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在患有差异化甲状腺癌的患者中,在全甲状腺切除术后抑制甲状腺刺激激素的充分剂量Levothyroxine
Hyun Jin Ryu1,2, Min Sun Choi1, Hyunju Park3
1Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Endocrinology and metabolism (Seoul, Korea)
|August 7, 2024
概括
对于差异化甲状腺癌 (DTC) 的全甲状腺切除术后的Levothyroxine (LT4) 剂量得到了澄清. 较高的体重指数 (BMI) 与在DTC患者中抑制甲状腺刺激激素 (TSH) 所需的较低的LT4剂量相关.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 对于差异化甲状腺癌 (DTC) 进行全甲状腺切除术 (TT) 后,确定最佳的利沃甲状腺素 (LT4) 剂量仍然具有挑战性.
- 轻微的甲状腺刺激激素 (TSH) 抑制是DTC管理中TT后的常见治疗目标.
研究的目的:
- 评估需要达到轻度TSH抑制的特异性LT4剂量,在TT后的DTC患者.
- 在这个患者群体中调查LT4剂量,体重指数 (BMI) 和年龄之间的关联.
主要方法:
- 对那些接受了DTC的TT并实现了轻微的TSH抑制的患者的电子病历的回顾性审查.
- 线性回归分析以评估LT4剂量 (μg/kg) 与BMI类别之间的关系,根据年龄和性别进行调整.
- 对不同BMI和年龄组的LT4剂量趋势分析.
主要成果:
- 123名患者符合轻度TSH抑制 (0.1-0.5mIU/L) 的标准.
- 在调整年龄和性别后,线性回归显示BMI和LT4剂量之间存在显著的负相关性 (P<0.001).
- 轻度TSH抑制所需的LT4剂量为1.86,1.71和1.71微克/千克,BMI类别分别为<23,2325和≥25千克/平方米 (P趋势<0.001). 较高的BMI与较低的LT4剂量有关,特别是在年轻的成年人 (2039岁).
结论:
- 这些发现表明,在DTC患者中,对于轻度TSH抑制后TT的LT4剂量应考虑体重.
- 将体重,BMI和年龄纳入LT4剂量估计可能有助于迅速达到目标TSH水平.
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