Ann Pediatr Endocrinol Metab.  2024 Dec;29(6):371-378. 10.6065/apem.2448014.007.

Age of menarche and final height in patients with permanent congenital hypothyroidism

• Karimian P
• Hovsepian S
• Alinia T
• Raispour H
• Mirshahzadeh N
• Hashemipour M

• KMID: 2563081
• DOI: http://doi.org/10.6065/apem.2448014.007

Abstract

Purpose
We compared the age at menarche and standard deviation score (SDS) of final height (FH) in permanent congenital hypothyroidism (CH) patients with those of healthy female adolescents and assessed their associations with CH screening-related variables or demographic factors.
Methods
In this cross-sectional study, we included 207 female CH patients and 598 healthy age-matched female adolescents. Ages at puberty onset and menarche, height at puberty and menarche, and the FH and its SDS were evaluated in the 2 groups and compared. Associations between screening variables and anthropometric data with age at menarche and SDS of FH were also assessed in CH patients.
Results
In the included population, 113 patients with CH and 453 healthy girls attained their FH. The mean ages at puberty onset and menarche in CH patients were higher than those in the healthy population (P<0.05). The mean height at menarche and the FH and its SDS were not different between the 2 groups (P>0.05). There was no significant association between FH SDS in CH patients and age of treatment (P=0.30). Age at menarche was significantly higher in CH patients with delayed age at treatment initiation (P=0.04). The difference between FH and target height was not significantly different among CH patients (P=0.83).
Conclusion
While CH patients had a significantly higher age at menarche compared to the healthy population, appropriate treatment changed this age to be similar to that in the healthy group. However, CH patients who experienced delayed treatment had a higher age at menarche. Age at treatment initiation was the only screening-related variable related to age at onset of menarche and puberty.

Keyword

Congenital hypothyroidism; Growth charts; Menarche; Puberty

Figure

• 

  Fig. 1. The z-scores of heights at puberty onset and menarche and of final height (FH) in a healthy population and patients with congenital hypothyroidism.

Reference

References

1. Eng L, Lam L. Thyroid function during the fetal and neonatal periods. Neoreviews. 2020; 21:e30–6.

2. Léger J, Delcour C, Carel JC. Fetal and neonatal thyroid dysfunction. J Clin Endocrinol Metab. 2022; 107:836–46.

3. Bowden SA, Goldis M. Congenital hypothyroidism. 2022 Jun 11. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; Jan–.

4. Nagasaki K, Minamitani K, Nakamura A, Kobayashi H, Numakura C, Itoh M, et al. Guidelines for newborn screening of congenital hypothyroidism (2021 revision). Clin Pediatr Endocrinol. 2023; 32:26–51.

5. Cherella CE, Wassner AJ. Update on congenital hypothyroidism. Curr Opin Endocrinol Diabetes Obes. 2020; 27:63–9.

6. Soliman AT, Azzam S, Elawwa A, Saleem W, Sabt A. Linear growth and neurodevelopmental outcome of children with congenital hypothyroidism detected by neonatal screening: a controlled study. Indian J Endocrinol Metab. 2012; 16:565–8.

7. Rahmani K, Yarahmadi S, Etemad K, Koosha A, Mehrabi Y, Aghang N, et al. Congenital hypothyroidism: optimal initial dosage and time of initiation of treatment: a systematic review. Int J Endocrinol Metab. 2016; 14:e36080.

8. Feizi A, Hashemipour M, Hovsepian S, Amirkhani Z, Klishadi R, Rafee Al Hosseini M, et al. Study of the efficacy of therapeutic interventions in growth normalization of children with congenital hypothyroidism detected by neonatal screening. Iran J Endocrinol Metab. 2011; 13:681–9.

9. Heidari Z, Feizi A, Hashemipour M, Kelishadi R, Amini M. Growth development in children with congenital hypothyroidism: the effect of screening and treatment variables-a comprehensive longitudinal study. Endocrine. 2016; 54:448–59.

10. Dalili S, Rezvani SM, Dalili H, Mohtasham Amiri Z, Mohammadi H, Abrisham Kesh S, et al. Congenital hypothyroidism: etiology and growth-development outcome. Acta Med Iran. 2014; 52:752–6.

11. Salerno M, Micillo M, Di Maio S, Capalbo D, Ferri P, Lettiero T, et al. Longitudinal growth, sexual maturation and final height in patients with congenital hypothyroidism detected by neonatal screening. Eur J Endocrinol. 2001; 145:377–83.

12. Adachi M, Asakura Y, Tachibana K. Final height and pubertal growth in Japanese patients with congenital hypothyroidism detected by neonatal screening. Acta Paediatr. 2003; 92:698–703.

13. Lee J, Lee J, Lee DH. Final height of Korean patients with early treated congenital hypothyroidism. Korean J Pediatr. 2018; 61:221–5.

14. Bain P, Toublanc JE. Adult height in congenital hypothyroidism: prognostic factors and the importance of compliance with treatment. Horm Res. 2002; 58:136–42.

15. Delvecchio M, Salerno M, Acquafredda A, Zecchino C, Fico F, Manca F, et al. Factors predicting final height in early treated congenital hypothyroid patients. Clin Endocrinol (Oxf). 2006; 65:693–7.

16. Nesi-França S, Silveira RB, Rojas Ramos JCR, Cardoso-Demartini AA, Lima Cat MN, de Carvalho JAR, et al. Pubertal development and adult height in patients with congenital hypothyroidism detected by neonatal screening in southern Brazil. J Pediatr Endocrinol Metab. 2020; 33:1449–55.

17. Léger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, et al. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab. 2014; 99:363–84.

18. Hashemipour M, Hovsepian S, Kelishadi R, Iranpour R, Hadian R, Haghighi S, et al. Permanent and transient congenital hypothyroidism in Isfahan-Iran. J Med Screen. 2009; 16:11–6.

19. Hashemipour M, Ghasemi M, Hovsepian S, Heiydari K, Sajadi A, Hadian R, et al. Etiology of congenital hypothyroidism in Isfahan: does it different? Adv Biomed Res. 2014; 3:21.

20. De Sanctis V, Elhakim IZ, Soliman AT, Elsedfy H, Elalaily R, Millimaggi G. Methods for rating sexual development in girls. Pediatr Endocrinol Rev. 2016; 14:27–32.

21. Kato S, Ashizawa K, Satoh K. An examination of the definition 'final height' for practical use. Ann Hum Biol. 1998; 25:263–70.

22. Tanner JM, Whitehouse RH, Takaishi M. Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II. Arch Dis Child. 1966; 41:613–35.

23. Dickerman Z, De Vries L. Prepubertal and pubertal growth, timing and duration of puberty and attained adult height in patients with congenital hypothyroidism (CH) detected by the neonatal screening programme for CH--a longitudinal study. Clin Endocrinol (Oxf). 1997; 47:649–54.

24. Esposito A, Vigone MC, Polizzi M, Wasniewska MG, Cassio A, Mussa A, et al. Effect of initial levothyroxine dose on neurodevelopmental and growth outcomes in children with congenital hypothyroidism. Front Endocrinol (Lausanne). 2022; 13:923448.