{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:44:28Z","timestamp":1793965468644,"version":"4.8.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>This study aims to evaluate the relationship between changes in thyroid stimulating hormone receptor antibody (TRAb) levels before and after treatment and the efficacy of radioactive iodine therapy (RAI) for Graves\u2019 disease (GD). Additionally, a decision tree model was developed to predict treatment outcomes based on variations in serum TRAb levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 728 patients were evaluated to investigate the association between TRAb level fluctuations and RAI treatment efficacy. A decision tree model was constructed using TRAb level changes at 3 and 6 months post-RAI to predict clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 728 patients, 326 (44.8%) achieved clinical remission. Patients with lower TRAb levels at 18 months post-RAI exhibited higher remission rates, particularly those whose TRAb levels returned to baseline. A greater decline in TRAb levels between 18 and 36 months post-RAI was also correlated with improved treatment outcomes. Decision tree models based on TRAb level changes at the 3rd and the 6th month post-RAI demonstrated predictive accuracies of 74.36% and 72.46%, respectively. Further analysis showed that patients with minimal TRAb elevation in the early phase after RAI had a higher likelihood of achieving remission.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Decision tree modeling identified early TRAb elevation patterns that serve as strong predictors of RAI efficacy. Incorporating TRAb fluctuations into clinical assessment may facilitate personalized <jats:sup>131<\/jats:sup>I dosing strategies, ultimately improving treatment outcomes for GD patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1581353","type":"journal-article","created":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T04:11:03Z","timestamp":1751343063000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of serum TRAb level changes on the efficacy of 131I therapy in Graves\u2019 disease: a decision tree prediction model"],"prefix":"10.3389","volume":"16","author":[{"given":"Ziyu","family":"Ma","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiwang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaowei","family":"Meng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn321828-20201109-00405","article-title":"Clinical guidelines for 131I treatment of Graves\u2032 hyperthyroidism (2021 edition)","volume":"41","year":"2021","journal-title":"Chin J Nucl Med Mol Imaging"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-024-01016-5","article-title":"Graves\u2019 disease: latest understanding of pathogenesis and treatment options","volume":"20","author":"Lanzolla","year":"2024","journal-title":"Nat Rev Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2024.119700","article-title":"Thyroid stimulating receptor autoantibodies","volume":"559","author":"Gao","year":"2024","journal-title":"Clin Chim Acta"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn121381-202209019-00376","article-title":"The variation characteristics of four thyroid antibodies and the value of the combined semi-quantitative scores in the evaluation of the efficacy of Graves\u2019 hyperthyroidism after 131I therapy","volume":"47","author":"Guan","year":"2023","journal-title":"Int J Radiat Med Nucl Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1982.tb03170.x","article-title":"Effect of radioiodine on stimulatory activity of Graves\u2019 immunoglobulins","volume":"16","author":"Atkinson","year":"1982","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/dom.15790","article-title":"Clinical factors influencing the success rate of radioiodine treatment for Graves\u2019 disease","volume":"26","author":"He","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"B7","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1186\/s12902-021-00905-4","article-title":"The effect of radioiodine treatment on the characteristics of TRAb in Graves\u2019 disease","volume":"21","author":"Fang","year":"2021","journal-title":"BMC Endocr Disord"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1042\/BSR20191609","article-title":"Predictive factors for the outcomes of Graves\u2032 disease patients with radioactive iodine (131I) treatment","volume":"40","author":"Xing","year":"2020","journal-title":"Biosci Rep"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1528","DOI":"10.3760\/cma.j.cn431274-20200630-00897","article-title":"Analysis of thyroid iodine uptake rate and 99Tcm imaging in the treatment of Graves hyperthyroidism with 131I","volume":"23","author":"Chen","year":"2021","journal-title":"J Chin Physician"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1000-6699.2015.05.010","article-title":"Analysis of 2\u2013125 patients with hyperthyroidism after 131I therapy: a retrospective study","volume":"31","author":"Wang","year":"2015","journal-title":"Chin J Endocrinol Metab"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.12659\/MSM.928796","article-title":"Predictive value of a thyroid-absorbed dose with a shorter effective half-life on efficacy in graves disease patients receiving iodine-131 therapy","volume":"27","author":"Yu","year":"2021","journal-title":"Med Sci Monit"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn321828-20221025-00319","article-title":"Predictive value of early thyroid function changes for the curative effect of 131I therapy in patients with Graves\u2032 disease","volume":"44","author":"Wang","year":"2024","journal-title":"Chin J Nucl Med Mol Imaging"},{"key":"B13","doi-asserted-by":"publisher","first-page":"291","DOI":"10.3760\/cma.j.issn.0253-9780.2003.05.024","article-title":"Slepp apnea syndrome needs more comprehensive and in-depth research","volume":"23","author":"Wu","year":"2003","journal-title":"Chin J Nucl Med Mol Imaging"},{"key":"B14","doi-asserted-by":"publisher","first-page":"83","DOI":"10.3760\/cma.j.issn.2095-2848.2013.02.002","article-title":"Clinical guidelines for 131I treatment of Graves hyperthyroidism (2013 edition)","volume":"33","year":"2013","journal-title":"Chin J Nucl Med Mol Imaging"},{"key":"B15","article-title":"Dosage determination with radioactive isotopes; practical considerations in therapy and protection","volume":"59","author":"Marinelli","year":"1948","journal-title":"Am J Roentgenol Radium Ther"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1001-1889.2001.01.007","article-title":"Comparative study of thyroid palpation and B-ultrasonography (sitting and lying position)","volume":"16","author":"Tan","year":"2001","journal-title":"Chin J Control Endemic Dis"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.19052","article-title":"Hyperthyroidism: A review","volume":"330","author":"Lee","year":"2023","journal-title":"JAMA"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.1982.tb03163.x","article-title":"Prediction of therapeutic response to radioactive iodine in Graves\u2019 disease using TSH-receptor antibodies and HLA-status","volume":"16","author":"Davies","year":"1982","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2021.03.068","article-title":"Predictive factors of radioiodine therapy failure in Graves\u2019 Disease: A meta-analysis","volume":"223","author":"Shalaby","year":"2022","journal-title":"Am J Surg"},{"key":"B20","article-title":"Effectiveness of radioactive iodine (131I) in the treatment of Graves\u2019 disease: single center experience in Assiut University hospital","volume":"10","author":"Mohamadien","year":"2020","journal-title":"Am J Nucl Med Mol Imaging"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn101721-20230427-000155","article-title":"To explore the value of TRAb\u00a0in\u00a0predicting permanent hypothyroidism after 131I treatment of Graves\u2019 disease","volume":"39","author":"Chen","year":"2023","journal-title":"Clin Med China"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1007\/s12026-018-9062-z","article-title":"A novel third-generation TSH receptor antibody (TRAb) enzyme-linked immunosorbent assay based on a murine monoclonal TSH receptor-binding antibody","volume":"66","author":"Roggenbuck","year":"2018","journal-title":"Immunol Res"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1159\/000495504","article-title":"The effect of radioiodine treatment on TRAb, anti-TPO, and anti-TG in graves\u2019 Disease","volume":"8","author":"Lindgren","year":"2019","journal-title":"Eur Thyroid J"},{"key":"B24","doi-asserted-by":"publisher","first-page":"13","DOI":"10.3760\/cma.j.issn.1673-4114.2016.01.003","article-title":"Analysis of the changes in early TRAb\u00a0and\u00a0TSAb after 131I treatment for patients with Graves hyperthyroidism","volume":"40","author":"Liang","year":"2016","journal-title":"Int J Radiat Med Nucl Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1581353\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T04:11:12Z","timestamp":1751343072000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1581353\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,1]]},"references-count":24,"alternative-id":["10.3389\/fendo.2025.1581353"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1581353","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,1]]},"article-number":"1581353"}}