Background: Congenital hypothyroidism (CH) defined as deficiency of thyroid hormone present at birth is a preventable cause for mental and growth retardation. Deceleration of growth is usually the first clinical manifestation of hypothyroidism in children, which often goes unrecognized. The complete absence of serial data on the auxological attainments of Indian children with congenital hypothyroidism, has prompted us to study longitudinal growth pattern of male and female children with congenital hypothyroidism(CH).
Methods: A total of 301 observations made on 114 children (Boys: 58, Girls:56) diagnosed as cases of CH, aged 1 to 5 years, enrolled from Pediatric Endocrinology Clinic of Advanced Pediatrics Centre, PGIMER, Chandigarh, India comprised sample for this mixed-longitudinal study. Weight, length/height, head circumference, mid-upper arm circumference(MUAC), triceps skinfold thickness (TSFT) and subscapular skinfold thickness (SSFT) measurements were recorded at 6 monthly age intervals using standardized techniques and instruments in Growth Laboratory/Growth Clinic. Mean (SD) for all anthropometric measurements were computed. Unpaired Student’s t-test was employed to ascertain gender differences.
Results: Children with CH demonstrated regular increase in mean weight and length/height from 1 to 5 years. While, growth of BMI, MUAC and skinfold thicknesses showed an inconsistent increase. CH children remained lighter, shorter and had smaller head circumferences when contrasted with their normal MGRS counterparts and became short statured around 3 years of age. However, their BMI and TSFT measured more than their normal MGRS peers.
Conclusions: Children with CH in general, depicted impaired physical growth during pre-school years when contrasted with their normal peers. However, higher TSFT, BMI and an early age of adiposity rebound recorded for these children indicate a higher tendency to accumulate subcutaneous fat and greater risk of developing metabolic syndrome later in life. Further longitudinal
studies need to be conducted to see the effect of disease on growth of these children beyond preschoolyears.