Soldin Offie Porat, Lai Shenghan, Lamm Steven H, Mosee Shiela
Consultants in Epidemiology and Occupational Health, Inc, Washington, DC 20007, USA.
Thyroid. 2003 Feb;13(2):193-8. doi: 10.1089/105072503321319503.
The growth and differentiation of the central nervous system are closely related to the presence of iodine and thyroid hormones. It has been hypothesized that neurobehavioral disabilities of childhood, such as attention deficit hyperactivity disorder (ADHD), learning disorders, and autism can be attributed to fetal thyroidal endocrine disruption in utero. To determine whether there is an association between neonatal thyroid status and a subsequent diagnosis of a neurobehavioral disability, neonatal thyroxine (T(4)) levels have been used as the indicator of the presence of intrauterine thyroidal dysfunction. Neonatal T(4) levels were obtained from the neonatal hypothyroidism screening program. All cases were diagnosed at medical school diagnostic clinics, the diagnostic categories being ADHD, autism spectrum disorder, behavioral disorder, cognitive disorder, developmental delay, emotional disorder, learning disability, and speech/language disorder. Conditional logistic regression analysis was performed for each clinical condition. Odds ratios for the conditions ranged from 0.92 to 1.13 with p values ranging between 0.19 and 0.84. No significant differences were detected between neonatal T(4) values of the cases and the controls for any of the neurobehavioral conditions. All neonatal T(4) values were within normal ranges. The data provide no evidence to suggest that intrauterine thyroid status as reflected by the neonatal T(4) values had an impact on the neurologic disorders diagnosed in childhood.
中枢神经系统的生长和分化与碘及甲状腺激素的存在密切相关。据推测,儿童期的神经行为障碍,如注意力缺陷多动障碍(ADHD)、学习障碍和自闭症,可归因于子宫内胎儿甲状腺内分泌紊乱。为了确定新生儿甲状腺状态与随后神经行为障碍诊断之间是否存在关联,新生儿甲状腺素(T(4))水平已被用作子宫内甲状腺功能障碍存在与否的指标。新生儿T(4)水平取自新生儿甲状腺功能减退筛查项目。所有病例均在医学院诊断诊所确诊,诊断类别包括ADHD、自闭症谱系障碍、行为障碍、认知障碍、发育迟缓、情绪障碍、学习障碍以及言语/语言障碍。对每种临床情况进行了条件逻辑回归分析。这些情况的优势比在0.92至1.13之间,p值在0.19至0.84之间。在任何神经行为状况下,病例组和对照组的新生儿T(4)值均未检测到显著差异。所有新生儿T(4)值均在正常范围内。数据没有提供证据表明新生儿T(4)值所反映的子宫内甲状腺状态对儿童期诊断出的神经疾病有影响。