PubMed · 3293385
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R Sakiyama. 1988. Common thyroid disorders.. https://pubmed.ncbi.nlm.nih.gov/3293385/
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Patients with chronic non-thyroid illness (NTI) generally show biochemical features of hypothyroidism despite their being clinically euthyroid. Using assays that employ the antibody coated tubes technique, we measured thyroid hormone levels in 52 patients with chronic renal failure. 30 of the patients were on conservative management while 22 were on regular haemodialysis (HD) for a mean period of 14.2 +/- 9.9 months. The findings were compared to those of 14 healthy controls. All patients were clinically euthyroid. Only 3 patients on HD had goitres. The mean value of total thyroxine (TT4) total triiodo thyronine (TT3), free thyroxine (FT4) and the free triiodothyronine (FT3) were low in patients compared with controls (P less than 0.01). The mean basal thyroid stimulating hormone (TSH) levels were significantly higher in patients than in controls (P less than 0.001). There were no significant differences in all parameters between the patients on conservative management and those on haemodialysis (P greater than 0.05). Although all patients were clinically euthyroid, the biochemical features suggest hypothyroidism.
We evaluated plasma selenium concentrations in patients with euthyroid sick syndrome express by low serum triiodothyronine (T3) concentrations. Selenium status in these patients was compared with that found in patients with both untreated and treated hypothyroidism. Selenium concentrations in plasma were significantly lower in hospitalized patients with either euthyroid sick syndrome (0.99 +/- 0.37 mumol/L) or treated hypothyroidism (1.09 +/- 0.25 mumol/L) than in patients with untreated hypothyroidism (1.39 +/- 0.28 mumol/L). However, there was no significant, independent relationship between selenium and the thyroid function indices determined in this study. The strongest association was between serum albumin concentration and either selenium (r = 0.65), T3 (r = 0.58), or the molar ratio of T3 to thyroxine (r = 0.64). The decreased average selenium concentration appears to be associated with the hypercatabolic state of severely ill patients, as indicated by the serum albumin concentration; these patients should be considered for selenium supplementation and their selenium status should be monitored.
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