Post-thyroidectomy thyroxine replacement dose in patients with or without compensated heart failure: the role of cytokines.

摘要

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. PATIENTS AND 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.