Document Detail


Variability in thyroid-stimulating hormone suppression by human chorionic [corrected] gonadotropin during early pregnancy.
MedLine Citation:
PMID:  18544616     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The objective of the study was to further explore relationships between human chorionic gonadotropin (hCG), TSH, and free T4 in pregnant women at 11 through 18 wk gestation. STUDY DESIGN: The design of the study was to analyze hCG in comparison with TSH and free T4, in paired first- and second-trimester sera from 9562 women in the First and Second Trimester Evaluation of Risk for Fetal Aneuploidy trial study. RESULTS: hCG is strongly correlated with body mass index, smoking, and gravidity. Correlations with selected maternal covariates also exist for TSH and free T4. As hCG deciles increase, body mass index and percent of women who smoke both decrease, whereas the percent of primigravid women increases (P < 0.0001). hCG/TSH correlations are weak in both trimesters (r2 = 0.03 and r2 = 0.02). TSH concentrations at the 25th and fifth centiles become sharply lower at higher hCG levels, whereas 50th centile and above TSH concentrations are only slightly lower. hCG/free T4 correlations are weak in both trimesters (r2 = 0.06 and r2 = 0.003). At 11-13 wk gestation, free T4 concentrations rise uniformly at all centiles, as hCG increases (test for trend, P < 0.0001), but not at 15-18 wk gestation. Multivariate analyses with TSH and free T4 as dependent variables and selected maternal covariates and hCG as independent variables do not alter these observations. CONCLUSIONS: In early pregnancy, a woman's centile TSH level appears to determine susceptibility to the TSH being suppressed at any given hCG level, suggesting that hCG itself may be the primary analyte responsible for stimulating the thyroid gland. hCG affects lower centile TSH values disproportionately.
Authors:
James E Haddow; Monica R McClain; Geralyn Lambert-Messerlian; Glenn E Palomaki; Jacob A Canick; Jane Cleary-Goldman; Fergal D Malone; T Flint Porter; David A Nyberg; Peter Bernstein; Mary E D'Alton;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural     Date:  2008-06-10
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  93     ISSN:  0021-972X     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-09-05     Completed Date:  2008-10-09     Revised Date:  2010-09-21    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3341-7     Citation Subset:  AIM; IM    
Affiliation:
The Warren Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA. jhaddow@ipmms.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Chorionic Gonadotropin / blood,  metabolism,  physiology*
Cohort Studies
Female
Humans
Pregnancy
Pregnancy Trimester, First / blood*,  metabolism
Pregnancy Trimester, Second / blood*,  metabolism
Thyrotropin / antagonists & inhibitors*,  blood,  metabolism
Thyroxine / blood
Grant Support
ID/Acronym/Agency:
R01 HD 38652/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Chorionic Gonadotropin; 7488-70-2/Thyroxine; 9002-71-5/Thyrotropin
Investigator
Investigator/Affiliation:
K Welch / ; R Denchy / ; R Ball / ; M Belfort / ; B Oshiro / ; L Cannon / ; K Nelson / ; C Loucks / ; A Yoshimura / ; D Luthy / ; S Coe / ; C Comstock / ; J Esler / ; R Bukowski / ; G Hankins / ; G Saade / ; J Lee / ; R Berkowitz / ; K Eddleman / ; Y Kharbutli / ; I Merkatz / ; S Carter / ; L Dugoff / ; J Hobbins / ; L Schultz / ; I Timor-Tritsch / ; M Paidas / ; J Borsuk / ; S Craigo / ; D Bianchi / ; B Isquith / ; B Berlin / ; S Carr / ; C Duquette / ; H Wolfe / ; R Baughman / ; J Hanson / ; F de la Cruz / ; K Dukes / ; T Tripp / ; D Emig / ; L Sullivan /
Comments/Corrections
Comment In:
J Clin Endocrinol Metab. 2008 Sep;93(9):3305-6   [PMID:  18772462 ]
Erratum In:
J Clin Endocrinol Metab. 2008 Nov;93(11):4552

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