Dawn Paul Edwin, T V Santhosh, Sulaiman Sumin V
General Surgery, Government Medical College Thrissur, Thrissur, IND.
Cureus. 2024 Apr 16;16(4):e58430. doi: 10.7759/cureus.58430. eCollection 2024 Apr.
Total thyroidectomy is evolving as the choice of treatment for non-malignant thyroid conditions. Therefore, an ideal method of thyroxine replacement is necessary to avoid the ill effects of under- and over-replacement in such patients.
To assess the correlation between optimal thyroxine dose and potential variables like lean body mass (LBM), body surface area (BSA), body mass index (BMI), body weight, age, and sex in patients who underwent total thyroidectomies for benign multinodular goiters in our institute.
A longitudinal cohort study was undertaken at the Government Medical College Thrissur, a tertiary care provider in India, between October 2018 and September 2019. One hundred adult patients who underwent a total thyroidectomy for various benign thyroid conditions were included. They were initially given thyroxine 75 µg upon discharge and received follow-up doses every two months until they achieved euthyroid status on two consecutive visits. The variables evaluated at this stage included age, sex, actual body weight, lean body weight, BMI, and biochemical data (triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH)). Correlation, multiple step-wise regression, and variance were carried out using EPI INFO version 7.2.2.6.
The best predictors for optimum thyroxine dose were BSA (0.923, P < 0.01) and LBM (0.921, P < 0.01), compared with body weight (0.833, P < 0.01) and BMI (0.523, P < 0.01). In our study, the least significant factor was the age of the patient (r = 0.117, P < 0.01). There was no significant association between gender and thyroxine dose. The mean thyroxine dose was 1.87 µg/kg of the patient's body weight.
The optimum thyroxine replacement based on BSA or LBM is a more ideal method than based on BMI or body weight alone.
全甲状腺切除术正逐渐成为非恶性甲状腺疾病的治疗选择。因此，需要一种理想的甲状腺素替代方法，以避免此类患者甲状腺素替代不足或过量的不良影响。
评估我院因良性多结节性甲状腺肿接受全甲状腺切除术患者的最佳甲状腺素剂量与瘦体重（LBM）、体表面积（BSA）、体重指数（BMI）、体重、年龄和性别等潜在变量之间的相关性。
2018年10月至2019年9月，在印度三级医疗服务机构特里苏尔政府医学院进行了一项纵向队列研究。纳入100例因各种良性甲状腺疾病接受全甲状腺切除术的成年患者。出院时最初给予他们75μg甲状腺素，每两个月接受一次随访剂量，直至连续两次就诊时达到甲状腺功能正常状态。此阶段评估的变量包括年龄、性别、实际体重、瘦体重、BMI和生化数据（三碘甲状腺原氨酸（T3）、甲状腺素（T4）、促甲状腺激素（TSH））。使用EPI INFO 7.2.2.6版本进行相关性、多元逐步回归和方差分析。
与体重（0.833，P<0.01）和BMI（0.523，P<0.01）相比，最佳甲状腺素剂量的最佳预测指标是BSA（0.923，P<0.01）和LBM（0.921，P<0.01）。在我们的研究中，最不显著的因素是患者年龄（r = 0.117，P<0.01）。性别与甲状腺素剂量之间无显著关联。平均甲状腺素剂量为患者体重的1.87μg/kg。
基于BSA或LBM的最佳甲状腺素替代方法比仅基于BMI或体重的方法更理想。
