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Published on: January 16, 2019
The Changes of Thyroid Function and Related Factors in Critical Patients without Thyroid Illness in ICU: A
1Department of Endocrinology, The First Hospital of Fuzhou, Fuzhou, 350009, People's Republic of China.
Insights
Critically ill patients may have central hypothyroidism, linked to higher fasting plasma glucose. Consider thyroid function tests when fasting plasma glucose exceeds 6.4 mmol/L.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Internal Medicine
Background:
- Non-thyroidal illness syndrome (NTIS) is common in critically ill patients.
- Thyroid dysfunction assessment in intensive care units (ICUs) is crucial for patient management.
- Understanding thyroid function changes in critical illness aids in identifying potential complications.
Purpose of the Study:
- To analyze thyroid function changes in critically ill patients with non-thyroidal illness.
- To identify indicators for thyroid function assessment in the ICU setting.
- To investigate the relationship between thyroid function and other clinical factors in critical care.
Main Methods:
- Retrospective analysis of 52 ICU patients from May 2018 to March 2019.
- Patients categorized into central hypothyroidism (CH) and low T3 syndrome (LT3S) groups.
- Correlation analysis using Spearman's or Pearson's coefficients.
Main Results:
- Central hypothyroidism (CH) group showed significantly lower thyroid-stimulating hormone (TSH) than LT3S group (0.3 vs 1.7 IU/mL, P < 0.001).
- Fasting plasma glucose (FPG) was significantly higher in the CH group compared to the LT3S group (10.3 vs 6.8 mmol/L, P = 0.002).
- APACHE II scores were comparable between the CH and LT3S groups.
Conclusions:
- Central hypothyroidism may occur in critically ill patients.
- Elevated fasting plasma glucose levels are associated with central hypothyroidism in this population.
- Active thyroid function examination is recommended when FPG is >6.4 mmol/L on admission.
Objective:
To retrospectively analyze the changes of thyroid function and related factors in critical patients with non-thyroid illness, hoping to find some indicators for the further examination of the thyroid function in the intensive care unit situation.
Methods:
The clinical data of 52 patients admitted to the ICU of Fuzhou First Hospital in Fujian Province, China, from May 2018 to March 2019 were collected. Patients were allocated into the central hypothyroidism group (CH group, n = 21) and the low T3 syndrome group (LT3S group, n = 31) based on thyroid function. All related medical data were collected, and the correlations between variables were identified using Spearman's or Pearson's rank correlation coefficients.
Results:
The Acute Physiology and Chronic Health Evaluation (APACHE) II score in the CH group and the LT3S group were 20.6 ± 3.6 and 19.3 ± 3.6, respectively, measured within 24 hours following hospital admission. The mean value of thyroid-stimulating hormone (TSH) in the CH group (0.3 ± 0.3 IU/mL) was significantly lower than that in the LT3S group (1.7 ± 0.9 IU/mL), P < 0.001. Fasting plasma glucose (FPG) level in the CH group was significantly higher than that in the LT3S group (10.3 ± 5.0 mmol/L vs 6.8 ± 2.5 mmol/L, P = 0.002).
Conclusion:
Central hypothyroidism may exist in critically ill patients and may be associated with elevated fasting plasma glucose levels; accordingly, it should be included as part of patient assessment. When FPG is higher than 6.4mmol/L on admission, thyroid function should be actively examined.
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