Effects of thyroid function on peripheral serum markers: results from a cohort of thyroid cancer patients

Maria Laura Monzani; Vincentis Sara De; Casa Venturelli Francesca Della; Francesca Piccinini; Simonetta Tagliavini; Robin P Peeters; Manuela Simoni; Giulia Brigante

doi:10.1530/endoabs.67.O14

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Endocrine Abstracts (2019) 67 O14 | DOI: 10.1530/endoabs.67.O14

EYES2019 7th ESE Young Endocrinologists and Scientists (EYES) Meeting Oral Presentations (67 abstracts)

Effects of thyroid function on peripheral serum markers: results from a cohort of thyroid cancer patients

Maria Laura Monzani ^1, , Sara De Vincentis ^1, , Francesca Della Casa Venturelli ¹ , Francesca Piccinini ^1, , Simonetta Tagliavini ³ , Robin P Peeters ⁴ , Manuela Simoni ^1, & Giulia Brigante ^1,

Err

Author affiliations

¹Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; ²Department of Medical Specialties, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy; ³Department of Laboratory Medicine and Pathology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy; ⁴ Department of Internal Medicine, Academic Center for Thyroid Diseases, Erasmus Medical Center, Rotterdam, the Netherlands.

Objective: The aim of this study was to identify changes in thyroid hormone metabolism occurring in different thyroid functional states and to evaluate tissue response to thyroid hormone changes.

Methods: Two hundred subjects (137 F, 63 M, mean age: 50.3±14.4 years) waiting to be treated or treated with total thyroidectomy for differentiated thyroid cancer were enrolled in this study. Thyroid function was investigated measuring TSH, fT4 and fT3, and total cholesterol, cholesterol HDL, triglycerides, CK and myoglobin were analyzed as serum markers of tissue thyroid state. According to time (before or after thyroidectomy) and LT4 therapy, patients were divided in 5 groups: euthyroid before total thyroidectomy (T0, n=17), hypothyroid before radioactive iodine (RAI) therapy (T1, n=69), hyperthyroid on LT4 TSH-suppressive therapy (T2, n=107), TSH-stimulated with rh-TSH (T3, n=116), euthyroid on LT4 replacement therapy (T4, n=33). The non-parametric Kruskal-Wallis test was used for comparison among 5 groups.

Results: Even though TSH, fT4 and fT3 levels were not significantly different among patients before (T0) and after thyroidectomy on LT4 replacement therapy (T4), fT3/fT4 ratio was lower in T4 than T0 patients, probably for a deranged conversion of T4-to-T3. Moreover, total cholesterol (P=0.306), calculated-LDL (P=0.463), triglycerides (P=0.318) and CK (P=1) levels did not show statistically significant differences between hypothyroid (T1) and euthyroid patients on LT4 replacement therapy (T4).

Conclusions: In thyroidectomized patients on LT4 replacement therapy, despite a biochemical restoration of euthyroidism, T3 levels in peripheral tissues are not fully normalized, with a consequent, documented worsening of lipid profile and skeletal muscle damage.