Short Bowel Syndrome Clinical Trial
Official title:
Nonthyroidal Illness Syndrome in Patients With Short Bowel Syndrome
Nonthyroidal illness syndrome (NTIS) is prevalent in critical illness; it is associated with poor outcomes. However, few studies have focused on the relationship between NTIS and short bowel syndrome (SBS). The aim of this study was to investigate the incidence, etiology, and prognosis of NTIS and its correlation in clinical variables in adult patients with SBS.
Nonthyroidal illness syndrome (NTIS), also known as euthyroid sick syndrome or low
triiodothyronine (T3) syndrome, is a condition characterized by decreased serum
concentrations of T3 and low or normal plasma concentrations of thyroxine (T4) without a
compensatory increase in the serum levels of thyroid stimulating hormone (TSH). However, such
typical changes differ from those in primary or secondary thyroid disorders. NTIS refers to
distortions in thyroid function without thyroid disease caused by various critical illnesses.
This condition has been described in different acute and chronic disease states over the past
30 years, including sepsis, starvation, trauma, burns, myocardial infarction, Crohn's
disease, enterocutaneous fistulas, chronic kidney disease, and major surgery.
Short bowel syndrome (SBS), the most common form of intestinal failure, is a rare condition
resulting from the loss of portions of the intestine, typically because of extensive surgical
resection or loss of intestinal function. Patients with SBS often stuffer from intestinal
insufficiency or intestinal failure because they are unable to maintain fluid and nutrient
balances on a normal diet. Therefore, SBS can cause various metabolic and physiologic
disturbances, many of which are associated with growth, intestinal adaptation, and hormone
secretion. Many previous studies of SBS have evaluated growth hormone, glucagon-like
peptide-1, glucagon-like peptide-2, vitamin D and parathyroid hormone, peptide YY, and
ghrelin. However, few studies have reported the association between SBS and the
hypothalamic-pituitary-thyroid axis and its balance.
The present study was performed to evaluate the association of thyroid hormone disturbance
and SBS in adult patients. Because NTIS is the main type of thyroid hormone disturbance, we
further investigated the incidence, underlying mechanisms, and correlation with clinical
variables and prognosis of NTIS in adult patients with SBS.
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