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Neonatal level of thyroid-stimulating hormone and acute childhood leukemia
U Lei1, J Wohlfahrt, H Hjalgrim
1Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark.
Insights
Thyroid-stimulating hormone (TSH) levels in newborns may influence childhood leukemia risk. Extreme TSH levels, both high and low, were associated with a decreased risk of acute lymphoblastic leukemia and acute myeloid leukemia.
Area of Science:
- Endocrinology
- Pediatric Oncology
- Epidemiology
Background:
- Childhood leukemia is linked to birth weight.
- Thyroid hormones play a crucial role in growth and differentiation.
- Neonatal thyroid hormone levels may impact early-life leukemia development.
Purpose of the Study:
- To investigate the association between neonatal thyroid-stimulating hormone (TSH) levels and the risk of childhood leukemia.
- To test the hypothesis that high TSH levels (indicating low thyroid hormone function) are associated with a reduced risk of leukemia.
Main Methods:
- A matched case-control study was conducted using data from Danish singleton births between 1986 and 1998.
- Neonatal TSH levels from congenital hypothyroidism screening were compared between 188 acute lymphoblastic leukemia (ALL) and 28 acute myeloid leukemia (AML) cases and their matched controls.
- Conditional logistic regression was used for analysis, adjusting for birth weight.
Main Results:
- A decreased risk of ALL and AML was associated with high neonatal TSH levels (OR(ALL) = 0.7; OR(AML) = 0.3).
- Both ALL and AML were also associated with low TSH levels (OR(ALL) = 0.4; OR(AML) = 0.3).
- Extreme TSH levels (both high and low) showed a protective association against acute childhood leukemia.
Conclusions:
- Extreme levels of thyroid-stimulating hormone shortly after birth are linked to a reduced risk of acute childhood leukemia.
- The findings suggest a complex relationship between thyroid function in early life and leukemia development.
- Further research is warranted to elucidate the mechanisms underlying this association.
Abstract:
One of the more consistent findings in leukemia research is the association between birth weight and childhood leukemia. Because thyroid hormones are critically involved in growth and differentiation, we speculated that hormone levels could be of significance to the development of leukemia in early life. Specifically, we hypothesized that high levels of thyroid-stimulating hormone (TSH) would be associated with a low risk of leukemia. Accordingly, high TSH (low free thyroid hormone) early after birth most likely reflects low function of the thyroid accompanied by low rate of cell turnover and so lower risk of faulty cell divisions leading to cancer. In a matched case-control study nested from all singleton children born in Denmark between 1986 and 1998, we compared levels of TSH (as measured in a neonatal screening program for congenital hypothyroidism) in 188 cases of acute lymphoblastic leukemia (ALL) and 28 of acute myeloid leukemia (AML) with levels in 1,450 and 216 matched controls, respectively. Data were analyzed using conditional logistic regression and odds ratios (OR) were adjusted for birth weight. As hypothesized, we found a decreased risk of ALL and AML associated with high TSH (OR(ALL) = 0.7 [0.5-1.0]; OR(AML) = 0.3 [0.1-1.0]). However, both conditions were also associated with low levels of TSH (OR(ALL) = 0.4 [0.2-0.7]; OR(AML) = 0.3 [0.1-1.4]). In conclusion, extreme TSH levels a few days after birth appears to be associated with a decreased risk of acute childhood leukemia.