ORIGINAL ARTICLE

Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment
Tirotropin Süpresyon Tedavisi Alan Diferansiye Tiroid Kanserli Hastalarda Oksidatif Stresin Yeni Bir Metot ile Değerlendirilmesi
Received Date : 14 Sep 2020
Accepted Date : 01 Jan 2021
Available Online : 09 Mar 2021
Doi: 10.25179/tjem.2020-78978 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:32-38
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Thyroid hormone suppression treatment (THST) is an essential modality in treating differentiated thyroid cancer (DTC). This study aimed to evaluate thiol/disulfide homeostasis with a new method in patients on THST, which causes a state of subclinical hyperthyroidism. Material and Methods: Serum thyrotrophin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), duration of disease, levothyroxine dose, and radioactive iodine (RAI) dose were evaluated along with native and total thiol and disulfide levels. Results: Data of 50 patients with DTC and 41 healthy subjects were analyzed. Though native thiol and total thiol were lower in patients with DTC, the difference was not statistically significant. Disulfide was found to be 18.25 μmol/L in DTC patients and 15.23 μmol/L in the control group. The ratios of native thiol to total thiol (N/T), disulfide to native thiol (D/N), and disulfide to total thiol (D/T) were similar in the 2 groups. Disulfide, D/N, and D/T were significantly higher, and N/T was lower in patients with overt thyrotoxicosis than patients with subclinical thyrotoxicosis and the control group. Disulfide, D/N, and D/T were both positively, and N/T was negatively correlated with fT4/fT3. Conclusion: Although the thiol/disulfide balance was maintained in patients with subclinical thyrotoxicosis, there was a shift of redox status toward disulfide in patients with overt thyrotoxicosis on THST. This suggests that the potency of oxidative stress is associated with the degree of thyrotoxicosis. Considering the potentially harmful effects of oxidative stress, overt thyrotoxicosis must be avoided in patients on THST.
ÖZET
Amaç: Diferansiye tiroid kanserinin (DTK) tedavisinde, tiroid hormon süpresyon tedavisi (THST) önemli bir modalitedir. Bu çalışmada, bir subklinik hipertiroidi durumuna yol açan THST alan hastalarda, thiol/disülfid homeostazını yeni bir metot ile değerlendirmeyi amaçladık. Gereç ve Yöntemler: Nativ ve total tiol ve disülfid seviyelerinin yanı sıra serum tirotropin (TSH), serbest triiyodotironin (sT3), serbest tiroksin (sT4), hastalık süresi, levotiroksin dozu ve radyoaktif iyot (RAI) dozu değerlendirildi. Bulgular: DTK’li 50 hasta ve 41 sağlıklı birey analiz edildi. Nativ tiol ve total tiol, DTK’li hastalarda daha düşüktü fakat farklılık istatistiksel olarak anlamlı değildi. Disülfid, DTK’li hastalarda 18,25 μmol/L ve kontrol grubunda 15,23 μmol/L’ydi. Nativ tiolün, total tiole (N/T); disülfidin, nativ tiole (D/N) ve disülfidin, total tiole (D/T) oranı her 2 grupta da benzerdi. Aşikâr tirotoksikozlu hastalarda, subklinik tirotoksikoz ve kontrol grubuna göre disülfid, D/N ve D/T anlamlı olarak daha yüksek ve N/T daha düşüktü. sT4/sT3 oranı disülfid, D/N ve D/T ile pozitif ve N/T ile negatif olarak koreleydi. Sonuç: THST alan ve subklinik tirotoksikozu olanlarda, her ne kadar tiol/disülfid dengesi korunmuş olsa da aşikâr tirotoksikozu olan hastalarda, redoks durumunda disülfid yönünde kayma vardı. Bu oksidatif stres potensinin, tirotoksikozun derecesiyle ilişkili olduğunu göstermektedir. Oksidatif stresin zararlı etkileri düşünüldüğünde, THST alan hastalarda aşikâr tirotoksikozdan kaçınılmalıdır.
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