Exploring the Link between Fasting And Postprandial Thyroid Function Tests In Clinical Euthyroidism
DOI:
https://doi.org/10.21649/akemu.v30i4.5678Keywords:
Thyroid function tests, fasting,, postprandial periodAbstract
Background: Thyroid disorders are common but testing is not standardized for time and prandial state. Subclinical hypothyroidism may be underdiagnosed in postprandial samples.
Objective: This study aimed to determine effects of fasting and postprandial state on thyroid function tests (TFTs) in clinically euthyroid patients and to develop a prediction model for fasting TSH if only postprandial levels are available.
Methods: This predictive correlational study conducted in King Edward Medical University in 2021 included 95 clinically euthyroid individuals between 18 and 60 years. After obtaining fasting TFTs, mixed-nutrient 400-500 calorie supervised meal was given. After 2 hours, postprandial TFTs were obtained. Data was analyzed using SPSS- 20.0 keeping significant level at p-value <0.05. Chi-square test, paired sample t-test & one-way ANOVA was used for initial analysis, Pearson product moment correlation and simple linear regression for prediction models.
Results:
The mean age of participants was 27.94±5.90 years with 54(56.84%) being male. Mean Fasting and Postprandial FT3 and FT4 were 4.89±0.99 pmol/L, 4.82±1.05 pmol/L (p= 0.328) & 19.34±4.15, 19.03±3.97 pmol/L (p=0.225) respectively. Fasting (FTSH) and Postprandial TSH (PPTSH) was 1.69±2.34 and 1.48±1.15 mIU/L (p=0.162). Compared to fasting, PPTSH declined in 54(56.8%), rose in 36(37.9%) and remained unchanged in 5(5.3%) cases. There was negative correlation between FTSH and postprandial change (r -0.92, p<0.001) and positive correlation between FTSH & PPTSH (r=0.87, p<0.001). PPTSH predicted FTSH as Fasting TSH = 1.765 PPTSH – 0.923 (p <0.001).
Conclusions:
PPTSH may predict FTSH but FTSH should be preferred especially in patients with strong suspicion of subclinical hypothyroidism
References
Ruddick‐Collins LC, Morgan PJ, Johnstone AM. Mealtime: A circadian disruptor and determinant of energy balance? J. Neurol. 2020;32(7):e12886. DOI: 10.1111/jne.12886
Zhang X, Wang X, Hu H, Qu H, Xu Y, Li Q. Prevalence and trends of thyroid disease among adults, 1999-2018. Endo Prac. 2023;29(11):875-880.
Khan H, Ahmed N. Screening of thyroid disorders in age and gender groups in a teaching hospital of Nowshera. J. Fat Jin Med Uni. 2021;15(1):27-30.
Korkmaz FN, Yilmaz-Oral D, Asker H, Guven B, Turkcan D, Kirlangic OF, et al. Combined levothyroxine and testosterone treatment for restoring erectile dysfunction in propylthiouracil-induced hypothyroid rats. J Sex Med. 2023;20(6):732-741.
Larson-Meyer DE, Gostas DE. Thyroid function and nutrient status in the athlete. Curr Sp Med Rep. 2020;19(2):84-94.
Mammen JS, Cappola AR. Autoimmune thyroid disease in women. Jama. 2021;325(23):2392-3.
Wang Y, Liu C, Liu L, Chen X, Wei L, Liu J, et al.. Association of Elevated Thyroid Stimulating Hormone with Atherosclerotic Cardiovascular Disease and Its Mortality in Elderly Community-Dwelling Chinese. Cl Int Aging. 2022;11(1):39-50.
Cojić M, Cvejanov-Kezunović L. Subclinical Hypothyroidism - Whether and When To Start Treatment? Open Access Maced J Med Sci. 2017;5(7):1042-1046.
Maganha CA, Mattar R, Mesa Júnior CO, Marui S, Solha STG, Teixeira PFDS, et al. Screening, diagnosis and management of hyperthyroidism in pregnancy. Rev Bras Ginecol Obstet. 2022;44(8):806-818.
Futela, D, Maheswari K, Khanna T. Fasting versus postprandial state: Impact on thyroid function testing. Thyroid Res Prac. 2021;18(2):61-66.
Bukhari SI, Ali G, Memom MY, Sandeelo N, Alvi H, Talib A, et al. Prevalence and predictors of thyroid dysfunction amongst patients with Type 2 diabetes mellitus in Pakistan. J Fam Med Prim Care. 2022;11(6):2739-43.
Rayman MP. Multiple nutritional factors and thyroid disease, with particular reference to autoimmune thyroid disease. Proc Nutr Soc. 2019;78(1):34-44.
Wang D, Yin Y, Yu S, Li H, Cheng X, Qiu L. Effect of sampling time on estimates of thyroid-stimulating hormone, free thyroxine, and free triiodothyronine levels. Scan J Cli Lab Inv. 2019;79(7):459-62.
Laclaustra M, Moreno-Franco B, Lou-Bonafonte JM, Mateo-Gallego R, Casasnovas JA, Guallar-Castillon P, et al. Impaired Sensitivity to Thyroid Hormones Is Associated With Diabetes and Metabolic Syndrome. Diabetes Care. 2019;42(2):303-10.
Khan S, Siddique R, Liu Y, Yong VW, Xue M. Towards improving the prognosis of stroke through targeting the circadian clock system. Int J Biol Sci. 2024;20(2):403-13.
Müller-Fielitz H, Schwaninger M. The Role of Tanycytes in the Hypothalamus-Pituitary-Thyroid Axis and the Possibilities for Their Genetic Manipulation. Exp Clin Endo Diab. 2020;128(6-07):388-394.
Heo J, Suh YL, Kim SH, Kong DS, Nam DH, Lee WJ, et al. Clinical Characteristics, Diagnosis, and Treatment of Thyroid Stimulating Hormone-Secreting Pituitary Neuroendocrine Tumor (TSH PitNET): A Single-Center Experience. Endocrinol Met. 2024;39(2):387-396.
Andersen MR, Suppli MP, Bagger JI, Christensen MB, Yosten GLC, Knop FK, et al. MECHANISMS IN ENDOCRINOLOGY: The physiology of neuronostatin. Eur J Endocrinol. 2021;185(4):93-101
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Annals of King Edward Medical University
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk