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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


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Volume 57, Issue 7

Issues

Reference intervals for thyroid-stimulating hormone, free thyroxine, and free triiodothyronine in elderly Chinese persons

Danchen Wang
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Songlin Yu
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Chaochao Ma
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Honglei Li
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Ling Qiu
  • Corresponding author
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Xinqi Cheng
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Xiuzhi Guo
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Yicong Yin
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Dandan Li
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Zhenjie Wang
  • Corresponding author
  • Department of Health Care, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China
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/ Yingying Hu
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Shuangyu Lu
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Guohua Yang
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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/ Huaicheng Liu
  • Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing, P.R. China
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Published Online: 2018-11-29 | DOI: https://doi.org/10.1515/cclm-2018-1099

Abstract

Background

Thyroid hormone levels are essential for diagnosing and monitoring thyroid diseases. However, their reference intervals (RIs) in elderly Chinese individuals remain unclear. We aimed to identify factors affecting thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) levels using clinical “big data” to establish hormone level RIs for elderly Chinese individuals.

Methods

We examined 6781, 6772, and 6524 subjects aged ≥65 years who underwent FT3, FT4, and TSH tests, respectively, at the Peking Union Medical College Hospital between September 1, 2013, and August 31, 2016. Hormones were measured using an automated immunoassay analyzer (ADVIA Centaur XP). RIs were established using the Clinical Laboratory Standards Institute document C28-A3 guidelines.

Results

The median TSH was significantly higher in women than in men; the opposite was true for median FT3 and FT4 levels. No differences were observed in TSH or FT4 by age in either sex or overall; FT3 levels significantly decreased with age. Seasonal differences were observed in TSH and FT3 levels but not FT4 levels; the median TSH was the highest in winter and lowest in summer, whereas the median FT3 was the lowest in summer (albeit not significantly). RIs for TSH were 0.53–5.24 and 0.335–5.73 mIU/L for men and women, respectively; those for FT3 were 3.76–5.71, 3.60–5.42, and 3.36–5.27 pmol/L in 64- to 74-, 75- to 84-, and 85- to 96-year-old subjects, respectively. The RI for FT4 was 11.70–20.28 pmol/L.

Conclusions

RIs for TSH in elderly individuals were sex specific, whereas those for FT3 were age specific.

Keywords: free thyroxine; free triiodothyronine; geriatrics; reference interval; thyroid function; thyroid-stimulating hormone

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About the article

Corresponding authors: Professor Ling Qiu, Department of Clinical Laboratory, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, No. 1 Shuaifu Yuan, Dongcheng District, Beijing 100730, P.R. China;and Professor Zhenjie Wang, Department of Health Care, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, P.R. China

aDanchen Wang, Songlin Yu, Chaochao Ma and Honglei Li contributed equally to this study.


Received: 2018-10-09

Accepted: 2018-10-30

Published Online: 2018-11-29

Published in Print: 2019-06-26


Author contributions: DCW, SYY, HLL, and ZJW designed the experiments. DCW and CCM analyzed the data. DCW, LQ, XQC, SLY, YCY, and HLL were involved in scientific discussions. DCW, SLY, HLL, CCM, LQ, and ZJW drafted and revised the manuscript. CCM, XZG and DDL drafted the figures. YYH, SYL, GHY, and HCL measured the TSH concentrations. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This work was funded by research grants from the National Natural Science Foundation of China (grant no. 81702060) (http://www.nsfc.gov.cn/).

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 7, Pages 1044–1052, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-1099.

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