TPOAb, TgAb, and TRAb status before first 131I treatment predicts post-treatment hypothyroidism in patients with Graves′ disease
10.3760/cma.j.cn311282-20240221-00069
- VernacularTitle:首次 131I治疗前TPOAb、TgAb及TRAb状态对Graves病患者治疗后甲状腺功能减退的预测价值
- Author:
Changping LIANG
1
;
Longmin LI
;
Xiaoxue TIAN
;
Yonghui CHEN
Author Information
1. 四川省攀枝花市中心医院核医学科，攀枝花 617000
- Keywords:
Graves′ disease;
Iodine radioisotope;
Thyroid peroxidase antibody;
Thyroglobulin antibody;
Thyrotropin receptor antibody;
Hypothyroidism
- From:
Chinese Journal of Endocrinology and Metabolism
2024;40(8):676-680
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of thyroid peroxidase antibody(TPOAb), thyroglobulin antibody(TgAb), and thyrotropin receptor antibody(TRAb) status prior to the first 131I treatment in the development of hypothyroidism in patients with Graves′ disease after 131I administration. Methods:The cohort of 89 males and 351 females, with a median age of 34 years (IQR 28-44) who underwent initial 131I therapy at Peking Union Medical College Hospital from December 2019 to December 2021 was established. Participants were classified into TPOAb-positive, TgAb-positive, TRAb-positive, and their respective negative groups based on pre-treatment serum levels of thyroid autoantibody. Sex, age, medical history, thyroid hormone level, thyroid autoantibodies, iodine uptake rate, thyroid estimation and 131I treatment dose were recorded. The 131I treatment dose was determined using the calculated dose method. Patients were followed up for one-year post-treatment to evaluate efficacy. Mann- Whitney U test and χ 2 test were used to compare and analyze the data between groups, and logistic regression was used to analyze the influencing factors of permanent hypothyroidism after treatment. Results:(1) In the TPOAb-positive group, transient hypothyroidism and permanent hypothyroidism occurred in 8.1%(26/321) and 44.9%(144/321), both of which were significantly higher than those in the TPOAb-negative group at 2.5%(3/119) and 31.9%(38/119); In the TRAb-negative group, permanent hypothyroidism occurred in 56.8%(25/44), which was significantly higher than that in the TRAb-positive group 39.5%(152/385). (2) After the first 131I treatment, males ( OR=0.518, 95% CI 0.314-0.855, P=0.010), TPOAb-positive ( OR=1.002, 95% CI 1.001-1.003, P=0.001), and TRAb-negative( OR=0.973, 95% CI 0.957-0.990, P=0.002) were independent influence factor, of permanent hypothyroidism. Conclusion:In the calculated dose method for treating GD, male, TPOAb-positivity, and TRAb-negativity prior to initial 131I treatment are associated with a higher likelihood of developing permanent hypothyroidism post-treatment.
