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Shi C, Liu X, Du Z, Tian L. Impaired Sensitivity to Thyroid Hormones is Associated with the Risk of Diabetic Nephropathy in Euthyroid Patients with Type 1 Diabetes Mellitus. Diabetes Metab Syndr Obes 2024; 17:611-618. [PMID: 38347912 PMCID: PMC10860863 DOI: 10.2147/dmso.s449870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/19/2024] [Indexed: 02/15/2024] Open
Abstract
Purpose This study aims to investigate the relationship between thyroid and type 1 diabetic nephropathy (T1DN) in euthyroid populations, focusing on thyroid hormone sensitivity. Methods A cross-sectional study was conducted between January 2016 and December 2021, including 357 euthyroid patients with type 1 diabetes mellitus (T1DM). Parameters representing thyroid hormone sensitivity were assessed, including the thyroid feedback quantile-based index (TFQI), parameter thyroid feedback quantile index (PTFQI), thyroid stimulating hormone index (TSHI), thyrotropin thyroxine resistance index (TT4RI), and free triiodothyronine/free thyroxine (FT3/FT4). Logistic regression and restricted cubic spline regression were performed to detect the association between thyroid hormone sensitivity and the risk of T1DN. Results The study found a negative correlation between the risk of T1DN and FT3/FT4 in euthyroid T1DM patients (OR 0.71, 95% CI 0.51-0.97, P <0.01). PTFQI (P<0.05), TSHI (P<0.05), and TT4RI (P<0.01) showed an M-shaped nonlinear relationship with the risk of T1DN. Elevated risk of T1DN was associated with PTFQI, TSHI, and TT4RI values outside the range of zero, 2.3-3.88, and 27.56-32.19, respectively. Conclusion This study confirms the relationship between impaired thyroid hormone sensitivity and the risk of T1DN in euthyroid patients. It emphasizes the importance of evaluating thyroid hormone sensitivity in T1DM patients, even when their thyroid function appears normal, to promptly prevent the occurrence of T1DN.
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Affiliation(s)
- Chunxia Shi
- School of Medicine, Jiangsu University, Zhenjiang, People’s Republic of China
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People’s Republic of China
- Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu Province, People’s Republic of China
| | - Xiaoning Liu
- Institution of Health Statistics and Epidemiology, School of Public Health, Lanzhou University, Lanzhou, People’s Republic of China
| | - Zouxi Du
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People’s Republic of China
- Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu Province, People’s Republic of China
- The First School of Clinical Medicine, Lanzhou University, Lanzhou, People’s Republic of China
| | - Limin Tian
- Department of Endocrinology, Gansu Provincial Hospital, Lanzhou, People’s Republic of China
- Clinical Research Center for Metabolic Diseases, Lanzhou, Gansu Province, People’s Republic of China
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2
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Liu X, Li Y, Chai Y, Zhang Y, Zhang L, Zhang H. Thyroid function and thyroid homeostasis parameters are associated with increased urinary albumin excretion in euthyroid individuals over 60 years old from NHANES. Front Endocrinol (Lausanne) 2024; 14:1285249. [PMID: 38260133 PMCID: PMC10800926 DOI: 10.3389/fendo.2023.1285249] [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: 09/15/2023] [Accepted: 12/04/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction The relationship between thyroid function/homeostasis parameters and renal function has been extensively studied. However, the relationship between thyroid function and thyroid homeostasis parameters with albuminuria among elderly individuals remains unclear. Methods The population was divided into an albuminuria group and a non-albuminuria group for baseline characteristic difference analysis. Multivariable logistic regression was used to test the association between thyroid function, and thyroid homeostasis parameters and albuminuria. The nonlinear relationship was explored with restricted cubic splines. Meanwhile, we investigated whether the relationship also existed in the diabetes and hypertension subgroups. Receiver operating characteristic (ROC) curves were used to assess the effectiveness of the indices. Results FT4 and TFQIFT4 were positively correlated with albuminuria (OR = 1.12; 95% CI = 1.02-1.23, p = 0.02; OR = 1.79; 95% CI = 1.08-2.99, p = 0.03), and FT3/FT4 was negatively correlated with albuminuria (OR = 0.03; 95% CI = 0.00-0.26, p = 0.003). Additionally, the nonlinear relationship between FT3/FT4 as well as TSHI and albuminuria was approximately U-shaped. Similar results were observed in the hypertension subgroup but not in the diabetes subgroup. There was a U-shaped nonlinear relationship between FT3 and albuminuria in the diabetes group. In addition, FT3/FT4 performed better than TFQI, TT4RI, and TSHI in ROC analyses for albuminuria prediction. Conclusion FT4, TFQIFT4, and a low FT3/FT4 ratio were risk factors for albuminuria in euthyroid individuals over 60 years old. However, FT3 was more associated with albuminuria in the diabetes subgroup. TSH was not associated with albuminuria in any analysis. In our study, we attempted to provide more reasonable thyroid parameters and basis for evaluating patients with underlying albuminuria. FT3/FT4 may be used as a helpful indicator to predict albuminuria and provide novel ideas for the evaluation and treatment of albuminuria.
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Affiliation(s)
- Xue Liu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuchen Li
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuwei Chai
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Yuhao Zhang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Zhang
- Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, China
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, China
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3
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Interplay between cardiovascular and thyroid dysfunctions: A review of clinical implications and management strategies. Endocr Regul 2022; 56:311-328. [DOI: 10.2478/enr-2022-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract
Cardiovascular diseases (CVD) and thyroid dysfunction are two of the most prevailing disorders in the world that are closely interlinked. Actions of thyroid hormones are mediated via thyroid receptors present in the myocardium and the vascular tissue. Primary mechanism that links thyroid dysfunction with CVD is the modification of cardiovascular risk factors (dyslipidemia, blood pressure, coagulation parameters, etc.) resulting in endothelial and left ventricular systolic and diastolic dysfunction.
Both overt and subclinical hyperthyroidism and hypothyroidism may cause adverse alterations in cardiac function. Hyperthyroidism gives rise to palpitation, atrial fibrillation, systolic hypertension, and heart failure, whereas hypothyroidism increases diastolic hypertension, pericardial effusion, and the risk of ischemic heart disease via altering lipid and coagulation parameters. Early recognition and treatment of thyroid dysfunction may prevent adverse cardiovascular events in patients with or without pre-existing CVD.
Certain cardiac conditions and medications can cause alterations in thyroid function that may predispose an individual to higher morbidity and mortality. In certain situations, thyroid dysfunction treatment may have cardiovascular benefits. This study deals with the interplay between cardiovascular and thyroid dysfunctions associated with clinical implications and management strategies.
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Effect of hypothyroidism on contractile performance of isolated end-stage failing human myocardium. PLoS One 2022; 17:e0265731. [PMID: 35404981 PMCID: PMC9000031 DOI: 10.1371/journal.pone.0265731] [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: 05/18/2021] [Accepted: 03/07/2022] [Indexed: 11/23/2022] Open
Abstract
The relationship between hypothyroidism and the occurrence and progression of heart failure (HF) has had increased interest over the past years. The low T3 syndrome, a reduced T3 in the presence of normal thyroid stimulating hormone (TSH), and free T4 concentration, is a strong predictor of all-cause mortality in HF patients. Still, the impact of hypothyroidism on the contractile properties of failing human myocardium is unknown. Our study aimed to investigate that impact using ex-vivo assessment of force and kinetics of contraction/relaxation in left ventricular intact human myocardial muscle preparations. Trabeculae were dissected from non-failing (NF; n = 9), failing with no hypothyroidism (FNH; n = 9), and failing with hypothyroidism (FH; n = 9) hearts. Isolated muscle preparations were transferred into a custom-made setup where baseline conditions as well as the three main physiological modulators that regulate the contractile strength, length-dependent and frequency-dependent activation, as well as β-adrenergic stimulation, were assessed under near-physiological conditions. Hypothyroidism did not show any additional significant impact on the contractile properties different from the recognized alterations usually detected in such parameters in any end-stage failing heart without thyroid dysfunction. Clinical information for FH patients in our study revealed they were all receiving levothyroxine. Absence of any difference between failing hearts with or without hypothyroidism, may possibly be due to the profound effects of the advanced stage of heart failure that concealed any changes between the groups. Still, we cannot exclude the possibility of differences that may have been present at earlier stages. The effects of THs supplementation such as levothyroxine on contractile force and kinetic parameters of failing human myocardium require further investigation to explore its full potential in improving cardiovascular performance and cardiovascular outcomes of HF associated with hypothyroidism.
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Yang Z, Duan P, Li W, Nie R, Lou X, Wang L, Wu K, Liu J, Tu P, Lai X. The Correlation between Thyroid Hormone Levels and the Kidney Disease Progression Risk in Patients with Type 2 Diabetes. Diabetes Metab Syndr Obes 2022; 15:59-67. [PMID: 35023940 PMCID: PMC8743497 DOI: 10.2147/dmso.s347862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/15/2021] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We investigated the relationship between thyroid hormones and the risk of diabetic kidney disease (DKD) progression. METHODS A total of 452 patients with type 2 diabetes were included, and a cross-sectional analysis was performed. Urine albumin/creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) were used to diagnose persistent albuminuria and stage chronic kidney disease, respectively. The Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline was used to describe the risk of DKD progression (low, moderate, and high or very high risks). RESULTS The DKD group had higher levels of thyroid-stimulating hormone (TSH) and lower levels of free triiodothyronine (FT3) and free thyroxine (FT4) than the non-DKD group. The prevalence of thyroid dysfunction in the DKD group was significantly higher than in the non-DKD group, especially the prevalence of subclinical hypothyroidism. FT3 levels decreased gradually with the deterioration of DKD. TSH levels increased with an increasing KDIGO category. FT3 and FT4 levels were negatively correlated with serum creatinine levels and ACR, and positively correlated with eGFR. Contrastingly, TSH was positively correlated with ACR, and negatively correlated with eGFR. After adjustment, an increase in FT3 levels significantly reduced the risk of DKD [odds ratio, OR (95% confidence interval, CI)=0.58 (0.42-0.79)] and DKD progression [ORs (95% CIs)=0.65 (0.45-0.93) for the moderate risk group and 0.50 (0.33-0.74) for the high or very high-risk group, using the low-risk group as a reference]. FT3 levels below 4.30 pmol/L in men and 3.99 pmol/L in women were the cut-off points for an increased risk of DKD progression. CONCLUSION Low FT3 level is an independent risk factor for DKD and DKD progression. FT3 ≤4.30 pmol/L in men and ≤3.99 pmol/L in women will greatly increase the risk of kidney disease progression in patients with type 2 diabetes.
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Affiliation(s)
- Zhi Yang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, People’s Republic of China
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
- Jiangxi Medical College of Nanchang University, Nanchang, 330036, Jiangxi, People’s Republic of China
| | - Peng Duan
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Weihong Li
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Ronghui Nie
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
- Jiangxi Medical College of Nanchang University, Nanchang, 330036, Jiangxi, People’s Republic of China
| | - Xiaoyang Lou
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
- Jiangxi University of Traditional Chinese Medicine, Nanchang, 330004, Jiangxi, People’s Republic of China
| | - Lina Wang
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Kexia Wu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Jiang Liu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Ping Tu
- Department of Endocrinology and Metabolism, The Third Hospital of Nanchang, Nanchang, 330000, Jiangxi, People’s Republic of China
| | - Xiaoyang Lai
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Nanchang University, Nanchang, 330008, Jiangxi, People’s Republic of China
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Luo Y, Yu F, Feng X, Liao D, Ying Y, Li X, Huang Q, Liu Z, Wei M, Zhao T, Zhang L, Tu R, Xia J. Molecular Biomarkers Associated with Early-Onset Symptomatic Intracranial Atherosclerosis. Clin Interv Aging 2021; 16:1013-1022. [PMID: 34103904 PMCID: PMC8179742 DOI: 10.2147/cia.s309945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/13/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose Previous studies have shown a rising incidence of early-onset symptomatic intracranial atherosclerosis (sICAS), which has brought a severe economic burden to social development. This study aimed to evaluate the molecular biomarkers associated with early-onset sICAS and to seek possible intervention strategies for early prevention. Patients and Methods We consecutively recruited patients with sICAS and divided them into two groups based on age: early-onset sICAS group as age ≤60 years old and late-onset sICAS group as age >60 years old. We collected and compared the demographic data and laboratory results of each group. A bivariate logistic regression model was applied to evaluate the independent molecular biomarkers of early-onset sICAS. Results A total of 1007 subjects with sICAS were enrolled in this study, comprising 519 patients in the early-onset sICAS group and 488 patients in the late-onset sICAS group. Bivariate logistic regression analysis demonstrated an increased level of white blood cell, platelet, albumin globulin ratio, free triiodothyronine, and a decreased level of total bile acid, urea nitrogen, high-density lipoprotein, homocysteine, and fibrinogen in the early-onset sICAS group when compared to the late-onset group. Conclusion Our study showed the relevance between early sICAS and circulating levels of different molecular biomarkers. Detection of these related molecular biomarkers may provide a simple way for early sICAS preventions in the future.
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Affiliation(s)
- Yunfang Luo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Fang Yu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Xianjing Feng
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Di Liao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Yuanlin Ying
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Xi Li
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Qin Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Zeyu Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Minping Wei
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Tingting Zhao
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Lin Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Ruxin Tu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.,Clinical Research Center for Cerebrovascular Disease of Hunan Province, Central South University, Changsha, Hunan, People's Republic of China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
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7
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UV-B Filter Octylmethoxycinnamate Alters the Vascular Contractility Patterns in Pregnant Women with Hypothyroidism. Biomedicines 2021; 9:biomedicines9020115. [PMID: 33530401 PMCID: PMC7912698 DOI: 10.3390/biomedicines9020115] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 02/06/2023] Open
Abstract
Increasing evidence relating the exposure and/or bioaccumulation of endocrine-disrupting compounds (EDCs) with cardiovascular system are arising. Octylmethoxycinnamate (OMC) is the most widely used UV-B filter and as EDC interacts with TH receptors. However, their effects on thyroid diseases during pregnancy remain unknown. The purpose of this work was to assess the short- and long-term effects of OMC on arterial tonus of pregnant women with hypothyroidism. To elucidate this, human umbilical artery (HUA) rings without endothelium were used to explore the vascular effects of OMC by arterial and cellular experiments. The binding energy and the modes of interaction of the OMC into the active center of the TSHR and THRα were analyzed by molecular docking studies. Our results indicated that OMC altered the contractility patterns of HUA contracted with serotonin, histamine and KCl, possibly due to an interference with serotonin and histamine receptors or an involvement of the Ca2+ channels. The molecular docking analysis show that OMC compete with T3 for the binding center of THRα. Taken together, these findings pointed out to alterations in HUA reactivity as result of OMC-exposure, which may be involved in the development and increased risk of cardiovascular diseases.
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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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9
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Jankauskas SS, Morelli MB, Gambardella J, Lombardi A, Santulli G. Thyroid hormones regulate both cardiovascular and renal mechanisms underlying hypertension. J Clin Hypertens (Greenwich) 2020; 23:373-381. [PMID: 33377271 PMCID: PMC8030083 DOI: 10.1111/jch.14152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/27/2020] [Accepted: 12/13/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Stanislovas S Jankauskas
- Department of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA
| | - Marco B Morelli
- Department of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA.,Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA
| | - Jessica Gambardella
- Department of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA.,Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA.,Department of Advanced Biomedical Science, "Federico II" University, and International Translational Research and Medical Education Consortium (ITME), Naples, Italy
| | - Angela Lombardi
- Department of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA.,Department of Microbiology and Immunology, Albert Einstein College of Medicine, New York, NY, USA
| | - Gaetano Santulli
- Department of Medicine, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Albert Einstein College of Medicine, New York, NY, USA.,Department of Molecular Pharmacology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Aging Research, Albert Einstein College of Medicine, New York, NY, USA.,Department of Advanced Biomedical Science, "Federico II" University, and International Translational Research and Medical Education Consortium (ITME), Naples, Italy
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10
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Khan R, Sikanderkhel S, Gui J, Adeniyi AR, O'Dell K, Erickson M, Malpartida J, Mufti Z, Khan T, Mufti H, Al-Adwan SA, Alvarez D, Davis J, Pendley J, Patel D. Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure. Cardiol Res 2020; 11:68-75. [PMID: 32256913 PMCID: PMC7092768 DOI: 10.14740/cr1034] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 02/21/2020] [Indexed: 12/12/2022] Open
Abstract
The association between thyroid hormones and cardiovascular conditions has been well studied, specifically, the effects of hypothyroidism on cardiomyopathy, and hyperthyroidism with arrhythmias. Nonetheless, an explicit correlation between hyperthyroidism and cardiomyopathy has yet to be established. Medical databases MEDLINE and PubMed were accessed and queried as primary sources for data acquisition. Search criteria consisted of “hyperthyroidism”, “heart failure”, and “thyroid and cardiovascular system”, which allowed the retrieval of relevant and recent works. From these sources, a consensus was developed and employed to yield an updated review of the etiology of heart failure in the setting of hyperthyroidism. It is rare for patients with hyperthyroidism to remain in a chronic hyperthyroid state, making it difficult to analyze subsequent long-term effects on the cardiovascular system. Related to heart failure, some studies have demonstrated no change in ejection fraction, while others have shown an acute change along with diastolic dysfunction, with or without an underlying rhythm abnormality. Further investigation is warranted to elucidate the mechanism driving such cardiac dysfunction, and whether it is due to vascular changes, tachyarrhythmias, or myocyte remodeling and fibrosis. The intent of this review article is to improve our understanding of how a hyperthyroid state affects cardiovascular function. An enhanced understanding of the effects on cardiovascular physiology will afford physicians the ability to provide more comprehensive care in consideration of both endocrine and cardiovascular pathologies.
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Affiliation(s)
- Rafay Khan
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Saad Sikanderkhel
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Junhong Gui
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Abdul-Razaq Adeniyi
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Kimberly O'Dell
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Marc Erickson
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Juan Malpartida
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Zarmina Mufti
- Frontier Medical College, Karakoram Highway, Mansehra Rd, Abbottabad, Khyber Pakhtunkhwa, Pakistan
| | - Taiba Khan
- Bucknell University, 701 Moore Ave, Lewisburg, PA 17837, USA
| | - Harris Mufti
- Frontier Medical College, Karakoram Highway, Mansehra Rd, Abbottabad, Khyber Pakhtunkhwa, Pakistan
| | - Saif Aldeen Al-Adwan
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Diana Alvarez
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Joshua Davis
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Joseph Pendley
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
| | - Dharmendra Patel
- Department of Cardiology, University of Tennessee at Chattanooga, 975 E 3rd Street, Chattanooga, TN 37403, USA
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von Hafe M, Neves JS, Vale C, Borges-Canha M, Leite-Moreira A. The impact of thyroid hormone dysfunction on ischemic heart disease. Endocr Connect 2019; 8:R76-R90. [PMID: 30959486 PMCID: PMC6499922 DOI: 10.1530/ec-19-0096] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/02/2019] [Indexed: 12/16/2022]
Abstract
Thyroid hormones have a central role in cardiovascular homeostasis. In myocardium, these hormones stimulate both diastolic myocardial relaxation and systolic myocardial contraction, have a pro-angiogenic effect and an important role in extracellular matrix maintenance. Thyroid hormones modulate cardiac mitochondrial function. Dysfunction of thyroid axis impairs myocardial bioenergetic status. Both overt and subclinical hypothyroidism are associated with a higher incidence of coronary events and an increased risk of heart failure progression. Endothelial function is also impaired in hypothyroid state, with decreased nitric oxide-mediated vascular relaxation. In heart disease, particularly in ischemic heart disease, abnormalities in thyroid hormone levels are common and are an important factor to be considered. In fact, low thyroid hormone levels should be interpreted as a cardiovascular risk factor. Regarding ischemic heart disease, during the late post-myocardial infarction period, thyroid hormones modulate left ventricular structure, function and geometry. Dysfunction of thyroid axis might even be more prevalent in the referred condition since there is an upregulation of type 3 deiodinase in myocardium, producing a state of local cardiac hypothyroidism. In this focused review, we summarize the central pathophysiological and clinical links between altered thyroid function and ischemic heart disease. Finally, we highlight the potential benefits of thyroid hormone supplementation as a therapeutic target in ischemic heart disease.
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Affiliation(s)
- Madalena von Hafe
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - João Sergio Neves
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal
- Correspondence should be addressed to J S Neves:
| | - Catarina Vale
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marta Borges-Canha
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Porto, Portugal
| | - Adelino Leite-Moreira
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
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12
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Venditti P, Reed TT, Victor VM, Di Meo S. Insulin resistance and diabetes in hyperthyroidism: a possible role for oxygen and nitrogen reactive species. Free Radic Res 2019; 53:248-268. [PMID: 30843740 DOI: 10.1080/10715762.2019.1590567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In addition to insulin, glycemic control involves thyroid hormones. However, an excess of thyroid hormone can disturb the blood glucose equilibrium, leading to alterations of carbohydrate metabolism and, eventually, diabetes. Indeed, experimental and clinical hyperthyroidism is often accompanied by abnormal glucose tolerance. A common characteristic of hyperthyroidism and type 2 diabetes is the altered mitochondrial efficiency caused by the enhanced production of reactive oxygen and nitrogen species. It is known that an excess of thyroid hormone leads to increased oxidant production and mitochondrial oxidative damage. It can be hypothesised that these species represent the link between hyperthyroidism and development of insulin resistance and diabetes, even though direct evidence of this relationship is lacking. In this review, we examine the literature concerning the effects of insulin and thyroid hormones on glucose metabolism and discuss alterations of glucose metabolism in hyperthyroid conditions and the cellular and molecular mechanisms that may underline them.
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Affiliation(s)
- Paola Venditti
- a Dipartimento di Biologia , Università di Napoli Federico II , Napoli , Italy
| | - Tanea T Reed
- b Department of Chemistry , Eastern Kentucky University , Richmond , KY , USA
| | - Victor M Victor
- c Service of Endocrinology, Dr. Peset University Hospital, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO) , Valencia , Spain.,d Department of Physiology , University of Valencia , Valencia , Spain
| | - Sergio Di Meo
- a Dipartimento di Biologia , Università di Napoli Federico II , Napoli , Italy
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13
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Das G, Taylor PN, Abusahmin H, Ali A, Tennant BP, Geen J, Okosieme O. Relationship between serum thyrotropin and urine albumin excretion in euthyroid subjects with diabetes. Ann Clin Biochem 2018; 56:155-162. [PMID: 30114929 DOI: 10.1177/0004563218797979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Microalbuminuria represents vascular and endothelial dysfunction. Thyroid hormones can influence urine albumin excretion as it exerts crucial effects on the kidney and on the vascular system. This study explores the relationship between serum thyrotropin and urine albumin excretion in euthyroid patients with diabetes. METHODS A total of 433 patients with type 1 or 2 diabetes were included in this retrospective cross-sectional study. Data included anthropometric measurements and biochemical parameters from diabetes clinic. Males with urine albumin creatinine ratio >2.5 and female's >3.5 mg/mmoL were considered to have microalbuminuria. RESULTS 34.9% of the patients had microalbuminuria. Prevalence of microalbuminuria increased according to TSH quartiles (26.9, 34.6, 38.5 and 44.9%, P for trend = 0.02). In a fully adjusted logistic regression model, higher TSH concentrations were associated with high prevalence of microalbuminuria (adjusted odds ratio 2.06 [95% CI: 1.14-3.72]; P = 0.02), while comparing the highest with the lowest quartile of TSH. Multiple linear regression analysis showed an independent association between serum TSH and urine albumin creatinine ratio (β = 0.007, t = 2.03 and P = 0.04). The risk of having microalbuminuria was higher with rise in TSH concentration in patients with younger age (<65 years), raised body mass index (≥25 kg/m2), hypertension, type 2 diabetes and hyperlipidaemia and age was the most important determinant ( P for interaction = 0.02). CONCLUSION Serum TSH even in the euthyroid range was positively associated with microalbuminuria in euthyroid patients with diabetes independent of traditional risk factors. This relationship was strongest in patients with components of the metabolic syndrome.
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Affiliation(s)
- Gautam Das
- 1 Department of Endocrinology, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK
| | - Peter N Taylor
- 2 Department of Endocrinology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, UK.,3 Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
| | - Hussam Abusahmin
- 1 Department of Endocrinology, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK
| | - Amer Ali
- 1 Department of Endocrinology, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK
| | - Brian P Tennant
- 4 Department of Clinical Biochemistry, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK
| | - John Geen
- 4 Department of Clinical Biochemistry, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK.,5 Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Onyebuchi Okosieme
- 1 Department of Endocrinology, Prince Charles Hospital, Cwm Taf University Health Board, Merthyr Tydfil, UK.,3 Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff, UK
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14
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Ogola B, Zhang Y, Iyer L, Thekkumkara T. 2-Methoxyestradiol causes matrix metalloproteinase 9-mediated transactivation of epidermal growth factor receptor and angiotensin type 1 receptor downregulation in rat aortic smooth muscle cells. Am J Physiol Cell Physiol 2018; 314:C554-C568. [DOI: 10.1152/ajpcell.00152.2017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Studies have demonstrated the therapeutic potential of estrogen metabolite 2-methoxyestradiol (2ME2) in several cardiovascular disorders, including hypertension. However, the exact mechanism(s) remains unknown. In this study, primary rat aortic smooth muscle cells (RASMCs) were exposed to 2ME2, and angiotensin type 1 receptor (AT1R) expression, function, and associated signaling pathways were evaluated. In RASMCs, 2ME2 downregulated AT1R expression in a concentration- and time-dependent manner, which was correlated with reduced mRNA expression. The 2ME2 effect was through G protein-coupled receptor 30 (GPR30) that inhibits second messenger cAMP. Moreover, 2ME2 exposure phosphorylated ERK1/2 that was sensitive to MEK inhibitor PD98059. Selective epidermal growth factor receptor (EGFR) inhibitor AG1478 blocked 2ME2-induced EGFR transactivation and attenuated subsequent phosphorylation of ERK1/2 preventing AT1R downregulation. The transactivation was dependent on 2ME2-induced release of matrix metalloproteinase 9 (MMP9) and epidermal growth factor demonstrated by ELISA. Furthermore, transfection with small interfering (si) RNA targeting MMP9 impeded ERK1/2 activation and AT1R downregulation in response to 2ME2 and G1 stimulation. Interestingly, under similar conditions, stimulation of GPR30 with the selective agonist G1 elicited similar signaling pathways and downregulated the AT1R expression that was reversed by GPR30 antagonist G15. Furthermore, 2ME2 and G1 inhibited angiotensin II (ANG II) induced Ca2+ release, a response consistent with AT1R downregulation. Collectively, our study demonstrates for the first time that 2ME2 binding to GPR30 induces MMP9 specific transactivation of EGFR that mediates ERK1/2-dependent downregulation of AT1R in RASMCs. The study provides critical insights into the newly discovered role and signaling pathways of 2ME2 in the regulation of AT1R in vascular cells and its potential to be developed as a therapeutic agent that ameliorates hypertension.
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Affiliation(s)
- Benard Ogola
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Yong Zhang
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Laxmi Iyer
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, Amarillo, Texas
| | - Thomas Thekkumkara
- Department of Biomedical Sciences, Texas Tech University Health Sciences Center, Amarillo, Texas
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15
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Rutigliano G, Zucchi R. Cardiac actions of thyroid hormone metabolites. Mol Cell Endocrinol 2017; 458:76-81. [PMID: 28069537 DOI: 10.1016/j.mce.2017.01.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 12/23/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
Thyroid hormones (THs) have a major role in regulating cardiac function. Their classical mechanism of action is genomic. Recent findings have broadened our knowledge about the (patho)physiology of cardiac regulation by THs, to include non-genomic actions of THs and their metabolites (THM). This review provides an overview of classical and non-classical cardiac effects controlled by: i) iodothyronines (thyroxine, T4; 3,5,3'-triiodothyronine,T3; 3, 5-diiodothyronine, T2); ii) thyronamines (thyronamine, T0AM; 3-iodothyronamine, T1AM); and iii) iodothyroacetic acids (3, 5, 3', 5'-tetraiodothyroacetic acid, tetrac; 3, 5, 3'-triiodothyroacetic acid, triac; 3-iodothyroacetic acid, TA1). Whereas iodothyronines enhance both diastolic and systolic function and heart rate, thyronamines were observed to have negative inotropic and chronotropic effects and might function as a brake with respect to THs, although their physiological role is unclear. Moreover, thyronamines showed a cardioprotective effect at physiological concentrations. The cardiac effects of iodothyroacetic acids seem to be limited and need to be elucidated.
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Affiliation(s)
- Grazia Rutigliano
- Scuola Superiore Sant'Anna, Piazza Martiri della Libertà 33, 56127 Pisa, Italy; National Research Council (CNR), Institute of Clinical Physiology (IFC), Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
| | - Riccardo Zucchi
- Department of Pathology, University of Pisa, Via Roma 55, 56126 Pisa, Italy.
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16
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Kang IS, Pyun WB. Life Threatening Complication of Self-made Remedy for Controlling High Blood Pressure-Coronary Artery Vasospasm Associated with Iatrogenic Thyrotoxicosis. Korean Circ J 2016; 46:870-874. [PMID: 27826349 PMCID: PMC5099346 DOI: 10.4070/kcj.2016.46.6.870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 12/14/2015] [Accepted: 01/05/2016] [Indexed: 11/30/2022] Open
Abstract
We report the case of a middle aged woman who was previously diagnosed with hypertension. She had been drinking a kelp concentrate solution daily for her hypertension instead of taking the prescribed medicine due to her personal beliefs about the kelp solution. As a consequence, she experienced vasospastic angina complicated by myocardial infarction and cardiogenic syncope resulting from iatrogenic thyrotoxicosis. Complementary medicine is widely used by the general population. However, there is still a lack of evidence regarding their efficacy and safety. This case shows that inadequate use of complementary medicine could have no effect and may even be harmful. In patients with chronic diseases such as hypertension, self-care in the form of life style modification, home blood pressure monitoring and medial adherence are important for disease management.
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Affiliation(s)
- In Sook Kang
- Department of Internal Medicine, Green hospital, Seoul, Korea.; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Wook Bum Pyun
- Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
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17
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Canpolat U, Turak O, Özcan F, Öksüz F, Mendi MA, Yayla Ç, Aydoğdu S. Impact of free thyroxine levels and other clinical factors on bare metal stent restenosis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2016; 61:130-136. [PMID: 28489156 PMCID: PMC10118861 DOI: 10.1590/2359-3997000000197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Accepted: 03/07/2016] [Indexed: 11/22/2022]
Abstract
Objective Thyroid hormones have both direct and indirect effects on thermogenesis such as modulating vascular smooth muscle cell proliferation. However, the influence of more subtle changes in thyroid hormones on coronary atherosclerosis remains a matter of speculation. Smooth muscle cells play a crucial role in the pathogenesis of in-stent restenosis (ISR). However, the relationship between free thyroxine (fT4) and ISR has not been studied. In the present study, we aimed to assess the role of preprocedural serum fT4 level on the development of ISR in patients undergoing coronary bare metal stent (BMS) implantation. Materials and methods We enrolled and analyzed clinical, biochemical, and angiographic data from 705 consecutive patients without a history of primary thyroid disease [mean age 60.3 ± 9.3 years, 505 (72%) male]; all patients had undergone BMS implantation and further control coronary angiography owing to stable or unstable angina pectoris. Patients were divided into 3 tertiles based on preprocedural serum fT4 levels. Results ISR was observed in 53 (23%) patients in the lowest tertile, 82 (35%) patients in the second tertile, and 107 (46%) patients in the highest fT4 tertile (p < 0.001). Using multiple logistic regression analysis, five characteristics emerged as independent predictors of ISR: diabetes mellitus, smoking, HDL-cholesterol, stent length, and preprocedural serum fT4 level. In receiver operating characteristics curve analysis, fT4 level > 1.23 mg/dL had 70% sensitivity and 73% specificity (AUC: 0.75, p < 0.001) in predicting ISR. Conclusion Higher preprocedural serum fT4 is a powerful and independent predictor of BMS restenosis in patients with stable and unstable angina pectoris.
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Affiliation(s)
- Uğur Canpolat
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Osman Turak
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Fırat Özcan
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Fatih Öksüz
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Mehmet Ali Mendi
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Çağrı Yayla
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
| | - Sinan Aydoğdu
- Türkiye Yüksek Ihtisas Training and Research Hospital, Cardiology Clinic, Ankara, Turkey
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18
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Abstract
Both hyperthyroidism and hypothyroidism affect the cardiovascular system. Hypothyroidism is known to be associated with enhanced atherosclerosis and ischemic heart diseases. The accelerated atherosclerosis in the hypothyroid state has been traditionally ascribed to atherogenic lipid profile, diastolic hypertension, and impaired endothelial function. However, recent studies indicate that thyroid hormone has direct anti-atherosclerotic effects, such as production of nitric oxide and suppression of smooth muscle cell proliferation. These data suggest that thyroid hormone inhibits atherogenesis through direct effects on the vasculature as well as modification of risk factors for atherosclerosis. This review summarizes the basic and clinical studies on the role of thyroid hormone in vascular remodeling. The possible application of thyroid hormone mimetics to the therapy of hypercholesterolemia and atherosclerosis is also discussed.
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19
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Watanabe Y, Yoshida M, Yamanishi K, Yamamoto H, Okuzaki D, Nojima H, Yasunaga T, Okamura H, Matsunaga H, Yamanishi H. Genetic analysis of genes causing hypertension and stroke in spontaneously hypertensive rats: Gene expression profiles in the kidneys. Int J Mol Med 2015; 36:712-24. [PMID: 26165378 PMCID: PMC4533772 DOI: 10.3892/ijmm.2015.2281] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 06/25/2015] [Indexed: 12/15/2022] Open
Abstract
Spontaneously hypertensive rats (SHRs) and stroke-prone SHRs (SHRSP) are frequently used as models not only of essential hypertension and stroke, but also of attention-deficit hyperactivity disorder (ADHD). Normotensive Wistar-Kyoto (WKY) rats are normally used as controls in these studies. In the present study, we aimed to identify the genes causing hypertension and stroke, as well as the genes involved in ADHD using these rats. We previously analyzed gene expression profiles in the adrenal glands and brain. Since the kidneys can directly influence the functions of the cardiovascular, endocrine and sympathetic nervous systems, gene expression profiles in the kidneys of the 3 rat strains were examined using genome-wide microarray technology when the rats were 3 and 6 weeks old, a period in which rats are considered to be in a pre-hypertensive state. Gene expression profiles were compared between the SHRs and WKY rats and also between the SHRSP and SHRs. A total of 232 unique genes showing more than a 4-fold increase or less than a 4-fold decrease in expression were isolated as SHR- and SHRSP-specific genes. Candidate genes were then selected using two different web tools: the 1st tool was the Database for Annotation, Visualization and Integrated Discovery (DAVID), which was used to search for significantly enriched genes and categorized them using Gene Ontology (GO) terms, and the 2nd was Ingenuity Pathway Analysis (IPA), which was used to search for interactions among SHR- and also SHRSP‑specific genes. The analyses of SHR-specific genes using IPA revealed that B-cell CLL/lymphoma 6 (Bcl6) and SRY (sex determining region Y)-box 2 (Sox2) were possible candidate genes responsible for causing hypertension in SHRs. Similar analyses of SHRSP-specific genes revealed that angiotensinogen (Agt), angiotensin II receptor-associated protein (Agtrap) and apolipoprotein H (Apoh) were possible candidate genes responsible for triggering strokes. Since our results revealed that SHRSP-specific genes isolated from the kidneys of rats at 6 weeks of age, included 6 genes related to Huntington's disease, we discussed the genetic association between ADHD and Huntington's disease.
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Affiliation(s)
- Yuko Watanabe
- Hirakata General Hospital for Developmental Disorders, Hirakata, Osaka 573-0122, Japan
| | - Momoko Yoshida
- Hirakata General Hospital for Developmental Disorders, Hirakata, Osaka 573-0122, Japan
| | - Kyosuke Yamanishi
- Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hideyuki Yamamoto
- Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Daisuke Okuzaki
- DNA-Chip Development Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Hiroshi Nojima
- DNA-Chip Development Center for Infectious Diseases, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Teruo Yasunaga
- Department of Genome Informatics, Research Institute for Microbial Diseases, Osaka University, Suita, Osaka 565-0871, Japan
| | - Haruki Okamura
- Institute for Advanced Medical Sciences, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hisato Matsunaga
- Department of Neuropsychiatry, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan
| | - Hiromichi Yamanishi
- Hirakata General Hospital for Developmental Disorders, Hirakata, Osaka 573-0122, Japan
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20
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Sun X, Sun Y, Li WC, Chen CY, Chiu YH, Chien HY, Wang Y. Association of thyroid-stimulating hormone and cardiovascular risk factors. Intern Med 2015; 54:2537-44. [PMID: 26466686 DOI: 10.2169/internalmedicine.54.4514] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Thyroid hormone plays an important role in regulating the lipid and glucose metabolism. Previously, much attention has been drawn to define the pathophysiological relationship between thyroid dysfunction and the incidence of cardiovascular diseases (CVDs). While the conditions of overt hypothyroidism and subclinical hypothyroidism were both emphasized, the association between CVD risks and the deregulated circulating thyroid-stimulating hormone (TSH) level remains to be elucidated. Nevertheless, multiple TSH-mediated physiological adaptations, including alteration of the serum lipids, body mass index, blood pressure and insulin sensitivity, have led to the difficulty of clearly examining the association between the TSH level and CVD prevalence. The current review aims to 1) summarize the evidence for the role of thyroid dysfunction and TSH abnormality in CVD pathogenesis and 2) explore the possible underlying molecular mechanisms of TSH-mediated cardiovascular pathology in hopes of providing better therapeutic strategies for the patients with deregulated TSH.
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Affiliation(s)
- Xianglan Sun
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong University, China
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21
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Liu KL, Lo M, Canaple L, Gauthier K, del Carmine P, Beylot M. Vascular Function of the Mesenteric Artery Isolated from Thyroid Hormone Receptor-E Knockout Mice. J Vasc Res 2014; 51:350-9. [DOI: 10.1159/000368195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 08/14/2014] [Indexed: 11/19/2022] Open
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Gerdes AM. Restoration of thyroid hormone balance: a game changer in the treatment of heart failure? Am J Physiol Heart Circ Physiol 2014; 308:H1-10. [PMID: 25380818 DOI: 10.1152/ajpheart.00704.2014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The link between low thyroid hormone (TH) function and heart failure is reviewed in the present report. The idea that TH dysfunction may contribute to diseases leading to HF has been discussed for over 60 yr. A growing body of evidence from animal and human studies, particularly in recent years, suggests that TH treatment may improve clinical outcomes. Indeed, if a similar amount of positive information were available for a newly developed heart drug, there is little doubt that large-scale clinical trials would be underway with considerable excitement. THs offer the promise of improving ventricular contraction and relaxation, improving coronary blood flow, and inhibiting atherosclerosis, and new results suggest they may even reduce the incidence of arrhythmias in heart diseases. Are the potential clinical benefits worth the risk of possible overdosing? After so many years, why has this question not been answered? Clearly, the concept has not been disproven. This review explores the body of clinical evidence related to TH dysfunction and heart failure, discuss insights into pathophysiological, cellular, and molecular mechanisms provided by animal research, and discuss what is needed to resolve this long-standing issue in cardiology and move forward.
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Affiliation(s)
- A Martin Gerdes
- Department of Biomedical Sciences, College of Osteopathic Medicine, New York Institute of Technology, Old Westbury, New York
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Abstract
Thyroid hormones modulate every component of the cardiovascular system necessary for normal cardiovascular development and function. When cardiovascular disease is present, thyroid function tests are characteristically indicated to determine if overt thyroid disorders or even subclinical dysfunction exists. As hypothyroidism, hypertension, and cardiovascular disease all increase with advancing age, monitoring of thyroid-stimulating hormone, the most sensitive test for hypothyroidism, is important in this expanding segment of our population. A better understanding of the impact of thyroid hormonal status on cardiovascular physiology will enable health care providers to make decisions about thyroid hormone evaluation and therapy in concert with evaluating and treating hypertension and cardiovascular disease. The goal of this review is to access contemporary understanding of the effects of thyroid hormones on normal cardiovascular function and the potential role of overt and subclinical hypothyroidism and hyperthyroidism in a variety of cardiovascular diseases.
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Affiliation(s)
- Ira Martin Grais
- Department of Medicine/Cardiology Division, Northwestern Feinberg School Medicine, Chicago, Ill.
| | - James R Sowers
- Department of Internal Medicine, University of Missouri School of Medicine, Columbia, Mo; Department of Medical Pharmacology and Physiology, University of Missouri School of Medicine, Columbia, Mo; Diabetes and Cardiovascular Center, University of Missouri School of Medicine, Columbia, Mo; Harry S. Truman Veterans Affair Medical Center, Columbia, Mo
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Freitas F, Estato V, Carvalho VF, Torres RC, Lessa MA, Tibiriçá E. Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction. Microcirculation 2014; 20:590-8. [PMID: 23510303 DOI: 10.1111/micc.12057] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 03/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The pathophysiology underlying hyperthyroidism-induced left ventricle (LV) dysfunction and hypertrophy directly involves the heart and indirectly involves the neuroendocrine systems. The effects of hyperthyroidism on the microcirculation are still controversial in experimental models. We investigated the effects of hyperthyroidism on the cardiac function and microcirculation of an experimental rat model. METHODS Male Wistar rats (170-250 g) were divided into two groups: the euthyroid group (n = 10), which was treated with 0.9% saline solution, and the hyperthyroid group (n = 10), which was treated with l-thyroxine (600 μg/kg/day, i.p.) during 14 days. An echocardiographic study was performed to evaluate the alterations in cardiac function, structure and geometry. The structural capillary density and the expression of angiotensin II AT1 receptor in the LV were analyzed using histochemistry and immunohistochemistry, respectively. RESULTS Hyperthyroidism was found to induce profound cardiovascular alterations, such as systolic hypertension, tachycardia, LV dysfunction, cardiac hypertrophy, and myocardial fibrosis. This study demonstrates the existence of structural capillary rarefaction and the down-regulation of the cardiac angiotensin II AT1 receptor in the myocardium of hyperthyroid rats in comparison with euthyroid rats. CONCLUSIONS Microvascular rarefaction may be involved in the pathophysiology of hyperthyroidism-induced cardiovascular alterations.
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Affiliation(s)
- Felipe Freitas
- Laboratory of Cardiovascular Investigation, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro, Brazil
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Iwaki H, Sasaki S, Matsushita A, Ohba K, Matsunaga H, Misawa H, Oki Y, Ishizuka K, Nakamura H, Suda T. Essential role of TEA domain transcription factors in the negative regulation of the MYH 7 gene by thyroid hormone and its receptors. PLoS One 2014; 9:e88610. [PMID: 24781449 PMCID: PMC4004540 DOI: 10.1371/journal.pone.0088610] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 01/14/2014] [Indexed: 12/20/2022] Open
Abstract
MYH7 (also referred to as cardiac myosin heavy chain β) gene expression is known to be repressed by thyroid hormone (T3). However, the molecular mechanism by which T3 inhibits the transcription of its target genes (negative regulation) remains to be clarified, whereas those of transcriptional activation by T3 (positive regulation) have been elucidated in detail. Two MCAT (muscle C, A, and T) sites and an A/T-rich region in the MYH7 gene have been shown to play a critical role in the expression of this gene and are known to be recognized by the TEAD/TEF family of transcription factors (TEADs). Using a reconstitution system with CV-1 cells, which has been utilized in the analysis of positive as well as negative regulation, we demonstrate that both T3 receptor (TR) β1 and α1 inhibit TEAD-dependent activation of the MYH7 promoter in a T3 dose-dependent manner. TRβ1 bound with GC-1, a TRβ-selective T3 analog, also repressed TEAD-induced activity. Although T3-dependent inhibition required the DNA-binding domain (DBD) of TRβ1, it remained after the putative negative T3-responsive elements were mutated. A co-immunoprecipitation study demonstrated the in vivo association of TRβ1 with TEAD-1, and the interaction surfaces were mapped to the DBD of the TRβ1 and TEA domains of TEAD-1, both of which are highly conserved among TRs and TEADs, respectively. The importance of TEADs in MYH7 expression was also validated with RNA interference using rat embryonic cardiomyocyte H9c2 cells. These results indicate that T3-bound TRs interfere with transactivation by TEADs via protein-protein interactions, resulting in the negative regulation of MYH7 promoter activity.
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Affiliation(s)
- Hiroyuki Iwaki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Shigekazu Sasaki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
- * E-mail:
| | - Akio Matsushita
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Kenji Ohba
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hideyuki Matsunaga
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Hiroko Misawa
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Yutaka Oki
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | - Keiko Ishizuka
- Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
| | | | - Takafumi Suda
- Second Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
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Zhou Y, Ye L, Wang T, Hong J, Bi Y, Zhang J, Xu B, Sun J, Huang X, Xu M. Free triiodothyronine concentrations are inversely associated with microalbuminuria. Int J Endocrinol 2014; 2014:959781. [PMID: 25484900 PMCID: PMC4248482 DOI: 10.1155/2014/959781] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Revised: 10/27/2014] [Accepted: 10/28/2014] [Indexed: 01/03/2023] Open
Abstract
Thyroid function and microalbuminuria are both associated with vascular disease and endothelial damage. However, whether thyroid function is associated with microalbuminuria is not well established. The objective was to explore the relationship between thyroid hormones and microalbuminuria in Chinese population. A community-based cross-sectional study was performed among 3,346 Chinese adults (aged ≥ 40 years). Serum free triiodothyronine (FT3), free thyroxine (FT4), and TSH (thyroid stimulating hormone) were determined by chemiluminescent microparticle immunoassay. A single-void first morning urine sample was obtained for urinary albumin-creatinine ratio measurement. The prevalence of microalbuminuria decreased according to FT3 quartiles (13.2, 9.5, 8.6, and 8.2%, P for trend = 0.0005). A fully adjusted logistic regression analysis showed that high FT3 levels were associated with low prevalent microalbuminuria. The adjusted odds ratios for microalbuminuria were 0.61 (95% CI, 0.43-0.87, P = 0.007) when comparing the highest with the lowest quartile of FT3. The exclusion of participants with abnormal FT3 did not appreciably change the results (OR = 0.69, 95% CI, 0.49-0.98, P = 0.02). We concluded that serum FT3 levels, even within the normal range, were inversely associated with microalbuminuria in middle-aged and elderly Chinese adults. FT3 concentrations might play a role in the pathogenesis of microalbuminuria.
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Affiliation(s)
- Yulin Zhou
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
| | - Lei Ye
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Tiange Wang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jie Hong
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
| | - Yufang Bi
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jie Zhang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Baihui Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Jichao Sun
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Xiaolin Huang
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
| | - Min Xu
- Shanghai Clinical Center for Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrinology and Metabolism, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai 200025, China
- Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, E-Institute of Shanghai Universities, Shanghai 200025, China
- *Min Xu:
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Tognini S, Pasqualetti G, Calsolaro V, Polini A, Caraccio N, Monzani F. Cardiovascular risk and quality of life in elderly people with mild thyroid hormone deficiency. Front Endocrinol (Lausanne) 2014; 5:153. [PMID: 25339939 PMCID: PMC4188129 DOI: 10.3389/fendo.2014.00153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 09/12/2014] [Indexed: 01/06/2023] Open
Abstract
Subclinical hypothyroidism (sHT) is a common condition in the general population, the prevalence increases with age, especially in women. An association between sHT and increased coronary heart disease (CHD) and heart failure (HF) risk and mortality has been described. However, this association is far to be established in older people (>65 years), especially in the oldest old (>85 years). Individuals with sHT may experience symptoms that resemble those observed in the overt form of the disease, leading to an impaired quality of life (QoL). Although very old people are frequently frail and potentially more susceptible to the effects of a disease, few studies were designed to assess the effect of sHT on QoL in this subset of population. Interestingly, the serum TSH concentration curve of general population has a skewed distribution with a "tail" toward higher values, which is amplified with aging. Thus, the diagnosis of sHT and the interpretation of its potential effects on CV function and QoL in older people may be a challenge for the clinician. Giving these premises, we reviewed the English scientific literature available on National Library of Medicine (www.pubmed.com) since 1980 regarding hypothyroidism, sHT, elderly, cardiovascular risk, CHD or HF events and mortality, health-related QoL, and LT4 therapy. Consistent results among large prospective cohort studies suggest an age-independent relationship between sHT and HF progression, while an impact of sHT on CHD events and mortality is essentially reported in young adults (aged below 65-70 years) with long-lasting disease. Scanty data are available on QoL of older people with sHT (>65 years) and, generally, no significant alterations are described.
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Affiliation(s)
- Sara Tognini
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giuseppe Pasqualetti
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valeria Calsolaro
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Antonio Polini
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nadia Caraccio
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio Monzani
- Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- *Correspondence: Fabio Monzani, Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa, Pisa 56100, Italy e-mail:
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Carrillo-Sepúlveda MA, Ceravolo GS, Furstenau CR, Monteiro PDS, Bruno-Fortes Z, Carvalho MH, Laurindo FR, Tostes RC, Webb RC, Barreto-Chaves MLM. Emerging role of angiotensin type 2 receptor (AT2R)/Akt/NO pathway in vascular smooth muscle cell in the hyperthyroidism. PLoS One 2013; 8:e61982. [PMID: 23637941 PMCID: PMC3634851 DOI: 10.1371/journal.pone.0061982] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 03/15/2013] [Indexed: 12/14/2022] Open
Abstract
Hyperthyroidism is characterized by increased vascular relaxation and decreased vascular contraction and is associated with augmented levels of triiodothyronine (T3) that contribute to the diminished systemic vascular resistance found in this condition. T3 leads to augmented NO production via PI3K/Akt signaling pathway, which in turn causes vascular smooth muscle cell (VSMC) relaxation; however, the underlying mechanisms involved remain largely unknown. Evidence from human and animal studies demonstrates that the renin-angiotensin system (RAS) plays a crucial role in vascular function and also mediates some of cardiovascular effects found during hyperthyroidism. Thus, in this study, we hypothesized that type 2 angiotensin II receptor (AT2R), a key component of RAS vasodilatory actions, mediates T3 induced-decreased vascular contraction. Marked induction of AT2R expression was observed in aortas from T3-induced hyperthyroid rats (Hyper). These vessels showed decreased protein levels of the contractile apparatus: α-actin, calponin and phosphorylated myosin light chain (p-MLC). Vascular reactivity studies showed that denuded aortic rings from Hyper rats exhibited decreased maximal contractile response to angiotensin II (AngII), which was attenuated in aortic rings pre-incubated with an AT2R blocker. Further study showed that cultured VSMC stimulated with T3 (0.1 µmol/L) for 24 hours had increased AT2R gene and protein expression. Augmented NO levels and decreased p-MLC levels were found in VSMC stimulated with T3, both of which were reversed by a PI3K/Akt inhibitor and AT2R blocker. These findings indicate for the first time that the AT2R/Akt/NO pathway contributes to decreased contractile responses in rat aorta, promoted by T3, and this mechanism is independent from the endothelium.
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MESH Headings
- Angiotensin II/pharmacology
- Animals
- Aorta/drug effects
- Aorta/metabolism
- Disease Models, Animal
- Gene Expression Regulation/drug effects
- Hyperthyroidism/genetics
- Hyperthyroidism/metabolism
- Male
- Models, Biological
- Muscle, Smooth, Vascular/metabolism
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Nitric Oxide/metabolism
- Proto-Oncogene Proteins c-akt/metabolism
- Rats
- Receptor, Angiotensin, Type 2/genetics
- Receptor, Angiotensin, Type 2/metabolism
- Signal Transduction/drug effects
- Triiodothyronine/pharmacology
- Vasoconstriction/drug effects
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Affiliation(s)
- Maria Alícia Carrillo-Sepúlveda
- Laboratory of Cell Biology and Functional Anatomy, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Graziela S. Ceravolo
- Laboratory of Hypertension, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Cristina R. Furstenau
- Laboratory of Cell Biology and Functional Anatomy, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Priscilla de Souza Monteiro
- Laboratory of Cell Biology and Functional Anatomy, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Zuleica Bruno-Fortes
- Laboratory of Hypertension, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Helena Carvalho
- Laboratory of Hypertension, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
| | - Francisco R. Laurindo
- Vascular Biology Laboratory of Heart Institute, University of Sao Paulo, Sao Paulo, Brazil
| | - Rita C. Tostes
- Laboratory of Hypertension, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
- Department of Physiology, Georgia Health Science University, Augusta, Georgia, United States of America
| | - R. Clinton Webb
- Department of Physiology, Georgia Health Science University, Augusta, Georgia, United States of America
| | - Maria Luiza M. Barreto-Chaves
- Laboratory of Cell Biology and Functional Anatomy, Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, Brazil
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Abstract
Accelerated atherosclerosis and arterial stiffness are the two leading causes of increased cardiovascular disease in patients with chronic kidney disease. Dysfunctional thyroid hormone metabolism has been suggested to play a role in atherosclerosis and arterial stiffness. Changes in cardiac contractility and output, myocardial oxygen demand, systemic and peripheral vascular resistance, blood pressure and lipid profile, increased inflammatory burden and endothelial dysfunction may be responsible for thyroid hormone-related cardiovascular disease. This article focuses on the mechanistic insights of this association and provides a concise review of the current literature.
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Abstract
CONTEXT Heart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction. EVIDENCE ACQUISITION Reports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English. EVIDENCE SYNTHESIS The outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or > 10 mU/l. CONCLUSIONS The timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.
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Affiliation(s)
- Bernadette Biondi
- Department of Clinical and Molecular Endocrinology and Oncology, University of Naples Federico II, Italy.
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Meuwese CL, Dekker FW, Lindholm B, Qureshi AR, Heimburger O, Barany P, Stenvinkel P, Carrero JJ. Baseline levels and trimestral variation of triiodothyronine and thyroxine and their association with mortality in maintenance hemodialysis patients. Clin J Am Soc Nephrol 2012; 7:131-8. [PMID: 22246282 DOI: 10.2215/cjn.05250511] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Conflicting evidence exists with regard to the association of thyroid hormones and mortality in dialysis patients. This study assesses the association between basal and trimestral variation of thyroid stimulating hormone, triiodothyronine, and thyroxine and mortality. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS In 210 prevalent hemodialysis patients, serum triiodothyronine, thyroxine, thyroid stimulating hormone, and interleukin-6 were measured 3 months apart. Cardiovascular and non-cardiovascular deaths were registered during follow-up. Based on fluctuations along tertiles of distribution, four trimestral patterns were defined for each thyroid hormone: persistently low, decrease, increase, and persistently high. The association of baseline levels and trimestral variation with mortality was investigated with Kaplan-Meier curves and Cox proportional hazard models. RESULTS During follow-up, 103 deaths occurred. Thyroid stimulating hormone levels did not associate with mortality. Patients with relatively low basal triiodothyronine concentrations had higher hazards of dying than patients with high levels. Longitudinally, patients with persistently low levels of triiodothyronine during the 3-month period had higher mortality hazards than those having persistently high levels. These associations were mainly attributable to cardiovascular-related mortality. The association between thyroxine and mortality was not altered after adjustment for triiodothyronine. CONCLUSIONS Hemodialysis patients with reduced triiodothyronine or thyroxine levels bear an increased mortality risk, especially due to cardiovascular causes. This was true when considering both baseline measurements and trimestral variation patterns. Our longitudinal design adds observational evidence supporting the hypothesis that the link may underlie a causal effect.
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Affiliation(s)
- Christiaan L Meuwese
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Vargas F, Rodríguez-Gómez I, Vargas-Tendero P, Jimenez E, Montiel M. The renin-angiotensin system in thyroid disorders and its role in cardiovascular and renal manifestations. J Endocrinol 2012; 213:25-36. [PMID: 22043064 DOI: 10.1530/joe-11-0349] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Thyroid disorders are among the most common endocrine diseases and affect virtually all physiological systems, with an especially marked impact on cardiovascular and renal systems. This review summarizes the effects of thyroid hormones on the renin-angiotensin system (RAS) and the participation of the RAS in the cardiovascular and renal manifestations of thyroid disorders. Thyroid hormones are important regulators of cardiac and renal mass, vascular function, renal sodium handling, and consequently blood pressure (BP). The RAS acts globally to control cardiovascular and renal functions, while RAS components act systemically and locally in individual organs. Various authors have implicated the systemic and local RAS in the mediation of functional and structural changes in cardiovascular and renal tissues due to abnormal thyroid hormone levels. This review analyzes the influence of thyroid hormones on RAS components and discusses the role of the RAS in BP, cardiac mass, vascular function, and renal abnormalities in thyroid disorders.
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Affiliation(s)
- Félix Vargas
- Departamento de Fisiología, Facultad de Medicina, Universidad de Granada, Granada, Spain.
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La Vignera S, Condorelli R, Vicari E, Calogero AE. Endothelial dysfunction and subclinical hypothyroidism: a brief review. J Endocrinol Invest 2012; 35:96-103. [PMID: 22186427 DOI: 10.3275/8190] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Subclinical hypothyroidism (SH) is characterized by normal serum free T4 and free T3 levels and increased serum TSH levels. The relationship between SH and cardiovascular diseases has been one of the most popular topics recently. There is still some controversy concerning the cardiovascular impact of SH and management protocols. The vast majority of the studies published so far, suggests that SH accelerates endothelial dysfunction through traditional effects on risk factors that promote atherosclerosis and nontraditional effects on vasculature. In particular, SH is associated with increased of LDL-cholesterol, diastolic blood pressure, and markers of chronic inflammation (C reactive protein) and simultaneously reduces the bioavailability of nitric oxide to blood vessels and increases the expression of angiotensin receptor. Furthermore, replacement therapy seems to improve all these aspects.
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Affiliation(s)
- S La Vignera
- Section of Endocrinology, Andrology and Internal Medicine and Master in Andrological, Human Reproduction and Biotechnology Sciences, Department of Internal Medicine and Systemic Diseases, University of Catania, Catania, Italy.
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Gunduz M, Gunduz E, Kircelli F, Okur N, Ozkaya M. Role of surrogate markers of atherosclerosis in clinical and subclinical thyroidism. Int J Endocrinol 2012; 2012:109797. [PMID: 22505888 PMCID: PMC3296143 DOI: 10.1155/2012/109797] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 11/30/2011] [Indexed: 11/17/2022] Open
Abstract
Background. Data on the relationship between homocysteine, plasminogen activator inhibitor 1, hs-CRP, fibrinogen, and carotid intima media thickness (CA-IMT) is plenty but contradicting and the majority of the studies investigated this issue in only specific thyroidism groups. The aim of this paper was to investigate these relations in patients with subclinical and clinical hypo- and hyperthyroidism. Methods. In this cross-sectional study, 16 patients from each thyroidism group and 20 healthy cases were enrolled. Fibrinogen levels and plasminogen activator inhibitor 1 (PAI-1) activity were assessed. CA-IMT was determined by gray-scale high-resolution color Doppler ultrasound. Results. Serum homocysteine levels were higher in hypothyroidic patients compared to the control (P = 0.003). Fibrinogen levels were higher in patients with subclinical hypothyroidism compared to other groups (P < 0.05). There was no difference between groups regarding PAI-1. Whereas total cholesterol, homocysteine, and LDL were correlated with CAIMT, hs-CRP, PAI-1, and fibrinogen were not. In the clinical hypothyroidism group, the correlation of homocysteine with CA-IMT was derived from the correlation between CA-IMT and homocysteine. Conclusions. Homocysteine and fibrinogen levels are higher in patients with clinical and subclinical hypothyroidism, respectively. Homocysteine level is associated with CA-IMTonly in patients with clinical hypothyroidism.
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Affiliation(s)
- Mehmet Gunduz
- Department of Internal Medicine, Kahramanmaras University, 46000 Kahramanmaras, Turkey
- *Mehmet Gunduz:
| | - Ercan Gunduz
- Department of Internal Medicine, Malatya Hekimhan State Hospital, 44400 Malatya, Turkey
| | - Fatih Kircelli
- Division of Nephrology, Yozgat State Hospital, 66000 Yozgat, Turkey
| | - Nazan Okur
- Department of Radiology, Kahramanmaras University, 46000 Kahramanmaras, Turkey
| | - Mesut Ozkaya
- Department of Radiology, Kahramanmaras University, 46000 Kahramanmaras, Turkey
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Tatar E, Kircelli F, Asci G, Carrero JJ, Gungor O, Demirci MS, Ozbek SS, Ceylan N, Ozkahya M, Toz H, Ok E. Associations of triiodothyronine levels with carotid atherosclerosis and arterial stiffness in hemodialysis patients. Clin J Am Soc Nephrol 2011; 6:2240-6. [PMID: 21836150 DOI: 10.2215/cjn.02540311] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES End-stage renal disease is linked to alterations in thyroid hormone levels and/or metabolism, resulting in a high prevalence of subclinical hypothyroidism and low triiodothyronine (T3) levels. These alterations are involved in endothelial damage, cardiac abnormalities, and inflammation, but the exact mechanisms are unclear. In this study, we investigated the relationship between serum free-T3 (fT3) and carotid artery atherosclerosis, arterial stiffness, and vascular calcification in prevalent patients on conventional hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS 137 patients were included. Thyroid-hormone levels were determined by chemiluminescent immunoassay, carotid artery-intima media thickness (CA-IMT) by Doppler ultrasonography, carotid-femoral pulse wave velocity (c-f PWV), and augmentation index by Sphygmocor device, and coronary artery calcification (CAC) scores by multi-slice computerized tomography. RESULTS Mean fT3 level was 3.70 ± 1.23 pmol/L. Across decreasing fT3 tertiles, c-f PWV and CA-IMT values were incrementally higher, whereas CACs were not different. In adjusted ordinal logistic regression analysis, fT3 level (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97), age, and interdialytic weight gain were significantly associated with CA-IMT. fT3 level was associated with c-f PWV in nondiabetics but not in diabetics. In nondiabetics (n = 113), c-f PWV was positively associated with age and systolic BP but negatively with fT3 levels (odds ratio = 0.57, 95% confidence interval 0.39 to 0.83). CONCLUSIONS fT3 levels are inversely associated with carotid atherosclerosis but not with CAC in hemodialysis patients. Also, fT3 levels are inversely associated with surrogates of arterial stiffness in nondiabetics.
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Affiliation(s)
- Erhan Tatar
- Ege University School of Medicine, Division of Nephrology, 35100, Bornova, Izmir, Turkey.
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Deegan RJ, Furman WR. Cardiovascular Manifestations of Endocrine Dysfunction. J Cardiothorac Vasc Anesth 2011; 25:705-20. [DOI: 10.1053/j.jvca.2010.12.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Indexed: 01/27/2023]
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Abstract
Hypothyroidism has been recognized as a cause of secondary hypertension. Previous studies on the prevalence of hypertension in subjects with hypothyroidism have demonstrated elevated blood pressure values. Increased peripheral vascular resistance and low cardiac output has been suggested to be the possible link between hypothyroidism and diastolic hypertension. The hypothyroid population is characterized by significant volume changes, initiating a volume-dependent, low plasma renin activity mechanism of blood pressure elevation. This article summarizes previous studies on the impact of hypothyroidism on blood pressure and early atherosclerotic process.
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Affiliation(s)
- Stella Stabouli
- Pediatric Intensive Care Unit, Hippokration Hospital, Thessaloniki, Greece
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Okada J, Iwata S, Hirose A, Kanda H, Yoshino M, Maeno Y, Matsuishi T, Iwata O. Levothyroxine replacement therapy and refractory hypotension out of transitional period in preterm infants. Clin Endocrinol (Oxf) 2011; 74:354-64. [PMID: 21070313 DOI: 10.1111/j.1365-2265.2010.03927.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Recent studies suggest that refractory hypotension from causes other than septicaemia or cardiac failure is common in extremely preterm infants even out of the transitional period. Marked response to low-dose cortisol suggests underlying adrenal insufficiency, although the exact mechanism remains unknown. METHODS To investigate potential triggers for and related short-term outcomes of early-onset (<Day 7) and late-onset (≥Day 7) refractory hypotension, clinical data for 70 infants <30 weeks gestation were assessed. RESULTS The incidence of early-onset refractory hypotension (n=7) was correlated with younger gestational ages <26 weeks (P < 0.05), whereas the incidence of late-onset refractory hypotension (n=14) was correlated with younger gestational ages and levothyroxine supplementation (P<0.05 and 0.01, respectively). The incidence of both early- and late-onset refractory hypotension was correlated with risks of short-term adverse outcomes such as prolonged mechanical ventilation and hospital stay. CONCLUSIONS Levothyroxine supplementation was identified as an independent variable correlated with an increased incidence of refractory hypotension out of the transitional period; as seen in hypothyroidism with Addison's disease, the immature hypothalamic-pituitary-adrenal axis may not respond properly to the increased demand for cortisol, which may precipitate premature infants into refractory hypotension. Following the administration of levothyroxine, preterm infants may have to be carefully monitored for early signs of refractory hypotension.
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Affiliation(s)
- Junichiro Okada
- Department of Paediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Axelband F, Dias J, Ferrão FM, Einicker-Lamas M. Nongenomic signaling pathways triggered by thyroid hormones and their metabolite 3-iodothyronamine on the cardiovascular system. J Cell Physiol 2010; 226:21-8. [PMID: 20658515 DOI: 10.1002/jcp.22325] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- F Axelband
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Ichiki T. Thyroid hormone and atherosclerosis. Vascul Pharmacol 2010; 52:151-6. [DOI: 10.1016/j.vph.2009.09.004] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 09/30/2009] [Indexed: 10/20/2022]
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Cini G, Carpi A, Mechanick J, Cini L, Camici M, Galetta F, Giardino R, Russo M, Iervasi G. Thyroid hormones and the cardiovascular system: Pathophysiology and interventions. Biomed Pharmacother 2009; 63:742-53. [DOI: 10.1016/j.biopha.2009.08.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2009] [Accepted: 08/24/2009] [Indexed: 10/20/2022] Open
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Barreto-Chaves MLM, Carrillo-Sepúlveda MA, Carneiro-Ramos MS, Gomes DA, Diniz GP. The crosstalk between thyroid hormones and the Renin-Angiotensin System. Vascul Pharmacol 2009; 52:166-70. [PMID: 19857605 DOI: 10.1016/j.vph.2009.10.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2009] [Accepted: 10/18/2009] [Indexed: 12/25/2022]
Abstract
Thyroid hormones (THs) exert multiple effects on the heart and vascular system. As a consequence, altered cardiovascular function observed in the thyroid diseases corresponds to one of the most important and clinically relevant aspects found in both hyperthyroidism and hypothyroidism. Besides THs' direct effects on the heart and vascular system, in the last three decades several studies have implicated the Renin-Angiotensin System (RAS) in some of the cardiovascular effects of THs, with this interaction suggesting that RAS may be an important mediator of THs actions. In the present review, we discuss the alterations in the circulating RAS, as well as modifications in cardiac and vascular RAS which are involved in the cardiovascular alterations found during the modulation of TH levels. In addition, considering the important role that both systems present during fetal and neonatal periods, we also review the interaction between THs and the RAS in the development of cardiovascular system. A greater understanding of the role of the RAS in hyperthyroidism and hypothyroidism, during early or adult life will presumably facilitate the evolution of newer, targeted therapies.
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Affiliation(s)
- Maria Luiza M Barreto-Chaves
- Laboratory of Cell Biology and Functional Anatomy, Department of Anatomy, Institute of Biomedical Sciences of University of São Paulo, São Paulo, Brazil.
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Thyroid function is associated with carotid intima-media thickness in euthyroid subjects. Atherosclerosis 2009; 204:e77-81. [DOI: 10.1016/j.atherosclerosis.2008.09.022] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2008] [Revised: 09/13/2008] [Accepted: 09/14/2008] [Indexed: 11/19/2022]
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44
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The role of thyroid hormone in the pathophysiology of heart failure: clinical evidence. Heart Fail Rev 2008; 15:155-69. [DOI: 10.1007/s10741-008-9126-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 11/06/2008] [Indexed: 11/26/2022]
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Miyazaki R, Ichiki T, Hashimoto T, Inanaga K, Imayama I, Sadoshima J, Sunagawa K. SIRT1, a longevity gene, downregulates angiotensin II type 1 receptor expression in vascular smooth muscle cells. Arterioscler Thromb Vasc Biol 2008; 28:1263-9. [PMID: 18420994 DOI: 10.1161/atvbaha.108.166991] [Citation(s) in RCA: 167] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Resveratrol (3,5,4'-trihydroxystilbene), a polyphenol found in red wine, is known to activate sirtuin1 (SIRT1), a longevity gene. Previous studies have demonstrated that resveratrol extends the life span of diverse species through activation of SIRT1. It was also reported that inhibition of angiotensin II function by angiotensin II type I receptor (AT1R) antagonist prolonged rat life span. We, therefore, hypothesized that resveratrol may inhibit the renin-angiontein system and examined whether resveratrol affects AT1R expression in vascular smooth muscle cells (VSMCs). METHODS AND RESULTS Northern and Western blot analysis revealed that resveratrol significantly decreased the expression of AT1R at mRNA and protein levels in a dose- and time-dependent manner. Overexpression of SIRT1 reduced AT1R expression whereas nicotinamide, an inhibitor of SIRT1, increased AT1R expression and reversed the resveratrol-induced AT1R downregulation. AT1R gene promoter activity was decreased by resveratrol, but resveratrol did not affect the AT1R mRNA stability. Deletion analysis showed that the most proximal region of AT1R gene promoter containing Sp1 site is responsible for downregulation. Administration of resveratrol suppressed AT1R expression in the mouse aorta and blunted angiotensin II-induced hypertension. CONCLUSIONS Resveratrol suppressed AT1R expression through SIRT1 activation both in vivo and in vitro. The inhibition of the renin-angiotensin system may contribute, at least in part, to the resveratrol-induced longevity and antiatherogenic effect of resveratrol.
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Affiliation(s)
- Ryohei Miyazaki
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashiku, 812-8582 Fukuoka, Japan
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Dullaart RPF, de Vries R, Roozendaal C, Kobold ACM, Sluiter WJ. Carotid artery intima media thickness is inversely related to serum free thyroxine in euthyroid subjects. Clin Endocrinol (Oxf) 2007; 67:668-73. [PMID: 17596198 DOI: 10.1111/j.1365-2265.2007.02943.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The effect of thyroid function on cardiovascular risk may extend to the euthyroid range. In euthyroid subjects, we determined whether carotid artery intima media thickness (IMT), a measure of subclinical atherosclerosis, is related to thyroid function. DESIGN AND SUBJECTS Cross-sectional study in a cohort of 78 nonsmoking, predominantly middle-aged, euthyroid subjects (44 men and 34 women, mean age 56 years, TSH between 0.5 mU/l and 4.0 mU/l and FT4 between 11.0 pmol/l and 19.5 pmol/l). MEASUREMENTS IMT (mean of three segments in both carotid arteries by ultrasonography), clinical factors, insulin resistance (HOMA(ir)), plasma lipids, C-reactive protein (CRP), serum FT4, TSH and thyroid autoantibodies. RESULTS In several multiple linear regression models, age- and sex-adjusted IMT was found to be independently related to either pulse pressure and body mass index (BMI), to high density lipoprotein (HDL) cholesterol or to FT4, but not to TSH, thyroid autoantibodies, HOMA(ir), CRP, non-HDL cholesterol and triglycerides. In a subsequent model which included age, sex, pulse pressure, body mass index (BMI), HDL cholesterol and FT4, IMT was independently and positively related to age (beta = 0.43, P < 0.001), male sex (beta = 0.34, P = 0.014), pulse pressure (beta = 0.29, P = 0.002), BMI (beta = 0.24, P = 0.007) and inversely related to FT4 (beta = -0.19, P = 0.046). IMT was also inversely related to FT4 in a model which included HDL cholesterol, non-HDL cholesterol and triglycerides. CONCLUSIONS In euthyroid subjects, IMT is associated with FT(4), after controlling for clinical factors, lipid levels and thyroid autoantibodies. These findings raise the possibility that, even within the euthyroid range, low normal thyroid function may adversely affect cardiovascular risk.
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Affiliation(s)
- Robin P F Dullaart
- Department of Endocrinology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
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Mori K, Yoshida K, Tani JI, Nakagawa Y, Hoshikawa S, Ozaki H, Ito S. Effects of angiotensin II blockade on the development of autoimmune thyroiditis in nonobese diabetic mice. Clin Immunol 2007; 126:97-103. [PMID: 17919982 DOI: 10.1016/j.clim.2007.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 08/21/2007] [Accepted: 08/25/2007] [Indexed: 11/27/2022]
Abstract
We evaluated the effects of angiotensin II (Ang II) blockers, losartan, an Ang II receptor blocker, and enalapril, an angiotensin converting enzyme inhibitor, on the development of autoimmune thyroiditis in nonobese diabetic (NOD) mice, an animal model of Hashimoto's thyroiditis (HT). Mice were assigned into three groups, untreated, losartan-treated (30 mg/kg/day), and enalapril-treated (10 mg/kg/day) groups. Thyroiditis was induced by iodide ingestion (experiment 1) or mouse thyroglobulin (Tg) immunization (experiment 2). Both procedures effectively induced thyroiditis. While iodide ingestion failed to induce anti-mouse Tg antibody (TgAb) production, Tg immunization resulted in a significant increase in serum TgAb levels. In both experiments, neither losartan nor enalapril interfered with the development of thyroiditis and TgAb production. These results suggest that Ang II may not be associated with the development of autoimmune thyroiditis in NOD mice. Thus, the Ang II blockade may not have therapeutic potential in HT.
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Affiliation(s)
- Kouki Mori
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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48
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Affiliation(s)
- Terry S Elton
- Davis Heart and Lung Research Institute, Ohio State University, DHLRI 515, 473 West 12th Ave, Columbus, OH 43210, USA.
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49
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Ohtsubo H, Ichiki T, Miyazaki R, Inanaga K, Imayama I, Hashiguchi Y, Sadoshima J, Sunagawa K. Inducible cAMP early repressor inhibits growth of vascular smooth muscle cell. Arterioscler Thromb Vasc Biol 2007; 27:1549-55. [PMID: 17463330 DOI: 10.1161/atvbaha.107.145011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The role of inducible cAMP early repressor (ICER), a transcriptional repressor, in the vascular remodeling process has not been determined. We examined whether ICER affects growth of vascular smooth muscle cells (VSMCs). METHODS AND RESULTS Semi-quantitative RT-PCR and Western blot analysis showed that expression of ICER was increased in beraprost (a prostaglandin I2 analogue)-stimulated VSMCs in a time- and dose-dependent manner. The induction of ICER was inhibited by pretreatment with H89, a protein kinase A (PKA) inhibitor, suggesting that PKA mediates the induction of ICER expression. Beraprost suppressed platelet-derived growth factor-induced thymidine incorporation in VSMCs, which was reversed by transfection of short interfering RNA for ICER, not by scramble RNA. Overexpression of ICER by an adenovirus vector attenuated neointimal formation (intima/media ratio) by 50% compared with overexpression of LacZ. The number of terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling-positive cells was increased and the number of Ki-67-positive cells was decreased in ICER-transduced artery. CONCLUSION These results suggest that ICER induces apoptosis and inhibits proliferation of VSMCs, and plays a critical role in beraprost-mediated suppression of VSMC proliferation. ICER may be an important endogenous inhibitor of vascular proliferation.
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MESH Headings
- Analysis of Variance
- Animals
- Aorta, Thoracic/cytology
- Apoptosis/drug effects
- Apoptosis/physiology
- Blotting, Western
- Cell Proliferation/drug effects
- Cells, Cultured
- Cyclic AMP Response Element Modulator/drug effects
- Cyclic AMP Response Element Modulator/metabolism
- Disease Models, Animal
- Epoprostenol/analogs & derivatives
- Epoprostenol/antagonists & inhibitors
- Epoprostenol/pharmacology
- In Situ Nick-End Labeling
- Male
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/growth & development
- Probability
- RNA, Messenger/analysis
- Rats
- Rats, Sprague-Dawley
- Reverse Transcriptase Polymerase Chain Reaction
- Sensitivity and Specificity
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Affiliation(s)
- Hideki Ohtsubo
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashiku, 812-8582 Fukuoka, Japan
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Fava G, Ueno Y, Glaser S, Francis H, Demorrow S, Marucci L, Marzioni M, Benedetti A, Venter J, Vaculin B, Vaculin S, Alpini G. Thyroid hormone inhibits biliary growth in bile duct-ligated rats by PLC/IP(3)/Ca(2+)-dependent downregulation of SRC/ERK1/2. Am J Physiol Cell Physiol 2006; 292:C1467-75. [PMID: 17192280 DOI: 10.1152/ajpcell.00575.2006] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The role of the thyroid hormone agonist 3,3',5 l-tri-iodothyronine (T3) on cholangiocytes is unknown. We evaluated the in vivo and in vitro effects of T3 on cholangiocyte proliferation of bile duct-ligated (BDL) rats. We assessed the expression of alpha(1)-, alpha(2)-, beta(1)-, and beta(2)-thyroid hormone receptors (THRs) by immunohistochemistry in liver sections from normal and BDL rats. BDL rats were treated with T3 (38.4 mug/day) or vehicle for 1 wk. We evaluated 1) biliary mass and apoptosis in liver sections and 2) proliferation in cholangiocytes. Serum-free T3 levels were measured by chemiluminescence. Purified BDL cholangiocytes were treated with 0.2% BSA or T3 (1 muM) in the absence/presence of U-73122 (PLC inhibitor) or BAPTA/AM (intracellular Ca(2+) chelator) before measurement of PCNA protein expression by immunoblots. The in vitro effects of T3 (1 muM) on 1) cAMP, IP(3), and Ca(2+) levels and 2) the phosphorylation of Src Tyr139 and Tyr530 (that, together, regulate Src activity) and ERK1/2 of BDL cholangiocytes were also evaluated. alpha(1)-, alpha(2)-, beta(1)-, and beta(2)-THRs were expressed by bile ducts of normal and BDL rats. In vivo, T3 decreased cholangiocyte proliferation of BDL rats. In vitro, T3 inhibition of PCNA protein expression was blocked by U-73122 and BAPTA/AM. Furthermore, T3 1) increased IP(3) and Ca(2+) levels and 2) decreased Src and ERK1/2 phosphorylation of BDL cholangiocytes. T3 inhibits cholangiocyte proliferation of BDL rats by PLC/IP(3)/Ca(2+)-dependent decreased phosphorylation of Src/ERK1/2. Activation of the intracellular signals triggered by T3 may modulate the excess of cholangiocyte proliferation in liver diseases.
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Affiliation(s)
- Giammarco Fava
- Central Texas Veterans Health Care System, Department of Medicine Temple, Texas 76504, USA
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