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Thyroid Prostate Axis. Does It Really Exist?
| Content Provider | Semantic Scholar |
|---|---|
| Author | Vignera, Sandro La Condorelli, Rosita Angela Cannarella, Rossella Calogero, Aldo Eugenio |
| Copyright Year | 2019 |
| Abstract | Relationships between Thyroid Hormone Levels and Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia” [1] published in The World Journal of Men’s Health. We thank the authors for citing one of our references in the selected bibliography [2] and we take the opportunity to comment this article with its possible effects on clinical practice and suggest an original point of view for the interpretation of these data. The authors demonstrated the existence of a relationship between some functional prostatic parameters and serum concentrations of free thyroxine (FT4). Measurement of thyroid stimulating hormone (TSH) levels, does not correlate with the parameters examined. The authors showed an increase in the percentage of patients with international prostatic symptoms score (IPSS) >7, maximal flow rate (peak urinary flow) <10 mL/s and total prostate volume (TVP) >30 mL among patients with FT4 levels in the highest quartile. The relationship between FT4 and TVP levels is maintained only in patients with high testosterone levels (>5.06 ng/mL). The results of this study justify the hypothesis of a functional involvement of thyroid hormones in the pathogenesis of prostatic hyperplasia, as previously reported in other studies [3,4]. In the discussion, a series of potential mechanisms concerning the connections between thyroid hormones and cancer have been analyzed, underlining the stimulating action of thyroid hormones on some functional systems involved in glandular proliferation (phosphatidylinositol-3-kinase; hypoxia-inducible factor 1; αVß3; ERK1/2; fibroblast growth factor 2; mitogen-activated protein kinase), in addition to the slight hyperestrogenism favored by the increase in levels of thyroid hormones, which represents a further stimulus of prostatic glandular proliferation. We share the hypotheses of mechanism advanced by the authors and we believe that this evidence could contribute to suggest pharmacological improvements for the treatment of prostatic hyperplasia, however we report briefly our clinical experience (unpublished data) which serves as a possible further explanation of these results. In our experience (Fig. 1) we evaluated the differences on prostate volume and severity of lower urinary tract symptoms (LUTS) between patients with subclinical hypertirodism (n=35; TSH levels <0.4 mU/L and normal serum concentrations of FT4 and FT3) and patients with subclinical hypothyroidism (n=40; TSH levels >4 mU/L and normal serum concentrations of FT4 and FT3). There are no statistically significant differences regarding TVP but patients with TSH levels <0.4 mIU/L showed a significant worsening of the LUTS |
| Starting Page | 257 |
| Ending Page | 260 |
| Page Count | 4 |
| File Format | PDF HTM / HTML |
| DOI | 10.5534/wjmh.190060 |
| PubMed reference number | 31190488 |
| Journal | Medline |
| Volume Number | 37 |
| Alternate Webpage(s) | https://synapse.koreamed.org/Synapse/Data/PDFData/2074WJMH/wjmh-37-257.pdf |
| Alternate Webpage(s) | https://doi.org/10.5534/wjmh.190060 |
| Journal | The world journal of men's health |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
