Sheikhi Vahid, Heidari Zahra
Department of Pediatric Nephrology, Zahedan University of Medical Sciences, Zahedan, Iran.
Department of Endocrinology and Metabolism, Zahedan University of Medical Sciences, Zahedan, Iran.
Med J Islam Repub Iran. 2021 Dec 15;35:167. doi: 10.47176/mjiri.35.167. eCollection 2021.
Prevalence and clinical significance of hyperprolactinemia in subclinical hypothyroidism have been reported in few studies. The upper limit of the normal range for TSH used to diagnose subclinical hypothyroidism is a matter of controversy. Some experts believe that the upper limit of the normal TSH range should be reduced from 4.2 to 2.5 mIU/L. Some evidence suggests a positive relationship between TSH > 2.5 mIU/L and cortisol as an indicator of metabolic stress. With this view prolactin as a stress hormone can be elevated in TSH >2.5 in comparison to TSH< 2.5. Hence the aim of this study was to evaluate the relationship between TSH and prolactin levels in the TSH range <10. This cross-sectional study was performed on apparently healthy subjects with TSH<10 mIU/L. Subjects with the age of 18 to 35 years were enrolled. The sera were analyzed for prolactin, FT3, FT4, TSH, TPO-Ab and Tg-Ab. From the total number of 519 participants, in 65 subjects (12.5%) TSH was < 2.5. Seventy-nine subjects (15.2%) had TSH: 2.5-4.2 and 375 (72.3%) of the participants had TSH> 4.2 mIU/L. The mean age, weight and BMI of subjects in the three TSH groups were not significantly different. In the three TSH groups, the prevalence of hyperprolactinemia was zero, 3.8 and 30.7%, respectively. There was a positive and significant correlation between prolactin and TSH levels (r=0.613). Hyperprolactinemia is common in patients with subclinical hypothyroidism (30.7%) and there is a positive correlation between TSH and PRL in subjects with TSH<10 mIU/l.
关于亚临床甲状腺功能减退症患者高催乳素血症的患病率及其临床意义,仅有少数研究进行过报道。用于诊断亚临床甲状腺功能减退症的促甲状腺激素(TSH)正常范围上限存在争议。一些专家认为,TSH正常范围上限应从4.2 mIU/L降至2.5 mIU/L。一些证据表明,TSH>2.5 mIU/L与作为代谢应激指标的皮质醇之间存在正相关关系。基于此观点,与TSH<2.5相比,TSH>2.5时作为应激激素的催乳素可能会升高。因此,本研究的目的是评估TSH范围<10时TSH与催乳素水平之间的关系。本横断面研究针对TSH<10 mIU/L的表面健康受试者开展。纳入年龄在18至35岁之间的受试者。对血清进行催乳素、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、TSH、甲状腺过氧化物酶抗体(TPO-Ab)和甲状腺球蛋白抗体(Tg-Ab)分析。在总共519名参与者中,65名受试者(12.5%)的TSH<2.5。79名受试者(15.2%)的TSH为2.5 - 4.2,375名(72.3%)参与者的TSH>4.2 mIU/L。三个TSH组受试者的平均年龄、体重和体重指数无显著差异。在三个TSH组中,高催乳素血症的患病率分别为零、3.8%和30.7%。催乳素与TSH水平之间存在显著正相关(r = 0.613)。高催乳素血症在亚临床甲状腺功能减退症患者中很常见(30.7%),且在TSH<10 mIU/l的受试者中TSH与PRL之间存在正相关。