ANALYSING ASSOCIATION BETWEEN ANTHROPOMETRIC INDICATORS OF INSULIN RESISTANCE AND INSULIN-LIKE GROWTH FACTOR-1 IN PATIENTS WITH NODULAR GOITER

Publications suggesting that thyroid nodule might be associated with insulin resistance (IR) and metabolic syndrome are quite interesting. In a very recent report, increased thyroid volume and nodule prevalence were also reported in patients with IR in an iodine-sufficient area []. The purpose of the work is to analyze the association between anthropometric indicators IR and IGF-1 in patients with nodular goiter. Materials and methods. During the study the authors examined 73 patients with euthyroid single-node (n = 34) and multinodular goiter (n = 39) aged 17 to 74 years (mean - (51.0 ± 10.6) years), determining WC, WC / HC, BMI, WHtR, ABSI, BFD, BRI, CI, AVI, BAI, IGF-1, TSH, fT4, fT3. Thyroid volume, its structure, number, size and location of foci was assessed by an ultrasonic complex Aloka SSD-1100 (Japan), using a linear sensor 7.5 MHz. Results and their discussion. In the total number of patients with nodular goiter IGF-1 is nonlinearly negatively associated with BMI (r = -0.30; P = 0.016), WC (r = -0.26; P = 0.036), WHtR (r = -0.30) ; P = 0.020), AVI (r = -0.27; P = 0.03), ABSI (r = -0.31; P = 0.015), nonlinear positive with BFD (r = 0.27; P = 0.033) ), BRI (r = 0.29; P = 0.02) and linearly positive with BAI (r = 0.36; P = 0.004); thyroid volume is linearly positively associated with age (r = 0.35; P = 0.009), nonlinearly positively with WC / HC (r = 0.43; P = 0.001), BFD (r = 0.26; P = 0.06 ) and CI (r = 0.31; P = 0.02). In patients with nodular goiter with BMI≥35 kg / m2 thyroid volume is linearly positively associated with BMI (r = 0.71; P = 0.049). In patients with nodular goiter with IRF-1 above the sex-age norm, thyroid volume is nonlinearly positively associated with WC / HC (r = 0.71; P = 0.01), BAI (r = 0.66; P = 0.03 ) and nonlinearly negative with BFD (r = -0.52; P = 0.01). It has been found that BAI explains 82.37% of the variance of IGF-1 in the general group and more than 90% of the variance of its level in groups of patients with nodular goiter with high IGF-1 with / without obesity. In patients with nodular goiter with high IGF-1 and obesity, the predictor of increased thyroid volume is BRI, which explains 81.14% of the variance of its volume. Conclusions: Patients with nodular goiter with IGF-1 level in blood above the sex-age norm have significantly higher values of anthropometric indicators IR (WHtR, ABSI, BFD and BAI) compared with patients with a normal level of this indicator; in patients with nodular goiter with II degree obesity and above, thyroid volume is significantly associated with BMI; BAI (R2 = 82.37%) is a predictor of increased levels of IGF-1 in blood of patients with nodular goiter, regardless of the obesity; BRI (R2 = 81.14%) is a predictor of increased thyroid volume in patients with nodular goiter with IGF -1 high level and obesity. Key words: nodular goiter, anthropometric indicators, insulin resistance

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Prevalence of iodine deficiency among multinodular goiter patients: a South Indian study

International Surgery Journal ◽

10.18203/2349-2902.isj20170213 ◽

2017 ◽

Vol 4 (2) ◽

pp. 680 ◽

Cited By ~ 1

Author(s):

Nishad Kerakada ◽

Ganesh Manikantan ◽

Meer M. Chisthi

Keyword(s):

Iodine Deficiency ◽

Multinodular Goiter ◽

Control Cell ◽

Nodular Goiter ◽

Cross Sectional Study ◽

Cross Sectional ◽

South Indian ◽

Number Of Patients ◽

High Prevalence ◽

The Government

Background: Mass iodization of table salt was introduced by the Government of India to treat as well as prevent iodine deficiency problems including goitres. However, even after so many years of introduction of iodized salt, the number of patients reporting with multi nodular goiter to the hospitals in Kerala seems to be high. The coastal districts of Trivandrum and Kollam report especially high prevalence of goitres and subsequently thyroidectomies. The aim of this study was to find the prevalence of iodine deficiency among patients with multi nodular goiter in South Kerala.Methods: This was a cross sectional study of 300 patients admitted with multinodular goitre in the general surgical wards of Government Medical College Trivandrum, Kerala, India. From June 2013 to June 2014, these patients were evaluated clinically and with the investigatory facilities available at this institution. Their urine spot iodine excretion levels were measured at the laboratory of state iodine deficiency control cell, Trivandrum, Kerala, India.Results: Out of the 300 cases, 6 patients were found to have mild iodine deficiency. Mean iodine level was normal at 170 microgram per decilitre. The prevalence of iodine deficiency in multinodular goiter cases studied was found to be 2%.Conclusions: The high prevalence of multinodular goiter cases in Kerala cannot be sited per se as due to iodine deficiency as only 2% of the total number of cases studied had low urine iodine levels. This raises a question whether the salt iodization programme needs to be re-analyzed and possibly re-structured for the state of Kerala.

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The Incidence of Thyroid Carcinoma in Multinodular Goiter: A Retrospective Study

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v10i4.12974 ◽

2015 ◽

Vol 10 (4) ◽

pp. 18-21 ◽

Cited By ~ 2

Author(s):

D. Shrestha ◽

S. Shrestha

Keyword(s):

Retrospective Study ◽

Multinodular Goiter ◽

Nodular Goiter ◽

Follicular Carcinoma ◽

Neck Surgery ◽

Anaplastic Carcinoma ◽

Histopathological Analysis ◽

Thyroid Lesion ◽

Number Of Patients ◽

Thyroid Malignancies

Background and Objective: To determine the incidence and the types of various thyroid malignancies in multi-nodular goiter.Material and methods: This is a retrospective study, conducted in Department of ENT and Head and Neck Surgery, National Academy of Medical Sciences Bir Hospital Kathmandu and Alka Hospital Pvt. Ltd Lalitpur. The study period was 3 years from 11 January 2011 to 10 January 2014. The study population consisted of 100 patients who were diagnosed as a multinodular thyroid nodule.Result: The highest frequency was 50 (50%) in 31-40 years. Among the total cases, 28 (28%) were males and 72(72%) females. Histopathological analysis showed that benign multi-nodular goiter was present in 87 (87%) cases, and malignant thyroid lesion in 13 (13%) cases. Among malignancies, papillary carcinoma was found as the commonest malignancy 11 (84.61%) cases followed by follicular carcinoma 1 (7.69%) case and anaplastic carcinoma 1(7.69%) case.Conclusion: The risk of malignancy in multinodular goiter should not be underestimated as significant number of patients with thyroid malignancies present with multinodular goiter.JCMS Nepal 2014; 10(4):18-21

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Pathogenetic aspects of the development of cholelithiasis in patients with metabolic syndrome

Terapevticheskii arkhiv ◽

10.26442/00403660.2021.02.200616 ◽

2021 ◽

Vol 93 (2) ◽

pp. 209-214

Author(s):

Yu. P. Uspenskiy ◽

Yu. A. Fominykh ◽

K. N. Nadzhafova ◽

A. V. Vovk ◽

A. V. Koshcheev

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Adipose Tissue ◽

Gallstone Disease ◽

Modifiable Risk Factors ◽

Tissue Lipid ◽

Lipid Metabolism Disorders ◽

Number Of Patients ◽

Main Components

Nowadays there is a steady tendency to increase the number of patients with gallstone disease and metabolic syndrome. Increasingly, gallstone disease is called a non-canonical cluster of metabolic syndrome, because the main components of metabolic syndrome are also modifiable risk factors for gallstone disease. This article discusses the pathogenetic parallels in the development of gallstone disease and metabolic syndrome - insulin resistance and hormones of adipose tissue, lipid metabolism disorders, immune factors and the cytokine system. There are described possible effects of cholecystectomy on metabolism in patients with metabolic syndrome.

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Insulin resistance: focus on the pathogenesis of cardiomyopathy

Consilium Medicum ◽

10.26442/20751753.2020.10.200341 ◽

2020 ◽

Vol 22 (10) ◽

pp. 52-54

Author(s):

Veronika N. Shishkova ◽

◽

Veronika N. Shishkova ◽

Anatolii I. Martynov ◽

◽

...

Keyword(s):

Heart Failure ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Chronic Heart Failure ◽

Developed Countries ◽

Therapeutic Strategies ◽

Lipid Lowering ◽

Modern World ◽

Unhealthy Lifestyle ◽

Number Of Patients

Insulin resistance is the main link of pathogenesis of a lot of diseases, including cardiovascular diseases which are the leading cause of morbidity and mortality worldwide. The combination of insulin resistance – associated disorders, such as obesity, type 2 diabetes mellitus, arterial hypertension and hypertriglyceridemia, refers to metabolic syndrome. The increase in the number of patients with metabolic syndrome is due to a prevalence of unhealthy lifestyle and inappropriate di-etary pattern in the modern world, and is also partially associated with the trend of population aging in most developed countries. In this regard, it is necessary to emphasize the relevance of the link between insulin resistance and the development of a specific complication – metabolic cardiomyopathy. Given that the triggering event in pathogenesis of this cardiomyopathy is alterations in substrate balance with following accumulation of lipotoxic metabolites in cardiomyocytes, the term “lipotoxic cardiomyopathy” has been proposed. This cardiomyodystrophy is associated with myocardial hypertrophy and diastolic dysfunction, which thereafter result into chronic heart failure with a preserved ejection fraction. Although the link between the lipotoxic cardiomyodystrophy and insulin resistance–associated disorders is quite close, till now all therapeutic strategies involving only complex therapy with antidiabetic and lipid-lowering drugs have not led to a decrease in the risk for cardiomyopathy. There is a need in searching for effective therapeutic strategies to reduce the incidence of both lipotoxic cardiomyody-strophy and associated chronic heart failure.

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STRUCTURE OF THE NODULAR GOITER IN CHILDREN

Bulletin of Siberian Medicine ◽

10.20538/1682-0363-2015-5-54-60 ◽

2015 ◽

Vol 14 (5) ◽

pp. 54-60

Author(s):

O. S. Rogova ◽

L. N. Samsonovа ◽

G. F. Okminyan

Keyword(s):

Thyroid Cancer ◽

Papillary Thyroid Cancer ◽

Multinodular Goiter ◽

Morphological Structure ◽

Nodular Goiter ◽

Thyroid Adenoma ◽

Papillary Thyroid ◽

Single Node ◽

Treatment And Prevention ◽

Functional Autonomy

For today the question of early diagnosis of nosological variants, the method of treatment and prevention of nodular goiter in children is still not fully resolved. There is a few available literature data about study of this problem in children. Objective: to study morphofunctional structure of thyroid nodules in children.The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A. Bashlyaeva Children’sCityClinicalHospital(Moscow) from 2003 to May 2015. The examination included an evaluation of the functional status of the pituitary-thyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hor-mone, also was performed thyroid scintigraphy 99mТc. In the postoperative period, there was carried out a final verification of the diagnosis according to the results of the histological conclusion. The histologi-cal type of nodal disease was defined by the WHO classification of 2004. It was established that in the structure of a single-node goiter in children prevail nodular colloid goiter with equal frequency in boys and girls, with the same frequency occurs thyroid adenoma, but more often in girls than in boys. The multinodular goiter equally often detected in girls and boys both nodular goiter colloidal with varying degree of proliferation and colloid in combination with follicular thyroid adenoma. "Hot" nodes in the multinodular goiter are more common than in the single-node goiter and more fre-quently in girls than in boys. The half of children with nodular pathology have "hot" nodes and one out of every three – decompensated form of functional autonomy. Decompensated form of functional autonomy of the thyroid gland in children with "hot" nodes detects regardless of the number of nodes. Papillary thyroid cancer occurs not only in patients with a single-node, but with a multinodular goiter. The results allow to draw conclusions about the heterogeneity of the morphological structure as a single-node and multinodular goiter in children, including papillary thyroid cancer.

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Working in Shifts and the Metabolic Syndrome: Epidemiological Evidence and Physiopathological Mechanisms

ARS Medica Tomitana ◽

10.2478/arsm-2018-0026 ◽

2018 ◽

Vol 24 (3) ◽

pp. 144-151

Author(s):

Oţelea Marina Ruxandra ◽

Raşcu Agripina ◽

Ion Ileana ◽

Arghir Ioan Anton ◽

Badiu Adela ◽

...

Keyword(s):

Physical Activity ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Hdl Cholesterol ◽

Gene Interaction ◽

Underlying Mechanism ◽

Epidemiological Evidence ◽

The Metabolic Syndrome ◽

Abnormal Metabolism ◽

High Level

Abstract The Metabolic syndrome (MetS) is considered as an association of the abdominal obesity, abnormal metabolism of the lipids and glucose (high level of triglycerides, low level of HDL-cholesterol and high level of glycemia) and high values of blood pressure, determined by an underlying mechanism of insulin resistance. As a result of environmental-gene interaction, MetS is associated with unhealthy nutrition, smoking, alcohol abuse, lack of physical activity, shorter sleep duration and desynchronization of the circadian rhytm caused by working in shifts. The aim of this article is to review the effects of working in shifts on the MetS through the epidemiological evidence and the perspective of the physiopathological mechanisms.

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W09.220 Endothelial dysfunction in subjects with early stages of the metabolic syndrome. Association with visceral adiposity and insulin resistance

Atherosclerosis ◽

10.1016/s0021-9150(04)90219-5 ◽

2004 ◽

Vol 5 (1) ◽

pp. 51

Author(s):

R GILABERT

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Endothelial Dysfunction ◽

Visceral Adiposity ◽

Early Stages ◽

The Metabolic Syndrome ◽

Syndrome Association

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Impact of the serum thyroglobulin concentration on the diagnostics of benign and malignant thyroid diseases

Nuklearmedizin ◽

10.1055/s-0038-1632259 ◽

2000 ◽

Vol 39 (05) ◽

pp. 133-138 ◽

Cited By ~ 4

Author(s):

W. Dembowski ◽

H.-J. Schroth ◽

K. Klinger ◽

Th. Rink

Keyword(s):

Hashimoto’S Thyroiditis ◽

Thyroid Volume ◽

Nodular Goiter ◽

Thyroid Diseases ◽

Hashimoto's Thyroiditis ◽

Graves Disease ◽

Normal Range ◽

Serum Thyroglobulin ◽

Diffuse Goiter ◽

Hyperthyroid Patients

Summary Aim of this study is to evaluate new and controversially discussed indications for determining the thyroglobulin (Tg) level in different thyroid diseases to support routine diagnostics. Methods: The following groups were included: 250 healthy subjects without goiter, 50 persons with diffuse goiter, 161 patients with multinodular goiter devoid of functional disorder (108 of them underwent surgery, in 17 cases carcinomas were detected), 60 hyperthyroid patients with autonomously functioning nodular goiter, 150 patients with Hashimoto’s thyroiditis and 30 hyperthyroid patients with Graves’ disease. Results: The upper limit of the normal range of the Tg level was calculated as 30 ng Tg/ml. The evaluation of the collective with diffuse goiter showed that the figure of the Tg level can be expected in a similar magnitude as the thyroid volume in milliliters. Nodular tissue led to far higher Tg values then presumed when considering the respective thyroid volume, with a rather high variance. A formula for a rough prediction of the Tg levels in nodular goiters is described. In ten out of 17 cases with thyroid carcinoma, the Tg was lower than estimated with thyroid and nodular volumes, but two patients showed a Tg exceeding 1000 ng/ml. The collective with functional autonomy had a significantly higher average Tg level than a matched euthyroid group being under suppressive levothyroxine substitution. However, due to the high variance of the Tg values, the autonomy could not consistently be predicted with the Tg level in individual cases. The patients with Hashimoto’s thyroiditis showed slightly decreased Tg levels. In Graves’ disease, a significantly higher average Tg level was observed compared with a matched group with diffuse goiter, but 47% of all Tg values were still in the normal range (< 30 ng/ml). Conclusion: Elevated Tg levels indicate a high probability of thyroid diseases, such as malignancy, autonomy or Graves’ disease. However, as low Tg concentrations cannot exclude the respective disorder, a routine Tg determination seems not to be justified in benign thyroid diseases.

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