Mirjanić-Azarić Bosa, Milinković Neda, Bogavac-Stanojević Natasa, Avram Sanja, Stojaković-Jelisavac Tanja, Stojanović Darja
University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and Herzegovina.
University of Belgrade, Faculty of Pharmacy, Department of Medical Biochemistry, Belgrade.
J Med Biochem. 2022 Apr 8;41(2):238-245. doi: 10.5937/jomb0-33543.
The aim of this study was to determine the reference intervals (RIs) for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and FT3/FT4 ratio using indirect methods.
We analyzed 1256 results TSH, FT4 and FT3 collected from a laboratory information system between 2017 and 2021. All measurements were performed on a Siemens ADVIA Centaur XP analyzer using the chemiluminescent immunoassay. We calculated the values of the 2.5th and 97.5th percentiles as recommended by the IFCC (CLSI C28-A3).
The RIs derived for TSH, FT4, FT3 and FT3/FT4 ratio were 0.34-4.10 mIU/L, 11.3-20.6 pmol/L, 3.5-6.32 pmol/L and 0.21-0.47, respectively. We found a significant difference between calculated RIs for the TSH and FT4 and those recommended by the manufacturer. Also, FT3 values were significantly higher in the group younger than 30 years relative to the fourth decade (5.26 vs. 5.02, p=0.005), the fifth decade (5.26 vs. 4.94, p=0.001), the sixth decade (5.26 vs. 4.87, p<0.001), the seventh decade (5.26 vs. 4.79, p<0.001) and the group older than 70 years old (5.26 vs. 4.55, p<0.001). Likewise, we found for TSH values and FT3/FT4 ratio a significant difference (p <0.001) between different age groups.
The establishing RIs for the population of the Republic of Srpska were significantly differed from the recommended RIs by the manufacturer for TSH and FT4. Our results encourage other laboratories to develop their own RIs for thyroid parameters by applying CLSI recommendations.
本研究的目的是使用间接方法确定促甲状腺激素（TSH）、游离甲状腺素（FT4）、游离三碘甲状腺原氨酸（FT3）和FT3/FT4比值的参考区间（RIs）。
我们分析了2017年至2021年从实验室信息系统收集的1256份TSH、FT4和FT3检测结果。所有检测均在西门子ADVIA Centaur XP分析仪上使用化学发光免疫分析法进行。我们按照国际临床化学和检验医学联合会（IFCC，CLSI C28-A3）的建议计算了第2.5百分位数和第97.5百分位数的值。
得出的TSH、FT4、FT3和FT3/FT4比值的参考区间分别为0.34 - 4.10 mIU/L、11.3 - 20.6 pmol/L、3.5 - 6.32 pmol/L和0.21 - 0.47。我们发现计算得出的TSH和FT4的参考区间与制造商推荐的参考区间存在显著差异。此外，30岁以下组的FT3值相对于第四年龄段（5.26对5.02，p = 0.005）、第五年龄段（5.26对4.94，p = 0.001）、第六年龄段（5.26对4.87，p < 0.001）、第七年龄段（5.26对4.79，p < 0.001）以及70岁以上组（5.26对4.55，p < 0.001）显著更高。同样，我们发现不同年龄组之间TSH值和FT3/FT4比值存在显著差异（p < 0.001）。
塞族共和国人群的参考区间在TSH和FT4方面与制造商推荐的参考区间存在显著差异。我们的结果鼓励其他实验室通过应用CLSI的建议来制定自己的甲状腺参数参考区间。
