Thyroid-Stimulating Hormone as a Biomarker for Stress After Thyroid Surgery: A Prospective Cohort Study
- 주제(키워드) Stress , Thyroid-Stimulating Hormon , Thyroidectomy , Thyroid Neoplasms
- 주제(DDC) 610
- 발행기관 아주대학교 일반대학원
- 지도교수 Soo Young Kim
- 발행년도 2024
- 학위수여년월 2024. 2
- 학위명 박사
- 학과 및 전공 일반대학원 의학과
- 실제URI http://www.dcollection.net/handler/ajou/000000033522
- 본문언어 한국어
- 저작권 아주대학교 논문은 저작권에 의해 보호받습니다.
초록/요약
Background: Thyroid-stimulating hormone (TSH), which is regulated by the negative feedback of triiodothyronine (T3) and thyroxine (T4), is affected by cortisol (a stress hormone) and cytokines during allostasis. Thus, we assessed changes in TSH levels under stress and its potential as a stress marker inpatients lacking T3 or T4 feedback after thyroid surgery. Material/Methods: Three stress questionnaires (Korean version of the Daily Stress Inventory, Social Readjustment Rating Scale,and Stress Overload Scale-Short [SOSS]), an open-ended questionnaire (OQ), and thyroid function tests were administered twice to 106 patients enrolled from January 2019 to October 2020. Results: In a multiple generalized linear mixed-effect model (GLMM) involving 106 patients, the T3 and free T4 levels,OQ, body weight, extent of thyroidectomy, and preoperative TSH levels were significantly correlated with log- transformed TSH (lnTSH). The modified SOSS (category) based on recent stressors on OQ interview was significantly associated with lnTSH. In the GLMM with modified SOSS (category), the lnTSH increased by 2.3 and 0.56 in the unconscious high- and high-risk group s, respectively, compared to that in the low-risk group (P<0.05). The calculated power of this study was 0.92 based on a=0.05. Conclusions: TSH had a significant relationship with stress and the extent of thyroidectomy. An OQ supported the SOSS to help detect unrecognized stressors. TSH has potential utility as a stress marker combined with the modified SOSS (category) with sufficient power. However, questionnaires on social environments and research on coping strategies for stress are necessary for future studies. Keywords: •Stress •Thyroid-Stimulating Hormon • Thyroidectomy • Thyroid Neoplasms
more목차
Ⅰ.Background 1
Ⅱ.Material and Methods 4
Ⅲ.Results 10
Ⅳ.Discussion 21
Ⅴ.Conclusions 27
References 29
