Age-Specific Reference Intervals for Thyroid-Stimulating Hormones and Free Thyroxine to Optimize Diagnosis of Thyroid Disease
Authors' conclusion
This study stressed the known importance of using age-specific RIs for TSH and FT4 in children. This study also showed the clinical relevance of using age-specific RIs for TSH in adulthood to reduce diagnoses of subclinical hypothyroidism in older persons.
Study context
- Population
- Thyroid-stimulating hormone (TSH) and free thyroxine (FT4) requests, 13 Dutch laboratories for general practitioners and local hospitals, 2008–2022; ages 2 to 100 years7.6 million TSH, 2.2 million FT4 requests
- Outcome
- Age-specific RIs for TSH and FT4 throughout life, and reclassification of thyroid disease diagnoses in adults
Methodological detailsmulticenter, retrospective, indirect reference intervals from big data, four immunoassay platforms
- Multicenter
- Retrospective
- Indirect reference intervals from big data
- Four immunoassay platforms
Main finding
As reported in the abstract
- TSH upper reference limits and FT4 lower reference limits were higher in early childhood and decreased toward adulthood
- In adulthood, TSH upper reference limits increased from 60 years in men and from 50 years in women
- FT4 upper reference limits increased from 70 years onward
- Reference interval (RIs) evaluated per manufacturer
Observational data: associations, not effects.
Further findings
Reclassification of diagnoses using adult age-specific RIs
- Decrease in diagnoses of subclinical and overt hypothyroidism in women above 50 and men above 60 years (Roche dataset)
Original publication
Age-Specific Reference Intervals for Thyroid-Stimulating Hormones and Free Thyroxine to Optimize Diagnosis of Thyroid Disease. Thyroid. Published 30 September 2024. doi:10.
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