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Horm Metab Res 2011; 43(13): 970-976
DOI: 10.1055/s-0031-1291273
Humans, Clinical
© Georg Thieme Verlag KG Stuttgart · New York

Further Studies on Delineating Thyroid-Stimulating Hormone (TSH) Reference Range

M. Žarković
1   School of Medicine, University of Belgrade, Belgrade, Serbia
2   Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
,
J. Ćirić
1   School of Medicine, University of Belgrade, Belgrade, Serbia
2   Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
,
B. Beleslin
1   School of Medicine, University of Belgrade, Belgrade, Serbia
2   Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
,
S. Ćirić
2   Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
,
P. Bulat
1   School of Medicine, University of Belgrade, Belgrade, Serbia
3   Serbian Institute of Occupational Health, Belgrade, Serbia
,
D. Topalov
4   Institute for Laboratory Diagnostics “Konzilijum”, Belgrade, Serbia
,
B. Trbojević
1   School of Medicine, University of Belgrade, Belgrade, Serbia
2   Clinic of Endocrinology, Clinical Center of Serbia, Belgrade, Serbia
,
Serbian Thyroid Study Group › Author Affiliations
Further Information

Publication History

received 23 May 2011

accepted 28 September 2011

Publication Date:
08 November 2011 (online)

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Abstract

The aim of the study was to evaluate thyroid-stimulating hormone (TSH) concentration in a reference group and to compare it with the TSH in subjects with high probability of thyroid dysfunction. The study population consisted of 852 subjects. The reference group consisting of 316 subjects was obtained by the exclusion of the subjects having thyroid disease, taking thyroid influencing drugs, having increased thyroid peroxidase (TPO) antibodies, or having abnormal thyroid ultrasound. 42 high probability of thyroid dysfunction subjects were defined by the association of increased TPO antibody concentration, changed echogenicity, and changed echosonographic structure of thyroid parenchyma. In the reference group TSH reference range was 0.45 mU/l (95% CI 0.39–0.56 mU/l) to 3.43 mU/l (95% CI 3.10–4.22 mU/l). To distinguish reference and high probability of thyroid dysfunction group a TSH threshold was calculated. At a threshold value of 3.09 mU/l (95% CI 2.93–3.38 mU/l), specificity was 95% and sensitivity 38.1%. Using 2 different approaches to find upper limit of the TSH reference range we obtained similar results. Using reference group only a value of 3.43 mU/l was obtained. Using both reference group and subjects with the high probability of thyroid dysfunction we obtained 95% CI for the upper reference limit between 2.93 and 3.38 mU/l. Based on these premises, it could be argued that conservative estimate of the TSH upper reference range should be 3.4 mU/l for both sexes.

Key words

thyrotropin - antibodies to thyroid peroxidise - hypothyroidism
*

*  Members of the Serbian Thyroid Study Group: Novi Sad: L. T. Djilas, B. Kovačev, M. Medić; Niš: M. Pešić, D. Dimić, S. Radenković; Pirot: F. Pejčić; Kragujevac: A. Đukić, D. Bubanja, V. Mladenović; Gornji Milanovac: J. Miljević.


 

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