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. 2021 Nov 10:12:769074.
doi: 10.3389/fendo.2021.769074. eCollection 2021.

Effect of Thyroid-Stimulating Hormone Suppression on Muscle Function After Total Thyroidectomy in Patients With Thyroid Cancer

Jun Choul Lee  1 , Byong-Sop Song  2 , Young Mi Kang  1 , Yu-Ri Kim  1 , Yea Eun Kang  1 , Ju Hee Lee  1 , Minho Shong  1 , Hyon-Seung Yi  1   2
Affiliations

Effect of Thyroid-Stimulating Hormone Suppression on Muscle Function After Total Thyroidectomy in Patients With Thyroid Cancer

Jun Choul Lee et al. Front Endocrinol (Lausanne). .

Abstract

Context: Thyroid-stimulating hormone (TSH) suppression is recommended to reduce tumor recurrence following surgery for differentiated thyroid cancer (DTC). However, prolonged subclinical hyperthyroidism caused by levothyroxine treatment has deleterious effects on various organs.

Objective: To evaluate the relationships of TSH concentration with muscle mass, muscle strength, and physical performance related to sarcopenia in patients with DTC undergoing TSH suppression following surgery.

Methods: We studied 134 patients of >60 years who were undergoing TSH suppression therapy following surgery for DTC. We evaluated muscle mass and muscle function-related parameters and diagnosed sarcopenia using the threshold for Asian people.

Results: The participants were 68.3 ± 7.2 years old and 36/134 (26.9%) were diagnosed with sarcopenia. They were allocated to high-TSH and low-TSH groups using a threshold concentration of 0.40 μU/mL, and grip strength was significantly lower in the low-TSH group. The data were further analyzed according to age and sex, and in the low-TSH group, male participants and those of <70 years were found to have significantly lower grip strength.

Conclusions: Low-TSH concentrations is associated with low grip strength, and this is most pronounced in individuals of <70 years of age. Therefore, muscle function should be considered an adverse effect of TSH suppression in patients with DTC who undergo TSH suppression therapy, especially in men of <70 years.

Keywords: muscle function and physical activity; sarcopenia; thyroid cancer; thyroid-stimulating hormone; thyroidectomy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Relationships of grip strength and chair-stand test result with serum TSH concentration and sex. (A) We allocated the participants to two groups on the basis of sex. Grip strength in men was significantly lower in the low-TSH group than in the high-TSH group. (B) However, grip strength in women was similar in the high-TSH and low-TSH groups. (C) The results of the chair-stand test were analyzed in the same way. The results of the test were similar in men in the high-TSH and low-TSH groups. (D) The results of the test were also similar in women in the high-TSH and low-TSH groups. ** in the figure indicates p-value < 0.01.
Figure 2
Figure 2
Relationships of grip strength and chair-stand test results with serum TSH concentration and age. (A) Participants were allocated to two groups on the basis of age: <70 years and >70 years. Grip strength in the under-70s was significantly lower in the low-TSH group (TSH-Lo, <0.40 μU/mL). (B) Grip strength in the over-70s was similar in the high- (TSH-Hi, 0.40–4.0 μU/mL) and low-TSH groups. (C) The chair-stand test results were similarly analyzed. Among the under-70s, there was no difference between the low- and high-TSH groups. (D) Among the over-70s, there was also no difference between the low- and high-TSH groups. ** in the figure indicates p-value < 0.01.
Figure 3
Figure 3
Correlation coefficients for the relationships between explanatory variables and the response variable for the participants with thyroid cancer. In the corrgram, the depth of shading at the correlation matrices indicates the magnitude of the correlation. Positive and negative correlations are represented in red and blue, respectively.
See this image and copyright information in PMC

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