Yıl: 2021 Cilt: 25 Sayı: 1 Sayfa Aralığı: 32 - 38 Metin Dili: İngilizce DOI: 10.25179/tjem.2020-78978 İndeks Tarihi: 20-12-2021

Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment

Öz:
Objective: Thyroid hormone suppression treatment (THST) is an essential modality in treating differentiated thyroid cancer (DTC). This study aimed to evaluate thiol/disulfide homeostasis with a new method in patients on THST, which causes a state of subclinical hyperthyroidism. Material and Methods: Serum thyrotrophin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), duration of disease, levothyroxine dose, and radioactive iodine (RAI) dose were evaluated along with native and total thiol and disulfide levels. Results: Data of 50 patients with DTC and 41 healthy subjects were analyzed. Though native thiol and total thiol were lower in patients with DTC, the difference was not statistically significant. Disulfide was found to be 18.25 μmol/L in DTC patients and 15.23 μmol/L in the control group. The ratios of native thiol to total thiol (N/T), disulfide to native thiol (D/N), and disulfide to total thiol (D/T) were similar in the 2 groups. Disulfide, D/N, and D/T were significantly higher, and N/T was lower in patients with overt thyrotoxicosis than patients with subclinical thyrotoxicosis and the control group. Disulfide, D/N, and D/T were both positively, and N/T was negatively correlated with fT4/fT3. Conclusion: Although the thiol/disulfide balance was maintained in patients with subclinical thyrotoxicosis, there was a shift of redox status toward disulfide in patients with overt thyrotoxicosis on THST. This suggests that the potency of oxidative stress is associated with the degree of thyrotoxicosis. Considering the potentially harmful effects of oxidative stress, overt thyrotoxicosis must be avoided in patients on THST.
Anahtar Kelime:

Tirotropin Süpresyon Tedavisi Alan Diferansiye Tiroid Kanserli Hastalarda Oksidatif Stresin Yeni Bir Metot ile Değerlendirilmesi

Öz:
Amaç: Diferansiye tiroid kanserinin (DTK) tedavisinde, tiroid hormon süpresyon tedavisi (THST) önemli bir modalitedir. Bu çalışmada, bir subklinik hipertiroidi durumuna yol açan THST alan hastalarda, thiol/disülfid homeostazını yeni bir metot ile değerlendirmeyi amaçladık. Gereç ve Yöntemler: Nativ ve total tiol ve disülfid seviyelerinin yanı sıra serum tirotropin (TSH), serbest triiyodotironin (sT3), serbest tiroksin (sT4), hastalık süresi, levotiroksin dozu ve radyoaktif iyot (RAI) dozu değerlendirildi. Bulgular: DTK’li 50 hasta ve 41 sağlıklı birey analiz edildi. Nativ tiol ve total tiol, DTK’li hastalarda daha düşüktü fakat farklılık istatistiksel olarak anlamlı değildi. Disülfid, DTK’li hastalarda 18,25 μmol/L ve kontrol grubunda 15,23 μmol/L’ydi. Nativ tiolün, total tiole (N/T); disülfidin, nativ tiole (D/N) ve disülfidin, total tiole (D/T) oranı her 2 grupta da benzerdi. Aşikâr tirotoksikozlu hastalarda, subklinik tirotoksikoz ve kontrol grubuna göre disülfid, D/N ve D/T anlamlı olarak daha yüksek ve N/T daha düşüktü. sT4/sT3 oranı disülfid, D/N ve D/T ile pozitif ve N/T ile negatif olarak koreleydi. Sonuç: THST alan ve subklinik tirotoksikozu olanlarda, her ne kadar tiol/disülfid dengesi korunmuş olsa da aşikâr tirotoksikozu olan hastalarda, redoks durumunda disülfid yönünde kayma vardı. Bu oksidatif stres potensinin, tirotoksikozun derecesiyle ilişkili olduğunu göstermektedir. Oksidatif stresin zararlı etkileri düşünüldüğünde, THST alan hastalarda aşikâr tirotoksikozdan kaçınılmalıdır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69-90. Erratum in: CA Cancer J Clin. 2011;61:134.[Crossref] [PubMed]
  • 2. Klein Hesselink EN, Links TP. Radioiodine treatment and thyroid hormone suppression therapy for differentiated thyroid carcinoma: adverse effects support the trend toward less aggressive treatment for low-risk patients. Eur Thyroid J. 2015;4:82- 92.[Crossref] [PubMed] [PMC]
  • 3. Nieto H, Boelaert K. Women in Cancer Thematic Review: Thyroid-stimulating hormone in thyroid cancer: does it matter? Endocr Relat Cancer. 2016;23:T109-T121.[Crossref] [PubMed]
  • 4. Liu X, Zhou Y, Liang N, Hong Y, Dionigi G, Sun H. The effect of long-term thyroid-stimulating hormone suppressive therapy on the gonadal steroid hormones of patients with thyroid carcinoma after surgery. Gland Surg. 2017;6:443-452.[Crossref] [PubMed] [PMC]
  • 5. Pajamäki N, Metso S, Hakala T, Ebeling T, Huhtala H, Ryödi E, Sand J, Jukkola-Vuorinen A, Kellokumpu- Lehtinen PL, Jaatinen P. Long-term cardiovascular morbidity and mortality in patients treated for differentiated thyroid cancer. Clin Endocrinol (Oxf). 2018;88:303-310.[Crossref] [PubMed]
  • 6. Topuz M, Şen O, Kaplan M, Akkus O, Erel O, Gur M. The role of thiol/disulphide homeostasis in anthracycline associated cardiac toxicity. Int Heart J. 2017;58:69-72.[Crossref] [PubMed]
  • 7. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem. 2014;47:326-332.[Crossref] [PubMed]
  • 8. Gumusyayla S, Vural G, Bektas H, Neselioglu S, Deniz O, Erel O. A novel oxidative stress marker in migraine patients: dynamic thiol-disulphide homeostasis. Neurol Sci. 2016;37:1311-1317. Erratum in: Neurol Sci. 2016;37:1381.[Crossref] [PubMed]
  • 9. Reddy VS, Bukke S, Mahato K, Kumar V, Reddy NV, Munikumar M, Vodelu B. A meta-analysis of the association of serum ischaemia-modified albumin levels with human hypothyroidism and hyperthyroidism. Biosci Rep. 2017;37:BSR20160268. [Crossref] [PubMed] [PMC]
  • 10. Aslan M, Cosar N, Celik H, Aksoy N, Dulger AC, Begenik H, Soyoral YU, Kucukoglu ME, Selek S. Evaluation of oxidative status in patients with hyperthyroidism. Endocrine. 2011;40:285- 289.[Crossref] [PubMed]
  • 11.Andryskowski G, Owczarek T. [The evaluation of selected oxidative stress parameters in patients with hyperthyroidism]. Pol Arch Med Wewn. 2007;117:285-289.[Crossref] [PubMed]
  • 12.Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff KG, Sherman SI, Sosa JA, Steward DL, Tuttle RM, Wartofsky L. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26:1-133.[Crossref] [PubMed] [PMC]
  • 13.Parker WA, Edafe O, Balasubramanian SP. Longterm treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature. Pragmat Obs Res. 2017;8:57-67.[Crossref] [PubMed] [PMC]
  • 14. Marcocci C, Leo M, Altea MA. Oxidative stress in graves' disease. Eur Thyroid J. 2012;1:80- 87.[Crossref] [PubMed] [PMC]
  • 15.Komosinska-Vassev K, Olczyk K, Kucharz EJ, Marcisz C, Winsz-Szczotka K, Kotulska A. Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves' disease during therapy. Clin Chim Acta. 2000;300:107- 117.[Crossref] [PubMed]
  • 16.Abalovich M, Llesuy S, Gutierrez S, Repetto M. Peripheral parameters of oxidative stress in Graves' disease: the effects of methimazole and 131 iodine treatments. Clin Endocrinol (Oxf). 2003;59:321- 327.[Crossref] [PubMed]
  • 17.Ateş İ, Ozkayar N, Altay M, Yilmaz FM, Topçuoğlu C, Alışık M, Erel Ö, Dede F. Is disulphide/thiol ratio related to blood pressure in masked hypertension? Clin Exp Hypertens. 2016;38:150-154.[Crossref] [PubMed]
  • 18. Selmer C, Olesen JB, Hansen ML, von Kappelgaard LM, Madsen JC, Hansen PR, Pedersen OD, Faber J, Torp-Pedersen C, Gislason GH. Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events: a large population study. J Clin Endocrinol Metab. 2014;99:2372-2382. [Crossref] [PubMed]
  • 19.Aubert CE, Floriani C, Bauer DC, da Costa BR, Segna D, Blum MR, Collet TH, Fink HA, Cappola AR, Syrogiannouli L, Peeters RP, Åsvold BO, den Elzen WPJ, Luben RN, Bremner AP, Gogakos A, Eastell R, Kearney PM, Hoff M, Le Blanc E, Ceresini G, Rivadeneira F, Uitterlinden AG, Khaw KT, Langhammer A, Stott DJ, Westendorp RGJ, Ferrucci L, Williams GR, Gussekloo J, Walsh JP, Aujesky D, Rodondi N; Thyroid Studies Collaboration. Thyroid function tests in the reference range and fracture: ındividual participant analysis of prospective cohorts. J Clin Endocrinol Metab. 2017;102:2719- 2728.[Crossref] [PubMed] [PMC]
  • 20.Gammage MD, Parle JV, Holder RL, Roberts LM, Hobbs FD, Wilson S, Sheppard MC, Franklyn JA. Association between serum free thyroxine concentration and atrial fibrillation. Arch Intern Med. 2007;167:928-934.[Crossref] [PubMed]
  • 21. Biondi B, Cooper DS. Benefits of thyrotropin suppression versus the risks of adverse effects in differentiated thyroid cancer. Thyroid. 2010;20:135-146.[Crossref] [PubMed]
APA Tam A, Ozdemir D, Bestepe N, Alkan A, Fakı S, EREL O, Ersoy R, Cakir B (2021). Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. , 32 - 38. 10.25179/tjem.2020-78978
Chicago Tam Abbas Ali,Ozdemir Didem,Bestepe Nagihan,Alkan Afra,Fakı Sevgul,EREL Ozcan,Ersoy Reyhan,Cakir Bekir Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. (2021): 32 - 38. 10.25179/tjem.2020-78978
MLA Tam Abbas Ali,Ozdemir Didem,Bestepe Nagihan,Alkan Afra,Fakı Sevgul,EREL Ozcan,Ersoy Reyhan,Cakir Bekir Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. , 2021, ss.32 - 38. 10.25179/tjem.2020-78978
AMA Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. . 2021; 32 - 38. 10.25179/tjem.2020-78978
Vancouver Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. . 2021; 32 - 38. 10.25179/tjem.2020-78978
IEEE Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B "Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment." , ss.32 - 38, 2021. 10.25179/tjem.2020-78978
ISNAD Tam, Abbas Ali vd. "Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment". (2021), 32-38. https://doi.org/10.25179/tjem.2020-78978
APA Tam A, Ozdemir D, Bestepe N, Alkan A, Fakı S, EREL O, Ersoy R, Cakir B (2021). Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. Turkish Journal of Endocrinology and Metabolism, 25(1), 32 - 38. 10.25179/tjem.2020-78978
Chicago Tam Abbas Ali,Ozdemir Didem,Bestepe Nagihan,Alkan Afra,Fakı Sevgul,EREL Ozcan,Ersoy Reyhan,Cakir Bekir Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. Turkish Journal of Endocrinology and Metabolism 25, no.1 (2021): 32 - 38. 10.25179/tjem.2020-78978
MLA Tam Abbas Ali,Ozdemir Didem,Bestepe Nagihan,Alkan Afra,Fakı Sevgul,EREL Ozcan,Ersoy Reyhan,Cakir Bekir Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. Turkish Journal of Endocrinology and Metabolism, vol.25, no.1, 2021, ss.32 - 38. 10.25179/tjem.2020-78978
AMA Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. Turkish Journal of Endocrinology and Metabolism. 2021; 25(1): 32 - 38. 10.25179/tjem.2020-78978
Vancouver Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment. Turkish Journal of Endocrinology and Metabolism. 2021; 25(1): 32 - 38. 10.25179/tjem.2020-78978
IEEE Tam A,Ozdemir D,Bestepe N,Alkan A,Fakı S,EREL O,Ersoy R,Cakir B "Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment." Turkish Journal of Endocrinology and Metabolism, 25, ss.32 - 38, 2021. 10.25179/tjem.2020-78978
ISNAD Tam, Abbas Ali vd. "Evaluation of Oxidative Stress with a New Method in Differentiated Thyroid Cancer Patients on Thyrotrophin Suppression Treatment". Turkish Journal of Endocrinology and Metabolism 25/1 (2021), 32-38. https://doi.org/10.25179/tjem.2020-78978