Establishment of reference distributions and decision values for thyroid antibodies against thyroid peroxidase (TPOAb), thyroglobulin (TgAb) and the thyrotropin receptor (TRAb)
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Esther A. Jensen
Abstract
Background: The National Academy of Clinical Biochemistry (NACB) stresses that the reference intervals for thyroid peroxidase antibodies (TPOAb), thyroglobulin antibodies (TgAb) and thyroid stimulating hormone (TSH)-receptor antibodies (TRAb) should be based on young men who lack certain risk factors and have serum TSH between 0.5 and 2.0mIU/L. However, some young men without any of the risk factors have autoantibodies, and cannot be identified by the present tools. A model for reference intervals and cut-off values should not be influenced by the prevalence of risk factors.
Methods: We developed a model of “composite logarithmic Gaussian distributions” and tested it in 1441 well-characterised subjects without clinically overt thyroid disease.
Results: TPOAb and TgAb could be measured in all individuals. The 97.5% upper limits 1) on a traditional non-parametric scale, 2) according to the NACB criteria, and 3) for our model were 284, 24 and 9.8kIU/L for TPOAb, and 84, 22 and 19kIU/L for TgAb, respectively. The decision value (defined as the concentration corresponding to 0.1% false positives) was 15kIU/L for TPOAb and 31kIU/L for TgAb. Concentrations above our reference intervals affected the corresponding distribution of TSH values. For TRAb the upper reference limits were 1) 0.75 and 2) 0.75IU/L, while our model was not applicable to TRAb because only 2–3% of the results were above the functional assay sensitivity.
Conclusions: In contrast to the NACB guidelines, our model for TPOAb and TgAb is more robust, as it is independent of the characteristics of the reference population.
Clin Chem Lab Med 2006;44:991–8.
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©2006 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Laboratory medicine in the 2000s: programmed death or rebirth?
- Polymorphisms of the inflammatory system and risk of ischemic cerebrovascular events
- Haptoglobin polymorphism in patients with preeclampsia
- Fifteen polymorphisms in endothelin-1, endothelin-2 and endothelin-receptor-A genotyped by four duplex assays and seven simple assays on a LightCycler using hybridization probes
- Optimization of an enzymatic method for the determination of lysosomal N-acetyl-β-D-hexosaminidase and β-glucuronidase in synovial fluid
- An improved laboratory protocol to assess subarachnoid haemorrhage in patients with negative cranial CT scan
- Association of aminothiols with the clinical outcome in hemodialysis patients: comparison of chromatography and immunoassay for homocysteine determination
- Poor prognosis indicated by nucleated red blood cells in peripheral blood is not associated with organ failure of the liver or kidney
- Detection of citrate overdose in critically ill patients on citrate-anticoagulated venovenous haemofiltration: use of ionised and total/ionised calcium
- Unchanged androgen-binding properties of sex hormone-binding globulin in male patients with liver cirrhosis
- Relationship between serum uric acid, creatinine, albumin and gestational diabetes mellitus
- Aminothiols in human brain tumors
- Measurement of carnitine in hemodialysis patients – adaptation of an enzymatic photometric method for an automatic analyzer
- A robust liquid chromatography tandem mass spectrometry method for total plasma homocysteine determination in clinical practice
- Establishment of reference distributions and decision values for thyroid antibodies against thyroid peroxidase (TPOAb), thyroglobulin (TgAb) and the thyrotropin receptor (TRAb)
- Effects of a long-distance run on cardiac markers in healthy athletes
- α-Tocopherol supplementation reduces the elevated 8-hydroxy-2-deoxyguanosine blood levels induced by training in basketball players
- Influence of the needle bore size used for collecting venous blood samples on routine clinical chemistry testing
- The ratio of apoB/apoAI, apoB and lipoprotein(a) are the best predictors of stable coronary artery disease
- Evaluation of the analytical performance of the advanced method for cardiac troponin I for the AxSYM platform: comparison with the old method and the Access system
- Preliminary performance evaluation of blood gas analyzers
- A cost-effectiveness evaluation of reticulocyte measurement in new outpatients with or without hematologic disorders
- Guidelines for setting up an External Quality Assessment Scheme for blood smear interpretation. Part II: survey preparation, statistical evaluation and reporting
- Free light chain testing in follow-up of multiple myeloma
- Blood reactive oxygen metabolites (ROMs) and total antioxidant status (TAS) in patients with laryngeal squamous cell carcinoma after surgical treatment
- SIBioC 2006 38th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology, Turin, Italy, September 19–22, 2006
- Third Santorini Biologie Prospective Conference 2006: From Human Genetic Variations to Prediction of Risks and Responses to Drugs and the Environment, Santorini Island, Greece, September 29 - October 2, 2006
