Using Hashimoto Thyroiditis As Gold Standard to Determine the Upper Limit Value of Thyroid Stimulating Hormone in a Chinese Cohort

Overview

Journal BMC Endocr Disord

Publisher Biomed Central

Specialty Endocrinology

Date 2016 Nov 7

PMID 27816062

Citations 3

Authors

Yu Li

Dong-Ning Chen

Jing Cui

Zhong Xin

Guang-Ran Yang

Ming-Jia Niu

Jin-Kui Yang

Affiliations

Soon will be listed here.

Abstract

Background: Subclinical 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.

Methods: The 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.

Results: Joinpoint 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.

Conclusions: A 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.

Citing Articles

Global prevalence and epidemiological trends of Hashimoto's thyroiditis in adults: A systematic review and meta-analysis.

Hu X, Chen Y, Shen Y, Tian R, Sheng Y, Que H Front Public Health. 2022; 10:1020709.

PMID: 36311599 PMC: 9608544. DOI: 10.3389/fpubh.2022.1020709.

Prevalence of Components of Metabolic Syndrome Among Adults with the Presence of Autoimmune Thyroid Condition in an Iodine-Sufficient Region.

Pan B, Zhang Q, Zhou H, Ma Z Biol Trace Elem Res. 2020; 199(8):2837-2843.

PMID: 33006706 DOI: 10.1007/s12011-020-02413-3.

High normal TSH is associated with lower mannan-binding lectin in women of childbearing age.

Karbownik-Lewinska M, Stepniak J, Marcinkowska M, Krygier A, Lewinski A BMC Endocr Disord. 2020; 20(1):1.

PMID: 31900145 PMC: 6942275. DOI: 10.1186/s12902-019-0484-y.

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