RESUMO
OBJECTIVE: To evaluate thyroid function and morphology in all diabetic outpatients from our institution. METHODS: From 1996 to 1998, all diabetic patients were submitted to thyroid ultrasonography (US) and serum measurement of free T4, TSH, TPOAB, and TRAb. The control group, encompassing outpatients of the same hospital without diabetes and thyroid diseases, was submitted to the same evaluation. A patient was shown to have thyroid disorder when two or more measurements were altered, or when the US was abnormal. RESULTS: The diabetic patients (n= 256) differed from controls (n= 75) by presenting a greater frequency of thyroid disorders (51.6% vs. 38.7%; P<0.05). In patients with thyroid disorders, both groups did not differ regarding thyroid function. In diabetic patients with thyroid disorders there was a higher frequency of women, type 2 diabetes, and family history of thyroid disorders. CONCLUSIONS: The high prevalence of thyroid disorders in the diabetic population leads us to recommend thyroid evaluations in all diabetic patients.
Assuntos
Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Doenças da Glândula Tireoide/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Bócio/diagnóstico , Bócio/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Ambulatório Hospitalar , Estatísticas não Paramétricas , Doenças da Glândula Tireoide/diagnóstico , Doenças da Glândula Tireoide/etiologia , Testes de Função TireóideaRESUMO
BACKGROUND: Steroidogenic factor 1 (SF-1) is a key determinant of endocrine development and function of adrenal cortex. SF-1 overexpression and gene amplification were previously demonstrated in a small group of pediatric adrenocortical tumors. OBJECTIVE: Our objective was to determine the frequency of SF-1 protein expression and gene amplification in a large cohort of pediatric and adult adrenocortical tumors. PATIENTS: SF-1 protein expression was assessed in a cohort of 103 adrenocortical tumors from 36 children and 67 adults, whereas gene amplification was studied in 38 adrenocortical tumors (17 from children). METHODS: Tissue microarray, multiplex ligation-dependent probe amplification, and quantitative real-time PCR were used. RESULTS: A strong nuclear SF-1 expression was detected by tissue microarray in 56% (20 of 36) and 19% (13 of 67) of the pediatric and adult adrenocortical tumors, respectively (P = 0.0004). Increased SF-1 copy number was identified in 47% (eight of 17) and 10% (two of 21) of the pediatric and adult adrenocortical tumors, respectively (P = 0.02). All adrenocortical tumors with SF-1 gene amplification showed a strong SF-1 staining, whereas most of the tumors (61%) without SF-1 amplification displayed a weak or negative staining (P = 0.0008). Interestingly, a strong SF-1 staining was identified in five (29%) pediatric adrenocortical tumors without SF-1 amplification. The frequency of SF-1 overexpression and gene amplification was similar in adrenocortical adenomas and carcinomas. CONCLUSION: We demonstrated a higher frequency of SF-1 overexpression and gene amplification in pediatric than in adult adrenocortical tumors, suggesting an important role of SF-1 in pediatric adrenocortical tumorigenesis.
Assuntos
Neoplasias do Córtex Suprarrenal/genética , Adenoma Adrenocortical/genética , Carcinoma Adrenocortical/genética , Amplificação de Genes/genética , Fator Esteroidogênico 1/genética , Adulto , Fatores Etários , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise Serial de TecidosRESUMO
OBJETIVO: Avaliar morfológica e funcionalmente a tireóide de pacientes com diabetes mellitus (DM) acompanhados ambulatorialmente no Hospital das Clínicas de Botucatu. MÉTODOS: No período de 1996 a 1998, a todo paciente com DM, exceto os com tireopatia prévia, era solicitada dosagem sérica de T4L, TSH, anti-TPO e TRAb e ultra-sonografia (US) da tireóide. Diagnosticou-se tireopatia quando havia dois ou mais parâmetros séricos ou a US alterados. Procedeu-se igualmente com pacientes ambulatoriais da mesma Instituicão, sem DM e não-tireopatas prévios (controle). RESULTADOS: Os 256 pacientes com DM apresentaram maior freqüência de tireopatias que os 75 controles (51,6 por cento vs. 38,7 por cento; P<0,05). Entre os com tireopatias, ambos os grupos não diferiram quanto ao estado funcional da tireóide. Entre os pacientes com DM com e sem tireopatias, os primeiros apresentaram maior freqüência de mulheres, de DM tipo 2 e de história familiar de tireopatia. CONCLUSÕES: A elevada prevalência de tireopatias na populacão com DM conduz à recomendacão de avaliacão tireoidiana em todo paciente com DM.