Jostel's TSH index
Jostel's TSH index | |
---|---|
Reference range | 1.3–4.1 |
Jostel's TSH index (TSHI or JTI), also referred to as Jostel's thyrotropin index or Thyroid Function index (TFI) is a method for estimating the thyrotropic (i.e. thyroid stimulating) function of the anterior pituitary lobe in a quantitative way.[1][2] The equation has been derived from the logarithmic standard model of thyroid homeostasis.[3][4][5][6] As of 2014 further study is required to show if it is useful.[7]
How to determine JTI
Jostel's TSH index can be calculated with
from equilibrium serum concentrations of thyrotropin (TSH), free T4 (FT4) and a correction coefficient derived from the logarithmic standard model (β = 0.1345).
An alternative standardised form (standardised TSH index or sTSHI) is calculated with.[1]
as a z-transformed value incorporating mean (2.7) and standard deviation (0.676) of TSHI in a reference population[5]
Reference ranges
Parameter | Lower limit | Upper limit | Unit |
TSHI | 1.3[1] | 4.1[1] | |
sTSHI | -2[1] | 2[1] |
Clinical significance
The TSH index is reduced in patients with secondary hypothyroidism resulting from thyrotropic insufficiency.[1][8][9] For this indication, it has, however, up to now only been validated in adults.[10] JTI was also found reduced in cases of TACITUS syndrome (non-thyroidal illness syndrome) as an example of type 1 thyroid allostasis.[11] Conversely, an elevated thyroid function index may serve as a biomarker for type 2 allostasis and contextual stress.[12]
Recent research demonstrated the TSH index to inversely correlate to thyroid's secretory capacity and thyroid volume.[13] It is unclear if this finding reflects shortcomings of the index (i.e. low specificity in the setting of subclinical hypothyroidism) or plastic responses of the pituitary gland to beginning hypothyroidism.
See also
- Thyroid function tests
- Thyrotroph Thyroid Hormone Sensitivity Index
- Thyroid's secretory capacity
- Sum activity of peripheral deiodinases
References
- ^ a b c d e f g Jostel A, Ryder WD, Shalet SM (October 2009). "The use of thyroid function tests in the diagnosis of hypopituitarism: definition und evaluation of the TSH Index". Clin. Endocrinol. (Oxf). 71 (4): 529–34. doi:10.1111/j.1365-2265.2009.03534.x. PMID 19226261.
{{cite journal}}
: CS1 maint: multiple names: authors list (link) - ^ Persani, L; Brabant, G; Dattani, M; Bonomi, M; Feldt-Rasmussen, U; Fliers, E; Gruters, A; Maiter, D; Schoenmakers, N; van Trotsenburg, ASP (October 2018). "2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism". European Thyroid Journal. 7 (5): 225–237. doi:10.1159/000491388. PMID 30374425.
- ^ Reichlin S, Utiger RD (February 1967). "Regulation of the pituitary-thyroid axis in man: relationship of TSH concentration to concentration of free and total thyroxine in plasma". J Clin Endocrinol Metab. 27 (2): 251–255. doi:10.1210/jcem-27-2-251. PMID 4163614.
- ^ Cohen, J. L., Thyroid-stimulation hormone and its disorders. In: Becker, K. L. (Hrsg.) Principles and Practice of Endocrinology and Metabolism. S. 144–52, J. B. Lippincott Company, Philadelphia, PA, USA, 1990
- ^ a b Johannes W. Dietrich, Gabi Landgrafe, Elisavet H. Fotiadou: TSH and Thyrotropic Agonists: Key Actors in Thyroid Homeostasis. In: Journal of Thyroid Research. 2012, 2012, S. 1–29, doi:10.1155/2012/351864. PMID 23365787.
- ^ Dietrich, Johannes W.; Landgrafe-Mende, Gabi; Wiora, Evelin; Chatzitomaris, Apostolos; Klein, Harald H.; Midgley, John E. M.; Hoermann, Rudolf (2016-06-09). "Calculated Parameters of Thyroid Homeostasis: Emerging Tools for Differential Diagnosis and Clinical Research". Frontiers in Endocrinology. 7: 57. doi:10.3389/fendo.2016.00057. PMC 4899439. PMID 27375554.
{{cite journal}}
: CS1 maint: unflagged free DOI (link) - ^ Fliers, Eric; Korbonits, Marta; Romijn, J. A. (2014). Clinical Neuroendocrinology. Elsevier. p. 146. ISBN 9780444626127.
- ^ Chiloiro, Sabrina; Tartaglione, Tommaso; Capoluongo, Ettore Domenico; Angelini, Flavia; Arena, Vincenzo; Giampietro, Antonella; Bianchi, Antonio; Zoli, Angelo; Pontecorvi, Alfredo; Colosimo, Cesare; De Marinis, Laura (1 August 2018). "Hypophysitis outcome and factors predicting responsiveness to glucocorticoid therapy: a prospective and double-arm study". The Journal of Clinical Endocrinology & Metabolism. 103 (10): 3877–3889. doi:10.1210/jc.2018-01021. PMID 30085134.
- ^ Persani, L; Cangiano, B; Bonomi, M (1 January 2019). "The diagnosis and management of central hypothyroidism in 2018". Endocrine connections. doi:10.1530/EC-18-0515. PMID 30645189.
- ^ Schoenmakers N, Alatzoglou KS, Chatterjee VK, Dattani MT. Recent advances in central congenital hypothyroidism. J Endocrinol. 2015 Dec;227(3):R51-71. doi:10.1530/JOE-15-0341. PMID 26416826; PMC 4629398.
- ^ Fan, S; Ni, X; Wang, J; Zhang, Y; Tao, S; Chen, M; Li, Y; Li, J (February 2016). "Low Triiodothyronine Syndrome in Patients With Radiation Enteritis: Risk Factors and Clinical Outcomes an Observational Study". Medicine. 95 (6): e2640. doi:10.1097/MD.0000000000002640. PMC 4753882. PMID 26871787.
- ^ Lei MK, Beach SR, Simons RL, Barr AB, Cutrona CE, Philibert RA. Stress, relationship satisfaction, and health among African American women: Genetic moderation of effects. J Fam Psychol. 2016 Mar;30(2):221-32. doi:10.1037/fam0000140. PMID 26376424; PMC 4749476.
- ^ Hoermann, R; Midgley, JEM; Larisch, R; Dietrich, JW (19 July 2018). "The Role of Functional Thyroid Capacity in Pituitary Thyroid Feedback Regulation". European Journal of Clinical Investigation. 48 (10): e13003. doi:10.1111/eci.13003. PMID 30022470.
External links
- SPINA Thyr: Open source software for TSHI
- Package "SPINA" for the statistical environment R