EUTHYROID SICK SYNDROME AND CYTOKINE IMBALANCE IN PATIENTS WITH FUNCTIONAL DYSPEPSIA

Abstract

The article presents the results of the study assessing the role of thyroid dysfunction and cytokine imbalance in the pathogenesis and manifestations of functional dyspepsia. We found that 31 % of the patients with functional dyspepsia had low serum triiodothyronine (T3) and/or free serum thyroxine (T4) levels as well as normal or mildly reduced serum TSH levels, thus confirming the presence of euthyroid sick syndrome in such patients. These changes in thyroid hormone levels were more frequent in postprandial functional dyspepsia than in epigastric pain syndrome. Moreover, the functional dyspepsia group was found to have elevated mean anti-TPO levels as compared with the controls. Thyroid imbalances were associated with mildly elevated pro-inflammatory (TNF-α, IL-1 ß, IL-6, IL-8) cytokine levels and low levels of serum anti-inflammatory IL-10 cytokine as compared with the healthy subjects. Along with this, hypercytokinemia was less pronounced in functional dyspepsia than in peptic ulcer. We obtained evidence of a strong correlation between clinical manifestations of functional dyspepsia and the severity of thyroid dysfunction. Positive correlation was found between T3, free T4, TNF-α, IL-1 ß, IL-6 and IL-8, while pro-inflammatory IL-10 cytokines were negatively correlated with free T4 leväs. Our findings suggest that thyroid dysfunction and regulatory cytokines play a significant role in the pathogenesis and manifestations of functional dyspepsia and represent objective markers of disease severity.