Park Sun Mi, Cho Yoon Young, Joung Ji Young, Sohn Seo Young, Kim Sun Wook, Chung Jae Hoon
Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Eur Thyroid J. 2015 Mar;4(1):36-42. doi: 10.1159/000375261. Epub 2015 Mar 4.
The relationship between iodine intake and effects of antithyroid drugs (ATD) for Graves' disease, especially in iodine-deficient areas, has been demonstrated in many studies. However, it was not clear how chronic high iodine intake influenced the effectiveness of ATD in an iodine-replete area. This study aimed to clarify the effect of iodine intake on clinical outcomes of Graves' disease after discontinuation of ATD in Korea, an iodine-replete area.
A total of 142 patients with Graves' disease who visited the outpatient clinic regularly and stopped their ATD between October 2011 and April 2013 were enrolled in our study. Urinary iodine concentration (UIC) was measured just before and after the discontinuation of ATD.
Median UIC was not significantly different between the remission and relapse groups, as well as among the four treatment groups (group 1, remission after initial treatment; group 2, remission after repeated treatment; group 3, early relapse within a year; group 4, late relapse after a year). Remission rates did not show a significant difference between the excessive iodine intake (UIC ≥300 μg/l) and average iodine intake groups (UIC <300 μg/l).
The present study suggests that excessive iodine intake does not have an effect on the clinical outcomes of Graves' disease in an iodine-replete area, and therefore diet control with iodine restriction might not be necessary in the management of Graves' disease.
许多研究已证实碘摄入量与抗甲状腺药物(ATD)治疗格雷夫斯病的效果之间的关系,尤其是在碘缺乏地区。然而,尚不清楚在碘充足地区长期高碘摄入如何影响ATD的疗效。本研究旨在阐明在碘充足地区韩国,碘摄入量对停用ATD后格雷夫斯病临床结局的影响。
本研究纳入了2011年10月至2013年4月期间定期到门诊就诊并停用ATD的142例格雷夫斯病患者。在停用ATD前后测量尿碘浓度(UIC)。
缓解组和复发组之间以及四个治疗组(组1,初始治疗后缓解;组2,重复治疗后缓解;组3,一年内早期复发;组4,一年后晚期复发)之间的UIC中位数无显著差异。碘摄入量过高(UIC≥300μg/l)组和平均碘摄入量组(UIC<300μg/l)的缓解率无显著差异。
本研究表明,在碘充足地区,碘摄入量过高对格雷夫斯病的临床结局没有影响,因此在格雷夫斯病的管理中可能无需进行限碘饮食控制。