{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:23:59Z","timestamp":1773113039739,"version":"3.50.1"},"reference-count":23,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T00:00:00Z","timestamp":1730419200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Key Project of Science and Technology Department of Sichuan Province","award":["2023YFG0278"],"award-info":[{"award-number":["2023YFG0278"]}]},{"name":"The Health science research project of Sichuan province","award":["2023-108"],"award-info":[{"award-number":["2023-108"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n               <jats:title>Background<\/jats:title>\n               <jats:p>Thyroid stimulating hormone releasing hormone (TSH) is a key indicator for diagnosing subclinical hypothyroidism (SCH). We evaluated factors affecting TSH levels in elderly SCH, establishing a composite reference interval, and comparing it with traditional one in diagnosis.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Methods<\/jats:title>\n               <jats:p>We collected data on patients aged \u226560 undergoing physical examinations in Chengdu, screening the influencing factors associated with TSH. Then, a two-dimensional composite reference interval was established for TSH and FT4, and the differences between the new and traditional diagnosing methods were compared.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Results<\/jats:title>\n               <jats:p>The incidence of subclinical thyroid dysfunction was about 14%, with SCH accounting for 97%. Regression analysis found that TSH levels increase as FT4 and uric acid levels decrease. Compared with the two-dimensional composite reference interval, the traditional one has a higher incidence rate of SCH.<\/jats:p>\n            <\/jats:sec>\n            <jats:sec>\n               <jats:title>Conclusion<\/jats:title>\n               <jats:p>Compared with the two-dimensional composite reference interval, the traditional one is more likely to overestimate the incidence rate of SCH, leading to excessive diagnosis and treatment.<\/jats:p>\n            <\/jats:sec>","DOI":"10.7717\/peerj.18417","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T09:28:58Z","timestamp":1730453338000},"page":"e18417","source":"Crossref","is-referenced-by-count":1,"title":["Application of composite reference intervals in the diagnosis of subclinical hypothyroidism in the elderly: a retrospective study"],"prefix":"10.7717","volume":"12","author":[{"given":"Peijuan","family":"Li","sequence":"first","affiliation":[{"name":"General Practice Ward\/International 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