ORIGINAL ARTICLE
Frequency of Nodular Goiter in Patients with Non-Functional Adrenal Incidentaloma
Non-Fonksiyonel Adrenal Insidentalomalı Hastalarda Nodüler Guatr Sıklığı
Received Date : 09 Apr 2020
Accepted Date : 24 Aug 2020
Available Online : 30 Sep 2020
Mustafa CAN, Melia KARAKÖSE, Muhammet KOCABAŞ, İlker ÇORDAN, Hatice ÇALIŞKAN BURGUCU, Mustafa KULAKSIZOĞLU, Feridun KARAKURT
Department of Endocrinology and Metabolism, Necmettin Erbakan University Meram Faculty of Medicine, Konya, TURKEY
Doi: 10.25179/tjem.2020-75427 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:270-276
ABSTRACT
Objective: Thyroid nodules and metabolic disorders such as
obesity, insulin resistance (IR), and dyslipidemia are frequently
reported in patients with non-functional adrenal incidentaloma
(NFAI). This study aimed to evaluate the
structural and functional properties of the thyroid gland and
to elucidate whether there is any relationship between these
and metabolic parameters in patients with NFAI. Material
and Methods: Fifty-four patients diagnosed with NFAI and
54 age, gender, and body mass index (BMI) matched healthy
controls were included in the study. Free thyroxine (fT4),
thyroid-stimulating hormone (TSH), anti-thyroperoxidase
antibody (anti-TPO), fasting blood glucose (FBG), fasting insulin
level, lipid profiles, C-reactive protein (CRP) levels were
estimated in the patients and controls. Furthermore, patients
and controls were evaluated by ultrasonography to determine
thyroid structure, thyroid volume, and thyroid
nodules. Results: The mean total thyroid volume of the NFAI
group (13.48±6.3 mL) was significantly higher as compared
to that of the control group (13.13±10 mL) (p<0.001).
Thyroid nodules were detected in 18 (33.3%) of 54 subjects
in the NFAI group and 16 (29.6%) of 54 subjects in the control
group, resulting in an insignificant difference (p =
0.836). However, the average number of thyroid nodules was
significantly higher in the NFAI group (1.72) compared to the
control group (1.06) (p<0.001). The thyroid nodule size of
the NFAI group (17.83±9.01 mm) was also significantly larger
than the control group (11.68±4.68 mm) (p=0.017).
Moreover, a significant association between the thyroid nodule
and TSH (p=0.026) and between thyroid nodule size
and adenoma size (p=0.046) in the NFAI group was pronounced.
Conclusion: In our study, we found that certain parameters
related to the thyroid gland, such as thyroid
volumes, average number of thyroid nodules, and thyroid
nodule sizes, were significantly higher in NFAI patients than
in healthy controls. There was no significant difference in
terms of thyroid functions and thyroid nodule frequency. In
this regard, studies with larger sample size, encompassing
all factors that may affect thyroid structure and functions,
are essential.
Keywords: Adrenal incidentaloma; thyroid nodule; goiter
ÖZET
Amaç: Nonfonksiyonel adrenal insidentalomalı (NFAİ) hastalarda;
tiroid nodülleri ve obezite, insülin direnci ve dislipidemi
gibi metabolik bozukluklar yaygın olarak görülür. Bu
çalışmanın amacı, NFAİ olan hastalarda tiroid bezinin yapısal
ve fonksiyonel özelliklerini ve bu özelliklerle metabolik parametreler
arasında bir ilişki olup olmadığını belirlemektir.
Gereç ve Yöntemler: NFAİ tanısı alan 54 hasta ile yaş, cinsiyet
ve vücut kitle indeksi (VKİ) uyumlu 54 sağlıklı kontrol
çalışmaya dâhil edildi. Hasta ve kontrol gruplarının serbest tiroksin
(sT4), tiroid stimülan hormon (TSH), anti-tiroperoksidaz
antikoru (anti-TPO), açlık kan şekeri (AKŞ), açlık insülin
seviyesi, lipid profilleri, C-reaktif protein (CRP) düzeyleri ölçüldü.
Ayrıca, hasta ve kontrol grupları tiroid yapısı, tiroid
hacmi ve tiroid nodüllerinin belirlenmesi için ultrasonografi
ile değerlendirildi. Bulgular: Ortalama toplam tiroid hacmi
NFAİ grubunda (13,48±6,3 ml) kontrol grubuna göre
(13,13±10 ml) anlamlı olarak yüksekti (p<0,001). NFAI grubundaki
54 hastanın 18’inde (%33,3), kontrol grubundaki 54
hastanın 16’sında (%29,6) tiroid nodülleri tespit edildi ve anlamlı
fark saptanmadı (p=0,836). Ortalama tiroid nodül sayısı
NFAİ grubunda (1,72) kontrol grubuna göre (1,06)
anlamlı olarak yüksekti (p<0,001). Tiroid nodülü boyutu
NFAİ grubunda (17,83±9,01 mm) kontrol grubuna göre
(11,68±4,68 mm) anlamlı olarak yüksekti (p=0,017). Ayrıca,
NFAI grubunda tiroid nodülü ile TSH (p=0,026) düzeyi
arasında ve tiroid nodülü boyutu ile adenom boyutu
(p=0,046) arasında anlamlı bir ilişki tespit edildi. Sonuç: Çalışmamızın
sonuçlarına göre, NFAI hastalarında tiroid hacimleri,
ortalama tiroid nodül sayıları ve tiroid nodül boyutları
normal popülasyona göre daha yüksek, tiroid fonksiyonları
ve tiroid nodül sıklığı normal popülasyonla benzer olarak tespit
edildi. Bu konu ile ilişkili olarak, daha büyük örneklem boyutuna
sahip olan, tiroid bezinin yapısını ve fonksiyonlarını
etkileyebilecek tüm parametreleri içeren çalışmalara ihtiyaç
vardır.
Anahtar Kelimeler: Adrenal insidentaloma; tiroid nodülü; guatr
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