Inappropriate suppression of thyrotropin concentrations in young patients with thyroid nodules including thyroid cancer: the Fukushima Health Management survey.

Inappropriate suppression of thyrotropin concentrations in young patients with thyroid nodules including thyroid cancer: the Fukushima Health Management survey.

Thyroid. 2016 Mar 14;

Authors: Suzuki S, Nakamura I, Suzuki S, Ohkouchi C, Mizunuma H, Midorikawa S, Fukushima T, Ito Y, Shimura H, Ohira T, Matsuzuka T, Ohtsuru A, Abe M, Yamashita S, Suzuki S

Abstract
BACKGROUND: Serum thyroid hormone concentration is regulated through the hypothalamic-pituitary-thyroid axis. We aimed at clarifying the relationships between thyroid hormone regulation and ultrasonographic findings in subjects with thyroid nodules detected during thyroid ultrasound examination for the Fukushima Health Management Survey.
METHODS: As of October 31, 2014, a total of 296,253 subjects, who had been living in Fukushima Prefecture at the time of the Fukushima nuclear power plant accident and were aged 18 years or younger on March 11, 2011, participated in two concurrent screening programs. In the primary screening, thyroid nodules were detected in a total of 2,241 subjects. A secondary confirmatory thyroid ultrasound examination and blood sampling for thyroid function tests were performed on 2,004 subjects. The subjects were re-assessed and classified into disease-free subjects (Group 1), subjects with cysts only (Group 2), subjects with nodules (Group 3), and subjects with malignancy or suspected malignancy (Group 4). Serum concentrations of FT3, FT4, thyrotropin (TSH), and thyroglobulin, as well as the FT3/FT4 ratio were classified according to the diagnoses.
RESULTS: Inverse relationships between age and log TSH values (Spearman's correlation r = -0.311, P = 0.015), serum FT3 concentration (r = -0,688, P < 0.001), and the FT3/FT4 ratio (r = -0.520, P < 0.001) were observed in Group 1. When ANCOVA with Bonferroni post hoc comparisons was used in the four groups, the log TSH values were significantly lower in either Group 3 or Group 4 compared to either Group 1 or Group 2 after correction for age (ANCOVA P < 0.001, Group 1 vs. Group 3; P = 0.016, Group 1 vs. Group 4; P = 0.022, Group 2 vs. Group 3; P = 0.001, Group 2 vs Group 4; P = 0.008). However, no significant differences were observed between the four groups regarding levels of FT3, FT4, FT3/FT4 ratio, and thyroglobulin (ANCOVA P = 0.304, 0.340, 0.208, and 0.583, respectively).
CONCLUSION: TSH suppression can be present in response to illness, including thyroid nodules, in young subjects. Low TSH levels may be associated with the finding of a papillary thyroid cancer, but also with thyroid nodules, in children and adolescents.

PMID: 26971545 [PubMed - as supplied by publisher]

from #ENT-PubMed via ola Kala on Inoreader http://ift.tt/1U3Blc4
via IFTTT