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Effect of thyroid replacement therapy on the stature of Colombian children with minimal thyroid dysfunction
C Hernández-Cassis1, C Cure-Cure, P López-Jaramillo
1Universidades del Norte y Metropolitana, Barranquilla, Colombia.
Insights
Thyroid replacement therapy (TRT) significantly improved height in children with minimal thyroid dysfunction (MTD). Untreated children experienced negative height recovery, highlighting TRT
Area of Science:
- Pediatric Endocrinology
- Thyroid Disorders
- Growth and Development
Background:
- Minimal thyroid dysfunction (MTD) presents diagnostic challenges in children.
- MTD can manifest as augmented TSH response to TRH, iodine deficiency, goiter, short stature, and retarded bone age.
- The impact of thyroid replacement therapy (TRT) on growth in MTD requires further elucidation.
Purpose of the Study:
- To evaluate the efficacy of TRT in promoting height recovery in children with MTD.
- To compare growth outcomes in children with MTD receiving TRT versus those who are untreated.
Main Methods:
- A cohort of 372 children with MTD underwent alternating 6-month periods of TRT and no TRT, with height changes monitored.
- A subset of 51 children with MTD were followed from Tanner I to final height, with 43 receiving L-thyroxine and 8 remaining untreated.
- Height standard deviation scores (SDS-H) were calculated and compared between treatment groups.
Main Results:
- Children receiving TRT demonstrated significant positive height recovery (P < 0.05), while periods without TRT showed negative height recovery.
- The L-thyroxine treated group (n=43) exhibited substantial height recovery (SDS-H change from 1.08 to 1.67) over 97 months.
- The untreated group (n=8) showed a significant decline in height SDS-H (from -1.93 to -1.50) over 114 months (P < 0.001).
Conclusions:
- TRT is effective in promoting significant height recovery in children diagnosed with minimal thyroid dysfunction.
- Continuous L-thyroxine treatment is crucial for sustained growth improvement in children with MTD.
- Early intervention with TRT may prevent growth deceleration in children with MTD.
Abstract:
The effect of thyroid replacement therapy (TRT) was evaluated in 372 children with minimal thyroid dysfunction (MTD; augmented TSH response to TRH, deficient iodine consumption, goiter, short stature and retarded bone age), by comparison of pre- with post-observation height in periods of 6 months with and without TRT alternated. A significant (P < 0.05) height recovery was observed when children received TRT; however, during the period without TRT they showed a negative height recovery. Additionally, we followed 51 children with MTD who were observed from Tanner I until final height. The group with L-thyroxine (n = 43) during all follow-up (97 months) showed an important recovery in height (SDS-H = 1.67 +/- 0.93 vs. 1.08 +/- 0.74) which when compared with the untreated group (n = 8; 114 months; SDS-H = -1.50 +/- 0.83 vs. -1.93 +/- 0.33) was significant (P < 0.001).