Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India.
Department of Pediatrics, Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India. Correspondence to: Dr Seema Kapoor, Director-Professor, Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
Indian Pediatr. 2019 Apr 15;56(4):281-286.
To determine an appropriate cut-off of capillary Thyroid stimulating hormone (TSH) for congenital hypothyroidism.
Cross-sectional.
174,000 neonates born in different hospitals of Delhi, India, from November 2014 to October 2016.
Correlation between initial and repeat capillary TSH level and subsequent venous free thyroxine (fT4) level.
102 newborns with initial/ repeat capillary TSH level of ≥20 mIU/L (n=174) were confirmed to have congenital hypothyroidism at mean (SD) age of 5 (4) days. A good correlation between capillary TSH level and confirmatory venous fT4 level and postnatal age of sampling was obtained (r -0.6, -0.4). The area under the ROC curve (AUC) was 0.81 (95%CI 0.75 to 0.88), indicating referral capillary TSH level of 20 mIU/L to be a good predictor of subsequent high venous TSH level.
A cut off of ≥20 mIU/L for capillary TSH screening beyond 24 hours of life is optimal in the Indian setting for deciding further recall and workup, keeping a balance between sensitivity and recall rate.
确定先天性甲状腺功能减退症的毛细血管促甲状腺激素（TSH）截断值。
横断面研究。
2014 年 11 月至 2016 年 10 月期间在印度德里不同医院出生的 174000 名新生儿。
初始和重复毛细血管 TSH 水平与随后静脉游离甲状腺素（fT4）水平之间的相关性。
102 名初始/重复毛细血管 TSH 水平≥20 mIU/L（n=174）的新生儿在平均（SD）5（4）天的年龄时被确诊为先天性甲状腺功能减退症。毛细血管 TSH 水平与确诊静脉 fT4 水平和采样后的年龄之间存在良好的相关性（r=-0.6，-0.4）。ROC 曲线下面积（AUC）为 0.81（95%CI 0.75 至 0.88），表明 20 mIU/L 的毛细血管 TSH 水平是随后高静脉 TSH 水平的良好预测指标。
在印度，对于超过 24 小时生命的毛细血管 TSH 筛查，截断值≥20 mIU/L 是决定进一步召回和检查的最佳选择，在敏感性和召回率之间取得平衡。
