A STUDY OF THE SERUM CONCENTRATION OF TUMOR-NECROSIS-FACTOR-ALPHA IN THYROIDAL AND NONTHYROIDAL ILLNESSES
A STUDY OF THE SERUM CONCENTRATION OF TUMOR-NECROSIS-FACTOR-ALPHA IN THYROIDAL AND NONTHYROIDAL ILLNESSES
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DOI：
10.1210/jcem-72-5-1113
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发表时间：
1991-05-01
影响因子：
5.8
通讯作者：
TECO, GNC
中科院分区：
文献类型：
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作者：
CHOPRA, IJ;SAKANE, S;TECO, GNC
我们研究了正常人(n=16)、非甲状腺疾病(NTI；n=13)、甲亢(n=10)和甲减(n=9)患者血清肿瘤坏死因子-α(TNF-α)和碘甲状腺原氨酸(T4、T3和rT3)的水平。正常组、NTI组、甲亢组、甲减组血清肿瘤坏死因子-α平均浓度分别为45+/-4.3、84+/-38、54+/-6.0、50+/-10，差异无统计学意义。除1例脑胶质瘤和感染患者外，所有NTI患者的血清肿瘤坏死因子-α水平均在正常范围内(540fmol/ml)。NTI患者血清肿瘤坏死因子-α水平与血清T_4、T_3、T_3水平无明显相关性。同样，当将正常受试者和NTI患者的数据结合起来时，血清肿瘤坏死因子-α和血清甲状腺激素(T3或T4)水平之间没有相关性。血清可透析性T_3浓度和游离T_3浓度与血清肿瘤坏死因子-α水平无相关性。而NTI患者T4可透析分数与血清肿瘤坏死因子-α浓度呈正相关(r=0.54；n=11；0.05；P<；0.1)。当将正常受试者和NTI患者的数据合并进行统计分析时，这两个参数之间的关系变得更加清晰(r=0.59；n=22；P<；0.005)。无论是对NTI患者进行单独分析(r=0.93P<；0.001)，还是结合正常对照组(r=0.85P<；0.001)进行分析，游离T4水平与血清肿瘤坏死因子-α水平均呈正相关。我们的数据提示，循环中的肿瘤坏死因子-α可能是NTI患者游离T4升高的原因之一。然而，在NTI(正常甲状腺疾病综合征)的其他血清甲状腺激素水平改变的发病机制中，它并不是一个普遍或共同的因素。
We have studied serum concentrations of immunoassayable tumor necrosis factor-alpha (TNF-alpha) and iodothyronines (T4, T3, and rT3) in normal subjects (n = 16) and patients with nonthyroidal illnesses (NTI; n = 13), hyperthyroidism (n = 10), and hypothyroidism (n = 9). The mean (+/- SEM; femtomoles per mL) serum concentration of TNF-alpha was 45 +/- 4.3 in normal subjects, 84 +/- 38 in NTI, 54 +/- 6.0 in hyperthyroidism, and 50 +/- 10 in hypothyroidism; the various values did not differ significantly from one another. Serum TNF-alpha was well within the normal range in all NTI patients, except one patient with a brain glioma and infection in whom it was elevated (540 fmol/mL). There was no significant correlation between serum TNF-alpha and serum T4, T3, or rT3 levels in NTI patients. Similarly, there was no correlation between serum TNF-alpha and serum thyroid hormone (T3 or T4) levels when data in normal subjects were combined with those in NTI patients. The dialyzable fraction of T3 and the free T3 concentration did not correlate with serum TNF-alpha levels. However, there was a tendency toward a positive correlation between dialyzable fraction of T4 and the serum concentration of TNF-alpha in NTI (r = 0.54; n = 11; 0.05 > P < 0.1). The relationship between these two parameters became more clear when data in normal subjects and NTI patients were combined for statistical analysis (r = 0.59; n = 22; P < 0.005). The free T4 concentration correlated positively with serum TNF-alpha levels whether the data in NTI patients were analyzed alone (r = 0.93; P < 0.001) or in combination with data from normal subjects (r = 0.85; P < 0.001). Our data suggest that circulating TNF-alpha may contribute to elevated free T4 in NTI. However, it is not a universal or common factor in the pathogenesis of other alteranations in serum thyroid hormone levels in NTI (euthyroid sickness syndrome).