{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T22:13:10Z","timestamp":1778019190397,"version":"3.51.4"},"reference-count":17,"publisher":"The Endocrine Society","issue":"11","license":[{"start":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T00:00:00Z","timestamp":1685750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The lack of syndrome-specific reference ranges for thyroid function tests (TFT) among pediatric patients with Down syndrome (DS) results in an overestimation of the occurrence of hypothyroidism in this population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To (a) outline the age-dependent distribution of TFT among pediatric patients with DS; (b) describe the intraindividual variability of TFT over time; and (c) assess the role of elevated thyrotropin (TSH) in predicting the future onset of overt hypothyroidism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective, monocentric, observational analysis, we included 548 patients with DS (0-18 years) longitudinally assessed between 1992 and 2022. Exclusion criteria were abnormal thyroid anatomy, treatments affecting TFT, and positive thyroid autoantibodies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We determined the age-dependent distribution of TSH, FT3, and FT4 and outlined the relative nomograms for children with DS. Compared with non-syndromic patients, median TSH levels were statistically greater at any age (P &amp;lt; .001). Median FT3 and FT4 levels were statistically lower than controls (P &amp;lt; .001) only in specific age classes (0-11 for FT3, 11-18 years for FT4). TSH levels showed a remarkable fluctuation over time, with a poor (23%-53%) agreement between the TSH centile classes at 2 sequential assessments. Finally, the 75th centile was the threshold above which TSH values predicted future evolution into overt hypothyroidism with the best statistical accuracy, with a satisfactory negative predictive value (0.91), but poor positive predictive value (0.15).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>By longitudinally assessing TFT in a wide pediatric DS population, we outlined the syndrome-specific reference nomograms for TSH, FT3, and FT4 and demonstrated a persistent upward shift of TSH compared to non-syndromic children.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgad333","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T13:24:22Z","timestamp":1686317062000},"page":"2779-2788","source":"Crossref","is-referenced-by-count":8,"title":["Thyroid Function Tests in Children and Adolescents With Trisomy 21: Definition of Syndrome-Specific Reference Ranges"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6933-6723","authenticated-orcid":false,"given":"Alessandro","family":"Cattoni","sequence":"first","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"},{"name":"School of Medicine and Surgery, University of Milano-Bicocca , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Molinari","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Capitoli","sequence":"additional","affiliation":[{"name":"B4 Center of Bioinformatics, Biostatistics e Bioimaging, University of Milano-Bicocca , 20854 Vedano al Lambro (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicoletta","family":"Masera","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Laura","family":"Nicolosi","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Barzaghi","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Marziali","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Lazzerotti","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandra","family":"Gazzarri","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Vimercati","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debora","family":"Sala","sequence":"additional","affiliation":[{"name":"Pediatrics, Fondazione IRCCS San Gerardo dei Tintori , 20900 Monza (MB) , 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