Effects of hypoxia on thyroid function tests

Moshang, Thomas; Chance, Katherine H.; Kaplan, Michael M.; Utiger, Robert D.; Takahashi, Osahiro

doi:10.1016/s0022-3476(80)80019-9

Cited by 26 publications

(15 citation statements)

References 8 publications

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“…Previous studies in hypoxemic infants with chronic respiratory disease have demonstrated either decreased (42) or normal (37) levels ofthyroid hormones. Our previous demonstration that levels ofT3 and Free T4 in chronically hypoxemic lambs are not different from control (40) does not support a role for thyroid hormone alterations in this model of cyanotic congenital heart disease.…”

Section: Discussionmentioning

confidence: 97%

Decreased serum insulin-like growth factor-I associated with growth failure in newborn lambs with experimental cyanotic heart disease.

Bernstein

Jasper

Rosenfeld³

et al. 1992

J. Clin. Invest.

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To determine whether chronic hypoxemia results in alterations in endocrine function that may contribute to growth failure, we measured growth hormone (GH), somatomedins (insulin-like growth factors I and II, IGF-I and IGF-2), hepatic growth hormone receptors, and circulating IGF-binding proteins IGFBP-3 and IGFBP-2 in 12 newborn lambs with surgically created pulmonic stenosis and atrial septal defect, and in 10 controls. During chronic hypoxemia (oxygen saturation of60-74% for 2 wk), weight gain was 60% of control (hypoxemic, 135±20 vs. control, 216±26 g/d, P < 0.02). IGF-I was decreased by 43% (hypoxemic 253.6±29.3 SE vs. control 448.0±75.5 ng/ml, P = 0.01), whereas GH was unchanged (19.9±5.1 vs. 11.9±3.0 ng/ml, NS). The increase in IGF-1 was associated with a decrease in IGFBP-3 (hypoxemic, 5.09±1.25 vs. control, 11.2±1.08 arbitrary absorbency units per mm (Au -mm), P < 0.01), and increase in IGFBP-2 (0.47±0.03 vs. 0.19±0.13 Auk mm, P < 0.05), but no significant downregulation of hepatic GH receptors (hypoxemic, 106.1±20.1 vs. control, 147.3±25.9 fmol/mg, NS). Thus, chronic hypoxemia in the newborn is associated with a decrease in IGF-I and IGFBP-3 in the face of normal GH. This suggests peripheral GH unresponsiveness, similar to protein-calorie malnutrition or GH receptor deficiency dwarfism, but mediated at a level distal to the hepatic GH receptor. (J. Clin.

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Section: Discussionmentioning

confidence: 97%

Decreased serum insulin-like growth factor-I associated with growth failure in newborn lambs with experimental cyanotic heart disease.

Bernstein

Jasper

Rosenfeld³

et al. 1992

J. Clin. Invest.

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“…Em animais, a hipóxia diminui a função tireoidiana e o metabolismo extratireóideo do T4 20 . Da mesma forma, Moshang e colaboradores 21 demonstraram aumento nos níveis de rT3 nos pacientes com hipoxemia aguda, sugerindo uma diminuição na sua degradação. Nesse mesmo estudo, verificou-se nos pacientes cronicamente hipoxêmicos, níveis de T3 diminuídos, além de níveis de rT3 elevados, refletindo alterações no metabolismo extratireóideo.…”

Section: Discussionunclassified

“…A elevação do rT3 observada no sangue de cordão poderia significar uma alteração no metabolismo periférico dos hormônios tireóideos, através da inibição da enzima 5'-deiodinase, à semelhança do que ocorre na hipóxia aguda 21 . Alterações no metabolismo hormonal tireóideo devido a doenças de origem não-tireóidea são conhecidas como síndrome do doente eutireóideo [23][24][25] .…”

Section: Discussionunclassified

Effect of Perinatal Asphyxia on Thyroid Hormones

Pereira¹,

Procianoy²

2001

J Pediatr (Rio J)

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ResumoObjetivo: verificar o efeito da asfixia perinatal sobre os hormô-nios tireóideos.Métodos: foi realizado um estudo de caso-controle, no hospital de Clínicas de Porto Alegre, envolvendo 17 recém-nascidos a termo asfixiados (A) e 17 não-asfixiados (N), pareados conforme a cor, sexo, tipo de parto, idade gestacional e peso de nascimento. Foram coletados T4, T3, T4 livre, T3 reverso e TSH do sangue do cordão e do recém-nascido com 18 a 24 horas de vida, entre os que sofreram ou não asfixia perinatal.Resultados: no sangue de cordão, não houve diferença na dosagem dos hormônios tireóideos, com exceção do T3 reverso, que foi mais elevado no grupo que sofreu asfixia [mediana (percentis 25-75):A= 2(1,4-2); N= 1,41(1,13-1,92); p=0,037]. Com 18 a 24 horas de vida, foram significativamente menores no grupo de asfixiados, com exceção do T3 reverso, que foi semelhante entre os dois grupos [média ± DP: T4 A= 9,79 ± 2,59; N=14,68 ± 3,05; p<0,001/ mediana T3 A= 40,83(37,4-80,4); N= 164(56,96-222,5); P=0,003/ média ± DP T4 livre A=1,85 ± 0,92; N= 2,8 ± 0,74; p=0,004/ mediana T3 reverso A= 1,54(1,16-1,91); N= 1,31(0,87-2); p=0,507/ TSH A= 9,1(6,34-12,95); N=14,5(12,9-17,85); p=0,008].Conclusões: nossos dados sugerem que os níveis diminuídos de T4, T4 livre e T3 no recém-nascido asfixiado com 18 a 24 horas de vida são secundários aos níveis diminuídos de TSH. Além disso, os valores baixos de T3 e normais de T3 reverso podem refletir alteração no metabolismo periférico do T4.J Pediatr (Rio J) 2001; 77 (3): 175-78: hormônios da tireóide, asfixia perinatal, síndrome do doente eutireóideo. AbstractObjective: to verify the effect of perinatal asphyxia on thyroid hormone levels in term newborn infants.Methods: we carried out a case-control study with 17 term and asphyxiated (A) and 17 term and control (N) newborn infants at the Hospital de Clínicas de Porto Alegre. Patients were paired according to color of skin, sex, mode of delivery, gestational age, and weight at birth. We collected plasmatic T4, T3, free T4, reverse T3, and TSH of the umbilical cord after 18 to 24 hours of life and from asphyxiated and control newborn infants.Results: there were no differences in thyroid hormones of cord blood, with the exception of reverse T3, which was higher in A than in controls [median (percentile 25-75): A= 2(1.4-2); N= 1.41 (1.13-1.92); P=0.037)]. Thyroid hormone levels were lower in A than in controls on 18-24-hour after birth samples, except for reverse T3, which was similar in both groups [average ± SD: T4 A= 9.79 ± 2.59; N=14.68 ± 3.05; P<0.001; median T3 A= 40.83 (37.4-80.4); N= 164 (56.96-222.5); P=0.003; average ± SD: free T4 A=1.85 ± 0.92; N= 2.8 ± 0.74; P=0.004; median: reverse T3 A=1.54 (1.16-1.91); N=1.31(0.87-2); P=0.507; TSH A=9.1 (6.34-12.95); N=14.5(12.9-17.85); P=0.008].Conclusions: our data suggests that lower T4, free T4, and T3 levels are secondary to lower TSH levels in asphyxiated newborns; also, peripheral metabolism of T4 in asphyxiated infants can be altered due to low T3 and normal reverse T3 levels.J Pediatr (Rio...

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“…Children who are chronically hypoxic from pathologic conditions such as congenital heart disease also have a pattern of serum iodothyronines that is consistent with the accelerated innerring deiodination of T4 (high TSH, low T4, high rT3; ref. 38). Even in patients who die in the intensive care unit, D3-specific activity in the liver and skeletal muscle correlates positively with inotrope requirements, suggesting that tissue ischemia stimulates higher D3 expression and a greater fall in serum T3 (11).…”

Section: Figurementioning

confidence: 99%

Hypoxia-inducible factor induces local thyroid hormone inactivation during hypoxic-ischemic disease in rats

Simonides¹,

Mulcahey²,

Redout³

et al. 2008

J. Clin. Invest.

161

176

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Thyroid hormone is a critical determinant of cellular metabolism and differentiation. Precise tissue-specific regulation of the active ligand 3,5,3′-triiodothyronine (T3) is achieved by the sequential removal of iodine groups from the thyroid hormone molecule, with type 3 deiodinase (D3) comprising the major inactivating pathway that terminates the action of T3 and prevents activation of the prohormone thyroxine. Using cells endogenously expressing D3, we found that hypoxia induced expression of the D3 gene DIO3 by a hypoxiainducible factor-dependent (HIF-dependent) pathway. D3 activity and mRNA were increased both by hypoxia and by hypoxia mimetics that increase HIF-1. Using ChIP, we found that HIF-1α interacted specifically with the DIO3 promoter, indicating that DIO3 may be a direct transcriptional target of HIF-1. Endogenous D3 activity decreased T3-dependent oxygen consumption in both neuronal and hepatocyte cell lines, suggesting that hypoxia-induced D3 may reduce metabolic rate in hypoxic tissues. Using a rat model of cardiac failure due to RV hypertrophy, we found that HIF-1α and D3 proteins were induced specifically in the hypertrophic myocardium of the RV, creating an anatomically specific reduction in local T3 content and action. These results suggest a mechanism of metabolic regulation during hypoxic-ischemic injury in which HIF-1 reduces local thyroid hormone signaling through induction of D3.

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Effects of hypoxia on thyroid function tests

Cited by 26 publications

References 8 publications

Decreased serum insulin-like growth factor-I associated with growth failure in newborn lambs with experimental cyanotic heart disease.

Decreased serum insulin-like growth factor-I associated with growth failure in newborn lambs with experimental cyanotic heart disease.

Effect of Perinatal Asphyxia on Thyroid Hormones

Hypoxia-inducible factor induces local thyroid hormone inactivation during hypoxic-ischemic disease in rats

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