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[Substrate metabolism in untreated and treated thyrotoxicosis].
Ugeskr Laeger. 1998 Mar 02; 160(10):1475-9.UL

Abstract

Accelerated metabolism is a hallmark of thyrotoxicosis, but the underlying biochemical mechanisms are incompletely understood. In order to elucidate these metabolic events further, we studied 12 patients with newly diagnosed diffuse (10 patients) or nodular (two patients) toxic goitre (ten women, two men; age 42.8 +/- 3.2 yr; BMI: 21.6 +/- 0.7 kg/m2) before ("TOX") and after ("TRE") 11.2 +/- 1.0 weeks treatment with methimazole and compared these patients to a control group ("CTR") of 11 subjects (nine women, two men; age 40.5 +/- 3.9 yr; BMI 22.5 +/- 1.0 kg/m2). All were studied for three hours in the basal state, using indirect calorimetry, isotope dilution for measurement of glucose turnover and the forearm technique for assessment of muscle metabolism. Prior to treatment patients with thyrotoxicosis were characterized by: Increased (p < 0.05) levels of T3 (3.75 +/- 0.23 [TOX], 1.89 +/- 0.08 [TRE] and 1.75 +/- 0.11 [CTR] nmol/l), resting energy expenditure (130.5 +/- 3.5 [TOX], 107.7 +/- 2.7 [TRE] and 106.3 +/- 3.1 [CTR] percent of predicted), protein oxidation (0.67 +/- 0.03 [TOX], 0.54 +/- 0.06 [TRE] and 0.46 +/- 0.05 [CTR] mg/kg/min), lipid oxidation (1.34 +/- 0.08 [TOX], 1.00 +/- 0.06 [TRE] and 1.02 +/- 0.04 [CTR] mg/kg/min), endogenous glucose production (2.51 +/- 0.13 [TOX], 1.86 +/- 0.12 [TRE] and 1.85 +/- 0.12 [CTR] mg/kg/min), non-oxidative glucose turnover (1.28 +/- 0.16 [TOX], 0.75 +/- 0.18 [TRE] and 0.71 +/- 0.11 [CTR] mg/kg/min) and a 50% increase in total forearm blood flow. Glucose oxidation (1.23 +/- 0.09 [TOX], 1.13 +/- 0.10 [TRE] and 1.13 +/- 0.09 [CTR] mg/kg/min), exchange of substrates in the muscles of the forearm and circulating levels of insulin, C-peptide, growth hormone or glucagon were not influenced by hyperthyroidism. Propranolol (20 mg thrice daily) given to seven of the patients for two days did not affect circulating levels of thyroid hormones, energy expenditure or glucose turnover rates. These results suggest that all major fuel sources contribute to the hypermetabolism of thyrotoxicosis and that augmented non-oxidative glucose metabolism may further aggravate the condition. All abnormalities recede with medical treatment of the disease.

Authors+Show Affiliations

Møller N
Arhus Universitetshospital, Arhus Kommunehospital, medicinsk afdeling M.
Hove KY
No affiliation info available
Nielsen S
No affiliation info available
Nyholm B
No affiliation info available
Pørksen NK
No affiliation info available
Weeke J
No affiliation info available

MeSH

AdultAntithyroid AgentsEnergy MetabolismFemaleGlucoseGoiterGoiter, NodularHumansMaleMethimazoleSubstrate CyclingThyroid HormonesThyrotoxicosis

Pub Type(s)

Clinical Trial
English Abstract
Journal Article
Randomized Controlled Trial

Language

dan

PubMed ID

9520616

Citation

Møller, N, et al. "[Substrate Metabolism in Untreated and Treated Thyrotoxicosis]." Ugeskrift for Laeger, vol. 160, no. 10, 1998, pp. 1475-9.
Møller N, Hove KY, Nielsen S, et al. [Substrate metabolism in untreated and treated thyrotoxicosis]. Ugeskr Laeger. 1998;160(10):1475-9.
Møller, N., Hove, K. Y., Nielsen, S., Nyholm, B., Pørksen, N. K., & Weeke, J. (1998). [Substrate metabolism in untreated and treated thyrotoxicosis]. Ugeskrift for Laeger, 160(10), 1475-9.
Møller N, et al. [Substrate Metabolism in Untreated and Treated Thyrotoxicosis]. Ugeskr Laeger. 1998 Mar 2;160(10):1475-9. PubMed PMID: 9520616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Substrate metabolism in untreated and treated thyrotoxicosis]. AU - Møller,N, AU - Hove,K Y, AU - Nielsen,S, AU - Nyholm,B, AU - Pørksen,N K, AU - Weeke,J, PY - 1998/4/1/pubmed PY - 1998/4/1/medline PY - 1998/4/1/entrez SP - 1475 EP - 9 JF - Ugeskrift for laeger JO - Ugeskr Laeger VL - 160 IS - 10 N2 - Accelerated metabolism is a hallmark of thyrotoxicosis, but the underlying biochemical mechanisms are incompletely understood. In order to elucidate these metabolic events further, we studied 12 patients with newly diagnosed diffuse (10 patients) or nodular (two patients) toxic goitre (ten women, two men; age 42.8 +/- 3.2 yr; BMI: 21.6 +/- 0.7 kg/m2) before ("TOX") and after ("TRE") 11.2 +/- 1.0 weeks treatment with methimazole and compared these patients to a control group ("CTR") of 11 subjects (nine women, two men; age 40.5 +/- 3.9 yr; BMI 22.5 +/- 1.0 kg/m2). All were studied for three hours in the basal state, using indirect calorimetry, isotope dilution for measurement of glucose turnover and the forearm technique for assessment of muscle metabolism. Prior to treatment patients with thyrotoxicosis were characterized by: Increased (p < 0.05) levels of T3 (3.75 +/- 0.23 [TOX], 1.89 +/- 0.08 [TRE] and 1.75 +/- 0.11 [CTR] nmol/l), resting energy expenditure (130.5 +/- 3.5 [TOX], 107.7 +/- 2.7 [TRE] and 106.3 +/- 3.1 [CTR] percent of predicted), protein oxidation (0.67 +/- 0.03 [TOX], 0.54 +/- 0.06 [TRE] and 0.46 +/- 0.05 [CTR] mg/kg/min), lipid oxidation (1.34 +/- 0.08 [TOX], 1.00 +/- 0.06 [TRE] and 1.02 +/- 0.04 [CTR] mg/kg/min), endogenous glucose production (2.51 +/- 0.13 [TOX], 1.86 +/- 0.12 [TRE] and 1.85 +/- 0.12 [CTR] mg/kg/min), non-oxidative glucose turnover (1.28 +/- 0.16 [TOX], 0.75 +/- 0.18 [TRE] and 0.71 +/- 0.11 [CTR] mg/kg/min) and a 50% increase in total forearm blood flow. Glucose oxidation (1.23 +/- 0.09 [TOX], 1.13 +/- 0.10 [TRE] and 1.13 +/- 0.09 [CTR] mg/kg/min), exchange of substrates in the muscles of the forearm and circulating levels of insulin, C-peptide, growth hormone or glucagon were not influenced by hyperthyroidism. Propranolol (20 mg thrice daily) given to seven of the patients for two days did not affect circulating levels of thyroid hormones, energy expenditure or glucose turnover rates. These results suggest that all major fuel sources contribute to the hypermetabolism of thyrotoxicosis and that augmented non-oxidative glucose metabolism may further aggravate the condition. All abnormalities recede with medical treatment of the disease. SN - 0041-5782 UR - https://www.unboundmedicine.com/medline/citation/9520616/[Substrate_metabolism_in_untreated_and_treated_thyrotoxicosis]_ DB - PRIME DP - Unbound Medicine ER -