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Distributions of serum thyroid-stimulating hormone in 2020 thyroid disease-free adults from areas with different iodine levels: a cross-sectional survey in China

Journal of Endocrinological Investigation volume 44, pages 1001–1010 (2021)Cite this article

Abstract

Purpose

The aim of the present study was to describe the distributions of serum thyroid- stimulating hormone (TSH) levels in thyroid disease-free adults from areas with different iodine levels in China. Meanwhile, we aimed to evaluate the influence of age and gender on the distribution of TSH, assess the relationship between concentrations of TSH and free thyroxine (FT4), and analyze the factors that may affect TSH levels.

Methods

2020 adults were included from April 2016 to June 2019. Urinary iodine concentration, serum iodine concentration, serum TSH, FT4, free triiodothyronine, thyroid peroxidase antibodies and thyroglobulin antibodies were measured, and thyroid ultrasonography was performed.

Results

The median of TSH in iodine-fortification areas (IFA), iodine-adequate areas (IAA), iodine-excessive areas (IEA) were 2.32, 2.11 and 2.34 mIU/L, respectively. Serum TSH concentrations were significantly higher in IFA and IEA than that in IAA (p = 0.005 and < 0.0001). The TSH values of most adults were distributed within the range of 1.01–3.00 mIU/L with the same trend in three groups. In our study, TSH levels did not change with age, and the TSH level of females was higher than that of males (p < 0.0001). There was a negative correlation between FT4 and TSH in IAA (r = − 0.160, p < 0.0001) and IEA (r = − 0.177, p < 0.0001), but there was no correlation between FT4 and TSH in IFA (r = − 0.046, p = 0.370). BMI, smoking status, education levels, and marital status were associated with TSH.

Conclusion

Our study provides a basis for establishing the reference intervals of TSH in different iodine level areas.

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Availability of data and material

The datasets generated during the current study are not publicly available due to involving personal privacy but are available from the corresponding author on reasonable request.

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Funding

This study was supported by grants from the National Natural Science Foundation of China (81872561).

Author information

Author notes

  1. Bingxuan Ren and Siyuan Wan are co-first authors.

Affiliations

  1. Centre for Endemic Disease Control, Chinese Centre for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China

    B. Ren, S. Wan, L. Liu, M. Qu, H. Wu & H. Shen

  2. Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China

    S. Wan

Authors
  1. B. Ren
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  2. S. Wan
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  3. L. Liu
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  4. M. Qu
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  5. H. Wu
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  6. H. Shen
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by BR, SW and HS. The first draft of the manuscript was written by BR and SW. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to H. Shen.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This project was approved by the Ethical Review Board of Harbin Medical University.

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Informed consent was obtained from all individual participants included in the study.

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Consent to publish from the participant was obtained to report individual participant data.

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Ren, B., Wan, S., Liu, L. et al. Distributions of serum thyroid-stimulating hormone in 2020 thyroid disease-free adults from areas with different iodine levels: a cross-sectional survey in China. J Endocrinol Invest 44, 1001–1010 (2021). https://doi.org/10.1007/s40618-020-01395-2

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  • DOI: https://doi.org/10.1007/s40618-020-01395-2

Keywords

  • Iodine level
  • Population study
  • Reference intervals
  • TSH