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Urine iodine excretion ın patients with euthyroid noduler disease.

Cakir E, Eskioglu E, Aydin Y, Ozkan SK, Guler S - Ann Saudi Med (2011 Mar-Apr)

Bottom Line: The presence of additional disease (hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder) and smoking rates were significantly higher in first group compared to the second and third group.Smoking rates were higher in iodine deficient groups.It is thought that smoking impairs iodine intake or absorption consistent with a previous report.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. evrimcakir@mynet.com

ABSTRACT

Background and objectives: Different nutritional and environmental factors are responsible for the pathogenesis of goiter, but iodine deficiency is the most important factor. However, little is known about the natural course of benign thyroid nodules in euthyroid patients over time. Few studies have used ultrasonographic evaluation to address this issue, especially in iodine-deficient areas. In this study, we present the long-term follow-up of benign thyroid nodules in a iodine-deficient area.

Design and setting: Cross-sectional study at a tertiary referral center.

Patients and methods: This study included 62 randomly selected patients with benign euthyroid nodule. Thyroid volume and nodules were measured with sonography. Iodine intake was estimated by patient diet history and by measuring iodine excretion in spot urine samples. Patients were followed one year.

Results: Patients were divided into three groups according to level of urine iodine excretion: Group 1: <50 μg/L (severe iodine deficiency group), Group 2: 50-100 μg/L (mild iodine deficiency group), Group 3: >100 g/L (iodine sufficient group). The presence of additional disease (hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder) and smoking rates were significantly higher in first group compared to the second and third group. Among groups, no significant difference was observed in either right or left thyroid lobe volume after one year. A clinically significant increase in nodule volume was observed in the first group, while there was a significant decrease in the second and third group.

Conclusion: In this study, iodine deficiency was associated with an increase in thyroid nodule volumes. Smoking rates were higher in iodine deficient groups. It is thought that smoking impairs iodine intake or absorption consistent with a previous report.

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Related in: MedlinePlus

Nodule volume changes between groups before and after follow up by urine iodine level. (Group 1: <50 μg/L [severe iodine deficiency group], Group 2: 50-100 μg/L [mild iodine deficiency], Group 3: >100 μg/L [iodine sufficiency]). The nodule volume increase in first group patients was statistically significant when compared to the nodule volume decrease in second and third group patients (P=.002, P<.001, respectively). The horizontal lines in the middle of each box indicate the median, the top and bottom borders of the box mark the 25th and 75th percentiles. The whiskers above and below the box mark the maximum and minimum levels. Open circles indicate outliers. Asterisks represents extreme cases.
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Figure 1: Nodule volume changes between groups before and after follow up by urine iodine level. (Group 1: <50 μg/L [severe iodine deficiency group], Group 2: 50-100 μg/L [mild iodine deficiency], Group 3: >100 μg/L [iodine sufficiency]). The nodule volume increase in first group patients was statistically significant when compared to the nodule volume decrease in second and third group patients (P=.002, P<.001, respectively). The horizontal lines in the middle of each box indicate the median, the top and bottom borders of the box mark the 25th and 75th percentiles. The whiskers above and below the box mark the maximum and minimum levels. Open circles indicate outliers. Asterisks represents extreme cases.

Mentions: In first group, the mean nodule volume was 0.468 cm3 at the initial visit and increased to 0.672 cm3 after one year follow up. This volume increase was 45.6%. Fifteen of 18 patients showed an increase, but two showed a decrease in nodule volume and one patient had no change. Although a decrease in mean nodule volume was observed in two patients, the difference was not found to be statistically significant. In third group mean nodule volume decreased from 0.47 cm3 to 0.33 cm3 . This volume decrease was 29.7% (Figure 1). Sixteen of 26 patients showed a decrease, but six showed an increase in nodule volume and four patients had no change. The nodule volume increase in first group patients was found to be statistically significant when compared to the nodule volume decrease in second and third group patients (P values; P=.002; P<.001 respectively).


Urine iodine excretion ın patients with euthyroid noduler disease.

Cakir E, Eskioglu E, Aydin Y, Ozkan SK, Guler S - Ann Saudi Med (2011 Mar-Apr)

Nodule volume changes between groups before and after follow up by urine iodine level. (Group 1: <50 μg/L [severe iodine deficiency group], Group 2: 50-100 μg/L [mild iodine deficiency], Group 3: >100 μg/L [iodine sufficiency]). The nodule volume increase in first group patients was statistically significant when compared to the nodule volume decrease in second and third group patients (P=.002, P<.001, respectively). The horizontal lines in the middle of each box indicate the median, the top and bottom borders of the box mark the 25th and 75th percentiles. The whiskers above and below the box mark the maximum and minimum levels. Open circles indicate outliers. Asterisks represents extreme cases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3102477&req=5

Figure 1: Nodule volume changes between groups before and after follow up by urine iodine level. (Group 1: <50 μg/L [severe iodine deficiency group], Group 2: 50-100 μg/L [mild iodine deficiency], Group 3: >100 μg/L [iodine sufficiency]). The nodule volume increase in first group patients was statistically significant when compared to the nodule volume decrease in second and third group patients (P=.002, P<.001, respectively). The horizontal lines in the middle of each box indicate the median, the top and bottom borders of the box mark the 25th and 75th percentiles. The whiskers above and below the box mark the maximum and minimum levels. Open circles indicate outliers. Asterisks represents extreme cases.
Mentions: In first group, the mean nodule volume was 0.468 cm3 at the initial visit and increased to 0.672 cm3 after one year follow up. This volume increase was 45.6%. Fifteen of 18 patients showed an increase, but two showed a decrease in nodule volume and one patient had no change. Although a decrease in mean nodule volume was observed in two patients, the difference was not found to be statistically significant. In third group mean nodule volume decreased from 0.47 cm3 to 0.33 cm3 . This volume decrease was 29.7% (Figure 1). Sixteen of 26 patients showed a decrease, but six showed an increase in nodule volume and four patients had no change. The nodule volume increase in first group patients was found to be statistically significant when compared to the nodule volume decrease in second and third group patients (P values; P=.002; P<.001 respectively).

Bottom Line: The presence of additional disease (hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder) and smoking rates were significantly higher in first group compared to the second and third group.Smoking rates were higher in iodine deficient groups.It is thought that smoking impairs iodine intake or absorption consistent with a previous report.

View Article: PubMed Central - PubMed

Affiliation: Department of Endocrinology and Metabolism, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey. evrimcakir@mynet.com

ABSTRACT

Background and objectives: Different nutritional and environmental factors are responsible for the pathogenesis of goiter, but iodine deficiency is the most important factor. However, little is known about the natural course of benign thyroid nodules in euthyroid patients over time. Few studies have used ultrasonographic evaluation to address this issue, especially in iodine-deficient areas. In this study, we present the long-term follow-up of benign thyroid nodules in a iodine-deficient area.

Design and setting: Cross-sectional study at a tertiary referral center.

Patients and methods: This study included 62 randomly selected patients with benign euthyroid nodule. Thyroid volume and nodules were measured with sonography. Iodine intake was estimated by patient diet history and by measuring iodine excretion in spot urine samples. Patients were followed one year.

Results: Patients were divided into three groups according to level of urine iodine excretion: Group 1: <50 μg/L (severe iodine deficiency group), Group 2: 50-100 μg/L (mild iodine deficiency group), Group 3: >100 g/L (iodine sufficient group). The presence of additional disease (hypertension, diabetes mellitus, coronary heart disease, chronic renal failure and a history of any medication for chronic disorder) and smoking rates were significantly higher in first group compared to the second and third group. Among groups, no significant difference was observed in either right or left thyroid lobe volume after one year. A clinically significant increase in nodule volume was observed in the first group, while there was a significant decrease in the second and third group.

Conclusion: In this study, iodine deficiency was associated with an increase in thyroid nodule volumes. Smoking rates were higher in iodine deficient groups. It is thought that smoking impairs iodine intake or absorption consistent with a previous report.

Show MeSH
Related in: MedlinePlus