Comparative Study of Peripheral Thyroid Hormone Homeostasis Disturbance in the Diabetic and Non-Diabetic Hemodialytic Patients

Anvari, Enayat; Fateh, Abolfazl; Noori Zadeh, Ali

doi:10.52547/sjimu.29.6.59

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Volume 29, Issue 6 (1-2022)

Journal of Ilam University of Medical Sciences 2022, 29(6): 59-68

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Comparative Study of Peripheral Thyroid Hormone Homeostasis Disturbance in the Diabetic and Non-Diabetic Hemodialytic Patients

Enayat Anvari¹

, Abolfazl Fateh²

, Ali Noori Zadeh ^*

1- Dept of physiology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
2- Dept of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
3- Dept of Clinical Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran , alincbc@gmail.com

Abstract: (1210 Views)

Introduction: Chronic kidney disease (CKD) is a leading cause of death and morbidity in developed countries. Although recent studies have shown that the prevalence of thyroid disorders is higher in individuals with CKD, the underlying mechanisms are not clear. Therefore, this study aimed to evaluate the blood levels of thyroid hormones in diabetic (diabetes type 2) and non-diabetic patients with end-stage renal disease under hemodialysis treatment.
Material & Methods: Thyroid-stimulating hormone (TSH), 3, 5, 3', 5'-tetraiodothyronine (T4/thyroxine), and 3, 3', 5-triiodothyronine (T3), were measured. Furthermore, kidney function tests (urea and creatinine), uric acid, serum lipid profile, and fasting blood glucose were measured using spectrophotometry-based methods.
(Ethic code: 991025/77)
Findings: There was no significant difference between the hemodialytic-diabetic subjects (HDS) and hemodialytic-non-diabetic subjects (HNDS) regarding the levels of thyroid function hormones, including TSH, T4, and T3. However, the ratio of triiodothyronine (T3) to thyroxine (T4) (T3/T4 ratio) was significantly different between the HDS and HNDS (P<0.05). These ratios (mean±standard error of the mean) were obtained at 0.220±0.026 and 0.554±0.12 in female HDS and HNDS, respectively. On the other hand, regarding males, these ratios were determined at 0.205±0.01 and 0.295±0.05 in HDS and HNDS, respectively.
Discussion & Conclusion: Homeostasis disturbance in the T3/T4 ratio hemostasis is present in HDS, compared to HNDS; however, it is not related to the hypothalamic-pituitary-thyroid axis. Peripheral factors, including the activities of iodothyronine deiodinase type 1 and type 2 enzymes, which are involved in regulating serum levels and converting T4 to T3, are probably responsible for the observed differences.

Keywords: Chronic kidney disease, Diabetes, Thyroid-stimulating hormone, Thyroxine, Triiodothyronine, T3/T4 ratio

Full-Text [PDF 704 kb] (445 Downloads)

Type of Study: Research | Subject: clinical biochemistry
Received: 2021/10/21 | Accepted: 2021/11/15 | Published: 2022/02/4

References

1. Mogensen CE. Practice guidelines for chronic kidney disease. Ann Int Med2004; 140: 933-4. doi.10.7326/0003-4819-140-11-200406010-00025.

2. Girndt M. Diagnosis and treatment of chronic kidney disease. Internist2017; 58: 243-256. doi.10.1007/s00108-017-0195-2.

3. Rhee CM, You AS, Nguyen DV, Brunelli SM, Budoff MJ, Streja E, et al. Thyroid status and mortality in a prospective hemodialysis cohort. J Clin Endocrinol Metab 2017; 102: 1568-77. doi.10.1210/jc.2016-3616.

4. Kaptein EM, Quionverde H, Chooljian CJ, Tang WW, Friedman PE, Rodriquez HJ, et al. The thyroid in end stage renal disease. Medicine1988; 67: 187-97. doi.10.1097/00005792-198805000-0005.

5. LaFave L, Haselby D, Hart A. Endocrine Complications of Chronic Kidney Disease. Chronic Renal Disease. 2nd ed. Elsevier; 2020; 541-9. Doi.org/10.1016/B978-0-12-815876-0.00034-6.

6. Zhang J, Lazar MA. The mechanism of action of thyroid hormones. Annu Rev Physiol. 2000; 62: 439-66. doi: 10.1146/annurev.physiol.62.1.439.

7. Mohamedali M, Maddika SR, Vyas A, Iyer V, Cheriyath P. Thyroid Disorders and Chronic Kidney Disease. Int J Nephrol. 2014; 2014:1-6. doi.10.1155/2014/520281

8. Rhee CM. Thyroid disease in end stage renal disease. Curr Opin Nephrol Hyp2019; 28: 621-30. doi.10.1097/MNH.0000000000000542.

9. Cotoi L, Borcan F, Sporea I, Amzar D, Schiller O, Schiller A, et al. Thyroid Pathology in End-Stage Renal Disease Patients on Hemodialysis. Diagnostics 2020; 10: 245. doi.10.3390/diagnostics10040245.

10. Iglesias P, Bajo MA, Selgas R, Díez JJ. Thyroid dysfunction and kidney disease an update. Rev Endocr Metab Dis2017; 18:131-44. doi.10.1007/s11154-016-9395-7.

11. Kutlay S, Atli T, Koseogullari O, Nergizoglu G, Duman N, Gullu S. Thyroid disorders in hemodialysis patients in an iodine deficient community. Art Org2005; 29: 329-32. doi.10.1111/j.1525-1594.2005.29055.x.

12. Vadakedath S, Kandi V. Dialysis a review of the mechanisms underlying complications in the management of chronic renal failure. Cureus2017; 9.1-8. doi.10.7759/cureus.1603.

13. Nederstigt C, Corssmit EP, de Koning EJ, Dekkers OM. Incidence and prevalence of thyroid dysfunction in type 1 diabetes. J Diabete Compl2016; 30: 420-5. doi.10.1016/j.jdiacomp. 2015.12.027.

14. Ray S, Ghosh S. Thyroid disorders and diabetes mellitus Double trouble. J Dia Res Ther 2016; 2: 1-7. doi.10.16966/2380-5544.113.

15. Nair A, Jayakumari C, Jabbar P, Jayakumar R, Raizada N, Gopi A, et al. Prevalence and associations of hypothyroidism in Indian patients with type 2 diabetes mellitus. J Thyr Res 2018; 2018. 1-7. doi.10.1155/2018/5386129.

16. ahmad Mirboluk A, Rohani F, Asadi R, Eslamian MR. Thyroid function test in diabetic ketoacidosis. Diabetes Metab Syndr. 2017; 11: S623-S5. Doi: 10.1016/j.dsx.2017.04.015.

17. Rosner MH, Reis T, Husainsyed F, Vanholder R, Hutchison C, Stenvinkel P, et al. Classification of uremic toxins and their role in kidney failure.Clin J Am Soc Nephrol2021; 16: 1918-28. doi.10.2215/CJN.02660221.

18. Nishikawa M, Ogawa Y, Yoshikawa N, Yoshimura M, Toyoda N, Shouzu A, et al. Plasma free thyroxine concentrations during hemodialysis in patients with chronic renal failure effects of plasma non-esterified fatty acids on FT4 measurement. Endocr J1996; 43: 487-93. doi.10.1507/endocrj.43.487.

19. Shamsadini S. [Effect of hemodialysis on thyroid hormone serum level of patients with chronic renal failure]. IJEM2000; 2: 187-90. (Persian).

20. Kutlay S, Atli T, Koseogullari O, Nergizoglu G, Duman N, Gullu S. Thyroid disorders in hemodialysis patients in an iodine deficient community. Art Org 2005; 29: 329-32. doi.10.1111/j.1525-1594.2005.29055.x.

21. Hakim RM, Lazarus MJ. Biochemical parameters in chronic renal failure. Am J Kid Dis1988; 11: 238-47. doi.10.1016/s0272-6386 (88) 80156-2.

22. Ozen KP, Asci G, Gungor O, Carrero JJ, Kircelli F, Tatar E, et al. Nutritional state alters the association between free triiodothyronine levels and mortality in hemodialysis patients. Am J Nephrol2011; 33: 305-12. doi.10.1159/000324883.

23. Utas C, Taskapan H, Oymak O, Akpolat T, Arinsoy T, Kelestimur F. Improvement of thyroid hormone profile and thyrotrophin surge alterations in hemodialysis patients on erythropoietin treatment. Clin Nephrol 2001; 55: 471-6.

24. Laurberg P. Mechanisms governing the relative proportions of thyroxine and triiodothyronine in thyroid secretion. Metabolism 1984; 33: 379-92. doi.10.1016/0026-0495 (84) 90203-8.

25. Burch HB. Drug effects on the thyroid. New Eng J Med2019; 381: 749-61. doi.10.1056/NEJMra

26. Kundra P, Burman KD. The effect of medications on thyroid function tests. Med Clin North Am 2012; 96: 283-95. doi.10.1016/j.mcna.2012.02.001.

27. Mortoglou A, Candiloros H. The serum triiodothyronine to thyroxine ratio in various thyroid disorders and after Levothyroxine replacement therapy. Hormones 2004; 3: 120-6. doi.10.14310/horm.2002.11120.

28. Maia AL, Goemann IM, Meyer EL, Wajner SM. Deiodinases: the balance of thyroid hormone: type 1 iodothyronine deiodinase in human physiology and disease. Endocrinology2011; 209: 283-97. doi.10.1530/JOE-10-0481.

29. Maia AL, Goemann IM, Souza Meyer E, Wajner SM. Type 1 iodothyronine deiodinase in human physiology and disease. Endocrinology 2011; 209, 283-297. doi.10.1530/JOE-10-0481.

30. Kawai M, Shoji Y, Onuma S, Etani Y, Ida S. Thyroid hormone status in patients with severe selenium deficiency. Clin Pediatr Endocrinol 2018; 27: 67-74. doi.10.1297/cpe.27.67.

31. Kralik A, Eder K, Kirchgessner M. Influence of zinc and selenium deficiency on parameters relating to thyroid hormone metabolism. Horm Metab Res1996; 28: 223-6. doi.10.1055/s-2007-979169.

32. Sobczak AIS, Stefanowicz F, Pitt SJ, Ajjan RA, Stewart AJ. Total plasma magnesium, zinc, copper and selenium concentrations in typeI and typeII diabetes. Biometals2019; 32: 123-38. doi.10.1007/s10534-018-00167-z.

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‎ 10.52547/sjimu.29.6.59

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Anvari E, Fateh A, Noori Zadeh A. Comparative Study of Peripheral Thyroid Hormone Homeostasis Disturbance in the Diabetic and Non-Diabetic Hemodialytic Patients. J. Ilam Uni. Med. Sci. 2022; 29 (6) :59-68
URL: http://sjimu.medilam.ac.ir/article-1-7322-en.html

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