Correlation of the Structural Changes in the Thyroid Gland with Clinical and Laboratory Parameters in Patients with Diabetes Mellitus Type 2
The article presents the results of the study on the influence of clinical and laboratory parameters on the presence of structural changes in the thyroid gland (TG) of patients with diabetes mellitus (DM) type 2. Objective — to evaluate the frequency and nature of the structural changes in the TG in DM type 2. Materials and methods. We have examined 122 patients, including 92 — with type 2 DM, and 30 — with obesity without DM type 2 (47 men and 75 women). Control group consisted of individuals without DM symptoms and obesity (n = 35). Examined groups did not differ by the age and sex. Results. In patients with type 2 DM, thyroid pathology was detected in 93.5 % of cases, in obesity without diabetes — in 86.7 %. These figures are significantly higher than population level (65.7 %). Structural changes in the form of nodules are detected significantly more often in DM type 2 (55.4 %). In general, nodules occurred 3.2 times more frequently in type 2 DM type than in obesity, and 4.9 times more often than in the control group. When comparing the nature of changes in the TG with clinical and laboratory parameters of DM type 2, it was found that with increasing duration of DM type 2, the number of nodules significantly increases. During insulin therapy in patients with DM, the percentage of thyroid nodules was significantly lower. Thyroid nodules are diagnosed significantly more frequently in the presence of microvascular complications and arterial hypertension. Nodules in type 2 DM were detected significantly more often in patients with obesity I degree than in patients with normal body mass (64.2 and 21.8 %, respectively) (p < 0.01). Nodules of the TG are found significantly more often in patients with DM, in whom hepatic steatosis criteria were detected by echography of the liver (p < 0.05). Conclusions. Dynamic ultrasound examination of the TG in the duration of DM type 2 over five years, the presence of microangiopathy, obesity I–III degree, echographic criteria of hepatic steatosis, hypertension syndrome, as well as in administration of oral antidiabetic agents allow timely detection of structural changes in the TG.
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