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Analysis of Clinical Factors for the Determination of Optimal Serum Level of Thyrotropin After Recombinant Human Thyroid-Stimulating Hormone Administration

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Abstract

Purpose

To determine the optimal levels of thyroid-stimulating hormone (TSH) levels after administration of recombinant human TSH (rhTSH) to patients with differentiated thyroid cancer (DTC), we have analyzed the clinical parameters that affected the degree of the increase in serum levels of TSH.

Methods

We retrospectively analyzed 276 patients with differentiated thyroid cancer (DTC), post-thyroidectomy and remnant ablation. Pearson’s correlation coefficient test was used to evaluate the correlation between serum levels of TSH after rhTSH stimulation and various clinical factors, including age, sex, height, weight, body mass index (BMI), body surface area (BSA), serum blood urea nitrogen, creatinine, and estimated glomerular filtration rate (GFR). Linear regression analysis was used to determine the predictors of the degree of increase in serum TSH level after rhTSH stimulation.

Results

After the rhTSH injections, all subjects achieved TSH levels of >30 μU/mL, with a mean of 203.8 ± 83.4 μU/mL. On univariate analysis, age (r = 0.255) and serum creatinine (r = 0.169) level were positive predictors for higher levels of serum TSH after rhTSH stimulation, while weight (r = –0.239), BMI (r = –0.223), BSA (r = –0.217), and estimated GFR (r = –0.199) were negative predictors. Multiple linear regression analysis revealed that serum creatinine was the most powerful independent predictor for serum levels of TSH, followed by age, BSA, and BMI.

Conclusions

An increment in serum TSH after rhTSH stimulation was significantly affected by age, BSA, BMI, and creatinine, with creatinine being the most powerful predictor. By understanding the difference in the increased levels of TSH in various subjects, their dose of rhTSH can be adjusted during scheduling for radioiodine ablation, or during follow-up (recurrence surveillance) after surgery and ablation.

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Submission Statement

This manuscript has not been published before or is not under consideration for publication anywhere else and has been approved by all co-authors.

Funding

This study was funded by the National Research Foundation of Korea (NRF) grant funded by the Korean government (MEST) (no. 2009-0078222, 2009-0078234); a grant of the Korea Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (grant no. A111345); and a grant of the Kyungpook National University Research Fund, 2012.

Conflict of Interest

Seung Hyun Son, Sang-Woo Lee, Ji-hoon Jung, Choon-Young Kim, Do-Hoon Kim, Shin Young Jeong, Byeong-Cheol Ahn, and Jaetae Lee declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Kyungpook National University Medical Center and School of Medicine, 50 Samduk-dong 2-ga, Jung-gu, Daegu, 700-721, Republic of Korea

    Seung Hyun Son, Sang-Woo Lee, Ji-hoon Jung, Choon-Young Kim, Do-Hoon Kim, Shin Young Jeong, Byeong-Cheol Ahn & Jaetae Lee

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  1. Seung Hyun Son
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Correspondence to Jaetae Lee.

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Son, S.H., Lee, SW., Jung, Jh. et al. Analysis of Clinical Factors for the Determination of Optimal Serum Level of Thyrotropin After Recombinant Human Thyroid-Stimulating Hormone Administration. Nucl Med Mol Imaging 49, 268–275 (2015). https://doi.org/10.1007/s13139-015-0348-y

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  • DOI: https://doi.org/10.1007/s13139-015-0348-y

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