{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:58:11Z","timestamp":1791831491217,"version":"4.3.4"},"reference-count":31,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005888","name":"Medical University of Lodz","doi-asserted-by":"publisher","award":["503\/1-107-03\/503-11-001"],"award-info":[{"award-number":["503\/1-107-03\/503-11-001"]}],"id":[{"id":"10.13039\/501100005888","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Central hypothyroidism is characterized by either decreased TSH or, more commonly, normal TSH. This study aims to check whether this biochemical difference related to the severity of the pituitary disease, metabolic processes and general well-being. Methods: A retrospective analysis was performed on 108 inpatients with hypopituitarism, aged 18\u201380, hospitalized (1 January 2020, through 31 December 2022) in the Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Poland. Hypopituitary patients with central hypothyroidism (n = 90) were divided into two subgroups: patients with TSH below normal ranges (low TSH; n = 52) and patients with TSH in reference ranges (normal TSH; n = 38). Results: Among patients with central hypothyroidism, surgical treatment due to pituitary disease was performed more commonly in those with low TSH than in those with normal TSH (65 vs. 42%, p = 0.010). Expectedly, five pituitary deficiencies were diagnosed more commonly in patients with low TSH than in those with normal TSH (46 vs. 13%, p = 0.001). In a regression analysis, the ACTH concentration was the only independent determinant negatively associated with low TSH (also after limiting the analysis to non-treated patients). Regarding lipid profile, decreased HDL cholesterol occurred more commonly in patients with low TSH vs. normal TSH (44% vs. 23%; p = 0.033), which was also observed after the limitation to non-treated patients (47% vs. 21%; p = 0.013). Conclusions: Low TSH in patients with central hypothyroidism is associated with more advanced pituitary disease and less favorable metabolic profile.<\/jats:p>","DOI":"10.3390\/metabo15020125","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T08:01:19Z","timestamp":1739433679000},"page":"125","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Central Hypothyroidism with Low TSH Compared to Normal TSH Is Associated with More Advanced Pituitary Disease and Less Favorable Metabolic Profile"],"prefix":"10.3390","volume":"15","author":[{"given":"Aleksandra E.","family":"Matusiak","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Medical University of \u0141\u00f3d\u017a, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"},{"name":"Polish Mother\u2019s Memorial Hospital\u2014Research Institute, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7547-6228","authenticated-orcid":false,"given":"Jan","family":"St\u0119pniak","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Medical University of \u0141\u00f3d\u017a, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9113-2804","authenticated-orcid":false,"given":"Krzysztof C.","family":"Lewandowski","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Medical University of \u0141\u00f3d\u017a, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"},{"name":"Faculty of Medicine, Mazovian University in P\u0142ock, D\u0105browskiego 2, 09-402 P\u0142ock, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Lewi\u0144ski","sequence":"additional","affiliation":[{"name":"Polish Mother\u2019s Memorial Hospital\u2014Research Institute, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3045-5669","authenticated-orcid":false,"given":"Ma\u0142gorzata","family":"Karbownik-Lewi\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolic Diseases, Medical University of \u0141\u00f3d\u017a, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"},{"name":"Polish Mother\u2019s Memorial Hospital\u2014Research Institute, Rzgowska 281\/289, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2632","DOI":"10.1016\/S0140-6736(24)00342-8","article-title":"Hypopituitarism","volume":"403","author":"Fleseriu","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1159\/000491388","article-title":"2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism","volume":"7","author":"Persani","year":"2018","journal-title":"Eur. Thyroid. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"R44","DOI":"10.1530\/EC-18-0515","article-title":"The diagnosis and management of central hypothyroidism in 2018","volume":"8","author":"Persani","year":"2019","journal-title":"Endocr. Connect."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Prencipe, N., Marinelli, L., Varaldo, E., Cuboni, D., Berton, A.M., Bioletto, F., Bona, C., Gasco, V., and Grottoli, S. (2023). Isolated anterior pituitary dysfunction in adulthood. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1100007"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.beem.2017.04.003","article-title":"The multiple genetic causes of central hypothyroidism","volume":"31","author":"Persani","year":"2017","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1038\/nrendo.2017.47","article-title":"Central hypothyroidism\u2014A neglected thyroid disorder","volume":"13","author":"Rodari","year":"2017","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3068","DOI":"10.1210\/jc.2012-1616","article-title":"Clinical review: Central hypothyroidism: Pathogenic, diagnostic, and therapeutic challenges","volume":"97","author":"Persani","year":"2012","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3888","DOI":"10.1210\/jc.2016-2118","article-title":"Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Fleseriu","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/B978-0-12-381296-4.00009-9","article-title":"Constitutively active thyrotropin and thyrotropin-releasing hormone receptors and their inverse agonists","volume":"485","author":"Neumann","year":"2010","journal-title":"Methods Enzymol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Matusiak, A.E., St\u0119pniak, J., Lewi\u0144ski, A., and Karbownik-Lewi\u0144ska, M. (2023). Decreased mannan-binding lectin level in adults with hypopituitarism; dependence on appropriate hormone replacement therapies. Front. Immunol., 14.","DOI":"10.3389\/fimmu.2023.1107334"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1530\/EJE-13-0515","article-title":"Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: Evidence for a better outcome independently of other patients\u2019 characteristics","volume":"169","author":"Losa","year":"2013","journal-title":"Eur. J. Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1210\/er.2013-1115","article-title":"Craniopharyngioma","volume":"35","year":"2014","journal-title":"Endocr. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1046\/j.1440-1754.2003.00119.x","article-title":"Evolving hypopituitarism following cranial irradiation","volume":"39","author":"Kanumakala","year":"2003","journal-title":"J. Paediatr. Child Health"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yu, P., Yuan, H., Chen, H., and Li, X. (2024). Thyroid function spectrum in Cushing\u2019s syndrome. BMC Endocr. Disord., 24.","DOI":"10.1186\/s12902-024-01614-4"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1507\/endocrj.EJ15-0337","article-title":"Impact of adult growth hormone deficiency on metabolic profile and cardiovascular risk [Review]","volume":"62","author":"Giovannini","year":"2015","journal-title":"Endocr. J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Chang, Y., Chen, J., Zhu, H., Huang, R., Wu, J., Lin, Y., Li, Q., Shen, G., and Feng, J. (2024). Metabolic Characteristics and Discriminative Diagnosis of Growth Hormone Deficiency and Idiopathic Short Stature in Preadolescents and Adolescents. Molecules, 29.","DOI":"10.3390\/molecules29071661"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"860","DOI":"10.1016\/S0025-6196(12)60694-6","article-title":"Hyperlipidemia in patients with primary and secondary hypothyroidism","volume":"68","author":"Dinneen","year":"1993","journal-title":"Mayo Clin. Proc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.tem.2014.07.001","article-title":"Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism","volume":"25","author":"Sinha","year":"2014","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Duntas, L.H., and Brenta, G. (2018). A Renewed Focus on the Association Between Thyroid Hormones and Lipid Metabolism. Front. Endocrinol., 9.","DOI":"10.3389\/fendo.2018.00511"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Karbownik-Lewi\u0144ska, M., St\u0119pniak, J., and Lewi\u0144ski, A. (2021). Potential Risk Factors for Isolated Hypothyroxinemia in Women of Childbearing Age\u2014Results from Retrospective Analysis. J. Clin. Med., 10.","DOI":"10.3390\/jcm10225384"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yao, J., Zhao, J., Liu, J., Jiang, S., Guo, S., Xu, L., Zhang, X., Sheng, Q., Wang, K., and Liao, L. (2023). The relationships between thyroid functions of short-term rapid hypothyroidism and blood lipid levels in post-thyroidectomy patients of differentiated thyroid cancer. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1114344"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Karbownik-Lewi\u0144ska, M., St\u0119pniak, J., \u017burawska, A., and Lewi\u0144ski, A. (2020). Less favorable lipid profile and higher prevalence of thyroid antibodies in women of reproductive age with high-normal TSH\u2014retrospective study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17062122"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Scarano, E., Riccio, E., Somma, T., Arianna, R., Romano, F., Di Benedetto, E., de Alteriis, G., Colao, A., and Di Somma, C. (2021). Impact of Long-Term Growth Hormone Replacement Therapy on Metabolic and Cardiovascular Parameters in Adult Growth Hormone Deficiency: Comparison Between Adult and Elderly Patients. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.635983"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1530\/EJE-16-0875","article-title":"Seven years of growth hormone (GH) replacement improves quality of life in hypopituitary patients with adult-onset GH deficiency","volume":"176","author":"Elbornsson","year":"2017","journal-title":"Eur. J. Endocrinol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1111\/cen.13059","article-title":"Decreased physical activity, reduced QoL and presence of debilitating fatigue in patients with Addison\u2019s disease","volume":"85","author":"Smans","year":"2016","journal-title":"Clin. Endocrinol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e210128","DOI":"10.1530\/ETJ-21-0128","article-title":"Central hypothyroidism: Are patients undertreated?","volume":"11","author":"Marlier","year":"2022","journal-title":"Eur. Thyroid. J."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Christensen, S.E., Smith, L.N., Rosendal, C.A.H., Gulisano, H.A., Ettrup, K.S., Vestergaard, P., Nielsen, E.H., Karmisholt, J.S., and Dal, J. (2023). The TRH test provides valuable information in the diagnosis of central hypothyroidism in patients with known pituitary disease and low T4 levels. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1226887"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"101752","DOI":"10.1016\/j.beem.2023.101752","article-title":"Pituitary and SARS CoV-2: An unremitting conundrum","volume":"37","author":"Capatina","year":"2023","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1007\/s11102-024-01463-3","article-title":"Hypopituitarism and COVID-19","volume":"27","author":"Carosi","year":"2024","journal-title":"Pituitary"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s11102-016-0718-1","article-title":"IGF-I levels reflect hypopituitarism severity in adults with pituitary dysfunction","volume":"19","author":"Tirosh","year":"2016","journal-title":"Pituitary"},{"key":"ref_31","first-page":"468","article-title":"National Program of Severe Growth Hormone Deficiency Treatment in Adults and Adolescents after Completion of Growth Promoting Therapy","volume":"69","author":"Stawerska","year":"2018","journal-title":"Endokrynol. Polska"}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/15\/2\/125\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:32:56Z","timestamp":1760027576000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/15\/2\/125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,13]]},"references-count":31,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["metabo15020125"],"URL":"https:\/\/doi.org\/10.3390\/metabo15020125","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,13]]}}}