Chemistry:Thyroid Feedback Quantile-based Index

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Thyroid Feedback Quantile-based Index
Medical diagnostics
Reference range–0.74 – +0.74
Test ofSensitivity of TSH-producing pituitary cells to thyroid hormones; also a marker for the set point of thyroid homeostasis

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

[math]\displaystyle{ TFQI = F_{FT4}(FT4) - (1 - F_{TSH}(TSH)) }[/math]

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

Parameter Lower limit Upper limit Unit
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


  1. 1.0 1.1 1.2 Laclaustra, M; Moreno-Franco, B; Lou-Bonafonte, JM; Mateo-Gallego, R; Casasnovas, JA; Guallar-Castillon, P; Cenarro, A; Civeira, F (February 2019). "Impaired Sensitivity to Thyroid Hormones Is Associated With Diabetes and Metabolic Syndrome.". Diabetes Care 42 (2): 303–310. doi:10.2337/dc18-1410. PMID 30552134. 
  2. "Schilddrüsenhormonresistenz und Risiko für Diabetes und metabolisches Syndrom". Diabetologie und Stoffwechsel 14 (2): 78. 16 April 2019. doi:10.1055/a-0758-5718. 
  3. Paschou, Stavroula A.; Alexandrides, Theodoros (19 October 2019). "A year in type 2 diabetes mellitus: 2018 review based on the Endorama lecture". Hormones 18 (4): 401–408. doi:10.1007/s42000-019-00139-z. PMID 31630372. 
  4. Guan, Haixia (April 2019). "Mild Acquired Thyroid Hormone Resistance Is Associated with Diabetes-Related Morbidity and Mortality in the General Population". Clinical Thyroidology 31 (4): 138–140. doi:10.1089/ct.2019;31.138-140. 
  5. Lou-Bonafonte, José Manuel; Civeira, Fernando; Laclaustra, Martín (20 February 2020). "Quantifying Thyroid Hormone Resistance in Obesity". Obesity Surgery 30 (6): 2411–2412. doi:10.1007/s11695-020-04491-7. PMID 32078724. 
  6. "甲状腺素抵抗与糖尿病和代谢综合征有关?看TFQI怎么说". 
  7. Yang, S; Lai, S; Wang, Z; Liu, A; Wang, W; Guan, H (December 2021). "Thyroid Feedback Quantile-based Index correlates strongly to renal function in euthyroid individuals.". Annals of Medicine 53 (1): 1945–1955. doi:10.1080/07853890.2021.1993324. PMID 34726096. 
  8. Alonso, SP; Valdés, S; Maldonado-Araque, C; Lago, A; Ocon, P; Calle, A; Castaño, L; Delgado, E et al. (1 December 2021). "Thyroid hormone resistance index and mortality in euthyroid subjects: study.". European Journal of Endocrinology 186 (1): 95–103. doi:10.1530/EJE-21-0640. PMID 34735370. 
  9. Alonso-Ventura, V; Civeira, F; Alvarado-Rosas, A; Lou-Bonafonte, M; Calmarza, P; Moreno-Franco, B; Andres-Otero, MJ; Calvo-Gracia, F et al. (26 July 2022). "A cross-sectional study examining the parametric thyroid feedback quantile index and its relationship with metabolic and cardiovascular diseases.". Thyroid. doi:10.1089/thy.2022.0025. PMID 35891590. 
  10. Nie, X; Ma, X; Xu, Y; Shen, Y; Wang, Y; Bao, Y (December 2020). "Increased Serum Adipocyte Fatty Acid-Binding Protein Levels Are Associated with Decreased Sensitivity to Thyroid Hormones in the Euthyroid Population.". Thyroid 30 (12): 1718–1723. doi:10.1089/thy.2020.0011. PMID 32394790. 
  11. Aweimer, A; El-Battrawy, I; Akin, I; Borggrefe, M; Mügge, A; Patsalis, PC; Urban, A; Kummer, M et al. (12 November 2020). "Abnormal thyroid function is common in takotsubo syndrome and depends on two distinct mechanisms: results of a multicentre observational study.". Journal of Internal Medicine 289 (5): 675–687. doi:10.1111/joim.13189. PMID 33179374. 
  12. Zhai, D; Chen, J; Guo, B; Retnakaran, R; Gao, S; Zhang, X; Hao, W; Zhang, R et al. (1 December 2021). "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 88 (5): 2297–2305. doi:10.1111/bcp.15163. PMID 34855997. 
  13. Zhao, Y; Guan, Q; Shi, J; Sun, J; Wang, Q; Yang, J; Retnakaran, R; Han, J et al. (15 February 2022). "Impaired central set point of thyroid homeostasis during quetiapine treatment in the acute phase of schizophrenia.". Schizophrenia Research 241: 244–250. doi:10.1016/j.schres.2022.02.010. PMID 35180663. 
  14. Lai, S; Li, J; Wang, Z; Wang, W; Guan, H (2021). "Sensitivity to Thyroid Hormone Indices Are Closely Associated With NAFLD.". Frontiers in Endocrinology 12: 766419. doi:10.3389/fendo.2021.766419. PMID 34803928.