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Growth development in children with congenital hypothyroidism: the effect of screening and treatment variables—a comprehensive longitudinal study

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Abstract

Investigating the screening and early treatment factors potentially affects the growth status of the patients with congenital hypothyroidism. In a longitudinal study, 760 (45 % girl) neonates born in 2002–2009 with congenital hypothyroidism diagnosed by neonatal screening in Isfahan–Iran were followed up to 5 years from the time of diagnosis (i.e., 3–4 records for the first year of age and 2–3 records after that). During follow-up, height, weight, and head circumferences of the patients were measured. Diagnostic and therapeutic factors included serum thyroxine and thyroid stimulating hormone concentration at diagnosis and after treatment initiation, the age at onset of treatment, the first therapeutic dosage, and age at first normalization of thyroxine and thyroid stimulating hormone. Quantile regression for longitudinal data was used for determining the effects of main factors on growth development. Longitudinal growth in height and weight was significantly correlated with the age at onset of treatment and the first therapeutic dosage (p < 0.01), while head circumference only with first therapeutic dosage (p < 0.05). Growth in weight and head circumference was affected by thyroid stimulating hormone at the time of diagnosis (p < 0.05). Also the age of thyroxine normalization had heterogeneous significant impact over the proposed quantiles on weight (p < 0.05), height (p < 0.01), and head circumference (p < 0.001). Among studied factors, the first therapeutic dosage, age at onset of treatment and age of thyroxine normalization seem to be more important for anthropometric development, suggesting that more optimal outcome might be achievable through earlier treatment and appropriate levothyroxine dosage.

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References

  1. A. Büyükgebiz, Newborn screening for congenital hypothyroidism. J. Clin. Res. Pediatr. Endocrinol. 5(Suppl 1), 8–12 (2013). doi:10.4274/Jcrpe.845

    PubMed  PubMed Central  Google Scholar 

  2. T. Unüvar, K. Demir, A. Abacı, A. Büyükgebiz, E. Böber, The role of initial clinical and laboratory findings in infants with hyperthyrotropinemia to predict transient or permanent hypothyroidism. J. Clin. Res. Pediatr. Endocrinol. 5(3), 170–173 (2013)

    Article  PubMed  PubMed Central  Google Scholar 

  3. A. Feizi, M. Hashemipour, S. Hovsepian, Z. Amirkhani, R. Kelishadi, M. Yazdi, K. Heydari, A. Sajadi, M. Amini, Growth and specialized growth charts of children with congenital hypothyroidism detected by neonatal screening in Isfahan, Iran. ISRN endocrinol. 2013, 1–9 (2013). doi:10.1155/2013/463939

  4. C. Corbetta, G. Weber, F. Cortinovis, D. Calebiro, A. Passoni, M.C. Vigone, P. Beck-Peccoz, G. Chiumello, L. Persani, A 7-year experience with low blood TSH cutoff levels for neonatal screening reveals an unsuspected frequency of congenital hypothyroidism (CH). Clin. Endocrinol. 71(5), 739–745 (2009)

    Article  CAS  Google Scholar 

  5. L.M.Z. Maciel, E.T. Kimura, C.R. Nogueira, G.M. Mazeto, P.K.R. Magalhães, M.L. Nascimento, S. Nesi-França, S.E. Vieira, Congenital hypothyroidism: recommendations of the Thyroid Department of the Brazilian Society of Endocrinology and Metabolism. Arq. Bras. Endocrinol. Metabol. 57(3), 184–192 (2013)

    Article  PubMed  Google Scholar 

  6. M. Hashemipour, M. Amini, R. Iranpour, G.H. Sadri, N. Javaheri, S. Haghighi, S. Hovsepian, A.A. Javadi, M. Nematbakhsh, G. Sattari, Prevalence of congenital hypothyroidism in Isfahan, Iran: results of a survey on 20,000 neonates. Horm. Res. Paediatr. 62(2), 79–83 (2004)

    Article  CAS  Google Scholar 

  7. E. Mohammadi, M.R. Baneshi, N. Nakhaee, The incidence of congenital hypothyroidism in areas covered by Kerman And Jiroft Universities Of Medical Sciences, Iran. J. Health Dev. 1(1), 47–55 (2012) (in Persian)

    Google Scholar 

  8. M. Hashemipour, S. Hovsepian, R. Kelishadi, R. Iranpour, R. Hadian, S. Haghighi, A. Gharapetian, M. Talaei, M. Amini, Permanent and transient congenital hypothyroidism in Isfahan–Iran. J. Med. Screen. 16(1), 11–16 (2009)

    Article  PubMed  Google Scholar 

  9. F. Darendeliler, M. Yıldırım, R. Bundak, M. Şükür, Ν Saka, H. Günöz, Growth of children with primary hypothyroidism on treatment with respect to different ages at diagnosis. J. Pediatr. Endocrinol. Metab. 14(2), 207–210 (2001)

    Article  CAS  PubMed  Google Scholar 

  10. S. Heyerdahl, A. Ilicki, J. Karlberg, B. Kase, A. Larsson, Linear growth in early treated children with congenital hypothyroidism. Acta Paediatr. 86(5), 479–483 (1997)

    Article  CAS  PubMed  Google Scholar 

  11. P. Bain, J.-E. Toublanc, Adult height in congenital hypothyroidism: prognostic factors and the importance of compliance with treatment. Horm. Res. Paediatr. 58(3), 136–142 (2002)

    Article  CAS  Google Scholar 

  12. D. Grant, Growth in early treated congenital hypothyroidism. Arch. Dis. Child. 70(6), 464–468 (1994)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. A. Feizi, M. Hashemipour, S. Hovsepian, Z. Amirkhani, R. Kelishadi, K. Heydari, A. Sajadi, M. Amini, The descriptive findings of growth status among children with congenital hypothyroidism referred to Isfahan Endocrine and Metabolism Research Center. J. Isfahan Med. School 29(167), 2437–2446 (2012). (in Persian)

  14. A. Feizi, M. Hashemipour, S. Hovsepian, Z. Amirkhani, R. Klishadi, M. Rafee Al Hosseini, M. Amini, Study of the efficacy of therapeutic interventions in growth normalization of children with congenital hypothyroidism detected by neonatal screening. Iranian J. Endocrinol. Metab. 13(6), 681–689 (2011) (in Persian)

    Google Scholar 

  15. S. Kalantari, M. Napharabadi, F. Azizi, The prevalence of hypothyroidism in Tehran mentally retarded patients' institutes. Res. Med. 25(3), 175–178 (2001) (in Persian)

    Google Scholar 

  16. D. Fisher, A. Grueters, Disorders of the thyroid in the newborn and infant. Pediatr. Endocrinol. 3, 198–226 (1996)

    Google Scholar 

  17. W. Hung, in Principles and Practice of Endocrinology and Metabolism, ed. by K. L. Becker, C. R. Kahn, R. W. Rebar, 3rd edn. (Lippincott Williams & Wilkins, Philadelphia, PA 2001), pp. 462–471.

  18. R. Klein, M. Mitchell, T. Foley, The Thyroid: A Fundamental and Clinical Text, 8th edn. (Lippincott, Williams and Wilkins, Philadelphia, PA, 2000), pp. 973–974

    Google Scholar 

  19. J.E. Frank, J.E. Faix, R.J. Hermos, D.M. Mullaney, D.A. Rojan, M.L. Mitchell, R.Z. Klein, Thyroid function in very low birth weight infants: effects on neonatal hypothyroidism screening. J. Pediatr. 128(4), 548–554 (1996)

    Article  CAS  PubMed  Google Scholar 

  20. M. Hashemipour, M. Ghasemi, S. Hovsepian, K. Heiydari, A. Sajadi, R. Hadian, M. Mansourian, N. Mirshahzadeh, R. Kelishadi, M. Dalvi, Etiology of congenital hypothyroidism in Isfahan: Does it different? Adv. Biomed. Res. 3(1), 21 (2014)

    Article  PubMed  PubMed Central  Google Scholar 

  21. Y. Liu, M. Bottai, Mixed-effects models for conditional quantiles with longitudinal data. Int. J. Biostat. 5(1), 1–22 (2009)

  22. R. Koenker, Quantile regression for longitudinal data. J. Multivar. Anal. 91(1), 74–89 (2004)

    Article  Google Scholar 

  23. S.R. Lipsitz, G.M. Fitzmaurice, G. Molenberghs, L.P. Zhao, Quantile regression methods for longitudinal data with drop‐outs: application to CD4 cell counts of patients infected with the human immunodeficiency virus. J. R. Stat. Soc. 46(4), 463–476 (1997)

    Article  Google Scholar 

  24. R. Koenker, Quantreg: Quantile Regression. R Package Version 4.17, (2005)

  25. L. Moschini, P. Costa, E. Marinelli, G. Maggioni, C.M. Sorcini, C. Fazzini, A. Diodato, G. Sabini, M. Grandolfo, S. Carta, Longitudinal assessment of children with congenital hypothyroidism detected by neonatal screening. Helv. Paediatr. Acta 41(5), 415–424 (1986)

    CAS  PubMed  Google Scholar 

  26. R. Aronson, R.M. Ehrlich, J.D. Bailey, J.F. Rovef, Growth in children with congenital hypothyroidism detected by neonatal screening. J. Pediatr. 116(1), 33–37 (1990)

    Article  CAS  PubMed  Google Scholar 

  27. M. Delvecchio, M.F. Faienza, A. Acquafredda, C. Zecchino, S. Peruzzi, L. Cavallo, Longitudinal assessment of levo-thyroxine therapy for congenital hypothyroidism: relationship with aetiology, bone maturation and biochemical features. Horm. Res. 68(3), 105–112 (2007)

    Article  CAS  PubMed  Google Scholar 

  28. Z. Dickerman, L. De Vries, Prepubertal and pubertal growth, timing and duration of puberty and attained adult height in patients with congenital hypothyroidism (CH) detected by the neonatal screening programme for CH—a longitudinal study. Clin. Endocrinol. 47(6), 649–654 (1997)

    Article  CAS  Google Scholar 

  29. C. Brook, The effect of initial dose of thyroxine in congenital hypothyroidism on final height. Clin. Endocrinol. 47(6), 655–656 (1997)

    Article  CAS  Google Scholar 

  30. A. Chiesa, L. Gruñeiro de Papendieck, A. Keselman, J. Heinrich, C. Bergada, Growth follow-up in 100 children with congenital hypothyroidism before and during treatment. J. Pediatr. Endocrinol. 7(3), 211–218 (1994)

    Article  CAS  PubMed  Google Scholar 

  31. A. Chiesa, L. Prieto, V. Mendez, P. Papendieck, M.L. Calcagno, L. Gruneiro-Papendieck, Prevalence and etiology of congenital hypothyroidism detected through an argentine neonatal screening program (1997-2010). Horm. Res. Paediatr. 80(3), 185–192 (2013)

    Article  CAS  PubMed  Google Scholar 

  32. M. Delvecchio, M. Salerno, M.C. Vigone, M. Wasniewska, P.P. Popolo, R. Lapolla, A. Mussa, G.M. Tronconi, I. D’Acunzo, R. Di Mase, Levothyroxine requirement in congenital hypothyroidism: a 12-year longitudinal study. Endocrine 50(3), 674–680 (2015)

    Article  CAS  PubMed  Google Scholar 

  33. M. Adachi, Y. Asakura, K. Tachibana, Final height and pubertal growth in Japanese patients with congenital hypothyroidism detected by neonatal screening. Acta Paediatr. 92(6), 698–703 (2003)

    Article  CAS  PubMed  Google Scholar 

  34. A. Morin, L. Guimarey, M. Apezteguia, M. Ansaldi, Z. Santucci, Linear growth in children with congenital hypothyroidism detected by neonatal screening and treated early: a longitudinal study. J. Pediatr. Endocrinol. 15(7), 973–978 (2002)

    Article  CAS  Google Scholar 

  35. M. Delvecchio, M.C. Vigone, M. Wasniewska, G. Weber, R. Lapolla, P.P. Popolo, G.M. Tronconi, R. Di Mase, F. De Luca, L. Cavallo, Final height in Italian patients with congenital hypothyroidism detected by neonatal screening: a 20-year observational study. Ital. J. Pediatr. 41(1), 1–6 (2015)

    Article  Google Scholar 

  36. M. Salerno, R. Militerni, C. Bravaccio, M. Micillo, D. Capalbo, S. Di Maio, A. Tenore, Effect of different starting doses of levothyroxine on growth and intellectual outcome at four years of age in congenital hypothyroidism. Thyroid 12(1), 45–52 (2002)

    Article  CAS  PubMed  Google Scholar 

  37. J.H. Jones, B. Gellen, W.F. Paterson, S. Beaton, M.D. Donaldson, Effect of high versus low initial doses of L-thyroxine for congenital hypothyroidism on thyroid function and somatic growth. Arch. Dis. Child. 93(11), 940–944 (2008)

    Article  CAS  PubMed  Google Scholar 

  38. B. Oerbeck, K. Sundet, B.F. Kase, S. Heyerdahl, Congenital hypothyroidism: influence of disease severity and L-thyroxine treatment on intellectual, motor, and school-associated outcomes in young adults. Pediatrics. 112(4), 923–930 (2003)

    Article  PubMed  Google Scholar 

  39. S.-I. Song, D. Daneman, J. Rovet, The influence of etiology and treatment factors on intellectual outcome in congenital hypothyroidism. J. Dev. Behav. Pediatr. 22(6), 376–384 (2001)

    Article  CAS  PubMed  Google Scholar 

  40. S.M. Ng, S.C. Wong, M. Didi, Head circumference and linear growth during the first 3 years in treated congenital hypothyroidism in relation to aetiology and initial biochemical severity. Clin. Endocrinol. 61(1), 155–159 (2004)

    Article  Google Scholar 

  41. M. Delvecchio, M. Salerno, A. Acquafredda, C. Zecchino, F. Fico, F. Manca, M.F. Faienza, L. Cavallo, Factors predicting final height in early treated congenital hypothyroid patients. Clin. Endocrinol. 65(5), 693–697 (2006)

    Article  Google Scholar 

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Author notes

    Authors and Affiliations

    1. Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran

      Zahra Heidari & Awat Feizi

    2. Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

      Awat Feizi, Mahin Hashemipour & Massoud Amini

    3. Department of Pediatric, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

      Mahin Hashemipour & Roya Kelishadi

    4. Child Growth and Development Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

      Mahin Hashemipour & Roya Kelishadi

    5. Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

      Roya Kelishadi

    6. Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

      Massoud Amini

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    1. Zahra Heidari
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    2. Awat Feizi
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    Correspondence to Awat Feizi or Mahin Hashemipour.

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    The authors declare that they have no competing interest.

    Ethical approval

    After explaining all aspects of study propose for who met the inclusion criteria; a written informed consent was obtained from all parents of CH patients agree to participate in our study. Regional bioethics committee of our university approved the study protocol.

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    Awat Feizi and Mahin Hashemipour contributed equally to this work.

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    Heidari, Z., Feizi, A., Hashemipour, M. et al. Growth development in children with congenital hypothyroidism: the effect of screening and treatment variables—a comprehensive longitudinal study. Endocrine 54, 448–459 (2016). https://doi.org/10.1007/s12020-016-1010-x

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    • DOI: https://doi.org/10.1007/s12020-016-1010-x

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