ABSTRACT

Non-thyroidal illness syndrome (NTIS) can be induced by chronic obstructive airway disease (COPD) exacerbation. The aim of this study was to evaluate the thyroid function impairments and the presence of thyroid antibodies in exacerbated COPD patients and to demonstrate the probable relationship with other clinical and biochemical parameters, such as the parameters of arterial blood gases, urea, creatinine, prothrombine time (PT), activated partial prothrombine time (APTT), and international normalized ratio (INR), etc.

We evaluated 21 patients within the exacerbation period of COPD who had undergone non-invasive mechanical ventilation and had measurements of serum fT3, fT4, and TSH levels and other laboratory tests (glucose, urea, creatinine, hematocrits, hemoglobin, PT, APTT) made on their first to third day of stay in the hospital. Ten of 21 patients had measurements of anti-Tg (antithyroglobulin) antibody and anti-TPO (antithyroperoxidase). The healthy control group consisted of 17 age-matched non-smoking voluntary men admitted to the internal medicine outpatient clinic for general check-up purposes without any complaints or diagnoses. Analyses were made with SPSS 17.0.

We found that 33.33% of the patients with COPD exacerbation had fT3 levels below the normal values, and 14.28% of the patients had TSH levels below the normal values. The average fT3 and TSH levels were lower in the patients with COPD exacerbation compared to the healthy volunteers, and fT4 levels were higher in patients compared to the healthy group (patient group mean±SD (median): fT3 2.52±0.48 (2.69), fT4 0.99±0.16 (1.01), TSH 0.95±0.7 (0.80), p=0.001, p=0.001, p=0.009, respectively). Prothrombin time was negatively correlated with fT3 (rs= -0.520, p=0.03).

Negative correlation of pH with platelet counts and fT3 with prothrombin time were the novel findings of this study. This study is the first one to determine the relationship with thyroid hormones and coagulation in COPD patients. The other finding of the study was lower fT3 levels than healthy controls, which has been supported by other studies. (JAREM 2014; 1: 18-24)

Keywords: Thyroid, COPD, COPD exacerbation