Journal of pediatric endocrinology & metabolism : JPEM最新文献

{"title":"Early-onset obesity and growth failure in children with pseudohypoparathyroidism type 1A: reference growth and weight curves from a Polish cohort.","authors":"Dorota Roztoczyńska, Katarzyna Gołąb-Jenerał, Dominika Januś, Ewelina Preizner-Rzucidło, Anna Wędrychowicz, Magdalena Ossowska, Magdalena Janeczko, Aleksandra Roztoczyńska, Agnieszka Zachurzok, Jerzy B Starzyk","doi":"10.1515/jpem-2026-0417","DOIUrl":"https://doi.org/10.1515/jpem-2026-0417","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate longitudinal growth and weight patterns in children with pseudohypoparathyroidism type 1A (PHP1A) and provide disease-specific growth and weight curves to aid clinical monitoring.</p><p><strong>Methods: </strong>Retrospective analysis of 26 children (12 girls and 14 boys) from 18 families, including 25 patients with PHP1A and one patient with PHP1B; 19 patients had genetically confirmed PHP1A. Height and weight measurements were analyzed using quantile regression to generate centile charts. The patient with PHP1B was excluded from growth-trend analyses. Biochemical and hormonal parameters were assessed.</p><p><strong>Results: </strong>PHP1A was diagnosed at a median age of 6.1 years. Growth deceleration became evident after age 8, with a median final height of 147.7 cm (-2.5 SDS) for girls and 156 cm (-2.9 SDS) for boys. Body weight was above the 97th percentile until age 10, with partial normalization during adolescence. No correlation was observed between biochemical or hormonal parameters and obesity. Growth and weight patterns were consistent with findings from larger international cohorts.</p><p><strong>Conclusions: </strong>Children with PHP1A show early-onset obesity and growth deceleration after age 8. Disease-specific centile charts may provide a practical tool for monitoring growth and weight trajectories in this population. Early clinical assessment and individualized interventions are recommended.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed diagnosis of familial glucocorticoid deficiency type 4 in a child with epilepsy: a case report and literature review.","authors":"Ni Zhen, Xiaoyu Ma, Lidan Zhang, Wenli Lu, Zhiya Dong, Yuan Xiao","doi":"10.1515/jpem-2026-0001","DOIUrl":"https://doi.org/10.1515/jpem-2026-0001","url":null,"abstract":"<p><strong>Objectives: </strong>Familial glucocorticoid deficiency type 4 (FGD4) is a rare autosomal recessive form of primary adrenal insufficiency caused by biallelic variants in the <i>NNT</i> gene and characterized predominantly by isolated glucocorticoid deficiency. Neurological presentations may obscure the underlying adrenal disorder. We describe a pediatric case with a novel <i>NNT</i> variant not previously associated with FGD4 and review the reported clinical and genetic spectrum.</p><p><strong>Case presentation: </strong>A 10-year-old girl presented with a 4-year history of epilepsy and longstanding diffuse hyperpigmentation. A homozygous frameshift variant in <i>NNT</i> (c.645delT; p.Phe215Leufs*17) was identified in the appendix to the previous whole-exome sequencing report and confirmed by Sanger sequencing; both parents were heterozygous carriers. The variant was classified as pathogenic according to ACMG criteria. The patient also had primary hypothyroidism, symptomatic epilepsy, and metabolic encephalopathy. During follow-up with glucocorticoid and thyroxine replacement therapy and continued antiepileptic treatment seizure frequency decreased, hyperpigmentation improved, and communication, attention, and social interaction improved.</p><p><strong>Conclusions: </strong>This case expands the mutational spectrum of <i>NNT</i>-related FGD4 and emphasizes the importance of considering adrenal insufficiency in pediatric patients presenting with seizures and hyperpigmentation. Early recognition and diagnosis of adrenal insufficiency enable timely hormone replacement therapy and may reduce the risk of neurological and metabolic complications.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone turnover markers in pediatric alkaptonuria: a case-control study.","authors":"Ece Öge Enver, Elif İşler Soylu, Pınar Vatansever, Tanyel Zubarioglu, Ertuğrul Kıykım, Yasemin Akın, Çiğdem Aktuğlu-Zeybek","doi":"10.1515/jpem-2026-0502","DOIUrl":"https://doi.org/10.1515/jpem-2026-0502","url":null,"abstract":"<p><strong>Objectives: </strong>Alkaptonuria (AKU) is a rare inherited metabolic disorder characterized by progressive connective tissue damage and ochronosis. Although skeletal involvement is well documented in adults with AKU, data on bone metabolism during childhood are limited. This study evaluated bone turnover markers and mineral metabolism parameters in children with AKU.</p><p><strong>Methods: </strong>This cross-sectional case-control study included 16 pediatric patients with AKU and 27 healthy controls. Anthropometric measurements, serum calcium, phosphorus, alkaline phosphatase (ALP), parathyroid hormone, 25-hydroxyvitamin D, osteocalcin, β-C-terminal telopeptide of type I collagen (β-CTX), and urinary homogentisic acid (HGA)/creatinine ratio were assessed. Correlation analyses were performed between bone turnover markers, biochemical parameters, and urinary HGA levels.</p><p><strong>Results: </strong>Serum calcium concentrations were slightly lower in the AKU group than in controls (p=0.048), although values remained within the reference range in both groups. No significant differences were observed in anthropometric measurements, other mineral metabolism parameters, or bone turnover markers. Urinary HGA levels were not correlated with bone turnover markers. However, the urinary HGA to creatinine ratio showed a moderate negative correlation with body mass index (r=-0.61, p=0.02) and waist circumference (r=-0.58, p=0.02). In healthy controls, osteocalcin and β-CTX correlated positively with ALP and serum phosphorus, whereas these associations were absent in the AKU group.</p><p><strong>Conclusions: </strong>Our findings suggest that circulating biochemical markers of bone remodeling are preserved in children with AKU. Nevertheless, these results do not exclude early skeletal involvement and support the need for longitudinal studies incorporating additional biomarkers and imaging modalities to better characterize bone health in children with AKU.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric prolactinoma-associated pituitary apoplexy presenting with acute visual loss: a case report, literature review, and management strategy.","authors":"Yunus Emre Yilmaz, Muhammed Erkan Emrahoglu, Senay Savas Erdeve, Keziban Asli Bala, Tuba Kara Akyuz, Sükriye Yilmaz, Efe Yetisgin, Hüseyin Hayri Kertmen","doi":"10.1515/jpem-2026-0379","DOIUrl":"https://doi.org/10.1515/jpem-2026-0379","url":null,"abstract":"<p><strong>Objectives: </strong>Hemorrhagic pituitary apoplexy (PA) in children is exceedingly rare, with approximately 32 cases reported since 1980. Current guidelines recommend cabergoline as first-line therapy; however, acute complete visual loss mandates emergency surgical decompression. No guideline defines the optimal extent of resection, despite gross total resection carrying a 48-54 % risk of panhypopituitarism.</p><p><strong>Case presentation: </strong>An 11-year-old prepubertal girl presented with a 2-day history of complete right-eye visual loss. Serum prolactin was 987 μg/L, and MRI demonstrated a hemorrhagic sellar-suprasellar mass compressing the optic chiasm. Emergency endoscopic transsphenoidal surgery was performed with an intentionally limited strategy - hematoma evacuation, optic decompression, and partial debulking - deliberately avoiding aggressive capsular dissection. Histopathology confirmed prolactinoma. Vision was fully restored immediately after extubation, with near-complete visual field recovery on postoperative day 5 (VFI 98 %). Adrenocortical function was preserved. Central hypothyroidism developed, and levothyroxine was initiated. Cabergoline (0.25 mg/week) was started on postoperative day 5, achieving a 93.7 % prolactin reduction by day 20 (987 → 61.9 μg/L).</p><p><strong>Conclusions: </strong>In pediatric prolactinoma-associated PA requiring emergency surgery, a decompression-first strategy prioritizing visual rescue and tissue diagnosis over gross total resection may reduce the risk of panhypopituitarism, with residual tumor subsequently managed with cabergoline. The rapid biochemical response documented here supports this approach, though multicenter prospective evaluation is required.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatty liver and adipokines: converging pathways linking insulin resistance to early atherosclerosis in obese children and adolescents.","authors":"Ashraf T Soliman, Noora AlHumaidi, Ahmed Elawwa, Fawzia Alyafei, Noor Hamed, Shayma Ahmed, Nada Alaaraj","doi":"10.1515/jpem-2026-0302","DOIUrl":"https://doi.org/10.1515/jpem-2026-0302","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood obesity drives nonalcoholic fatty liver disease (NAFLD) and adipokine dysregulation, converging on insulin resistance (IR) to promote subclinical vascular injury measurable as increased carotid intima-media thickness (cIMT). Pediatric-specific mechanistic integration of these pathways with early atherosclerosis remains incompletely characterized. This review synthesizes evidence on NAFLD severity and cIMT in obese youth, examines the roles of resistin, high-molecular-weight (HMW) adiponectin, chemerin, and inflammatory mediators in IR-driven vascular remodeling, and evaluates their diagnostic and therapeutic implications.</p><p><strong>Content: </strong>A structured narrative review following SANRA guidance was conducted. PubMed/MEDLINE was searched from January 2000 to March 2025 for studies enrolling children aged 2-18 years with obesity and reporting cIMT measured by B-mode ultrasonography alongside NAFLD or adipokine measures. Quality was assessed using the Newcastle-Ottawa Scale (NOS) and AMSTAR-2. Across ten included studies (NOS scores: 5-8/9), obese children with NAFLD demonstrated consistently higher cIMT than controls (pooled weighted mean difference: +0.06 mm; 95% CI: 0.04-0.08 mm). Biopsy-proven nonalcoholic steatohepatitis independently predicted greater cIMT than simple steatosis (r=0.41; p<0.01). Resistin showed the strongest adipokine-cIMT association (r=0.47; p<0.001), with direct (β=0.31) and indirect effects via HOMA-IR (β=0.18) and high-sensitivity C-reactive protein (β=0.12). HMW-adiponectin deficiency, rather than total adiponectin, defined the preatherosclerotic phenotype. Chemerin correlated with cIMT (r=0.44; p<0.01) and metabolic syndrome score (β=0.39; p<0.001). Weight-loss intervention reduced cIMT by 0.03 mm (p<0.05), accompanied by adipokine normalization.</p><p><strong>Summary and outlook: </strong>NAFLD and adipokine dysregulation constitute interdigitated, IR-centered pathways associated with early atherosclerosis in obese youth, detectable from age 7 and partially reversible with timely intervention. A tiered algorithm incorporating BMI, liver enzymes, HOMA-IR, cIMT, and adipokine profiling is proposed for clinical risk stratification.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iodine exposure and thyroid function after prophylactic intragastric iodinated contrast administration for meconium obstruction of prematurity in extremely low birth weight infants.","authors":"Tomoyuki Shimokaze, Katsuaki Toyoshima, Hideyuki Hawaka, Takahiro Noguchi, Tomoko Saito, Jun Shibasaki, Junko Hanakawa, Koji Muroya","doi":"10.1515/jpem-2026-0270","DOIUrl":"https://doi.org/10.1515/jpem-2026-0270","url":null,"abstract":"<p><strong>Objectives: </strong>Maternal hypertensive disorders of pregnancy (HDP) increase the risk of meconium obstruction of prematurity in small-for-gestational-age (SGA) extremely low birth weight (ELBW) infants. While prophylactic intragastric amidotrizoate (Gastrografin^®) promotes meconium excretion, concerns persist regarding iodine load and thyroid dysfunction.</p><p><strong>Methods: </strong>We retrospectively analyzed infants (<30 weeks, <700 g) born 2016-2024. The treated group (n=20) comprised SGA infants of mothers with HDP receiving prophylactic 5-fold diluted Gastrografin (iodine: 148-222 mg/kg) after stabilization. Controls included nontreated SGA infants (n=17), mostly lacking maternal HDP (thus not meeting prophylaxis criteria), and an appropriate-for-gestational-age (AGA) reference cohort (n=48). A 2018-2022 unexposed subcohort (n=21) provided baseline urinary iodine concentration (UIC) data.</p><p><strong>Results: </strong>Treatment failure, necessitating therapeutic enema, occurred in 1/20 treated infants (5 %). Baseline UIC was 32 (IQR 25-127) vs. 25 (IQR 25-35) µg/L in combined controls (p=0.23). Day 1 postadministration, UIC surged to 326,000 (IQR 201,500-455,350) µg/L; by 2 weeks, it normalized to 348 vs. 267 μg/L (p=0.51). At 2 weeks, thyroid function was comparable between treated and nontreated SGA groups for TSH (5.8 vs. 5.1 μIU/mL; p=0.94), free T3 (1.56 vs. 1.55 pg/mL; p=0.68), and free T4 (0.98 vs. 0.78 ng/dL; p=0.31), though baseline HDP differences necessitate careful interpretation. Levothyroxine supplementation rates were 26 % vs. 13 %, respectively (p=0.42).</p><p><strong>Conclusions: </strong>Early postnatal iodine levels in preterm infants are low. Prophylactic intragastric Gastrografin facilitated meconium evacuation in high-risk SGA ELBW infants. The associated iodine elevation is transient. A nonsignificant numerical increase in levothyroxine supplementation within our small cohort necessitates further large-scale studies.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic cataract at type 1 diabetes onset: frequency and characteristics.","authors":"Arne J Speidel, Mariella Krielen, Stephanie Brandt-Heunemann, Martin Wabitsch, Armin Wolf, Christian Denzer","doi":"10.1515/jpem-2026-0545","DOIUrl":"https://doi.org/10.1515/jpem-2026-0545","url":null,"abstract":"<p><strong>Objectives: </strong>Pediatric diabetic cataract is a rare acute complication of diabetes mellitus and may result in permanent visual impairment. Reported prevalences range from 0.25 % to 3.4 %, while data from Germany remain limited. This study aimed to describe the prevalence and clinical characteristics of cataract in children with newly diagnosed type 1 diabetes at a German tertiary medical center.</p><p><strong>Methods: </strong>We retrospectively evaluated children and adolescents admitted to the Department of Pediatrics and Adolescent Medicine, University Medical Center Ulm, with newly diagnosed type 1 diabetes between January 2008 and February 2024 who underwent ophthalmologic screening at the Department of Ophthalmology of the same center. A final cohort of 141 patients was analyzed.</p><p><strong>Results: </strong>Cataract was diagnosed in 6 of 141 patients, corresponding to 4.3 % of the ophthalmologically examined cohort. The median age of patients with cataract was 12.4 years. Mean HbA_1c was significantly higher in patients with cataract than in those without cataract (15.8 % vs. 12.4 %; p<0.05). Visual acuity was significantly lower in patients with cataract than in those without cataract (0.19 vs. 0.03 logMAR; p<0.05). The predominant morphology was snowflake-like posterior subcapsular cataract. Retinal findings were normal in all patients, irrespective of cataract status.</p><p><strong>Conclusions: </strong>In this single-center cohort of screened children with newly diagnosed type 1 diabetes, cataract was detected more frequently in our ophthalmologically examined cohort than previously reported. Pediatric diabetic cataract may be underdiagnosed at diabetes onset. Initial ophthalmologic evaluation in children and adolescents with new-onset type 1 diabetes should, therefore, include slit-lamp examination, especially in patients with visual symptoms or markers of prolonged hyperglycemia.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of central precocious puberty rates during the prepandemic, pandemic, and endemic COVID-19 periods.","authors":"Barbara Garza-Ornelas, Krithika Sundaram, Umida Burkhanova, Sindhoosha Malay, Katherine Kutney","doi":"10.1515/jpem-2026-0220","DOIUrl":"https://doi.org/10.1515/jpem-2026-0220","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluate the frequency of central precocious puberty (CPP) diagnosis before, during, and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>New patient referrals for precocious puberty among patients aged 1-12 seen at the Rainbow Babies and Children's Hospital's Pediatric Endocrinology Practice were analyzed during three separate periods: \"pre-pandemic\" between 7/1/2018 and 12/31/2019, \"pandemic\" between 7/1/2020 and 12/31/2021, and \"endemic\" between 07/01/2022 and 12/31/2023. Demographic characteristics were compared between time periods.</p><p><strong>Results: </strong>Of 6,162 new patients seen, 75 were confirmed to be idiopathic CPP. A significant increase in the total number of CPP cases compared to prepandemic levels was only seen during the pandemic period (p=0.038). Analysis across all three periods also did not reveal a statistically significant linear trend in the proportion of CPP cases (p=0.642). The median age of diagnosis was younger during the pandemic (7.7 years) compared to the endemic period (8.5 years), p=0.006, but no other demographic differences were found, including BMI.</p><p><strong>Conclusions: </strong>Our study is the third single-center study in the literature to demonstrate the rise in the cases of CPP as a specific phenomenon to the pandemic period. Increase in stress during the pandemic is the most likely explanation for this transitory rise in the rates of idiopathic CPP.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alkaline phosphatase in paediatric practice: a practical approach with a proposed diagnostic algorithm.","authors":"Jakub Parys, Jakub Krzysztof Nowicki, Elżbieta Jakubowska-Pietkiewicz","doi":"10.1515/jpem-2026-0400","DOIUrl":"https://doi.org/10.1515/jpem-2026-0400","url":null,"abstract":"<p><p>This review summarises the clinical relevance of alkaline phosphatase (ALP) in paediatrics, placing emphasis on its biochemical heterogeneity, age-dependent physiology and diagnostic value in bone and hepatobiliary disorders. ALP is a group of membrane-bound enzymes, predominantly represented in serum by tissue-nonspecific alkaline phosphatase, with major contributions from bones and the liver. In children, interpretation of ALP concentration is complicated due to marked physiological variation occurring in growth and puberty, as well as by method-dependent differences in laboratory reference ranges. An elevated ALP activity may reflect normal growth; however, it may also result from benign transient hyperphosphatasaemia, rickets, fibrous dysplasia, juvenile Paget's disease, metabolic bone disease of prematurity or cholestatic liver disease. Low ALP activity, although less common, may be associated with hypophosphatasia, malnutrition, micronutrient deficiencies or medication effects. ALP should, therefore, be interpreted in the context of age, clinical presentation and supplementary findings of biochemical tests and diagnostic imaging.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mild TSH elevation is independently associated with height in children.","authors":"Mengying Zhang, Mengqi Li","doi":"10.1515/jpem-2026-0397","DOIUrl":"https://doi.org/10.1515/jpem-2026-0397","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether mildly elevated thyroid stimulating hormone (TSH) (<10 mIU/L) is associated with height in children independently of the growth hormone-insulin-like growth factor 1 (GH-IGF-1) axis, and to assess sex differences.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 2,447 children aged 2-10 years presenting for slow growth evaluation (2022-2024). Multivariable linear regression was used with adjustment for age, sex, and IGF-1 SDS; restricted cubic splines (RCS) were used to assess the dose-response relationship. Sex-stratified and sensitivity analyses were performed.</p><p><strong>Results: </strong>Mildly elevated TSH was present in 96 (3.92 %) children. Overall, TSH was inversely associated with height SDS (β=-0.03, p<0.001) independently of IGF-1; RCS confirmed linearity. The association was significant in boys (β=-0.03, p=0.002) and borderline in girls. Boys with elevated TSH had lower height SDS (β=-0.18, p=0.025). Sensitivity analyses: the association persisted after excluding low IGF-1 (β=-0.02, p=0.004) but not in children with short stature (height SDS ≤-2).</p><p><strong>Conclusions: </strong>Mildly elevated TSH is independently associated with reduced height in children aged 2-10 years, independent of IGF-1. The association was significant in boys and borderline in girls, with no significant interaction. The absence of bone age and parental height data is a major limitation. These findings support growth monitoring rather than routine levothyroxine therapy.</p>","PeriodicalId":520684,"journal":{"name":"Journal of pediatric endocrinology & metabolism : JPEM","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}