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Thyroid nodules are frequently observed in the thyroid gland, with a malignancy rate of less than 5%. The etiology of nodule formation remains unclear, and various hypotheses have been proposed. Vitamin D, known to influence cell turnover, may also play a role in the development of thyroid nodules. This study aims to investigate the association between vitamin D deficiency and thyroid nodule formation. Blood samples were collected from individuals categorized into two groups based on the presence of thyroid nodules. 100 patients with thyroid nodules detected by ultrasonography and 100 individuals with no thyroid nodules were included in the study. The 25-hydroxyvitamin D [25(OH)D3] levels were measured in a single session. The mean 25(OH)D3 levels were 15.39±9.1 ng/ml in the patient group and 13.33±7.1 ng/ml in the control group. Vitamin D deficiency was identified in 72% of the patient group and 82% of the control group. No significant correlation was found between 25(OH)D3 levels and the presence of thyroid nodules. Further research is needed to elucidate this relationship. [Med-Science 2024; 13(3.000): 598-602]

Routine calcitonin measurement in patients with nodular thyroid disease is rather controversial. The aim of this study was to evaluate the contribution of serum calcitonin measurement in the diagnostic evaluation of thyroid nodules with insufficient, indeterminate, or suspicious cytology. Out of 1668 patients who underwent thyroidectomy with the diagnosis of nodular thyroid disease and were screened, 873 patients with insufficient, indeterminate, or suspicious fine needle aspiration biopsy results were included in the study. From the total number of patients in this study, 10 (1.1%) were diagnosed as medullary thyroid cancer (MTC) using histopathology. The calcitonin level was detected to be above the assay-specific cut-off in 23 (2.6%) patients ranging between 6.5 - 4450 pg/mL. While hypercalcitoninemia was detected in all 10 MTC patients, a false positive elevation of serum calcitonin was detected in 13 patients (1.5%). Of the MTC group, 7 patients had cytology results that were suspicious for malignancy (Bethesda V), one patient’s cytology showed atypia of undetermined significance (Bethesda III) and two patient’s cytology results were suspicious for follicular neoplasm (Bethesda IV). Among the cases with non-diagnostic cytology (Bethesda I), none of the patients were diagnosed with MTC. In conclusion, routine serum calcitonin measurement can be performed in selected cases rather than in all nodular thyroid patients. While it is reasonable to perform routine calcitonin measurement in patients with Bethesda IV and Bethesda V, this measurement was not useful in Bethesda I patients. In Bethesda III patients, patient-based decisions can be made according to their calcitonin measurement.

ABSTRACT Objective Ultrasound assessment plays an important role in the diagnosis, and monitoring of subacute thyroiditis (SAT). However, the relationship between ultrasonographic findings and severity or prognosis of the disease is not known. The aim of the present study was to evaluate the relationship between bilateral and unilateral disease involvement and severity and prognosis of the disease. Subjects and methods The initial laboratory values, ultrasonographic findings and long-term outcomes of 247 SAT patients were evaluated retrospectively. Results In the ultrasonographic evaluation, bilateral involvement was detected in 154 patients, and unilateral involvement in 93 patients at the time of diagnosis. No significant difference was found between patients with bilateral or unilateral disease at the time of diagnosis in respect of the initial acute phase reactants. FT4 was significantly higher and TSH was significantly lower in the group with bilateral disease. Bilobar or unilobar disease on ultrasound at the time of diagnosis was not found to be a risk factor for permanent hypothyroidism or recurrence. The mean thyroid volume was determined to be 22.5 ± 10 cm3 at the beginning of treatment, and 11.2 ± 8 cm3 at the end of treatment. The initial thyroid volume and the thyroid volume at the end of treatment were significantly lower in patients who developed hypothyroidism. Conclusion There was no relationship between initial acute phase reactants and bilateral or unilateral involvement of the disease. FT4 levels were found to be associated with the extension of the disease. The risk of recurrence and permanent hypothyroidism are not associated with the initial ultrasonographic aspect. Arch Endocrinol Metab. 2020;64(3):306-11

Background: Vasculopathy is a major cause of mortality and morbidity in Behcet’s Disease (BD). Subclinical atherosclerosis can even be detected in the early stage of BD. Soluble tumor necrosis factor-like (TNF) weak inducer of apoptosis (TWEAK) is known as a good marker of the inflammation in vascular tree. The aim of this study is to examine the relationship between carotid artery intima-media thickness (cIMT) and serum TWEAK levels in patients with BD. Materials and Methods: In line with International BD Study Group criteria, 48 BD, and 30 controls were included in our study. Disease activity was evaluated according to BD current activity form (BDCAF). C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), lipid parameters, serum TWEAK levels, and cIMT were measured. Results: Disease activity score of BD patients was found as 2 (range 0–7). cIMT, serum TWEAK, CRP and ESR levels of BD patients were significantly higher comparing to cIMT (0.62 ± 0.13 mm vs. 0.43 ± 0.09 mm, p < 0.001), serum TWEAK (667.5 ± 130.6 vs. 603.4 ± 89.6 pg/ml, p = 0.015), CRP (3.9 ± 4.3 vs. 1.4 ± 1.0 mg/dl, p < 0.001) and ESR (10.2 ± 10.0 vs. 5.6 ± 3.7 mm/h, p = 0.005) levels of the control group. There was a positive correlation between serum TWEAK level and disease activity (r = 0.251, p = 0.030) and cIMT (r = 0.463, p < 0.001). Our study also revealed an independent correlation between cIMT and serum TWEAK levels (beta = 0.354, p < 0.001). Conclusion: Increased serum TWEAK levels can play a part in the development of atherosclerotic heart disease in BD. Due to their liability to atherosclerosis, patients with BD must followed closely.

Objective:Acromegaly is a chronic disease that causes high concentrations of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). GH and IGF-1 levels have important effects on bone homeostasis, bone turnover, and bone remodeling. The results of studies investigating the relationship between acromegaly and bone mineral density (BMD) are controversial. The aim of the current study was to evaluate BMD in newly diagnosed acromegaly patients and to determine the relationship between GH and IGF-1 levels with BMD.Materials and Methods:This cross-sectional study was conducted on 36 newly diagnosed acromegaly patients without a history of hypogonadism, whose BMD values can be obtained from the records of University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital. The relationship between GH and IGF-1 levels and BMD measured from the femur and lumbar regions was examined separately.Results:The mean age of the patients was 46.2±12.5 years. Median IGF-1 and BH levels were 551 ng/mL and 8.2 ng/mL, respectively. While 58.3% of the patients had osteopenia, no osteoporosis was found in any patient. A positive correlation was found between the BMD value measured from the femoral neck and IGF-1 (r=0.484, p=0.036) and GH (r=0.595, p=0.007) levels. There was no significant correlation between BMD measurements evaluated from lumbar vertebrae and GH and IGF-1 levels.Conclusion:It was found that the increase in GH and IGF-1 levels in newly diagnosed eugonadal acromegaly patients increased BMD measured from the femur. There was no significant relationship between BMD measured from the lumbar region and GH and IGF-1 levels.

INTRODUCTION: Although GLP-1 agonists have been shown to reduce cardiovascular events, their effect on the progression of subclinical atherosclerosis is not clear. In this respect, it was planned to evaluate cardiovascular risk markers in obese and diabetic patients receiving exenatide therapy. METHODS: This retrospective study included 56 patients with Type 2 Diabetes Mellitus (DM) with a body mass index (BMI) >35. Demographic, anthropometric and clinic characteristics before and after six-month treatment with exenatide were screened. Cardiovascular risk marker Atherogenic Index of Plasma (AIP), uric acid, carotis intima media thickness (CIMT), HbA1c, fasting blood glucose (FBS) and postprandial blood glucose (TCG) levels were evaluated. RESULTS: Eleven of the fifty-six patients had discontinued exenatide due to side effects, etc. 45 patients (35 females, 10 males; age 50 +- 9.5 years) completed the study. AIP, HbA1c, uric acid, fasting plasma glucose, postprandial glucose, waist circumference, hip circumference, body mass index (BMI), total cholesterol, and triglyceride levels were improved with exenatide treatment. However, no change was detected in CIMT, blood pressure, spot urine albumin/creatinine ratio, LDL, and HDL levels. DISCUSSION AND CONCLUSION: Glycemic parameters, AIP and uric acid levels, which are biochemical predictors of subclinical atherosclerosis, were improved with GLP-1 agonist exetide treatment. However, no change was observed in CIMT measurements. These findings can be interpreted as exenatide therapy, can slow down the progression of subclinical atherosclerosis, but has no effect on existing atherosclerotic plaque.