Endocrine Abstracts

Aim: Changes in thyroid functions, parenchymal structure and increased frequency of thyroid diseases in inflammatory bowel diseases(IBD) have been described in various studies. In the literature, studies using the data scanning method, most of which belong to the past period, stand out. In this study, we wanted to investigate the relationship between IBD and thyroid diseases in a non-retrospective study. The aim of this study is to systematically check whether there is a relationship between Hashimoto’s thyroiditis and IBD, which is especially common and whether the thyroid parenchymal structure of people with IBD is impaired, using the newly defined/started to be used VESINC scoring system. In this study which was conducted with subgroups receiving classical treatment and biological agent treatment for ulcerative colitis(UC) and Crohn’s disease(CD), the thyroid health was examined.

Material and Method: Among the patients diagnosed with CD and UC who were followed up in our hospital’s IBD outpatient clinic those who applied to the hospital between January-June 2023, met the study criteria and accepted to attend the study were included. A healthy control group similar to patient group in terms of age and gender was also included in the study. Thyroid stimulating hormone(TSH), free T₃(fT₃), free T₄(fT₄), anti thyroid peroxidase(anti-Tpo), anti thyroglobulin(anti-Tg) was measured and thyroid gland structure was evaluated using the VESINC system by thyroid USG in patients with a known diagnosis of UC/CD and healty control group. At the same time, sociodemographic characteristics, clinical/endoscopic parameters were recorded from the patients’ files. Each group was also separated and compared according to the drug groups they used(conventional treatments, biological agents).

Results: A total of 260 individuals, including 203 patients and 57 healthy controls were evaluated cross-sectionally/prospectively. In the IBD arm, it was observed that the thyroid structure was impaired, the number of nodules increased and the gland volume increased compared to the healthy control group. Biological agents used in the treatment of IBD also have different effects on thyroid gland echogenicity;it was concluded that the rate of thyroid isoechogenicity was higher in patients receiving ustekinumab and infiliximab compared to other groups. TSH, fT₃, fT₄levels were similar between CD/UC and control groups regardless of treatments. Autoantibody levels were also found to be similar in all groups regardless of treatment.

Conclusion: Thyroid gland morphology changes in IBD. There are changes in gland volume, nodule number and heterogeneity compared to the healthy population. Since the study was cross-sectional, long-term prospective follow-up of these patients may reveal the high rate of thyroid dysfunction and autoantibody positivity that may be overlooked during the disease process. The positive effect of ustekinumab on thyroid morphology may be worth investigating as a potential therapeutic approach.