Acute immunometabolic changes in first-presentation Graves' hyperthyroidism patients undergoing strenuous physical...

Area of Science:

• Exercise Physiology
• Endocrinology
• Immunometabolism

Background:

• Graves' hyperthyroidism is associated with muscle wasting and altered metabolic profiles.
• The impact of high-intensity intermittent exercise (HIIE) on immunometabolic responses in these patients is not well understood.
• Understanding these responses is crucial for developing safe and effective exercise prescriptions.

Purpose of the Study:

• To systematically evaluate the immunometabolic responses to repeated HIIE in newly diagnosed female Graves' hyperthyroidism patients compared to healthy controls.
• To explore the associations between thyroid hormone levels, muscle mass, and these exercise-induced responses.

Main Methods:

• 25 newly diagnosed female Graves' hyperthyroidism patients and 25 healthy controls underwent three HIIE sessions.
• Blood samples were analyzed for glucose, lactate, leptin, irisin, creatine kinase (CK), IL-6, IL-15, and TNF-α.
• Baseline thyroid hormones and skeletal muscle index (SMI) were measured; data analyzed using ANOVA and Bayesian network analysis.

Main Results:

• Hyperthyroid patients had higher FT3/FT4, lower TSH, and reduced SMI. Both groups showed decreased HIIE power, but distinct fatigue patterns emerged.
• Exercise increased lactate, glucose, and leptin in both groups, with significant inter-group differences in leptin response.
• IL-6 increased post-exercise, showing significant group interaction, while IL-15 and TNF-α showed group differences but no significant exercise-induced changes.

Conclusions:

• Muscle loss in hyperthyroidism may impair endurance, though not short-term explosive power.
• The hyperthyroid state significantly alters exercise-induced immunometabolic dynamics.
• Personalized exercise regimens must comprehensively consider the complex physiological impact of hyperthyroidism.