Reference Intervals of Thyroid Function Tests Assessed by Immunoassay and Mass Spectrometry in Healthy Pregnant Women Living in Catalonia

Hernández, José María; Soldevila, Berta; Velasco, Inés; Moreno-Flores, Fernando; Ferrer, Laura; Oca, Alejandra Pérez-Montes de; Santillan, Cecilia; Muñoz, Carla; Ballesta, Sílvia; Canal, C. Fernández; Puig-Domingo, Manel; Granada, María Luisa

doi:10.3390/jcm10112444

Cited by 9 publications

(11 citation statements)

References 27 publications

(37 reference statements)

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“…Until then, assay specific reference intervals for pregnant women, ideally per trimester, are necessary. Reference intervals in pregnant women for different trimesters were established for several immunoassays of Roche, Abbott, Beckman Coulter and Siemens and an ultrafiltration LC-MS/MS method as well [41][42][43][44][45][46][47][48][49][50][51] .…”

Section: Discussionmentioning

confidence: 99%

Pregnancy disrupts the accuracy of automated fT4 immunoassays

Jansen

Herwaarden

Huijgen

et al. 2022

European Thyroid Journal

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Objective: Thyroid hormone measurements are often performed in pregnant women, as hypo- and hyperthyroidism during pregnancy can severely affect the fetus. Serum free thyroxine (fT4) measurements are well known for their analytical challenges, due to low serum concentrations and the subtle equilibrium between free and bound T4 (to thyroid-binding globulin (TBG), transthyretin and albumin). Pregnant women have high TBG concentrations due to an increase in human chorionic gonadotropin (hCG) and estrogen and lower albumin concentrations which changes the equilibrium and may affect the validity of fT4 measurements in their samples. As accurate serum fT4 measurements in pregnant women are important for the long-term health of the fetus, we aimed to evaluate the accuracy of several fT4 immunoassays in serum of pregnant women. Methods: FT4 was measured in healthy controls and pregnant women using a candidate-reference method (LC-MS/MS) and 5 commercially available automated immunoassays (Alinity (Abbott), Atellica (Siemens), Cobas (Roche), Lumipulse (Fujirebio) and UniCel DXI (Beckman Coulter)). Method comparisons (Bland Altman plots and Passing and Bablok analyses) were performed. Results: Serum samples from both healthy controls (n=30) and pregnant women (n=30; mean gestational age 24.8 weeks) were collected. The fT4 immunoassays deviated +7 to +29% more from the LC-MS/MS in serum samples of pregnant women vs healthy controls (falsely high). Conclusions: Our results indicate that immunoassays overestimate fT4 in pregnant women, which might lead to an overestimation of thyroid status. Physicians and laboratory specialists should be aware of this phenomenon to avoid drawing false conclusions about thyroid function in pregnant women.

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Section: Discussionmentioning

confidence: 99%

Pregnancy disrupts the accuracy of automated fT4 immunoassays

Jansen

Herwaarden

Huijgen

et al. 2022

European Thyroid Journal

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“…44 Another study used liquid chromatography-tandem mass spectrometry and immunoassay techniques; FT4 showed significant differences between these techniques during the first trimester, while no significant difference was noticed regarding TSH. 45 A study from China showed a considerable decline in TSH values during the first trimester compared to non-pregnancy values, while there was an increase in the second trimester, and throughout pregnancy, there was a gradual decrease in FT4 and FT3. 46 Another study done by Kurioka, et al, in Japan indicated significant changes in TSH and FT4 during the first trimester and showed a substantial decrease of FT4 during the progress of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Trimester-Specific Thyroid Hormones Reference Intervals in Iraqi Pregnant Women

Ahmad

Alabdaly

Sulaiman

2022

Kesmas: Jurnal Kesehatan Masyarakat Nasional

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In Iraq, there is no obvious considerable data regarding trimester-specific reference intervals of thyroid hormones despite documented multiple physiological hormonal changes during pregnancy. Thus, this study aimed to determine trimester-specific reference intervals for serum TSH, FT3, and FT4 and assess the incidence of thyroid function test misinterpretation and misdiagnosis among pregnant women using non-pregnant reference intervals. A thyroid function test was performed for 774 enrolled pregnant women. Reference intervals of TSH, FT3, and FT4 were ascertained in each pregnancy trimester. It was then compared to the adult non-pregnant values, and the incidence of misinterpretation was later calculated. TSH and FT4 reference interval values were lower than non-pregnant reference interval values. The application of non-pregnant women references values in pregnant women caused a serious misinterpretation and misdiagnosis in 66 (8.5%) pregnant women regarding TSH, and 34 (4.4%) pregnant women regarding FT4, while no misdiagnosis was noticed regarding FT3. The trimester-specific reference interval values of TSH, FT3, and FT4 in Iraqi pregnant women showed an obvious variation from non-pregnant reference intervals and the urgent advice to use the trimester-specific reference intervals to avoid misclassification of thyroid dysfunction during pregnancy.

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“…D concentrations depending on the assessment of 25(OH)-D regarding the commercial kits’ instructions (Immunodiagnostic-AG, Bensheim, Germany) [ 22 ]. Chemiluminescence immunoassay assay (CLIA) was used for measuring the serum concentrations of free thyroid hormones: T4 and TSH, using commercial kits (Architect ® CLIA, Abbott Diagnostic, Longford, Ireland) [ 23 , 24 ]. The enzymatic colorimetric method was used for the estimation of creatinine (Cr) by Siemens ADVIA Enzymatic reagent according to kits’ instructions (National Institute for Standards and Technology) [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

Metabolic Syndrome and Cardiometabolic Risk Factors in the Mixed Hypercholesterolemic Populations with Respect to Gender, Age, and Obesity in Asir, Saudi Arabia

Ahmed

Alsamghan

Momenah

et al. 2022

IJERPH

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This record study aimed to investigate the prevalence of metabolic syndrome (MetS) profiles regarding sex, age, and obesity for the riskier factor of cardiovascular diseases in a general population in Saudi Arabia. Laboratory and anthropometric measurements were performed on non-specific participants with variant ages and BMI in either sex. Serobiochemical changes were measured for metabolic profiles, i.e., A1C/FSG, TC, TGC, HDLC/LDLC, Vit.D, TSH/T4, Hb, and Cr. The study was applied in a Polyclinic, Abha, Saudi Arabia in 2020 G. The general population showed variable incidences of MetS profiles, such as 69.4% diabetes, 85.5% hypothyroidism, and 92.2% obesity. Hypothyroidism showed a higher incidence in women rather than in men, but men were more dyslipidemic, with higher TGC and LDLC but low HDLC, compared to women. Men <40 Y. showed diabetes and hypothyroidism, but elders were dyslipidemic. Women <40 Y. showed anemia and hypovitaminosis-D but were suffering from hypothyroidism at all ages. Diabetes, hypothyroidism, hypovitaminosis-D, and dyslipidemia were the main MetS components in both overweight and obese participants, and an incidence of more than 50% in each profile was recorded. Diabetes with hypertension was characteristic of obese participants rather than those overweight. About 66.1% of the mixed-hypercholesterolemic cases were diabetic, but 18.9% of the mixed-diabetic participants were hypercholesterolemic. Castelli’s risk factors, CRI-I and CRI-II, and atherogenic indices, AIP and AC, were measured for evaluating the cardiac risk in different populations based on the AUC–ROC and cut-off values. Insulin-resistance marker (TyG) was also measured, showing considerable cut-off values for diabetic susceptibility in the lipidemic participants with higher TGC and TC rather than HDLC or LDLC. In conclusion, MetS showed higher susceptibility to sex and age with increased incidence in women rather than men. However, the cardiac risk was more susceptible to men of higher TGC and low HDLC than women. Type 2 Diabetes mellitus (T2DM) was more prominent in both elders (≥40 Y.) than younger ages of either sex. Anemia and deficiency of Vit. D was characteristic of young women (<40 Y.). Hypothyroidism affects young men <40 Y. but was recorded in women of all ages. Both dyslipidemia and diabetes could trigger CVD, showing higher cardiac risk in mixed-hypercholesterolemic men rather than women. Our study strongly suggests that the consumption of unhealthy junk food, tobacco smoking, lack of exercise, and physical inactivity could be conclusive evidence of MetS in the Saudi population.

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Reference Intervals of Thyroid Function Tests Assessed by Immunoassay and Mass Spectrometry in Healthy Pregnant Women Living in Catalonia

Cited by 9 publications

References 27 publications

Pregnancy disrupts the accuracy of automated fT4 immunoassays

Pregnancy disrupts the accuracy of automated fT4 immunoassays

The Significance of Trimester-Specific Thyroid Hormones Reference Intervals in Iraqi Pregnant Women

Metabolic Syndrome and Cardiometabolic Risk Factors in the Mixed Hypercholesterolemic Populations with Respect to Gender, Age, and Obesity in Asir, Saudi Arabia

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