{
  "abstract": "Objective: To examine whether pretreatment nocturnal sleep duration and Clinical Activity Score (CAS) are associated with thyroid functional remission after radioactive iodine (¹³¹I) therapy in Graves’ disease (GD) with concomitant thyroid-associated ophthalmopathy (TAO). The primary endpoint was thyroid functional remission, not ocular cure.\n\nMethods: We retrospectively reviewed 153 patients at a single center (53 in remission; 100 not in remission), followed for at least 12 months after ¹³¹I therapy. Sleep duration and CAS were pretreatment baseline measures; 20 patients received prednisone before ¹³¹I therapy (discontinued ≥ 3 days prior) and 133 received none; no thyroid-directed or immunosuppressive treatment was given during follow-up. Remission was coded using the response categories of the 2021 Chinese Society of Nuclear Medicine ¹³¹I treatment guideline (euthyroidism or hypothyroidism vs. partial or ineffective response). Missing continuous values were multiply imputed (20 chains). Analyses included false discovery rate (FDR)–controlled univariate screening, cross-validated least absolute shrinkage and selection operator (LASSO) selection, post-selection logistic regression, Firth sensitivity analysis, interaction tests, and mutually adjusted restricted cubic splines (RCS).\n\nResults: No patient sleeping less than 6h achieved remission [0/31; 95% confidence interval (CI) 0%–9.2%]. After FDR adjustment, GD duration, TAO duration, sleep duration, and CAS remained associated with remission. LASSO (one-standard-error rule, C = 0.142) retained GD duration, sleep duration, and CAS. In the post-selection model, the odds ratio (OR) per month of GD duration was 0.991 (95% CI 0.979–1.003; P = 0.152); per additional sleep hour, 6.13 (95% CI 3.16–11.91; P < 0.001; Firth OR 5.64, 95% CI 2.99–10.63); and per CAS point, 0.64 (95% CI 0.48–0.86; P = 0.003). The CAS × sleep interaction was not significant (Wald P = 0.096; likelihood-ratio P = 0.086). Mutually adjusted RCS supported non-linearity for CAS ( P < 0.001) but not for sleep ( P = 0.585).\n\nConclusions: Longer pretreatment nocturnal sleep and lower CAS were associated with thyroid functional remission after ¹³¹I therapy in this single-center cohort, with consistent directions across sensitivity models. These retrospective, post-selection associations require prospective validation; the absence of remission below 6h and the fitted threshold effects are exploratory post hoc observations, not validated thresholds.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Nuclear Medicine, The People’s Hospital of Guangxi Zhuang Autonomous Region"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kehua Liao"
    },
    {
      "affs": [
        0
      ],
      "name": "Xiaojuan Wei"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Chen"
    },
    {
      "affs": [
        0
      ],
      "name": "Dongyun Meng"
    },
    {
      "affs": [
        0
      ],
      "name": "Shaozhou Mo"
    },
    {
      "affs": [
        0
      ],
      "name": "Zeyong Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Fengyang Song"
    },
    {
      "affs": [
        0
      ],
      "name": "Lu Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Wentan Huang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4kbeteqtd8f74.bib",
  "cited_by": 0,
  "doi": "10.3389/fendo.2026.1954035",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13719339/?tool=EBI",
  "id": "4kbeteqtd8f74",
  "issns": [
    "1664-2392"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1954035/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2734|Ophthalmology and Eye Disorders"
    ]
  ],
  "openalex": "W7222631756",
  "pdf_url": "https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1954035/pdf",
  "pmcid": "PMC13719339",
  "pmid": "42964047",
  "published": "2026-10-16",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/4kbeteqtd8f74.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:20Z",
      "native_id": "10.3389/fendo.2026.1954035",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fendo.2026.1954035/full"
    },
    {
      "first_seen": "2026-10-31T12:21:36Z",
      "native_id": "PMC:PMC13719339",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13719339"
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    {
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      "native_id": "PMC13719339",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fendo.2026.1954035"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1664-2392",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Nocturnal sleep duration, clinical activity score, and thyroid functional remission after radioactive iodine therapy in Graves’ disease with thyroid-associated ophthalmopathy",
  "title_text": "Nocturnal sleep duration, clinical activity score, and thyroid functional remission after radioactive iodine therapy in Graves’ disease with thyroid-associated ophthalmopathy",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:20:25Z",
  "url": "https://research.draconitic.com/paper/4kbeteqtd8f74",
  "venue": "Frontiers in Endocrinology",
  "versions": []
}