Reference ranges for thyroid hormones in normal Italian children and adolescents and overweight adolescents

J Endocrinol Invest. 2013 May;36(5):326-30. doi: 10.3275/8581. Epub 2012 Aug 29.

Abstract

Background: As thyroid hormones are essential for normal pubertal growth and sexual development, TSH, free T₃ (FT₃) and free T₄ (FT₄) levels undergo progressive modification during childhood and puberty.

Aim: To establish thyroid hormone reference ranges in pre-pubertal children, pubertal adolescents, and adults and to evaluate any differences in thyroid function between overweight and normalweight pubertal subjects.

Subjects and methods: Chemiluminescent microparticle immunoassay was used to analyze TSH, FT₃ and FT₄ concentrations in serum samples from 508 children and adolescents aged 6 to 18 yr and 100 healthy adults aged 30 to 60 yr, and from 68 overweight pubertal adolescents. As data were not normally distributed, we compared them through non-parametric tests for independent samples and the reference ranges were assumed to lie between the 2.5th and 97.5th percentile.

Results: We found a progressive and significant reduction in TSH, FT₃, and FT₄ levels in the three groups with increasing age. TSH levels were significantly higher in overweight patients than in the normal-weight group, but there were no significant differences for FT₃ or FT₄.

Conclusions: This study revealed significant differences in levels of thyroid hormone between different age groups and allowed us to establish normal reference ranges for pre-pubertal children between 0.87-5.19 mIU/l for TSH, 4.75-8.59 pmol/l for FT₃, and 13.09-20.61 pmol/l for FT₄, and for pubertal adolescents between 0.76- 4.51 mIU/l for TSH, 4.26-8.46 pmol/l for FT₃ and 10.94-19.09 pmol/l for FT₄.

MeSH terms

  • Adolescent
  • Adolescent Development*
  • Adult
  • Body Mass Index
  • Child
  • Child Development*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Overweight / blood*
  • Reference Values
  • Rome
  • Thyrotropin / blood*
  • Thyroxine / blood*
  • Triiodothyronine / blood*

Substances

  • Triiodothyronine
  • Thyrotropin
  • Thyroxine