Comparison of relationships between FT4 and log TSH in Access DXI 800 Unicel, Modular E170 and ADVIA Centaur XP Analyzer

Serdar, Muhittin; Özgürtaş, Taner; İspir, Emre; Kenar, Levent; Şeneş, Mehmet; Yücel, Doğan; Bilgi, Cumhur; Kurt, İsmail

doi:10.1515/cclm-2012-0193

Cited by 7 publications

(6 citation statements)

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“…This relationship is shown graphically in Figure 1 (37). An evaluation of three commercially available immunoassays found relatively poor correlation coefficients between log-transformed TSH and FT4 ranging from 0.72 – 0.76 in a euthyroid population (38). Worse correlation coefficients (0.08 – 0.58) are reported when the population includes patients with thyroid disease (16–18, 39).…”

Section: Limitations Of Current Free Thyroid Hormone Immunoassaysmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: How reliable are free thyroid and total T3 hormone assays?

Welsh

Soldin

2016

European Journal of Endocrinology

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Hypothyroidism is a very common disorder worldwide, for which the usual treatment is monotherapy with levothyroxine (L-T4). However, a number of patients treated with L-T4 continue to report symptoms of hypothyroidism despite seemingly normal levels of thyroid stimulating hormone (TSH), free-T3 (FT3), and free-T4 (FT4) measured by immunoassay. This review summarizes the limitations of the immunoassays commonly used to measure thyroid hormones and emphasizes the advantages of the role of liquid chromatography-tandem mass spectrometry (LC-MSMS). Immunoassays for free thyroid hormone are affected by alterations in serum binding proteins that occur in many physiologic and disease states. Multiple studies show falsely normal values for T3, FT3, and FT4 by immunoassay that are below the reference interval when measured by (ultrafiltration) LC-MSMS, a reference method. We suggest evaluation of thyroid hormone levels by ultrafiltration LC-MSMS for patients who continue to experience hypothyroid symptoms on LT-4. This may help identify the approximately 20% subset of patients who would benefit from addition of T3 to their treatment regimen (combination therapy).

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Section: Limitations Of Current Free Thyroid Hormone Immunoassaysmentioning

confidence: 99%

DIAGNOSIS OF ENDOCRINE DISEASE: How reliable are free thyroid and total T3 hormone assays?

Welsh

Soldin

2016

European Journal of Endocrinology

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“…Comparison of three methods, analyzed by EP Evaluator, was statistically different for FT4 results. The differences between three analyzers were p<0.001 (Cronbach's Alpha, 0.989) and p=0.430 (Cronbach's Alpha, 0.994) for FT4 and TSH, respectively [5].…”

Section: Discussionmentioning

confidence: 91%

Comparison of four immunoassay analyzers for relationship between thyroid stimulating hormone (TSH) and free thyroxine (FT4)

et al. 2015

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Comparison of four immunoassay analyzers for relationship between thyroid stimulating hormone (TSH) and free thyroxine (FT4) [Dört immünolojik ölçüm cihazının tiroid stimüle edici hormon (TSH) ve serbest tiroksin (FT4) arasındaki ilişki yönünden karşılaştırılması] ABSTRACTObjective: There is an inverse log/linear relationship between TSH and FT4 due to the negative feedback of these hormones on the pituitary. The objective of our study was to compare this relationship of TSH and FT4 between four different immunoassay analyzers. Methods: In our study, four data sets obtained from the database of four different hospital laboratories each using only a single method of measurement was used to evaluate this relationship between TSH and FT4.These data sets with their assay methods include: 21. for DxI 800 Unicel, Modular E 170, Architect i2000sr and ADVIA Centaur XP, respectively. In our study, all immunoassay analyzers showed poor correlation in a concentration range of TSH between 1.0 to 10.0 uIU/mL and the inverse log/linear relationship was not observed. Inverse relationship between TSH and FT4 is the result of negative thyroid pituitary hypothalamic feedback mechanism and this relationship is important especially in the diagnosis and treatment of hypo and hyperthyroidism. In data sets obtained from four different immunoassay analyzers, poor and statistically different correlation was observed between analyzers at TSH values ranged from 1.0 to 10.0 uIU/mL compared with FT4. Conclusion: These variations between analyzers may affect the clinical decisions especially in the evaluation of subclinical hypothyroidism, clinicians and laboratory specialists should be aware of these situation.

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“…All immunoassays were carried out in the clinical laboratory of Peking Union Medical College Hospital in a blinded manner, with different experienced operators for each. ID-LC-MS/MS was carried out at the National Center for Clinical Laboratory in China, on an API 4000 triple quadrupole mass spectrometer (AB Sciex, Framingham, MA, USA) coupled with an Agilent 1200 LC system (Agilent Technologies, Santa Clara, CA, USA) and equipped with Analyst 1.4.2 software (AB Sciex) [13].…”

Section: Methodsmentioning

confidence: 99%

“…However, it is unknown whether these have improved the performance of TT4 immunoassays from different manufacturers. One study reported a weak correlation between log thyroid-stimulating hormone (TSH) and TT4 (R=0.25) [10]; however, FT4 measured by ID-LC-MS/MS showed a stronger correlation with log TSH than that measured by immunoassays [1314]. Hence, we compared the performance of six automated immunoassays with that of ID-LC-MS/MS as a reference method and assessed the correlation of TT4 with log TSH measured by ID-LC-MS/MS and the immunoassays.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Six Automated Immunoassays With Isotope-Diluted Liquid Chromatography–Tandem Mass Spectrometry for Total Thyroxine Measurement

Zhou

Cheng

et al. 2019

Ann Lab Med

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Background Accurate serum total thyroxine (TT4) measurement is important for thyroid disorder diagnosis and management. We compared the performance of six automated immunoassays with that of isotope-diluted liquid chromatography-tandem mass spectrometry (ID-LC-MS/MS) as the reference method. We also evaluated the correlation of thyroid stimulating hormone (TSH) with TT4 measured by ID-LC-MS/MS and immunoassays. Methods Serum was collected from 156 patients between October 2015 and January 2016. TT4 was measured by immunoassays from Abbott (Architect), Siemens (ADVIA Centaur XP), Roche (E601), Beckman-Coulter (Dxi800), Autobio (Autolumo A2000), and Mindray (CL-1000i), and by ID-LC-MS/MS. Results were analyzed using Passing-Bablok regression and Bland-Altman plots. Minimum requirements based on biological variation were as follows: a mean bias of ≤4.5% and total imprecision (CV) of ≤3.7%. Results All immunoassays showed a correlation >0.945 with ID-LC-MS/MS; however, the slope of the Passing-Bablok regression line varied from 0.886 (Mindray) to 1.23 (Siemens) and the intercept from −12.8 (Siemens) to 4.61 (Mindray). Only Autobio, Beckman-Coulter, and Roche included the value of one in the 95% confidence interval for slope. The mean bias ranged from −10.8% (Abbott) to 9.0% (Siemens), with the lowest value noted for Roche (3.5%) and the highest for Abbott (−10.8%). Only Abbott and Roche showed within-run and total CV ≤3.7%. Conclusions Though all immunoassays correlated strongly with ID-LC-MS/MS, most did not meet the minimum clinical requirement. Laboratories and immunoassay manufacturers must be aware of these limitations.

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Comparison of relationships between FT4 and log TSH in Access DXI 800 Unicel, Modular E170 and ADVIA Centaur XP Analyzer

Cited by 7 publications

References 0 publications

DIAGNOSIS OF ENDOCRINE DISEASE: How reliable are free thyroid and total T3 hormone assays?

DIAGNOSIS OF ENDOCRINE DISEASE: How reliable are free thyroid and total T3 hormone assays?

Comparison of four immunoassay analyzers for relationship between thyroid stimulating hormone (TSH) and free thyroxine (FT4)

Comparison of Six Automated Immunoassays With Isotope-Diluted Liquid Chromatography–Tandem Mass Spectrometry for Total Thyroxine Measurement

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