Non-linear association between thyroid scintigraphy-derived thyroid weight and I-131 treatment efficacy in graves’ disease: a multicenter restricted cubic spline and threshold analysis - Summary - MDSpire
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Non-linear association between thyroid scintigraphy-derived thyroid weight and I-131 treatment efficacy in graves’ disease: a multicenter restricted cubic spline and threshold analysis
To characterize the non-linear relationship between thyroid weight and I-131 efficacy in Graves’ disease and identify critical clinical thresholds influencing therapeutic success.
Approach:
Study Design: A retrospective multicenter cohort study involving 888 records, focusing on 612 GD patients who received initial I-131 treatment between 2018 and 2024.
Data Analysis: Thyroid weight was estimated using thyroid scintigraphy. Restricted cubic splines (RCS) were used to model non-linear associations, and piecewise threshold analysis identified optimal inflection points.
Key Findings:
Among 612 patients (mean age 41.2 ± 12.4 years; 73.9% female), 250 (40.8%) experienced non-remission after initial I-131 therapy.
Significant non-linear association between thyroid weight and treatment outcome was found (P-nonlinear = 0.034 unadjusted; P-nonlinear = 0.032 adjusted).
Exploratory inflection point identified at 46 g (adjusted LRT: P = 0.030).
Independent predictors of non-remission included thyroid weight, female gender, disease duration >2 years, and study center.
Interpretation:
Limitations:
Retrospective design may introduce selection bias.
Single treatment center data may limit generalizability.
