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Titin and dystrophin serum concentration changes in patients affected by thyroid disorders


- Department of Endocrinology, Metabolism, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
- Department of Cardiology-Intensive Therapy and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
open access
Abstract
Introduction: It is well established that thyroid hormones significantly affect skeletal muscle function, causing symptoms like myalgia and muscle weakness. Hypothyroid patients present increased levels of creatine kinase (CK), indicating muscle destruction. Lately, we proposed new serum markers of muscle disturbances in thyroid disorders: titin (TTN) and dystrophin (DMD). The aim of this study is to determine the association between thyroid status, muscle metabolism, and serum levels of TTN and DMD in patients affected by hypoand hyperthyroidism, before and after the treatment.
Material and methods: In the study 56 subjects were enrolled. The studied group consisted of 16 patients with newly diagnosed overt hypothyroidism and 20 patients with hyperthyroidism. Twenty healthy controls were also included in the study. Body composition, thyroid hormones, and biochemical markers of muscle deterioration levels were evaluated before and after restoration of euthyroidism.
Results: Dystrophin and TTN levels were noticeably lower in the hypothyroid group and hyperthyroid group in comparison with controls, at the border of statistical significance. Along with the thyroid hormones and CK normalisation, DMD levels increased in the hypothyroid group, with no significant lowering of TTN levels. However, TTN concentrations and the fT3/fT4 ratio became significantly lower than in controls. Hyperthyroid patients experienced no significant changes in TTN and DMD.
Conclusions: The presented data indicate that TTN and DMD are potential new markers of musculoskeletal deterioration in thyroid disorders. In addition, the shift in TTN and DMD serum concentrations after the treatment of hypothyroidism accompanied by decreased fT3/fT4 ratio suggest the influence of the chosen therapeutic approach on muscle metabolism.
Abstract
Introduction: It is well established that thyroid hormones significantly affect skeletal muscle function, causing symptoms like myalgia and muscle weakness. Hypothyroid patients present increased levels of creatine kinase (CK), indicating muscle destruction. Lately, we proposed new serum markers of muscle disturbances in thyroid disorders: titin (TTN) and dystrophin (DMD). The aim of this study is to determine the association between thyroid status, muscle metabolism, and serum levels of TTN and DMD in patients affected by hypoand hyperthyroidism, before and after the treatment.
Material and methods: In the study 56 subjects were enrolled. The studied group consisted of 16 patients with newly diagnosed overt hypothyroidism and 20 patients with hyperthyroidism. Twenty healthy controls were also included in the study. Body composition, thyroid hormones, and biochemical markers of muscle deterioration levels were evaluated before and after restoration of euthyroidism.
Results: Dystrophin and TTN levels were noticeably lower in the hypothyroid group and hyperthyroid group in comparison with controls, at the border of statistical significance. Along with the thyroid hormones and CK normalisation, DMD levels increased in the hypothyroid group, with no significant lowering of TTN levels. However, TTN concentrations and the fT3/fT4 ratio became significantly lower than in controls. Hyperthyroid patients experienced no significant changes in TTN and DMD.
Conclusions: The presented data indicate that TTN and DMD are potential new markers of musculoskeletal deterioration in thyroid disorders. In addition, the shift in TTN and DMD serum concentrations after the treatment of hypothyroidism accompanied by decreased fT3/fT4 ratio suggest the influence of the chosen therapeutic approach on muscle metabolism.
Keywords
hypothyroidism; hyperthyroidism; muscle tissue; titin; dystrophin


Title
Titin and dystrophin serum concentration changes in patients affected by thyroid disorders
Journal
Issue
Article type
Original paper
Pages
1-7
Published online
2020-12-07
Page views
1175
Article views/downloads
657
DOI
10.5603/EP.a2020.0083
Pubmed
Bibliographic record
Endokrynol Pol 2021;72(1):1-7.
Keywords
hypothyroidism
hyperthyroidism
muscle tissue
titin
dystrophin
Authors
Ariadna Zybek-Kocik
Nadia Sawicka-Gutaj
Remigiusz Domin
Ewelina Szczepanek-Parulska
Tomasz Krauze
Przemysław Guzik
Marek Ruchała


- Duyff RF, Van den Bosch J, Laman DM, et al. Neuromuscular findings in thyroid dysfunction: a prospective clinical and electrodiagnostic study. J Neurol Neurosurg Psychiatry. 2000; 68(6): 750–755.
- Olson BR, Klein I, Benner R, et al. Hyperthyroid myopathy and the response to treatment. Thyroid. 1991; 1(2): 137–141.
- Da Nóbrega AC, Vaisman M, De Araújo CG. Skeletal muscle function and body composition of patients with hyperthyroidism. Med Sci Sports Exerc. 1997; 29(2): 175–180.
- Khaleeli AA, Edwards RH. Effect of treatment on skeletal muscle dysfunction in hypothyroidism. Clin Sci (Lond). 1984; 66(1): 63–68.
- Kocabas H, Yazicioglu G, Karaman N, et al. Isokinetic evaluation of muscle strength in patients with thyroid dysfunction. Isokinetics Exerci Sci. 2009; 17(2): 69–72.
- Gruener R, Stern LZ, Payne C, et al. Hyperthyroid myopathy. Intracellular electrophysiological measurements in biopsied human intercostal muscle. J Neurol Sci. 1975; 24(3): 339–349.
- Brennan MD, Powell C, Kaufman KR, et al. The impact of overt and subclinical hyperthyroidism on skeletal muscle. Thyroid. 2006; 16(4): 375–380.
- McGrowder DA, Fraser YP, Gordon L, et al. Serum creatine kinase and lactate dehydrogenase activities in patients with thyroid disorders. Niger J Clin Pract. 2011; 14(4): 454–459.
- Klein SM, Prantl L, Geis S, et al. Circulating serum CK level vs. muscle impairment for in situ monitoring burden of disease in Mdx-mice. Clin Hemorheol Microcirc. 2017; 65(4): 327–334.
- Sönmez E, Bulur O, Ertugrul DT, et al. Hyperthyroidism influences renal function. Endocrine. 2019; 65(1): 144–148.
- Zybek-Kocik A, Sawicka-Gutaj N, Szczepanek-Parulska E, et al. The association between irisin and muscle metabolism in different thyroid disorders. Clin Endocrinol (Oxf). 2018; 88(3): 460–467.
- Lee JW, Kim NH, Milanesi A. Thyroid Hormone Signaling in Muscle Development, Repair and Metabolism. J Endocrinol Diabetes Obes. 2014; 2(3): 1046–15.
- Simonides WS, van Hardeveld C. Thyroid hormone as a determinant of metabolic and contractile phenotype of skeletal muscle. Thyroid. 2008; 18(2): 205–216.
- Bloise FF, Cordeiro A, Ortiga-Carvalho TM. Role of thyroid hormone in skeletal muscle physiology. J Endocrinol. 2018; 236(1): R57–R68.
- Brennan MD, Coenen-Schimke JM, Bigelow ML, et al. Changes in skeletal muscle protein metabolism and myosin heavy chain isoform messenger ribonucleic acid abundance after treatment of hyperthyroidism. J Clin Endocrinol Metab. 2006; 91(11): 4650–4656.
- Monforte R, Fernández-Solà J, Casademont J, et al. [Hypothyroid myopathy. A clinical and histologic prospective study of 19 patients]. Med Clin (Barc). 1990; 95: 126–129.
- Mortoglou A, Candiloros H. The serum triiodothyronine to thyroxine (T3/T4) ratio in various thyroid disorders and after Levothyroxine replacement therapy. Hormones (Athens). 2004; 3(2): 120–126.
- Hernik A, Szczepanek-Parulska E, Filipowicz D, et al. The hepcidin concentration decreases in hypothyroid patients with Hashimoto's thyroiditis following restoration of euthyroidism. Sci Rep. 2019; 9(1): 16222.
- Okosieme O, Gilbert J, Abraham P, et al. Management of primary hypothyroidism: statement by the British Thyroid Association Executive Committee. Clin Endocrinol (Oxf). 2016; 84(6): 799–808.
- Esco MR, Fedewa MV, Freeborn TJ, et al. Agreement between supine and standing bioimpedance spectroscopy devices and dual-energy X-ray absorptiometry for body composition determination. Clin Physiol Funct Imaging. 2019; 39(5): 355–361.