title: Reference intervals for thyreotropin and thyroid hormones for healthy adults based on the NOBIDA material and determined using a Modular E170.
abstract: BACKGROUND
  The aim of the present study was to establish Nordic reference intervals for thyreotropin (TSH) and the thyroid hormones in heparinized plasma.
  
  
  METHODS
  We used 489 heparinized blood samples, collected in the morning, from the Nordic NOBIDA reference material, from healthy adults without medication. TSH, thyroxine, free thyroxine, triiodothyronine, free triiodothyronine, and thyroglobulin antibodies (Tg-ab) were measured using assays for Roche Modular E170 and thyroid peroxidase antibodies (TPO-ab) were measured using the Brahms Kryptor assay.
  
  
  RESULTS
  The measured concentrations for the thyroid hormones, but not TSH, followed a Gaussian distribution. There were more TPO-ab and Tg-ab positive women than men. After exclusion of the TPO-ab and the Tg-ab positive individuals, the reference interval TSH was 0.64 (0.61-0.72) to 4.7 (4.4-5.0) mIU/L. The exclusion of these ab-positive samples also minimized the differences in TSH concentrations between the sexes and the different Nordic countries. For the thyroid hormones, there were only minor differences between the reference intervals between the Nordic populations and between men and women. These reference intervals were unaffected by removal of the TPO-ab and TG-ab positive samples.
  
  
  CONCLUSIONS
  The upper limit of the TSH reference interval in our study is high compared to some other recent reports. This could be due to blood sampling in the morning. Furthermore, the Roche platform gives slightly higher results than other platforms. The number and distribution of the samples in the NOBIDA material makes it suitable for the determination of hormone Nordic reference intervals.
authors.affiliation: Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. lfh@rh.dk
authors.forename: Lennart
authors.initials: L
authors.lastname: Friis-Hansen
authors.forename: Linda
authors.initials: L
authors.lastname: Hilsted
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002624:Chemistry, Clinical / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D005260:Female; D006262:Health; D006493:Heparin / Q000378:metabolism; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012016:Reference Values; D013963:Thyroid Hormones / Q000097:blood*; D013972:Thyrotropin / Q000097:blood*
chemical_list: D013963:Thyroid Hormones; D013972:Thyrotropin; D006493:Heparin