Endocrinologia e Síndrome Metabólica
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To Assess the Relationship between Hyper-insulinism and Thyroid Nodules in Children with Overweight and Obesity

Chiarpenello Javier, Parma Ricardo, Carretto Hugo, Guardia Mayra, Pena Carolina, Riccobene Anina, Baella Ana, Strallnicoff Maia, Fernández Lorena, Castagnani Verónica, Laurenti Nieves and Sabrina Aita

Introduction: Obesity and insulin resistance determine metabolic disturbances that are deleterious for the organism. It was shown the association between hyper-insulinemia and increased prevalence of thyroid nodules, related to the goitrogenic action of insulin and insulin-like growth factor. Objective: To establish the prevalence of heterogeneous thyroid ultrasound and its association with hyperinsulinemia in children and adolescents with overweight and obesity. Material and Methods: Descriptive cross-sectional study of 50 children between 2 and 14 years old referred to the Department of Endocrinology for overweight or obesity. Results: Heterogeneity was observed in 10 of 50 ultrasounds performed (20%).The 90% of heterogeneous ultrasound, defined by the presence of thyroid nodules or anatomical changes of the gland, had hyper-insulinemia insulin resistance. Of heterogeneous ultrasound with hyper-insulinism, 6 patients had acanthosis nigricans. Of all thyroid ultrasound thyroid nodules were found in 5 cases (9.8%); cysts: in 2 (40%), thyroid nodules: in 2 (40%), pseudonodules: in 1 (20%). Of these patients, 80% had hyperinsulinism. Conclusions: 90% of heterogeneous ultrasound presented as well hyper-insulinism. 80% of patients with thyroid nodules have hyper-insulinism and this fact can be explained by the goitrogenic action of insulin.