Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area

Objective. Insulin resistance (IR) is a key factor involved in the pathogenesis of impaired glucose metabolism. IR is associated with increased thyroid volume and nodule prevalence in patients with metabolic syndrome. Data on the association of thyroid morphology and abnormal glucose metabolism are limited. This prospective study was carried out to evaluate thyroid volume and nodule prevalence in patients with pre-diabetes and type 2 diabetes mellitus (DM) in a mild-to-moderate iodine deficient area. Materials and Methods. Data were gathered on all newly diagnosed patients with prediabetes and type 2 diabetes mellitus between May 2008 and February 2010. 156 patients with pre-diabetes and 123 patients with type 2 DM were randomly matched for age, gender, and smoking habits with 114 subjects with normal glucose metabolism. Serum thyroid-stimulating hormone (Tar) and thyroid ultrasonography was performed in all participants. Results. Mean TSH level in the diabetes group (1.9 +/- 0.9 mIU/L) was higher than in the control group (1.4 +/- 0.8 mIU/L) and the pre-diabetes group (1.5 +/- 0.8 mIU/L) (P<0.0001 for both). Mean thyroid volume was higher in the pre-diabetes (18.2 +/- 9.2 mL) and diabetes (20.0 +/- 8.2 mL) groups than in controls (11.4 +/- 3.8 mL) (P<0.0001 for both). Percentage of patients with thyroid nodules was also higher in the pre-diabetes (51.3%) and diabetes groups (61.8%) than in controls (23.7%) (P<0.0001 for both). Conclusions. The results suggest that patients with impaired glucose metabolism have significantly increased thyroid volume and nodule prevalence. (C) 2013 Elsevier Inc. All rights reserved.