Sergio Valdés1,2, Cristina Maldonado-Araque1,2, Ana Lago-Sampedro1,2, Juan Antonio Lillo-Muñoz3, Eduardo Garcia-Fuentes2,4, Vidal Perez-Valero3, Carolina Gutiérrez-Repiso1,2, Eva Garcia-Escobar1,2, Albert Goday5, Inés Urrutia1,6, Laura Peláez2, Alfonso Calle-Pascual1,7, Elena Bordiú8, Luis Castaño1,6, Conxa Castell9, Elias Delgado10, Edelmiro Menéndez10, Josep Franch-Nadal1,11, Sonia Gaztambide1,12, Joan Girbés13, Emilio Ortega4,14, Joan Vendrell1,15, Matilde R Chacón1,15, F Javier Chaves1,16, Federico Soriguer1,2, Gemma Rojo-Martínez1,2. 1. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III, Madrid, Spain. 2. Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, IBIMA, Málaga, Spain. 3. UGC de Laboratorio (Bioquímica), Hospital Regional Universitario de Málaga, Málaga, Spain. 4. CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. 5. Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain. 6. Hospital Universitario Cruces, BioCruces, UPV/EHU, Barakaldo, Spain. 7. Department of Endocrinology and Nutrition, Hospital Universitario S. Carlos de Madrid, Spain. 8. Laboratorio de Bioquímica, Hospital Universitario S. Carlos de Madrid, Spain. 9. Public Health Agency, Department of Health, Autonomous Government of Catalonia, Barcelona, Spain. 10. Department of Endocrinology and Nutrition, Hospital Central de Asturias, Oviedo, Spain. 11. EAP Raval Sud, Institut Català de la Salut, Red GEDAPS, Primary Care, Unitat de Suport a la Recerca (IDIAP - Fundació Jordi Gol), Barcelona, Spain. 12. Department of Endocrinology and Nutrition, Hospital Universitario Cruces - UPV-EHU, Baracaldo, Spain. 13. Diabetes Unit, Hospital Arnau de Vilanova, Valencia, Spain. 14. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic de Barcelona, Spain. 15. Department of Endocrinology and Nutrition, Hospital Universitario Joan XXIII, Institut d'Investigacions Sanitaries Pere Virgili, Tarragona, Spain. 16. Genotyping and Genetic Diagnosis Unit, Fundación de Investigación del Hospital Clínico de Valencia-INCLIVA, Valencia, Spain.
Abstract
OBJECTIVE: To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. METHODS: The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [TPO Abs] <50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). RESULTS: The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 µUI/mL in the underweight category (BMI<20 kg/m2 ), 0.6 to 5.5 µUI/mL in the normal-weight category (BMI 20-24.9 kg/m2 ), 0.6 to 5.5 µUI/mL in the overweight category (BMI 25-29.9 kg/m2 ), 0.5 to 5.9 µUI/mL in the obesity category (BMI 30-39.9 kg/m2 ), and 0.7 to 7.5 µUI/mL in the morbid obesity category (BMI ≥40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). CONCLUSIONS: Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them.
OBJECTIVE: To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. METHODS: The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [TPO Abs] <50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). RESULTS: The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 µUI/mL in the underweight category (BMI<20 kg/m2 ), 0.6 to 5.5 µUI/mL in the normal-weight category (BMI 20-24.9 kg/m2 ), 0.6 to 5.5 µUI/mL in the overweight category (BMI 25-29.9 kg/m2 ), 0.5 to 5.9 µUI/mL in the obesity category (BMI 30-39.9 kg/m2 ), and 0.7 to 7.5 µUI/mL in the morbid obesity category (BMI ≥40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). CONCLUSIONS:Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them.
Authors: Raquel Andrade de Siqueira; Matias Noll; Ana Paula dos Santos Rodrigues; Erika Aparecida Silveira Journal: Asian Pac J Cancer Prev Date: 2019-03-26