Peculiarities of Indices of Thyroid Homeostasis in Patients with Metabolic Syndrome Depending on Body Mass Index
Introduction. Nonthyroidal illness syndrome develops in patients against the background of chronic comorbidity as a result of impaired peripheral conversion of thyroid hormones and is characterized by low levels of triiodothyronine (T3).
Objective of the study: to find out the features of thyroid homeostasis in patients with metabolic syndrome (MS).
Materials and methods. 64 patients with MS and 20 healthy individuals were involved in the investigation. We determined the level of thyroid stimulating hormone (TSH), free thyroxine (fT4) and free triiodothyronine (fT3). To study the functional status of the pituitary-thyroid axis, we calculated fT3/fT4 ratio and thyroid index (TI). Peripheral activity of thyroid hormones was estimated by total thyroid index (TTI).
Results. In the course of our study, lower fT3 levels and increased levels of TSH and fT4 was revealed in patients with MS compared with the group of healthy subjects (p < 0.05). We found a reduction of fT3/fT4 ratio (p < 0.05) compared to the control group (p< 0.05). TTI was lower in the examined patients compared with the group of healthy individuals (p < 0.05).
As a result of correlation analysis, it was established that body mass index negatively correlated with the level of fT3 (r = –0.341, p < 0.05), fT3/fT4 index (r = –0.458, p < 0.05), TI (r = –0.415, p < 0.05) and TTI (r = –0.335, p < 0.05) and positively — with levels of fT4 (r = 0.405, p < 0.05) and TSH (r = 0.327, p < 0.05).
Conclusion. The obtained data suggests the development of nonthyroidal illness syndrome in patients with metabolic syndrome as a result of impaired peripheral conversion of thyroid hormones, which deepens with body mass index growth, i.e. the class of obesity.
Zaretskyy M.M. Chernykova N.M., Lobachevskaya T.V. [Metabolic syndrome in clinical practice]. News of Medicine and Pharmacy. 2010;17(340):9 – 15. Russian
Kandor V.Y., author, Starkova N.T., editor. Syntez, sekretsyya y metabolyzm tyreoydnыkh hormonov: Rukovodstvo po klynycheskoy эndokrynolohyy [Synthesis, secretion and metabolism of thyroid hormones: A guide to clinical endocrinology]. N.t.-spb.: Pyter press;1996.115 – 124. Russian
Starkova N.T. Klynycheskaya эndokrynolohyya [Clinical endocrinology] M.: Medytsyna;1991.151–153.
Araujo RL, Andrade BM, da Silva ML, et al. Tissue-specific deiodinase regulation during food restriction and low replacement dose of leptin in rats. Am J Physiol Endocinol Metab. 2009;296:E1157-E1163.
Bello G., Ceaichisiuc I, Silva S, Antonelli M. The role of thyroid disfunction in critically ill: a review of the literature. Minerva anestesiol. 2010;76:919 – 928a.
Zimmermann-Belsing T, Brabant G, Holst J.J., Feldt-Rasmussen U. Circulating leptin and thyroid dysfunction. Eur J Endocrinol. 2003; 149(4):257 – 271.
Dentice M, Salvatore D. Deiodinases: the balance of thyroid hormone: local impact of thyroid hormone inactivation. J Endocrinol. 2011; Jun;209(3):273-82.
Michalaki MA, Gkotsina MI, Mamali I, Markantes GK, Faltaka A, Kalfarentzos F, Vagenakis AG, Markou KB. Does extreme obesity affect tyroid hormone metabolism? Clinical thyroidology. 2011;23 (6): 9 – 10.
Kelly G, Peripheral Metabolism of Thyroid Hormones: A Review. Alt Med Rev. 2000;5(4):306-333.
Myers Adler S., Wartofsky L. The nonthyroidal illness syndrome. Endocrinol Metab Clin N Am. 2007;36:657 – 672.
Pappa T. A., Vagenacis A.G. The nonthyroidal illness syndrome in the non-critically ill patient. European journal of clinical investigation. 2011;41(2): 212 – 220.
Shanta. G., Kumar A. Association between primary hypothyroidism and metabolic syndrome and the role of C reactive protein: a cross-sectional study from South India. Thyroid Research. 2009;2(2):175 – 185.
Williams Graham R , Duncan Bassett J. H. Local control of thyroid hormone action: role of type 2 deiodinase Deiodinases: the balance of thyroid hormone. Journal of Endocrinology. 2011;209:261 – 272.
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