The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Sung Su Kim; Dong Hoon Lew; Ja Yoon Choi; Eun Ju Lee; Min Gyo Kim; Kyong Young Kim; Soo Kyoung Kim; Jung Hwa Jung; Jae Hoon Jung; Jong Ryea l Hahm

doi:10.7180/kmj.2014.29.2.125

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Kim, Lew, Choi, Lee, Kim, Kim, Kim, Jung, Jung, and Hahm: The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Original Article

Kosin Medical Journal 2014;29(2):125-134.

Published online: 18 December 2014

DOI: https://doi.org/10.7180/kmj.2014.29.2.125

The Change of Thyroid Stimulating Hormone Values of Healthy Subjects According toTemperature and Aging

Sung Su Kim¹, Dong Hoon Lew¹, Ja Yoon Choi¹, Eun Ju Lee¹, Min Gyo Kim¹, Kyong Young Kim¹, Soo Kyoung Kim^1,², Jung Hwa Jung^1,², Jae Hoon Jung^1,², Jong Ryea l Hahm^1,^2,

¹Department of Internal Medicine, GyeongsangNational University School of Medicine, Jinju, Korea

²Institute of Health Science, GyeongsangNational University School of Medicine, Jinju, Korea

Corresponding Author : Jong Ryeal Hahm, Department of Internal Medicine, Gyeongsang National University School of Medicine, 79, Gangnam-ro, Jinju, 660-702, Korea TEL: +82-55-750-8736 FAX: +82-55-758-9122 E-mail: jrhahm@gnu.ac.kr

Received 20 August 201322 January 2014 Accepted 13 February 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective:

We conducted a study to investigate the normal range for TSH and within-individual variations of TSH according to temperat䴸re and aging.

Patients and Methods:

We enrolled patients who underwent periodic medical examinations five times over a six year period (2007.8~2013.6). Anthropometric data and thyroid ultrasonography were evaluated, and serum TSH, T3, and T4 were assayed.

Results:

Subjects were 19-64 years old, 120 were female, and 208 were male. Reference ranges for TSH were 0.53-4.94 mlU/L in the first test, 0.49-5.61 mlU/L in the second test, 0.46-6.06 mlU/L in the third test, 0.48-5.99 mlU/L in the fourth test, and 0.52-6.3 mlU/L in the fifth test. When the TSH level was analyzed according to temperature and sex, mean TSH was higher in months in which the average monthly temperatures were below 10⁰C in Jinju, Gyeongnam and female. The aging and low temperatures are associated with increased serum TSH concentrations in the within-individual.

Conclusions:

This study showed that aging is associated with increased serum TSH concentrations in the within- individual and serum TSH concentrations are different in the within-individual according to the temperature.

Keywords: Reference range for TSH, TSH, Variation of TSH

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Fig. 1

Schematic presentation of enrolled subjects for analysis.

Fig.2

Estimated marginal means natural logarithm(TSH) 士 SE that was checked five times for six years

Fig, 3

Within-individual TSH levels separated by average monthly temperature(10ⁱC) for 146 subjects.

Table 1.

Baseline characteristics of subjects in first check-up

Characteristic	Total (n=328)
Age (Years), mean±SD	42.1±8.09
Age stratum (Years), n(%)
≤29	20 (6.1)
30-39	111(33.8)
40-49	139(42.4)
50-59	48(14.6)
60≥	10(3.0)
Female, n(%)	120(36.6)
BMI, mean±SD	23.34土 2.91
Presence of thyroid nodules n(%)	21(6.4)
Presence of Fatty liver, n(%)
Normal echogenecity	277(84.4)
Mild	18(5.5)
Moderate-severe	33(10.1)
Alcoliol intake, n(%)
Nearly not	117(37.5)
< 20 g/day	102(31.1)
≥ 20 g/day	109(33.2)

SD: Standard Deviation, BMI: Body mass index

Table 2.

Mean TSH and thyroid hormones values for each subject check-up.

Sequence of tests	TFT(n=328)
	T3(ng/dL)	T4(ug/dL)	T4(ng/dL)
First	107.2±15.6	7.55±1.24	1.29±0.16^∗
Second	109.3±15.2	7.44±1.14	1.32±0.18^†
Third	109.5±16.9	7.54±1.18	1.32±0.17
Fourth	110.3±15.8	7.34±1.24	1,30±0.18
Fifth	108.2±15.9	7.67±1.29	1.29±0.15

Values are mean ± SD SD: Standard Deviation

^∗ 249 analyzed

^† 295 analyzed due to missing values.

Table 3.

Reference range of TSH values according to the serial check-ups.

Sequence of tests	TSH reference range(mIU/L)
Sequence of tests	Lower limit	Mean	Upper limit
First	0.53	1.62	4.94
Second	0.49	1.65	5.61
Third	0.46	1.67	6.00
Fourth	0.48	1.70	5.99
Fifth	0.52	1.78	6.13

The ranges were calculated as mean ± 2SD of log-transformed serum TSH concentrations for each sequence of check-up

Table 4.

Mean TSH value according to gender, age stratum, thyroid nodules, alcohol intake, fatty liver, temperature, and BMI.

Factors	TSH(mIU/L)
Factors	First	Second	Third	Fourth	Fifth
Age, year	42.1±8.09	43.3±8.11	44.6±8.14	45.8±8.12	47.1±8.18
Female(120)	1.98±1.15	2.06±1.11	2.08±1.18	2.15±1.33	2.29±1.30^∗
Male(208)	1.83±1.02	1.87±1.04	1.93±1.20	1.95±1.20	2.00±1.76^∗
Age stratum
30 내이하(131)	1.86±0.95	1.87±1.03	1.88±1.04	1.92±1.03	2.01±0.98
40 내(139)	1.89±1.16	1.99±1.05	2.05±1.30	2.05±1.23	2.09±1.27
50 내이성(58)	1.94±1.11	1.96±1.21	2.08±1.26	2.20±1.22	2.38±1.59
Nodule(-)	1.90± 1.07(307)	1.97±1.04(298)	2.01±1.20(300)	2.05±1.22(301)	2.14±1.23(298)
Nodule(+)	1.67± 1.06(21)	l.66±0.73(29)	1.71±1.15(28)	1.67±1.24(27)	1.83± 1.22(30)
Alcohol
Not intake(H7)	1.B6±1.10	1.97±1.08	1.96±1.13	2.05±1.31	2.16±1.25
<20g/day(102)	1.90±1.07	1.90±1.05	1.97±1.16	2.08±1.27	2.09±1.18
≥20g/day(109)	1.90±1.04	1.94±1.08	2.03±1.30	1.94±1.07	2.08±1.27
Fatty Liver
(-)	1.90±1.07(277)	1.97±1.09(259)	2.02±1.24(259)	2.06±1.20(24S)	2.15±1.26(234)
(+)	1.82±1.07(51)	1.82±0.97(68)	1.85±1.01{69)	1.91±1.28(80)	2.01±1.13(94)
월평균 기온
A	1.81±1.02^†(239)	1.84±1.04^‡(231)	1.95±1.18(237)	2.05±1.27(230)	2.06±1.21(228)
B	2.10±1.16^†(89)	2.17±1.11^‡(97)	2.09±1.23(91)	1.96±1.08(98)	2.22±1.28(100)
BMI
<23kg/m²	1.88±1.06(172)	1.93±1.16(155)	2.05±1.18(151)	1.97±1.06(141)	2.13±1.13(146)
23-24	1.80±94(54)	1.71±0.75(76)	1.83±1.06(79)	2.06±1.22(85)	2.07±132(71)
≥25kg/m²	1.96±1.14(100)	2.12±1.17(95)	2.01±1.31(97)	2.10±1.22(102)	2.10±1.23(110)

Values are mean ± SD SD: Standard Deviation, T: Temperature, A:months that average monthly temperature is above 10°C in Jinju, Gyeongnam, B:months that average monthly temperature is below 10°C in Jinju, Gyeongnam, BMI: Body Mass Index P value(mean±SD

^∗ is 0.032, P value(mean±SD

^† )is 0.034, P value(mean±SD

^‡ )is 0.008. P value by T-test or ANOVA(Analysis of variance)

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