南方医科大学学报

南方医科大学学报 ›› 2023, Vol. 43 ›› Issue (1): 1-7.doi: 10.12122/j.issn.1673-4254.2023.01.01

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中国老年人群促甲状腺激素水平的多中心调查

王科宇，李海侠，邓新立，闫双通，裘宇容，丛玉隆   

  1. 解放军总医院第二医学中心检验科//国家老年疾病临床研究中心，北京 100853；南方医科大学南方医院检验科，广东 广州 510515；解放军总医院第二医学中心内分泌科//国家老年疾病临床研究中心，北京 100853
  • 出版日期:2023-01-20 发布日期:2023-02-22

A multi-center analysis of thyroid-stimulating hormone level in apparently healthy elderly population in China

WANG Keyu, LI Haixia, DENG Xinli,YAN Shuangtong, QIU Yurong, CONG Yulong   

  1. Department of Clinical Laboratory, Department of Endocrinology, National Clinical Research Center for Geriatric Diseases, Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Department of Laboratory Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
  • Online:2023-01-20 Published:2023-02-22

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摘要： 目的 调查中国表观健康老年人群血清促甲状腺激素（TSH）水平及其变化特征，对比罗氏电化学发光免疫分析仪和新产业全自动化学发光免疫分析仪检测TSH水平的差异。方法 收集中国具有地域代表性的10个中心共5451例表观健康老年人（>60岁）一般临床资料及冻存空腹血清样本，通过罗氏电化学发光免疫分析仪和新产业全自动化学发光免疫分析仪检测TSH等甲状腺功能指标。使用中位数（P2.5，P97.5）表示老年人群TSH水平。分析不同地域、性别、年龄组（组距为5）TSH水平差异，探索各因素对TSH水平的影响。结果 罗氏电化学发光法和新产业全自动化学发光法调查TSH参考区间分别为0.42~9.47 mU/L；0.36~7.98 mU/L，两种方法检测TSH结果有差异（P<0.001）。2个西部地区中心TSH水平显著高于其他中心（P<0.05）；老年女性TSH水平不随年龄增长，而老年男性TSH水平随年龄增长有增长趋势；60~75岁女性TSH水平普遍高于男性，>75岁男性女性TSH水平无显著差异。结论 TSH水平受地区、性别、年龄因素影响，但老年人群无需再根据地区、性别、年龄再分组建立参考区间。TSH结果解读应注意不同检测方法之间的差异。

关键词: 促甲状腺激素；老年人群；参考区间；性别

Abstract: Objective To investigate serum thyroid stimulating hormone (TSH) level and its changes with age in apparently healthy Chinese elderly population and analyze the differences between TSH levels detected using Roche and Snibe electrochemiluminescence immunoassay analyzers. Methods General clinical data and frozen fasting serum samples were collected from 5451 apparently healthy Chinese elderly individuals (>60 years) from 10 centers in different geographic regions in China. Thyroid function indexes including TSH level were detected using Roche and Snibe electrochemiluminescence immunoassay analyzer, and the median (2.5% and 97.5% quantiles) TSH level was calculated. The variations of TSH level among the participants with geographic regions, gender, and age (with an interval of 5 years) were analyzed to determine the influence of these factors on TSH level. Results The reference ranges of serum TSH level established using Roche and Snibe electrochemiluminescence immunoassay analyzers were 0.42-9.47 mU/L and 0.36-7.98 mU/L, respectively, showing significant differences between the two methods (P<0.001). The TSH levels measured at two centers in Western China were significantly higher than those at the other centers (P<0.05). In elderly male population, serum TSH level tended to increase with age, which was not observed in elderly female population. At the age of 60-75 years, women generally had higher serum TSH level than men, but this difference was not observed in the population beyond 75 years. Conclusion In elderly population, serum TSH level can vary with geographic region, gender, and age, but there was no need for establishing specific reference ranges for these factors. The differences between different detection methods should be evaluated when interpreting the detection results of TSH level.

Key words: thyroid-stimulating hormone; elderly population; reference range; gender