Cardiovascular Implications of Cumulative Radioiodine Doses in Patients With Differentiated Thyroid Cancer and Type 2 Diabetes Mellitus, Bihar, India: A Retrospective Study.

Abstract

Background:The study aims to investigate the cardiovascular effects associated with cumulative doses of radioiodine therapy in people diagnosed with differentiated thyroid cancer (DTC) and comorbid Type 2 diabetes mellitus, with a focus on elucidating potential risks and outcomes for this patient population. Methods:A retrospective cohort study was conducted, enrolling 75 female participants categorized into DTC/−T2DM (Category I) and DTC/+T2DM (Category II). Data on demographic characteristics, radioiodine therapy, cardiovascular outcomes, and clinical parameters were collected from medical records. Statistical analyses were accomplished using SPSS software ver. 18. Results:Patients with DTC and without T2DM (DTC/−T2DM) exhibited higher average age (60 ± 6.3 years) and BMI (28.5 kg/m²) compared to patients with both DTC and T2DM (55 ± 5.2 years, 25.1 kg/m²). Patients with both DTC and T2DM received higher cumulative doses of radioiodine (200 mCi ± 25) over a longer duration (14 months) compared to patients with DTC and without T2DM (180 mCi ± 20, 12 months). The prevalence of hypertension, arrhythmias, and myocardial infarctions was higher in patients with DTC and without T2DM than in patients with both DTC and T2DM. Statistical analysis revealed significant variations in hypertension incidence (p < 0.001) and myocardial infarction occurrence (p = 0.03) between the groups. Multivariate regression analysis showed an independent association of T2DM with a higher risk of hypertension (p < 0.001) and myocardial infarction (p = 0.015) among DTC patients. Conclusion:The study highlights the importance of considering cardiovascular risks associated with radioiodine therapy in DTC patients, particularly those with T2DM. Personalized treatment strategies balancing cancer management and cardiovascular risk mitigation are crucial for optimizing patient outcomes. Recommendations:Clinicians should adopt a multidisciplinary approach integrating endocrinology, oncology, and cardiology to optimize the management of DTC patients with T2DM.