Sexual dimorphism of thyroid function in newborns with congenital hypothyroidism
Sexual dimorphism of thyroid function in newborns with congenital hypothyroidism
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DOI：
10.1210/jc.2004-2320
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发表时间：
2005-05-01
影响因子：
5.8
通讯作者：
Van Vliet, G
中科院分区：
文献类型：
--
作者：
Eugène, D;Djemli, A;Van Vliet, G
先天性甲状腺功能减退症（CH）的甲状腺发育不全（异位和甲状腺发育不全）的几个特征是性二态性的：女孩更经常受到影响，男孩是女孩的两倍，有可能在诊断时没有膝关节骨骺，CH的严重程度的指标。CH的生化严重程度是否是性二态性尚不清楚。因此，我们回顾了1990年至2004年因新生儿筛查时TSH大于15 mU/L而转诊至我们诊所的所有新生儿的图表。异位（24名男孩，78名女孩）筛选时，男孩的中位TSH低于女孩（75对135 mU/L，P = 0.017），而总T（4）较高（123与68 mmol/L，P = 0.003）;诊断时存在相同的差异：男孩和女孩的TSH分别为90和284 mU/L（P = 0.001），游离T4分别为10和7 pmol/L（P = 0.049）。筛查和诊断时TSH和T（4）之间的对数线性关系在两种性别中相似。在筛查和诊断时的甲状腺机能不全（10名男孩，14名女孩）中，男孩的TSH较高[ 308 vs. 207（P = 0.053）和712 vs. 555 mU/L（P = 0.0057）]。在婴儿原位腺体（激素异常，9名男孩，13名女孩），有没有性别差异的生化严重程度CH。总之，性别二型性的生化严重程度CH甲状腺发育不全是明显的，但根据病因不同。这些新的发现表明，性二型应被视为异位甲状腺细胞的命运和功能的机制的调制器。
Several characteristics of congenital hypothyroidism ( CH) from thyroid dysgenesis (ectopy and athyreosis) are sexually dimorphic: girls are more often affected, and boys are twice more likely than girls to have absent knee epiphysis at diagnosis, an indicator of severity of CH. Whether the biochemical severity of CH is sexually dimorphic is unknown. We therefore reviewed the charts of all newborns referred to our clinic from 1990 to 2004 because of a TSH greater than 15 mU/liter on newborn screening. In ectopy ( 24 boys, 78 girls) at screening, median TSH was lower in boys than girls (75 vs. 135 mU/liter, P = 0.017), whereas total T(4) was higher (123 vs. 68 mmol/liter, P = 0.003); the same differences were present at diagnosis: TSH was 90 and 284 mU/liter (P = 0.001) and free T(4) 10 and 7 pmol/liter (P = 0.049) in boys and girls, respectively. The log-linear relationships between TSH and T(4) at screening and diagnosis were similar in both sexes. In athyreosis ( 10 boys, 14 girls) at screening and diagnosis, TSH was higher in boys [ 308 vs. 207 (P = 0.053) and 712 vs. 555 mU/liter (P = 0.0057)]. In infants with an orthotopic gland (dyshormonogenesis, nine boys, 13 girls), there was no sex difference in biochemical severity of CH. In conclusion, sexual dimorphism in biochemical severity of CH from thyroid dysgenesis is apparent but differs according to etiology. These novel findings suggest that sexual dimorphism should be considered as a modulator of the mechanisms underlying the fate and function of ectopic thyroid cells.