Abstract
summaryBackgroundThe aim of this study was to determine the reference values for thyrotropin (TSH), thyroid hormones (total and free thyroxine, T4 and fT4; total and free triiodothyronine, T3 and fT3), thyroglobulin (Tg) and thyroid antibodies (thyroid peroxidase, TPOAb and thyroglobulin antibody, TgAb) in the population of the Republic of Srpska.MethodsA total of 250 euthyroid subjects were enrolled in this study. A direct method for choosing reference subjects was used to establish reference intervals. The hormones and thyroid antibodies were measured by an electrochemiluminescence immunoassay method (ECLIA, Roche Diagnostics, Mannheim, Germany). We calculated the reference intervals by MedCalc, version 12.1.4.0 (MedCalc software, Belgium) as recommended by the IFCC (CLSI C28-A3).ResultsUsing guidelines recommended by the National Academy of Clinical Biochemistry (NACB) and based on standard statistical approaches, the reference intervals derived for TSH, fT4, T4, fT3, T3 were 0.75–5.32 mIU/L, 12.29–20.03 pmol/L, 73.49–126,30 nmol/L, 4.11–6.32 pmol/L, 1.15–2.32 nmol/L and for Tg, TPOAb, TgAb were 3.63–26.00 μg/L, <18.02 mIU/L, < 98.00 mIU/L, respectively. We found a significant difference (p<0.05) in TSH and fT3 values between different age groups as well as in T4, fT4 and fT3 values between ge nder groups.ConclusionsThe established reference values for the population of the Republic of Srpska were significantly different from the values recommended by the manufacturer of reagents (Roche Diagnostics). Our results showed that a laboratory needs to establish its own reference values in order to set up a proper diagnosis, as well as to treat patients successfully.
Highlights
The improvement of sensitivity and specificity of biochemical thyroid tests has had a strong influence on the clinical strategy for detecting and treating thyroid diseases in the last forty years
The established reference values for the population of the Republic of Srpska were significantly different from the values recommended by the manufacturer of reagents (Roche Diagnostics)
Our results showed that a laboratory needs to establish its own reference values in order to set up a proper diagnosis, as well as to treat patients successfully
Summary
The improvement of sensitivity and specificity of biochemical thyroid tests has had a strong influence on the clinical strategy for detecting and treating thyroid diseases in the last forty years. TSH is a first-line test for the assessment of thyroid function, mainly due to suspicion of subclinical hypothyroidism, if it is determined by the third generation methods with a functional sensitivity of 0.01 mIU/L [1]. To use this test, the following conditions must be fulfilled as follows: 1. Thyroid peroxidase antibodies (TPOAb) are very important for the diagnosis of autoimmune diseases of the thyroid gland, Hashimoto’s disease They are often present in euthyroid subjects (prevalence of 12–26%) [3] and they are important for the evaluation of future clinical status of euthyroid persons [4]. The measuring of TPOAb has much greater influence than measuring of TgAb in euthyroid persons, which can be used to identify people at increased risk of hypothyroidism
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