SPINA

With immediate effect, SPINA Thyr 4.2 (Kontinuum) is available at Sourceforge and Zenodo. This is a major new release that provides new features including roaming folder support and bug fixes. The new version is available for macOS, Windows and Linux from http://spina.sourceforge.net or via the DOI 10.5281/zenodo.3596049.

With immediate effect, SPINA Thyr 4.1.1, a bug fix release mainly addressing issues on Windows 10 and macOS Catalina, is available from http://spina.sf.net .

SPINA Thyr has been updated to version 4.1. This is a major upgrade, which comes with a plethora of new features including enhanced Drag & Drop support, export of LOINC identifiers, support for comments in case records and compatibility with macOS Cocoa. SPINA Thyr 4.1 is available for Windows, Linux and macOS from http://spina.sf.net.

In 2018, the SPINA methodology continued to enjoy world-wide scientific interest. More and more papers from several countries and continents demonstrated interesting physiological and clinical implications of calculated structure parameters. The ... [More] paper by a group in South Korea demonstrated in patients suffering from Graves’ disease that thyroid’s secretory capacity (SPINA-GT) and total deiodinase activity (SPINA-GD) correlate to basal metabolic rate and that these parameters decrease during treatment [1]. This is an interesting confirmation of the physiological validity of these parameters. As many as five papers were published by a group in Poland. The first one showed that a gluten-free diet results in increased SPINA-GT in patients with autoimmune thyroiditis – in parallel to sinking antibody titres [2]. The second study showed that in women with latent (euthyroid) autoimmune thyroiditis SPINA-GT increases due to therapy with statins (provided that the supply with vitamin D is sufficient) [3]. This effect may be caused by positive effects on autoimmune processes. Men were investigated in a third group. They were hyperthyroid, and in this population with pathological metabolism the results showed that both both SPINA-GT and SPINA-GD correlate negatively to erectile function, intercourse satisfaction, orgasmic function and sexual desire [4]. A fourth paper showed that in women with autoimmune thyroiditis substitution with vitamin D results in increases SPINA-GT. This effect is augmented by selenomethionine [5]. Similar effects were observed in men. Here selenomethionine therapy also leads to increased SPINA-GD [6]. The paper of a dutch-spanish group received considerable public interest. It showed that SPINA-GT and SPINA-GD are significantly reduced in chronic fatigue syndrome (compared to age- and sex-matched controls) [7]. Obviously, this is the correlative of type 1 thyroid allostasis, as it is also known from critically ill patients, where it is referred to as non-thyroidal illness syndrome or TACITUS. We ourselves [8] could show that the pituitary function correlates to SPINA-GT and that this relation is modified in autoimmune thyroiditis. Obviously, both functional thyroid capacity and preferential T3 formation are essential elements for adjusting the sensitivity of central components of the feedback loop. On the basis of these insights it is advisable to consider parameters like SPINA-GD in future studies and to include them in multivariable prediction models or in stratification strategies [9]. References: Kim MJ, Cho SW, Choi S, Ju DL, Park DJ, Park YJ. Changes in Body Compositions and Basal Metabolic Rates during Treatment of Graves' Disease. Int J Endocrinol. 2018 May 3;2018:9863050. doi: 10.1155/2018/9863050. PMID 29853888; PMCID PMC5960571. https://www.ncbi.nlm.nih.gov/pubmed/29853888 https://www.ncbi.nlm.nih.gov/pubmed/29853888 https://doi.org/10.1155/2018/9863050 https://doi.org/10.1155/2018/9863050 Krysiak R, Szkróbka W, Okopień B. The Effect of Gluten-Free Diet on Thyroid Autoimmunity in Drug-Naïve Women with Hashimoto's Thyroiditis: A Pilot Study. Exp Clin Endocrinol Diabetes. 2018 Jul 30. doi: 10.1055/a-0653-7108. PMID 30060266. https://www.ncbi.nlm.nih.gov/pubmed/30060266 https://www.ncbi.nlm.nih.gov/pubmed/30060266 https://doi.org/10.1055/a-0653-7108 https://doi.org/10.1055/a-0653-7108 Krysiak R, Szkróbka W, Okopień B. The Relationship Between Statin Action On Thyroid Autoimmunity And Vitamin D Status: A Pilot Study. Exp Clin Endocrinol Diabetes. 2018 Aug 27. doi: 10.1055/a-0669-9309. PMID 30149415. https://www.ncbi.nlm.nih.gov/pubmed/30149415 https://www.ncbi.nlm.nih.gov/pubmed/30149415 https://doi.org/10.1055/a-0669-9309 https://doi.org/10.1055/a-0669-9309 Krysiak R, Marek B, Okopień B. Sexual function and depressive symptoms in men with overt hyperthyroidism. Endokrynol Pol. 2018 Oct 11. doi: 10.5603/EP.a2018.0069. PMID 30307028 https://www.ncbi.nlm.nih.gov/pubmed/30307028 https://www.ncbi.nlm.nih.gov/pubmed/30307028 https://doi.org/10.5603/EP.a2018.0069 https://doi.org/10.5603/EP.a2018.0069 Robert Krysiak, Karolina Kowalcze, Bogusław Okopień. SELENOMETHIONINE POTENTIATES THE IMPACT OF VITAMIN D ON THYROID AUTOIMMUNITY IN EUTHYROID WOMEN WITH HASHIMOTO’S THYROIDITIS AND LOW VITAMIN D STATUS. Pharmacological Reports 2018, ISSN 1734-1140, https://doi.org/10.1016/j.pharep.2018.12.006 https://doi.org/10.1016/j.pharep.2018.12.006 Robert Krysiak, Witold Szkróbka, Bogusław Okopień. The effect of vitamin D and selenomethionine on thyroid antibody titers, hypothalamic-pituitary-thyroid axis activity and thyroid function tests in men with Hashimoto’s thyroiditis: a pilot study. Pharmacological Reports, 2018, ISSN 1734-1140, https://doi.org/10.1016/j.pharep.2018.10.012 https://doi.org/10.1016/j.pharep.2018.10.012. Ruiz-Núñez B, Tarasse R, Vogelaar EF, Janneke Dijck-Brouwer DA, Muskiet FAJ. Higher Prevalence of „Low T3 Syndrome“ in Patients With Chronic Fatigue Syndrome: A Case-Control Study. Front Endocrinol (Lausanne). 2018 Mar 20;9:97. doi: 10.3389/fendo.2018.00097. PMID: 29615976; PMCID: PMC5869352. https://www.ncbi.nlm.nih.gov/pubmed/?term=Tarasse-R+2018 https://www.ncbi.nlm.nih.gov/pubmed/?term=Tarasse-R+2018 https://doi.org/10.3389/fendo.2018.00097 https://doi.org/10.3389/fendo.2018.00097 Hoermann R, Midgley JEM, Larisch R, Dietrich JW. The role of functional thyroid capacity in pituitary thyroid feedback regulation. Eur J Clin Invest. 2018 Oct;48(10):e13003. doi: 10.1111/eci.13003. PMID: 30022470. https://www.ncbi.nlm.nih.gov/pubmed/30022470 https://www.ncbi.nlm.nih.gov/pubmed/30022470 https://doi.org/10.1111/eci.13003 https://doi.org/10.1111/eci.13003 Hoermann R, Midgley JEM, Larisch R, Dietrich JW. Lessons from Randomised Clinical Trials for Triiodothyronine Treatment of Hypothyroidism: Have They Achieved Their Objectives? J Thyroid Res. 2018 Jul 16;2018:3239197. doi: 10.1155/2018/3239197. PMID 30174821; PMCID PMC6098896. https://www.ncbi.nlm.nih.gov/pubmed/30174821 https://www.ncbi.nlm.nih.gov/pubmed/30174821 https://doi.org/10.1155/2018/3239197 https://doi.org/10.1155/2018/3239197 [Less]

Recently, we published a package for the statistical environment R that implements SPINA. If facilitates calculating SPINA-GT and SPINA-GD as well as Jostel's TSH index and TTSI. Although the previously published generic S functions are usable with ... [More] R, too, the new package makes it easier to integrate SPINA Thyr in the evaluation of clinical trials and in large-scale computational statistics. SPINA for R (key word "SPINA") can be directly downloaded and installed from R's package management menu. More information is available from https://cran.r-project.org/package=SPINA . [Less]

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). ... [More] 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. References: 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 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 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 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 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 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 [Less]

A recent trial published in the journal Therapeutic Advances in Endocrinology and Metabolism demonstrated that patients with ensuing hypothyroidism have increased T-wave dispersion as quantified with Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio ... [More] from resting ECG. SPINA-GT, which was significantly lower in a group with subclinical hypothyroidism compared to normal controls, showed a significant negative correlation to the Tp-e interval (r = −0.54, p < 0.01). SPINA might help to predict the risk of malignant arrhythmia in otherwise healthy subjects. Reference Ahmet Gürdal, Hatice Eroğlu, Füsun Helvaci, Mutlu Çağan Sümerkan, Kamber Kasali, Şükrü Çetin, Gökhan Aksan, Kadriye Kiliçkesmez. Evaluation of Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio in patients with subclinical hypothyroidism. Therapeutic Advances in Endocrinology and Metabolism. First published date: January-30-2017. doi 10.1177/2042018816684423 [Less]

The newest LOINC version, release 2.58, published on December 12st, 2016, includes thyroid's secretory capacity (SPINA-GT) and sum activity of peripheral deiodinases (SPINA-GD) with the codes 82368-2 and 82367-4, respectively. LOINC (Logical ... [More] Observation Identifiers Names and Codes) is a database and standard of universal identifiers for laboratory and other clinical observations. It facilitates exchange and storage of clinical results or vital signs for patient care and clinical research. LOINC is endorsed and/or recommended by the American Clinical Laboratory Association, the College of American Pathologists (CAP), Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), and the organisations for Health Level 7 (HL7) and Digital Imaging and Communications in Medicine (DICOM) as well as by other national and international organisations. Covering SPINA in LOINC will facilitate exchange of calculation results in hospital information systems, electronic health records and other platforms for medical communication. The upcoming version 4.1 of SPINA Thyr will support both LOINC codes in its HL7 import and export feature. [Less]

SPINA Thyr 4.0.1 has been tested with macOS 10.12 (Sierra) and found to be compatible and well functional.

On August 23rd, 2016 the Regenstrief Institute, colocated at the Indiana University School of Medicine and creator of the LOINC standard, announced to include SPINA-GT and SPINA-GD in the next version of LOINC. LOINC (Logical Observation Identifiers ... [More] Names and Codes) is a database and standard of universal identifiers for laboratory and other clinical observations. It facilitates exchange and storage of clinical results or vital signs for patient care and clinical research. LOINC is endorsed and/or recommended by the American Clinical Laboratory Association, the College of American Pathologists (CAP), Deutsches Institut für Medizinische Dokumentation und Information (DIMDI), and the organisations for Health Level 7 (HL7) and Digital Imaging and Communications in Medicine (DICOM) as well as by other national and international organisations. SPINA-GT and SPINA-GD will be included in the next version of LOINC, which is expected to be available by the end of 2016. Covering SPINA in LOINC will facilitate exchange of calculation results in hospital information systems and other platforms for medical communication. http://loinc.org/ [Less]