title: Association between worse metabolic control and increased thyroid volume and nodular disease in elderly adults with metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome has been associated with nodular goiter. Our aim was to evaluate which metabolic parameters in elderly patients with metabolic syndrome are associated with thyroid enlargement or increased prevalence of thyroid nodules.
  
  
  METHODS
  In this cross-sectional study, 77 patients >65 years of age with metabolic syndrome were included. We evaluated the presence of thyroid nodules and thyroid volume by ultrasonography and several biochemical, metabolic and anthropometric parameters. Only patients with thyrotropin (thyroid-stimulating hormone, TSH) levels between 0.3 and 6 mU/L were included. We further divided subjects into two groups-type 2 diabetes mellitus (T2DM) and non-T2DM and established comparisons between them.
  
  
  RESULTS
  Among all parameters analyzed we found a significant correlation between glycated hemoglobin (HbA1c) and volume (r=0.261, P=0.027) or number of nodules (r=0.266, P=0.023). Neither sex, age, body mass index (BMI), metformin, nor levothyroxine use were associated with thyroid volume or nodularity. Within the whole cohort, those patients with T2DM had larger thyroid volumes compared to non-T2DM [median (confidence interval, CI) 6.976 (5.220-10.789) vs. 5.034 (3.796-6.034) mL, P<0.008). Furthermore, a larger proportion of T2DM patients presented thyroid volumes >5.8 mL [69 vs. 23%, P<0.001; odds ratio=7.25 (CI 2.04-25.56)].
  
  
  CONCLUSIONS
  In elderly patients with metabolic syndrome, worse metabolic control, represented by higher HbA1c levels, was found associated to increased prevalence of thyroid nodules and larger thyroid volume. Moreover, within the whole metabolic syndrome group, patients with T2DM had the largest thyroid volumes.
authors: 1 Department of Endocrinology and Metabolism, Cesar Milstein Hospital , Buenos Aires, Argentina .
authors: Evelyn
authors: E
authors: Blanc
authors: Cecilia
authors: C
authors: Ponce
authors: Dafne
authors: D
authors: Brodschi
authors: Alejandra
authors: A
authors: Nepote
authors: Adriana
authors: A
authors: Barreto
authors: Marta
authors: M
authors: Schnitman
authors: Pia
authors: P
authors: Fossati
authors: Pablo
authors: P
authors: Salgado
authors: Claudia
authors: C
authors: Cejas
authors: Cristina
authors: C
authors: Faingold
authors: Carla
authors: C
authors: Musso
authors: Gabriela
authors: G
authors: Brenta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D001118:Argentina; D015992:Body Mass Index; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood; D005260:Female; D006442:Glycated Hemoglobin / Q000737:chemistry; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology*; D008687:Metformin / Q000627:therapeutic use; D011446:Prospective Studies; D013959:Thyroid Diseases / Q000150:complications*; D013961:Thyroid Gland / Q000502:physiology*; D016606:Thyroid Nodule / Q000150:complications* / Q000000981:diagnostic imaging / Q000378:metabolism; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000627:therapeutic use; D014463:Ultrasonography
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D013972:Thyrotropin; D013974:Thyroxine; C517652:hemoglobin A1c protein, human