Elsevier

Metabolism

Volume 23, Issue 2, February 1974, Pages 101-113
Metabolism

Effect of age and role of kidneys and liver on thyrotropin turnover in man

https://doi.org/10.1016/0026-0495(74)90107-3Get rights and content

Abstract

In order to determine the role played by the kidneys and liver in TSH catabolism, plasma TSH concentrations, total and free T4, plasma disappearance of 131I-hTSH, its distribution volume, pituitary secretion and plasma clearance rate, have been measured in nine healthy subjects (five young and four elderly subjects), in four patients suffering from chronic renal disease, and in six others with hepatic diseases. Normal young subjects displayed a T12 of 56 min ± 3.0, a distribution volume of 2.4 I, a clearance rate of 31.1 ml/min and a secretion rate of 179 mU24 hr, with a mean plasma TSH level of 3.6 ± 1.4 μU/ml. The T12 values in young and old subjects were not significantly different, but in the elderly subjects, plasma TSH concentrations and secretion rates were increased (resp. 6.5 μU/ml and 277 mU24 hr). Besides, the TSH response to TRH decreased with advancing age. In hepatic insufficiency, the two patients suffering from viral hepatitis showed values quite similar to those found in healthy young subjects. Patients with cirrhosis, however, displayed increased plasma TSH levels, a TSH T12 of 64 min ± 5, a marked increase in the volume of distribution (6.11), in the clearance (97 ml/min) and in the secretion rates (595 mU24 hr), a normal total T4 but an increased free T4 concentration. In patients with chronic renal diseases, the T12 was significantly extended to 163 min, as was the distribution volume (4.31), while clearance (17 ml/min) and secretion rates (102 mU24 hr) were decreased. The TSH response to TRH was lower than in the control group. These findings show the different roles played by the kidneys and the liver in TSH catabolism and distribution in man. In some cases, they can be responsible for increased plasma TSH levels in the presence of an euthyroid clinical state.

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    Supported in part by a research grant from the Fonds National Swiss de la Recherche Scientifique (request no. 3.364.70).

    1

    Serge Cuttelod, M.D.: Research Assistant, Department of Clinical Biochemistry, University Cantonal Hospital, Lausanne, Switzerland.

    2

    Thérèse Lemarchand-Béraud, Ph.D.: Privat Docent, and Chief of the Thyroid Unit, Department of Clinical Biochemistry, University Cantonal Hospital, Lausanne, Switzerland.

    3

    Pierre Magnenat, M.D.: Professor of Medicine, and Chief of the Therapeutic Unit, University Cantonal Hospital, Lausanne, Switzerland.

    4

    Claude Perret, M.D.: Professor of Physiopathology, and Chief of the Intensive Care Unit, University Cantonal Hospital, Lausanne, Switzerland.

    5

    Sergio Poli, M.D.: Consultant Physician, Intensive Care Unit, University Cantonal Hospital, Lausanne, Switzerland.

    6

    Alfredo Vannotti, M.D.: Professor of Medicine, and Chief of the Department of Internal Medicine, University Cantonal Hospital, Lausanne, Switzerland.

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