Thyroid hormones modulate irisin concentrations in patients with recently onset hypothyroidism following total thyroidec
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ORIGINAL ARTICLE
Thyroid hormones modulate irisin concentrations in patients with recently onset hypothyroidism following total thyroidectomy R. Bocale1 · A. Barini2 · A. D‘Amore1 · M. Boscherin1 · S. Necozione3 · A. Barini2 · G. Desideri3 · C. P. Lombardi1 Received: 30 March 2020 / Accepted: 23 September 2020 © The Author(s) 2020
Abstract Purpose Irisin is a newly discovered adipo-myokine known for having significant effects on body metabolism. Currently, there is a discussion regarding the relation between thyroid function and irisin concentration. This study was designed to evaluate the influential role of levothyroxine replacement therapy on circulating levels of irisin in patients with recently onset hypothyroidism following total thyroidectomy. Methods Circulating levels of thyroid hormones, irisin and other metabolic parameters, were assessed in 40 recently thyroidectomized patients (34 females, mean age 50.1 ± 15.2 years) at baseline (5–7 day after surgery) and after 2 months under replacement therapy with levothyroxine. Results At baseline, circulating levels of thyroid hormones were indicative of hypothyroidism (TSH 12.7 ± 5.0 μU/mL, FT3 1.9 ± 0.7 pg/mL, FT4 8.7 ± 3.6 pg/mL). Mean serum irisin concentrations significantly increased after 2 months under replacement therapy with levothyroxine (from 2.2 ± 0.6 to 2.9 ± 0.6 μg/mL, p 30 kg/m2). Circulating levels of thyroid hormones at baseline were indicative of either subclinical or overt hypothyroidism (TSH 12.7 ± 5.0 μU/ mL, FT3 1.9 ± 0.7 pg/mL, FT4 8.7 ± 3.6 pg/mL) (Table 1, supplementary figures 1, 2 and 3). The mean serum irisin concentration at baseline was 2.2 ± 0.6 μg/mL (Table 1 and supplementary figure 4). After 2 months under L-T4 replacement therapy, a significant improvement of thyroid hormone profile was observed in the general study population (Table 1) although a few patients did not achieve a completely satisfactory thyroid hormones replacement or retained the condition of hypothyroidism (supplementary figures 1, 2 and 3). Serum irisin levels significantly increased under L-T4 replacement therapy (Fig. 1 and supplementary figure 4). Circulating levels of both HDL cholesterol and glucose slightly but significantly increased during replacement therapy while triglycerides concentrations significantly decreased (Table 1). A slight but significant reduction of eGFR was observed after 2 months under replacement therapy (Table 1).
Journal of Endocrinological Investigation
Gender (females/males) Age (years) BMI (kg/m2) SBP (mmHg) DBP (mmHg) TC (mmol/L) LDL-C (mmol/L) HDL-C (mmol/L) TG (mmol/L) Glucose (mmol/L) Insulin (mU/L) HOMA-IR TSH (μU/mL) FT3 (pg/mL) FT4 (pg/mL) eGFR (ml/min) Irisin (μg/mL)
Baseline
2 months
p value*
34/6 50.1 ± 15.2 26.5 ± 5.1 125.7 ± 10.5 76.9 ± 6.4 4.7 ± 0.9 2.8 ± 0.8 1.3 ± 0.4 1.3 ± 0.6 4.6 ± 0.9 10.4 ± 5.1 2.2 ± 1.1 12.7 ± 5.0 1.9 ± 0.7 8.7 ± 3.6 86.7 ± 26.9 2.2 ± 0.6
– – 26.6 ± 5.1 126.0 ± 8.5 77.4 ± 5.7 4.8 ± 0.8 2.9 ± 0.6 1.4 ± 0.4 1.1 ± 0.4 5.1 ± 0.6 10.0 ± 5.0 2.3 ± 1.3 3.7 ± 4.3 2.9 ± 0.5 15.5 ± 2.7
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