Erythrocyte zinc content in critically ill patients

2005 ◽  
Vol 43 (9) ◽  
Author(s):  
Darren Cutinha ◽  
Sashi Vaja ◽  
David Treacher ◽  
R. Swaminathan
Keyword(s):  
Thyroid Hormone ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Zinc Content ◽  
Tissue Level ◽  
Thyroid Hormone Metabolism ◽  
Tissue Marker ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients ◽  
Surgical Group

AbstractAbnormalities in thyroid hormone metabolism are common in critically ill patients. However, it is not known if these patients are truly hypothyroid at tissue level. Erythrocyte zinc has been shown to be a tissue marker of thyroid hormone status. In this study we have measured the erythrocyte zinc in critically ill patients.In this observational study we measured the zinc content of young erythrocytes in blood samples from 33 healthy subjects, 26 hypothyroid patients, four hyperthyroid patients, and 44 patients in the intensive care unit – 22 of these were admitted after a major surgical procedure (surgical group) and the other 22 patients had a variety of conditions (non-surgical group). Erythrocytes were separated according to age by centrifugation. Plasma thyroid hormone concentrations were abnormal in 70% of the critically ill group. Erythrocyte zinc was significantly lower in hyperthyroid patients and higher in hypothyroid patients. In the non-surgical patients, erythrocyte zinc of young cells (median 256μmol/L of cells) was significantly higher than (p<0.01) the corresponding cells in the healthy controls (202μmol/L of cells), whereas in the surgical group it was not different (197μmol/L of cells). We conclude that in non-surgical critically ill patients, erythrocyte zinc content is higher, suggesting that these patients may be hypothyroid at tissue level.

scholarly journals Erythrocyte zinc in hospital patients

2005 ◽  
Vol 42 (6) ◽  
pp. 448-452 ◽  
Author(s):  
L Batchat ◽  
S Vaja ◽  
D Treacher ◽  
M Kinerons ◽  
R Swaminathan
Keyword(s):  
Critically Ill ◽  
Thyroid Function ◽  
Critically Ill Patients ◽  
Geriatric Patients ◽  
Tissue Level ◽  
Hospitalized Patients ◽  
Thyroid Function Tests ◽  
Thyroid Status ◽  
Free Triiodothyronine ◽  
Hospital Patients

Background: Abnormal thyroid function tests (serum thyrotropin [TSH], free thyroxine [T4] and free triiodothyronine [T3]) are frequently seen in hospitalized patients. Assessment of thyroid function in these patients is difficult. It has been suggested that acutely ill patients may be hypothyroid at the tissue level. Erythrocyte zinc (EZn) has been shown to be increased in hypothyroidism. The aim of this study was to examine EZn as an index of thyroid status of hospital patients. Methods: In order to assess the thyroid status at tissue level, we measured EZn in 26 healthy subjects, 39 critically ill patients and 19 hospitalized geriatric patients. EZn was measured in young cells, as the effect of illness is likely to be seen in the newly formed cells. Result: TSH and free T3 were lower in critically ill patients and serum free T3 was lower in geriatric patients. EZn in young cells was higher in both patient groups (by 13% and 23%, respectively). EZn in old cells was also higher in the geriatric group. Conclusion: We conclude that EZn is higher in hospitalized patients, suggesting that these patients may be hypothyroid at the tissue level.

scholarly journals Reduced Activation and Increased Inactivation of Thyroid Hormone in Tissues of Critically Ill Patients

2003 ◽  
Vol 88 (7) ◽  
pp. 3202-3211 ◽  
Author(s):  
Robin P. Peeters ◽  
Pieter J. Wouters ◽  
Ellen Kaptein ◽  
Hans van Toor ◽  
Theo J. Visser ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Critically Ill ◽  
Critically Ill Patients

scholarly journals Expression of thyroid hormone transporters during critical illness

2009 ◽  
Vol 161 (2) ◽  
pp. 243-250 ◽  
Author(s):  
Liese Mebis ◽  
Deborah Paletta ◽  
Yves Debaveye ◽  
Björn Ellger ◽  
Lies Langouche ◽  
...  
Keyword(s):  
Gene Expression ◽  
Skeletal Muscle ◽  
Critical Illness ◽  
Thyroid Hormone ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Rabbit Model ◽  
Monocarboxylate Transporter ◽  
Expression Levels ◽  
Gene Expression Levels

ObjectiveProlonged critically ill patients have low circulating thyroid hormone (TH) levels without a rise in TSH, a condition labeled ‘the low tri-iodothyronine (T3) syndrome’. Currently, it is not clear whether this represents an adaptive response. We examined the role of TH transporters monocarboxylate transporter 8 (MCT8, also known as SLC16A2) and MCT10 in the pathogenesis of the low T3 syndrome in prolonged critical illness.MethodsA clinical observational study in critically ill patients and an intervention study in an in vivo animal model of critical illness. Gene expression levels of MCT8 and MCT10 were measured by real-time PCR.ResultsIn prolonged critically ill patients, we measured increased MCT8 but not MCT10 gene expression levels in liver and skeletal muscle as compared with patients undergoing acute surgical stress. In a rabbit model of prolonged critical illness, gene expression levels of MCT8 in liver and of MCT10 in skeletal muscle were increased as compared with healthy controls. Treatment of prolonged critically ill rabbits with TH (thyroxine+T3) resulted in a downregulation of gene expression levels of MCT8 in liver and of MCT10 in muscle. Transporter expression levels correlated inversely with circulating TH parameters.ConclusionsThese data suggest that alterations in the expression of TH transporters do not play a major role in the pathogenesis of the ‘low T3 syndrome’ but rather reflect a compensatory effort in response to hypothyroidism.

Thyroid Hormone Receptor Isoform Expression in Livers of Critically Ill Patients

Thyroid ◽  
2007 ◽  
Vol 17 (2) ◽  
pp. 105-112 ◽  
Author(s):  
Daphne C. Thijssen-Timmer ◽  
Robin P. Peeters ◽  
Pieter Wouters ◽  
Frank Weekers ◽  
Theo J. Visser ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hormone Receptor ◽  
Thyroid Hormone Receptor ◽  
Isoform Expression

scholarly journals Prognostic Significance of Thyroid Hormone For Prolonged Mechanical Ventilation In Critically Ill Patients With Cardiac Surgery

2021 ◽  
Author(s):  
Xiao Shen ◽  
Jiakui Sun ◽  
Liang Hong ◽  
Xiaochun Song ◽  
Cui Zhang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Thyroid Hormone ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
Prognostic Significance ◽  
Multivariate Logistic Regression Analysis ◽  
Free Triiodothyronine ◽  
Total Triiodothyronine

Abstract Background: This study aimed to examine the correlation between thyroid hormone and prolonged mechanical ventilation (MV) in the adult critically ill patients having undergone cardiac surgery. Methods: The present study refers to a retrospective, cohort study that was conducted at Cardiovascular Intensive Care Unit (CVICU) of Nanjing First Hospital from March 2019 to December 2020. Patients receiving cardiac surgery and admitted to the center of the authors in the study period were screen for a potential inclusion. Demographic information, thyroid hormone and other laboratory measurements and outcome variables were recorded for analyses. Prolonged MV was defined as the duration of MV after cardiac surgery longer than 5 days. Thyroid hormones were assessed for the prognostic significance for prolonged MV.Results: On the whole, 118 patients having undergone cardiac surgery were included and analyzed in this study. Patients fell to the control (n=64) and the prolonged MV group (n=54) by complying with the duration of MV after cardiac surgery. The median total triiodothyronine (TT3) and free triiodothyronine (FT3) were 1.03 nmol/L and 3.52 pmol/L in the prolonged MV group before cardiac surgery, significantly lower than 1.23 nmol/L (P=0.005) and 3.87 pmol/L, respectively in the control (P=0.038). multivariate logistic regression analysis indicated that TT3 before surgery (pre-op TT3) had a good prognostic significance for prolonged MV (OR: 0.049, P=0.012). Conclusions: This study concluded that decreased triiodothyronine (T3) could be common in the cardiac patients with prolonged MV, and it would be further reduced after patients undergoing cardiac surgery. Besides, decreased T3 before surgery could act as an effective predictor for prolonged MV after cardiac surgery.

scholarly journals Thyroid Hormone Replacement Therapy in Critically Ill Patients: Lack of Promising Evidence for Physiologically Sound Approaches

2019 ◽  
Vol 7 (1) ◽  
pp. 48
Author(s):  
Tara Sabzevari ◽  
Masoumeh Emamvidri
Keyword(s):  
Hormone Replacement Therapy ◽  
Thyroid Hormone ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Replacement Therapy ◽  
Sick Euthyroid ◽  
Low Serum

The sick euthyoid syndrome, also known as nonthyroidal illness syndrome, refers to changes seen in patient thyroid function tests administered in the medical intensive care unit during episodes of critical illness(1). Low serum T3 is the most common abnormality in euthyroid sick syndrome. Both low T3 and low T4 syndrome are reported in critically ill patients and low serum T4 is related with worst outcome. These features in laboratory findings of sick euthyroid patients have been explained by circulating thyroid binding hormone inhibitor (2). Thyroid hormone signalling regulates crucial biological functions, including energy expenditure, thermogenesis, development and growth. Fliers et al. (3), in their review “Thyroid function in critically ill patients”, concluded that routine thyroid hormone replacement therapy is not recommended in non-thyroid illness syndrome in critically ill patients. As we know, decreased plasma concentrations of thyroid hormones, especially T3, in critically ill patients represent the severity of the disorder and are associated with poor outcomes. On the other hand, thyroid hormone administration has been reported to be associated with improved hemodynamics, increased cardiac output, decreased ICU length of stay, reduced need for inotropic agents and mechanical devices, decreased incidence of myocardial ischaemia and decreased incidence of atrial fibrillation and pacemaker therapy (4-6). There are some studies reported the link between low levels of thyroid hormone and sarcopenia which leads to critical ill weakness (7.8). So it may be a rational to use hormone replacement therapy in selected critically ill patients with sick euthyroid syndrome.Not to implement physiologically sound approaches just because “evidence is lacking” might be disadvantageous for these patients over time as it might probably take years until clinical evidence become available. Subsequently, based on previous trials that have introduced effectiveness or at least no effects of hormone replacement therapy for non-thyroid illness syndrome, it seems that critically ill patients without limiting conditions such as advanced age or cardiac dysfunction (e.g. CHF or ACS) might benefit from thyroid replacement therapy and depriving these patients from what they might have benefited seems unethical.As we mentioned sick euthyroid syndrome occurs with different faces in critically ill patients with some good and some bad characteristics. Tolerating the early onset hibernation response with its concomitant changes in thyroid hormone parameters seems to be beneficial and safe. But the other type of sick euthyroid syndrome which develops later during prolong ICU admission may have a different face and needs some interventions as it has impact on patients outcome.

scholarly journals Thyroid hormone increases mannan-binding lectin levels

2005 ◽  
Vol 153 (5) ◽  
pp. 643-649 ◽  
Author(s):  
Anne Lene Dalkjær Riis ◽  
Troels Krarup Hansen ◽  
Steffen Thiel ◽  
Claus Højbjerg Gravholt ◽  
Signe Gjedde ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Healthy Subjects ◽  
Paired Comparison ◽  
Innate Immune ◽  
Before And After ◽  
Low Levels ◽  
Mannan Binding Lectin ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients ◽  
Binding Lectin

Background: Recent studies have indicated the existence of causal links between the endocrine and immune systems and cardiovascular disease. Mannan-binding lectin (MBL), a protein of the innate immune system, may constitute a connection between these fields. Methods: To test whether thyroid hormone regulates MBL levels, we studied eight patients with Graves’ hyperthyroidism before and after methimazole therapy, eight healthy subjects before and after short-term experimental hyperthyroidism, and eight hypothyroid patients with chronic auto-immune thyroiditis before and after L-thyroxine substitution. Results: In all hyperthyroid patients, MBL levels were increased – median (range), 1886 ng/ml (1478–7344) – before treatment and decreased to 954 ng/ml (312–3222) after treatment (P = 0.01, paired comparison: Wilcoxon’s signed ranks test). The healthy subjects had MBL levels of 1081 ng/ml (312–1578). Administration of thyroid hormones to these persons induced mild hyperthyroidism and increased MBL levels significantly to 1714 ng/ml (356–2488) (P = 0.01). Two of the eight hypothyroid patients had undetectably low levels of MBL both before and after L-thyroxine substitution. The other six hypothyroid patients had decreased levels of MBL of 145 ng/ml (20–457) compared with 979 ng/ml (214–1533) after L-thyroxine substitution (P = 0.03, paired comparison: Wilcoxon’s signed ranks test). Conclusion: Our data show that thyroid hormone increases levels of MBL. MBL is part of the inflammatory complement system, and this modulation of complement activation may play a role in the pathogenesis of a number of key components of thyroid diseases.

Opposite effects of thyroid hormones on binding proteins for steroid hormones (sex hormone-binding globulin and corticosteroid-binding globulin) in humans

1995 ◽  
Vol 132 (5) ◽  
pp. 594-598 ◽  
Author(s):  
Sonia C Dumoulin ◽  
Bertrand P Perret ◽  
Antoine P Bennet ◽  
Philippe J Caron
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Steroid Hormones ◽  
Sex Hormone ◽  
Sex Hormone Binding Globulin ◽  
Hormone Binding ◽  
Thyroid Status ◽  
Corticosteroid Binding Globulin ◽  
Hypothyroid Patients ◽  
Hyperthyroid Patients

Dumoulin SC, Perret BP, Bennet AP, Caron PJ. Opposite effects of thyroid hormones on binding proteins for steroid hormones (sex hormone-binding globulin and corticosteroid-binding globulin) in humans. Eur J Endocrinol 1995;132:594–8. ISSN 0804–4643 Sex hormone-binding globulin (SHBG) and corticosteroid-binding globulin (CBG) levels were evaluated in euthyroid (N = 111), hyper- (N = 58) and hypothyroid (N = 38) men, in pre- and postmenopausal women (study 1) and in hyper- (N = 24) and hypothyroid (N = 15) patients before and after treatment with carbimazole or levothyroxine therapy (study 2). The SHBG levels are increased in hyper- and decreased in hypothyroid patients, whereas CBG levels are increased in hypo- and decreased in hyperthyroid patients. The SHBG levels are higher in women than in men with similar thyroid status. Plasma SHBG levels are correlated positively whereas CBG levels are correlated negatively with free thyroid hormone concentrations in men as well as women. In hypothyroid patients, SHBG concentrations increased (p < 0.01) and CBG concentrations decreased (p < 0.01) during levothyroxine treatment. In hyperthyroid patients, SHBG concentrations decreased (p < 0.01) and CBG concentrations increased (p < 0.01) during antithyroid treatment. The SHBG and CBG concentrations in treated hypo- and hyperthyroid patients were not significantly different from those of euthyroid controls. Our data indicate that SHBG and CBG levels depend on thyroid status. Corticosteroid-binding globulin is an index of thyroid hormone action at the liver level whose changes are opposite to those of SHBG in hyper- and hypothyroidism. Philippe Caron, Service d'Endocrinologie et Maladies Métaboliques, CHU Rangueil, 1 Avenue J Poulhès, 31054 Toulouse Cedex, France

scholarly journals Thyroid hormone alterations in critically and non-critically ill patients with SARS-CoV-2 infection

2021 ◽  
Author(s):  
Dimitra Argyro Vassiliadi ◽  
Ioannis Ilias ◽  
Maria Pratikaki ◽  
Edison Jahaj ◽  
Alice G Vassiliou ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Critically Ill ◽  
Thyroid Function ◽  
Critically Ill Patients ◽  
Icu Patients ◽  
Similar Frequency ◽  
Normal Thyroid ◽  
Severity Of Disease ◽  
Normal Thyroid Function ◽  
High Prevalence

Objective: Following evolution of COVID-19 pandemic, reports pointed on a high prevalence of thyroiditis related thyrotoxicosis. Interpretation of thyroid tests during illness, however, is hampered by changes occurring in the context of non-thyroidal illness syndrome (NTIS). In order to elucidate these findings, we studied thyroid function in carefully selected cohorts of COVID-19 positive and negative patients. Design: Cohort observational study. Methods: We measured TSH, FT4, T3 within 24hours of admission in 196 patients without thyroid disease and/or confounding medications. 102 patients were SARS-CoV-2 positive; 41 admitted in the ICU, 46 in the ward and 15 outpatients. Controls consisted of 94 SARS-CoV-2 negative patients; 39 in the ICU and 55 in the ward. We designated the thyroid hormone patterns as consistent with NTIS, thyrotoxicosis and hypothyroidism. Results: A NTIS pattern was encountered in 60% of ICU and 36% of ward patients, with similar frequencies between SARS-CoV-2 positive and negative patients (46.0% vs 46.8%, p=NS). A thyrotoxicosis pattern was observed in 14.6% SARS-CoV-2 ICU patients vs. 7.7% in ICU negative (p=NS) and, overall in 8.8% of SARS-CoV-2 positive vs. 7.4% of negative patients. In these patients thyroglobulin levels were similar to those with normal thyroid function or NTIS. The hypothyroidism pattern was rare. Conclusions: NTIS pattern is common and relates to the severity of disease rather than SARS-CoV-2 infection. A thyrotoxicosis pattern is less frequently observed with similar frequency between patients with and without COVID-19. It is suggested that thyroid hormone monitoring in COVID-19 should not differ from other critically ill patients.

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