Seasonal Changes in Serum Thyrotropin Concentrations Observed from Big Data Obtained During Six Consecutive Years from 2010 to 2015 at a Single Hospital in Japan

Yoshihara, Ai; Noh, Jaeduk Yoshimura; Watanabe, Natsuko; Iwaku, Kenji; Kunii, Yo; Ohye, Hidemi; Suzuki, Miho; Matsumoto, Masako; Suzuki, Nami; Sugino, Kiminori; Thienpont, Linda M.; Hishinuma, Akira; Ito, Koichi

doi:10.1089/thy.2017.0600

Cited by 32 publications

(24 citation statements)

References 25 publications

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“…For median TSH values, this was more heterogeneous. The median TSH value was similar to that found in the NHANES III cohort and the study reported by Yoshihara et al in Japan [2,15], but lower than in studies conducted in Spain and China [16,17]. This might be related to the age of the patients included and also to the iodine status of the population.…”

Section: Discussionsupporting

confidence: 87%

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Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices

Raverot

Bonjour

Payrat

et al. 2020

JCM

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It is well known that thyroid dysfunction increases with age. This study is aimed to determine reference intervals, in males and females, suitable for thyroid disease exploration during adult life using routinely collected serum thyrotropin (TSH) data in a tertiary center from 2007 to 2018. Over 11 years, 295,775 TSH levels were measured in a single lab. Among the 156,025 TSH results available for analysis, 90,538 values were from female subjects, 82,019 were from patients aged >60 years and 26,825 were from patients aged >80 years. By using an indirect approach, we determined reference values of TSH adapted to age and sex, and we then evaluated the proportion of patients who would have been reclassified with these reference values. The median TSH ranged from 1.2-1.4 mUI/L during the study period. The upper limit of reference range of TSH increased with age; in females the median to 97.5th percentile values increased continuously from the age of 30 years to the oldest age group. Using new calculated reference values in patients with TSH above the conventional upper-limit reference value (4 mUI/L), the proportion of results reclassified as within the reference interval among patients aged >60 years ranged, according to age group, from 50.5% to 65.1% of females and from 33.0% to 37.7% of males. The use of TSH age-specific and sex-specific upper-limit reference values led to the reclassification of a great number of samples, notably among women. This suggests that age-specific TSH upper-limit reference intervals in daily practice should be used in order to avoid misclassification.

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Section: Discussionsupporting

confidence: 87%

“…Yoshihara et al [15] found a relationship between TSH and daily temperatures represented by months of the year. They studied TSH values obtained from a single center for six consecutive years and measured with a single analytic method.…”

Section: Discussionmentioning

confidence: 98%

Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices

Raverot

Bonjour

Payrat

et al. 2020

JCM

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“…In adults, TSH hypersecretion secondary to low ambient temperatures has indeed been reported in patients with primary hypothyroidism on constant replacement dosage of thyroxine (31). Recently, Yoshihara et al (32) reported seasonal changes in TSH in 135,417 Japanese adult patients and a negative correlation between TSH and daily temperature. Another possible explanation is the relationship between maternal vitamin D and fetal TSH levels.…”

Section: Discussionmentioning

confidence: 94%

A Detailed Analysis of the Factors Influencing Neonatal TSH: Results From a 6-Year Congenital Hypothyroidism Screening Program

et al. 2020

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Background: Neonatal thyrotropin (TSH) on dried blood spot (DBS), the most common screening strategy for primary congenital hypothyroidism (CH), is influenced by numerous factors that may hinder a true CH diagnosis. A second test can thus be performed to clarify the initial findings, although its application varies among screening programs. Objectives: The aim of this study was to evaluate the effect of maternal and neonatal factors on neonatal TSH levels and offer practical screening recommendations. Methods: We retrospectively analyzed screening data of 62,132 neonates born in Abruzzo, an Italian region considered mildly iodine deficient, between 2011 and 2016. We then performed a multiple linear regression to model the relationship between TSH (the dependent variable) and 13 independent variables extracted from blood collection cards. Results: Most neonates (53,551 of 62,132, 86%) had normal TSH and no clinical indications for a second screening. A minority (1,423, 2.3%) had elevated TSH in the initial DBS, which was confirmed in 97 cases (7%) on a second screen. The remaining neonates (6,594, 10.6%) had a normal initial TSH but underwent a second test in accordance with screening protocols, and were found to have delayed TSH elevation in 23 cases (0.4%). Those 120 newborns (97 + 23), considered highly suspicious for primary CH, were referred to a pediatrician for confirmatory testing and excluded from subsequent analysis of factors influencing TSH levels. Sex (β regression coefficient, β = 1.11 female to male, 95% CI 1.09, 1.12) and age at collection (β = 0.78 day 5 to days 2-3, 95% CI 0.74, 0.83) affected neonatal TSH, suggesting the utility of specific nomograms. In addition, prematurity (β = 0.85 term to preterm, 95% CI 0.80, 0.91), dopamine use (β = 0.71, 95% CI 0.62, 0.81), and birth weight (β = 1.40 normal vs. very low, 95% CI 1.05, 1.89) strongly influenced neonatal TSH. Conclusions: Neonatal TSH is influenced by several factors supporting the delineation of local sex-and age-adjusted TSH cutoffs, and the universal adoption of a second TSH test in neonates at risk of missed primary CH diagnosis.

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“…In a study involving euthyroid and SCH subjects in Korea [19] the serum TSH increased during the winter and spring seasons leading to transition to SCH. And a study conducted for six years in Japan, another country with a temperate climate, reported a decreased TSH concentration during summer that got reversed in winter; there existed a negative correlation between the daily temperatures and TSH and FT3 concentrations [27]. But these two studies [19, 27] had a shortcoming; the entire study, i.e., the follow-up, was not carried out on the same subjects.…”

Section: Discussionmentioning

confidence: 99%

“…And a study conducted for six years in Japan, another country with a temperate climate, reported a decreased TSH concentration during summer that got reversed in winter; there existed a negative correlation between the daily temperatures and TSH and FT3 concentrations [27]. But these two studies [19, 27] had a shortcoming; the entire study, i.e., the follow-up, was not carried out on the same subjects. The subjects who developed thyroid disease or were on thyroid treatment throughout the study could not be excluded because the studies were carried out retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Relation of Different Components of Climate with Human Pituitary-Thyroid Axis and FT3/FT4 Ratio: A Study on Euthyroid and SCH Subjects in Two Different Seasons

Mahwi

Abdulateef

2019

International Journal of Endocrinology

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Background Various changes in thyroid hormones (TH) and thyroid-stimulating hormone (TSH) level were observed in different seasons among euthyroid and hypothyroid subjects living in areas with an extreme temperature difference between summer and winter. Objectives This study aims at finding the effect of temperate climate on the seasonal variations of TSH and TH in euthyroid and subclinical hypothyroidism (SCH) subjects and at evaluating if the test season has an effect on the number of subjects diagnosed as SCH. It basically focuses on the relation of different components of climate with TH and TSH. Method In a prospective study on 152 healthy (euthyroid) volunteers and 25 SCH subjects, the serum hormone levels (TSH, FT4, and FT3) were measured in both the summer and winter seasons and correlated with all the climate components using Pearson's correlation coefficient. The effect of duration of outdoor exposure on hormone levels was compared using a paired sample t-test (P < 0.05). Results Small but statistically significant increased FT3 level and decreased FT4 level were observed during the winter season in euthyroid and SCH subjects, respectively. There was a significant negative correlation between FT3 and FT3/FT4 ratio with temperature and sunshine duration and a positive correlation with humidity and atmospheric pressure. A positive correlation was found between FT4 and sunshine duration. Conclusion The climate components contributed to the slight variance in hormone levels in different seasons, and the effect was mostly on peripheral conversion of FT4 to FT3 rather than the pituitary-thyroid axis leading to slightly higher FT3 in winter. Seasonal variation does not affect the diagnosis of SCH cases.

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Seasonal Changes in Serum Thyrotropin Concentrations Observed from Big Data Obtained During Six Consecutive Years from 2010 to 2015 at a Single Hospital in Japan

Abstract: The fact that the TSH concentrations show annual changes in areas where the temperature ranges during the year are rather wide should be borne in mind for interpretation of results.

Cited by 32 publications

References 25 publications

Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices

Age- and Sex-Specific TSH Upper-Limit Reference Intervals in the General French Population: There Is a Need to Adjust Our Actual Practices

A Detailed Analysis of the Factors Influencing Neonatal TSH: Results From a 6-Year Congenital Hypothyroidism Screening Program

Relation of Different Components of Climate with Human Pituitary-Thyroid Axis and FT3/FT4 Ratio: A Study on Euthyroid and SCH Subjects in Two Different Seasons

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