function. We also found that women with high breast milk iodine concentration (BMIC) at baseline had more thyroid dysfunction at follow-up than the women with lower BMIC at baseline.
Conclusions
At follow-up, the prevalence of thyroid dysfunction was still high and had not changed during the 3 years between studies and from a postpartum period. The women still had a high iodine intake indicated by high UIC. Breast milk iodine concentration from baseline predicted thyroid dysfunction at follow-up.
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Åsvold, Bjørn Olav; Vatten, Lars Johan; Bjøro, Trine; Bauer, Douglas C.; Bremner, Alexandra & Cappola, Anne R.
[Show all 29 contributors for this article]
(2015).
Thyroid function within the normal range and risk of coronary heart disease an individual participant data analysis of 14 cohorts.
JAMA Internal Medicine.
ISSN 2168-6106.
175(6),
p. 1037–1047.
doi:
10.1001/jamainternmed.2015.0930.
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Importance Some experts suggest that serum thyrotropin levels in the upper part of the current reference range should be considered abnormal, an approach that would reclassify many individuals as having mild hypothyroidism. Health hazards associated with such thyrotropin levels are poorly documented, but conflicting evidence suggests that thyrotropin levels in the upper part of the reference range may be associated with an increased risk of coronary heart disease (CHD).
Objective To assess the association between differences in thyroid function within the reference range and CHD risk.
Design, Setting, and Participants Individual participant data analysis of 14 cohorts with baseline examinations between July 1972 and April 2002 and with median follow-up ranging from 3.3 to 20.0 years. Participants included 55 412 individuals with serum thyrotropin levels of 0.45 to 4.49 mIU/L and no previously known thyroid or cardiovascular disease at baseline.
Exposures Thyroid function as expressed by serum thyrotropin levels at baseline.
Main Outcomes and Measures Hazard ratios (HRs) of CHD mortality and CHD events according to thyrotropin levels after adjustment for age, sex, and smoking status.
Results Among 55 412 individuals, 1813 people (3.3%) died of CHD during 643 183 person-years of follow-up. In 10 cohorts with information on both nonfatal and fatal CHD events, 4666 of 48 875 individuals (9.5%) experienced a first-time CHD event during 533 408 person-years of follow-up. For each 1-mIU/L higher thyrotropin level, the HR was 0.97 (95% CI, 0.90-1.04) for CHD mortality and 1.00 (95% CI, 0.97-1.03) for a first-time CHD event. Similarly, in analyses by categories of thyrotropin, the HRs of CHD mortality (0.94 [95% CI, 0.74-1.20]) and CHD events (0.97 [95% CI, 0.83-1.13]) were similar among participants with the highest (3.50-4.49 mIU/L) compared with the lowest (0.45-1.49 mIU/L) thyrotropin levels. Subgroup analyses by sex and age group yielded similar results.
Conclusions and Relevance Thyrotropin levels within the reference range are not associated with risk of CHD events or CHD mortality. This finding suggests that differences in thyroid function within the population reference range do not influence the risk of CHD. Increased CHD risk does not appear to be a reason for lowering the upper thyrotropin reference limit.
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Brauckhoff, Michael; Machens, Andreas; Lorenz, Kerstin; Bjøro, Trine; Varhaug, Jan Erik & Dralle, Henning
(2014).
Surgical curability of medullary thyroid cancer in multiple endocrine neoplasia 2B: a changing perspective.
Annals of Surgery.
ISSN 0003-4932.
259(4),
p. 800–806.
doi:
10.1097/SLA.0b013e3182a6f43a.
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Åsvold, Bjørn Olav; Bjøro, Trine & Vatten, Lars Johan
(2013).
Associations of TSH levels within the reference range with future blood pressure and lipid concentrations: 11-year follow-up of the HUNT study.
European Journal of Endocrinology (EJE).
ISSN 0804-4643.
169(1),
p. 73–82.
doi:
10.1530/EJE-13-0087.
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Åsvold, Bjørn Olav; Vatten, Lars Johan & Bjøro, Trine
(2013).
Changes in the prevalence of hypothyroidism: the HUNT Study in Norway.
European Journal of Endocrinology (EJE).
ISSN 0804-4643.
169(5),
p. 613–620.
doi:
10.1530/EJE-13-0459.
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Brydøy, Marianne; Fosså, Sophie Dorothea; Klepp, Olbjørn; Bremnes, Roy M.; Wist, Erik & Bjøro, Trine
[Show all 8 contributors for this article]
(2012).
Sperm counts and endocrinological markers of spermatogenesis in long-term survivors of testicular cancer.
British Journal of Cancer.
ISSN 0007-0920.
107(11),
p. 1833–1839.
doi:
10.1038/bjc.2012.471.
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Background: The objective of this study was to assess markers of spermatogenesis in long-term survivors of testicular cancer (TC) according to treatment, and to explore correlations between the markers and associations with achieved paternity following TC treatment. Methods: In 1191 TC survivors diagnosed between 1980 and 1994, serum-follicle stimulating hormone (s-FSH; n=1191), s-inhibin B (n=441), and sperm counts (millions per ml; n=342) were analysed in a national follow-up study in 1998–2002. Paternity was assessed by a questionnaire. Results: At median 11 years follow-up, 44% had oligo- (<15 millions per ml; 29%) or azoospermia (15%). Sperm counts and s-inhibin B were significantly lower and s-FSH was higher after chemotherapy, but not after radiotherapy (RT), when compared with surgery only. All measures were significantly more abnormal following high doses of chemotherapy (cisplatin (Cis)>850 mg, absolute cumulative dose) compared with lower doses (Cis ⩽850 mg). Sperm counts were moderately correlated with s-FSH (−0.500), s-inhibin B (0.455), and s-inhibin B : FSH ratio (−0.524; all P<0.001). All markers differed significantly between those who had achieved post-treatment fatherhood and those with unsuccessful attempts. Conclusion: The RT had no long-term effects on the assessed markers of spermatogenesis, whereas chemotherapy had. At present, the routine evaluation of s-inhibin B adds little in the initial fertility evaluation of TC survivors.
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Åsvold, Bjørn Olav; Vatten, Lars Johan; Midthjell, Kristian & Bjøro, Trine
(2012).
Serum TSH within the Reference Range as a Predictor of Future Hypothyroidism and Hyperthyroidism: 11-Year Follow-Up of the HUNT Study in Norway.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
97(1),
p. 93–99.
doi:
10.1210/jc.2011-1724.
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Åsvold, Bjørn Olav; Bjøro, Trine; Platou, Carl Geoffrey Parrinder & Vatten, Lars Johan
(2012).
Thyroid function and the risk of coronary heart disease: 12-year follow-up of the HUNT Study in Norway.
Clinical Endocrinology.
ISSN 0300-0664.
77(6),
p. 911–917.
doi:
10.1111/j.1365-2265.2012.04477.x.
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Svare, Anders; Nilsen, Tom Ivar Lund; Bjøro, Trine; Åsvold, Bjørn Olav & Langhammer, Arnulf
(2011).
Serum TSH related to measures of body mass: longitudinal data from the HUNT Study, Norway.
Clinical Endocrinology.
ISSN 0300-0664.
74(6),
p. 769–775.
doi:
10.1111/j.1365-2265.2011.04009.x.
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Heilo, Arne; Sigstad, Eva; Fagerlid, Kristin Holgersen; Håskjold, Olav Inge; Kotanska-Grøholt, Krystyna & Berner, Aasmund
[Show all 8 contributors for this article]
(2011).
Efficacy of Ultrasound-Guided Percutaneous Ethanol Injection Treatment in Patients with a Limited Number of Metastatic Cervical Lymph Nodes from Papillary Thyroid Carcinoma.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
96(9),
p. 2750–2755.
doi:
10.1210/jc.2010-2952.
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Haakensen, Vilde Drageset; Bjøro, Trine; Luders, Torben; Riis, Margit; Bukholm, Ida Rashida Khan & Kristensen, Vessela N.
[Show all 11 contributors for this article]
(2011).
Serum estradiol levels associated with specific gene expression patterns in normal breast tissue and in breast carcinomas.
BMC Cancer.
11.
doi:
10.1186/1471-2407-11-332.
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Background High serum levels of estradiol are associated with increased risk of postmenopausal breast cancer. Little is known about the gene expression in normal breast tissue in relation to levels of circulating serum estradiol. Methods We compared whole genome expression data of breast tissue samples with serum hormone levels using data from 79 healthy women and 64 breast cancer patients. Significance analysis of microarrays (SAM) was used to identify differentially expressed genes and multivariate linear regression was used to identify independent associations. Results Six genes (SCGB3A1, RSPO1, TLN2, SLITRK4, DCLK1, PTGS1) were found differentially expressed according to serum estradiol levels (FDR = 0). Three of these independently predicted estradiol levels in a multivariate model, as SCGB3A1 (HIN1) and TLN2 were up-regulated and PTGS1 (COX1) was down-regulated in breast samples from women with high serum estradiol. Serum estradiol, but none of the differentially expressed genes were significantly associated with mammographic density, another strong breast cancer risk factor. In breast carcinomas, expression of GREB1 and AREG was associated with serum estradiol in all cancers and in the subgroup of estrogen receptor positive cases. Conclusions We have identified genes associated with serum estradiol levels in normal breast tissue and in breast carcinomas. SCGB3A1 is a suggested tumor suppressor gene that inhibits cell growth and invasion and is methylated and down-regulated in many epithelial cancers. Our findings indicate this gene as an important inhibitor of breast cell proliferation in healthy women with high estradiol levels. In the breast, this gene is expressed in luminal cells only and is methylated in non-BRCA-related breast cancers. The possibility of a carcinogenic contribution of silencing of this gene for luminal, but not basal-like cancers should be further explored. PTGS1 induces prostaglandin E2 (PGE2) production which in turn stimulates aromatase expression and hence increases the local production of estradiol. This is the first report studying such associations in normal breast tissue in humans.
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Åsvold, Bjørn Olav; Bjøro, Trine & Vatten, Lars Johan
(2011).
Association of thyroid function with estimated glomerular filtration rate in a population-based study: the HUNT study.
European Journal of Endocrinology (EJE).
ISSN 0804-4643.
164(1),
p. 101–105.
doi:
10.1530/EJE-10-0705.
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Svare, Anders; Nilsen, Tom Ivar Lund; Bjøro, Trine; Forsmo, Siri; Schei, Berit & Langhammer, Arnulf
(2009).
Hyperthyroid levels of TSH correlate with low bone mineral density: the HUNT 2 study.
European Journal of Endocrinology (EJE).
ISSN 0804-4643.
161(5),
p. 779–786.
doi:
10.1530/EJE-09-0139.
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Åsvold, Bjørn Olav; Bjøro, Trine & Vatten, Lars Johan
(2009).
Association of serum TSH with high body mass differs between smokers and never-smokers.
Journal of Clinical Endocrinology and Metabolism (JCEM).
ISSN 0021-972X.
94(12),
p. 5023–5027.
doi:
10.1210/jc.2009-1180.
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Kiserud, Cecilie E.; Fossa, A; Bjøro, Trine; Holte, Harald; Cvancarova, M & Fosså, Sophie Dorothea
(2009).
Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy.
British Journal of Cancer.
ISSN 0007-0920.
100(3),
p. 455–463.
doi:
10.1038/sj.bjc.6604892.
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Berg, Arne Stenrud; Dahl, Alv A; Bruland, Øyvind; Bjøro, Trine; Aanensen, MS & Fosså, Sophie Dorothea
(2009).
Definitive radiotherapy with adjuvant long-term antiandrogen treatment for locally advanced prostate cancer: health-related quality of life and hormonal changes.
Prostate Cancer and Prostatic Diseases.
ISSN 1365-7852.
12(3),
p. 269–276.
doi:
10.1038/pcan.2009.8.
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Hellevik, Alf Inge; Asvold, BO; Åsvold, Bjørn Olav; Bjøro, Trine; Romundstad, Pål Richard & Nilsen, Tom Ivar Lund
[Show all 7 contributors for this article]
(2009).
Thyroid Function and Cancer Risk: A Prospective Population Study.
Cancer Epidemiology, Biomarkers and Prevention.
ISSN 1055-9965.
18(2),
p. 570–574.
doi:
10.1158/1055-9965.EPI-08-0911.
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Background: It has been hypothesized that thyroid function may influence cancer risk, but few studies with adequate statistical power have investigated this question, and the results have not been consistent.
Methods: In a prospective study of 29,691 people (19,710 women and 9,981 men) without previously known thyroid disease, thyrotropin was measured at baseline, and cancer incidence was recorded during 9 years of follow-up. Using Cox regression analysis, we studied the associations (hazard ratios) of thyrotropin categories with total cancer risk, and specifically, with risk of lung, colon, prostate, and breast cancer adjusted for age, sex, and smoking status.
Results: Low thyrotropin levels (< 0.50 mU/L) were associated with increased cancer risk [adjusted hazard ratio (HR), 1.34; 95% confidence interval (CI), 1.06-1.69] compared with the euthyroid reference group. The higher risk was driven by lung cancer (adjusted HR, 2.34; 95% CI, 1.24-4.40) and prostate cancer (adjusted HR, 1.97; 95% CI, 1.04-3.76). After excluding the first 2 years of follow-up, the associations were strengthened to 2.91 (1.49-5.70) for lung cancer and 2.60 (1.36-4.99) for prostate cancer.
Conclusion: Thyrotropin levels suggestive of hyperthyroid function are associated with increased cancer risk, and specifically, with increased risk of lung and prostate cancer, whereas hypothyroid function does not seem to be associated with cancer risk.
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Bjerner, Johan; Biernat, D; Fosså, Sophie Dorothea & Bjøro, Trine
(2009).
Reference intervals for serum testosterone, SHBG, LH and FSH in males from the NORIP project.
Scandinavian Journal of Clinical and Laboratory Investigation.
ISSN 0036-5513.
69(8),
p. 873–U101.
doi:
10.3109/00365510903380886.
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Telhaug, Ragnar; Varhaug, Jan Erik; Sørbye, Halfdan; Bjøro, Trine; Haugen, Dagny Faksvåg & Gladhaug, Ivar P.
(2009).
Endokrine svulster.
In Dahl, Olav (Eds.),
Medikamentell kreftbehandling. Cytostatikaboken.
Universitetet i Oslo.
ISSN 9788299233125.
p. 387–395.
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Åsvold, Bjørn Olav; Bjøro, Trine; Nilsen, Tom Ivar Lund; Gunnell, David & Vatten, Lars Johan
(2008).
Thyrotropin levels and risk of fatal coronary heart disease.
Archives of Internal Medicine.
ISSN 0003-9926.
168(8),
p. 855–860.
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Background Recent studies suggest that relatively low thyroid function within the clinical reference range is positively associated with risk factors for coronary heart disease (CHD), but the association with CHD mortality is not resolved.
Methods In a Norwegian population-based cohort study, we prospectively studied the association between thyrotropin levels and fatal CHD in 17 311 women and 8002 men without known thyroid or cardiovascular disease or diabetes mellitus at baseline.
Results During median follow-up of 8.3 years, 228 women and 182 men died of CHD. Of these, 192 women and 164 men had thyrotropin levels within the clinical reference range of 0.50 to 3.5 mIU/L. Overall, thyrotropin levels within the reference range were positively associated with CHD mortality (P for trend = .01); the trend was statistically significant in women (P for trend = .005) but not in men. Compared with women in the lower part of the reference range (thyrotropin level, 0.50-1.4 mIU/L), the hazard ratios for coronary death were 1.41 (95% confidence interval [CI], 1.02-1.96) and 1.69 (95% CI, 1.14-2.52) for women in the intermediate (thyrotropin level, 1.5-2.4 mIU/L) and higher (thyrotropin level, 2.5-3.5 mIU/L) categories, respectively.
Conclusions Thyrotropin levels within the reference range were positively and linearly associated with CHD mortality in women. The results indicate that relatively low but clinically normal thyroid function may increase the risk of fatal CHD.
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Sigstad, Eva; Heilo, Arne; Paus, Elisabeth; Holgersen, Kjersti; Grøholt, Krystyna Kotanska & Jørgensen, Lars H.
[Show all 9 contributors for this article]
(2007).
The usefulness of detecting thyroglobulin in fine-needle aspirates from patients with neck lesions using a sensitive thyroglobulin assay.
Diagnostic Cytopathology.
ISSN 8755-1039.
35(12),
p. 761–767.
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Raastad, Truls; Glomsheller, Trond; Bjøro, Trine & Hallén, Jostein
(2003).
Recovery of skeletal muscle contractility and hormonal responses to strength exercise after two weeks of high-volume strength training.
Scandinavian Journal of Medicine & Science in Sports.
ISSN 0905-7188.
13(3),
p. 159–168.
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Nord, Carina; Bjøro, Trine; Ellingsen, Dag; Mykletun, Arnstein; Dahl, Olav & Klepp, Olbjørn
[Show all 9 contributors for this article]
(2003).
Gonadal hormones in long-term survivors 10 years after treatment for unilateral testicular cancer.
European Urology.
ISSN 0302-2838.
44(3),
p. 322–328.
doi:
10.1016/S0302-2838(03)00263-X.
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Objective: To investigate whether unilaterally orchiectomised testicular cancer survivors (TCSs) are more likely to display reduced Leydig cell function than healthy males.
Methods: A national multi-centre survey of 1235 TCSs was performed in 1998-2000 (mean age: 44 years) treated between 1980 and 1994 (mean follow-up: 11 years). Serum hormone analyses were performed on 1183 TCSs, as 52 TCSs used androgen replacement (AR). TCSs were allocated to four treatment groups: Surgery only (251); Radiotherapy only (515); Chemotherapy 1, cisplatin </=850 mg (373); Chemotherapy 2, cisplatin >850 mg (96). The Controls were represented by 200 healthy blue-collar workers (mean age: 44 years). LH >12 IU/l and testosterone <8 nmol/l and the use of AR indicated hypogonadism.
Results: Serum testosterone was similar in TCSs and Controls (16.9 vs.17.1 nmol/l), but TCSs had higher age-adjusted LH levels than the Controls (5.2 vs. 3.5 IU/l). LH increased with treatment intensity, but was elevated even in TCSs treated with surgery only. The age-adjusted odds ratio of hypogonadism was 3.8 (95%CI: 2.0-7.3) in TCSs, and increased with treatment intensity.
Conclusion: TCSs are at risk to develop pre-mature reduced Leydig cell function and hypogonadism. They may therefore be predisposed for the syndrome of androgen deficiency of aging males (ADAM).
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Bjerke, Synnøve; Bjøro, Trine & Heyerdahl, Sonja
(2001).
Psykiatriske og kognitive aspekter ved hypotyreose.
Tidsskrift for Den norske legeforening (Tidsskriftet).
ISSN 0029-2001.
121(20),
p. 2373–2376.
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Ved hypotyreose kan diffuse symptomer som endring av atferd, stemningsleie og kognisjon representere diagnostiske og terapeutiske utfordringer.
Vi presenterer aktuell litteratur og fire illustrerende pasienthistorier. Fra diagnosetidspunkt ble pasientene fulgt i 6 – 12 måneder under tyroksinbehandling. Symptomforløpet ble kartlagt ved hjelp av intervjuer, spørreskjema og tester.
Pasientene hadde betydelig redusert livskvalitet, depresjon, angst og redusert korttidshukommelse, samt mer diffuse psykiske og kognitive plager. Alle plager ble redusert med tyroksin, uten at normal funksjon nødvendigvis ble nådd på 6 – 12 måneder. I henhold til faglitteraturen er årsaker og virkningsmekanismer ved stemningslidelser og kognitiv dysfunksjon ved hypotyreose usikre. Noen mener hypotyreose i sentralnervesystemet hos systemisk eutyreote kan medvirke til depresjon, og at lokal trijodtyroninmangel i hjernen er mulig årsak til affektive og kognitive plager ved latent hypotyreose.
Pasienter med hypotyreose og psykiske plager bør behandles med både tyroksin og tiltak som retter seg mot de psykiske symptomene.
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Johansen, Per Wiik; Paulssen, Ruth H; Bjøro, Trine; Gautvik, Kaare M & Gordeladze, Jan Oxholm
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Raastad, Truls; Bjøro, Trine; Glomsheller, Trond & Hallén, Jostein
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To examine neuromuscular and hormonal changes during two weeks of heavy strength training, 18 weight-trained male students were recruited into a heavy training group (HT, n=11) and a control group (Ctr, n=7). The heavy training protocol con sisted of leg-extensor workouts performed daily, while workouts were performed twice a week in the Ctr group. Test of one repetition maximum (1 RM) was performed pre heavy training and on the 2nd day post heavy training. Isokinetic knee extensions, electrical stimulation, and squat jumps were performed pre, on the 8th day of heavy training, and on the 4th day post heavy training. Morning blood samples (08.00 h) were drawn pre, on the 8th day of heavy training, and on the 4th day p ost heavy training. 24 h urine samples were collected pre and on the 5th day post heavy training. 1 RM leg press increased by 6(2)% in the HT group. Testosterone and IGF-1 concentrations were respectively 12(5)% a nd 11(3)% lower than baseline on the 8th day of heavy training; however, hormone levels were back to baseline on the 4th day post heavy training. A significant correlation between individual changes in 1 RM leg press and changes in testosterone concentrations was observed in the HT group (r=0.69). In the HT group, 24 h urinary catecholamine excretion increased by 26(12)%, 3-methylhistidine excretion increased by 21(6)% and creatinine excretion increased by 11 (5)%. There were no significant changes in the Ctr group. This work addressesth e role of changes in basal hormonal status (morning samples) for skeletal muscle adaptation to heavy strength training.
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Bjøro, Trine; Holmen, Jostein; Krüger, Øystein; Midthjell, Kristian; Hunstad, Kristin & Schreiner, T
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Sand, Olav; Chen, Boming; Li, Q.; Bjøro, Trine; Karlsen, Hans Erik & Haug, Egil
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Gordeladze, Jan Oxholm; Bjøro, Trine; Torjesen, PA; Østberg, BC; Haug, Egil & Gautvik, Kaare M
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Gordeladze, Jan Oxholm; Bjøro, Trine; Østberg, BC; Sand, Olav; Torjesen, Peter A & Haug, Egil
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Bjøro, Trine; Østberg, BC; Sand, Olav; Torjesen, Peter A; Penman, E & Gordeladze, Jan Oxholm
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Bjøro, Trine; Torjesen, P.A.; Østberg, Bjørn Christian; Sand, Olav; Iversen, Jens Gustav & Gautvik, Kaare M.
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Bjøro, Trine; Østberg, Bjørn Christian; Sand, Olav; Gordeladze, Jan; Iversen, Jens Gustav & Torjesen, P. A.
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(1987).
Vasoactive intestinal peptide (VIP) and peptide (P) with N terminal histidine and C terminal isoleucine (PHI) increase prolactin (PRL) secretion in cultured rat pituitary cells (GH4C1) via a cAMP dependent mechanism which involves transient elevation of intracellular Ca2+.
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Østberg, Bjørn Christian; Sand, Olav; Bjøro, Trine & Haug, Egil
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Egil, Haug; Bjøro, Trine; Sand, Olav; Gordeladze, Jan & Gautvik, Kaare m.
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Bjøro, Trine; Haug, Egil; Sand, Olav & Gautvik, Kaare m.
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Aakre, Inger; Dahl, Lisbeth; Nordheim, Ingrid & Bjøro, Trine
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Panicker, Vijay; Evans, Jonathan; Bjøro, Trine; Åsvold, Bjørn Olav; Dayan, Colin & Bjerkeset, Ottar
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Full text in Research Archive
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Åsvold, Bjørn Olav; Bjøro, Trine; Nilsen, Tom Ivar Lund & Vatten, Lars Johan
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Full text in Research Archive
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Åsvold, Bjørn Olav; Vatten, Lars Johan; Nilsen, Tom Ivar Lund & Bjøro, Trine
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Normal thyroid function and concentrations of serum lipids in a population study.
Full text in Research Archive
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Åsvold, Bjørn Olav; Bjøro, Trine; Nilsen, Tom Ivar Lund & Vatten, Lars Johan
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Bjøro, Trine & Midthjell, Kristian
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Raastad, Truls; Bjøro, Trine; Hallén, Jostein; Avela, Janne; Komi, Pavo V. & Komulainen, Jyrki
(2000).
Changes in 24-h urinary excretion of epinephrine, nor-epinephrine, 3-methylhistidine and creatinine after two weeks of heavy strength training.
Full text in Research Archive
Show summary
Seventeen strength trained subjects were randomly divided into a heavy training (HT, n=10) and a control (Ctr, n=7) group. Heavy training consisted of 3 sets of 6 RM in leg-press and hack-squats performed every day, and upper body exercises trained twice a week in two weeks. Urine was collected for 24-h before heavy training and on the fifth day afterheavy training. Urine was analysed for epinephrine, nor-epinephrine,3-methylhisitdine (3-MH) and creatinine. 1 RM leg-press increased by 6±2% (p<0.05) in the HT group and by 4±2% (p<0.1) in the Ctr group. Urinary excretion of epinephrine, nor-epinephrine, 3-MH and creatinine increased significantly in the HT group, but only the relative change in 3-MH was significantly different between groups.
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Jacobsen, T.F.; Sand, Olav; Bjøro, Trine; Karlsen, Hans Erik & Iversen, Jens Gustav
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How does the bushman poison, diamphidia toxin, act.
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17,
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Full text in Research Archive
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Gautvik, Kaare M.; Bjøro, Trine; Paulsen, E.; Sletholt, Kjersti; Gordeladze, Jan Oxholm & Østberg, Bjørn Christian
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(1988).
The molecular actions of thyroliberin (TRH) and vasoactive intestinal polypeptide (VIP) involve "cross-talk" between different intracellular signalling systems in controlling prolactin (PRL) secretion.
Acta Physiologica Scandinavica.
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Full text in Research Archive
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Østberg, Bjørn Christian; Bjøro, Trine; Egil, Haug; Torjesen, P.; Gordeladze, Jan & Gautvik, Kaare M.
[Show all 7 contributors for this article]
(1986).
Effects of the phorbol ester TPA on hormone release and electrical activity in clonal rat pituitary cells (GH4C1).
Acta Physiologica Scandinavica.
ISSN 0001-6772.
128,
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Full text in Research Archive
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Østberg, B.C.; Bjøro, Trine; Haug, Egil; Sand, Olav; Torjesen, P. & Gautvik, Kaare M.
(1985).
Differences in the latency of the secretory response of clonal rat pituitary cells to VIP and TRH.
Acta Physiologica Scandinavica.
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124,
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Full text in Research Archive
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Bjøro, Trine; Haug, Egil; Sand, Olav & Gautvik, Kaare m.
(1984).
Vasoactive intestinal peptide causes a calcium dependent stimulation of prolactin secretion without altering electrophysiological membrane properties in GH4C1 cells.
Acta Physiologica Scandinavica.
ISSN 0001-6772.
121,
p. 8A–8A.
Full text in Research Archive
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Published
Apr. 13, 2011 2:55 PM
- Last modified
May 30, 2016 2:01 PM