Document Detail


Age- and race-based serum thyrotropin reference limits.
MedLine Citation:
PMID:  19965925     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: TSH reference limits, particularly the upper limit, are controversial. The traditional and prevailing method for setting limits uses TSH distribution of thyroid disease-free individuals. The curve is not Gaussian, but skewed to higher concentrations, even after log-transformation; values in the skewed area are assumed to reflect mild hypothyroidism. The underlying assumption for this traditional approach, which has not previously been tested, is that the limits derived from this curve are applicable to all people. However, recent studies suggest that distinct subpopulations have unique TSH distribution and reference limits that are significantly different from limits established by the traditional approach.
EVIDENCE ACQUISITION: A search was focused on articles that provide the basis for current recommendations for setting TSH reference limits as well as articles that suggest that the traditional method does not reflect accurately the TSH distribution and reference limits of distinct subpopulations within the United States.
EVIDENCE SYNTHESIS: TSH distribution and reference limits shift to higher concentrations with age, even up to centenarians, and are unique for different racial/ethnic groups, being at higher concentrations in Caucasians than either Blacks or Hispanics originating from Puerto Rico or the Dominican Republic. The distribution curve derived by the traditional approach represents a composite of curves from specific subpopulations that do not provide appropriate reference limits for those unique groups.
CONCLUSIONS: Age- and race-specific TSH distribution and reference limits, possibly influenced by genetic factors, should be employed to provide clinicians accurate limits for specific populations and guidance for further evaluation of thyroid dysfunction.
Authors:
Martin I Surks; Laura Boucai
Related Documents :
22967055 - Incidence, prevalence, and hybrid approaches to calculating disability-adjusted life ye...
17730915 - Modeling periodically surging glaciers.
21335805 - The minnesota pelvic trainer: a hybrid vr/physical pelvis for providing virtual mentors...
24857335 - Mortality following hip arthroplasty-inappropriate use of national joint registry (njr)...
20661995 - Improved model for myocardial diffuse reflectance spectra by including mitochondrial cy...
21644015 - Dispersal constraints for stream invertebrates: setting realistic timescales for biodiv...
Publication Detail:
Type:  Journal Article; Review     Date:  2009-12-04
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-05     Completed Date:  2010-03-02     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  496-502     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
African Continental Ancestry Group
Age Factors
Aged
European Continental Ancestry Group
Humans
Middle Aged
Reference Values
Thyroid Diseases / classification
Thyrotropin / blood*
Thyroxine / blood
Chemical
Reg. No./Substance:
9002-71-5/Thyrotropin; Q51BO43MG4/Thyroxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Associations of birthweight and gestational age with reproductive and metabolic phenotypes in women ...
Next Document:  Risk Factors for Hemodynamic Instability during Surgery for Pheochromocytoma.