Thyroid nodular disease in patients with debut diabetes mellitus
Keywords:
diabetes mellitus, nodular thyroid disease, goiterAbstract
Introduction: diabetes mellitus is one of the most important health problems in the contemporary world and causes an enormous social, economic and health impact. Nodular thyroid disease, defined as the presence of a single or multiple nodule within the thyroid gland, is also a common health problem that requires multidisciplinary management.Objective: to characterize patients with nodular thyroid disease and debut diabetes mellitus.
Methods: an observational, descriptive, cross-sectional research was developed in the “Arnaldo Milián Castro” Hospital from Villa Clara Province in 32 patients attended by Endocrinology Specialists and selected by a non-probabilistic sampling at convenience in the period from September 2018 to December 2019.
Results: nodular thyroid disease was frequent from 50 years of age (21 patients) and with greater presence in the female sex (71.9%). Type 2 diabetes mellitus was the main form of debut (30 patients) and the main causes of nodular thyroid disease were adenomas (53.1%) and thyroid cysts (25%). Subclinical hypothyroidism was identified in seven patients with debut diabetes mellitus (21.9%).
Conclusions: This study highlights the frequent coexistence of diabetes mellitus, nodular thyroid disease and subclinical states of thyroid hypofunction in type 2 diabetes mellitus.
Downloads
References
1. Asociación Lationoamericana de Diabetes. Guías ALAD sobre el Diagnóstico, Control y Tratamiento de la Diabetes Mellitus Tipo 2 con Medicina Basada en Evidencia Edición 2019. Rev ALAD [Internet]. 2019 [citado 25/11/2019]:[aprox. 125]. Disponible en: www.revistaalad.com/guias/5600AX191_guias_alad_2019.pdf
2. American Diabetes Association. 1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2021. Diabetes Care [Internet]. 2021 [citado 21/12/2021];44(Suppl. 1):S7–S14. Disponible en: https://diabetesjournals.org/care/article/44/Supplement_1/S7/30540/1-Improving-Care-and-Promoting-Health-in. https://doi.org/10.2337/dc21-S001
3. Salci MA, Schlindwein Meirelles BH, Guerreiro Vieira da Silva DM. Primary care for diabetes mellitus patients from the perspective of the care model for chronic conditions. Rev Latino-Am Enfermagem [Internet]. 2017 [citedo 20/01/2021];25:e2882. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692017000100309&lng=en. https://doi.org/10.1590/1518-8345.1474.2882
4. Guerrero Godinez JM, Barragán Vigil AM, Navarro Macias CL, Murillo Bonilla LM, Uribe González RP, Sánchez Cruz MA. Diabetes Mellitus en el Adulto Mayor. Rev Med Clin [Internet]. 2017 [citado 20/09/2020];1(2):81-94. Disponible en: https://medicinaclinica.org/index.php/rmc/article/download/36/34/
5. Mendoza Romo MA, Padrón Salas A, Cossío Torres PE, Soria Orozco M. Prevalencia mundial de la diabetes mellitus tipo 2 y su relación con el índice de desarrollo humano. Rev Panam Salud Publica [Internet]. 2017 [citado 07/04/2020];41:e103. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6645285/. https://doi.org/10.26633/RPSP.2017.103
6. Arnold Domínguez Y, González Hernández O, Martínez Vázquez N, Formental Hidalgo BI, Arnold Alfonso ML, González Calero TM, et al. Incidencia de la diabetes mellitus en Cuba, según tipo, en menores de 18 años de edad. Rev Cubana Endocrinol [Internet]. 2017 [citado 03/04/2019];28(3):[aprox. 19 p.]. Disponible en: http://scielo.sld.cu/pdf/end/v28n3/a06_317.pdf
7. Bustillo Madrigal E, Bustillo Solano E, Denis Cancio H. Prevalencia y caracterización de la enfermedad tiroidea nodular y del bocio difuso en un área urbana. Rev Cubana Endocrinol [Internet]. 2014 [citado 03/04/2019];25(2):87-103 Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-29532014000200006
8. Solarana Ortíz JA, Vera López R, Rodríguez Pascual Y, Velázquez Martín JI. Comportamiento de la enfermedad nodular del tiroides en el Servicio de Cirugía General del Hospital Vladimir Iich Lenin de Holguín. CCM [Internet]. 2013 [citado 03/04/2019];17(3):275-283. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1560-43812013000300004
9. González Tabares R, Díaz de Armas MC, Fernández Cedeño O. Necesidad de un sistema ecográfico de estratificación del riesgo de malignidad en lesiones nodulares del tiroides. Rev Cub Med Mil [Internet]. 2020 [citado 03/04/2019];49(2):352-363. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138-65572020000200013
10. Anda E, Ernaga A. Protocolo de manejo clínico del nódulo tiroideo. Medicine [Internet]. 2016 [citado 21/12/2020];12(13):754-757. Disponible en: https://www.sciencedirect.com/science/article/pii/S0304541216300907. https://doi.org/10.1016/j.med.2016.06.005
11. Jerkovich F, Moncet D, Remón JA, Isaac G. Prevalencia de tiroideopatías en pacientes con Diabetes tipo 2. Rev Argent Endocrinol Metab [Internet]. 2014 [citado 27/04/2018];51(3):123-129. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S1851-30342014000300001
12. Malvetti Maffei MV, Báez Cabral SA, Santa Cruz FV. Disfunción tiroidea en pacientes con diabetes mellitus tipo 2: ¿Una asociación frecuente? Rev Virtual Soc Parag Med Int [Internet]. 2016 [citado 21/03/2020];3(1):33-41. Disponible en: http://scielo.iics.una.py/scielo.php?pid=S2312-38932016000100004. https://doi.org/10.18004/rvspmi/2312-3893/2016.03(01)33-041
13. Miraval León LJ. La disfunción tiroidea en pacientes con diabetes mellitus tipo 2. Hospital Nacional Dos de Mayo 2013-2015 [tesis]. Lima: Universidad Nacional Mayor de San Marcos; 2016 [citado 27/04/2020]. Disponible en: http://cybertesis.unmsm.edu.pe/bitstream/handle/20.500.12672/4779/Miraval_ll.pdf
14. Sanz Fernández M, Rodríguez Arnao MD. Hipertiroidismo en infancia y adolescencia. Protoc Diagn Ter Pediatr [Internet]. 2019 [citado 27/04/2020];1:157-169. Disponible en: https://www.aeped.es/sites/default/files/documentos/10_hipertiroidismo.pdf
15. Sierra-Castrillo J, Gómez-Rave LJ, Chacín-González M, Rojas Quintero J, Bermúdez-Pirela V. Alteraciones tiroideas en diabetes mellitus tipo 2. Rev Latinoam Hipertens [Internet]. 2019 [citado 27/04/2020];14(5):579-582. Disponible en: https://www.revhipertension.com/rlh_5_2019/11_alteraciones_tiroideas.pdf
16. Vázquez Aguirre MV, Rojas J, Bermúdez V. Comportamiento epidemiológico del hipotiroidismo en pacientes con diabetes mellitus tipo 2 en la ciudad de Loja - Ecuador. Rev Latinoam Hipertens [Internet]. 2013 [citado 14/04/2020];8(4):95-102. Disponible en: http://www.redalyc.org/articulo.oa?id=170231793003
17. Centeno Maxzud M, Gómez Rasjido L, Fregenal M, Arias Calafiore F, Córdoba Lanus M, D´Urso M, et al. Prevalencia de disfunción tiroidea en pacientes con diabetes mellitus tipo 2. Medicina (B. Aires) [Internet]. 2016 [citado 04/06/2019];76(6):355-358. Disponible en: http://www.scielo.org.ar/scielo.php?script=sci_arttext&pid=S0025-76802016000600006
18. Tang Y, Yan T, Wang G, Chen Y, Zhu Y, Jiang Z, et al. Correlation between Insulin Resistance and Thyroid Nodule in Type 2 Diabetes Mellitus. Int J Endocrinol [Internet]. 2017 [citado 04/06/2019];2017:[aprox. 8 p.]. Disponible en: https://www.hindawi.com/journals/ije/2017/1617458. https://doi.org/10.1155/2017/1617458
19. Rodríguez Ramos JF, Boffill Corrales AM, Rodríguez Soria A. Factores de riesgo de las enfermedades tiroideas. Hospital del Seguro Social Ambato. Rev Ciencias Médicas [Internet]. 2016 [citado 04/06/2020];20(5):113-128. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561-31942016000500014
20. Noriega Ruiz V, Torres Samame L, Huachin-Soto M, Villena J, Loza J. Presencia de nódulos tiroideos en pacientes con síndrome metabólico en un hospital de tercer nivel de atención peruano. Acta Méd Peru [Internet]. 2020 [citado 04/06/2020];37(3):312-7. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1728-59172020000300312. http://dx.doi.org/10.35663/amp.2020.373.1007
21. Mayers RA, Soria Montoya A, Piscoya Rivera A, Silva Caso WG. Asociación entre el síndrome metabólico y el bocio nodular eutiroideo: un estudio de casos y controles. Colomb Med [Internet]. 2019 [citado 04/06/2020];50(4):239-251. Disponible en: http://www.scielo.org.co/pdf/cm/v50n4/es_1657-9534-cm-50-04-00239.pdf. https://doi.org/10.25100/cm.v50i4.2833
22. Aydoğan Y, Altay M, Ünsal O, Kaplanoğlu V, Çağır Y, Yildiz C, et al. An assessment of the relationship between thyroid nodule characteristics, insulin resistance and arterial stiffness in euthyroid nodular goiter. Endocrine [Internet]. 2018 [citado 04/06/2020];62(2):440-447. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30084100/. https://doi.org/10.1007/s12020-018-1701-6
23. Rezzónico JN, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord [Internet]. 2009 [citado 04/06/2020];7(4):375–380. Disponible en: https://pubmed.ncbi.nlm.nih.gov/19320560/. https://doi.org/10.1089/met.2008.0062
24. Amit B, Aundhkar SC, Jyotsna J, Rahi B. Evaluation of Thyroid Function Tests in Patients with Uncontrolled Type 2 Diabetes Mellitus. Int J Health Sci Res (IJHSR) [Internet]. 2014 [citado 04/06/2020];4(5):129-138. Disponible en: https://www.ijhsr.org/IJHSR_Vol.4_Issue.5_May2014/21.pdf
25. Lardiés Sánchez B, Verdes Sanz G, López Valverde ME, Pérez Fernández L, Melchor Lacleta I, Boj Carceller D, et al. Estudio de la prevalencia de patología tiroidea en pacientes diabéticos ingresados por descompensación hiperglucémica en una planta de endocrinología. Av Diabetol [Internet]. 2014 [citado 14/04/2018];30(Espec Congr):160. Disponible en: https://www.elsevier.es/es-revista-avances-diabetologia-326-congresos-xxv-congreso-nacional-sociedad-espanola-9-sesion-otros-875-comunicacion-estudio-de-la-prevalencia-de-8964-pdf
26. Quintana-Marrero A, López-Medina GG, Rivas-Alpízar EM, González-Ramos JO. Disfunción tiroidea en pacientes con diabetes mellitus tipo 2. Rev Finlay [Internet]. 2020 [citado 01/04/2021];10(3):222-230. Disponible en: http://revfinlay.sld.cu/index.php/finlay/article/view/847/1889
27. Miraval León LJ. La disfunción tiroidea en pacientes con diabetes mellitus tipo 2. Hospital Nacional Dos de Mayo 2013-2015 [tesis]. Lima: Universidad Nacional Mayor de San Marcos; 2016 [citado 01/04/2021. Disponible en: https://cybertesis.unmsm.edu.pe/handle/20.500.12672/4779
Downloads
Published
How to Cite
Issue
Section
License
Authors who have publications with this journal agree to the following terms:
- Authors will retain their copyright and assign to the journal the right of first publication of their work, which will simultaneously be subject to a Creative Commons License / Attribution-Noncommercial 4.0 International (CC BY-NC 4.0) that allows third parties to share the work as long as its author and first publication in this journal are indicated.
- Authors may adopt other non-exclusive license agreements for distribution of the published version of the work (e.g., depositing it in an institutional repository or publishing it in a monographic volume) as long as the initial publication in this journal is indicated.
- Authors are allowed and encouraged to disseminate their work through the Internet (e.g., in institutional telematic archives or on their web page) before and during the submission process, which can produce interesting exchanges and increase citations of the published work. (See The effect of open access).