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Related Experiment Videos

Thyroid function in very low birth weight infants

R Z Klein1, E L Carlton, J D Faix

  • 1Department of Pediatrics, Dartmouth Medical School, Lebanon, NH 03756, USA. Robert.z.klein@dartmouth.edu

Clinical Endocrinology
|December 24, 1997
PubMed
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Low thyroxine (T4) in very low birth weight (VLBW) infants is due to lower thyroxine binding globulin (TBG) levels, not protein binding. Free T4 remains normal, but sick VLBW infants show a transient sick euthyroid syndrome.

Area of Science:

  • Neonatal endocrinology
  • Thyroid hormone metabolism
  • Perinatal medicine

Background:

  • Very low birth weight (VLBW) neonates (< 1500 g) often exhibit low circulating thyroxine (T4) concentrations.
  • The underlying mechanisms and clinical significance of these low T4 levels in VLBW infants require elucidation.

Purpose of the Study:

  • To test the hypothesis that low T4 in VLBW neonates results from decreased thyroid hormone protein binding.
  • To identify the specific mechanisms responsible for altered thyroid hormone levels in VLBW infants.
  • To explore the potential clinical significance of these findings.

Main Methods:

  • Cross-sectional and longitudinal study comparing thyroid-related measurements in VLBW and full-term infants.
  • Analysis of cord blood specimens from 47 VLBW and 45 full-term infants.

Related Experiment Videos

  • Longitudinal analysis of cord, 2-week, and 4-week blood specimens from 32 VLBW infants, measuring T4, free T4 (FT4), T3, thyroxine binding globulin (TBG), and TSH.

    • Main Results:

    • VLBW infants had significantly lower cord blood TBG and T4 concentrations (60% of term infants) compared to full-term infants.
    • Cord blood FT4 concentrations were within the normal adult range for both VLBW and term neonates.
    • At 2 weeks, VLBW infants showed decreased T4 and T4/TBG ratios, with elevated FT4, particularly in sicker infants, resembling the 'sick euthyroid syndrome'.

    Conclusions:

    • Lower TBG concentrations in VLBW infants, not altered protein binding, explain their reduced T4 levels.
    • Cord FT4 levels are normal in both VLBW and term infants.
    • Ill VLBW infants can exhibit transiently depressed T4 and elevated FT4 at 2 weeks, characteristic of the 'sick euthyroid syndrome'.