Movatterモバイル変換

[0]ホーム
URL:

Jump to content
WikipediaThe Free Encyclopedia
Search

Thyroid function tests

From Wikipedia, the free encyclopedia
Collective term for blood tests used to check the function of the thyroid
Medical intervention
Thyroid function tests
MeSHD013960
MedlinePlus003444

Thyroid function tests (TFTs) is a collective term forblood tests used to check the function of thethyroid.[1]TFTs may be requested if a patient is thought to suffer fromhyperthyroidism (overactive thyroid) orhypothyroidism (underactive thyroid), or to monitor the effectiveness of either thyroid-suppression or hormone replacement therapy. It is also requested routinely in conditions linked to thyroid disease, such asatrial fibrillation andanxiety disorder.

A TFTpanel typically includesthyroid hormones such asthyroid-stimulating hormone (TSH, thyrotropin) andthyroxine (T4), andtriiodothyronine (T3) depending on local laboratory policy.

Thyroid-stimulating hormone

[edit]

Thyroid-stimulating hormone (TSH, thyrotropin) is generally increased in hypothyroidism and decreased in hyperthyroidism,[2] making it the most important test for early detection of both of these conditions.[3][4] The result of thisassay is suggestive of the presence and cause of thyroid disease, since a measurement of elevated TSH generally indicateshypothyroidism, while a measurement of low TSH generally indicateshyperthyroidism.[2] However, when TSH is measured by itself, it can yield misleading results, so additional thyroid function tests must be compared with the result of this test for accurate diagnosis.[4][5][6]

TSH is produced in thepituitary gland. The production of TSH is controlled bythyrotropin-releasing hormone (TRH), which is produced in thehypothalamus. TSH levels may be suppressed by excess free T3 (fT3) or free T4 (fT4) in the blood.[citation needed]

History

[edit]

First-generation TSH assays were done byradioimmunoassay and were introduced in 1965.[3] There were variations and improvements upon TSH radioimmunoassay, but their use declined as a new immunometric assay technique became available in the middle of the 1980s.[3][4] The new techniques were more accurate, leading to the second, third, and even fourth generations of TSH assay, with each generation possessing ten times greater functional sensitivity than the last.[7] Third generation immunometric assay methods are typically automated.[3] Fourth generation TSH immunometric assay has been developed for use in research.[4]

Modern standard

[edit]

Third generation TSH assay is the requirement for modern standards of care. TSH testing in the United States is typically carried out with automated platforms using advanced forms of immunometric assay.[3] Nonetheless, there is no international standard for measurement of thyroid-stimulating hormone.[4]

Interpretation

[edit]

Accurate interpretation takes a variety of factors into account, such as the thyroid hormones i.e.thyroxine (T4) andtriiodothyronine (T3), current medical status (such as pregnancy[3]),[4] certain medications likepropylthiouracil,[4] temporal effects includingcircadian rhythm[8] andhysteresis,[9] and other pastmedical history.[10]

Thyroid hormones

[edit]

Total thyroxine

[edit]

Total thyroxine is rarely measured, having been largely superseded by free thyroxine tests. Totalthyroxine (Total T4) is generally elevated inhyperthyroidism and decreased inhypothyroidism.[2] It is usually slightly elevated in pregnancy secondary to increased levels ofthyroid binding globulin (TBG).[2]

Total T4 is measured to see the bound and unbound levels of T4. The total T4 is less useful in cases where there could be protein abnormalities. The total T4 is less accurate due to the large amount of T4 that is bound. The total T3 is measured in clinical practice since the T3 has decreased amount that is bound as compared to T4.[citation needed]

Reference ranges depend on the method of analysis. Results should always be interpreted using the range from the laboratory that performed the test. Example values are:

Lower limitUpper limitUnit
4,[11] 5.5[12]11,[11] 12.3[12]μg/dL
60[11][13]140,[11] 160[13]nmol/L

Free thyroxine

[edit]

Freethyroxine (fT4 or free T4) is generally elevated inhyperthyroidism and decreased inhypothyroidism.[2]

Reference ranges depend on the method of analysis. Results should always be interpreted using the range from the laboratory that performed the test. Example values are:

Patient typeLower limitUpper limitUnit
Normal adult0.7,[14] 0.8[12]1.4,[14] 1.5,[12] 1.8[15]ng/dL
9,[16][17] 10,[11] 12[13]18,[16][17] 23[13]pmol/L
Infant 0–3 d2.0[14]5.0[14]ng/dL
26[17]65[17]pmol/L
Infant 3–30 d0.9[14]2.2[14]ng/dL
12[17]30[17]pmol/L
Child/Adolescent
31 d – 18 y		0.8[14]2.0[14]ng/dL
10[17]26[17]pmol/L
Pregnant0.5[14]1.0[14]ng/dL
6.5[17]13[17]pmol/L

Total triiodothyronine

[edit]

Totaltriiodothyronine (Total T3) is rarely measured, having been largely superseded by free T3 tests. Total T3 is generally elevated in hyperthyroidism and decreased in hypothyroidism.[2]

Reference ranges depend on the method of analysis. Results should always be interpreted using the range from the laboratory that performed the test. Example values are:

TestLower limitUpper limitUnit
Totaltriiodothyronine60,[12] 75[11]175,[11] 181[12]ng/dL
0.9,[16] 1.1[11]2.5,[16] 2.7[11]nmol/L

Free triiodothyronine

[edit]

Freetriiodothyronine (fT3 or free T3) is generally elevated in hyperthyroidism and decreased in hypothyroidism.[2]

Reference ranges depend on the method of analysis. Results should always be interpreted using the range from the laboratory that performed the test. Example values are:

Patient typeLower limitUpper limitUnit
Normal adult3.0[11]7.0[11]pg/mL
3.1[18]7.7[18]pmol/L
Children 2–16 y3.0[19]7.0[19]pg/mL
1.5[18]15.2[18]pmol/L

Carrier proteins

[edit]

Thyroxine-binding globulin

[edit]
Main article:Thyroxine-binding globulin

An increasedthyroxine-binding globulin results in an increased total thyroxine and total triiodothyronine without an actual increase in hormonal activity of thyroid hormones.

Reference ranges:

Lower limitUpper limitUnit
12[12]30[12]mg/L

Thyroglobulin

[edit]

Reference ranges:

Lower limitUpper limitUnit
1.5[11]30[11]pmol/L
1[11]20[11]μg/L

Other binding hormones

[edit]

Protein binding function

[edit]

Thyroid hormone uptake

[edit]

Thyroid hormone uptake (Tuptake or T3 uptake) is a measure of the unboundthyroxine binding globulins in the blood, that is, the TBG that is unsaturated with thyroid hormone.[2] Unsaturated TBG increases with decreased levels of thyroid hormones. It is not directly related to triiodothyronine, despite the name T3 uptake.[2]

Reference ranges:

Patient typeLower limitUpper limitUnit
Females25[2]35[2]%
In pregnancy15[2]25[2]%
Males25[2]35[2]%

Other protein binding tests

[edit]

Mixed parameters

[edit]

Free thyroxine index

[edit]

The Free Thyroxine Index (FTI or T7) is obtained by multiplying the total T4 with T3 uptake.[2] FTI is considered to be a more reliable indicator of thyroid status in the presence of abnormalities in plasma protein binding.[2] This test is rarely used now that reliable free thyroxine and free triiodothyronine assays are routinely available.

FTI is elevated in hyperthyroidism and decreased in hypothyroidism.[2]

Patient typeLower limitUpper limitUnit
Females1.8[2]5.0[2]
Males1.3[2]4.2[2]

Calculated and structure parameters

[edit]
Reference ranges for thyroid's secretory capacity (SPINA-GT) and Jostel's TSH index (TSHI or JTI) compared to univariable reference ranges for thyrotropin (TSH) and free thyroxine (FT4), shown in the two-dimensional phase plane defined by serum concentrations of TSH and FT4.
Reference ranges for thyroid's secretory capacity (SPINA-GT) and Jostel's TSH index (TSHI or JTI) compared to univariable reference ranges for thyrotropin (TSH) and free thyroxine (FT4), shown in the two-dimensional phase plane defined by serum concentrations of TSH and FT4.

Derivedstructure parameters that describe constant properties of the overallfeedback control system may add useful information for special purposes, e.g. in diagnosis ofnonthyroidal illness syndrome orcentral hypothyroidism.[20][21][22][23]

Secretory capacity (GT)

[edit]
Main article:Thyroid's secretory capacity

Thyroid's secretory capacity (GT, also referred to as SPINA-GT) is the maximum stimulated amount of thyroxine the thyroid can produce in one second.[24]GT is elevated in hyperthyroidism and reduced in hypothyroidism.[25]

GT is calculated with

G^T=βT(DT+[TSH])(1+K41[TBG]+K42[TBPA])[FT4]αT[TSH]{\displaystyle {\hat {G}}_{T}={{\beta _{T}(D_{T}+[TSH])(1+K_{41}[TBG]+K_{42}[TBPA])[FT_{4}]} \over {\alpha _{T}[TSH]}}}

or

G^T=βT(DT+[TSH])[TT4]αT[TSH]{\displaystyle {\hat {G}}_{T}={{\beta _{T}(D_{T}+[TSH])[TT_{4}]} \over {\alpha _{T}[TSH]}}}

αT{\displaystyle \alpha _{T}}: Dilution factor for T4 (reciprocal of apparent volume of distribution, 0.1 l−1)
βT{\displaystyle \beta _{T}}: Clearance exponent for T4 (1.1e-6 sec−1)
K41: Dissociation constant T4-TBG (2e10 L/mol)
K42: Dissociation constant T4-TBPA (2e8 L/mol)
DT: EC50 for TSH (2.75 mU/L)[24]

Lower limitUpper limitUnit
1.41[24]8.67[24]pmol/s

Sum activity of peripheral deiodinases (GD)

[edit]
Main article:Sum activity of peripheral deiodinases

Thesum activity of peripheral deiodinases (GD, also referred to as SPINA-GD) is reduced in nonthyroidal illness with hypodeiodination.[21][22][26]

GD is obtained with

G^D=β31(KM1+[FT4])(1+K30[TBG])[FT3]α31[FT4]{\displaystyle {\hat {G}}_{D}={{\beta _{31}(K_{M1}+[FT_{4}])(1+K_{30}[TBG])[FT_{3}]} \over {\alpha _{31}[FT_{4}]}}}

or

G^D=β31(KM1+[FT4])[TT3]α31[FT4]{\displaystyle {\hat {G}}_{D}={{\beta _{31}(K_{M1}+[FT_{4}])[TT_{3}]} \over {\alpha _{31}[FT_{4}]}}}

α31{\displaystyle \alpha _{31}}: Dilution factor for T3 (reciprocal of apparent volume of distribution, 0.026 L−1)
β31{\displaystyle \beta _{31}}: Clearance exponent for T3 (8e-6 sec−1)
KM1: Dissociation constant of type-1-deiodinase (5e-7 mol/L)
K30: Dissociation constant T3-TBG (2e9 L/mol)[24]

Lower limitUpper limitUnit
20[24]40[24]nmol/s

TSH index

[edit]
Main article:Jostel's TSH index

Jostel's TSH index (JTI or TSHI) helps to determine thyrotropic function of anteriorpituitary on a quantitative level.[27] It is reduced in thyrotropic insufficiency[27] and in certain cases of non-thyroidal illness syndrome.[26]

It is calculated with

TSHI=LN(TSH)+0.1345∗FT4{\displaystyle TSHI=LN(TSH)+0.1345*FT4}.

Additionally, a standardized form of TSH index may be calculated with

sTSHI=(TSHI−2.7)/0.676{\displaystyle sTSHI=(TSHI-2.7)/0.676}.[27]

ParameterLower limitUpper limitUnit
TSHI1.3[27]4.1[27]
sTSHI-2[27]2[27]

TTSI

[edit]
Main article:Thyrotroph Thyroid Hormone Sensitivity Index

TheThyrotroph Thyroid Hormone Sensitivity Index (TTSI, also referred to asThyrotroph T4 Resistance Index or TT4RI) was developed to enable fast screening forresistance to thyroid hormone.[28][29] Somewhat similar to the TSH Index it is calculated from equilibrium values for TSH and FT4, however with a different equation.

Lower limitUpper limitUnit
100150

TFQI

[edit]
Main article:Thyroid Feedback Quantile-based Index

TheThyroid Feedback Quantile-based Index (TFQI) is another parameter for thyrotropic pituitary function. It was defined to be more robust to distorted data than JTI and TTSI. It is calculated with

TFQI=FFT4(FT4)−(1−FTSH(TSH)){\displaystyle TFQI=F_{FT4}(FT4)-(1-F_{TSH}(TSH))}

from quantiles of FT4 and TSH concentration (as determined based oncumulative distribution functions).[30] Per definition the TFQI has amean of 0 and astandard deviation of 0.37 in a reference population.[30] Higher values of TFQI are associated withobesity,metabolic syndrome, impairedrenal function,diabetes, and diabetes-relatedmortality.[30][31][32][33][34][35][36] TFQI results are also elevated intakotsubo syndrome,[37] potentially reflecting type 2allostatic load in the situation ofpsychosocial stress. Reductions have been observed in subjects withschizophrenia after initiation of therapy withoxcarbazepine, potentially reflecting declining allostatic load.[38]

Lower limitUpper limitUnit
–0,74+0.74

Reconstructed set point

[edit]

In healthy persons, the intra-individual variation of TSH and thyroid hormones is considerably smaller than the inter-individual variation.[39][40][41] This results from a personalset point of thyroid homeostasis.[42] In hypothyroidism, it is impossible to directly access the set point,[43] but it can be reconstructed with methods of systems theory.[44][45][46]

A computerised algorithm, called Thyroid-SPOT, which is based on this mathematical theory, has been implemented in software applications.[47] In patients undergoing thyroidectomy it could be demonstrated that this algorithm can be used to reconstruct the personal set point with sufficient precision.[48]

Effects of drugs

[edit]

Drugs can profoundly affect thyroid function tests. Listed below is a selection of important effects.

Effects of some drugs on Tests of Thyroid function[49][23][50]
CauseDrugEffect on hormone concentrationsEffect on structure parameters
Inhibited TSH secretionDopamine,L-DOPA,glucocorticoids,somatostatin↓T4; ↓T3; ↓TSH↔SPINA-GT; ↓JTI
Inhibited synthesis or release of thyroid hormoneIodine,lithium↓T4; ↓T3; ↑TSH↓SPINA-GT; ↔JTI
Inhibited conversion of T4 to T3 (Step-up hypodeiodination)Amiodarone,glucocorticoids,propranolol,propylthiouracil,radiographic contrast agents↓T3; ↑rT3; ↓, ↔, ↑T4 and fT4; ↔, ↑TSH↓SPINA-GD
Inhibited binding of T4/T3 to serum proteinsSalicylates,phenytoin,carbamazepine,furosemide,nonsteroidal anti-inflammatory agents,heparin (in vitro effect)↓T4; ↓T3; ↓fT4E, ↔, ↑fT4; ↔TSH↓T4/fT4 ratio
Stimulated metabolism of iodothyroninesPhenobarbital,phenytoin,carbamazepine,rifampicin↓T4; ↓fT4; ↔TSH
Inhibited absorption of ingested T4Aluminium hydroxide,ferrous sulfate,cholestyramine,colestipol, ironsucralfate,soybean preparations,kayexalate↓T4; ↓fT4; ↑TSH
Increase in concentration of T4-binding proteinsEstrogen,clofibrate,opiates (heroin,methadone),5-fluorouracil,perphenazine↑T4; ↑T3; ↔fT4; ↔TSH↔SPINA-GT; ↔SPINA-GD; ↔JTI; ↑T4/fT4 ratio
Decrease in concentration of T4-binding proteinsAndrogens,glucocorticoids↓T4; ↓T3; ↔fT4; ↔TSH↔SPINA-GT; ↔SPINA-GD; ↔JTI; ↓T4/fT4 ratio

↓: reduced serum concentration or structure parameter; ↑: increased serum concentration or structure parameter; ↔: no change; TSH: Thyroid-stimulating hormone; T3: Total triiodothyronine; T4: Total thyroxine; fT4: Free thyroxine; fT3: Free triiodothyronine; rT3: Reverse triiodothyronine

See also

[edit]
Reference ranges for blood tests, sorted by mass and molar concentration, with thyroid function tests marked inpurple boxes in left half of diagram.

References

[edit]
  1. ^Dayan CM (February 2001). "Interpretation of thyroid function tests".Lancet.357 (9256):619–24.doi:10.1016/S0140-6736(00)04060-5.PMID 11558500.S2CID 3278073.
  2. ^abcdefghijklmnopqrstuvMilitary Obstetrics & Gynecology > Thyroid Function Tests In turn citing: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300"Normal Reference Range Table". Archived fromthe original on 25 December 2011. Retrieved2011-12-25.
  3. ^abcdefSpencer, Carole (2000). "Assay of Thyroid Hormones and Related Substances".Endotext [Internet].PMID 25905337.
  4. ^abcdefgToft, Anthony; Beckett, Geoffrey (2005).Werner & Ingbar's The Thyroid: A Fundamental & Clinical Text (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. pp. 329–344.ISBN 978-0-7817-5047-9. Archived fromthe original on 2020-05-06. Retrieved2018-04-07.
  5. ^Hoermann, Rudolf; Midgley, John E. M.; Larisch, Rolf; Dietrich, Johannes W. (22 December 2017)."Recent Advances in Thyroid Hormone Regulation: Toward a New Paradigm for Optimal Diagnosis and Treatment".Frontiers in Endocrinology.8: 364.doi:10.3389/fendo.2017.00364.PMC 5763098.PMID 29375474.
  6. ^Midgley, JEM; Toft, AD; Larisch, R; Dietrich, JW; Hoermann, R (18 April 2019)."Time for a reassessment of the treatment of hypothyroidism".BMC Endocrine Disorders.19 (1): 37.doi:10.1186/s12902-019-0365-4.PMC 6471951.PMID 30999905.
  7. ^Spencer, Carole; Takeuchi, Michael; Kazarosyan, Margarita (1996)."Current status and performance goals for serum thyrotropin (TSH) assays".Clinical Chemistry.42 (1):141–145.PMID 8565217. Retrieved5 November 2013.
  8. ^Hoermann, Rudolf; Midgley, John E. M.; Larisch, Rolf; Dietrich, Johannes W. (2015)."Homeostatic Control of the Thyroid–Pituitary Axis: Perspectives for Diagnosis and Treatment".Frontiers in Endocrinology.6: 177.doi:10.3389/fendo.2015.00177.PMC 4653296.PMID 26635726.
  9. ^Leow, Melvin Khee-Shing (2016)."A Review of the Phenomenon of Hysteresis in the Hypothalamus–Pituitary–Thyroid Axis".Frontiers in Endocrinology.7: 64.doi:10.3389/fendo.2016.00064.PMC 4905968.PMID 27379016.
  10. ^Dayan, Colin (24 February 2001)."Interpretation of thyroid function tests"(PDF).The Lancet.357 (9256):619–624.doi:10.1016/s0140-6736(00)04060-5.PMID 11558500.S2CID 3278073. Archived fromthe original(PDF) on 25 June 2013. Retrieved5 November 2013.
  11. ^abcdefghijklmnoTable 4: Typical reference ranges for serum assaysArchived July 1, 2011, at theWayback Machine - Thyroid Disease Manager
  12. ^abcdefghNormal Reference Range TableArchived 2011-12-25 at theWayback Machine from The University of Texas Southwestern Medical Center at Dallas. Used in Interactive Case Study Companion to Pathologic basis of disease.
  13. ^abcdvan der Watt G, Haarburger D, Berman P (July 2008)."Euthyroid patient with elevated serum free thyroxine".Clin. Chem.54 (7):1239–41.doi:10.1373/clinchem.2007.101428.PMID 18593963.
  14. ^abcdefghijFree T4; Thyroxine, Free; T4, FreeArchived 2010-12-22 at theWayback Machine UNC Health Care System
  15. ^Derived from molar values using molar mass of 776.87 g/mol
  16. ^abcdReference range list from Uppsala University Hospital ("Laborationslista"). Artnr 40284 Sj74a. Issued on April 22, 2008
  17. ^abcdefghijDerived from mass values using molar mass of 776.87 g/mol
  18. ^abcdDerived from mass values using molar mass of 650.98 g/mol
  19. ^abCioffi M, Gazzerro P, Vietri MT, et al. (2001). "Serum concentration of free T3, free T4 and TSH in healthy children".J. Pediatr. Endocrinol. Metab.14 (9):1635–9.doi:10.1515/JPEM.2001.14.9.1635.PMID 11795654.S2CID 34910563.
  20. ^Dietrich JW, Stachon A, Antic B, Klein HH, Hering S (2008)."The AQUA-FONTIS study: protocol of a multidisciplinary, cross-sectional and prospective longitudinal study for developing standardized diagnostics and classification of non-thyroidal illness syndrome".BMC Endocr Disord.8: 13.doi:10.1186/1472-6823-8-13.PMC 2576461.PMID 18851740.
  21. ^abRosolowska-Huszcz D, Kozlowska L, Rydzewski A (August 2005). "Influence of low protein diet on nonthyroidal illness syndrome in chronic renal failure".Endocrine.27 (3):283–8.doi:10.1385/ENDO:27:3:283.PMID 16230785.S2CID 25630198.
  22. ^abLiu S, Ren J, Zhao Y, Han G, Hong Z, Yan D, Chen J, Gu G, Wang G, Wang X, Fan C, Li J (2012). "Nonthyroidal Illness Syndrome: Is it Far Away From Crohn's Disease?".J Clin Gastroenterol.47 (2):153–9.doi:10.1097/MCG.0b013e318254ea8a.PMID 22874844.S2CID 35344744.
  23. ^abDietrich, Johannes W.; Landgrafe-Mende, Gabi; Wiora, Evelin; Chatzitomaris, Apostolos; Klein, Harald H.; Midgley, John E. M.; Hoermann, Rudolf (9 June 2016)."Calculated Parameters of Thyroid Homeostasis: Emerging Tools for Differential Diagnosis and Clinical Research".Frontiers in Endocrinology.7: 57.doi:10.3389/fendo.2016.00057.PMC 4899439.PMID 27375554.
  24. ^abcdefgDietrich, J. W. (2002).Der Hypophysen-Schilddrüsen-Regelkreis. Berlin, Germany: Logos-Verlag Berlin.ISBN 978-3-89722-850-4.OCLC 50451543.OL 24586469M. 3897228505.
  25. ^Dietrich, J., M. Fischer, J. Jauch, E. Pantke, R. Gärtner und C. R. Pickardt (1999). "SPINA-THYR: A Novel Systems Theoretic Approach to Determine the Secretion Capacity of the Thyroid Gland."European Journal of Internal Medicine 10, Suppl. 1 (5/1999): S34.
  26. ^abFan, S; Ni, X; Wang, J; Zhang, Y; Tao, S; Chen, M; Li, Y; Li, J (February 2016)."Low Triiodothyronine Syndrome in Patients With Radiation Enteritis: Risk Factors and Clinical Outcomes an Observational Study".Medicine.95 (6): e2640.doi:10.1097/MD.0000000000002640.PMC 4753882.PMID 26871787.
  27. ^abcdefgJostel A, Ryder WD, Shalet SM (October 2009). "The use of thyroid function tests in the diagnosis of hypopituitarism: definition and evaluation of the TSH Index".Clin. Endocrinol.71 (4):529–34.doi:10.1111/j.1365-2265.2009.03534.x.PMID 19226261.S2CID 10827131.
  28. ^Yagi H, Pohlenz J, Hayashi Y, Sakurai A, Refetoff S (1997)."Resistance to thyroid hormone caused by two mutant thyroid hormone receptors beta, R243Q and R243W, with marked impairment of function that cannot be explained by altered in vitro 3,5,3'-triiodothyroinine binding affinity".J. Clin. Endocrinol. Metab.82 (5):1608–14.doi:10.1210/jcem.82.5.3945.PMID 9141558.
  29. ^Pohlenz J, Weiss RE, Macchia PE, Pannain S, Lau IT, Ho H, Refetoff S (1999)."Five new families with resistance to thyroid hormone not caused by mutations in the thyroid hormone receptor beta gene".J. Clin. Endocrinol. Metab.84 (11):3919–28.doi:10.1210/jcem.84.11.6080.PMID 10566629.
  30. ^abcLaclaustra, M; Moreno-Franco, B; Lou-Bonafonte, JM; Mateo-Gallego, R; Casasnovas, JA; Guallar-Castillon, P; Cenarro, A; Civeira, F (February 2019)."Impaired Sensitivity to Thyroid Hormones Is Associated With Diabetes and Metabolic Syndrome".Diabetes Care.42 (2):303–310.doi:10.2337/dc18-1410.PMID 30552134.
  31. ^"Schilddrüsenhormonresistenz und Risiko für Diabetes und metabolisches Syndrom".Diabetologie und Stoffwechsel.14 (2): 78. 16 April 2019.doi:10.1055/a-0758-5718.S2CID 243074371.
  32. ^Paschou, Stavroula A.; Alexandrides, Theodoros (19 October 2019). "A year in type 2 diabetes mellitus: 2018 review based on the Endorama lecture".Hormones.18 (4):401–408.doi:10.1007/s42000-019-00139-z.PMID 31630372.S2CID 204786351.
  33. ^Guan, Haixia (April 2019). "Mild Acquired Thyroid Hormone Resistance Is Associated with Diabetes-Related Morbidity and Mortality in the General Population".Clinical Thyroidology.31 (4):138–140.doi:10.1089/ct.2019;31.138-140.S2CID 145947179.
  34. ^Lou-Bonafonte, José Manuel; Civeira, Fernando; Laclaustra, Martín (20 February 2020). "Quantifying Thyroid Hormone Resistance in Obesity".Obesity Surgery.30 (6):2411–2412.doi:10.1007/s11695-020-04491-7.PMID 32078724.S2CID 211217245.
  35. ^"甲状腺素抵抗与糖尿病和代谢综合征有关？看TFQI怎么说".www.medinfo-sanofi.cn. Retrieved14 April 2020.[permanent dead link‍]
  36. ^Yang, S; Lai, S; Wang, Z; Liu, A; Wang, W; Guan, H (December 2021)."Thyroid Feedback Quantile-based Index correlates strongly to renal function in euthyroid individuals".Annals of Medicine.53 (1):1945–1955.doi:10.1080/07853890.2021.1993324.PMC 8567884.PMID 34726096.
  37. ^Aweimer, A; El-Battrawy, I; Akin, I; Borggrefe, M; Mügge, A; Patsalis, PC; Urban, A; Kummer, M; Vasileva, S; Stachon, A; Hering, S; Dietrich, JW (12 November 2020)."Abnormal thyroid function is common in takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study".Journal of Internal Medicine.289 (5):675–687.doi:10.1111/joim.13189.PMID 33179374.
  38. ^Zhai, D; Chen, J; Guo, B; Retnakaran, R; Gao, S; Zhang, X; Hao, W; Zhang, R; Zhao, Y; Wen, SW (1 December 2021)."Oxcarbazepine was associated with risks of newly developed hypothyroxinemia and impaired central set point of thyroid homeostasis in schizophrenia patients".British Journal of Clinical Pharmacology.88 (5):2297–2305.doi:10.1111/bcp.15163.PMID 34855997.S2CID 244818801.
  39. ^Andersen, S; Pedersen, KM; Bruun, NH; Laurberg, P (March 2002)."Narrow individual variations in serum T(4) and T(3) in normal subjects: a clue to the understanding of subclinical thyroid disease".The Journal of Clinical Endocrinology and Metabolism.87 (3):1068–72.doi:10.1210/jcem.87.3.8165.PMID 11889165.
  40. ^Larisch, R; Giacobino, A; Eckl, W; Wahl, HG; Midgley, JE; Hoermann, R (2015). "Reference range for thyrotropin. Post hoc assessment".Nuklearmedizin. Nuclear Medicine.54 (3):112–7.doi:10.3413/Nukmed-0671-14-06.PMID 25567792.S2CID 9607904.
  41. ^Hoermann, R; Midgley, JEM; Larisch, R; Dietrich, JW (2019)."Functional and Symptomatic Individuality in the Response to Levothyroxine Treatment".Frontiers in Endocrinology.10: 664.doi:10.3389/fendo.2019.00664.PMC 6775211.PMID 31616383.
  42. ^Cappola, AR; Desai, AS; Medici, M; Cooper, LS; Egan, D; Sopko, G; Fishman, GI; Goldman, S; Cooper, DS; Mora, S; Kudenchuk, PJ; Hollenberg, AN; McDonald, CL; Ladenson, PW (13 May 2019)."Thyroid and Cardiovascular Disease Research Agenda for Enhancing Knowledge, Prevention, and Treatment".Circulation.139 (25):2892–2909.doi:10.1161/CIRCULATIONAHA.118.036859.hdl:10150/633369.PMC 6851449.PMID 31081673.
  43. ^Hoermann, R; Midgley, JEM; Larisch, R; Dietrich, JW (2019)."Individualised requirements for optimum treatment of hypothyroidism: complex needs, limited options".Drugs in Context.8: 212597.doi:10.7573/dic.212597.PMC 6726361.PMID 31516533.
  44. ^Goede, SL; Leow, MK; Smit, JW; Dietrich, JW (March 2014). "A novel minimal mathematical model of the hypothalamus-pituitary-thyroid axis validated for individualized clinical applications".Mathematical Biosciences.249:1–7.doi:10.1016/j.mbs.2014.01.001.PMID 24480737.
  45. ^Goede, SL; Leow, MK; Smit, JW; Klein, HH; Dietrich, JW (June 2014). "Hypothalamus-pituitary-thyroid feedback control: implications of mathematical modeling and consequences for thyrotropin (TSH) and free thyroxine (FT4) reference ranges".Bulletin of Mathematical Biology.76 (6):1270–87.doi:10.1007/s11538-014-9955-5.PMID 24789568.S2CID 23894743.
  46. ^Leow, MK; Goede, SL (8 August 2014)."The homeostatic set point of the hypothalamus-pituitary-thyroid axis--maximum curvature theory for personalized euthyroid targets".Theoretical Biology & Medical Modelling.11: 35.doi:10.1186/1742-4682-11-35.PMC 4237899.PMID 25102854.
  47. ^Sim, Jia-Zhi; Zang, Yu; Nguyen, Phi-Vu; Leow, Melvin Khee-Shing; Gan, Samuel Ken-En (December 2017)."Thyroid-SPOT for mobile devices: personalised thyroid treatment management app".Scientific Phone Apps and Mobile Devices.3 (1): 4.doi:10.1186/s41070-017-0016-y.
  48. ^Li, E; Yen, PM; Dietrich, JW; Leow, MK (17 August 2020). "Profiling retrospective thyroid function data in complete thyroidectomy patients to investigate the HPT axis set point (PREDICT-IT)".Journal of Endocrinological Investigation.44 (5):969–977.doi:10.1007/s40618-020-01390-7.PMID 32808162.S2CID 221146170.
  49. ^Burtis CA, Ashwood ER, Bruns DE (2012).Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 5th edition. Elsevier Saunders. p. 1920.ISBN 978-1-4160-6164-9.
  50. ^Chatzitomaris, Apostolos; Hoermann, Rudolf; Midgley, John E.; Hering, Steffen; Urban, Aline; Dietrich, Barbara; Abood, Assjana; Klein, Harald H.; Dietrich, Johannes W. (20 July 2017)."Thyroid Allostasis–Adaptive Responses of Thyrotropic Feedback Control to Conditions of Strain, Stress, and Developmental Programming".Frontiers in Endocrinology.8: 163.doi:10.3389/fendo.2017.00163.PMC 5517413.PMID 28775711.

Further reading

[edit]

External links

[edit]

CDC laboratory procedure manuals

[edit]

TheCenters for Disease Control and Prevention has published the following laboratory procedure manuals for measuring thyroid-stimulating hormone:


Clinical biochemistryblood tests
Electrolytes
Acid-base
Iron tests
Hormones
Metabolism
Cardiovascular
Liver function tests
Pancreas
Small molecules
Blood sugar level
Nitrogenous
Proteins
LFT
Other
Endocrine
glands
Hypothalamic–
pituitary
Hypothalamus
Posterior pituitary
Anterior pituitary
Adrenal axis
Thyroid
Parathyroid
Gonadal axis
Testis
Ovary
Placenta
Pancreas
Pineal gland
Other
Thymus
Digestive system
Stomach
Duodenum
Ileum
Liver/other
Adipose tissue
Skeleton
Kidney
Heart
Retrieved from "https://en.wikipedia.org/w/index.php?title=Thyroid_function_tests&oldid=1255778389"
Categories:
Hidden categories:
[8]ページ先頭
©2009-2025 Movatter.jp