Final height in Italian patients with congenital hypothyroidism detected by neonatal screening: a 20-year observational study.
Final height in Italian patients with congenital hypothyroidism detected by neonatal screening: a 20-year observational study.
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DOI：
10.1186/s13052-015-0190-y
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发表时间：
2015-10-28
影响因子：
3.6
通讯作者：
Faienza MF
中科院分区：
文献类型：
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作者：
Delvecchio M;Vigone MC;Wasniewska M;Weber G;Lapolla R;Popolo PP;Tronconi GM;Di Mase R;De Luca F;Cavallo L;Salerno M;Faienza MF
在新生儿筛查时期，先天性甲状腺功能减退症患者的线性生长和最终身高被报道为正常。我们评估了215名先天性甲状腺功能减退症患者的最终身高，以评估其在过去20年中是否有所改善。最终身高（-0.1 ± 1.0 SDS）高于目标身高（-0.8 ± 1.0 SDS，p < 0.001），且出生日期的4个四分位数之间无差异。它与目标身高（r2 = 0.564，p < 0.001）和青春期开始时的身高（r2 = 0.685，p < 0.001）相关，但与诊断时的年龄或起始LT 4/kg/天剂量无关。曲线拟合分析显示，在20年的研究期间，诊断时的年龄逐渐降低，而目标身高和起始LT 4/kg/d增加。最终身高不受出生日期、诊断时年龄、起始LT 4剂量的影响。最终身高高于目标身高，但尽管筛查和治疗有所改善，但在过去20年中并没有改善。这些结果与所描述的长期趋势一致，并表明早期诊断和替代治疗不会显著改变这些患者的最终身高。
Linear growth and final height are reported as normal in congenital hypothyroid patients in the neonatal screening era. We evaluated the final height in 215 patients with congenital hypothyroidism to assess if it improved over the last 2 decades. Final height (-0.1 ± 1.0 SDS) was higher than target height (-0.8 ± 1.0 SDS, p < 0.001) and not different among the 4 quartiles for birthdate. It was correlated with target height (r2 = 0.564, p < 0.001) and height at puberty onset (r2 = 0.685, p < 0.001), but not with age at diagnosis or the starting LT4/kg/day dose. The curve fitting analysis showed that the age at diagnosis progressively decreased during the 20-year study period, while the target height and the starting LT4/kg/day increased. Final height was not affected by the birthdate, the age at diagnosis, the starting LT4 dose. The final height is higher than the target height, but despite the improvement in the screening and the treatment, it did not improve over the last 20 years. These findings are in keeping with the described secular trend and suggest that earlier diagnosis and replacement therapy do not significantly modify final height in these patients.