Abstract: SA-PO183
Does Thyroid Hormone (TH) Substitution Alter Hormonal Metabolism in Patients with Hypothyroidism and Renal Failure (RF)?
Session Information
- Nutrition, Inflammation, Metabolism: Clinical Trials, Biomarkers, Epidemiology
November 04, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Nutrition, Inflammation, and Metabolism
- 1401 Nutrition, Inflammation, Metabolism
Authors
- Niemczyk, Longin, Medical University of Warsaw, Warszawa, Poland
- Dubchak, Ivanna, Military Institute of Medicine, Warsaw, Poland
- Gomolka, Malgorzata, Military Institute of Medicine, Warsaw, Poland
- Szamotulska, Katarzyna, National Research Institute of Mother and Child, Warsaw, Poland
- Niemczyk, Stanislaw, Military Institute of Medicine, Warsaw, Poland
Background
RF disrupts the metabolism of TH, and disorders are exacerbated by concomitant hypothyroidism. TH replacement therapy should equalize hormone levels but lack comprehensive research in this area. In patients with ESRD there is a tendency for higher TSH and lower triiodothyronine (T3) and thyroxine (T4) levels probably due to reduced TH conversion (T4 to T3) .
The aim of the study was to evaluate the effect of TH substitution on conversion factors and rT3 concentration in patients with coexisting RF and hypothyroidism.
Methods
The study involved 2 groups of patients with hypothyroidism and TH replacement therapy: Group A - 13 pts. without RF (12 F, 1 M) 48,4±10,67y.o., Group B - 26 pts. with ESRD treated with HD (16 F, 10 M) 58,8±15,52y.o. Pts. with ESRD, treated with HD, were studied during planned dialysis. CRP, creatinine, urea, PTH, TSH and TH: total - (TT4), (TT3), free fractions - (fT4), (fT3), and rT3 were measured and conversion factors (rT3/TT4, rT3/TT3) were calculated. Basic descriptive statistics, Pearson's linear correlation, the Mann-Whitney nonparametric test and Fisher's test were used. Adopted significance level was 0,05.
Results
Results were shown in table.
Conclusion
There is a tendency for a higher rT3 levels during thyroid hormone substitution in hypothyroid patients without renal failure. The inhibitory effect of renal failure on rT3 production in hypothyroid patients is still present during thyroid hormones substitution.
HORMONES LEVELS AND CONVERSION FACTORS
| Group | TSH | TT4 | TT3 | fT4 | fT3 | rT3 | rT3/TT4 | rT3/TT3 | |
| A | N | 13 | 13 | 13 | 13 | 13 | 13 | 13 | 13 |
| Mean | 2,35 | 107,47 | 1,74 | 17,65 | 4,21 | 488,13 | 4,65 | 285,51 | |
| SD | 1,93 | 14,26 | 0,23 | 5,71 | 0,83 | 175,27 | 1,73 | 107,85 | |
| Median | 1,57 | 104,3 | 1,82 | 16,84 | 4,1 | 501,81 | 4,82 | 281,38 | |
| Min. | 0,17 | 87,74 | 1,35 | 11,63 | 2,4 | 24,32 | 0,2 | 14,22 | |
| Max. | 6,47 | 132,9 | 2,13 | 35,6 | 5,37 | 724,09 | 6,54 | 399,93 | |
| B | N | 19 | 20 | 20 | 20 | 20 | 20 | 20 | 20 |
| Mean | 2,9 | 90,54 | 1,23 | 16,03 | 3,21 | 198,72 | 2,32 | 169,61 | |
| SD | 2,45 | 22,41 | 0,26 | 3,98 | 1,37 | 91,84 | 1,23 | 87,76 | |
| Median | 1,56 | 90,15 | 1,22 | 15,37 | 2,93 | 185,36 | 2,16 | 170,77 | |
| Min. | 0,14 | 44,52 | 0,59 | 9,95 | 1,54 | 61,79 | 0,92 | 51,92 | |
| Max. | 8,56 | 134,7 | 1,94 | 26,18 | 8,24 | 367,87 | 4,79 | 357,16 | |
| p | NS | =0,022 | =0,001 | NS | =0,025 | <0,001 | <0,001 | =0,002 | |