Russo Lucia, Nguyen Thi Ngoc Huyen, Kyrilli Aglaia, Robin Martin, Bel Lassen Pierre, Moreno-Reyes Rodrigo, Corvilain Bernard
Department of Medicine, DIMED, Internal Medicine 3, University of Padua, Padova, Italy.
Department of Endocrinology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium.
Eur Thyroid J. 2021 Jul;10(5):382-389. doi: 10.1159/000512734. Epub 2021 Jan 25.
Endogenous subclinical hyperthyroidism (eSCH) is defined by subnormal serum thyroid-stimulating hormone (TSH) level. There is limited evidence of metabolic changes induced by eSCH. The aim of our work was to evaluate changes in BMI and lipid parameters after radioiodine treatment in patients with grade 1 (TSH: 0.1-0.39 mlU/L) and 2 (TSH <0.1 mlU/L) eSCH.
A retrospective study was performed on 74 patients with eSCH caused by benign autonomous nodular goiter which was treated with radioiodine.
We assessed BMI, lipids parameters, and TSH after radioiodine therapy. The 12-month follow-up time point was used to compare the primary outcome variables. TSH was measured by the electrochemiluminescence method.
After radioiodine therapy, the absolute and relative increases in BMI at 12 months were significantly higher in the grade 2 group than in the grade 1 group (1.07 ± 0.27 kg/m vs. 0.26 ± 0.15 kg/m, respectively; = 0.023 and 4.01 ± 0.98% vs. 1.01 ± 0.56%, respectively; = 0.026). Compared to baseline, significant increases in the levels of total cholesterol and LDL were observed after treatment in the grade 2 eSCH group (16.7 ± 4.5 mg/dL < 0.01 and 14.3 ± 4.1 mg/dL < 0.01, respectively) but not in the grade 1 group. In a multivariate model, a negative correlation was observed between pretreatment TSH levels and absolute BMI gain ( < 0.01).
After correction of eSCH, increases in BMI and LDL levels were observed only in patients with grade 2 eSCH. Pretreatment serum TSH was the main independent factor associated with BMI changes after radioiodine treatment.
内源性亚临床甲状腺功能亢进症（eSCH）由血清促甲状腺激素（TSH）水平低于正常范围定义。关于eSCH引起的代谢变化的证据有限。我们研究的目的是评估1级（TSH：0.1 - 0.39 mIU/L）和2级（TSH <0.1 mIU/L）eSCH患者接受放射性碘治疗后体重指数（BMI）和血脂参数的变化。
对74例因良性自主性结节性甲状腺肿接受放射性碘治疗的eSCH患者进行了一项回顾性研究。
我们评估了放射性碘治疗后的BMI、血脂参数和TSH。采用12个月的随访时间点比较主要结局变量。TSH通过电化学发光法测量。
放射性碘治疗后，2级组12个月时BMI的绝对增加值和相对增加值均显著高于1级组（分别为1.07±0.27 kg/m²对0.26±0.15 kg/m²，P = 0.023；分别为4.01±0.98%对1.01±0.56%，P = 0.026）。与基线相比，2级eSCH组治疗后总胆固醇和低密度脂蛋白水平显著升高（分别为16.7±4.5 mg/dL，P < 0.01和14.3±4.1 mg/dL，P < 0.01），而1级组未出现这种情况。在多变量模型中，观察到治疗前TSH水平与BMI绝对增加值呈负相关（P < 0.01）。
纠正eSCH后，仅2级eSCH患者的BMI和低密度脂蛋白水平升高。治疗前血清TSH是放射性碘治疗后与BMI变化相关的主要独立因素。
