Laboratory of Endocrinology, Department of Oncology and Nuclear Medicine, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Paediatrics, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia.
Biochem Med (Zagreb). 2021 Oct 15;31(3):030702. doi: 10.11613/BM.2021.030702. Epub 2021 Aug 5.
Evaluation of thyroid function is often requested and therefore defining paediatric reference intervals (RIs) is of vital importance. Currently, there is a distinct lack of paediatric RIs for thyroid function tests in Croatia. Thus, we established RIs for thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3) and free thyroxine (FT4) in the Croatian paediatric population.
Reference intervals were calculated from 397 apparently healthy children, aged from 2 days to < 19 years. Serum samples were analysed for thyroid function tests on the Abbott Architect i2000. Age- and sex-specific 95% RIs with 90% confidence intervals were established according to Clinical and Laboratory Standards Institute guidelines. To express the magnitude of sex and age variation, standard deviation ratio (SDR) was calculated using two-level nested ANOVA. The criterion for considering partitioning reference values was set to SDR > 0.3.
All thyroid function tests required age partitioning, confirmed by SDR above 0.3. There was no need for sex partitioning, confirmed by SDR below 0.3. Still, FT3 was partitioned due to visually noticeable sex related difference for the oldest group (12 years to < 19 years).
This is the first study to establish RIs for thyroid function tests in the Croatian paediatric population. We propose RIs for widely used Abbott platform, thus giving laboratories method- and population-specific paediatric RIs for thyroid function tests that should improve clinical test interpretation.
甲状腺功能的评估经常被要求，因此定义儿科参考区间（RI）至关重要。目前，克罗地亚缺乏甲状腺功能测试的儿科 RI。因此，我们在克罗地亚儿科人群中建立了促甲状腺激素（TSH）、总三碘甲状腺原氨酸（TT3）、总甲状腺素（TT4）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）的 RI。
参考区间是从 397 名年龄在 2 天至<19 岁的看似健康的儿童中计算出来的。血清样本在雅培 Architect i2000 上分析甲状腺功能测试。根据临床和实验室标准协会指南，建立了年龄和性别特异性 95%RI 和 90%置信区间。为了表达性别和年龄变化的幅度，使用两水平嵌套 ANOVA 计算标准偏差比（SDR）。考虑分割参考值的标准设定为 SDR>0.3。
所有甲状腺功能测试都需要年龄分割，这一点通过 SDR 高于 0.3 得到了证实。不需要性别分割，这一点通过 SDR 低于 0.3 得到了证实。尽管如此，由于最年长组（12 岁至<19 岁）存在明显的性别相关差异，FT3 仍需要进行分割。
这是第一项在克罗地亚儿科人群中建立甲状腺功能测试 RI 的研究。我们提出了 Abbott 平台广泛使用的 RI，从而为实验室提供了针对甲状腺功能测试的特定于方法和人群的儿科 RI，这应该会改善临床测试解释。
