Endocrine Abstracts

JOINT4036

Introduction: Graves’ Disease (GD) is the most common cause of primary hyperthyroidism in children and adolescents and is associated with weight loss before treatment. During treatment, weight gain is frequently observed. This study aims to evaluate weight fluctuations in newly diagnosed GD patients receiving pharmacological treatment.

Materials and Methods: The records of 27 newly diagnosed GD patients who started pharmacological treatment (methimazole) between October 2022 and January 2024 were retrospectively reviewed. Patients who had started treatment before their first endocrinology visit, had thyroid malignancies, or had incomplete records were excluded from the study. Patients with a body mass index (BMI) percentile of 85-95 at diagnosis were classified as overweight, while those above the 95th percentile were classified as obese. The patients were divided into two groups: those who were overweight/obese and those who were not. The groups were compared in terms of age, gender, puberty status, BMI at diagnosis, BMI standard deviation score (SDS) at diagnosis, BMI and BMI-SDS at 6 and 12 months, thyroid function tests, TSH receptor-blocking antibody levels (TRAB), thyroid volume, follow-up duration, duration of antithyroid drug use, and initial methimazole dose. Changes in BMI over the first year were expressed as Δ BMI-SDS (0-12).

Results: The median age of the patients was 14.11 years, 74.1% were female, and only one patient was prepubertal. A family history of thyroid disease was present in 66.7% of the patients. The most common presenting symptoms were palpitations (33.3%), weight loss (25.9%), and hand tremors (14.8%). Among patients with a history of weight loss, 71% were in the normal weight group. There were no significant differences between the groups in terms of age, thyroid function tests, thyroid volume, thyroid volume SDS, follow-up duration, initial methimazole dose, or duration of antithyroid drug use (P >0.05). The increase in BMI and BMI-SDS at 6 and 12 months after diagnosis was significantly greater in the non-obese and non-overweight groups. Δ BMI-SDS (0-12) was correlated with weight, BMI, BMI-SDS, ST3-ST4, and TRAB levels at diagnosis.

Conclusion and Discussion: Our study highlights the importance of weight management in the treatment of GD alongside the regulation of thyroid function. Weight management should be a focal point for all patients receiving antithyroid drugs to minimize the development of obesity and mitigate the harmful effects of weight gain. Particularly, obese and overweight patients who are at high risk for metabolic syndrome and cardiovascular complications should be monitored more closely.