Assessment of Neurodevelopment and Growth in Congenital Hypothyroidism: Serial 6-Year Follow-up Study of 408 Patients.

Autor:	Ha EK; Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, 07441 Seoul, Korea., Kim JH; Department of Pediatrics, Kyung Hee University Hospital, Kyung Hee University School of Medicine, 02447 Seoul, Korea., Cha HR; Department of Computer Science and Engineering, Sungkyunkwan University, 16419 Suwon, Korea., Lee GC; School of Computer Science and Engineering, Konkuk University, 05029 Seoul, Korea., Shin J; Department of Pediatrics, CHA Bundang Medical Center, CHA University, 13496 Seongnam, Korea., Lee E; Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, 61469 Gwangju, Korea., Lee WS; Department of Pediatrics, CHA Ilsan Medical Center, CHA University, 10414 Goyang, Korea., Yoo EG; Department of Pediatrics, CHA Bundang Medical Center, CHA University, 13496 Seongnam, Korea., Jung MK; Department of Pediatrics, CHA Bundang Medical Center, CHA University, 13496 Seongnam, Korea., Han MY; Department of Pediatrics, CHA Bundang Medical Center, CHA University, 13496 Seongnam, Korea.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2023 Nov 17; Vol. 108 (12), pp. e1588-e1596.
DOI:	10.1210/clinem/dgad364
Abstrakt:	Context: The link between congenital hypothyroidism (CH) and neurodevelopment is suggested, yet studies applying quantifiable measures are lacking. Moreover, socioeconomic disparities and subtle variation in timing of approach make the relationship difficult to detect. Objective: To evaluate associations between CH and abnormalities in neurodevelopment and growth and determine the critical period for intervention. Methods: We utilized a nationwide database to conduct a longitudinal analysis of 919 707 children. Exposure to CH was identified using claims-based data. The primary outcome of interest was suspected neurodevelopmental disorder, as measured using the Korean Ages & Stages Questionnaires (K-ASQ) administered annually from 9 to 72 months of age. Secondary outcomes were height and BMI z-scores. After randomly matching cases and controls at a 1:10 ratio, we employed inverse probability of treatment weighting and generalized estimating equation models for our analyses. We conducted subgroup analysis based on the age of treatment initiation. Results: The prevalence of CH in our population was 0.05% (n = 408). Relative to the control group, the CH group had higher risk of suspected neurodevelopmental disorders (propensity score-weighted odds ratio: 4.52; 95% CI: 2.91, 7.02), and significantly increased risk in each of the 5 K-ASQ domains. No time interactions were noted at any rounds for the outcomes according to when the neurodevelopmental assessment was conducted (all P for interaction >.05). The CH group also had higher risk for low height-for-age z-score, but not for elevated BMI-for-age z-score. In subgroup analysis, delayed medication for CH correlated with worse neurodevelopmental outcomes. Conclusion: The CH group had worse neurodevelopmental outcomes and reduced height-for-age z-score. Outcomes were worse when onset of treatment was increasingly delayed. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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