1
|
王 科, 李 海, 邓 新, 闫 双, 裘 宇, 丛 玉. [A multi-center analysis of thyroid-stimulating hormone level in apparently healthy elderly population in China]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2023; 43:1-7. [PMID: 36856204 PMCID: PMC9978719 DOI: 10.12122/j.issn.1673-4254.2023.01.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To investigate serum thyroid stimulating hormone (TSH) level and its changes with age in apparently healthy Chinese elderly population and analyze the differences between TSH levels detected using Roche and Snibe electrochemiluminescence immunoassay analyzers. METHODS General clinical data and frozen fasting serum samples were collected from 5451 apparently healthy Chinese elderly individuals (> 60 years) from 10 centers in different geographic regions in China. Thyroid function indexes including TSH level were detected using Roche and Snibe electrochemiluminescence immunoassay analyzer, and the median (2.5% and 97.5% quantiles) TSH level was calculated. The variations of TSH level among the participants with geographic regions, gender, and age (with an interval of 5 years) were analyzed to determine the influence of these factors on TSH level. RESULTS The reference ranges of serum TSH level established using Roche and Snibe electrochemiluminescence immunoassay analyzers were 0.42-9.47 mU/L and 0.36-7.98 mU/L, respectively, showing significant differences between the two methods (P < 0.001). The TSH levels measured at two centers in Western China were significantly higher than those at the other centers (P < 0.05). In elderly male population, serum TSH level tended to increase with age, which was not observed in elderly female population. At the age of 60-75 years, women generally had higher serum TSH level than men, but this difference was not observed in the population beyond 75 years. CONCLUSION In elderly population, serum TSH level can vary with geographic region, gender, and age, but there was no need for establishing specific reference ranges for these factors. The differences between different detection methods should be evaluated when interpreting the detection results of TSH level.
Collapse
Affiliation(s)
- 科宇 王
- 解放军总医院第二医学中心检验科//国家老年疾病临床研究中心,北京 100853Department of Clinical Laboratory, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - 海侠 李
- 南方医科大学南方医院检验科,广东 广州 510515Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 新立 邓
- 解放军总医院第二医学中心检验科//国家老年疾病临床研究中心,北京 100853Department of Clinical Laboratory, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - 双通 闫
- 解放军总医院第二医学中心内分泌科//国家老年疾病临床研究中心,北京 100853Department of Endocrinology, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - 宇容 裘
- 南方医科大学南方医院检验科,广东 广州 510515Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - 玉隆 丛
- 解放军总医院第二医学中心检验科//国家老年疾病临床研究中心,北京 100853Department of Clinical Laboratory, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| |
Collapse
|
2
|
Xie T, Su M, Feng J, Pan X, Wang C, Tang T. The reference intervals for thyroid hormones: A four year investigation in Chinese population. Front Endocrinol (Lausanne) 2023; 13:1046381. [PMID: 36686466 PMCID: PMC9852975 DOI: 10.3389/fendo.2022.1046381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction The reference intervals (RIs) are of great importance for physicans to determine whether or not an individual is healthy. However, many clinical laboratories in China still adopted the default RI provided by the manufacturers; and these "uncalibrated" RIs might lead to the misdiagnosis of diseases. In the present study, we enroll reference people with the purpose of determining the RIs of serum triiodothyronine (T3), thyroxine (T4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) in Chinese population, and explore the possible roles of age and sex on the levels of biomarkers. Methods Serum samples from 66,609 individuals who met the inclusion criteria were analyzed using an Roche Cobas E 601 hormone analyzer. The dynamic trends of biomarker were visually assessed by their concentrations over age and sex. Specific partitions were determined by the method of Harris and Boyd. RIs, corresponding to the 2.5th and 97.5th percentiles, as well as the 0.5th, 25th, 50th, 75th and 99.5th percentiles were calculated for each reference partition using a non-parametric rank approach. Results The serum level of T3, T4, FT4 or TSH showed a right-skewed distribution in both males and females while FT3 presented an approximate normal distribution. Females had a higher mode value of serum T3 or T4, but a lower mode value of serum TSH, FT3 or FT4. All five biomarkers did not need age partitioning according to the approach of harris and boyd, while T3 and FT3 need sex partitioning. Conclusions The present study not only determined the age- and sex-specific trends of the five thyroid hormones, but provided sex-stratified RIs for T3 and FT3, valuably contributing to the current literature and timely evaluation of thyroid health and disease.
Collapse
Affiliation(s)
- Tiancheng Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mingchuan Su
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Feng
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoying Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chuan Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| | - Tian Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
- West China-PUMC C.C. Chen Institute of Health, Sichuan University, Chengdu, Sichuan, China
| |
Collapse
|
3
|
Ma C, Zhong J, Zou Y, Liu Z, Li H, Pang J, Liu X, Zejipuchi, Tian L, Hou L, Wang D, Cheng X, Qiu L. Establishment of Reference Intervals for Thyroid-Associated Hormones Using refineR Algorithm in Chinese Population at High-Altitude Areas. Front Endocrinol (Lausanne) 2022; 13:816970. [PMID: 35222276 PMCID: PMC8874314 DOI: 10.3389/fendo.2022.816970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/04/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Diagnosis of thyroid disease among individuals dwelling at high altitude remains a challenge. Reference intervals (RIs) for thyroid-associated hormones among Tibetans living at various high altitudes were established to improve diagnosis. Methods One thousand two hundred eighty-one subjects were randomly recruited from Nyingchi, Shigatse/Lhasa, and Ali of Tibet. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were measured by the Cobas e601 electrochemiluminescence analyzer. We used multiple linear regression and variance component analysis to assess the effect of sex, age, and altitude on hormones. RIs were established by refineR algorithm and compared with those provided by the manufacturer. Results Serum TSH was significantly lower in males than in females, while FT3 and FT4 were higher in males. Both FT3 and FT4 decreased with increasing age. FT3 increased with altitude, while TSH and FT4 were less influenced by altitude. The RI for TSH was 0.764–5.784 μIU/ml, while for FT4, the RIs were 12.36–19.38 pmol/L in females and 14.84–20.18 pmol/L in males. The RIs for FT3 at Nyingchi, Shigatse/Lhasa, and Ali in females were 4.09–4.98, 4.31–5.45, and 4.82–5.58 pmol/L, while in males, the values were 4.82–5.41, 4.88–5.95, and 5.26–6.06 pmol/L, respectively. The obtained RIs for TSH and FT4 were generally higher, while that for FT3 was narrower than the RIs provided by Cobas. Conclusions Specific RIs were established for thyroid-associated hormones among Tibetans, which were significantly different from those provided by the manufacturer.
Collapse
|
4
|
Yao C, Wu M, Liu M, Chen X, Zhu H, Xiong C, Wang D, Xiang Y, Suo G, Wang J, Sun H, Yuan C, Xia Y. Age- and sex-specific reference intervals for thyroid hormones in a Chinese pediatrics: a prospective observational study of 1,279 healthy children. Transl Pediatr 2021; 10:2479-2488. [PMID: 34765471 PMCID: PMC8578761 DOI: 10.21037/tp-21-389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/16/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Thyroid hormones are essential for early neurocognitive development and growth and development in childhood and adolescence. However, the reference intervals (RIs) for thyroid hormones in Chinese pediatric individuals remain unclear. This study aimed to establish thyroid hormone RIs for a Chinese pediatric population according to appropriate age- and sex-specific partitioning. METHODS In this prospective observational study, a total of 1,279 healthy children (singletons, aged from 1 day to 12 years) were recruited, and serum samples were analyzed on a Mindray automated chemiluminescence immunoassay analyzer CL-6000i for thyroid hormone detection, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (T3), and total thyroxine (T4). Age and sex-specific RIs were established, and the corresponding 95% confidence intervals (CIs) were calculated in accordance with the Clinical Laboratory Standards Institute (CLSI) document C28-A3 guidelines. RESULTS Quantile testing revealed that the median (P50) and RIs [2.5th percentile (P2.5)-97.5th percentile (P97.5)] for TSH, FT3, T3, and T4 of males differed significantly from those of females (P<0.05), except for FT4 (P=0.483). For FT3 and T3, the RIs of males were higher than that of females, and the RI of T4 for males was narrower and higher than that of females [P2.5-P97.5: 72.33-171.60 vs. 72.31-176.27 nmol/L; P50: 116.75 vs. 113.47 nmol/L, P=0.011]. RIs for TSH, FT3, FT4, T3, and T4 showed sex- and age-specific properties and displayed a wide variation during the first month of life but gradually narrowed and concentrated with increasing age. In addition, RIs of TSH, FT3, FT4, and T3 in males differed significantly from females in the first month of life (TSH: 1.46-10.87 vs. 1.08-11.35 mIU/L; FT3: 2.96-7.08 vs. 2.35-7.27 pmol/L, FT4: 13.34-28.65 vs. 13.82-31.83 pmol/L; T3: 0.83-2.33 vs. 0.72-2.46 nmol/L). The RI of T4 also exhibited a difference between males and females in the 9- to 12-year age group (59.31-150.72 vs. 63.29-146.94 pmol/L for males and females, respectively). CONCLUSIONS Pediatric RIs of thyroid hormones display age- and sex-specific trends. The RIs established in this study will improve the accuracy of TSH assay result interpretations and clinical decision-making in clinical laboratories that utilize the Mindray analytical platform.
Collapse
Affiliation(s)
- Cong Yao
- Health Care Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Mo Wu
- Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Mei Liu
- Department of Laboratory Medicine, Wuhan Hankou Hospital, Wuhan, China
| | - Xiaoqian Chen
- Department of Endocrinology, Genetics & Metabolism, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Hongmin Zhu
- Department of Neurology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Chen Xiong
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China
| | - Dan Wang
- Department of Neonatology, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yun Xiang
- Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Guori Suo
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China
| | - Jun Wang
- Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Hong Sun
- Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Chunhui Yuan
- Department of Laboratory Medicine, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Yong Xia
- Clinical Medical Laboratory, Peking University Shenzhen Hospital, Shenzhen, China
| |
Collapse
|
5
|
Li ZZ, Yu BZ, Wang JL, Yang Q, Ming J, Tang YR. Reference intervals for thyroid-stimulating hormone and thyroid hormones using the access TSH 3rd IS method in China. J Clin Lab Anal 2020; 34:e23197. [PMID: 31912542 PMCID: PMC7246370 DOI: 10.1002/jcla.23197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/16/2019] [Accepted: 12/18/2019] [Indexed: 11/09/2022] Open
Abstract
Background To calculate the reference intervals for thyroid‐stimulating hormone (TSH) and thyroid hormones using the Access TSH 3rd IS method and evaluate the differences between age and genders in Chinese populations. Methods This study collected 349 serum samples of healthy subjects were from Shengli Oilfield Central Hospital in China. Subjects who tested positive for thyroid peroxidase antibody or thyroglobulin antibody were excluded. Accordingly, 313 subjects were included for establishing reference intervals for the thyroid hormones. The serum concentrations of TSH, total and free thyroxine (TT4 and FT4), and total and free triiodothyronine (TT3 and FT3) were measured using the Access TSH 3rd IS method. The 2.5th and 97.5th percentiles or mean with standard deviation were calculated as the reference interval as appropriate. Results The reference intervals for TSH, FT4, FT3, TT4, and TT3 calculated in present study were 0.61‐4.16 mIU/L, 0.67‐1.11 ng/dL, 2.63‐4.33 pg/mL, 5.56‐11.33 μg/dL, and 0.72‐1.32 ng/mL, respectively. The FT3, TT4, and TT3 levels in males were significantly higher than in females (P < .05), while TSH levels in males were significantly lower than in females (P < .05). The levels of FT3 in subjects with the age of less than 30 years were significantly higher than other groups (P < .05). Conclusion The present study provided a valid basis for the reference intervals for TSH, FT4, FT3, TT4, and TT3 in Chinese populations. In addition, this present study indicated that age and gender should be considered in diagnostic evaluation of thyroid diseases.
Collapse
Affiliation(s)
- Zhen-Zhen Li
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| | - Ben-Zhang Yu
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| | - Ji-Liang Wang
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| | - Qin Yang
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| | - Jia Ming
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| | - Yu-Rong Tang
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China
| |
Collapse
|