Endocrine Abstracts

Objective: Thyroid nodules are one of the most common thyroid diseases. Ultrasonography is an reliable and the most commonly used imaging method in the evaluation of thyroid nodules with a high sensitivity (Sn) and specificity (Sp). The prevelance of obesity, especially severe obesity, is increasing at an alarming rate in the worldwide. Although obesity and thyroid disorders are related to each other, the pathological relationship between those is not clear. Several studies have revealed that thyroid nodules are associated with adiposity which is assessed by body mass index (BMI). In this study we aimed to evaluate the morphological structure of the thyroid gland and thyroid nodules in obese patients according to the degree of the obesity.

Methods: 273 patients with BMI>30 kg/m² and applied to our endocrinology outpatient clinic between 2019 and 2022 years for obesity or any other reason and also requested thyroid ultrasonography and thyroid function tests were analyzed retrospectively. The demographic data of the patients (sex, age), thyroid function tests, thyroid ultrasonography features (thyroid gland size, volume, parenchyma structure, and, if any, nodule and nodule features) and also if there is thyroid nodule cytology, were evaluated. According the body mass index patients were divided as class I (BMI;30-34.9 kg/m²), class II (BMI; 35-39.9 kg/m²) or class III (BMI; ≥40 kg/m²) obesity.

Results: Total of the 273 patients, 53 (19.4%) were male, 220 (80.6%) were female. 19 (7%), 60 (22%), and 194 (71%) of the 273 patients had class I, II, and class III obesity, respectively. Ultrasonographically, the thyroid parenchyma was heterogeneous in 221 (92.9%) of the patients. But there was no statistically significant thyroid gland heterogeneity between the groups. Anti thyroglobulin antibody positivity was significantly higher in class III obese patients (P=0.047), but no significant difference was found in antiTPO antibody positivity and thyroid function tests between obesity classes. Also there was no significant difference between obesity classes and thyroid nodule features including; echogenicity, structure, halo sign, border regularity, presence of calcification and also thyroid nodule cytology. Conclusıon: Although we could not found a relationship between obesity classes and thyroid function tests and nodule features, most of the obese patients had parenchymal heterogeneity. Considering the increasing incidence of obesity and frequency of thyroid nodules, thyroid ultrasonography will be useful in obese patients.