Session: SAT 449-497-Thyroid Neoplasia & Case Reports
Poster Board SAT-462
One hundred patients (37 inpatients and 63 outpatients) consented to give a blood sample for the study. Physiologic data and medical conditions were documented. 3, 3-diiodothyronine and 3-iodothyronamine concentrations were measured by liquid chromatography tandem mass spectrometry.
In univariate analyses decreased 3-iodothyronamine concentrations (0 vs > 0 pg/ml) were associated with a diagnosis of stroke (15% vs 0%, p value 0.023), hospitalization in the critical care unit (43% vs 16%, p value 0.008), and being an inpatient (47% vs 16%, p value 0.025). The following groups of 3, 3-diiodothyronine concentrations (2.01-7.48 vs 7.74-12.4 vs 12.5-17 vs 17.9-45.8 pg/ml) were associated with decreasing occurrence of critical illness (58% vs 11% vs 0% vs 8%,), stroke (29% vs 7.7% vs 4% vs 0%), being in a critical care unit (75% vs 39% vs 8.3 % vs 12%), and being an inpatient (83% vs 42% vs 8% vs 12%), p values for each of these 3 conditions being <0.0001. The same concentration groups were associated with increased occurrence of the athyreotic, levothyroxine replaced state in outpatients (4% vs 11% vs 17 % vs 60%). No other medical conditions such as hypertension or diabetes were associated.
In multivariate analyses, accounting for age and gender, inpatient status was associated with decreased concentrations of 3, 3-diiodothyronine (estimate -0.62, standard error 0.12, p value <0.0001), and 3-iodothyronamine (odds ratio 0.145, 95% CI 0.045-0.471). The athyreotic state remained associated with increased concentrations of 3, 3-diiodothyronine (estimate 0.26, SE 0.13, p value 0.04). No other specific conditions continued to be significant.
We confirm that sufficient 3, 3-diiodothyronine is made from peripheral conversion to maintain levels in patients dependent on levothyroxine. We also newly demonstrate associations between the inpatient status and reduced 3, 3-diiodothyronine and 3-iodothyronamine concentrations. The finding of an association between low 3-iodothyronamine concentrations and being an inpatient was unanticipated, given that prior studies suggest elevated levels in some pathologic conditions, These would appear to be global changes associated with illness in general, given that associations with specific medical conditions were not identified. Whether these are adaptive or maladaptive generalized changes associated with illness would need to be elucidated in an appropriately powered non-pilot study.
Nothing to Disclose: JJ, AS, HW, DF, OPS, KDB, SS
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