Effects of iodine contrast media on thyroid function - a prospective study.

IF 3.5 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM European Thyroid Journal Pub Date : 2024-11-11 Print Date: 2024-12-01 DOI:10.1530/ETJ-24-0244
Jeanette Carlqvist, Ulf Nyman, John Brandberg, Helena Filipsson Nyström, Mikael Hellström
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Abstract

Objectives: When exposed to iodine contrast medium (ICM), thyroid dysfunction may develop, due to excess amounts of iodide. The incidence of contrast-induced thyroid dysfunction has been difficult to interpret, because of the observational and retrospective designs of most previous studies. With the Swedish CArdioPulmonary bioImage Study (SCAPIS), where randomly selected individuals aged 50-65 years, underwent contrast-enhanced coronary CT angiography (CCTA), we were able to prospectively assess the incidence, magnitude and clinical impact of contrast-induced thyroid dysfunction.

Methods: In 422 individuals, thyroid hormone levels were analysed before and 4-12 weeks after CCTA. Thyroid-related patient-reported outcome questionnaires (ThyPRO) at the time of pre and post-CCTA blood samplings were provided by 368 of those individuals. Thyroid peroxidase antibodies (TPOab) were analysed and an ultrasound of the thyroid gland was performed to detect any thyroid nodules.

Results: There was a small statistically significant effect on thyroid hormone levels but no cases of overt hypo- or hyperthyroidism after ICM. Subclinical hypo- or hyperthyroidism or isolated low/high levels of free thyroxine (fT4) developed in 3.5% of the population with normal hormone levels pre-CCTA but without any increased thyroid-related symptoms compared to the remaining cohort. Elevated TPOab and being born outside Sweden were risk factors for developing subclinical hypothyroidism. The presence of thyroid nodules was not associated with ICM-induced thyroid dysfunction.

Conclusion: The results of this prospective study support the notion that in iodine-sufficient countries, ICM-associated thyroid dysfunction is rare, usually mild, self-limiting and oligo/asymptomatic in subjects aged 50-65 years.

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碘造影剂对甲状腺功能的影响--一项前瞻性研究。
目的:暴露于碘造影剂 (ICM) 时,由于碘化物过量,可能会导致甲状腺功能障碍。造影剂诱发甲状腺功能障碍的发生率一直难以解释,因为之前的大多数研究都是观察性和回顾性设计。瑞典CArdio-Pulmonary bioImage研究(SCAPIS)随机选取了50-65岁的人群进行造影剂增强冠状动脉CT血管造影术(CCTA),通过该研究,我们能够对造影剂诱发甲状腺功能障碍的发生率、程度和临床影响进行前瞻性评估:方法:对 422 名患者在 CCTA 之前和之后 4-12 周的甲状腺激素水平进行分析。其中 368 人在 CCTA 前后采血时提供了甲状腺相关的患者报告结果问卷(ThyPRO)。对甲状腺过氧化物酶抗体(TPOab)进行了分析,并对甲状腺进行了超声波检查,以检测是否存在甲状腺结节:结果:ICM 对甲状腺激素水平有微小的统计学影响,但没有出现明显的甲状腺功能减退或亢进病例。有 3.5% 的人在 ICM 前激素水平正常,但与其余人群相比,没有出现任何甲状腺相关症状。TPOab升高和在瑞典境外出生是亚临床甲减的风险因素。甲状腺结节的存在与 ICM 引起的甲状腺功能障碍无关:这项前瞻性研究的结果支持这样一种观点,即在碘充足的国家,ICM 引起的甲状腺功能障碍在 50-65 岁的人群中很少见,通常是轻度、自限性和少症状/无症状的。
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来源期刊
European Thyroid Journal
European Thyroid Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
6.70
自引率
2.10%
发文量
156
期刊介绍: The ''European Thyroid Journal'' publishes papers reporting original research in basic, translational and clinical thyroidology. Original contributions cover all aspects of the field, from molecular and cellular biology to immunology and biochemistry, from physiology to pathology, and from pediatric to adult thyroid diseases with a special focus on thyroid cancer. Readers also benefit from reviews by noted experts, which highlight especially active areas of current research. The journal will further publish formal guidelines in the field, produced and endorsed by the European Thyroid Association.
期刊最新文献
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