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Introduction <p>Graves' disease and subacute thyroiditis (SAT) are two of the most common causes of thyrotoxicosis. free T3 to free T4 ratio (fT3/fT4), neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) have not been analysed in detail for diagnosis in previous studies.</p> Materials and Methods <p>A total of 141 patients with subacute thyroiditis, 133 with Graves' disease and 126 healthy volunteers were included in the study. Thyroid stimulating hormone (TSH), fT3, fT4, C-reactive protein (CRP), MPV, NLR, erythrocyte sedimentation rate (ESR) and TSH receptor antibody (TRAb) levels were recorded. The laboratory parameters were compared between the two groups. ROC analysis was performed to evaluate fT3/fT4 ratio, ft4/TSH ratio, NLR and MPV to aid diagnosis, as well as cut-off values, sensitivity and specificity.</p> Results <p>The fT3/fT4 ratio was significantly different between the subacute thyroiditis (SAT) and Graves' disease groups (2.45 ± 0.68 vs. 3.48 ± 1.8, <i>p</i> &lt; 0.01). The MPV was lowest in the SAT group (8.83 ± 1.29). The NLR ratio was highest in the SAT group (2.84 ± 1.48 <i>p</i> &lt; 0.01). The fT4/TSH ratio was highest in the Graves group (461.85 ± 536.2 <i>p</i> &lt; 0.01).The AUC of ft3/ft4 ratio for estimating Graves' disease was 0.773, the specificity was 77.9%, the sensitivity was 66.2% (<i>p</i> &lt; 0.01), and the cut-off value was 2.95. The AUC of the NLR ratio for the assessment of SAT was 0.742, the specificity was 80% and the sensitivity was 50% (<i>p</i> = 0.02).</p> Conclusions <p>The ratio of fT3 to fT4, fT4/TSH ratio, MPV and NLR differ significantly between SAT and Graves’ disease and can provide helpful information in the differential diagnosis.</p>

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The Importance of Laboratory Parameters in the Differential Diagnosis of Graves' Disease and Subacute Thyroiditis

  • 期刊论文

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  • 发表日期：

    2025年1月27日

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  • Kenan Çağlayan,
  • Savaş Karataş,
  • Levent Özsarı,
  • Özge Kıran,
  • İsra Oğuz,
  • Adnan Gökçel

摘要

Introduction

Graves' disease and subacute thyroiditis (SAT) are two of the most common causes of thyrotoxicosis. free T3 to free T4 ratio (fT3/fT4), neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) have not been analysed in detail for diagnosis in previous studies.

Materials and Methods

A total of 141 patients with subacute thyroiditis, 133 with Graves' disease and 126 healthy volunteers were included in the study. Thyroid stimulating hormone (TSH), fT3, fT4, C-reactive protein (CRP), MPV, NLR, erythrocyte sedimentation rate (ESR) and TSH receptor antibody (TRAb) levels were recorded. The laboratory parameters were compared between the two groups. ROC analysis was performed to evaluate fT3/fT4 ratio, ft4/TSH ratio, NLR and MPV to aid diagnosis, as well as cut-off values, sensitivity and specificity.

Results

The fT3/fT4 ratio was significantly different between the subacute thyroiditis (SAT) and Graves' disease groups (2.45 ± 0.68 vs. 3.48 ± 1.8, p < 0.01). The MPV was lowest in the SAT group (8.83 ± 1.29). The NLR ratio was highest in the SAT group (2.84 ± 1.48 p < 0.01). The fT4/TSH ratio was highest in the Graves group (461.85 ± 536.2 p < 0.01).The AUC of ft3/ft4 ratio for estimating Graves' disease was 0.773, the specificity was 77.9%, the sensitivity was 66.2% (p < 0.01), and the cut-off value was 2.95. The AUC of the NLR ratio for the assessment of SAT was 0.742, the specificity was 80% and the sensitivity was 50% (p = 0.02).

Conclusions

The ratio of fT3 to fT4, fT4/TSH ratio, MPV and NLR differ significantly between SAT and Graves’ disease and can provide helpful information in the differential diagnosis.