Iodine-131 intervention in hyperthyroidism with hepatic insufficiency: Metabolomic evaluation

Area of Science:

• Endocrinology and Metabolism
• Hepatology
• Nuclear Medicine

Background:

• Hyperthyroidism co-occurring with hepatic insufficiency (HI) presents complex clinical management challenges.
• There is a critical need for optimized therapeutic strategies and early diagnostic biomarkers for improved patient outcomes in hyperthyroidism with HI.

Purpose of the Study:

• To establish the optimal iodine-131 (¹³¹I) dose for treating hyperthyroidism in the presence of HI.
• To identify serum metabolic biomarkers for the early diagnosis of hyperthyroidism with HI using UPLC-Q/TOF-MS.

Main Methods:

• Development of a mouse model to assess early ¹³¹I intervention effects on physiological parameters, thyroid, and liver function.
• Utilized Ultra-Performance Liquid Chromatography-Quadrupole Time-of-Flight Mass Spectrometry (UPLC-Q/TOF-MS) for metabolite profiling and identification.
• Metabolomic data analyzed using MetaboAnalyst, with biomarker validation through Receiver Operating Characteristic (ROC) analysis.

Main Results:

• An early intervention dose of 80 μCi ¹³¹I per gram of thyroid tissue effectively controlled hyperthyroidism and ameliorated liver dysfunction.
• Identified six key serum metabolic biomarkers (L-kynurenine, Taurochenodesoxycholic acid, Glycocholic acid, Phytosphingosine, Tryptamine, and Betaine) indicative of early-stage hyperthyroidism with HI.
• These identified biomarkers demonstrated a trend towards normalization following ¹³¹I intervention.

Conclusions:

• UPLC-Q/TOF-MS is a valuable technology for discovering metabolic biomarkers for early diagnosis of hyperthyroidism complicated by HI.
• Early ¹³¹I intervention shows therapeutic promise in managing hyperthyroidism with HI and normalizing identified metabolic biomarkers.