SERUM THYROGLOBULIN IN HOSPITALIZED CHRONIC GERIATRIC-PATIENTS - ITS RELATIONSHIP TO AGE, NONTHYROIDAL ILLNESS, GOITER AND THYROID-DYSFUNCTION IN A FOLLOW-UP-STUDY
I. Szabolcs et al., SERUM THYROGLOBULIN IN HOSPITALIZED CHRONIC GERIATRIC-PATIENTS - ITS RELATIONSHIP TO AGE, NONTHYROIDAL ILLNESS, GOITER AND THYROID-DYSFUNCTION IN A FOLLOW-UP-STUDY, European journal of endocrinology, 131(5), 1994, pp. 462-466
The objectives were to determine whether the serum thyroglobulin (TG)
level is influenced by age or by non-thyroidal illness (NTI) of the ag
ed, to investigate the constancy of the TG level after 1- and 2-month
intervals and to investigate if the TG level could help to differentia
te whether a subnormal thyrotrophin (TSH) level in a geriatric patient
is caused by autonomous thyroid function, by age or by NTI., Two-hund
red and twenty-six non-selected, chronic hospitalized patients over 60
years old and 82 healthy adults (20-40 years) participated in the stu
dy, and TSH, thyroxine, free thyroxine, triiodothyronine and TG were e
stimated. In 122 euthyroid geriatric patients with normal TSH the mean
TG was normal (12.18 mu g/l), but elevated (> 45 mu g/l) TG values oc
curred more often than in healthy control persons (15/122 vs 3/82; chi
((1))(2) = 4.54, p = 0.03). The severity of the clinical state of the
euthyroid patients had no influence on the TG values. If TG was measur
ed after 1 and/or 2 months, in only 3/123 non-selected geriatric patie
nts was there a fluctuation between the normal and abnormal range (ver
sus fluctuation of the corresponding TSH values in 19/123 cases; chi((
1))(2) = 12.78, p = 0.0012). In 28 patients with subnormal TSH, a norm
al TG value had a predictive value of 0.6 to exclude autonomous thyroi
d function. Age and NTI of the geriatric patients have no significant
influence on their mean TG level but high TG levels occur more often,
even in euthyroid patients. The predictive value of TG is not sufficie
ntly high to allow a clear differentiation of whether a subnormal TSH
is caused by autonomous thyroid function or by the age process or by N
TI. Nevertheless, the advantage of TG estimation to be more constant t
han TSH could be of benefit in screening studies.