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Biomedical subjects

A Rapa

Publications and source records attributed to A Rapa.

26 records · Page 2Linked to original sources
PubMed1999

IGF-1 and IGFBP in congenital and acquired hypothyroidism after long-term replacement treatment.

BACKGROUND: Thyroid hormones are involved in the regulation of the GH/IGF axis. Hypothyroidism is associated with a reduction in GH pulsatility and in GH-response to stimulatory tests. In hypothyroidism, serum levels of IGF-1 and IGFBP-3 fall and these changes are reversed after short term replacement with L-T4. This study was undertaken to determine the effect of long term replacement therapy with T4 in IGF-1 and IGFBP-3 serum levels. METHODS: The study included 12 patients affected with hypothyroidism and in replacement treatment with T4. They were divided into 3 groups according to age at the beginning of treatment. Group A consisted of 4 pre-pubertal subjects with Congenital Hypothyroidism (CH) diagnosed with neonatal screening, where T4 treatment was started within 15 days of life. Group B consisted of 5 young adults where CH was clinically diagnosed at the median age of 6 months and replacement therapy started at this age. Group C consisted of 3 subjects affected with hypothyroidism secondary to thyroiditis where diagnosis and replacement treatment were delayed at age 11, 12 and 14 respectively. All subjects were matched with a control of the same age, sex, weight and pubertal stage. RESULTS: FT3, FT4 and TSH were in the normal range both in patients and in controls. No correlation was found between FT3 or FT4 and IGF-1 or IGFBP-3 serum levels. IGF-1 serum levels in group A (198 +/- 122 ng/ml) were significantly lower than that in group B (624 +/- 105, p < 0.001) and in group C (649 +/- 98, p = 0.003). IGFBP-3 serum levels in group A (1.98 +/- 0.56 micrograms/ml) were significantly lower than in group B (3.65 +/- 1.10, p = 0.03) and in group C (4.13 +/- 0.49, p = 0.003). The increase in IGF-1 and IGFBP-3 levels was seen also in control groups B and C when compared with control group A. IGF-1 and IGFBP-3 were positively correlated with age both in patients and in controls. A linear correlation was found between IGF-1 and IGFBP-3 which was positive for controls (r = 0.946, p < 0.001) and patient group A and B (r = 0.839, p = 0.005) but tended to be negative for patient group C (r = -0.65, n.s.). CONCLUSIONS: Our data demonstrate that long term replacement therapy in children with hypothyroidism is associated with a physiological increase in IGF-1 and IGFBP-3. The positive correlation between IGF-1 and IGFBP-3 levels in group A and B confirm the efficacy of long term replacement treatment on the IGF-1/BP-3 axis in pre- and post-pubertal patients treated for CH. However, this correlation tended to be negative in patients with hypothyroidism secondary to thyroiditis, suggesting that the cause of thyroid insufficiency and/or the age at the beginning of replacement therapy may have a role in the post-pubertal hormonal status in IGF-1 and IGFBP-3 balance.

Adolescent↗
PubMed1998

Neonatal transient hypothyroidism: aetiological study. Italian Collaborative Study on Transient Hypothyroidism.

AIMS: To define the aetiology of neonatal transient hypothyroidism (NTH) and recommend preventive measures. METHODS: Maternal and perinatal clinical data on the use of antiseptics, drugs, and contrast agents containing iodine were collected from 40 subjects. Thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroxine (T4), thyroglobulin (TG), TSH receptor antibodies, thyroid peroxidase antibodies and urinary iodine were measured in random neonatal samples. In the mothers with known or suspected thyroid disorders, TSH, FT4, TSH receptor antibodies and thyroid peroxidase antibodies were also measured. RESULTS: The NTH aetiology was identified in 85% of cases. More than 50% of the babies with transient hypothyroidism had been exposed to iodine; maternal transfer of antibodies had occurred in a third of them. CONCLUSIONS: It is suggested that the practice of using iodine containing disinfectants should be withdrawn, and chlorhexidine substituted instead; that pregnant women should be advised of the adverse effects of using iodine products; and that thyroid function should be monitored whenever iodine is used.

Adult↗
PubMed1998

[Prevalence of goiter and urine iodine in a school population in an area of the Bolognese Apennines].

We evaluated goiter prevalence and urinary iodine excretion (UIE) in schoolchildren living in three villages of the Appennines in the Bologna district-Castel d'Aiano (CA), Gaggio Montano (GM) and Pietracolora (PC). 175 age-matched schoolchildren living in the urban area of Bologna were considered as control group. In the control area the presence of goiter was documented in 11 out of 175 subjects (6.3%). In the mountain area the presence of goiter was documented in 42 out of 233 subjects (18%) (p < 0.0001 vs control area). In the urban control area the UIE was 159 micrograms/l (median; range 19-298). In the mountain area the UIE was 119 micrograms/l (median; range 10-286) (p < 0.001 vs control area). We observed the highest prevalence of goiter and UIE levels < 100 micrograms/l only in the village of PC, which is still characterized by geographical isolation and rural economy.

Biomarkers↗
PubMed1998

IGF-1 and IGFBP-3 in congenital and acquired hypothyroidism after long-term replacement treatment.

BACKGROUND: Thyroid hormones are involved in the regulation of the GH/IGF axis. Hypothyroidism is associated with a reduction in GH pulsatility and in GH-response to stimulatory tests. In hypothyroidism, serum levels of IGF-I and IGFBP-3 fall and these changes are reserved after short-term replacement with L-T4. This study was undertaken to determine the effect of long-term replacement therapy with T4 in IGF-1 and IGFBP-3 serum levels. METHODS: The study included 12 patients affected with hypothyroidism and in replacement treatment with T4. They were divided into 3 groups according to age at the beginning of treatment. Group A consisted of 4 pre-pubertal subjects with Congenital Hypothyroidism (CH) diagnosed with neonatal screening, where T4 treatment was started within 15 days of life. Group B consisted of 5 young adults where CH was clinically diagnosed at the median age of 6 months and replacement therapy started at this age. Group C consisted of 3 subjects affected with hypothyroidism secondary to thyroiditis where diagnosis and replacement treatment were delayed at age 11, 12 and 14 respectively. All subjects were matched with a control of the same age, sex, weight and pubertal stage. RESULTS: FT3, FT4 and TSH were in the normal range both in patients and in controls. No correlation was found between FT3 or FT4 and IGF-1 or IGFBP-3 serum levels. IGF-1 serum levels in group A (198 +/- 122 ng/ml) were significantly lower than that in group B (624 +/- 105, p < 0.001) and in group C (649 +/- 98, p=0.003). IGFBP-3 serum levels in group A (1.98 +/- 0.56 microgram/ml) were significantly lower than in group B (3.65 +/- 1.10, p=0.03) and in group C (4.13 +/- 0.49, p=0.003). The increase of IGF-1 and IGFBP-3 levels was seen also in control groups B and C when compared with control group A. IGF-1 and IGFBP-3 were positively correlated with age both in patients and in controls. A linear correlation was found between IGF-1 and IGFBP-3 which was positive for controls (r=0.946, p < 0.001) and patient group A and B (r=0.839, p = 0.005) but tended to be negative for patient group C (r=0.65, n.s.). CONCLUSIONS: : Our data demonstrate that long-term replacement therapy in children with hypothyroidism is associated with a physiological increase in IGF-1 and IGFBP-3. The positive correlation between IGF-1 and IGFBP-3 levels in group A and B confirm the efficacy of long-term replacement treatment on the IGF-1/BP-3 axis in pre- and post-pubertal patients treated for CH. However, this correlation tended to be negative in patients with hypothyroidism secondary to thyroiditis, suggesting that the cause of thyroid insufficiency and/or the age at the beginning of replacement therapy may have a role in the post-pubertal hormonal status in IGF-1 and IGFBP-3 balance.

Adolescent↗
PubMedDate not supplied

Puberty onset in Northern Italy: a random sample of 3597 Italian children.

Entering puberty is one of the most important milestones in life. Studies from around the world have shown that age of pubertal changes onset can vary with race and ethnicity, environmental conditions, geographical location and nutrition. In the last century, the onset of puberty progressively shifted back towards younger ages in several European countries, with a levelling off in the last decades. The aim of our study was to describe the prevalence of secondary sexual characteristics in a group of children living in Northern Italy comparing them with the percentile values published by Tanner in 1976. We enrolled 3496 children drawn from public schools and evaluated height, weight and pubertal stages. The analysis of our data evidenced that the 50th percentile age of puberty onset in both sexes decreased by about 1 yr compared to data published by Tanner. Mean body mass index (BMI) z-score was significantly higher (p = 0.01) in pubertal than in pre-pubertal girls, on the contrary it was higher (p = 0.005) in pre-pubertal than in pubertal boys. In conclusion, our study found that girls and boys of our region are beginning pubertal development about 1 yr earlier than Tanner's British population. Taking into consideration the 3rd percentile age for Tanner's breast stage 2 in girls and testicular volume (TV) of 4 ml in boys, the current internationally used cut-off age for precocious puberty, i.e. 8 yr for girls and 9 yr for boys, can be maintained in our population.

Age Factors↗
PubMedDate not supplied

Measurement of urinary iodine excretion to reveal iodine excess in neonatal transient hypothyroidism.

This study was undertaken to confirm the importance of iodine excess in neonatal transient hypothyroidism. In 30 transient hypothyroid newborns at screening we measured urinary iodine excretion and TSH. They were divided into two groups: group A consisted of 21 newborns who had been exposed to iodine; group B of 9 non-exposed newborns. The two groups were significantly different only for median urinary iodine excretion (p = 0.001). In 61.5% of newborns of group A, iodine exposure caused iodine excess (urinary iodine excretion higher than 185 micrograms/l); this correlated with a higher prevalence of prematurity and a lower mean gestational age. Clinical records should reveal iodine exposure, but only urinary iodine excretion shows iodine excess. We suggest that evaluation at birth of urinary iodine excretion in every newborn with high TSH could help in predicting a good prognosis, since hypothyroidism due to the Wolff-Chaikoff effect is always spontaneously reversible, even if treatment may be suggested.

Female↗