Fischli S, et al. – Researchers conducted a prospective observational study which indicated that iron metabolism in patients with Graves’ hyperthyroidism (GH) undergoes dynamic changes in patients with GH that resemble an acute phase reaction. It was noted that inflammatory parameters and cytokines were unaffected by thyroid status. In addition, gender and smoking status had an impact on ferritin, hepcidin and thyroid hormones.

Methods

• This was prospective observational study.
• Researchers recruited patients (n=31) with new-onset and untreated GH.
• They analyzed laboratory parameters indicative of iron metabolism (ferritin, transferrin, hepcidin), inflammatory markers/cytokines and smoking status at the diagnosis of GH (T0) and at euthyroidism (T1) in the same patients using multivariable analyses.
• They assessed hepcidin by mass spectrometry (hepcidinMS) and ELISA (hepcidinEL).
• They studied the effect of T3 on hepatic hepcidin expression in a cell culture model using HepG2 cells.

Results

• The data showed that median ferritin levels were significantly lower and transferrin significantly higher at T1 than at T0.
• It was noted that hepcidinMS levels were lower in males and females at T1 (statistically significant in males only).
• There was no statistically significant difference in hepcidinEL between T0 and T1.
• The obtained data demonstrated that plasma levels of inflammatory markers (high-sensitive CRP, procalcitonin) and cytokines (interleukin 6, interleukin 1(beta), tumor necrosis factor alpha) were not different between T0 and T1.
• Remarkably, smokers tended to have lower fT3 and fT4 at T0 than non-smoking GH patients. T3 significantly induced hepcidin mRNA expression in HepG2 cells.