Construction and evaluation of recurrence risk model of Graves′ disease treated with antithyroid drugs
10.3760/cma.j.cn311282-20210812-00514
- VernacularTitle:抗甲状腺药物治疗Graves病复发风险模型的构建与评估
- Author:
Wenjin CUI
1
;
Shuhang XU
;
Xin HU
;
Pingping XIANG
;
Zhoujun LIU
;
Guofang CHEN
;
Chao LIU
Author Information
1. 南京中医药大学附属中西医结合医院，江苏省中医药研究院，内分泌科 210028
- Keywords:
Antithyroid drugs;
Graves′ disease;
Risk factors of recurrence;
Predictive model
- From:
Chinese Journal of Endocrinology and Metabolism
2022;38(5):382-390
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish and evaluate a predictive model for recurrence risk of Graves′ disease after antithyroid drugs(ATD) withdrawal.Methods:Among 308 patients with newly onset Graves′ disease taking ATD from 2012 to 2019, 170 patients who completed follow-up were enrolled and divided into relapse and remission groups according to whether hyperthyroidism reoccurred within 2 years after ATD withdrawal to establish the discovery cohort. An internal validation cohort was constructed by repeating the sampling with bootstrap. Cox regression analysis was used to screen risk factors and establish a predictive model, named Graves′ Recurrence Evaluation System(GRES). The differentiation and accuracy of GRES model were evaluated and compared with the GREAT score.Results:Of 170 patients, 90 Graves′ disease cases relapsed within 2 years after ATD withdrawal. According to Cox regression analysis, family history of Graves′ disease, younger age(<30 years), grade Ⅱ-Ⅲ goiter, high level of TRAb(≥13 IU/L), large thyroid volume(≥26.4 cm 3) and low 25(OH) D(<14.7 ng/mL) were included in the predictive model: PI=0.672×family history+ 0.405×age+ 0.491×severity of goiter+ 0.808×TRAb+ 1.423×thyroid volume+ 0.579×25(OH) D. PI≥1.449 was associated with a higher risk of recurrence after drug withdrawal. The GRES model has good prediction in assessing Graves′ disease relapse within 2 years after ATD withdrawal and better than GREAT score. Conclusion:GRES model can be used to evaluate the recurrence risk within 2 years for patients with newly onset Graves′ disease after ATD withdrawal, and facilitate clinicians to reasonably select treatment modalities in order to improve the remission rate.
