Hu Yue, Liu Shan, Xiong Xiaoliang, Wang Lixing, Zhao Yinlong
Department of Nuclear Medicine, The Second Hospital of Jilin University, Changchun, China.
Front Endocrinol (Lausanne). 2025 Jun 10;16:1568699. doi: 10.3389/fendo.2025.1568699. eCollection 2025.
Recent studies suggest that metabolic and organ function indicators could influence radioactive iodine treatment (RAIT) efficacy in hyperthyroid patients, but their relationships with thyroid function remain unclear.
This study aims to explore the impact of these markers on RAIT efficacy and thyroid function.
A total of 135 hyperthyroid patients undergoing RAIT were enrolled, with biomarkers collected at baseline and 1, 3, and 6 months posttreatment. These included thyrotropin receptor antibody (TRAb), free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), urinary iodine concentration (UIC), serum iodine concentration (SIC), 25-hydroxyvitamin D, alanine aminotransferase, aspartate aminotransferase, and serum creatinine (Scr). We mainly focus on the outcomes of the impact of metabolic and organ function markers on RAIT efficacy and their correlation with changes in thyroid function.
Logistic regression identified age as a predictor of RAIT efficacy (OR = 0.957, = 0.025), with older patients less likely to achieve clinical improvement. Scr showed borderline significance ( = 0.049). Early after treatment, SIC was positively correlated with TSH ( = 0.204, = 0.018), whereas UIC and SIC were significantly negatively correlated with TSH at 6 months during treatment ( < 0.05). In addition, higher Scr levels were consistently and significantly associated with lower FT3 and FT4 and higher TSH at multiple time points ( < 0.05).
Age was a relative factor influencing RAIT efficacy, while iodine nutritional status exhibited dynamic, time-dependent effects on TRAb and TSH. Elevated Scr promotes reductions in FT3 and FT4 and an increase in TSH.
近期研究表明,代谢和器官功能指标可能会影响甲状腺功能亢进患者的放射性碘治疗(RAIT)疗效,但其与甲状腺功能的关系仍不明确。
本研究旨在探讨这些标志物对RAIT疗效和甲状腺功能的影响。
共纳入135例接受RAIT治疗的甲状腺功能亢进患者,在基线、治疗后1个月、3个月和6个月收集生物标志物。这些标志物包括促甲状腺素受体抗体(TRAb)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、尿碘浓度(UIC)、血清碘浓度(SIC)、25-羟基维生素D、丙氨酸氨基转移酶、天冬氨酸氨基转移酶和血清肌酐(Scr)。我们主要关注代谢和器官功能标志物对RAIT疗效的影响结果及其与甲状腺功能变化的相关性。
逻辑回归分析确定年龄是RAIT疗效的预测因素(OR = 0.957,P = 0.025),年龄较大的患者临床改善的可能性较小。Scr显示出临界显著性(P = 0.049)。治疗早期,SIC与TSH呈正相关(r = 0.204,P = 0.018),而在治疗6个月时,UIC和SIC与TSH显著负相关(P < 0.05)。此外,在多个时间点,较高的Scr水平与较低的FT3和FT4以及较高的TSH持续且显著相关(P < 0.05)。
年龄是影响RAIT疗效的相关因素,而碘营养状况对TRAb和TSH呈现动态、时间依赖性影响。Scr升高会促使FT3和FT4降低以及TSH升高。