Kornelius Edy, Chiou Jeng-Yuan, Yang Yi-Sun, Lo Shih-Chang, Peng Chiung-Huei, Lai Yung-Rung, Huang Chien-Ning
1 Department of Internal Medicine, Division of Endocrinology and Metabolism, Chung Shan Medical University Hospital , Taichung, Taiwan .
2 Institute of Medicine of Chung Shan Medical University , Taichung, Taiwan .
Thyroid. 2016 Aug;26(8):1030-8. doi: 10.1089/thy.2016.0051.
The risks of thyroid dysfunction after iodinated contrast media exposure in patients with euthyroid nodular goiter are largely unknown.
This observational, retrospective cohort study included a random selection of one million people in Taiwan. All patients with iodinated contrast media exposure during this study period were selected. Patients with euthyroid nodular goiter were identified as cases, while patients without thyroid nodule were selected as controls. We followed these patients until the first event of thyroid dysfunction including hyperthyroidism or hypothyroidism after iodinated contrast media exposure.
A total of 334 cases and 2672 matched controls were selected in this study. The mean age of cases and controls were 58.6 and 58.4 years old, and mean follow-up durations were 2.1 and 2 years respectively. After adjustment, patients with euthyroid nodular goiter had a higher risk of thyroid dysfunction (hazard ratio 5.43, [confidence interval (CI) 3.01-9.80]) compared with controls after iodinated contrast media exposure. In the subgroup analysis, the risks of hyperthyroidism and hypothyroidism in cases compared with controls were 5.77 [CI 2.64-12.62] and 4.95 [CI 2.15-11.40] respectively. Half of the euthyroid nodular goiter cases developed thyroid dysfunction within one year after iodinated contrast media exposure. Interestingly, all thyroid-related comorbidities and drug prescriptions did not increase the risk of thyroid dysfunction.
Presence of euthyroid nodular goiter was associated with higher risk of thyroid dysfunction including hyperthyroidism and hypothyroidism after iodinated contrast media exposure.
甲状腺功能正常的结节性甲状腺肿患者在接触含碘造影剂后发生甲状腺功能障碍的风险很大程度上未知。
这项观察性回顾队列研究随机选取了台湾的100万人。选取了在本研究期间所有接触含碘造影剂的患者。将甲状腺功能正常的结节性甲状腺肿患者确定为病例组，而无甲状腺结节的患者作为对照组。我们对这些患者进行随访，直至出现甲状腺功能障碍的首个事件，包括接触含碘造影剂后发生的甲状腺功能亢进或减退。
本研究共选取了334例病例和2672例匹配的对照组。病例组和对照组的平均年龄分别为58.6岁和58.4岁，平均随访时间分别为2.1年和2年。调整后，甲状腺功能正常的结节性甲状腺肿患者在接触含碘造影剂后发生甲状腺功能障碍的风险高于对照组（风险比5.43，[置信区间（CI）3.01 - 9.80]）。在亚组分析中，病例组与对照组相比，甲状腺功能亢进和减退的风险分别为5.77 [CI 2.64 - 12.62]和4.95 [CI 2.15 - 11.40]。一半的甲状腺功能正常的结节性甲状腺肿病例在接触含碘造影剂后一年内发生甲状腺功能障碍。有趣的是，所有甲状腺相关合并症和药物处方均未增加甲状腺功能障碍的风险。
甲状腺功能正常的结节性甲状腺肿与接触含碘造影剂后发生甲状腺功能障碍（包括甲状腺功能亢进和减退）的较高风险相关。
