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Thyroid function in children with Prader-Willi syndrome in Southern China: a single-center retrospective case series
Xinjiang Huang1,2, Xi Yin3, Dongyan Wu3
1Jinan University, Guangzhou, 510632, China.
Insights
Central hypothyroidism (C-HT) affects over a third of Prader-Willi syndrome (PWS) patients, peaking between ages 1-3 years. This thyroid dysfunction is not linked to nutritional status, genetics, or growth hormone therapy.
Area of Science:
- Pediatric Endocrinology
- Genetics
- Metabolic Disorders
Background:
- Prader-Willi syndrome (PWS) is a complex genetic disorder affecting multiple endocrine functions.
- Hypothalamic-pituitary-thyroid (HPT) axis dysfunction is a recognized complication in PWS.
- Understanding thyroid hormone dynamics in PWS is crucial for patient management.
Purpose of the Study:
- To evaluate HPT function in children with PWS across various ages, nutritional states, and genetic profiles.
- To assess the impact of recombinant human growth hormone (rhGH) therapy on thyroid hormone levels in PWS patients.
Main Methods:
- A cohort of 130 PWS patients (newborn to 15 years) was studied over two years.
- Serum thyroid hormone levels, including TSH and FT4, were monitored regularly.
- Central hypothyroidism (C-HT) was defined by low/normal TSH and low FT4.
Main Results:
- The overall prevalence of C-HT in PWS patients was 36.2% (47/130).
- C-HT was not observed in neonates (<1 month) or older children (>12 years).
- Prevalence increased with age, peaking between 1-3 years, then declining; no correlation with nutritional phases, genotypes, or rhGH therapy was found.
Conclusions:
- C-HT prevalence in PWS increases in early childhood, peaking between 1-3 years, and subsequently declines.
- Nutritional status, genetic variations, and rhGH treatment did not show a significant correlation with C-HT prevalence in this cohort.
Background:
To investigate hypothalamic-pituitary-thyroid function in children of different ages, nutritional phases, and genotypes that were diagnosed with Prader-Willi syndrome (PWS), as well as the effects of recombinant human growth hormone (rhGH) treatment on thyroid hormones in PWS patients.
Methods:
One hundred and thirty PWS patients (87 boys and 43 girls) aged from newborn to 15 years (y) (median 1.25 y, mean, SD: 2.95 ± 3.45 y), were surveyed in this study. Serum thyroid hormone levels were examined at least once per3-6 months during the 2 years follow-up study. Central hypothyroidism (C-HT) was identified as low/normal thyroid-stimulating hormone (TSH) and low free thyroxine 4 (FT4).
Results:
All study participants had normal neonatal TSH screening test results. The prevalence of C-HT is 36.2% (47/130). No C-HT cases were diagnosed in PWS either below 1 month (m) or above 12 y. The prevalence of C-TH would be increased with age before 3 y until reaching the peak, followed by a gradual decline over the years. The prevalence of C-HT varies significantly at different ages (Pearson's χ2 = 19.915; p < 0.01). However, there is no correlation between the C-HT prevalence and nutritional phases (Pearson's χ2 = 4.992; p = 0.288), genotypes (Pearson's χ2 = 0.292; p = 0.864), or rhGH therapy (Pearson's χ2 = 1.799; p = 0.180).
Conclusions:
This study suggests the prevalence of C-TH was increased with the age before 3 y, and reached the peak in the 1 to 3 y group, then gradually declined over the years. There is no correlation between C-HT prevalence and nutritional phases, genotypes, or rhGH treatment.
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