Predictive factors of permanent versus transient congenital hypothyroidism: a pragmatic cohort study.

IF 3.3 Q3 ENDOCRINOLOGY & METABOLISM

Annals of Pediatric Endocrinology & Metabolism Pub Date : 2025-06-01 Epub Date: 2025-03-20 DOI:10.6065/apem.2448126.063

Niki Dermitzaki, Vasileios Giapros, Marianna Deligeorgopoulou, Vasiliki Rengina Tsinopoulou, Eleni Kotanidou, Maria Baltogianni, Foteini Balomenou, Anastasios Serbis

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Abstract

Purpose: To identify clinical predictors of permanent congenital hypothyroidism (PCH) and transient congenital hypothyroidism (TCH).

Methods: This retrospective cohort study enrolled neonates with risk factors for congenital hypothyroidism as diagnosed by neonatal screening test or blood testing. Levothyroxine (LT4) dose and serum thyroid stimulating hormone (TSH) concentrations were recorded from birth to 3 years of age.

Results: We enrolled 88 neonates, 35 with PCH and 53 with TCH. An LT4 dose > 3.8 μg/kg/day at 6 months (sensitivity 62%, specificity 96%), 3.0 μg/kg/day at 12 months (64%, 97%, respectively), 2.6 μg/kg/day at 2 years (80%, 98%), and 2.5 μg/kg/day at 3 years (89%, 98%) of age could predict PCH. Daily total LT4 doses > 50 µg at any time during the follow-up period were found solely in the PCH group (28% vs 0%, P<0.001). Independent discriminative predictors of PCH and TCH were TSH concentrations at diagnosis (beta=-4.3, P<0.001); daily LT4 dose at 6 (beta=-2.9, P=0.004), 12 (beta=-3.4, P=0.001), and 24 months of age (beta=-3.2, P=0.001); TSH > 5 μIU/mL at any time after treatment initiation (beta=-3.6, P<0.001); and increase in LT4 dose by more than twice (beta=-3.2, P<0.001).

Conclusion: Discrimination between PCH and TCH was achieved based on serum TSH concentrations at diagnosis, TSH > 5 μIU/mL during treatment, LT4 dose, LT4 > 50 µg during treatment, and increasing LT4 dose during treatment.

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永久性与暂时性先天性甲状腺功能减退症的预测因素。一项实用的队列研究。

目的：探讨可用于临床区分永久性先天性甲状腺功能减退症（PCH）和短暂性先天性甲状腺功能减退症（TCH）的潜在预测因素。方法：采用回顾性队列研究，纳入因危险因素通过新生儿筛查试验或血液检查诊断为先天性甲状腺功能减退症（CH）的新生儿。记录出生至3岁儿童左旋甲状腺素（LT4）剂量及促甲状腺激素（TSH）水平。结果：共纳入88例新生儿，其中PCH 35例，TCH 53例。年龄≥3.8μg/kg/d（敏感性62%，特异性96%）、≥3.0μg/kg/d（敏感性64%，特异性97%）、≥2.6μg/kg/d（敏感性80%，特异性98%）、≥2.5μg/kg/d（敏感性89%，特异性98%）的剂量均可预测PCH。在随访期间的任何时间，仅在PCH组中观察到每日总LT4剂量bb50 µ；g的需求(治疗开始后任何时间28% vs 0% p5μIU/ml (β:-3.6, p=0.0003)，并且LT4剂量的需求增加了两倍以上（β:-3.2, p=0.0009）。结论：为了在本研究中区分PCH和TCH，可以使用LT4剂量，以及诊断时总LT4>50µ；g和TSH水平等预后标志物的组合，在治疗期间需要增加LT4剂量和治疗期间任何时候TSH水平>5μIU/mL。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Pediatric Endocrinology & Metabolism Multiple-

CiteScore

4.00

自引率

18.20%

发文量

审稿时长

24 weeks

期刊介绍： The Annals of Pediatric Endocrinology & Metabolism Journal is the official publication of the Korean Society of Pediatric Endocrinology. Its formal abbreviated title is “Ann Pediatr Endocrinol Metab”. It is a peer-reviewed open access journal of medicine published in English. The journal was launched in 1996 under the title of ‘Journal of Korean Society of Pediatric Endocrinology’ until 2011 (pISSN 1226-2242). Since 2012, the title is now changed to ‘Annals of Pediatric Endocrinology & Metabolism’. The Journal is published four times per year on the last day of March, June, September, and December. It is widely distributed for free to members of the Korean Society of Pediatric Endocrinology, medical schools, libraries, and academic institutions. The journal is indexed/tracked/covered by web sites of PubMed Central, PubMed, Emerging Sources Citation Index (ESCI), Scopus, EBSCO, EMBASE, KoreaMed, KoMCI, KCI, Science Central, DOI/CrossRef, Directory of Open Access Journals(DOAJ), and Google Scholar. The aims of Annals of Pediatric Endocrinology & Metabolism are to contribute to the advancements in the fields of pediatric endocrinology & metabolism through the scientific reviews and interchange of all of pediatric endocrinology and metabolism. It aims to reflect the latest clinical, translational, and basic research trends from worldwide valuable achievements. In addition, genome research, epidemiology, public education and clinical practice guidelines in each country are welcomed for publication. The Journal particularly focuses on research conducted with Asian-Pacific children whose genetic and environmental backgrounds are different from those of the Western. Area of specific interest include the following : Growth, puberty, glucose metabolism including diabetes mellitus, obesity, nutrition, disorders of sexual development, pituitary, thyroid, parathyroid, adrenal cortex, bone or other endocrine and metabolic disorders from infancy through adolescence.