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Circulating Citrate is Elevated During Profound Hypothyroidism:An Observational Study

Title: Circulating Citrate is Elevated During Profound Hypothyroidism:An Observational Study
Authors: Li, Yakun; Links, Mirthe H.; Post, Adrian; Connelly, Margery A.; Links, Thera P.; Dullaart, Robin P.F.
Source: Li, Y, Links, M H, Post, A, Connelly, M A, Links, T P & Dullaart, R P F 2025, 'Circulating Citrate is Elevated During Profound Hypothyroidism : An Observational Study', Metabolic syndrome and related disorders, vol. 23, no. 7, pp. 366-370. https://doi.org/10.1089/met.2025.0026
Publication Year: 2025
Collection: University of Groningen research database
Subject Terms: circulating citrate; differentiated thyroid carcinoma; hypothyroidism; ketone bodies; mitochondrial dysfunction; nuclear magnetic resonance spectroscopy; thyroid stimulating hormone
Description: Purpose: We conducted an observational study on how profound hypothyroidism affects circulating citrate, a potential biomarker of mitochondrial dysfunction linked to mortality. Methods: Sixteen differentiated thyroid carcinoma patients were first studied during hypothyroidism, i.e., 4-6 weeks after total thyroidectomy, and subsequently after 20 weeks of thyroid hormone supplementation. 5 patients were also studied during euthyroidism, i.e., before total thyroidectomy. Circulating citrate and total ketone bodies were measured by nuclear magnetic resonance spectroscopy. Results: During profound hypothyroidism (mean thyroid stimulating hormone [TSH] 106 ± 77 mU/L), circulating citrate was 72% higher (95% CI: 48%-96%), reaching 157 ± 48 µmol/L, compared to 93 ± 25 µmol/L during thyroid hormone administration (mean TSH 0.20 ± 0.53 mU/L). This increase remained significant after adjusting for estimated glomerular filtration rate (eGFR) (P < 0.001) and body mass index (BMI) (P < 0.001). Citrate during hypothyroidism was also higher compared to five euthyroid patients studied before total thyroidectomy (P = 0.014). Total ketone bodies did not significantly change during hypothyroidism (P = 0.62). Conclusion: Short-term profound hypothyroidism gives rise to a major increase in circulating citrate, also when adjusted for changes in eGFR and BMI, conceivably attributable to hypothyroidism-related mitochondrial dysfunction. It is suggested that thyroid function status should be taken into consideration when evaluating the association of circulating citrate with adverse health outcomes.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1540-4196
Relation: info:eu-repo/semantics/altIdentifier/hdl/https://hdl.handle.net/11370/41de6dfc-9f64-489c-9f1c-3a20d60db50f; info:eu-repo/semantics/altIdentifier/pissn/1540-4196
DOI: 10.1089/met.2025.0026
Availability: https://hdl.handle.net/11370/41de6dfc-9f64-489c-9f1c-3a20d60db50f; https://research.rug.nl/en/publications/41de6dfc-9f64-489c-9f1c-3a20d60db50f; https://doi.org/10.1089/met.2025.0026; https://pure.rug.nl/ws/files/1419859966/Circulating_Citrate_is_Elevated_During_Profound_Hypothyroidism_An_Observational_Study.pdf; https://www.scopus.com/pages/publications/105008583325
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.F99E861F
Database: BASE