Changes in thyrotropin in children under five years of age with chronic malnutrition and their association with neuro-psychomotor development

Abstract

Introduction: Malnutrition has a mortality of 45% in pre-schools and predominates in rural areas. Iodine deficiency can lead to hypothyroidism, manifested by elevated TSH, and can be associated with delayed psychomotor neurodevelopment (PMDN). This study aimed to determine the prevalence of TSH alterations in children with chronic malnutrition and their association with DNPM alterations in the indigenous population under 5 years of age.

Methods: This cross-sectional study analyzes the database of the "Wawapak-kausay" Project of the indigenous child population in four cantons of the province of Chimborazo-Ecuador from 2018 - 2019. A univariate analysis was carried out with the calculation of frequency and percentages; a bivariate analysis with reporting OR and 95% CI, considering P<0.05 significant.

Results: There were 350 cases of chronic malnutrition; 50.6% were men from the lowest quartile of economic income (32%) and the Riobamba canton (44%); 88.6% reported normal TSH, 10.8% high TSH, and 0.6% low TSH. The irregular supply of water and alteration of TSH was statistically significant (P<0.01). The Denver II test was applied to 82 children; 70.7% presented normal development, 8.5% suspected delay, and 20.7% psychomotor delay, predominantly in the language area (15.9%); women were more affected (P=0.02).

Conclusions: 1 out of 10 children with chronic malnutrition had elevated TSH. No significant association was found between altered TSH values and suspected or delayed psychomotor development.