Relating circulating thyroid hormone concentrations to serum interleukins-6 and -10 in association with non-thyroidal illnesses including chronic renal insufficiency

被引：30

作者：

Abo-Zenah H.A. ^{[1
]}

Shoeb S.A. ^{[1
]}

Sabry A.A. ^{[3
]}

Ismail H.A. ^{[2
]}

机构：

[1] Department of Internal Medicine, Faculty Of Medicine, Menufiya University, Shebin El-kom

[2] Molecular Diagnostic Department, Genetic Engineering and Biotechnology Research Institute, Menufiya University, Shebin El-kom

[3] Mansura Urology and Nephrology Institute, Mansura University, Mansoura

来源：

BMC Endocrine Disorders | / 8卷 / 1期

关键词：

Thyroid Hormone; Thyroid Stimulate Hormone; Chronic Renal Insufficiency; Congestive Heart Failure Patient; Thyroid Stimulate Hormone Level;

D O I：

10.1186/1472-6823-8-1

中图分类号：

学科分类号：

摘要：

Background: Because of the possible role of cytokines including interleukins (IL) in systemic non-thyroidal illnesses' (NTI) pathogenesis and consequently the frequently associated alterations in thyroid hormone (TH) concentrations constituting the euthyroid sick syndrome (ESS), we aimed in this research to elucidate the possible relation between IL-6 & IL-10 and any documented ESS in a cohort of patients with NTI. Methods: Sixty patients and twenty healthy volunteers were recruited. The patients were subdivided into three subgroups depending on their underlying NTI and included 20 patients with chronic renal insufficiency (CRI), congestive heart failure (CHF), and ICU patients with myocardial infarction (MI). Determination of the circulating serum levels of IL-6 and IL-10, thyroid stimulating hormone (TSH), as well as total T4 and T3 was carried out. Results: In the whole group of patients, we detected asignificantly lower T3 and T4 levels compared to control subjects (0.938 ± 0.477 vs 1.345 ± 0.44 nmol/L, p = 0.001 and 47.9 ± 28.41 vs 108 ± 19.49 nmol/L, p < 0.0001 respectively) while the TSH level was normal (1.08+0.518 μIU/L). Further, IL-6 was substantially higher above controls' levels (105.18 ± 72.01 vs 3.35 ± 1.18 ng/L, p < 0.00001) and correlated negatively with both T3 and T4 (r = -0.620, p < 0.0001 & -0.267, p < 0.001, respectively). Similarly was IL-10 level (74.13 ± 52.99 vs 2.64 ± 0.92 ng/ml, p < 0.00001) that correlated negatively with T3 (r = -0.512, p < 0.0001) but not T4. Interestingly, both interleukins correlated positively (r = 0.770, p = <0.001). Moreover, IL-6 (R2 = 0.338, p = 0.001) and not IL-10 was a predictor of low T3 levels with only a borderline significance for T4 (R2 = 0.082, p = 0.071). By subgroup analysis, the proportion of patients with subnormal T3, T4, and TSH levels was highest in the MI patients (70%, 70%, and 72%, respectively) who displayed the greatest IL-6 and IL-10 concentrations (192.5 ± 45.1 ng/L & 122.95 ± 46.1 ng/L, respectively) compared with CHF (82.95 ± 28.9 ng/L & 69.05 ± 44.0 ng/L, respectively) and CRI patients (40.05 ± 28.9 ng/L & 30.4 ± 10.6 ng/L, respectively). Surprisingly, CRI patients showed the least disturbance in IL-6 and IL-10 despite the lower levels of T3, T4, and TSH in a higher proportion of them compared to CHF patients (40%, 45%, & 26% vs 35%, 25%, & 18%, respectively). Conclusion: the high prevalence of ESS we detected in NTI including CRI may be linked to IL-6 and IL-10 alterations. Further, perturbation of IL-6 and not IL-10 might be involved in ESS pathogenesis although it is not the only key player as suggested by our findings in CRI. © 2008 Abo-Zenah et al; licensee BioMed Central Ltd.

引用

共 50 条

[1]

Tibaldi J.M., Surks M.I., Effects of non-thyroidal illness on thyroid function, Med Clin North Am, 69, pp. 899-911, (1985)

[2]

Carter J.N., Eastmen C.J., Corcoran J.M., Lazarus L., Inhibition of conversion of thyroxine to triiodothyronine in patients with severe chronic illness, Clin Endocrinol (Oxf), 5, pp. 587-594, (1976)

[3]

The low T3 syndrome, Proceedings of the Serono Symposia, 40, (1981)

[4]

Wartofsky I., Burman K.D., Alterations in thyroid function in patients with systemic illnesses: The "euthyroid sick syndrome, Endocrine Review, 3, pp. 164-217, (1982)

[5]

Faber J., Kirkegaard C., Lumholtz I.B., Nielsen K.S., Friis T., Variations in serum T3, sT3, 3,30-diiodothyronine and 3,5-diiodothyronine induced by acute myocardial infarction and propranolol, Acta Endocrinologica, 94, pp. 341-345, (1980)

[6]

Dinarello C.A., Mier J.W., Lymphokines, N Eng J Med, 317, pp. 940-945, (1987)

[7]

Hermus A.R., Sweep C.G., Van der Meer M.J., Ross H.A., Smals A.G., Benraad T.J., Kloppenborg P.W., Continuous infusion of interleukin 1-β induces a nonthyroidal illness syndrome in the rat, Endocrinol, 131, pp. 2139-2149, (1992)

[8]

Van der Poll T., Romijn J.A., Wiersinga W.M., Sauerwein H.P., Tumor necrosis factor: A putative mediator of the sick euthyroid syndrome, J Clin Endocrinol Metab, 71, pp. 1567-1572, (1990)

[9]

Mooradian A.D., Reed R.L., Osterweil D., Schiffman R., Scuderi P., Decreased serum triiodothyroinin is associated with increased concentrations of tumor necrosis factor, J Clin Endocrinol Metabol, 71, pp. 1239-1242, (1990)

[10]

Chopra I.J., Sakane S., Teco G.N., A study of the serum concentration of tumor necrosis factor-alpha in thyroidal and nonthyroidal illnesses, J Clin Endocrinol Metab, 72, pp. 1113-1116, (1991)

← 1 2 3 4 5 →