Efficacy of levothyroxine on growth and development in children with congenital hypothyroidism: A meta-analysis

Abstract

Background: The aim of this study is to systematically assess the efficacy of levothyroxine (L-T4) in the treatment of growth and development among children diagnosed with congenital hypothyroidism (CH) through meta-analysis, with the ultimate goal to provide clinicians with a more robust and effective evidence-based foundation for treatment decisions. Methods: We conducted a comprehensive search of relevant literature from both domestic and international resources, and meticulously screened out clinical studies which meet our inclusion criteria, that is without any time restrictions and the deadline was September 25, 2024, and the language was limited to English and Chinese only. Subsequently, we integrated and analyzed the data using standard meta-analysis methodologies under the Preferred Reporting Items for Systematic reviews and Meta-Analyses rules, aiming to derive more precise and reliable conclusions by summarizing and comparing the findings of multiple studies. Results: A total of 17 studies with 5 diagnostic indexes of IQ, height, weight, head circumference, and bone age were included, and these studies collectively reported on 1934 patients, with 951 and 983 patients, respectively being divided into the experimental and control group. The included studies were of high quality, and the results of our meta-analysis showed that L-T4 treatment could effectively promote the physical development of children with CH. Specifically, children in the experimental group had a higher level of IQ [mean difference [MD] = 8.38, 95% confidence intervals [CI] (6.89, 987)], height [MD = 6.71, 95% CI (6.08, 7.35)], weight [MD = 1.31, 95% CI (1.14, 1.49)], head circumference [MD = 3.83, 95% CI (3.52, 4.13)], and bone age [OR = 3.49, 95% CI (2.15, 5.68)] compared to those in the control group. Conclusion: L-T4 is an effective drug for the treatment with CH in children, which significantly promote their growth and development while improving thyroid function. This finding provides strong evidence and support for clinicians, contributing to the progress and advancement in the field of CH treatment.