-transparent.png){kind=logo}
OBJECTIVE We evaluated pulsatile and circadian TSH secretion in primary hypothyroidism. METHODS In a prospective study, blood was sampled every 10 minutes during 24 hours for assay of TSH (IRMA). Thyroid hormones and TSH responsiveness to TRH were then measured. METHODS Nine patients with overt primary hypothyroidism, seven patients with subclinical hypothyroidism and 16 healthy controls. METHODS Computer-assisted analysis by the Desade and Cluster programs. RESULTS Both computer-assisted programs revealed an increased TSH pulse amplitude in both overt and subclinical hypothyroidism versus controls (Desade: 36.9 +/- 31.4 (mean +/- SD) (P < 0.001) and 2.8 +/- 1.9 (P < 0.001) vs 0.4 +/- 0.2 mU/l; Cluster: 25.6 +/- 25.1 (P < 0.001) and 2.4 +/- 1.4 (P < 0.001) vs 0.4 +/- 0.2 mU/l). TSH pulse frequency remained unchanged with approximately 10 pulses/24 hours. A highly significant correlation was found between the mean 24-hour TSH concentration and the TSH pulse amplitude in all controls and patients but not to TSH pulse frequency. The nocturnal TSH surge was absent in six out of nine patients with overt primary hypothyroidism. The deficient nocturnal rise of TSH in primary hypothyroidism vs controls (22 +/- 51 vs 82 +/- 41%, P < 0.001), was associated with a loss of the usual nocturnal increase in TSH pulse amplitude and frequency. CONCLUSIONS Mean 24-hour TSH pulse amplitude is increased in primary hypothyroidism, but TSH pulse frequency remains unchanged. The decrease of the nocturnal TSH increase in primary hypothyroidism is associated with a loss of the usual nocturnal increase in TSH pulse amplitude and frequency.
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
April 1991,
Acta endocrinologica,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
June 1998,
Der Internist,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
January 1990,
Hormone and metabolic research. Supplement series,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
January 2013,
Endocrine research,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
January 1981,
La Ricerca in clinica e in laboratorio,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
July 1980,
Clinical endocrinology,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
November 1977,
The Journal of clinical endocrinology and metabolism,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
November 1989,
Journal of endocrinological investigation,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
September 2005,
Journal of the Royal Society of Medicine,
R Adriaanse, and
G Brabant, and
K Prank, and
E Endert, and
W M Wiersinga
November 2010,
Thyroid : official journal of the American Thyroid Association,
