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Endocrine Abstracts (2015) 37 EP652 | DOI: 10.1530/endoabs.37.EP652

1Endocrinology Department, Elias Hospital, Bucharest, Romania; 2Endocrinology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 3Laboratory Department, Elias Hospital, Bucharest, Romania.


Introduction: Thyroid hormones influence GH/IGF1 axis, but previous studies reported discrepant results regarding serum IGF1 levels in hyperthyroidism. We have therefore investigated, at diagnosis, the relationship between serum IGF1 levels/IGF1 z scores and clinical and biological characteristics of Graves’ disease (GD) patients. We also compared IGF1 levels/IGF1 z scores, at diagnosis, between GD and autonomous hyperthyroidism patients.

Methods: This cross-sectional study included 119 newly diagnosed hyperthyroid patients (98 with GD and 21 with toxic multinodular goitre) that presented consecutively to our clinic. The main measured parameters: TSH, FT4, FT3, TT3, thyroglobulin, TPOAb, ATA, TRAb, and IGF1. Patients were considered IGF-deficient if IGF1 z score was ≤−2 S.D. from mean for age.

Results: In GD patients men had higher IGF1 levels (P=0.023) and IGF1 z scores (P=0.013) than women. 18.4% of GD patients were, at diagnosis, IGF1 deficient. Compared with patients without IGF1 deficiency, these patients presented, at diagnosis, higher thyroglobulin (median=72.55, IQR=116.02 vs median=11.40, IQR=80.74 ng/ml, P=0.002), FT3 (median=11.30, IQR=7.64 vs median=7.33, IQR=5.72 pg/ml, P=0.027), and lower ATA (median=20, IQR=0 vs median=34.05, IQR=161 UI/ml, P=0.001) levels. Thyroglobulin was identified as strong predictor for IGF1 deficiency (AUROC=0.732, 95% CI: 0.620–0.844, P=0.002; cut-off for thyroglobulin=50.40 ng/ml, Se=77.8%, Sp=70%). IGF1 status was not influenced by gender (P=0.08), current smoking (P=0.55), goitre size (P=0.53), opthalmopathy (P=0.33), TRAb (P=0.23), and TPOAb status (P=0.36). The prevalence of IGF1 deficiency was higher in GD patients compared to patients with toxic goitre (18% vs 0%, χ2=4.54, P=0.033).

Conclusions: Our study shows, for the first time, the presence of IGF1 deficiency in nearly one-fifth of newly diagnosed GD patients. IGF1 deficiency was associated with lower ATA titres, higher thyroglobulin levels and more severe FT3 hyperthyroidism. The presence of active GO did not influence IGF1 status. GD patients had higher prevalence of IGF1 deficiency than patients with toxic multinodular goitre.

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