Lauro Wanderley University Hospital, Federal University of Paraíba, João Pessoa, Paraíba, Brazil.
University Center of João Pessoa - UNIPE, João Pessoa, PB, Brazil.
Eur Thyroid J. 2024 Jul 31;13(4). doi: 10.1530/ETJ-24-0068. Print 2024 Aug 1.
The type 2 deiodinase and its Thr92Ala-DIO2 polymorphism have been linked to clinical outcomes in acute lung injury and coronavirus disease 2019 (COVID-19).
The objective was to identify a potential association between Thr92Ala-DIO2 polymorphism and body composition (appendicular muscle mass, myosteatosis, and fat distribution) and to determine whether they reflect the severity or mortality associated with the disease.
In this prospective cohort study (June-August 2020), 181 patients hospitalized with moderate-to-severe COVID-19 underwent a non-contrast-enhanced computed tomography (CT) of the thorax to assess body composition, laboratory tests, and genotyping for the Thr92Ala-DIO2 polymorphism.
In total, 181 consecutive patients were stratified into three subgroups according to the genotype: Thr/Thr (n = 64), Thr/Ala (n = 96), and Ala/Ala (n = 21). The prevalence of low muscle area (MA) (< 92 cm²) was 52.5%. Low MA was less frequent in Ala/Thr patients (44.8%) than in Thr/Thr (60.9%) or Ala/Ala patients (61.9%) (P = 0.027). Multivariate logistic regression analysis confirmed that the Thr/Ala allele was associated with a reduced risk of low MA (41% to 69%) and myosteatosis (62% to 72%) compared with Thr/Thr + Ala/Ala (overdominant model). Kaplan-Meier curves showed that patients with low muscle mass and homozygosity had lower survival rates than the other groups. Notably, the heterozygotes with MA ≥92 cm² exhibited the best survival rate.
Thr92Ala-DIO2 heterozygosity is associated with increased skeletal MA and less myosteatosis in patients with COVID-19. The protective effect of Thr92Ala-DIO2 heterozygosity on COVID-19 mortality is restricted to patients with reduced MA.
2 型脱碘酶及其 Thr92Ala-DIO2 多态性与急性肺损伤和 2019 年冠状病毒病（COVID-19）的临床结局相关。
本研究旨在确定 Thr92Ala-DIO2 多态性与身体成分（四肢肌肉量、肌内脂肪增多和脂肪分布）之间的潜在关联，并确定它们是否反映了与疾病相关的严重程度或死亡率。
在这项前瞻性队列研究（2020 年 6 月至 8 月）中，181 名因中度至重度 COVID-19 住院的患者接受了非增强胸部计算机断层扫描（CT）以评估身体成分、实验室检查和 Thr92Ala-DIO2 多态性的基因分型。
总共根据基因型将 181 例连续患者分为三组：Thr/Thr（n = 64）、Thr/Ala（n = 96）和 Ala/Ala（n = 21）。低肌肉面积（MA）（<92 cm²）的患病率为 52.5%。Ala/Thr 患者的低 MA 发生率（44.8%）低于 Thr/Thr（60.9%）或 Ala/Ala 患者（61.9%）（P = 0.027）。多变量逻辑回归分析证实，与 Thr/Thr + Ala/Ala 相比，Thr/Ala 等位基因与低 MA（41%至 69%）和肌内脂肪增多（62%至 72%）的风险降低相关（超显性模型）。Kaplan-Meier 曲线显示，肌肉质量低且纯合的患者生存率低于其他组。值得注意的是，MA≥92 cm² 的杂合子患者的生存率最高。
Thr92Ala-DIO2 杂合性与 COVID-19 患者的四肢 MA 增加和肌内脂肪增多减少相关。Thr92Ala-DIO2 杂合性对 COVID-19 死亡率的保护作用仅限于 MA 降低的患者。
