We studied the role of serum free fatty acid (FFA) in the elevation of serum dializable fraction of T
4 (DFT
4) and evaluated the serum free T
4 (FT
4) level in low T
3 syndrome.
Serum DFT
4 and DFT
3 were measured by equilibrium dialysis method with phosphate buffer, and serum FFA concentration was obtained by gas chromatography.
In patients with nonthyroidal systemic illnesses who showed reduced serum total T
3 (TT
3) and normal total T
4 (TT
4) (loW T
3 group, TT
3 48± 14 ng/dl, n = 10), mean (-± SD) DFT
4 value (0.032±0.05%) was significantly higher than that of the group of systemic illnesses with normal TT
3 and TT
4 (normal T
3 group, TT
3 79±7 ng/dl, n = 10). Mean TT
4 value of low T
3 group (6.5± 1.0μg/dl) was lower than that of normal T
3 group (8.6±2.4μg/dl, p<0.02). There was no difference in mean absolute FT
4 (AFT
4) value between the two groups (2.07±0.46 vs 2.19±0.53 ng/dl). On the other hand, there was no significant difference in DFT
3 value between the groups (0.274±0.043 vs 0.247±0.035%), and mean AFT
3 of low T
3 group (1.29±0.39 pg/ml) was low than that of normal T
3 group (1.92±0.26 pg/ml, p<0.01). In cases of low and normal T
3 groups (n = 20), serum thyroxine binding globulin (TBG) concentration had a negative correlation with DFT
3 (r =-0.707, p<0.001), but not with DFT
4. Although there were no significant differences in serum albumin and TBG concentrations between the two groups, the mean serum total FFA concentration and molar ratio of FFA to albumin in low T
3 group (579± 249 μM and 1.31±0.61) were significantly higher than those in normal T
3 group (345±170 μM and 0.75±0.32, p<0.05 and <0.025, respectively). All of FFA concentrations in low T
3 group, especially oleate, were higher than those in normal T
3 group. Moreover, the higher the total FFA concentration was, the greater was the percent fraction of oleate.
DFT
4 values were significantly increased by the addition of 1 mM oleate to the sera of low T
3 group, and this effect was more marked in the sera of the patients with lower albumin concentration. This effect of oleate on FT
4 fraction was also observed by column adsorption chromatography method with Sephadex LH-20. The effect of oleate on DFT
4 of subject with TBG deficiency was remarkable, and this was getting less as TBG concen-tration was increased by the addition of the serum containing high TBG to the original serum. In the study of 1-T
4 load to the normal serum, this effect of oleate on DFT
4 became greater as the amount of 1-T
4 loaded was above the maximal binding capacities of TBG and/or thyroxine binding prealbumin (TBPA). And this effect of oleate on DFT
4 was not attenuated with barbital buffer which inhibits the binding of T
4 to TBPA.
We also studied the ability of oleate in displacing
125I-T
4 from HSA or purified TBG (Ka for T
4 : 10
10M
-1). One half maximal B/F were obtained at 3.58 × 10
-5M oleate and 1.54 × 10
-5M HSA (molar ratio : 2.32) or at 1.96 × 10
-5 oleate and 7.7 × 10
-9M TBG (molar ratio : 2,545). Although oleate was about 3,000 times less potent than T
4 in dis-placing
125I-T
4 from TBG,
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