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Title: Contribution of nutritional deficit to the pathogenesis of the nonthyroidal illness syndrome in critical illness: a rabbit model study
Authors: Mebis, Liese
Eerdekens, An
Güiza, Fabian
Princen, Leslie
Derde, Sarah
Vanwijngaerden, Yoo-Mee
Vanhorebeek, Ilse
Darras, Veerle
Van den Berghe, Greet
Langouche, Lies # ×
Issue Date: Feb-2012
Publisher: Association for the Study of Internal Secretions
Series Title: Endocrinology vol:153 issue:2 pages:973-984
Abstract: Both starvation and critical illness are hallmarked by changes in circulating thyroid hormone parameters with typically low T(3) concentrations in the absence of elevated TSH. This constellation is labeled nonthyroidal illness (NTI). Because critical illness is often accompanied by anorexia and a failing gastrointestinal tract, the NTI of critical illness may be confounded by nutrient deficiency. In an experimental study performed in a rabbit model, we investigated the impact of nutritional deficit on the NTI of sustained critical illness. Critically ill rabbits were randomly allocated to parenteral nutrition (moderate dose 270 kcal/d) initiated on the day after injury and continued until d 7 of illness or to infusing a similar volume of dextrose 1.4% (14 kcal/d). With early parenteral nutrition during illness, the decrease in serum T(3) observed with fasting was reversed, whereas the fall in T(4) was not significantly affected. The rise in T(3) with parenteral nutrition paralleled an increase of liver and kidney type-1 and a decrease of liver and kidney type-3 deiodinase activity and an increase in circulating and central leptin. Nuclear staining of constitutive androstane receptor and its downstream expression of sulfotransferases were reduced in fasting ill animals. TRH expression in the hypothalamus was not different in fasted and fed ill rabbits, although circulating TSH levels were higher with feeding. In conclusion, in this rabbit model of sustained critical illness, reduced circulating T(3), but not T(4), levels could be prevented by parenteral nutrition, which may be mediated by leptin and its actions on tissue deiodinase activity.
URI: 
ISSN: 0013-7227
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Intensive Care Medicine
Laboratory for Intensive Care Medicine (-)
Animal Physiology and Neurobiology Section - miscellaneous
× corresponding author
# (joint) last author

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