SFEBES2018 Poster Presentations Thyroid (27 abstracts)
Controlled Antenatal Thyroid Screening (CATS) II: long-term cardiometabolic effects of treating maternal sub-optimal thyroid function
Ilaria Muller 1 , Rhian Daniel 1 , Charlotte Hales 1 , Anna Scholz 1 , Xiaochen Yin 1 , Toby Candler 2 , Rebecca Pettit 3 , William Evans 3 , Peter Taylor 1 , Dionne Shillabeer 1 , Mohd Draman 1 , Colin Dayan 1 , Carolyn Tang 1 , Onyebuchi Okosieme 1 , John Gregory 1 , John Lazarus 1 , Aled Rees 1 & Marian Ludgate 1
1Cardiff University School of Medicine, Cardiff, UK; 2MRC, The Gambia at the London School of Hygiene and Tropical Medicine, London, UK; 3Department of Medical Physics and Clinical Engineering, University Hospital of Wales, Cardiff, UK.
Objectives: The Controlled Antenatal Thyroid Screening (CATS) study I was a randomised trial investigating the effects of levothyroxine treatment for suboptimal gestational thyroid function (SGTF), evaluating mothers with normal gestational thyroid function (NGTF), SGTF who received (SGTF-T), or didn’t (SGTF-U), levothyroxine during pregnancy. The present follow-up study (CATS II) reports the long-term effects of SGTF and levothyroxine treatment on anthropometric and cardiometabolic outcomes in children and mothers.
Methods: 332 mothers aged 41.2±5.3 years (mean±SD) and 326 paired children were evaluated 9.3±1.0 years after delivery/birth: 197 NGTF, 56 SGTF-U, 79 SGTF-T. BMI was calculated; in children this was expressed as BMI-SDS against current UK standards (1990). Subsets underwent: i) dual-energy x-ray absorptiometry (DXA) scan of lean/fat mass; ii) Vicorder® analysis of heart rate, systolic/diastolic blood pressure, augmentation index, total peripheral resistance and aortic pulse wave velocity; iii) measurement of serum TSH, FT4, FT3, TPOAb, lipids, insulin and adiponectin. The difference between means of the 3 groups (NGTF, SGTF-U, SGTF-T) was analysed using linear regression.
Results: No significant differences between groups were detected in any of the parameters in the children. SGTF-U mothers had significantly higher BMI and percent fat mass compared with NGTF/SGTF-T and had higher TSH, since 64% of SGTF-U were never started on levothyroxine treatment.
| NGTF | SGTF-U | SGTF-T | P | |
| TSH | 1.54 | 2.45 | 1.68 | 0.042 |
| median (IQR) | (1.12-2.07) | (1.43-3.50) | (0.89-2.96) | |
| BMI Kg/m2 | 25.73 | 28.30 | 25.80 | 0.034 |
| median (IQR) | (22.76-29.99) | (24.62-32.60) | (23.11-29.84) | |
| Subtotal % FAT mass | 40.24±7.16 | 42.84±7.18 | 40.40±7.43 | 0.017 |
| mean±SD (range) | (20.45-54.78) | (17.45-55.11) | (21.80-54.85) |
Conclusions: Thyroxine supplementation of women with SGTF during pregnancy did not benefit children’s BMI or other cardiometabolic parameters. However, screening for SGTF during pregnancy identified women that would benefit from levothyroxine replacement: absence of such treatment was associated with sustained long-term BMI increase.
Volume 59
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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