Cui Yushan, Wang Yang, Zhang Dandan, Duan Yani, Li Fang, Li Wenfeng, Chen Lu, Jia Guang
Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, China.
Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100083, China.
Biol Trace Elem Res. 2023 Dec;201(12):5575-5584. doi: 10.1007/s12011-023-03624-0. Epub 2023 Mar 11.
Reference intervals (RIs) for serum thyroid-stimulating hormone (TSH), free triiodothyronine (FT), and free thyroxine (FT) suitable for local children are urgently needed in northern China. The reference interval for thyroid volume (Tvol) in Chinese children also differed greatly from that recommended by the WHO. This study aimed to establish TSH, FT, FT, and Tvol RIs suitable for children in northern China. A total of 1070 children aged 7 ~ 13 were recruited from iodine nutrition-sufficient areas in Tianjin, China, from 2016 to 2021. Four hundred fifty-eight children aged 7 ~ 13 years, and 815 children aged 8 ~ 10 years were eventually included to study RIs for the thyroid hormones and Tvol. RIs for thyroid hormones were established in accordance with the Clinical Laboratory Standards Institute (CLSI) document C28-A3 guidelines. Quantile regression was used to analyze the influencing factors of Tvol. RIs for TSH, FT, and FT were 1.23 (1.14 ~ 1.32) to 6.18 (5.92 ~ 7.26) mIU/L, 5.43 (5.29 ~ 5.52) to 7.89 (7.66 ~ 7.98) pmol/L, and 13.09 (12.85 ~ 13.73) to 22.22 (21.61 ~ 22.51) pmol/L. There was no need to establish RIs by age and gender. Our RIs could increase the prevalence of subclinical hyperthyroidism (P < 0.001) and reduce the prevalence of subclinical hypothyroidism (P < 0.001). Body surface area (BSA) and age are correlated with the 97th percentile of Tvol (both P < 0.001). Our reference interval could increase the goiter rate in children from 2.97 to 4.96% (P = 0.007). The thyroid hormones' reference intervals suitable for local children should be established. In addition, BSA and age should be considered when establishing Tvol reference interval.
中国北方迫切需要适用于当地儿童的血清促甲状腺激素（TSH）、游离三碘甲状腺原氨酸（FT）和游离甲状腺素（FT）的参考区间。中国儿童甲状腺体积（Tvol）的参考区间也与世界卫生组织推荐的有很大差异。本研究旨在建立适用于中国北方儿童的TSH、FT、FT和Tvol参考区间。2016年至2021年，从中国天津碘营养充足地区招募了1070名7至13岁的儿童。最终纳入458名7至13岁儿童和815名8至10岁儿童，以研究甲状腺激素和Tvol的参考区间。甲状腺激素参考区间依据临床实验室标准协会（CLSI）文件C28 - A3指南建立。采用分位数回归分析Tvol的影响因素。TSH、FT和FT的参考区间分别为1.23（1.14至1.32）至6.18（5.92至7.26）mIU/L、5.43（5.29至5.52）至7.89（7.66至7.98）pmol/L和13.09（12.85至13.73）至22.22（21.61至22.51）pmol/L。无需按年龄和性别建立参考区间。我们的参考区间可提高亚临床甲状腺功能亢进症的患病率（P < 0.001）并降低亚临床甲状腺功能减退症的患病率（P < 0.001）。体表面积（BSA）和年龄与Tvol的第97百分位数相关（均P < 0.001）。我们的参考区间可使儿童甲状腺肿率从2.97%提高到4.96%（P = 0.007）。应建立适用于当地儿童的甲状腺激素参考区间。此外，建立Tvol参考区间时应考虑BSA和年龄。
