Thyroid-stimulating hormone reference range and factors affecting it in a nationwide random sample

AbstractPrevious studies with mainly selected populations have proposed contradicting reference ranges for thyroid-stimulating hormone (TSH) and have disagreed on how screening, age and gender affect them. This study aimed to determine a TSH reference range on the Abbott Architect ci8200 integrated system in a large, nationwide, stratified random sample. To our knowledge this is the only study apart from the NHANES III that has addressed this issue in a similar nationwide setting. The effects of age, gender, thyroid peroxidase antibody (TPOAb)-positivity and medications on TSH reference range were also assessed.TSH was measured from 6247 participants randomly drawn from the population register to represent the Finnish adult population. TSH reference ranges were established of a thyroid-healthy population and its subpopulations with increasing and cumulative rigour of screening: screening for overt thyroid disease (thyroid-healthy population, n=5709); screening for TPOAb-positivity (risk factor-free subpopulation, n=4586); and screening for use of any medications (reference subpopulation, n=1849).The TSH reference ranges of the thyroid-healthy population, and the risk factor-free and reference subpopulations were 0.4–4.4, 0.4–3.7 and 0.4–3.4 mU/L (2.5th–97.5th percentiles), respectively. Although the differences in TSH between subgroups for age (p=0.002) and gender (p=0.005) reached statistical significance, the TSH distribution curves of the subgroups were practically superimposed.We propose 0.4–3.4 mU/L as a TSH reference range for adults for this platform, which is lower than those presently used in most laboratories. Our findings suggest that intensive screening for thyroid risk factors, especially for TPOAb-positivity, decreases the TSH upper reference limit.

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Is thyroid-stimulating hormone within the normal reference range a risk factor for atherosclerosis in women?

Internal and Emergency Medicine ◽

10.1007/s11739-011-0743-z ◽

2011 ◽

Vol 9 (1) ◽

pp. 51-57 ◽

Cited By ~ 11

Author(s):

Anna Boggio ◽

Fulvio Muzio ◽

Michela Fiscella ◽

Domenico Sommariva ◽

Adriana Branchi

Keyword(s):

Risk Factor ◽

Reference Range ◽

Thyroid Stimulating Hormone ◽

Normal Reference Range ◽

Normal Reference ◽

Stimulating Hormone

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CARRIAGE OF THYROID ANTIBODIES AS A RISK FACTOR IN THE DEVELOPMENT AND PROGRESSION OF ENDOCRINE OPHTHALMOPATHY

I P Pavlov Russian Medical Biological Herald ◽

10.23888/pavlovj20172270-278 ◽

2017 ◽

Vol 25 (2) ◽

pp. 270-278

Author(s):

V. G. Likhvantseva ◽

M. S. Afanasyev ◽

E. A. Rudenko ◽

С. С. Afanasyev ◽

E. V. Korosteleva ◽

...

Keyword(s):

Risk Factor ◽

Clinical Course ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Thyroid Autoantibodies ◽

Thyroid Antibodies ◽

Increased Risk ◽

Endocrine Ophthalmopathy ◽

Toxic Goiter ◽

Stimulating Hormone

The influence of the carrier of thyroid autoantibodies (to thyroid-stimulating hormone receptor, to thyroglobulin, to thyroid peroxidase) on the clinical course of endocrine ophthalmopathy (EOP), developed on the background of diffuse toxic goiter (139 patients). We studied the role of carrier of monoantibodies and their combinations. It has been proven a direct link between the presence of the analyzed thyroid autoantibodies and the clinical course of EOP. It is shown that the presence of antibodies to thyroid peroxidase and anti-thyroglobulin antibodies is not a lesser important risk factor for the development of EOP in patients with diffuse toxic goiter than the presence of antibodies to the receptor for thyroid-stimulating hormone, and the multiple carriers is associated with more frequent development of active forms of EOP and higher amplitude of inflammation of the orbit. Thus, serological indices and spectrum of thyroid antibodies revealed the depth of systemic disorders of autoimmunity, associated with an increased risk of the development of local autoimmune inflammation in the orbit and can serve as prognostic risk markers of development of highly active and severe forms of EOP.

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Influence of Serum Levels of Thyroid-Stimulating Hormone and Anti-Thyroid Peroxidase Antibodies, Age and Gender on Depression as Measured by the Zung Self-Rating Depression Scale

Folia Medica ◽

10.2478/folmed-2014-0004 ◽

2014 ◽

Vol 56 (1) ◽

pp. 24-31

Author(s):

Alexander D. Shinkov ◽

Anna-Maria I. Borisova ◽

Russanka D. Kovacheva ◽

Yordan D. Vlahov ◽

Lilia N. Dakovska ◽

...

Keyword(s):

Odds Ratio ◽

Body Height ◽

Depression Scale ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Age And Gender ◽

Self Rating ◽

Thyroid Peroxidase Antibodies ◽

And Gender ◽

Stimulating Hormone

ABSTRACT The AIM of the present study was to explore the level of depression in the respondents using the Zung self-rating depression scale (SDS) and find a correlation with the levels of the thyroid-stimulating hormone (TSH) and the anti-thyroid peroxidase antibodies (anti-TPO), the age and gender of the participants. PATIENTS AND METHODS: 2401 subjects aged 20-84 yrs were included, 1344 of them female aged 48.7 ± 14.4 yrs and 1057 male, aged 46.5 ± 14.5 yrs (p < 0.001). All participants completed the Zung SDS questionnaire and a depressive score was calculated and interpreted as follows: less than 49 points - no depression, between 50 and 59 points - mild depression, between 60 and 69 points - moderate depression and more than 69 points - severe depression. Body height and weight were measured and serum TSH and Anti-TPO were determined. RESULTS: SDS was higher in the females (47.6 ± 9.7 vs. 41.7 ± 8.6, p < 0.001) and correlated with the subjects’ age (Spearman’s ρfemale = 0.447, p < 0.001, ρmale = 0.402, p < 0.001). Depression was more prevalent in the females (all p < 0.001) with hypothyroidism than in the euthyroid subjects (odds ratio 1.8, 95% CI 1.15-2.80, p < 0.011). The odds ratio for depression was 3.47 (2.64-4.57) for the female gender and the risk of depression increased by 6% (5 - 7) with each added year of age. The anti-TPO, BMI and waist circumference did not influence the regression models. CONCLUSION: The depressive score was higher in the females and increased with age. Hypothyroidism determined a higher risk of depression in the females

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Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults. The importance of environmental factors, including thyroid antibodies

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm.2004.136 ◽

2004 ◽

Vol 42 (7) ◽

Cited By ~ 59

Author(s):

Esther Jensen ◽

Per Hyltoft Petersen ◽

Ole Blaabjerg ◽

Pia Skov Hansen ◽

Thomas H. Brix ◽

...

Keyword(s):

Thyroid Disease ◽

Reference Interval ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Thyroid Antibodies ◽

Common Reference ◽

History Of ◽

And Gender ◽

Serum Tsh ◽

Stimulating Hormone

AbstractIt has previously been shown that thyroid antibodies affect thyroid stimulating hormone (TSH) concentrations in men and women and that TSH levels are predictive of future thyroid disease. We investigated the validity of the National Academy of Clinical Biochemistry (NACB) guidelines regarding the TSH reference interval by studying 1512 individuals. Two hundred and fifty had at least one thyroid antibody, 121 were taking medications other than estrogens and occasional analgesics, and 105 reported a family history of thyroid disease. Serum TSH, thyroid peroxidase antibodies (TPOab) and thyroglobulin antibodies (Tgab) were determined on AutoDELFIA and TSHRab by a radioreceptor assay (RRA) from Brahms Diagnostica.For individuals without thyroid antibodies and other risk factors, no effect of age and gender was seen for serum TSH. Neither medication nor the presence of Tgab alone had any influence on serum TSH. TPOab alone or in combination with Tgab were associated with an increased serum TSH level.The ‘cumulative percentage distributions’ of subgroups, as well as the combined population, was ln-Gaussian distributed. The central 95% of the population was within the 95% CI in rankit-plots. Consequently, a common reference interval for serum TSH of 0.58–4.07 mIU/l for all adults between 17 and 66 years of age was established. This reference interval is much higher than expected from the NACB-guidelines.

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Effect of thyroid peroxidase antibodies on thyroid-stimulating hormone reference limits in a primarily Latina population

Obstetric Medicine ◽

10.1258/om.2009.090039 ◽

2009 ◽

Vol 2 (4) ◽

pp. 154-156

Author(s):

Richard H Lee ◽

Carole A Spencer ◽

Martin N Montoro ◽

Paola Aghajanian ◽

T Murphy Goodwin ◽

...

Keyword(s):

Pregnant Women ◽

First Trimester ◽

Thyroid Stimulating Hormone ◽

Thyroid Peroxidase ◽

Reference Ranges ◽

Serum Samples ◽

Reference Limit ◽

Thyroid Peroxidase Antibodies ◽

Reference Limits ◽

Stimulating Hormone

The aim of the paper is to determine the prevalence of thyroid peroxidase antibodies (TPOAb) and assess its effect on the thyroid-stimulating hormone (TSH) reference range during pregnancy in a primarily Latina population. Serum samples were collected from healthy pregnant women and non-pregnant controls. TSH reference ranges were calculated when TPOAb-positive patients were either included or excluded. A total of 134 pregnant women and 107 non-pregnant controls were recruited. Positive TPOAb titres were found in 23 (17.2%) of the 134 pregnant women, and in 14 (13.1%) of the 107 non-pregnant controls. When the TPOAb-positive women were included in the TSH analysis, the upper reference limit using two different methods was consistently higher: 0–2.2 fold in the non-pregnant women, 2.01–2.78 fold in the first trimester, 3.18–4.7 fold in the second and 1.05–1.42 fold in the third. The lower TSH reference limit was not affected by the inclusion of TPOAb-positive subjects. In conclusion, inclusion of TPOAb-positive patients results in higher upper reference limits during pregnancy.

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Vitamin D Deficiency as a Risk Factor for Myocardial Ischemia

Medicina ◽

10.3390/medicina57080774 ◽

2021 ◽

Vol 57 (8) ◽

pp. 774

Author(s):

Christina Batsi ◽

Evangelia Gkika ◽

Loukas Astrakas ◽

Athanassios Papadopoulos ◽

Ioannis Iakovou ◽

...

Keyword(s):

Vitamin D ◽

Risk Factor ◽

Myocardial Ischemia ◽

Single Photon ◽

Statistical Significance ◽

Photon Emission ◽

Serum Levels ◽

Emission Computed Tomography ◽

And Gender ◽

D Values

Background and Objectives: Vitamin D (Vit D) deficiency has been implicated in various conditions, including cardiovascular disease. The purpose of this retrospective study was to investigate the incidence of patients with myocardial ischemia in relation to their serum levels of vitamin D. Materials and Methods: A 64-month search (January 2016 to April 2021) in our database of the Nuclear Medicine Laboratory revealed 113 patients who had both myocardial perfusion imaging with single photon emission computed tomography (MPI SPECT) and Vit D measurements. MPI SPECT obtained myocardial images during both stress (summed stress score, SSS) and rest (summed rest score, SRS). Abnormal MPI SPECT was when the SSS was ≥4. Vit D was determined by radioimmunoassay (RIA). Patients with Vit D values <10 ng/mL, 10–29 ng/mL and ≥30 ng/mL were defined as having a deficiency, insufficiency and sufficiency, respectively. Results: Among patients, 46/113 (40.7%) were male and 67/113 (59.3%) were female. Abnormal MPI was found in 58/113 (51.3%) patients. Vit D deficiency was noted in 20/113 (17.7%) patients, insufficiency in 86/113 (76.1%) patients, and normal Vit D was noted in only 7/113 (6.2%) patients. Sixteen of the 20 patients (80%) with Vit D deficiency, and 38/86 (44.2%) with insufficiency had an abnormal MPI SPECT. In contrast, only 1/7 (14.3%) patients with sufficient Vit D levels had an abnormal MPI SPECT. The Mann-Whitney U-test showed that ischemia reduced the values of Vit D. Correlation analysis showed a negative association of Vit D levels with SSS (rho = −0.232, p = 0.014) and SRS (rho = −0.250, p = 0.008). Further evaluation with a Vit D cut off 20 ng/mL retrieved no statistical significance. Finally, Vit D and gender were independently associated with myocardial ischemia. Conclusions: Low Vit D levels may represent a risk factor for myocardial ischemia.

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Plasma mineral (selenium, zinc or copper) concentrations in the general pregnant population, adjusted for supplement intake, in relation to thyroid function

British Journal Of Nutrition ◽

10.1017/s000711452000255x ◽

2020 ◽

Vol 125 (1) ◽

pp. 71-78

Author(s):

Victor Pop ◽

Johannes Krabbe ◽

Wolfgang Maret ◽

Margaret Rayman

Keyword(s):

Thyroid Function ◽

Reference Range ◽

First Trimester ◽

Future Research ◽

Thyroid Peroxidase ◽

Reference Ranges ◽

Lower Plasma ◽

The Mean ◽

The Impact ◽

Supplement Intake

AbstractThe present study reports on first-trimester reference ranges of plasma mineral Se/Zn/Cu concentration in relation to free thyroxine (FT4), thyrotropin (TSH) and thyroid peroxidase antibodies (TPO-Ab), assessed at 12 weeks’ gestation in 2041 pregnant women, including 544 women not taking supplements containing Se/Zn/Cu. The reference range (2·5th–97·5th percentiles) in these 544 women was 0·72–1·25 µmol/l for Se, 17·15–35·98 µmol/l for Cu and 9·57–16·41 µmol/l for Zn. These women had significantly lower mean plasma Se concentration (0·94 (sd 0·12) µmol/l) than those (n 1479) taking Se/Zn/Cu supplements (1·03 (sd 0·14) µmol/l; P < 0·001), while the mean Cu (26·25 µmol/l) and Zn (12·55 µmol/l) concentrations were almost identical in these sub-groups. Women with hypothyroxinaemia (FT4 below reference range with normal TSH) had significantly lower plasma Zn concentrations than euthyroid women. After adjusting for covariates including supplement intake, plasma Se (negatively), Zn and Cu (positively) concentrations were significantly related to logFT4; Se and Cu (but not Zn) were positively and significantly related to logTSH. Women taking additional Se/Zn/Cu supplements were 1·46 (95 % CI 1·09, 2·04) times less likely to have elevated titres of TPO-Ab at 12 weeks of gestation. We conclude that first-trimester Se reference ranges are influenced by Se-supplement intake, while Cu and Zn ranges are not. Plasma mineral Se/Zn/Cu concentrations are associated with thyroid FT4 and TSH concentrations. Se/Zn/Cu supplement intake affects TPO-Ab status. Future research should focus on the impact of trace mineral status during gestation on thyroid function.

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