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Maturation in Serum Thyroid Function Parameters Over Childhood and Puberty: Results of a Longitudinal Study
Peter N Taylor1,2, Adrian Sayers2,3, Onyebuchi Okosieme1,4
1Thyroid Research Group, Systems Immunity Research Institute, Cardiff University School of Medicine, Cardiff CF14 4XN, United Kingdom.
Insights
Thyroid hormone levels, including free tri-iodothyronine (FT3), significantly change throughout childhood, particularly during puberty. These shifts in thyroid-stimulating hormone (TSH) and FT3 correlate with pubertal development and may inform pediatric thyroid hormone replacement therapy.
Area of Science:
- Pediatric endocrinology
- Longitudinal health studies
- Thyroid function assessment
Background:
- Serum thyroid hormone levels exhibit differences between children and adults.
- Longitudinal studies tracking thyroid hormone changes throughout childhood are limited.
Purpose of the Study:
- To evaluate the longitudinal changes in thyroid-stimulating hormone (TSH) and thyroid hormone levels during childhood.
- To investigate the interrelationships between these hormone levels over time.
Main Methods:
- Utilized data from the Avon Longitudinal Study of Parents and Children, a population-based birth cohort.
- Analyzed thyroid function measurements (TSH, FT3, FT4) from 4442 children at age 7 and 1263 at age 15, with 884 having measurements at both ages.
Main Results:
- Free tri-iodothyronine (FT3) levels were higher at age 7 compared to age 15 (P < 0.0001).
- Elevated FT3 at age 7 was associated with advanced pubertal stage at age 13 in both boys and girls.
- TSH showed a positive association with FT3 and a negative association with free thyroxine (FT4) at both ages.
Conclusions:
- Significant changes in TSH and thyroid hormone levels occur during childhood, especially FT3, correlating with pubertal status.
- Findings offer insights into the developmental trajectory of the pituitary-thyroid axis in children.
- Results may aid in establishing optimal pediatric reference ranges for thyroid hormone replacement therapy.
Context:
Serum thyroid hormone levels differ between children and adults, but have not been studied longitudinally through childhood.
Objective:
To assess changes in thyroid-stimulating hormone (TSH) and thyroid hormone levels over childhood and their interrelationships.
Design:
Cohort study.
Setting:
The Avon Longitudinal Study of Parents and Children, a population-based birth cohort.
Participants:
A total of 4442 children who had thyroid function measured at age 7, and 1263 children who had thyroid function measured at age 15. Eight hundred eighty-four children had measurements at both ages.
Main Outcome Measures:
Reference ranges for TSH, free tri-iodothyronine (FT3), free thyroxine (FT4), their longitudinal stability, and interrelationships.
Results:
Children at age 7 years had a higher FT3 [6.17 pmol/L, standard deviation (SD) 0.62] than children at age 15 (5.83 pmol/L, SD 0.74); P < 0.0001 with 23.2% of children at age 7 having FT3 above the adult reference range. Higher FT3 levels at age 7 in boys (P = 0.0001) and girls (P = 0.04) were associated with attainment of a more advanced pubertal stage at age 13. TSH was positively associated with FT3 at age 7 and age 15 even after adjusting for confounders. In contrast, TSH was negatively associated with FT4.
Conclusions:
There are substantial changes in TSH and thyroid hormone levels over childhood, in particular for FT3, which appear to relate to pubertal readiness. Our data provide increased insight into the evolution of the pituitary-thyroid axis over childhood and may have implications for determining optimal ranges for thyroid hormone replacement in children.
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