Hu Yanyan, Zhu Liping, Liu Qiang, Xue Yongzhen, Sun Xuemei, Li Guimei
Department of Pediatrics, Linyi People's Hospital, NO. 27, Eastern Jiefang Road, Linyi, 276003, Shandong Province, China.
Department of Pediatrics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China.
Hormones (Athens). 2021 Dec;20(4):707-713. doi: 10.1007/s42000-021-00323-0. Epub 2021 Sep 28.
Few studies have focused on thyroid function in children with isolated pituitary hypoplasia (IPH). The purpose of this study was to investigate thyroid function in children with short stature accompanied by IPH and evaluate the values of thyroid function for the diagnosis of IPH.
This was a retrospective observational study. A total of 100 children with short stature accompanied by IPH were enrolled. Among them, 68 children presenting with isolated growth hormone deficiency (IGHD) were chosen as the IPH group. Sixty-eight age-matched and sex-matched IGHD children without pituitary abnormalities were chosen as the control group. Clinical, hormonal, and imaging parameters were analyzed. The diagnostic value of thyroid function for IGHD children with IPH was evaluated.
Children in the IPH group had significantly lower height standard deviation score (HSDS), HSDS-target height standard deviation score (THSDS), free thyroxine (FT4), insulin-like growth factor-1 standard deviation score (IGF-1SDS), and pituitary height than the control subjects (p = 0.027, p = 0.033, p < 0.001, p = 0.03, and p < 0.001, respectively). The value of the area under the curve (AUC) was 0.701 (95% CI 0.614-0.788, p < 0.001) when the cut-off value for FT4 was ≤ 16.43 pmol/L and the sensitivity and specificity were 72.1 and 61.8%, respectively. FT4 levels were positively correlated with FT3, GH peak, and IGF-1 SDS levels in all children with short stature accompanied by IPH (p < 0.001, p = 0.009, and p = 0.01, respectively).
IGHD children with IPH had lower FT4 levels than IGHD children without pituitary abnormalities. FT4 levels may have diagnostic value for IGHD children with IPH.
很少有研究关注孤立性垂体发育不全（IPH）患儿的甲状腺功能。本研究的目的是调查伴有IPH的身材矮小患儿的甲状腺功能，并评估甲状腺功能对IPH诊断的价值。
这是一项回顾性观察研究。共纳入100例伴有IPH的身材矮小患儿。其中，68例表现为孤立性生长激素缺乏（IGHD）的患儿被选为IPH组。选取68例年龄和性别匹配、无垂体异常的IGHD患儿作为对照组。分析临床、激素和影像学参数。评估甲状腺功能对伴有IPH的IGHD患儿的诊断价值。
IPH组患儿的身高标准差评分（HSDS）、HSDS-靶身高标准差评分（THSDS）、游离甲状腺素（FT4）、胰岛素样生长因子-1标准差评分（IGF-1SDS）和垂体高度均显著低于对照组（p分别为0.027、0.033、<0.001、0.03和<0.001）。当FT4的截断值≤16.43 pmol/L时，曲线下面积（AUC）值为0.701（95%CI 0.614-0.788，p<0.001），敏感性和特异性分别为72.1%和61.8%。在所有伴有IPH的身材矮小患儿中，FT4水平与FT3、GH峰值和IGF-1 SDS水平呈正相关（p分别<0.001、0.009和0.01）。
伴有IPH的IGHD患儿的FT4水平低于无垂体异常的IGHD患儿。FT4水平可能对伴有IPH的IGHD患儿具有诊断价值。
