Study On The Factors Influencing The Occurrence Of Hypothyroidism After Radioactive 131 Iodine Treatment Of Graves Disease

Objective:In this study,we investigated the clinical characteristics,examination results,and follow-up indicators of GD patients before and after RAI treatment to explore the influencing factors of hypothyroidism in GD patients who had finished RAI.We want to study the diagnostic value of TPOAb antibody in GD patients who had finished RAI,and predict hypothyroidism after RAI.Methods:1.Clinical DataFrom August 2016 to August 2018,117 patients who met the inclusion criteria and exclusion criteria were diagnosed as graves' hyperthyroidism and hospitalized in the endocrine Department of Shandong provincial hospital.Radioiodine therapy(RAI)was selected.According to the incidence of hypothyroidism 18 months after the treatment of Graves hyperthyroidism I-131,117 patients were divided into hypothyroidism group(n=81)and non-hyperthyroidism group(n=36).We study the factors that affect hypothyroidism after RAI in GD patients.Based on the further analysis,the diagnostic value of TPOAb antibody to hypothyroidism after RAI was studied.2.Clinical Data StatisticsThe subjects included complete medical history,vital signs,general information and previous history,etc.Peripheral vein test was taken when the patient was fasting and related indicators were recorded:white blood cells(WBC),neutrophils(NEUT),aspartate aminotransferase(AST),alanine aminotransferase(ALT),triglyceride(TG),total cholesterol(TC),low density lipoprotein(LDL),High density lipoprotein(HDL),thyrotropin(TSH),anti-thyroglobulin antibodies(TGAb),serum free triiodothyronine(FT3),thyroid peroxidase Antibodies(TPOAb),thyroid stimulating hormone receptor antibodies(TRAb),serum free thyroxine(FT4).3.Statistics AnalysisUsing SPSS 22.0 statistical software,the classification data is expressed as a percentage(%),the normal distribution count data is expressed as the mean±standard deviation(x±s),and the non-normal distribution count data is expressed as the median(full range).Chi-square test was used for single factor analysis of disordered classification data,and non-parametric rank sum test was used for single factor analysis of ordered classification data.ANOVA was used to compare the normally distributed numerical data between groups,and a nonparametric rank sum test was used to compare the non-normally distributed numerical data between groups.Binary logistic regression analysis was used to identify the influencing factors of hypothyroidism after GD iodine treatment(calculated OR value and 95%confidence interval).P<0.05 indicates that the difference is statistically significant.Then the TPOAb was analyzed by ROC curve.Results:1.Comparison of baseline data between hypothyroidism and non?hypothyroidism groups.ALT normal(P=0.036),TPOAb(P=0.007),thyroid weight(P=0.012)and HDL(P=0.017)are statistical differences.2.Perform binary logistic regression analysis,TPOAb is a factor affecting the occurrence of hypothyroidism after iodine treatment(P=0.004,OR(95%CI)=11.895(2.738-51.678)),Thyroid weight is a factor that affects the occurrence of hypothyroidism after iodine treatment(P=0.001,OR(95%CI)=0.047(0.008-0.27)),ALT is a factor affecting the occurrence of hypothyroidism after iodine treatment(P=0.007,OR(95%CI)=5.369(1.586-18.178)).3.Draw the ROC curve of TPOAb.TPOAb has statistical significance for P=0.009 after hypothyroidism,AUC area is 0.652,which has general diagnostic value,sensitivity is 45.7%,specificity is 86.1%.According to the cutoff value calculated by the Youden index,TPOAb in patients with GD is more likely to hypothyroidism after RAI when it exceeds 775.7 IU/ml.Conclusions:1.TPOAb concentration level is a factor that affects hypothyroidism after iodine treatment.TPOAb has a significant positive effect on whether hypothyroidism occurs after RAI treatment.When TPOAb?775.7 IU/ml,there is a high possibility of hypothyroidism after iodine treatment.2.ALT is a factor that affects hypothyroidism after iodine treatment.When ALT is higher than the normal range,hypothyroidism is more likely to occur.3.When the patient's thyroid weight before treatment is greater than 50g,the risk of hypothyroidism after RAI is low.