Thyroid Volume Measured by99m Tc-Pertechnetate Scintigraphy and Its Relationship with Clinical Parameters in Korean Patients with Autoimmune Thyroiditis

Sang Ah Lee; Seong Man Lee; So-Yeon Yoo; Young Hwan Kim; Gwanpyo Koh

doi:10.11106/ijt.2016.9.2.137

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Lee, Lee, Yoo, Kim, and Koh: Thyroid Volume Measured by99m Tc-Pertechnetate Scintigraphy and Its Relationship with Clinical Parameters in Korean Patients with Autoimmune Thyroiditis

Original Article

Int J Thyroidol 2016;9(2):137-144.

Published online: 20 November 2016

DOI: https://doi.org/10.11106/ijt.2016.9.2.137

Thyroid Volume Measured by⁹9m Tc-Pertechnetate Scintigraphy and Its Relationship with Clinical Parameters in Korean Patients with Autoimmune Thyroiditis

Sang Ah Lee^1,², Seong Man Lee¹, So-Yeon Yoo², Young Hwan Kim³, Gwanpyo Koh^1,^2,

¹Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea

²Jeju National University Hospital, Jeju, Korea

³Department of Nuclear Medicine and Molecular Imaging, Kangbuk Samsung Medical Center, Seoul, Korea

Correspondence: Gwanpyo Koh, MD, PhD, Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran1 3-gil, Jeju 63241, Korea Tel: 82-64-754-8163, Fax: 82-64-717-1131, E-mail: okdom@jejunu.ac.kr

Received 30 December 2015 Revised 15 June 2016 Accepted 4 September 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives

Autoimmune thyroiditis (AIT) is a form of thyroiditis associated with autoimmune antibodies. Few studies have measured thyroid volume in Asians. This study was undertaken to determine the distribution of thyroid volume and to explore possible correlations between thyroid volume and other factors in a Korean cohort.

Materials and Methods

Two hundred eleven patients who underwent^99m Tc-pertechnetate thyroid scintigraphy between 2009 and 2011 were recruited and their thyroid volume was measured. AIT was defined as having thyroperoxidase antibody (TPOAb) and/or thyroglobulin antibody (TgAb) positivity and TRAb negativity, regardless of thyroid function.

Results

The mean thyroid volume was 32.1 mL in AIT patients. The distribution of thyroid volume was normal after log transformation. Thyroid volume was larger in patients with both autoantibodies than in patients with only one antibody (p＜0.001). The first quartile of patients grouped according to thyroid volume were older (52.1 years, p=0.037) than the patients in other quartile groups. Thyroid volume correlated independently with TPOAb titer, and TgAb titer adjusted for other factors in a multivariate analysis.

Conclusion

Thyroid volume in Korean AIT patients had an unimodal distribution and correlated with autoantibody titer.

Keywords: Autoimmune thyroiditis, Antithyroid peroxidase antibody, Antithyroglobulin antibody

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Fig. 1.

Distribution of thyroid volume in AIT patients (A), histogram (B) Q-Q plots.

Fig. 2.

Association between thyroid volume and clinical characteristics (A) thyroid volume related with number of autoantibody (B) correlation between thyroid volume and titer of TPOAb (C) correlation between thyroid volume and titer of TgAb (D) correlation between thyroid volume and serum TSH levels. TgAb: antithyroglobulin antibody, TPOAb: antithyroperoxidase antibody, TV: thyroid volume.

Table 1.

Basal characteristics of AIT patients

Factor
Age (years)	46.70±1.40
Sex (female, %)	84.1
Height (cm)	160.75±0.94
Weight (kg)	59.13±1.37
Goiter (yes, %)	36.6
T3 (ng/dL)	1.21±0.04
Free T4 (ng/dL)	1.26±0.04
TSH (μ U/mL)	5.13±1.32
TgAb (IU/mL)	414.15±51.89
TPOAb (IU/mL)	787.19±103.91
Right volume (mL)	16.77±0.78
Left volume (mL)	15.32±0.68
Total volume (mL)	32.10±1.03
Tc-99m uptake (%)	4.28±0.19

Tc: technetium, TgAb: thyroglobulin antibody, TPOAb: thyroid peroxidase antibody, TSH: thyroid-stimulating hormone

Table 2.

Clinical characteristic of stratified quartiles groups based on thyroid volume

Factor	Thyroid volume				p value (ANOVA)	p value (linear trend)
Factor	1 ^st quartile (n=52)	2 ^nd quartile (n=53)	3 ^rd quartile (n=53)	4 ^th quartile (n=53)	p value (ANOVA)	p value (linear trend)
Age (years)	52.07±3.01	46.80±2.99	42.59±2.58	42.59±2.48	0.037^{† ∗}	0.044^∗
Sex (female, %)	77.78	90.00	82.14	93.33	0.271	0.251
Height (cm)	157.66±2.42	16.35±3.43	164.20±1.60	162.17±1.74	0.195	0.083
Weight (kg)	59.91±2.49	60.80±5.38	63.15±3.23	62.7±2.21	0.890	0.474
T3 (ng/dL)	1.12±0.06	1.25±0.08	1.11±0.05	1.09±0.06	0.298	0.407
Free T4 (ng/dL)	1.19±0.07	1.29±0.07	1.16±0.07	1.03±0.07	0.306	0.264
TSH (μ U/mL)	1.72±0.34	2.01±0.55	7.38±2.76	12.06±2.77	0.010^{‡ ∗}	0.001^∗
TgAb (IU/mL)	122.64±41.31	488.39±111.15	376.44±93.34	644.58±154.43	0.005^{† ∗}	0.007^∗
TPOAb (IU/mL)	29.59±10.77	157.02±53.66	488.48±117.97	1591.60±230.53	＜0.001^{‡ ∗}	0.001^∗
Antibody number (both, %)	3.8	7.5	30.2	66.0	＜0.001^{‡ ∗}	0.001^∗
Total volume (mL)	13.72±0.50	24.24±0.63	34.90±0.60	55.69±1.62	–	–

TgAb: thyroglobulin antibody, TPOAb: thyroid peroxidase antibody, TSH: thyroid-stimulating hormone

^∗ p value＜0.05

^† 1 ^st quartile vs. 2 ^nd, 3 ^rd, 4 ^th quartile groups

^‡ 1^st and 2^nd quartile vs. 3^rd and 4^th quartile groups

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