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The relationship between TSH and systemic inflammation in extremely preterm newborns
Carmen L Soto-Rivera1, Raina N Fichorova, Elizabeth N Allred
1Department of Medicine, Divisions of Endocrinology and Medicine Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA, carmen.soto@childrens.harvard.edu.
Endocrine
|July 6, 2014
Summary
Thyroid-stimulating hormone (TSH) levels in premature infants may indicate current inflammation, not recovery from illness. This finding helps understand infant thyroid function during critical illness.
Area of Science:
- Neonatalogy
- Endocrinology
- Immunology
Background:
- Elevated thyroid-stimulating hormone (TSH) in premature infants is often linked to transient hypothyroidism or non-thyroidal illness syndrome.
- The role of systemic inflammation in TSH regulation in extremely premature newborns requires further investigation.
Purpose of the Study:
- To test if high TSH levels in the first two postnatal weeks follow recovery from systemic inflammation in extremely premature infants.
- To explore the temporal relationship between hyperthyrotropinemia and inflammation markers.
Main Methods:
- A cohort of 880 infants (<28 weeks gestation) across 14 NICUs was studied.
- Blood spots were collected on postnatal days 1, 7, and 14 to measure TSH and 25 inflammation-related proteins.
- Hyperthyrotropinemia (HTT) was defined as TSH in the highest quartile for gestational age and postnatal day.
Main Results:
- Elevated inflammation markers did not precede day-14 HTT.
- Day-7 inflammation was linked to day-14 HTT only if inflammation persisted.
- HTT frequently coincided with elevated inflammation markers on the same day.
Conclusions:
- The hypothesis that HTT follows recovery from illness is weakly supported.
- Findings suggest TSH reflects concomitant inflammation in extremely premature newborns rather than recovery from prior illness.
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