Clinical Chemistry
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Clinical Chemistry 35: 931-934, 1989;
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Clinical Chemistry, Vol 35, 931-934, Copyright © 1989 by American Association for Clinical Chemistry

Do nonesterified fatty acids displace thyroxin from its plasma binding sites in severe nonthyroidal illnesses?

RE Nicolson, CP Reilly, PR Pannall, L Esposito and ML Wellby
Department of Clinical Chemistry, Queen Elizabeth Hospital, Woodville, Adelaide, South Australia.

Severe nonthyroidal illnesses have been associated with increases in nonesterified fatty acids (NEFA) and the dialyzable fraction of thyroxin (T4) in plasma. We have further investigated their possible relationship in severe nonthyroidal illnesses as well as in induced in vivo and in vitro situations involving increased NEFA. We demonstrate that there is no relationship between NEFA and the dialyzable fraction of T4, either in severe nonthyroidal illnesses or in the other situations, unless plasma NEFA concentrations exceed 5 mmol/L in normal persons or 1.7 mmol/L in nonthyroidal illnesses, and that this concentration was not reached in the patients we studied, with one exception. We conclude that NEFA are unlikely to contribute to an inhibition of the binding of T4 to the binding proteins that might be present in plasma of patients with severe nonthyroidal illnesses unless their NEFA concentrations are very high.




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Copyright © 1989 by the American Association for Clinical Chemistry.