Dataset Information

The incidence of congenital hypothyroidism (CH) in Guangxi, China and the predictors of permanent and transient CH.

ABSTRACT: BACKGROUND:The incidence of congenital hypothyroidism (CH) differs significantly among different ethnicities and regions, and early differentiation of transient CH is important to avoid unnecessary prolonged treatment with L-T4. OBJECTIVE:To investigate the incidence of CH based on the newborn screening program in Guangxi Zhuang Autonomous Region, China, and to analyze the predictors that might allow for an early differentiation between permanent (P) and transient (T) CH. DESIGN AND METHODS:Data from newborn screening program over a seven-year period (January 2009 to January 2016) at Guangxi Maternal and Child Health Hospital are analyzed. Blood samples were collected on filter paper between 3 and 7 days after birth, and TSH level was measured by time-resolved fluorescence assay. Individuals with increased TSH (TSH???8?IU/L) levels detected by newborn screening were recalled for further evaluation. Serum TSH, FT3 and FT4 were determined by electrochemiluminescence assay using venous blood samples. Diagnosis of CH is based on elevated TSH levels (>10?IU/L) and decreased FT4 levels (<12?pmol/L). Patients with elevated TSH levels and normal FT4 levels were diagnosed as hyperthyrotropinemia. Permanent or transient CH was determined by using the results of thyroid function tests after temporary withdrawal of L-T4 therapy at approximately 2-3 years of age. RESULTS:Among 1,238,340 infants in the newborn screening program, 14,443 individuals were recalled for reevaluation (re-call rate 1.18%), 911 and 731 individuals were subsequently determined to have hyperthyrotropinemia and CH respectively; thus, a prevalence of 1:1359 and 1:1694 for hyperthyrotropinemia and CH. Of the 731 patients with CH, 161 patients were diagnosed with permanent CH (PCH), and 159 patients were diagnosed with transient CH (TCH), the other 411 patients are too young to determine their subtypes. Patients with PCH required an increasing dose of L-T4 during the first few years, whereas patients with TCH required a decreased dose of L-T4. The TSH levels at diagnosis and the dose of L-T4 used were significantly higher in PCH cases than in transient cases. The FT4 levels at diagnosis were significantly lower in PCH cases than in TCH cases. The TSH levels at diagnosis, FT4 levels at diagnosis and L-T4 doses at 90 days were evaluated as predictors for differentiating PCH and TCH, and their accuracy at their respective optimal cutoffs were determined to be 60.6%, 66.7% and 93.9%, respectively. CONCLUSIONS:The CH incidence in Guangxi Zhuang Autonomous Region is slightly higher (1:1694) compared to the worldwide levels (1/2000-1/4000). The PCH and TCH ratio is close to 1; thus, the estimated PCH incidence is 1/3388, which is similar to reported worldwide average incidence (1/3000). The L-T4 dose required at 90 days (>30??g/day) has the highest predictive value for PCH. Earlier differentiation of PCH and TCH helps to determine appropriate treatment course.

SUBMITTER: Fu C

PROVIDER: S-EPMC5704446 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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The incidence of congenital hypothyroidism (CH) in Guangxi, China and the predictors of permanent and transient CH.

Fu Chunyun C Luo Shiyu S Li Yingfeng Y Li Qifei Q Hu Xuehua X Li Mengting M Zhang Yue Y Su Jiasun J Hu Xuyun X Chen Yun Y Wang Jin J Xie Bobo B Luo Jingsi J Fan Xin X Chen Shaoke S Shen Yiping Y

Endocrine connections 20171026 8

<h4>Background</h4>The incidence of congenital hypothyroidism (CH) differs significantly among different ethnicities and regions, and early differentiation of transient CH is important to avoid unnecessary prolonged treatment with L-T<sub>4</sub>.<h4>Objective</h4>To investigate the incidence of CH based on the newborn screening program in Guangxi Zhuang Autonomous Region, China, and to analyze the predictors that might allow for an early differentiation between permanent (P) and transient (T) C ...[more]

PMID: 29074613

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Project description:BackgroundTuberculosis (TB) remains a serious public health problem with substantial financial burden in China. The incidence of TB in Guangxi province is much higher than that in the national level, however, there is no predictive study of TB in recent years in Guangxi, therefore, it is urgent to construct a model to predict the incidence of TB, which could provide help for the prevention and control of TB.MethodsBox-Jenkins model methods have been successfully applied to predict the incidence of infectious disease. In this study, based on the analysis of TB incidence in Guangxi from January 2012 to June 2019, we constructed TB prediction model by Box-Jenkins methods, and used root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) to test the performance and prediction accuracy of model.ResultsFrom January 2012 to June 2019, a total of 587,344 cases of TB were reported and 879 cases died in Guangxi. Based on TB incidence from January 2012 to December 2018, the SARIMA((2),0,(2))(0,1,0)12 model was established, the AIC and SC of this model were 2.87 and 2.98, the fitting accuracy indexes, such as RMSE, MAE and MAPE were 0.98, 0.77 and 5.8 respectively; the prediction accuracy indexes, such as RMSE, MAE and MAPE were 0.62, 0.45 and 3.77, respectively. Based on the SARIMA((2),0,(2))(0,1,0)12 model, we predicted the TB incidence in Guangxi from July 2019 to December 2020.ConclusionsThis study filled the gap in the prediction of TB incidence in Guangxi in recent years. The established SARIMA((2),0,(2))(0,1,0)12 model has high prediction accuracy and good prediction performance. The results suggested the change trend of TB incidence predicted by SARIMA((2),0,(2))(0,1,0)12 model from July 2019 to December 2020 was similar to that in the previous two years, and TB incidence will experience slight decrease, the predicted results can provide scientific reference for the prevention and control of TB in Guangxi, China.

Project description:BackgroundAlthough congenital hypothyroidism (CH) has been widely studied in Western countries, CH incidence at different administrative levels in China during the past decade remains unknown. This study aimed to update the incidence and revealed the spatial pattern of CH incidence in the mainland of China, which could be helpful in the planning and implementation of preventative measures.MethodsThe data used in our study were derived from 245 newborns screening centers that cover 30 provinces of the Chinese Newborn Screening Information System. Spatial auto-correlation was analyzed by Global Moran I and Getis-Ord Gi statistics at the provincial level. Kriging interpolation methods were applied to estimate a further detailed spatial distribution of CH incidence at city level throughout the mainland of China, and Kulldorff space scanning statistical methods were used to identify the spatial clusters of CH cases at the city level.ResultsA total of 91,921,334 neonates were screened from 2013 to 2018 and 42,861 cases of primary CH were identified, yielding an incidence of 4.66 per 10,000 newborns screened (95% confidence interval [CI]: 4.62-4.71). Neonates in central (risk ratio [RR] = 0.84, 95% CI: 0.82-0.85) and western districts (RR = 0.71, 95% CI: 0.69-0.73) had lower probability of CH cases compared with the eastern region. The CH incidence indicated a moderate positive global spatial autocorrelation (Global Moran I value = 0.394, P < 0.05), and the CH cases were significantly clustered in spatial distribution. A most likely city-cluster (log-likelihood ratio [LLR] = 588.82, RR = 2.36, P < 0.01) and 25 secondary city-clusters of high incidence were scanned. The incidence of each province and each city in the mainland of China was estimated by kriging interpolation, revealing the most affected province and city to be Zhejiang Province and Hangzhou city, respectively.ConclusionThis study offers an insight into the space clustering of CH incidence at provincial and city scales. Future work on environmental factors need to focus on the effects of CH occurrence.

Dataset Information

The incidence of congenital hypothyroidism (CH) in Guangxi, China and the predictors of permanent and transient CH.

Publications

The incidence of congenital hypothyroidism (CH) in Guangxi, China and the predictors of permanent and transient CH.

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