Abstract

ObjectiveThe purpose of this study was to predict elevated TSH levels by developing an effective machine learning model based on large-scale physical examination results.MethodsSubjects who underwent general physical examinations from January 2015 to December 2019 were enrolled in this study. A total of 21 clinical parameters were analyzed, including six demographic parameters (sex, age, etc.) and 15 laboratory parameters (thyroid peroxidase antibody (TPO-Ab), thyroglobulin antibody (TG-Ab), etc.). The risk factors for elevated TSH levels in the univariate and multivariate Logistic analyses were used to construct machine learning models. Four machine learning models were trained to predict the outcome of elevated TSH levels one year/two years after patient enrollment, including decision tree (DT), linear regression (LR), eXtreme Gradient boosting (XGBoost), and support vector machine (SVM). Feature importance was calculated in the machine learning models to show which parameter plays a vital role in predicting elevated TSH levels.ResultsA total of 12,735 individuals were enrolled in this study. Univariate and multivariate Logistic regression analyses showed that elevated TSH levels were significantly correlated with gender, FT3/FT4, total cholesterol (TC), TPO-Ab, Tg-Ab, creatinine (Cr), and triglycerides (TG). Among the four machine learning models, XGBoost performed best in the one-year task of predicting elevated TSH levels (AUC (0.87(+/- 0.03))). The most critical feature in this model was FT3/FT4, followed by TPO-Ab and other clinical parameters. In the two-year task of predicting TSH levels, none of the four models performed well.ConclusionsIn this study, we trained an effective XGBoost model for predicting elevated TSH levels one year after patient enrollment. The measurement of FT3 and FT4 could provide an early warning of elevated TSH levels to prevent relative thyroid diseases.

Highlights

  • Thyroid-stimulating hormone (TSH) is secreted by the pituitary gland and plays an important role in maintaining normal thyroid functions

  • The most significant risk factor in the univariate Logistic regression analysis was FT3/FT4 (OR = 6.696, 95% confidence intervals (CIs): 4.668–9.605)

  • From the multivariate Logistic regression analysis, there was one significant protective factor and six risk factors for elevated TSH levels, among which the most statistically significant risk factors were FT3/FT4 (OR = 3.170, 95% CI: 2.033-4.206) and Tg-Ab (OR = 2.746, 95% CI: 1.953-3.009), which indicated that the two factors were highly related with elevated TSH levels

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Summary

Introduction

Thyroid-stimulating hormone (TSH) is secreted by the pituitary gland and plays an important role in maintaining normal thyroid functions. An elevated TSH level is usually a signal of illness, such as hypothyroidism and Hashimoto thyroiditis [1, 2]. Elevated TSH levels are risk factors for many pathological states. Since an elevated TSH level is a risk factor for thyroid diseases, accurate prediction of TSH levels can promote early, preventative intervention for high-risk patients and warn them to keep their eyes on potential thyroid diseases. It can be seen from our dataset that when subjects first came to do the physical examination, their TSH levels were usually normal. It is essential to predict elevated TSH levels over 1–2 years after patient enrollment

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