Doménech Martínez E, Barroso Guerrero F
Departamento de Pediatría. Facultad de Medicina. Universidad de La Laguna. Centro Regional para la Detección y Prevención de la Subnormalidad de Origen Metabólico de Canarias. Tenerife. España.
An Pediatr (Barc). 2003 Apr;58(4):357-63. doi: 10.1016/s1695-4033(03)78070-9.
Newborns in European cities where iodine intake is low have been demonstrated to present high frequencies of transitory hypothyroidism. Because the neonatal period is critical for cerebral development, this is a cause for concern. Published studies (WHO/UNICEF/ICCIDD) indicate that neonates with a thyroid-stimulating hormone (TSH) concentration of more than 5 mU/ml revealed by screening for congenital hypothyroidism present mild iodine deficiency.
To analyze the utility of TSH values as an indicator of the prevalence of iodine deficiency in the general population.
We prospectively evaluated 19 809 neonates, corresponding to all the neonates screened from May 2001 to April 2002 in the Canary Islands.TSH determination in whole blood dried on filter paper was performed using immunofluorescence (Delphia) in the Center for the Detection of Metabolic Disorders in the Canary Islands. The percentage of neonates in each island with TSH values of > 5 mU/l was calculated. Samples of cord blood were not used.
A total of 19 809 infants were analyzed. Of these 1800 had values of TSH > 5 mU/L, representing 9.08 % of neonates. The mean age at blood extraction was 4.31 6 3.78 days (range: 0.5-40). The percentage of neonates with values of THS > 5 mU/L in each island was 13.1 % in Gran Canaria, 5.1 % in Lanzarote, 7.3 % in Fuerteventura, 6.0 % in Tenerife, 6.2 % in La Palma, 6.6 % in Gomera and 10.1 % in Hierro. In 77.5 % of neonates in Gran Canaria blood was extracted for screening within the first 72 hours of life and 15.2 % of these neonates had TSH concentrations of > 5 mU/L. In 22.5 % of neonates blood was extracted on the third day of life or later and 7.9 % of these neonates had TSH values of > 5 mU/L.
In the Canary Islands, the percentage of neonates with iodine deficiency, according to elevated TSH levels detected screening for congenital hyperthyroidism, was small. The validity of TSH level as an indicator of the prevalence of iodine deficiency in the general population is influenced by the days of life at which the blood sample is taken.
在碘摄入量低的欧洲城市，已证实新生儿出现短暂性甲状腺功能减退的频率很高。由于新生儿期对大脑发育至关重要，这令人担忧。已发表的研究（世界卫生组织/联合国儿童基金会/国际控制碘缺乏病理事会）表明，先天性甲状腺功能减退筛查显示促甲状腺激素（TSH）浓度超过5 mU/ml的新生儿存在轻度碘缺乏。
分析TSH值作为一般人群碘缺乏患病率指标的效用。
我们前瞻性评估了19809名新生儿，这些新生儿对应于2001年5月至2002年4月在加那利群岛筛查的所有新生儿。在加那利群岛代谢紊乱检测中心，使用免疫荧光法（德菲亚）对滤纸上干燥的全血进行TSH测定。计算每个岛屿TSH值>5 mU/l的新生儿百分比。未使用脐血样本。
共分析了19809名婴儿。其中1800名婴儿的TSH值>5 mU/L，占新生儿的9.08%。采血时的平均年龄为4.31±3.78天（范围：0.5 - 40天）。每个岛屿TSH值>5 mU/L的新生儿百分比在大加那利岛为13.1%，在兰萨罗特岛为5.1%，在富埃特文图拉岛为7.3%，在特内里费岛为6.0%，在拉帕尔马岛为6.2%，在戈梅拉岛为6.6%，在耶罗岛为10.1%。在大加那利岛，77.5%的新生儿在出生后72小时内采血进行筛查，其中15.2%的新生儿TSH浓度>5 mU/L。在22.5%的新生儿出生第三天或更晚采血，其中7.9%的新生儿TSH值>5 mU/L。
在加那利群岛，根据先天性甲状腺功能亢进筛查中检测到的TSH水平升高判断，碘缺乏新生儿的百分比很小。TSH水平作为一般人群碘缺乏患病率指标的有效性受采血时的日龄影响。
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