Thyroid panel reference intervals in healthy children and adolescents: A Spanish cohort
Abstract
Objectives In children, thyroid hormones are essential for correct physical and neurological development. The recommended process for defining reference intervals (RIs) is the direct approach; however, indirect methods are an effective alternative. This study aimed to explore age- and sex-dependent relationships between serum concentrations of thyroid hormones in a large population-based cohort of healthy Spanish Caucasian children and calculate RIs.Material and methods Results of serum thyroid-stimulating hormone (TSH) and free thyroxine (fT4) were collected from laboratory data of N (TSH = 23201; fT4 = 20728) patients aged 1 month - 15 years. These results were validated with a prospective study. Analyses of serum concentrations of TSH and fT4 were performed on ARCHITECT i2000 (Abbott Diagnostics, US). Percentiles (2.5th to 97.5th) were determined for each variable and taken as the RI.Results No difference was found between serum TSH concentrations in male and female children of all age groups. A difference between serum fT4 concentrations in males and females and an age-dependent correlation for both sexes were found.Conclusion There is very little consensus on RIs in children. Our data confirm it is possible to use data mining techniques to calculate reliable and clinically useful RIs.
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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 [120]
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 [37]
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- Authors
- Argente del Castillo, P., Pastor García, M. I., Morell-Garcia, D., Martinez-Gomez, L., Ballesteros, M. A., & Barcelo, A.
- Affiliations
- Spanish National Cancer Research Centre (ES)
- Venue
- Clinical Biochemistry
- Publisher
- Elsevier BV
- Published
- 2021-05
- Volume
- 91
- Pages
- 39-44
- ISSN
- 0009-9120 (ISSN-L)
- OpenAlex
- W3127076812
- Cited by
- 18
- References
- 30
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2023: 4 · 2022: 4 · 2021: 2
- FWCI
- 2.05
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Biochemistry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- thyroid-stimulating hormone, free thyroxine, children, adolescents, age-related reference values, sex differences, percentile calculation, thyroid function
- MeSH terms
- Adolescent, Age Factors, Child, Child, Preschool, Female, Humans, Infant, Male, Prospective Studies, Sex Factors, Spain, Thyroid Function Tests, Thyroid Gland, Thyroid Hormones
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