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Cited by 57Thyroid Disorders and TreatmentsAdrenal Hormones and DisordersClinical Nutrition and Gastroenterology

Increased Thyroxine Sulfate Levels in Critically Ill Patients as a Result of a Decreased Hepatic Type I Deiodinase Activity

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Peeters, Robin P., Kester, Monique H. A., Wouters, Pieter J., Kaptein, Ellen, van Toor, Hans, Visser, Theo J., Van den Berghe, Greet·2005·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2005-0866
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Abstract

INTRODUCTION: Marked changes in peripheral thyroid hormone metabolism occur in critical illness, resulting in low serum T3 and high rT3 levels. In this study, we investigated whether T4S levels are increased in patients who died after intensive care and whether T4S levels are correlated with liver type I deiodinase (D1) or sulfotransferase (SULT) activity. METHODS: A total of 64 blood samples and 65 liver biopsies were obtained within minutes after death from 79 intensive care patients, randomized for intensive or conventional insulin treatment. Serum T4S and the activities of hepatic D1 and 3,3'-diiodothyronine (T2)-SULT and estrogen-SULT were determined. RESULTS: No differences in T4S or hepatic SULT activities were found between patients treated with intensive or with conventional insulin therapy. T4S levels were significantly elevated compared with healthy references. Furthermore, hepatic D1, but not SULT activity, showed a strong correlation with serum T4S (R = -0.53; P < 0.001) and T4S/T4 ratio (R = -0.62; P < 0.001). Cause of death was significantly correlated with hepatic T2- and estrogen-SULT activities (P < 0.01), with SULT activities being highest in the patients who died of severe brain damage and lowest in the patients who died of a cardiovascular collapse. A longer period of intensive care was associated with higher levels of T4S (P = 0.005), and high levels of bilirubin were associated with low T2-SULT (P = 0.04) activities and high levels of T4S (P < 0.001). CONCLUSION: Serum T4S levels were clearly elevated compared with healthy references, and the decreased deiodination by liver D1 during critical illness appears to play a role in this increase in serum T4S levels.

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  • Illness results in marked downregulation of liver DIO1 both in humans and experimental animals.

    “Illness results in marked downregulation of DIO1 both in humans and experimental animals [15, 20, 21].”

    From An update on non-thyroidal illness syndrome (2021) · cites this paper as [20]

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Authors
Peeters, R. P., Kester, M. H. A., Wouters, P. J., Kaptein, E., van Toor, H., Visser, T. J., & Van den Berghe, G.
Affiliations
  • Erasmus MC (NL)
  • KU Leuven (BE)
ORCID
Peeters, Robin P.
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2005-12
Volume
90
Issue
12
Pages
6460-6465
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2005-0866
OpenAlex
W2126433076
Cited by
57
References
39
Citations by year
2026: 1 · 2023: 1 · 2022: 1 · 2021: 7 · 2020: 1 · 2019: 5 · 2018: 2 · 2017: 1 · 2016: 2 · 2015: 4 · 2014: 3 · 2013: 3
FWCI
2.90
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
Funders
ZonMw
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
Keywords
thyroid hormone metabolism, sulfotransferase, critical illness, intensive care, liver biopsy, insulin therapy, thyroid hormone deiodination, causes of death, brain damage, cardiovascular collapse, bilirubin
MeSH terms
Aged, Brain Damage, Chronic, Cardiovascular Diseases, Cause of Death, Female, Humans, Insulin, Intensive Care Units, Iodide Peroxidase, Isoenzymes, Kidney, Length of Stay, Liver, Male, Middle Aged, Thyroxine, Sulfotransferases, Randomized Controlled Trials as Topic, Critical Illness

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