MedStar Health Research Institute, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Faculty of Medicine, University of Medicine, Tirana, Albania.
Thyroid. 2021 Aug;31(8):1160-1170. doi: 10.1089/thy.2020.0866. Epub 2021 May 26.
Biotin has been reported to interfere with several commonly used laboratory assays resulting in misleading values and possible erroneous diagnosis and treatment. This report describes a prospective study of possible biotin interference in thyroid-related laboratory assays, with a comparison of different commonly used assay platforms. Thirteen adult subjects (mean age 45 ± 13 years old) were administered biotin 10 mg/day for eight days. Blood specimens were collected at three time points on day 1 and on day 8 (baseline, two, and five hours after biotin ingestion). Thyrotropin (TSH), free triiodothyronine (fT3), free thyroxine (fT4), total triiodothyronine (TT3), total thyroxine (TT4), thyroxine binding globulin (TBG), and thyroglobulin (Tg) levels were analyzed with four different platforms: Abbott Architect, Roche Cobas 6000, Siemens IMMULITE 2000, and liquid chromatography with tandem mass spectrometry (LC-MS/MS). TSH, fT3, fT4, TT3, and TT4 were measured with Abbott Architect and Roche Cobas 6000. fT3, fT4, TT3, and TT4 were also measured by LC-MS/MS. Tg was measured by Siemens IMMULITE 2000. TBG was assessed with Siemens IMMULITE 2000. Significant changes in TSH, fT4, and TT3 measurements were observed after biotin exposure when the Roche Cobas 6000 platform was used. Biotin intake resulted in a falsely lower Tg level when measurements were performed with Siemens IMMULITE 2000. At the time points examined, maximal biotin interference was observed two hours after biotin exposure both on day 1 and day 8. A daily dose of 10 mg was shown to interfere with specific assays for TSH, fT4, TT3, and Tg. Physicians must be aware of the potential risk of erroneous test results in subjects taking biotin supplements. Altered test results for TSH and Tg can be particularly problematic in patients requiring careful titration of levothyroxine therapy such as those with thyroid cancer.
生物素已被报道会干扰几种常用的实验室检测，导致结果出现误导性，并可能导致错误的诊断和治疗。本报告描述了一项关于甲状腺相关实验室检测中生物素干扰的前瞻性研究，比较了不同常用的检测平台。13 名成年受试者（平均年龄 45±13 岁）每天服用生物素 10mg，连续 8 天。在第 1 天和第 8 天（基线、摄入生物素后 2 小时和 5 小时）的三个时间点采集血样。使用四种不同平台分析促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、甲状腺素结合球蛋白（TBG）和甲状腺球蛋白（Tg）水平：雅培Architect、罗氏 Cobas 6000、西门子 IMMULITE 2000 和液相色谱-串联质谱法（LC-MS/MS）。TSH、fT3、fT4、TT3 和 TT4 采用雅培 Architect 和罗氏 Cobas 6000 进行检测。LC-MS/MS 还可检测 fT3、fT4、TT3 和 TT4。西门子 IMMULITE 2000 检测 Tg。西门子 IMMULITE 2000 评估 TBG。在罗氏 Cobas 6000 平台使用后，生物素暴露后 TSH、fT4 和 TT3 的测量值发生了显著变化。当使用西门子 IMMULITE 2000 进行测量时，生物素摄入导致 Tg 水平被错误地降低。在检查的时间点，在第 1 天和第 8 天，在摄入生物素后 2 小时观察到最大的生物素干扰。每天 10mg 的剂量被证明会干扰 TSH、fT4、TT3 和 Tg 的特定检测。医生必须意识到服用生物素补充剂的患者检测结果出现错误的潜在风险。需要仔细调整左甲状腺素治疗的患者（如甲状腺癌患者）的 TSH 和 Tg 检测结果改变可能特别成问题。
