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Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study.
Clin Endocrinol (Oxf) 2006; 64(1):97-104CE

Abstract

OBJECTIVE

Overt or subclinical thyroid dysfunction is common within the community, yet the significance of subtle anomalies in thyroid function tests remains contentious. The aims of this study were to: (a) establish reference intervals for serum-free thyroxine (FT4), thyroid-stimulating hormone (TSH) and thyroid antibodies (antithyroperoxidase, TPOAb and antithyroglobulin, TgAb) in the Busselton community of south-western Western Australia; and (b) determine the prevalence of thyroid hormone anomalies in this community.

SUBJECTS AND DESIGN

In 1981, 2115 adults residing in Busselton participated in a cross-sectional health survey that involved blood collection and a questionnaire on lifestyle and general health history.

MEASUREMENTS

Serum samples were analysed for FT4, TSH, TPOAb and TgAb by immunochemiluminescent assays.

RESULTS

Based on standard statistical approaches and using guidelines recommended by the National Academy of Clinical Biochemistry (NACB), reference intervals were derived for each analyte: 9-23 pmol/l for FT4, 0.4-4.0 mIU/l (TSH), < 35 KIU/l (TPOAb) and < 55 KIU/l (TgAb). The prevalence of elevated thyroid antibodies was 12.4% among subjects without a history of thyroid disease and is more common in women than in men. Elevated thyroid antibody levels were observed at both extremes of TSH abnormality, but were more commonly increased when TSH levels were above 4.0 mIU/l (63% subjects) than for those with TSH levels 0.4-4.0 mIU/l (7.8% subjects).

CONCLUSIONS

This study establishes the prevalence of antibodies to thyroperoxidase and thyroglobulin in a community-based sample and reference intervals for free T4 and TSH. When the NACB decision limits are applied to older men or women, there is a markedly increased number with 'elevated' autoantibody levels compared to sex- and age-specific reference intervals.

Authors+Show Affiliations

Clinical Biochemistry, Women's and Children's Health Service, Princess Margaret Hospital, Subiaco Western Australia, Australia. peter.oleary@health.wa.gov.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16402936

Citation

O'Leary, Peter C., et al. "Investigations of Thyroid Hormones and Antibodies Based On a Community Health Survey: the Busselton Thyroid Study." Clinical Endocrinology, vol. 64, no. 1, 2006, pp. 97-104.
O'Leary PC, Feddema PH, Michelangeli VP, et al. Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. Clin Endocrinol (Oxf). 2006;64(1):97-104.
O'Leary, P. C., Feddema, P. H., Michelangeli, V. P., Leedman, P. J., Chew, G. T., Knuiman, M., ... Walsh, J. P. (2006). Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. Clinical Endocrinology, 64(1), pp. 97-104.
O'Leary PC, et al. Investigations of Thyroid Hormones and Antibodies Based On a Community Health Survey: the Busselton Thyroid Study. Clin Endocrinol (Oxf). 2006;64(1):97-104. PubMed PMID: 16402936.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigations of thyroid hormones and antibodies based on a community health survey: the Busselton thyroid study. AU - O'Leary,Peter C, AU - Feddema,Peter H, AU - Michelangeli,Valdo P, AU - Leedman,Peter J, AU - Chew,Gerard T, AU - Knuiman,Matthew, AU - Kaye,Joey, AU - Walsh,John P, PY - 2006/1/13/pubmed PY - 2006/4/18/medline PY - 2006/1/13/entrez SP - 97 EP - 104 JF - Clinical endocrinology JO - Clin. Endocrinol. (Oxf) VL - 64 IS - 1 N2 - OBJECTIVE: Overt or subclinical thyroid dysfunction is common within the community, yet the significance of subtle anomalies in thyroid function tests remains contentious. The aims of this study were to: (a) establish reference intervals for serum-free thyroxine (FT4), thyroid-stimulating hormone (TSH) and thyroid antibodies (antithyroperoxidase, TPOAb and antithyroglobulin, TgAb) in the Busselton community of south-western Western Australia; and (b) determine the prevalence of thyroid hormone anomalies in this community. SUBJECTS AND DESIGN: In 1981, 2115 adults residing in Busselton participated in a cross-sectional health survey that involved blood collection and a questionnaire on lifestyle and general health history. MEASUREMENTS: Serum samples were analysed for FT4, TSH, TPOAb and TgAb by immunochemiluminescent assays. RESULTS: Based on standard statistical approaches and using guidelines recommended by the National Academy of Clinical Biochemistry (NACB), reference intervals were derived for each analyte: 9-23 pmol/l for FT4, 0.4-4.0 mIU/l (TSH), < 35 KIU/l (TPOAb) and < 55 KIU/l (TgAb). The prevalence of elevated thyroid antibodies was 12.4% among subjects without a history of thyroid disease and is more common in women than in men. Elevated thyroid antibody levels were observed at both extremes of TSH abnormality, but were more commonly increased when TSH levels were above 4.0 mIU/l (63% subjects) than for those with TSH levels 0.4-4.0 mIU/l (7.8% subjects). CONCLUSIONS: This study establishes the prevalence of antibodies to thyroperoxidase and thyroglobulin in a community-based sample and reference intervals for free T4 and TSH. When the NACB decision limits are applied to older men or women, there is a markedly increased number with 'elevated' autoantibody levels compared to sex- and age-specific reference intervals. SN - 0300-0664 UR - https://www.unboundmedicine.com/medline/citation/16402936/Investigations_of_thyroid_hormones_and_antibodies_based_on_a_community_health_survey:_the_Busselton_thyroid_study_ L2 - https://doi.org/10.1111/j.1365-2265.2005.02424.x DB - PRIME DP - Unbound Medicine ER -