Application of composite reference intervals in the diagnosis of subclinical hypothyroidism in the elderly: a retrospective study.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-11-01 eCollection Date: 2024-01-01 DOI:10.7717/peerj.18417

Peijuan Li, Wenming Yang, Guohua Tang, Zhipeng Li

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Abstract

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.

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综合参考区间在诊断老年人亚临床甲状腺功能减退症中的应用：一项回顾性研究。

背景：促甲状腺激素释放激素（TSH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亚临床甲减患者促甲状腺激素释放激素水平的因素，建立了一个综合参考区间，并将其与传统的诊断区间进行了比较：方法：我们收集了成都地区年龄≥60岁的体检者数据，筛选出与TSH相关的影响因素。然后，建立 TSH 和 FT4 的二维复合参考区间，比较新诊断方法与传统诊断方法的差异：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 水平随着 FT4 和尿酸水平的降低而升高。与二维复合参考区间相比，传统参考区间的 SCH 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的发病率，导致过度诊断和治疗。

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