Research Article
BibTex RIS Cite

Etkili Tedavi Edilmiş Akromegali Hastalarında Tiroid Bozuklarının Değerlendirilmesi

Year 2025, Volume: 15 Issue: 2, 119 - 124, 15.06.2025

Abdullatif Sirin , Osman Köstek , Mümtaz Takır , Mehmet Uzunlulu

https://doi.org/10.16919/bozoktip.1523690

Abstract

Giriş: Tiroid foliküllerinin growth hormon (GH) ve insülin-like growth faktör-1 (IGF-1) aracılığıyla sürekli uyarılması akromegali hastalarında guatr ve tiroid nodüllerinin gelişmesine neden olur. Güncel çalışmalar, başarılı şekilde tedavi edilen hastalarda tiroid hastalığı sıklığının azaldığını ileri sürmektedir. Bu çalışma, kür veya kontrol altına alınmış hastalardaki tiroid bozukluklarını araştırmak için yapılmıştır.
Gereç ve Yöntemler: GH düzeyleri 1ng/mL’den düşük ve IGF-1 seviyeleri yaşa ve cinsiyete göre normal aralıkta olan hastalar kontrol altına alınmış hastalar olarak kategorize edildi. Tiroid bezinin sonografik ve biyokimyasal bulguları kaydedildi.
Bulgular: Çalışmada 33 akromegali hastası (14 erkek ve 19 kadın) ve 50 gönüllü yer aldı. (14 erkekve 36 kadın). Akromegali hastalarındaki guatr sıklığı kontrol grubuna kıyasla daha fazla idi (sırasıyla, 21.2% ve 6%, p<0.001). Akromegali hastalarında tiroid nodülü daha sık görülmekle beraber 1 cm'den büyük nodül sıklığı iki grup arasında benzerdi.
Sonuç: Akromegali hastalarında multinodüler guatr sıklığı halen yüksektir. Hastalığın tam kontrol altına alınması tiroid kanseri ve riskli nodül sıklığını azaltabilir.

Keywords

akromegali tiroid hastalıkları tiroid nodülü

References

  • 1. Melmed S, Bronstein MD, Chanson P, Klibanski A, Casanueva FF, Wass JAH, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018;14(9):552-61.
  • 2. Lavrentaki A, Paluzzi A, Wass JA, Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary. 2017;20(1):4-9.
  • 3. Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51.
  • 4. Herrmann BL, Baumann H, Janssen OE, Görges R, Schmid KW, Mann K. Impact of disease activity on thyroid diseases in patients with acromegaly: basal evaluation and follow-up. Exp Clin Endocrinol Diabetes. 2004;112(5):225-30.
  • 5. Chen Z, Jiang X, Feng Y, Li X, Chen D, Mao Z, et al. Decrease in acromegaly-assocıated thyroıd enlargement after normalızatıon of IGF-1 levels: a prospective observation and in vıtro study. Endocr Pract. 2020;26(4):369-77.
  • 6. Boguszewski CL, Ayuk J. Management Of Endocrine Disease: Acromegaly and cancer: an old debate revisited. Eur J Endocrinol. 2016;175(4):147-56.
  • 7. Vitti P, Rago T, Mazzeo S, Brogioni S, Lampis M, De Liperi A, et al. Thyroid blood flow evaluation by color-flow Doppler sonography distinguishes Graves' di-sease from Hashimoto's thyroiditis. J Endocrinol Invest. 1995;18(11):857-61.
  • 8. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133.
  • 9. Mo C, Zhong L. The effect of acromegaly on thyroid disease. Endocr J. 2023;70(11):1051-60.
  • 10. Manavela M, Vigovich C, Danilowicz K, Juri A, Miechi L, Fernandez Valoni V, et al. Thyroid autoimmune disorders in patients with acromegaly. Pituitary. 2015;18(6):912-15.
  • 11. Ock S, Ahn J, Lee SH, Kang H, Offermanns S, Ahn HY, et al. IGF-1 receptor deficiency in thyrocytes impairs thyroid hormone secretion and completely inhibits TSH-stimulated goiter. FASEB J. 2013;27(12):4899-908.
  • 12. Wu X, Gao L, Guo X, Wang Q, Wang Z, Lian W, et al. GH, IGF-1, and Age Are Important Contributors to Thyroid Abnormalities in Patients with Acromegaly. Int J Endocrinol. 2018;2018:6546832.
  • 13. Natchev E, Vandeva S, Kovatcheva R, Kirilov G, Kalinov K, Zacharieva S. Thyroid gland changes in patients with acromegaly. Arch Endocrinol Metab. 2020;64(3):269-75.
  • 14. Gasperi M, Martino E, Manetti L, Arosio M, Porretti S, Faglia G, et al. Prevalence of thyroid diseases in patients with acromegaly: results of an Italian multi-center study. J Endocrinol Invest. 2002;25(3):240- 5.
  • 15. Cankurtaran Y, Örük GG, Tozduman B. Evaluation of thyroid disease and thyroid malignancy in acromegalic patients. Minerva Endocrinol (Torino). 2023;48(2):130-9.
  • 16. Woliński K, Stangierski A, Gurgul E, Bromińska B, Czarnywojtek A, Lodyga M, et al. Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis. Endokrynol Pol. 2017;68(1):2-6.
  • 17. Dagdelen S, Cinar N, Erbas T. Increased thyroid cancer risk in acromegaly. Pituitary. 2014;17(4):299-306.
  • 18. Dogan S, Atmaca A, Dagdelen S, Erbas B, Erbas T. Evaluation of thyroid diseases and differentiated thyroid cancer in acromegalic patients. Endocrine. 2014;45(1):114-21.
  • 19. Dogansen SC, Salmaslioglu A, Yalin GY, Tanrikulu S, Yarman S. Evaluation of the natural course of thyroid nodules in patients with acromegaly. Pituitary. 2019;22(1):29-36.
  • 20. Xu D, Wu B, Li X, Cheng Y, Chen D, Fang Y, et al. Evaluation of the thyroid characteristics of patients with growth hormone-secreting adenomas. BMC Endocr Disord. 2019;19(1):94.
  • 21. Kan S, Kizilgul M, Celik B, Beysel S, Caliskan M, Apaydin M, et al. The effect of disease activity on thyroid nodules in patients with acromegaly. Endocr J. 2019;66(4):301-7.
  • 22. Gullu BE, Celik O, Gazioglu N, Kadioglu P. Thyroid cancer is the most common cancer associated with acromegaly. Pituitary. 2010;13(3):242-8.
  • 23. Wolinski K, Czarnywojtek A, Ruchala M. Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--metaanalysis and systematic review. PLoS One. 2014;9(2):e88787.
  • 24. Keskin FE, Ozkaya HM, Ferahman S, Haliloglu O, Karatas A, Aksoy F, et al. The Role of Different Molecular Markers in Papillary Thyroid Cancer Patients with Acromegaly. Exp Clin Endocrinol Diabetes. 2019;127(7):437-444.
  • 25. Petroff D, Tönjes A, Grussendorf M, Droste M, Dimopoulou C, Stalla G, et al. The Incidence of Cancer Among Acromegaly Patients: Results From the German Ac-romegaly Registry. J Clin Endocrinol Metab. 2015;100(10):3894-902.
  • 26. Uchoa HB, Lima GA, Corrêa LL, Vidal AP, Cavallieri SA, Vaisman M, et al. Prevalence of thyroid diseases in patients with acromegaly: experience of a Brazilian center. Arq Bras Endocrinol Metabol. 2013;57(9):685-90.

Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients

Year 2025, Volume: 15 Issue: 2, 119 - 124, 15.06.2025

Abdullatif Sirin , Osman Köstek , Mümtaz Takır , Mehmet Uzunlulu

https://doi.org/10.16919/bozoktip.1523690

Abstract

Abstract
Objective: Acromegaly patients often develop goiter and thyroid nodules due to continuous
stimulation of the thyroid follicle by growth hormon (GH) and insulin-like growth factor-1 (IGF-1). Recent studies suggest a decrease in thyroid disease rates in patients who have been successfully treated. This study aimed to investigate thyroid disorders in patients who had cured or controlled the disease.
Material and Methods: The patients’ GH levels less than 1 ng/mL and IGF-1 levels within the age-sex-adjusted normal range were categorized into controlled patients. Sonographic and biochemical findings of the thyroid gland were recorded.
Results: The study included 33 patients with acromegaly (14 males and 19 females) and 50 volunteers (14 males and 36 females). The prevalence of goiter was higher in patients with acromegaly compared to control group (21.2% vs. 6%, respectively; p<0.001). Acromegaly patients had a higher frequency of thyroid nodules, but nodules larger than 1 cm were similar between the two groups.
Conclusion: Acromegaly patients still have a high multinodular goiter incidence. Well control of disease may reduce the prevelance of thyroid cancer and risky nodules.
acromegaly, thyroid disease, thyroid nodule

Keywords

acromegaly thyroid disease thyroid nodule

References

  • 1. Melmed S, Bronstein MD, Chanson P, Klibanski A, Casanueva FF, Wass JAH, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018;14(9):552-61.
  • 2. Lavrentaki A, Paluzzi A, Wass JA, Karavitaki N. Epidemiology of acromegaly: review of population studies. Pituitary. 2017;20(1):4-9.
  • 3. Katznelson L, Laws ER Jr, Melmed S, Molitch ME, Murad MH, Utz A, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51.
  • 4. Herrmann BL, Baumann H, Janssen OE, Görges R, Schmid KW, Mann K. Impact of disease activity on thyroid diseases in patients with acromegaly: basal evaluation and follow-up. Exp Clin Endocrinol Diabetes. 2004;112(5):225-30.
  • 5. Chen Z, Jiang X, Feng Y, Li X, Chen D, Mao Z, et al. Decrease in acromegaly-assocıated thyroıd enlargement after normalızatıon of IGF-1 levels: a prospective observation and in vıtro study. Endocr Pract. 2020;26(4):369-77.
  • 6. Boguszewski CL, Ayuk J. Management Of Endocrine Disease: Acromegaly and cancer: an old debate revisited. Eur J Endocrinol. 2016;175(4):147-56.
  • 7. Vitti P, Rago T, Mazzeo S, Brogioni S, Lampis M, De Liperi A, et al. Thyroid blood flow evaluation by color-flow Doppler sonography distinguishes Graves' di-sease from Hashimoto's thyroiditis. J Endocrinol Invest. 1995;18(11):857-61.
  • 8. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1-133.
  • 9. Mo C, Zhong L. The effect of acromegaly on thyroid disease. Endocr J. 2023;70(11):1051-60.
  • 10. Manavela M, Vigovich C, Danilowicz K, Juri A, Miechi L, Fernandez Valoni V, et al. Thyroid autoimmune disorders in patients with acromegaly. Pituitary. 2015;18(6):912-15.
  • 11. Ock S, Ahn J, Lee SH, Kang H, Offermanns S, Ahn HY, et al. IGF-1 receptor deficiency in thyrocytes impairs thyroid hormone secretion and completely inhibits TSH-stimulated goiter. FASEB J. 2013;27(12):4899-908.
  • 12. Wu X, Gao L, Guo X, Wang Q, Wang Z, Lian W, et al. GH, IGF-1, and Age Are Important Contributors to Thyroid Abnormalities in Patients with Acromegaly. Int J Endocrinol. 2018;2018:6546832.
  • 13. Natchev E, Vandeva S, Kovatcheva R, Kirilov G, Kalinov K, Zacharieva S. Thyroid gland changes in patients with acromegaly. Arch Endocrinol Metab. 2020;64(3):269-75.
  • 14. Gasperi M, Martino E, Manetti L, Arosio M, Porretti S, Faglia G, et al. Prevalence of thyroid diseases in patients with acromegaly: results of an Italian multi-center study. J Endocrinol Invest. 2002;25(3):240- 5.
  • 15. Cankurtaran Y, Örük GG, Tozduman B. Evaluation of thyroid disease and thyroid malignancy in acromegalic patients. Minerva Endocrinol (Torino). 2023;48(2):130-9.
  • 16. Woliński K, Stangierski A, Gurgul E, Bromińska B, Czarnywojtek A, Lodyga M, et al. Thyroid lesions in patients with acromegaly - case-control study and update to the meta-analysis. Endokrynol Pol. 2017;68(1):2-6.
  • 17. Dagdelen S, Cinar N, Erbas T. Increased thyroid cancer risk in acromegaly. Pituitary. 2014;17(4):299-306.
  • 18. Dogan S, Atmaca A, Dagdelen S, Erbas B, Erbas T. Evaluation of thyroid diseases and differentiated thyroid cancer in acromegalic patients. Endocrine. 2014;45(1):114-21.
  • 19. Dogansen SC, Salmaslioglu A, Yalin GY, Tanrikulu S, Yarman S. Evaluation of the natural course of thyroid nodules in patients with acromegaly. Pituitary. 2019;22(1):29-36.
  • 20. Xu D, Wu B, Li X, Cheng Y, Chen D, Fang Y, et al. Evaluation of the thyroid characteristics of patients with growth hormone-secreting adenomas. BMC Endocr Disord. 2019;19(1):94.
  • 21. Kan S, Kizilgul M, Celik B, Beysel S, Caliskan M, Apaydin M, et al. The effect of disease activity on thyroid nodules in patients with acromegaly. Endocr J. 2019;66(4):301-7.
  • 22. Gullu BE, Celik O, Gazioglu N, Kadioglu P. Thyroid cancer is the most common cancer associated with acromegaly. Pituitary. 2010;13(3):242-8.
  • 23. Wolinski K, Czarnywojtek A, Ruchala M. Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--metaanalysis and systematic review. PLoS One. 2014;9(2):e88787.
  • 24. Keskin FE, Ozkaya HM, Ferahman S, Haliloglu O, Karatas A, Aksoy F, et al. The Role of Different Molecular Markers in Papillary Thyroid Cancer Patients with Acromegaly. Exp Clin Endocrinol Diabetes. 2019;127(7):437-444.
  • 25. Petroff D, Tönjes A, Grussendorf M, Droste M, Dimopoulou C, Stalla G, et al. The Incidence of Cancer Among Acromegaly Patients: Results From the German Ac-romegaly Registry. J Clin Endocrinol Metab. 2015;100(10):3894-902.
  • 26. Uchoa HB, Lima GA, Corrêa LL, Vidal AP, Cavallieri SA, Vaisman M, et al. Prevalence of thyroid diseases in patients with acromegaly: experience of a Brazilian center. Arq Bras Endocrinol Metabol. 2013;57(9):685-90.
There are 26 citations in total.

Details

Primary Language English
Subjects Endocrinology
Journal Section Original Research
Authors

Abdullatif Sirin 0000-0002-4001-9887

Osman Köstek 0000-0002-1901-5603

Mümtaz Takır 0000-0003-4363-3193

Mehmet Uzunlulu 0000-0001-8754-1069

Publication Date June 15, 2025
Submission Date July 28, 2024
Acceptance Date April 14, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

APA Sirin, A., Köstek, O., Takır, M., Uzunlulu, M. (2025). Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients. Bozok Tıp Dergisi, 15(2), 119-124. https://doi.org/10.16919/bozoktip.1523690
AMA Sirin A, Köstek O, Takır M, Uzunlulu M. Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients. Bozok Tıp Dergisi. June 2025;15(2):119-124. doi:10.16919/bozoktip.1523690
Chicago Sirin, Abdullatif, Osman Köstek, Mümtaz Takır, and Mehmet Uzunlulu. “Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients”. Bozok Tıp Dergisi 15, no. 2 (June 2025): 119-24. https://doi.org/10.16919/bozoktip.1523690.
EndNote Sirin A, Köstek O, Takır M, Uzunlulu M (June 1, 2025) Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients. Bozok Tıp Dergisi 15 2 119–124.
IEEE A. Sirin, O. Köstek, M. Takır, and M. Uzunlulu, “Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients”, Bozok Tıp Dergisi, vol. 15, no. 2, pp. 119–124, 2025, doi: 10.16919/bozoktip.1523690.
ISNAD Sirin, Abdullatif et al. “Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients”. Bozok Tıp Dergisi 15/2 (June 2025), 119-124. https://doi.org/10.16919/bozoktip.1523690.
JAMA Sirin A, Köstek O, Takır M, Uzunlulu M. Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients. Bozok Tıp Dergisi. 2025;15:119–124.
MLA Sirin, Abdullatif et al. “Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients”. Bozok Tıp Dergisi, vol. 15, no. 2, 2025, pp. 119-24, doi:10.16919/bozoktip.1523690.
Vancouver Sirin A, Köstek O, Takır M, Uzunlulu M. Evaluation of Thyroid Disorders in Effectively Treated Acromegalic Patients. Bozok Tıp Dergisi. 2025;15(2):119-24.
 Download Cover Image
Copyright © BOZOK Üniversitesi - Tıp Fakültesi