Ghasemi Mahmoud, Hashemipour Mahin, Hovsepian Silva, Heiydari Kamal, Sajadi Ali, Hadian Rezvaneh, Mansourian Marjan, Mirshahzadeh Naghme, Dalvi Marzie
Department of Pediatrics, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran ; Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatric Endocrinology, Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2013 Aug;18(8):699-703.
Congenital hypothyroidism (CH) considered a common endocrine disorder in Iran. We report the epidemiologic findings of CH screening program in Isfahan, seven years after its development, regarding the prevalence of transient CH (TCH) and its screening properties comparing with permanent CH (PCH).
In this cross-sectional study, children with primary diagnosis of CH were studied. Considering screening and follow-up lab data and the decision of pediatric endocrinologists, the final diagnosis of TCH was determined.
A total of 464,648 neonates were screened. The coverage percent of the CH screening and recall rate was 98.9 and 2.1%, respectively. Out of which, 1,990 neonates were diagnosed with primary CH. TCH was diagnosed in 1,580 neonates. The prevalence of TCH was 1 in 294 live births. 79.4% of patients with primary CH had TCH. Mean of screening (54.7 ± 59.0 in PCH vs 21.8 ± 28.9 in TCH), recall (56.5 ± 58.8 in PCH vs 36.6 ± 45.0 in TCH), and thyroid stimulating hormone (TSH) and mean of TSH before (2.0 ± 2.9 in PCH vs 1.6 ± 1.6 in TCH) and after (37.7 ± 29.5 in PCH vs 4.3 ± 1.9 in TCH) discontinuing treatment at 3 years of age was significantly higher in PCH than TCH (P < 0.0000).
The higher rate of CH in Isfahan is mainly due to the transient form of the disease. Further studies for evaluating the role of other environmental, autoimmune and/or genetic factors in the pathophysiology of the disease is warranted.
先天性甲状腺功能减退症(CH)被认为是伊朗常见的内分泌疾病。我们报告了设拉子CH筛查项目开展七年后的流行病学结果,涉及短暂性CH(TCH)的患病率及其与永久性CH(PCH)相比的筛查特性。
在这项横断面研究中,对初步诊断为CH的儿童进行了研究。根据筛查和随访实验室数据以及儿科内分泌学家的诊断,确定TCH的最终诊断。
共筛查了464,648名新生儿。CH筛查的覆盖率和召回率分别为98.9%和2.1%。其中,1990名新生儿被诊断为原发性CH。1580名新生儿被诊断为TCH。TCH的患病率为每294例活产中有1例。原发性CH患者中79.4%患有TCH。PCH组的筛查均值(PCH为54.7±59.0,TCH为21.8±28.9)、召回均值(PCH为56.5±58.8,TCH为36.6±45.0)、甲状腺刺激激素(TSH)以及3岁时停止治疗前(PCH为2.0±2.9,TCH为1.6±1.6)和停止治疗后(PCH为37.7±29.5,TCH为4.3±1.9)的TSH均值均显著高于TCH(P<0.0000)。
设拉子CH发病率较高主要是由于该病的短暂形式。有必要进一步研究评估其他环境、自身免疫和/或遗传因素在该疾病病理生理学中的作用。