Endocrine Abstracts

JOINT2190

Background: Endocrine system (ES) is distinct amongst all organ systems (OS) in human body. ES is a conglomeration of different endocrine organs. So far, the only models of proof of physiological cohesiveness between anatomically separated endocrine glands within ES are APUD cell concept; HPA axis; HPG axis; biochemical pathways of hormones. We wanted to investigate a hypothesis, that there is hormonal inter-dependance between different endocrine organs. We took nontoxic goiter (thyroid) and primary hyperparathyroidism as prototypes.

Material and Methods: This prospective case-control study was conducted on 200 cases (175 thyroid and 25 parathyroid) and age matched 200 controls from healthy blood donors over a period of 12 months. Institutional ethical committee approval was obtained. All thyroid and parathyroid cases underwent uneventful curative thyroidectomy and parathyroidectomy respectively. Exclusion criteria were subjects with any febrile illness, candidates with stress, anxiety neurosis, allergies, chronic drug use, diabetes, systemic or chronic inflammatory disease or calcium/vitamin D supplements, any medication which interferes with the normal function of the hypothalamic-pituitary axis, menopausal age group. Serum samples were collected preoperatively, from all the subjects in both groups as per the standard collection times and procedures. Statistical analysis was performed by SPSS 20.0. P =value of < 0.05 was considered significant.

Results: Mean prolactin, Luteinising hormone (LH), follicular stimulating hormone (FSH), parathormone, cortisol and testesterone in thyroid cases and controls were 27.6 ± 8.1 ng/ml (12 – 87), 24.5 ± 1.7 IU/l(10– 57), 16.8 ± 3.3 IU/l(8.4 – 41), 24.5 ± 3.9 pg/ml (15 – 65), 7.1 ± 2.5 mg/dl (4- 16.5), 257 ± 56 ng/dl(167 – 478) and 14.6 ± 3.5 ng/ml (8 – 18), 11.4 ± 2.5 IU/l(2.5 – 12.5), 6.1 ± 2.9 IU/l(3.5 – 21), 21.2 ±5.3 pg/ml (9 – 46), 11.3 ± 3.6 mg/dl (5.5- 19), 214 ± 45 ng/dl (115 – 368) respectively. There was statistically significant difference of prolactin, LH, FSH and cortisol values between thyroid cases and controls. But statistical difference was significant only for prolactin, FSH and LH between parathyroid cases and controls.

Conclusions: This study highlights an unique model of endocrine homeostasis and hormonal cross talk within the ES. The results provides a distinct proof to screen for subclinical endocrine diseases. But, the exact pathophysiological mechanism and significance of hormonal cross talk between varied endocrine organs needs active research.

Key words: Thyroid; Parathyroid; Prolactin; Goiter; Cortisol; Insulin.