ABSTRACT Objective: In Graves' disease (GD), thyroid nodules are the principal determinant of differentiated thyroidcaneer(DTC); however, the predictors of nodules and DTC remain uncertain. The role of thyroid peroxidase antibodies (TPOAb) in this context is controversial. Hence, this study aimed to determine whether TPOAb status is associated with thyroid nodules and DTC in GD and to compare the prevalence of DTC across subtypes of hyperthyroid disease. Subjects and methods: We conducted a retrospective cohort study (September 2020-July 2023) including patients with GD (n = 577) and toxic nodular/multinodular goiter (TNG/ TMNG) (n = 216) who had available TPOAb measurements and thyroid ultrasonography. Within the GD cohort, multivariable logistic regression was used to assess associations of TPOAb titer with nodules and DTC. Results: TPOAb positivity was more frequent in GD than in TNG/TMNG (60.4% vs. 7.4%, p < 0.001). Among GD patients, thyroid nodules were detected in 25.8% and were less frequent in TPOAb-positive patients compared with TPOAb-negative patients (8.3% vs. 52.6%, p < 0.001). Within GD, DTC was rare among those without nodular disease (0.93%) but substantially higher in nodular GD (14.1%, p < 0.001), exceeding the prevalence observed in TNG/TMNG (p = 0.009). TPOAb status further stratified DTC risk in GD: DTC was present in 1.15% of TPOAb-positive compared to 9.21% of TPOAb-negative patients (p < 0.001), with 84% of GD-associated DTCs arising in the TPOAb-negative subgroup. Regression analyses showed that TPOAb titer was independently associated with lower frequencies of both DTC and nodules in GD, whereas thyrotropin receptor antibodies levels showed no independent association. Conclusion: In GD, our study showed that TPOAb positivity was strongly associated with lower prevalence of thyroid nodules and DTC, whereas TPOAb-negative patients constitute a clinically relevant, higher-risk subgroup.
ABSTRACT Objective: Research examining the connection between Life's Essential 8 score (LE8) and arterial stiffness (AS) in patients with diabetes is currently insufficient. This study aimed to investigate the relationship between cardiovascular health and the development of AS in patients with type 2 diabetes (T2D) in a cohort study. Subjects and methods: A total of 2,685 patients with T2D were enrolled in this study. All patients were divided into four groups based on quartiles of cumulative exposure of LE8 (cum-LE8) score. The study endpoint was increased AS (iAS), which was defined as a brachial – ankle pulse wave velocity ≥ 1800 cm/s. The Kaplan-Meier method was used to determine the cumulative incidence of iAS, while the log-rank test was utilized to evaluate the differences among groups. Cox proportional hazards regression model was applied to investigate the impact of various cum-LE8 groups on the risk of iAS. Results: Over a median follow-up of 9.76 years, we identified 1,375 cases of iAS. The incidence rate of iAS in the quartile 1-4 were 71.02 (64.24-78.52), 67.68 (61.13-74.94), 56.05 (50.28-62.47) and 50.47 (45.05-56.53) per 1000 person-years, respectively. The cumulative incidence of iAS was highest in quartile 1 and gradually decreased from quartile 1 to quartile 4 (log-rank P < 0.01). Compared with quartile 1, the hazard ratios (95% confidence intervals) of quartile 2-4 were 0.69 (0.59-0.80), 0.41 (0.35-0.49), and 0.15 (0.12-0.18), respectively. Conclusion: Attaining a superior long-term cardiovascular health status is related to a reduced risk of iAS.
