Thyroid Volume As Measured By Ultrasonography in Patients With Type 1 Diabetes Mellitus without Thyroid Dysfunction

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Abstract
The aim of this cross-sectional study was to assess and compare thyroid volume and its derminants in a cohort of type 1 diabetes mellitus (DM1) and compare the results to a healthy control group. We studied 65 DM1 patients treated with an intensive insulin regimen and 65 matched controls. In all participants we evaluated weight, height, BMI, waist-hip ratio, body surface area and body composition variables determined by using a bioelectrical impedance analyser. Thyroid size was estimated by ultrasonography. We determined basal TSH, anti-thyroid antibodies and urinary iodine excretion. Body weight, height, BMI and body surface area were similar in DM1 patients and in controls. Fat-free mass was higher in both male and female DM1 patients than in controls (64.4 ± 6.9 vs. 60.4 ± 8.2 kg, p = 0.03 and 48.3 ± 5.7 vs. 45.4 ± 6, p = 0.04, respectively), and fat mass was lower in male DM1 patients than in controls (9.7 ± 7 vs. 14.2 ± 8.1 kg, p = 0.01). Thyroid volume was greater in both male and female DM1 patients than in controls (11.12 ± 2.87 vs. 9.63 ± 2.27 ml, p = 0.0001 and 9.5 ± 2.3 vs. 7.7 ± 2 ml, p = 0.002, respectively). Urinary iodine excretion was similar in the two groups. In both DM1 patients and controls, thyroid volume correlated with weight, height, BMI, waist-hip ratio, body surface area, fat-free mass and the multivariate linear regression analysis with thyroid volume as the dependent variable showed that fat-free mass in either group was the only significant determinant of thyroid volume. We conclude that DM1 patients had larger thyroid volume compared with healthy controls with similar anthropometry; body composition is different in DM1 patients and that the anthropometric and body composition variables, especially fat-free mass and body surface area, predict thyroid volume either in DM1 patients or in healthy controls.

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