Bunevicius R, Kazanavicius G, Telksnys A
Institute of Endocrinology, Kaunas Medical Academy, Lithuania.
Biol Psychiatry. 1994 Oct 15;36(8):543-7. doi: 10.1016/0006-3223(94)90618-1.
Two thyroid axis findings are often reported in depressed patients: autoimmune thyroiditis and abnormal thyrotropin (thyroid stimulating hormone, TSH) responses to thyrotropin-releasing hormone (TRH). The TSH response to TRH can be exaggerated, suggesting subclinical hypothyroidism; it can alternatively be blunted, for reasons poorly understood. We selected 28 women who had been found to have major depression for TRH testing. Fifteen patients had autoimmune thyroiditis and 13 had diffuse nontoxic goiter. The endocrinological diagnoses were verified by fine-needle aspiration biopsy and cytological assessment. Patients with overt hypothyroidism and hyperthyroidism were excluded from the study. There were no differences between the two groups in total triiodthyronine and thyroxine plasma levels or severity of depression. In the autoimmune group, basal TSH and Dmax TSH tended to be higher (p < 0.1); peak TSH was significantly higher (p < 0.05), suggesting that the prevalence of subclinical hypothyroidism was also higher. Blunted TSH responses were found about as often in one group as the other.
自身免疫性甲状腺炎以及促甲状腺激素（甲状腺刺激激素，TSH）对促甲状腺激素释放激素（TRH）的反应异常。TSH对TRH的反应可能增强，提示亚临床甲状腺功能减退；也可能减弱，原因尚不清楚。我们选取了28名被诊断为重度抑郁症的女性进行TRH检测。15名患者患有自身免疫性甲状腺炎，13名患有弥漫性非毒性甲状腺肿。通过细针穿刺活检和细胞学评估对内分泌诊断进行了验证。明显甲状腺功能减退和甲状腺功能亢进的患者被排除在研究之外。两组患者的总三碘甲状腺原氨酸和甲状腺素血浆水平或抑郁严重程度无差异。在自身免疫组中，基础TSH和最大TSH倾向于更高（p<0.1）；峰值TSH显著更高（p<0.05），表明亚临床甲状腺功能减退的患病率也更高。两组中TSH反应减弱的情况出现频率相近。
