Department of Endocrinology, Aydın State Hospital, Aydın, Turkey.
Endocr Res. 2011;36(4):167-74. doi: 10.3109/07435800.2011.593011.
Insulin had been shown to have a mitogenic effect on thyroid cell cultures. The aim of this study was to investigate insulin resistance in patients with euthyroid nodular goiter.
Sixty-three patients with nodular thyroid disease and 83 healthy controls were included in the study. Both the patient and the control group were euthyroid, euglycemic and normotensive. None of the study subjects had risk factors for insulin resistance. All the study subjects were evaluated by serum insulin levels and biochemical parameters and thyroid ultrasound. All subjects with thyroid nodules greater than 1cm (n = 36) were offered to undergo thyroid fine needle aspiration biopsy.
The two groups were similar with respect to age, gender, BMI, waist circumference, serum lipid levels, serum fT3, fT4 and TSH levels. But HOMA was found to be significantly higher in the patient group (p: 0.007) and thyroid volume was significantly greater in the patient group (p = 0.03). In the patient group there was a significant correlation between HOMA and nodule volume (p < 0.001) while there was not a significant correlation between HOMA and number of thyroid nodules. Thyroid cancer was diagnosed in 3 of the 36 patients (8.33 %).
Insulin resistance may induce increased thyroid proliferation and nodule volume and nodule formation. Therefore, insulin resistance may be a risk factor for euthyoid nodular goiter.
胰岛素已被证明对甲状腺细胞培养具有促有丝分裂作用。本研究旨在探讨甲状腺功能正常的结节性甲状腺肿患者的胰岛素抵抗情况。
本研究纳入了 63 例结节性甲状腺疾病患者和 83 例健康对照者。患者和对照组均为甲状腺功能正常、血糖正常和血压正常。所有研究对象均无胰岛素抵抗的危险因素。所有研究对象均通过血清胰岛素水平和生化参数以及甲状腺超声进行评估。所有甲状腺结节大于 1cm 的患者（n=36）均接受甲状腺细针抽吸活检。
两组在年龄、性别、BMI、腰围、血脂水平、血清游离三碘甲状腺原氨酸（fT3）、游离甲状腺素（fT4）和促甲状腺激素（TSH）水平方面相似。但患者组的 HOMA 显著升高（p=0.007），且甲状腺体积显著增大（p=0.03）。在患者组中，HOMA 与结节体积之间存在显著相关性（p<0.001），而 HOMA 与甲状腺结节数量之间无显著相关性。36 例患者中有 3 例（8.33%）诊断为甲状腺癌。
胰岛素抵抗可能导致甲状腺增殖和结节体积及结节形成增加。因此，胰岛素抵抗可能是甲状腺功能正常的结节性甲状腺肿的一个危险因素。
