Background: Spot urine albumin/creatinine ratio is a reliable estimate of 24-hour urine albumin excretion. In a pilot study, we observed that the spot urine osmolality/creatinine ratio (Uosm/Ucr) in healthy adults is reproducible. Therefore, we postulated that Uosm/Ucr of a spot urine sample may give an overall estimate of urinary excretion of solutes, renal concentrating ability and body hydration status. Method: Early morning spot urine samples were collected from healthy humans, frozen and analyzed in batches to establish spot Uosm/Ucr and its variation in relation to sex, age, body weight and height. Results: Two hundred and twenty-nine healthy volunteers participated. They were stratified into seven age groups: (a) 1.5–5, (b) >5–10, (c) >10–20, (d) >20–30, (e) >30–45, (f) >45–60, and (g) >60 years. Fifteen males and 15 females were allocated to each age category. A spot urine sample was collected from all subjects in the morning after the first void and was analyzed for osmolality and creatinine. The influence of age, sex, body weight and height on spot Uosm/Ucr was investigated using multiple linear regression. Only height showed a significant correlation (R2 = 0.02). Further analysis after excluding the 1.5–5 years age group revealed no significant correlation between age, sex, body weight and height and the Uosm/Ucr ratio. Conclusion: Spot Uosm/ Ucr of healthy humans is a consistent index in steady state and needs no correction for sex, age and body weight above the age of 5 years.
Thyroid stimulating hormone (TSH) secretion shows a circadian rhythm, affecting free thyroxine (fT4) secretion in the same manner. Samples are collected randomly throughout the day for serum TSH & fT4 measurement in current practice. This may affect interpretation of results if the follow up samples are collected at different times of the day from the same individual. We aimed to assess the diurnal variation in serum TSH and fT4 levels in healthy adults. Healthy adult volunteers with Sinhalese ethnicity aged 21 -50 years were selected for the study. Subjects with thyroid or any other disease, on medications including oral contraceptives and postmenopausal women were excluded. Two blood samples were drawn from each subject at 8-9 am and 3-4 pm on the same day. TSH and fT4 were measured using VITROS ECi Immunodiagnostic system. Paired T test was used to assess whether there was a statistically significant diurnal variation in hormone values. Data were analyzed using IBM SPSS Statistics Version 20 and Microsoft Excel 2013. A total number of 36 subjects with an equal number of males & females participated in the study. There was no variation in hormone levels due to age or gender. Log transformed TSH and fT4, showed a statistically significant difference for both TSH (p=0.013) and freeT4 (p<0.001) values in the morning and afternoon. Standardization of sample collection time may be important for TSH and fT4 hormone assays as this study revealed a statistically significant diurnal variation for both hormones. However further studies are needed in patients with thyroid diseases and individuals of other age groups as well to ascertain the clinical significance.
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