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A Sensitive Thyroid Stimulating Hormone Assay for Screening of Thyroid Functional Disorder in Elderly Japanese
Author(s) -
Okamura Ken,
Ueda Kazuo,
Sone Hisao,
Ikenoue Hiroshi,
Hasuo Yutaka,
Sato Kaori,
Yoshinari Mototaka,
Fujishima Masatoshi
Publication year - 1989
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.1989.tb05497.x
Subject(s) - medicine , thyroid , hormone , thyroid stimulating hormone , subclinical infection , endocrinology , thyrotropin releasing hormone , population , environmental health
The use of a screening test for thyroid functional disorder by sensitive thyroid stimulating hormone assay in the elderly was investigated. The basal thyroid stimulating hormone levels predicted the response of thyroid stimulating hormone to thyrotropin releasing hormone; it was suppressed in 99 (99.0%) of 100 hyperthyroid patients. Therefore, not only primary hypothyroidism but also hyperthyroidism can be excluded when the serum thyroid stimulating hormone levels are normal. An epidemiological study was then performed on 2,421 (76.7%) of the Japanese general population aged 40 or over recruited from the residents in Hisayama town and also in 122 residents between 20 and 40 years of age. Additional free T 4 measurement was necessary in about 10% of the residents with abnormal TSH levels to confirm the diagnosis of hyperthyroidism or distinguish latent from overt hypothyroidism. There was a significant correlation between age and serum thyroid stimulating hormone levels after logarithmic conversion ( r = 0.1533 , P < .001). The prevalence of thyroid dysfunction found in 1,026 males and in 1,395 females aged 40 or over was, respectively: hyperthyroidism, < 0.1% and 0.2%, latent (subclinical) hypothyroidism, 3.2% and 5.5%, and overt hypothyroidism, 0.4% and 0.7%. We conclude that the screening with this sensitive thyroid stimulating hormone assay and additional free T 4 measurement is useful for detection of patients with thyroid functional disorder.