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2011, Number 2

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Rev Cuba Endoc 2011; 22 (2)

Bone mineralization in children and adolescents presenting with a congenital hypothyroidism

Granela CK, Pérez GC, Carvajal Mf, Navarro DD, Domínguez AE, Díaz HO, Monteagudo PG

Language: Spanish
References: 29
Page: 118-132
PDF size: 139.90 Kb.


ABSTRACT

Introduction: in the case of the congenital hypothyroidism the bone mineralization may be affected by disease or by the effects of the thyroid hormones treatment.
Objective: to determine the bone mineralization in patients presenting with congenital hypothyroidism.
Methods: a cross-sectional, matched and descriptive study was conducted in Cuban children with congenital hypothyroidism (n= 67) and a control group (n= 67). The bone mineralization was analyzed by densitometry taking into account age, sex, bone and sexual maturation, hormonal diagnosis and treatment. The 95 % CI were applied, variance analysis and correlation with significance.
Results: density, bone mineral content and z-score in Cuban children with congenital hypothyroidism and the control group there was significantly different (p= 0,466; 0,155; 0,416), respectively. The estimations of bone mineralization association according to age showed a significant difference in bone mineralization density and the bone mineral content (p= 0,000) for both groups, and the z-score only for the sick persons. The bone mineralization was marked in mean dose with levothyroxine during the second and third bone phase and the treatment time. In the case of permanent congenital hypothyroidism there was a correlation with hormonal diagnosis and the treatment time (p= 0,000).
Conclusions: the bone mineralization is homogeneous in both groups. Density and bone mineral content in Cuban children with congenital hypothyroidism and the control group are associated with age independently of sex in both groups. Density and bone mineral content are different in the children with congenital hypothyroidism.


REFERENCES

  1. Demartini AC, Kulak Carolina AM, Borba VC. Bone mineral density of children and adolescents with congenital hypothyroidism. J Pediatr Endocrinol Metab. 2007;51(7):1-14.

  2. Kopp P. Perspective: genetic defects in the etiology of congenital hypothyroidism. Endocrinology. 2002;143:2019-24.

  3. Brown RS, Demmer LA. Editorial: the etiology of thyroid dysgenesis-still an enigma after all these years. J Clin Endocrinol Metab. 2002;87:4069-71.

  4. Güell R. Enfermedades del tiroides en el niño y el adolescente. Barcelona: Permanyer Publications Mallorca; 1998. p. 21-47.

  5. Dussault JH. The anecdotal history of screening for congenital hypothyroidsm. J Clin Endocrinol Metabol. 1999;84:4332-4.

  6. Vogiatzi MG, Kirkland JL. Frequency and necessity of thyroid function test in neonates and infants with congenital hypothyroidism. Pediatrics. 1997;100:1-4.

  7. Güell R. Cuban national program for detection of congenital hypothyroidism: results after five years of screening. In: Wilcken B, Webster D. eds. Neonatal Screening in the nineties. Australia: Kelvin Press; 1995. p. 345-51.

  8. Mayayo E, Santisteban P, Vinces Calvet E. Patología tiroidea fetal y neonatal. En: Argente Oliver J, Carrascosa Lezcano A, Gracia Bouthelier R, Rodríguez Hierro eds. Tratado de Endocrinología Pediátrica y de la Adolescencia. Madrid: Doyma. 2000. p. 64-70.

  9. Mayayo E, Santisteban P, Labarta JI, Fernández A. Hipotiroidismo congénito. En: Pombo M. ed. Tratado de Endocrinología Pediátrica. 3ra. ed. Madrid: McGraw-Hill Interamericana; 2002. p. 532-56.

  10. Nuñez Almache O. Hipotiroidismo congénito. Pediátrica. 2003;5(2):93-100.

  11. Álvarez P, Cordido F. Hipotiroidismo. Guías Clínicas. 2002;2(22).

  12. Carvajal Martínez F. Hipotiroidismo. En: De La Torre ME, González VJ, Gutiérrez MJA, Rodríguez JJ, eds. Pediatría. La Habana: Editorial Ciencias Médicas; 2004. p. 64-6.

  13. Gruters A, Finkc R, Krude H, Meinbold H. Etiogenical grouping of permanent congenital hythyroidism with thyroid gland in situ. Horm Res. 1994;41:3-9.

  14. Sánchez-Ventura J. Cribado neonatal de metabolopatias congénitas. Folleto sobre hipotiroidismo. 2004. p. 2-4.

  15. Dallas J, Foley T. Hypothyroidism. Pediatric endocrinology. 1996;8:391-9.

  16. Kopp P. Perspective: genetics defects in the etiologic of congenital hypothyroidism. Endocrinology. 2002;143:2019-24.

  17. Subregistro del Departamento de Estadística. Instituto Nacional de Endocrinología. 2007.

  18. Renón EA. Efecto de la severidad del hipotiroidismo congénito y su tratamiento sobre el crecimiento [trabajo de terminación de residencia]. Instituto Nacional de Endocrinología; 2001.

  19. Velásquez PA. Malformaciones congénitas extratiroideas y posibles factores asociados a su aparición en pacientes del programa nacional de diagnóstico precoz de hipotiroidismo congénito en Ciudad de la Habana y La Habana [trabajo de terminación de residencia]. Instituto Nacional de Endocrinología; 2004.

  20. Sánchez Cruz JC, Navarro Despaigne D, Hernández Ortega A. Acción fisiopatológica integrada de las hormonas sobre el tejido óseo. Rev Cubana Endocrinol. 2006;17(2):1-3.

  21. Diagnostic Medical Systems. Bone Densitometer. Dual Emission X-Ray Absorptiometry. Manual. Francia. 2005.

  22. Lakatos P. Thyroid hormones: beneficial or deleterious for bone? Calcif Tissue Int. 2003;73:205-9.

  23. Abe E, Marians RC, Yu W, Xue-Bin W, Ando T, Li Y, et al. TSH is a negative regulator of skeletal remodeling. Cell. 2003;115:151-62.

  24. Hase H, Ando T, Eldeiry L, Brebene A, Yuanzhen P, Liu L, et al. TNFa mediates the skeletal effects of thyroid-stimulating hormone. Proc Natl Acad Sci USA. 2006;103:12849-54.

  25. Léger J, Ruiz JC, Guibourdenche J, Kindermans C, Garabedian M, Czernichow P. Bone mineral density and metabolism in children with congenital hypothyroidism after prolonged L-thyroxine therapy. 1997;86:704-10.

  26. Weber G, Mora S, Bellini A, Bosco M, Prinster C, Siragusa V, di Natale B, Chiumello G. Bone mineral metabolism and thyroid replacement therapy in congenital hypothyroid infants and young children. J Endocrinol Invest. 1995 Apr;18(4):277-82.

  27. Salerno S, Lettiero T, Esposito del Puente A, Esposito V, Capalbo D, Carpinelli A, et al. Effect of long-term L-thyroxine treatment on bone mineral density in young adults with congenital hypothyroidism. Eur J Endocrinol. 2004;151:689-94.

  28. Kooh SW, Brnjac L, Ehrlich RM, Qureshi R, Krishnan S. Bone mass in children with congenital hypothyroidism treated with thyroxine since birth. J Pediatr Endocrinol Metab. 1996;9:59-62.

  29. Kempers MJ, Vulsma T, Wiedijk BM, de Vijlder JJ, van Eck-Smit BL, Verberne HJ The effect of life-long thyroxine treatment and physical activity on bone mineral density in young adult women with congenital hypothyroidism. J Pediatr Endocrinol Metab. 2006 Dec;19:1405-12.




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