Correlation Between Thyroid Nodules and Insulin Resistance in Egyption Patients Without Diabetes Mellitus | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 09 August 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.355474.2115 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
khaled Nagy Elfayoumy1; Mohamed Mohamed Elashry2; Ahmed Yahia Ahmed Ashour 3; Sherif Ibrahim ElGhannam4; Moustafa Mahmoud Keshk  5
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| 1internal medicine department faculty of medicin demitta al-azhar university | ||||
| 2Department of Internal Medicine, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. | ||||
| 3Department of Diagnostic and Interventional Cardiology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt. | ||||
| 4Clinical Pathology Department, Damietta Faculty of Medicine, Al-Azhar University, Egypt | ||||
| 5Department of internal medicine, Faculty of medicine, Al Azhar University, Damietta,Egypt | ||||
| Abstract | ||||
| Background: Thyroid nodules (TNs) exhibit a higher prevalence in individuals with type 2 diabetes mellitus compared to those without diabetes. The underlying mechanisms encompass insulin resistance, enhanced oxidative stress, and elevated thyroid stimulating hormone levels. Aim and objectives: This study aimed to study the association between clinically relevant thyroid nodules and insulin resistance in euthyroid individuals without diabetes mellitus. Patients & Methods: This case-control study was conducted on sixty-two patients presenting concerns regarding thyroid nodules at the Endocrinology Outpatient Clinic at Al-Azhar University Hospital in Damietta. Further, fifty-three healthy volunteers, matched for age, sex, and body mass index, were selected as a control group without clinical, laboratory, or radiological evidence of thyroid dysfunction. The thyroid profile and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) were determined for all participants. In addition to clinical assessment, the thyroid was evaluated using ultrasonographic imaging. Results: HOMA-IR was significantly higher in subjects with thyroid nodules compared to controls (P<0.001) and elevated HOMA-IR was an independent predictor of thyroid nodule occurrence. The cutoff point of HOMA-IR above which thyroid nodularity risk increased was 1.59 with 85.48% sensitivity and 86.79% specificity (AUC=0.874, P<0.001). Nevertheless, HOMA-IR didn’t differ among individuals with either solitary or multiple nodules and it shows no significant variations concerning the Thyroid Imaging Reporting and Data System (TIRAD) scoring (P<0.57). Conclusion: Our findings suggest that HOMA-IR serves as a reliable marker for distinguishing patients with substantial thyroid nodules. However, no correlation between this marker and the TIRAD score was observed. | ||||
| Keywords | ||||
| Diabetes Mellitus; Nodule; Thyroid; Prediction | ||||
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