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| |  Children With Subclinical Hypothyroidism Do Not Experience Increase in Height With Thyroxine Therapy: Presented at ENDO 09 By Crina Frincu-Mallos, PhD WASHINGTON, DC -- June 22, 2009 -- Paediatric patients with subclinical hypothyroidism (SH) treated with L-thyroxine (LT4) for more than 6 months do not benefit from treatment, either in terms of height or growth velocity, according to findings reported here at the Endocrine Society’s 91st Annual Meeting (ENDO 09). The study addressed the lack of significant research on SH in the paediatric population as it sought to evaluate the prevalence of SH in children with short stature, as well as the effect of thyroxine replacement therapy on growth parameters. Lead author Vanessa L. Zen, MD, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, presented the data here June 12. A total of 766 outpatients participated in the study. All participants had their TSH levels measured by electrochemiluminescence assay at the Short Stature Clinic of the Hospital de Clínicas de Porto Alegre. Children suffering from chronic systemic diseases, genetic syndromes, hypopituitarism and overt hypothyroidism were excluded, reducing the participant pool to 367. Of these, 282 children (mean age 10.5 +- 4 years) met the eligibility criteria and were selected, all having more than 6 months of follow-up. Based on TSH levels > 4.2 mIU/L, a total of 46 patients were diagnosed with SH. Patients were divided into 3 cohorts: those treated with LT4 (SHT group; n = 20), those not treated with LT4 (SHNT group; n = 26), and the normal TSH level group (control group; n = 236). Anthropometric parameters such as height standard deviation score (HSDS), growth velocity (GV), and GV standard deviation scores (GVSDS) for each of the groups were analysed at 6 and 12 months of follow-up. According to Dr. Zen, the groups were similar in terms of gender, age, and pubertal stage. At 6 months, the GV values in the SHT, SHNT, and control groups were 3.53 +- 1.8 cm, 3.07 +- 1.40 cm, and 2.89 +- 1.28 cm (P = .113) respectively; at 12 months, the GV values increased to 6.83 +- 2.12 cm, 6.30 +- 2.21 cm, and 5.98 +- 2.09 cm in the SHT, SHNT, and control groups, respectively (P = .247). However, the use of LT4 did not show benefit on either GVSDS or HSDS at 6 and 12 months in the study, noted Dr. Zen. During follow-up, the median TSH in the SHT group was 2.07 mIU/L (range, 0.54-4.15 mIU/L). Based on this preliminary data, the investigators concluded that treatment with LT4 did not provide significant improvement in height in the pediatric population with SH. [Presentation title: Thyroxin Replacement Therapy Does Not Improve Growth Velocity in Children with Subclinical Hypothyroidism and Short Stature. Abstract P3-700]
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