{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:48:43Z","timestamp":1777934923860,"version":"3.51.4"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T00:00:00Z","timestamp":1668643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018664","name":"Mongolian National University of Medical Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100018664","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Graves\u2019 ophthalmopathy (GO) is a complex inflammatory condition affecting the orbit and is often associated with Graves\u2019 disease (GD). This study aims to determine the levels of thyroid-stimulating immunoglobulin (TSI) and thyroid-stimulating hormone receptor autoantibody (TSHR-ab) in the serum of patients with GO, compare it with the GD, and determine whether there is a correlation with the clinical course of GO. The cross-sectional study included 82 patients with GO, 81 patients with GD, and 75 healthy subjects. The ocular manifestations of GO were identified and evaluated by the clinical activity score (CAS) and severity of GO using the European Group of Graves\u2019 Orbitopathy (EUGOGO). TSI and TSHR-ab levels in the serum of participants were determined with ELISA kits and correlated with clinical findings. A total of 238 participant\u2019s data were analyzed. There were 14 patients (17%) with unilateral GO. The most common ocular signs were eyelid retraction 68 (82.3%) and proptosis 61 (74.4%). The mean CAS score was 2.65\u00b11.64 in GO patients and was higher in men than women (<jats:italic>P<\/jats:italic> = 0.008). The mean of TSI was 37.95\u00b135.41 in GO, 14.16\u00b115.67 in GD, and 4.33\u00b12.94 in healthy controls (<jats:italic>P<\/jats:italic>&lt;0.0001). The TSI was significantly higher in patients with GO than in those with GD (<jats:italic>P<\/jats:italic>&lt;0.0001). There were no correlations between TSI and TSHR-ab levels and CAS scores. However, we observed a correlation between the TSI level and the severity of GO (<jats:italic>P<\/jats:italic> = 0.023). The area under the ROC curve (AUC) of TSI was 0.933 and selected 14.1 IU\/ml was the optimal cutoff value (98.78% of sensitivity, 83.97% of specificity). Our study showed that TSI is significantly related to GO and the severity of GO. Therefore, TSI can be used as a predictor of severe GO to help in prognostication, follow-up and treatment planning.<\/jats:p>","DOI":"10.1371\/journal.pone.0277055","type":"journal-article","created":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T19:07:31Z","timestamp":1668712051000},"page":"e0277055","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Association of clinical course with thyroid-stimulating immunoglobulin in Graves\u2019 ophthalmopathy in Mongolians"],"prefix":"10.1371","volume":"17","author":[{"given":"Oyungerel","family":"Bayarmunkh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chimedlkhamsuren","family":"Ganbold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sima","family":"Das","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uranchimeg","family":"Davaatseren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nomin-Erdene","family":"Minjuurdorj","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3032-4490","authenticated-orcid":true,"given":"Sarantuya","family":"Jav","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,17]]},"reference":[{"issue":"5","key":"pone.0277055.ref001","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2169\/internalmedicine.53.1518","article-title":"Graves\u2019 ophthalmopathy: epidemiology and natural history","volume":"53","author":"Y. Hiromatsu","year":"2014","journal-title":"Internal medicine (Tokyo, Japan)"},{"issue":"2","key":"pone.0277055.ref002","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4274\/tjo.80688","article-title":"Thyroid-associated Ophthalmopathy.","volume":"47","author":"E. \u015eahl\u0131","year":"2017","journal-title":"Turkish journal of ophthalmology"},{"key":"pone.0277055.ref003","doi-asserted-by":"crossref","first-page":"7453260","DOI":"10.1155\/2019\/7453260","article-title":"Immunological Aspects of Graves\u2019 Ophthalmopathy.","volume":"2019","author":"D. \u0141acheta","year":"2019","journal-title":"BioMed research international"},{"key":"pone.0277055.ref004","doi-asserted-by":"crossref","first-page":"678194","DOI":"10.1155\/2015\/678194","article-title":"Thyroid Stimulating but Not Blocking Autoantibodies Are Highly Prevalent in Severe and Active Thyroid-Associated Orbitopathy: A Prospective Study","volume":"2015","author":"E. Kampmann","year":"2015","journal-title":"International journal of endocrinology"},{"issue":"4","key":"pone.0277055.ref005","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/cen.14296","article-title":"Prevalence of thyroid eye disease in Graves\u2019 disease: A meta-analysis and systematic review","volume":"93","author":"Y. H. Chin","year":"2020","journal-title":"Clinical endocrinology"},{"issue":"8","key":"pone.0277055.ref006","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1056\/NEJMra0905750","article-title":"Graves\u2019 ophthalmopathy","volume":"362","author":"R. S. Bahn","year":"2010","journal-title":"The New England journal of medicine"},{"issue":"4","key":"pone.0277055.ref007","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3341\/kjo.2015.29.4.213","article-title":"Clinical Association of Thyroid Stimulating Hormone Receptor Antibody Levels with Disease Severity in the Chronic Inactive Stage of Graves\u2019 Orbitopathy.","volume":"29","author":"Y. J. Woo","year":"2015","journal-title":"Korean journal of ophthalmology: KJO"},{"issue":"10","key":"pone.0277055.ref008","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1038\/eye.2013.193","article-title":"Relevance of TSH-receptor antibody levels in predicting disease course in Graves\u2019 orbitopathy: comparison of the third-generation TBII assay and Mc4-TSI bioassay","volume":"27","author":"S. Y. Jang","year":"2013","journal-title":"Eye"},{"issue":"1","key":"pone.0277055.ref009","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1515\/cclm-2016-0197","article-title":"Evaluation of the first fully automated immunoassay method for the measurement of stimulating TSH receptor autoantibodies in Graves\u2019 disease","volume":"55","author":"R. Tozzoli","year":"2017","journal-title":"Clinical chemistry and laboratory medicine"},{"issue":"2","key":"pone.0277055.ref010","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1309\/AJCPZUT7CNUEU7OP","article-title":"Analytical performance and clinical utility of a bioassay for thyroid-stimulating immunoglobulins","volume":"139","author":"J. J. Leschik","year":"2013","journal-title":"American journal of clinical pathology"},{"issue":"5","key":"pone.0277055.ref011","doi-asserted-by":"crossref","first-page":"2123","DOI":"10.1210\/jc.2009-2470","article-title":"A novel thyroid stimulating immunoglobulin bioassay is a functional indicator of activity and severity of Graves\u2019 orbitopathy","volume":"95","author":"S. D. Lytton","year":"2010","journal-title":"The Journal of clinical endocrinology and metabolism"},{"issue":"4","key":"pone.0277055.ref012","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.3349\/ymj.2013.54.4.1033","article-title":"Correlation between TSH receptor antibody assays and clinical manifestations of Graves\u2019 orbitopathy","volume":"54","author":"S. Y. 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Woo","year":"2013","journal-title":"Korean journal of ophthalmology: KJO"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277055","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,17]],"date-time":"2022-11-17T19:08:08Z","timestamp":1668712088000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277055"}},"subtitle":[],"editor":[{"given":"Naranjargal","family":"Dashdorj","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,17]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0277055","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,17]]}}}