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3,3'-Diiodothyronine Concentrations in the Sera of Patients with Nonthyroidal Illnesses and Brain Tumors and of Healthy Subjects during Acute Stress¹

Departments of Radiology and Nuclear Medicine, Neuropathology (G.S.-D.) and Psychiatry (M.B.), Universitätsklinikum Benjamin Franklin, Free University of Berlin, and the Department of Medicine (K.-J.G.), Universitätsklinikum Rudolf Virchow, Humboldt University, 12200 Berlin, Germany

Address all correspondence and requests for reprints to: Dr. Andreas Baumgartner, Department of Radiological Diagnostics and Nuclear Medicine, Hindenburgdamm 30, 12200 Berlin, Germany.

In this article we describe the development of a highly sensitive, accurate, and reproducible RIA for the measurement of 3,3'-diiodothyronine (3,3'-T₂) in human serum and brain tissue. The detection limits were 1.8 fmol/g and 1.5 pmol/L in human brain tissue and serum, respectively.

Serum concentrations of 3,3'-T₂ were measured in 4 groups of patients with nonthyroidal illnesses (NTI), i.e. brain injuries (n = 15), sepsis (n = 24), liver disease (n = 22), and brain tumors (n = 23). The mean serum concentration of 3,3'-T₂ in 62 healthy controls was 46.6 ± 20.0 pmol/L. 3,3'-T₂ levels declined significantly with increasing age. They were significantly lower in patients with brain injury (34.2 ± 19.4 pmol/L; P = 0.006), were at the upper limit of normal in patients with sepsis (57.0 ± 36.9 pmol/L; P = 0.06), and were elevated in patients with liver disease (72.6 ± 56.7 pmol/L; P = 0.04) and brain tumors (89.0 ± 40.9 pmol/L; P = 0.01). The serum levels of T₃ were significantly lower than those in controls in all 4 patient groups. Serum concentrations of 3,3'-T₂ were significantly enhanced in 9 patients with hyperthyroidism (85.4 ± 43.0 pmol/L; P = 0.01) and were reduced in 12 patients with hypothyroidism (14.9 ± 9.2 pmol/L; P = 0.001). In both normal brain tissue, obtained either intraoperatively or excised postmortem, and brain tumors, the concentrations of 3,3'-T₂ ranged between 50–300 fmol/g. In healthy controls, 2 different forms of acute stress (sleep deprivation and delivering a lecture) significantly increased serum levels of T₄ and T₃, but did not affect those of 3,3'-T₂ or 3,5-T₂.

In conclusion, our results show that, contrary to expectation, a low T₃ syndrome in NTI is not always associated with low serum concentrations of 3,3'-T₂. The production of 3,3'-T₂ in NTI seems to be regulated in a disease-specific manner, resulting in unchanged, reduced, or elevated hormone concentrations.

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