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Influence of Body Surface Area on Serum Peak Thyrotropin (TSH) Levels after Recombinant Human TSH Administration

Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica (G.V., G.A.L., A.C., M.R.F., F.F., A.P., G.L.), Dipartimento di Medicina Clinica, Scienze Cardiovascolari ed Immunologiche (A.L.), Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli "Federico II", 80127 Napoli, Italy

Address all correspondence and requests for reprints to: Prof. Giovanni Lupoli, Dipartimento di Endocrinologia ed Oncologia Molecolare e Clinica, Università degli Studi di Napoli "Federico II", Via Tasso 113, 80127 Naples, Italy. E-mail: lupoli{at}unina.it or gelsyl{at}hotmail.com.

Recombinant human TSH (rhTSH) has been proposed as an alternative method to the withdrawal of thyroid hormones in the follow-up of differentiated thyroid cancer. The aim of the present study was to evaluate the influence of several demographic and anthropometric parameters [age, body weight, height, body mass index, and body surface area (BSA)] on serum peak TSH levels after rhTSH administration.

rhTSH was administered to 112 patients with differentiated thyroid carcinoma according to the conventional two-dose schedule (0.9 mg/d). Serum TSH levels were measured 24 h before and after the first administration of rhTSH, and then 24, 48, and 72 h after the second administration of rhTSH.

In one severely obese patient, serum peak TSH values did not reach a valid stimulation range. Serum peak TSH levels were negatively related to body weight (r = -0.69; P < 0.0001), body mass index (r = -0.51; P < 0.0001), and BSA (r = -0.72; P < 0.0001). In a multivariate regression analysis including demographic and anthropometric variables, only BSA was independently associated to serum peak TSH concentrations (standardized ß coefficient = -0.721; P < 0.0001).

In conclusion, body size seems to influence serum peak TSH levels after rhTSH administration. Future studies should evaluate the possibility of using personalized rhTSH doses, adjusted in relation to BSA.

Abbreviations: BMI, Body mass index; BSA, body surface area; rhTSH, recombinant human TSH.

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