In order to evaluate further the possibility that transient hypothyroidism and hyperthyrotropinemia in newborn infants could result from a state of relative iodine deficiency, the urinary concentration of iodine, used as an index of the dietary intake of iodine was determined in casual urine samples collected in 1,076 full-term infants aged 3–6 days in 16 cities in 10 different European countries and in Toronto, Canada. In addition, the results obtained by programs of systematic neonatal screening for congenital hypothyroidism in the same areas were compared. There were marked regional differences in iodine nutrition during the neonatal period in Europe (median urinary iodine: 16.2 μg/dl in Rotterdam, the Netherlands, and 1.1 μg/dl in Freiburg, FRG. A low iodine supply in newborn populations was accompanied by, and probably explained, an elevated frequency of transient disorders of thyroid function in young infants. Iodine prophylaxis is urgently needed in some European countries not only for the prevention of goiter, but mostly for the prevention of impairment of thyroid function during the critical period of brain development.
Thyroxine (T4), triiodothyronine (T3) and thyroxine-binding globulin (TBG) were determined in healthy individuals ranging in age from newborn to 95 years. T4: 10.25 +/- 1.62 microng/100 ml, T3: 1.62 +/- 0.35 ng/ml and TBG: 1.34 +/- 0.15 mg/100 ml, were found elevated until puberty compared to a middle age group with T4: 7.27 +/- 2.26 microng/100 ml, T3: 1.15 +/- 0.24 ng/ml and TBG: 0.98 +/- 14 mg/100 ml. T4 and T3 followed almost TBG concentration. In old age is dissociation between T4: 5.79 +/- 1.56 microng/100 ml, T3: 0.79 +/- 0.21 ng/ml and TBG: 1.28 +/- 0.15 mg/100 ml was found. Except for old age the ratio T4/TBG and T3/TBG minimized the age dependent variation of T4 and T3 and reduced the coefficient of variance from 26% to 17.7% for T4 and from 26.5 to 25% for T3. Age reduction of T4/TBG is 15% and of T3/TBG 13% respectively more pronounced than for T4 and T3 alone. These data indicate: 1) age related variations of T4 and T3 due to age dependency of TBG, 2) deviation of T4 and T3 values in old age from that expected by their TBG levels and 3) the importance of the routine use of hormone/TBG ratio.
91 girls with Turner syndrome (TS) with a mean chronological age (CA) and bone age (BA) of 10.3 ± 2.3 and 8.9 ± 1.9 years, respectively, were randomly assigned to subcutaneous treatment with recombinant human growth hormone (rhGH) alone (n = 47), 2.6 IU/m2 body surface area daily or combination treatment (n = 44) with the same dose of rhGH and oxandrolone 0.1 mg/kg body weight orally, for the first 12 months of this study. During the 1 st year of therapy, there was a striking increase in height velocity (HV) in both groups, from 4.0 ± 0.8 to 6.3 ± 1.3 cm/year [HV standard (standards of untreated Turner patients) deviation score (SDS) for CA from 0.0 ± 0.7 to 2.9 ± 1.3] in the rhGH group and from 4.2 ± 1.2 to 8.5 ± 1.7 cm/year (HV SDS-CA from +0.3 ± 1.0 to+5.6 ± 1.6) in the combination group. The difference between the groups was statistically significant (p < 0.01). During the 2nd year of treatment, the rhGH dose was increased to 3.4 IU/m2 daily for the rhGH-alone group, whereas in the combination treatment group the oxandrolone dose was reduced to 0.05 mg/kg daily. HV was maintained at significantly higher levels than those prior to treatment, at 5.3 ± 1.1 cm/year (HV SDS-CA:+2.1 ± 1.3) and 6.2 ± 1.5 cm/year (HV SDS-CA:+3.6 ± 1.4) in the rhGH-alone and the combination group, respectively (p < 0.001). After 2 years of treatment, the mean predictable adult height had increased by +3.6 ± 2.4 cm in the rhGH-alone group and by +5.3 ± 3.6 cm in the combination group. Both treatment regimens were very well tolerated although clitoral enlargement was seen in 15 of the 44 girls of the combination group who had been treated with 0.1 mg oxandrolone daily for the 1 st year. Impaired glucose tolerance was infrequently seen in girls of either group and the higher oxandrolone dose of the 1st year affected serum lipoprotein levels. Our data suggest that rhGH may improve adult height in girls with TS. This beneficial effect may be further increased by the addition of a low dose of oxandrolone (0.05 mg/kg/day).
This study was performed to evaluate the influence of stress on growth hormone, glycerol and glucose levels in the blood in different age groups of full-term, newborn infants. Growth hormone decreased whereas glycerol and blood glucose increased after aseries of heel-pricks. Since glycerol und glucose changes may weil be explained by catecholamine release, the failure of the newborn infant to increase growth hormone concentration as do individuals during Iater life is evidence that adaptation of metabolic and hormonal reactions occurs during the postnatal period.
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