Prospective study of hypothalamic-pituitary-adrenal axis in neonates with congenital hypothyroidism

Doctoral Dissertation uoadl:2876660 350 Read counter

Unit:
Faculty of Medicine
Library of the School of Health Sciences
Deposit date:
2019-06-24
Year:
2019
Author:
Galanou Sofia
Dissertation committee:
Χρούσος Γεώργιος, Ομότιμος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Δάκου- Βουτετάκη Αικατερίνη, Ομότιμη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ζουμάκης Εμμανουήλ, Επίκουρος Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κανακά- Gantenbein Χριστίνα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Μίχος Αθανάσιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σιαχανίδου Σουλτάνα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Περβανίδου Παναγιώτα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Προοπτική μελέτη του άξονα υποθαλάμου-υποφύσεως - επινεφριδίων σε νεογνά με συγγενή υποθυρεοειδισμό
Languages:
Greek
Translated title:
Prospective study of hypothalamic-pituitary-adrenal axis in neonates with congenital hypothyroidism
Summary:
Context: The adrenal gland undergoes significant remodeling during the neonatal period, an essential developmental process that still remains incompletely understood. With respect to control over the remodeling process and, specifically, the role of thyroid hormones (TH), no human studies have been published. The effect of both hypo- and hyper-thyroidism on the adrenal glands has only been evaluated in adults, focusing on the mature adrenal. Recently, Huang et al identified expression of the thyroid hormone receptor β1 in the mouse adrenal X-zone and demonstrated that T3 administration could alter the postnatal adrenal remodeling process.
Objective: To address whether TH influence adrenal remodeling during the neonatal period.
Methods: We compared the adrenal steroid profile of a naturally occurring prototype, female neonates with severe congenital hypothyroidism (CH, n=22, upon diagnosis of CH), with that of euthyroid neonates (n=20).
Results: Significantly higher levels of adrenal steroids (17-OH-progesterone, DHEAS, Δ4- androstenedione and testosterone) were detected in neonates with severe CH compared to euthyroid neonates, returning to within normal range after euthyroid state had been established with L-thyroxine replacement therapy. The cortisol levels did not differ between the two groups. TSH values in the CH group were positively, while FT4 levels were negatively correlated with circulating adrenal steroids.
Conclusions: The hormonal profile of female neonates with severe CH suggests a more active adrenal fetal zone compared to controls. These data indirectly associate TH with the adrenal remodeling and maturation process in humans. Based on our results we suggest that severe hypothyroidism decelerates the involution of the adrenal fetal zone that normally occurs postnatally.
Main subject category:
Health Sciences
Keywords:
Neonates, hypothyroidism, androgens, adrenal gland
Index:
No
Number of index pages:
0
Contains images:
Yes
Number of references:
79
Number of pages:
90

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