Ultrasonographic assessment of thyroid volume in oldest-old individuals

Duarte, Glaucia Cruzes; Araujo, Lara Miguel Quirino; Magalhães, Felix; Almada, Clineu Mello; Cendoroglo, Maysa Seabra

doi:10.1590/2359-3997000000223

Acessibilidade / Reportar erro

Brasil

Archives of Endocrinology and Metabolism

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Articles • Arch. Endocrinol. Metab. 61 (3) • May-Jun 2017 • https://doi.org/10.1590/2359-3997000000223 copy

Ultrasonographic assessment of thyroid volume in oldest-old individuals

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

The aim of this study was to describe the relationship between thyroid volume and age, gender, anthropometric characteristics, and echogenicity in oldest-old subjects in an iodine-sufficient area.

Subjects and methods

The study included 81 independent elderly individuals aged ≥ 80 years (65 [80.2%] women). We determined these individuals’ anthropometric characteristics, body mass index (BMI), and lean body mass, as well as thyroid volume and echogenicity by ultrasonography.

Results

We observed that octogenarians and nonagenarians had different profiles of thyroid echogenicity. The volume of the thyroid was smaller in nonagenarians than octogenarians (p = 0.012, r = 0.176), and subjects aged 80–89 years had more often hypoechoic glands than those aged ≥ 90 years (p = 0.01 versus 0.602).

Conclusion

The identification of ultrasonographic differences in oldest-old individuals will contribute to establishing preclinical markers, such as echogenicity, to identify individuals at risk of developing autoimmune thyroid disease. Future prospective studies should identify if 80–89-year-old individuals with hypoechoic glands progress to hypothyroidism, and if the absence of changes in echogenicity (i.e. a normal thyroid parenchyma) would have a positive impact on longevity among nonagenarians.

Thyroid diseases; thyroiditis, autoimmune; ultrasonography; oldest old

	80-89 years			≥ 90 years

	Normal TSH	Increased TSH	P	Normal TSH	Increased TSH	P
Characteristics
Mean ± SD	(n = 35)	(n = 19)		(n = 17)	(n = 10)
Weight (kg)	63.78 ± 14.06	57.77 ± 10.84	0.112*	60.25 ± 10.15	61.40 ± 9.22	0.841^a
Height (m)	1.55 ± 0.09	1.52 ± 0.06	0.118*	1.54 ± 0.07	1.47 ± 0.03	0.010a
BMI (kg/m²)	26.19 ± 4.22	25.05 ± 4.31	0.384a	25.28 ± 3.72	28.36 ± 4.22	0.040a
Lean body mass (kg)	40.11 ± 9.42	34.28 ± 5.18	0.027a	37.89 ± 7.64	35.59 ± 4.73a	0.353*
TSH mIU/mL	2.95 ± 1.81	5.69 ± 4.78	0.031a	3.17 ± 1.90	5.56 ± 2.39	0.013a
T4L ng/dL	1.19 ± 0.23	1.20 ± 0.24	0.911*	1.26 ± 0.25	1.72 ± 1.18	0.414a

	80-89 years			≥ 90 years

	Normal TSH	Increased TSH	P	Normal TSH	Increased TSH	P
Thyroid volume (mL) – Mean ± SD	(n = 35)	(n = 19)		(n = 17)	(n = 10)
Thyroid volume (mL) – Mean ± SD
Total	10.07 ± 3.60	9.18 ± 6.59	0.105a	11.50 ± 4.13	7.37 ± 3.29	0.012*
< 6 mL (n; %)	6; 17.1%	8; 42.1%	0.058^b	2; 11.8%	4; 40.0%	0.154^b
> 20 mL (n; %)	0; 0.0%	1; 5.3%	0.352^b	0; 0.0%	0;0.0%	-
Echogenicity – (n; %)
ECO1	22; 62.9%	4; 21.1%	0.001^c	8; 47.1%	3; 30%	0.602^b
ECO2	11; 31.4%	7; 36.8%		4; 23.5%	2; 20%
ECO3	2; 5.7%	8; 42.1%		5; 29.4%	5; 50%
Nodules – (n; %)
Yes	23; 65.7%	7; 36.8%	0.080^c	14; 82.4%	7; 70%	> 0.999^b
No	12; 34.3%	12; 63.2%		3; 17.6%	3; 30%

	Male		Female

	Normal TSH	Increased TSH	Normal TSH	Increased TSH	P
Characteristics	(n = 14)	(n = 2)	(n = 38)	(n = 27)
Mean ± SD	(n = 14)	(n = 2)	(n = 38)	(n = 27)
Weight (kg)	69.76 ± 12.56	54.00 ± 6.08	60.00 ± 12.20	59.40 ± 10.52	0.905^a
Height (m)	1.63 ± 0.08	1.57 ± 0.08	1.52 ± 0.07	1.50 ± 0.05	0.124^a
BMI (kg/m²)	26.24 ± 3.05	22.15 ± 4.88	25.76 ± 4.39	26.49 ± 4.42	0.513*
Lean body mass (kg)	47.76 ± 9.66	38.45 ± 0.49	36.04 ± 5.90	34.49 ± 5.04^a	0.305*
TSH mIU/mL	3.07 ± 2.11	5.05	3.01 ± 1.74	5.67 ± 4.02	0.003^a
FT4 ng/dL	1.21 ± 0.22	1.00	1.22 ± 0.25	1.43 ± 0.80	0.074^a

	Men			Women
	Normal TSH	Increased TSH	P	Normal TSH	Increased TSH	P
	(n = 35)	(n = 19)		(n = 17)	(n = 10)
	(n = 35)	(n = 19)		(n = 17)	(n = 10)
Thyroid volume (mL) – Mean ± SD
Total	11.66 ± 3.40	12.86 ± 4.78		10.13 ± 3.90	8.24 ± 5.68	0.015^a
< 6 mL (n; %)	0; 0.0%	0; 0.0%		8; 21.1%	12; 44.4%	0.082^c
> 20 mL (n; %)	0; 0.0%	0; 0.0%		0; 0.0%	1;3.7%	0.415^b
Echogenicity – (n; %)
ECO1	10; 71.4%	2; 100.0%		20; 52.6%	5; 18.5%	0.001^c
ECO2	1; 7.1%	0; 0.0%		14; 36.8%	9; 33.3%
ECO3	3; 21.4%	0; 0.0%		4; 10.5%	13; 48.1%
Nodules – (n; %)
Yes	8; 57.1%	1; 50.0%		29; 67.4%	14; 32.6%	0.074^c
No	12; 34.3%	12; 63.2%		3; 17.6%	3; 30%

Sociedade Brasileira de Endocrinologia e Metabologia Rua Botucatu, 572 - Conjuntos 81/83, 04023-061 São Paulo SP Brasil, Tel: (55 11) 5575-0311 - São Paulo - SP - Brazil
E-mail: aem.editorial.office@endocrino.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence to: Glaucia Cruzes Duarte Rua Professor Francisco de Castro, 105 04020-050 – São Paulo, SP, Brasil endocrino.draglauciaduarte@gmail.com