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中国高龄老人血清甲状腺相关激素参考区间的建立。

Establishment of Reference Intervals for Serum Thyroid-related Hormones in the Chinese Oldest-old.

作者信息

Liu Dizhi, Fang Sihang, Gao Danni, Wang Zhaoping, Wang Tenger, Tang Lei, Jiang Mingjun, Jiao Juan, Zhao Hongye, Su Huabin, Li Rongqiao, Huang Bin, Lv Yuan, Pang Guofang, Hu Caiyou, Yang Ze, Yuan Huiping

机构信息

The Key Laboratory of Geriatrics, Beijing Institute of Geriatrics, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology of National Health Commission, Beijing, 100730, P.R. China.

Respiratory Department, Beijing Children's Hospital, Capital Medical University, China National Clinical Research Center of Respiratory Diseases, National Center for Children's Health, Beijing, 100045, P.R. China.

出版信息

Int J Med Sci. 2025 Apr 28;22(10):2408-2418. doi: 10.7150/ijms.109606. eCollection 2025.

Abstract

Thyroid function differs between the oldest-old and younger adults, however, there is a lack of appropriate RIs for the serum FT4, T4, FT3, T3, and TSH concentrations for the oldest-old. A total of 349 people was selected from the natural longevity cohort of Guangxi residents over 90 years old. The distributions of serum FT4, T4, FT3, T3, and TSH concentrations and the FT3/FT4 ratio were also analyzed. Regression curves and centile curves were constructed. Correlations between body indices and blood pressure and serum thyroid-related hormone levels were analyzed. The RIs were determined using a nonparametric approach (2.5th-97.5th percentiles) following the CLSI guidelines. The RIs for Chinese oldest-old are different from the current standard RIs for younger adults. A notable correlation was found between FT4 levels and age. BMI and WHtR were positively correlated with FT4, FT3, T3 and the FT3/FT4 ratio. The T3 level is correlated with SBP and DBP, and the FT3/FT4 ratio is correlated with SBP. The RIs established for the healthy oldest-old were as follows: T4, 81-193 nmol/L; FT4, 10.39-20.46 pmol/L; T3, 0.94-2.05 nmol/L; FT3, 3.56-6.43 pmol/L; TSH, 0.29-5.28 μIU/ml; and FT3/FT4, 0.197-0.496. In this study, we established RIs of thyroid-related hormone levels for the oldest-old in China and evaluated the associations between thyroid hormone levels and body indices. These findings may provide evidence for the diagnosis and treatment of thyroid-related diseases in the oldest-old.

摘要

高龄老人与年轻人的甲状腺功能存在差异,然而,目前缺乏适用于高龄老人血清游离甲状腺素(FT4)、甲状腺素(T4)、游离三碘甲状腺原氨酸(FT3)、三碘甲状腺原氨酸(T3)和促甲状腺激素(TSH)浓度的参考区间(RI)。从广西90岁以上居民的自然长寿队列中选取了349人。分析了血清FT4、T4、FT3、T3、TSH浓度及FT3/FT4比值的分布情况。构建了回归曲线和百分位数曲线。分析了身体指标与血压及血清甲状腺相关激素水平之间的相关性。按照临床和实验室标准协会(CLSI)指南,采用非参数方法(第2.5百分位数至第97.5百分位数)确定参考区间。中国高龄老人的参考区间与目前年轻人的标准参考区间不同。发现FT4水平与年龄之间存在显著相关性。体重指数(BMI)和腰高比(WHtR)与FT4、FT3、T3及FT3/FT4比值呈正相关。T3水平与收缩压(SBP)和舒张压(DBP)相关,FT3/FT4比值与SBP相关。为健康高龄老人建立的参考区间如下:T4,81 - 193 nmol/L;FT4,10.39 - 20.46 pmol/L;T3,0.94 - 2.05 nmol/L;FT3,3.56 - 6.43 pmol/L;TSH,0.29 - 5.28 μIU/ml;FT3/FT4,0.197 - 0.496。在本研究中,我们建立了中国高龄老人甲状腺相关激素水平的参考区间,并评估了甲状腺激素水平与身体指标之间的关联。这些发现可能为高龄老人甲状腺相关疾病的诊断和治疗提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a15/12080571/97fb9a93150c/ijmsv22p2408g001.jpg

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