Límanová Z, Sonka J, Kratochvíl O, Wilczek H, Marek J
Endokrinologie. 1981 Mar;77(1):70-8.
Serum levels of T4, T3, rT3, RT3U and TSH were estimated in 12 obese women in the course of a 14-day fasting. Seven of these patients were treated with T3 in a daily dose of 60--80 micrograms. Fasting led to a small increase of serum T4, while fasting combined with T3 administration was accompanied by a small decrease of serum T4. Serum T3 decreased in the course of the first 2 days of fasting to 40--50% of initial values and remained at this low level up to the 15th day of fasting. In the T3 treated group a prompt increase of serum T3 was recorded (+80%), followed by a steady decrease, reaching the control values on day 15, in spite of a continuous T3 administration. Serum rT3 in the untreated fasting group steadily increased up to the 12th day (+43%) and then dropped below the control value (-28%). In the treated group after a non-significant increase (+22%), a decrease of serum rT3 was also observed (-42%). Fasting was accompanied by a tendency to increased serum RT3U values, in the T3 treated group no change occurred. TSH in the untreated fasting women remained practically unchanged while T3 administration was accompanied by a tendency to a transient decrease. The heart rate showed a non-significant tendency to increase in the T3 treated group and the last week of fasting was also accompanied in several patients by a larger weight loss. These results suggest that in addition to an enhanced synthesis of rT3 to the detriment of a decreased production of T3 from T4, an increased catabolism of administered T3 and of endogenous rT3 is involved in a strict calorie restriction. An abortive T3-TRH-TSH feed-back may also operate in these conditions.
对12名肥胖女性在为期14天的禁食过程中进行了血清T4、T3、反T3、反T3摄取率（RT3U）和促甲状腺激素（TSH）水平的评估。其中7名患者每日接受60 - 80微克的T3治疗。禁食导致血清T4略有升高，而禁食联合T3给药则伴随着血清T4略有下降。禁食的头2天血清T3降至初始值的40% - 50%，并在禁食第15天前一直维持在这一低水平。在T3治疗组中，记录到血清T3迅速升高（+80%），随后持续下降，尽管持续给予T3，但在第15天达到对照值。未治疗的禁食组血清反T3在第12天前稳步升高（+43%），然后降至对照值以下（-28%）。在治疗组中，血清反T3在无显著升高（+22%）后也出现下降（-42%）。禁食伴随着血清反T3摄取率值升高的趋势，在T3治疗组中则无变化。未治疗的禁食女性的TSH基本保持不变，而给予T3则伴随着短暂下降的趋势。心率在T3治疗组中有不显著的升高趋势，并且在禁食的最后一周，几名患者体重也有较大幅度下降。这些结果表明，除了rT3合成增加不利于T4转化为T3外，给予的T3和内源性反T3的分解代谢增加也参与了严格的热量限制。在这些情况下，可能也存在T3 - 促甲状腺激素释放激素（TRH） - TSH反馈的异常。
