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fT3:fT4 ratio in Graves’ disease — correlation with TRAb level, goiter size and age of onset

Mari Minasyan Aleksandra Dulęba Anna Smalarz Maria Stręk Paweł Bryniarski Elwira Przybylik-Mazurek Alicja Hubalewska-Dydejczyk
Folia Medica Cracoviensia | 2020 | Vol. 60 | No 2 | 15-27 | DOI: 10.24425/fmc.2020.135010
Keywords Grave’s disease fT3:fT4 ratio TRAb
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Abstract

Introduction: Graves’ Disease (GD) is an autoimmune hyperthyroidism occurring mostly in young women. The main pathogenic role of the disease is attributed to TSH receptor antibodies (TRAb), which stimulate the thyroid gland to increase production of the most active thyroid hormone- triiodothyronine (T3). High level of TRAb and a large goiter size are commonly known as poor prognostic factors for the disease and are used to predict relapse.

The aim: The purpose of our study was to check the correlation between fT3:fT4 ratio with TRAb concentration, total volume of thyroid and age of GD onset.

Materials and Methods: 114 patients with onset or relapse of GD were analyzed. Those after thyroidectomy or radioiodine therapy were not taken into analysis. The data was retrospectively retrieved from the hospital’s records consisting of patients’ sex, age, level of TRAb, fT3, fT4 and thyroid volume on ultrasonography. The association between fT3:fT4 and TRAb concentration, thyroid volume and age was evaluated using Pearson correlation coefficient.

Results: The group was predominated by women (19.3% men, 80.7% women). The average age was 47.0. The analysis revealed positive correlation between: 1) fT3:fT4 ratio and total volume of thyroid (correla-tion ratio: 0.37; p <0.05) 2) fT3:fT4 ratio and level of TRAb (correlation ratio: 0.26; p <0.05) 3) negative correlation between fT3:fT4 ratio and patient’s age (correlation ratio: –0.14; p = 0.144.

Conclusions: Positive correlations between fT3:fT4 ratio and TRAb level and total volume of thyroid (poor predictors of GD) may confirm that high level of fT3 can also be a prognostic factor for GD severity.

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Authors and Affiliations

Mari Minasyan
Aleksandra Dulęba
Anna Smalarz
Maria Stręk
Paweł Bryniarski
Elwira Przybylik-Mazurek
Alicja Hubalewska-Dydejczyk

Vitamin D status and its associations with clinical and laboratory parameters in patients with Addison’s disease

Karolina Zawadzka Katarzyna Matwiej Grzegorz Sokołowski Małgorzata Trofimiuk-Müldner Anna Skalniak Alicja Hubalewska-Dydejczyk
Folia Medica Cracoviensia | 2021 | Vol. 61 | No 2 | 65-78 | DOI: 10.24425/fmc.2021.137224
Keywords primary adrenal insufficiency Addison’s disease vitamin D autoimmunity
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Abstract

Introduction: There is increasing evidence that several autoimmune diseases, as well as their activity, are associated with vitamin D (VD) deficiency. Our study aimed to evaluate the prevalence of VD insufficiency in patients with Addison’s disease (AD), as well as to evaluate associations between VD concentrations and various clinical and laboratory parameters of the disease.
Materials and Methods: We retrospectively analyzed medical records of 31 adult patients diag-nosed with autoimmune Addison’s disease, in whom serum VD was measured. We assessed correlations between serum VD and various clinical and laboratory parameters.
Results: 90.3% of AD patients had inadequate VD concentrations (<30 ng/mL), and 19.3% of them were found to be severely VD deficient (<10 ng/mL). Among assessed laboratory variables, only serum calcium concentrations significantly correlated with VD status (r = 0.53, p = 0.006). The mean serum VD con-centration was significantly lower in patients with severe fatigue (15.17 ± 8.41 vs 26.83 ± 12.29 ng/mL, p = 0.011) and limited exercise capacity (12.38 ± 6.9 vs 21.63 ± 10.87 ng/mL, p = 0.016).
Conclusions: This study demonstrates a high prevalence of VD deficiency in AD patients, as well as the association between low VD concentrations with symptoms such as severe fatigue or limited exercise capacity. Further studies are needed to clarify if impaired VD status is a risk factor in the pathogenesis of AD and to assess if VD supplementation improves the quality of life of AD patients.
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Authors and Affiliations

Karolina Zawadzka
1
Katarzyna Matwiej
1
Grzegorz Sokołowski
2
Małgorzata Trofimiuk-Müldner
2
Anna Skalniak
2
Alicja Hubalewska-Dydejczyk
2
  1. Students’ Scientific Group of Endocrinology at the Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
  2. Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland

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