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

• Published in: Respiratory medicine Vol. 101; no. 7; pp. 1439 - 1446
• Main Authors: Karadag, Fisun, Ozcan, Hatice, Karul, Aslihan B, Yilmaz, Mustafa, Cildag, Orhan
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2007; Elsevier; Elsevier Limited
• Subjects: Acute Disease; Aged; Biological and medical sciences; Body mass index; Carbon Dioxide - blood; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; Disease; Euthyroid Sick Syndromes - blood; Euthyroid Sick Syndromes - etiology; Euthyroid Sick Syndromes - physiopathology; Follow-Up Studies; Forced Expiratory Volume; Hormone replacement therapy; Humans; Interleukin-6; Interleukin-6 - blood; Medical sciences; Middle Aged; Non-thyroidal illness syndrome; Older people; Oxygen - blood; Partial Pressure; Pneumology; Pulmonary Disease, Chronic Obstructive - blood; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary/Respiratory; Studies; Thyroid Function Tests - methods; Thyroid gland; Thyroid hormones; Thyroid Hormones - blood; Tumor necrosis factor-alpha; Tumor Necrosis Factor-alpha - blood; Vital Capacity; Non-thyroidal illness syndrome; fT3; Free triiodothyronine (pg/ml); TSH; Total triiodothyronine (ng/ml); Forced expiratory volume in 1 s (%predicted); IL-6; Interleukin-6; TNF- α; Tumor necrosis factor-alpha; TT3; FEV 1; Total thyroxine (μg/dl); TT4; Interleukin-6 (pg/ml); Chronic obstructive pulmonary disease; Thyroid-stimulating hormone (μIU/ml); Thyroid hormones; PaO 2: Arterial oxygen partial pressure (mmHg); Tumor necrosis factor-alpha (pg/ml); Lung disease; Euthyroid sick syndrome; Respiratory disease; Chronic disease; Interleukin 6; Chronic; Bronchus disease; Thyroid hormone; Obstructive pulmonary disease; Tumor necrosis factor α; Tumor necrosis factor- alpha; Pneumology
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2007.01.016

Summary Non-thyroidal illness syndrome (NTIS) is frequently detected in chronic, systemic diseases. The objectives of the current study is to assess the alterations of thyroid hormones during exacerbation period, recovery of exacerbation and stable phase of chronic obstructive pulmonary disease (COPD) and correlates of these hormonal alterations. A total of 83 stable COPD patients, 20 patients with acute exacerbation and 30 control subjects were evaluated. TT3, fT3, TT3/TT4 levels of both stable and exacerbation COPD groups were lower than control subjects. TSH was also decreased during exacerbation period. In follow-up of COPD exacerbation group, TSH, TT3, fT3 and TT3/TT4 were found to be increased in measurements on the day of discharge from hospital and after 1 month, compared to baseline values. TT3 and TT3/TT4 were lower in severe COPD; whereas TSH, fT3, TT3 and TT3/TT4 were lower in patients with severe hypoxemia. IL-6 and TNF- α were higher in both stable and exacerbation phase COPD groups and IL-6 was correlated to TT3 in stable COPD. As a result, there are significant alterations in thyroid hormones of stable COPD patients, which are related to severity of disease and hypoxemia. The hormonal changes are more significant during exacerbation and partially regress after 1 month when the disease is stabilized. We conclude that COPD patients should not be evaluated for thyroid disease during exacerbation of the disease, and thyroid function alterations during stable phase of the disease should be considered cautiously, since thyroid function abnormalities in non-thyroid illness may mimic or mask biochemical abnormalities observed in true thyroid disease.