The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Sung Su Kim; Dong Hoon Lew; Ja Yoon Choi; Eun Ju Lee; Min Gyo Kim; Kyong Young Kim; Soo Kyoung Kim; Jung Hwa Jung; Jae Hoon Jung; Jong Ryea l Hahm

doi:10.7180/kmj.2014.29.2.125

Articles

Page Path: HOME > Kosin Med J > Volume 29(2); 2014 > Article

Original Article The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging: Sung Su Kim¹, Dong Hoon Lew¹, Ja Yoon Choi¹, Eun Ju Lee¹, Min Gyo Kim¹, Kyong Young Kim¹, Soo Kyoung Kim^1,2, Jung Hwa Jung^1,2, Jae Hoon Jung^1,2, Jong Ryea l Hahm^1,2; Kosin Medical Journal 2014;29(2):125-134.
DOI: https://doi.org/10.7180/kmj.2014.29.2.125
Published online: December 18, 2014

¹Department of Internal Medicine, GyeongsangNational University School of Medicine, Jinju, Korea

²Institute of Health Science, GyeongsangNational University School of Medicine, Jinju, Korea

Corresponding Author : Jong Ryeal Hahm, Department of Internal Medicine, Gyeongsang National University School of Medicine, 79, Gangnam-ro, Jinju, 660-702, Korea TEL: +82-55-750-8736 FAX: +82-55-758-9122 E-mail: jrhahm@gnu.ac.kr

• Received: August 20, 2013 • Accepted: February 13, 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

1,761 Views
6 Download
1 Crossref

prev next

Full Article

Download PDF

Abstract
References

Abstract

Objective:
We conducted a study to investigate the normal range for TSH and within-individual variations of TSH according to temperat䴸re and aging.
Patients and Methods:
We enrolled patients who underwent periodic medical examinations five times over a six year period (2007.8~2013.6). Anthropometric data and thyroid ultrasonography were evaluated, and serum TSH, T3, and T4 were assayed.
Results:
Subjects were 19-64 years old, 120 were female, and 208 were male. Reference ranges for TSH were 0.53-4.94 mlU/L in the first test, 0.49-5.61 mlU/L in the second test, 0.46-6.06 mlU/L in the third test, 0.48-5.99 mlU/L in the fourth test, and 0.52-6.3 mlU/L in the fifth test. When the TSH level was analyzed according to temperature and sex, mean TSH was higher in months in which the average monthly temperatures were below 10⁰C in Jinju, Gyeongnam and female. The aging and low temperatures are associated with increased serum TSH concentrations in the within-individual.
Conclusions:
This study showed that aging is associated with increased serum TSH concentrations in the within- individual and serum TSH concentrations are different in the within-individual according to the temperature.
Keywords: Reference range for TSH; TSH; Variation of TSH

Fig. 1

Schematic presentation of enrolled subjects for analysis.

Fig.2

Estimated marginal means natural logarithm(TSH) 士 SE that was checked five times for six years

Fig, 3

Within-individual TSH levels separated by average monthly temperature(10ⁱC) for 146 subjects.

Table 1.

Baseline characteristics of subjects in first check-up

Characteristic	Total (n=328)
Age (Years), mean±SD	42.1±8.09
Age stratum (Years), n(%)
≤29	20 (6.1)
30-39	111(33.8)
40-49	139(42.4)
50-59	48(14.6)
60≥	10(3.0)
Female, n(%)	120(36.6)
BMI, mean±SD	23.34土 2.91
Presence of thyroid nodules n(%)	21(6.4)
Presence of Fatty liver, n(%)
Normal echogenecity	277(84.4)
Mild	18(5.5)
Moderate-severe	33(10.1)
Alcoliol intake, n(%)
Nearly not	117(37.5)
< 20 g/day	102(31.1)
≥ 20 g/day	109(33.2)

SD: Standard Deviation, BMI: Body mass index

Table 2.

Mean TSH and thyroid hormones values for each subject check-up.

Sequence of tests	TFT(n=328)
	T3(ng/dL)	T4(ug/dL)	T4(ng/dL)
First	107.2±15.6	7.55±1.24	1.29±0.16^∗
Second	109.3±15.2	7.44±1.14	1.32±0.18^†
Third	109.5±16.9	7.54±1.18	1.32±0.17
Fourth	110.3±15.8	7.34±1.24	1,30±0.18
Fifth	108.2±15.9	7.67±1.29	1.29±0.15

Values are mean ± SD SD: Standard Deviation

^∗249 analyzed

^†295 analyzed due to missing values.

Table 3.

Reference range of TSH values according to the serial check-ups.

Sequence of tests	TSH reference range(mIU/L)
Sequence of tests	Lower limit	Mean	Upper limit
First	0.53	1.62	4.94
Second	0.49	1.65	5.61
Third	0.46	1.67	6.00
Fourth	0.48	1.70	5.99
Fifth	0.52	1.78	6.13

The ranges were calculated as mean ± 2SD of log-transformed serum TSH concentrations for each sequence of check-up

Table 4.

Mean TSH value according to gender, age stratum, thyroid nodules, alcohol intake, fatty liver, temperature, and BMI.

Factors	TSH(mIU/L)
Factors	First	Second	Third	Fourth	Fifth
Age, year	42.1±8.09	43.3±8.11	44.6±8.14	45.8±8.12	47.1±8.18
Female(120)	1.98±1.15	2.06±1.11	2.08±1.18	2.15±1.33	2.29±1.30^∗
Male(208)	1.83±1.02	1.87±1.04	1.93±1.20	1.95±1.20	2.00±1.76^∗
Age stratum
30 내이하(131)	1.86±0.95	1.87±1.03	1.88±1.04	1.92±1.03	2.01±0.98
40 내(139)	1.89±1.16	1.99±1.05	2.05±1.30	2.05±1.23	2.09±1.27
50 내이성(58)	1.94±1.11	1.96±1.21	2.08±1.26	2.20±1.22	2.38±1.59
Nodule(-)	1.90± 1.07(307)	1.97±1.04(298)	2.01±1.20(300)	2.05±1.22(301)	2.14±1.23(298)
Nodule(+)	1.67± 1.06(21)	l.66±0.73(29)	1.71±1.15(28)	1.67±1.24(27)	1.83± 1.22(30)
Alcohol
Not intake(H7)	1.B6±1.10	1.97±1.08	1.96±1.13	2.05±1.31	2.16±1.25
<20g/day(102)	1.90±1.07	1.90±1.05	1.97±1.16	2.08±1.27	2.09±1.18
≥20g/day(109)	1.90±1.04	1.94±1.08	2.03±1.30	1.94±1.07	2.08±1.27
Fatty Liver
(-)	1.90±1.07(277)	1.97±1.09(259)	2.02±1.24(259)	2.06±1.20(24S)	2.15±1.26(234)
(+)	1.82±1.07(51)	1.82±0.97(68)	1.85±1.01{69)	1.91±1.28(80)	2.01±1.13(94)
월평균 기온
A	1.81±1.02^†(239)	1.84±1.04^‡(231)	1.95±1.18(237)	2.05±1.27(230)	2.06±1.21(228)
B	2.10±1.16^†(89)	2.17±1.11^‡(97)	2.09±1.23(91)	1.96±1.08(98)	2.22±1.28(100)
BMI
<23kg/m²	1.88±1.06(172)	1.93±1.16(155)	2.05±1.18(151)	1.97±1.06(141)	2.13±1.13(146)
23-24	1.80±94(54)	1.71±0.75(76)	1.83±1.06(79)	2.06±1.22(85)	2.07±132(71)
≥25kg/m²	1.96±1.14(100)	2.12±1.17(95)	2.01±1.31(97)	2.10±1.22(102)	2.10±1.23(110)

Values are mean ± SD SD: Standard Deviation, T: Temperature, A:months that average monthly temperature is above 10°C in Jinju, Gyeongnam, B:months that average monthly temperature is below 10°C in Jinju, Gyeongnam, BMI: Body Mass Index P value(mean±SD

^∗is 0.032, P value(mean±SD

^†)is 0.034, P value(mean±SD

^‡)is 0.008. P value by T-test or ANOVA(Analysis of variance)

References

1.Vanderpump MPJ, Tunbridge WMG. The epidemiology of thyroid diseases. Wemer and Ingbar's the Thyroid 1996;474–82.
2.Ladenson PW, Singer PA, Ain KB, Bagchi N, Bigos ST, Levy EG, et al. American thyroid association guidelines for detection of thyroid dysfunction. Arch Intern Med 2000;160:1573–7.Article PubMed
3.Andersen S, Pedersen KM, Bruun NH, Laurberg P. Narrow individual variations in serum T4 and T3 in normal subjects: A clue to the understanding of subclinical thyroid disease. J Clin Endocrinol Metab 2002;87:1068–72.Article PubMed
4.Sailer B, Broda N, Heydarian R, Gorges R, Mann K. Utility of third generation thyrotropin assays in thyroid function testing. Experimental and Clinical Endocrinology and Diabetes 1998;106:S29–33.Article PubMed
5.Hollowell JG, Staehling NW, Dana Flanders W, Harry Hannon W, Gunter EW, Spencer CA, et al. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES ΙΠ). J Clin Endocrinol Metab 2002;87:489–99.PubMed
6.Wartofsky L, Dickey RA. The evidence for a narrower thyrotropin reference range is compelling. J Clin Endocrinol Metab 2005;90:5483–8.Article PubMed
7.Surks MI, Goswami G, Daniels GH. The thyrotropin reference range should remain unchanged. J Clin Endocrinol Metab 2005;90(9):5489–96.Article PubMed
8.American association of clinical endocrinologists medical guidelines for clinical practice for the evaluation and treatment of hyperthyroidism and hypothyroidism. Endocrine Practice 2002;8:457–69.
9.Vanderpump MPJ, Tunbridge WMG, French JM, Appleton D, Bates D, Clark F, et al. The incidence of thyroid disorders in the community: A twenty-year follow-up of the Whickham Survey. Clin Endocrinol (Oxf) 1995;43:55–68.Article PubMed
10.Reed HL. Circannual changes in thyroid hormone physiology: the role of cold environmental temperatures. Arctic Med Res 1995;54:9–15.PubMed
11.Konno N, Morikawa K. Seasonal variation of serum thyrotropin concentration and thyrotropin response to thyrotropin-releasing hormone in patients with primary hypothyroidism on constant replacement dosage of thyroxine. J Clin Endocrinol Metab 1982;54:1118–24.Article PubMed
12.Leppaluoto J, Sikkila K, Has si J. Seasonal variation of serum TSH and thyroid hormones in males living in subarctic environmental conditions. Int J Circumpolar Health 1998;57:383–5.PubMed
13.Weeke J, Gundersen HJG. Circadian and 30 minutes variations in serum TSH and thyroid hormones in normal subjects. Acta Endocrinol 1978;89:659–72.Article
14.Parker DC, Pekary AE, Hershman JM. Effect of normal and reversed sleep wake cycles upon nyctohemeral rhythmicity of plasma thyrotropin: evidence suggestive of an inhibitory influence in sleep. J Clin Endocrinol Metab 1976;43:318–29.Article PubMed
15.Danel T, Touitou Y. Alcohol decreases the nocturnal peak of TSH in healthy volunteers. Psychopharmacology (Berl) 2003;170:213–4.Article PubMed
16.Surks MI, Hollowell JG. Age-specific distribution of serum thyrotropin and antithyroid antibodies in the U.S. population: Implications for the prevalence of subclinical hypothyroidism. J Clin Endocrinol Metab 2007;92:4575–82.Article PubMed
17.Mclver B, Gorman CA. Euthyroid sick syndrome: An overview. Thyroid 1997;7:125–32.Article PubMed
18.Weeke A, Weeke J. The 24-hour pattern of serum TSH in patients with endogenous depression. Acta Psychiatr Scand 1980;62:69–74.Article PubMed
19.Haugen BR. Drugs that suppress TSH or cause central hypothyroidism. Best Practice and Research: Clinical Endocrinology and Metabolism 2009;23:793–800.Article
20.Nyrnes A, Jorde R, Sundsfjord J. Serum TSH is positively associated with BMI. Int J Obes 2006;30:100–5.Article
21.Chung GE, Kim D, Kim W, Yim JY, Park MJ, Kim YJ, et al. Non-alcoholic fatty liver disease across the spectrum of hypothyroidism. J Hepatol 2012;57:150–6.Article PubMed
22.YW C. Clinical implication od serum TSH concentration. Endocrinologyy and Metabolism 2007;22:87–94.
23.Jang YY, Kim CY, Hwang TY, Kim KD, Lee CH. Reference interval of serum thyroid hormones in healthy Korean adults. Journal of preventive medicine and public health = Yebang? ihakhoe chi 2008;41:128–34.Article
24.Lingjaerde O. Thyroid function in Seasonal Affective Disorder. J Affect Disord 1995;33:39–45.Article PubMed
25.Kim TH, Kim KW, Ahn HY, Choi HS, Won H, Choi Y, et al. Effect of seasonal changes on the transition between sub-clinical hypothyroid and euthyroid status. J Clin Endocrinol Metab. 2013;98:3420.Article PubMed
26.Mariotti S, Franceschi C, Cossarizza A, Pinchera A. The aging thyroid. Endocr Rev 1995;16:686–715.Article PubMed
27.Atzmon G, Barzilai N, Hollow ell JG, Surks MI, Gabriely I. Extreme Longevity is associated with increased serum thyrotropin. J Clin Endocrinol Metab 2009;94:1251–4.Article PubMed PMC
28.Boucai L, Surks MI. Reference limits of serum TSH and free T4 are significantly influenced by race and age in an urban outpatient medical practice. Clin Endocrinol (Oxf) 2009;70:788–93.Article PubMed
29.Surks MI, Boucai L. Age- and race-based serum thyrotropin reference limits. J Clin Endocrinol Metab 2010;95:496–502.Article PubMed
30.Bremner AP, Feddema P, Leedman PJ, Brown SJ, Beilby JP, Lim EM, et al. Age-related changes In thyroid function: A longitudinal study of a community-based cohort. J Clin Endocrinol Metab 2012;97:1554–62.Article PubMed
31.Lee YK, Kim JE, Oh HJ, Park KS, Kim SK, Park SW, et al. Serum TSH level in healthy koreans and the association of TSH with serum lipid concentration and metabolic syndrome. Korean J Intern Med 2011;26:432–9.Article PubMed PMC

Figure & Data

References

Citations

Citations to this article as recorded by

Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming
Apostolos Chatzitomaris, Rudolf Hoermann, John E. Midgley, Steffen Hering, Aline Urban, Barbara Dietrich, Assjana Abood, Harald H. Klein, Johannes W. Dietrich
Frontiers in Endocrinology.2017;[Epub] CrossRef

PubReader
Cite

CITE

export Copy Format

Close

Download Citation

Download Citation

Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

Format:

RIS — For EndNote, ProCite, RefWorks, and most other reference management software
BibTeX — For JabRef, BibDesk, and other BibTeX-specific software

Include:

Citation for the content below
Citation and abstract for the content below

The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Kosin Med J. 2014;29(2):125-134. Published online December 18, 2014

DOI: https://doi.org/10.7180/kmj.2014.29.2.125

XML Download

Figure

The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Fig. 1 Schematic presentation of enrolled subjects for analysis.

Fig.2 Estimated marginal means natural logarithm(TSH) 士 SE that was checked five times for six years

Fig, 3 Within-individual TSH levels separated by average monthly temperature(10iC) for 146 subjects.

Fig. 1

Fig.2

Fig, 3

The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Baseline characteristics of subjects in first check-up

Characteristic	Total (n=328)
Age (Years), mean±SD	42.1±8.09
Age stratum (Years), n(%)
≤29	20 (6.1)
30-39	111(33.8)
40-49	139(42.4)
50-59	48(14.6)
60≥	10(3.0)
Female, n(%)	120(36.6)
BMI, mean±SD	23.34土 2.91
Presence of thyroid nodules n(%)	21(6.4)
Presence of Fatty liver, n(%)
Normal echogenecity	277(84.4)
Mild	18(5.5)
Moderate-severe	33(10.1)
Alcoliol intake, n(%)
Nearly not	117(37.5)
< 20 g/day	102(31.1)
≥ 20 g/day	109(33.2)

Mean TSH and thyroid hormones values for each subject check-up.

Sequence of tests	TFT(n=328)
	T3(ng/dL)	T4(ug/dL)	T4(ng/dL)
First	107.2±15.6	7.55±1.24	1.29±0.16^∗
Second	109.3±15.2	7.44±1.14	1.32±0.18^†
Third	109.5±16.9	7.54±1.18	1.32±0.17
Fourth	110.3±15.8	7.34±1.24	1,30±0.18
Fifth	108.2±15.9	7.67±1.29	1.29±0.15

Reference range of TSH values according to the serial check-ups.

Sequence of tests	TSH reference range(mIU/L)
Sequence of tests	Lower limit	Mean	Upper limit
First	0.53	1.62	4.94
Second	0.49	1.65	5.61
Third	0.46	1.67	6.00
Fourth	0.48	1.70	5.99
Fifth	0.52	1.78	6.13

Mean TSH value according to gender, age stratum, thyroid nodules, alcohol intake, fatty liver, temperature, and BMI.

Factors	TSH(mIU/L)
Factors	First	Second	Third	Fourth	Fifth
Age, year	42.1±8.09	43.3±8.11	44.6±8.14	45.8±8.12	47.1±8.18
Female(120)	1.98±1.15	2.06±1.11	2.08±1.18	2.15±1.33	2.29±1.30^∗
Male(208)	1.83±1.02	1.87±1.04	1.93±1.20	1.95±1.20	2.00±1.76^∗
Age stratum
30 내이하(131)	1.86±0.95	1.87±1.03	1.88±1.04	1.92±1.03	2.01±0.98
40 내(139)	1.89±1.16	1.99±1.05	2.05±1.30	2.05±1.23	2.09±1.27
50 내이성(58)	1.94±1.11	1.96±1.21	2.08±1.26	2.20±1.22	2.38±1.59
Nodule(-)	1.90± 1.07(307)	1.97±1.04(298)	2.01±1.20(300)	2.05±1.22(301)	2.14±1.23(298)
Nodule(+)	1.67± 1.06(21)	l.66±0.73(29)	1.71±1.15(28)	1.67±1.24(27)	1.83± 1.22(30)
Alcohol
Not intake(H7)	1.B6±1.10	1.97±1.08	1.96±1.13	2.05±1.31	2.16±1.25
<20g/day(102)	1.90±1.07	1.90±1.05	1.97±1.16	2.08±1.27	2.09±1.18
≥20g/day(109)	1.90±1.04	1.94±1.08	2.03±1.30	1.94±1.07	2.08±1.27
Fatty Liver
(-)	1.90±1.07(277)	1.97±1.09(259)	2.02±1.24(259)	2.06±1.20(24S)	2.15±1.26(234)
(+)	1.82±1.07(51)	1.82±0.97(68)	1.85±1.01{69)	1.91±1.28(80)	2.01±1.13(94)
월평균 기온
A	1.81±1.02^†(239)	1.84±1.04^‡(231)	1.95±1.18(237)	2.05±1.27(230)	2.06±1.21(228)
B	2.10±1.16^†(89)	2.17±1.11^‡(97)	2.09±1.23(91)	1.96±1.08(98)	2.22±1.28(100)
BMI
<23kg/m²	1.88±1.06(172)	1.93±1.16(155)	2.05±1.18(151)	1.97±1.06(141)	2.13±1.13(146)
23-24	1.80±94(54)	1.71±0.75(76)	1.83±1.06(79)	2.06±1.22(85)	2.07±132(71)
≥25kg/m²	1.96±1.14(100)	2.12±1.17(95)	2.01±1.31(97)	2.10±1.22(102)	2.10±1.23(110)