Objectives: The determination of assay-dependent upper and lower reference limits (URL, LRL) of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) during childhood and adolescence, is challenging. Methods: Thyroid hormones were measured via the Abbott Alinity system in 502 euthyroid children partitioned in the following age groups: ≤2, 2.1-10, and 10.1-18 years. The 97.5th and 2.5th percentiles (URL and LRL) were derived according to CLSI EP28- A3c guidelines. Quantile regression models were used to assess: (a) 90% confidence intervals of the URL and LRL, (b) the effect of age on URL and LRL within each age class and on overall age range, (c) the difference between the URLs and LRLs estimated for each age partition with an estimate of the confidence interval divided by the reference interval being derived (CI/RI). Results: The CI/RI for the LRLs are smaller as compared to the URLs, except for FT4 for the 2.1-10 years age group. Considering the CI/RI and the overlap between CIs across the three age groups, one single LRL might be considered for TSH, FT3 and FT4 between 0 and 18 years. However, for the URL, there was a noticeable decrease in the URL over the 3 age groups for all three biomarkers, with there being no overlap in CIs for the URL between the ≤2 vs. the 10.1-19 years age groups. Conclusions: A common LRL for TSH, FT4 and FT3 for patients aged ≤18 years may be utilized when these biomarkers are measured with the Alinity system. For the URLs the use of age-specific URLs for these biomarkers is recommended.

Reference intervals of thyroid hormones and related indices to enhance the assessment of thyroid status in childhood and adolescence / S. Ferraro, E. Luconi, V. Calcaterra, E. Cordaro, A. Bianchi, C. Cereda, G. Zuccotti, P. Kavsak, M. Plebani, E. Biganzoli, G. Marano, P. Boracchi. - In: CLINICAL CHEMISTRY AND LABORATORY MEDICINE. - ISSN 1437-4331. - (2023), pp. 1-10. [Epub ahead of print] [10.1515/cclm-2022-1053]

Reference intervals of thyroid hormones and related indices to enhance the assessment of thyroid status in childhood and adolescence

E. Luconi
Co-primo
;
G. Zuccotti;E. Biganzoli
Co-ultimo
;
G. Marano
Co-ultimo
;
P. Boracchi
Co-ultimo
2023

Abstract

Objectives: The determination of assay-dependent upper and lower reference limits (URL, LRL) of free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) during childhood and adolescence, is challenging. Methods: Thyroid hormones were measured via the Abbott Alinity system in 502 euthyroid children partitioned in the following age groups: ≤2, 2.1-10, and 10.1-18 years. The 97.5th and 2.5th percentiles (URL and LRL) were derived according to CLSI EP28- A3c guidelines. Quantile regression models were used to assess: (a) 90% confidence intervals of the URL and LRL, (b) the effect of age on URL and LRL within each age class and on overall age range, (c) the difference between the URLs and LRLs estimated for each age partition with an estimate of the confidence interval divided by the reference interval being derived (CI/RI). Results: The CI/RI for the LRLs are smaller as compared to the URLs, except for FT4 for the 2.1-10 years age group. Considering the CI/RI and the overlap between CIs across the three age groups, one single LRL might be considered for TSH, FT3 and FT4 between 0 and 18 years. However, for the URL, there was a noticeable decrease in the URL over the 3 age groups for all three biomarkers, with there being no overlap in CIs for the URL between the ≤2 vs. the 10.1-19 years age groups. Conclusions: A common LRL for TSH, FT4 and FT3 for patients aged ≤18 years may be utilized when these biomarkers are measured with the Alinity system. For the URLs the use of age-specific URLs for these biomarkers is recommended.
pediatric; reference interval; statistics; thyroid
Settore MED/01 - Statistica Medica
2023
27-gen-2023
Article (author)
File in questo prodotto:
File Dimensione Formato  
Thyroid+children6.10.22-2.pdf

accesso riservato

Descrizione: Pre-print Article
Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 1.62 MB
Formato Adobe PDF
1.62 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
10.1515_cclm-2022-1053.pdf

Open Access dal 28/01/2024

Descrizione: Article
Tipologia: Publisher's version/PDF
Dimensione 2.09 MB
Formato Adobe PDF
2.09 MB Adobe PDF Visualizza/Apri
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/956828
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 4
social impact