Značaj vremena uzorkovanja na nivoe tireostimulišućeg hormona, slobodnog tiroksina i slobodnog trijodtironina

Uticaj vremena uzorkovanja na parametre TSH, fT4 i fT3

  • Mahmut Mert Dağlar Department of Biochemistry Laboratory, Dr. Lutfi Kirdar City Hospital, Istanbul
  • Asuman Orçun Department of Biochemistry Laboratory, Dr. Lutfi Kirdar City Hospital, Istanbul https://orcid.org/0000-0002-5155-3591
DOI: https://doi.org/10.5937/jomb0-61454

Sažetak


Pozadina: Vreme uzimanja uzorka je od suštinskog značaja za analite sa cirkadijalnim ritmom. Iako se uzorci krvi obično uzimaju ujutro, oni se često prikupljaju i u popodnevnim satima. Naša studija ima za cilj da proceni značaj uticaja vremena uzorkovanja na parametre tireostimulišućeg hormona (TSH), slobodnog tiroksina (fT4) i slobodnog trijodtironina (fT3).

Materijal i metode: Merenja serumski TSH, fT4 i fT3 vrednosti kod 216.278 pacijenata koji su posetili ambulantne klinike naše ustanove tokom dvogodišnjeg perioda (2021–2023) dobijena su iz laboratorijskih podataka. Nakon isključivanja, rezultati 5.953 pacijenata prikupljeni između 8 i 17 časova grupisani su u intervale od po 1 sat. Sva merenja su sprovedena pomoću uređaja Cobas e801 (Roche Diagnostics, Penzberg, Nemačka), primenom metode elektrohemiluminiscencijske imunoese. Statistička značajnost je testirana standardnim testom normalne devijacije (Z-test), a klinička značajnost je procenjena pomoću procentualnih bias vrednosti dobijenih na osnovu procena biološke varijacije sa veb-sajta Evropske federacije za kliničku hemiju i laboratorijsku medicinu (EFLM).

Rezultati: Svaka TSH satna grupa između 11 i 17 časova pokazala je statistički i klinički značajne razlike u poređenju sa referentnom grupom. Nisu uočene statistički značajne razlike ni za fT4 ni za fT3. Međutim, fT4 vrednosti su pokazale klinički značajnu razliku u jednoj vremenskoj tački kod muškaraca, dok su fT3 vrednosti pokazale klinički značajne razlike između 15–17 časova kod žena i 14–17 časova kod muškaraca.

 

Zaključak: Analiza našeg obimnog skupa podataka ukazuje da vreme uzorkovanja krvi značajno utiče na rezultate TSH. Ovo može dovesti do pogrešne interpretacije u kliničkoj praksi ukoliko ne postoji standardizacija.

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2026/02/18
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Sva prava zadržana (c) 2026 Mahmut Mert Dağlar, Asuman Orçun

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