Fenzi G F, Ceccarelli C, Macchia E, Monzani F, Bartalena L, Giani C, Ceccarelli P, Lippi F, Baschieri L, Pinchera A
Clin Endocrinol (Oxf). 1985 Aug;23(2):115-22. doi: 10.1111/j.1365-2265.1985.tb00205.x.
Subjects living in iodine deficient areas were reported to have elevated serum thyroglobulin (Tg) concentrations. This finding was interpreted as related to thyroid stimulation. Discrepant results, however, were found when serum Tg concentrations were correlated either with serum TSH or with goitre size. In this study we investigated the relationships between goitre size, serum Tg and serum TSH in 488 unselected adult subjects living in an endemic area of North-Western Tuscany (Garfagnana district). The control group comprised 352 subjects residing in a non-endemic area. In the endemic area a high prevalence of goitre was found (80.1%), thyroid enlargement being slight to moderate in the majority of cases and very large only in six subjects. Serum Tg concentrations increased and serum TSH levels decreased with the size of goitre. Statistical analysis by the chi-square cross correlation test showed that the converse changes of serum Tg and serum TSH in relation to goitre size were highly significant. These findings indicate that the increase of serum Tg occurring in endemic goitrous subjects may be related to factors other than TSH stimulation. Functional autonomy of the thyroid may account for the finding of low serum TSH and elevated serum Tg values in patients with large goitres. The present data do not exclude the possibility that the release of Tg is influenced by TSH stimulation, but indicate that other factors may be responsible for the increased levels of Tg found in endemic goitre.
据报道，生活在碘缺乏地区的人群血清甲状腺球蛋白（Tg）浓度升高。这一发现被解释为与甲状腺刺激有关。然而，当血清Tg浓度与血清促甲状腺激素（TSH）或甲状腺肿大小相关联时，却发现了不一致的结果。在本研究中，我们调查了居住在托斯卡纳西北部（加尔法尼亚纳地区）一个地方性甲状腺肿流行区的488名未经挑选的成年受试者的甲状腺肿大小、血清Tg和血清TSH之间的关系。对照组由居住在非流行区的352名受试者组成。在流行区，甲状腺肿的患病率很高（80.1%），大多数病例的甲状腺肿大为轻度至中度，只有6名受试者的甲状腺肿大非常严重。血清Tg浓度随着甲状腺肿大小的增加而升高，血清TSH水平则降低。通过卡方交叉相关检验进行的统计分析表明，血清Tg和血清TSH相对于甲状腺肿大小的相反变化具有高度显著性。这些发现表明，地方性甲状腺肿患者血清Tg升高可能与TSH刺激以外的因素有关。甲状腺的功能自主性可能解释了甲状腺肿大患者血清TSH降低和血清Tg升高的现象。目前的数据并不排除Tg的释放受TSH刺激影响的可能性，但表明其他因素可能是地方性甲状腺肿患者Tg水平升高的原因。
