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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1422464
This article is part of the Research Topic Levothyroxine Therapy in Patients with Hypothyroidism: Volume II View all 11 articles

Gender, FT4 Levels, T Stage, and BMI as Predictors of TSH Levels in Thyroid Cancer Patients

Provisionally accepted
Sen Zhang Sen Zhang *Shuli Niu Shuli Niu Ling Zhou Ling Zhou
  • Department of nuclear medicine, People’s Hospital of Deyang City, Deyang, China

The final, formatted version of the article will be published soon.

    Background: After initial treatment, levothyroxine (LT4) administration is necessary for thyroid cancer patients to achieve target thyroid-stimulating hormone (TSH) levels. However, the clinical efficacy of weight-based LT4 dosing has been suboptimal, highlighting the need to identify factors influencing the attainment of desired TSH levels and guide personalized treatment. Methods: We constructed a retrospective cohort comprising 215 patients diagnosed with thyroid cancer. The identification of factors influencing the attainment of expected TSH levels was accomplished through univariate and multivariate logistic regression analysisanalyses. Subsequently, we developed a nomogram based on these prognostic factors and performed internal validation using the bootstrap resampling method. Results: Univariate and multivariate logistic regression analyses were conducted to analyze the clinical and demographic parameters. A nomogram was constructed using bootstrap resampling to predict the risk of TSH suppression failure, which was validated. The nomogram demonstrated moderate discrimination in estimating the risk of TSH suppression failure, with a Hosmer-Lemeshow test p-value of 0.393 and a bootstrapped calibrated C-index of 0.757 (95% CI 0.687-0.814). The calibration curve indicated good consistency of the model, and decision curve analysis suggested that the nomogram had clinical utility. Conclusion: Gender, preoperative serum free thyroxine (FT4) levels, T stage, and body mass index exhibit independent associations with the expected level of TSH. The established nomogram effectively predicts the risk of TSH suppression failure. Further research is warranted to investigate how these factors can be utilized in developing a personalized LT4 dosage calculator.

    Keywords: thyroid cancer, nomogram, Thyrotropin suppression, individualized medication regimens, Levothyroxine

    Received: 23 May 2024; Accepted: 07 Jan 2025.

    Copyright: © 2025 Zhang, Niu and Zhou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Sen Zhang, Department of nuclear medicine, People’s Hospital of Deyang City, Deyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.