Post-thyroidectomy thyroxine replacement dose in patients with or without compensated heart failure: the role of cytokines.
OBJECTIVE
To investigate the potential association between serum inflammatory cytokine levels and post-thyroidectomy thyroxine replacement dose in patients with or without compensated heart failure.


METHODS
The study included 42 patients (group A: 20 men, mean age of 54.5+/-6.8 years) with NYHA I or II heart failure and 54 patients (group B: 25 men, mean age of 52.9+/-7.1 years) without heart failure. All patients had undergone total thyroidectomy and were euthyroid on a stable thyroxine replacement dose. Serum Interleukin-1b (IL-1b), Tumor Necrosis Factor alpha (TNF-alpha), Interleukin-6 (IL-6), TSH, T3, T4, fT3 and fT4 were measured.


RESULTS
Both groups exhibited a significant positive correlation between IL-6 and levothyroxine replacement dosage (group A: r=0.708, p<0.001; group B: r=0.345, p=0.012) and a negative correlation between IL-6 and T3 (group A: r=-0.342, p=0.023, group B: r=-0.294, p=0.035). Significant independent predictors of levothyroxine replacement dosage were IL-6 (p<0.001) and TNF-alpha (p=0.007) in group A (58.3% of dosage variation) and only IL-6 (p=0.012) in group B (10.1% of dosage variation).


CONCLUSIONS
In both groups, a significant positive correlation was observed between IL-6 and levothyroxine replacement dosage, but this correlation was stronger in group A. In the same group, there was evidence for a more pronounced influence of cytokines on levothyroxine dosage.
Papanas
N
N
Second Department of Internal Medicine, Democritus University of Thrace, Ethnikis Antistasis 44, Alexandroupolis 68100, Greece. papanasnikos@yahoo.gr
Papatheodorou
K
K
Papazoglou
D
D
Gioka
T
T
Antonoglou
C
C
Kotsiou
S
S
Maltezos
E
E
D016207:Cytokines / Q000502:physiology*; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D013965:Thyroidectomy; D013974:Thyroxine / Q000008:administration & dosage*
D016207:Cytokines; D015850:Interleukin-6; D013974:Thyroxine