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[Establishing reference intervals of thyroid hormone based on a laboratory information system].

X T Zhu1, K J Wang1, Q Zhou2

  • 1Department of Laboratory Medicine, The First Hospital of Jilin University, Changchun 130021, China.

Zhonghua Nei Ke Za Zhi
|February 20, 2020
PubMed
Summary

This study established reliable thyroid hormone reference intervals (RIs) using laboratory data from 45,742 healthy individuals. Age and sex influenced free triiodothyronine and free thyroxine levels, but not thyroid-stimulating hormone.

Keywords:
Indirect methodReference intervalThyroid Hormones

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Area of Science:

  • Clinical Biochemistry
  • Endocrinology
  • Laboratory Medicine

Background:

  • Accurate reference intervals (RIs) are crucial for interpreting thyroid hormone test results.
  • Establishing RIs using indirect methods from laboratory information systems (LIS) offers a practical approach.
  • Previous RIs may not reflect current population demographics or laboratory methodologies.

Purpose of the Study:

  • To determine age- and sex-specific reference intervals for thyroid hormones.
  • To validate the indirect method of RI establishment using a large LIS dataset.
  • To provide reliable thyroid hormone RIs for clinical laboratory application.

Main Methods:

  • Utilized a large dataset (n=45,742) from a hospital LIS (May 2014-December 2018).
  • Applied statistical methods including Kolmogorov-Smirnov test, BOX-COX transformation, Turkey outlier identification, LMS method for percentile curves, decision trees for age cut-offs, and Z-tests for group comparisons.
  • Analyzed 2.5th and 97.5th percentiles using non-parametric methods to define RIs.

Main Results:

  • Thyroid-stimulating hormone (TSH) RIs (0.60-4.41 mIU/L) showed no significant age or sex differences.
  • Free triiodothyronine (FT3) levels decreased with age, with distinct RIs established for different age and sex groups.
  • Free thyroxine (FT4) levels were higher in younger males (20-49 years) than females, with age- and sex-independent RIs observed after 50 years.

Conclusions:

  • The indirect method of establishing thyroid hormone RIs from LIS data is reliable and efficient.
  • Age and sex significantly impact FT3 and FT4 levels, necessitating specific RIs.
  • The derived RIs are suitable for routine clinical laboratory use, aiding in accurate patient diagnosis.