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. 2022 Apr 8;41(2):238-245.
doi: 10.5937/jomb0-33543.

Indirect estimation of reference intervals for thyroid parameters using advia centaur XP analyzer

Bosa Mirjanić-Azarić  1 , Neda Milinković  2 , Natasa Bogavac-Stanojević  2 , Sanja Avram  3 , Tanja Stojaković-Jelisavac  3 , Darja Stojanović  3
Affiliations

Indirect estimation of reference intervals for thyroid parameters using advia centaur XP analyzer

Bosa Mirjanić-Azarić et al. J Med Biochem. .

Abstract
in English, Serbian

Background: The aim of this study was to determine the reference intervals (RIs) for thyroid stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and FT3/FT4 ratio using indirect methods.

Methods: We analyzed 1256 results TSH, FT4 and FT3 collected from a laboratory information system between 2017 and 2021. All measurements were performed on a Siemens ADVIA Centaur XP analyzer using the chemiluminescent immunoassay. We calculated the values of the 2.5th and 97.5th percentiles as recommended by the IFCC (CLSI C28-A3).

Results: The RIs derived for TSH, FT4, FT3 and FT3/FT4 ratio were 0.34-4.10 mIU/L, 11.3-20.6 pmol/L, 3.5-6.32 pmol/L and 0.21-0.47, respectively. We found a significant difference between calculated RIs for the TSH and FT4 and those recommended by the manufacturer. Also, FT3 values were significantly higher in the group younger than 30 years relative to the fourth decade (5.26 vs. 5.02, p=0.005), the fifth decade (5.26 vs. 4.94, p=0.001), the sixth decade (5.26 vs. 4.87, p<0.001), the seventh decade (5.26 vs. 4.79, p<0.001) and the group older than 70 years old (5.26 vs. 4.55, p<0.001). Likewise, we found for TSH values and FT3/FT4 ratio a significant difference (p <0.001) between different age groups.

Conclusions: The establishing RIs for the population of the Republic of Srpska were significantly differed from the recommended RIs by the manufacturer for TSH and FT4. Our results encourage other laboratories to develop their own RIs for thyroid parameters by applying CLSI recommendations.

Uvod: Cilj ove studije bio je da se odrede referentni intervali (RI) tireotropnog hormona (TSH), slobodnog tiroksina (FT4), slobodnog trijodotironina (FT3) i odnosa FT3/FT4 indirektnom metodom procene referentnih intervala.

Metode: Analizirali smo 1256 dobijenih vrednosti TSH, FT4 i FT3 u periodu između 2017. i 2021. godine. Rezultate smo uzeli iz laboratorijskog informacionog sistema. Sva merenja su izvedena na Siemens ADVIA Centaur XP analizatoru pomo}u hemiluminiscentnih imunohemijskih testova. Izračunali smo vrednosti 2,5-og i 97,5-og percentila prema preporuci IFCC-a (CLSI C28-A3).

Rezultati: Procenjeni RI za TSH, FT4, FT3 i odnos FT3/FT4 bili su 0,34-4,10 mIU/L; 11,3-20,6 pmol/L; 3,5-6,32 pmol/L i 0,21-0,47. Utvrdili smo značajnu razliku između izračunatih RI za TSH i FT4 i onih koje preporučuje proizvođač. Takođe, vrednosti FT3 bile su značajno ve}e u grupi mlađoj od 30 godina u odnosu na četvrtu deceniju (5,26 vs. 5,02; p = 0,005), petu deceniju (5,26 vs. 4,94; p = 0,001), šestu deceniju (5,26 vs. 4,87; p<0,001), sedmu deceniju (5,26 vs. 4,79; p<0,001) i grupu stariju od 70 godina (5,26 vs. 4,55; p<0,001). Isto tako, za vrednosti TSH i odnos FT3/FT4 pronašli smo značajnu razliku (p <0,001) između različitih dobnih grupa.

Zaključak: Procenjene vrednosti referentnih intervala za TSH i FT4 za stanovništvo Republike Srpske značajno su se razlikovale od preporučenih RI od strane proizvođača. Naši rezultati podstiču druge laboratorije da izrade sopstvene RI za parametre štitne žlezde primenom CLSI preporuka.

Keywords: indirect methods; reference intervals; thyroid parameters.

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Conflict of interest statement

Conflict of Interest: The authors stated that they have no conflicts of interest regarding the publication of this article.

Figures

Figure 1
Figure 1. Proposed criteria for indirect method determination of RIs
Figure 2
Figure 2. Distribution of the analyzed thyroid parameters: thyroid stimulating hormone, TSH; free thyroxine, FT4; free triiodothyronine FT3
Figure 3
Figure 3. Median and interquartile range for the overall analyzed TSH, FT4, FT3 and FT3/FT4 values relative to decades of life
See this image and copyright information in PMC

References

    1. Demers L M, Spencer C A. Laboratory Medicine Practice Guidelines: Laboratory Support for the Diagnosis and Monitoring of Thyroid Disease. Thyroid. 2003;13:3–126. - PubMed
    1. Mirjanic-Azaric B, Jerin A, Radic Z. Thyroid Stimulating Hormone Values of Clinical Decisions of Hypothyroidism Measurement by Three Different Automated Immunoassays. Scand J Clin Lab Invest. 2020;80(2):151. doi: 10.1080/00365513.2019.1703215. - DOI - PubMed
    1. Thienpont L M, van Uytfanghe K, Beastall G, et al. Report of the IFCC Working Group for Standardization of Thyroid Function Tests; Part 2: Free Thyroxine and Free Triiodothyronine. Clin Chem. 2010;56(6):912. doi: 10.1373/clinchem.2009.140194. - DOI - PubMed
    1. Kazerouni F, Amirrasouli H. Performance Characteristics of Three Automated Immunoassays for Thyroid Hormones Casp J Int Med. 2012;3:400–404. - PMC - PubMed
    1. Hendriks H A, Kortlandt W, Verweij W M. Analytical Performance Comparison of Five New Generation Immunoassay Analyzers Ned Tijdschr Klin Chem. 2000;25:170–177. - PubMed

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