Interrelationships between age, thyroid volume, thyroid nodularity, and thyroid function in patients with sporadic nontoxic goiter

doi:10.1016/0002-9343(90)90178-G

The American Journal of Medicine

Volume 89, Issue 5, November 1990, Pages 602-608

https://doi.org/10.1016/0002-9343(90)90178-G Get rights and content

Abstract

purpose: To test the hypothesis that during the natural history of sporadic nontoxic goiter (SNG), a diffuse goiter precedes a multinodular goiter with gradual development of autonomous thyroid function.

patients and methods: A cross-sectional survey of 102 consecutive patients with SNG (seven male, 95 female) was performed. Thyroid volume was measured by ultrasonography, and plasma thyroid-stimulating hormone (TSH) by a sensitive assay (TSH immunoradiometric assay).

results: Patients with a multinodular goiter were older and had a larger thyroid volume than patients with a diffuse or uninodular goiter. Plasma free thyroxine (T₄) and total triiodothyronine (T₃) were higher and plasma TSH was lower in patients than in normal subjects. Free T₄ was higher in the subgroup of patients with a multinodular goiter and a decreased TSH response to thyrotropin-releasing hormone. Plasma TSH (y, in mU/L) was negatively related to thyroid volume (x, in mL): y = 8.2x^−0.667 (r = 0.578, p <0.001). Thyroid volume (y, in mL) was positively related to age (x, in years): y = −21.8 + 2.0x (r = 0.455, p <0.001); and to duration of goiter (x, in years): y = 40.6 + 2.1x (r = 0.505, p <0.001). The annual increase in thyroid volume was calculated at 4.5%.

conclusion: The data suggest a continuous growth of SNG and provide support for the concept of increasing thyroid nodularity and autonomy of thyroid function—related to increasing thyroid volume—during the natural history of this disorder.

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^☆: This study was supported by Grant 28–961 from the Dutch Preventie Fonds.

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Clinical studyInterrelationships between age, thyroid volume, thyroid nodularity, and thyroid function in patients with sporadic nontoxic goiter☆

Abstract

J Clin Endocrinol Metab

Lancet

Lancet

Lancet

Clin Endocrinol

Nontoxic goiter

J Clin Endocrinol Metab

The epidemiology of thyroid disease

The prevalence of thyroid disorders in a middle-aged population, with special reference to the solitary thyroid nodule

Acta Chir Scand

Simple and nodular sporadic goiter

Further studies on thyroid growth stimulating immunoglobulins in euthyroid nonendemic goiter

J Clin Endocrinol Metab

Simple goiter and its variants: euthyroid and hyperthyroid multinodular goiters

Endocr Rev

Natural heterogeneity of thyroid cells: the basis for understanding thyroid function and nodular goiter growth

Endocr Rev

Pathogenesis of heterogeneity in human multinodular goiter

J Clin Invest

Toxic multinodular goiter

The evolution of nodular goiter

J Clin Endocrinol Metab

The evolution of toxic nodular goiter

Arch Intern Med

Functional autonomy in multinodular goiter

JAMA

Effect of selective goitre resection on absent thyrotrophin response to thyrotrophin releasing hormone in idiopathic euthyroid goitres

Clin Endocrinol

Preclinical hyperthyroidism in multinodular goitre

J Clin Endocrinol Metab

Response to thyrotropin-releasing hormone and triiodothyronine suppressibility in euthyroid multinodular goitre

Clin Endocrinol

Sporadic non-toxic goitre: an investigation of the hypothalamic-pituitary-thyroid axis

Clin Endocrinol

The determination of thyroid volume by ultrasound and its relation to bodyweight, age and sex in normal subjects

J Clin Endocrinol Metab

Determinants of thyroid volume as measured by ultrasonography in healthy adults in a non-iodine deficient area

Clin Endocrinol

The value of thyroid volume measured by ultrasonography in the diagnosis of goiter

Clin Endocrinol

Endemic goiter and cretinism: public health, significance and prevention

WHO Chronicle

The peripheral conversion of thyroxine (T4) into triiodothyronine (T3) and reverse triiodothyronine (rT3)

Radioimmunoassay for measurement of thyroglobulin in human serum

J Clin Invest

Hereditary congenital goiter with thyroglobulin deficiency in a breed of goats

Endocrinology

Clinical study
Interrelationships between age, thyroid volume, thyroid nodularity, and thyroid function in patients with sporadic nontoxic goiter☆