title: Thyroid ultrasound in diabetic patients without overt thyroid disease.
abstract: OBJECTIVE
  To assess thyroid volume and to evaluate possible lesions in the gland structure using thyroid ultrasound in patients with diabetes mellitus type 1 (DM1) and 2 (DM2) without overt thyroid disease.
  
  
  METHODS
  Consecutive adult patients with DM2 (n = 98) and DM1 (n = 30) without overt thyroid disease referred to our department because of poorly controlled disease and/or diabetic complications were prospectively analyzed. Thyroid volumes, gland echogenicity, thyroid nodules incidence, and TSH levels were compared with control groups (n = 50 and 38) and matched according to sex and age.
  
  
  RESULTS
  Significant increases in median thyroid volume were observed in both subjects with DM1 (17.3 cm3, interquartile range (IR) 13.9-21.6 cm3 versus 14.4 cm3, IR 11.3-18.3 cm3; P < 0.05) and DM2 (20.5 cm3, IR 14.9-27.1 cm3 versus 14.1 cm3, IR 11.3-18.3 cm3; P < 0.001) in comparison to their control groups. Moreover, in the population of type 2 diabetics, thyroid nodules (OR 2.37, 95% CI 1.14-4.93), parenchymatous goiter (OR 5.40, 95% CI 1.20-24.30), and all kinds of thyroid goiter according to the WHO definition (OR 4.18, 95% CI 2.02-8.66) were remarkably more frequent. In our patients, reduced (but within normal range) TSH level occurred in DM1 (median 0.97 mIU/l, IR 0.61-1.58 mIU/l versus median 1.66 mIU/l, IR 0.76-2.09 mIU/l; P < 0.05). The presence of a negative linear correlation between thyroid volume and TSH concentration was noticed in patients with DM2 (RS = -0.38, P < 0.01).
  
  
  CONCLUSIONS
  In individuals with DM1 and DM2 treated for poorly controlled disease and/or diabetic complications, thyroid volumes were significantly higher than in the normal population. Moreover, nodular thyroid structure and parenchymatous goiter occurred more frequently in these type 2 diabetic patients.
authors.affiliation: Department of Endocrinology and Diabetology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Junik
authors.forename: M
authors.initials: M
authors.lastname: Kozinski
authors.forename: K
authors.initials: K
authors.lastname: Debska-Kozinska
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013959:Thyroid Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D013961:Thyroid Gland / Q000473:pathology*; D014463:Ultrasonography