Greggio Nella Augusta, Rossi Elisa, Calabria Silvia, Meneghin Alice, Gutierrez de Rubalcava Joaquin, Piccinni Carlo, Pedrini Antonella
Pediatric Endocrinology and Adolescence UnitDepartment of Woman and Child Health, University of Padova, Padova, Italy.
CINECA - Interuniversity Consortium (Health Service)Bologna, Italy.
Endocr Connect. 2017 Aug;6(6):367-374. doi: 10.1530/EC-17-0066. Epub 2017 Jun 14.
To estimate the prevalence of subclinical hypothyroidism (SH) among children, by using levothyroxine low dosage as disease proxy, and to describe prescription pattern.
An historical cohort study was performed through administrative databases of 12 Italian Local Health Units covering 3,079,141 inhabitants. A cohort of children (aged 0-13 years) was selected in the period 2001-2014. A subgroup of new users (aged 0-9 years) was identified and followed up for 5 years.
The prevalence was provided as mean value of the whole period, as annual trend, by patient gender and age. Demographic details, information on levothyroxine dosage, comorbidities and co-medications were provided. Therapy duration and medication persistence were evaluated among new users.
644 children treated with levothyroxine low dosage was selected, with a mean annual prevalence of 0.20 per 1000 children. The temporal trend of prevalence was stable, with a slight reduction in the 2005-2008. Prevalence by age showed an increase after 10 years. Patients were treated with an average annual dose of 4290 µg/year and 66.9% of children were affected by comorbidities. Among 197 new users, 62.9% received therapy only for one year, whereas out of those treated two or more years, 89.0% resulted persistent to the therapy.
This study provides real-world epidemiology of SH among children, and it depicts the clinical and therapeutic characteristics of these subjects. Its findings showed that the SH treatment of this disorder was widely variable, also due to lack of evidence concerning paediatric population.
通过使用低剂量左甲状腺素作为疾病替代指标，估算儿童亚临床甲状腺功能减退症（SH）的患病率，并描述处方模式。
通过覆盖3079141名居民的12个意大利地方卫生单位的行政数据库进行一项历史性队列研究。在2001年至2014年期间选取一组儿童（0至13岁）。确定了一个新用户亚组（0至9岁）并对其进行了5年随访。
患病率以整个时期的平均值、年度趋势、患者性别和年龄来表示。提供了人口统计学细节、左甲状腺素剂量信息、合并症和联合用药情况。对新用户的治疗持续时间和用药持续性进行了评估。
选取了644名接受低剂量左甲状腺素治疗的儿童，平均年患病率为每1000名儿童中有0.20例。患病率的时间趋势稳定，在2005 - 2008年略有下降。按年龄划分的患病率在10岁后有所增加。患者的平均年剂量为4290 µg/年，66.9%的儿童患有合并症。在197名新用户中，62.9%仅接受了一年治疗，而在接受治疗两年或更长时间的患者中，89.0%持续接受治疗。
本研究提供了儿童SH的真实世界流行病学情况，并描述了这些受试者的临床和治疗特征。研究结果表明，由于缺乏关于儿科人群的证据，这种疾病的SH治疗差异很大。
