Trimester-Specific Changes in Maternal Thyroid Hormone, Thyrotropin, and Thyroglobulin Concentrations During Gestation: Trends and Associations Across Trimesters in Iodine Sufficiency

Soldin, Offie P.; Tractenberg, Rochelle E.; Hollowell, Joseph G.; Jonklaas, Jacqueline; Janicic, Nataša; Soldin, Steven J.

doi:10.1089/thy.2004.14.1084

Cited by 220 publications

(162 citation statements)

References 39 publications

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“…Interpretation of thyroid function tests should be trimester-specific, 28,47,48 and locally generated trimester-specific reference levels should be applied when available. 47,49 Of note, it has been reported that the upper 95% Cl for plasma TSH in the first trimester is 2.5 mU=L.…”

Section: Diagnosis Of Suspected Diseasementioning

confidence: 99%

Autoimmune Thyroid Disease in Pregnancy: A Review

Galofré

Davies

2009

Journal of Women's Health

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The maternal physiological changes that occur in normal pregnancy induce complex endocrine and immune responses. During a normal pregnancy, thyroid gland volume may enlarge, and thyroid hormone production increases. Hence, the interpretation of thyroid function during gestation needs to be adjusted according to pregnancy-specific ranges. The elevated prevalence of gestation-related thyroid disorders (10%-15%) and the important repercussions for both mother and fetus reported in multiple studies throughout the world denote, in our opinion, the necessity for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is suspected or confirmed, management of the thyroid disorder necessitates regular monitoring in order to ensure a successful outcome. The aim of treating hyperthyroidism in pregnancy with antithyroid drugs is to maintain serum thyroxine (T 4 ) in the upper normal range of the assay used with the lowest possible dose of drug, whereas in hypothyroidism, the goal is to return serum thyroid-stimulating hormone (TSH) to the range between 0.5 and 2.5 mU=L.

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Section: Diagnosis Of Suspected Diseasementioning

confidence: 99%

Autoimmune Thyroid Disease in Pregnancy: A Review

Galofré

Davies

2009

Journal of Women's Health

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“…Pediatric reference intervals for many analytes can vary significantly by both sex and age from those found in adults, and are of great importance in differentiating between the "healthy" and the "diseased" populations [1][2][3][4][5][6][7]. Reference intervals for alpha fetoprotein (AFP), homocysteine (HCS), insulin, insulin-like growth factor-1(IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), C-peptide, immunoglobulin E (IgE) and intact parathyroid hormone (i-PTH) are currently unavailable on the IMMULITE 2000® analyzer (Siemens, Los Angeles, CA).…”

Section: Introductionmentioning

confidence: 99%

IMMULITE® 2000 age and sex-specific reference intervals for alpha fetoprotein, homocysteine, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, C-peptide, immunoglobulin E and intact parathyroid hormone

Soldin

Dahlin

Gresham

et al. 2008

Clinical Biochemistry

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Objectives-To determine age and sex-specific pediatric reference intervals for serum alpha fetoprotein, homocysteine, insulin, insulin-like growth factor-I, insulin-like growth factor binding protein-3, C-peptide, immunoglobulin E and parathyroid hormone.Design and methods-The study was conducted at both Children's National Medical Center and Georgetown University, Washington D.C. Results for the above analytes were obtained from the Children's National Medical Center laboratory information system over the period of 1/5/2001-3/8/2007.Patient results using the IMMULITE 2000® were accessed and used to establish reference intervals for the analytes studied. All patient identifiers were removed except age and sex. Analysis of the data was performed at Georgetown University in the Bioanalytical Core Laboratory. The data was analyzed using the Hoffmann approach, and was computer adapted. The number of patient samples studied varied with each analyte and were: Alpha fetoprotein (557), homocysteine (924), insulin-like growth factor-1 (1352), insulin-like growth factor binding protein-3 (711), insulin (3239), C-peptide (267), immunoglobulin E (2691) and parathyroid hormone (513).Results and conclusions-This study provides pediatric reference intervals for the eight analytes for children from birth to 18 years of age. All the analytes exhibited at least some age dependence. Sex differences between early and late childhood and adolescence were also frequently found.

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“…The two preferred laboratory tests to assess thyroid function today are free T4 and TSH. The role of mass spectrometry in the measurement of total T4 and T3 has been recently explored [3][4][5][6][7][8][9][10]. We have previously developed an isotope dilution tandem mass spectrometric method (LC/MS/MS) for the simultaneous measurement of T4 and T3 [3].…”

Section: Introductionmentioning

confidence: 99%

“…We have previously developed an isotope dilution tandem mass spectrometric method (LC/MS/MS) for the simultaneous measurement of T4 and T3 [3]. This method was subsequently used to evaluate immunoassays for total T4 and T3 [4][5][6]. It was clear that while immunoassays for T4 gave somewhat higher results than LC/MS/ MS, they correlated fairly well with results by LC/MS/MS with the single major exception of pregnant women (r =0.802-0.900).…”

Section: Introductionmentioning

confidence: 99%

The measurement of free thyroxine by isotope dilution tandem mass spectrometry

Soldin¹,

Soukhova²,

Janicic³

et al. 2005

Clinica Chimica Acta

111

119

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Background-Most clinical chemistry laboratories measure free thyroxine (FT4) by an analogue (direct) method. Nevertheless, the validity of analogue FT4 immunoassays has been questioned and patient's results using this approach frequently do not fit in with the clinical presentation. Because of these problems we routinely send out all direct free T4's that are < 2.5th percentile and many that are > 97.5th percentile for measurement by equilibrium dialysis, the gold standard method. In approximately half of these cases, the FT4 by equilibrium dialysis was normal. We developed a rapid, reliable free T4 method employing isotope dilution tandem mass spectrometry and compared our results with both the analogue (direct) free T4 and equilibrium dialysis procedures.Methods-An API-4000 tandem mass spectrometer (Sciex, Toronto, Canada) equipped with TurboIonSpray and Agilent HPLC system was used employing isotope dilution with deuterium labeled internal standard (IS=L-thyroxine-d 2 ). Serum was filtered through the Centrifree YM-30 ultrafiltration device by centrifugation, IS added to the ultrafiltrate, and 400 μL injected onto a C-18 column. After washing, the switch valve is activated and a methanol gradient allows for elution of both T4 and the IS into the LC/MS/MS system. Quantitation was by MRM analysis in the negative mode. Equilibrium dialysis was performed by the Nichols method and analogue free T4 results were obtained on the Dade Dimension RxL.Results-The within-day and between-day CV's were < 7.1% at all concentrations tested. The results correlated well with equilibrium dialysis (Eq Dial=0.971 MS+0.041, n =68, Syx=1.381, r =0.954). A poor correlation was found with the analogue (direct) free T4 method (IA=0.326 MS +6.27, n =154, Syx=1.96, r =0.459). Conclusions-Samples can be processed in batches of 30. The free T4 tandem MS method has a rapid turn-around-time vs the equilibrium dialysis procedure, with a chromatographic run time of 8 min per sample. NIH Public Access

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Trimester-Specific Changes in Maternal Thyroid Hormone, Thyrotropin, and Thyroglobulin Concentrations During Gestation: Trends and Associations Across Trimesters in Iodine Sufficiency

Cited by 220 publications

References 39 publications

Autoimmune Thyroid Disease in Pregnancy: A Review

Autoimmune Thyroid Disease in Pregnancy: A Review

IMMULITE® 2000 age and sex-specific reference intervals for alpha fetoprotein, homocysteine, insulin, insulin-like growth factor-1, insulin-like growth factor binding protein-3, C-peptide, immunoglobulin E and intact parathyroid hormone

The measurement of free thyroxine by isotope dilution tandem mass spectrometry

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