Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Search for other papers by Stine Linding Andersen in
Google Scholar
PubMed
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Search for other papers by Louise Knøsgaard in
Google Scholar
PubMed
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Search for other papers by Aase Handberg in
Google Scholar
PubMed
Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark
Steno Diabetes Center North Jutland, Aalborg University Hospital, Aalborg, Denmark
Search for other papers by Peter Vestergaard in
Google Scholar
PubMed
Department of Geriatrics, Aalborg University Hospital, Aalborg, Denmark
Search for other papers by Stig Andersen in
Google Scholar
PubMed
Denmark Region, as previously described in detail ( 5 , 6 ). In 2017–2018, the samples were used for measurement of maternal thyroid-stimulating hormone (TSH), free T4 (fT4), free T3 (fT3), total T4 (TT4), total T3 (TT3), and T-uptake on a Cobas 8000
Search for other papers by Chun-feng Lu in
Google Scholar
PubMed
Search for other papers by Wang-shu Liu in
Google Scholar
PubMed
Search for other papers by Xiao-qin Ge in
Google Scholar
PubMed
Search for other papers by Feng Xu in
Google Scholar
PubMed
Search for other papers by Jian-bin Su in
Google Scholar
PubMed
Search for other papers by Xue-qin Wang in
Google Scholar
PubMed
Search for other papers by Yan Wang in
Google Scholar
PubMed
images, and biochemical indicators (each criterion must be met: low thyroid-stimulating hormone – TSH, high free triiodothyronine – FT3, high free thyroxine – FT4, elevated TSH receptor antibody – TRAb) ( 14 ). The exclusion criteria were as follows: (1
Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
Search for other papers by Josi Vidart in
Google Scholar
PubMed
Search for other papers by Paula Jaskulski in
Google Scholar
PubMed
Search for other papers by Ana Laura Kunzler in
Google Scholar
PubMed
Search for other papers by Rafael Aguiar Marschner in
Google Scholar
PubMed
Search for other papers by André Ferreira de Azeredo da Silva in
Google Scholar
PubMed
Internal Medicine Division, Hospital de Clínicas de Porto Alegre, Internal Medicine Department, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
Search for other papers by Simone Magagnin Wajner in
Google Scholar
PubMed
units: T4 (nmol/L), T3 (nmol/L), free T4 (pmol/L), fT3 (pmol/L), and TSH (μIU/mL). The odds ratio (OR) with 95% CI for all-cause mortality were pooled using a meta-analysis. For this purpose, only studies that presented results from multiregression
Search for other papers by Jia Liu in
Google Scholar
PubMed
Search for other papers by Min Liu in
Google Scholar
PubMed
Search for other papers by Zhe Chen in
Google Scholar
PubMed
Search for other papers by Yumei Jia in
Google Scholar
PubMed
Search for other papers by Guang Wang in
Google Scholar
PubMed
-Yang Hospital, Capital Medical University from March 2014 to January 2015. Meanwhile, 17 healthy volunteers without AIT were enrolled as the control group. Free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), anti-peroxidase antibody (TPOAb
Search for other papers by Ling Hu in
Google Scholar
PubMed
Search for other papers by Ting Li in
Google Scholar
PubMed
Search for other papers by Xiao-Ling Yin in
Google Scholar
PubMed
Search for other papers by Yi Zou in
Google Scholar
PubMed
-density lipoprotein cholesterol (HDL-C) measurements were performed by lipid spectroscopy. Uric acid level was determined by uricase. Fasting insulin, thyroid-stimulating hormone (TSH), free T3 (FT3), and free T4 (FT4) levels were detected by electrochemiluminescence
Search for other papers by Chenjia Tang in
Google Scholar
PubMed
Department of Endocrinology, Suichang County Hospital of Traditional Chinese Medicine, Lishui, China
Search for other papers by Yanting Dong in
Google Scholar
PubMed
Search for other papers by Lusi Lu in
Google Scholar
PubMed
Search for other papers by Nan Zhang in
Google Scholar
PubMed
Medical International Limited, Shenzhen, China). CRP was determined using immunoturbidimetry. Triiodothyronine (T3), free triiodothyronine (fT3), thyroxine (T4), fT4, TSH, thyroid peroxidase antibody (aTPO), thyroglobulin antibody (aTG), and thyrotropin
Search for other papers by Xi Cao in
Google Scholar
PubMed
Search for other papers by Ming Lu in
Google Scholar
PubMed
Search for other papers by Rong-Rong Xie in
Google Scholar
PubMed
Search for other papers by Li-Ni Song in
Google Scholar
PubMed
Search for other papers by Wei-Li Yang in
Google Scholar
PubMed
Search for other papers by Zhong Xin in
Google Scholar
PubMed
Search for other papers by Guang-Ran Yang in
Google Scholar
PubMed
Search for other papers by Jin-Kui Yang in
Google Scholar
PubMed
definition The reference range of TSH concentration was 0.4–4.0 mIU/L, the reference range of free triiodothyronine (FT3) was 2.3–6.3 pmol/L, and the reference range of free thyroxine (FT4) was 10–23 pmol/L. Euthyroidism was defined as both free thyroxine
Search for other papers by Carmen Sydlik in
Google Scholar
PubMed
Search for other papers by Ilja Dubinski in
Google Scholar
PubMed
Search for other papers by Susanne Bechtold in
Google Scholar
PubMed
Search for other papers by Heinrich Schmidt in
Google Scholar
PubMed
, as triiodothyronine/free triiodothyronine (T3/fT3) levels may be low ( 1 , 2 ). In healthy individuals, fT3 levels can be stable over a wide range of corresponding TSH levels ( 3 ). The regulation of thyroid hormones is reflected in an adjusting fT3
Medical Science Laboratory, Children’s Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
Department of pathology, Children’s Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
Search for other papers by Chunyun Fu in
Google Scholar
PubMed
Search for other papers by Shiyu Luo in
Google Scholar
PubMed
Department of pathology, Children’s Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, People’s Republic of China
Search for other papers by Yingfeng Li in
Google Scholar
PubMed
Search for other papers by Qifei Li in
Google Scholar
PubMed
Search for other papers by Xuehua Hu in
Google Scholar
PubMed
Search for other papers by Mengting Li in
Google Scholar
PubMed
Search for other papers by Yue Zhang in
Google Scholar
PubMed
Search for other papers by Jiasun Su in
Google Scholar
PubMed
Search for other papers by Xuyun Hu in
Google Scholar
PubMed
Search for other papers by Yun Chen in
Google Scholar
PubMed
Search for other papers by Jin Wang in
Google Scholar
PubMed
Search for other papers by Bobo Xie in
Google Scholar
PubMed
Search for other papers by Jingsi Luo in
Google Scholar
PubMed
Search for other papers by Xin Fan in
Google Scholar
PubMed
Search for other papers by Shaoke Chen in
Google Scholar
PubMed
Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
Search for other papers by Yiping Shen in
Google Scholar
PubMed
Background
The incidence of congenital hypothyroidism (CH) differs significantly among different ethnicities and regions, and early differentiation of transient CH is important to avoid unnecessary prolonged treatment with L-T4.
Objective
To investigate the incidence of CH based on the newborn screening program in Guangxi Zhuang Autonomous Region, China, and to analyze the predictors that might allow for an early differentiation between permanent (P) and transient (T) CH.
Design and methods
Data from newborn screening program over a seven-year period (January 2009 to January 2016) at Guangxi Maternal and Child Health Hospital are analyzed. Blood samples were collected on filter paper between 3 and 7 days after birth, and TSH level was measured by time-resolved fluorescence assay. Individuals with increased TSH (TSH ≥ 8 IU/L) levels detected by newborn screening were recalled for further evaluation. Serum TSH, FT3 and FT4 were determined by electrochemiluminescence assay using venous blood samples. Diagnosis of CH is based on elevated TSH levels (>10 IU/L) and decreased FT4 levels (<12 pmol/L). Patients with elevated TSH levels and normal FT4 levels were diagnosed as hyperthyrotropinemia. Permanent or transient CH was determined by using the results of thyroid function tests after temporary withdrawal of L-T4 therapy at approximately 2–3 years of age.
Results
Among 1,238,340 infants in the newborn screening program, 14,443 individuals were recalled for reevaluation (re-call rate 1.18%), 911 and 731 individuals were subsequently determined to have hyperthyrotropinemia and CH respectively; thus, a prevalence of 1:1359 and 1:1694 for hyperthyrotropinemia and CH. Of the 731 patients with CH, 161 patients were diagnosed with permanent CH (PCH), and 159 patients were diagnosed with transient CH (TCH), the other 411 patients are too young to determine their subtypes. Patients with PCH required an increasing dose of L-T4 during the first few years, whereas patients with TCH required a decreased dose of L-T4. The TSH levels at diagnosis and the dose of L-T4 used were significantly higher in PCH cases than in transient cases. The FT4 levels at diagnosis were significantly lower in PCH cases than in TCH cases. The TSH levels at diagnosis, FT4 levels at diagnosis and L-T4 doses at 90 days were evaluated as predictors for differentiating PCH and TCH, and their accuracy at their respective optimal cutoffs were determined to be 60.6%, 66.7% and 93.9%, respectively.
Conclusions
The CH incidence in Guangxi Zhuang Autonomous Region is slightly higher (1:1694) compared to the worldwide levels (1/2000–1/4000). The PCH and TCH ratio is close to 1; thus, the estimated PCH incidence is 1/3388, which is similar to reported worldwide average incidence (1/3000). The L-T4 dose required at 90 days (>30 μg/day) has the highest predictive value for PCH. Earlier differentiation of PCH and TCH helps to determine appropriate treatment course.
Search for other papers by Yukari Maki in
Google Scholar
PubMed
Search for other papers by Kiyomi Horiuchi in
Google Scholar
PubMed
Search for other papers by Takahiro Okamoto in
Google Scholar
PubMed
showed that the levels of free triiodothyronine (fT3) and free thyroxine (fT4) were not significantly associated with the Brief Fatigue Inventory score among thyroid cancer survivors ( 16 ). A retrospective longitudinal study found that the complaints
