Defining the Newborn Blood Spot Screening Reference Interval for TSH: Impact of Ethnicity
Defining the Newborn Blood Spot Screening Reference Interval for TSH: Impact of Ethnicity
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DOI：
10.1210/jc.2016-1822
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发表时间：
2016-09-01
影响因子：
5.8
通讯作者：
Cole, Tim J.
中科院分区：
文献类型：
--
作者：
Peters, Catherine;Brooke, Ivan;Cole, Tim J.
内容：有变异性在先天性甲状腺功能减退症（CH）新生儿筛查TSH截断横跨英国。目的：以确定影响的年，性别和种族的筛选变异性，并检查是否有一个最佳的操作TSH截断。设计和设置：单中心，使用2006年至2012年期间大奥蒙德街医院筛查实验室收到的血斑TSH卡进行的回顾性人群研究。患者：共824 588名新生儿筛查血斑TSH卡.干预：血斑TSH结果记录人口统计学数据，包括种族分类代码.主要结果测量：样本超过不同TSH临界值的比例，按种族排序.结果：超过TSH临界值的样本比例随着时间的推移而增加，临界值为4 mU/L，但不是6 mU/L。有一个一致的趋势与种族，无论截止，超过TSH截止值的比值比最低（类似于1.0）在白色婴儿，较高的巴基斯坦和孟加拉国（>2.0），最高的中国（>3.5）。这表明甲状腺生理学可能存在种族差异。在建立和解释筛查TSH临界值时，需要考虑人群中的种族多样性。
Context: There is variability in the congenital hypothyroidism (CH) newborn screening TSH cutoff across the United Kingdom.Objective: To determine the influences of year, gender, and ethnicity on screening variability and examine whether there is an optimal operational TSH cutoff.Design and Setting: Single center, retrospective population study using blood spot TSH cards received by the Great Ormond Street Hospital Screening Laboratory between 2006 and 2012.Patients: A total of 824 588 newborn screening blood spot TSH cards.Intervention: Blood spot TSH results were recorded with demographic data including the Ethnic Category Code.Main Outcome Measures: The proportions of samples exceeding different TSH cutoffs, ranked by ethnicity.Results: The proportion of samples exceeding the TSH cutoff increased over time, with the cutoff at 4 mU/L, but not at 6 mU/L. There was a consistent trend with ethnicity, irrespective of cutoff, with the odds ratio of exceeding the TSH cutoff lowest (similar to 1.0) in White babies, higher in Pakistani and Bangladeshi (>2.0), and highest in Chinese (>3.5).Conclusions: The blood spot TSH screening data demonstrate a clear ranking according to ethnicity for differences in mean TSH. This suggests that there may be ethnic differences in thyroid physiology. Ethnic diversity within populations needs to be considered when establishing and interpreting screening TSH cutoffs.