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Different Effects of Thyroid Disease on Serum Levels of Procollagen III N-Pep tide and Hyaluronic Acid

Medical Department F, Herlev University Hospital DK-2400, Denmark
Medical Department E, Frederiksberg Hospital DK-2400, Denmark
The Department of Rheumatology, Hvidoure University Hospital DK-2400, Denmark
Medical Department G, Bispebjerg Hospital DK-2400, Denmark

Address all correspondance and requests to: Jens Faber, M.D., Steno Memorial Hospital, Niels Steensensvej 2, DK-2820 Gentofte, Denmark.

Serum levels of procollagen III iV-peptide (PIIINP) and hyaluronic acid (HA) reflect secretion of procollagen III and HA from fibroblasts, a cell type sensitive to thyroid hormones. Serum PIIINP and HA concentrations were measured in different thyroid function states, the former by two different assays, one detecting intact and aggregated PIIINP (PIIINP assay) and another detecting low mol wt degradation products of PIIINP as well (Fab-PIIINP assay).

Two thirds of 28 hyperthyroid patients had elevated serum PIIINP values (mean, 192% in the PIIINP assay and 243% in the Fab-PIIINP assay) compared to age- and sex-matched controls (P < 0.001). Normalization was seen after medical treatment (n = 16). In contrast, serum HA levels increased from 49 ± 30 to 68 ± 37 ng/mL (P < 0.01) when a euthyroid state was achieved. Hypothyroid patients (n = 23) had increased serum HA levels (mean, 162%; P < 0.05), which normalized after L-T₄ treatment (71 ± 50 before and 41 ± 20 ng/mL after treatment (n = 16; P < 0.02). L-T₄ treatment also increased serum PIIINP levels significantly.

Subjects with familial dysalbuminemic hyperthyroxinemia (n = 8), representing a situation with elevated circulating levels of T₄ due to enhanced protein binding, and patients with nontoxic goiter with serum TSH levels ranging from 3.6-0.05 mU/L had normal serum levels of PIIIINP and HA.

Our data suggest that the secretion of procollagen III and that of HA from fibroblasts are influenced differently by thyroid hormones, since the secretion of procollagen III seems enhanced by thyroid hormones, whereas the secretion of HA seems reduced. Neither euthyroidism with enhanced serum T₄ levels (familial dysalbuminemic hyperthyroxinemia) nor euthyroidism with reduced serum TSH levels (nontoxic goiter) seems associated with alterations at the connective tissue level.

Received March 19, 1990.