ECE2020 Audio ePoster Presentations Thyroid (144 abstracts)
Age and sex-specific TSH upper-limit reference intervals in the general French population: There is a need to adjust our actual practices
Véronique RAVEROT 1 , Bonjour Maxime 2 , Abeillon Juliette 3 , Perrin Pauline 1 , Roucher Florence 1 , Lasolle Hélène 3 , Subtil Fabien 2 & Francoise Borson-Chazot 3
1Hospices Civils de Lyon, LBMMS, Lyon, France; 2Hospices Civils de Lyon, Service de Biostatistique, Lyon, France; 3Hospices Civils de Lyon, Fédération d’endocrinologie, Lyon, France
Background: The increasing age of the general population represents a new challenge for endocrinologists and caregivers since it is well know that the occurrence of thyroid dysfunction increases with age. It is still controversial whether or not reference values of thyrotropin (TSH) adapted to age and sex need to be used. Herein, we aimed to determine reference intervals, in males and females, suitable for thyroid disease exploration and follow-up during adult life in a tertiary center in France.
Methods: Over 11 years, 295775 TSH were measured in a single lab that used the same TSH reagent during this period. Among the 156025 TSH results available for analysis, 90 538 values were from female subjects, 82019 were from patients aged >60 years and 26825 aged >80 years. By using an indirect approach, we determined references values of TSH adapted to age and sex, and we then evaluated the proportion of patients who would have been reclassified with these reference values.
Results: The median TSH ranged from 1.2 to 1.4 mUI/l during the study period. The circannual range of the upper limit of the reference value was 4.6 to 5.4 mUI/l. By contrast, the upper limit of reference range of TSH increased with age; in females the median to 97.5th percentile values increased continuously with age from the age of 30 years to the oldest age group (90–108 years). Using new calculated reference values in patients with TSH above the conventional upper limit reference value (4 mUI/l), the proportion of results reclassified as physiologicalranged, according to age-group, from 26.3 to 65.1% in females and from 13.6 to 37.7% in males; in among those aged >60 years, 50.5 to 65.1% of females and 33.0 to 37.7% of males were reclassified.
Conclusions: The use of TSH age-specific and sex-specific upper-limitreferences values led to the reclassification of a great number of samples, notably among women. This suggests that age-specific TSH upper-limitreference intervals in daily practice should be used in order to avoid misclassification.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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