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A Thyroid Stimulating Hormone Reference Range: Iranian Thyroid Cohort study.

Rokhsareh Meamar1, Awat Feizi2, Ashraf Aminorroaya3

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|November 5, 2021
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Summary

This study established thyroid-stimulating hormone (TSH) and thyroxine (T4) reference ranges for the Isfahan population, improving thyroid function test accuracy. These new ranges account for age and sex, aiding clinical diagnosis in this iodine-sufficient region.

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Area of Science:

  • Endocrinology
  • Clinical Chemistry
  • Population Health

Background:

  • Current thyroid function test reference values lack ethnic and geographic specificity.
  • Existing guidelines from the National Academy of Clinical Biochemistry (NACB) require localized validation.
  • Isfahan, Iran, an iodine-sufficient metropolitan area, was selected for localized reference range determination.

Purpose of the Study:

  • To establish specific reference limits for TSH and T4 in the Isfahanian population.
  • To adapt NACB guidelines for local application in thyroid function testing.
  • To enhance the accuracy of thyroid disorder diagnosis in the region.

Main Methods:

  • The study utilized data from the prospective Isfahan Thyroid Study (ITS) cohort (2006-2011).
  • Participants aged over twenty were included, with measurements of TSH, total T4, TPOAb, and TgAb.
  • NACB criteria were applied for participant recruitment and data analysis.

Main Results:

  • Age and sex-specific reference ranges for TSH and T4 were determined for the Isfahanian population.
  • In 2006, TSH 2.5th-97.5th percentiles were 0.4-4.96 mU/L (males: 0.4-4.72, females: 0.5-5.3).
  • In 2011, TSH 2.5th-97.5th percentiles were 0.7-4.9 mU/L (males: 0.6-5.7, females: 0.77-5.57).

Conclusions:

  • The study successfully determined age and sex-specific TSH and T4 reference ranges for Isfahan.
  • These localized ranges can potentially improve the accuracy of patient classification by clinicians.
  • The findings contribute to more precise thyroid function assessment in iodine-sufficient populations.