[Free fatty acids in the serum in critical diseases: do they play a role in the protein binding of thyroid hormones?].

As a contribution to the question if the elevated concentrations of free fatty acids in sera of critically ill patients described in literature play a role in the decrease of thyroid hormone levels in these patients, serum levels of the important free fatty acids were measured in 31 patients of our intensive care unit in the course of their disease using gas chromatography. After admission to the ward, only palmitoleic acid was significantly increased compared with 174 control persons, arachidonic acid was not different from the controls, palmitic, stearic, linoleic and linolenic acid were significantly decreased. In the course of the disease, no relevant changes were observed. The 21 patients not surviving their disease showed significantly lowered levels of palmitic, stearic and linoleic acid before death compared with the surviving patients at the end of the observation period. The hypothetical role of single free fatty acids as inhibitors of the binding of thyroid hormones to their transport proteins must be questioned because of the results.