Alterations in serum thyroid hormones, lipids and dehydroepiandrosterone sulfate levels in the fasting and postprandial states

Örnek alımı sırasında kişinin aç veya tok olmasının değişik biyokimyasal testleri farklı oranlarda etkileyerek preanalitik hatalara neden olduğu bilinmektedir. Çalışmamızda Total T3 (T3), Total T4 (T4), Serbest T3, Serbest T4, TSH, dehidroepiandrosteron sülfat (DHEA-SO4) ve lipid parametrelerinin açlık ve tokluk düzeyleri arasındaki olası değişikliklerin incelenmesi amaçlanmıştır. 35 sağlıklı gönüllüden 12 saatlik açlık sonrası (saat 08:00-09:00 arasında) açlık kan örnekleri ve aynı gün postprandial 2.saatte (saat 10:00-11:00 arasında) tokluk kan örnekleri alınmıştır. Tüm açlık ve tokluk kanlarında serum lipidleri (total kolesterol, trigliserid, HDL kolesterol, LDL kolesterol, VLDL kolesterol), tiroid hormonları "e DHEA-SO4 testleri çalışılmıştır.Total kolesterol, trigliserid, HDL kolesterol düzeyleri aynı gün otanalizörde enzimatik yöntemle, tiroid testleri kemilüminesans immunassay metoduyla, DHEA-S04 düzeyleri ise radyoimmunassay ile ölçülmüştür. Açlık trigliserid (p=0.042), VLDL (p=0.038) ve DHEA-S04 değerlerinde (p=0.002) tokluk değerlerine gore istatistiksel olarak anlamlı düşüklük saptanmıştır. Açlık LDL kolesterol (p=0.027) ve TSH değerlerinde (p=0.002) ise tokluk değerlerine oranla istatistiksel olarak anlamlı yükseklik saptanmıştır. T3, T4, Serbest T3 ve Serbest T4 düzeylerinin açlık ve tokluk değerleri arasında anlamlı bir fark gözlenmemiştir. Bu çalışmada, serum TSH ve DHEA-S04 düzeylerinde görülen anlamlı değişiklik nedeniyle preanalitik hatadan kaçınmak için örnek alımı sırasında hastaların en az 12 saat aç olması gerektiği sonucuna varılmıştır.

Serum tiroid hormonları, lipid parametreleri ve dehidroepiandrosteron sülfat düzeylerinin açlık ve toklukla ilişkisi

Biochemical tests are known to be affected by fasting or postprandial state. The aim of the present study is to assess the possible alterations between the fasting and postprandial serum levels of total triiodothyronine (T3), total thyroxine (T4), free T3, free T4, thyroid stimulating hormone (TSH) dehydroepiandrosterone sulfate (DHEA-SO4) and lipids. In 35 healthy cases blood samples were obtained aftera 12-hour-fasting period at 08:00-09:00 hours and postprandial samples after 2 hours at 10:00-11:00 hours. In both groups of samples, serum lipids (total cholesterol, triglyceride, HDL cholesterol, LDL cholesterol, VLDL cholesterol), thyroid hormones and DHEA-SO4 were assayed on the same day. Total cholesterol, triglyceride and HDL cholesterol were analyzed on an automatic analyzer by enzymatic methods, thyroid hormones by cheiluminescence and DHEA-SO4 by radioimmunoassay. Fasting triglyceride, VLDL and DHEA-SO4 values were significantly (p=0.042, p=0.038 and p=0.002, respectively) lower than the postprandial values, while fasting LDL cholesterol and TSH values were found significantly (p=0.027, p=0.002, respectively) higher than the postprandial values. However, no differences were found between the postprandial and fasting values of total T3, total T4, free T3 and free T4. In conclusion, to avoid preanalitical errors especially serum TSH and DHEA-SO4 levels should be assessed on samples obtained after a 12-hour-fasting period.

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Ege Tıp Dergisi-Cover
  • ISSN: 1016-9113
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1962
  • Yayıncı: Ersin HACIOĞLU