Thyroid Function Reference Intervals by Age, Sex, and Race

作者：Qihang Li, Yi‐Da Tang, Xuefeng Yu, Guijun Qin, Limin Tian, Lianjiang Cheng, Yi Lü, Zhigang Zhao, Libin Liu, Kai Zhang, Changjun Wang, Shuqing Zhang, Yong Xu, Guangyao Song, Fang Zhong, Xiude Fan, Zhixiang Wang, Yiman Wu, Yongfeng Song, Jiajun Zhao · 发表于：Annals of Internal Medicine · 年份：2025 · DOI：10.7326/annals-24-01559 · 被引用次数：24 · 研究领域：Thyroid Disorders and Treatments、Thyroid Cancer Diagnosis and Treatment、Hormonal and reproductive studies

BACKGROUND: Current clinical practice uses a one-size-fits-all approach to define reference intervals for the results of diagnostic tests about thyroid function. This approach does not recognize subgroup differences according to age, sex, or race. OBJECTIVE: To identify age-, sex-, and race-specific reference intervals for the common diagnostic tests that measure thyroid function and to examine how these new reference intervals reclassify persons into disease categories when compared with current reference intervals. DESIGN: Cross-sectional analysis. SETTING: Data from the U.S. NHANES (National Health and Nutrition Examination Survey) supplemented with data from a multicenter Chinese study. PARTICIPANTS: = 314 302). MEASUREMENTS: The thyroid function reference interval was defined as the interval of diagnostic indicator levels from the 2.5th (lower limit) to the 97.5th (upper limit) percentile by age, sex, and race subgroups. RESULTS: levels, and White participants had higher TSH levels. Using current reference intervals, the prevalence of subclinical hypothyroidism increased from 2.4% for ages 20 to 29 years to 5.9% for ages 70 years and older. In contrast, using age-, sex-, and race-specific reference intervals reclassified 48.5% of persons with subclinical hypothyroidism as normal, especially women and White participants, and reclassified 31.2% of persons with subclinical hyperthyroidism as normal, especially women, Black participants, and Hispanic participants. When compa...