Yotsapon Thewjitcharoen, Waralee Chatchomchuan, Hussamon Prasatkaew, Panita Srichomchey, Siriwan Butadej, Soontaree Nakasatien, Ekgaluck Wanothayaroj, Rajata Rajatanavin, Thep Himathongkam
Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Heliyon. 2022 May 18;8(5):e09471. doi: 10.1016/j.heliyon.2022.e09471. eCollection 2022 May.
Weight gain post-radioiodine (RAI) treatment is observed in patients with hyperthyroid Graves' disease. Previous studies, mostly in Caucasian patients, demonstrated excessive weight gain averaging 5-7 kg from initial presentation.
The aim of this study was to determine the extent and risk factors of weight gain in Thai patients with RAI-treated Graves' disease.
This was a 5-year retrospective study of patients with hyperthyroid Graves' disease who received RAI treatment during 2016-2020. The proportion and associated risk factors of weight gain ≥5% in patients who was followed for at least 3 months when compared with weight at RAI administration were analyzed.
There were 347 patients with Graves' disease (females 81.0%, mean age 38.8 ± 12.1 years, BMI 23.3 ± 4.0 kg/m) who were treated with RAI. Almost all RAI-treated patients (91.9%) eventually developed hypothyroidism. During the median follow-up period of 25 months, 73.1% of them had weight gain. The mean weight change was +2.5 ± 4.9 kgs when compared with weight at the time RAI administration and +3.4 ± 6.5 kgs when compared with recalled body weight before the onset of hyperthyroidism. The proportion of patient in the obesity class I (BMI 25.0-29.9 kg/m) increased from 23.6% to 28.0% and obesity class II (BMI ≥30.0 kg/m) increased from 5.2% to 8.9%. Duration of antithyroid drug treatment less than 6 months after the diagnosis of hyperthyroidism was the only factor associated with weight gain ≥5%.
Weight gain post-RAI treatment was common, and a significant proportion of patients went on to develop obesity. Early intervention with weight management support should be employed in patients with less than 6 months of antithyroid drug treatment before RAI.
甲状腺功能亢进的格雷夫斯病患者在接受放射性碘（RAI）治疗后会出现体重增加。以往的研究大多针对白种人患者，结果显示从初次就诊开始平均体重过度增加5 - 7千克。
本研究旨在确定接受RAI治疗的泰国格雷夫斯病患者体重增加的程度及风险因素。
这是一项对2016年至2020年期间接受RAI治疗的甲状腺功能亢进格雷夫斯病患者进行的为期5年的回顾性研究。分析了与RAI给药时体重相比，随访至少3个月的患者体重增加≥5%的比例及相关风险因素。
共有347例格雷夫斯病患者（女性占81.0%，平均年龄38.8±12.1岁，体重指数23.3±4.0千克/平方米）接受了RAI治疗。几乎所有接受RAI治疗的患者（91.9%）最终都发展为甲状腺功能减退。在25个月的中位随访期内，73.1%的患者体重增加。与RAI给药时的体重相比，平均体重变化为+2.5±4.9千克，与甲亢发病前回忆的体重相比为+3.4±6.5千克。肥胖I级（体重指数25.0 - 29.9千克/平方米）患者的比例从23.6%增至28.0%，肥胖II级（体重指数≥30.0千克/平方米）患者的比例从5.2%增至8.9%。甲亢诊断后抗甲状腺药物治疗时间少于6个月是与体重增加≥5%相关的唯一因素。
RAI治疗后体重增加很常见，且相当一部分患者会发展为肥胖。对于在RAI治疗前抗甲状腺药物治疗时间少于6个月的患者，应尽早采取体重管理支持的干预措施。
