Incidence Of Thyroid Disorders Research Articles

Association between air pollutants, thyroid disorders, and thyroid hormone levels: a scoping review of epidemiological evidence.

Over the past two decades, the incidence of thyroid disorders has been steadily increasing. There is evidence to suggest that air pollution may be one of the etiological factors of thyroid diseases. This comprehensive review aimed to examine the evidence related to air pollutants and thyroid disorders and thyroid hormones levels from an epidemiological perspective. The scoping review adopted a systematic approach to search for, identify, and include peer-reviewed articles published in English. We performed a comprehensive search of three databases-PubMed, Embase, and Web of Science to identify relevant literature on the relationship between air pollution [particulate matter, nitrogen oxide, carbon monoxide (CO), ozone (O3), sulfur dioxide (SO2)] exposure and thyroid disorders, including hypothyroidism, congenital hypothyroidism (CH), thyroid nodules, thyroid cancer, autoimmune thyroid diseases, as well as thyroid hormone levels, such as thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4). Articles published until August 1, 2023, were included. A total of 3,373 studies were retrieved, and among them, 25 studies covering eight different air pollutants were relevant. The most frequently studied air pollutants in this review included fine particulate matter (with fine particulate matter (PM2.5), n=21; inhalable particles (PM10), n=10; PM10-2.5, n=1) and nitrogen oxides (with NO2, n=13; NOx, n=3). The thyroid disorders and thyroid hormone levels most commonly associated with evidence of air pollution exposure were hypothyroidism (n=7) and TSH (n=12). Despite variations in study designs and exposure assessments, the findings consistently highlight the substantial health risks that air pollution, particularly PM2.5, poses to thyroid health, especially among vulnerable populations. Given that our study was limited to epidemiological investigations and the increasing prevalence of toxic substances in the environment, there is an urgent need for further research to elucidate the mechanisms by which these pollutants disrupt thyroid function and contribute to the development of thyroid diseases.

Updates on the Association Between Vitiligo and Thyroid Diseases: A Systematic Review.

The main objective of this study is to estimate the prevalence of thyroid diseases in patients with vitiligo and investigate the potential shared autoimmune mechanisms underlying the co-occurrence of vitiligo and thyroid diseases. To locate research that met the inclusion criteria, a thorough computerized search of relevant databases was carried out. A comprehensive search was carried out on PubMed, SCOPUS, Science Direct, and Web of Science to locate relevant material. Our data included 13 trials with 82,230 participants, and 40,116 (48.8%) of them were males. The prevalence of thyroid disorders ranged from 3.2% to 32.1%, with a total prevalence of 2,906 (3.5%). Vitiligo patients are more likely to have a number of immunological comorbidities, underscoring the serious effects of the illness on overall health, especially thyroid disorders. The correlation between vitiligo and positive thyroid peroxidase antibodies, hypothyroidism, and autoimmune thyroiditis is notably high. We found a strong association between vitiligo and the incidence of thyroid disorders, particularly autoimmune thyroid disorders. The findings emphasize the necessity of identifying and treating thyroid dysfunction in vitiligo patients, as it might affect the clinical course of the skin condition and overall patient health. Future research is required to standardize study methodology, investigate underlying mechanisms, and create integrated therapy and screening regimens.

AYURVEDIC PERSPECTIVE ON THYROID DISORDER: A CRITICAL REVIEW

Endocrine disorders are most common in India, of which thyroid disorders represent a major subset. Thyroid dysfunction is rising at an alarming rate in the Indian population. Hypothyroidism & hyperthyroidism constitute the maximum percentage of thyroid disease in India. The thyroid gland fails to produce enough thyroid hormone due to structural or functional impairment. The incidence of thyroid disorders is increasing daily, so there is a need to increase demand to treat thyroid disease by the Ayurvedic method, as they are entirely safe and natural. In this article, effort is made to review some Ayurvedic diets, such as medicines, yoga, and pranayama, towards the correction of tridosha and the function of the thyroid gland.

A systematic review and meta-analysis investigating the relationship between metabolic syndrome and the incidence of thyroid diseases

PurposeTo assess the prospective association between metabolic syndrome (MetS), its components, and incidence of thyroid disorders by conducting a systematic review and meta-analysis.MethodsA systematic search was performed in Ovid Medline, Embase.com, and Cochrane CENTRAL from inception to February 22, 2023. Publications from prospective studies were included if they provided data on baseline MetS status or one of its components and assessed the incidence of thyroid disorders over time. A random effects meta-analysis was conducted to calculate the odds ratio (OR) for developing thyroid disorders.ResultsAfter full-text screening of 2927 articles, seven studies met our inclusion criteria. Two of these studies assessed MetS as an exposure (N = 71,727) and were included in our meta-analysis. The association between MetS at baseline and incidence of overt hypothyroidism at follow-up yielded an OR of 0.78 (95% confidence interval [CI]: 0.52–1.16 for two studies, I2 = 0%). Pooled analysis was not possible for subclinical hypothyroidism, due to large heterogeneity (I2 = 92.3%), nor for hyperthyroidism, as only one study assessed this association. We found evidence of an increased risk of overt (RR: 3.10 (1.56–4.64, I2 = 0%) and subclinical hypothyroidism (RR 1.50 (1.05–1.94), I2 = 0%) in individuals with obesity at baseline. There was a lower odds of developing overt hyperthyroidism in individuals with prediabetes at baseline (OR: 0.68 (0.47–0.98), I2 = 0%).ConclusionsWe were unable to draw firm conclusions regarding the association between MetS and the incidence of thyroid disorders due to the limited number of available studies and the presence of important heterogeneity in reporting results. However, we did find an association between obesity at baseline and incidence of overt and subclinical hypothyroidism.

Changing Iodine Status and the Incidence of Thyroid Disease in Mainland China: A Prospective 20-Year Follow-Up Study.

Background: We aimed to assess the long-term effects of the transition in iodine status on the incidence of thyroid disorders over 20 years of follow-up. Methods: The original prospective cohort study, started in 1999 (n = 3761), classified three regions in north China based on iodine status (insufficient iodine, more than adequate iodine, and excessive iodine, respectively) for 5 years. Subsequently, participants were followed for up to another 15 years to assess the long-term effects of shifts to adequate iodine on the incidence of thyroid disorders. Panshan transitioned from insufficient to adequate iodine, and Huanghua transitioned from excessive to more than adequate iodine. Both regions were compared with Zhangwu, in which iodine status changed from more than adequate to adequate iodine (from 214 to 167.2 μg/L). A cluster sampling method was used to select participants in the three regions. Participants completed questionnaires and underwent thyroid ultrasonography. Urinary iodine concentrations (UICs), serum thyroid hormone concentration, and thyroid antibodies were measured. Results: When the iodine status changed from insufficient to adequate (with the median UIC increasing from 88 to 141.9 μg/L), the incidence density of subclinical hyperthyroidism, positive thyroperoxidase antibody, positive thyroglobulin antibody (TgAb), and goiter decreased significantly (p < 0.05 for all). Additionally, the cumulative incidence of subclinical hypothyroidism was significantly lower compared with the region where the iodine status changed from being more than adequate to adequate (1.9% vs. 6.0%, p < 0.001). When the iodine status changed from excessive to more than adequate (median UIC from 634 to 266.7 μg/L), a significant decrease in the incidence density of subclinical hyperthyroidism, positive thyroid antibodies, positive TgAb, and goiter (p < 0.05 for all) were also found. However, an increase in thyroid nodule incidence density (17.26 vs. 28.25 per 1000 person-years, p < 0.001) was seen. Conclusions: The incidence of thyroid disorders (except for thyroid nodules) stabilized or decreased among adults in the three communities from year 5 to year 15 of follow-up. Appropriate iodine fortification is safe and effective over the long term. Restoring urinary iodine to appropriate levels reduces population risk for thyroid disorders.

Organochlorine pesticides induce thyroid tumors through oxidative stress; an in vivo and in silico study.

Thyroid disease is one of the most common endocrine problems around the world. Among the numerous factors, exposure to environmental elements such as pesticides is associated with an increase in the incidence of thyroid disorders. The aim of the present study was to investigate the role of organochlorine pesticides (OCPs) in induction of oxidative stress (OS) and development of thyroid tumors. This case-control study was conducted on 61 patients with papillary thyroid carcinoma (PTC), 70 patients with benign thyroid nodules (BTN), and 73 healthy individuals as control. Seven derived OCPs residues measured by gas chromatography (GC), and enzyme activities of acetylcholinesterase (AChE), superoxide dismutase3 (SOD3), catalase (CAT), glutathione peroxidase3 (GPx3) and paraoxonase1 (PON1) and also, non-enzymatic antioxidant including; malondialdehyde (MDA), total antioxidant capacity (TAC), protein carbonyl (PC), and nitric oxide (NO) biomarkers in all participants were investigated. Furthermore, all of the above enzymes were docked against measured OCPs. The results revealed that β-HCH, γ-HCH, 2,4 DDE, 4,4 DDE, 2,4-DDT, and 4,4-DDT levels along with MDA, NO, and PC levels were elevated, while AChE, SOD3, GPx3, CAT, and PON1 activities and TAC levels were decreased in the PTC and BTN groups compared with the control group. Therefore, OCPs might play a role in the development of thyroid tumors through several mechanisms including generation of OS. Importantly, in silico analysis confirmed the in vivo findings.

Association of PDE8B gene polymorphisms with thyroid disorders

Thyroid disorders are the most common endocrine disorders worldwide. PDE8B is strongly expressed in the thyroid and to a lower extent in the pituitary and hypothalamus. PDE8B gene affects the synthesis of T3 and T4 and regulates the release of TSH by the pituitary gland. Therefore, PDE8B single nucleotide polymorphisms (SNPs) rs 6885099 and rs2046045 play a crucial part in the incidence of thyroid disorders, but the existing data is insufficient and contradictory. Materials &amp; Methods. Meta-analysis was carried out to assess the relationship between PDE8B SNP’s rs 6885099 and rs 2046045 and thyroid diseases. The present meta-analysis included 9 distinct studies from January 2005 to 2021 accessible at PubMed, Embase and Google scholar. The funnel plot was used to assess the publication bias. Meta Essentials 1.5 software was employed for statistical data analysis. Q test was used to calculate heterogeneity between the studies. The heterogeneity-related variation was calculated by I2. The association between PDE8B polymorphism and thyroid diseases was analysed by fixed and random effect models.

Thyroid Disorders in Patients Treated with Dimethyl Fumarate for Multiple Sclerosis: A Retrospective Observational Study.

Background: Dimethyl fumarate (DMF), a drug used for the treatment of multiple sclerosis (MS) and psoriasis, has been shown to activate the Keap1/Nrf2 antioxidant response. Nrf2 exerts pleiotropic roles in the thyroid gland; among others, single nucleotide polymorphisms (SNPs) in the gene encoding Nrf2 modulate the risk of Hashimoto’s thyroiditis (HT), suggesting that pharmacological activation of Nrf2 might also be protective. However, a patient with acute exacerbation of HT after starting DMF for MS was recently reported, raising questions about the thyroidal safety of Nrf2 activators. Methods: In a retrospective observational study, we investigated the prevalence and incidence of thyroid disorders (TD) among 163 patients with MS treated with DMF. Results: Only 7/163 patients (4.3%) were diagnosed with functional TD; most (5/163, 3.0%) were diagnosed before DMF treatment. Functional TD were diagnosed under or after DMF in only 2 patients (1.2%). Under DMF, one patient developed transient mild hypothyroidism with negative thyroid autoantibodies. After DMF discontinuation, another patient developed hyperthyroidism due to Graves’ disease. No patient developed thyroid structural disease under or after DMF. Conclusions: The very low incidence of functional TD indicates an overall very good thyroid tolerance of DMF, arguing against screening for TD in MS patients considered for or treated with DMF, and supporting the further study of Nrf2 activators for the prevention and treatment of TD.

A STUDY OF PREVALENCE AND INCIDENCE OF THYROID DISORDER DURING PREGNANCY AT MUZAFFARPUR, BIHAR

To study prevalence and incidence of thyroid disorders in pregnancy at Sri Krishna Medical College Hospital, Muzaffarpur, Bihar. This was a prospective cross sectional study done on 535 pregnant women at department of obstetrics and gynaecology at Sri Krishna Medical College Hospital, Muzaffarpur, Bihar for duration of six months. The prevalence of thyroid disorders during pregnancy was 35.2 % and incidence was 23.98 % in our study. Signicant number of overt hypothyroid cases were detected among rural people (P – 0.003). There was signicant difference of incidence of euthyroid (P – 0.173) and SCHTh (P - 0.195) cases at different age groups. There were also signicant number of cases with goitre (P - ฀0.001) and TPOAb (P – ฀0.001) in different patient groups.

Iodine nutrition level and thyroid function in pregnant women in the Yongchuan district of Chongqing

This study aims to investigate thyroid function-associated parameters and the incidence of thyroid disorders in pregnant women, with the overarching aim to ensure that pregnant women do not develop said disorders due to aberrant iodine levels during the course of pregnancy. A total of 300 pregnant women who underwent routine check-ups at the Yongchuan Hospital Affiliated to Chongqing Medical University from January to December 2021 were enrolled. Venous blood and morning urine were collected. Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) were determined by chemiluminescence immunoassay. Urinary iodine concentration (UIC) was detected by arsenic cerium catalytic spectrophotometry. Thyroid disorders were extrapolated from the measured parameters. The overall median UIC was 203 μg/L, which was within normal range. Subgroup analysis revealed that the median UIC in the first trimester was 187.5 μg/L, 211.8 μg/L in the second trimester, and 239.9 μg/L in the third trimester. However, based on the WHO criteria, 32%, 30%, and 18% of pregnant women were iodine deficient during their first, second, and third trimester, respectively. The proportion of women with iodine deficiency in the first and second trimesters was higher compared to the third trimester (P < 0.05). Serum FT3 and FT4 concentrations were higher in subjects in their first and second trimester versus the third trimester, while serum TSH levels were lower in subjects in their first and second trimester versus the third trimester (P < 0.05). The TSH concentration in subjects with inadequate iodine intake (UIC < 150 μg/L) was lower compared to subjects with adequate iodine intake (UIC 150 - 249 μg/L), but higher than in subjects with more than adequate intake (UIC 250 - 499 μg/L) and excess iodine intake (UIC ≥ 500 μg/L) (P < 0.05). TSH concentration and UIC were positively correlated (r = 0.1945, P = 0.0007), while no relationship was observed between UIC and FT3 and FT4 serum levels (r1 = -0.0593, P1 = 0.3053; r2 = -0.0149, P2 = 0.7968). There was no significant difference in FT3 and FT4 concentration between different UIC strata (P > 0.05). The incidence of thyroid disease during pregnancy in iodine-deficient women was greater compared to pregnant women with adequate iodine intake (P < 0.05) and higher in subjects in the more than adequate as well as excessive iodine intake cohorts (P < 0.05). The iodine nutritional intake by pregnant women in Yongchuan District, Chongqing, was generally sufficient to meet developmental and metabolic needs. However, about a third of women in their first and second trimester exhibited iodine deficiency. Iodine deficiency was associated with an increased incidence of thyroid diseases. In clinical practice, the UIC of pregnant women should be measured during key stages in the pregnancy to prevent the manifestation of thyroid diseases.

Retrospective Analysis of Patients Undergoing Total Thyroidectomy for the Last Three Years in a Tertiary Care Hospital

Background: The incidence of thyroid disorders has increased in the past decade in South India and the increase may be attributed to the phenomenon of overdiagnosis. The thyroid gland secretes hormones, which have various metabolic effects in the body. Most commonly the patients with thyroid disorders present with symptoms of hyperthyroid, hypothyroid and at times, though euthyroid, they may develop a swelling in the neck that has been caused by a goiter (single/multiple), thyroiditis, Grave’s disease, or thyroid carcinoma. In these conditions where there is an associated hyperthyroid or hypothyroid state, it is essential for the consulting physician to provide appropriate management with the aim of bringing the thyroid gland to a euthyroid state prior to further surgical methods. These benign and malignant conditions are initially medically managed but, surgical interventions are indicated sometimes. Total thyroidectomy, subtotal thyroidectomy, partial thyroidectomy, hemi thyroidectomy are the most common surgical procedures performed. Among these procedures, the total thyroidectomy procedure has been gaining an increase of incidence in the past decade.&#x0D; Objectives: The aim of the study is to analyze the indication rate of various conditions requiring total thyroidectomy surgery, to analyze the most affected age group and sex and to know if the incidence rate coincides with the known international standard. The post-operative complication incidence is also analyzed.&#x0D; Materials and Methods: This is a retrospective study conducted over a period of three years at Department of General Surgery, Saveetha Medical College, Thandalam.&#x0D; Results: The study shows an increased occurrence between 21-40 years old age group, mostly affecting the female population. Nodular goiter is the most common indication for total thyroidectomy surgery, carcinomas are the second most common. Among carcinomas, papillary is the most common type observed in this study.&#x0D; Conclusion: Total thyroidectomy is effective in treating several thyroid disorders and the risk of recurrence in subtotal, partial or hemi thyroidectomy outweighs the risk of complication during surgery in total thyroidectomy.

Isfahan Thyroid Cohort Study (ITCS).

The Isfahan Thyroid Cohort Study (ITCS) is one of the few population-based epidemiological studies in Iran that investigates the prevalence and incidence of thyroid disorders including hypothyroidism, hyperthyroidism, goiter, nodule, and iodine status. This cohort is located in Isfahan, Iran. The first phase was initiated in 2006 with 2523 participants (1275 males, 1248 females). The participants were selected using multi-stage cluster sampling from the general residents of Isfahan, Iran. The study had two phases (2006 and 2011) and its third stage is planned for 2020-2021. The prevalence of thyroid function states was euthyroid (89.3%, 95% CI: 88%-90%), overt hypothyroidism (2.8%, 95% CI: 2%‒3%), subclinical hypothyroidism (5.8%, 95% CI: 4%-6%), overt hyperthyroidism (0.8%, 95% CI: 0.4%‒1%), and subclinical hyperthyroidism (0.99%, 95% CI: 0.6%-1%). Hypothyroidism and hyperthyroidism were significantly associated with goiter. The incidence of thyroid dysfunction was reported as follows: overt hypothyroidism (2.7, 95% CI: 1.6-3.7), subclinical hypothyroidism (20.6, 95% CI: 18-23), overt hyperthyroidism (1.9, 95% CI: 1-2.7) and subclinical hyperthyroidism (2.7, 95% CI: 1.6-3.7) per 1000 (person-year). We assessed the prevalence and incidence of thyroid disorders in Isfahan in the first and second phase, respectively. We are conducting the third phase of the ITCS in order to study the associations between thyroid peroxidase antibody (TPOAb) level and environmental factors such as infection.

Retrospective Study on the Incidence of Thyroid Disorders in Bisha and Evolving Surgical Management Considerations

There is a high prevalence of goiter in Bisha despite more than 15 years of the national campaign for increased dietary iodine supplementation. The cause is multifactorial. It is associated with non-neoplastic and neoplastic conditions. Surgical management has evolved over many years.

Study of thyroid profile in pre and post-menopausal women: a case control study

Background:The prevalence and incidence of thyroid disorders is influenced primarily by sex and age are more common in women and in older adults. Thyroid disorders if left untreated will increase risk of cardiovascular diseases and osteoporosis. Hence, screening for thyroid dysfunction must be done as routine investigation in the women presenting with menopausal symptoms.Methods:This case control study includes 50 pre-menopausal women of age group 34-49 years and 50 post-menopausal women of age group 50-55 years, visiting General medicine department of Victoria hospital and hospital affiliated to Bangalore Medical College and Research Institute. All the subjects were subjected for serum triiodothyronine (T3), tetraiodothyronine or thyroxine (T4), thyroid stimulating hormone (TSH), free T3 and T4 levels.Results:Out of all subjects; 23 were hyperthyroid out of which 14 were post-menopausal women, 37 were hypothyroid out of which 19 were post-menopausal women. Chi-square test showed no significant association. Negative and weak correlation was seen between total T3 and age; total T4 and age; TSH and age; free T3 and age; free T4 and age in pre-menopausal women. Negative and moderate correlation was seen between total T3 and age; total T4 and age; free T3 and age. There was a positive and weak correlation seen between TSH and age; weak positive non-significant correlation seen between free T4 and age. Significant correlation was seen between total T3 and age in post-menopausal women.Conclusions:Post-menopausal women should be monitored for serum T3, T4, TSH levels for reducing risk of thyroid dysfunction.

Morbidity and mortality associated with thyroid surgery - retrospective analysis 19912010.

The incidence of thyroid disorders has been rising worldwide. Unlike the incidence, mortality associated with malignant thyroid cancer shows only amodest increase. Between 1979 and 2009, mortality in Czech women increased from 1.21 to 1.31 and in Czech men from 0.54 to 0.74 cases per 100,000 individuals. Methods: Aretrospective statistical analysis was performed in patients undergoing thyroid surgery at the Department of Otorhinolaryngology and Head and Neck Surgery of the 1st Faculty of Medicine, Charles University and University Hospital Motol, and at the Department of Otorhinolaryngology of the Institute for Postgraduate Medical Education in Prague from 1991 to 2010 (twenty years). In this period, 11,005 procedures were done for thyroid disease. The study analysed the incidence, morbidity, mortality, surgical complications and lethality. The study group included surgeries in 1588 male and 9417 female patients. The male/female ratio was 1:5.93. Benign thyroid tumours - mean patient age is 54.7 years; recurrent nerve morbidity is 1.37% (calculated from exposed nerves). Hypocalcaemia incidence is low, 5.4% of permanent hypocalcaemia or hypoparathyroidism, respectively, based on decreased serum parathyroid hormone (PTH) levels. Temporary hypocalcaemia is much more frequent, occurring in almost 15% cases depending on age, season of the year, and nutritional status. Hypoparathyroidism was demonstrated based on laboratory serum PTH levels only in 0.3% patients. In total, 442 patients were operated for the mechanic syndrome (alarge goitre). The mean thyroid volume was 493 ml±136 ml; however, the maximum volume was 980 ml and weight 1115 g. The incidence of recurrent nerve injury occurs in 4.5%, i.e. the morbidity is 2 times higher compared to surgeries for other diagnoses. The incidence of hypoparathyroidism is not higher compared to other surgeries. Revision surgeries were indicated more commonly in malignant thyroid diseases, particularly in papillary and follicular carcinomas. Cervical lymph nodes procedures comprise another large segment in tumour treatment. Our analysis supports selective neck dissections while preserving non-lymphatic structures. As arule, mortality associated with thyroid surgery is divided as mortality in the perioperative period (within 24 hours after the procedure) and early postoperative mortality (within 120 hours after the procedure). Surgery-related mortality was never classified as perioperative or within 24 hours after the procedure. Despite that, we believe that perioperative mortality within 120 hours after the procedure, which occurred in 7 cases, is very important. Mortality of the group was 0.007%. Each surgery procedure is associated with complications, morbidity and mortality. Experience of endocrine surgeons of all disciplines leads to avery low incidence of recurrent nerve and parathyroid gland injuries while at the same time achieving sufficient radicality. This, in cooperation with other medical fields such as endocrinologists, nuclear medicine specialists and oncologists, supports asafe and effective management of all thyroid disorders, including agood prognosis of patients with most types of cancer. Key word: thyroid surgery - complications recurrent nerve - hypoparathyroidism lethality.

Metabolic, Hormonal, Immunologic, and Genetic Factors Associated With the Incidence of Thyroid Disorders in Polycystic Ovarian Syndrome Patients.

Many endocrinopathies have been increasingly affecting females of reproductive age. Polycystic ovary syndrome (PCOS) and hypothyroidism are some of the most common endocrinopathies seen in females. The aim of this study is to find a relationship between the incidence of thyroiditis in polycystic ovarian syndrome patients. Literature review search was conducted via a series of systematic searches using multiple databases which lead to cross-referencing of articles within assigned criteria. Our study resulted in a review of 42 articles pertaining to our study. In this literature review article, factors were identified associating PCOS with thyroiditis. A viable relationship was found between the incidence of PCOS and thyroiditis. The combination of factors seen in this study proposes that clinicians may need to focus on certain markers regarding the screening of the incidence of thyroiditis. We also recommend future cohort studies to be conducted to further confirm the associations identified in this article.

Evaluation of the Bethesda System and the ACR TIRADS in an Endemic Goiter Region

ABSTRACT Background Various factors can affect incidence of thyroid disorders and disease profiles may show abrupt changes in endemic goitrous areas. In this study, it was aimed to analyze the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS) and the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) in terms of risk of malignancy and general recommendations in an endemic goiter region (EGR). Methods In this retrospective study, a total of 500 patients who had thyroidectomy following thyroid fine needle aspiration biopsy were enrolled. For the assessment of thyroid cytology, BSRTC was used and for the evaluation of ultrasound features of thyroid nodules, ACR TIRADS lexicon was adopted. For the assessment of thyroid cytology, Bethesda classification was used and for the evaluation of ultrasound features of thyroid nodules, ACR TIRADS lexicon was adopted. Results In the EGR setting, benign category of BSRTC had a cancer risk of 6.2% which was two times more than the 2017 BSRTC revision reported. Nodules 10–14.9 mm in diameter had nearly 4 times higher malignancy risk than nodules >15 mm. In this group of patients, the risk of malignancy for TIRADS level 1, 2, 3, 4 and 5 was 1.16%, 2.94%, 7%, 45.64% and 94.44%, respectively. The malignancy rates for Bethesda system category I, II, III, IV, V and VI were as follows: 14.43%, 6.2%, 19.05%, 36.73%, 75.68% and 100%. Conclusions There are slight differences between the common set of standards and this study results regarding risk of malignancy. This brings up the question whether there is need for revision for the use of categories and the appropriate management in endemic goiter regions.

Incidence of thyroid disorders in the second decade of adequate iodine supply in Slovenia.

The incidence of thyroid disorders importantly depends on iodine supply and may change over time. There are only afew data available regarding the change in the incidence of thyroid disorders following the increase in iodine supply. Therefore, the aim of this study was to establish the incidence of thyroid disorders in the second decade of adequate iodine supply in Slovenia. The medical records of 17,828 adult patients who were examined at this department for the first time in the years 2011, 2012, 2013 and 2014 were reviewed. The incidence of diffuse and nodular goiter, thyroid autonomy, Graves' disease, non-hypothyroid and hypothyroid Hashimoto's thyroiditis in the stable catchment area of the University Medical Centre Ljubljana with 1,000,000 inhabitants was followed. Asignificantly lower incidence of thyroid autonomy was observed in the year 2014 as compared to 2011 (p = 0.006), asignificantly higher incidence of Hashimoto's thyroiditis in 2014 as compared to 2013 (p = 0.003), and asignificantly higher incidence of non-hypothyroid Hashimoto's thyroiditis in 2014 as compared to 2011 and 2013 (p = 0.005 and p = 0.022, respectively). The incidence of other thyroid diseases did not change significantly in the observed period. In the second decade of adequate iodine supply in Slovenia, we established asimilar or even alower incidence of most thyroid diseases in the observed 4 years with the exception of Hashimoto's thyroiditis.

Thyroid disease in peri‑ and postmenopause period (literature review)

The interpretation of thyroid function tests should be cautiously made during the perimenopause and postmenopause period bearing in mind that physiologic changes do exist in this group of women in terms of secretion and metabolism of thyrotropin and thyroid hormones. Moreover the incidence of thyroid disorders increases in postmenopausal and elderly women. There is no consensus for screening postmenopausal women even though there is well‑known evidence about the effect of thyroid status on cognitive function, cardiovascular risk, bone turnover, and longevity. The diagnosis of any thyroid disorder is challenging in these patients because the symptoms are more subtle and attributed to menopausal symptoms. Management requires more attention in this population than that of younger groups, because high doses of L‑thyroxine can lead to cardiac complications and increased bone turnover. Furthermore radio‑iodine is preferred in treatment of hyperthyroidism in older patients. The risk of nodular thyroid disease and thyroid cancers increases in this group. Although the diagnostic approach is the same as for young patients, the risk of surgery is high and disease prognosis is worse. Decision for menopausal hormonal therapy should be individualized regardless of the concomitant presence of thyroid disorders.

A review on association between diabetes and thyroid disease

Two endocrinopathies namely diabetes and thyroid disorders are most often encountered in general population either individually or together mutually influencing one another. Both the disorders have complex biochemical pathophysiology along with hormonal and genetic malfunctions. Thyroid hormones are important regulators of carbohydrate and lipid metabolism, pancreatic function while diabetes affects functioning of thyroid hormones to a variable extent. The main underlying basis of such link could be the interconnections between common signalling pathways among these disorders. Thyroid dysfunctions that are also associated with insulin resistance, when present in diabetic individuals can impair metabolic control. Both hyperthyroidism and hypothyroidism are reported to be associated diabetes mellitus. Researches that investigated the potentiality of thyroid hormone analogues to alleviate obesity, diabetes, and atherosclerosis are also being conducted in clinical practice. This requires a vivid knowledge of this multifarious and complex relationship between diabetes and thyroid hormone so that it can aid in optimisation of treatment modalities in diabetic patients. Thus, in this review article we emphasized on the incidence of thyroid disorders in diabetes and possible links between the two disorders. Keywords: Diabetes, Hypothyroidism, Hyperthyroidism, Euthyroid, Tri-iodothyronine, Thyroxine, Thyroid stimulating hormone.