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Clinical significance of thyroglobulin antibodies and thyroid peroxidase antibodies in Graves’ disease: a cross-sectional study

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Abstract

Purpose

The significance of thyroglobulin antibodies (TgAbs) and thyroid peroxidase antibodies (TPOAbs) in Graves’ disease (GD) remains unclear. Therefore, this study aimed to clarify the clinical significance of TgAbs and TPOAbs in GD.

Methods

A total of 442 patients with GD were recruited and divided into four groups based on TgAb and TPOAb positivity. Their clinical parameters and the characteristics of the groups were compared. Cox proportional hazard regression analysis was performed to assess risk factors for GD remission.

Results

The free triiodothyronine (FT3) level was significantly higher in groups positive for TgAbs and TPOAbs than in the other groups. The FT3 to free thyroxine (FT4) (FT3/FT4) ratio was significantly higher and thyrotropin-stimulating hormone (TSH) receptor antibodies (TRAbs) were significantly lower in the TgAb+/TPOAb− group. Time to FT4 recovery was significantly shorter for groups negative for TPOAbs, whereas time to TSH recovery was significantly longer for groups positive for TPOAbs. Cox proportional hazard regression analysis revealed that TgAb positivity, prolonged treatment duration with antithyroid drugs, and Graves’ ophthalmopathy treated with methylprednisolone were significantly associated with GD remission and that a smoking history, elevated FT3/FT4 ratio, and treatment with propylthiouracil hindered GD remission.

Conclusion

The contributions of TgAbs and TPOAbs to GD pathogenesis differ. Patients positive for TgAbs develop GD with lower TRAb titers and undergo earlier remission than those negative for TgAbs. Patients positive for TPOAbs develop GD with high TRAb titers and need a long time to achieve remission.

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Authors and Affiliations

  1. Aichi Prefectural University School of Nursing and Health, Togoku, Kamishidami, Moriyama-ku, Nagoya, 463-8502, Japan

    Masahito Katahira

  2. Department of Endocrinology and Diabetes, Ichinomiya Municipal Hospital, 2-2-22 Bunkyo, Ichinomiya, 491-8558, Japan

    Masahito Katahira, Taku Tsunekawa, Akira Mizoguchi, Mariko Yamaguchi, Kahori Tsuru, Hiromi Takashima & Ryoma Terada

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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Masahito Katahira, Taku Tsunekawa, and Akira Mizoguchi. The first draft of the manuscript was written by Masahito Katahira, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Masahito Katahira.

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Ethics approval

This study was approved by the Ethics Committee of Aichi Prefectural University and Ichinomiya Municipal Hospital and was conducted in accordance with the Declaration of Helsinki.

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Informed consent was obtained from all participants included in the study.

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The authors declare no competing interests.

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Supplementary information

Supplementary materials 1:

Supplementary table 1. Clinical characteristics of four groups based on TgAb and TPOAb positivity in the RIA subgroup. Supplementary table 2. Clinical characteristics of four groups based on TgAb and TPOAb positivity in the ECLIA subgroup. Supplementary table 3. Cox proportional hazard multivariate regression analysis using GO as an independent risk factor. Supplementary table 4. Cox proportional hazard multivariate regression analysis using GO treated with MPDS as an independent risk factor.

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Katahira, M., Tsunekawa, T., Mizoguchi, A. et al. Clinical significance of thyroglobulin antibodies and thyroid peroxidase antibodies in Graves’ disease: a cross-sectional study. Hormones 22, 253–261 (2023). https://doi.org/10.1007/s42000-023-00437-7

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