Thyroid Research最新文献

{"title":"The utility of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT in predicting the response to tyrosine kinase inhibitors in patients with advanced medullary thyroid cancer.","authors":"Eline C Jager, James McNeil, Alexander J Papachristos, Mark Sywak, Stan B Sidhu, Rhonda Siddall, Jeremy Hoang, Geoffrey P Schembri, Venessa H M Tsang, Ayanthi Wijewardene, Lyndal Tacon, Bruce Robinson, Roderick J Clifton-Bligh, Martyn Bullock, Adrienne H Brouwers, Thera P Links, Schelto Kruijff, Anthony R Glover, Matti L Gild","doi":"10.1186/s13044-025-00250-x","DOIUrl":"10.1186/s13044-025-00250-x","url":null,"abstract":"<p><strong>Background: </strong>Tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of patients with advanced medullary thyroid cancer (MTC). However, treatment response heterogeneity leads to challenges in predicting individual favourable response. This study evaluated the correlation between PET metrics on ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CTs prior to treatment, and TKI response.</p><p><strong>Methods: </strong>This study retrospectively evaluated patients with metastatic MTC who received TKIs at a tertiary care hospital and had prior ⁶⁸Ga-DOTATATE and/or ¹⁸F-FDG PET/CT imaging. Patient demographics, treatment and PET/CT data were collected. Standardized Uptake Value (SUV) max, SUVmean, Total Lesion Activity (TLA) and Metabolic Tumor Volume (MTV) were determined per PET/CT.</p><p><strong>Results: </strong>In the 25 patients, mean age at diagnosis was 48 (±15) years; 11 (44%) were female and 21 tumors harbored RET driver alterations. Thirty-six TKI treatments were administered (11 patients received two TKIs sequentially). RECIST response rates (available in 32/36 treatments) included; stable disease in 8/32 (25%), partial response in 23/32 (72%) and complete response in 1/32 (3%) treatments. In total, 30 pre-TKI PET/CTs (24 ⁶⁸Ga-DOTATATE PET/CTs, 6 ¹⁸F-FDG PET/CTs) were performed. Pre-TKI ⁶⁸Ga-DOTATATE PET/CTs did not correlate with TKI treatment response. In the ¹⁸F-FDG cohort, high MTV and TLA correlated with a better structural response (p < 0.001) and high SUVmean correlated with a longer time to reach optimal response (p = 0.037).</p><p><strong>Conclusions: </strong>In a small cohort of MTC patients, MTV and TLA on ¹⁸F-FDG PET/CT were associated with the structural response of TKI treatment, suggesting their potential utility in identifying patients who are likely to respond significantly. In contrast, TKI response showed no correlation with uptake on ⁶⁸Ga-DOTATATE PET/CT.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"31"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A lymph node metastasis of papillary thyroid carcinoma as a giant cervical cyst without a primary tumor in the thyroid gland: a case report.","authors":"Xili Lu, Pingping Zhou, Jili Wang, Xinhui Su, Jun Yang","doi":"10.1186/s13044-025-00244-9","DOIUrl":"10.1186/s13044-025-00244-9","url":null,"abstract":"<p><strong>Background: </strong>Papillary thyroid carcinoma (PTC) comprises the vast majority of all thyroid cancers. Lymph node metastases may be present even when the primary tumor is small and intrathyroidal. Metastatic lymph nodes of PTC presenting as giant solitary cervical cysts with no evidence of primary tumors in the thyroid gland even by postoperative pathological examination are rare.</p><p><strong>Case presentation: </strong>A 33-year-old Chinese woman presented to the hospital with an incidental mass in her right neck. Ultrasonography and magnetic resonance imaging revealed a giant right cystic mass in the inferior submandibular gland. The patient underwent mass dissection. Histopathological assessment indicated metastatic papillary carcinoma from the thyroid. Total thyroidectomy and bilateral selective neck dissection were performed. Meticulous pathological examination revealed no lesions in the thyroid. After 18 months of follow-up, no signs of recurrence were noted.</p><p><strong>Conclusion: </strong>It is difficult and challenging to differentially diagnose between ectopic PTC and lymph node metastasis from PTC. Meticulous pathological evaluation of surgical specimens is key to making a definitive diagnosis.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"28"},"PeriodicalIF":1.9,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy outcome following radioactive iodine therapy for Graves' disease in women of childbearing age: a systematic review.","authors":"Churun Xu, Lingge Wei, Peng Xie","doi":"10.1186/s13044-025-00242-x","DOIUrl":"10.1186/s13044-025-00242-x","url":null,"abstract":"<p><strong>Objective: </strong>Graves' disease (GD) patients treated with radioactive iodine may face health risks from potential radiation exposure, both for themselves and their offspring. This systematic review aims to comprehensively evaluate the association between prior radioactive iodine (RAI) therapy for GD and subsequent pregnancy outcomes in women of childbearing age.</p><p><strong>Methods: </strong>A search of the bibliographic databases PubMed/MEDLINE and Web of Science was conducted up to December 2024 to identify relevant studies.</p><p><strong>Results: </strong>The final systematic review included 1055 patients from 5 articles, all of which were retrospective cohort studies. Two studies reported the incidence of miscarriage after RAI treatment of 2.3% (3/130) and 22.2% (6/27). One study indicated that the miscarriage rate in the RAI group was not significantly different from that in the control groups, while the other did not provide a statistical comparison between groups. Two studies reported the incidence of neonatal hyperthyroidism (NH) after RAI therapy of 11.3% (5/44) and 5.5% (8/145). Both studies indicated that high levels of serum TRAb during late pregnancy were significantly associated with NH (P < 0.05). One study reported the incidence of postpartum thyrotoxicosis (PT) after RAI therapy of 2.1%. Compared with surgical treatment and ATD treatment, patients with RAI therapy had a significantly lower incidence of PT (P < 0.05).</p><p><strong>Conclusion: </strong>Based on the limited evidence from retrospective studies, current data does not demonstrate a statistically significant increase in the risk of miscarriage or postpartum thyrotoxicosis following RAI therapy, compared to ATDs or surgical treatment. Elevated maternal TRAb levels in late pregnancy were strongly associated with neonatal hyperthyroidism. However, the small sample sizes and heterogeneity in study designs preclude definitive conclusions. Further prospective studies are required to establish more comprehensive and reliable conclusions and to evaluate more pregnancy outcomes.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"26"},"PeriodicalIF":1.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of thyroid dysfunction in highly active antiretroviral therapy -Exposed people living with human immunodeficiency virus.","authors":"Asma A Adan, Redemtor A Ojuang, Steven G Nyanjom, Edward K Maina","doi":"10.1186/s13044-025-00240-z","DOIUrl":"10.1186/s13044-025-00240-z","url":null,"abstract":"<p><strong>Background: </strong>The incidence of thyroid dysfunction is high in HIV patients, contributing to the high mortality and morbidity associated with HIV.</p><p><strong>Objectives: </strong>This study focused on evaluating the prevalence of thyroid dysfunction and associated factors among people living with HIV (PLWH) attending Comprehensive care centre at Maua Methodist Hospital, Kenya.</p><p><strong>Methods: </strong>Clinical and sociodemographic data of participants were collected including HIV viral loads, CD4 counts, HAART regimen and type, age, gender, marital and education status, and co-infection. Serum levels of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were assessed in all groups. Regression analysis and Pearson correlation were performed to assess thyroid dysfunction and associated factors.</p><p><strong>Results: </strong>The prevalence of thyroid dysfunction was 51.9% (95% CI: 50.8 ~ 53.2) in this population. 77% (77%) of the HAART group had thyroid dysfunction compared to 47% of the HAART naïve group. Additionally, the prevalence of thyroid dysfunction was high in the HIV-non-suppressed individuals (97%, 95% CI: 97.1 ~ 97.9) compared to suppressed group (83%, 95% CI: 82.7 ~ 84.3). HIV (p < 0.001), HAART exposure (p < 0.001), TB (p < 0.001) and duration of infection (p = 0.002) were significantly associated with thyroid dysfunction. There was a positive correlation between TSH (r = 0.28; p < 0.01) and HIV + individuals under HAART, TSH (r = 0.37; p < 0.001) and TB, and FT3 (r = 0.35; p < 0.001) and duration of infection. Additionally, there was positive corelation between thyroid dysfunction and age (r = 0.13, p = 0.13), and a negative correlation between thyroid dysfunction and CD4 counts (r = -0.39, p < 0.055) though statistically not significant.</p><p><strong>Conclusions: </strong>Thyroid dysfunction is more common in HIV patients on HAART, mainly manifested as subclinical hypothyroidism. Routine screening for thyroid dysfunction should be considered for PLWH, especially those on HAART and with viral blips.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"24"},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TGF-β induces EMT in thyroid cancer cells by regulating transcription factors.","authors":"Jianjian Xiang, Nannan Lv, Shanyu Yin, Tong Zhao, Fei Liu, Lan Cheng, Feng Liu, Jinsong Kuang","doi":"10.1186/s13044-025-00243-w","DOIUrl":"10.1186/s13044-025-00243-w","url":null,"abstract":"<p><strong>Background: </strong>Transforming growth factor-β (TGF-β) plays well-established roles in cancer cell invasion and epithelial-mesenchymal transition (EMT); however, its role in thyroid carcinoma (TC) remains unclear. This study aimed to evaluate the effects of TGF-β on EMT in TC and determine its underlying mechanisms.</p><p><strong>Methods: </strong>Treatment of TC cell lines with TGF-β the morphology of thyroid cancer cells changed, Immunofluorescence staining revealed that the localization of E-cadherin shifted from the cell membrane to the cytoplasm, and the fluorescence intensity decreases. Wound-healing assay in BCPAP and TPC-1 revealed that migration ability was significantly higher in the TGF-β (5 ng/mL) treatment group than in the control group (P < 0.01).</p><p><strong>Results: </strong>Transwell assays showed that the invasive abilities of TGF-β-treated BCPAP, TPC-1, and K1 cells were 7-, 10-, and 6-fold higher than those of the control group, respectively (P < 0.05). After TGF-β treatment, mRNA levels of SNAI1 significantly increased in TPC-1 and BCPAP cell lines. Treatment of TC cell lines with TGF-β downregulated the epithelial marker E-cadherin and upregulated the mesenchymal markers N-cadherin and vimentin, at the mRNA level. Western blotting indicated similar results at the protein level, TSH could enhance this process.</p><p><strong>Conclusions: </strong>TGF-β promotes EMT-like phenotypic changes in thyroid cancer cells, accompanied by upregulation of SNAI1 and EMT-related markers, which is enhanced by TSH. Overall, this study provides a basis for the development of therapeutic strategies for TC targeting the EMT.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"25"},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of micronutrient status with thyroid function in adolescent Afghan refugees; a cross-sectional study.","authors":"Saima Shaheen, Muhammad Shahzad, Nabila Sher, Muhammad Shabbir Khan, Khalid Iqbal, Habab Ali Ahmad, Simon C Andrews","doi":"10.1186/s13044-025-00239-6","DOIUrl":"10.1186/s13044-025-00239-6","url":null,"abstract":"<p><p>Micronutrients play a crucial role in several metabolic processes including thyroid hormone metabolism and functions. The current study aimed to assess the associations between thyroid hormone levels and micronutrient status in a cohort of adolescents Afghan refugees residing in a refugee camp in Pakistan. A randomised, community based, cross-sectional study design was employed to recruit 206 adolescent (both male and female) Afghan refugees aged 10-19 years. Sociodemographic data, anthropometric assessments and blood samples were collected using standard methods. Serum vitamins, minerals and thyroid hormones levels were assessed using ELISA, electrochemiluminescence and inductively coupled plasma mass spectrometry (ICP-MS) respectively. Overall results showed the median levels of T3 and TSH were significantly higher (p < 0.05) in younger adolescents (10-14 years) compared to 15-18 year olds while T4 was significantly higher in boys compared to girls. Correlational analysis between serum micronutrients status (vitamin D, vitamin B12, ferritin, folate, zinc, copper, selenium) and thyroid hormones revealed significant relationships in different age groups. Overall, vitamin D exhibited a statistically significant positive correlation with T4 (r = 0.279) in the combined, younger (r = 0.277) and older (r = 0.319) age groups. In contrast, a statistically significant but negative correlation was observed when zinc levels were compared with T3 (r=-0.288) in the older age group and with T4 (r=-0.195) in the younger age group. In conclusion, micronutrients status, especially vitamin D and zinc, have important implications for thyroid health and thereby require close monitoring in any thyroid deficiency related disorders in vulnerable population such as refugees.Clinical trial number: Not applicable.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"23"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Importance of iodide sufficiency and normal thyroid function in fertility and during gestation.","authors":"Ulla Feldt-Rasmussen","doi":"10.1186/s13044-025-00235-w","DOIUrl":"10.1186/s13044-025-00235-w","url":null,"abstract":"<p><p>Appropriate management of thyroid dysfunction in pregnancy is challenging in both its primary, secondary and tertiary forms of the disease. Primary hypothyroidism is by far most prevalent globally. Main causes are insufficiency of iodide supplementation in developing countries and autoimmunity in developed countries. However, after a very successful global implementation by World Health Organisation over decades accompanied by specific recommendations for management of the iodide supplementation during pregnancy, recent studies found that women both in USA and EU are again mild to moderately iodide deficient during pregnancy or going through assisted fertility treatment. This poses a disturbing risk in relation to foetal neurological and brain development. The diagnosis and treatment monitoring of the thyroid function during pregnancy are very challenged due to the extensive physiological as well as pathophysiological adaptations of the thyroid axis hormones to encompass a sufficient foetal supply. This is distorting the hormone measurements, since the normal limits are exceeded, and current biochemical methods are not calibrated for the adapted concentrations. Even though clinical guidelines exist there are still gaps in the evidence-based recommendations to guide clinicians to thyroid function management during pregnancy. Debut of hypothyroidism during pregnancy requires immediate diagnosis as it can lead to poor foetal outcome with intrauterine growth restriction and foetal demise on top of the risk for the neurocognition. Hypothyroidism in stable replacement treatment needs careful monitoring during pregnancy to adapt to the physiological changes in the requirement of the thyroid hormone thyroxine, and combination therapy with triiodothyronine is contraindicated. The frequent use of assisted reproduction technology (ART) with controlled ovarian hyperstimulation in these patient groups having disease induced low fertility has created an unrecognised risk of under-replacement due to accelerated oestrogen stimulation with increased risk of severe complications for both the woman and foetus. Longitudinal studies of the thyroid function bridging pre-ART, through ART to pregnancy and postpartum in different clinical settings are recommended. The area needs consensus recommendations between gynaecologists and endocrinologists in specialised centres to alleviate such increased gestational risk. There is a strong need of more research on improvement of thyroid hormone replacement, and biomarkers for treatment optimisation in this field of non-communicable diseases, which suffers from both limited attention from the health authorities and poor funding.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"22"},"PeriodicalIF":1.9,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothyroidism: playing the cardiometabolic risk concerto.","authors":"George J Kahaly, Youshuo Liu, Luca Persani","doi":"10.1186/s13044-025-00233-y","DOIUrl":"10.1186/s13044-025-00233-y","url":null,"abstract":"<p><strong>Background: </strong>Thyroid hormones influence the function of essentially every system of the body, including the cardiovascular and metabolic system. Thyroid hormone replacement with levothyroxine (LT4) is the mainstay of pharmacological management for people with (especially clinically overt) hypothyroidism, and it is important to ensure the cardiovascular and metabolic safety of this treatment. This is especially so as in hypothyroidism, cardiometabolic risk factors and cardiovascular disease are highly prevalent conditions and will often coexist in an individual patient. Accordingly, we have reviewed the cardiometabolic consequences of hypothyroidism and intervention with thyroid hormone replacement.</p><p><strong>Main body: </strong>Numerous observational studies and meta-analyses have described multiple potentially adverse cardiometabolic consequences of hypothyroidism, including exacerbation of cardiovascular and metabolic risk factors (especially dyslipidaemia), functional impairment of the heart and vasculature (including accelerated atherosclerosis) and increased risk of advanced cardiovascular outcomes. LT4 usually improves cardiometabolic risk factors in people with hypothyroidism and some (but not all) studies have reported improved vascular and cardiac function in LT4-treated populations. Observational data have suggested the possibility of improved cardiometabolic outcomes with LT4 treatment, particularly in younger people with hypothyroidism, although data from randomised, controlled trials are needed here. Importantly, LT4 (with or without additional triiodothyronine) appears to be safe from a cardiovascular perspective, as long as overtreatment and iatrogenic thyrotoxicosis are avoided.</p><p><strong>Conclusions: </strong>Overall, the current evidence base supports intervention with LT4 to protect the cardiometabolic health of people with hypothyroidism who require thyroid hormone replacement, although more data on long-term clinical outcomes are needed.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"20"},"PeriodicalIF":1.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing antithyroid drugs vs. radioactive iodine in paediatric Graves' disease: literature review.","authors":"Akshat Sinha, Reuben Oza, Brandon Karamveer Sangha, Arshia Akhavan-Mofrad, Arvin Suddhi","doi":"10.1186/s13044-025-00238-7","DOIUrl":"https://doi.org/10.1186/s13044-025-00238-7","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric Graves' disease (PGD) is an autoimmune condition, which if left untreated, can result in cardiac complications. National Institute for Health and Care Excellence (NICE) Guidance (NG145) advocates the use of antithyroid drugs (ATD) as first-line therapy for PGD, with a consultation to consider a move to definitive therapy in the form of radioactive iodine (RAI) or thyroidectomy if the initial 2-year course failed to achieve normal thyroid function. We aim to evaluate the effectiveness, adverse events, and potential predictors of remission for ATD and RAI in treating PGD.</p><p><strong>Methods: </strong>A thorough guideline search of NICE Evidence and Royal College of Physicians (RCP) guidelines and policy was conducted to yield a guideline relevant to our review question. A literature search of the Cochrane Library, MEDLINE, EMBASE and PubMed, alongside a clear inclusion and exclusion criteria was utilised to generate systematic reviews and primary literature exploring the efficacy and adverse effects (AEs) of ATD and RAI. Our guideline, systematic reviews and primary literature were appraised using AGREE-II, AMSTAR 2 and CASP respectively.</p><p><strong>Results: </strong>The search strategy yielded one NICE guideline (NG145) published in November 2019, two systematic reviews published after November 2019 and four primary studies, published after the most recent systematic review (August 2020). All studies concluded that ATD and RAI are effective treatment options for PGD. With regards to AEs, RAI and ATD were safe treatment options, with the latter having the least severity of complications.</p><p><strong>Conclusions: </strong>In patients who have been identified to have predictors of remission, we agree with NG145 and ATD should be offered as first-line treatment. However, for those who do not have characteristics aligning with the predictors of remission, RAI should be offered as first-line therapy. Future studies should investigate the effect of biochemical parameters to identify predictors of remission, to aid the choice of treatment in paediatric Graves' disease treatment.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"27"},"PeriodicalIF":1.9,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors linked to poor self-rated health in thyroid disorder patients: findings from LASI Wave-I.","authors":"Pawan Kumar, Arunima Sen, Priyanshu Priyanshu, Mahalaqua Nazli Khatib, R Roopashree, Mandeep Kaur, Manish Srivastava, Amit Barwal, G V Siva Prasad, Pranchal Rajput, Muhammed Shabil, Rukshar Syed, Gajendra Sharma, Abhay M Gaidhane, Diptismita Jena, Ganesh Bushi, Rachana Mehta, Amit Verma, Hashem Abu Serhan, Ahmad Neyazi, Prakasini Satapathy","doi":"10.1186/s13044-025-00229-8","DOIUrl":"10.1186/s13044-025-00229-8","url":null,"abstract":"<p><strong>Background: </strong>Thyroid disorders affect the physical, behavioural, and psychological aspects of an individual, leading to poor self-rated health (SRH). Hence, we aimed to determine the prevalence of poor SRH and the factors associated with it among thyroid disorder patients.</p><p><strong>Methods: </strong>This is an observational study consisting of 2336 thyroid disorder patients from LASI, 2017-19. Descriptive statistics were employed to calculate prevalence. The association between poor SRH and socio-demographic variables was evaluated using regression analysis, with results expressed as (AOR) and 95% CI.</p><p><strong>Results: </strong>The findings showed poor self-rated health predictors among thyroid disorder patients, where 25% rated their health as poor. Significant predictors included older age, with patients aged ≥ 75 years having a higher likelihood of reporting poor health (aOR = 2.36, 95% CI = 1.32-4.22, p = 0.004), and rural residence (aOR = 1.34, 95% CI = 1.07-1.67, p = 0.011). Belonging to the OBC caste (aOR = 1.57, 95% CI = 1.23-2.00, p < 0.001) and practicing Christianity (aOR = 1.90, 95% CI = 1.25-2.89, p = 0.003) were also associated with increased odds of poor SRH. Previous employment (aOR = 1.65, 95% CI = 1.20-2.25, p = 0.002), co-morbidities (aOR = 2.59, 95% CI = 1.88-3.59, p < 0.001), and lower education levels (aOR = 1.50, 95% CI = 1.06-2.13, p = 0.022) were significant. Limitations in activities of daily living and instrumental activities of daily living were linked to poorer health outcomes (aOR = 1.76, 95% CI = 1.33-2.31, p < 0.001; IADL: aOR = 1.41, 95% CI = 1.11-1.79, p = 0.004). Depression (aOR = 1.84, 95% CI = 1.32-2.56, p < 0.001) and healthcare utilization in the past year (aOR = 1.86, 95% CI = 1.33-2.58, p < 0.001) also predicted poor SRH, with most healthcare utilization (79.8%) occurring in private facilities.</p><p><strong>Conclusion: </strong>The study highlights a high prevalence of poor SRH among patients, with significant associations observed with age, residence, comorbidity, and healthcare utilization. Targeted interventions focusing on healthcare access, physical activity, and mental health support are crucial to improve SRH.</p>","PeriodicalId":39048,"journal":{"name":"Thyroid Research","volume":"18 1","pages":"21"},"PeriodicalIF":1.9,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}