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Janovsky CCPS, Meneghini V, Tebar W, Martins JRM, Sgarbi JA, Teixeira PDFDS, Jones SR, Blaha MJ, Toth PP, Lotufo PA, Bittencourt MS, Santos RD, Santos IS, Chaker L, Bensenor IM. Branched-Chain Amino Acids, Alanine, and Thyroid Function: A Cross-Sectional, Nuclear Magnetic Resonance (NMR)-Based Approach from ELSA-Brasil. Metabolites 2024; 14:437. [PMID: 39195533 DOI: 10.3390/metabo14080437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/26/2024] [Accepted: 08/01/2024] [Indexed: 08/29/2024] Open
Abstract
The association of thyroid function with essential and non-essential amino acids is understudied, despite their common metabolic roles. Thus, our aim was to evaluate the association of thyroid function with the levels of branched-chain amino acids (BCAAs-leucine, isoleucine, and valine) and of alanine in the general population. We utilized data from the São Paulo research center of ELSA-Brasil, a longitudinal population-based cohort study. Thyroid parameters included thyroid stimulating hormone (TSH), free T4 and free T3 levels, and the FT4:FT3 ratio. BCAAs and alanine were analyzed on a fully automated NMR platform. The current analysis included euthyroid participants and participants with subclinical hyperthyroidism and hypothyroidism. We used Pearson's coefficient to quantify the correlation between thyroid-related parameters and amino acids. Linear regression models were performed to analyze whether thyroid parameters were associated with BCAAs and alanine levels. We included 4098 participants (51.3 ± 9.0 years old, 51.5% women) in this study. In the most adjusted model, higher levels of TSH were associated with higher levels of alanine, FT4 levels were inversely associated with isoleucine levels, FT3 levels were statistically significant and positively associated with valine and leucine, and the T3:T4 ratio was positively associated with all amino acids. We observed that subclinical hypothyroidism was positively associated with isoleucine and alanine levels in all models, even after full adjustment. Our findings highlight the association of subclinical hypothyroidism and thyroid-related parameters (including TSH, free T4, free T3, and FT4:FT3 ratio) with BCAAs and alanine. Further studies are needed to explore the mechanisms underlying this association. These insights contribute to our understanding of the influence of thyroid-related parameters on BCAA and alanine metabolism.
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Grants
- grants of baseline: 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ; and grants of 4-year follow-up 01 10 0643-03 RS, 01 10 0742-00 BA, 01 12 0284-00 ES, 01 10 0746-00 MG, 01 10 0773-00 SP, and 01 National Council for Scientific and Technological Development
- 2015/17213- 2 Fundação de Amparo à Pesquisa do Estado de São Paulo
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Affiliation(s)
- Carolina Castro Porto Silva Janovsky
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
- Division of Endocrinology, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo 04039-032, Brazil
| | - Vandrize Meneghini
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - William Tebar
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Joao Roberto Maciel Martins
- Division of Endocrinology, Federal University of São Paulo/Escola Paulista de Medicina, São Paulo 04039-032, Brazil
| | - José Augusto Sgarbi
- Division of Endocrinology, Faculty of Medicine of Marília (FAMEMA), Marília 17519-030, Brazil
| | | | - Steven R Jones
- Johns Hopkins, Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287, USA
| | - Michael J Blaha
- Johns Hopkins, Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD 21287, USA
| | - Peter P Toth
- CGH Medical Center, Department of Preventive Cardiology, Sterling, IL 61081, USA
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Marcio S Bittencourt
- Department of Medicine and Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Raul D Santos
- Heart Institute (InCor), University of São Paulo, São Paulo 05403-900, Brazil
- Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil
| | - Itamar S Santos
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
| | - Layal Chaker
- Department of Internal Medicine and Rotterdam Thyroid Center, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Isabela M Bensenor
- Center for Clinical and Epidemiological Research, University Hospital, University of São Paulo, São Paulo 05508-000, Brazil
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Bechtold MA, Lin Y, Miller ML, Prieto JM, Frederick CE, Bennett LL, Peterson ME, Simpson KW, Loftus JP. Serum metabolome analysis in hyperthyroid cats before and after radioactive iodine therapy. PLoS One 2024; 19:e0305271. [PMID: 38857299 PMCID: PMC11164369 DOI: 10.1371/journal.pone.0305271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/27/2024] [Indexed: 06/12/2024] Open
Abstract
Hyperthyroidism is the most common feline endocrinopathy. In hyperthyroid humans, untargeted metabolomic analysis identified persistent metabolic derangements despite achieving a euthyroid state. Therefore, we sought to define the metabolome of hyperthyroid cats and identify ongoing metabolic changes after treatment. We prospectively compared privately-owned hyperthyroid cats (n = 7) admitted for radioactive iodine (I-131) treatment and euthyroid privately-owned control (CON) cats (n = 12). Serum samples were collected before (T0), 1-month (T1), and three months after (T3) I-131 therapy for untargeted metabolomic analysis by MS/MS. Hyperthyroid cats (T0) had a distinct metabolic signature with 277 significantly different metabolites than controls (70 increased, 207 decreased). After treatment, 66 (T1 vs. CON) and 64 (T3 vs. CON) metabolite differences persisted. Clustering and data reduction analysis revealed separate clustering of hyperthyroid (T0) and CON cats with intermediate phenotypes after treatment (T1 & T3). Mevalonate/mevalonolactone and creatine phosphate were candidate biomarkers with excellent discrimination between hyperthyroid and healthy cats. We found several metabolic derangements (e.g., decreased carnitine and α-tocopherol) do not entirely resolve after achieving a euthyroid state after treating hyperthyroid cats with I-131. Further investigation is warranted to determine diagnostic and therapeutic implications for candidate biomarkers and persistent metabolic abnormalities.
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Affiliation(s)
- Molly A. Bechtold
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Yimei Lin
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Meredith L. Miller
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Jennifer M. Prieto
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Carol E. Frederick
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Lucinda L. Bennett
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Mark E. Peterson
- Animal Endocrine Clinic, New York, New York, United States of America
| | - Kenneth W. Simpson
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - John P. Loftus
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
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Ornstrup MJ, Høst C, Rittig N, Gravholt CH. Acute effects of testosterone on whole body protein metabolism in hypogonadal and eugonadal conditions: a randomized, placebo-controlled, crossover study. J Appl Physiol (1985) 2024; 136:1460-1467. [PMID: 38634506 DOI: 10.1152/japplphysiol.00078.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/19/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Chronic testosterone (T) substitution and short-term T administration positively affect protein metabolism, however, data on acute effects in humans are sparse. This study aimed to investigate T's acute effects on whole body protein metabolism in hypogonadal and eugonadal conditions. We designed a randomized, double-blind, placebo-controlled, crossover study, including 12 healthy young males. Whole body protein metabolism was evaluated during 1) eugonadism, and after medically induced hypogonadism, with application of a gel on each trial day containing either 2) placebo, 3) T 50 mg, or 4) T 150 mg; under basal (5-h basal period) and insulin-stimulated conditions (3-h clamp). The main outcome measure was a change in net protein balance. The net protein loss was 62% larger in the placebo-treated hypogonadal state compared with the eugonadal state during the basal period (-5.5 ± 3.5 µmol/kg/h vs. -3.4 ± 1.2 µmol/kg/h, P = 0.038), but not during the clamp (P = 0.06). Also, hypogonadism resulted in a 25% increase in whole body urea flux (P = 0.006). However, T did not result in any significant changes in protein breakdown, synthesis, or net balance during either the basal period or clamp (all P > 0.05). Protein breakdown was reduced during clamp compared with the basal period regardless of gonadal status or T exposure (all P ≤ 0.001). In conclusion, the application of transdermal T did not counteract the negative effects of hypogonadism with no effects on protein metabolism within 5 h of administration. Insulin (during clamp) mitigated the effects of hypogonadism. This study is the first to investigate acute protein metabolic effects of T in hypogonadal men.NEW & NOTEWORTHY In a model of medically induced hypogonadism in male volunteers, we found increased whole body urea flux and net protein loss as an expected consequence of hypogonadism. Our study demonstrates the novel finding that the application of transdermal testosterone had no acute effects on whole body protein metabolism under eugonadal conditions, nor could it mitigate the hypogonadism-induced changes in protein metabolism. In contrast, insulin (during clamp) mitigated the effects of hypogonadism on protein metabolism.
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Affiliation(s)
- Marie Juul Ornstrup
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Christian Høst
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Nikolaj Rittig
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Claus H Gravholt
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
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Liu Z, Liu G, Wang Y, Zheng C, Guo Y. Association between skeletal muscle and left ventricular mass in patients with hyperthyroidism. Front Endocrinol (Lausanne) 2024; 15:1301529. [PMID: 38356960 PMCID: PMC10864587 DOI: 10.3389/fendo.2024.1301529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
Objective This study aims to investigate the relationship between skeletal muscle and left ventricular mass (LVM) in patients with hyperthyroidism, providing theoretical and data-based foundations for further research on the interaction between secondary muscle atrophy and cardiac remodeling. Methods A retrospective data collection was conducted, including 136 patients with hyperthyroidism (Study group) and 50 healthy participants (control group). The Study group was further divided into Group A (high LVM) and Group B (low LVM) based on LVM size. Multiple linear regression analysis was performed to examine the correlation between skeletal muscle and LVM, with model evaluation. Based on the results, further nonlinear regression analysis was conducted to explore the detailed relationship between skeletal muscle and LVM. Results Compared to the control group, the Study group exhibited significantly lower LVM, skeletal muscle mass index (SMI), and skeletal muscle mass (SMM) (P<0.05). Within the subgroups, Group A had significantly higher SMI, SMM, and hand grip strength compared to Group B (P<0.05). The results of the multiple linear regression showed a certain correlation between SMI (β=0.60, P=0.042, 95% CI=0.02~1.17) and hand grip strength (β=0.34, P=0.045, 95% CI=0.01~0.67) with LVM. However, the residuals of the multiple regression did not follow a normal distribution (K-S=2.50, P<0.01). Further results from a generalized linear model and structural equation modeling regression also demonstrated a correlation between SMI (β=0.60, P=0.040, 95% CI=0.03~1.17) (β=0.60, P=0.042, 95% CI=0.02~1.17) and hand grip strength (β=0.34, P=0.043, 95% CI=0.01~0.67) (β=0.34, P=0.045, 95% CI=0.01~0.67) with LVM. Conclusion Patients with hyperthyroidism may exhibit simultaneous decreases in LVM, SMM, and SMI. The LVM in patients is correlated with SMM and hand grip strength, highlighting the need for further exploration of the causal relationship and underlying mechanisms. These findings provide a basis for the prevention and treatment of secondary sarcopenia and cardiac pathology in patients with hyperthyroidism.
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Affiliation(s)
- Zhenchao Liu
- Institute of Integrative Medicine, Qingdao University, Qingdao, Shandong, China
| | - Guang Liu
- Shandong Provincial Sports Center, Shandong Administration of Sports, Jinan, Shandong, China
| | - Yanzhi Wang
- Academic Affairs Office, Binzhou Medical University, Yantai, Shandong, China
| | - Chongwen Zheng
- Department of Neurology, The 2nd Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Yunliang Guo
- Institute of Integrative Medicine, Qingdao University, Qingdao, Shandong, China
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Zhang H, Li X, Zhang N, Tian L. Effect of thyroid dysfunction on N-terminal pro-B-type natriuretic peptide levels: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1083171. [PMID: 36777339 PMCID: PMC9909547 DOI: 10.3389/fendo.2023.1083171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE Thyroid hormones (THs) significantly affect the cardiovascular system. N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful biomarker for diagnosing, evaluating, and predicting outcomes in heart failure (HF). This comprehensive review and meta-analysis aimed to investigate the effects of thyroid dysfunction (hypothyroidism and hyperthyroidism) on NT-proBNP levels. METHODS Two investigators independently searched PubMed, Embase, Cochrane Library, and Web of Science databases for studies published from inception to July 31, 2022, without any restrictions on language. RESULTS 21 studies were included. In participants without HF, NT-proBNP levels may be elevated in those with overt hyperthyroidism (standardized mean difference [SMD] 2.38, 95% confidence interval [CI]:1.0-3.76). Notably, among patients with preexisting HF, significantly higher NT-proBNP levels were found in patients with overt hyperthyroidism, overt hypothyroidism, or subclinical hypothyroidism than in euthyroid subjects (SMD [95%CI] = 0.31[0.01, 0.62], 0.32[0.08, 0.56], and 0.33[0.21, 0.46], respectively). Seven trials compared NT-proBNP levels in patients with thyroid dysfunction before and after therapy, and significant drops in NT-proBNP levels were observed in patients with hyperthyroidism (SMD [95%CI] = -1.53[-2.50, -0.55]) upon achieving a euthyroid state. In contrast, increased NT-proBNP levels were observed in hypothyroid patients after treatment (SMD [95%CI] = 1.07[0.28, 1.85]). CONCLUSION Thyroid dysfunction can significantly affect NT-proBNP levels, which may change upon achieving a euthyroid state. Notably, the effect of thyroid dysfunction on cardiac function may depend on the underlying cardiac status. Thus, timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction are mandatory because the prognosis of HF may be improved with appropriate treatment of thyroid dysfunction. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/prospero, identifier CRD42022353700.
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Affiliation(s)
- Hongling Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Xiaotao Li
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, China
| | - Nawen Zhang
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
| | - Limin Tian
- The First Clinical Medical College of Gansu University of Chinese Medicine (Gansu Provincial Hospital), Lanzhou, China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, China
- Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu, China
- *Correspondence: Limin Tian,
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Ho WE, Sun L, Goh HJ, Tint MT, Sun L, Leow MKS. Brown adipose tissue influences adiponectin and thyroid hormone changes during Graves' disease therapy. Adipocyte 2022; 11:389-400. [PMID: 35894647 PMCID: PMC9336474 DOI: 10.1080/21623945.2022.2104509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Thyroid hormones (TH), adiponectin and brown adipose tissue (BAT) are regulators of energy homoeostasis. Influence of BAT activity on the relationship between TH and adiponectin remains unexplored. The aim of the study was to identify the relationship between TH and adiponectin and to clarify the impact of active BAT on the metabolic effects of adiponectin before and after the correction of thyrotoxicosis. Twenty-one patients with newly diagnosed hyperthyroidism from Graves' disease were recruited. A titration dosing regimen of thionamide anti-thyroid drug (ATD) was used to establish euthyroidism over 12-24 weeks. Anthropometric, biochemical and adipocytokine parameters were measured before and after control of hyperthyroidism. BAT activity was quantified by fusion 18 F-fluorodeoxyglucose (18 F-FDG) PET/MR imaging, and patients were grouped based on BAT status. Plasma adiponectin level was significantly increased following correction of hyperthyroidism in the overall sample. Free thyroxine (FT4) was also identified as a predictor of adiponectin level in thyroid dysfunction. However, significant changes in adiponectin level and correlations involving adiponectin were absent in BAT-positive patients but maintained in BAT-negative patients. BAT activity diminishes the correlative relationship with body composition and abolishes TH and adiponectin relationships when transitioning from a hyperthyroid to euthyroid state.
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Affiliation(s)
- Wei-En Ho
- Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore, Singapore
| | - Lijuan Sun
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A *STAR), Singapore
| | - Hui Jen Goh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A *STAR), Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A *STAR), Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lei Sun
- Cardiovascular and Metabolic Disorders Program, Duke-NUS Medical School, Singapore
| | - Melvin Khee Shing Leow
- Lee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A *STAR), Singapore.,Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Endocrinology, Division of Medicine, Tan Tock Seng Hospital (TTSH), Singapore
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Zhu X, Zou Y, Qi X, Sheng Y, Lv S, Yu J, Wang X, Ding G, Duan Y. 2,3',4,4',5-Pentachlorobiphenyl attenuated fast-twitch fibers and fiber size of skeletal muscle via disturbing thyroid hormone signaling and mitochondrial dynamics. J Appl Toxicol 2022; 42:1628-1638. [PMID: 35411558 DOI: 10.1002/jat.4330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 04/02/2022] [Accepted: 04/07/2022] [Indexed: 11/08/2022]
Abstract
Polychlorinated biphenyls (PCBs) affect multiple organs, and some of the effects are mediated by interfering with thyroid hormone (TH) signaling that regulates physiological processes in mammals. It remains unclear how PCBs affect skeletal muscle (SM). In our study, wistar rats were injected 2,3',4,4',5-Pentachlorobiphenyl (PCB118) intraperitoneally at 0, 10, 100, and 1,000 μg / kg / day for 13 weeks and C2C12 myoblasts were treated PCB118 (0, 0.25, 25, and 50 nM) for 24 hours or 48 hours. We found that myocyte cross sectional area (MCSA) was reduced, MyHC IIa and MyHC IIb mRNA levels significantly decreased, and muscle strength was weakened in PCB118-exposed rats. TH receptor α (TRα) and iodothyronine deiodinase type 2 (DIO2) were upregulated after PCB118 exposure both in vivo and vitro. Transmission electron microscopy showed significant mitochondrial abnormalities in PCB118-treated rats, and the expression of mitochondrial regulators such as PTEN-induced kinase 1 (PINK1) and GTPase dynamin-related protein 1 (DRP1) were altered after PCB118 exposure. These results suggest that PCB118 could weaken muscle strength and attenuate fast-twitch fibers and fiber size of SM in rats. TH signaling, mitochondrial dynamics and mitophagy were also disturbed by PCB118, which may contribute to the alternations of SM structure and function.
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Affiliation(s)
- Xiaoxia Zhu
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yuxin Zou
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyu Qi
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yunlu Sheng
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Shan Lv
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Yu
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaodong Wang
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guoxian Ding
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Duan
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Sawicka-Gutaj N, Erampamoorthy A, Zybek-Kocik A, Kyriacou A, Zgorzalewicz-Stachowiak M, Czarnywojtek A, Ruchała M. The Role of Thyroid Hormones on Skeletal Muscle Thermogenesis. Metabolites 2022; 12:metabo12040336. [PMID: 35448523 PMCID: PMC9032586 DOI: 10.3390/metabo12040336] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/30/2022] [Accepted: 04/02/2022] [Indexed: 02/01/2023] Open
Abstract
Nowadays obesity becomes a significant global problem. Hence, recently more and more attention has been paid to substances present in the body that have a significant impact on metabolic processes and thermogenesis, in the context of their potential use in the prevention and treatment of obesity. It is well known that the relationship between thyroid hormones and obesity is multilayered, however recently, more and more information about the possible relation between thyroid hormones and muscle metabolism has been published. The aim of this review is to present the most updated information on the physiological impact of thyroid hormones on muscle tissue, as well as pathological changes related to the occurrence of various types of thyroid disorders, including hypothyroidism, hyperthyroidism and sick euthyroid syndrome. However, the data in humans still remains insufficient, and further studies are needed to fully explore the thyroid-muscle cross-talk.
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Affiliation(s)
- Nadia Sawicka-Gutaj
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.E.); (A.Z.-K.); (M.R.)
- Correspondence: ; Tel.: +48-607-093-970
| | - Abikasinee Erampamoorthy
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.E.); (A.Z.-K.); (M.R.)
| | - Ariadna Zybek-Kocik
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.E.); (A.Z.-K.); (M.R.)
| | - Angelos Kyriacou
- CEDM, Centre of Endocrinology, Diabetes and Metabolism, Limassol 3075, Cyprus;
- Department of Diabetes, Endocrinology & Obesity Medicine, Salford Royal NHS Foundation & University Teaching Trust, Salford M6 8HD, UK
- Medical School, European University of Cyprus, Nicosia 2404, Cyprus
| | - Małgorzata Zgorzalewicz-Stachowiak
- Laboratory of Medical Electrodiagnostics, Department of Health Prophylaxis, University of Medical Sciences, 6 Święcickiego St., 60-781 Poznan, Poland;
| | - Agata Czarnywojtek
- Department of Pharmacology, Poznan University of Medical Sciences, 61-701 Poznań, Poland;
| | - Marek Ruchała
- Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (A.E.); (A.Z.-K.); (M.R.)
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Sun L, Goh HJ, Verma S, Govindharajulu P, Sadananthan SA, Michael N, Henry CJ, Goh JPN, Velan SS, Leow MKS. Brown adipose tissues mediate the metabolism of branched chain amino acids during the transitioning from hyperthyroidism to euthyroidism (TRIBUTE). Sci Rep 2022; 12:3693. [PMID: 35256693 PMCID: PMC8901628 DOI: 10.1038/s41598-022-07701-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/22/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractBoth hyperthyroidism and elevated plasma branched chain amino acids (BCAA) are associated with insulin resistance. BCAA utilization and clearance relative to thyroid status changes remains unclear. We investigate amino acids changes, specifically BCAA, during the transition from hyperthyroidism to euthyroidism, and the impact of active brown adipose tissue (BAT) on the metabolic effects of BCAA. Newly diagnosed Graves’ disease participants were recruited. Hyperthyroidism was treated via a titration dosing regimen of thionamide anti-thyroid drug to establish euthyroidism over 12–24 weeks. All underwent energy expenditure (EE) measurement within a chamber calorimeter, 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography/magnetic resonance (PET/MR) imaging and plasma amino acids measurement during hyperthyroidism and euthyroidism. PET BAT maximum standardized uptake value (SUVmax), SUVmean and MR supraclavicular fat fraction (FF) quantified BAT activity. Twenty-two patients completed the study. Plasma BCAA level was significantly reduced in BAT-positive but not in BAT-negative patients during the transition from hyperthyroidism to euthyroidism. Plasma valine but not leucine and isoleucine correlated positively with insulin and HOMA-IR in hyperthyroidism. Plasma valine, leucine and isoleucine correlated with insulin and HOMA-IR in euthyroidism. Plasma valine correlated with insulin and HOMA-IR in BAT-negative but not in BAT-positive participants in both hyperthyroid and euthyroid state. However, the change (i.e. decrease) in plasma valine concentration from hyperthyroid to euthyroid state was affected by BAT-status. BAT utilizes and promotes BCAA plasma clearance from hyperthyroid to euthyroid state. Active BAT can potentially reduce circulating BCAA and may help to ameliorate insulin resistance and improve metabolic health.Clinical trial registration: The trial was registered at clinicaltrials.gov as NCT03064542.
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Li Y, Chen C, Chen F, Chen C, Gao R, Yang B, Si R, Lv X. Serum Raman spectroscopy combined with Deep Neural Network for analysis and rapid screening of hyperthyroidism and hypothyroidism. Photodiagnosis Photodyn Ther 2021; 35:102382. [PMID: 34091096 DOI: 10.1016/j.pdpdt.2021.102382] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/18/2021] [Accepted: 06/01/2021] [Indexed: 10/21/2022]
Abstract
Hyperthyroidism and hypothyroidism may cause a series of clinical complications have a high incidence, and early diagnosis is beneficial to treatment. Based on Raman spectroscopy and deep learning algorithms, we propose a rapid screening method to distinguish serum samples of hyperthyroidism patients, hypothyroidism patients and control subjects. We collected 99 serum samples, including 38 cases from hyperthyroidism patients, 32 cases from hypothyroidism patients and 29 cases from control subjects. By comparing and analyzing the Raman spectra of the three, we found differences in the peak intensity of the spectra, indicating that Raman spectra can be used for the subsequent identification of diseases. After collecting the spectral data, Vancouver Raman algorithm (VRA) was used to remove the fluorescence background of the data, and kernel principal component analysis (KPCA) was used to extract the spectral data features with a cumulative explained variance ratio of 0.9999. Then, five neural network models, the adjusted AlexNet, LSTM-CNN, IndRNNCNN, the adjusted GoogLeNet and the adjusted ResNet, were constructed for classifications. The total accuracy was 91%, 84%, 82%, 75% and 71% respectively. The results of our study show that it is feasible to use Raman spectroscopy combined with deep learning to distinguish hyperthyroidism, hypothyroidism and control subjects. After comparing the models, we found that as the neural network deepens and the complexity of the model increases, the classification effect of Raman spectroscopy gradually deteriorates, and we put forward three conjectures for this.
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Affiliation(s)
- Yizhe Li
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Cheng Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China; Key Laboratory of signal detection and processing, Xinjiang University, Urumqi 830046, Xinjiang, China.
| | - Fangfang Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Chen Chen
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Rui Gao
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Bo Yang
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Rumeng Si
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Xiaoyi Lv
- College of Information Science and Engineering, Xinjiang University, Urumqi 830046, China; College of Software, Xinjiang University, Urumqi 830046, Xinjiang, China; Key Laboratory of signal detection and processing, Xinjiang University, Urumqi 830046, Xinjiang, China
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11
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Piras C, Pibiri M, Leoni VP, Balsamo A, Tronci L, Arisci N, Mariotti S, Atzori L. Analysis of metabolomics profile in hypothyroid patients before and after thyroid hormone replacement. J Endocrinol Invest 2021; 44:1309-1319. [PMID: 33025552 DOI: 10.1007/s40618-020-01434-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE The serum metabolic changes occurring during the transition from hypothyroidism to euthyroidism are not known. This study aimed to determine the metabolomic profile in hypothyroid patients before (HypoT0) and after (HypoT1) euthyroidism achieved through levothyroxine (L-T4) treatment. METHODS Eighteen patients with overt primary hypothyroidism were recruited for the study. All patients were treated with L-T4 to achieve euthyroidism. Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and metabolomics profiles were measured before and after 3 months of treatment. The euthyroid control group consisted of 28 healthy volunteers. Metabolomics analysis was performed using Nuclear Magnetic Resonance (NMR) spectroscopy. RESULTS 1H NMR-based metabolomics profiling of patients with newly diagnosed hypothyroidism (HypoT0) showed significantly higher levels of citrate, creatinine, glycerol, myo-inositol and serine, and lower levels of proline and taurine compared to controls. Interestingly, some metabolic changes were persistent three months after pharmacological treatments, despite normal serum TSH and thyroid hormone concentrations (HypoT1). When an Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA) model was built to evaluate possible differences in the metabolic profile between HypoT0 and HypoT1, the data obtained were not significantly different. CONCLUSION These results suggest that metabolic changes in the patients with hypothyroidism may persist after normalization of serum levels of FT3, FT4, and TSH, which currently represent the gold standard in laboratory testing for diagnosis and evaluation of thyroid pathology. So, the metabolomics approach may contribute to integrate classical hormone assays and to determine the euthyroid status achievement with greater efficacy.
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Affiliation(s)
- C Piras
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - M Pibiri
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - V P Leoni
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - A Balsamo
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - L Tronci
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
| | - N Arisci
- Department of Medical Sciences and Public Health, University of Cagliari, 09042, Monserrato, Italy
| | - S Mariotti
- Department of Medical Sciences and Public Health, University of Cagliari, 09042, Monserrato, Italy.
| | - L Atzori
- Department of Biomedical Sciences, University of Cagliari, 09042, Monserrato, Italy
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Effraimidis G, Watt T, Feldt-Rasmussen U. Levothyroxine Therapy in Elderly Patients With Hypothyroidism. Front Endocrinol (Lausanne) 2021; 12:641560. [PMID: 33790867 PMCID: PMC8006441 DOI: 10.3389/fendo.2021.641560] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/03/2021] [Indexed: 01/06/2023] Open
Abstract
Levothyroxine (L-T4) treatment of overt hypothyroidism can be more challenging in elderly compared to young patients. The elderly population is growing, and increasing incidence and prevalence of hypothyroidism with age are observed globally. Elderly people have more comorbidities compared to young patients, complicating correct diagnosis and management of hypothyroidism. Most importantly, cardiovascular complications compromise the usual start dosage and upward titration of L-T4 due to higher risk of decompensating cardiac ischemia and -function. It therefore takes more effort and care from the clinician, and the maintenance dose may have to be lower in order to avoid a cardiac incidence. On the other hand, L-T4 has a beneficial effect on cardiac function by increasing performance. The clinical challenge should not prevent treating with L-T4 should the patient develop e.g., cardiac ischemia. The endocrinologist is obliged to collaborate with the cardiologist on prophylactic cardiac measures by invasive cardiac surgery or medical therapy against cardiac ischemic angina. This usually allows subsequent successful treatment. Management of mild (subclinical) hypothyroidism is even more complex. Prevalent comorbidities in the elderly complicate correct diagnosis, since many concomitant morbidities can result in non-thyroidal illness, resembling mild hypothyroidism both clinically and biochemically. The diagnosis is further complicated as methods for measuring thyroid function (thyrotropin and thyroxine) vary immensely according to methodology and background population. It is thus imperative to ensure a correct diagnosis by etiology (e.g., autoimmunity) before deciding to treat. Even then, there is controversy regarding whether or not treatment of such mild forms of hypothyroidism in elderly will improve mortality, morbidity, and quality of life. This should be studied in large cohorts of patients in long-term placebo-controlled trials with clinically relevant outcomes. Other cases of hypothyroidism, e.g., medications, iodine overload or hypothalamus-pituitary-hypothyroidism, each pose specific challenges to management of hypothyroidism; these cases are also more frequent in the elderly. Finally, adherence to treatment is generally challenging. This is also the case in elderly patients, which may necessitate measuring thyroid hormones at individually tailored intervals, which is important to avoid over-treatment with increased risk of cardiac morbidity and mortality, osteoporosis, cognitive dysfunction, and muscle deficiency.
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Affiliation(s)
- Grigoris Effraimidis
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Torquil Watt
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Internal Medicine, Endocrine Section, Copenhagen University Hospital Herlev Gentofte, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Cros-Brunsó L, Camacho-Rodríguez L, Martínez-González Á, Llévenes P, Salaices M, García-Redondo AB, Blanco-Rivero J. A Blunted Sympathetic Function and an Enhanced Nitrergic Activity Contribute to Reduce Mesenteric Resistance in Hyperthyroidism. Int J Mol Sci 2021; 22:ijms22020570. [PMID: 33430047 PMCID: PMC7826714 DOI: 10.3390/ijms22020570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
We aimed to determine whether an experimental model of hyperthyroidism could alter the function of sympathetic and nitrergic components of mesenteric innervation. For this purpose, male Wistar rats were divided into (1) control rats (CT) and (2) rats infused with L-Thyroxine (HT). Body weight gain and adipose tissue accumulation were lower in HT rats, while systolic blood pressure and citrate synthase activity in the soleus muscle were increased by HT. In segments from the superior mesenteric artery, the application of an electrical field stimulation (EFS) induced a vasoconstrictor response, which was lower in arteries from HT animals. The alpha-adrenoceptor antagonist phentolamine diminished EFS-induced vasoconstriction to a lower extent in HT arteries, while the purinergic receptor antagonist suramin reduced contractile response to EFS only in segments from CT. In line with this, noradrenaline release, tyrosine hydroxylase expression and activation and dopamine β hydroxylase expression were diminished in HT. The unspecific nitric oxide synthase (NOS) inhibitor L-NAME increased EFS-induced vasoconstriction more markedly in segments from HT rats. NO release was enhanced in HT, probably due to an enhancement in neuronal NOS activity, in which a hyperactivation of both PKC and PI3K-AKT signaling pathways might play a relevant role. In conclusion, perivascular mesenteric innervation might contribute to reduce the vascular resistance observed in hyperthyroidism.
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Affiliation(s)
- Laia Cros-Brunsó
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
| | - Laura Camacho-Rodríguez
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
| | - Ángel Martínez-González
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
| | - Pablo Llévenes
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
| | - Mercedes Salaices
- Department of Pharmacology and Therapeutics, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain;
- Research Institute University Hospital la Paz (IdIPaz), Calle de Pedro Rico 6, 28029 Madrid, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Calle de Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Ana Belen García-Redondo
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
- Research Institute University Hospital la Paz (IdIPaz), Calle de Pedro Rico 6, 28029 Madrid, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Calle de Melchor Fernández Almagro 3, 28029 Madrid, Spain
- Correspondence: (A.B.G.-R.); (J.B.-R.); Tel.: +34-91-497-5446 (A.B.G.-R. & J.B.-R.)
| | - Javier Blanco-Rivero
- Department of Physiology, School of Medicine, Universidad Autónoma de Madrid, Calle de Arzobispo Morcillo 4, 28029 Madrid, Spain; (L.C.-B.); (L.C.-R.); (Á.M.-G.); (P.L.)
- Research Institute University Hospital la Paz (IdIPaz), Calle de Pedro Rico 6, 28029 Madrid, Spain
- Center for Biomedical Research Network in Cardiovascular Diseases (CIBERCV), Calle de Melchor Fernández Almagro 3, 28029 Madrid, Spain
- Correspondence: (A.B.G.-R.); (J.B.-R.); Tel.: +34-91-497-5446 (A.B.G.-R. & J.B.-R.)
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14
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Grove-Laugesen D, Cramon PK, Malmstroem S, Ebbehoj E, Watt T, Hansen KW, Rejnmark L. Effects of Supplemental Vitamin D on Muscle Performance and Quality of Life in Graves' Disease: A Randomized Clinical Trial. Thyroid 2020; 30:661-671. [PMID: 31910101 DOI: 10.1089/thy.2019.0634] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background: Vitamin D deficiency has been proposed to have a role in the development and course of Graves' disease (GD). Muscle weakness and quality of life (QoL) impairments are shared features of GD and vitamin D deficiency. We aimed at investigating whether vitamin D supplementation would improve restoration of muscle performance and thyroid-related QoL in GD and at describing the effect of anti-thyroid medication (ATD) on these outcomes. Methods: In a double-blinded clinical trial, hyperthyroid patients with a first-time diagnosis of GD were randomized to vitamin D 70 μg (2800 IU)/day or matching placebo as add-on to standard ATD. At baseline and after 3 and 9 months of intervention, we assessed isometric muscle strength, muscle function tests, postural stability, body composition, and QoL-impairment by using the ThyPRO questionnaire. Linear mixed modeling was used to analyze between-group differences. (The DAGMAR study clinicaltrials.gov ID NCT02384668). Results: Nine months of vitamin D supplementation caused an attenuation of muscle strength increment in all muscle measures investigated, significant at knee extension 60° where the increase was 24% lower (p = 0.04) in the vitamin D group compared with placebo. Compared with placebo, vitamin D supplementation tended to reduce gain of lean body mass (-24%, p = 0.08). Vitamin D supplementation significantly impeded alleviation of Composite QoL and the same trend was observed for the Overall QoL-Impact and Impaired Daily Life scales. In response to ATD, all measures improved significantly. The increase in muscle strength ranged from 25% to 40% (pall < 0.001), and increment of lean body mass was 10% (p < 0.001). Large changes were observed in all QoL scales. Conclusions: Nine months of vitamin D supplementation caused unfavorable effects on restoration of muscle performance. In contrast, ATD treatment was associated with marked improvement in all measures of muscle performance and thyroid-related QoL. In patients with newly diagnosed GD, high-dose vitamin D supplementation should not be recommended to improve muscle function, but ATD is of major importance to alleviate muscle impairment.
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Affiliation(s)
- Diana Grove-Laugesen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Sofie Malmstroem
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Eva Ebbehoj
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Torquil Watt
- Department of Internal Medicine, Gentofte and Herlev Hospital, Herlev, Denmark
| | | | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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15
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Malmstroem S, Grove-Laugesen D, Riis AL, Bruun BJ, Ebbehoj E, Hansen KW, Watt T, Rejnmark L. Muscle Performance and Postural Stability Are Reduced in Patients with Newly Diagnosed Graves' Disease. Thyroid 2019; 29:783-789. [PMID: 30880636 DOI: 10.1089/thy.2018.0318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Reduced muscle strength is an acknowledged symptom of Graves' disease, but the knowledge on severity is sparse. This study aimed to investigate muscle strength, balance, and muscle function in patients with Graves' disease compared to age- and sex-matched healthy controls. Methods: Using a cross-sectional design, 55 patients newly diagnosed with Graves' disease were compared to 55 euthyroid controls, matched on sex, age, and menopausal status. Isometric muscle strength (N) and maximum force production (N/s) were measured across different muscles groups using a dynamometer chair and postural stability (balance) in different positions using a stadiometer. Muscle function was assessed using the Timed-Up-and-Go test and the Repeated Chair Stand test. Results: Patients and controls were well matched. Handgrip maximum muscle strength as well as strength at elbow and knee flexion and extension were significantly impaired in patients compared to controls. Maximum force production was only significantly reduced at elbow flexion. Patients performed the Timed-Up-and-Go and the Repeated Chair Stand test significantly slower than controls, and postural stability was significantly reduced in patients compared to controls in all positions. Free triiodothyronine correlated with reduced muscle strength and postural stability. Conclusions: At the time of diagnosis, Graves' disease is associated with impaired maximum muscle strength, performance, and balance, whereas maximum force production is overall comparable to euthyroid controls.
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Affiliation(s)
- Sofie Malmstroem
- 1 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Diana Grove-Laugesen
- 1 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Anne Lene Riis
- 2 Medical Department, Regional Hospital Horsens, Horsens, Denmark
| | | | - Eva Ebbehoj
- 1 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Torquil Watt
- 5 Department of Medical Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- 6 Department of Internal Medicine Gentofte Herlev, Copenhagen University Hospital, Gentofte Herlev, Denmark
| | - Lars Rejnmark
- 1 Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
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Shkil F, Siomava N, Voronezhskaya E, Diogo R. Effects of hyperthyroidism in the development of the appendicular skeleton and muscles of zebrafish, with notes on evolutionary developmental pathology (Evo-Devo-Path). Sci Rep 2019; 9:5413. [PMID: 30931985 PMCID: PMC6443675 DOI: 10.1038/s41598-019-41912-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Accepted: 03/20/2019] [Indexed: 12/17/2022] Open
Abstract
The hypothalamus-pituitary-thyroid (HPT) axis plays a crucial role in the metabolism, homeostasis, somatic growth and development of teleostean fishes. Thyroid hormones regulate essential biological functions such as growth and development, regulation of stress, energy expenditure, tissue compound, and psychological processes. Teleost thyroid follicles produce the same thyroid hormones as in other vertebrates: thyroxin (T4) and triiodothyronine (T3), making the zebrafish a very useful model to study hypo- and hyperthyroidism in other vertebrate taxa, including humans. Here we investigate morphological changes in T3 hyperthyroid cases in the zebrafish to better understand malformations provoked by alterations of T3 levels. In particular, we describe musculoskeletal abnormalities during the development of the zebrafish appendicular skeleton and muscles, compare our observations with those recently done by us on the normal developmental of the zebrafish, and discuss these comparisons within the context of evolutionary developmental pathology (Evo-Devo-Path), including human pathologies.
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Affiliation(s)
- Fedor Shkil
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, ul. Vavilova 26, Moscow, 119334, Russia
- Severtsov Institute of Ecology and Evolution, Russian Academy of Sciences, pr. Leninskii 33, Moscow, 119071, Russia
| | - Natalia Siomava
- Department of Anatomy, Howard University College of Medicine, 520W Street NW, 20059, Washington, DC, USA
| | - Elena Voronezhskaya
- Koltzov Institute of Developmental Biology, Russian Academy of Sciences, ul. Vavilova 26, Moscow, 119334, Russia
| | - Rui Diogo
- Department of Anatomy, Howard University College of Medicine, 520W Street NW, 20059, Washington, DC, USA.
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Abstract
Branched chain amino acids (BCAAs) are building blocks for all life-forms. We review here the fundamentals of BCAA metabolism in mammalian physiology. Decades of studies have elicited a deep understanding of biochemical reactions involved in BCAA catabolism. In addition, BCAAs and various catabolic products act as signaling molecules, activating programs ranging from protein synthesis to insulin secretion. How these processes are integrated at an organismal level is less clear. Inborn errors of metabolism highlight the importance of organismal regulation of BCAA physiology. More recently, subtle alterations of BCAA metabolism have been suggested to contribute to numerous prevalent diseases, including diabetes, cancer, and heart failure. Understanding the mechanisms underlying altered BCAA metabolism and how they contribute to disease pathophysiology will keep researchers busy for the foreseeable future.
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Affiliation(s)
- Michael Neinast
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Danielle Murashige
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
| | - Zoltan Arany
- Cardiovascular Institute, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA;
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18
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Marinello PC, Bernardes SS, Guarnier FA, Da Silva TNX, Borges FH, Lopes NMD, Simão ANC, Armani A, Cecchini R, Cecchini AL. Isoflavin-β modifies muscle oxidative stress and prevents a thyrotoxicosis-induced loss of muscle mass in rats. Muscle Nerve 2017; 56:975-981. [PMID: 28029692 DOI: 10.1002/mus.25546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/19/2016] [Accepted: 12/26/2016] [Indexed: 12/14/2022]
Abstract
INTRODUCTION We sought to verify whether isoflavin-beta (Iso-β), a mixture of isoflavones with antioxidant properties, could prevent thyrotoxicosis-induced loss of muscle mass and the participation of oxidative stress (OS) in the mechanisms of this prevention. METHODS Two experimental periods of thyrotoxicosis induction were used in Wistar rats: 3 and 5 days to assess Iso-β effects before and after thyrotoxicosis-induced muscle wasting. After euthanasia, peritoneal fat and gastrocnemius muscle were collected, weighed, and muscle OS was assessed. RESULTS Iso-β prevented the loss of gastrocnemius mass in thyrotoxic rats through the prevention of muscle OS generation during thyrotoxicosis, increasing muscle total antioxidant capacity and decreasing mitochondrial cytochrome c oxidase activity, lipid peroxidation, and protein carbonyl content. CONCLUSION Iso-β decreased oxidative modification of proteins, which is known to exert a major role during proteolysis induction and is present in thyrotoxic myopathy, highlighting the potential action of Iso-β in this complication of the disease. Muscle Nerve 56: 975-981, 2017.
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Affiliation(s)
- Poliana C Marinello
- Laboratory of Molecular Pathology, State University of Londrina, Rodovia Celso Garcia Cid, PR445, Km 380 Campus Universitário, Londrina, CEP 86051-990, Paraná, Brazil
| | - Sara S Bernardes
- Laboratory of Molecular Pathology, State University of Londrina, Rodovia Celso Garcia Cid, PR445, Km 380 Campus Universitário, Londrina, CEP 86051-990, Paraná, Brazil
| | - Flávia A Guarnier
- Laboratory of Pathophysiology and Muscle Adaptation, State University of Londrina, Londrina, Paraná, Brazil
| | - Thamara N X Da Silva
- Laboratory of Pathophysiology and Muscle Adaptation, State University of Londrina, Londrina, Paraná, Brazil
| | - Fernando H Borges
- Laboratory of Pathophysiology and Free Radicals, State University of Londrina, Londrina, Paraná, Brazil
| | - Natália M D Lopes
- Laboratory of Molecular Pathology, State University of Londrina, Rodovia Celso Garcia Cid, PR445, Km 380 Campus Universitário, Londrina, CEP 86051-990, Paraná, Brazil
| | - Andréa N C Simão
- Department of Pathology, Clinical and Toxicological Analysis, University Hospital of State University of Londrina, Londrina, Paraná, Brazil
| | - André Armani
- Department of Surgery, University Hospital of State University of Londrina, Londrina, Paraná, Brazil
| | - Rubens Cecchini
- Laboratory of Pathophysiology and Free Radicals, State University of Londrina, Londrina, Paraná, Brazil
| | - Alessandra L Cecchini
- Laboratory of Molecular Pathology, State University of Londrina, Rodovia Celso Garcia Cid, PR445, Km 380 Campus Universitário, Londrina, CEP 86051-990, Paraná, Brazil
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Gołyński M, Szpetnar M, Tatara MR, Lutnicki K, Gołyńska M, Kurek Ł, Szczepanik M, Wilkołek P. Content of selected amino acids in the gastrocnemius muscle during experimental hypothyroidism in rats. J Vet Res 2016. [DOI: 10.1515/jvetres-2016-0072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Abstract
Introduction: Thyroid hormones affect protein turnover, and in the case of hypothyroidism a decrease in protein synthesis and reduced release of certain amino acids from skeletal muscles are observed. Changes in the amino acid system of skeletal muscles may be responsible for the occurrence of muscle disorders. Material and Methods: The study measured the content of selected amino acids in the gastrocnemius muscle of Wistar rats during experimental hypothyroidism induced by oral administration of methimazole at a concentration of 0.05% in drinking water for 90 d. The rats were divided into four groups: E1 (n = 6) - experimental males, E2 (n = 6) - experimental females, C1 (n = 6) - control males, and C2 (n = 6) control females. Results: A statistically significant reduction occurred in leucine, isoleucine, and 1-methylhistidine levels in males, and 1-methylhistidine in females, in comparison to the control groups. Conclusion: The hypothyroidism-induced changes in amino acid content may be responsible for the occurrence of skeletal muscle function disorders.
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Affiliation(s)
- Marcin Gołyński
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
| | - Maria Szpetnar
- Chair and Department of Medical Chemistry, Medical University, 20-093 Lublin, Poland
| | - Marcin R. Tatara
- Department of Animal Physiology, Faculty of Veterinary Medicine, University of Life Sciences, 20-033 Lublin, Poland
| | - Krzysztof Lutnicki
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
| | - Magdalena Gołyńska
- Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
| | - Łukasz Kurek
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
| | - Marcin Szczepanik
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
| | - Piotr Wilkołek
- Department and Clinic of Animal Internal Diseases, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland
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Chng CL, Lim AYY, Tan HC, Kovalik JP, Tham KW, Bee YM, Lim W, Acharyya S, Lai OF, Chong MFF, Yen PM. Physiological and Metabolic Changes During the Transition from Hyperthyroidism to Euthyroidism in Graves' Disease. Thyroid 2016; 26:1422-1430. [PMID: 27465032 DOI: 10.1089/thy.2015.0602] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The serum metabolomic profile and its relationship to physiological changes during hyperthyroidism and restoration to euthyroidism are not known. This study aimed to examine the physiological, adipokine, and metabolomic changes that occur when subjects with Graves' disease transition from hyperthyroidism to euthyroidism with medical treatment. METHODS Chinese women between 21 and 50 years of age and with newly diagnosed Graves' disease attending the endocrine outpatient clinics in a single institution were recruited between July 2012 and September 2014. All subjects were treated with thioamides to achieve euthyroidism. Clinical parameters (body weight, body composition via bioelectrical impedance analysis, resting energy expenditure and respiratory quotient via indirect calorimetry, and reported total energy intake via 24 h food diary), biochemical parameters (thyroid hormones, lipid profile, fasting insulin and glucose levels), serum leptin, adiponectin, and metabolomics profiles were measured during hyperthyroidism and repeated in early euthyroidism. RESULTS Twenty four Chinese women with an average age of 36.3 ± 8.6 years were included in the study. The average duration of treatment that was required to reach euthyroidism for these subjects was 38 ± 16.3 weeks. There was a significant increase in body weight (52.6 ± 9.0 kg to 55.3 ± 9.4 kg; p < 0.001) and fat mass (14.3 ± 6.9 kg to 16.8 ± 6.5 kg; p = 0.005). There was a reduction in resting energy expenditure corrected for weight (28.7 ± 4.0 kcal/kg to 21.5 ± 4.1 kcal/kg; p < 0.001) and an increase in respiratory quotient (0.76 to 0.81; p = 0.037). Resting energy expenditure increased significantly with increasing free triiodothyronine levels (p = 0.007). Significant increases in total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were noted. There was no significant change in leptin levels, but adiponectin levels increased significantly (p = 0.018). Significant reductions in fasting C2, medium-chain, long-chain, and total acylcarnitines were observed, but no changes in the fat-free mass, branched chain amino acid levels, or insulin sensitivity during recovery from hyperthyroidism were noted. CONCLUSIONS Serum metabolomics profile changes complemented the physiological changes observed during the transition from hyperthyroidism to euthyroidism. This study provides a comprehensive and integrated view of the changes in fuel metabolism and energy balance that occur following the treatment of hyperthyroidism.
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Affiliation(s)
- Chiaw-Ling Chng
- 1 Department of Endocrinology, Singapore General Hospital , Singapore
| | | | - Hong Chang Tan
- 1 Department of Endocrinology, Singapore General Hospital , Singapore
| | - Jean-Paul Kovalik
- 2 Cardiovascular and Metabolic Disorders Program, Duke-NUS Graduate Medical School , Singapore
| | - Kwang Wei Tham
- 1 Department of Endocrinology, Singapore General Hospital , Singapore
| | - Yong Mong Bee
- 1 Department of Endocrinology, Singapore General Hospital , Singapore
| | - Weiying Lim
- 1 Department of Endocrinology, Singapore General Hospital , Singapore
| | - Sanchalika Acharyya
- 3 Centre for Quantitative Medicine, Duke-NUS Graduate Medical School , Singapore
| | - Oi Fah Lai
- 4 Department of Clinical Research, Singapore General Hospital , Singapore
| | - Mary Foong-Fong Chong
- 5 Singapore Institute for Clinical Sciences (SICS) , A*star, Brenner Centre for Molecular Medicine, Singapore
| | - Paul Michael Yen
- 2 Cardiovascular and Metabolic Disorders Program, Duke-NUS Graduate Medical School , Singapore
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21
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Peterson ME, Castellano CA, Rishniw M. Evaluation of Body Weight, Body Condition, and Muscle Condition in Cats with Hyperthyroidism. J Vet Intern Med 2016; 30:1780-1789. [PMID: 27667652 PMCID: PMC5115195 DOI: 10.1111/jvim.14591] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 07/16/2016] [Accepted: 08/31/2016] [Indexed: 01/29/2023] Open
Abstract
Background The contribution of fat loss versus muscle wasting to the loss of body weight seen in hyperthyroid cats is unknown. Objectives To investigate body weight, body condition score (BCS), and muscle condition score (MCS) in hyperthyroid cats. Animals Four hundred sixty‐two cats with untreated hyperthyroidism, 117 of which were reevaluated after treatment. Methods Prospective cross‐sectional and before–after studies. Untreated hyperthyroid cats had body composition evaluated (body weight, BCS, and MCS). A subset of these cats were reevaluated 3–12 months after treatment when euthyroid. Results Pretreatment body weight (median, 4.36 kg; IQR, 3.5 to 5.2 kg) was lower than premorbid weight (5.45 kg; IQR, 4.6 to 6.4 kg, P < .0001) recorded 1–2 years before diagnosis. 154 (35.3%) cats were thin or emaciated; 357 (77.3%) had loss of muscle mass. Cats showed increases in body weight (median, 4.1 kg to 5.0 kg), BCS (median, 3/5 to 3.5/5), and MCS (2/3 to 3/3) after treatment (P < .001), but mild‐to‐moderate muscle wasting persisted in 45% of treated cats. Conclusions and Clinical Importance Most hyperthyroid cats lose body weight but maintain an ideal or overweight BCS, with only a third being underweight. As in human hyperthyroid patients, this weight loss is associated with muscle wasting, which affects >75% of hyperthyroid cats. Successful treatment leads to weight gain and increase of BCS in most cats, but almost half fail to regain normal muscle mass.
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Affiliation(s)
- M E Peterson
- Animal Endocrine Clinic, New York, NY.,College of Veterinary Medicine, Cornell University, Ithaca, NY
| | | | - M Rishniw
- College of Veterinary Medicine, Cornell University, Ithaca, NY.,Veterinary Information Network, Davis, CA
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22
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Pirkmajer S, Chibalin AV. Na,K-ATPase regulation in skeletal muscle. Am J Physiol Endocrinol Metab 2016; 311:E1-E31. [PMID: 27166285 DOI: 10.1152/ajpendo.00539.2015] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 05/02/2016] [Indexed: 12/17/2022]
Abstract
Skeletal muscle contains one of the largest and the most dynamic pools of Na,K-ATPase (NKA) in the body. Under resting conditions, NKA in skeletal muscle operates at only a fraction of maximal pumping capacity, but it can be markedly activated when demands for ion transport increase, such as during exercise or following food intake. Given the size, capacity, and dynamic range of the NKA pool in skeletal muscle, its tight regulation is essential to maintain whole body homeostasis as well as muscle function. To reconcile functional needs of systemic homeostasis with those of skeletal muscle, NKA is regulated in a coordinated manner by extrinsic stimuli, such as hormones and nerve-derived factors, as well as by local stimuli arising in skeletal muscle fibers, such as contractions and muscle energy status. These stimuli regulate NKA acutely by controlling its enzymatic activity and/or its distribution between the plasma membrane and the intracellular storage compartment. They also regulate NKA chronically by controlling NKA gene expression, thus determining total NKA content in skeletal muscle and its maximal pumping capacity. This review focuses on molecular mechanisms that underlie regulation of NKA in skeletal muscle by major extrinsic and local stimuli. Special emphasis is given to stimuli and mechanisms linking regulation of NKA and energy metabolism in skeletal muscle, such as insulin and the energy-sensing AMP-activated protein kinase. Finally, the recently uncovered roles for glutathionylation, nitric oxide, and extracellular K(+) in the regulation of NKA in skeletal muscle are highlighted.
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Affiliation(s)
- Sergej Pirkmajer
- Institute of Pathophysiology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; and
| | - Alexander V Chibalin
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Nandi-Munshi D, Taplin CE. Thyroid-related neurological disorders and complications in children. Pediatr Neurol 2015; 52:373-82. [PMID: 25661286 DOI: 10.1016/j.pediatrneurol.2014.12.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 12/23/2014] [Accepted: 12/25/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Thyroid hormones exert critical roles throughout the body and play an important and permissive role in neuroendocrine, neurological, and neuromuscular function. METHODS We performed a PubMed search through June 2014 with search terms including "hypothyroidism," "hyperthyroidism," "neurological complications," "neuropathy," "myopathy," "congenital hypothyroidism," and "encephalopathy." Relevant publications reviewed included case series, individual case reports, systematic reviews, retrospective analyses, and randomized controlled trials. The neurological outcomes of congenital hypothyroidism were reviewed, along with the clinical features of associated neuromuscular syndromes of both hypothyroidism and hyperthyroidism, including other autoimmune conditions. Evidence for, and pathophysiological controversies surrounding, Hashimoto encephalopathy was also reviewed. RESULTS The establishment of widespread newborn screening programs has been highly successful in attenuating or preventing early and irreversible neurological harm resulting from congenital thyroid hormone deficiency, but some children continue to display neuromuscular, sensory, and cognitive defects in later life. Acquired disorders of thyroid function such as Hashimoto thyroiditis and Graves' disease are associated with a spectrum of central nervous system and/or neuromuscular dysfunction. However, considerable variation in clinical phenotype is described, and much of our knowledge of the role of thyroid disease in childhood neurological disorders is derived from adult case series. CONCLUSIONS Early and aggressive normalization of thyroxine levels in newborn infants with congenital hypothyroidism is important in minimizing neurological sequelae, but maternal thyroid hormone sources are also critically important to the early developing brain. A spectrum of neurological disorders has been reported in older children with acquired thyroid disease, but the frequency with which these occur remains poorly defined in the literature, and much must be extrapolated from adult data. A high index of suspicion for acquired thyroid disease is paramount in the investigation of many neurological disorders of youth, as many reported sequelae of hypothyroidism and hyperthyroidism are reversible with appropriate endocrine management.
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Affiliation(s)
- Debika Nandi-Munshi
- Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Craig E Taplin
- Division of Endocrinology and Diabetes, Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington.
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24
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Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; 2:819-29. [PMID: 24731660 PMCID: PMC4156923 DOI: 10.1016/s2213-8587(14)70034-8] [Citation(s) in RCA: 665] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The term sarcopenia refers to the loss of muscle mass that occurs with ageing. On the basis of study results showing that muscle mass is only moderately related to functional outcomes, international working groups have proposed that loss of muscle strength or physical function should also be included in the definition. Irrespective of how sarcopenia is defined, both low muscle mass and poor muscle strength are clearly highly prevalent and important risk factors for disability and potentially mortality in individuals as they age. Many chronic diseases, in addition to ageing, could also accelerate decrease of muscle mass and strength, and this effect could be a main underlying mechanism by which chronic diseases cause physical disability. In this Review, we address both age-related and disease-related muscle loss, with a focus on diabetes and obesity but including other disease states, and potential common mechanisms and treatments. Development of treatments for age-related and disease-related muscle loss might improve active life expectancy in older people, and lead to substantial health-care savings and improved quality of life.
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Affiliation(s)
- Rita Rastogi Kalyani
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Mark Corriere
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, The Johns Hopkins University, Baltimore, MD, USA
| | - Luigi Ferrucci
- Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA.
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Santini F, Marzullo P, Rotondi M, Ceccarini G, Pagano L, Ippolito S, Chiovato L, Biondi B. Mechanisms in endocrinology: the crosstalk between thyroid gland and adipose tissue: signal integration in health and disease. Eur J Endocrinol 2014; 171:R137-52. [PMID: 25214234 DOI: 10.1530/eje-14-0067] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Obesity and thyroid diseases are common disorders in the general population and they frequently occur in single individuals. Alongside a chance association, a direct relationship between 'thyroid and obesity' has been hypothesized. Thyroid hormone is an important determinant of energy expenditure and contributes to appetite regulation, while hormones and cytokines from the adipose tissue act on the CNS to inform on the quantity of energy stores. A continuous interaction between the thyroid hormone and regulatory mechanisms localized in adipose tissue and brain is important for human body weight control and maintenance of optimal energy balance. Whether obesity has a pathogenic role in thyroid disease remains largely a matter of investigation. This review highlights the complexity in the identification of thyroid hormone deficiency in obese patients. Regardless of the importance of treating subclinical and overt hypothyroidism, at present there is no evidence to recommend pharmacological correction of the isolated hyperthyrotropinemia often encountered in obese patients. While thyroid hormones are not indicated as anti-obesity drugs, preclinical studies suggest that thyromimetic drugs, by targeting selected receptors, might be useful in the treatment of obesity and dyslipidemia.
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Affiliation(s)
- Ferruccio Santini
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Paolo Marzullo
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Mario Rotondi
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Giovanni Ceccarini
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Loredana Pagano
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Serena Ippolito
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Luca Chiovato
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
| | - Bernadette Biondi
- Endocrinology UnitObesity Center, University Hospital of Pisa, Pisa, ItalyDepartment of Translational MedicineUniversity of Piemonte Orientale, Novara, ItalyDivision of General MedicineI.R.C.C.S. Istituto Auxologico Italiano, Verbania, ItalyUnit of Internal Medicine and EndocrinologyFondazione Salvatore Maugeri I.R.C.C.S., University of Pavia, Pavia, ItalyDepartment of Clinical Medicine and SurgeryUniversity of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy
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Peterson ME, Eirmann L. Dietary Management of Feline Endocrine Disease. Vet Clin North Am Small Anim Pract 2014; 44:775-88, vi-vii. [DOI: 10.1016/j.cvsm.2014.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Bjergved L, Jørgensen T, Perrild H, Laurberg P, Krejbjerg A, Ovesen L, Rasmussen LB, Knudsen N. Thyroid function and body weight: a community-based longitudinal study. PLoS One 2014; 9:e93515. [PMID: 24728291 PMCID: PMC3984087 DOI: 10.1371/journal.pone.0093515] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 03/07/2014] [Indexed: 01/17/2023] Open
Abstract
Objective Body weight and overt thyroid dysfunction are associated. Cross-sectional population-based studies have repeatedly found that thyroid hormone levels, even within the normal reference range, might be associated with body weight. However, for longitudinal data, the association is less clear. Thus, we tested the association between serum thyrotropin (TSH) and body weight in a community-based sample of adult persons followed for 11 years. Methods A random sample of 4,649 persons aged 18–65 years from a general population participated in the DanThyr study in 1997–8. We included 2,102 individuals who participated at 11-year follow-up, without current or former treatment for thyroid disease and with measurements of TSH and weight at both examinations. Multiple linear regression models were used, stratified by sex and adjusted for age, smoking status, and leisure time physical activity. Results Baseline TSH concentration was not associated with change in weight (women, P = 0.17; men, P = 0.72), and baseline body mass index (BMI) was not associated with change in TSH (women, P = 0.21; men, P = 0.85). Change in serum TSH and change in weight were significantly associated in both sexes. Weight increased by 0.3 kg (95% confidence interval [CI] 0.1, 0.4, P = 0.005) in women and 0.8 kg (95% CI 0.1, 1.4, P = 0.02) in men for every one unit TSH (mU/L) increase. Conclusions TSH levels were not a determinant of future weight changes, and BMI was not a determinant for TSH changes, but an association between weight change and TSH change was present.
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Affiliation(s)
- Lena Bjergved
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark
- * E-mail:
| | - Torben Jørgensen
- Research Centre for Prevention and Health, The Capital Region of Denmark, Glostrup, Denmark
- Faculty of Health Sciences, Copenhagen, Denmark
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
| | - Hans Perrild
- Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Peter Laurberg
- Faculty of Medicine, Aalborg University, Aalborg, Denmark
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Anne Krejbjerg
- Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
| | - Lars Ovesen
- Department of Gastroenterology, Slagelse Hospital, Slagelse, Denmark
| | - Lone Banke Rasmussen
- Department of Nutrition, National Food Institute, Technical University of Denmark, Søborg, Denmark
| | - Nils Knudsen
- Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark
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Abstract
Thyroid disorders are common in the general population and in hospitalized patients. Thyroid disease may present first with neurological complications or else may occur concurrently in patients suffering other neurological disorders, particularly those with an autoimmune etiology. For this reason neurologists will commonly encounter patients with thyroid disease. This chapter provides an overview of the neurological complications and associations of disorders of the thyroid gland. Particular emphasis is placed on conditions such as thyrotoxic periodic paralysis and myxedema coma in which the underlying thyroid disorder may be occult leading to a first, often emergency, presentation to a neurologist. Information about clinical features, diagnosis, pathogenesis, therapy, and prognosis is provided. Emphasis is placed on those aspects most likely to be relevant to the practicing neurologist and the interested reader is directed to references to good, recent review articles for further information.
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Affiliation(s)
- Clare A Wood-Allum
- Sheffield Institute for Translational Neuroscience, University of Sheffield and Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK
| | - Pamela J Shaw
- Sheffield Institute for Translational Neuroscience, University of Sheffield and Department of Neurology, Royal Hallamshire Hospital, Sheffield, UK.
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Huang YY, Gusdon AM, Qu S. Cross-talk between the thyroid and liver: A new target for nonalcoholic fatty liver disease treatment. World J Gastroenterol 2013; 19:8238-8246. [PMID: 24363514 PMCID: PMC3857446 DOI: 10.3748/wjg.v19.i45.8238] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 10/04/2013] [Accepted: 10/18/2013] [Indexed: 02/06/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) has been recognized as the most common liver metabolic disease, and it is also a burgeoning health problem that affects one-third of adults and is associated with obesity and insulin resistance now. Thyroid hormone (TH) and its receptors play a fundamental role in lipid metabolism and lipid accumulation in the liver. It is found that thyroid receptor and its isoforms exhibit tissue-specific expression with a variety of functions. TRβ1 is predominantly expressed in the brain and adipose tissue and TRβ2 is the major isoform in the liver, kidney and fat. They have different functions and play important roles in lipid metabolism. Recently, there are many studies on the treatment of NAFLD with TH and its analogues. We review here that thyroid hormone and TR are a potential target for pharmacologic treatments. Lipid metabolism and lipid accumulation can be regulated and reversed by TH and its analogues.
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30
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Udupa SV, Manjrekar PA, Udupa VA, Vivian D. Altered fructosamine and lipid fractions in subclinical hypothyroidism. J Clin Diagn Res 2013; 7:18-22. [PMID: 23449765 DOI: 10.7860/jcdr/2012/5011.2660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 11/10/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Thyroid function disorders lead to changes in the lipoprotein metabolism. OBJECTIVES To study the lipid and the glycaemic abnormalities in the subclinical hypothyroidism cases and to compare the same with the euthyroid, overt hypothyroid and the hyperthyroid subjects. METHODOLOGY Four groups, euthyroid (Group-I), hypothyroid (Group-II), subclinical hypothyroid (Group-III) and hyperthyroid (Group-IV), which consisted of 30 subjects each, of either sex, who were aged 25-55 years, underwent Fasting Plasma Glucose (FPG), fructosamine, lipid profile and total T3, T4 and TSH estimations. The subjects who were on lipid lowering or thyroid disorder drugs and known diabetics were excluded from the study. RESULTS In Group-III, all the lipid fractions were comparable to those of Group-II and they were significantly deranged, as compared to those of Group-I. The fructosamine levels were significantly higher in Group-II and Group-III (p<0.05), but the subclinical hypothyroid pool had statistically lower levels than the hypothyroid pool (376.63±54.73, 587.80±65.10). In the Group-IV patients, the LDL-C levels were significantly higher as compared to those in the euthyroid pool. The fructosamine levels were significantly lower in comparison with both the euthyroid and the hypothyroid pools (both in Groups-II and III). The FPG levels were higher in all the classes of the thyroid abnormalities (subclinical hypothyroidnot significant) but within the reference range of 70-100mg/dl. CONCLUSION Since the lipid derangement in subclinical hypothyroidism is on par with that in overt hypothyrodism, the subclinical hypothyroid cases also need to be treated similarly. The fructosamine values which are largely in excess of the FPG values, indicate a higher propensity to glycation and a decreased turnover of the proteins in the hypothyroid and the subclinical hypothyroid pools. Vice versa is true of the hyperthyroid pool. Fructosamine can be included in the thyroid work up of the patients to assess the metabolic function and the subsequent response after the initiation of the therapy.
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Affiliation(s)
- Sridevi V Udupa
- Assistant Professor, Department of Biochemistry, Tadikela Subbaiah Institute of Medical Sciences and Research Centre , Shivamogga, India
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Yeap BB, Alfonso H, Chubb SAP, Walsh JP, Hankey GJ, Almeida OP, Flicker L. Higher free thyroxine levels are associated with frailty in older men: the Health In Men Study. Clin Endocrinol (Oxf) 2012; 76:741-8. [PMID: 22077961 DOI: 10.1111/j.1365-2265.2011.04290.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Frailty is common in the elderly and predisposes to ill-health. Some symptoms of frailty overlap those of thyroid dysfunction, but it is unclear whether differences in thyroid status influence risk of frailty. We evaluated associations between thyroid status and frailty in older men. DESIGN Cross-sectional epidemiological study. PARTICIPANTS Community-dwelling men aged 70-89 years. MEASUREMENTS Circulating thyrotropin (TSH) and free thyroxine (FT(4) ) were assayed. Frailty was assessed as ≥3 of the Fatigue, Resistance, Ambulation, Illnesses and Loss (FRAIL) scale's 5 domains: fatigue; resistance (difficulty climbing flight of stairs); ambulation (difficulty walking 100 m); illness (>5); or weight loss (>5%), blinded to hormone results. RESULTS Of 3943 men, 27 had subclinical hyperthyroidism, 431 subclinical hypothyroidism and 608 were classified as being frail (15·4%). There was an inverse log-linear association of TSH with FT(4). There was no association between TSH and frailty. After adjusting for covariates, men with FT(4) in the highest two quartiles had increased odds of being frail (Q3:Q1, odds ratio [OR] = 1·32, 95% confidence interval [CI] = 1·01-1·73 and Q4:Q1, OR = 1·36, 95% CI = 1·04-1·79, P = 0·010 for trend). Higher FT(4) was associated with fatigue (P = 0·038) and weight loss (P < 0·001). The association between FT(4) and frailty remained significant when the analysis was restricted to euthyroid men. CONCLUSIONS High-normal FT(4) level is an independent predictor of frailty among ageing men. This suggests that even within the euthyroid range, circulating thyroxine may contribute to reduced physical capability. Further studies are needed to clarify the utility of thyroid function testing and the feasibility of preventing or reversing frailty in older men.
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Affiliation(s)
- Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Western Australia, Australia.
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Vigário PDS, Chachamovitz DSDO, Cordeiro MFN, Teixeira PDFDS, de Castro CLN, de Oliveira FP, Vaisman M. Effects of physical activity on body composition and fatigue perception in patients on thyrotropin-suppressive therapy for differentiated thyroid carcinoma. Thyroid 2011; 21:695-700. [PMID: 21615309 DOI: 10.1089/thy.2010.0052] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Subclinical thyrotoxicosis (scTox) may be associated with alterations in body composition and fatigue that can be possibly reversed with physical activity. The aim of the present study was to evaluate whether the systematic practice of physical activity improves lower extremity muscle mass and fatigue perception in patients with scTox. MATERIALS AND METHODS We studied 36 patients (2 men) with median age of 48.0 (43.0-51.0) years, body mass index of 27.4 (22.1-30.2) kg/m(2), thyrotropin <0.4 mU/L, and free thyroxine between 0.8 and 1.9 ng/dL and 48 control subjects (C group; 7 men). Patients were randomly divided in two groups according to the adherence to the exercise training: scTox-Tr (n = 19)-patients who adhered to the exercise intervention and scTox-Sed (n = 17)--patients who did not adhere to it. The C group did not participate in the randomization. The exercise training was supervised by a physical education instructor, and it was composed of 60 minutes of aerobic activity and stretching exercises, twice a week, during 12 weeks. In both groups, body composition was assessed (anthropometric method), and the Chalder Fatigue Scale was determined at baseline and after 3 months of intervention (scTox-Tr group) or observation (scTox-Sed group). RESULTS At baseline, patients with scTox had lower muscle mass and mid-thigh girth and more fatigue on the Chalder Fatigue Scale than euthyroid control subjects. The scTox-Tr group had an increase in muscle mass, reduction in the variables reflecting whole body fat, and lesser perception of fatigue during the exercise training period (p ≤ 0.05 for these parameters at the start and end of the exercise training period). CONCLUSIONS scTox is associated with lower muscle mass and mid-thigh girth and more fatigue. Physical activity training can partially ameliorate these characteristics. More studies are needed to determine what training program would be optimum, both in terms of beneficial effects and for avoiding potential adverse responses.
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Affiliation(s)
- Patrícia dos Santos Vigário
- Endocrine Clinic, University Hospital Clementino Fraga Filho, Physical Education School Federal University of Rio de Janeiro, Brazil.
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Gjedde S, Gormsen LC, Rungby J, Nielsen S, Jørgensen JOL, Pedersen SB, Riis AL, Weeke J, Møller N. Decreased lipid intermediate levels and lipid oxidation rates despite normal lipolysis in patients with hypothyroidism. Thyroid 2010; 20:843-9. [PMID: 20615126 DOI: 10.1089/thy.2009.0212] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Hypothyroidism decreases energy expenditure and combustion of fuels, but the reported effects on lipid metabolism and insulin sensitivity are divergent and there is a lack of studies assessing rates of lipolysis and lipid oxidation. The present study was conducted to test the hypotheses that hypothyroidism decreases lipolysis, blood concentrations of free fatty acid, lipid oxidation, and insulin sensitivity. METHODS We studied 11 hypothyroid patients (thyroid-stimulating hormone: 150 mU/L) with autoimmune thyroiditis (i) before and (ii) after 2 months of triiodothyronine-euthyroidism upon levothyroxine treatment and (iii) compared the patients to 10 healthy volunteers. Subjects underwent a 3-hour study in the basal state followed by a 3-hour euglycemic clamp study, and we used a combination of lipid blood concentrations, palmitate tracer dilution, and indirect calorimetry to assess lipid metabolism. RESULTS Compared to euthyroid control subjects and/or euthyroid posttreatment values hypothyroid patients were characterized by (i) 40%-50% decreased concentrations of plasma free fatty acids, palmitate, and 3-OH-butyrate (p < 0.05); (ii) >50% decreased lipid oxidation by indirect calorimetry (p < 0.001); (iii) unchanged whole-body lipolysis by palmitate dilution (all p's > 0.45); (iv) 50% increased triglyceride levels (p < 0.05); and (v) approximately 30% decreased insulin sensitivity judged by glucose infusion rate values (p = 0.05). CONCLUSIONS Our data show that hypothyroidism leads to decreased concentrations and oxidation rates of lipid intermediates and increased triglyceride concentrations in the presence of unaltered rates of lipolysis. The combination of normal lipolysis, low lipid oxidation rates, and high triglyceride concentrations is compatible with increased triglyceride synthesis.
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Affiliation(s)
- Signe Gjedde
- Medical Department M (Endocrinology and Diabetes), Aarhus University Hospital , Aarhus, Denmark.
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Mainenti MRM, Vigário PS, Teixeira PFS, Maia MDL, Oliveira FP, Vaisman M. Effect of levothyroxine replacement on exercise performance in subclinical hypothyroidism. J Endocrinol Invest 2009; 32:470-3. [PMID: 19468264 DOI: 10.1007/bf03346488] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Although muscle metabolism and exercise capacity seem to be affected in patients with subclinical hypothyroidism, there is little evidence indicating improvement of the exercise tolerance due to levothyroxine (L-T(4)) replacement. The aim of the present study was to verify possible cardiopulmonary changes during exercise in patients with subclinical hypothyroidism on L-T(4) replacement with a normal serum TSH for six months. Twenty-three patients with subclinical hypothyroidism were randomized into treated (no.=11) and untreated (no.=12) patients. A cardiopulmonary test was performed with a treadmill, using the modified Balke protocol. Heart rate, oxygen uptake, minute ventilation and other cardiopulmonary parameters were assessed at the 5th minute of exercise. FT4 levels increased while TSH normalized after hormone replacement. Oxygen uptake decreased significantly after hormone replacement (24.1+/-6.3 vs 17.1+/-4.2 ml x kg x min(-1); p=0.03).Minute ventilation also showed an enhanced performance in treated patients (28.0+/-8.1 vs 23.5+/-5.6 l x min(-1); p=0.03), as did the heart rate (128+/-17 vs 121+/-17 bpm; p=0.03). There were no changes in the untreated group. The results demonstrate that submaximal cardiopulmonary exercise performance improved after six months of TSH normalization and this improvement can help enhance the ability to carry out daily life activities in patients with subclinical hypothyroidism.
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Affiliation(s)
- M R M Mainenti
- Endocrine Clinic, University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil.
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Gjedde S, Vestergaard ET, Gormsen LC, Riis ALD, Rungby J, Møller N, Weeke J, Jørgensen JOL. Serum ghrelin levels are increased in hypothyroid patients and become normalized by L-thyroxine treatment. J Clin Endocrinol Metab 2008; 93:2277-80. [PMID: 18381578 DOI: 10.1210/jc.2007-2619] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
CONTEXT An interaction between ghrelin, which is implicated in the regulation of short- and long-term energy balance, and thyroid function has been reported in hyperthyroidism in which ghrelin levels are reversibly suppressed. We measured serum ghrelin levels and metabolic indices in hypothyroid patients before and after L-thyroxine replacement. PATIENTS AND METHODS Eleven patients were examined twice: 1) in the hypothyroid state and 2) after at least 2 months of euthyroidism. Ten healthy subjects served as a control group. Ghrelin was measured in conjunction with indirect calorimetry and a hyperinsulinemic euglycemic clamp. RESULTS Serum ghrelin levels were increased by 32% under basal conditions in the hypothyroid state (PRE) as compared with posttreatment (POST) (picograms per milliliter): 976.4 +/- 80.8 vs. 736.8 +/- 67.1 (P < 0.001). This difference prevailed during the clamp, but a decline was observed in both states: 641.4 +/- 82.2 vs. 444.3 +/- 66.8 microg/ml (P = 0.005). The hypothyroid state was associated with decreased resting energy expenditure, increased respiratory quotient, and insulin resistance. Serum ghrelin levels as well as the metabolic aberrations became normalized after L-thyroxine replacement as compared with the control subjects. CONCLUSION Serum ghrelin levels are reversibly increased in hypothyroid patients. It remains to be investigated whether this represents a direct effect of iodothyronines on ghrelin secretion or clearance or a compensatory response to the abnormal energy metabolism in hypothyroid patients.
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Affiliation(s)
- Signe Gjedde
- Medical Department M, Aarhus University Hospital, Nørrebrogade 42, Aarhus C, Denmark.
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Abstract
Leptin, which is produced by adipocytes, is known to be an important regulator of food intake and energy storage. Disturbance of thyroid function is associated with marked changes in both body weight and energy expenditure, and it has therefore been the subject of much research to study the mutual roles of leptin and thyroid hormones in this respect. Despite intensive research in this field, results are still not very clear. The aim of this review has been to update the current state of knowledge of leptin related to thyroid pathophysiology.
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Affiliation(s)
- Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Rigshospitalet, National University Hospital, Copenhagen, Denmark.
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Short KR, Nygren J, Nair KS. Effect of T(3)-induced hyperthyroidism on mitochondrial and cytoplasmic protein synthesis rates in oxidative and glycolytic tissues in rats. Am J Physiol Endocrinol Metab 2007; 292:E642-7. [PMID: 17047159 DOI: 10.1152/ajpendo.00397.2006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hyperthyroidism increases metabolic rate, mitochondrial ATP production, and protein synthesis, but it remains to be determined whether all tissues and synthesis of specific protein pools are equally affected by hyperthyroidism. Previous studies showed that mitochondrial function was less responsive to elevated triiodothyronine (T(3)) levels in the low-oxidative plantaris muscle compared with other tissues in rats. We tested the hypothesis that in T(3)-treated animals mitochondrial protein synthesis would increase in oxidative but not glycolytic tissues. Male rats received either T(3) (200 mug/day, n = 10) or saline (controls, n = 9) by subcutaneous pump for 14 days, and then in vivo protein synthesis rates were measured using [(15)N]phenylalanine in liver, heart, plantaris, and red gastrocnemius (Red Gast). Mitochondrial protein synthesis rate in T(3)-treated rats was higher than in controls by 62% in Red Gast and plantaris and 89 and 115% in liver and heart, respectively (P < 0.01). Cytoplasmic protein synthesis rates in the T(3) group were 107-176% higher than control values (P < 0.01). There was also indirect evidence that protein breakdown was increased in all tissues of the T(3)-treated rats. Phosphorylation of selected regulators of protein synthesis in plantaris and Red Gast (mTOR, p70 S6 kinase, 4E-BP1), however, were not significantly affected by T(3). We conclude that T(3) infusion stimulates a general increase in mitochondrial and cytoplasmic protein synthesis rate among tissues and that this does not appear to explain the tissue-specific responses in mitochondrial oxidative capacity.
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Affiliation(s)
- Kevin R Short
- Endocrine Research Unit, Mayo Clinic College of Medicine, 200 First St. SW, Rochester, MN 55905, USA
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Pantos C, Mourouzis I, Paizis I, Malliopoulou V, Xinaris C, Moraitis P, Cokkinos AD, Cokkinos DV. Pharmacological inhibition of TRalpha1 receptor potentiates the thyroxine effect on body weight reduction in rats: potential therapeutic implications in controlling body weight. Diabetes Obes Metab 2007; 9:136-8. [PMID: 17199732 DOI: 10.1111/j.1463-1326.2006.00587.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
It has been previously reported that thyroid hormone receptor alpha1 (TRalpha1) is involved in the regulation of food intake and heart rhythm. Herein, we show that pharmacological inhibition of TRalpha1 by dronedarone, an amiodarone like compound (shown to antagonize thyroid hormone binding to TRalpha1), prevented the thyroid hormone induced increase in food intake and heart rate acceleration in rats. This resulted in a marked reduction in body weight. It is likely that thyroid analogs may prove potential therapeutic agents for controlling body weight.
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Bousquet-Santos K, Vaisman M, Barreto ND, Cruz-Filho RA, Salvador BA, Frontera WR, Nobrega AC. Resistance Training Improves Muscle Function and Body Composition in Patients With Hyperthyroidism. Arch Phys Med Rehabil 2006; 87:1123-30. [PMID: 16876559 DOI: 10.1016/j.apmr.2006.04.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2006] [Accepted: 04/26/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the effect of resistance training on skeletal muscle performance and body composition in patients with medically treated hyperthyroidism. DESIGN Nonrandomized controlled trial. SETTING Large public tertiary hospital. PARTICIPANTS Sixteen sedentary patients with recent clinical diagnosis and laboratory confirmation of hyperthyroidism (7 men, 9 women; age, 38+/-11 y; weight, 58.4+/-2.6 kg; height, 1.6+/-0.3m) were assigned to the control group (medical therapy; n=9) or training group (medical therapy associated with resistance training; n=7). An age- and sex-matched healthy group served as controls (3 men, 5 women; age, 40+/-3 y; weight, 68.4+/-4.3 kg; height, 1.6+/-0.3m). INTERVENTION Resistance training twice a week for 16 weeks. MAIN OUTCOME MEASURES Peak muscular strength (by dynamometry and 1 repetition maximum method) and endurance (30% of peak force) for 7 movements and anthropometric measurements. RESULTS The hyperthyroid patients as a group had lower baseline overall strength values when compared with healthy subjects (200.3+/-16.0 kg vs 274.9+/-21.8 kg, respectively; P=.006). Overall absolute increases in strength (49 kg vs 91 kg, P<.05) and endurance (78.5x10(2)kg/s vs 176.9x10(2)kg/s, P<.05) were higher in the training group compared with the control group. Body weight increased in both groups, but the sum of muscular circumference increased only in the training group (training group, 92.6+/-3.3 cm vs 97.1+/-3.8 cm; control group, 94.6+/-2.2 cm vs 94.4+/-2.1cm; P<.05), with no change in the sum of skinfolds. CONCLUSIONS Resistance training accelerates the recovery of skeletal muscle function and promotes weight gain based on muscle mass improvement in patients with medically treated hyperthyroidism.
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Affiliation(s)
- Kelb Bousquet-Santos
- Department of Physiology and Pharmacology, Universidade Federal Fluminense, Niteroi, RJ, Brazil
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Yamada T, Mishima T, Sakamoto M, Sugiyama M, Matsunaga S, Wada M. Oxidation of myosin heavy chain and reduction in force production in hyperthyroid rat soleus. J Appl Physiol (1985) 2006; 100:1520-6. [PMID: 16397059 DOI: 10.1152/japplphysiol.01456.2005] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We tested the hypothesis that a force reduction in hyperthyroid rat soleus muscle would be associated with oxidative modification in myosin heavy chain (MHC). Daily injection of thyroid hormone [3,5,3'-triiodo-L-thyronine (T3)] for 21 days depressed isometric forces of whole soleus muscle across a range of stimulus frequencies (P < 0.01). In fiber bundles, hyperthyroidism also led to pronounced reductions (P < 0.01) in both K+ - and 4-chloro-m-cresol-induced contracture forces. The degrees of the reductions were similar between these two contractures that were induced by distinct reagents. Treatment with T3 elicited a significant decrease ( approximately 14%; P < 0.05) in the relative content of MHC contained in myofibrillar proteins. The content of carbonyl groups in myofibrillar protein extracts was elevated (P < 0.05) by approximately 50% in T3-treated muscles. Immunoblot analyses on T3-treated muscles showed a greater increase (106%; P < 0.05) of the carbonyl content in MHC than in myofibrillar protein extracts. These data suggest that in hyperthyroidism the decrease in force production of skeletal muscles may stem primarily from failure in myofibrillar protein function resulting from oxidative modification of MHC.
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Affiliation(s)
- Takashi Yamada
- Graduate School of Biosphere Science, Hiroshima University, Hiroshima, Japan
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