JBM  Vol.6 No.11 , November 2018
Age- and Gender-Specific Changes in Thyroid Size and Thyroid Function Test Values of Euthyroid Subjects
Background: The thyroid status is evaluated by two clinical diagnostic tests which are thyroid ultrasonography and thyroid function tests. The objective of this research is to critically analyze the age and gender based variations of thyroid volume and thyroid hormone levels in the hospital based euthyroid subjects. Methodology: A total of 221 euthyroid subjects aged 1 - 86 years were selected to observe the normal thyroid size by ultrasonography at Department of Radiology and the thyroid function test values (FT3, FT4 and TSH) of 2413 euthyroid subjects aged (<1)-93 years were observed at Department of Biochemistry, Tribhuvan University Teaching Hospital, Kathmandu, Nepal during January 2017 to February 2018. The observed data were analyzed graphically and statistically to check the cross-correlations among the variables. Results: The best fitted equations with significant correlation coefficients and p < 0.05 provide the empirical relations between any two of the observed variables: age, thyroid lobe volumes, FT3, FT4 and TSH. The mean ± SD (p < 0.0001) of thyroid volume, FT3, FT4 and TSH are 4.74 ± 2.30 mL, 5.46 ± 0.82 pmol/L, 14.09 ± 2.71 pmol/L and 2.30 ± 0.98 mIU/L, respectively. Conclusion: The thyroid size first increases and then decreases whereas the thyroxin level first decreases and then increases with aging. Left lobe volume is almost same for both genders and right lobe volume is higher in males. The thyroid size in menarche and menopause periods of females is larger than that of males. Such age- and gender-specific changes recommend the new refer-ence ranges for the normal thyroid functions.
Cite this paper: Lamichhane, T. , Pant, S. , Lamichhane, B. , Gautam, C. , Paudel, S. , Yadav, B. and Lamichhane, H. (2018) Age- and Gender-Specific Changes in Thyroid Size and Thyroid Function Test Values of Euthyroid Subjects. Journal of Biosciences and Medicines, 6, 59-73. doi: 10.4236/jbm.2018.611007.

[1]   Warner, A. and Mittag, J. (2012) Thyroid Hormone and the Central Control of Homeostasis. Journal of Molecular Endocrinology, 49, R29-R35.

[2]   Führer, D., Brix, K. and Biebermann, H. (2015) Understanding the Healthy Thyroid State in 2015. European Thyroid Journal, 4, 1-8.

[3]   Vadiveloo, T., Donnan, P.T., Murphy, M.J. and Leese, G.P. (2013) Age- and Gender-Specific TSH Reference Intervals in People with No Obvious Thyroid Disease in Tayside, Scotland: The Thyroid Epidemiology, Audit, and Research Study (TEARS). The Journal of Clinical Endocrinology & Metabolism, 98, 1147-1153.

[4]   Kratzsch, J., Fiedler, G.M., Leichtle, A., Brügel, M., Buchbinder, S., Otto, L., Sabri, O., Matthes, G. and Thiery, J. (2005) New Reference Intervals for Thyrotropin and Thyroid Hormones Based on National Academy of Clinical Biochemistry criteria and Regular Ultrasonography of the Thyroid. Clinical Chemistry, 51, 1480-1486.

[5]   Bremner, A.P., Feddema, P., Leedman, P.J., Brown, S.J., Beilby, J.P., Lim, E.M., Wilson, S.G., O’leary, P.C. and Walsh, J.P. (2012) Age-Related Changes in Thyroid Function: A Longitudinal Study of a Community-Based Cohort. The Journal of Clinical Endocrinology, 97, 1554-1562.

[6]   Suzuki, S., Nishio, S.I., Takeda, T. and Komatsu, M. (2012) Gender-Specific Regulation of Response to Thyroid Hormone in Aging. Thyroid Research, 5, 1-8.

[7]   Völzke, H., Alte, D., Kohlmann, T., Lü-demann, J., Nauck, M., John, U. and Meng, W. (2005) Reference Intervals of Serum Thyroid Function Tests in a Previously Iodine-Deficient Area. Thyroid, 15, 279-285.

[8]   Porcu, E., Medici, M., Pistis, G., Volpato, C.B., Wilson, S.G., Cappola, A.R., Bos, S.D., Deelen, J., den Heijer, M., Freathy, R.M. and Lahti, J. (2013) A Meta-Analysis of Thyroid-Related Traits Reveals Novel Loci and Gender-Specific Differences in the Regulation of Thyroid Function. PLoS Genetics, 9, e1003266.

[9]   Hansen, P.S., Brix, T.H., Bennedbæk, F.N., Bonnema, S.J., Kyvik, K.O. and Hegedus, L. (2004) Genetic and Environmental Causes of Individual Differences in Thyroid Size: A Study of Healthy Danish Twins. The Journal of Clinical Endocrinology & Metabolism, 89, 2071-2077.

[10]   Kayastha, P., Paudel, S., Shrestha, D.M., Ghimire, R.J. and Pradhan, S. (2010) Study of Thyroid Volume by Ultrasonography in Clinically Euthyroid Patients. Journal of Institute of Medicine, 32, 36-43.

[11]   Turcios, S., Lence-Anta, J.J., Santana, J.L., Pereda, C.M., Velasco, M., Chappe, M., Infante, I., Bustillo, M., García, A., Clero, E. and Maillard, S. (2015) Thyroid Volume and Its Relation to Anthropometric Measures in a Healthy Cuban Population. European Thyroid Journal, 4, 55-61.

[12]   Ivanac, G., Rozman, B., Skreb, F., Brkljacic, B. and Pavic, L. (2004) Ultrasonographic Measurement of the Thyroid Volume. Collegium Antropologicum, 28, 287-291.

[13]   Chanoine, J.P., Toppet, V., Lagasse, R., Spehl, M. and Delange, F. (1991) Determination of Thyroid Volume by Ultrasound from the Neonatal Period to Late Adolescence. European Journal of Pediatrics, 150, 395-399.

[14]   Hegedus, L., Perrild, H., Poulsen, L.R., Andersen, J.R., Holm, B., Schnohr, P., Jensen, G. and Hansen, J.M. (1983) The Determination of Thyroid Volume by Ultrasound and Its Relationship to Body Weight, Age, and Sex in Normal Subjects. The Journal of Clinical Endocrinology & Metabolism, 56, 260-263.

[15]   Berghout, A., Wiersinga, W.M., Smits, N.J. and Touber, J.L. (1987) Determinants of Thyroid Volume as Measured by Ultrasonography in Healthy Adults in a Non-Iodine Deficient Area. Clinical Endocrinology, 26, 273-280.

[16]   Leppäluoto, J., Sikkilä, K. and Hassi, J. (1998) Seasonal Variation of Serum TSH and Thyroid Hormones in Males Living in Subarctic Environmental Conditions. International Journal of Circumpolar Health, 57, 383-385.

[17]   Raj, K.C.S. (2014) Thyroid Function Tests and Its Interpretation. Journal of Pathology of Nepal, 4, 584-590.

[18]   Biondi, B. (2013) The Normal TSH Reference Range: What Has Changed in the Last Decade? The Journal of Clinical Endocrinology & Metabolism, 98, 3584-3587.

[19]   Shivaraj, G., Prakash, B.D., Sonal, V., Shruthi, K., Vinayak, H. and Avinash, M. (2009) Thyroid Function Tests: A Review. European Review for Medical and Pharmacological Sciences, 13, 341-349.

[20]   Mahato, R.V., Jha, B., Singh, K.P., Yadav, B.K., Shah, S.K. and Lamsal, M. (2015) Status of Thyroid Disorders in Central Nepal: A Tertiary Care Hospital Based Study. International. Journal of Applied Science and Biotechnology, 3, 119-122.

[21]   Dangol, R.K., Lanjekar, P. and Pulipati, C. (2017) Thyroid Function Abnormalities among Hospital Patients of Hilly Nepal. Journal of Lumbini Medical College, 5, 29-33.

[22]   Fontes, R., Coeli, C.R., Aguiar, F. and Vaisman, M. (2013) Reference Interval of Thyroid Stimulating Hormone and Free Thyroxine in a Reference Population over 60 Years Old and in Very Old Subjects (over 80 Years): Comparison to Young Subjects. Thyroid Research, 6, 13.

[23]   Chaurasia, P., Modi, B., Mangukiya, S., Jadav, P. and Shah, R. (2011) Variation in Thyroid Hormones Level among People of Different Age, Gender and Seasons, Piparia, Gujarat. National Journal of Medical Research, 1, 57-59.

[24]   Lipson, A., Nickoloff, E.L., Hsu, T.H., Kasecamp, W.R., Drew, H.M., Shakir, R. and Wagner, J.H. (1979) A Study of Age-Dependent Changes in Thyroid Function Tests in Adults. Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine, 20, 1124-1130.

[25]   Chaudhary, V. and Shahina, B. (2013) Thyroid Ultrasound. Indian Journal of Endocrinology and Metabolism, 17, 219.

[26]   Hendee, W.R. and Ritenour, E.R. (2011) Medical Imaging Physics. 4th Edition, John Wiley & Sons, US.

[27]   Abu-Zidan, F.M., Hefny, A.F. and Corr, P. (2011) Clinical Ultrasound Physics. Journal of Emergencies, Trauma and Shock, 4, 501.

[28]   Fereja, T.H., Hymete, A. and Gunasekaran, T. (2013) A Recent Review on Chemiluminescence Reaction, Principle and Application on Pharmaceutical Analysis. ISRN Spectroscopy, 2013, Article ID: 230858.

[29]   Weeks, I., Sturgess, M.L. and Woodhead, J.S. (1986) Chemiluminescence Immunoassay: An Overview. Clinical Science, 70, 403-408.

[30]   Seker, S. and Tas, I. (2010) Determination of Tthyroid Volume and Its Relation with Isthmus Thickness. European Journal of General Medicine, 7, 125-129.

[31]   Oberhofer, R., Ober, A., Oberkofler, F. and Amor, H. (1989) Thyroid Gland Volumes of Healthy Adults in an Area with Endemic Goiter. Acta Medica Austriaca, 16, 38-41.

[32]   Ying, M. and Yung, D. (2009) Asymmetry of Thyroid Lobe Volume in Normal Chinese Subjects: Association with Handedness and Position of Esophagus. The Anatomical Record, 292, 169-174.

[33]   Lewiński, A., Gerendai, I., Pawlikowski, M. and Halász, B. (1982) Unilateral Posterior Deafferentation of Hypothalamus and Mitotic Activity of Thyroid Follicular Cells under Normal Conditions and after Hemithyroidectomy. Endocrinologia Experimentalis, 16, 75-80.

[34]   Gerendai, I. and Halász, B. (2001) Asymmetry of the Neuroendocrine System. Physiology, 16, 92-95.

[35]   Rohil, V., Mishra, A.K., Shrewastwa, M.K., Mehta, K.D., Lamsal, M., Baral, N. and Majhi, S. (2010) Subclinical Hypothyroidism in Eastern Nepal: A Hospital Based Study. Kathmandu University Medical Journal, 8, 231-237.

[36]   Franklyn, J.A., Ramsden, D.B. and Sheppard, M.C. (1985) The Influence of Age and Sex on Tests of Thyroid Function. Annals of Clinical Biochemistry, 22, 502-505.

[37]   Meng, Z., Liu, M., Zhang, Q., Liu, L., Song, K., Tan, J., Jia, Q., Zhang, G., Wang, R., He, Y. and Ren, X. (2015) Gender and Age Impacts on the Association between Thyroid Function and Metabolic Syndrome in Chinese. Medicine, 94, 1-9.