Bolu, Düzce ve Zonguldak illerinde konjenital hipotiroidi taraması (pilot çalışma)
Küçük Resim Yok
Tarih
2003
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Bolu Abant İzzet Baysal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmada Batı Karadeniz Bölgesi'nde konjenital hipotiroidi insidansının belirlenmesi ve bölgenin iyot eksikliği yönünden araştırılması amaçlandı. Bu amaçla üç ilde (Bolu, Düzce ve Zonguldak) yenidoğanlardan filtre kağıtlarına kan örneği alındı.Tarama filtre kağıtlarına alınan kan örneklerinden tirotiropin (TSH) konsantrasyonları ölçülerek yapıldı. Taramada konjenital hipotiroidi açısından geri çağrılma eşiği olarak TSH değeri >20 uU/ml alındı. Geri çağrılan olgulardan serum TSH, serbest tiroksin (FT4) ve tiroglobulin (Tg) çalışıldı. Bölgenin iyot eksikliği açısından değerlendirilmesi için rastgele seçilen 212 anne ve yenidoğandan idrarda iyot, yenidoğanlardan ayrıca tiroglobulin çalışıldı. İki yıl içinde 18606 yenidoğan tarandı. Geri çağrılma oram %1.6 ve konjenital hipotiroidi insidansı 1/2326 bulundu. TSH değeri %26.7 olguda 5 uU/ml üzerinde bulundu. Yenidoğanlarda median idrar iyot konsantrasyonu 8.5 ug/dl, median Tg 26 ng/ml ve annelerde median idrar iyot konsantrasyonu 4.0 ug/dl bulundu. Sonuç: Batı Karadeniz Bölgesi'nde konjenital hipotiroidi insidansı ve geri çağrılma oram birçok Avrupa ülkesinden yüksektir. Çalışma yapılan Batı Karadeniz Bölgesi hafif dereceden orta dereceye kadar değişen endemik iyot eksikliği bölgesidir. Primer olarak TSH ölçümü ile ulusal konjenital hipotiroidi çalışmasının başlatılması konjenital hipotiroidi olgularının belirlenmesini sağlaması yanında ülkenin iyot eksikliği olan bölgelerini ve iyot eksikliğini önlemeye yönelik önlemlerin etkilerinin izlenmesini de sağlayacaktır.
The aim of this study was to investigate the incidence of Congenital Hypothyroidism (CH) and the iodine status in The West Black Sea Region in Turkey. Neonatal screening for CH was performed by using blood specimens collected onto filter paper. Thyrotropin (TSH) was measured by radioimmunoassay and the value >20 uU/ml used as a cut-off point for re-examining a baby. Venous serum was taken from babies for measurements of serum TSH, thyroxine (T4), free T4 (FT4), and thyroglobulin (Tg). To interpret the iodine status of the study area, median urinary iodine was measured in 212 randomly selected neonates and their mothers, and thyroglobuline in 212 randomly selected neonates. Within two years, 18606 neonates were screened. Recall rate was 1.6 % and the incidence of the diagnosed 8 cases with CH was 1/2326. The percentage of TSH values above 5 uU/ml was 26.7%, median UI in neonates and their mothers were 8.5 (ig/dl and 4.0 ug/dl, respectively. Median Tg in neonates was 26 ng/ml. Conclusions The incidence of Congenital Hypothyroidism and the recall rate were higher in Turkey than many countries in Europe. The study area has been affected by mild to moderate iodine deficiency. Neonatal screening for Congenital Hypothyroidism (CH) using primary measurement of TSH is a sensitive index to interpret the iodine status in selected area. Neonatal screening for Congenital Hypothyroidism should be started in Turkey as soon as possible. A national comprehensive infantile hypothyroidism and iodine prophylaxis policies may be developed.
The aim of this study was to investigate the incidence of Congenital Hypothyroidism (CH) and the iodine status in The West Black Sea Region in Turkey. Neonatal screening for CH was performed by using blood specimens collected onto filter paper. Thyrotropin (TSH) was measured by radioimmunoassay and the value >20 uU/ml used as a cut-off point for re-examining a baby. Venous serum was taken from babies for measurements of serum TSH, thyroxine (T4), free T4 (FT4), and thyroglobulin (Tg). To interpret the iodine status of the study area, median urinary iodine was measured in 212 randomly selected neonates and their mothers, and thyroglobuline in 212 randomly selected neonates. Within two years, 18606 neonates were screened. Recall rate was 1.6 % and the incidence of the diagnosed 8 cases with CH was 1/2326. The percentage of TSH values above 5 uU/ml was 26.7%, median UI in neonates and their mothers were 8.5 (ig/dl and 4.0 ug/dl, respectively. Median Tg in neonates was 26 ng/ml. Conclusions The incidence of Congenital Hypothyroidism and the recall rate were higher in Turkey than many countries in Europe. The study area has been affected by mild to moderate iodine deficiency. Neonatal screening for Congenital Hypothyroidism (CH) using primary measurement of TSH is a sensitive index to interpret the iodine status in selected area. Neonatal screening for Congenital Hypothyroidism should be started in Turkey as soon as possible. A national comprehensive infantile hypothyroidism and iodine prophylaxis policies may be developed.
Açıklama
Düzce Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı
Anahtar Kelimeler
Çocuk Sağlığı ve Hastalıkları, Child Health and Diseases
