确定70岁以上健康成年人的TSH参考间隔:澳大利亚ASPREE队列研究
Cammie Tran1, Duncan J Topliss2,3, Hans G Schneider1,4
1School of Public Health and Preventive Medicine, 2541 Monash University , Melbourne, VIC, Australia.
Clinical chemistry and laboratory medicine
|October 2, 2024
概括
这项研究在70岁以上的健康成年人中为甲状腺刺激激素 (TSH) 建立了一个新的参考间隔 (RI). 建议的0.34-3.75mIU/L的RI适用于老年人群的临床使用.
科学领域:
- 内分泌学 在内分泌学.
- 老年医学 老年医学
- 临床化学 临床化学
背景情况:
- 甲状腺疾病在老年人群中很普遍.
- 确定甲状腺刺激激素 (TSH) 的准确参考间隔对于诊断老年人甲状腺功能障碍至关重要.
- 现有的TSH RIs可能不会准确地反映70岁及以上的个体的甲状腺状况.
研究的目的:
- 确定甲状腺刺激激素 (TSH) 的特定参考间隔 (RI) 在70岁及以上的健康社区成年人中.
- 通过评估其与甲状腺相关症状和疾病结果的关联来验证拟议的TSH RI.
- 提供基于证据的TSH RI,以优化老年人的临床管理.
主要方法:
- 利用了来自澳大利亚参与ASPirin减少老年人事件 (ASPREE) 试验的数据.
- 排除了患有先前疾病 (心血管疾病,甲状腺癌,痴呆症) 或服用甲状腺药物的参与者.
- 通过化学发光免疫试验测量的日志转化基线TSH水平的中间第95百分位数来确定RI.
- 使用考克斯比例危险回归模型验证RI以评估疾病发病率.
主要成果:
- 分析了从10,995名参与者 (平均年龄73.9岁) 的TSH基线水平.
- 建议的TSH参考区间为0.34-3.75mIU/L.
- 根据年龄或性别,TSH水平没有显著差异.
- 在11年的随访期间,在拟议的RI和甲状腺相关症状或长期疾病结果之间没有观察到TSH基线水平之间的联系.
结论:
- 对于70岁及以上的健康成年人,建议TSH参考区间为0.34-3.75mIU/L.
- 这一RI准确地代表了这个老年人群中的甲状腺状况.
- 建议的TSH RI被证实适合临床应用,没有显示增加与甲状腺相关不良结果的风险.
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