[Show abstract][Hide abstract]ABSTRACT: Objective: The aim of this study was to investigate the effects of metformin on thyroid volume and nodule size. Subjects and Methods: Prospective data were gathered on 100 newly diagnosed subjects with insulin resistance (68 female, 32 male) between August 2008 and May 2010. Each subject followed a standard diet and exercise program, and received 1,700 mg/day of metformin therapy for 6 months. The height, weight, waist circumference (WC) and thyroid hormone levels of each subject were measured. Additionally, the dimensions of the thyroid lobes and maximum diameter of each thyroid nodule were determined by ultrasonography. BMI and thyroid volumes were also calculated. Insulin resistance was estimated by homeostasis model assessment. All these parameters were measured at the beginning and at the end of the treatment period. Results: BMI and WC decreased significantly after metformin therapy (34.5 +/- 5.1 vs. 32.7 +/- 4.8, p < 0.0001, and 106.3 +/- 11.8 vs. 101.8 +/- 19.0 cm, p = 0.008, respectively). Insulin resistance also decreased after metformin therapy (4.5 +/- 1.9 vs. 2.9 +/- 1.7, p < 0.0001). The mean thyroid volume (22.5 +/- 11.2 vs. 20.3 +/- 10.4 ml, p < 0.0001) and mean thyroid nodule size (12.9 +/- 7.6 vs. 11.7 +/- 7.2 mm, p < 0.0001) also decreased after treatment. Conclusion: In subjects with insulin resistance, metformin therapy significantly decreased thyroid volume and nodule size. (C) 2015 S. Karger AG, Basel
Full-text Article · Jan 2016 · Medical Principles and Practice
[Show abstract][Hide abstract]ABSTRACT: Objective Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume.
We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p<0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p≤0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p<0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r=0.92, p<0.001) and TSH (r=0.435, p<0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.
Article · Nov 2014 · Arquivos brasileiros de endocrinologia e metabologia
[Show abstract][Hide abstract]ABSTRACT: The present retrospective study aimed to investigate the relationship between thyroid volume and prevalence of thyroid cancer. We investigated the data of 3,850 patients who underwent fine-needle aspiration biopsy (FNAB). Biopsy results were evaluated as diagnostic or nondiagnostic, and diagnostic results were classified as benign, malignant, and indeterminate. We included 2,672 patients who underwent FNAB firstly in our hospital and evaluated as diagnostic biopsy except subgroup of indeterminate. We obtained cytologic data, levels of serum thyroid-stimulating hormone (TSH), and thyroid volumes of those patients retrospectively. Among 2,672 patients with thyroid nodule, 2,562 (95.9 %) patients had benign cytology and 110 (%4,1) patients had malignant cytology. There was no correlation between the malignancy and gender (p = 0.935), and patients with malignant cytology were younger (52 vs 59, p < 0.001). Also, TSH levels were higher in patients with malignant than benign cytology (p = 0.017). Median volume of right part, left part, and total thyroid for patients who had malignant cytology was significantly lower than patients who had benign cytology (8.3, 7.1, 15.9 vs 10.8 ml, 9.0 mml, 20.6 ml, respectively, p ≤ 0.001 for all parameters). The results demonstrated that thyroid cancer prevalence was higher in patients with low thyroid volume. According to our results, thyroid volume should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.
[Show abstract][Hide abstract]ABSTRACT: Although obesity is a powerful risk factor for metabolic syndrome (MetS) it is not present in all obese individuals. Increased visceral adipose tissue is the hallmark of this syndrome. In this cross sectional survey we aimed to use abdominal bioelectrical impedance analysis to measure the visceral adipose tissue (VAT) and trunk fat percentages (TF%) in the study population, correlate these findings with traditional anthropometric measures and biochemical parameters of metabolic syndrome and estimate a cut-off value of visceral fat for development of MetS. A total of 285 subjects were enrolled. VAT and TF% were measured by the AB-140 device via abdominal bioelectrical impedance analysis. Fat% was measured by a body composition analyzer (TBF-300). VAT was significantly positively correlated with body mass index, waist circumference, TF%, HOMA IR, fat percentage, fasting plasma glucose and triglycerides. Strongest correlations were between VAT and TF%, VAT and device measured waist circumference and between VAT and manual waist circumference (r=0.95, r=0.93, r=0.92 respectively). Correlations of VAT and TF% with metabolic parameters were significant but weak. The mean VAT and TF% in MetS (+) groups were significantly higher than patients in MetS (-) groups in both sexes. The areas under the ROC curves were 0.730 (95% CI: 0.661-0.791) for female VAT and 0.702 (95% CI: 0.654-0.749) for male VAT in predicting MetS which were similar to the areas under ROC curves calculated for device and manually measured waist circumference, HOMA IR and TF% in predicting MetS (p>0.05 for all comparisons). The accuracy of VAT and TF% for predicting MetS was not sufficient. From our results we can deduce that the performance of abdominal BIA in predicting MetS is weak but could be used in the follow-up of patients with obesity and/or MetS. This has to be confirmed in future studies.
Article · May 2013 · Experimental and Clinical Endocrinology & Diabetes
[Show abstract][Hide abstract]ABSTRACT: Although advances in endocrinologic and neuroradiologic research allow easier recognition of pituitary adenomas, giant pituitary tumours are relatively rare. In the literature, the term "giant" is generally used when a pituitary tumour becomes larger than 4 cm in diameter. Cabergoline is a potent and long-acting inhibitor of prolactin secretion, which exhibits high specificity and affinity for dopamine D2 receptor. Herein, we report a 46-year-old woman with a giant lactosomatotroph pituitary adenoma, sized 6 × 5 × 5.5 cm, who is treated successfully only with cabergoline. The patient showed dramatic response to cabergoline treatment by means of clinical, biochemical and radiological imaging findings. Cabergoline seems to be safe and effective in the treatment of prolactin and growth hormone cosecreting pituitary adenomas as well as prolactinomas. However, surgical or more aggressive approach must be considered where indicated.
Full-text Article · May 2013 · Case Reports in Endocrinology
[Show abstract][Hide abstract]ABSTRACT: Usage of immunosuppressive therapy after organ transplantation increases the risk of development of diabetes. Other than this therapy some demographic properties of patients increases this risk. Although the development of post transplant diabetes mellitus (PTDM) ranges between 3-46% in different studies, hyperglycemic emergencies such as hyperosmolar hyperglycemic state (HHS) are much rarer. Here we present a case using tacrolimus after a renal transplantation and developing HHS attributed to tacrolimus toxicity. It has been previously reported that discontinuation of tacrolimus in the first three weeks period could result in reversibility of PTDM. In our case we switched tacrolimus to cyclosporine-A. The patient’s insulin requirement dose decreased by 50% at the 6th month of follow up. The reasons for non reversibility could be usage of antithymocyte globulin in the early transplant phase and diabetogenic effects of glucocorticoids and cyclosporine-A.
[Show abstract][Hide abstract]ABSTRACT: Background:
Previous studies have shown a positive relationship between insulin resistance and several common adult cancers. The present retrospective study aimed to investigate the association between glucose metabolism disorders (GMDs) and the prevalence of thyroid cancer.
We investigated the data of 4272 patients who had undergone fine-needle aspiration biopsy (FNAB) of thyroid nodules. The biopsy results were evaluated as diagnostic or non-diagnostic and the diagnostic results were classified as benign, malignant, and indeterminate. In this study, we included 2234 of the above patients who had undergone FNAB at our hospital and whose biopsy results were evaluated as diagnostic and were classified as either benign or malignant. We obtained the cytologic data and the glucose metabolism status of these patients retrospectively.
Of the 2234 patients, 629 (28.1 %) had GMD (impaired fasting glucose, impaired glucose tolerance). Malignant cytology was determined in 106 (4.7 %) patients overall. Of the 629 patients with GMD, 582 (92.5 %) patients had benign cytology and 47 (7.5 %) patients had malignant cytology. Fifty-nine (3.7 %) of the 1605 normoglycemic patients had malignant cytology. Malignant cytology was determined more frequently ın the patients who had GMDs (p < 0.001).
The results demonstrated that thyroid cancer prevalence was higher in patients with GMD. According to our results, GMD should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.
Article · Jun 2012 · International Journal of Clinical Oncology
[Show abstract][Hide abstract]ABSTRACT: Context. For control of blood glucose in diabetic patients on enteral feeding either insulin infusion or multiple insulin injections are used. However, both of these methods necessitate a very close follow-up and arc not easy to apply during home care. Objective. In this study we aimed to see whether insulin glarginc once daily is proper for glucose regulation in enterally fed diabetic patients. DESIGN: Insulin glarginc is given to enterally fed diabetic patients and they are followed up for three months. Subjects and methods. Thirteen diabetic stroke patients with PEG arc involved in the study. Treatment of these patients is switched from insulin infusion or multiple insulin injections to once daily insulin glarginc and they are followed up for 3 months. Results. Mean blood glucose values arc improved with once daily insulin glarginc regimen. HbAlc decreased from 7.2% ± 1.5 5. to 6.7% ± 0.8 with insulin glarginc. Daily insulin requirement of the patients is significantly decreased as well. A significant decrease in the hypoglycemic episodes is detected with glargine (p<0,0001). Conclusion. Insulin glargine once daily is a safe and effective regimen for diabetic patients with PEG.