Delvecchio Maurizio, Vigone Maria Cristina, Wasniewska Malgorzata, Weber Giovanna, Lapolla Rosa, Popolo Pietro Pio, Tronconi Giulia Maria, Di Mase Raffaella, De Luca Filippo, Cavallo Luciano, Salerno Mariacarolina, Faienza Maria Felicia
Section of Pediatrics, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy.
Department of Pediatrics Endocrinology, IRCCS Vita-Salute San Raffaele University, Milan, Italy.
Ital J Pediatr. 2015 Oct 28;41:82. doi: 10.1186/s13052-015-0190-y.
Linear growth and final height are reported as normal in congenital hypothyroid patients in the neonatal screening era.
We evaluated the final height in 215 patients with congenital hypothyroidism to assess if it improved over the last 2 decades.
Final height (-0.1 ± 1.0 SDS) was higher than target height (-0.8 ± 1.0 SDS, p < 0.001) and not different among the 4 quartiles for birthdate. It was correlated with target height (r(2) = 0.564, p < 0.001) and height at puberty onset (r(2) = 0.685, p < 0.001), but not with age at diagnosis or the starting LT4/kg/day dose. The curve fitting analysis showed that the age at diagnosis progressively decreased during the 20-year study period, while the target height and the starting LT4/kg/day increased. Final height was not affected by the birthdate, the age at diagnosis, the starting LT4 dose.
The final height is higher than the target height, but despite the improvement in the screening and the treatment, it did not improve over the last 20 years. These findings are in keeping with the described secular trend and suggest that earlier diagnosis and replacement therapy do not significantly modify final height in these patients.
在新生儿筛查时代，先天性甲状腺功能减退症患者的线性生长和最终身高据报道是正常的。
我们评估了215例先天性甲状腺功能减退症患者的最终身高，以评估其在过去20年中是否有所改善。
最终身高（-0.1±1.0 SDS）高于目标身高（-0.8±1.0 SDS，p<0.001），且在4个出生日期四分位数之间无差异。它与目标身高（r²=0.564，p<0.001）和青春期开始时的身高（r²=0.685，p<0.001）相关，但与诊断年龄或起始左甲状腺素/千克/天剂量无关。曲线拟合分析表明，在20年的研究期间，诊断年龄逐渐降低，而目标身高和起始左甲状腺素/千克/天剂量增加。最终身高不受出生日期、诊断年龄、起始左甲状腺素剂量的影响。
最终身高高于目标身高，但尽管筛查和治疗有所改善，但在过去20年中并未改善。这些发现与所描述的长期趋势一致，表明早期诊断和替代治疗并不能显著改变这些患者的最终身高。
