Department of Laboratory Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, China.
Department of Clinical Laboratory, People's Hospital of Tibet Autonomous Region, Lhasa, China.
Front Endocrinol (Lausanne). 2022 Feb 11;13:816970. doi: 10.3389/fendo.2022.816970. eCollection 2022.
Diagnosis of thyroid disease among individuals dwelling at high altitude remains a challenge. Reference intervals (RIs) for thyroid-associated hormones among Tibetans living at various high altitudes were established to improve diagnosis.
One thousand two hundred eighty-one subjects were randomly recruited from Nyingchi, Shigatse/Lhasa, and Ali of Tibet. Thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) were measured by the Cobas e601 electrochemiluminescence analyzer. We used multiple linear regression and variance component analysis to assess the effect of sex, age, and altitude on hormones. RIs were established by refineR algorithm and compared with those provided by the manufacturer.
Serum TSH was significantly lower in males than in females, while FT3 and FT4 were higher in males. Both FT3 and FT4 decreased with increasing age. FT3 increased with altitude, while TSH and FT4 were less influenced by altitude. The RI for TSH was 0.764-5.784 μIU/ml, while for FT4, the RIs were 12.36-19.38 pmol/L in females and 14.84-20.18 pmol/L in males. The RIs for FT3 at Nyingchi, Shigatse/Lhasa, and Ali in females were 4.09-4.98, 4.31-5.45, and 4.82-5.58 pmol/L, while in males, the values were 4.82-5.41, 4.88-5.95, and 5.26-6.06 pmol/L, respectively. The obtained RIs for TSH and FT4 were generally higher, while that for FT3 was narrower than the RIs provided by Cobas.
Specific RIs were established for thyroid-associated hormones among Tibetans, which were significantly different from those provided by the manufacturer.
在高海拔地区人群中诊断甲状腺疾病仍然具有挑战性。本研究旨在建立不同海拔藏族人群甲状腺相关激素的参考区间（RI），以提高诊断水平。
本研究共纳入 1281 名来自西藏林芝、日喀则/拉萨和阿里的研究对象。采用电化学发光法检测促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT3）和游离甲状腺素（FT4）。采用多元线性回归和方差分量分析评估性别、年龄和海拔对激素的影响。采用 refineR 算法建立 RI，并与厂家提供的 RI 进行比较。
男性的血清 TSH 显著低于女性，而 FT3 和 FT4 高于女性。FT3 和 FT4 均随年龄的增加而降低。FT3 随海拔的升高而升高，而 TSH 和 FT4 受海拔的影响较小。TSH 的 RI 为 0.764-5.784 μIU/ml，而女性 FT4 的 RI 为 12.36-19.38 pmol/L，男性 FT4 的 RI 为 14.84-20.18 pmol/L。女性在林芝、日喀则/拉萨和阿里的 FT3 RI 分别为 4.09-4.98、4.31-5.45 和 4.82-5.58 pmol/L，男性分别为 4.82-5.41、4.88-5.95 和 5.26-6.06 pmol/L。本研究获得的 TSH 和 FT4 的 RI 普遍较高，而 FT3 的 RI 较窄。
本研究为藏族人群建立了甲状腺相关激素的特异性 RI，与厂家提供的 RI 存在显著差异。
