Department of Guangzhou Newborn Screening Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, P.R. China.
Department of Genetics and Endocrinology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, P.R. China.
J Pediatr Endocrinol Metab. 2022 Aug 30;35(9):1141-1146. doi: 10.1515/jpem-2022-0107. Print 2022 Sep 27.
An increased incidence of congenital hypothyroidism (CH) has been described worldwide over the years. In this study, we aimed to investigate the epidemiologic characteristics of CH, the iodine status in Guangzhou, China and to investigate which factors might influence the CH incidence during the period 2010-2020.
We retrospectively reviewed all cases of CH detected by newborn screening during the period 2010-2020. CH was classified as either suspected thyroid dyshormonogenesis (SDH) or thyroid dysgenesis (TD) based on thyroid ultrasound at first diagnosis. Patients were re-evaluated after 4 weeks of L-thyroxine withdrawal at age of 2-3 years to confirm the diagnosis of permanent CH (PCH) or transient CH (TCH).
From 2010 to 2020, 1,655 patients with CH were confirmed from 2,400,383 newborns (1:1,450). The CH incidence increased from 1:2,584 in period [2010-2014] to 1:1,086 in period [2015-2020]. Among the 1,337 patients with thyroid ultrasound, 84.29% were SDH whereas 15.71% had TD. Further analysis revealed that more SDH (78.32%) were TCH whereas more TD (87.12%) turned to be PCH. The proportion of blood spot thyrotropin values >5 mIU/L ranged from 8.03 to 20.46%, indicating iodine deficiency. The prevalence of preterm infants increased from 5.50% in period [2010-2014] to 7.06% in period [2015-2020] (p<0.001).
In the past decade, the CH incidence has increased progressively. SDH was the majority of CH, most of which were TCH, while most patients with TD were PCH. The increased incidence might be mainly due to iodine deficiency and increased rates of preterm infants in our study.
近年来，全世界范围内先天性甲状腺功能减退症（CH）的发病率有所增加。本研究旨在调查中国广州 CH 的流行病学特征、碘状况，并探讨 2010-2020 年期间可能影响 CH 发病率的因素。
我们回顾性分析了 2010-2020 年期间通过新生儿筛查发现的所有 CH 病例。根据首次诊断时的甲状腺超声结果，将 CH 分为疑似甲状腺激素合成障碍（SDH）或甲状腺发育不良（TD）。在 2-3 岁时停用左甲状腺素 4 周后，对患者进行重新评估，以确认永久性 CH（PCH）或暂时性 CH（TCH）的诊断。
2010-2020 年期间，从 2400383 名新生儿中确诊了 1655 例 CH（1:1450）。CH 的发病率从[2010-2014]期间的 1:2584 上升至[2015-2020]期间的 1:1086。在 1337 例甲状腺超声患者中，84.29%为 SDH，15.71%为 TD。进一步分析显示，更多的 SDH（78.32%）为 TCH，而更多的 TD（87.12%）转为 PCH。血斑促甲状腺激素值>5mIU/L 的比例为 8.03%~20.46%，表明存在碘缺乏。早产儿的比例从[2010-2014]期间的 5.50%上升至[2015-2020]期间的 7.06%（p<0.001）。
在过去十年中，CH 的发病率呈逐渐上升趋势。SDH 是 CH 的主要类型，其中大多数为 TCH，而大多数 TD 患者为 PCH。发病率的增加可能主要归因于碘缺乏和本研究中早产儿比例的增加。
