ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2022) 19 3.2 | DOI: 10.1530/ey.19.3.2


Thyroid. 2022 Apr;32(4):459-471. doi: 10.1089/thy.2021.0535. PMID: 35044245

Brief Summary: This study combines animal model and patient cohort data on the effect of hyperthyroidism and hypothyroidism at birth on adrenal gland development and function. The data revealed reciprocal effects of neonatal hyper- and hypothyroidism on adrenal development, activity of the adrenal steroidogenic pathway and the adrenal medulla.

In the mouse model, neonatal hyperthyroidism increased adrenal weight by X-zone hypertrophy, while hypothyroidism impaired X-zone development. T4 levels correlated with adrenal weight. Gene expression was altered at two months of age. Genes involved in cholesterol synthesis and catecholamine synthesis were highly up-, or downregulated by neonatal hyperthyroidism, respectively. In contrast, expression levels of genes involved in steroidogenesis were only slightly downregulated in both, hyper- and hypothyroidism. Then, the authors investigated 17-hydroxyprogesterone levels in 14 patients with congenital hypothyroidism and found a mild correlation of TSH and 17-hydroxyprogesterone levels. In a cohort of 73 patients with premature adrenarche, they observed correlations between TSH and dehydroepiandrosterone levels.

Thyroid hormones play important roles in development of different organs. Recent animal and patient data suggested relevant effects of thyroid hormones on adrenal development and function and the pituitary-adrenal axis in patients and in the animal model [1, 2]. The authors documented the effect of thyroid hormones on adrenal development in detail. However, human adrenal development does not seem to be as dependent as hepatocyte differentiation (see paper 3.1 in this chapter) on normal thyroid hormone levels.

References: 1. Adrenal steroids in female hypothyroid neonates: Unraveling an association between thyroid hormones & adrenal remodeling. Galanou S, Chouliaras G, Girginoudis P, Mengreli C, Sertedaki A, Dracopoulou M, Farakla I, Platis D, Iliadi A, Chrousos GP, Dacou-Voutetakis C, Zoumakis E, Magiakou AM, Kanaka-Gantenbein C, Voutetakis A. J Clin Endocrinol Metab. 2019 Feb 20:jc.2018-02013. doi: 10.1210/jc.2018-02013. Online ahead of print. PMID: 30785998. 2. Thyroid Hormone Deficiency Suppresses Fetal Pituitary-Adrenal Function Near Term: Implications for the Control of Fetal Maturation and Parturition. Camm EJ, Inzani I, De Blasio MJ, Davies KL, Lloyd IR, Wooding FBP, Blache D, Fowden AL, Forhead AJ. Thyroid. 2021 Jun;31(6):861-869. doi: 10.1089/thy.2020.0534. Epub 2020 Nov 26. PMID: 33126831.

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