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Original Articles
Thyroid
Efficacy and Safety of Long-Term Methimazole versus Radioactive Iodine in the Treatment of Toxic Multinodular Goiter
Fereidoun Azizi, Navid Saadat, Mir Alireza Takyar, Hengameh Abdi, Ladan Mehran, Atieh Amouzegar
Endocrinol Metab. 2022;37(6):861-869.   Published online November 23, 2022
DOI: https://doi.org/10.3803/EnM.2022.1476
  • 3,686 View
  • 364 Download
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study compared the degree of sustained control of hyperthyroidism in patients with toxic multinodular goiter (TMNG) treated with long-term methimazole (LT-MMI) or radioactive iodine (RAI).
Methods
In this clinical trial, 130 untreated patients with TMNG were randomized to either LT-MMI or RAI treatment. Both groups were followed for 108 to 148 months, with median follow-up durations of 120 and 132 months in the LT-MMI and RAI groups, respectively. Both groups of patients were followed every 1 to 3 months in the first year and every 6 months thereafter.
Results
After excluding patients in whom the treatment modality was changed and those who were lost to follow-up, 53 patients in the LT-MMI group and 54 in the RAI group completed the study. At the end of the study period, 50 (96%) and 25 (46%) patients were euthyroid, and two (4%) and 25 (46%) were hypothyroid in LT-MMI and RAI groups, respectively. In the RAI group, four (8%) patients had subclinical hyperthyroidism. The mean time to euthyroidism was 4.3±1.3 months in LT-MMI patients and 16.3± 15.0 months in RAI recipients (P<0.001). Patients treated with LT-MMI spent 95.8%±5.9% of the 12-year study period in a euthyroid state, whereas this proportion was 72.4%±14.8% in the RAI-treated patients (P<0.001). No major treatment-related adverse events were observed in either group.
Conclusion
In patients with TMNG, LT-MMI therapy is superior to RAI treatment, as shown by the earlier achievement of euthyroidism and the longer duration of sustained normal serum thyrotropin.

Citations

Citations to this article as recorded by  
  • Mechanism of Huatan Sanjie Fang in improving goiter in Graves' disease mice based on the Hippo signaling pathway
    Huimin Yuan, Wenxin Ma, Yifei Song, Hang Wang, Shuxin Yan, Silan Hao, Xiaoyun Zhu, Yang Tang
    Journal of Traditional Chinese Medical Sciences.2023; 10(3): 289.     CrossRef
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Thyroid
Clinical Outcomes of Repeated Radioactive Iodine Therapy for Graves’ Disease
Min Joo Kim, Sun Wook Cho, Ye An Kim, Hoon Sung Choi, Young Joo Park, Do Joon Park, Bo Youn Cho
Endocrinol Metab. 2022;37(3):524-532.   Published online June 16, 2022
DOI: https://doi.org/10.3803/EnM.2022.1418
  • 4,599 View
  • 223 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Radioactive iodine (RAI) therapy is a successful therapeutic modality for Graves’ disease. However, RAI therapy can fail, and RAI therapy after antithyroid drugs (ATDs) has a lower remission rate. Therefore, many patients require repeated RAI therapy. This study investigated the clinical outcomes of repeated RAI therapy for Graves’ disease.
Methods
Patients who underwent RAI therapy as second-line therapy after failure of ATD treatment between 2001 and 2015 were reviewed. Remission was defined as hypothyroid or euthyroid status without ATD, and with or without levothyroxine at 12 months after RAI therapy.
Results
The 1-year remission rate after 2nd RAI therapy (66%, 152/230) is significantly higher than that after 1st RAI therapy (48%, 393/815) or long-term ATD treatment after 1st RAI therapy failure (42%). The clinical response to 2nd RAI therapy was more rapid. The median time intervals from the 2nd RAI therapy to ATD discontinuation (1.3 months) and to the start of levothyroxine replacement (2.5 months) were significantly shorter than those for the 1st RAI therapy. A smaller goiter size, a longer time interval between the 1st and 2nd RAI therapies, and a longer ATD discontinuation period predicted remission after the 2nd RAI therapy. Finally, in 78 patients who failed the 2nd RAI therapy, the mean ATD dosage significantly reduced 5.1 mg over 12 months.
Conclusion
Repeated RAI therapy can be a good therapeutic option, especially in patients with smaller goiters and those who are more responsive to the 1st RAI therapy.

Citations

Citations to this article as recorded by  
  • The Early Changes in Thyroid-Stimulating Immunoglobulin Bioassay over Anti-Thyroid Drug Treatment Could Predict Prognosis of Graves’ Disease
    Jin Yu, Han-Sang Baek, Chaiho Jeong, Kwanhoon Jo, Jeongmin Lee, Jeonghoon Ha, Min Hee Kim, Jungmin Lee, Dong-Jun Lim
    Endocrinology and Metabolism.2023; 38(3): 338.     CrossRef
  • Effect of liver dysfunction on outcome of radioactive iodine therapy for Graves’ disease
    Yuyang Ze, Fei Shao, Xuefeng Feng, Shanmei Shen, Yan Bi, Dalong Zhu, Xiaowen Zhang
    BMC Endocrine Disorders.2022;[Epub]     CrossRef
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Thyroid
Seaweed and Iodine Intakes and SLC5A5 rs77277498 in Relation to Thyroid Cancer
Tung Hoang, Eun Kyung Lee, Jeonghee Lee, Yul Hwangbo, Jeongseon Kim
Endocrinol Metab. 2022;37(3):513-523.   Published online May 24, 2022
DOI: https://doi.org/10.3803/EnM.2021.1306
  • 3,155 View
  • 134 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aims to elucidate the associations among dietary seaweed (gim and miyeok/dashima) and iodine intakes, the rs77277498 polymorphism of the SLC5A5 gene codifying the sodium/iodine symporter, and thyroid cancer risk in a Korean population.
Methods
We conducted a case-control study of 117 thyroid cancer cases and 173 controls who participated in the Cancer Screenee Cohort between 2002 and 2014 at the National Cancer Center, Korea. The amount of seaweed and iodine consumption (g/day) was estimated using the residual energy adjustment method. We calculated odds ratios (ORs) and their 95% confidence intervals (CIs) using a multivariable logistic regression model for the separate and combined effect of dietary iodine-based intake and SLC5A5 polymorphism (rs77277498, C>G) on thyroid cancer.
Results
Dietary gim and iodine intakes were inversely associated with thyroid cancer, with ORs of 0.50 (95% CI, 0.30 to 0.83) and 0.57 (95% CI, 0.35 to 0.95), respectively, whereas the associations for dietary miyeok/dashima and total seaweed intakes were not significant. However, compared with individuals carrying the C/C genotype of the rs77277498 polymorphism with a low intake of all dietary factors, those carrying the G allele with a high intake had a lower risk of thyroid cancer, with ORs of 0.25 (95% CI, 0.10 to 0.56), 0.31 (95% CI, 0.12 to 0.77), 0.26 (95% CI, 0.10 to 0.62), and 0.30 (95% CI, 0.12 to 0.73) for the consumption of gim, miyeok/dashima, total seaweed, and iodine, respectively.
Conclusion
In summary, our results supported the evidence of the protective effects of dietary gim and iodine intake against thyroid cancer risk, and this association can be strengthened by SLC5A5 rs77277498 genotypes.

Citations

Citations to this article as recorded by  
  • Iodine nutrition and papillary thyroid cancer
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Chuyao Feng, Weiping Teng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
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Thyroid
Big Data Articles (National Health Insurance Service Database)
Risk of Diabetes in Patients with Long-Standing Graves’ Disease: A Longitudinal Study
Eyun Song, Min Ji Koo, Eunjin Noh, Soon Young Hwang, Min Jeong Park, Jung A Kim, Eun Roh, Kyung Mook Choi, Sei Hyun Baik, Geum Joon Cho, Hye Jin Yoo
Endocrinol Metab. 2021;36(6):1277-1286.   Published online December 16, 2021
DOI: https://doi.org/10.3803/EnM.2021.1251
  • 4,996 View
  • 180 Download
  • 8 Web of Science
  • 9 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The detrimental effects of excessive thyroid hormone on glucose metabolism have been widely investigated. However, the risk of diabetes in patients with long-standing hyperthyroidism, especially according to treatment modality, remains uncertain, with few longitudinal studies.
Methods
The risk of diabetes in patients with Graves’ disease treated with antithyroid drugs (ATDs) for longer than the conventional duration (≥2 years) was compared with that in age-and sex-matched controls. The risk was further compared according to subsequent treatment modalities after a 24-month course of ATD: continuation of ATD (ATD group) vs. radioactive iodine ablation (RIA) group.
Results
A total of 4,593 patients were included. Diabetes was diagnosed in 751 (16.3%) patients over a follow-up of 7.3 years. The hazard ratio (HR) for diabetes, after adjusting for various known risk factors, was 1.18 (95% confidence interval [CI], 1.10 to 1.28) in patients with hyperthyroidism. Among the treatment modality groups, the RIA group (n=102) had a higher risk of diabetes than the ATD group (n=4,491) with HR of 1.56 (95% CI, 1.01 to 2.42). Further, the risk of diabetes increased with an increase in the ATD treatment duration (P for trend=0.019).
Conclusion
The risk of diabetes was significantly higher in patients with long-standing Graves’ disease than in the general population, especially in patients who underwent RIA and prolonged ATD treatment. Special attention to hyperglycemia during follow-up along with effective control of hyperthyroidism may be necessary to reduce the risk of diabetes in these patients.

Citations

Citations to this article as recorded by  
  • Safety of non-standard regimen of systemic steroid therapy in patients with Graves’ orbitopathy: a single-centre experience
    Nadia Sawicka-Gutaj, Dawid Gruszczyński, Natalia Zawalna, Kacper Nijakowski, Agnieszka Skiba, Mateusz Pochylski, Jerzy Sowiński, Marek Ruchała
    Pharmacological Reports.2024; 76(1): 185.     CrossRef
  • Prevalencia de diabetes en personas con disfunción tiroidea
    Juan J. Díez, Pedro Iglesias
    Medicina Clínica.2023; 160(8): 333.     CrossRef
  • Control of Thyroid Dysfunction in Spanish Population Registered in the Primary Care Clinical Database: An Analysis of the Proportion of Patients with Thyrotropin Values Outside the Reference Range
    Juan J. Díez, Pedro Iglesias
    Hormone and Metabolic Research.2023; 55(03): 184.     CrossRef
  • Prevalence of thyroid dysfunction and its relationship to income level and employment status: a nationwide population-based study in Spain
    Juan J. Díez, Pedro Iglesias
    Hormones.2023; 22(2): 243.     CrossRef
  • Prevalence of diabetes in people with thyroid dysfunction
    Juan J. Díez, Pedro Iglesias
    Medicina Clínica (English Edition).2023; 160(8): 333.     CrossRef
  • Diabetes Mellitus Secondary to Endocrine Diseases: An Update of Diagnostic and Treatment Particularities
    Mihaela Simona Popoviciu, Lorena Paduraru, Raluca Marinela Nutas, Alexandra Maria Ujoc, Galal Yahya, Kamel Metwally, Simona Cavalu
    International Journal of Molecular Sciences.2023; 24(16): 12676.     CrossRef
  • Thyroid Eye Disease and Its Association With Diabetes Mellitus: A Major Review
    Roshmi Gupta, Pramila Kalra, Lakshmi B. Ramamurthy, Suryasnata Rath
    Ophthalmic Plastic & Reconstructive Surgery.2023; 39(6S): S51.     CrossRef
  • Metabolite Changes during the Transition from Hyperthyroidism to Euthyroidism in Patients with Graves’ Disease
    Ho Yeop Lee, Byeong Chang Sim, Ha Thi Nga, Ji Sun Moon, Jingwen Tian, Nguyen Thi Linh, Sang Hyeon Ju, Dong Wook Choi, Daiki Setoyama, Hyon-Seung Yi
    Endocrinology and Metabolism.2022; 37(6): 891.     CrossRef
  • Diabetes and Hyperthyroidism: Is There a Causal Link?
    Sang Yong Kim
    Endocrinology and Metabolism.2021; 36(6): 1175.     CrossRef
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Thyroid
Association between Iodine Intake, Thyroid Function, and Papillary Thyroid Cancer: A Case-Control Study
Kyungsik Kim, Sun Wook Cho, Young Joo Park, Kyu Eun Lee, Dong-Wook Lee, Sue K. Park
Endocrinol Metab. 2021;36(4):790-799.   Published online August 11, 2021
DOI: https://doi.org/10.3803/EnM.2021.1034
  • 4,587 View
  • 229 Download
  • 9 Web of Science
  • 12 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to assess the effects of iodine intake, thyroid function, and their combined effect on the risk of papillary thyroid cancer (PTC) and papillary thyroid microcarcinoma (PTMC).
Methods
A case-control study was conducted including 500 community-based controls who had undergone a health check-up, and 446 overall PTC cases (209 PTC and 237 PTMC) from the Thyroid Cancer Longitudinal Study. Urinary iodine concentration (UIC), was used as an indicator of iodine intake, and serum for thyroid function. The risk of PTC and PTMC was estimated using unconditional logistic regression.
Results
Excessive iodine intake (UIC ≥220 μg/gCr) was associated with both PTC (odds ratio [OR], 18.13 95% confidence interval [CI], 8.87 to 37.04) and PTMC (OR, 8.02; 95% CI, 4.64 to 13.87), compared to adequate iodine intake (UIC, 85 to 219 μg/gCr). Free thyroxine (T4) levels ≥1.25 ng/dL were associated with PTC (OR, 1.97; 95% CI, 1.36 to 2.87) and PTMC (OR, 2.98; 95% CI, 2.01 to 4.41), compared to free T4 levels of 0.7 to 1.24 ng/dL. Individuals with excessive iodine intake and high free T4 levels had a greatly increased OR of PTC (OR, 43.48; 95% CI, 12.63 to 149.62), and PTMC (OR, 26.96; 95% CI, 10.26 to 70.89), compared to individuals with adequate iodine intake and low free T4 levels.
Conclusion
Excessive iodine intake using creatinine-adjusted UIC and high free T4 levels may have a synergistic effect on PTC and PTMC. Considering both iodine intake and thyroid function is important to assess PTC and PTMC risk.

Citations

Citations to this article as recorded by  
  • Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study
    Yerin Hwang, Hyun-Kyung Oh, Jae Hoon Chung, Sun Wook Kim, Jung-Han Kim, Jee Soo Kim, Myung-Hee Shin
    Scientific Reports.2023;[Epub]     CrossRef
  • Association between iodine nutrition and cervical lymph node metastasis of papillary thyroid microcarcinoma
    Hengqiang Zhao, Jin Hu, Le Cui, Yiping Gong, Tao Huang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Sex-specific Associations between Body Mass Index and Thyroid Cancer Incidence among Korean Adults
    Kyoung-Nam Kim, Kyungsik Kim, Sangjun Lee, Sue K. Park
    Cancer Epidemiology, Biomarkers & Prevention.2023; 32(9): 1227.     CrossRef
  • Nomogram Model Based on Iodine Nutrition and Clinical Characteristics of Papillary Thyroid Carcinoma to Predict Lateral Lymph Node Metastasis
    Junrong Wang, Yuzhang Gao, Yuxuan Zong, Weitong Gao, Xueying Wang, Ji Sun, Susheng Miao
    Cancer Control.2023;[Epub]     CrossRef
  • Content of Copper, Iron, Iodine, Rubidium, Strontium and Zinc in Thyroid Malignant Nodules and Thyroid Tissue adjacent to Nodules
    Vladimir Zaichick, Qiping Dong
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 7.     CrossRef
  • Distinguish Thyroid Malignant from Benign Alterations using Trace Element Contents in Nodular Tissue determined by Neutron Activation and Inductively Coupled Plasma Mass Spectrometry
    Vladimir Zaichick
    Journal of Clinical and Diagnostic Pathology.2022; 1(4): 18.     CrossRef
  • Seaweed and Iodine Intakes and SLC5A5 rs77277498 in Relation to Thyroid Cancer
    Tung Hoang, Eun Kyung Lee, Jeonghee Lee, Yul Hwangbo, Jeongseon Kim
    Endocrinology and Metabolism.2022; 37(3): 513.     CrossRef
  • Iodine nutrition and papillary thyroid cancer
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Chuyao Feng, Weiping Teng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
  • The relationship between urinary iodine concentration and papillary thyroid cancer: A systematic review and meta-analysis
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Renaguli Aihaiti, Chuyao Feng, Deshi Chen, Xu Zhao, Weiping Teng
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Screening and validation of lymph node metastasis risk-factor genes in papillary thyroid carcinoma
    Qiaoyue Zhang, Jing Li, Hengyan Shen, Xinyu Bai, Tao Zhang, Ping Liu
    Frontiers in Endocrinology.2022;[Epub]     CrossRef
  • Diagnosis of Thyroid Malignancy using Levels of Chemical Element Contents in Nodular Tissue
    Vladimir Zaichick
    Journal of Health Care and Research.2022; 3(1): 16.     CrossRef
  • Associations of Habitual Mineral Intake with New-Onset Prediabetes/Diabetes after Acute Pancreatitis
    Claire F. Norbitt, Wandia Kimita, Juyeon Ko, Sakina H. Bharmal, Maxim S. Petrov
    Nutrients.2021; 13(11): 3978.     CrossRef
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Thyroid
Evaluation of Iodine Status among Korean Patients with Papillary Thyroid Cancer Using Dietary and Urinary Iodine
Ji Yeon Choi, Joon-Hyop Lee, YoonJu Song
Endocrinol Metab. 2021;36(3):607-618.   Published online June 21, 2021
DOI: https://doi.org/10.3803/EnM.2021.1005
  • 3,817 View
  • 119 Download
  • 2 Web of Science
  • 3 Crossref
AbstractAbstract PDFPubReader   ePub   
Background
Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients.
Methods
Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed.
Results
The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine.
Conclusion
Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.

Citations

Citations to this article as recorded by  
  • Association between iodine nutrition and cervical lymph node metastasis of papillary thyroid microcarcinoma
    Hengqiang Zhao, Jin Hu, Le Cui, Yiping Gong, Tao Huang
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Effect of iodine restriction on short-term changes in thyroid function in patients with subclinical hypothyroidism
    Obin Kwon, Dong Yeob Shin, Eun Jig Lee
    Journal of Nutrition and Health.2022; 55(2): 250.     CrossRef
  • Iodine nutrition and papillary thyroid cancer
    Xueqi Zhang, Fan Zhang, Qiuxian Li, Chuyao Feng, Weiping Teng
    Frontiers in Nutrition.2022;[Epub]     CrossRef
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Review Article
Thyroid
Antithyroid Drug Treatment in Graves’ Disease
Jae Hoon Chung
Endocrinol Metab. 2021;36(3):491-499.   Published online June 16, 2021
DOI: https://doi.org/10.3803/EnM.2021.1070
  • 4,798 View
  • 322 Download
  • 6 Web of Science
  • 9 Crossref
AbstractAbstract PDFPubReader   ePub   
Graves’ disease is associated with thyrotropin (TSH) receptor stimulating antibody, for which there is no therapeutic agent. This disease is currently treated through inhibition of thyroid hormone synthesis or destruction of the thyroid gland. Recurrence after antithyroid drug (ATD) treatment is common. Recent studies have shown that the longer is the duration of use of ATD, the higher is the remission rate. Considering the relationship between clinical outcomes and iodine intake, recurrence of Graves’ disease is more common in iodine-deficient areas than in iodine-sufficient areas. Iodine restriction in an iodine-excessive area does not improve the effectiveness of ATD or increase remission rates. Recently, Danish and Korean nationwide studies noted significantly higher prevalence of birth defects in newborns exposed to ATD during the first trimester compared to that of those who did not have such exposure. The prevalence of birth defects was lowest when propylthiouracil (PTU) was used and decreased by only 0.15% when methimazole was changed to PTU in the first trimester. Therefore, it is best not to use ATD in the first trimester or to change to PTU before pregnancy.

Citations

Citations to this article as recorded by  
  • Выраженность окислительного стресса и энзиматическая активность нейтрофилов крови у пациентов с болезнью Грейвса в зависимости от компенсации гипертиреоза
    М. А. Дудина, С. А. Догадин, А. А. Савченко, И. И. Гвоздев
    Ateroscleroz.2023; 18(4): 411.     CrossRef
  • Application of oral inorganic iodine in the treatment of Graves’ disease
    Yixuan Huang, Yihang Xu, Murong Xu, Xiaotong Zhao, Mingwei Chen
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Sex-specific risk factors associated with graves’ orbitopathy in Korean patients with newly diagnosed graves’ disease
    Jooyoung Lee, Jinmo Kang, Hwa Young Ahn, Jeong Kyu Lee
    Eye.2023; 37(16): 3382.     CrossRef
  • Methimazole, an Effective Neutralizing Agent of the Sulfur Mustard Derivative 2-Chloroethyl Ethyl Sulfide
    Albert Armoo, Tanner Diemer, Abigail Donkor, Jerrod Fedorchik, Severine Van slambrouck, Rachel Willand-Charnley, Brian A. Logue
    ACS Bio & Med Chem Au.2023; 3(5): 448.     CrossRef
  • Increased risk of incident gout in patients with hyperthyroidism: a nationwide retrospective cohort study
    Ju-Yeun Lee, So-Yeon Park, Seo Young Sohn
    Rheumatology International.2023; 44(3): 451.     CrossRef
  • The influence of thionamides on intra-thyroidal uptake of 131I during radioiodine-131 treatment of Graves’ disease
    Christian Happel, Benjamin Bockisch, Britta Leonhäuser, Amir Sabet, Frank Grünwald, Daniel Groener
    Scientific Reports.2023;[Epub]     CrossRef
  • Usefulness of Real-Time Quantitative Microvascular Ultrasonography for Differentiation of Graves’ Disease from Destructive Thyroiditis in Thyrotoxic Patients
    Han-Sang Baek, Ji-Yeon Park, Chai-Ho Jeong, Jeonghoon Ha, Moo Il Kang, Dong-Jun Lim
    Endocrinology and Metabolism.2022; 37(2): 323.     CrossRef
  • The chemiluminescent and enzymatic activity of blood neutrophils in patients with Graves' disease depending on hyperthyroidism compensation
    M. A. Dudina, A. A. Savchenko, S. A. Dogadin, I. I. Gvozdev
    Clinical and experimental thyroidology.2022; 18(1): 4.     CrossRef
  • Risk of Diabetes in Patients with Long-Standing Graves’ Disease: A Longitudinal Study
    Eyun Song, Min Ji Koo, Eunjin Noh, Soon Young Hwang, Min Jeong Park, Jung A Kim, Eun Roh, Kyung Mook Choi, Sei Hyun Baik, Geum Joon Cho, Hye Jin Yoo
    Endocrinology and Metabolism.2021; 36(6): 1277.     CrossRef
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Original Articles
Clinical Study
Clinical Outcomes after Early and Delayed Radioiodine Remnant Ablation in Patients with Low-Risk Papillary Thyroid Carcinoma: Propensity Score Matching Analysis
Jonghwa Ahn, Meihua Jin, Eyun Song, Min Ji Jeon, Tae Yong Kim, Jin-Sook Ryu, Won Bae Kim, Young Kee Shong, Ji Min Han, Won Gu Kim
Endocrinol Metab. 2020;35(4):830-837.   Published online November 18, 2020
DOI: https://doi.org/10.3803/EnM.2020.747
  • 4,131 View
  • 129 Download
  • 3 Web of Science
  • 5 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
The clinical outcomes of delayed radioiodine remnant ablation (RRA) therapy in patients with low-risk papillary thyroid carcinoma (PTC) are unclear. We aimed to evaluate the clinical impact of the interval between total thyroidectomy (TT) and RRA therapy in patients with low-risk PTC.
Methods
We included 526 patients who underwent TT and RRA for low-risk PTC with a primary tumor size of >1 cm between 2000 and 2012. Patients were divided into the early (<90 days) and the delayed (≥90 days) RRA groups based on the interval between TT and RRA. The results of diagnostic whole-body scan (DxWBS), ongoing risk stratification (ORS; response to therapy), and disease-free survival (DFS) were evaluated before and after propensity score matching (PSM).
Results
Among the 526 patients, 75 (14.3%) patients underwent delayed RRA; they had more cervical lymph node metastasis and received a higher RRA dose than those who underwent early RRA. The median follow-up period was 9.1 years after initial therapy, and the structural recurrence rate was 1.9%. In DxWBS, 60 patients had focal iodine uptake limited in operative bed, with no significant difference between groups. According to ORS, 78%, 20%, 1%, and 1% patients were classified into excellent, indeterminate, biochemical incomplete, and structural incomplete response groups, respectively. There was no significant difference in ORS or DFS between groups before and after PSM.
Conclusion
The timing of the first RRA had no clinical impact in patients with low-risk PTC. Thus, the clinical decision for RRA can be determined >3 months after TT considering other prognostic factors.

Citations

Citations to this article as recorded by  
  • Dynamic risk assessment in patients with differentiated thyroid cancer
    Erika Abelleira, Fernando Jerkovich
    Reviews in Endocrine and Metabolic Disorders.2024; 25(1): 79.     CrossRef
  • Ablation Rates and Long-Term Outcome Following Low-Dose Radioiodine for Differentiated Thyroid Cancer in the West of Scotland: A Retrospective Analysis
    Kathryn Graham, Fay Tough, Helena Belikova, Irene Wotherspoon, David Colville, Nicholas Reed
    Endocrine Practice.2024;[Epub]     CrossRef
  • Patient Preparation and Radiation Protection Guidance for Adult Patients Undergoing Radioiodine Treatment for Thyroid Cancer in the UK
    J. Wadsley, N. Armstrong, V. Bassett-Smith, M. Beasley, R. Chandler, L. Cluny, A.J. Craig, K. Farnell, K. Garcez, N. Garnham, K. Graham, A. Hallam, S. Hill, H. Hobrough, F. McKiddie, M.W.J. Strachan
    Clinical Oncology.2023; 35(1): 42.     CrossRef
  • Delay of initial radioactive iodine therapy beyond 3 months has no effect on clinical responses and overall survival in patients with thyroid carcinoma: A cohort study and a meta‐analysis
    Fang Cheng, Juan Xiao, Fengyan Huang, Chunchun Shao, Shouluan Ding, Canhua Yun, Hongying Jia
    Cancer Medicine.2022; 11(12): 2386.     CrossRef
  • Delayed (>3 Months) Postoperative Radioactive Iodine Ablation Does Not Impact Clinical Response or Survival in Differentiated Thyroid Cancers
    Tatiana Fedorova, Lilah F. Morris-Wiseman
    Clinical Thyroidology.2022; 34(10): 456.     CrossRef
Close layer
Clinical Study
A Phase II Multi-Center, Non-Randomized, Parallel Group, Non-Inferiority Study to Compare the Efficacy of No Radioactive Iodine Remnant Ablation to Remnant Ablation Treatment in Low- to Intermediate-Risk of Papillary Thyroid Cancer: The MOREthyroid Trial Protocol
Eun Kyung Lee, You Jin Lee, Young Joo Park, Jae Hoon Moon, Ka Hee Yi, Koon Soon Kim, Joo Hee Lee, Sun Wook Cho, Jungnam Joo, Yul Hwangbo, Sujeong Go, Do Joon Park
Endocrinol Metab. 2020;35(3):571-577.   Published online September 22, 2020
DOI: https://doi.org/10.3803/EnM.2020.681
  • 4,542 View
  • 115 Download
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Radioactive iodine (RAI) remnant ablation is recommended in patients with papillary thyroid cancer (PTC) and extrathyroidal extension or central lymph node metastasis. However, there exists little evidence about the necessity of remnant ablation in PTC patients with low- to intermediate-risk, those have been increasing in recent decades.
Methods
This multicenter, prospective, non-randomized, parallel group clinical trial will enroll 310 eligible patients with low- to intermediate-risk of thyroid cancer. Inclusion criteria are patients who recently underwent total thyroidectomy for PTC with 3 or less tumors of size 1≤ to ≤2 cm with no microscopic extension and N0/x, or size ≤2 cm with microscopic extension and/or N1a (number of lymph node ≤3, size of tumor foci ≤0.2 cm, and lymph node ratio <0.4). Patients choose to undergo RAI ablation (131I, dose 1.1 GBq) or diagnostic whole-body scan (DxWBS) (131I or 123I, dose 0.074 to 0.222 GBq), followed by subsequent measurement of stimulated thyroglobulin (sTg) within 1 year. Survey for quality of life (QOL) will be performed at baseline and at 1 year after follow-up. The total enrollment period is 5 years, and patients will be followed up for 1 year. The primary endpoint is the non-inferiority of surgery alone to surgery with ablation in terms of biochemical remission (BCR) rate (sTg ≤2 ng/mL) without evidence of structural recurrence. The secondary endpoint was the difference of QOL.
Conclusion
This study will evaluate whether surgery alone achieves similar BCR and improved QOL compared to RAI ablation in patients with low- to intermediate-risk PTC within 1 year.
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Review Article
Thyroid
Update on Thyroid Hormone Levels and Thyroid Dysfunction in the Korean Population Based on Data from the Korea National Health and Nutrition Examination Survey VI (2013 to 2015)
Jae Hoon Chung
Endocrinol Metab. 2020;35(1):7-13.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.7
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In 2017, the first Korean nationwide data on serum thyroid stimulating hormone (TSH) levels, serum free thyroxine (fT4) levels, and urinary iodine concentration (UIC) were published based on a population of 7,061 Koreans who participated in the Korea National Health and Nutrition Examination Survey VI. The mean TSH level was 2.16 mIU/L, with a reference interval of 0.59 to 7.03 mIU/L (men 2.09 mIU/L, women 2.24 mIU/L, P<0.001). A U-shaped association was found between serum TSH levels and age. The mean fT4 level was 1.25 ng/dL, and its reference interval was 0.92 to 1.60 ng/dL (men 1.29 ng/dL, women 1.20 ng/dL, P<0.0001). Serum fT4 levels decreased with age (P for trend <0.0001). Serum thyroid peroxidase antibody (TPOAb) was detected in 7.30% of participants (men 4.33%, women 10.62%). TPOAb titers tended to increase with age, and were higher in women than in men. The median UIC was 294 µg/L, and UIC showed a U-shaped relationship with age. According to the World Health Organization recommendations, only 23% of participants were in the adequate range of iodine intake, while 65% were in the above requirements or excessive, and 12% in insufficient. The prevalence of overt hyperthyroidism and hypothyroidism in Koreans was 0.34% to 0.54% and 0.73% to 1.43%, respectively.

Citations

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  • Association between Thyroid Function and Insulin Resistance Indices in Korean Adolescents: Findings from the 2014–2015 Korea National Health and Nutrition Examination Survey
    Eunji Mun, Hye Ah Lee, Jung Eun Choi, Rosie Lee, Kyung Hee Kim, Hyesook Park, Hae Soon Kim
    Children.2024; 11(3): 370.     CrossRef
  • Hyperthyroidism
    Sun Y. Lee, Elizabeth N. Pearce
    JAMA.2023; 330(15): 1472.     CrossRef
  • Exploring the Association between Thyroid Function and Frailty: Insights from Representative Korean Data
    Youn-Ju Lee, Min-Hee Kim, Dong-Jun Lim, Jung-Min Lee, Sang Ah Chang, Jeongmin Lee
    Endocrinology and Metabolism.2023; 38(6): 729.     CrossRef
  • Subclinical Hypothyroidism: Prevalence, Health Impact, and Treatment Landscape
    Won Sang Yoo, Hyun Kyung Chung
    Endocrinology and Metabolism.2021; 36(3): 500.     CrossRef
  • Association between Iodine Intake, Thyroid Function, and Papillary Thyroid Cancer: A Case-Control Study
    Kyungsik Kim, Sun Wook Cho, Young Joo Park, Kyu Eun Lee, Dong-Wook Lee, Sue K. Park
    Endocrinology and Metabolism.2021; 36(4): 790.     CrossRef
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Original Articles
Clinical Study
Quality of Life in Patients with Papillary Thyroid Microcarcinoma According to Treatment: Total Thyroidectomy with or without Radioactive Iodine Ablation
Jonghwa Ahn, Min Ji Jeon, Eyun Song, Tae Yong Kim, Won Bae Kim, Young Kee Shong, Won Gu Kim
Endocrinol Metab. 2020;35(1):115-121.   Published online March 19, 2020
DOI: https://doi.org/10.3803/EnM.2020.35.1.115
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AbstractAbstract PDFPubReader   ePub   
Background

Recently, there has been some controversy regarding the role of radioactive iodine (RAI) ablation in the treatment of low-risk differentiated thyroid carcinoma (DTC), especially papillary thyroid microcarcinoma (PTMC). This study aimed to compare quality of life (QoL) parameters between patients with PTMC who underwent total thyroidectomy (TT) alone and those who underwent TT with RAI ablation.

Methods

In this cross-sectional study, patients with PTMC who underwent TT with/without RAI remnant ablation were prospectively enrolled between June 2016 and October 2017. All patients completed three questionnaires: the 12-item short-form health survey (SF-12), thyroid cancer-specific quality of life (THYCA-QoL) questionnaire, and fear of progression (FoP) questionnaire.

Results

The TT and TT with RAI groups comprised 107 and 182 patients, respectively. The TT with RAI group had significantly lower serum thyrotropin (TSH) levels than the TT group. However, after matching for TSH levels between the groups (n=100 in both groups), there were no significant differences in baseline characteristics. According to the SF-12, the score for general health was significantly lower in the TT with RAI group than in the TT group (P=0.047). The THYCA-QoL also showed a significant difference in the “felt chilly” score between groups (P=0.023). No significant differences in FoP scores were observed between the groups.

Conclusion

Patients with PTMC who underwent TT with RAI ablation experienced more health-related problems than those managed with TT alone. These findings support the idea that RAI ablation should be carefully considered in patients with low-risk DTCs.

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  • Quality of life of patients with thyroid cancer in Colombia
    Oscar Gómez, Alvaro Sanabria
    Endocrinología, Diabetes y Nutrición.2024; 71(2): 61.     CrossRef
  • Review: Improving quality of life in patients with differentiated thyroid cancer
    Pia Pace-Asciak, Jonathon O. Russell, Ralph P. Tufano
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    Changlian Chen, Jiayan Cao, Yueyang Wang, Xuya Han, Yaju Zhang, Shumei Zhuang
    Thyroid.2023; 33(4): 474.     CrossRef
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    Kyle Alexander, Sum-Yu Christina Lee, Stelios Georgiades, Constantina Constantinou
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    Deenraj Kush Dhoomun, HuiLan Cai, Ning Li, YanHuan Qiu, XingRui Li, XiaoPeng Hu, WenZhuang Shen
    Cancer Medicine.2023; 12(15): 16604.     CrossRef
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    Shinje Moon, Ka Hee Yi, Young Joo Park
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    Elizabeth J de Koster, Olga Husson, Eveline W C M van Dam, G Sophie Mijnhout, Romana T Netea-Maier, Wim J G Oyen, Marieke Snel, Lioe-Fee de Geus-Oei, Dennis Vriens, _ _
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    Poliane A.L. Santos, Maria E.D.M. Flamini, Felipe A. Mourato, Fernando R.A. Lima, Joelan A.L. Santos, Fabiana F. Lima, Estelita T.B. Albuquerque, Alexandra C. De Freitas, Simone C.S. Brandão
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A Study on the Urinary Iodine Excretion in Normal subjects and Patients with Thyroid disease.
Seong Yeon Kim, Bo Youn Cho, Hong Kyu Lee, Seok In Lee, Woon Bae Kim, Hye Young Park, Chang Soon Koh
J Korean Endocr Soc. 1995;10(4):386-394.   Published online November 7, 2019
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AbstractAbstract PDF
An adequate supply of dietary iodine is essential for the synthesis of the thyroid hormons. The measurement of dietary iodine intake is important for the clinical assessment of thyroid disease, especially in areas where iodine intake is excessive or deficient.To evaluate dietary iodine intake in Korean and its effects on thyroid function, we measured urinary iodine excretion with morning urine by electrode method in 184 normal subjects, 96 postpartum women and 181 patients with thyroid disease from October 1994 to February 1995. The results were as follows;1) In normal control, the mean value of urinary iodine excretion was 3.8+-2.7mg/L (range 0.1-15.0mg/L). However, there was no sex and age differences in the urinary iodine excretion.2) In postpartum women, the urinary iodine excretion was 9.0+-10.8mg/L who were not taken high iodine diet(Miyok-Guk), the mean value was statistically higher than normal control(p<0.01) and significant increased the urinary iodine excretion after eating of high iodine diet(p<0.01).3) In volunteer, there were increase of urinary iodine excretion more than 10 folds after high iodine diet and medication.4) The urinary iodine excretion in patients with thyroid diseases was not different from normal control, and there were no significant differences of urinary iodine excretion among the patient groups. The urinary iodine excretion in the acute stage of patients with subactue thyroiditis or painless thyroiditis was significantly increased compared to the recovery stage. However, it was not significantly different from that of normal control.In conclusion, urinary iodine excretion in Korean population is very high comparing to the reported data in Western population but similar with Japanese. The urinary iodine excretion is significant increase( more than 10-folds of basal level) after high iodine diet or high iodine containing medication in postpartum women or healthy persons. As a clue of destruction induced thyrotoxicosis, the urinary iodine excretion measurement is not valid in area where iodine intake is excessive like Korea.
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Analysis of Daily Intake and Urinary Excretion of Iodine normal Control and Patient with Thyroid Disease.
Yong Wook Cho, Young Sun Kim, Seung Ho Baick, Do Yeon Oh, Whyui Joon Kim, Myung Wha Kang, Kyung Sook Kim
J Korean Endocr Soc. 1994;9(4):307-317.   Published online November 6, 2019
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AbstractAbstract PDF
Iodine in physiological dosage is necessary for thyroid hormone. But insufficient or excessive intake of iodine could affect on thyroid function. However, little study is available on the current iodine state in Korea. To evaluate the current state of iodine intake and its effects on thyroid function, we measured the iodine intake, urinary excretion and thyroid status in 67 normal controls and 110 patients with thyroid disease from June 1991 to August 1993.The result were as follows; 1) There were no differences in the physical and daily intake of calorie between controls and patients with thyroid disease. 2) The mean daily intake of iodine was 391.4 ug in normal controls, 695.0 ug in patients with simple goiter, 672.0 ug in hypothyroidism, 453.5 ug in hyperthyroidism, and 297.4 ug in thyroid nodule. 3) The mean urinary iodine excretion was 640 ug/L in normal controls, 875 ug/L in patients with hyperthyroidism, 612 ug/L in thyroid nodule, 563 ug/L in hypothyroidism, and 549 ug/L in simple goiter. 4) There was decreasing tendency of the serum T_3, t_4 and significant increase in TSH concentration in subjects who ingest the dietary iodine above 1000 ug/day compared with the subjects who ingest below 150 ug/day(p<0.05). 5) Subjects who live in coastal area had much intake of iodine(1.8-2.5 times)than those of subjects live in inland area.In conculsion, Korean ingested more iodine than Europian and American but fewer than Japanese. Some of the patients with simple goiter and hypothyroidism patients may associated with excessive ingestion of iodine, but further systemized study will be required.
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Review Article
Thyroid
Graves' Disease: Can It Be Cured?
Wilmar M. Wiersinga
Endocrinol Metab. 2019;34(1):29-38.   Published online March 21, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.1.29
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Whether or not Graves' hyperthyroidism can be really cured, depends on the definition of “cure.” If eradication of thyroid hormone excess suffices for the label “cure,” then all patients can be cured because total thyroidectomy or high doses of 131I will abolish hyperthyroidism albeit at the expense of creating another disease (hypothyroidism) requiring lifelong medication with levothyroxine. I would not call this a “cure,” which I would like to define as a state with stable thyroid stimulating hormone (TSH), free thyroxine, and triiodothyronine serum concentrations in the normal range in the absence of any thyroid medication. Surgery and radioiodine are unlikely to result in so-defined cures, as their preferable aim as stated in guidelines is to cause permanent hypothyroidism. Discontinuation of antithyroid drugs is followed by 50% recurrences within 4 years; before starting therapy the risk of recurrences can be estimated with the Graves' Recurrent Events After Therapy (GREAT) score. At 20-year follow-up about 62% had developed recurrent hyperthyroidism, 8% had subclinical hypothyroidism, and 3% overt hypothyroidism related to TSH receptor blocking antibodies and thyroid peroxidase antibodies. Only 27% was in remission, and might be considered cured. If the definition of “cure” would also include the disappearance of thyroid antibodies in serum, the proportion of cured patients would become even lower.

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Close layer
Original Article
Thyroid
99mTc-Pertechnetate Scintigraphy Predicts Successful Postoperative Ablation in Differentiated Thyroid Carcinoma Patients Treated with Low Radioiodine Activities
Luca Giovanella, Gaetano Paone, Teresa Ruberto, Luca Ceriani, Pierpaolo Trimboli
Endocrinol Metab. 2019;34(1):63-69.   Published online February 15, 2019
DOI: https://doi.org/10.3803/EnM.2019.34.1.63
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Background

Postoperative routine radioiodine (RAI) treatment is currently debated for patients with low-risk differentiated thyroid carcinoma (DTC) patients. If performed, a low 131I activity (i.e., 1 to 2 GBq) is recommended with the aim to ablate thyroid remnant and facilitate subsequent follow-up by thyroglobulin measurement. The purpose of this study was to evaluate the relationship between postsurgical technetium-99m (99mTc)-pertechnetate scintigraphy and the rate of successful remnant ablation after low activity radioiodine ablation in patients with DTC.

Methods

Enrolled were 193 patients with low risk DTC who underwent total thyroidectomy and RAI ablation with a fixed 1.1 GBq activity of 131I. 99mTc-pertechnetate scans were done and thyrotropin stimulated thyroglobulin (sTg) levels measured just before ablation. Ablation effectiveness was assessed 6 to 12 months later by sTg measurement, neck ultrasound and diagnostic whole body scan.

Results

A negative 99mTc-perthecnetate scans was the best predictor of successful ablation (P<0.001) followed by preablative sTg levels <0.8 ng/mL (P=0.008) and 99mTc-pertechnetate uptake rate values <0.9% (P=0.065). Neither sex nor age of the patient at the time of ablation or tumor histology and size showed a significant association with the rate of successful ablation.

Conclusion

The 99mTc-pertechnetate scintigraphy is a simple and feasible tool to predict effectiveness of low activity 131I thyroid to ablate thyroid remnants in patients with DTC.

Citations

Citations to this article as recorded by  
  • The prognostic value of post thyroidectomy Tc-99m pertechnetate thyroid scan in patients with differentiated thyroid cancer
    L.M. Eloteify, Samy M. Algizawy, Aya K.M. Abdelnaim, Nesreen Mekkawy
    Nuclear Medicine Communications.2023; 44(1): 38.     CrossRef
  • Correlation analysis of I-131 SPECT/CT uptake parameters with the success ablation treatment of thyroid remnant in patients with low-intermediate-risk differentiated thyroid cancer
    Qian Zhang, Weina Xu
    Nuclear Medicine Communications.2022; 43(10): 1051.     CrossRef
  • Clinical significance of extra-thyroid 99mTc-pertechnetate uptake before initial radioiodine therapy for differentiated thyroid carcinoma
    Bin Long, Li-Fang Yao, Shou-Cong Chen, Jin Shui, Xue-Mei Ye, He-Qing Yi, Cen Lou
    Journal of International Medical Research.2021; 49(5): 030006052110126.     CrossRef
  • Thyroglobulin Changes are Highly Dependent on TSH in Low-risk DTC Patients not Treated with Radioiodine
    Antonio Matrone, Alessio Faranda, Francesco Latrofa, Carla Gambale, Delio Stefani Donati, Eleonora Molinaro, Laura Agate, David Viola, Paolo Piaggi, Liborio Torregrossa, Fulvio Basolo, Rossella Elisei
    The Journal of Clinical Endocrinology & Metabolism.2020; 105(8): e2845.     CrossRef
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Endocrinol Metab : Endocrinology and Metabolism