Evaluation of the natural course of thyroid nodules in patients with acromegaly
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To investigate the nodular thyroid disease (NTD) and the natural course of thyroid nodules in patients with acromegaly.
138 patients with acromegaly (73 F/65 M), whose initial thyroid ultrasonography performed in our university hospital, were included in this study. The frequencies of NTD, papillary thyroid cancer (PTC) and associated factors on nodule formation were investigated at initial assessment. Patients who had NTD continued to follow-up (n = 56) were re-evaluated with a ultrasonography performed after a mean 7-years follow-up period. The nodule size changes were compared with the initial data and the factors affecting nodule growth were investigated.
The frequency of NTD was found 69%. Patients with NTD were older (p = 0.05), with higher baseline IGF-1%ULN (upper limit of normal) (p = 0.01). In patients with NTD, the majority had similar nodule size (45%), decreased nodule size in 30% and nodule growth in 25%. In patients with active acromegaly at last visit, nodule growth was more significant (p < 0.001). For one unit change in the IGF-1 levels, nodule growth increased by 1.01 folds and presence of active acromegaly disease was related with ninefolds increase in nodule growth. The frequency of PTC was 14% in patients with nodule growth and PTC was diagnosed 11% of all acromegalic patients.
Both NTD and nodule growth is more frequent in active acromegalic patients. Thyroid nodules may show dynamic changes according to the disease activity and nodule growth should be closely monitored due to the risk of malignancy in patients with active acromegaly disease.
KeywordsAcromegaly Thyroid nodule growth Natural course IGF-1 Papillary thyroid carcinoma
The authors highly appreciate the efforts of Assistant Professor Feyza Nur Tuncer (Istanbul University Aziz Sancar Institute of Experimental Medicine, Department of Genetics) in the language editing of this paper. And also, the authors would like to thank Sakin Tekin, MD for valuable comments in the interpretation of statistical results.
This research did not receive any spesific grant from any funding agency in the public, commercial or not-for-profit sector.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in this study involving human participants were approved by the institutional and/or national research ethics committee and complied with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of Istanbul University, Istanbul Faculty of Medicine.
Informed consent was obtained from all individual participants included in the study.
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