Predictive value of serum IGF-1 combined with TPOAb for the occurrence of hypothyroidism after 131I treatment in patients with hyperthyroidism

doi:10.16150/j.1671-2870.2025.05.005

Abstract

Abstract:

Objective To explore the predictive value of serum insulin-like growth factor-1 (IGF-1), thyroid peroxidase antibodies (TPOAb), thyrotropin receptor antibodies (TRAb), and interleukin 17 (IL-17) for the occurrence of hypothyroidism after ¹³¹I treatment in patients with hyperthyroidism. Methods A total of 121 patients with hyperthyroidism who received ¹³¹I treatment in the Department of Nuclear Medicine of the Second Nanning People's Hospital from January 2022 to June 2023 were enrolled and followed up for one year. Based on the occurrence of hypothyroidism after ¹³¹I treatment, patients were divided into the hypothyroidism and non-hypothyroidism groups. The differences in general data and laboratory indicators before treatment between the two groups were compared. Binary logistic regression analysis was performed on the indicators with statistical differences between groups, and the receiver operating characteristic (ROC) curves were constructed to evaluate the predictive value of these indicators for the progression to hypothyroidism in patients with hyperthyroidism after ¹³¹I treatment. Results After ¹³¹I treatment, there were 55 cases in the hypothyroidism group and 66 cases in the non-hypothyroidism group. The median TPOAb level in the hypothyroidism group was 965.23 IU/mL, significantly higher than that in the non-hypothyroidism group at 188.70 IU/mL. Meanwhile, the median IGF-1 level in the hypothyroi-dism group was 140.97 ng/mL, lower than that in the non-hypothyroidism group at 224.28 ng/mL, with both differences being statistically significant (P<0.001). The regression analysis results showed that elevated IGF-1 level acted as a protective factor against hypothyroidism in patients with hyperthyroidism after ¹³¹I treatment, while increased TPOAb level was a risk factor. ROC curve analysis showed that an IGF-1 level <149.00 ng/mL predicted early hypothyroidism with an area under the curve (AUC) of 0.827, and a TPOAb level >473.6 IU/mL yielded an AUC of 0.835. Moreover, the combination of serum IGF-1 and TPOAb yielded the largest AUC of 0.899 for predicting hypothyroidism in patients with hyperthyroidism after ¹³¹I treatment, demonstrating the strongest predictive ability. Conclusion Observing the levels of serum IGF-1 combined with TPOAb in patients with hyperthyroidism before ¹³¹I treatment demonstrates certain clinical predictive value for the occurrence of hypothyroidism after ¹³¹I treatment.

Key words: Hyperthyroidism, Hypothyroidism, ¹³¹I treatment, Insulin-like growth factor, Thyroid peroxidase antibodies

CLC Number:

R817.8
R445

ZENG Beibei, HUANG Yi, ZHANG Buteng, HUANG Ronghe, QIN Lihua, ZHOU Qiting. Predictive value of serum IGF-1 combined with TPOAb for the occurrence of hypothyroidism after ¹³¹I treatment in patients with hyperthyroidism[J]. Journal of Diagnostics Concepts & Practice, 2025, 24(05): 505-511.

Figures/Tables 3

Table 1

Table 2

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References 28

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Element	Hypothyroidism group	Non-hypothyroidism group	P value
Age（years）	43.27±10.201	43.38±11.174	0.086
Body mass Index（kg/m²）	20.83（19.57，23.46）	19.63（18.49，20.86）	0.004
Heart rate（beats per minute）	100.00（94.00，107.00）	97.00（89.00，107.00）	0.313
Iodine intake（mci）	5.5（5.0，6.55）	6.1（5.0，6.6）	0.141
TT₃（nmol/L）	4.89（3.03，6.04）	5.23（3.58，8.14）	0.061
FT₃（pmol/L）	15.96（8.58，23.60）	17.81（10.46，30.72）	0.123
TT₄（nmol/L）	215.19（171.43，268.89）	206.76（159.63，283.86）	0.639
FT₄（pmol/L）	36.11（24.18，50.79）	37.16（26.32，51.87）	0.763
TSH（uIU/mL）	0.0028（0.0015，0.0040）	0.0026（0.0013，0.0047）	0.460
TPOAb（IU/mL）	965.23（583.96，1537.66）	188.70（40.85，556.50）	<0.001
TRAb（IU/mL）	24.80（10.64，30.175）	25.62（11.18，33.23）	0.551
IGF-1（ng/mL）	140.97（113.37，196.31）	224.28（172.86，277.99）	<0.001
IL-17（pg/mL）	9.12（7.52，11.87）	10.55（8.37，12.38）	0.058

Factor	Regression coefficient （B）	Wald	0R value	95％CI	P value
Body mass index	0.216	3.463	1.241	0.989-1.558	0.063
TPOAb	0.020	15.179	1.002	1.001-1.003	<0.001
IGF-1	-0.026	17.743	0.974	0.962-0.986	<0.001

Predictive value of serum IGF-1 combined with TPOAb for the occurrence of hypothyroidism after ¹³¹I treatment in patients with hyperthyroidism

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