Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/259811 |
Resumo: | Low T3 syndrome occurs frequently in patients with sepsis. Type 3 deiodinase (DIO3) is present in immune cells, but there is no description of its presence in patients with sepsis. Here, we aimed to determine the prognostic impact of thyroid hormones levels (TH), measured on ICU admission, on mortality and evolution to chronic critical illness (CCI) and the presence of DIO3 in white cells. We used a prospective cohort study with a follow-up for 28 days or deceased. Low T3 levels at admission were present in 86.5% of the patients. DIO3 was induced by 55% of blood immune cells. The cutoff value of 60 pg/mL for T3 displayed a sensitivity of 81% and specificity of 64% for predicting death, with an odds ratio of 4.89. Lower T3 yielded an area under the receiver operating characteristic curve of 0.76 for mortality and 0.75 for evolution to CCI, thus displaying better performance than commonly used prognostic scores. The high expression of DIO3 in white cells provides a novel mechanism to explain the reduction in T3 levels in sepsis patients. Further, low T3 levels independently predict progression to CCI and mortality within 28 days for sepsis and septic shock patients. |
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Vidart, JosiAxelrud, Luiza KvitkoBraun, André CardosoMarschner, Rafael AguiarWajner, Simone Magagnin2023-07-04T03:49:13Z20231422-0067http://hdl.handle.net/10183/259811001168386Low T3 syndrome occurs frequently in patients with sepsis. Type 3 deiodinase (DIO3) is present in immune cells, but there is no description of its presence in patients with sepsis. Here, we aimed to determine the prognostic impact of thyroid hormones levels (TH), measured on ICU admission, on mortality and evolution to chronic critical illness (CCI) and the presence of DIO3 in white cells. We used a prospective cohort study with a follow-up for 28 days or deceased. Low T3 levels at admission were present in 86.5% of the patients. DIO3 was induced by 55% of blood immune cells. The cutoff value of 60 pg/mL for T3 displayed a sensitivity of 81% and specificity of 64% for predicting death, with an odds ratio of 4.89. Lower T3 yielded an area under the receiver operating characteristic curve of 0.76 for mortality and 0.75 for evolution to CCI, thus displaying better performance than commonly used prognostic scores. The high expression of DIO3 in white cells provides a novel mechanism to explain the reduction in T3 levels in sepsis patients. Further, low T3 levels independently predict progression to CCI and mortality within 28 days for sepsis and septic shock patients.application/pdfengInternational journal of molecular sciences. Basel. Vol. 24, no. 4 (Feb. 2023), 3935, 11 p.Iodeto peroxidaseEstresse oxidativoEstudos prospectivosCurva ROCChoque sépticoTri-IodotironinaLow T3 syndromeOxidative stressSepsisSeptic shockThyroid hormoneType 3 deiodinaseRelationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomesEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001168386.pdf.txt001168386.pdf.txtExtracted Texttext/plain41371http://www.lume.ufrgs.br/bitstream/10183/259811/2/001168386.pdf.txt0820e530347d2d6ec44a64fb2a96c1d3MD52ORIGINAL001168386.pdfTexto completo (inglês)application/pdf1899117http://www.lume.ufrgs.br/bitstream/10183/259811/1/001168386.pdfc8c7b9147de34a582b7db770caeab618MD5110183/2598112023-07-05 03:47:04.705611oai:www.lume.ufrgs.br:10183/259811Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-07-05T06:47:04Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
title |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
spellingShingle |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes Vidart, Josi Iodeto peroxidase Estresse oxidativo Estudos prospectivos Curva ROC Choque séptico Tri-Iodotironina Low T3 syndrome Oxidative stress Sepsis Septic shock Thyroid hormone Type 3 deiodinase |
title_short |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
title_full |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
title_fullStr |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
title_full_unstemmed |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
title_sort |
Relationship among low T3 levels, type 3 deiodinase, oxidative stress, and mortality in sepsis and septic shock : defining patient outcomes |
author |
Vidart, Josi |
author_facet |
Vidart, Josi Axelrud, Luiza Kvitko Braun, André Cardoso Marschner, Rafael Aguiar Wajner, Simone Magagnin |
author_role |
author |
author2 |
Axelrud, Luiza Kvitko Braun, André Cardoso Marschner, Rafael Aguiar Wajner, Simone Magagnin |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Vidart, Josi Axelrud, Luiza Kvitko Braun, André Cardoso Marschner, Rafael Aguiar Wajner, Simone Magagnin |
dc.subject.por.fl_str_mv |
Iodeto peroxidase Estresse oxidativo Estudos prospectivos Curva ROC Choque séptico Tri-Iodotironina |
topic |
Iodeto peroxidase Estresse oxidativo Estudos prospectivos Curva ROC Choque séptico Tri-Iodotironina Low T3 syndrome Oxidative stress Sepsis Septic shock Thyroid hormone Type 3 deiodinase |
dc.subject.eng.fl_str_mv |
Low T3 syndrome Oxidative stress Sepsis Septic shock Thyroid hormone Type 3 deiodinase |
description |
Low T3 syndrome occurs frequently in patients with sepsis. Type 3 deiodinase (DIO3) is present in immune cells, but there is no description of its presence in patients with sepsis. Here, we aimed to determine the prognostic impact of thyroid hormones levels (TH), measured on ICU admission, on mortality and evolution to chronic critical illness (CCI) and the presence of DIO3 in white cells. We used a prospective cohort study with a follow-up for 28 days or deceased. Low T3 levels at admission were present in 86.5% of the patients. DIO3 was induced by 55% of blood immune cells. The cutoff value of 60 pg/mL for T3 displayed a sensitivity of 81% and specificity of 64% for predicting death, with an odds ratio of 4.89. Lower T3 yielded an area under the receiver operating characteristic curve of 0.76 for mortality and 0.75 for evolution to CCI, thus displaying better performance than commonly used prognostic scores. The high expression of DIO3 in white cells provides a novel mechanism to explain the reduction in T3 levels in sepsis patients. Further, low T3 levels independently predict progression to CCI and mortality within 28 days for sepsis and septic shock patients. |
publishDate |
2023 |
dc.date.accessioned.fl_str_mv |
2023-07-04T03:49:13Z |
dc.date.issued.fl_str_mv |
2023 |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
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http://hdl.handle.net/10183/259811 |
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1422-0067 |
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001168386 |
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http://hdl.handle.net/10183/259811 |
dc.language.iso.fl_str_mv |
eng |
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eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
International journal of molecular sciences. Basel. Vol. 24, no. 4 (Feb. 2023), 3935, 11 p. |
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info:eu-repo/semantics/openAccess |
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openAccess |
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