Endocrine Abstracts

Introduction: Nodular thyroid disease (NTD) is one of the commonest endocrine disease with incidence ranging from 5–30% in various populations Worldwide. They often require surgery for indications such as pressure symptoms or size related reasons. The natural history and etiopathogenesis are largely unclear except in few endemic regions. Immunomodulatory role has often been implicated in their pathogenesis. In this context, we set out study the association between Pro- inflammatory cytokines and NTD.

Material and methods: This prospective case-control study was conducted on surgically managed NTD patients. Institutional ethical committee approval was obtained. Diagnosis of NTD was based on thyroid function tests, imaging, fine needle aspiration cytology and histopathology. Exclusion criteria were subjects any systemic or chronic inflammatory disease or any medication which interferes with the normal function of the hypothalamic-pituitary-gonadal axis. Serum samples were collected from 100 HT subjects and 98 age matched healthy controls. Interleukin-6 (IL-6), Tumour necrosis factor-alpha (TNF-α) and high sensitive C reactive protein (hsCRP), Leptin levels were measured in all serum samples. Statistical analysis was performed by one way ANOVA with Dunnet’s test and Pearson correlation tests.

Results: The mean hSCRP level in NTD and controls were 11.7±1.8 mg/mL and 6.2±1.3 mg/mL respectively. The mean TNF-α level, IL-6 level and Leptin levels were 198.4±18 pg/mL, 15.3±3.2 pg/mL and 2.9±1.8 ng/mL respectively. Serum leptin level in controls was 3.8±2.1 ng/mL. There was statistically significant difference of all the pro-inflammatory cytokines compared to controls (P value < 0.05).

Conclusions: This study shows raised titers of pro-inflammatory markers – IL-6, TNF-α and hsCRP correlated with NTD suggesting a contributory role. Leptin appears to have no definitive correlation with NTD. But, the exact immuno-modulatory role and pathogenetic mechanism needs active research.

Keywords: Thyroid nodules, Tumour necrosis factor, Interleukin-6, Goiter, Auto-immunity, Leptin