Preview

Clinical and experimental thyroidology

Advanced search

Clinical Aspects of Thyrotropin Circadian Variability

https://doi.org/10.14341/ket20095438-41

Abstract

We retrospectively analyzed the results of measurements of serum TSH concentrations perfomed in 14760 outpatients since October 2008 till October 2009 (n = 14760) in Federal Endocrinological Research Center. Data have been parted on two groups. Results of measurements of serum TSH concentrations between 8.00 and 11.00 h have been included in the first group (n = 14397), between 15.00 and 17.00 h – in the second group (n = 363). The median of TSH concentrations of the first group was 1,58 mU/l, the second group – 1,1 mU/l (р <0,05). According to the present TSH reference ranges (0,4–4,0 mU/l), prevalence of a hypothyroidism in the first group was 13%, in the second group was 6% (р <0.0001). Also smaller prevalence of TSH 2,5–4,0 mU/l has been defined in the second group (р <0,0001). Prevalence of TSH 0,4–2,5 mU/l has been calculated as 60% in the first group and as 69% – in the second. Тhus thyrotropin circadian variability are necessary for considering at discussion of changes in TSH reference range.

References

1. Свиридонова М.А., Фадеев В.В. Значение вариабельности уровня ТТГ в клинической практике // Клин. и экспер. тиреоидол. 2008. № 4. С. 16–24.

2. Adriianse R., Brabant G., Prank K. et al. Circadian changes in pulsatile TSH release in primary hypothyroidism // Clin. Endocrinol. (Oxf.). 1992. V. 37. P. 504–510.

3. Adriaanse R., Romijn J.A., Endert E., Wiersinga W.M. The nocturnal TSH surge is absent in overt but present in mild primary hypothyroidism and equivocal in central hypothyroidism // Acta Endocrinol. (Copenh). 1992. Р. 126 206–126212.

4. Baloch Z., Carayon P., Conte-Devolx B. et al. Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine practice guidelines. Laboratory support for КЛИНИЧЕСКИЕ АСПЕКТЫ ЦИРКАДИАННОЙ ВАРИАБЕЛЬНОСТИ УРОВНЯ ТТГ М.А. Свиридонова и соавт. the diagnosis and monitoring of thyroid disease // Thyroid. 2003. V. 13. P. 3–126.

5. Brabant G., Beck-Peccoz P., Jarzab B. et al. Is there a need to redefine the upper normal limit of TSH? // Eur. J. Endocrin. 2006. V. 154. P. 633–637.

6. Canaris G.J., Manowitz N.R., Mayor G., Ridgway E.C. The Colorado thyroid disease prevalence study // Arch. Intern. Med. 2000. V. 160(4). P. 526–534.

7. Darzy K.H., Shalet S.M. Circadian and stimulated thyrotropin secretion in cranially irradiated adult cancer survivors // J. Clin. Endocrinol. Metab. 2005. V. 90. P. 6490–6497.

8. Gharib H., Tuttle R.M., Baskin H.J. et al. American Association of Clinical Endocrinologists/American Thyroid Association/ Endocrine Society. Subclinical thyroid dysfunction: a joint statement on management from the American Association of Clinical Endocrinologists, the American Thyroid Association, and the Endocrine Society // Endocrin. Pract. 2004. V. 10(6). P. 497–501.

9. Hollowell J.G., Staehling N.W., Flanders W.D. et al. Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III) // J. Clin. Endocrin. Metab. 2002. V. 87. P. 489–499.

10. McDermott M.T., Haugen B.R., Lezotte D.C. et al. Management practices among primary care physicians and thyroid specialists in the care of hypothyroid patients // Thyroid. 2001. V. 11. P. 757–764.

11. Persani L., Terzolo M., Asteria C. et al. Circadian variations of thyrotropin bioactivity in normal subjects and patients with primary hypothyroidism // J. Clin. Endocrinol. Metab. 1995. V. 80. Р. 2722–2728.

12. Scobbo R.R., VonDohlen T.W., Hassan M., Islam S. Serum TSH variability in normal individuals: the influence of time of sample collection // W. V. Med. J. 2004. V. 100(4). P. 138–142.

13. Wartofsky L., Dickey R.A. The Evidence for a Narrower Thyrotropin Reference Range Is Compelling // J. Clin. Endocrinol. Metab. 2005. V. 90. P. 5483–5488.


Review

For citations:


 ,  ,   Clinical Aspects of Thyrotropin Circadian Variability. Clinical and experimental thyroidology. 2009;5(4):38-41. (In Russ.) https://doi.org/10.14341/ket20095438-41

Views: 394


ISSN 1995-5472 (Print)
ISSN 2310-3787 (Online)