Euthyroid sick syndrome and nutritional status are correlated with hyposelenemia in hemodialysis patients.

BACKGROUND: Maintenance hemodialysis (HD) patients have altered levels of thyroid hormone (TH) in euthyroid sick syndrome, along with low T3 levels and several nutritional metabolic disturbances. Selenium (Se) is an essential trace element for living organisms, which has been shown to play a major role in thyroid hormone levels and the nutritional metabolism. The aims of the present study were to assess the changes in serum levels of selenium and their correlation with disorders of the endocrine and nutritional metabolism in HD patients. METHODS: Fifty-three uremic patients with hemodialysis were evaluated; 30 healthy volunteers served as controls. Baseline serum concentrations of total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), and free thyroxine (FT4) were determined by radioimmunoassay (RIA). Serum levels of thyroid-stimulating hormone (TSH) and intact parathyroid hormone (iPTH) were measured by a sensitive immunoradiometric assay (IRMA). Serum selenium was analyzed using Hitachi Z- 2000 polarized Zeeman atomic absorption spectrometry. Other metabolic variables were measured in all patients and control subjects. Multiple correlation analysis was performed among variables. RESULTS: Higher serum triglyceride, LDL-C, ApoB and lower albumin, HDL-C levels were found in subjects with HD. Mean serum selenium concentration was significantly lower in the HD group than in the control group (p<0.01). The levels of serum TT3 and FT3 in HD patients were significantly lower than in healthy control subjects (p<0.01; p<0.05, respectively), but TT4, FT4 and TSH were not different. However, serum iPTH levels were significantly higher in patients than in controls (p<0.01). In the group of HD patients, serum selenium levels were significantly positively correlated with albumin, HDL-C, TT3 and FT3 ; and negatively correlated with triglyceride (TG), LDL-C, ApoB and iPTH. Both serum TT3 and FT3 levels were significantly positively correlated with HDL-C; and negatively correlated with TG, LDL-C and ApoB. CONCLUSIONS: These data suggest that hyposelenemia in HD patients correlated with euthyroid sick syndrome with low T3 levels, and nutritional status with hyperlipidemia and hypoalbuminemia which might be involved in dysfunction in the endocrine and nutrition metabolism in dialysis patients.

[Proliferation of the mesenchymal stem cells in a delayed fat flap: an experimental study in rabbits].

OBJECTIVE: To investigate the possibility to enhance the proliferation of adipose-derived stem cells (ASCs) in a delayed fat flap in rabbits. METHODS: A delayed fat flap was formed in one side of inguinal region of a rabbit. 21 days after operation, the fat tissues at the delayed flaps and at the unoperated side were harvested and digested with 0.25% collagenase and sieved. The cell suspensions were centrifuged. The cells were obtained from tissue precipitate after centrifugation. The expression rates of the surface marker (CD29, CD44, CD14 and CD45) were measured by FCM and compared between the experimental and control groups. RESULTS: Expression rates of CD29 and CD44 were higher in the delayed fat flap (74.06% and 90.74%) than in the contralateral fat tissue (62.88% and 77.54%, P < 0.05), while those of CD14 and CD45 were lower in the delayed fat flap (57.66% and 4.84%) than in the contralateral fat tissue (72.10% and 75.82%, P < 0.05 and P < 0.01). CONCLUSIONS: Tissue hypoxic ischemia such as fat tissue in a delayed fat flap can promote proliferation of ASCs. It indicates that tissue in the delayed flap may be transplanted with better survival rate. The ischemia pretreatment of fat tissue may become a new method for fat transplantation.

Th1 polarization and low-T3 syndrome are correlated with hyperleptinemia in hemodialysis patients.

BACKGROUND: Patients undergoing chronic hemodialysis (HD) have an impaired immune response with a dysregulated Th1/Th2 cytokine network and altered the levels of thyroid hormone (TH) in euthyroid sick syndrome. Leptin, an adipocyte-secreted hormone, is considered to be a proinflammatory adipocytokine, with multiple effects on several tissues acting on the intermediate and energy metabolism. The aims of the present study were to assess the changes in serum levels of leptin and their correlation with Th1/Th2 cytokine and TH production in HD patients. METHODS: Fifty-three uremic patients with hemodialysis were evaluated; 30 healthy volunteers served as controls. Baseline serum concentrations of interleukin-2 (IL-2), sIL-2R, interferon-gamma (IFN-gamma), IL-4 and IL-10 were analyzed using ELISA. Serum levels of leptin, total triiodothyronine (TT3), free triiodothyronine (FT3), total thyroxine (TT4), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were determined by radioimmunoassay (RIA). Other metabolic variables were measured in all patients and control subjects. Multiple correlation analysis was performed among variables. RESULTS: Mean serum leptin concentration was significantly higher in HD patients than that in controls (p<0.01), especially in women (p<0.001). While the fasting serum levels of sIL-2R and Th1-type cytokines including IL-2 and IFN-gamma were significantly higher in HD patients compared with controls, Th2-type cytokine, including IL-4 and IL-10, levels did not differ between patients and controls. The serum TT3 and FT3 levels were lower in patients than controls, but TT4, FT4 and TSH were no different. Serum leptin levels in HD patients were significantly positively correlated with IL-2, IFN-gamma, sIL-2R and TSH; and negatively correlated with IL-4, IL-10, TT3 and FT3. Serum IL-2 levels correlated positively with serum IL-4, sIL-2R, TT3 and FT3. A negative correlation was observed between serum IFN-gamma and IL-4 levels in the patients. CONCLUSIONS: These data suggest that hyperleptinemia in HD patients correlated with cytokine dysregulation with a high level of Th1-type cytokines, and euthyroid sick syndrome with low T3 levels which might be involved in Th1 polarization and low-T3 syndrome in dialysis patients.