title: Subclinical hypothyroidism in childhood - current knowledge and open issues.
abstract: Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T4or free T4. This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals.
authors.affiliation: Department of Translational Medical Sciences - Pediatric Section, University of Naples Federico II, Naples, 80131, Italy.
authors.forename: Mariacarolina
authors.initials: M
authors.lastname: Salerno
authors.affiliation: Department of Pediatrics, University Hospital Federico II, Naples, 80131, Italy.
authors.forename: Donatella
authors.initials: D
authors.lastname: Capalbo
authors.affiliation: Department of Translational Medical Sciences - Pediatric Section, University of Naples Federico II, Naples, 80131, Italy.
authors.forename: Manuela
authors.initials: M
authors.lastname: Cerbone
authors.affiliation: Department of Pediatric, Gynecology, Microbiological and Biochemical Sciences, University of Messina, Messina, 98125, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: De Luca
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects; D000998:Antiviral Agents / Q000009:adverse effects; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000453:epidemiology / Q000378:metabolism*; D001851:Bone Diseases, Metabolic / Q000209:etiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002648:Child; D060825:Cognitive Dysfunction / Q000209:etiology; D004314:Down Syndrome / Q000150:complications; D000074623:Dual Oxidases; D050171:Dyslipidemias / Q000453:epidemiology / Q000378:metabolism*; D006130:Growth Disorders / Q000209:etiology; D050031:Hashimoto Disease / Q000150:complications; D020249:Hormone Replacement Therapy; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism*; D016898:Interferon-alpha / Q000009:adverse effects; D007455:Iodine / Q000172:deficiency; D019255:NADPH Oxidases / Q000235:genetics; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D011547:Pseudohypoparathyroidism / Q000150:complications; D011989:Receptors, Thyrotropin / Q000235:genetics; D012306:Risk; D013972:Thyrotropin / Q000378:metabolism; D013974:Thyroxine / Q000378:metabolism / Q000627:therapeutic use; D014284:Triiodothyronine / Q000378:metabolism
chemical_list: D000927:Anticonvulsants; D000998:Antiviral Agents; D016898:Interferon-alpha; D011989:Receptors, Thyrotropin; D014284:Triiodothyronine; D013972:Thyrotropin; D007455:Iodine; D000074623:Dual Oxidases; D019255:NADPH Oxidases; C431515:DUOX2 protein, human; D013974:Thyroxine