Dijagnostički značaj TRH testa kod starijih osoba

Abstract

This study presents examinations performed regarding a thyroid gland function and capability of thyroid-stimulating hormone (TSH) and prolactine (PRL) response to thyrotrophinreleasing hormone (TRH) in dynamic TRH test depending on age and gender of the examinees. The study examined 43 euthyroid males and 49 euthyroid females, who were grouped into the age groups - 40-70 years, and the results were compared with the results of the control group comprising 42 healthy examinees aged 20-40 years. All the patients had total T3 (triiodothyronine), T4 (thyroxine), free T3 and T4 (FT3 and FT4), TSh and PRL basal and after TRH stimulation determined. The results showed that with ageing, there was a significant decrease of total and free T4 values and slightly lesser intensity of T3 in the male group, while in the female group, it was noted a mild increase of the total hormones values, but within the normal euthyrosis values with no changes in free hormone values. Basal values of TSH and PRL remained within their normal values with ageing in both groups of examinees. Diminished sensibility in TSH response to the negative recurrent relation with the thyroid hormones, i.e. certain resistance of adenohypophysis to thyroid hormones was noted with ageing. TSH and PRL response in TRH test was diminished with ageing in the female group of examinees. It may be concluded that, despite of euthyroid status, TSH and PRL response has been changed in elderly examinees, more in women than men. The results also show difficulties in evaluating thyroid gland function in elderly examinees and TRH test limitations as diagnostic tool. In interpreting of the results of thyroid gland function tests, it is certainly necessary to take into consideration the age and gender of the examinee. There is a need for a review of our strategy in thyroid gland function testing in elderly population.