![]() ![]() Clinical and laboratory data were collected retrospectively from medical records. 2017 were recruited consecutively (if informed consent was obtained). A total of 271 patients hospitalized at the Affiliated Drum Tower Hospital of Nanjing University Medical School (Nanjing, China) from Dec. We hypothesized that as a critical metabolic hormone, low FT3 levels may be associated with disease activity and the lipid profile in patients with SLE.Ī single-center, observational and cross-sectional study was performed. The aim of the present study was to explore the prevalence and clinical significance of NTIS in a Chinese cohort with SLE. Nonthyroidal illness syndrome (NTIS also known as low triiodothyronine syndrome or euthyroid sick syndrome) is also prevalent in SLE and characterized by decreased serum T3, normal to low thyroxine (T4), and thyroid-stimulating hormone (TSH) levels. Importantly, dyslipidemia is associated with disease activity (e.g., kidney damage and cardiovascular disease), and is closely related to the long-term prognosis of SLE patients. Dyslipidemia, characterized as increased total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and/or decreased high-density lipoprotein (HDL) levels in the serum, is prevalent in SLE patients with an incidence ranging between 18.1% and 75%. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by autoantibody production in women of childbearing age. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper.įunding: This study was supported by Nanjing Medical Science and Technique Development Foundation (Z.C., ZKX16039). Received: DecemAccepted: MaPublished: April 16, 2020Ĭopyright: © 2020 Zhang et al. PLoS ONE 15(4):Įditor: Deyu Fang, Northwestern University Feinberg School of Medicine, UNITED STATES (2020) Clinical significance of non-thyroidal illness syndrome on disease activity and dyslipidemia in patients with SLE. doi: 10.1210/: Zhang X, Liu L, Ma X, Hu W, Xu X, Huang S, et al. Impaired thyroxine and 3,5,3'-triiodothyronine handling by rat hepatocytes in the presence of serum of patients with nonthyroidal illness. Vos RA, De Jong M, Bernard BF, Docter R, Krenning EP, Hennemann G. Plasma membrane transport of thyroid hormones and its role in thyroid hormone metabolism and bioavailability. Hennemann G, Docter R, Friesema EC, de Jong M, Krenning EP, Visser TJ. Beyond low plasma T3: local thyroid hormone metabolism during inflammation and infection. Disorder of thyroid hormone transport into the tissues. Minireview: thyroid hormone transporters: the knowns and the unknowns. Thus, there is a clear need for adequately powered randomized clinical trials (RCT) with clinically relevant endpoints to fill this knowledge gap.ĭeiodinase Low T3 syndrome Sick euthyroid syndrome T3 T4 TH TRH TSH rT3. Although endocrinologists have been tempted to correct NTIS by TH supplementation, there is at present insufficient evidence that this is beneficial. A fascinating role for TH metabolism in innate immune cells, including neutrophils and monocytes/macrophages, was reported in recent years, but there is no evidence at this early stage that this may be a determinant of susceptibility to infections. Finally, the role of inflammatory pathways in these non-systemic changes has begun to be clarified. These differential changes now have a solid basis in molecular studies on organ-specific TH transporters, receptors and deiodinases. Moreover, both experimental animal and clinical studies have shown that tissue TH concentrations during NTIS do not necessarily reflect serum low TH concentrations and may decrease, remain unaltered, or even increase according to the organ and type of illness studied. ![]() In recent years, it has become clear that (parenteral) feeding in patients with critical illness should be taken into account as a major determinant not only of NTIS but also of clinical outcome. Ever since, NTIS has remained an intriguing phenomenon not only because of the robustness of the decrease in serum triiodothyronine (T3), but also by its clear correlation with morbidity and mortality. The non-thyroidal illness syndrome (NTIS) was first reported in the 1970s as a remarkable ensemble of changes in serum TH (TH) concentrations occurring in probably any severe illness. ![]()
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