Obesity is Associated with Increased Thyroid Volume and Heterogeneity in Ultrasonography
Obezite Tiroid Ultrasonografisinde Artmış Tiroid Volümü ve Heterojeniteyle İliÅŸkilidir
Received Date : 26 Aug 2019
Accepted Date : 12 Mar 2020
Available Online : 24 Oct 2020
Abbas Ali TAM, Didem ÖZDEMİR, Berna EVRANOS ÖĞMEN, Fatma Dilek DELLAL, Afra ALKAN*, Oya TOPALOĞLU, Reyhan ERSOY, Bekir ÇAKIR
Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey
*Ankara Yıldırım Beyazıt University Faculty of Medicine, Department of Biostatistics, Ankara, Turkey
Doi: 10.25179/tjem.2019-71171 - Makale Dili: EN
Turk J Endocrinol Metab 2020;24:9-15
ABSTRACT
Objective: The aim of the present study was to investigate
the possible association between obesity and thyroid functions
and thyroid morphology. Material and Methods: A total
of 674 subjects-121 obese and 553 nonobese-were included
in the study. Body mass index, serum thyrotrophic, free triiodothyronine
(fT3), free thyroxine (fT4), antithyroid peroxidase
antibody, and antithyroglobulin antibody (antiTg) were
evaluated in each subject. The subjects with thyroid nodules
in ultrasonography (USG) were excluded. The thyroid volume
of each subject was calculated and analyzed. Results: Obesity
was significantly associated with increased age and low
fT4 in univariate analysis (p<0.05). With multivariate analysis,
the odds of obesity was found to increase by 21.8% (95%
CI: 12.4-31.9%) for each 5-year increase in age anddecrease
by 53.1% (95% CI: 0.4-77.9%) for each 1 ng/dL increase in
fT4. The odds of obesity in patients with positive antiTg was
1.603 (95% 1.047-2.454) times higher than the odds of obesity
in patients with negative antiTg. The median total thyroid
volume was significantly higher in obese as compared to nonobese
subjects (12.11 mL vs. 10.77 mL, p<0.001). Heterogeneous
gland with negative thyroid antibodies was observed
in 17 (14%) obese and 40 (7.2%) nonobese subjects
(p=0.024). Conclusion: Obesity was positively associated
with antiTg and age, whereas negatively associated with fT4.
Approximately, in every seven obese subjects, one showed
heterogeneity in US despite negative thyroid autoantibodies.
This suggests that the value of US in the diagnosis of autoimmune
thyroiditis might decrease in obese patients.
Keywords: Obesity; thyroid functions; thyroid volume; heterogeneity; thyroid morphology
ÖZET
Amaç: Obezite ile tiroid fonksiyonları ve tiroid morfolojisi
arasındaki muhtemel ilişkiyi araştırmaktır. Gereç ve Yöntemler:
Çalışmaya toplam 121’i obez 553’ü nonobez olmak
üzere 674 birey alındı. Her bireyde beden kitle indeksi,
serum tirotiropin, serbest triodotironin (sT3), serbest tiroksin
(sT4), antitiroid peroksidaz antikoru ve antitiroglobulin
antikoru (antiTg) deÄŸerlendirildi. Ultrasonografi (USG) de tiroid
nodülü olanlar çalışma dışında bırakıldı. Her bireyde tiroid
volümü hesaplandı ve analiz edildi. Bulgular:
Univariate analizde obezite anlamlı olarak artan yaş ve
düşük sT4 ile ilişkiliydi (p<0,05). Multivariate analizde obezite
riski yaşta artan her 5 yıl için %21,8 (%95 güven aralığı
(GA): %12,4-31,9) ve sT4’teki her bir ng/dL azalışta
%53,1 (%95 GA: %0,4-77,9) artmaktaydı. AntiTg negatif
hastalara göre antiTg pozitif olan hastalarda obezite riski
1,603 (%95 1,047-2,454) kat daha fazlaydı. Obezlerde nonobezlere
göre median total tiroid volümü anlamlı olarak
daha fazlaydı (12,11 mL’ye karşı 10,77 mL, p<0,001). Heterojen
glandıyla birlikte tiroid antikorlarının negatifliği 17
(%14) obez ve 40 (%7,2) nonobez bireyde tespit edildi
(p=0,024). Sonuç: Obezite antiTg ve yaş ile pozitif ve sT4
ile negatif olarak ilişkiliydi. Obezitesi olan yaklaşık olarak
her 7 bireyin birinde tiroid antikorları negatif olmasına rağmen
USG’de heterojenite vardı. Bu bize, obez hastalarda
otoimmün tiroidit tanısında USG'nin değerinin azalabileceğini
göstermektedir.
Anahtar Kelimeler: Obezite; tiroid fonksiyonları; tiroid volümü; heterojenite; tiroid morfolojisi
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