Research Center for Endocrine and Metabolic Diseases, Chungnam National University School of Medicine, Daejeon, South Korea.
Department of Core Laboratory of Translational Research, Biomedical Convergence Research Center, Chungnam National University Hospital, Daejeon, South Korea.
Front Endocrinol (Lausanne). 2021 Nov 10;12:769074. doi: 10.3389/fendo.2021.769074. eCollection 2021.
Thyroid-stimulating hormone (TSH) suppression is recommended to reduce tumor recurrence following surgery for differentiated thyroid cancer (DTC). However, prolonged subclinical hyperthyroidism caused by levothyroxine treatment has deleterious effects on various organs.
To evaluate the relationships of TSH concentration with muscle mass, muscle strength, and physical performance related to sarcopenia in patients with DTC undergoing TSH suppression following surgery.
We studied 134 patients of >60 years who were undergoing TSH suppression therapy following surgery for DTC. We evaluated muscle mass and muscle function-related parameters and diagnosed sarcopenia using the threshold for Asian people.
The participants were 68.3 ± 7.2 years old and 36/134 (26.9%) were diagnosed with sarcopenia. They were allocated to high-TSH and low-TSH groups using a threshold concentration of 0.40 μU/mL, and grip strength was significantly lower in the low-TSH group. The data were further analyzed according to age and sex, and in the low-TSH group, male participants and those of <70 years were found to have significantly lower grip strength.
Low-TSH concentrations is associated with low grip strength, and this is most pronounced in individuals of <70 years of age. Therefore, muscle function should be considered an adverse effect of TSH suppression in patients with DTC who undergo TSH suppression therapy, especially in men of <70 years.
甲状腺刺激激素（TSH）抑制被推荐用于降低分化型甲状腺癌（DTC）手术后的肿瘤复发率。然而，左甲状腺素治疗引起的长期亚临床甲状腺功能亢进对各种器官都有不良影响。
评估 DTC 患者手术后接受 TSH 抑制治疗时 TSH 浓度与肌肉质量、肌肉力量和与肌肉减少症相关的身体表现之间的关系。
我们研究了 134 名年龄>60 岁的 DTC 术后接受 TSH 抑制治疗的患者。我们评估了肌肉质量和肌肉功能相关参数，并使用亚洲人的阈值诊断了肌肉减少症。
参与者的年龄为 68.3±7.2 岁，36/134（26.9%）被诊断为肌肉减少症。我们使用 0.40μU/mL 的阈值浓度将参与者分为高 TSH 组和低 TSH 组，低 TSH 组的握力明显较低。根据年龄和性别进一步分析数据，在低 TSH 组中，男性参与者和<70 岁的参与者握力明显较低。
低 TSH 浓度与握力降低相关，在<70 岁的个体中最为明显。因此，在接受 TSH 抑制治疗的 DTC 患者中，肌肉功能应被视为 TSH 抑制的不良反应，尤其是在<70 岁的男性中。
