1.Trajectories of body mass index for age z-score and its influencing factors among children with congenital hypothyroidism
CHENG Lingling ; YAN Yaqiong ; BAI Zenghua ; ZHANG Xiaogang ; HAO Liting ; YANG Huiying
Journal of Preventive Medicine 2025;37(8):858-863
Objective:
To analyze the trajectories of body mass index for age z-score (BAZ) and its influencing factors among children with congenital hypothyroidism (CH) based on latent class growth modeling (LCGM), so as to provide the evidence for improving treatment measures and optimizing growth management among children with CH. Methods Children with CH aged 0 to 3 years from the Newborn Disease Screening Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) between 2017 and 2022 were selected as the research subjects. Basic information, height and weight data from 3 to 36 months of age, age at treatment initiation, thyroid-stimulating hormone (TSH) levels at diagnosis, and family information were retrospectively collected. BAZ for children with CH at each month of age was calculated based on the WHO Child Growth Standards. The trajectories of BAZ were analyzed using LCGM, and factors affecting the trajectories of BAZ among children with CH were analyzed using a multinomial logistic regression model.
Methods:
Children with CH aged 0 to 3 years from the Newborn Disease Screening Center of Shanxi Children's Hospital (Shanxi Maternal and Child Health Hospital) between 2017 and 2022 were selected as the research subjects. Basic information, height and weight data from 3 to 36 months of age, age at treatment initiation, thyroid-stimulating hormone (TSH) levels at diagnosis, and family information were retrospectively collected. BAZ for children with CH at each month of age was calculated based on the WHO Child Growth Standards. The trajectories of BAZ were analyzed using LCGM, and factors affecting the trajectories of BAZ among children with CH were analyzed using a multinomial logistic regression model.
Results:
A total of 299 children with CH were included. There were 140 boys (46.82%) and 159 girls (53.18%). The median of BAZ was 0.50 (interquartile range, 1.68). The LCGM analysis categorized the subjects into three groups: the persistent high-growth pattern group with 24 cases (8.03%), the slow-growth pattern group with 39 cases (13.04%), and the appropriate-growth pattern group with 236 cases (78.93%). Multinomial logistic regression analysis showed that compared to the children with CH in the appropriate-growth pattern group, those who started treatment at the age of 30 to 60 days (OR=0.109, 95%CI: 0.016-0.732; OR=0.166, 95%CI: 0.032-0.852) had a lower risk of persistent high-growth and slow-growth patterns; CH children with TSH levels of 50 to 150 mIU/L at diagnosis (OR=3.554, 95%CI: 1.201-10.514) and those whose paternal had a senior high school/technical secondary school education (OR=2.975, 95%CI: 1.003-8.823) exhibited a higher risk of the persistent high-growth pattern. Conversely, CH children whose paternal reproductive age was 30 to 35 years (OR=0.166, 95%CI: 0.034-0.806) had a lower risk of the persistent high-growth pattern.
Conclusions
The BAZ trajectory of children with CH aged 0 to 3 years exhibited three patterns: persistent high-growth, slow-growth, and appropriate-growth. The persistent high-growth and slow-growth patterns were associated with treatment timing, TSH levels at diagnosis, paternal reproductive age, and paternal education level. It is recommended to strengthen early treatment interventions and provide family follow-up guidance.
2.Analysis of the compliance and the influencing factors of the treatments of children with congenital hypothy-roidism
Yaqiong YAN ; Jianping YANG ; Lixia BAI ; Hua ZHANG ; Zenghua BAI ; Liting HAO ; Haifeng ZHAO
Chinese Journal of Primary Medicine and Pharmacy 2016;23(5):667-670
Objective To analyze the compliance and the influencing factors of the children with congenital hypothyroidism (CH).Methods 231 children with CH were collected for this study.The questionnaire survey and referring the case were used to collect relative factors.According to regular follow -up treatment,the children were divided into two groups,one group was good compliance and the other one was bad compliance.The results were ana-lyzed by two -independent sample t -test,2 -test and unconditioned logistic regression analysis.Results (1)Blood TSH(χ2 =59.870,P =0.00) and blood FT4 (χ2 =6.468,P =0.01) were normal,short distance from the hospital (χ2 =16.375,P =0.00),level of education of their mothers was high(χ2 =7.483,P =0.02),and regular compli-ance treatment of children with CH(χ2 =7.483,P =0.024) was good.(2) Logistic stepwise regression analysis showed that serum TSH value(OR =17.135),the short distance(OR =1.692) and diagnosis of CH(OR =4.028) were introduced into the logistic regression model (all P <0.05).Conclusion It is essential to take measures actively and reinforce the management of children with long distance,low -educated,and the diagnosis of TSH.More-over,enhancing the regular treatment compliance of children with CH is the key to improve the growth and develop-ment status of children with CH.
3.Meta Analysis on the Effect of Acupuncture Treatment on Anxiety
Tieming MA ; Zenghua BAI ; Lu REN
Chinese Journal of Information on Traditional Chinese Medicine 2006;0(02):-
Objective To assess the effectiveness of the acupuncture treatmeat on anxiety compared with non-acupuncture intervention. Method All of the randomized or quasi-randomized trials involving were reviewed systemantically with the Meta analysis method. The homogeneity test was mode, the standandised mean difference (95% CI) and add risk (OR, 95% CI) were tested. Results Homogeneity test was made among the trials and no significant difference between the acupucture and non-acupuncture groups. Fixed effect model was used. ORP =1.759 419 579, 95% CI (1.336 391, 2.316 356), there was significant difference between the acupuncture group and medicine group as the interventions used to treat anxiety while there was no difference between the two group on the influence in HAMA. Conclusion The Meta analysis results was a trend in favor of acupuncture effectiveness. It seems no serious adverse reactions have been found. But there was no sufficient reliable evidence due to the low quality of the trials and possible publication bias. Further randomized, double blind controlled trials are needed.


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