Skip to main content
Erschienen in: Journal of Endocrinological Investigation 8/2018

01.08.2018 | Original Article

Reference intervals for thyrotropin in an area of Northern Italy: the Pordenone thyroid study (TRIPP)

verfasst von: R. Tozzoli, F. D’Aurizio, P. Metus, A. Steffan, C. Mazzon, M. Bagnasco

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 8/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Thyrotropin (TSH) is the most accurate marker of thyroid dysfunction in the absence of pituitary or hypothalamic disease. Studies on TSH reference intervals (RIs) showed wide inter-individual variability and prompted an intense debate about the best estimation of TSH RIs.

Design

We performed a population study on TSH RIs, using current data stored in the laboratory information system (LIS), at the Hospital Department of Laboratory Medicine, Pordenone (Italy), historically an area of mild–moderate iodine deficiency with a relatively high goiter prevalence.

Methods

136,650 individuals constituted the final sample. A TSH immunoassay was performed on fasting serum samples with the Dimension Vista 1500 analyzer (Siemens Healthineers). We adopted the Kairisto’s procedure to analyze TSH data downloaded by the LIS, applying the indirect strategy for deriving RIs.

Results

TSH RIs of the entire population were 0.32–3.36 mIU/L with a distribution skewed towards higher values. RIs were 0.26–3.61 mIU/L for females, and 0.32–3.01 mIU/L for males. Unlike other studies, TSH median levels progressively decreased from 0–4 to 85–104 years in the overall population, both in male and in female subgroups, showing an inverse correlation between TSH and age in all groups.

Conclusions

This study is the first to analyze a high percentage (40%) of individuals from an ethnically homogenous Caucasian population. The results obtained emphasize the opportunity to define the TSH RIs according to age, gender and race, in addition to assay methods, and provide further insight about the possible role of iodine status.
Literatur
3.
Zurück zum Zitat Vanderpump MP, Turnbridge WM, French JM et al (1995) The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol 43:55–68CrossRef Vanderpump MP, Turnbridge WM, French JM et al (1995) The incidence of thyroid disorders in the community: a twenty-year follow-up of the Whickham survey. Clin Endocrinol 43:55–68CrossRef
4.
Zurück zum Zitat Knudsen N, Jörgensen T, Rasmussen S et al (1999) The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol 51:361–367CrossRef Knudsen N, Jörgensen T, Rasmussen S et al (1999) The prevalence of thyroid dysfunction in a population with borderline iodine deficiency. Clin Endocrinol 51:361–367CrossRef
5.
Zurück zum Zitat Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado thyroid disease prevalence study. Arch Intern Med 160:526–534CrossRefPubMed Canaris GJ, Manowitz NR, Mayor G, Ridgway EC (2000) The Colorado thyroid disease prevalence study. Arch Intern Med 160:526–534CrossRefPubMed
6.
Zurück zum Zitat Bjoro T, Holmen J, Kruger O et al (2000) Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large unselected population: the Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol 143:639–664CrossRefPubMed Bjoro T, Holmen J, Kruger O et al (2000) Prevalence of thyroid disease, thyroid dysfunction and thyroid peroxidase antibodies in a large unselected population: the Health Study of Nord-Trondelag (HUNT). Eur J Endocrinol 143:639–664CrossRefPubMed
12.
Zurück zum Zitat CLSI (2010) Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline. 3rd ed. vol 28. CLSI document EP28-A3c. Wayne, PA, pp 1–59 CLSI (2010) Defining, establishing, and verifying reference intervals in the clinical laboratory; approved guideline. 3rd ed. vol 28. CLSI document EP28-A3c. Wayne, PA, pp 1–59
14.
Zurück zum Zitat Demers LM, Spencer CA (2003) Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 13:3–126CrossRefPubMed Demers LM, Spencer CA (2003) Laboratory support for the diagnosis and monitoring of thyroid disease. Thyroid 13:3–126CrossRefPubMed
16.
Zurück zum Zitat Takeda K, Mishiba M, Sugiura H et al (2009) Evaluated reference intervals for serum free thyroxine and thyrotropin using the conventional outliner rejection test without regard to presence of thyroid antibodies and prevalence of thyroid dysfunction in Japanese subjects. Endocr J 56:1059–1066CrossRefPubMed Takeda K, Mishiba M, Sugiura H et al (2009) Evaluated reference intervals for serum free thyroxine and thyrotropin using the conventional outliner rejection test without regard to presence of thyroid antibodies and prevalence of thyroid dysfunction in Japanese subjects. Endocr J 56:1059–1066CrossRefPubMed
17.
Zurück zum Zitat Rosario PW, Xavier ACM, Calsolari MR (2010) TSH reference values for adult Brazilian population. Arq Bras Endocrinol Metab 54:603–606CrossRef Rosario PW, Xavier ACM, Calsolari MR (2010) TSH reference values for adult Brazilian population. Arq Bras Endocrinol Metab 54:603–606CrossRef
19.
Zurück zum Zitat Li C, Guan H, Teng X et al (2011) An epidemiological study of the serum thyrotropin reference range and factors that influence serum thyrotropin levels in iodine sufficient areas of China. Endocr J 58:995–1002CrossRefPubMed Li C, Guan H, Teng X et al (2011) An epidemiological study of the serum thyrotropin reference range and factors that influence serum thyrotropin levels in iodine sufficient areas of China. Endocr J 58:995–1002CrossRefPubMed
20.
Zurück zum Zitat Yoshihara A, Yoshimura Noh J, Ohye H et al (2011) Reference limits for serum thyrotropin in a Japanese population. Endocr J 58:585–588CrossRefPubMed Yoshihara A, Yoshimura Noh J, Ohye H et al (2011) Reference limits for serum thyrotropin in a Japanese population. Endocr J 58:585–588CrossRefPubMed
28.
Zurück zum Zitat Inal TC, Serteser M, Coskun A et al (2010) Indirect reference intervals estimated form hospitalized population for thyrotropin and free thyroxine. Croat Med J 51:124–130CrossRefPubMedPubMedCentral Inal TC, Serteser M, Coskun A et al (2010) Indirect reference intervals estimated form hospitalized population for thyrotropin and free thyroxine. Croat Med J 51:124–130CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Wang Y, Zhang Y, Zhou Y, Xia J (2017) Establishment of reference intervals for serum thyroid-stimulating hormone, free and total thyroxine, and free and total triiodothyronine for the Beckman Coulter Dxl-800 analyzers by indirect method using data obtained from Chinese population in Zhejiang province, China. J Clin Lab Anal. https://doi.org/10.1002/jcla.22069 CrossRefPubMedPubMedCentral Wang Y, Zhang Y, Zhou Y, Xia J (2017) Establishment of reference intervals for serum thyroid-stimulating hormone, free and total thyroxine, and free and total triiodothyronine for the Beckman Coulter Dxl-800 analyzers by indirect method using data obtained from Chinese population in Zhejiang province, China. J Clin Lab Anal. https://​doi.​org/​10.​1002/​jcla.​22069 CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Kairisto V, Poola A (1995) Software for illustrative presentation of basic clinical characteristics of laboratory tests: GraphROC for Windows. Scand J Clin Lab Invest 55(suppl222):43–60CrossRef Kairisto V, Poola A (1995) Software for illustrative presentation of basic clinical characteristics of laboratory tests: GraphROC for Windows. Scand J Clin Lab Invest 55(suppl222):43–60CrossRef
45.
Zurück zum Zitat Romero-Villareal JB, Palacios-Saucedo GC, Ocana-Hernandez LA et al (2014) Reference intervals for total triiodothyronine (TT3), free thyroxine (FT4) and thyrotropin (TSH) by chemiluminescence immunoassay in children younger than six years old from northeastern Mexico. Gac Med Mex 150(suppl2):248–254 Romero-Villareal JB, Palacios-Saucedo GC, Ocana-Hernandez LA et al (2014) Reference intervals for total triiodothyronine (TT3), free thyroxine (FT4) and thyrotropin (TSH) by chemiluminescence immunoassay in children younger than six years old from northeastern Mexico. Gac Med Mex 150(suppl2):248–254
51.
Zurück zum Zitat Pearce SHS, Brabant G, Duntas LH et al (2013) 2013 ETA guideline: management of subclinical hypothyroidism. Eur J Thyroid 2:215–228CrossRef Pearce SHS, Brabant G, Duntas LH et al (2013) 2013 ETA guideline: management of subclinical hypothyroidism. Eur J Thyroid 2:215–228CrossRef
52.
53.
Zurück zum Zitat Kussmaul T, Greiser KH, Haerting J et al (2014) Thyroid analytes TSH, FT3, FT4, in serum of healthy elderly subjects as measured by the Roche Modular system: do we need age and gender dependent reference levels? Clin Lab 60:1551–1559CrossRefPubMed Kussmaul T, Greiser KH, Haerting J et al (2014) Thyroid analytes TSH, FT3, FT4, in serum of healthy elderly subjects as measured by the Roche Modular system: do we need age and gender dependent reference levels? Clin Lab 60:1551–1559CrossRefPubMed
54.
Zurück zum Zitat Knudsen N, Bulow I, Jorgensen T et al (2000) Comparative study of thyroid function and types of thyroid dysfunction in two areas of Denmark with slightly different iodine status. Eur J Endocrinol 143:485–491CrossRefPubMed Knudsen N, Bulow I, Jorgensen T et al (2000) Comparative study of thyroid function and types of thyroid dysfunction in two areas of Denmark with slightly different iodine status. Eur J Endocrinol 143:485–491CrossRefPubMed
61.
Zurück zum Zitat Itterman T, Khattak RM, Nauck M et al (2015) Shift of TSH reference range with improved iodine supply in Northeast Germany. Eur J Endocrinol 172:261–267CrossRef Itterman T, Khattak RM, Nauck M et al (2015) Shift of TSH reference range with improved iodine supply in Northeast Germany. Eur J Endocrinol 172:261–267CrossRef
63.
Zurück zum Zitat Mian C, Vitaliano P, Pozza D et al (2009) Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol 70:776–780CrossRef Mian C, Vitaliano P, Pozza D et al (2009) Iodine status in pregnancy: role of dietary habits and geographical origin. Clin Endocrinol 70:776–780CrossRef
64.
Zurück zum Zitat Magri F, Zerbini F, Gaiti M et al (2017) Migration flows affect women’s dietary iodine intake and jeopardize their iodine sufficiency: a pilot study. Endocrine 56:205–207CrossRefPubMed Magri F, Zerbini F, Gaiti M et al (2017) Migration flows affect women’s dietary iodine intake and jeopardize their iodine sufficiency: a pilot study. Endocrine 56:205–207CrossRefPubMed
Metadaten
Titel
Reference intervals for thyrotropin in an area of Northern Italy: the Pordenone thyroid study (TRIPP)
verfasst von
R. Tozzoli
F. D’Aurizio
P. Metus
A. Steffan
C. Mazzon
M. Bagnasco
Publikationsdatum
01.08.2018
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 8/2018
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-018-0825-0

Weitere Artikel der Ausgabe 8/2018

Journal of Endocrinological Investigation 8/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Bei seelischem Stress sind Checkpoint-Hemmer weniger wirksam

03.06.2024 NSCLC Nachrichten

Wie stark Menschen mit fortgeschrittenem NSCLC von einer Therapie mit Immun-Checkpoint-Hemmern profitieren, hängt offenbar auch davon ab, wie sehr die Diagnose ihre psychische Verfassung erschüttert

Antikörper mobilisiert Neutrophile gegen Krebs

03.06.2024 Onkologische Immuntherapie Nachrichten

Ein bispezifischer Antikörper formiert gezielt eine Armee neutrophiler Granulozyten gegen Krebszellen. An den Antikörper gekoppeltes TNF-alpha soll die Zellen zudem tief in solide Tumoren hineinführen.

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.