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LARSEN et al.
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TABLE LV BASELINE SERUM TSH CONCENTRATIONS AND RESPONSE
10 500 yg THYROTROPIN RELEASING HORMONE(TRH) IN CONTROL
MARSHAL LESE SUBJECTS
a9
Basal seruan TSH concenteations and response to TRE
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Mean 1 SD
Since the most sensitive index of aapaaed thyroid function ts an clevahion
i scHin PSH which occurs through the hy potiadanie-pilunary diy cod feedback
ants, scruin TSP concentrations aid then iespumse to PRED were measured: an
both Wie conuol and tlie exposed Rongelep population. fa praunary by pothyronlisa,
wu/ul
Basal YSU
[AEA-SM-224/607
the wesponse of the pituitary to PRED is cxcessively preat (8) Mea basal OSH
Mean t SD
2020.75
was 2 U/l in 25 non-exposed cuthytou Marshallese, and dhe tauge was from
Range
U.5- 3.0
undetectable (0 05 pll/ial) to 3 pU final (Fable IV)
Serta PSH 20 minutes
folowing ERGE was ticdeascd an all control subjeots
“Thre gncan increimcnt was
OSH 20 san alter TRH
absras
Range
11.5 24.5 4¢SD) with a range of from 4 7 to 20 pU find Phese cesulls aie not
47-20
sigitlicantly different from these previously reported mn uther populations |9]
Ohi the basis of Giese studies, celerta were established for clussiication of
paticnts as having biochemical evidence of unpaued Unyroid function.
Phese
citleria ate subiaiized oo dable V, and include cither two basal PSEE dedermiiaations giculer thaa 5 pU find (> 4 stundaid deviaiions above he meuab or basal
TABLE Vo CRITERIA FOR THE DIAGNOSIS OF BIOCHEMICAL THYROID
BYSEUNCTION
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Hasal plasina ISH
>
§ pu/mi
plasma VSOP > 3 wU/inl (but <5 gl/aid) aud piasmia V Std alterPRU 22 pU/md.
Consistent observations ta Uhese tanges were requited On EWo Occasions fo mel
the critenta fos bigchcamcab evidence of thyroid dysfunction While scrim Ty
concentration is ao dmportant determin’ in the thyrout status of the todiidual,
prewiods studies have indicated hat evidence Of mmipaimed dhytoul fuactioan can
On (wo Occasions
be ehemted by these lests belare serum Py comcentiaions dave fallen below the
normal range FLO] Pheretore, the serum Py codceutiatior was nod used as a
or
20a
i)
Basal plasina TSH
~
Phasing PSdlatler FRH
> 22 pU/ml
chilcion pt establishing dhe diagnosis Of panned thyroid bane tion
JpUf/ul
in Table Vitis shown the drequency of ul deust a single chewaled basal PSGL
OU Iwo OLcusions
coaccntiahion dn vatiows Maishalicse populations. Ing comlrot group of 115
why were nol exposed to cfadiation, § 1 sabpects ar 100 of tie population bad
aseruin PUSH) greater thao 3 g/ml. dn ten of these, serui PSH wis only
nuainally elevated (4 O pU/ial of less), the remuming value was oO | wU/il None
of these patients had detectable clinical hypothyroidism of thyroid colargement,
but serum Ty concentrations were generally ui the low normal range.
le the exposed Unk population, }2 of 99 subjects tested had at least one
TABLE VIO FREQUENCY OF AT LEAST A SINGLE ELEVATED BASAL
SERUM [SH CONCENTRATION IN THLE MARSHALLESE POPULATION
basal scrum TSU greater than 3 pU/nd, though none of Uiesc was in excess of
Contra uncapused
Utiusk exposed
(thyroid dase <. 95 padss
Kungclip aid Aiingnae ¢expused
(Subjects without surgery
Number
Number
lesied
> 3.0 pU/ial
*
S aU/ind ‘ble ancidence of elevated TSiiin this population is not signiticantly
different tron that of the unexposed group. dn the Rongelap wad Adingnae
Lis
Ml
tO
serum PSH greater than 3 wU/inb, and im two cases seruan VSEL was in excess of
yy
12
43
fi
‘
populaion, EL uf 43 subjects were tound tu have al least a single elevated basal
7 wU fol, and in two causes scam PSU was in excess of 7 U/l
12
“Thus isa
slentiicandly lugher prevaleace than inthe offer bwo groups pooled (p <0 05)
Ia Fig. | ate shown the respomses to PRE of the tour midiviaduals who met the
Zo
criteria given in Table Vo The nociaal basal PSU) and response to TRIE ae shown
and excluding Nus 3 & 9)
tn the shaded burs. In these four individuals, the basal serum VSI was elevated,
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