Thyroid function changes and cytokine alterations following major surgery.
To establish whether cytokine release is implicated in thyroid hormone changes during surgical stress we studied 36 adult patients (20 men; mean age +/- SD: 68.5 +/- 10.5 years) undergoing elective major abdominal operations. We measured tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, IL-8 and IL-10 and thyrotropin (TSH), free thyroxine (FT(4)) and triiodothyronine (T(3)) before scheduled non-emergency surgery, immediately postoperatively, on the 1st postoperative day (post-1) and on the 2nd postoperative day (post-2). TNF-alpha, IL-6 and IL-8 peaked on day post-1 whereas IL-10 peaked immediately postoperatively. Fourteen of 36 patients had low T(3) levels after surgery, indicating non-thyroidal illness (NTI). Significant negative correlations were noted among TNF-alpha, IL-6 and IL-8 against T(3) and FT(4). Cytokines are responsible, at least in part, for NTI following major operations.
Ilias
Ioannis
I
Department of Endocrinology, Elena Venizelou Hospital, Athens, Greece. iiliasmd@yahoo.com
Tzanela
Marinella
M
Mavrou
Irini
I
Douka
Evangelia
E
Kopterides
Petros
P
Armaganidis
Apostolos
A
Orfanos
Stylianos
S
Kostopanagiotou
Georgia
G
Macheras
Anastasios
A
Tsagarakis
Stylianos
S
Dimopoulou
Ioanna
I
D000005:Abdomen / Q000601:surgery; D000367:Age Factors; D000368:Aged; D016207:Cytokines / Q000097:blood* / Q000378:metabolism; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007037:Hypothyroidism / Q000097:blood / Q000276:immunology; D007107:Immune System / Q000276:immunology; D007249:Inflammation / Q000097:blood / Q000276:immunology / Q000503:physiopathology; D007378:Interleukins / Q000097:blood / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000276:immunology* / Q000503:physiopathology; D013312:Stress, Physiological / Q000097:blood* / Q000276:immunology* / Q000503:physiopathology; D013961:Thyroid Gland / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D013963:Thyroid Hormones / Q000097:blood* / Q000378:metabolism; D013972:Thyrotropin / Q000097:blood / Q000378:metabolism; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000378:metabolism; D015854:Up-Regulation / Q000276:immunology
D016207:Cytokines; D007378:Interleukins; D013963:Thyroid Hormones; D014409:Tumor Necrosis Factor-alpha; D013972:Thyrotropin