Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint-Maurice Cedex, France.
Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint-Maurice Cedex, France.
Ann Epidemiol. 2016 Feb;26(2):100-105.e4. doi: 10.1016/j.annepidem.2015.11.005. Epub 2015 Dec 12.
Recent studies have shown an increased incidence of congenital hypothyroidism over the past 2 or 3 decades. The etiology of this change is unknown, but it has been related by several authors to lowering of cutoffs. We sought to determine whether the incidence of congenital hypothyroidism (CH) in France has changed.
We analyzed data from the nationwide neonatal screening program for CH during the period 1982-2012. We included all children having thyroid-stimulating hormone values above the threshold and for whom diagnosis of CH confirmed by the pediatrician. We estimated multicentric temporal trends in the annual incidence rates adjusted for screening methods for thyroid dysgenesis and eutopic gland.
We found 6622 cases of CH (28.0 per 100,000 newborns); 1895 had a eutopic gland, and 4727 had thyroid dysgenesis. The incidence of eutopic glands showed a significant annual average increase of (5.1%; 95% confidence interval: 4.3-5.9) regardless of the screening method or screening center. This increase was confirmed in severe cases (thyroid-stimulating hormone ≥ 50: 2.1%; 95% confidence interval, 1.4-2.9). The incidence of dysgenesis remained constant.
The incidence of eutopic glands increased in France, not only in mild forms but also in severe cases.
最近的研究表明，在过去的 20 到 30 年中，先天性甲状腺功能减退症的发病率有所增加。这种变化的病因尚不清楚，但有几位作者认为与截止值降低有关。我们试图确定法国先天性甲状腺功能减退症（CH）的发病率是否发生了变化。
我们分析了 1982 年至 2012 年期间全国新生儿 CH 筛查计划的数据。我们纳入了所有 TSH 值超过阈值且经儿科医生确诊为 CH 的儿童。我们根据甲状腺发育不良和异位腺体的筛查方法，估计了多中心时间趋势的年度发病率。
我们发现 6622 例 CH（28.0/100000 新生儿）；1895 例有正常腺体，4727 例有甲状腺发育不良。无论筛查方法或筛查中心如何，正常腺体的发病率均呈显著的年均增长（5.1%；95%置信区间：4.3-5.9）。在严重病例中（TSH≥50：2.1%；95%置信区间，1.4-2.9），这种增加得到了证实。发育不良的发病率保持不变。
法国正常腺体的发病率增加，不仅在轻度病例中如此，在严重病例中也是如此。
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