title: Age influences TSH serum levels after withdrawal of l-thyroxine or rhTSH stimulation in patients affected by differentiated thyroid cancer.
abstract: Recombinant human TSH (rhTSH) has been recently suggested for radioiodine ablation in patients with differentiated thyroid cancer (DTC). To date, studies are still not available about the effectiveness of rhTSH stimulation depending on the age, since serum TSH clearance may be different in younger and in older patients. The aim of this study was to investigate the influence of age to serum TSH levels after rhTSH stimulation and thyroid hormone withdrawal (THW). We retrospectively evaluated two groups of consecutive DTC patients: group 1 (311 patients, age 49.0+/-13.6 years, ranging 15-86) underwent rhTSH stimulation 6-12 months after thyroid ablation (rhTSH-group); group 2 (84 patients, age 46.9+/-13.5 years, ranging 20-77) was followed by THW (THW-group). The influence of age, gender, body mass index and body surface area to serum TSH levels were evaluated in both groups. RhTSH-group: on day 5 (d5), TSH levels were 32.7+/-21.4 microU/ml (range 0.8-136.6). By univariate analysis, d5-TSH was positively related to age (r=0.27, p=0.0001) and no correlations were found with the other parameters. At multivariate analysis, both age and gender (female) were independently associated with d5-TSH levels. THW-group: after thyroid hormone withdrawal, TSH levels were 71.1+/-36.4 microU/ml (range 8.5-200). At univariate analysis, only age was significantly and negatively related to serum TSH levels (r=-0.31, p=0.004). Our data indicate that age and gender seem to positively influence serum TSH levels after rhTSH stimulation. An opposite effect of age on serum TSH levels has been observed after THW. Therapeutic implications ((131)I-treatment) of these findings have to be better investigated in prospective studies.
authors.affiliation: Dipartimento di Scienze Cliniche, Università "La Sapienza", Viale del Policlinico, 155, 00161 Roma, Italy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Montesano
authors.forename: Cosimo
authors.initials: C
authors.lastname: Durante
authors.forename: Marco
authors.initials: M
authors.lastname: Attard
authors.forename: Umberto
authors.initials: U
authors.lastname: Crocetti
authors.forename: Domenico
authors.initials: D
authors.lastname: Meringolo
authors.forename: Rocco
authors.initials: R
authors.lastname: Bruno
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tumino
authors.forename: Domenico
authors.initials: D
authors.lastname: Rubello
authors.forename: Adil
authors.initials: A
authors.lastname: Al-Nahhas
authors.forename: Marzia
authors.initials: M
authors.lastname: Colandrea
authors.forename: Marianna
authors.initials: M
authors.lastname: Maranghi
authors.forename: Laura
authors.initials: L
authors.lastname: Travascio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ronga
authors.forename: Massimo
authors.initials: M
authors.lastname: Torlontano
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015992:Body Mass Index; D001830:Body Surface Area; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000627:therapeutic use; D012189:Retrospective Studies; D012737:Sex Factors; D013964:Thyroid Neoplasms / Q000097:blood* / Q000188:drug therapy*; D013972:Thyrotropin / Q000097:blood* / Q000627:therapeutic use*; D013974:Thyroxine / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D013972:Thyrotropin; D013974:Thyroxine