TSH index

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With the help of the TSH index ( TSHI ) introduced by Andreas Jostel , which is also called the Jostel index after him , the thyrotropic function of the anterior pituitary can be estimated quantitatively. The equation is derived from the standard logarithmic model of thyroid homeostasis .

calculation

He will be with

calculated from the mirrors for TSH, FT4 and a correction coefficient for the logarithmic standard model (β = 0.1345).

In addition, a standardized TSH index was defined that is labeled with

is calculated. In the sense of a z-transformation, it takes into account the mean (2.7) and standard deviation (0.676) of the TSHI.

Reference ranges:

parameter Lower limit Upper limit Unit of measurement
TSHI 1.3 4.1
sTSHI -2 2

Clinical significance

The TSH index is reduced in patients with thyroid insufficiency. A reduction in the standardized TSH index was also observed in cases of non-thyroidal illness syndrome .

See also

literature

  1. ↑ a b c d e f g Jostel A, Ryder WD, Shalet SM: The use of thyroid function tests in the diagnosis of hypopituitarism: definition and evaluation of the TSH Index . In: Clin. Endocrinol. (Oxf) . 71, No. 4, October 2009, pp. 529-34. doi : 10.1111 / j.1365-2265.2009.03534.x . PMID 19226261 .
  2. ↑ L Persani, G Brabant, M Dattani, M Bonomi, U Feldt-Rasmussen, E Fliers, A Gruters, D Maiter, N Schoenmakers, ASP van Trotsenburg: 2018 European Thyroid Association (ETA) Guidelines on the Diagnosis and Management of Central Hypothyroidism . . In: European Thyroid Journal . 7, No. 5, October 2018, pp. 225-237. doi : 10.1159 / 000491388 . PMID 30374425 .
  3. ↑ L Persani, B Cangiano, M Bonomi: The diagnosis and management of central hypothyroidism in 2018 . In: Endocrine connections . January 1, 2019. doi : 10.1530 / EC-18-0515 . PMID 30645189 .
  4. ^ Reichlin S, Utiger RD: Regulation of the pituitary-thyroid axis in man: relationship of TSH concentration to concentration of free and total thyroxine in plasma. . In: J Clin Endocrinol Metab . 27, No. 2, February 1967, pp. 251-255. doi : 10.1210 / jcem-27-2-251 . PMID 4163614 .
  5. ^ Cohen, JL, Thyroid-stimulation hormone and its disorders . In: Becker, KL (Ed.) Principles and Practice of Endocrinology and Metabolism. Pp. 144-52, JB Lippincott Company, Philadelphia, PA, USA, 1990
  6. ^ 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, pp. 1–29, doi : 10.1155 / 2012/351864 . PMID 23365787 .
  7. ↑ Johannes W. Dietrich, Gabi Landgrafe-Mende, Evelin Wiora, Apostolos Chatzitomaris, Harald H. Klein, John EM Midgley, Rudolf Hoermann: Calculated Parameters of Thyroid Homeostasis: Emerging Tools for Differential Diagnosis and Clinical Research . In: Frontiers in Endocrinology . 7, 9 June 2016. doi : 10.3389 / fendo.2016.00057 . PMID 27375554 . PMC 4899439 (free full text).
  8. ↑ S Fan, X Ni, J Wang, Y Zhang, S Tao, M Chen, Y Li, J Li: Low Triiodothyronine Syndrome in Patients With Radiation Enteritis: Risk Factors and Clinical Outcomes an Observational Study. . In: Medicine . 95, No. 6, February 2016, p. E2640. doi : 10.1097 / MD.0000000000002640 . PMID 26871787 .