ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
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
Doi: 10.25179/tjem.2020-75427 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:270-276
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
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.
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.
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