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先天性甲状腺功能减退症的认知结果:社会经济地位的影响-病例对照研究。

Cognitive Outcomes in Congenital Hypothyroidism: Impact of Socioeconomic Status - A Case-Control Study.

机构信息

Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Horm Res Paediatr. 2022;95(3):224-232. doi: 10.1159/000522257. Epub 2022 Apr 21.

Abstract

OBJECTIVE

Chile is one of the few high-income countries in Latin America, being a pioneer in implementing a national newborn screening (NBS) program in 1992. Currently, it covers 98% of the population, but no long-term outcomes have been described so far. The aim of this study was to report the neurocognitive outcomes of children with congenital hypothyroidism (CH) diagnosed by the NBS program in Chile between 2005 and 2012 and to identify variables associated with the outcomes.

METHODS

We performed a case-control study in children with CH born in the two largest regions of the country. The Leiter-R and TEVI-R tests were administered at home to 69 children with CH and 68 matched control subjects. Other variables affecting cognition were obtained. Multivariate logistic regression analyses were performed for Leiter-R and TEVI-R tests, using a model for cases alone and another model for cases and controls.

RESULTS

No differences in Leiter-R and TEVI-R results were observed between children with CH and the control group. Children who performed better, regardless of whether they had CH, had a higher family income and more assets.

CONCLUSIONS

These results suggest that the Chilean NBS program strategy results in children with normal language, attention, and memory development. Socioeconomic disadvantage represents a significant detriment in cognitive function.

摘要

目的

智利是拉丁美洲少数几个高收入国家之一,早在 1992 年就率先实施了全国新生儿筛查(NBS)计划。目前,该计划已经覆盖了 98%的人口,但迄今为止尚未描述其长期结果。本研究的目的是报告智利在 2005 年至 2012 年间通过 NBS 计划诊断出的先天性甲状腺功能减退症(CH)患儿的神经认知结果,并确定与结果相关的变量。

方法

我们在该国两个最大的地区对患有 CH 的儿童进行了病例对照研究。对 69 名 CH 患儿和 68 名匹配的对照儿童进行了在家进行的 Leiter-R 和 TEVI-R 测试。还获得了影响认知的其他变量。使用仅适用于病例的模型和适用于病例和对照的另一个模型,对 Leiter-R 和 TEVI-R 测试进行了多变量逻辑回归分析。

结果

CH 患儿与对照组在 Leiter-R 和 TEVI-R 结果上无差异。无论是否患有 CH,表现更好的儿童的家庭收入更高,资产更多。

结论

这些结果表明,智利的 NBS 计划策略导致儿童的语言、注意力和记忆力发育正常。社会经济劣势对认知功能有重大影响。

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