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Cited by 77Thyroid Disorders and TreatmentsPotassium and Related DisordersThyroid and Parathyroid Surgery

Hyperinsulinaemia and Na+, K+ ‐ATPase activity in thyrotoxic periodic paralysis

Chan, A., Shinde, R., Chow, C. C., Cockram, C. S., Swaminathan, R.·1994·Clinical Endocrinology
DOI 10.1111/j.1365-2265.1994.tb02532.x
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Abstract

Summary: OBJECTIVE Thyrotoxic periodic paralysis (TPP) usually follows a heavy carbohydrate meal and this may be explained by hyperinsulinaemia stimulating Na+, K+ ‐ATPase activity. To clarify this the effect of glucose load on serum insulin concentration and platelet Na+, K+ ‐ATPase activity In thyrotoxic periodic paralysis (TPP) was examined. DESIGN In all subjects a standard 75‐g glucose tolerance test was done and blood samples were taken at 0, 1 and 2 hours. SUBJECTS Twenty‐five healthy controls (8 M and 17 F), 17 uncomplicated thyrotoxic patients (7M and 10 F), 15 TPP patients who presented with paralysis and 4 TPP patients after treatment with antithyrold drugs. MEASUREMENTS Plasma glucose was measured by the glucose oxidase method, serum insulin by radioimmunoassay and platelet Na+, K+ ‐ATPase by the release of phosphate from ATP. RESULTS TPP patients showed glucose intolerance (area under the curve (AUC) 16·5 ± 4·4 (mean ± SD) In TPP compared to 12·9 ± 4·5 In controls (P < 0·01) and hyperinsulinaemia (AUC 189·6 ±100·6 vs 98·5 ±53·4, P < 0·001). In uncomplicated thyrotoxicosis the results were similar to that in healthy controls. Platelet Na+, K+ ‐ATPase were significantly higher in thyrotoxic patients compared to controls and In TPP patients were even higher. Ingestion of glucose increased platelet Na+, K+ ‐ATPase in all groups. AUC for platelet Na+, K+ ‐ATPase in TPP patients were significantly higher than in uncomplicated thyrotoxicosis (601 ±99·3 vs 482 ± 109·4, P < 0·01) or healthy controls (320 ± 107·3). In the 4 TPP patients studied after antithyroid treatment the results were similar to healthy controls. CONCLUSION Patients with thyrotoxic periodic paralysis have hyperinsulinaemia and this is accompanied by higher Na+, K+‐ATPase activity.

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Crossref · 10.1111/j.1365-2265.1994.tb02532.x

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  • Hyperinsulinemia is observed during acute attacks of TPP and TPP patients have exaggerated insulin responses to oral glucose challenge compared with patients with pure hyperthyroidism.

    “The role of insulin in TPP was revealed by the finding that hyperinsulinemia was observed during acute attacks of TPP and that TPP patients had exaggerated insulin responses to oral glucose challenge in comparison with patients with pure hyperthyroidism (17, 18, 19).”

    From A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants (2013) · cites this paper as [18]

  • Insulin stimulates Na+/K+-ATPase activity.

    “Insulin-response sequences are present in the upstream region of Na+/K+-ATPase genes, and insulin has been shown to stimulate Na+/K+-ATPase activity [10].”

    From Thyrotoxic Periodic Paralysis: Clinical Challenges (2014) · cites this paper as [10]

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Authors
Chan, A., Shinde, R., Chow, C. C., Cockram, C. S., & Swaminathan, R.
Affiliations
  • Prince of Wales Hospital (CN)
  • Guy's Hospital (GB)
Corresponding author
Swaminathan, R.
Venue
Clinical Endocrinology
Publisher
Wiley
Published
1994-08
Volume
41
Issue
2
Pages
213-216
ISSN
  • 0300-0664 (ISSN-L)
  • 1365-2265
DOI
10.1111/j.1365-2265.1994.tb02532.x
OpenAlex
W2163997660
Cited by
77
References
17
Citations by year
2026: 1 · 2025: 2 · 2024: 3 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 5 · 2013: 3 · 2012: 3
FWCI
0.00
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4977 d)
Locations
  • Clinical Endocrinology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
Keywords
thyrotoxic periodic paralysis, hyperinsulinemia, Na+/K+-ATPase, glucose tolerance, hyperinsulinemic hypoglycemia, thyrotoxicosis, antithyroid drug therapy, carbohydrate load
MeSH terms
Sodium-Potassium-Exchanging ATPase, Adult, Blood Platelets, Female, Glucose Tolerance Test, Humans, Insulin, Male, Middle Aged, Muscular Diseases, Paralysis, Thyroid Diseases

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