Using Hashimoto thyroiditis as gold standard to determine the upper limit value of thyroid stimulating hormone in a Chinese cohort

BMC Endocrine Disorders

Research Article

Jin-Kui Yang¹  Guang-Ran Yang¹  Zhong Xin¹  Ming-Jia Niu²  Yu Li³  Dong-Ning Chen³  Jing Cui³ 

[1] Department of Endocrinology, Beijing Key Laboratory of Diabetes Research and Care, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China;Department of Endocrinology, First Hospital of Qinghuangdao, 066000, Qinghuangdao, China;Physical Examination Department, Beijing Tongren Hospital, Capital Medical University, 100730, Beijing, China;

关键词: Thyroid Stimulate Hormone;    Subclinical Hypothyroidism;    Research Population;    Hashimoto Thyroiditis;    Framingham Score;   

DOI  :  10.1186/s12902-016-0137-3

 received in 2016-02-26, accepted in 2016-09-28,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundSubclinical hypothyroidism, commonly caused by Hashimoto thyroiditis (HT), is a risk factor for cardiovascular diseases. This disorder is defined as merely having elevated serum thyroid stimulating hormone (TSH) levels. However, the upper limit of reference range for TSH is debated recently. This study was to determine the cutoff value for the upper normal limit of TSH in a cohort using the prevalence of Hashimoto thyroiditis as “gold” calibration standard.MethodsThe research population was medical staff of 2856 individuals who took part in health examination annually. Serum free triiodothyronine (FT3), free thyroxine (FT4), TSH, thyroid peroxidase antibody (TPAb), thyroglobulin antibody (TGAb) and other biochemistry parameters were tested. Meanwhile, thyroid ultrasound examination was performed. The diagnosis of HT was based on presence of thyroid antibodies (TPAb and TGAb) and abnormalities of thyroid ultrasound examination. We used two different methods to estimate the cutoff point of TSH based on the prevalence of HT.ResultsJoinpoint regression showed the prevalence of HT increased significantly at the ninth decile of TSH value corresponding to 2.9 mU/L. ROC curve showed a TSH cutoff value of 2.6 mU/L with the maximized sensitivity and specificity in identifying HT. Using the newly defined cutoff value of TSH can detect patients with hyperlipidemia more efficiently, which may indicate our approach to define the upper limit of TSH can make more sense from the clinical point of view.ConclusionsA significant increase in the prevalence of HT occurred among individuals with a TSH of 2.6–2.9 mU/L made it possible to determine the cutoff value of normal upper limit of TSH.

【 授权许可】

CC BY   
© The Author(s). 2016