title: Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis.
abstract: BACKGROUND
  Acromegaly results from oversecretion of growth hormone and subsequently insulin growth factor-1. According to some authors, the disease can cause increased prevalence of nodular goitre and thyroid cancer (TC). However, the number of studies comparing acromegalic patients with control groups is low. We aimed to assess the prevalence of thyroid lesions in patients with acromegaly in comparison to an age- and sex-matched control group and to update the meta-analysis previously performed in our department by the same authors.
  
  
  METHODS
  We searched medical documentation of patients with acromegaly treated in our department between 2003 and 2013. The prevalence of thyroid abnormalities was compared with the group of patients with hormonally inactive adrenal incidentalomas. To perform the meta-analytic part of the paper we also searched ten databases to find relevant papers.
  
  
  RESULTS
  Two hundred and five patients with acromegaly and 184 patients with incidentalomas were included. Any thyroid lesions were present in 77.6% of patients with acromegaly vs. 63.0% with incidentalomas (p = 0.002), multinodular goitre - 66.8% vs. 47.8% (p = 0.0002), and TC- 5.4% vs. 2.7% (p = 0.21) respectively. For thyroid lesions the pooled odds ratio (OR) was 3.1 (95% confidence interval [CI] 1.8-5.5), and for TCs the OR was 4.5 (95% CI 1.9-10.3).
  
  
  CONCLUSIONS
  According to our results thyroid lesions were significantly more common in patients with acromegaly; in case of TC the difference was not significant. The updated meta-analysis showed significantly increased prevalence of both disorders. In conclusion, systematic thyroid examination should be an important part of follow-up in case of acromegalic patients. (Endokrynol Pol 2017; 68 (1): 2-6).
authors.affiliation: Department of Endocrinology, Metabolism and Internal Medicine, Poznan University of Medical Sciences. kosma1644@poczta.onet.pl.
authors.forename: Kosma
authors.initials: K
authors.lastname: Woliński
authors.forename: Adam
authors.initials: A
authors.lastname: Stangierski
authors.forename: Edyta
authors.initials: E
authors.lastname: Gurgul
authors.forename: Barbara
authors.initials: B
authors.lastname: Bromińska
authors.forename: Agata
authors.initials: A
authors.lastname: Czarnywojtek
authors.forename: Martha
authors.initials: M
authors.lastname: Lodyga
authors.forename: Marek
authors.initials: M
authors.lastname: Ruchała
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000473:pathology*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006044:Goiter, Nodular / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013961:Thyroid Gland / Q000002:abnormalities* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology
keywords: acromegaly; meta-analysis; pituitary; thyroid; thyroid cancer