title: Thyroid morphology and function in adults with untreated isolated growth hormone deficiency.
abstract: OBJECTIVE
  GH influences thyroid function and anatomy. Although goiter is frequent in acromegalic patients, the effects of GH deficiency (GHD) are difficult to assess, because hypopituitaric subjects who lack GH often also have a partial or complete deficit of TSH.
  
  
  METHODS
  We studied thyroid morphology and serum levels of thyroid hormones in adult members of a large Brazilian kindred with untreated isolated GHD due to a homozygous mutation in the GHRH receptor gene (GHRHR; nine men and 15 women; GHD group) and compared them to subjects heterozygous for the same mutation (eight men and 10 women; HET group) and subjects homozygous for the wild-type allele [seven men and 11 women; control (CO) group].
  
  
  RESULTS
  GHD subjects had a smaller thyroid volume (TV) than HET and CO. The TV of the HET group was intermediate between those of the GHD and CO groups. When TV was corrected by body surface area, it remained smaller in the GHD and HET groups than in the CO group, but the difference between GHD and HET groups disappeared. The GHD group had lower serum T3 levels than the CO group and higher free T4 levels than HET and CO groups.
  
  
  CONCLUSIONS
  Individuals with severe untreated GHD due to a homozygous GHRHR mutation and heterozygous carriers of the same mutation have smaller TV than normal subjects, suggesting that GH has a permissive role in the growth of the thyroid gland. In addition, GHD subjects have reduced serum total T3 and increased serum free T4, suggesting a reduction in the function of the deiodinase system.
authors.affiliation: Division of Endocrinology, Johns Hopkins University, 1830 East Monument Street, Suite 333, Baltimore, Maryland 21287, USA.
authors.forename: Marta Regina Silva
authors.initials: MR
authors.lastname: Alcântara
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvatori
authors.forename: Paula Regina Silva
authors.initials: PR
authors.lastname: Alcântara
authors.forename: Luciana Michele A
authors.initials: LM
authors.lastname: Nóbrega
authors.forename: Vera Simone
authors.initials: VS
authors.lastname: Campos
authors.forename: Elma Cristina O
authors.initials: EC
authors.lastname: Oliveira
authors.forename: Marcelo Henrique S
authors.initials: MH
authors.lastname: Oliveira
authors.forename: Anita Hermínia Oliveira
authors.initials: AH
authors.lastname: Souza
authors.forename: Manuel Hermínio
authors.initials: MH
authors.lastname: Aguiar-Oliveira
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006720:Homozygote; D019382:Human Growth Hormone / Q000172:deficiency*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009929:Organ Size; D011986:Receptors, Somatotropin / Q000097:blood; D013961:Thyroid Gland / Q000033:anatomy & histology* / Q000473:pathology / Q000503:physiopathology; D013972:Thyrotropin / Q000097:blood
chemical_list: D011986:Receptors, Somatotropin; D019382:Human Growth Hormone; D013972:Thyrotropin