Uchoa Helena Bandeira de Melo Paiva, Lima Giovanna Aparecida Balarini, Corrêa Lívia Lugarinho, Vidal Ana Paula Sieiro, Cavallieri Suzana Aquino, Vaisman Mário, Buescu Alexandru, Gadelha Mônica Roberto
Arq Bras Endocrinol Metabol. 2013 Dec;57(9):685-90. doi: 10.1590/s0004-27302013000900003.
Acromegaly is frequently associated with thyroid diseases. In this study, we evaluated the frequency of thyroid disorders in a series of acromegalic patients.
We evaluated 106 acromegalic patients using thyroid ultrasonography (US) and measurements of GH, IGF-I, free T4, TSH and anti-thyroperoxidase antibody levels. IGF-I was expressed in mass units and age-related standard deviation scores (SD-scores). Fine-needle aspiration biopsy (FNAB) was performed on thyroid nodules with a diameter greater than one centimeter or with suspicious characteristics.
Thyroid disorders were found in 75 patients. Eleven patients had diffuse goiter, 42 patients had nodular goiter, and 22 patients had unspecific morphological abnormalities. Four patients (3.8%) had thyroid carcinoma. Considering the patients with diffuse or nodular goiter, thyroid volume was greater in patients with active acromegaly, and was positively correlated with GH, IGF-I, and IGF-I SD-score.
Our study confirmed that benign thyroid diseases are frequent in acromegalic patients. The prevalence of thyroid cancer was higher than in the overall population. We suggest that thyroid US should be routinely performed in patients with acromegaly.
肢端肥大症常与甲状腺疾病相关。在本研究中，我们评估了一系列肢端肥大症患者中甲状腺疾病的发生率。
我们对106例肢端肥大症患者进行了甲状腺超声检查（US），并测量了生长激素（GH）、胰岛素样生长因子-I（IGF-I）、游离甲状腺素（free T4）、促甲状腺激素（TSH）和抗甲状腺过氧化物酶抗体水平。IGF-I以质量单位和年龄相关标准差评分（SD评分）表示。对直径大于1厘米或具有可疑特征的甲状腺结节进行细针穿刺活检（FNAB）。
75例患者发现有甲状腺疾病。11例患者有弥漫性甲状腺肿，42例患者有结节性甲状腺肿，22例患者有非特异性形态异常。4例患者（3.8%）患有甲状腺癌。在考虑弥漫性或结节性甲状腺肿患者时，活动期肢端肥大症患者的甲状腺体积更大，且与GH、IGF-I和IGF-I SD评分呈正相关。
我们的研究证实肢端肥大症患者中良性甲状腺疾病很常见。甲状腺癌的患病率高于总体人群。我们建议对肢端肥大症患者应常规进行甲状腺超声检查。
