Journal of Diagnostics Concepts & Practice >

2025 , Vol. 24 >Issue 05: 505 - 511

DOI: https://doi.org/10.16150/j.1671-2870.2025.05.005

Original articles

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

  • ZENG Beibei ,
  • HUANG Yi ,
  • ZHANG Buteng ,
  • HUANG Ronghe ,
  • QIN Lihua ,
  • ZHOU Qiting
Expand
  • Department of Nuclear Medicine, Second Nanning People's Hospital, The Third Affiliated Hospital of Guangxi Medical University, Guangxi Nanning 530031, China

Received date: 2024-12-05

  Revised date: 2025-02-19

  Accepted date: 2025-03-23

  Online published: 2025-10-23

Fold

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

Cite this article

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 . DOI: 10.16150/j.1671-2870.2025.05.005

References

[1] LI Y, TENG D, CHEN B, et al. Efficacy and safety of long-term universal salt iodization on thyroid disorders:epidemiological evidence from 31 provinces of mainland China[J]. Thyroid, 2020, 30(4):568-579.
[2] HE Q Y, DONG H, GONG M M, et al. New therapeutic horizon of Graves' hyperthyroidism: treatment regimens based on immunology and ingredients from traditional Chinese medicine[J]. Frontiers in pharmacology, 2022, 13(1):862831.
[3] METWALLEY K A, FARGHALY H S. Graves' disease in children: an update[J/OL]. Clin Med Insights Endocrinol Diabetes, 2023-05-03[2024-12-05]. https://pubmed.ncbi.nlm.nih.gov/37151843/.
[4] 尹卓娜, 金文胜, 张晓宇, 等. 伴促甲状腺激素瘤的多发性内分泌腺瘤病1型一例报道及文献复习[J]. 中华内分泌代谢杂志, 2020, 36(1):43-50.
  YIN Z N, JIN W S, ZHANG X Y, et al. A case report of multiple endocrine neoplasia type 1 with thyrotropinoma and literature review[J]. Chin J Endocrinol Metab, 2020, 36(1):43-50.
[5] 宋诗涵, 张曹旭, 李润钏. 甲状腺眼病球后组织不同肌群受累差异的原因初探[J]. 中华内分泌代谢杂志, 2024, 40(3):242-247.
  SONG S H, ZHANG C X, LI R C. Preliminary exploration of the reasons for the differential involvement of different muscle groups in the retrobulbar tissues of thyroid eye disease[J]. Chin J Endocrinol Metab, 2024, 40(3):242-247.
[6] 谢培林, 徐聂, 黄露萍. Graves甲亢患者131I治疗后甲减发生情况及与血清TGAb、TPOAb的关系[J]. 分子诊断与治疗杂志, 2024, 16(7):1303-1306.
  XIE P L, XU N, HUANG L P. Incidence of hypothyroi-dism after 131I treatment in patients with Graves hyperthyroidism and its relationship with serum TGAb and TPOAb[J]. J Mol Diagn Ther, 2024, 16(7):1303-1306.
[7] 郑敏, 潘莉珍, 谭建强, 等. 先天性甲状腺功能减低症治疗前后TSH、FT4、IGF-1水平的变化及与体格生长的关系[J]. 中国儿童保健杂志, 2013, 21(8):793-795.
  ZHENG M, PAN L Z, TAN J Q, et al. Changes of TSH, FT4, IGF-1 levels before and after treatment of congenital hypothyroidism and their relationship with physical growth[J]. Chin J Child Health Care, 2013, 21(8):793-795.
[8] 杨铭, 潘天荣, 钟兴. IL-23/IL-17轴因子在初诊Graves病患者治疗前后的变化[J]. 安徽医科大学学报, 2017, 52(11):1718-1720.
  YANG M, PAN T R, ZHONG X. Changes of IL-23/IL-17 axis factors before and after treatment in patients with newly diagnosed Graves' disease[J]. Acta Univ Medi Anhui, 2017, 52(11):1718-1720.
[9] 冯婧, 李新胜, 侯振江. Th17细胞分化与调控的研究进展①[J]. 中国免疫学杂志, 2021, 37(13):1648-1655.
  FENG J, LI X S, HOU Z J. Research progress in the differentiation and regulation of Th17 cells①[J]. Chin J Immunol, 2021, 37(13):1648-1655.
[10] 张银仙, 赵良宇, 方艳玲. TRAb、TSH、IFN-γ和IL-17水平变化在甲状腺功能亢进患者诊断中的应用[J]. 检验医学与临床, 2021, 18(14):2068-2071.
  ZHANG Y X, ZHAO L Y, FANG Y L. Application of changes in TRAb, TSH, IFN-γ and IL-17 levels in the diagnosis of patients with hyperthyroidism[J]. Lab Med Clin, 2021, 18(14):2068-2071.
[11] ROSS D S, BURCH H B, COOPER D S, et al. 2016 American Thyroid Association Guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis[J]. Thyroid, 2016, 26(10):1343-1421.
[12] OKOSIEME O E, TAYLOR P N, EVANS C, et al. Primary therapy of Graves' disease and cardiovascular morbidity and mortality:a linked-record cohort study[J]. Lancet Diabetes Endocrinol, 2019, 7(4):278-287.
[13] 刘莎. 甲亢131碘治疗后早发甲减患者的临床分析[J]. 首都食品与医药, 2020, 27(2):55.
  LIU S. Clinical analysis of patients with early-onset hypothyroidism after 131I treatment for hyperthyroidism[J]. Capital Food Med, 2020, 27(2):55.
[14] 祖拉亚提·库尔班, 刘立水, 秦永德, 等. 血清TPOAb、TMAb及TRAb水平对甲状腺功能亢进患者131I治疗后甲状腺功能减退风险的预测价值[J]. 疑难病杂志, 2023, 22(5):494-498,504.
  ZULAYATI K, LIU L S, QIN Y D, et al. Predictive value of serum TPOAb, TMAb and TRAb levels for the risk of hypothyroidism after 131I treatment in patients with hyperthyroidism[J]. J Difficult Complicated Cases, 2023, 22(5):494-498,504.
[15] STOKKEL M P M, H JUNAK D, LASSMANN M, et al. EANM procedure guidelines for therapy of benign thyroid disease[J]. Eur J Nucl Med Mol Imaging, 2010, 37(11):2218-2228.
[16] 中华医学会全科医学分会. 甲状腺功能亢进症基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2019, 18(12):1118-1128.
  Chinese Medical Association General Practice Society. Guideline for primary care of hyperthyroidism (2019)[J]. Chin J Gene Pract, 2019, 18(12):1118-1128.
[17] 中华医学会核医学分会. 131I治疗格雷夫斯甲亢指南(2021版)[J]. 中华核医学与分子影像杂志, 2021, 44(4):244-245.
  Chinese Society of Nuclear Medicine. Clinical guidelines for 131I treatment of Graves′ hyperthyroidism (2021 edition)[J]. Chin J Nucl Med Mol Imag, 2021, 44(4):244-245.
[18] ZHAO L, WANG Y, ZHANG Y, et al. IGF-1 attenuates oxidative stress-induced thyroid cell apoptosis via Nrf2/HO-1 pathway[J]. Redox Biol, 2019, 24(1):101213.
[19] 孙文英, 徐辉. IGF-1、IL-18、TNF-α水平与妊娠期亚临床甲减相关性[J]. 中国计划生育学杂志, 2022, 30(4):918-921,926.
  SUN W Y, XU H. Correlation between the levels of IGF-1, IL-18, TNF-α and subclinical hypothyroidism during pregnancy[J]. Chin J Fam Plann, 2022, 30(4):918-921,926.
[20] FORNES B E, BLYTH A J, WIT J M. Disorders of IGFs and IGF-1R signaling pathways[J]. Mol Cell Endocrinol, 2020, 518(1):111035.
[21] 康春嵋, 李山, 郭志玲. 基于调控PI3K-AKT通路探讨艾灸关元穴治疗甲状腺功能减退的作用机制[J]. 世界中西医结合杂志, 2021, 16(10):1831-1835.
  KANG C M, LI S, GUO Z L. Exploring the mechanism of moxibustion at Guanyuan (CV4) in the treatment of hypothyroidism based on the regulation of the PI3K-AKT pathway[J]. World J Integr Tradit West Med, 2021, 16(10):1831-1835.
[22] 梁昌平, 李隆敏, 田小雪, 等. 首次131I治疗前TPOAb、TgAb及TRAb状态对Graves病患者治疗后甲状腺功能减退的预测价值[J]. 中华内分泌代谢杂志, 2024, 40(8):676-680.
  LIANG C P, LI L M, TIAN X X, et al. Predictive value of TPOAb, TgAb and TRAb status before the first 131I treatment on hypothyroidism in patients with Graves' disease[J]. Chin J Endocrinol Metab, 2024, 40(8):676-680.
[23] HAZKANI I, STEIN E, EDWARDS E, et al. Abnormal TSH prior to surgery in children with Graves’disease predicts abnormal TSH following thyroidectomy[J]. Laryngoscope, 2023, 133(9):2402-2406.
[24] 淡立琴, 张中林, 罗志刚. 血清胰岛素样生长因子-1水平在原发性甲状腺功能亢进症诊疗中的价值[J]. 实用临床医药杂志, 2024, 28(24):73-76.
  DAN L Q, ZHANG Z L, LUO Z G. Value of serum insulin-like growth factor-1 level in the diagnosis and treatment of primary hyperthyroidism[J]. J Clin Med Pract, 2024, 28(24):73-76.
[25] MOHYI M, SMITH T J. IGF1 receptor and thyroid-asso-ciated ophthalmopathy[J]. J Mol Endocrinol, 2018, 61(1):T29-T43.
[26] 蔡鹄. 薯蓣皂苷元对Ad-TSHR-289诱导Graves病模型小鼠甲状腺细胞增殖及免疫功能的影响[D]. 山东大学, 2013.
  CAI H. Effects of diosgenin on the proliferation of thyroid cells and immune function in Ad-TSHR-289-induced mouse model of Graves' disease[D]. Shandong University, 2013.
[27] MAO D, WANG K, JIANG H, et al. Suppression of overactive insulin-like growth factor 1 attenuates trauma-induced heterotopic ossification in mice[J]. Am J Pathol, 2024, 194(3):430-446.
[28] 吉盈肖. IGF1减轻ALS-SOD1G93A转基因小鼠坐骨神经炎症的研究[D]. 河北医科大学, 2018.
  JI Y X. Study on the Effect of IGF1 on alleviating sciatic nerve inflammation in ALS-SOD1G93A transgenic mice[D]. Hebei Medical University, 2018.
Options
Outlines

/

〈 〉