Predictors of euthyreosis in hyperthyroid patients treated with radioiodine 131I-: a retrospective study

BMC Endocr Disord. 2020 Jun 1;20(1):77. doi: 10.1186/s12902-020-00551-2.

Abstract

Background: Radioiodine (RAI) treatment for hyperthyroidism is a very common modality, chosen by physicians worldwide. The outcome of the therapy, however, is not always predictable. While rendering a patient hypo- or euthyroid is meant as a therapeutic success, the latter does not require lifelong hormonal supplementation. The aim of our study is to determine predictors of euthyreosis in patients who underwent RAI treatment.

Methods: Medical records of 144 patients who had undergone RAI therapy were examined. Laboratory and clinical data were analyzed statistically. Ultrasonography findings, such as thyroid volume, nodules' size and characteristics had been collected at the beginning of treatment and 6 months after the administration of radioiodine 131I-. Moreover, scintigraphy results were taken into account. Multivariate logistic regression analysis model has been used to find predictors of euthyroidism after 12 months of follow-up. The predictors of normal thyroid function have also been analyzed separately for patients with GD (Graves' disease) and TMNG (toxic multinodular goiter).

Results: The analysis showed that age (OR 1,06; 95%CI 1.025-1.096, p = 0,001), thyroid gland volume (OR 1,04; 95%CI 1,02-1,06; p < 0.001) and iodine uptake level (OR 0,952; 95%CI 0,91-0,98; p = 0,004) were significant factors of achieving normal thyroid function after RAI therapy. According to multivariate logistic regression analysis, in GD patients only age has been shown to be a significant factor (OR 1,06; 95%CI 1,001-1,13; p = 0.047), while in TMNG patients' age (OR 1,04; 95%CI 1-1,09; p = 0.048), thyroid gland volume (OR 1.038; 95%CI 1.009-1.068; p = 0.009) and iodine uptake level (OR 0.95; 95%CI 0.9-0.99; p = 0.02) all have been proven to be significant predictors of achieving euthyroidism.

Conclusions: The more advanced age, larger volume of thyroid gland and lower iodine uptake level are predictors of euthyreosis after RAI treatment.

Keywords: 131I−; Euthyreosis; Factors; Graves’ disease; Hyperthyroidism; Predictors; Radioiodine; Toxic multinodular goiter.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Female
  • Goiter, Nodular / blood
  • Goiter, Nodular / complications
  • Graves Disease / blood
  • Graves Disease / complications
  • Humans
  • Hyperthyroidism / blood
  • Hyperthyroidism / etiology
  • Hyperthyroidism / radiotherapy*
  • Iodine Radioisotopes / therapeutic use*
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Organ Size
  • Radionuclide Imaging
  • Retrospective Studies
  • Thyroid Gland / diagnostic imaging
  • Thyroid Gland / pathology
  • Thyrotropin / blood
  • Thyroxine / blood
  • Treatment Outcome
  • Triiodothyronine / blood

Substances

  • Iodine Radioisotopes
  • Iodine-131
  • Triiodothyronine
  • Thyrotropin
  • Thyroxine