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Cited by 29Thyroid Disorders and TreatmentsClinical Laboratory Practices and Quality ControlThyroid Cancer Diagnosis and Treatment

Reference intervals for thyrotropin in an area of Northern Italy: the Pordenone thyroid study (TRIPP)

Tozzoli, R., D’Aurizio, F., Metus, P., Steffan, A., Mazzon, C., Bagnasco, M.·2018·Journal of Endocrinological Investigation
DOI 10.1007/s40618-018-0825-0
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Abstract

Purpose Thyrotropin (TSH) is the most accurate marker of thyroid dysfunction in the absence of pituitary or hypothalamic disease. Studies on TSH reference intervals (RIs) showed wide inter-individual variability and prompted an intense debate about the best estimation of TSH RIs.Design We performed a population study on TSH RIs, using current data stored in the laboratory information system (LIS), at the Hospital Department of Laboratory Medicine, Pordenone (Italy), historically an area of mild-moderate iodine deficiency with a relatively high goiter prevalence.Methods 136,650 individuals constituted the final sample. A TSH immunoassay was performed on fasting serum samples with the Dimension Vista 1500 analyzer (Siemens Healthineers). We adopted the Kairisto's procedure to analyze TSH data downloaded by the LIS, applying the indirect strategy for deriving RIs.Results TSH RIs of the entire population were 0.32-3.36 mIU/L with a distribution skewed towards higher values. RIs were 0.26-3.61 mIU/L for females, and 0.32-3.01 mIU/L for males. Unlike other studies, TSH median levels progressively decreased from 0-4 to 85-104 years in the overall population, both in male and in female subgroups, showing an inverse correlation between TSH and age in all groups.Conclusions This study is the first to analyze a high percentage (40%) of individuals from an ethnically homogenous Caucasian population. The results obtained emphasize the opportunity to define the TSH RIs according to age, gender and race, in addition to assay methods, and provide further insight about the possible role of iodine status.

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  • Cross-sectional studies generally show higher TSH upper limits in younger children (<5 years) compared with older children (≥5 years), with a gradual decline in TSH concentration towards adult age (15-18 years), and lower FT3 with higher increases in FT4 concentrations from age 4 years.

    “Cross-sectional studies generally show higher TSH upper limits in younger children (<5 years) compared with older children (≥5 years), with a gradual decline in TSH concentration towards adult age (15-18 years), 119-124 and lower FT3 with higher increases in FT4 concentrations from age 4 years.[125][126][127][128]”

    From Hypothyroidism (2024) · cites this paper as [122]

  • In some studies, TSH concentration was higher in boys than in girls.

    “In some studies, TSH concentration was higher in boys than in girls [38]”

    From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [38]

  • Cross-sectional studies generally show higher TSH upper limits in younger children (<5 years) compared to older children, with a gradual decline in TSH concentration as adult age is approached.

    “Cross-sectional studies generally show higher TSH upper limits in younger children (< 5 years) compared to older children, with a gradual decline in TSH concentration as the adult age is approached [33, 36–39].”

    From Age-related variation in thyroid function – a narrative review highlighting important implications for research and clinical practice (2023) · cites this paper as [38]

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Authors
Tozzoli, R., D’Aurizio, F., Metus, P., Steffan, A., Mazzon, C., & Bagnasco, M.
Affiliations
  • Azienda sanitaria universitaria Friuli Centrale (IT)
  • Ospedale Policlinico San Martino (IT)
Corresponding author
D’Aurizio, F.
ORCID
Venue
Journal of Endocrinological Investigation
Publisher
Springer Science and Business Media LLC
Published
2018-01-16
Volume
41
Issue
8
Pages
985-994
ISSN
  • 0391-4097 (ISSN-L)
  • 1720-8386
DOI
10.1007/s40618-018-0825-0
OpenAlex
W2783238874
Cited by
29
References
67
Citations by year
2026: 2 · 2025: 2 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 6 · 2019: 4 · 2018: 2
FWCI
3.38
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of Endocrinological Investigation (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
Keywords
thyroid-stimulating hormone, TSH reference intervals, thyroid function, sex differences, iodine deficiency, goiter, population-based reference values, Pordenone
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Infant, Infant, Newborn, Italy, Male, Middle Aged, Prognosis, Reference Values, Thyroid Diseases, Thyroid Gland, Thyrotropin, Biomarkers, Prevalence, Young Adult

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