复合参考区间在老年亚临床甲状腺功能减退症诊断中的应用：一项回顾性研究。
Application of composite reference intervals in the diagnosis of subclinical hypothyroidism in the elderly: a retrospective study.
机构信息
General Practice Ward/International Medical Center Ward, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
Health Management Center, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, China.
出版信息
PeerJ. 2024 Nov 1;12:e18417. doi: 10.7717/peerj.18417. eCollection 2024.
BACKGROUND
Thyroid stimulating hormone releasing hormone (TSH) is a key indicator for diagnosing subclinical hypothyroidism (SCH). We evaluated factors affecting TSH levels in elderly SCH, establishing a composite reference interval, and comparing it with traditional one in diagnosis.
METHODS
We collected data on patients aged ≥60 undergoing physical examinations in Chengdu, screening the influencing factors associated with TSH. Then, a two-dimensional composite reference interval was established for TSH and FT4, and the differences between the new and traditional diagnosing methods were compared.
RESULTS
The incidence of subclinical thyroid dysfunction was about 14%, with SCH accounting for 97%. Regression analysis found that TSH levels increase as FT4 and uric acid levels decrease. Compared with the two-dimensional composite reference interval, the traditional one has a higher incidence rate of SCH.
CONCLUSION
Compared with the two-dimensional composite reference interval, the traditional one is more likely to overestimate the incidence rate of SCH, leading to excessive diagnosis and treatment.
背景
促甲状腺激素释放激素（TSH）是诊断亚临床甲状腺功能减退症（SCH）的关键指标。我们评估了影响老年 SCH 患者 TSH 水平的因素，建立了复合参考区间，并与传统方法进行了比较。
方法
我们收集了成都地区≥60 岁体检患者的数据，筛选与 TSH 相关的影响因素。然后，建立 TSH 和 FT4 的二维复合参考区间，并比较新的和传统的诊断方法之间的差异。
结果
亚临床甲状腺功能障碍的发生率约为 14%，其中 SCH 占 97%。回归分析发现，TSH 水平随 FT4 和尿酸水平的降低而升高。与二维复合参考区间相比，传统参考区间 SCH 的发生率更高。
结论
与二维复合参考区间相比，传统参考区间更容易高估 SCH 的发生率，导致过度诊断和治疗。
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