Endocrine Abstracts

Introduction: The aim of study was to perform a comprehensive structural and functional assessment of thyroid gland in men with metabolic syndrome (MS).

Methods: Main group (MG) of 116 men aged 35–60 years with MS (by International Diabetes Federation definition) and 34 healthy controls of the same age profile underwent a comprehensive examination of thyroid gland which included physical assessment, full serum thyroid hormonal profile – total and free triiodothyronine (T₃) and thyroxine (T₄), serum TSH, and high resolution ultrasonography. Conventional criteria for hyper- and hypothyroidism by thyroid hormonal levels were used; subclinical hypothyroidism was detected by elevated TSH with normal thyroid hormone levels.

Results: Thyroid volume was higher in MG than in controls (16.6±1.48 vs 10.1±0.75, P<0.05), and overall structural abnormalities – much more frequent (in 71.6 vs 44.1%, P<0.05). Heterogeneous thyroid structures of all types with and without gland enlargement were seen in 19.0 and 42.2% in MG vs 8.8 and 35.3% in controls, whereas nodal changes (with size more than 1 cm) – only in MG (8.6%). Subclinical hypothyroidism was detected in 6 (5.2%) patients of MG, and in none of controls. However, in the rest of MG (cases of hypothyroidism excluded), mean TSH appeared to be lower than in controls (1.0±0.19 vs 2.1±0.24 mIU/l, P<0.05), with free T₄ being somewhat higher, albeit still within normal range (17.3±0.69 vs 13.5±0.63 pmol/l, P<0.05), and free T₃ also normal and almost the same between groups. No manifested cases of hyper- or hypothyroidism were found in any group. Thus, contrary to structure, thyroid function was mostly normal in men with MS, and there was no clear association between structural and functional variables.

Conclusion: Structural abnormalities in thyroid gland are frequent in men with MS; usually they are not accompanied by significant hormonal dysfunction, and most hormonal alterations fall within normal range.