Department of Nuclear Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Ultrasound in Medicine, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Endocrinol (Lausanne). 2023 Jun 22;14:1164789. doi: 10.3389/fendo.2023.1164789. eCollection 2023.
Endothelial dysfunction, which was associated with chronic hypothyroidism, was an early event in atherosclerosis. Whether short-term hypothyroidism following thyroxine withdrawal during radioiodine (RAI) therapy was associated with endothelial dysfunction in patients with differentiated thyroid cancer (DTC) was unclear. Aim of the study was to assess whether short-term hypothyroidism could impair endothelial function and the accompanied metabolic changes in the whole process of RAI therapy.
We recruited fifty-one patients who underwent total thyroidectomy surgery and would accept RAI therapy for DTC. We analyzed thyroid function, endothelial function and serum lipids levels of the patients at three time points: the day before thyroxine withdrawal(P), the day before I administration(P) and 4-6 weeks after RAI therapy(P). A high-resolution ultrasound named flow-mediated dilation (FMD) was used to measure endothelial function of the patients.
We analyzed the changes of FMD, thyroid function and lipids at three time points. FMD(P) decreased significantly compared to FMD(P) (PvsP, 8.05 ± 1.55vs 7.26 ± 1.50, p<0.001). There was no significant difference between FMD(P) and FMD(P) after restoring TSH (thyroid stimulating hormone) suppression therapy (P vs P3, 8.05 ± 1.55 vs 7.79 ± 1.38, p=0.146). Among all parameters, the change of low-density lipoprotein (ΔLDL) was the only factor correlated negatively with the change of FMD (ΔFMD) throughout the RAI therapy process (P, r=-0.326, p=0.020; P, r=-0.306, p=0.029).
Endothelial function was transiently impaired in DTC patients at short-term hypothyroidism state during the RAI therapy, and immediately returned to the initial state after restoring TSH suppression therapy.
与慢性甲状腺功能减退症相关的内皮功能障碍是动脉粥样硬化的早期事件。甲状腺素（T4）撤药后短期甲状腺功能减退症是否与分化型甲状腺癌（DTC）患者的内皮功能障碍有关尚不清楚。本研究旨在评估短期甲状腺功能减退症是否会在放射性碘（RAI）治疗的全过程中损害内皮功能和伴随的代谢变化。
我们招募了 51 名接受全甲状腺切除术并将接受 DTC 放射性碘治疗的患者。我们分析了患者在三个时间点的甲状腺功能、内皮功能和血清脂质水平：T4 撤药前 1 天（P）、I 治疗前 1 天（P）和 RAI 治疗后 4-6 周（P）。使用高分辨率超声测量患者的内皮功能，即血流介导的扩张（FMD）。
我们分析了 FMD、甲状腺功能和脂质在三个时间点的变化。与 FMD（P）相比，FMD（P）显著降低（PvsP，8.05±1.55 vs 7.26±1.50，p<0.001）。在恢复 TSH（促甲状腺激素）抑制治疗后，FMD（P）与 FMD（P）之间没有显著差异（P vs P3，8.05±1.55 vs 7.79±1.38，p=0.146）。在所有参数中，只有低密度脂蛋白（LDL）的变化与 RAI 治疗过程中 FMD（ΔFMD）的变化呈负相关（P，r=-0.326，p=0.020；P，r=-0.306，p=0.029）。
在 RAI 治疗期间，DTC 患者在短期甲状腺功能减退症状态下内皮功能短暂受损，在恢复 TSH 抑制治疗后立即恢复到初始状态。
