Department of Internal Medicine, Ito Hospital, Tokyo 150-8308, Japan.
Department of Surgery, Ito Hospital, Tokyo 150-8308, Japan.
Endocr J. 2023 May 29;70(5):541-549. doi: 10.1507/endocrj.EJ22-0505. Epub 2023 Mar 25.
The effect of potassium iodide (KI) on radioiodine uptake (RAIU) before radioisotope therapy in Graves' disease (GD) patients was investigated. A total of 82 patients who had been treated with KI monotherapy before 24-hour RAIU (24 h RAIU) were evaluated and 354 of those who had been treated with thiamazole (MMI) monotherapy were extracted from the 1,130 GD patients who were identified as having had appropriate iodine restriction based on urinary iodine excretion. Urinary iodine excretion (UIE) <200 μg/day was confirmed in all subjects. Propensity score-matching was performed to identify the difference in 24 h RAIU between the KI group and the MMI group. In addition, multiple regression analysis was performed to evaluate related to 24 h RAIU. Propensity score-matching resulted in 57 matched patients in each group. After matching, 24 h RAIU was still significantly lower in the KI group than in the MMI group (median 53% (interquartile range 47-61%) vs. 63% (56-66%); p = 0.001). In addition, KI monotherapy was weakly negatively correlated with 24 h RAIU, whereas the female sex and FT3 were very weakly positively correlated on multiple regression analysis. The results suggest that KI monotherapy likely suppressed 24 h RAIU more than MMI monotherapy in GD patients with appropriate iodine restriction, given the difference in the mechanism of hormone suppression.
研究了碘化钾 (KI) 在格雷夫斯病 (GD) 患者放射性碘摄取 (RAIU) 前的治疗效果。对 82 例接受 KI 单药治疗后 24 小时 RAIU(24 h RAIU)的患者进行了评估,并从 1130 例 GD 患者中提取了 354 例接受他巴唑(MMI)单药治疗的患者,这些患者被认为根据尿碘排泄进行了适当的碘限制。所有受试者的尿碘排泄(UIE)<200 μg/天。采用倾向评分匹配法比较 KI 组和 MMI 组的 24 h RAIU 差异。此外,进行多元回归分析以评估与 24 h RAIU 相关的因素。倾向评分匹配后,每组各有 57 例匹配患者。匹配后,KI 组的 24 h RAIU 仍明显低于 MMI 组(中位数 53%(四分位距 47-61%)vs. 63%(56-66%);p=0.001)。此外,KI 单药治疗与 24 h RAIU 呈弱负相关,而女性和 FT3 在多元回归分析中呈极弱正相关。这些结果表明,在适当碘限制的 GD 患者中,KI 单药治疗可能比 MMI 单药治疗更能抑制 24 h RAIU,这与激素抑制的机制不同有关。