Enzyme response to thyrotoxicosis and hypothyroidism in human liver and muscle: comparative aspects

Mechanisms of impaired exercise capacity in short duration experimental hyperthyroidism

To investigate the mechanism of reduced exercise tolerance in hyperthyroidism, we characterized cardiovascular function and determinants of skeletal muscle metabolism in 18 healthy subjects aged 26 +/- 1 yr (mean +/- SE) before and after 2 wk of daily ingestion of 100 micrograms of triiodothyronine (T3). Resting oxygen uptake, heart rate, and cardiac output increased and heart rate and cardiac output at the same submaximal exercise intensity were higher in the hyperthyroid state (P less than 0.05). However, maximal oxygen uptake decreased after T3 administration (3.08 +/- 0.17 vs. 2.94 +/- 0.19 l/min; P less than 0.001) despite increased heart rate and cardiac output at maximal exercise (P less than 0.05). Plasma lactic acid concentration at an equivalent submaximal exercise intensity was elevated 25% (P less than 0.01) and the arteriovenous oxygen difference at maximal effort was reduced (P less than 0.05) in the hyperthyroid state. These effects were associated with a 21-37% decline in activities of oxidative (P less than 0.001) and glycolytic (P less than 0.05) enzymes in skeletal muscle and a 15% decrease in type IIA muscle fiber cross-sectional area (P less than 0.05). Lean body mass was reduced (P less than 0.001) and the rates of whole body leucine oxidation and protein breakdown were enhanced (P less than 0.05). Thus, exercise tolerance is impaired in short duration hyperthyroidism because of decreased skeletal muscle mass and oxidative capacity related to accelerated protein catabolism but cardiac pump function is not reduced.

Ontogenesis of triiodothyronine nuclear receptors in three skeletal muscles in male and female chicks

The ontogenesis of nuclear triiodothyronine receptors was determined in the pectoralis (alpha W fibers: fast contracting, glycolytic metabolism), adductor brevis (alpha R fibers: fast contracting, oxido-glycolytic metabolism) and adductor magnus (beta R fibers: slow contracting, oxidative metabolism), muscles of male and female chickens at 18 days in ovo and 0, 6, and 30 days ex ovo. In the fast muscles (adductor brevis and pectoralis major), the T3 receptor number decreases from the 18th day of incubation to hatching or the 6th day after hatching, respectively, and then increases. In the slow muscle (adductor magnus), the T3 receptor number increases from 18 days in ovo to hatching and then decreases. At 30 days after hatching, the number of T3 receptors was higher in the fast muscles than in the slow one. A comparison of the two fast muscles reveals that the number of T3 receptors was more elevated in the pectoralis (glycolytic) fibers than in the adductor brevis (oxido-glycolytic) fibers. An overall test of significance showed a higher number of T3 nuclear receptors in muscles from females than from males.

Effect of hyperthyroidism on fibre-type composition, fibre area, glycogen content and enzyme activity in human skeletal muscle

Seven hyperthyroid patients were studied by repeated muscle biopsies (vastus lateralis) before and after a period of medical treatment which averaged 10 months. The biopsies were analysed with regard to fibre-type composition, fibre area, capillary density, glycogen content and enzyme activities representing the glycolytic capacity (hexokinase, 6-phosphofructokinase), oxidative capacity (oxoglutarate dehydrogenase, citrate synthase) and Ca2+- and Mg2+-stimulated ATPase in muscle. In the pretreatment biopsy (hyperthyroid state), there was a significantly lower proportion of type I fibres (30% vs. 41%), a higher capillary density (23%), lower glycogen content (33%), and higher hexokinase activity (32%) compared with the post-treatment biopsy. No significant changes in the activity of the remaining enzymes were observed. The present study indicates that hyperthyroidism induces a transformation from type I to type II fibres in human skeletal muscle. The increase in hexokinase activity probably reflects a higher glucose utilization by skeletal muscle in order to compensate partially for the reduced glycogen content.

The role of thyroid hormones in the control of energy expenditure

Thyroid hormones have a direct effect on the basal or resting metabolic rate in man and a permissive effect on the adaptive thermogenesis of small animals, while altering the energy expended in exercise to the extent that patients with thyroid disorders exercise to a greater or lesser degree. The physiological concepts of energy expenditure need to be seen in the context of a new method for measuring 'thyroid thermogenesis'. Thyroid hormones seem, in evolutionary terms, to have developed a thermogenic role during the transition from poikilothermy to homeothermy; they are responsible for the increased heat production required for homeotherms to maintain body temperature above that of the environment. The potential mechanisms responsible for thyroid hormone-controlled energy expenditure are complex. Uncoupled oxidative phosphorylation is probably not responsible for thyroid hormone-controlled thermogenesis except in the special case of brown adipose tissue thermogenesis, where thyroid hormones act permissively. The concept that increased ATP generation must be coupled to ATP utilization needs to be linked with the idea that thyroid hormone-controlled thermogenesis must be through inefficient pathways of metabolism. Several of these potentially important pathways of intermediary metabolism in thyroid hormone-controlled thermogenesis can now be defined and measured, but their role in the regulation of nutritionally induced alterations in thyroid status and thermogenesis remains to be explored.

Thyroid hormone action on intermediary metabolism. Part III. Protein metabolism in hyper- and hypothyroidism

In their physiological concentrations, thyroid hormones stimulate the synthesis as well as the degradation of proteins, whereas in supraphysiological doses protein catabolism predominates. In hyperthyroidism skeletal muscle protein stores suffer depletion which is reflected by an increased urinary N- and methylhistidine -excretion. Due to the enhanced skeletal muscle amino acid release, the plasma concentration of glucoplastic amino acids are often enhanced, contributing by means of an elevated substrate supply to the increased hepatic gluconeogenesis. Thyroid hormone excess induces cardiac hypertrophy which is in direct contrast to the hypotroph skeletal muscle in hyperthyroid patients. Thyroid hormones stimulate a series of intracellular and secretory proteins in the liver, although in hyperthyroid liver alcohol dehydrogenase and the enzymes of histidine and tryptophan metabolism show reduced activities. The stimulatory effect is due to thyroid hormone-induced increase in the protein synthesis at a pretranslational level and is supported experimentally for malic enzyme, alpha 2u-globulin and albumin by the measurement of their specific messenger RNA activities. Thyroid hormone action at the cellular level is reflected by a generalized increase in total cellular RNA with a selective increase or decrease in a small population of specific mRNA. The activities of protein catabolizing lysosomal enzymes are stimulated by thyroid hormones; up to now effects of T3 on the degradation of specific enzymes have not been reported. Serum total protein concentration is slightly reduced or even unchanged in hyperthyroidism. The thyroid hormone-induced increase in the turnover of total body protein is part of the hypermetabolism observed in hyperthyroidism.

Evidence that thyroid hormones regulate gluconeogenesis from glycerol in man

We have previously reported that glucose production assessed using radioisotopic methods is 50% increased in hyperthyroidism but 30% decreased in hypothyroidism. These studies, however, do not distinguish between glycogenolysis and gluconeogenesis. In fasting man more than 80% of circulating glycerol is cleared by the liver and enters the gluconeogenic pathway. We have therefore measured glycerol clearance following bolus intravenous glycerol administration as an indirect assessment of gluconeogenic capacity. Hyperthyroid and hypothyroid subjects were compared with separate matched controls after an overnight fast. In hyperthyroid subjects blood glucose and blood glycerol were increased but lactate, pyruvate, and alanine concentrations were normal. Glycerol clearance was increased in hyperthyroidism and followed a double exponential decay with a shortened second component half-time. Endogenous glycerol production was increased three-fold. In hypothyroidism fasting circulating levels of glucose, lactate, pyruvate, alanine, and glycerol were normal but glycerol clearance was diminished. Both first and second component half-times were prolonged in hypothyroidism and endogenous glycerol production was decreased by 50%. Thus in hyperthyroidism glycerol clearance is greatly enhanced whilst in hypothyroidism glycerol clearance is diminished. The magnitude of the changes suggests that alterations in gluconeogenesis are probably the major factors concerned in the reported increase and decrease in glucose production in hyperthyroidism and hypothyroidism respectively.

Metabolic aspects of the calorigenic effect of thyroid hormone in mammals

The increased BMR in hyperthyroidism may be accounted for by the use of chemical energy for metabolic processes and work. Major contributors are the heart work and futile cycling of FFA into triglyceride in adipose tissue, whereas gluconeogenesis in liver and the maintenance of sodium and potassium concentration gradients across the plasma membranes are unlikely to play any significant role. Information on the use of energy for protein turnover and urea production is lacking. The rate of oxygen uptake is not increased in the brain, spleen and testis. The main metabolic fuel seems to be free fatty acid. The mechanism which enables the hyperthyroid tissue to maintain normal concentrations of ATP, ADP and inorganic phosphate, (Pi) despite an increased turnover of energy-rich phosphates, is not fully elucidated. However, ultimately the increased rate of oxygen uptake in hyperthyroidism seems to rely upon an increased capacity for the transport of cytosolic ADP and Pi into mitochondria. The transport capacity is increased by an increased area of the mitochondrial membrane per g tissue and by a change in the kinetics of translocation of substrates for oxidative phosphorylation. Other transport processes across the mitochondrial membrane are also changed by hyperthyroidism, e.g. long chain fatty acid transport via carnitine acyl transferase, and oxaloacetate transport via substrate shuttles.

Thyroid hormone action at the cellular level

A large body of circumstantial evidence suggests that the basic unit of thyroid hormone action is the triiodothyronine nuclear receptor complex. This complex stimulates the formation, directly or indirectly, of a diversity of messenger RNA (mRNA) sequences. A generalized increase in mRNA as well as a disproportionate increase in a limited number of RNA sequences have been demonstrated. Regulation of thyroid hormone effects may be carried out largely at a local cellular level. Highly selective alterations in sensitivity to the triiodothyronine nuclear receptor complex may occur at specific target genes. Metabolic factors and hormones participate in such regulation. In a given tissue, alterations in the total number of receptor sites has not been shown to be useful as an index of thyroid hormone response, and local modulation of the response to the triiodothyronine receptor complex by a variety of factors other than triiodothyronine may be carried out at a postreceptor level.

Freeze-fracturing studies of mitochondrial myopathy. A correlated clinical, biochemical and morphological investigation

Freeze-fracture studies of pathologically changed mitochondria in situ from muscle biopsies of a 9.5-year-old girl with a mitochondrial myopathy were correlated with clinical, biochemical and histochemical investigations. In the ultrathin sections giant mitochondria with densely packed cristae membranes - often reoriented to concentric circles - and, in addition, paracrystalline mitochondrial inclusions were found. The freeze fracture faces of such transformed mitochondria and preparations of their inner and outer membranes provided a morphological insight in the macromolecular structure of the mitochondrial membrane under such pathological conditions. The results lead to the hypothesis that part of the transformed mitochondria stay active functionally for an extended period by maintaining the delimitation from the cytoplasm and by preserving the macromolecular membrane architecture. This hypothesis could explain the slow progression of the myogenic symptoms.

Response of mitochondria of different types of skeletal muscle to thyrotoxicosis

To determine the effect of long-term thyrotoxicosis on muscle mitochondria, we measured representative mitochondrial enzymes from three different types of skeletal muscle (fast-twitch red and fast-twitch white from the quadriceps, and slow-twitch red from the soleus) in rats given 3 mg L-thyroxine and 1 mg triiodo-L-thyronine per kilogram of diet for 12 wk. Marker enzymes of the electron transport chain and citric acid cycle (cytochrome oxidase, cytochrome c, and citrate synthase) increase approximately twofold in soleus muscle in response to this treatment. The fast-twitch muscles exhibit no more than 44% increases in these enzymes in response to the same treatment. Relative to initial concentration, 3-hydroxybutyrate dehydrogenase increased to the same extent in fast-twitch red muscle as it did in the soleus (70%). Mitochondrial alpha-glycerophosphate dehydrogenase increased 76% in red quadriceps and 170% in soleus, but did not change in white muscle in the thyrotoxic rats. This differential sensitivity of the three types of muscle provides a tool for studying the mechanisms underlying the action of thyroid hormones on muscle mitochondria.

M. Quadriceps femoris of man, a muscle with an unusual enzyme activity pattern of energy supplying metabolism in mammals

1. The following enzyme activities were estimated in needle-biopsy samples of the lateral part of the human quadriceps femoris muscle: triosephosphate dehydrogenase (TPDH), lactate dehydrogenase (LDH), NAD : glycerol-3-phosphate dehydrogenase (GPDH), hexokinase (HK), NAD: malate dehydrogenase (MDH), citrate synthase (CS) and hydroxyacyl-CoA dehydrogenase. 2. Although the enzyme activities in muscles of women were lesser than in those of men, no difference was found in the calculated enzyme activity ratios. There is thus no sex-dependent metabolic type-differentiation in this muscle. 3. The human quadriceps femoris is a low-activity muscle, in comparison with muscles of homoiotherm laboratory animals. The enzyme activity ratio of TPDH to CS, characterizing the glycolytic pyruvate formation to aerobic oxidative capacities, shows this muscle to be of an intermediate type in this respect, similarly as the extensor digitorum longus of the rat. The relatively very high capacity of glucose phosphorylation (HK), the high aerobic regeneration of cytoplasmic dehydrogenated NAD (GPDH) and the very low anaerobic regeneration (LDH), show the unusually high proportion of carbohydrates (glucose) which can be broken down aerobically.