Startseite Medizin Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population
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Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population

  • Clement K.M. Ho ORCID logo EMAIL logo , Edward T.H. Tan , Mor Jack Ng , George S.H. Yeo , Bernard Chern , Nancy W.S. Tee , Kenneth Y.C. Kwek und Kok Hian Tan
Veröffentlicht/Copyright: 10. April 2017
Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 55 Heft 11

Abstract

Background:

Thyroid disorders are common during pregnancy. To date, a limited number of studies have reported differences in serum thyroid hormone concentrations between different ethnic groups. We sought to establish gestational age-specific reference intervals for serum levels of thyroid hormones in a multi-ethnic population and investigate whether separate reference intervals should be used for different ethnic groups.

Methods:

A total of 926 pregnant women from multiple ethnic groups attended four separate study visits spanning the three trimesters. Venous blood samples were taken at 9 to 14 weeks, 18 to 22 weeks, 28 to 32 weeks, and 34 to 39 weeks of gestation. Serum concentrations of thyroid-stimulating hormone (TSH), free thyroxine (T4), free triiodothyronine (T3), total T4, total T3, thyroid peroxidase antibody and thyroglobulin antibody were measured using Abbott Architect immunoassays. A total of 562 women with singleton pregnancies were found to be negative for both thyroid autoantibodies at all four study visits and thus included in the reference sample group for the establishment of reference intervals (2.5th to 97.5th percentiles).

Results:

Reference intervals for serum thyroid hormones at 9–14 weeks of gestation derived from the combined group of pregnant women are as follows: TSH, 0.01–2.39 mIU/L; free T4, 11.4–19.5 pmol/L; free T3, 4.23–6.69 pmol/L; total T4, 77.8–182.4 nmol/L; total T3, 1.39–2.97 nmol/L. No differences in the five thyroid parameters’ reference intervals are detectable among the ethnic groups except that at study visit 3 (28–32 weeks of gestation), the upper reference limit of total T3 in Malays (3.20 nmol/L; 90% CI, 2.99–3.76 nmol/L) is slightly higher than that in Chinese (2.86 nmol/L; 90% CI, 2.70–2.98 nmol/L).

Conclusions:

The findings from this study on a multi-ethnic cohort highlight the importance of establishing locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters.

Keywords: ethnicity; pregnancy; reference interval; thyroid
Corresponding author: Dr. Clement K.M. Ho, Department of Pathology and Laboratory Medicine, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore

Acknowledgments

We thank Abbott Laboratories for providing reagents for the hormone assays used in this study and Dr. Carlum Shiu (Abbott Laboratories) for his constructive comments.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This study was funded by the National Medical Research Council of Singapore.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Supplemental Material:

The online version of this article offers supplementary material (DOI: https://doi.org/10.1515/cclm-2016-0790).

Received: 2016-9-6
Accepted: 2017-3-6
Published Online: 2017-4-10
Published in Print: 2017-10-26

©2017 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

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  2. Editorial
  3. High-sensitivity assays for cardiac troponins – continued
  4. Reviews
  5. The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications
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  28. Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population
  29. Cancer Diagnostics
  30. Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS)
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  45. Congress Abstracts
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https://doi.org/10.1515/cclm-2016-0790
Schlagwörter für diesen Artikel
ethnicity; pregnancy; reference interval; thyroid

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. High-sensitivity assays for cardiac troponins – continued
  4. Reviews
  5. The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications
  6. Vitamin B1 in critically ill patients: needs and challenges
  7. Opinion Papers
  8. Point
  9. High-sensitivity cardiac troponin: do think twice, it’s not all right
  10. Counterpoint
  11. Terminology of cardiac troponin assays and data censoring
  12. Establishing consensus-based, assay-specific 99th percentile upper reference limits to facilitate proper utilization of cardiac troponin measurements
  13. Fast track protocols using highly sensitive troponin assays for ruling out and ruling in non-ST elevation acute coronary syndrome
  14. Genetics and Molecular Diagnostics
  15. Relationship between polymorphisms in the CRP, LEP and LEPR genes and high sensitivity C-reactive protein levels in Spanish children
  16. General Clinical Chemistry and Laboratory Medicine
  17. An approach for estimating measurement uncertainty in medical laboratories using data from long-term quality control and external quality assessment schemes
  18. Selecting multi-rule quality control procedures based on patient risk
  19. Moving sum of number of positive patient result as a quality control tool
  20. Multidisciplinary training activities for decreasing preanalytical mistakes in samples from primary care
  21. Harmonization protocols for TSH immunoassays: a multicenter study in Italy
  22. Circulating free light chain measurement in the diagnosis, prognostic assessment and evaluation of response of AL amyloidosis: comparison of Freelite and N latex FLC assays
  23. Serum prolactin revisited: parametric reference intervals and cross platform evaluation of polyethylene glycol precipitation-based methods for discrimination between hyperprolactinemia and macroprolactinemia
  24. Temporal and regional variability in the request of vitamin D from general practitioners in Spain
  25. Fibrinogen determination according to Clauss: commutability assessment of International and commercial standards and quality control samples
  26. Reference Values and Biological Variations
  27. S100B maternal blood levels are gestational age- and gender-dependent in healthy pregnancies
  28. Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population
  29. Cancer Diagnostics
  30. Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS)
  31. Cardiovascular Diseases
  32. A new immunochemistry platform for a guideline-compliant cardiac troponin T assay at the point of care: proof of principle
  33. Diabetes
  34. Adiponectin and leptin as first trimester markers for gestational diabetes mellitus: a cohort study
  35. Letters to the Editor
  36. Can we still trust hemoglobin A1c in all situations?
  37. Automated detection of unstable hemoglobin variants by Sysmex XE-Series analyzers
  38. Mean hemoglobin concentrations in fasting venous and non-fasting capillary blood of Cambodian women using a hemoglobinometer and an automated hematology analyzer
  39. Evaluation of a POCT device for C-reactive protein, hematocrit and leukocyte differential
  40. New perspectives on existing data in comparative measurements: a simple extension of the regression analysis
  41. Evaluation of a human anti-mouse antibody rapid test for patients requiring radio-immunodiagnostic
  42. The cortisol-CBG ratio affects cortisol immunoassay bias at elevated CBG concentrations
  43. Prognostic value of total antioxidant capacity to predict functional outcome in traumatic brain injury patients
  44. Use of IFCC guidelines to verify acetylcholinesterase reference interval in adults determined with ChE check mobile testing system
  45. Congress Abstracts
  46. 49th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC – Laboratory Medicine)
  47. Congress of Clinical Chemistry and Laboratory Medicine
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