Asli NAR, Cüneyd ANIL, Sevinç CAN, Alptekin GÜRSOY

Benign nodüler ve malign tiroid hastalıklarında metabolik sendrom ve bileşenlerinin değerlendirilmesi

Amaç: Metabolik Sendrom (MetS) insülin direncinin belirgin rol oynadığı ve metabolik anormalliklerin kümelendiği bir tablodur. Bu çalışmanın amacı benign ve malign nodüler tiroid hastalığı olanlarda metabolik sendrom ve bileşenlerini değerlendirmektir. Gereç ve yöntem: Dörtyüzotuz ötiroid benign nodüler ve 370 ötiroid malign nodüler tiroid hastalığı olan toplam 800 hasta metabolik sendrom ve bileşenleri yönünden incelendi. MetS parametrelerinin yanı sıra insülin düzeyleri ve homeostasis model assessment- IR (HOMA-IR) ile hesaplanan İD seviyeleri değerlendirildi. Bulgular: Çalışmaya alınan 800 hastanın %59,8’inde metabolik sendrom saptandı. Benign ve malign nodüler tiroid hastalığı olan gruplar arasında metabolik sendrom sıklığı açısından anlamlı fark saptanmadı (benign nodüler grupta %61,4, malign nodüler grupta %57,8, p>0,05). Tüm çalışma grubunda en sık karşılaşılan MetS bileşeni abdominal obezite (%65), ardından düşük HDL kolesterol düzeyi (%64,8) ve en az bileşen de yüksek kan glukoz düzeyi (%30,8) idi. Benign ve malign nodüler tiroid hastaları ayrı ayrı incelendiklerinde ise benign grubun MetS bileşen dağılımı genel ortalama ile benzer sıklıkta olup, malign grubun MetS bileşen dağılımında en sık düşük HDL kolesterol düzeyi (%71,9), en az ise kan basıncı yüksekliği (%26,2) olduğu bulundu. Benign ve malign nodüler tiroid hastaları arasında insülin düzeyleri ve insülin direnci açısından anlamlı fark saptanmadı. Sonuç: Sonuçlar nodüler tiroid patolojisi olan hastaların, nodüler tiroid hastalığı olmayanlara göre anlamlı olarak artmış metabolik sendrom prevalansına sahip olduklarını göstermektedir. Ancak benign ve malign noduler gruplar arasında MetS bileşen dağılımı açısından fark saptanmamıştır.

The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases

Purpose: Metabolic syndrome (MetS) is a condition harboring a group of metabolic abnormalities where insulin resistance (IR) plays a major role. The aim of our study is to evaluate MetS and its components in patients with benign and malignant nodular thyroid disease (NTD). Materials and methods: A total of 800 patients (430 euthyroid benign nodular and 370 euthyroid malignant NTD) were analyzed for MetS and its components. Serum insulin levels and IR estimated by homeostasis model assessment (HOMA-IR), as well as other MetS parameters were evaluated. Results: Metabolic syndrome was detected in 59.8% of 800 patients. There was no significant difference between benign and malignant NTD groups related to the prevalence of the MetS (61.4% in benign nodular group, 57.8% in malignant nodular group, p>0.05). In the whole study group, the most common MetS component was abdominal obesity (65%), followed by low HDL-C level (64.8%), and the least component was high blood glucose level (30.8%). When patients with benign and malignant NTD were evaluated separately, the occurrence of the MetS components were found in similar frequency in the benign group compared to the overall average. In the malignant group, it was determined that low HDL-C level was the most common and high blood pressure was the least common component. There was no significant difference between benign and malignant NTD groups in terms of insulin levels and HOMA-IR. Conclusions: The results suggest that patients with NTD have significantly increased MetS prevalence compared to patients without NTD. However, there was no significant difference between benign and malignant NTD in this respect.

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