Low T3 syndrome in psychiatric depression

Abstract INTRODUCTION Reduced triiodothyronine (T3) concentrations were implicated in worse prognosis of brain tumor patients. We investigated the association of thyroid hormone concentrations with health-related quality of life (HRQoL), discharge outcomes and prognosis of brain tumor patients. METHODS Two-hundred and thirty brain tumor patients (70% women) before brain tumor surgery were evaluated for HRQoL (ERTC QLQ-C30 and QLQ-BN20 questionnaires); and thyroid function profile. The Low tri-iodothyronine (T3) syndrome was defined as T3 concentration below the reference range. Unfavorable hospital discharge outcomes were determined as Glasgow outcome scale score of = 3. Follow-up continued until November, 2015. RESULTS >Seventy-four percent of patients had Low T3 syndrome. After adjusting for the brain tumor histological diagnosis, patients' age, gender and functional status, lower free T3 concentrations were associated with worse HRQOL on the QLQ-C30 Global health status (ß = 0.302, P = 0.017), Emotional functioning (ß = 0.422, p<.001) and Cognitive functioning (ß = 0.259, P = 0.042) domains, and with greater symptom severity on the QLQ-BN20 Fatigue (ß = −0.238, p = .041), Motor dysfunction (ß = −0.283, P = 0.013) and Weakness of legs (ß = −0.269. P = 0.027) domains. Preoperative Low T3 syndrome increased risk for unfavorable discharge outcomes adjusting for age, gender and histological diagnosis (OR = 2.944, 95%CI [1.314-6.597], p = .009). In all patients, lower total (p = .038) and free (p = .014) T3 concentrations were associated with greater mortality adjusting for age, gender, extent of resection, adjuvant treatment and histological diagnosis. The Low T3 syndrome was associated with greater 5-year mortality for glioma patients (HR = 2.197; 95%CI [1.160-4.163], p = .016) and with shorter survival (249 [260] vs. 352 [399] days; p = .029) of high grade glioma patients independent of age, gender, extent of resection and adjuvant treatment. CONCLUSION The Low T3 syndrome is common in brain tumor patients and is associated with worse health status, impaired emotional and physical aspects of HRQoL and worse discharge outcomes. The Low T3 syndrome is associated with shorter survival of glioma patients.

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The Prevalence of low T3 syndrome in chronic heart failure: A Hospital-based study

PERSPECTIVES IN MEDICAL RESEARCH - 2 ◽

10.47799/pimr.0803.05 ◽

2021 ◽

Vol 8 (3) ◽

pp. 20-24

Author(s):

Nishanam Gururaj ◽

Nithin Voruganti

Keyword(s):

Heart Failure ◽

Chronic Heart Failure ◽

Ejection Fraction ◽

Complete Blood Count ◽

General Medicine ◽

Left Ventricular ◽

Biologically Active ◽

Low T3 Syndrome ◽

Low T3 ◽

The Mean

Background: Effect of thyroid hormone on cardiac functions is mediated by biologically active T3 which binds to nuclear TR. There is increasing evidence that patients with mild thyroid dysfunctions are presenting with adverse cardiovascular manifestations which includes heart failure. Aim: The present study aimed to determine the existence of low T3 syndrome in patients with chronic heart failure. Material and Methods: This prospective study was conducted in the Department of General Medicine and Cardiology, KMC, and MGM Hospital, Warangal. patients with heart failure were included in the study. A total of n=100 patients were included in the study detailed physical examination was conducted to assess the patient's volume status (rales, edema, jugular venous distension), weight, height, body mass index, and orthostatic blood pressure changes. Complete blood count, blood glucose (fasting and 2 hours postprandial), Fasting serum lipid profile, blood urea, serum creatinine, and serum electrolytes were measured in all patients. Two-dimensional echocardiography was done in patients. Results:Analysis of Echocardiography parametersCompared to patients who were alive (n=90),left ventricular end-diastolic diameter was higher in those whodied (n=10). The mean ejection fraction in died and alive groups were27.19% and 35.12% respectively. Persons who died had asignificantly lower ejection fraction than those alive.When the mean ejection fraction was compared betweenpatients with low total T3 (T3<80 ng/dl) and normal T3 , patients with low T3 had a mean ejection fraction of 29.2% and those with normal T3 levels had a mean ejection fraction of 34.78%. This indicates the mean ejection fraction is lower in patients with low total T3 levels. Conclusion:Within the limitations of the present study it can be concluded that the prevalence of low T3 syndrome in patients with chronic heart failure is common. It was found that patients with lower T3 levels were having a lower ejection fraction.The LVEDD diameterwas negatively correlated with total T3. Therefore, Total T3 levels can be used as an adjunct to other parameters for risk stratification and survival estimation in chronic heart failure.

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