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Review
. 2024 Jun 7:15:1393126.
doi: 10.3389/fendo.2024.1393126. eCollection 2024.

A meta-analysis: elucidating diagnostic thresholds of peak systolic flow velocities in thyroid arteries for the discrimination of Graves' disease and destructive thyrotoxicosis

Sinong Li #  1 , Zheng Ding #  2 , Xiang Li #  1 , Miao Fu  1 , Li Sang  3 , Mingxia Yang  4 , Rubo Tang  5 , Tianxiang Gu  2 , Liang Sang  1
Affiliations
Review

A meta-analysis: elucidating diagnostic thresholds of peak systolic flow velocities in thyroid arteries for the discrimination of Graves' disease and destructive thyrotoxicosis

Sinong Li et al. Front Endocrinol (Lausanne). .

Abstract

Objective: This meta-analysis examines peak systolic velocities (PSVs) in thyroid arteries as potential biomarkers for thyroid disorders, which includes treated and untreated Graves' disease(GD) and destructive thyrotoxicosis(DT).

Methods: A search across databases including PubMed, Google Scholar, Embase, and Web of Science identified studies assessing peak systolic flow velocity in the inferior thyroid artery (ITA-PSV) and superior thyroid artery (STA-PSV) diagnostic efficacy in GD and DT.And the search was restricted to publications in the English language.The analysis compared STA-PSV and ITA-PSV across patient groups, evaluating intra-group variances and synthesizing sensitivity and specificity data.

Results: The analysis covered 18 studies with 1276 GD, 564 DT patients, and 544 controls. The difference of STA-PSV between GD group, DT group and normal group and the difference of ITA-PSV were analyzed in subgroups, and there was no statistical significance between subgroups when comparing any two groups. Normal subjects displayed intra-group ITA-PSV and STA-PSV differences with established cut-off values of 20.33 cm/s (95% CI, 17.48-23.18) for ITA-PSV and 25.61 cm/s (95% CI, 20.37-30.85) for STA-PSV. However, no significant intra-group differences were observed in the STA-PSV and ITA-PSV cut-off values among groups with GD or DT. The combined cut-off values for these patient groups and normal subjects were 68.63 cm/s (95% CI, 59.12-78.13), 32.08 cm/s (95% CI, 25.90-38.27), and 23.18 cm/s (95% CI, 20.09-26.28), respectively. The diagnostic odds ratio(DOR) for these values was 35.86 (95% CI, 18.21-70.60), and the area under the summary receiver operating characteristic (SROC) curve was 0.91, with a sensitivity estimate of 0.842 (95% CI, 0.772-0.866).

Conclusion: PSVs in thyroid arteries are useful diagnostic tools in distinguishing DT from GD. A PSV above 68.63 cm/s significantly improves GD diagnosis with up to 91% efficacy. No notable differences were found between superior and inferior thyroid arteries in these conditions.

Keywords: destructive thyrotoxicosis; graves’ disease; inferior thyroid artery; peak systolic velocities; superior thyroid artery.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Literature screening strategy map.
Figure 2
Figure 2
Document quality assessment map.
Figure 3
Figure 3
Meta-analysis of inter-group. ((A). Group GD VS Group Normal (B). Group DT VS Group Normal (C). Group DT VS Group GD). GD Graves Disease Group, DT Destructive Thyrotoxicosis, SD Standard deviations, SMD, Standardized Mean Differences.
Figure 4
Figure 4
Meta-analysis of intra-group. ((A). Group Normal (B) Group GD (C). Group DT). GD Graves Disease Group, DT Destructive Thyrotoxicosis, SD Standard deviations, MRAW Mean of Raw data.
Figure 5
Figure 5
Diagnostic odds ratio estimation.
Figure 6
Figure 6
SROC curve. Summary Receiver Operating Characteristic (SROC) curve.
See this image and copyright information in PMC

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