甲状腺ホルモン分泌調節機構及び血中T<SUB>3</SUB>に関する臨床的研究:第3篇 不顕性甲状腺機能低下状態 (橋本病およびバセドウ病<SUP>131</SUP>I療法遠隔例) におけるホルモン分泌動態に関する研究

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概要

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• Changes in thyroid hormone levels and their relationship with TSH in cases with Hashimoto's thyroiditis and <SUP>131</SUP>I treated Graves' disease in subclinical hypothyroid state were investigated : <BR>1)In 34 cases with Hashimoto's thyroiditis, TSH level was 14.7±26.8 μU/ml (mean±s.d.), T3 144.5±33.6 ng/100 ml; T4 6.7±2.4 μg/100 ml; T3RU 25.4±3.2%; F.T.I. 2.09±0.89; T3/T4 2.46±1.04%.<BR>It was noted that TSH levels revealed significant positive correlation with T3/T4 (r=0.77); significant inverse correlation with F.T.I. (r=-51); and non-significant inverse correlation with T3 levels (r=-0.06).<BR>These results indicate that T3 might play a more important role than T4 in maintaining normal thyroid function (so-called T3 euthyroidism). This is probably based on metabolic disturbance of iodine which is common in Hashimoto's thyroid.<BR>In several cases with rather high normal basal T3 levels, no significant elevation in T3 was observed in spite of elevated TSH level following TRH administration. This might indicate that the thyroid is fully functioning and that no more reserve is left for the thyroid to respond further to elevated TSH.<BR>2) In 30 cases with <SUP>131</SUP>I treated Graves' disease, TSH concentration was 22.3±29.8 μU/ml (mean±s.d.); T3 100.7±35.4 ng/100 ml; T4 6.2±2.9 μg/100 ml; T3RU 25.6±2.3%; F.T.I. 1.87±0.85; T3/T4 1.80±0.64.<BR>Significant inverse correlation was noted between TSH levels and F.T.I. as well as T3 levels. Although TSH levels showed significant positive correlation with T3/T4 (r=0.44), its degree of correlation was not as good as that with F.T.I. (r=-0.71) and T3 (r=-0.53).<BR>These results indicate that there is no preference in T3 production. From the responsiveness of thyroid and pituitary following TRH administration, assumption can be drawn that <SUP>131</SUP>I treated Graves' patients, who become euthyroid, may in fact be on the way to hypothyroidism.

• 一般社団法人 日本内分泌学会の論文

著者

• 竹田 洋祐

  京都大学医学部放射線科

関連論文

• 甲状腺ホルモン分泌調節機構及び血中T3に関する臨床的研究:第1篇 固相法ラジオイムノアッセイ法による血清TSH測定法ならびにその臨床応用
• 甲状腺ホルモン分泌調節機構及び血中T3に関する臨床的研究:第2篇 迅速ラジオイムノアッセイ法による血清T3測定法ならびにその臨床応用
• 甲状腺ホルモン分泌調節機構及び血中T3に関する臨床的研究:第3篇 不顕性甲状腺機能低下状態 (橋本病およびバセドウ病131I療法遠隔例) におけるホルモン分泌動態に関する研究

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