甲状腺刺激激素和自由甲状腺素的特定年龄参考间隔,以优化甲状腺疾病的诊断
Heleen I Jansen1,2,3, Niek F Dirks3,4,5, Jacquelien J Hillebrand2,3
1Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Laboratory Medicine, Endocrine Laboratory, Amsterdam, The Netherlands.
Thyroid : official journal of the American Thyroid Association
|September 16, 2024
概括
确定甲状腺刺激激素 (TSH) 和自由甲状腺素 (FT4) 的特定年龄参考间隔至关重要. 使用成人TSH年龄特定的间隔可以减少老年人甲状腺功能低下的诊断.
科学领域:
- 临床化学 临床化学
- 内分泌学 在内分泌学.
- 实验室医学 实验室医学
背景情况:
- 甲状腺刺激激素 (TSH) 和自由甲状腺素 (FT4) 参考间隔 (RI) 对于诊断甲状腺疾病至关重要.
- 目前的实验室RI通常缺乏超越童年时代的年龄特异性,尽管已知TSH的年龄相关变化.
- 这种限制可能导致成年人甲状腺功能的错误分类.
研究的目的:
- 为了确定TSH和FT4在整个生命周期中的特定年龄的RI.
- 评估使用这些年龄特定的RI对成人甲状腺疾病诊断的影响.
主要方法:
- 一个多中心的回顾性横截面研究,利用来自13个荷兰实验室 (2008-2022) 的大数据.
- 在四个免疫测试平台上使用TMC和refineR分析确定TSH和FT4的间接RI.
- 建立从2岁到100岁的年龄组,为童年,成年和老年人设定特定的类别.
主要成果:
- 在TSH和FT4RI中观察到与年龄相关的显著变化,儿童时期的上限较高,在成年期下降.
- 在50岁 (女性) 和60岁 (男性) 的成年人中,TSH上RI增加,而FT4上RI从70岁开始增加.
- 在罗氏平台上,针对成人年龄的TSH RIs的应用导致老年人 (女性>50,男性>60) 亚临床和明显的甲状腺功能低下症诊断的减少.
结论:
- 特定年龄的RI对于准确的TSH和FT4解释至关重要,特别是在儿童中.
- 在成年人中实施特定年龄的TSH RIs对于减少老年人过度诊断甲状腺功能低下症具有临床意义.
- 需要进一步的研究,以建立统一和临床适用的特定年龄的FT4RI.
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