Correlates of non-thyroidal illness syndrome in chronic obstructive pulmonary disease

Karadağ, Fisun; Özcan, Hatice Nursun; Karul, Aslıhan; Yılmaz, Mustafa; Çildağ, Orhan

doi:10.1016/j.rmed.2007.01.016

Cited by 54 publications

(68 citation statements)

References 31 publications

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“…BMI doesn't correlate with severity of disease. This is in agreement with Karadag F et al and Yumin Zhou et al 5,6 There was highly significant difference was seen in mid arm circumference between COPD cases and control group (p<0.001). But there was a significant difference between moderate to severe and very severe and no significance observed between severe to very severe group of COPD patients.…”

Section: Discussionsupporting

confidence: 91%

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

et al. 2017

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Background: The potential ill effects of malnutrition are numerous, such as decreased maximal respiratory muscle force, decreased hypoxic Ventilatory response and decreased resistance to infection. The objective was to assess nutritional profile in chronic obstructive pulmonary disease (COPD) patient.Methods: The study was conducted at a tertiary care referral hospital. Period of study was one year. Present study was case control study. Institutional Ethics committee permission was taken. A total of 75 cases of chronic obstructive pulmonary disease and comparable controls were included in the study.Results: Present study shows that there was significant difference in mid arm circumference and mid-thigh circumference between COPD cases and control groups as well as between serum pre-albumin and serum transferrin level, serum uric acid (p=0.018) and serum calcium level (p=0.002). There was no statistically difference with respect to serum total protein (p=0.308), serum albumin (p=0.533) and serum phosphorus level (p=0.064) between COPD patient and control groups. There was statistically significant difference in total lymphocyte count between COPD cases and control groups as well as between serum LDL and serum HDL, serum LDL and serum HDL with COPD grading. As COPD grading increased there was significant decrease in serum LDL and serum HDL level. There was no significant difference with respect serum TG (p=0.738), VLDL and total cholesterol level (p=0.063) between COPD cases and control groups.Conclusions: Simple measurement of BMI, mid arm circumference and mid-thigh circumference can assess mal-nutrition in COPD patients and biochemical parameter like serum pre-albumin and serum transferrin may helpful in early detection of malnutrition.

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Section: Discussionsupporting

confidence: 91%

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

et al. 2017

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“…In critically ill patients as well as those under outpatient care, NTIS has been associated with increased proinflammatory markers [9,22,23]. Pro-inflammatory cytokines such as tumour necrosis factor-α [24], interleukin-1 [25] and 6 (IL-6) [26] have a major role in thyroid hormone imbalances.…”

Section: Discussionmentioning

confidence: 99%

The influence of body mass index and low-grade systemic inflammation on thyroid hormone abnormalities in patients with type 2 diabetes

et al. 2013

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The relaTionship between diabetes mellitus (DM) and thyroid hormones (TH) is a complex one. It is known that TH levels affect not only glycaemic control but also hepatic and muscular insulin resistance and play a major role in energy homeostasis [1]. Both hypothyroidism and thyrotoxicosis have been shown to increase insulin resistance [2]. Decompensated hyperthyroidism can worsen glycaemic control and predispose patients to diabetic ketoacidosis [3].On the other hand, patients with DM may show abstract. Previous reports highlight the role of systemic inflammation in the genesis of non-thyroidal illness syndrome and type 2 diabetes mellitus (T2DM). Our objective was to assess whether body mass index and the low-grade systemic inflammation would be associated with changes in thyroid hormone metabolism in patients with type 2 diabetes. This was a cross-sectional study of 104 subjects; 52 patients with type 2 diabetes and 52 in a control group, paired by age, gender and body mass index. We measured total (T) and free (F) thyroxine (T4) and triiodothyronine (T3), reverse T3 (rT3), the ratios FT3/rT3, FT3/FT4 and FT4/rT3, clinical parameters (age, gender, diabetes duration and complications, body mass index, waist circumference, hypertension, HbA1c), and high sensitivity C-reactive protein. Patients with DM presented lower levels of TT4 (p=0.006), TT3 (p<0.001) and FT3 (p<0.001) and higher of FT4 (p<0.001), waist circumference (p=0.047) and C-reactive protein (p<0.001). Body mass index was inversely correlated with FT4 (p=0.036) and TT3 (p=0.008). C-reactive protein was positively correlated with rT3 (p=0.001) and inversely with FT4/rT3 (p<0.001) and FT3/rT3 (p=0.014). Body mass index was an independent predictor for FT4 (B=-0.011, p=0.029) and TT3 levels (B=-1.118, p=0.003). Inflammation predicted the FT4/rT3 ratio (B=-0.190, p<0.001). C-reactive protein (B=0.235, p<0.001) and body mass index (B=-0.008, p=0.047) were independent predictors for rT3. In conclusion, type 2 diabetes was associated with a low T3 state. Body mass index and the low-grade systemic inflammation are related to the non-thyroidal illness syndrome in these patients, possibly by altering the activity of peripheral deiodinases.Key words: Diabetes mellitus, Low T3, Inflammation, Non-thyroidal illness syndrome abnormalities in serum TH levels in the absence of intrinsic disease of the thyroid axis. These are similar to those present in critically ill patients with the non-thyroidal illness syndrome (NTIS), such as low serum triiodothyronine (T3) and thyroxine (T4) levels and elevated reverse T3 (rT3), with concurrent normal serum TSH levels [4,5]. This finding is more frequent in those with poor glycaemic control, especially when HbA1c levels are above 10.5-11% [6] and are reversible upon restoration of adequate metabolic control [7]. Although classically related to glycaemic control, the pathophysiology of TH abnormalities in patients with DM has never been fully investigated. Previous reports highlight the role of systemic inflammation in the genes...

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“…A body of evidence suggests that the stimulation of the immune system also induces down-regulation of the hypothalamus-pituitary-thyroid (HPT) axis and related changes in thyroid hormone metabolism, resulting in low circulating levels of T 3 and T 4 hormones (Karadag et al, 2007;Warner and Beckett, 2010). Accordingly, Castro et al (2013) reported that the continuous intravenous infusion of 3.5 to 5.0 µg of LPS kg −1 BW per hour for 48 h induced a reduction in T 3 and T 4 levels in serum and in specific tissues, including heart, liver, kidney cortex, and skeletal muscle.…”

Section: Neuroendocrine Adjustmentsmentioning

confidence: 99%

Physiological responses of growing pigs to high ambient temperature and/or inflammatory challenges

et al. 2017

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-Global warming is one of the major environmental threats facing the world in the 21st century. This fact will have a significant impact on pig production due to its direct effects on welfare, health, and performance of pigs. Besides, the effects of high temperatures will presumably become more important over the next decades due to the development of pig production in developing countries mainly located in tropical and subtropical areas, where animals are often exposed to ambient temperatures above their thermal comfort zone. Furthermore, pigs reared in tropical areas are often confronted to sanitary challenges including poor hygiene conditions, lack of respect for sanitary rules, and pathogens. This results in the stimulation of the immune system and, as a consequence, in the production of pro-inflammatory cytokines and neuroendocrine adjustments that, in turn, usually have a negative impact on growth and feed efficiency. Although the effects of high ambient temperature and disease on pig physiology and performance have been well documented in literature, little is known about the associated effects of both factors. This understanding may contribute to a better quantification and comprehension of the physiological and metabolic disturbances occurring in practical conditions of pig production in tropical areas and, more generally, in many other geographic areas that will be influenced by the perspective of global warming. Therefore, the objective of this work is to provide an overview of recent research advances on the physiological responses of growing pigs during acclimation to high ambient temperature and on the potential effects of high ambient temperature on the ability of growing pigs to resist, cope with, or recover from an inflammatory challenge.

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Correlates of non-thyroidal illness syndrome in chronic obstructive pulmonary disease

Cited by 54 publications

References 31 publications

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

A study to assess nutritional profile in chronic obstructive pulmonary disease patients

The influence of body mass index and low-grade systemic inflammation on thyroid hormone abnormalities in patients with type 2 diabetes

Physiological responses of growing pigs to high ambient temperature and/or inflammatory challenges

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