International Journal of General Medicine (Feb 2024)
Optimizing Levothyroxine Replacement: A Precision Dosage Model for Post-Thyroidectomy Patients
Abstract
Guanghua Yang,1,* Jiaxi Pu,1,* Sibo Zhu,2 Yong Shi,3 Yi Yang,3 Jiangnan Mao,3 Yongkang Sun,1 Bin Zhao1 1Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, 200137, People’s Republic of China; 2School of Life Sciences, Fudan University, Shanghai, 200438, People’s Republic of China; 3Cinoasia Institute, Shanghai, 200438, People’s Republic of China*These authors contributed equally to this workCorrespondence: Bin Zhao, Department of General Surgery, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, No. 358, Datong Road, Gaoqiao, Pudong New Area, Shanghai, 200137, People’s Republic of China, Tel +86 13918468421, Email [email protected] Yongkang Sun, Department of Ultrasound, Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine, No. 358, Datong Road, Gaoqiao, Pudong New Area, Shanghai, 200137, People’s Republic of China, Tel +86 13601659860, Email [email protected]: Thyroidectomy is commonly performed for benign or malignant thyroid tumors, often resulting in hypothyroidism. Levothyroxine (LT4) supplementation is crucial to maintain hormone levels within the normal range and suppress TSH for cancer control. However, determining the optimal dosage remains challenging, leading to uncertain outcomes and potential side effects.Methods: We analyzed clinical examination data from 510 total thyroidectomy patients, including demographic information, blood tests, and thyroid function. Using R, we applied data preprocessing techniques and identified 274 samples with 98 variables. Principal Component Analysis, correlation analysis, and regression analysis were conducted to identify factors associated with optimal LT4 dosage.Results: The analysis revealed that only eight variables significantly influenced the final satisfactory dosage of LT4 in tablets: Benign0/Malignant1 (benign or malignant), BQB (electrophoretic albumin ratio), TP (total protein), FDP (fibrin degradation products), TRAB_1 (thyroid-stimulating hormone receptor antibody), PT (prothrombin time), MONO# (monocyte count), and HCV0C (hepatitis C antibody). The resulting predictive model was: .Conclusion: Parameters such as benign/malignant status, TRAB_1, and BQB ratio during medication can serve as observational indicators for postoperative LT4 dosage. The calculated linear model can predict the LT4 dosage for patients after thyroidectomy, leading to improved treatment effectiveness and conserving medical resources.Keywords: thyroid, levothyroxine, dosage, model, prediction
