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Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Ten-year longitudinal study of thyroid function in children with Down's syndrome
Lorenzo Iughetti1, Barbara Predieri, Patrizia Bruzzi
1Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.
Insights
Thyroid dysfunction is common in children with Down syndrome, increasing significantly by age 10. Early and regular monitoring is crucial for timely detection and management of these thyroid issues.
Area of Science:
- Pediatric Endocrinology
- Genetics
- Thyroidology
Background:
- The natural history of thyroid function in children with Down syndrome is not well understood.
- Down syndrome is associated with an increased risk of thyroid dysfunction.
Purpose of the Study:
- To investigate the developmental trajectory of thyroid function in children with Down syndrome.
- To determine the incidence and progression of thyroid dysfunction from birth to 10 years of age.
Main Methods:
- Longitudinal study of 145 children with Down syndrome, with annual thyroid function assessments from birth to 10 years.
- Statistical analysis using heteroskedastic binary and ordinary logistic regression for repeated measures to assess the relationship between time and thyroid function.
Main Results:
- Congenital hypothyroidism was present in 7% of cases.
- The probability of acquired thyroid dysfunction rose from 30% at birth to 49% by age 10 (p < 0.001).
- Hypothyroidism incidence increased from 7% to 24% by age 10 (p < 0.001), with anti-thyroid peroxidase antibodies being a strong predictor.
Conclusions:
- Thyroid dysfunction significantly increases during childhood development in individuals with Down syndrome.
- Annual monitoring is recommended for early identification and management of thyroid dysfunction in this population.
Background/Aims:
The natural history of thyroid function in children with Down's syndrome is relatively unknown. We hypothesized that in these patients the occurrence of thyroid dysfunction rises during development.
Methods:
Thyroid function was assessed yearly in 145 children with Down's syndrome, all followed from birth up to 10 years of age. Heteroskedastic binary and ordinary logistic regression for repeated measures was used to evaluate the relationship of thyroid function with continuous time.
Results:
Congenital hypothyroidism was detected in 7% of cases. The probability of acquired thyroid dysfunction increased from 30% at birth to 49% at 10 years (p < 0.001). The subclinical hypothyroidism was nearly stable during the follow-up. The probability of hypothyroidism increased from 7 to 24% at 10 years (p < 0.001). Positive anti-thyroglobulin antibodies were associated with higher odds of more severe hypothyroidism (odds ratio 3.6). Positive anti-thyroid peroxidase antibodies were a better predictor of more severe hypothyroidism (odds ratio 6.1). Diffuse hypoechogenicity on thyroid ultrasound was found in 34 out of 145 children.
Conclusion:
The probability of thyroid dysfunction increasing during development is higher than previously reported. Such children should be carefully monitored annually to early identify thyroid dysfunction.
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