Tip 2 diyabetes mellitus ve metabolik sendromlu hastalarda iyot eksikliği, tiroid volüm artışı ve tiroid nodülü varlığının sağlıklı kontrol grubu ile karşılaştırılması

Year 2022, Volume: 47 Issue: 2, 672 - 681, 30.06.2022

Seher Çetinkaya Altuntaş , Mehtap Evran Olgun , Ozl Gorur , Murat Sert , Bekir Tamer Tetiker

Abstract

Amaç: Bu çalışmada, Çukurova Bölgesi’nde yaşayan insanlarda iyot tayini, iyotlu tuz kullanım oranını ve bu parametrelerle tiroid volümü ve tiroid nodülü arasında ilişki olup olmadığını, ayrıca Tip 2 Diyabetes Mellitus (T2DM) ve Metabolik Sendrom (MetS) tanılı hastalarda bu parametrelerin nasıl değiştiğini göstermeyi amaçladık.
Gereç ve Yöntem: Çalışmaya 2017-2018 yılları arasında kliniğimizde takipli olan ve yeni tanı konulan, 18-65 yaş aralığında olup T2DM (n=131) ve MetS (n=113) tanısı olan toplam 244 hasta kaydedildi. Seksensekiz birey kontrol grubu olarak çalışmaya dâhil edildi. Kontrol grubu içindeki 54 birey tiroid nodülü, tiroid volüm artışı veya TSH yüksekliği saptananlar sağlıksız kontrol grubu olarak değerlendirildi.
Bulgular: Üriner iyot konsantrasyonu (ÜİK) T2DM, MetS, sağlıksız kontrol ve sağlıklı kontrol grubu için sırası ile 11.5 ± 7.9, 9.5 ± 5.5, 10.5±5.2 ve 8.9±4.5 mcg/L saptandı. Çalışmaya alınanlarda % 89.5 (n=289) ciddi iyot eksikliği (IE), %10.2 (n=33) orta derecede IE ve %0.3 (n=1) hafif derecede IE saptandı. Tiroid volümleri T2DM’li hastalarda sağlıksız ve sağlıklı kontrollere göre (sırası ile 19.2 ± 9.4ml vs, 15.2±8.0 ml/8.7±3.1 ml; MetS’lu hastalarda sağlıklı kontrol grubuna göre (sırası ile 18.0 ± 10.3 ml vs8.7±3.1 ml) istatiksel olarak anlamlı yüksekti. Serum TSH düzeyi MetS grubunda, hem T2DM grubuna göre (1.8 ± 1.0 vs 1.5 ± 0.8 mlU/l) hem de sağlıksız kontrol grubuna göre (1.8 ± 1.0 vs1.5±0.7 mlU/l) anlamlı olarak daha yüksekti.
Sonuç: Bu sonuçlara göre bölgemiz hâlâ ciddi derecede IE olan bir bölgedir. Çalışmamız sonucuna göre ÜİK tayini organizmanın iyot durumunun belirlemesinde kullanıldığı gibi insülin rezistansı ile ilişkili bir biomarker olarak kullanıp kullanılamayacağı hâlen tartışmalıdır.

Keywords

iyot, iyotlu tuz, metabolik sendrom, diyabetes mellitus

Comparison of iodine deficiency, thyroid volume increase, and the presence of thyroid nodules in patients with type 2 diabetes mellitus and metabolic syndrome and healthy controls

Abstract

Purpose: This study aimed to show levels of iodine in people living in the Cukurova region, the rate of use of iodized salt, and whether there was a relationship between these parameters and thyroid volume and thyroid nodules, and how these parameters changed in patients with type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS).
Materials and Methods: A total of 244 patients aged 18-65 years who were newly diagnosed as having T2DM (n = 131) and MetS (n = 113), who were followed up in our clinic between 2017 and 2018, were enrolled in the study. Eighty-eight individuals were included in the study as a control group. Among the control group, 54 individuals with thyroid nodules, increased thyroid volume, or increased thyroid-stimulating hormone (TSH) were considered as unhealthy controls.
Results: The urinary iodine concentration was 11.5 ± 7.9, 9.5 ± 5.5, 10.5 ± 5.2, and 8.9 ± 4.5 mcg/L for the T2DM, MetS, unhealthy control, and healthy control groups, respectively, 89.5% (n = 289) had severe iodine deficiency (ID), 10.2% (n = 33) had moderate ID, and 0.3% (n = 1) had mild IE. Thyroid volumes in patients with T2DM compared with unhealthy and healthy controls were 19.2 ± 9.4 mL vs. 15.2 ± 8.0 mL / 8.7 ± 3.1 mL, respectively. Thyroid volumes were statistically significantly higher in patients with MetS compared with the healthy control group (18.0 ± 10.3 mL vs 8.7 ± 3.1 mL, respectively). Serum TSH levels were significantly higher in the MetS group compared with the T2DM group (1.8 ± 1.0 vs 1.5 ± 0.8 mlU/l) and the unhealthy control group (1.8 ± 1.0 vs. 1.5 ± 0.7 mlU/l).
Conclusion: According to the results, our region is still a region with severe ID. It remains controversial whether it can be used as a biomarker associated with insulin resistance as it is used to determine the iodine status of the organism.

Keywords

Diabetes mellitus, iodine; iodized salt, metabolic syndrome, nodule, thyroid volume

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