Kumar Juhi, Gordillo Roberto, Kaskel Frederick J, Druschel Charlotte M, Woroniecki Robert P
Division of Pediatric Nephrology, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
J Pediatr. 2009 Feb;154(2):263-6. doi: 10.1016/j.jpeds.2008.08.023. Epub 2008 Sep 27.
We investigated the prevalence of congenital renal and urologic anomalies in children with congenital hypothyroidism to determine whether further renal and urologic investigations would be of benefit.
Prevalence of congenital hypothyroidism was obtained from the New York State Congenital Malformation Registry. The occurrence of urinary tract anomalies were calculated for children with congenital hypothyroidism and compared to children without congenital hypothyroidism. In addition we obtained congenital hypothyroidism data from New York State newborn screening, and the cases were matched to Congenital Malformation Registry.
Analysis of Congenital Malformation Registry data showed 980 children with congenital hypothyroidism and 3 661 585 children without congenital hypothyroidism born in New York State (1992-2005). Children with congenital hypothyroidism have a significantly increased risk of congenital renal and urological anomalies with the odds ratio (OR) of 13.2 (10.6-16.5). The other significantly increased defects in congenital hypothyroidism were cardiac, gastrointestinal, and skeletal. Analysis of matched data confirmed an increase of congenital renal and urologic anomalies with OR of 4.8 (3.7-6.3).
Children with congenital hypothyroidism have an increased prevalence of congenital renal and urologic anomalies. We suggest that these children should be evaluated for the presence of congenital renal and urologic anomalies with renal ultrasonography, and that further studies of common genes involved in thyroid and kidney development are warranted.
我们调查了先天性甲状腺功能减退症患儿先天性肾脏和泌尿系统异常的患病率,以确定进一步的肾脏和泌尿系统检查是否有益。
先天性甲状腺功能减退症的患病率来自纽约州先天性畸形登记处。计算先天性甲状腺功能减退症患儿尿路异常的发生率,并与非先天性甲状腺功能减退症患儿进行比较。此外,我们从纽约州新生儿筛查中获取先天性甲状腺功能减退症数据,并将病例与先天性畸形登记处进行匹配。
对先天性畸形登记处数据的分析显示,纽约州(1992 - 2005年)出生的980例先天性甲状腺功能减退症患儿和3661585例非先天性甲状腺功能减退症患儿。先天性甲状腺功能减退症患儿先天性肾脏和泌尿系统异常的风险显著增加,优势比(OR)为13.2(10.6 - 16.5)。先天性甲状腺功能减退症中其他显著增加的缺陷是心脏、胃肠道和骨骼方面的。对匹配数据的分析证实先天性肾脏和泌尿系统异常增加,OR为4.8(3.7 - 6.3)。
先天性甲状腺功能减退症患儿先天性肾脏和泌尿系统异常的患病率增加。我们建议应通过肾脏超声检查评估这些患儿是否存在先天性肾脏和泌尿系统异常,并且有必要进一步研究参与甲状腺和肾脏发育的常见基因。