Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

12 Issues per year


IMPACT FACTOR 2016: 3.432

CiteScore 2016: 2.21

SCImago Journal Rank (SJR) 2016: 1.000
Source Normalized Impact per Paper (SNIP) 2016: 1.112

Online
ISSN
1437-4331
See all formats and pricing
More options …
Volume 43, Issue 9 (Sep 2005)

Issues

Erythrocyte zinc content in critically ill patients

Darren Cutinha / Sashi Vaja / David Treacher / R. Swaminathan
Published Online: 2011-09-21 | DOI: https://doi.org/10.1515/CCLM.2005.159

Abstract

Abnormalities in thyroid hormone metabolism are common in critically ill patients. However, it is not known if these patients are truly hypothyroid at tissue level. Erythrocyte zinc has been shown to be a tissue marker of thyroid hormone status. In this study we have measured the erythrocyte zinc in critically ill patients.

In this observational study we measured the zinc content of young erythrocytes in blood samples from 33 healthy subjects, 26 hypothyroid patients, four hyperthyroid patients, and 44 patients in the intensive care unit – 22 of these were admitted after a major surgical procedure (surgical group) and the other 22 patients had a variety of conditions (non-surgical group). Erythrocytes were separated according to age by centrifugation. Plasma thyroid hormone concentrations were abnormal in 70% of the critically ill group. Erythrocyte zinc was significantly lower in hyperthyroid patients and higher in hypothyroid patients. In the non-surgical patients, erythrocyte zinc of young cells (median 256μmol/L of cells) was significantly higher than (p<0.01) the corresponding cells in the healthy controls (202μmol/L of cells), whereas in the surgical group it was not different (197μmol/L of cells). We conclude that in non-surgical critically ill patients, erythrocyte zinc content is higher, suggesting that these patients may be hypothyroid at tissue level.

Keywords: critical illness; erythrocyte zinc; hypothyroidism; non-thyroidal illness; tissue markers

References

  • 1.

    Chopra IJ. Euthyroid sick syndrome: is it a misnomer? J Clin Endocrinol Metab 1995; 82: 329–34. Google Scholar

  • 2.

    LoPresti JS, Nicoloff JT. Thyroid response to critical illness. Contemporary endocrinology. In: Ober KP, editor. Endocrinology of critical disease. Totowa, New Jersey: Humana Press, 1997:155–73. Google Scholar

  • 3.

    Maldonado LS, Murata GH, Hershman JM, Braunstein GD. Do thyroid function tests independently predict survival in the critically ill? Thyroid 1992; 2: 119–23. CrossrefGoogle Scholar

  • 4.

    Iervasi G, Pingitore A, Landi P, Raciti M, Ripoli A, L'abbate A, et al. Low T 3 syndrome: a strong prognostic predictor of death in patients with heart disease. Circulation 2003; 107: 708–11. Google Scholar

  • 5.

    Mak YT, Chan EL, Chan A, Woo J, Swaminathan R. Free triiodothyronine in serum of acutely ill general medical patients: a prognostic indicator? Clin Chem 1992; 38: 414–5. Google Scholar

  • 6.

    Ray DC, Drummond GB, Wilkinson E, Beckett GJ. Admission tyrotrophin concentrations do not predict outcome in critical illness. Anaesthesia 1995; 50: 1022–5. CrossrefGoogle Scholar

  • 7.

    Ekins R. Measurement of free hormones in blood. Endocr Rev 1990; 11: 5–46. CrossrefGoogle Scholar

  • 8.

    De Groot LJ. Dangerous dogmas in medicine: the non-thyroid illness syndrome. J Clin Endocrinol Metab 1999; 84: 151–64. Google Scholar

  • 9.

    Melmed S, Geola FL, Reed AW, Packary AE, Park J, Her-shaman JM. A comparison of methods for assessing thyroid function in non thyroidal illness. J Clin Endocrinol Metab 1982; 54: 300–6. Google Scholar

  • 10.

    Arem R, Wiener GJ, Kaplan SG, Kim HS, Reichlim S, Kaplan MM. Reduced tissue thyroid hormone levels in fatal illness. Metabolism 1993; 42: 1102–8. Google Scholar

  • 11.

    Brent GA, Hershman JM, Reed AW, Sasta A, Lieberman J. Serum angiotensin converting enzyme in severe non-thyroidal illness associated with low serum thyroxine concentration. Ann Intern Med 1986; 100: 680–3. Google Scholar

  • 12.

    Seppel T, Becker A, Lippert F, Schlaghecke F. Serum sex hormone binding globulin and osteocalcin in systemic non-thyroidal illness associated with low thyroid hormone concentrations. J Clin Endocrinol Metab 1996; 8: 1663–5. Google Scholar

  • 13.

    Yoshida K, Kiso Y, Watanabe T, Kaisi K, Kaisi N, Fukazawa H, et al. Clinical utility of red blood cell carbonic anhydrase I and zinc concentrations in patients with thyroid diseases. Metabolism 1991; 40: 1048–51. CrossrefGoogle Scholar

  • 14.

    Swaminathan R, Segall WH, Chapman C, Morgan DB. Red blood cell composition in thyroid disease. Lancet 1976; 2: 1382–5. CrossrefGoogle Scholar

  • 15.

    Lao TT, Chin RK, Swaminathan R, Panesar NS, Cockram CS. Erythrocyte zinc in the differential diagnosis of hyperthyroidism in pregnancy: a preliminary report. Br Med J 1987; 294: 1064–5. Google Scholar

  • 16.

    Chan AY, Mak YT, Shek CC, Swaminathan R. Changes in erythrocyte zinc in a case of transient thyrotoxicosis. Ann Clin Biochem 1991; 28: 524–5. Google Scholar

  • 17.

    Murphy JR. Influence of temperature and method of centrifugation on the separation of erythrocytes. J Lab Clin Med 1993; 82: 334–41. Google Scholar

  • 18.

    Arumanayagam M, MacDonald D, Cockram CS, Swaminathan R. The effect of hyperthyroidism on in vivo ageing of erythrocyte ouabain binding sites and intracellular sodium and potassium. J Clin Endocrinol Metab 1990; 71: 260–3. Google Scholar

  • 19.

    Li PK, Lee JT, Li CS, Deshpande G. Improved method for determining erythrocyte creatine by the diacetyl-alpha-naphthol reaction: elimination of endogenous glutathione interference. Clin Chem 1982; 28: 92–6. Google Scholar

  • 20.

    Hambridge M. Biomarkers of trace mineral intake and status. Am J Clin Nutr 2003; 133: 9485–555. Google Scholar

  • 21.

    Mafra D, Cozzolino MF. Erythrocyte zinc and carbonic anhydrase levels in nondialyzed chronic kidney disease patients. Clin Biochem 2004; 37: 67–71. Google Scholar

  • 22.

    Gorodetsky R, Fuks Z, Sulkes A, Ginsburg H, Weshler Z. Correlation of erythrocyte and plasma levels of zinc, copper, and iron with evidence of metastatic spread in cancer patients. Cancer 1985; 15: 779–87. CrossrefGoogle Scholar

  • 23.

    Frithz G, Ronquist G. Increased red cell content of Zn 2+ in essential hypertension. Acta Med Scand 1979; 205: 647–9. Google Scholar

  • 24.

    Bergomi M, Rovesti S, Vinceti M, Vivoli R, Caselgrandi E, Vivoli G. Zinc and copper status and blood pressure. J Trace Elem Med Biol 1997; 11: 166–9. CrossrefGoogle Scholar

  • 25.

    Hori H, Yosida K, Fukazawatl H, Kiso Y, Sayama N, Mori A, et al. Effects of thyroid hormones on carbonic anhydrase I gene expression in human erythroid cells. Thyroid 1998; 8: 525–31. CrossrefGoogle Scholar

  • 26.

    Klein I, Ojamaa, K. Thyroid hormone and the cardiovascular system. N Engl J Med 2001; 344: 501–9. Google Scholar

  • 27.

    Klemperer JD, Klein I, Gomez LL, Hehma RE, Ojama K, Thomas JS, et al. Thyroid hormone treatment after coronary artery bypass surgery. N Engl J Med 1995; 333: 1522–7. Google Scholar

  • 28.

    Beltendorf M, Schmidt KG, Grulich-Henn J, Ulme HE, Heintich UE. Triiodothyronine treatment in children after cardiac surgery: a double blind randomised, placebo-controlled study. Lancet 2000; 365: 529–34. Google Scholar

About the article

Corresponding author: Professor R. Swaminathan, Department of Chemical Pathology, St Thomas' Hospital, London SE1 7EH, United Kingdom Phone: +44-20-7188-1285, Fax: +44-20-7928-4226,


Received: 2005-05-16

Accepted: 2005-07-04

Published Online: 2011-09-21

Published in Print: 2005-09-01


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2005.159.

Export Citation

©2005 by Walter de Gruyter Berlin New York. Copyright Clearance Center

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

[1]
Joseph I. Boullata
Journal of Infusion Nursing, 2013, Volume 36, Number 1, Page 16

Comments (0)

Please log in or register to comment.
Log in