Thyroid Feedback Quantile-based Index explained

Thyroid Feedback Quantile-based Index
Test Of:Sensitivity of TSH-producing pituitary cells to thyroid hormones; also a marker for the set point of thyroid homeostasis
Synonyms:TFQI, PTFQI
Reference Range:–0.74 – +0.74

The Thyroid Feedback Quantile-based Index (TFQI) is a calculated parameter for thyrotropic pituitary function. It was defined to be more robust to distorted data than established markers including Jostel's TSH index (JTI) and the thyrotroph thyroid hormone sensitivity index (TTSI).

How to determine the TFQI

The TFQI can be calculated with

TFQI=FFT4(FT4)-(1-FTSH(TSH))

from quantiles of FT4 and TSH concentration (as determined based on cumulative distribution functions).[1] Per definition the TFQI has a mean of 0 and a standard deviation of 0.37 in a reference population.[1] This explains the reference range of –0.74 to + 0.74.

Reference range

ParameterLower limitUpper limitUnit - TFQI (PTFQI) –0.74 +0.74 -

Clinical significance

Higher values of TFQI are associated with obesity, metabolic syndrome, impaired renal function, diabetes, and diabetes-related mortality.[1] [2] [3] [4] [5] [6] [7] In a large population of community-dwelling euthyroid subjects the thyroid feedback quantile-based index predicted all-cause mortality, even after adjustment for other established risk factors and comorbidities.[8]

A cross-sectional study from Spain observed increased prevalence of type 2 diabetes, atrial fibrillation, ischemic heart disease and hypertension in persons with elevated PTFQI.[9]

Serum Concentrations of Adipocyte Fatty Acid-Binding Protein (A-FABP) are significantly correlateted to TFQI, suggesting some form of cross-talk between adipose tissue and HPT axis.[10]

TFQI results are also elevated in takotsubo syndrome,[11] potentially reflecting type 2 allostatic load in the situation of psychosocial stress. Reductions have been observed in subjects with schizophrenia after initiation of therapy with oxcarbazepine[12] and quetiapine,[13] potentially reflecting declining allostatic load.

Despite positive association to metabolic syndrome and type 2 allostatic load a large population-based study failed to identify an association to risks of dyslipidemia and non-alcoholic fatty liver disease (NAFLD).[14]

See also

Notes and References

  1. Laclaustra . M . Moreno-Franco . B . Lou-Bonafonte . JM . Mateo-Gallego . R . Casasnovas . JA . Guallar-Castillon . P . Cenarro . A . Civeira . F . Impaired Sensitivity to Thyroid Hormones Is Associated With Diabetes and Metabolic Syndrome. . Diabetes Care . February 2019 . 42 . 2 . 303–310 . 10.2337/dc18-1410 . 30552134. free .
  2. Schilddrüsenhormonresistenz und Risiko für Diabetes und metabolisches Syndrom . Diabetologie und Stoffwechsel . 16 April 2019 . 14 . 2 . 78 . 10.1055/a-0758-5718. 243074371 .
  3. Paschou . Stavroula A. . Alexandrides . Theodoros . 204786351 . A year in type 2 diabetes mellitus: 2018 review based on the Endorama lecture . Hormones . 19 October 2019 . 18 . 4 . 401–408 . 10.1007/s42000-019-00139-z. 31630372 .
  4. Guan . Haixia . Mild Acquired Thyroid Hormone Resistance Is Associated with Diabetes-Related Morbidity and Mortality in the General Population . Clinical Thyroidology . April 2019 . 31 . 4 . 138–140 . 10.1089/ct.2019;31.138-140. 145947179 .
  5. Lou-Bonafonte . José Manuel . Civeira . Fernando . Laclaustra . Martín . 211217245 . Quantifying Thyroid Hormone Resistance in Obesity . Obesity Surgery . 20 February 2020 . 30 . 6 . 2411–2412 . 10.1007/s11695-020-04491-7. 32078724 .
  6. Web site: 甲状腺素抵抗与糖尿病和代谢综合征有关？看TFQI怎么说 . www.medinfo-sanofi.cn . 14 April 2020 .
  7. Yang . S . Lai . S . Wang . Z . Liu . A . Wang . W . Guan . H . Thyroid Feedback Quantile-based Index correlates strongly to renal function in euthyroid individuals. . Annals of Medicine . December 2021 . 53 . 1 . 1945–1955 . 10.1080/07853890.2021.1993324 . 34726096. 8567884 .
  8. Alonso . SP . Valdés . S . Maldonado-Araque . C . Lago . A . Ocon . P . Calle . A . Castaño . L . Delgado . E . Menéndez . E . Franch-Nadal . J . Gaztambide . S . Girbés . J . Chaves . F . Garcia-Serrano . S . Garcia-Escobar . E . Fernandez-García . JC . Olveira . G . Colomo . N . Rojo-Martínez . G . Thyroid hormone resistance index and mortality in euthyroid subjects: Di@bet.es study. . European Journal of Endocrinology . 1 December 2021 . 186 . 1 . 95–103 . 10.1530/EJE-21-0640 . 34735370. 243762070 . free .
  9. Alonso-Ventura . V . Civeira . F . Alvarado-Rosas . A . Lou-Bonafonte . M . Calmarza . P . Moreno-Franco . B . Andres-Otero . MJ . Calvo-Gracia . F . de Diego-Garcia . P . Laclaustra . M . A cross-sectional study examining the parametric thyroid feedback quantile index and its relationship with metabolic and cardiovascular diseases. . Thyroid . 26 July 2022 . 32 . 12 . 1488–1499 . 10.1089/thy.2022.0025 . 35891590. 9807248 . 251103068 .
  10. Nie . X . Ma . X . Xu . Y . Shen . Y . Wang . Y . Bao . Y . Increased Serum Adipocyte Fatty Acid-Binding Protein Levels Are Associated with Decreased Sensitivity to Thyroid Hormones in the Euthyroid Population. . Thyroid . December 2020 . 30 . 12 . 1718–1723 . 10.1089/thy.2020.0011 . 32394790. 218600030 .
  11. Aweimer . A . El-Battrawy . I . Akin . I . Borggrefe . M . Mügge . A . Patsalis . PC . Urban . A . Kummer . M . Vasileva . S . Stachon . A . Hering . S . Dietrich . JW . Abnormal thyroid function is common in takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study. . Journal of Internal Medicine . 12 November 2020 . 289 . 5 . 675–687 . 10.1111/joim.13189 . 33179374. free .
  12. Zhai . D . Chen . J . Guo . B . Retnakaran . R . Gao . S . Zhang . X . Hao . W . Zhang . R . Zhao . Y . Wen . SW . Oxcarbazepine was associated with risks of newly developed hypothyroxinemia and impaired central set point of thyroid homeostasis in schizophrenia patients. . British Journal of Clinical Pharmacology . 1 December 2021 . 88 . 5 . 2297–2305 . 10.1111/bcp.15163 . 34855997. 244818801 . free .
  13. Zhao . Y . Guan . Q . Shi . J . Sun . J . Wang . Q . Yang . J . Retnakaran . R . Han . J . Zhang . X . Hao . W . Huang . X . Zhang . R . Zhai . D . Wen . SW . Impaired central set point of thyroid homeostasis during quetiapine treatment in the acute phase of schizophrenia. . Schizophrenia Research . 15 February 2022 . 241 . 244–250 . 10.1016/j.schres.2022.02.010 . 35180663. 246830155 .
  14. Lai . S . Li . J . Wang . Z . Wang . W . Guan . H . Sensitivity to Thyroid Hormone Indices Are Closely Associated With NAFLD. . Frontiers in Endocrinology . 2021 . 12 . 766419 . 10.3389/fendo.2021.766419 . 34803928. 8602917 . free .

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