Urine iodine excretion ın patients with euthyroid noduler disease

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: <50μg/L (severe iodine deficiency group), Group 2: 50-100μg/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.

The relationship between LH and thyroid volume in patients with PCOS

“…In recent studies, thyroid volume (TV) has been found to be associated with age, anthropometry, smoking, iodine status and hyperinsulinemia [5-8]. Additionally, growth hormone and growth factors such as insulin like growth factor, epidermal growth factor have been shown to affect TV [9,10].…”

Association between urinary iodine concentration and the risk of papillary thyroid cancer by sex and age: a case–control study

“…Several studies have investigated the association between UIC and thyroid diseases 15 , 16 and thyroid cancer 17 – 19 , but to our knowledge, well-designed epidemiologic studies on the association between UIC and the risk of thyroid cancer are sparse.…”

Response to comments on urine iodine excretion in patients with euthyroid nodular disease

“…To the Editor: In the September–October/2011 issue of your journal I commented 1 on the article by Cakir and colleagues on urinary iodine excretion in patients with euthyroid nodular disease. 2 I am glad that Cakir responded to my concerns. 3 Cakir made the point that there are controversies about the cut-off values on urinary iodine excretion and that measurement of iodine levels in spot urine sample is found to be as sensitive as other screening modalities.…”

“…Second, Cakir and colleagues started their original study 2 with three groups significantly different in the proportions of smokers and those with additional diseases. Any difference in outcome after one year of follow up could be attributed to one of these two variables.…”