Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, People's Republic of China.
JPEN J Parenter Enteral Nutr. 2021 Jul;45(5):973-981. doi: 10.1002/jpen.1967. Epub 2020 Aug 10.
Nonthyroidal illness syndrome (NTIS) is prevalent in critical illness and is associated with poor outcomes. However, only few studies have focused on the relationship between NTIS and short-bowel syndrome (SBS). The aim of this study was to investigate the prevalence, etiology, and prognosis of NTIS and its correlation with clinical variables in adult patients with SBS.
Sixty-one eligible adults diagnosed with SBS, from December 2016 to December 2018, were retrospectively identified from a prospectively maintained database. Demographic and clinical characteristics (including thyroid hormones and nutrition variables) were evaluated for each participant.
The prevalence of NTIS in adults with SBS was 52.5%. Patients with NTIS tended to have a longer duration of hospital stay and poor survival, but the results were not significant. A decreased, standard thyroid-stimulating hormone index and sum activity of deiodinases and an increased secretory capacity by the thyroid were observed in the NTIS group. Receiver operating characteristic curve analysis showed that insulin-like growth factor-1 (IGF-1) had better performance for distinguishing NTIS from patients with euthyroidism, with an area under the curve of 0.862 (cutoff, 101.0; sensitivity, 0.813; and specificity, 0.800).
NTIS is a common complication in adult patients with SBS. Patients with NTIS tend to have a worse nutrition status and poor prognosis. A potential pituitary thyrotroph dysfunction and hypodeiodination condition may play a role in the pathophysiology of NTIS in SBS. Furthermore, IGF-1 is a meaningful predictor for distinguishing NTIS from euthyroid.
非甲状腺疾病综合征（NTIS）在危重病中很常见，与不良预后相关。然而，仅有少数研究关注 NTIS 与短肠综合征（SBS）之间的关系。本研究旨在探讨成人 SBS 患者 NTIS 的患病率、病因和预后及其与临床变量的关系。
从 2016 年 12 月至 2018 年 12 月，从一个前瞻性维护的数据库中回顾性确定了 61 名符合 SBS 诊断的合格成年人。评估了每位参与者的人口统计学和临床特征（包括甲状腺激素和营养变量）。
成人 SBS 患者中 NTIS 的患病率为 52.5%。患有 NTIS 的患者住院时间较长，生存状况较差，但结果无统计学意义。NTIS 组观察到标准促甲状腺激素指数、脱碘酶总活性降低和甲状腺分泌能力增加。受试者工作特征曲线分析显示，胰岛素样生长因子-1（IGF-1）在区分 NTIS 与甲状腺功能正常患者方面具有更好的性能，曲线下面积为 0.862（临界值为 101.0；敏感性为 0.813；特异性为 0.800）。
NTIS 是成人 SBS 患者的常见并发症。患有 NTIS 的患者往往营养状况较差，预后较差。潜在的垂体甲状腺刺激功能障碍和脱碘功能减退可能在 SBS 中 NTIS 的病理生理学中发挥作用。此外，IGF-1 是区分 NTIS 与甲状腺功能正常的有意义的预测因子。
