• Title/Summary/Keyword: TSH

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An Evaluation on the Thyroid Function Tests of the Patients with Autoimmune Thyroiditis (자가면역성 갑상선염환자의 갑상선기능 검사소견)

  • Lim, Jae-Yang;Lee, Jae-Tae;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.343-349
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    • 1994
  • The study was taken to analyze the laboratory findings of the 161 patients with autoimmune thyroiditis treated at Kyungpook University Hospital from January 1992 to July 1993. They were all female and mean age was 33 years ranging from 10 to 73 years. Mean radioactive iodine uptake(RAIU) of the thyroid was $30.90{\pm}21.80(mean{\pm}SD)%$ at 6 hours and $37.97{\pm}23.25%$ at 24 hours. Mean serum levels of thyroid hormones were $1.41{\pm}0.48$(ng/ml) of T3, $7.26{\pm}3.23$(ug/dl) of T4, and $1.11{\pm}0.66$(ng/dl) of free T4, while mean serum level of TSH was $17.99{\pm}30.72$(uIU/ml). Mean levels of serum autoantibodies were 24. $43{\pm}31.91$(U/ml) of antithyroglobulin antibody and $55.32{\pm}41.97$(U/ml) of antimicrosomal antibody. The correlation between RAIU and serum thyroid hormone levels was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, but the positive correlation between RAIU and serum TSH was noted. The correlation between thyroid hormones and TSH was significantly negative, while antimicrosomal antibody titer revealed significantly positive correlation with TSH. The RAIU and free T4 showed negatively correlated with the increasing age. The Initial clinical findings of the patients with autoimmune thyroiditis revealed euthyroidism in 83.2%, hypothyroidism in 14.9%, and hyperthyroidism in 1.9%. The incidence of abnormally increased serum thyroglobulin, antithyroglobulin antibody, and antimicrosomal antibody were 21.3%, 97.5%, and 87.6%, respectively and these abnormalities were more frequent in the patients with documented clinical thyroid functional disturbances.

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Value of the Serum Thyroglobulin Level Alteration at the First High Dose Radioiodine Treatment in Patients with Differentiated Thyroid Carcinoma (분화성갑상선암에서 최초 고용량 방사성요오드 치료시 혈청 갑상선글로불린 수치 변화의 의의)

  • Nam, Hyun-Yeol;Kim, In-Joo;Kim, Yong-Ki;Kim, Seong-Jang;Jun, Sung-Min;Kim, Bum-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.4
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    • pp.294-300
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    • 2009
  • Purpose: The purpose of this study was to evaluate if short-term serum thyroglobulin (Tg) elevation after radioiodine administration can predict successful radioiodine remnant ablation (RRA) and whether comparable RRA effectiveness is exhibited between a group administered with recombinant human thyrotropin (rhTSH) and a group experiencing thyroid hormone withdrawal (THW), in preparation for RRA. Materials and Methods: A retrospective chart review was performed on 39 patients in the rhTSH group and 46 patients in the THW group. They were treated for differentiated thyroid carcinoma by total or near total thyroidectomy, and referred for RRA between 2003 and 2006 (the rhTSH group) and between January and June of 2006 (the THW group). They were assessed for serum Tg levels just before I-131 administration (TgD0), reassessed 9 days later (TgD9), and again 6-12 months later. Results: RRA was successful in 64 (37 from the THW group and 27 from the rhTSH group) of the total 85 patients. The success rates of RRA had no statistically significant differences between the two groups. In both groups, TgD9/TgD0 values were significantly higher in the RRA success group (the rhTSH group; P = 0.03, the THW group; P = 0.04). By combining cutoff values of TgD0 and TgD9/TgD0, the successful RRA value was determined to be 96.7% (29/30) with TgD0$\leq$5.28 ng/mL and TgD9/TgD0>4.37 in both groups (the rhTSH group; 100% (16/16), the THW group; 92.9% (13/14)). Using logistic multivariate analysis, only TgD0 was independently associated with successful RRA. Conclusion: We may predict successful ablation by evaluating short-term serum Tg elevation after I-131 administration for RRA, in both rhTSH and THW patients.

Correlations of Subclinical Hypothyroidism with Serum Lipid Profiles and Obesity Index (준임상적 갑상선 기능저하증과 혈청 지질 및 비만도의 상관관계)

  • Kim, Ho-jun;Park, Jung-Hyun;Lee, Myeong-Jong;Park, Ji-Hun;Song, Mi-Young
    • The Journal of Korean Medicine
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    • v.29 no.3
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    • pp.38-49
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    • 2008
  • Objectives: Though overt thyroid dysfunction is well recognized to affect serum lipid profiles and obesity, there are conflicting reports on the effect of subclinical hypothyroidism on serum lipid profiles and obesity. In most reports, the definition of the upper normal limit of serum thyroid stimulation hormone (TSH) of 4.0${\sim}$5.0mU/L has been used to diagnose. However, recent studies have suggested a much lower TSH cut off with an upper limit of 2.5mU/L, because >95% of rigorously screened normal euthyroid volunteers had serum TSH values between 0.4 and 2.5mU/L. Therefore we defined subclinical hypothyroidism as a TSH level greater than 2.5mU/L. We sought to evaluate the correlations of subclinical hypothyroidism with obesity index and serum lipid profiles Methods: TSH levels were measured in 6190 men and 4223 women that participated in health examination and free T4, lipid profiles (total-cholesterol, triglyceride, LDL-C), and obesity index (body mass index, body fat, waist circumference, C-reactive protein) were also measured. Results: There were significant differences of triglyceride between subclinical hypothyroidism men and normal control subjects. In women, there were also significant differences of triglyceride and LDL-C between subclinical hypothyroidism and normal control subjects. Subclinical hypothyroidism women showed significant correlations of TSH with total cholesterol, LDL-C, triglyceride, and C-reactive protein. Subclinical hypothyroidism men and women with a TSH level 2.5${\sim}$4.0mU/L had significant differences of triglyceride and body fat. In men, there were significant differences of waist circumference andC-reactive protein. In women, there were significant differences of LDL-C. Conclusions: We have demonstrated correlations of subclinical hypothyroidism with serum lipid profiles and obesity index. These findings suggested that subclinical hypothyroidism people had an increased risk of dyslipidemia and obesity. Subclinical hypothyroidism people with a TSH level 2.5${\sim}$4.0mU/L may be also considered suspect since it may signal a case of evolving thyroid underactivity eligible to be prevented.

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The Roles of the TSH Receptor Antibodies in Autoimmune Thyroid Diseases (자가면역성 갑상선질환에서 TSH 수용체 항체의 역활에 관한 연구)

  • Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.20 no.2
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    • pp.85-100
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    • 1986
  • To evaluate the clinical and pathogenetic roles of TSH receptor antibodies in autoimmune thyroid diseases, TBII were measured by TSH-radioreceptor assay methods in 352 patients with Graves' disease, 108 patients with other thyroid diseases and 69 normal persons. The normal range of TBII activity was less than 15%. The frequencies of detectable TBII in 169 patients with untreated Graves' disease, 31 patients with hyperthyroidism under treatment and 70 patients with euthyrodism under treatment were 92.4%, 87.1% and 54.3% respectively. However 12 (21.8%) out of 55 patients who have been in remission more than one year after discontinuation of antithyroid drugs treatment had detectable TBII activities in their sera. In 196 patients with untreated Graves' disease, the frequency of TBII increased by increasing size of goiter and the frequency of proptosis was significantly high in patients whose TBII activities were more than 60%. TBII activities were roughly correlated with total $T_3,\;T_4$ and free $T_4$ index but low $\gamma^2$ value(less than 0.1). In 67 patients with Graves' disease who were positive TBII before antithyroid drugs treatment, TBII activities began to decrease from the third months and it was converted to negative in 35.8% of patients at 12 months after treatment. There were no significant differences of the declining and disappearing rates of TBII activities between high dose and conventional dose groups. TBII activities were significantly increased initially (2-4 months) and then began to decrease from 5-9 months after $^{131}I$ treatment. There were two groups, one whose TBII activities decreased gradually and the other did not change untill 12 months after subtotal thyroidectomy. Although preoperative clinical and laboratory findings of both groups were not different, TBII activities of non-decreasing group were significantly higher than those of decreasing group$(74.6{\pm}18.6%\;vs\;39.2{\pm}15.2%;\;P<0.01)$. Thirty three(55.9%) out of 59 patients with Graves' disease relapsed within 1 year after discontinuation of antithyroid drugs. The positive rate of TBII at the end of antithyroid drug treatment in relapse group(n=33) was significantly higher than those in remission group (n=26) (63.6% vs 23.1%; P < 0.05). The mean value of TBII activities at the end of antithyroid drug treatment in relapse group was significantly elevated $(29.7{\pm}21.4%\;vs\;14.7{\pm}11.1%,\;P<0.05)$. Positive predictive value of TBII for relapse was 77.8%, which was not different from those of TRH nonresponsiveness(78.6%). The frequencies of detectable TBII in 68 patients with Hashimoto's thyroiditis, 10 patients with painless thyroiditis and 5 patients subacute thyroiditis were 14.7%, 20% and 0%, respectively. However in 25 patients with primary nongoitrous myxedema, 11 patients(44%) showed TBII activities in their sera. 9 out of 11 patients who had TBII activities in their sera showed high TBII activities(more than 70% binding inhibition) and their IgG concentrations showing 50% binding inhibition of $^{125}I-bTSH$ to the TSH receptor were ranges of 0.1-2.6 mg/dl. One patient who had high titer of TBII in her serum delivered a hypothyroid baby due to transplacental transfer of maternal TBII. These findings suggested that 1) TSH receptor antibodies are closely related to a pathogenetic factor of Graves' hyperthyroidism and of some patients with primary non-goitrous myxedema, 2) measurement of TSH receptor antibodies is helpful in evaluating the clinical outcome of patients with Graves' disease during antithyroid drug treatment and in predicting the neonatal transient hypothyroidism of baby delivered from primary myxedema patients. 3) there are 2 or more different types of TSH receptor antibodies in autoimmune thyroid diseases including one which stimulates thyroid by binding to the TSH receptor and another which blocks adenylate cyclase stimulation by TSH.

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Thyroid Function Test in Thyroid Diseases and Pregnancy - The diagnostic value of free thyroxine by RIA - (임신 및 각종 갑상선질환에서 갑상선 기능 판정에 관한 연구 - 혈청유리 $T_4$의 진단적 의의에 관한 고찰 -)

  • Yoo, M.H.;Yoon, H.J.;Shin, Y.T.;Lee, J.C.;Chung, S.I.;Cho, B.Y.;Lee, M.;Lee, M.C.
    • The Korean Journal of Nuclear Medicine
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    • v.15 no.1
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    • pp.1-11
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    • 1981
  • To evaluate the diagnostic accuracy of the measurement of free thyroxine (FT4) by radioimmunoassay, we measured free $T_4\;and\;T_4,\;T_3,\;T_3RU$, TSH and TBG serum levels by radioimmunoassay in 18 healthy persons and 52 patients with various thyroid diseases and 11 normal pregnant women. The results are as follows. 1. In 19 cases of overt hyperthyroidism, $T_3,\;free\;T_4$ and FTI, $T_4/TBG$ ratio reflect hyperfunction in all cases. $T_4$ is increased in 94% (18/19) and TBG and TSH are decreased in 79% (15/19). 2. In 8 patients with overt hypothyroidism, TSH is increased in all cases and free $T_4$ and FTI is decreased in all cases. $T_4$ is decreased in 87.5% (7/8), $T_3$ is decreased in 75% (6/8) and $T_4/TBG$ ratio is decreased in 62.5% (5/8). 3. In 5 patients who are clinically in euthyroid state after treatment of hyperthyroidism, $T_4,\;free\;T_4$, FTI and TSH are in the normal range in all cases and $T_3$ is normal in 60% (3/5) and slightly increased in 40% (2/5). 4. In 10 patients who showed clinically borderline hypothyroidism after treatment of hyperthyroidism, TSH is increased in all cases and free $T_4$ and FTI are decreased in all cases, but $T_4\;and\;T_3,\;T_4/TBG$ ratio are in the normal limit in all cases. So after treatment of hyperthyroidism, TSH, free $T_4$ or FTI are recommended as optimal thyroid function test. 5. In normal pregnancy, free $T_4$, FTI and $T_4/TBG$ ratio reflect normal function, but the other parameters revealed unreliable due to the influence of increased TBG. Also TBG and TSH level in pregnancy is increased significantly compared with normal healthy control group. 6. The coefficients of correlation between free $T_4$ and FTI were 0.862 (p<0.001) and 0.685 (p<0.001) between free $T_4\;and\;T_4/TBG$ ratio. In most patients, diagnostic value of free $T_4$ was comparable and even superior to FTI, so free $T_4$ measurement can be used routinely with thyrotropin assay in the diagnosis of hypothyrodism or with $T_3$ for the diagnosis of hyperthyroidism.

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Influence of subclinical hypothyroidism on metabolic parameters in obese children and adolescents

  • Kara, Ozlem
    • Clinical and Experimental Pediatrics
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    • v.63 no.3
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    • pp.110-114
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    • 2020
  • Background: Subclinical hypothyroidism (SH) is a common condition in obese children. However, its effect on glucose and lipid metabolism in obese children remains controversial. Purpose: The present study aimed to investigate the association between SH and metabolic parameters. Methods: A total of 215 obese children and adolescents aged 6-18 years were included in this retrospective cross-sectional study. The patients' anthropometric measurements such as thyrotropin (TSH), free thyroxine (fT4), fasting plasma glucose, and insulin levels, as well as homeostasis model assessment for insulin resistance (HOMA-IR) index, and lipid profiles were evaluated. The patients were allocated to the SH group (fT4 normal, TSH 5-10 mIU/L) (n=77) or the control group (fT4 normal, TSH<5 mIU/L) (n=138). The glucose and lipid metabolisms of the 2 groups were compared. Results: SH was identified in 77 of 215 patients (36%). Mean body mass index was similar in both groups. The mean serum insulin, HOMA-IR, and triglyceride (TG) levels were higher and the mean high-density lipoprotein cholesterol level was lower in the SH group than in the control group (P=0.007, P=0.004, P=0.01, and P=0.02, respectively). A positive correlation was observed between TSH level and insulin level, HOMA-IR, and TG level. Conclusion: SH was identified in some of the obese children and adolescents. A clear association was observed between SH, insulin resistance, and dyslipidemia in obese children.

A Study on the Solitary Adenomatous, Thyroid Nodule (자율성(自律性) 결절성(結節性) 갑상선종(甲狀腺腫)에 관(關)한 연구(硏究))

  • Cho, Min-Koo;Koh, Yong-Bak;Park, Chung-Ok;Lee, Jung-Sang;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.8 no.1_2
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    • pp.49-55
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    • 1974
  • The authors studied on the 5 cases of solitary thyroid nodule by T3 suppression test and TSH stimulation test. Radioiodine uptake and thyroid scan were observed after administration of dssicated thyroid and TSH. 3 of 5 cases were teated by $^{131}I$ and 2 by long-term adiministration of dessicated thyroid. Following were the results: 1. Nodular tissue was not affected by the administration of dessicated thyroid or TSH. 2. Extranodular tissue responded as normal thyroid tissue on the administration of dessicated thyroid or TSH. 3. There were many gradations from euthyroid to hyperthroid in clinical state. 4. Treatments were succesful in all cases except one case who was treated by long-term administration of dessicated thyroid.

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