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中国西南地区健康人群血清 TSH 参考区间的间接建立方法。

Establishment of Serum TSH Reference Intervals by an Indirect Method for Healthy Population in Southwest China.

出版信息

Clin Lab. 2021 Sep 1;67(9). doi: 10.7754/Clin.Lab.2021.210101.

DOI:10.7754/Clin.Lab.2021.210101
PMID:34542978
Abstract

BACKGROUND

Serum thyroid stimulating hormone (TSH) detection is of great clinical significance in monitoring thyroid function. The aim of the present study was to establish reference intervals (RIs) for serum TSH in healthy Han population in Southwest China using data from routine health check-up individuals.

METHODS

Healthy subjects (n = 7,116) were enrolled from January 2019 to September 2020. Serum TSH values were determined in the Beckman Coulter UniCel™ DxI 800 Access® immunoassay system. Outliers were identified and removed using Dixon's interactive principle. The 95th percentile range was calculated as RIs for serum TSH. All the statistical analyses were run on R statistical software version 4.0.3.

RESULTS

A total of 6,668 (1,324 female and 5,344 male) suitable individuals were included in this study. Serum TSH results showed a non-Gaussian distribution by Kolmogorov-Smirnov test. According to Mann-Whitney U analysis, the serum TSH values for the female group differ from the male group's (p < 0.05). Besides, Spearman's rank correlation test disclosed that no obvious correlation was observed between serum TSH levels and age (r = -0.0039, p > 0.05). Accordingly, the RIs for serum TSH in Southwest China Han population were 0.64 (95% CI: 0.62 to 0.65) to 4.05 (95% CI: 4.02 to 4.09) mIU/L in male and 0.72 (95% CI: 0.67 to 0.77) to 5.66 (95% CI: 5.58 to 5.75) mIU/L in female, respectively.

CONCLUSIONS

In this study, the laboratory specific RIs for serum TSH were successfully established by indirect method using the data from health check-up population. It implies that the indirect method is an easy and lowcost pathway for each laboratory to establish its own RIs.

摘要

背景

血清促甲状腺激素(TSH)检测在监测甲状腺功能方面具有重要的临床意义。本研究旨在使用常规健康检查个体的数据,建立中国西南地区健康汉族人群的血清 TSH 参考区间(RI)。

方法

本研究纳入了 2019 年 1 月至 2020 年 9 月期间的健康受试者(n=7116)。采用贝克曼库尔特 UniCel™ DxI 800 Access®免疫分析系统检测血清 TSH 值。采用 Dixon 交互原则识别并剔除离群值。计算第 95 百分位范围作为血清 TSH 的 RI。所有统计分析均在 R 统计软件版本 4.0.3 上进行。

结果

本研究共纳入 6668 名(女性 1324 名,男性 5344 名)合适的个体。Kolmogorov-Smirnov 检验显示血清 TSH 结果呈非正态分布。根据 Mann-Whitney U 分析,女性组的血清 TSH 值与男性组不同(p<0.05)。此外,Spearman 秩相关检验显示血清 TSH 水平与年龄之间无明显相关性(r=-0.0039,p>0.05)。因此,中国西南地区汉族人群的血清 TSH RI 为男性 0.64(95%CI:0.620.65)至 4.05(95%CI:4.024.09)mIU/L,女性 0.72(95%CI:0.670.77)至 5.66(95%CI:5.585.75)mIU/L。

结论

本研究采用间接法,利用健康检查人群的数据成功建立了实验室特异性血清 TSH RI。这表明间接法是每个实验室建立自身 RI 的一种简单、低成本的途径。

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