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6 "Triiodothyronine"
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Original Articles
Thyroid Hormone Profile and Its Prognostic Impact on the Coronavirus Disease 2019 in Korean Patients
Jiyeon Ahn, Min Kyung Lee, Jae Hyuk Lee, Seo Young Sohn
Endocrinol Metab. 2021;36(4):769-777.   Published online August 27, 2021
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  • 15 Citations
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Data on the association between coronavirus disease 2019 (COVID-19) and thyroid have been reported, including overt thyrotoxicosis and suppression of thyroid function. We aimed to evaluate the thyroid hormone profile and its association with the prognosis of COVID-19 in Korean patients.
The clinical data of 119 patients with COVID-19, admitted in the Myongji Hospital, Goyang, South Korea, were retrospectively evaluated. The thyroid hormone profiles were analyzed and compared based on disease severity (non-severe disease vs. severe to critical disease). Clinical outcomes were analyzed according to the tertiles of thyroid hormones.
Of the 119 patients, 76 (63.9%) were euthyroid, and none presented with overt thyroid dysfunction. Non-thyroidal illness syndrome was the most common manifestation (18.5%), followed by subclinical thyrotoxicosis (14.3%) among patients with thyroid dysfunction. Thyroid stimulating hormone (TSH) and triiodothyronine (T3) levels were significantly lower in patients with severe to critical disease than in those with non-severe disease (P<0.05). Patients in the lowest T3 tertile (<0.77 ng/mL) had higher rates of mechanical ventilation, intensive care unit admission, and death than those in the middle and highest (>1.00 ng/mL) T3 tertiles (P<0.05). COVID-19 patients in the lowest T3 tertile were independently associated with mortality (hazard ratio, 5.27; 95% confidence interval, 1.09 to 25.32; P=0.038) compared with those in the highest T3 tertile.
Thyroid dysfunction is common in COVID-19 patients. Changes in serum TSH and T3 levels may be important markers of disease severity in COVID-19. Decreased T3 levels may have a prognostic significance in COVID-19 related outcome.


Citations to this article as recorded by  
  • Thyroxine changes in COVID-19 pandemic: A systematic review and meta-analysis
    Ziqi Li, Pengwei Hou, Shuwen Mu, Renzhi Wang, Hui Miao, Ming Feng, He Wang, Wentai Zhang, Yihao Chen, Tianshun Feng, Shousen Wang, Yi Fang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • The Influence of SARS-CoV-2 Infection on the Thyroid Gland
    Aleksandra Piekarska, Marta Góral, Marta Kozula, Aleksandra Jawiarczyk-Przybyłowska, Katarzyna Zawadzka, Marek Bolanowski
    Biomedicines.2023; 11(2): 614.     CrossRef
  • Thyroid Function Abnormalities and Outcomes in Hospitalized Patients with COVID-19 Infection: A Cross-Sectional Study
    Deepika Patel, Dukhabandhu Naik, Sadishkumar Kamalanathan, Kadhiravan Tamilarasu, Jayaprakash Sahoo, Ayan Roy, Chandhana Merugu, Varun Suryadevara
    Hormone and Metabolic Research.2023; 55(03): 169.     CrossRef
  • The Spectrum of Thyroid Function Tests and Autoantibodies During Hospitalization and After Six Months of Discharge in COVID-19 Patients: Does COVID-19 Trigger Autoimmunity?
    Ziynet Alphan Uc, Pinar Yagcı, Zelal Adibelli, Cevdet Duran
    Endocrine Research.2023; 48(2-3): 44.     CrossRef
  • Transient low T3 syndrome in patients with COVID-19: a new window for prediction of disease severity
    Mingyao Zhong, Yue Gao, Hongling Hu, Xuan Zhu, Lulu Gan, Ling Li, Cheng Xiang, Yimin Yan, Zhe Dai
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • The Association Between COVID-19 and Thyroxine Levels: A Meta-Analysis
    Yiru Chen, Xiuneng Li, Yu Dai, Jingjing Zhang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • The New Entity of Subacute Thyroiditis amid the COVID-19 Pandemic: From Infection to Vaccine
    Mihaela Popescu, Adina Ghemigian, Corina Maria Vasile, Andrei Costache, Mara Carsote, Alice Elena Ghenea
    Diagnostics.2022; 12(4): 960.     CrossRef
  • Potential of Endogenous Oxytocin in Endocrine Treatment and Prevention of COVID-19
    Stephani C. Wang, Fengmin Zhang, Hui Zhu, Haipeng Yang, Yang Liu, Ping Wang, Vladimir Parpura, Yu-Feng Wang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • The Association Between FT3 With the Outcome and Inflammation/Coagulopathy/Fibrinolysis of COVID-19
    Jiayi Deng, Siye Zhang, Fei Peng, Quan Zhang, Yi Li, Yanjun Zhong
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Primary hypothyroidism with an episode of ventricular tachycardia in a patient with COVID-19
    Pin-Hsu Liao, Yu-Cheng Cheng, Po-Yu Liu, I-Te Lee
    Medicine.2022; 101(25): e29243.     CrossRef
  • Low triiodothyronine syndrome is associated with stroke‐associated pneumonia
    Huijun Chen, Minjie Xu, Yezhi Huang, Jincai He, Wenwei Ren
    European Journal of Clinical Investigation.2022;[Epub]     CrossRef
  • Association of thyroid dysfunction and COVID-19: A systematic review and meta-analysis
    Mohammad Darvishi, Mohammad Reza Nazer, Hamze Shahali, Majid Nouri
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • The prognostic utility of serum thyrotropin in hospitalized Covid-19 patients: statistical and machine learning approaches
    E. Pappa, P. Gourna, G. Galatas, M. Manti, A. Romiou, L. Panagiotou, R. Chatzikyriakou, N. Trakas, G. Feretzakis, C. Christopoulos
    Endocrine.2022; 80(1): 86.     CrossRef
  • Thyrotropin Levels in Patients with Coronavirus Disease 2019: Assessment during Hospitalization and in the Medium Term after Discharge
    Abdallah Al-Salameh, Noémie Scherman, Imane Adda, Juliette André, Yoann Zerbib, Julien Maizel, Jean-Daniel Lalau, Etienne Brochot, Claire Andrejak, Rachel Desailloud
    Life.2022; 12(12): 2014.     CrossRef
  • COVID-19 and thyroid function: What do we know so far?
    Camila Lüdke Rossetti, Juliana Cazarin, Fabio Hecht, Fabyan Esberard de Lima Beltrão, Andrea Cláudia Freitas Ferreira, Rodrigo Soares Fortunato, Helton Estrela Ramos, Denise Pires de Carvalho
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
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Clinical Study
Subclinical Hypothyroidism Affects the Long-Term Outcomes of Patients Who Undergo Coronary Artery Bypass Grafting Surgery but Not Heart Valve Surgery
Hana Kim, Sung Hye Kong, Jae Hoon Moon, Sang Yoon Kim, Kay-Hyun Park, Jun Sung Kim, Joong Haeng Choh, Young Joo Park, Cheong Lim
Endocrinol Metab. 2020;35(2):308-318.   Published online June 24, 2020
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  • 148 Download
  • 8 Citations
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
The aim of this study was to determine the associations between subclinical hypothyroidism (SCH) and long-term cardiovascular outcomes after coronary artery bypass grafting (CABG) or heart valve surgery (HVS).
We retrospectively reviewed and compared all-cause mortality, cardiovascular mortality, and cardiovascular events in 461 patients who underwent CABG and 104 patients who underwent HVS.
During a mean±standard deviation follow-up duration of 7.6±3.8 years, there were 187 all-cause deaths, 97 cardiovascular deaths, 127 major adverse cardiovascular events (MACE), 11 myocardial infarctions, one unstable angina, 70 strokes, 30 hospitalizations due to heart failure, 101 atrial fibrillation, and 33 coronary revascularizations. The incidence of all-cause mortality after CABG was significantly higher in patients with SCH (n=36, 55.4%) than in euthyroid patients (n=120, 30.3%), with a hazard ratio of 1.70 (95% confidence interval, 1.10 to 2.63; P=0.018) after adjustment for age, sex, current smoking status, body mass index, underlying diseases, left ventricular dysfunction, and emergency operation. Interestingly, low total triiodothyronine (T3) levels in euthyroid patients who underwent CABG were significantly associated with increased risks of all-cause mortality, cardiovascular mortality, and MACE, but those associations were not observed in HVS patients. Both free thyroxine and thyroid-stimulating hormone levels in euthyroid patients were not related with any cardiovascular outcomes in either the CABG or HVS group.
SCH or low total T3 might be associated with a poor prognosis after CABG, but not after HVS, implying that preoperative thyroid hormonal status may be important in ischemic heart disease patients.


Citations to this article as recorded by  
  • The Association Between Hypothyroidism Treatment and Mortality in Patients Hospitalized in Surgical Wards
    Hiba Masri-Iraqi, Yaron Rudman, Carmel Friedrich Dubinchik, Idit Dotan, Talia Diker-Cohen, Liat Sasson, Tzipora Shochat, Ilan Shimon, Eyal Robenshtok, Amit Akirov
    Endocrine Research.2023; 48(2-3): 68.     CrossRef
  • Mid-term outcomes of patients with subclinical hypothyroidism after coronary bypass surgery
    Dong Zhao, Wei Zhao, Chuangshi Wang, Fei Xu, Wei Zhao, Xieraili Tiemuerniyazi, Hao Ma, Wei Feng
    Interdisciplinary CardioVascular and Thoracic Surgery.2023;[Epub]     CrossRef
  • Thyroid Pathology in High-Risk Cardiac Surgery Patients with Coronary Artery Disease
    Olena K. Gogayeva, Anatoliy V. Rudenko, Vasyl V. Lazoryshynets, Serhii A. Rudenko, Tetiana A. Andrushchenko
    Ukrainian Journal of Cardiovascular Surgery.2022; 30(1 (46)): 9.     CrossRef
  • High-TSH Subclinical Hypothyroidism Is Associated With Postoperative Mortality in Acute Type A Aortic Dissection
    Shi-Pan Wang, Yuan Xue, Hai-Yang Li, Wen-Jian Jiang, Hong-Jia Zhang
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Triiodothyronine improves contractile recovery of human atrial trabeculae after hypoxia/reoxygenation
    Petra Kleinbongard, Philipp Kuthan, Chantal Eickelmann, Philipp Jakobs, Joachim Altschmied, Judith Haendeler, Arjang Ruhparwar, Matthias Thielmann, Gerd Heusch
    International Journal of Cardiology.2022; 363: 159.     CrossRef
  • Hypothyroidism Is Correlated with Ventilator Complications and Longer Hospital Days after Coronary Artery Bypass Grafting Surgery in a Relatively Young Population: A Nationwide, Population-Based Study
    Jiun-Yu Lin, Pei-Chi Kao, Yi-Ting Tsai, Chi-Hsiang Chung, Wu-Chien Chien, Chih-Yuan Lin, Chieh-Hua Lu, Chien-Sung Tsai
    Journal of Clinical Medicine.2022; 11(13): 3881.     CrossRef
  • Minor perturbations of thyroid homeostasis and major cardiovascular endpoints—Physiological mechanisms and clinical evidence
    Patrick Müller, Melvin Khee-Shing Leow, Johannes W. Dietrich
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
    Won Sang Yoo, Hyun Kyung Chung
    Endocrinology and Metabolism.2021; 36(3): 500.     CrossRef
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Development of Competitive Enzyme - Linked Immunosorbent Assay for the Measurenment of Total Triiodothyronine in Serum.
Myoung Lyeh Park, Youn Kyu Kim, Chang Kyu Kim, Jong Bae Kim
J Korean Endocr Soc. 1996;11(4):447-454.   Published online November 7, 2019
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  • 37 Download
AbstractAbstract PDF
Triiodothyronine(T3) is a hormone secreted from thyroid gland which exerts a stimulating effect on metabolism. The disorder of thyroid system brings about several serious diseases like hypothymidism or hyperthyroidism. Therefore, the determination of T in blood is very important on monitoring thyroid function. Methods: Rabbit anti-T3 antibody was generated by immunization of T-BSA as an immunogen and purified hom antisera using Affi-gel protein A kit. The titer and specificity of purified antibody were characterized. To detect T3, competitive ELISA was performed using anti-T3 antibody and T3-HRP conjugate which was synthesized by glutaraldehyde method. The sensitivity and precision assay wer~e deterrnined and compared with that of RIA. Results: The titer of purified anti-T3 antibody was about 1:100 and the optimal dilution of T3- HRP conjugate was 1:1000. When the standard curve was constructed by ELISA, its sensitivity was about 0.5ng/ml. The eoefficient variations of intra- and inter-assay were 4.9~9.3% and 7.5~13.8%, respectively. The results obtained by ELISA and RIA correlated well with each other(n =50, r= 0.97), The linear regression equation was y= 1.09*0.08(P<0.01). Conclusion: We successfully developed a method for the measurement of T3 on ELISA which was based on competitive reaction between antigen(T3) and enzyme labeled antigen(T3-HRP). These results demonstrated that competitive ELISA is a convenient, fast, reproducible and aecurate method for the determinstion of T in serum and can be used as practical alternative to RIA.
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Clinical Study
Triiodothyronine Levels Are Independently Associated with Metabolic Syndrome in Euthyroid Middle-Aged Subjects
Hye Jeong Kim, Ji Cheol Bae, Hyeong Kyu Park, Dong Won Byun, Kyoil Suh, Myung Hi Yoo, Jae Hyeon Kim, Yong-Ki Min, Sun Wook Kim, Jae Hoon Chung
Endocrinol Metab. 2016;31(2):311-319.   Published online May 13, 2016
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  • 30 Download
  • 23 Citations
AbstractAbstract PDFSupplementary MaterialPubReader   

Recent studies have shown an association between thyroid hormone levels and metabolic syndrome (MetS) among euthyroid individuals; however, there have been some inconsistencies between studies. Here, we evaluated the relationship between thyroid hormone levels and MetS in euthyroid middle-aged subjects in a large cohort.


A retrospective analysis of 13,496 euthyroid middle-aged subjects who participated in comprehensive health examinations was performed. Subjects were grouped according to thyroid stimulating hormone, total triiodothyronine (T3), total thyroxine (T4), and T3-to-T4 ratio quartile categories. We estimated the odds ratios (ORs) for MetS according to thyroid hormone quartiles using logistic regression models, adjusted for potential confounders.


Of the study patients, 12% (n=1,664) had MetS. A higher T3 level and T3-to-T4 ratio were associated with unfavourable metabolic profiles, such as higher body mass index, systolic and diastolic blood pressure, triglycerides, fasting glucose and glycated hemoglobin, and lower high density lipoprotein cholesterol levels. The proportion of participants with MetS increased across the T3 quartile categories (P for trend <0.001) and the T3-to-T4 ratio quartile categories (P for trend <0.001). The multi-variate-adjusted OR (95% confidence interval) for MetS in the highest T3 quartile group was 1.249 (1.020 to 1.529) compared to the lowest T3 quartile group, and that in the highest T3-to-T4 ratio quartile group was 1.458 (1.141 to 1.863) compared to the lowest T3-to-T4 ratio quartile group, even after adjustment for potential confounders.


Serum T3 levels and T3-to-T4 ratio are independently associated with MetS in euthyroid middle-aged subjects. Longitudinal studies are needed to define this association and its potential health implications.


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  • The effect of endocrine disrupting chemicals on the vitronectin-receptor (integrin αvβ3)-mediated cell adhesion of human umbilical vein endothelial cells
    Maša Kenda, Urša Pečar Fonović, Janko Kos, Marija Sollner Dolenc
    Toxicology in Vitro.2022; 79: 105275.     CrossRef
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    Stella Iacovides, Shane K. Maloney, Sindeep Bhana, Zareena Angamia, Rebecca M. Meiring, Carla Pegoraro
    PLOS ONE.2022; 17(6): e0269440.     CrossRef
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    Han-Bin Huang, Po-Keng Cheng, Chi-Ying Siao, Yuan-Ting C. Lo, Wei-Chun Chou, Po-Chin Huang
    Environmental Health.2022;[Epub]     CrossRef
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    Kyung A. Shin, Eun Jae Kim
    Medicine.2021; 100(51): e28409.     CrossRef
  • Clinical Parameters Are More Likely to Be Associated with Thyroid Hormone Levels than with Thyrotropin Levels: A Systematic Review and Meta-Analysis
    Stephen P. Fitzgerald, Nigel G. Bean, Henrik Falhammar, Jono Tuke
    Thyroid.2020; 30(12): 1695.     CrossRef
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    Therapeutic Advances in Endocrinology and Metabolism.2020; 11: 204201882091786.     CrossRef
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    Obesity Facts.2020; 13(3): 358.     CrossRef
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    Current Opinion in Endocrinology, Diabetes & Obesity.2019; 26(5): 256.     CrossRef
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    Won-Young Lee
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Case Report
A Case of Primary Hypothyroidism with Anti-Triiodothyronine Autoantibody.
Jae Ho Park, Ji Hoon Ahn, Mi Hee Kang, Jong Chul Won, Kyung Wook Lee, Yeo Joo Kim, Ji Oh Mok, Hyeong Kyu Park, Chul Hee Kim, Sang Jin Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo
J Korean Endocr Soc. 2006;21(5):428-432.   Published online October 1, 2006
  • 1,726 View
  • 23 Download
  • 1 Citations
AbstractAbstract PDF
Antithyroid hormone autoantibodies can be present in the sera of patients with thyroid and non-thyroid disorders. Antithyroid hormone autoantibodies in a patient's serum interfere with radioimmunoassay of thyroid hormones. Clinically, this interference can result in discordance between the serum thyroid hormone levels and the clinical features of the patient, which can lead to misdiagnosis or inappropriate treatment. We experienced a woman who had primary hypothyroidism with unexpectedly high concentrations of serum total triiodothyronine (T(3)) and free T(3), and she had been treated for Graves' disease in the past. Through the use of a polyethylene glycol precipitation method, we detected the anti-triiodothyronine autoantibodies in her serum. We report on this case along with a review of the related literature.


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  • Thyroxine (T4) Autoantibody Interference of Free T4 Concentration Measurement in a Patient With Hashimoto’s Thyroiditis
    Mi-Na Lee, Soo-Youn Lee, Kyu Yeon Hur, Hyung-Doo Park
    Annals of Laboratory Medicine.2017; 37(2): 169.     CrossRef
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Original Article
A Case of Hashimotos Thyroiditis with Anti-Triiodothyronine Autoantibody.
Yun Ey Chung, Jeong Hee Han, Seong Jin Lee, Won Ki Min, Ki Young Park, Kun Ku Park, Dae Hyunk Moon, Il Min Ahn
J Korean Endocr Soc. 2001;16(2):245-251.   Published online April 1, 2001
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  • 19 Download
AbstractAbstract PDF
Autoantibodies against thyroid hormones can be detected in the sera of patients with both thyroidal and non-thyroidal disorders. These antibodies interfere with the radioimmunoassay of serum total and free thyroid hormone concentrations, resulting in a discrepancy between the measured hormone levels and clinical features. This can in turn lead to an erroneous diagnosis and patients may receive unnecessary treatment from physicians who are unaware of the presence of the autoantibodies. We experienced a woman having Hashimotos' thyroiditis with a spurious elevation of total T3 and free T3 values according to one-step analog-tracer radioimmunoassay who was had been treated as Graves' disease in past. Through the use of a polyethylene glycol precipitation method, she was subsequently revealed to have anti-triiodothyronine autoantibodies. We report this case with a review of related literature.
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