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Gestational TSH and FT4 Reference Intervals in Chinese Women: A Systematic Review and Meta-Analysis

Overview of attention for article published in Frontiers in endocrinology, August 2018
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Title
Gestational TSH and FT4 Reference Intervals in Chinese Women: A Systematic Review and Meta-Analysis
Published in
Frontiers in endocrinology, August 2018
DOI 10.3389/fendo.2018.00432
Pubmed ID
Authors

Xiaotong Gao, Yongze Li, Jiashu Li, Aihua Liu, Wei Sun, Weiping Teng, Zhongyan Shan

Abstract

Background: Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) change dynamically during pregnancy. Differences in geographic regions, populations, and manufacturer's methodologies can affect the reference intervals for thyroid function tests. The 2017 guidelines of the American Thyroid Association (ATA) recommended 4.0 mU/L as the cut-off point for the upper limit of serum TSH in early pregnancy. A systematic review is called for to establish practical, gestational-specific TSH and FT4 reference intervals for pregnant Chinese women and to explore whether the criteria are suitable for China. Methods: English and Chinese articles published from inception to Aug 2017 were searched in the PubMed, EMBASE, and SCIE English-language databases and the CNKI, WanFang, and CQVIP Chinese databases. The relative descent or ascent rates of serum TSH and FT4 were calculated, after which Comprehensive Meta-Analysis V2.0 software was used to analyze the data. Results: Eleven studies (6 in English and 5 in Chinese), five kits and 11,629 Chinese women from nine cities were considered in this meta-analysis. Compared with the reference ranges provided by manufacturers, serum TSH decreased in the first trimester, with the upper limit declining by 21.7% (5.0-36.6%), to a value close to 4.0 mU/L, and the lower limit declining by 85.7% (73.5-97.1%). It continued decreasing in the second trimester, with the upper limit declining by 24.0% (6.4-40.9%) and the lower limit declining by 40.7% (9.0-85.7%). For FT4, the upper limit fluctuated slightly, and the lower limit increased by 6.8% (1.0-14.6%) in the first trimester. Serum FT4 dropped gradually, with the upper limit declining by 21.8% (2.5-31.8%) and the lower limit declining by 12.7% (2.6-19.6%) in the second trimester. During the third trimester, the upper limit decreased by 25.1% (12.7-35.0%), while the lower limit decreased by 20.9% (14.8-27.3%). Conclusions: Various regions, kits and test methods affect the gestational TSH and FT4 levels. The non-pregnant serum TSH upper limit minus 22% is very close to 4.0 mU/L, which can be used as a sub-optimal approach to represent the cut-off value for pregnant Chinese women in the first trimester.

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Mendeley readers

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The data shown below were compiled from readership statistics for 23 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 23 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 13%
Student > Doctoral Student 2 9%
Student > Postgraduate 2 9%
Student > Bachelor 1 4%
Professor 1 4%
Other 4 17%
Unknown 10 43%
Readers by discipline Count As %
Medicine and Dentistry 10 43%
Unspecified 1 4%
Engineering 1 4%
Unknown 11 48%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 August 2018.
All research outputs
#20,653,740
of 26,243,859 outputs
Outputs from Frontiers in endocrinology
#6,046
of 13,401 outputs
Outputs of similar age
#253,897
of 345,176 outputs
Outputs of similar age from Frontiers in endocrinology
#113
of 198 outputs
Altmetric has tracked 26,243,859 research outputs across all sources so far. This one is in the 18th percentile – i.e., 18% of other outputs scored the same or lower than it.
So far Altmetric has tracked 13,401 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.3. This one is in the 47th percentile – i.e., 47% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 345,176 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 21st percentile – i.e., 21% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 198 others from the same source and published within six weeks on either side of this one. This one is in the 33rd percentile – i.e., 33% of its contemporaries scored the same or lower than it.