Endocrine Abstracts

Background: Endocrine system (ES) is unique amongst all organ systems (OS) in human body. ES is a conglomeration of different endocrine organs. So far, the only models of proof o fintegrity within ES are APUD cell concept; HPA axis; HPG axis; biochemical pathways of hormones. But, the flaws in the above models are their presumptive and extrapolative nature. We wanted to test a model that every endocrine disease has collateral effect on other endocrine organs. We took nontoxic goiter (thyroid) and primary hyperparathyroidism as prototypes.

Material and Methods: This prospective case-control study was conducted on 300 cases (270 thyroid and 30 parathyroid) and age matched 300 controls from healthy blood donors over a period of 12 months. Institutional ethical committee approval was obtained. All thyroid and parathyroid cases underwent uneventful curative thyroidectomy and parathyroidectomy respectively. Exclusion criteria were subjects with any febrile illness, candidates with stress, anxiety neurosis, allergies, chronic drug use, diabetes, systemic or chronic inflammatory disease or calcium/vitamin D supplements, any medication which interferes with the normal function of the hypothalamic-pituitary axis, menopausal age group. Serum samples were collected preoperatively, from all the subjects in both groups as per the standard collection times and procedures. Statistical analysis was performed by SPSS 20.0. P value of <0.05 was considered significant.

Results: Mean prolactin, Luteinising hormone (LH), follicular stimulating hormone (FSH), parathormone, cortisol and testesterone in thyroid cases and controls were 28.6 ± 8.2 ng/ml (12–87), 24.3 ± 1.9 IU/l (10–57), 16.6 ± 3.4 IU/l (8.4–41), 23.5 ± 4.7 pg/ml (15–65), 7.2 ± 2.4 mg/dl (4–16.5),256 ± 57 ng/dl (167–478) and 14.5 ± 3.4 ng/ml (8–18), 11.4 ± 2.5 IU/l (2.5–12.5), 6.2 ± 2.9 IU/l (3.5–21), 21.1 ± 5.3 pg/ml (9–46), 11.2 ± 3.6 mg/dl (5.5–19), 212 ± 45 ng/dl (115–368) respectively. There was statistically significant difference of prolactin, LH, FSH and cortisol values between thyroid cases and controls. But statistical difference was significant only for prolactin, FSH and LH between parathyroid cases and controls.

Conclusions: Our study highlights an unique model of endocrine homeostasis and integrity of ES. The results provides a distinct opportunity to screen and pre-emptively treat subclinicalendocrine diseases. But, the exactpathophysiological mechanism and significance ofhormonal interplay between varied endocrine organs needs active research.

Keywords: thyroid, parathyroid, prolactin, goiter, cortisol, insulin.