Korean pediatric reference intervals for FT4, TSH, and TPO Ab and the prevalence of thyroid dysfunction: A population-based study
Abstract
Background The appropriate age-related reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are important in interpreting the results of thyroid function tests in children and adolescents. However, these reference intervals are scanty. This study aimed to establish the reference intervals for FT4, TSH, and thyroid peroxidase antibody (TPO Ab), and identify the epidemiological prevalence of thyroid dysfunction in a Korean pediatric population.Methods The data from a sample of 2042 children and adolescents aged 10-18years who underwent a nationwide Korean representative sampling and cross-sectional survey with blood collection for a thyroid function test using an electrochemiluminescence immunoassay were evaluated.Results Based on the National Academy of Clinical Biochemistry (NACB) criteria, the median and range (2.5th - 97.5th percentile) for FT4 and TSH in total were 16.47pmol/L (12.61-21.49pmol/L) and 2.48mIU/L (0.63-7.03mIU/L), respectively. Positive TPO Ab (3.1%) by NACB was >19.16kIU/L (boys) and >29.30kIU/L (girls) for adolescents aged 10-18years. FT4 and TSH were associated with increasing and decreasing age, respectively. Boys' FT4 and girls' TPO Ab levels were greater than for the other sex, respectively. Using the new reference interval, overt hypothyroidism, subclinical hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were found in 0.5%, 2.1%, 1.3%, and 1.2%, respectively, of Korean children and adolescents.Conclusions This study provides evidence-based age- and sex-specific reference intervals for thyroid hormones and autoantibodies, and identifies the current prevalence of thyroid dysfunction in a Korean pediatric group.
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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 [123]
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 [39]
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- Authors
- Lim, H. H.
- Affiliations
- Chungnam National University (KR)
- Corresponding author
- Lim, Han Hyuk
- ORCID
- Lim, Han Hyuk
- Venue
- Clinical Biochemistry
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 50
- Issue
- 18
- Pages
- 1256-1259
- ISSN
- 0009-9120 (ISSN-L)
- OpenAlex
- W2762917622
- Cited by
- 11
- References
- 15
- Citations by year
- 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 1
- FWCI
- 1.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Biochemistry (publishedVersion)
- PubMed (publishedVersion)
- 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
- pediatric reference intervals, free thyroxine, thyroid-stimulating hormone, thyroid peroxidase antibodies, thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, overt hypothyroidism, overt hyperthyroidism, thyroid autoantibodies, age- and sex-specific reference values, Korean children and adolescents
- MeSH terms
- Adolescent, Autoantibodies, Child, Female, Humans, Iodide Peroxidase, Male, Sex Characteristics, Thyroid Diseases, Thyrotropin, Thyroxine, Prevalence, Republic of Korea
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