Correlation between thyrotropin receptor antibody and thyroid-stimulating immunoglobulin and methimazole responsiveness in patients with Graves' disease

Chen Ying; Tan Jie; Li Xingjia; Chen Guofang; Wang Zhiguo; Xu Shuhang

doi:10.13406/j.cnki.cyxb.003132

您当前的位置：

首页 >

文章列表页 >

Correlation between thyrotropin receptor antibody and thyroid-stimulating immunoglobulin and methimazole responsiveness in patients with Graves' disease

The discussion on thyroid dysfunction | 更新时间：2025-10-21

- Correlation between thyrotropin receptor antibody and thyroid-stimulating immunoglobulin and methimazole responsiveness in patients with Graves' disease
- Journal of Chongqing Medical University Vol. 47, Issue 11, Pages: 1327-1332(2022)
- 作者机构：
  
  1.南京中医药大学附属中西医结合医院内分泌科，南京 210028
  2.江苏省中医药研究院，南京 210028
  3.南京中医药大学附属中西医结合医院检验科，南京 210028
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003132
  CLC： R581.1
- Received：23 May 2022，
  
  Published：28 November 2022
- 稿件说明：
移动端阅览
陈莹,谭婕,李兴佳,等.Graves病患者的促甲状腺素受体抗体与甲状腺刺激性免疫球蛋白及甲巯咪唑治疗反应的相关性[J].重庆医科大学学报,2022,47(11):1327-1332.

Chen Ying,Tan Jie,Li Xingjia,et al.Correlation between thyrotropin receptor antibody and thyroid-stimulating immunoglobulin and methimazole responsiveness in patients with Graves' disease[J].Journal of Chongqing Medical University,2022,47(11):1327-1332.
陈莹,谭婕,李兴佳,等.Graves病患者的促甲状腺素受体抗体与甲状腺刺激性免疫球蛋白及甲巯咪唑治疗反应的相关性[J].重庆医科大学学报,2022,47(11):1327-1332. DOI： 10.13406/j.cnki.cyxb.003132.

Chen Ying,Tan Jie,Li Xingjia,et al.Correlation between thyrotropin receptor antibody and thyroid-stimulating immunoglobulin and methimazole responsiveness in patients with Graves' disease[J].Journal of Chongqing Medical University,2022,47(11):1327-1332. DOI： 10.13406/j.cnki.cyxb.003132.

摘要

目的

评估Graves病（Graves' disease，GD）患者促甲状腺激素受体抗体（thyrotropin receptor antibody，TRAb）与甲状腺刺激性免疫球蛋白（thyroid-stimulating immunoglobulin，TSI）水平之间的相关性，比较TRAb和TSI对甲巯咪唑治疗反应的临床预测能力。

方法

收集2020年1月至2021年12月在江苏省中西医结合医院就诊的患者2 145例。使用Pearson分析方法对游离甲状腺素（free thyroxine，FT4）、TRAb、TSI进行相关性分析。从2 145名患者中选取50名接受甲巯咪唑治疗的GD患者并进行随访。收集患者基线资料，甲巯咪唑治疗期间患者甲状腺自身抗体水平及甲巯咪唑剂量变化（Δ

甲巯咪唑

）等。使用logistic回归分析确定与甲巯咪唑治疗快速反应性相关的预测因子。

结果

GD患者的TRAb与TSI水平极强相关（

0.001）。甲巯咪唑≥10 mg/d治疗的GD患者中FT4、TRAb、Δ

甲巯咪唑

与治疗反应显著相关（均

0.05），TSI无统计学意义；甲巯咪唑

10 mg/d治疗的GD患者中各指标均与治疗反应无关（均

0.05）。受试者工作特征（receiver operating characteristics，ROC）曲线显示FT4水平是GD患者对甲巯咪唑治疗快速反应的最佳预测因子。

结论

GD患者的TRAb水平与TSI水平密切相关。与TRAb相比，TSI 对甲巯咪唑的治疗反应性可能更弱。

Abstract

Objective

To evaluate the correlation between thyrotropin receptor antibody（TRAb） and thyroid-stimulating immunoglobulin（TSI） levels， and to compare the clinical ability of TRAb and TSI in predicting methimazole responsiveness in patients with Graves' disease（GD）.

Methods

A total of 2 145 patients treated in the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine，Nanjing University of Chinese Medicine from January 2020 to December 2021 were recruited. The correlations between free thyroxine（FT4），TRAb and TSI levels were assessed by Pearson correlation analysis. Of the 2 145 patients，50 GD patients treated with methimazole were followed up in our center. Baseline characteristics，thyroid autoantibody levels and doses of methimazole during treatment（Δ

methimazole

） were retrospectively analyzed. Clinical predictors of rapid responsiveness to methimazole in GD patients were identified by logistic

regression analysis.

Results

TRAb level was strongly correlated with TSI level in GD patients（

0.001）. FT4， TRAb and Δ

methimazole

were significantly correlated with rapid responsiveness to methimazole in GD patients treated with ≥10 mg/d methimazole（all

0.05），and TSI was not statistically significant. While all indicators were not correlated with the rapid responsiveness to methimazole in GD patients treated with

10 mg/d methimazole（all

0.05）. The receiver operating characteristic（ROC） curves revealed that FT4 level was the optimal predictor of rapid responsiveness to methimazole in GD patients.

Conclusion

TRAb level is closely correlated with TSI level in GD patients. Compared with TRAb，TSI is likely less predictive of methimazole responsiveness.

关键词

Keywords

references

Smith TJ ， Hegedüs L . Graves' disease [J ] . N Engl J Med ， 2016 ， 375 （ 16 ）： 1552 - 1565 .

Kahaly GJ ， Bartalena L ， Hegedüs L ， et al . 2018 European thyroid association guideline for the management of Graves' hyperthyroidism [J ] . Eur Thyroid J ， 2018 ， 7 （ 4 ）： 167 - 186 .

Ross DS ， Burch HB ， Cooper DS ， et al . 2016 American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis [J ] . Thyroid ， 2016 ， 26 （ 10 ）： 1343 - 1421 .

Morshed SA ， Davies TF . Graves' disease mechanisms：the role of stimulating，blocking，and cleavage region TSH receptor antibodies [J ] . Horm Metab Res ， 2015 ， 47 （ 10 ）： 727 - 734 .

钟　丽，张　静，张双婕，等 . IMMULITE化学发光TSI检测分析性能验证及临床性能评估 [J ] . 标记免疫分析与临床， 2021 ， 28 （ 2 ）： 339 - 342 .

Zhong L ， Zhang J ， Zhang SJ ， et al . An analytical verification and clinical performance evaluation for IMMULITE chemiluminescence TSI detection [J ] . Labeled Immunoass Clin Med ， 2021 ， 28 （ 2 ）： 339 - 342 .

Liu K ， Fu Y ， Li T ， et al . Clinical efficacy of thyroid-stimulating immunoglobulin detection for diagnosing Graves' disease and predictors of responsiveness to methimazole [J ] . Clin Biochem ， 2021 ， 97 ： 34 - 40 .

Tong MH ， Ding J ， Huang B ， et al . Evaluation of the application of TSH receptor stimulating autoantibodies and the optimization of detection strategy in Graves' disease [J ] . Clin Chimica Acta ， 2021 ， 521 ： 34 - 39 .

Zuhur SS ， Bilen O ， Aggul H ， et al . The association of TSH-receptor antibody with the clinical and laboratory parameters in patients with newly diagnosed Graves' hyperthyroidism：experience from a tertiary referral center including a large number of patients with TSH-receptor antibody-negative patients with Graves' hyperthyroidism [J ] . Endokrynol Pol ， 2021 ， 72 （ 1 ）： 14 - 21 .

Barbesino G ， Tomer Y . Clinical utility of TSH receptor antibodies [J ] . J Clin Endocrinol Metab ， 2013 ， 98 （ 6 ）： 2247 - 2255 .

Kahaly GJ ， Diana T ， Kanitz M ， et al . Prospective trial of functional thyrotropin receptor antibodies in Graves disease [J ] . J Clin Endocrinol Metab ， 2019 ， 105 （ 4 ）： e1006 - e1014 .

Diana T ， Ponto KA ， Kahaly GJ . Thyrotropin receptor antibodies and Graves' orbitopathy [J ] . J Endocrinol Invest ， 2021 ， 44 （ 4 ）： 703 - 712 .

Scappaticcio L ， Trimboli P ， Keller F ， et al . Diagnostic testing for Graves' or non-Graves' hyperthyroidism：a comparison of two thyrotropin receptor antibody immunoassays with thyroid scintigraphy and ultrasonography [J ] . Clin Endocrinol （Oxf）， 2020 ， 92 （ 2 ）： 169 - 178 .

Zhou YL ， Zhou MX ， Qi YC ， et al . The prognostic value of thyroid-stimulating immunoglobulin in the management of Graves' disease [J ] . Ther Adv Endocrinol Metab ， 2021 ， 12 ： 20420188211044943 .

Hwang S ， Shin DY ， Song MK ， et al . High cut-off value of a chimeric TSH receptor（Mc4）-based bioassay may improve prediction of relapse in Graves' disease for 12 months [J ] . Endocrine ， 2015 ， 48 （ 1 ）： 89 - 95 .

Giuliani C ， Cerrone D ， Harii N ， et al . A TSHR-LH/CGR Chimera that measures functional thyroid-stimulating autoantibodies（TSAb）can predict remission or recurrence in Graves' patients undergoing antithyroid drug（ATD）treatment [J ] . J Clin Endocrinol Metab ， 2012 ， 97 （ 7 ）： E1080 - E1087 .

Da Silva Santos T ， Oliveira JC ， Freitas C ， et al . Thyroid-stimulatory antibody as a predictive factor for Graves' disease relapse [J ] . Cureus ， 2022 ， 14 （ 2 ）： e22190 .

Kwon H ， Kim WG ， Jang EK ， et al . Usefulness of measuring thyroid stimulating antibody at the time of antithyroid drug withdrawal for predicting relapse of Graves disease [J ] . Endocrinol Metab（Seoul）， 2016 ， 31 （ 2 ）： 300 - 310 .

Baek HS ， Lee J ， Jeong CH ， et al . The prediction model using thyroid-stimulating immunoglobulin bioassay for relapse of Graves' disease [J ] . J Endocr Soc ， 2022 ， 6 （ 5 ）： bvac023 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Clinical study on regulatory T cells and follicular regulatory T cells detection of peripheral blood in patients with newly-diagnosed Graves' disease

Related Author

Feng Wenwen

Yang Yanli

Chen Shiying

Hu Yifang

Jiang Lin

Xu Kuanfeng

Cui Dai

Related Institution

Department of Endocrinology，The First Affiliated Hospital of Nanjing Medical University

⁰