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. 1986 Jan;1(1):104-12.
doi: 10.3904/kjim.1986.1.1.104.

Changes of serum angiotensin-converting enzyme activity during treatment of patients with Graves' disease

D S Lee, J K Chung, B Y Cho, C S Koh, M Lee

Changes of serum angiotensin-converting enzyme activity during treatment of patients with Graves' disease

D S Lee et al. Korean J Intern Med. 1986 Jan.

Abstract

Serum angiotensin-converting enzyme activity was measured spectrophotometrically, and serum thyrotropin-binding-inhibitory immunoglobulin (TBII) activity was measured by radioreceptor assay in normal subjects and in patients with Graves’ disease serially before and during treatment, and these activities were compared with each other and with thyroid hormone levels in various thyroid functional status. Correlation between serum angiotensin-converting enzyme activity and serum thyroid hormone level was pursued with relation to the changes of thyroid functional status in patients with Graves’ disease during treatment.

Serum angiotensin-converting enzyme activity was significantly elevated in patients with hyperthyroid Graves’ disease before the start of treatment (35 ± 13 nmol/min/ml, n=50), and not in patients with Graves’ disease, euthyroid state during treatment with antithyroid drugs or radioactive iodine (23 ± 9 nmol/min/ml, n=12), but decreased significantly in patients with Graves’ disease, hypothyroid state transiently during treatment (15 ± 4 nmol/min/ml, n=12), respectively in comparison with normal control subjects. Serum angiotensin-converting enzyme activity was positively correlated with the log value of serum T3 concentration (r=0.62, p<0.001, n=95), and with the log value of free thyroxine index (r=0.66, p<0.001, n=91) but not statistically significantly with serum TBII activity. Serum angiotensin-converting enzyme activity was followed in 11 patients with initially increased activity and the activity decreased in proportion to serum thyroid hormone level during treatment, irrespective of treatment modality. It is suggested that thyroid hormones play a role in the increase and decrease of serum angiotensin-converting enzyme activity directly or indirectly influencing the peripheral tissues (probably reticuloendothelial cells or peripheral endothelial cells) in patients with Graves’ disease.

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Figures

Fig 1.
Fig 1.
Serum ACE activity in healthy control subjects and in patients with Graves’ disease in various functional status.
Fig. 2.
Fig. 2.
Correlation between serum T3 and ACE activity (N=95).
Fig. 3.
Fig. 3.
Correlation between serum thyroxine and ACE activity (N = 91).
Fig. 4.
Fig. 4.
Correlation between serum TBII activity and ACE activity.
Fig. 5.
Fig. 5.
Serial changes of serum ACE activity in Graves’ disease during treatment.
Fig. 6.
Fig. 6.
Serial changes of serum ACE activity in a patient treated with radioiodine alone.
Fig. 7.
Fig. 7.
Serial changes of serum ACE activity in a patient unresponsive to treatment with antithyroid drug.
Fig. 8.
Fig. 8.
Serial changes of serum ACE activity in a patient with fluctuating disease activity despite treatment.
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References

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