ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2008) 16 P700

Cigarette smoking but not the TSHR germline polymorphism D727E is associated with toxic multinodular goitre (TMNG) and the thyroid volume

Jakob Jörn, Konstanze Miehle, Claudia Schmidt, Juliane Wicht & Ralf Paschke

Third Department of Medicine, University of Leipzig, Saxony, Germany.

Objective: There are contradictory results regarding the possible association of the TSHR polymorphism D727E with TMNG. Furthermore the influence of smoking on the thyroid volume has been reported by several authors. A possible association of smoking with thyroid nodules and particularly TMNG has not been investigated up to date.

Methods: In this study, 88 patients with TMNG were included. Diagnosis was verified by ultrasonography, scinthiscan, and measurement of TSH, fT4 and fT3. Patients were age- and sex-matched to 88 controls without any thyroid disorders. The polymorphism was detected by denaturating gel electrophoresis (DGGE).

Results: The prevalence of polymorphism D727E in the TMNG population (23.9%) did not deviate significantly (P=0.355) from the control group (18.2%). There was no significant (P=0.601) difference for thyroid volumes between polymorphism carriers (PC) (16.5 ml) and wildtype probands (WP) (18.5 ml). Moreover, also within the TMNG group (n=88) and the control group (n=88) there was no significant (TMNG: P=0.603; controls: P=0.332) difference for thyroid volumes between PC and WP (TMNG: PC 36 ml, WP 36.5 ml; controls: PC 13.9 ml, WP 11.6 ml). Compared to nonsmokers (n=132, 44.7%) the prevalence of TMNG was significantly higher (P<0.05) for smokers (n=44, 65.9%) in the entire population (TMNG and controls). Smokers also had a significantly higher thyroid volume than nonsmokers in the entire population (TMNG and controls, n=176) (smokers: 34 ml, nonsmokers: 15.7 ml, P<0.05). Moreover, also within the TMNG group thyroid volumes of smokers (43 ml) differed significantly from nonsmokers (31 ml, P<0.05) and in the control group smokers tended to have a higher thyroid volume (smokers: 15.8 ml, nonsmokers: 11.6 ml, P=0.119).

Conclusion: Neither an association of the polymorphism with TMNG nor its association with the thyroid volume was evident in this study. However, smoking clearly showed a positive association with the thyroid volume. Furthermore, our results suggest an association of smoking with TMNG.

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