Skip to main content
Erschienen in: Endocrine 2/2018

06.08.2018 | Original Article

An assessment of the relationship between thyroid nodule characteristics, insulin resistance and arterial stiffness in euthyroid nodular goiter

verfasst von: Yasemin Aydoğan, Mustafa Altay, Oktay Ünsal, Veysel Kaplanoğlu, Yavuz Çağır, Canan Yıldız, Esin Beyan, Selma Uysal Ramadan

Erschienen in: Endocrine | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Publications suggesting that thyroid nodule might be associated with insulin resistance and metabolic syndrome are quite interesting. There is a need for studies assessing the relationship between nodule presence and cardiovascular risk in individuals with non-functioning nodular goiter. The purpose of the present study is to reveal whether or not insulin resistance, nodule presence, and nodule stiffness affect arterial stiffness, which is a reliable and valid cardiovascular risk indicator, in individuals with euthyroid nodular goiter using the pulse wave analysis (PWA).

Materials and methods

50 patients with euthyroid nodular goiter and 50 healthy volunteers were included in the study. All participants were examined by B-mode thyroid ultrasound, and the participants in the nodular goiter group were also examined by strain elastography (SE). The strain index of nodules was calculated according to the Rago scoring. Also, fasting plasma glucose (FPG) and insulin levels were measured, and HOMA-IR. Arterial stiffness measurements of the participants were performed using a PWA device which employs a cuff-based oscillometric method from the brachial artery.

Results

PWV was found to be significantly higher in the euthyroid nodular goiter group (p < 0.001). PWV was found to be positively correlated with FPG and waist circumference. Fasting plasma glucose was found to be higher in the group with nodular goiter (p = 0.03). However, no difference was found between the groups in terms of HOMA-IR and insulin level. HOMA-IR was not correlated with thyroid volume, nodule volume, and nodule count. Also, HOMA-IR was not correlated with strain index value and PWA data.

Conclusion

We found that PWV was significantly higher in patients with euthyroid nodular goiter. This result suggests that these patients may be at risk for cardiovascular disease.
Literatur
1.
Zurück zum Zitat H. Studer, M. Derwahl, Mechanisms of nonneoplastic endocrine hyperplasia—a changing concept: A review focused on the thyroid gland. Endocr. Rev. 16, 411–426 (1995)PubMed H. Studer, M. Derwahl, Mechanisms of nonneoplastic endocrine hyperplasia—a changing concept: A review focused on the thyroid gland. Endocr. Rev. 16, 411–426 (1995)PubMed
2.
Zurück zum Zitat K. Westermark, F.A. Karlsson, B. Westermark, Thyrotropin modulates EGF receptor function in porcine thyroid follicle cells. Mol. Cell. Endocrinol. 40, 17–23 (1985)CrossRef K. Westermark, F.A. Karlsson, B. Westermark, Thyrotropin modulates EGF receptor function in porcine thyroid follicle cells. Mol. Cell. Endocrinol. 40, 17–23 (1985)CrossRef
3.
Zurück zum Zitat M.C. Eggo, W.J. King, E.G. Black, M.C. Sheppard, Functional human thyroid cells and their insulin-like growth factor-binding proteins: Regulation by thyrotropin cyclic 3’,5’ adenosine monophosphate, and growth factors. J. Clin. Endocrinol. Metab. 81, 3056–3062 (1996)PubMed M.C. Eggo, W.J. King, E.G. Black, M.C. Sheppard, Functional human thyroid cells and their insulin-like growth factor-binding proteins: Regulation by thyrotropin cyclic 3’,5’ adenosine monophosphate, and growth factors. J. Clin. Endocrinol. Metab. 81, 3056–3062 (1996)PubMed
4.
Zurück zum Zitat R. Burikhanov, K. Coulonval, I. Pirson, F. Lamy, J.E. Dumont, P.P. Roger, Thyrotropin via cyclic AMP induces insulin receptor expression and growth factor signaling pathways in dog thyroid epithelial cells. J. Biol. Chem. 271, 29400–29406 (1996)CrossRef R. Burikhanov, K. Coulonval, I. Pirson, F. Lamy, J.E. Dumont, P.P. Roger, Thyrotropin via cyclic AMP induces insulin receptor expression and growth factor signaling pathways in dog thyroid epithelial cells. J. Biol. Chem. 271, 29400–29406 (1996)CrossRef
5.
Zurück zum Zitat N.W. Cheung, S.C. Boyages, The thyroid gland in acromegaly: An ultrasonographic study. Clin. Endocrinol. 46, 545–549 (1997)CrossRef N.W. Cheung, S.C. Boyages, The thyroid gland in acromegaly: An ultrasonographic study. Clin. Endocrinol. 46, 545–549 (1997)CrossRef
6.
Zurück zum Zitat T. Kimura, A. Van Keymeulen, J. Golstein, A. Fusco, J.E. Dumont, P.P. Roger, Regulation of thyroid cell proliferation by TSH and other factors: a critical evaluation of in vitro models. Endocr. Rev. 22, 631–656 (2001)CrossRef T. Kimura, A. Van Keymeulen, J. Golstein, A. Fusco, J.E. Dumont, P.P. Roger, Regulation of thyroid cell proliferation by TSH and other factors: a critical evaluation of in vitro models. Endocr. Rev. 22, 631–656 (2001)CrossRef
7.
Zurück zum Zitat J. Shin, M.H. Kim, K.H. Yoon et al. Relationship between metabolic syndrome and thyroid nodules in healthy Koreans. Korean J. Intern. Med. 31(1), 98–105 (2016)CrossRef J. Shin, M.H. Kim, K.H. Yoon et al. Relationship between metabolic syndrome and thyroid nodules in healthy Koreans. Korean J. Intern. Med. 31(1), 98–105 (2016)CrossRef
8.
Zurück zum Zitat Z. Heidari, M.A. Mashhadi, S. Nosratzehi, Insulin resistance in patients with benign thyroid nodules. Arch. Iran. Med. 18(9), 572–576 (2015)PubMed Z. Heidari, M.A. Mashhadi, S. Nosratzehi, Insulin resistance in patients with benign thyroid nodules. Arch. Iran. Med. 18(9), 572–576 (2015)PubMed
9.
Zurück zum Zitat P. Nahon, G. Thabut, M. Ziol, M.T. Htar, F. Cesaro, N. Barget et al. Liver stiffness measurement versus clinicians’ prediction or both for the assessment of liver fibrosis in patients with chronic hepatitis C. Am. J. Gastroenterol. 101, 2744–2751 (2006)CrossRef P. Nahon, G. Thabut, M. Ziol, M.T. Htar, F. Cesaro, N. Barget et al. Liver stiffness measurement versus clinicians’ prediction or both for the assessment of liver fibrosis in patients with chronic hepatitis C. Am. J. Gastroenterol. 101, 2744–2751 (2006)CrossRef
10.
Zurück zum Zitat A. Gotschy, E. Bauer, C. Schrodt, G. Lykowsky, Y.X. Ye, E. Rommel et al. Local arterial stiffening assessed by MRI precedes atherosclerotic plaque formation. Circ. Cardiovasc. Imag. 6, 916–923 (2013)CrossRef A. Gotschy, E. Bauer, C. Schrodt, G. Lykowsky, Y.X. Ye, E. Rommel et al. Local arterial stiffening assessed by MRI precedes atherosclerotic plaque formation. Circ. Cardiovasc. Imag. 6, 916–923 (2013)CrossRef
11.
Zurück zum Zitat J. Blacher, B. Pannier, A.P. Guerin, S.J. Marchais, M.E. Safar, G.M. London, Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32, 570–574 (1998)CrossRef J. Blacher, B. Pannier, A.P. Guerin, S.J. Marchais, M.E. Safar, G.M. London, Carotid arterial stiffness as a predictor of cardiovascular and all-cause mortality in end-stage renal disease. Hypertension 32, 570–574 (1998)CrossRef
12.
Zurück zum Zitat J. Wuerfel, F. Paul, B. Beierbach, U. Hamhaber, D. Klatt, S. Papazoglou et al. MR-elastography reveals degradation of tissue integrity in multiple sclerosis. Neuroimage 49, 2520–2525 (2010)CrossRef J. Wuerfel, F. Paul, B. Beierbach, U. Hamhaber, D. Klatt, S. Papazoglou et al. MR-elastography reveals degradation of tissue integrity in multiple sclerosis. Neuroimage 49, 2520–2525 (2010)CrossRef
13.
Zurück zum Zitat M.J. Paszek, N. Zahir, K.R. Johnson, J.N. Lakins, G.I. Rozenberg, A. Gefen et al. Tensional homeostasis and the malignant phenotype. Cancer Cell. 8, 241–254 (2005)CrossRef M.J. Paszek, N. Zahir, K.R. Johnson, J.N. Lakins, G.I. Rozenberg, A. Gefen et al. Tensional homeostasis and the malignant phenotype. Cancer Cell. 8, 241–254 (2005)CrossRef
14.
Zurück zum Zitat M.F. Berry, A.J. Engler, Y.J. Woo, T.J. Pirolli, L.T. Bish, V. Jayasankar et al. Mesenchymal stem cell injection after myocardial infarction improves myocardial compliance. Am. J. Physiol. Heart Circ. Physiol. 290, H2196–H2203 (2006)CrossRef M.F. Berry, A.J. Engler, Y.J. Woo, T.J. Pirolli, L.T. Bish, V. Jayasankar et al. Mesenchymal stem cell injection after myocardial infarction improves myocardial compliance. Am. J. Physiol. Heart Circ. Physiol. 290, H2196–H2203 (2006)CrossRef
15.
Zurück zum Zitat A.J. Engler, S. Sen, H.L. Sweeney, D.E. Discher, Matrix elasticity directs stem cell lineage specification. Cell 126, 677–689 (2006)CrossRef A.J. Engler, S. Sen, H.L. Sweeney, D.E. Discher, Matrix elasticity directs stem cell lineage specification. Cell 126, 677–689 (2006)CrossRef
16.
Zurück zum Zitat C.M. Lo, H.B. Wang, M. Dembo, Y.L. Wang, Cell movement is guided by the rigidity of the substrate. Biophys. J. 79, 144–152 (2000)CrossRef C.M. Lo, H.B. Wang, M. Dembo, Y.L. Wang, Cell movement is guided by the rigidity of the substrate. Biophys. J. 79, 144–152 (2000)CrossRef
17.
Zurück zum Zitat M.L. Previtera, C.G. Langhammer, B.L. Firestein, Effects of substrate stiffness and cell density on primary hippocampal cultures. J. Biosci. Bioeng. 110, 459–470 (2010)CrossRef M.L. Previtera, C.G. Langhammer, B.L. Firestein, Effects of substrate stiffness and cell density on primary hippocampal cultures. J. Biosci. Bioeng. 110, 459–470 (2010)CrossRef
18.
Zurück zum Zitat M.L. Previtera, A. Sengupta, Substrate stiffness regulates proinflammatory mediator production through TLR4 activity in macrophages. PLoS ONE 10(12), e0145813 (2015)CrossRef M.L. Previtera, A. Sengupta, Substrate stiffness regulates proinflammatory mediator production through TLR4 activity in macrophages. PLoS ONE 10(12), e0145813 (2015)CrossRef
19.
Zurück zum Zitat A.B. Dabrowa, M. Wierzbicka, J.H. Goch, Proinflammatory cytokines in cardiovascular diseases as potential therapeutic target. Wiad. Lek. 60(9–10), 433–438 (2007) A.B. Dabrowa, M. Wierzbicka, J.H. Goch, Proinflammatory cytokines in cardiovascular diseases as potential therapeutic target. Wiad. Lek. 60(9–10), 433–438 (2007)
20.
Zurück zum Zitat T. Akkan, M. Altay, Y. Ünsal, M. Dağdeviren, E. Beyan, Nonfunctioning adrenal incidentaloma affecting central blood pressure and arterial stiffness parameters. Endocrine 58(3), 513–520 (2017)CrossRef T. Akkan, M. Altay, Y. Ünsal, M. Dağdeviren, E. Beyan, Nonfunctioning adrenal incidentaloma affecting central blood pressure and arterial stiffness parameters. Endocrine 58(3), 513–520 (2017)CrossRef
21.
Zurück zum Zitat T. Sehestedt, J. Jeppesen, T.W. Hansen et al. Risk prediction is improved by adding markers of subclinical organ damage to SCORE. Eur. Heart J. 31(7), 883–891 (2010)CrossRef T. Sehestedt, J. Jeppesen, T.W. Hansen et al. Risk prediction is improved by adding markers of subclinical organ damage to SCORE. Eur. Heart J. 31(7), 883–891 (2010)CrossRef
22.
Zurück zum Zitat T. Weber, S. Wassertheurer, M. Rammer, A. Haiden, B. Hametner, B. Eber, Wave reflections, assessed with a novel method for pulse wave separation, are associated with end-organ damage and clinical outcomes. Hypertension 60, 534–541 (2012)CrossRef T. Weber, S. Wassertheurer, M. Rammer, A. Haiden, B. Hametner, B. Eber, Wave reflections, assessed with a novel method for pulse wave separation, are associated with end-organ damage and clinical outcomes. Hypertension 60, 534–541 (2012)CrossRef
23.
Zurück zum Zitat C. Vlachopoulos, K. Aznaouridis, C. Stefanadis, Prediction of cardiovascular events and all-cause mortality with arterial stiffness. A systematic review and meta-analysis. J. Am. Coll. Cardiol. 55(13), 1318–1327 (2010)CrossRef C. Vlachopoulos, K. Aznaouridis, C. Stefanadis, Prediction of cardiovascular events and all-cause mortality with arterial stiffness. A systematic review and meta-analysis. J. Am. Coll. Cardiol. 55(13), 1318–1327 (2010)CrossRef
24.
Zurück zum Zitat Y. Ben-Shlomo, M. Spears, C. Boustred et al. Aortic pulse wave velocity improves cardiovascular event prediction: An individual participant meta-analysis of prospective observational data from 17,635 subjects. J. Am. Coll. Cardiol. 63(7), 636–646 (2014)CrossRef Y. Ben-Shlomo, M. Spears, C. Boustred et al. Aortic pulse wave velocity improves cardiovascular event prediction: An individual participant meta-analysis of prospective observational data from 17,635 subjects. J. Am. Coll. Cardiol. 63(7), 636–646 (2014)CrossRef
25.
Zurück zum Zitat B. Hametner, S. Wassertheurer, J. Kropf, C. Mayer, B. Eber, T. Weber, Oscillometric estimation of aortic pulse wave velocity: Comparison with intra-aortic catheter measurements. Blood Press. Monit. 18(3), 173–176 (2013)CrossRef B. Hametner, S. Wassertheurer, J. Kropf, C. Mayer, B. Eber, T. Weber, Oscillometric estimation of aortic pulse wave velocity: Comparison with intra-aortic catheter measurements. Blood Press. Monit. 18(3), 173–176 (2013)CrossRef
26.
Zurück zum Zitat S. Wassertheurer, J. Kropf, T. Weber et al. A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J. Hum. Hypertens. 24(8), 498–504 (2010)CrossRef S. Wassertheurer, J. Kropf, T. Weber et al. A new oscillometric method for pulse wave analysis: comparison with a common tonometric method. J. Hum. Hypertens. 24(8), 498–504 (2010)CrossRef
27.
Zurück zum Zitat D.R. Matthews, J.P. Hosker, S.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: İnsülin resistance and beta cell function from fasting plasma glucose and insülin concentrations in man. Diabetologia 28(7), 412–419 (1985)CrossRef D.R. Matthews, J.P. Hosker, S.S. Rudenski, B.A. Naylor, D.F. Treacher, R.C. Turner, Homeostasis model assessment: İnsülin resistance and beta cell function from fasting plasma glucose and insülin concentrations in man. Diabetologia 28(7), 412–419 (1985)CrossRef
28.
Zurück zum Zitat A. Şişik, F. Başak, E. Köse, Tiroid nodüllerine güncel yaklaşım: “2015 ATA” ve “2016 AACE/ACE/AME” kılavuzları derlemesi. Arch. Clin. Exp. Med. 2, 18–23 (2017)CrossRef A. Şişik, F. Başak, E. Köse, Tiroid nodüllerine güncel yaklaşım: “2015 ATA” ve “2016 AACE/ACE/AME” kılavuzları derlemesi. Arch. Clin. Exp. Med. 2, 18–23 (2017)CrossRef
29.
Zurück zum Zitat M. Haksever, Tiroit İnce İğne Aspirasyon Biyopsisi ve Sitopatolog Klinisyen İletişimi. Kocatepe Tıp Derg. 15(3), 349–354 (2014) M. Haksever, Tiroit İnce İğne Aspirasyon Biyopsisi ve Sitopatolog Klinisyen İletişimi. Kocatepe Tıp Derg. 15(3), 349–354 (2014)
30.
Zurück zum Zitat C. Li, E.S. Ford, L.C. McGuire, A.H. Mokdad, R.R. Little, G.M. Reaven, Trends in hyperinsulinemia among nondiabetic adults in the U.S. Diabetes Care 29, 2396–2402 (2006). 26CrossRef C. Li, E.S. Ford, L.C. McGuire, A.H. Mokdad, R.R. Little, G.M. Reaven, Trends in hyperinsulinemia among nondiabetic adults in the U.S. Diabetes Care 29, 2396–2402 (2006). 26CrossRef
31.
Zurück zum Zitat J. Rezzonico, M. Rezzonico, E. Pusiol, F. Pitoia, H. Niepomniszcze, Introducing the thyroid gland as another victim of the insulin resistance syndrome. Thyroid 18, 461–464 (2008)CrossRef J. Rezzonico, M. Rezzonico, E. Pusiol, F. Pitoia, H. Niepomniszcze, Introducing the thyroid gland as another victim of the insulin resistance syndrome. Thyroid 18, 461–464 (2008)CrossRef
32.
Zurück zum Zitat J. Rezzónico, M. Rezzónico, E. Pusiol, F. Pitoia, H. Niepomniszcze, High prevalence of thyroid nodules in patients with achrocordons(skin tags). Possib. role Insul. -Resist. Med. 69(3), 302–304 (2009) J. Rezzónico, M. Rezzónico, E. Pusiol, F. Pitoia, H. Niepomniszcze, High prevalence of thyroid nodules in patients with achrocordons(skin tags). Possib. role Insul. -Resist. Med. 69(3), 302–304 (2009)
33.
Zurück zum Zitat R. Burikhanov, K. Coulonval, I. Pirson, F. Lamy, J.E. Dumont, P.P. Roger, Thyrotropin via cyclic AMP induces insulin receptor expression and insulin co stimulation of growth and amplifies insulin and insulin like growth factor signaling pathways in dog thyroid epithelial cells. J. Biol. Chem. 271, 29400–29406 (1996)CrossRef R. Burikhanov, K. Coulonval, I. Pirson, F. Lamy, J.E. Dumont, P.P. Roger, Thyrotropin via cyclic AMP induces insulin receptor expression and insulin co stimulation of growth and amplifies insulin and insulin like growth factor signaling pathways in dog thyroid epithelial cells. J. Biol. Chem. 271, 29400–29406 (1996)CrossRef
34.
Zurück zum Zitat N.W. Cheung, S.C. Boyages, The thyroid gland in acromegaly: An ultrasonographic study. Clin. Endocrinol. 46, 545–549 (1997)CrossRef N.W. Cheung, S.C. Boyages, The thyroid gland in acromegaly: An ultrasonographic study. Clin. Endocrinol. 46, 545–549 (1997)CrossRef
35.
Zurück zum Zitat T. Kimura, J.E. Dumont, A. Fusco, J. Golstein, Insulin and TSH promote growth in size of PC Cl3 rat thyroid cells, possibly via a pathway different from DNA synthesis: Comparison with FRTL-5 cells. Endocr. Rev. 22, 631–656 (2001)CrossRef T. Kimura, J.E. Dumont, A. Fusco, J. Golstein, Insulin and TSH promote growth in size of PC Cl3 rat thyroid cells, possibly via a pathway different from DNA synthesis: Comparison with FRTL-5 cells. Endocr. Rev. 22, 631–656 (2001)CrossRef
36.
Zurück zum Zitat C. Anıl, A. Kut, B. Atesagaoglu et al. Metformin decreases thyroid volume and nodule size in subjects with insulin resistance. A preliminary study. Med. Princ. Pract. 25, 233–236 (2015)CrossRef C. Anıl, A. Kut, B. Atesagaoglu et al. Metformin decreases thyroid volume and nodule size in subjects with insulin resistance. A preliminary study. Med. Princ. Pract. 25, 233–236 (2015)CrossRef
37.
Zurück zum Zitat Duran O.A., Anıl C., Gürsoy A. et al. Thyroid volume in patients with glucose metabolism disorders. Arq. Bras. Endocrinol. Metab. 58(8), 824–827 (2014)CrossRef Duran O.A., Anıl C., Gürsoy A. et al. Thyroid volume in patients with glucose metabolism disorders. Arq. Bras. Endocrinol. Metab. 58(8), 824–827 (2014)CrossRef
38.
Zurück zum Zitat O.A. Duran, C. Anıl, A. Gürsoy et al. The relationship between glucose metabolism disorders and malignant thyroid disease. Int. J. Clin. Oncol. 18, 585–589 (2013)CrossRef O.A. Duran, C. Anıl, A. Gürsoy et al. The relationship between glucose metabolism disorders and malignant thyroid disease. Int. J. Clin. Oncol. 18, 585–589 (2013)CrossRef
39.
Zurück zum Zitat A. Lyshchik, T. Higashi, R. Asato et al. Thyroid gland tumor diagnosis at US elastography. Radiology 237, 202–211 (2005)CrossRef A. Lyshchik, T. Higashi, R. Asato et al. Thyroid gland tumor diagnosis at US elastography. Radiology 237, 202–211 (2005)CrossRef
40.
Zurück zum Zitat D. Huang, M. Refaat, K. Mohammedi et al. Macrovascular complications in patients with diabetes and prediabetes. Biomed. Res. Int. 2017, 7839101 (2017)PubMedPubMedCentral D. Huang, M. Refaat, K. Mohammedi et al. Macrovascular complications in patients with diabetes and prediabetes. Biomed. Res. Int. 2017, 7839101 (2017)PubMedPubMedCentral
41.
Zurück zum Zitat B. Brannick, S. Dagogo-Jack, Prediabetes and cardiovascular disease: Pathophysiology and interventions for prevention and risk reduction. Endocrinol. Metab. Clin. North. Am. 47(1), 33–50 (2018)CrossRef B. Brannick, S. Dagogo-Jack, Prediabetes and cardiovascular disease: Pathophysiology and interventions for prevention and risk reduction. Endocrinol. Metab. Clin. North. Am. 47(1), 33–50 (2018)CrossRef
42.
Zurück zum Zitat A.G. Dagre, J.P. Lekakis, T.G. Papaioannou et al. Arterial stiffness is increased in subjects with hypothyroidism. Int. J. Cardiol. 103, 1–6 (2005)CrossRef A.G. Dagre, J.P. Lekakis, T.G. Papaioannou et al. Arterial stiffness is increased in subjects with hypothyroidism. Int. J. Cardiol. 103, 1–6 (2005)CrossRef
43.
Zurück zum Zitat T. Nagasaki, M. Inaba, Y. Kumeda et al. Decrease of arterial stiffness at common carotid artery in hypothyroid patients by normalization of thyroid function. Biomed. Pharmacother. 59, 8–14 (2005)CrossRef T. Nagasaki, M. Inaba, Y. Kumeda et al. Decrease of arterial stiffness at common carotid artery in hypothyroid patients by normalization of thyroid function. Biomed. Pharmacother. 59, 8–14 (2005)CrossRef
44.
Zurück zum Zitat E.A. Palmieri, S. Fazio, V. Palmieri et al. Myocardial contractility and total arterial stiffness in patients with overt hyperthyroidism: acute effects of beta1-adrenergic blockade. Eur. J. Endocrinol. 150, 757–762 (2004)CrossRef E.A. Palmieri, S. Fazio, V. Palmieri et al. Myocardial contractility and total arterial stiffness in patients with overt hyperthyroidism: acute effects of beta1-adrenergic blockade. Eur. J. Endocrinol. 150, 757–762 (2004)CrossRef
45.
Zurück zum Zitat T. Nagasaki, M. Inaba, Y. Kumeda et al. Increased pulse wave velocity in subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 91, 154–158 (2006)CrossRef T. Nagasaki, M. Inaba, Y. Kumeda et al. Increased pulse wave velocity in subclinical hypothyroidism. J. Clin. Endocrinol. Metab. 91, 154–158 (2006)CrossRef
46.
Zurück zum Zitat M.D. Gammage, J.V. Parle, R.L. Holder et al. Association between serum free thyroxine concentration and atrial fibrillation. Arch. Intern. Med. 167(9), 928–934 (2007)CrossRef M.D. Gammage, J.V. Parle, R.L. Holder et al. Association between serum free thyroxine concentration and atrial fibrillation. Arch. Intern. Med. 167(9), 928–934 (2007)CrossRef
47.
Zurück zum Zitat H. Nishi, K. Toda, S. Miyagawa, Y. Yoshigawa et al. Novel evaluation of liver stiffness using transient elastography to evaluate perioperative status in severe heart failure patients. Circulation 128, 12745 (2013) H. Nishi, K. Toda, S. Miyagawa, Y. Yoshigawa et al. Novel evaluation of liver stiffness using transient elastography to evaluate perioperative status in severe heart failure patients. Circulation 128, 12745 (2013)
Metadaten
Titel
An assessment of the relationship between thyroid nodule characteristics, insulin resistance and arterial stiffness in euthyroid nodular goiter
verfasst von
Yasemin Aydoğan
Mustafa Altay
Oktay Ünsal
Veysel Kaplanoğlu
Yavuz Çağır
Canan Yıldız
Esin Beyan
Selma Uysal Ramadan
Publikationsdatum
06.08.2018
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2018
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-018-1701-6

Weitere Artikel der Ausgabe 2/2018

Endocrine 2/2018 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.