Related Experiment Video
Updated: Jul 8, 2025
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Permanent vs Transient Congenital Hypothyroidism in Chinese Children: Physical Growth and Predictive Nomogram
Xuejing Ding1, Zhiwei Liu1, Bin Zhang1
1Changzhou Medical Center, Changzhou Maternal and Child Health Care Hospital, Nanjing Medical University, Changzhou 213000, China.
Insights
Thyroid-stimulating hormone (TSH) at newborn screening and levothyroxine (L-T4) doses help differentiate transient congenital hypothyroidism (TCH) from permanent congenital hypothyroidism (PCH). A nomogram improves early prediction, with similar growth observed in both groups by age three.
Area of Science:
- Pediatric Endocrinology
- Neonatal Screening
- Growth and Development
Background:
- Distinguishing transient congenital hypothyroidism (TCH) from permanent congenital hypothyroidism (PCH) lacks reliable markers.
- Growth patterns in children with TCH versus PCH are not well-understood.
Purpose of the Study:
- To analyze growth differences between TCH and PCH patients.
- To develop a nomogram for early differentiation of TCH and PCH.
Main Methods:
- Retrospective analysis of children diagnosed with TCH or PCH.
- Receiver operating characteristic (ROC) analysis to evaluate predictive markers.
- Development of multivariate prediction models and growth comparisons.
Main Results:
- Initial TSH levels at newborn screening were lower in TCH than PCH.
- Levothyroxine (L-T4) dosage decreased with age in TCH but not PCH.
- Multivariate models and a nomogram showed improved predictive efficacy for differentiating TCH from PCH, with AUCs up to 0.922.
- No significant growth differences were found between TCH and PCH groups by age three.
Conclusions:
- TSH at newborn screening and L-T4 doses are valuable for early TCH/PCH differentiation.
- Multivariable models and nomograms enhance predictive accuracy.
- Children with TCH and PCH exhibit similar growth trajectories by age three.
Context:
Few reliable markers are available to distinguish transient congenital hypothyroidism (TCH) and permanent congenital hypothyroidism (PCH). Additionally, the differences in growth between TCH and PCH remain unclear.
Objective:
To investigate the growth of children with TCH and PCH and develop a nomogram for early differentiation of these forms.
Methods:
This retrospective study included children with TCH or PCH. The predictive efficacy of the prognostic predictors was analyzed using receiver operating characteristic analysis. Multivariate prediction models were developed. Measurements of growth were compared between groups.
Results:
Patients with TCH had lower initial thyroid-stimulating hormone (TSH) than those with PCH at newborn screening (NBS). The supplementary dose of levothyroxine (L-T4) gradually decreased with age in TCH but not in PCH. The area under the curve (AUC) values of the initial TSH, L-T4 dose at 1 year of age, and L-T4 dose at 2 years of age for distinguishing TCH from PCH were 0.698, 0.71, and 0.879, respectively. The predictive efficacy of the multivariate models at 1 and 2 years of age improved, with AUC values of 0.752 and 0.922, respectively. A nomogram was built based on the multivariate model at 1 year of age. The growth did not differ between children with TCH and those with PCH. However, at 1 year of age, girls with CH exhibited higher z-scores in terms of height and weight than boys with CH.
Conclusion:
TSH at NBS and L-T4 doses during treatment can be used to distinguish between PCH and TCH early in life, and the predictive efficacy can be improved using multivariable models with a visualized nomogram. At 3 years of age, patients with TCH and PCH showed similar growth.
Related Concept Videos
01:10Nature and Nurture
01:27Signs of Puberty
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
01:20Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...
01:18Polygenic Traits