Frequency Of Thyroid Disorders Research Articles

Study of Oxidative Stress and Inflammatory Status in Thyroid Dysfunction: A Systematic Review

Background: The frequency of thyroid disorders is rising quickly, making them a major socioeconomic issue. Oxidative stress is also connected to thyroid disorders with increasing frequency. Moreover, an association between underlying inflammatory processes and oxidative damage must be considered because most thyroid ailments are seen to have an underlying inflammatory basis. Aim & objectives: This systematic review assesses the oxidative stress in thyroid dysfunctions and their association with inflammatory processes. Methodology: A systematic review of the literature was done using databases that included- PubMed, Scopus, Science Direct, Research Gate and Google Scholar using the keywords “oxidative stress”, “inflammatory markers,” and “thyroid disorders” from 2000-2022. After separately evaluating citations and abstracts, two reviewers examined full-text publications and came to an agreement on the research that should be included. We conducted this research using the preferred reporting items for systematic research and meta-analysis (PRISMA). Results: A total of 531 articles were found, out of which only 51 met the criteria of inclusion. A significant heterogeneity across the studies was found. In these studies, various oxidant/antioxidant and inflammatory markers were used to determine oxidative stress and its association with inflammatory processes. Most studies found a high level of reactive oxygen species (ROS) induced by an imbalance of thyroid hormones that can cause oxidative stress with a consequent lipid peroxidation response and accelerated inflammatory response. Conclusion: Data from the literature demonstrated a significant correlation between oxidative damage results and elevated ROS production. Thyroid issues can potentially trigger or exacerbate oxidative stress and ROS generation, which can worsen oxidative damage. Additionally, recent research indicates that OS and inflammation may be related in some way since mitochondrial reactive species are signalling molecules that cause the release of proinflammatory cytokines

Thyroid Disorders in Pediatric Long Term Survivors after Hematopoietic Stem Cell Transplantation

Background Thyroid dysfunction is one of the major long term endocrinopathies shown after hematopoietic stem cell transplantation (HSCT), it is usually described after total body irradiation, thyroid dysfunction after the use of chemotherapy only in conditioning regimen was evaluated in our study. Aim of the Study To assess the frequency of thyroid dysfunction after HSCT in children using chemotherapy only in conditioning and to relate the thyroid dysfunction after HSCT to the underlying disease and transplant related factors. Subjects and methods This cross sectional observational study was conducted over 12 months duration, from 1st of September 2020 to 1st of September 2021, at Pediatric Transplant Unit, Children,s hospital, Ain Shams University, on pediatric long term survivors who received HSCT in the duration between 2011 to 2019. They were investigated for thyroid dysfunction by measuring Thyroid-stimulating hormone (TSH), free thyroxine (Free T4) and free triiodothyronine (Free T3), Antithyroglobulin antibody (Anti-TG) and by thyroid US. Results The frequency of thyroid dysfunction among the long term survivors was 30% (6/20) including: subclinical hypothyroidism 50%, subclinical hyperthyroidism 16.7%, primary hyperthyroidism 16.7% and graves’ disease 16.7%. The most common thyroid disorder was subclinical hypothyroidism. No significant correlation was observed between the frequency of thyroid disorders and type of conditioning regimen used (p = 0.16), underlying disease (p = 0.5), age at transplantation(p = 0.35). Also, no significant correlation was observed between the thyroid disorders and graft versus host disease (GVHD) (p = 0.92) or Anti-TG (p = 0.26). Conclusion HSCT recipients had a high frequencyyof thyroid gland disorders, therefore, the thyroid status of each HSCT recipient should be screened before and after transplant. These findings also emphasize the need for long-term monitoring of thyroid function following HSCT.

Thyroid gland dysfunction and vitamin D receptor gene polymorphism in keratoconus

ObjectivesTo detect the serum level of thyroid hormones, vitamin D and vitamin D receptors (VDR) polymorphism in keratoconus (KC) patients and to identify the association between vitamin D deficiency and thyroid dysfunction in KC.MethodsThis cross sectional study included 177 KC patients with no thyroid disorders compared to 85 healthy controls with normal corneal tomography. Measurements of thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4) and serum 25-OH vitamin D were done using Enzyme linked immusoassay (ELISA test). VDR polymorphisms were tested including [Taq I (rs731236), Apa I (rs7975232) and Bsm I (rs1544410)] using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).ResultsAn increase in frequency of thyroid disorders (P = 0.04), decrease in serum 25(OH) vitamin D level (P < 0.001), Taq 1 and tt genotype (P < 0.001) were significantly distributed in KC patients. A significantly higher serum 25(OH) vitamin D level was reported in TT genotype, while insufficient level was more common in Tt genotype (P < 0.001). A deficient serum 25(OH) vitamin D level was predominant in tt genotype (P < 0.001). A 95% confidence interval was in TSH (1.603, 2.946), FT4 (24.145, 77.06), hypothyroidism (1.062, 67.63), insufficient (2.936, 11.643) and deficient vitamin D (5.283, 28.704) and all were significant risk factors for KC with (P < 0.05).ConclusionsBoth thyroid disorders and low vitamin D are potential factors for KC development. Studying VDR at the molecular level provides interesting avenues for future research toward the identification of new KC cases.

Epidemiologic Profile of Thyroid Disorders in a Tertiary Care Hospital, a Five Years Analysis

Background: Thyroid disorders are commonly encountered endocrine ailments in clinical practice.Objective: To determine the trends and frequency of thyroid disorders in patients presented for thyroid dysfunction at the department of Pathology Benazir Bhutto hospital RawalpindiStudy Design: Cross-sectional retrospective study. Materials and Methods: Patients who underwent thyroid function tests were enrolled in the study Thyroid function tests were performed on a fully automated Chemistry Analyzer. Graph Pad Prism version 7 and SPSS version 25 were used for statistical analysis of the data.Results: Out of 2856 patients, 81.9% were females and 18.1% were males. The mean age of the participants was 38.12 ± 14.51 years and the median was 35(13-96). Overall, 1951 (68.3%) of the subjects were euthyroid, 343(12.0%) had subclinical hyperthyroidism, 200 (7.0%) had subclinical hypothyroidism, 192(6.7%) had overt hyperthyroidism and 168 (5.9%) had overt hypothyroidism. Females have a significantly high percentage of thyroid disorders as compared to males(χ2 =0.976 p =0.027). The major age group 798(27.9 %) tested for thyroid dysfunction suspicion was 24 to 33 years followed by 34-43 (22.9%).Conclusions: The thyroid dysfunction prevalence was higher in females than males. An upward trend in the frequency of thyroid dysfunction was observed with increasing age. Subclinical hyperthyroidism was the commonest abnormality observed. A steep rise in subclinical hyperthyroidism may be attributed to the high intake of iodized salt.

THYROID DISORDERS IN PATIENTS WITH MELASMA

Background and objectives: Melasma, a common pigmentary disorder is major cosmetic concernamong patients. The aim of our study was to determine the frequency of thyroid disorders in melasma cases. Methodology: Thisobservational study was conducted at RIHS DermatologyDepartment Islamabad from 20thFeb–20thMay 2021. Diagnosed cases of melasma (&gt;18 years) were selected via consecutive sampling technique.Themedically/surgically treated cases of thyroid, melasma secondary to other dermatosis, organ failure, Addisons disease, pregnancy and subclinical thyroid disorders were excluded. After detailed clinical evaluation, thyroid status documented on the basis of thyroid function tests. Data analysed by SPSS with significant p-value&lt;0.05. Results: Amongst 150 melasma cases 117(78%) females and 33(22%) males, mean age was 35.45+9.68 years. 36(24%) were euthyroid, 109(72.7%) hypothyroid and 5(3.3%) hyperthyroid. Mean TSH was 1.82+18.64 mIU/L. 75(50%) had epidermal, 38(25.3%) dermal and 37(24.7%) mixed melasma, hypothyroidism frequent in all three types. Dermal melasma frequent in 41-50 years, epidermal in 20-30 years and mixed in 31-40 years. Thyroid status had significant association with age group, hypothyroidism more common in 41-50 years and Euthyroid in &lt;30 years. Obesity observed in 55(36.7%) having significant association with hypothyroidism. Mandibular melasma observed in 88%, malar 77.3%, centro-facial18.7% and neck melasma 9.3%. Conclusion: Thyroid disorders, particularly hypothyroidism is frequent among melasma cases.Authors recommend to screen all melasma cases regardless of age or gender for thyroid disorders, in particular obese cases. The diagnosis and management of thyroid disease in melasma cases may improve quality of life, prevent thyroid related complications and improve outcome of melasma treatment.

Demographic and clinical characterization of multiple sclerosis in Mexico: The REMEMBer study

BackgroundMultiple sclerosis (MS) is a chronic neurodegenerative disease of the central nervous system with high prevalence in young adults around the world. The vast majority of epidemiological studies and statistics are based on European and American data, so most clinical guidelines and medical consensus are based on this information. There is very limited evidence in Mexico regarding demographic and clinical aspects of MS. Therefore, this study comprehensively described the epidemiological and clinical features of MS in a large cohort of patients from eight tertiary-level centers in Mexico. MethodsA cross-sectional multicenter study was conducted. A group of neurologists, the “Registro Mexicano de Esclerosis Multiple” (REMEMBer) group, compiled the information of MS patients (January to December 2019) from eight tertiary-level centers. Clinical and demographic data were extracted. ResultsA total of 1,185 patients were included. The mean age was 40.65 ± 11.43 years old. Women represented more than half of the whole cohort (64.9% vs. 35.1%). Of the whole cohort, forty-three percent of MS patients had a relative with at least one autoimmune disease (MS: 24%, other autoimmune disorders: 74.9%) or thyroid disease (28%). Furthermore, the mean age of clinical onset was 31.23 ± 9.71 (range: 16–68) years old, and the disease duration was 9.33 ± 7.25 (0.46–40.19) years. The most prevalent phenotype of MS was relapsing-remitting (87.76%). Primary (1.18%) and secondary (9.11%) progressive, as well as clinically isolated syndrome (CIS, 1.43%), were also found. Clinical phenotypes (facial, hearing, and speech disorders, and movement impairment and ataxia) and the frequency of thyroid disorders were different between genders. ConclusionIn Mexico, the frequency of MS seems to be higher in the female gender (2:1 women/men ratio) compared to other series. In addition, there was a predominance of facial, hearing and speech disorders, as well as movement impairment and ataxia. Thyroid diseases were more common in women with multiple sclerosis than men.

Frequency and relation of thyroid dysfunction and inflammation in chronic kidney diseases in the Nephrology Unit, Zagazig University

EnContextThyroid hormones play an important role in renal development, functioning renal mass, and early renal function. Pituitary–thyroid axis and metabolism of the peripheral thyroid hormones have been affected by chronic kidney disease (CKD).AimsThe aim was to evaluate the frequency and relationship between thyroid disorders and high-sensitivity C-reactive protein (Hs-CRP) among CKD patients including hemodialysis (HD).Settings and designIn Zagazig University Hospital.Participants and methodsA case–control study that included 150 adult participants who were divided into: group I which included 50 patients with an estimated glomerular filtration rate (eGFR) of 41.8±23.6 ml/min/1.73 m2. Group II included 50 patients with an eGFR of 11.3±4.2 ml/min/1.73 m2. Group III included 50 participants with normal eGFR. All participants were evaluated for serum creatinine and albumin, complete blood count, estimation of GFR by modification of diet in renal disease (MDRD) equation, and serum thyroid-stimulating hormone (TSH), free T3, free T4, and Hs-CRP.Statistical analysisUsing the Statistical Package for the Social Sciences under windows version 20. Qualitative variables were expressed by frequency and percentage, mean±SD, χ2-test, Student’s t-test, analysis of variance (F-test), and correlation analysis.ResultsThe frequency of subclinical hypothyroidism (46%) and overt hypothyroid (42%) in groups I and II, respectively, has been much higher in CKD patients. There was a strong significant negative correlation of Hs-CRP with eGFR, FT3, FT4 (P<0.001), highly significant positive correlation with serum creatinine, TSH (P<0.001) in non-HD patients, but in HD patients there was high statistically significant negative correlation of Hs-CRP with hemoglobin, albumin, FT3 (P<0.001), FT4, and significant positive correlation with dialysis duration (P<0.001) and TSH.ConclusionThe frequency of thyroid disorders mostly subclinical hypothyroid (46%) and overt hypothyroid (42%) is common in CKD patients and is highly correlated with Hs-CRP in these patients. So we recommend a thyroid investigation in chronic kidney patients for early detection and reduction of its morbidity and mortality.

To Study the Frequency of Thyroid Disorders in Patients with Type II Diabetes Mellitus

To Study the Frequency of Thyroid Disorders in Patients with Type II Diabetes Mellitus

The frequency of thyroid disorders among a population of very low birth weight premature infants

The frequency of thyroid disorders among a population of very low birth weight premature infants

Study Of The Prevalence Of Autoimmune Thyroid Disease In Women With Breast Cancer

The aim of this study was to analyze the prevalence of thyroid disorders in patients with a positive biopsy for breast cancer prior to specific antitumor treatment. The frequency and pattern of thyroid disorders were evaluated in 112 patients with breast cancer (G1) and 125 control patients (G2) by analyzing serum thyroid-stimulating hormone (TSH), anti-thyroid peroxidase antibodies, and anti-thyroglobulin antibodies. In addition, the expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2) was assessed in the breast biopsies by immunohistochemistry. The frequency of thyroid disorders, such as changes in TSH levels and/or the presence of thyroid antibodies, was not different between the 2 groups examined (30.4% in G1 versus 28.0% in G2) (P = .69). However, a family history of thyroid disease was more frequent in patients with breast cancer (50.5% in G1 versus 28.2% in G2) (P = .001). Regarding the clinical stage of breast cancer, there was no difference between women with autoimmune thyroiditis and those without thyroid dysfunction (P = .316). Similarly, there were no differences in hormone receptor (estrogen or progesterone) and HER2 expression between patients who tested positive and those who tested negative for anti-thyroid antibodies (P = .052 and P = .549, respectively). The data obtained in this study did not reveal a higher frequency of autoimmune thyroid disease in patients with breast cancer compared to controls. A family history of thyroid disease was more common in those with breast cancer.

Evaluation of autoimmune thyroid disease in melasma.

Melasma is one of the most frequently acquired hyperpigmentation disorders clinically characterized by symmetrical brown patches on sun-exposed areas. To date, few studies have been conducted about the relationship between thyroid autoimmun-ity and melasma. To evaluate the thyroid dysfunction and autoimmunity in nonpregnant women with melasma. A total of 70 women with melasma and 70 age-matched healthy women with no history of melasma were enrolled in the study. We studied the thyroid hormone profile in both groups. The statistical analysis was performed using SPSS software. Patients with melasma had 18.5% frequency of thyroid disorders, and 15.7% had positive anti-TPO, while subjects from the control group had a 4.3% frequency of thyroid abnormalities, and only 5.7% had positive anti-TPO. There was a significantly higher prevalence of thyroid dysfunction in women with melasma compared with control group (P = 0.008). This study suggests that there is a relationship between thyroid autoimmunity and melasma. However, to make recommendations on screening for thyroid disease in patients with melasma, future research of good methodological quality is needed.

Evaluation of thyroid function and autoimmunity in HIV-infected women

Autoimmune thyroid diseases (AITD) are the main causes of thyroid dysfunction and the most common autoimmune diseases in the world. An association between AITD and infections with the human immunodeficiency virus (HIV), in combination with the effects of highly active anti-retroviral therapy (HAART), has been suggested by several research groups. The aim of the present study was to evaluate the frequency of thyroid dysfunction and AITD in women > 35 years of age infected with HIV, and to identify factors associated with the emergence of these thyroid abnormalities. HIV-infected women (n = 153) selected from the infectious disease outpatient clinic at a University Hospital in Rio de Janeiro were characterized based on their circulating CD4+ lymphocytes levels, viral loads, serum TSH levels, and the presence of FT4 and anti-thyroperoxidase antibodies (TPO-Ab). A total of 129 participants were on HAART and 24 were not. The frequency of thyroid disorders was 7.8% (12/153 patients) and all were on HAART at the time of diagnosis, yielding a prevalence of 9.3% in patients receiving HAART compared with 0% in patients not on HAART. AITD, hyper, and hypothyroidism were detected in 4.6%, 3.1%, and 4.1% of HAART patients. It was not detected any thyroid dysfunction or autoimmunity in HIV-infected women not on HAART. This study demonstrated an association between HAART and the development of AITD. In addition AITD only developed in HAART patients also presenting with undetectable viral loads and slightly elevated CD4+ T cell counts.

AB0576 The frequency of autoimmune thyroid disorders in patients with psoriatic arthritis and the effect of anti tnf-alpha treatment on autoimmune thyroid disease.

BackgroundPsoriatic Arthritis (PsA)is an inflammatory rheumatic disease accompanied by psoriasis. Coexistence of autoimmune thyroid disorders and rheumatic diseases such as Sjögren’s syndrome, systemic lupus erythematosus and rheumatoid arthritis has been...

Geographic variations in the frequency of thyroid disorders and thyroid peroxidase antibodies in persons without former thyroid disease within Germany

To investigate regional variations in the frequency of undiagnosed thyroid disorders among 25- to 88-year-old men and women in two communities in the northeast and the south of Germany. In addition, autoantibodies to thyroperoxidase (TPO-Abs) and urinary iodine excretion were determined. Two population-based surveys of men and women using a common standardized protocol, the Study of Health in Pomerania (SHIP) in the northeast of Germany (2505 participants) and the Kooperative Gesundheitsforschung in der Region Augsburg (KORA) in the south of Germany (2316 participants), were compared with regard to the frequency of undiagnosed thyroid disorders. Compared with the northeast of Germany, urinary iodine excretion and serum thyroid-stimulating hormone (TSH) levels were significantly higher in the south. The median urinary iodine concentration was 110 μg/l (64; 169 μg/l) in SHIP and 151 μg/l (97; 214 μg/l) in KORA, and the median TSH value was 0.81 mIU/l (0.56; 1.15 mIU/l) in SHIP and 1.22 mIU/l (0.84; 1.80 mIU/l) in KORA. The frequency of elevated TSH (TSH ≥ 2.12 mIU/l) was 4.3% in SHIP and 14.1% in KORA (P<0.001); the corresponding values for suppressed TSH (<0.25 mIU/l) were 3.5 and 1.7% (P<0.001). The proportion of ultrasonographic findings was 55.5% in SHIP and 68.0% in KORA. The frequency of serum TPO-Abs did not differ significantly between northeast and south Germany. There were considerable regional disparities in the frequency of thyroid disorders within Germany. These differences can be explained not only by different regional histories of natural iodine deficiency but also by current differences in the iodine supply under an identical nationwide iodine fortification program.

Thyroid involvement in ankylosing spondylitis and relationship of thyroid dysfunction with anti-TNF α treatment

Association between rheumatological and autoimmune thyroid disorders has been demonstrated by many studies. However, a few data exist indicating the association between thyroid disorders and ankylosing spondylitis (AS). In this study, the frequency of thyroid disorders in patients with AS and the impact of anti-TNF α therapy on this were investigated. Data of 108 patients (female/male (F/M) 27/81) were analyzed. Data on free T3, free T4, thyroid-stimulating hormone, anti-thyroid peroxidase antibodies (TPO), anti-thyroglobulin antibodies, and thyroid ultrasound were assessed retrospectively. 44 (F/M 15/29) patients were receiving anti-TNF α, while 64 (F/M 12/52) were receiving other drugs [(sulfasalazine, anti-inflammatory drug (NSAIDs)]. Among those not receiving anti-TNF α therapy, TPO level was high in 23 patients (mean TPO value 86.69 ± 65.28 U/ml), while it was high only in nine receiving anti-TNF α (mean TPO 36.61 ± 14.02 U/ml) (p < 0.05). Investigating the data regarding gender in both populations, autoimmune thyroid disease frequency was found to be lower in the patient group receiving anti-TNF α treatment. Subclinical hyperthyroidism was discovered in three patients (one female two male), and subclinical hypothyroidism in two (two male). Thyroid nodule was detected in 29 patients. It was concluded that the frequency of thyroid autoimmune disease was higher in our study than that reported in the literature, and the frequency of thyroid disorder in patients with AS was lower in those receiving anti-TNF α compared to those not. This may arise from the role of TNF α on pathogenesis of thyroid disorders.

Thyroid Disorders in Patients with Inflammatory Bowel Diseases

Background: The rate of thyroid disorders is reported to be increased in patients with Ulcerative Colitis (UC) and Crohn’s disease (CD) than the normal population. The purpose of this study is to evaluate the prevalance of Thyroid disorders in a group of patients with inflammatory bowel diseases (IBD). Material and Methods: 146 IBD patients (113 UC and 33 CD patients) and 66 healthy control subjects were enrolled into the study. Serum free T4 (FT4), free T3 (FT3), TSH and anti TPO levels of the patients were analyzed retrospectively and and compared with a control group. These cases were also investigated with thyroid ultrasound and nuclear (scintigraphy) imaging. Results: The mean age of IBD patients (76 women) was 42.9 ± 12.4 years. Among the control group 42 were female and their mean age was 40.9 ± 12.1 years. Thyroid gland disease was found in 14 (9.5%, 8 female, 6 male) of 146 IBD patients. The frequency of thyroid disorders has been found to be higher than the control group in patients with control group (14/146 vs. 1/66, p = 0.042). No statistically significant difference has been observed at the thyroid disorder rates between the UC and CD patients (11/113 vs. 3/33, p = 0.912). Hashimoto thyroiditis has been found at 4 (2.7%) of the IBD patients. Conclusion: In accordance with several works published in literature, we have found a higher rate of thyroid disease apperance at IBD patients.

Autoimmune hypothyroidism and lupus-like syndrome

The frequency of thyroid disorders, particularly Hashimoto's thyroiditis, may be increased in patients with connective tissue diseases. Both hypothyroidism and connective tissue diseases often cause muscle and joint aches, pains and stiffness. Skin, renal and cardiovascular involvement seen in the course of autoimmune hypothyroidism (AIH) may simulate connective tissue diseases such as systemic lupus erythematosus (SLE). We herein report a case of AIH who presented with massive proteinuria, haematuria, pleural fluid and arthritis simulating SLE.

Frequency of thyroid disorders during interferon and ribavirin therapy in chronic hepatitis C infection.

The objective of this study was to assess the frequency of thyroid dysfunction in response to combination of interferon and ribavirin therapy in chronic hepatitis C (CHC) patients and HCV outcome. Descriptive study. This study was conducted at Outpatient Department of Liaquat University of Medical and Health Sciences, Jamshoro, Hyderabad from September 2005 to September 2007. One hundred cases of CHC, proven by anti-HCV and HCV RNA-positive with baseline TSH, FT4 and FT3 within the normal reference range, who were treated with interferon alpha-2b (3 million unit subcutaneously three times per week) and oral ribavirin (1000-1200 mg per day) were included in this study. All patients were assessed for TSH, FT4, FT3 levels at 12 weeks and 24 weeks during therapy. Among the 100 patients, overt thyroid disease developed in 13 (13%) and sub-clinical thyroid disease in 5 (5%). Out of 13 patients of overt thyroid disorders, 11 (84.6%) had hypothyroidism and 02 (15.3%) hyperthyroidism. Four (80%) patients were of sub-clinical hypothyroidism and 01 (20%) patient was of sub-clinical hyperthyroidism. Overall, thyroid disorders developed in 18 (18%) both as overt and sub-clinical thyroid disorders. Ninety one (91%) patients became negative by HCV RNA. Treatment of HCV with IFN-alpha and ribavirin can be safely continued in patients with over and sub clinical hypothyroidism because thyroid disease responds well to treatment.

High prevalence of differentiated thyroid carcinoma in acromegaly

Acromegaly is a chronic disease caused by increased GH secretion and associated with a greater risk of developing both benign and malignant tumours. In the present study we evaluated the prevalence of thyroid disorders and thyroid malignancies in a series of acromegalic subjects. We studied, retrospectively, a continuous series of 125 acromegalic patients referred to the Endocrinology Centres at the University Hospitals of Catania and Ferrara, Italy, over a 22-year period. Diagnosis and management of acromegaly were based on standardized criteria. In all patients thyroid function and morphology were evaluated by serum free T4, free T3, TSH measurements and ultrasound scanning, respectively. Fine-needle aspiration biopsy (FNAB) was performed in all solid-mixed thyroid nodules of diameter greater than 1 cm. IGF-1 expression was assessed by semiquantitative immunohistochemical analysis in some patients with differentiated thyroid cancer. Abnormal thyroid function was found in eight cases (6%). A diffuse or nodular goitre was present in 102 cases (82%). Thyroidectomy was performed in 17 patients. Histological examination revealed a differentiated thyroid cancer in seven of the patients. No significant association of thyroid cancer with GH or IGF-1 levels was found. Semiquantitative assessment of IGF-1 expression by immunohistochemistry revealed a more intense staining in thyroid cancer from acromegalic subjects than in papillary thyroid cancer from nonacromegalic subjects. The frequency of thyroid disorders in our series of acromegalic subjects was similar to that previously observed in these patients. However, the prevalence of thyroid cancer was not only strikingly elevated (5.6%) in comparison to the estimated prevalence in the general population (0.093%), but it was even higher than that reported for acromegalic subjects. Sustained exposure to high serum IGF-1 levels is likely to play a role in the development of thyroid cancer in this disease. An additive role for the autocrine/paracrine action of locally produced IGF-1 is also possible. Our results suggest that thyroid function and morphology should be carefully monitored in all acromegalic patients.

Gastric Carcinoma and Thyroid Status

Gastric carcinoma is reported to be more frequent in geographical areas where diets are either iodine-deficient or iodine-excessive. Reports have also shown an association between thyroid diseases and some of the risk factors for gastric carcinoma. We investigated the frequency of thyroid disorders in 61 patients with gastric carcinoma compared with 55 healthy control subjects. Thyroid health was evaluated by physical examination and by measuring the serum levels of thyroid hormones and thyroid autoantibodies. More patients with gastric cancer had goitre compared with healthy controls (49.1% versus 20%, respectively). Significantly more patients with gastric cancer had non-toxic goitre compared with control subjects. There was also a significant difference in the incidence of autoimmune thyroid disease--27.8% of patients with gastric cancer versus 10.9% of control subjects were affected. These results indicate that there is a significant association between gastric cancer and thyroid disorders.