ESPE2019 Poster Category 3 Growth and Syndromes (to include Turner Syndrome) (28 abstracts)
The Effect of Thyroxine Treatment on Linear Growth and Weight Gain in Infants and Children with Down Syndrome (DS) and High TSH Versus Children with DS and Normal Thyroid Function: A Controlled Study
Nada Alaaraj , Ashraf Soliman , Maya Itani , Shayma Mohammed & Ahmed Khalil
Hamad General Hospital, Doha, Qatar
Background: Subclinical hypothyroidism is the most common in DS. Thyroxin administration to improve growth early in life is still controversial.
We measured linear growth (BMI, height SDS (HtSDS) and weight gain/day ) in 3 groups of infants and young children with Down syndrome (trisomy 21) and divided them retrospectively into 3 groups according to their thyroid function. Group 1 (n = 25) with normal FT4 and TSH, group 2 (n = 20) with high TSH > 5 < 15 mIU/L with normal FT4, and group 3 ( n = 12) with TSH > 15 mIU/L and/or FT4 < 9 pmol/L. ANOVA test was used.
Results:
| Groups | Age-1 | TSH | FT4 | L thyroxine | Age-2 | FT4 -2 | TSH- 2 | |
| Groups | yr | mIU/L | pmol/L | ug/day | yr | pmol/L | mIU/L | |
| TSH > 15 or FT4<9 | Mean | 3.86 | 50.75 | 10.93 | 34.38 | 7.73 | 13.85 | 8.05 |
| Treated | SD | 5.63 | 38.80 | 3.47 | 16.93 | 5.52 | 2.14 | 4.00 |
| TSH >5 <15 | Mean | 2.88 | 9.50 | 13.88 | 29.32 | 8.88 | 14.29 | 8.14 |
| Treated | SD | 2.70 | 4.83 | 4.13 | 9.34 | 5.04 | 4.00 | 3.80 |
| Normal | Mean | 1.64 | 9.80 | 15.16 | NT | 4.15 | 14.16 | 5.77 |
| NT | SD | 2.03 | 4.06 | 3.33 | NT | 2.81 | 2.45 | 2.73 |
| P= | 0.077 | 0.000035 | 0.0032 | 0.65 | 0.0008 | 0.973 | 0.45 | |
| Age 1, 2: before and after treatment, NT = not treated with thyroxine. | ||||||||
| Groups | Age 1 (yr) | L/HtSDS1 | BMISDS-1 | Age 2 (yr) | HtSDS2 | BMISDS-2 | Wt gain/d | Delta HTSDS | Delta BMISDS | ||||
| TSH > 15 or FT4<9 | Mean | 3.86 | -2.15 | -0.77 | 7.73 | -2.39 | 0.66 | 9.95 | -0.24 | 1.43 | |||
| Treated | SD | 5.63 | 1.46 | 2.63 | 5.52 | 1.01 | 1.69 | 5.80 | 1.32 | 2.49 | |||
| TSH >5 <15mIU/L | Mean | 2.88 | -1.57 | 0.38 | 8.88 | -2.18 | 1.37 | 7.67 | -0.62 | 1.23 | |||
| Treated | SD | 2.70 | 1.04 | 1.82 | 5.04 | 1.27 | 1.98 | 5.95 | 1.09 | 3.25 | |||
| Normal TFT | Mean | 1.64 | -1.90 | -0.13 | 4.65 | -2.08 | 0.59 | 8.35 | -0.17 | 0.69 | |||
| No treatment | SD | 2.03 | 1.36 | 1.68 | 2.81 | 0.93 | 1.48 | 4.18 | 0.97 | 1.41 | |||
| P= | 0.08 | 0.11 | 0.0 | 0.0008 | 0.47 | 0.29 | 0.84 | 0.211 | 0.28 | ||||
| Age 1 and 2: before and after treatment. | |||||||||||||
Discussion: At presentation and after 3 years of treatment with L thyroxine, we did not find a significant difference in linear growth or weight gain in infants and children with DS with high TSH compared to those with normal thyroid function.
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