The prevalence of thyroid nodule in healthy people in outpatient department, Bach Mai hospital

THE PREVALENCE OF THYROID NODULE IN HEALTHY PEOPLE IN OUTPATIENT DEPARTMENT, BACH MAI HOSPITAL

 Do trung Quan

Hanoi Medical University

ABSTRACT

Objective: 1/ to investigate the prevalence of thyroid nodule in healthy people in Outpatient department, Bach Mai hospital.Subjects and Method:This descriptive study enrolled 1301 people who had their health checked in Outpatient department from April to August 2014.Results and conclusion: Prevalence of thyroid nodules detected by physical examination is 5,7%, and by thyroid sonography is 22,6%. In 1301 participants, male is 44,4%; female is 55,6%. Thyroid nodules were more common in the group age of 31 – 40 years.

Main correspondence:Do Trung Quan

Submission date: 8 Feb 2017

Revised date: 20 Feb 2017

Acceptance date: 15Mar 2017

I. INTRODUCTION

Thyroid nodule is a condition in which there appears one or many nodules in thyroid, including begnin or malignant. This is a common disease, according to WHO, the rate of thyroid nodule was 5% of polpulation all over the world in 1995 [1]. This rate is different in each geographic area. The rate of thyroid nodule is from 4% to 7% of population in US [2][3][4]. A study in Framinghaam shows that the rate of thyroid nodule is 4,6% of population (in which female is 6,4% and male is 1,5%) [5]. Although there haven’t been any national data about this problem in Viet Nam, the rate of thyroid nodule is not low through area data analysis. This is a common disease but almost of all patients don’t have symptom, they are accidentally diagnosed by the patients, their relatives or physicians when examining their health. So we carry out this study with following objective: to investigate the rate of thyroid nodule in healthy people in outpatient department in Bach Mai hospital.

II. MATERIALS AND METHODS

1.Patients:

1301 healthy people who exam their health in outpatient department in Bach Mai hospital

  • Patinet included:
  • All people are from 20 to 70 years old
  • No history of thyroid disease
  • Agree to take part in our study
  • Patient excluded:
  • People are over 70 or under 20 years old
  • Not agree to take part in our study
  • History of Grave’s disease, other thyroid disease such as: thyroiditis, hypothyroidism, or diagnosed thyroid nodule before
  • Hypopituitarism
  • History of thyroid surgery

2. Study procedure:

2.1. Informations are collected based on a form, as following:

–    History and clinical examination

–    Thyroid sonography

–    Basic blood test, FT4, TSH…

–    Sonographically guided fine-needle aspiration

–    Fine-needle aspiration biopsy reports

–    Thyroid scintigraphy in patients with low TSH

–    CT scanner or MRI in patients with atopic thyroid in the chest

2.2. Method: descritive cross-sectional study. The study was carried out from the April 2014 to the August 2014

2.3. Statistics: Data analyses were performed úing statistical analysis software SPSS 16.0

III. RESULTS

3.1. Characteristic of patients in our study:

3.1.1. Sex:

Table 1. Distribution of participants into sex

In 1301 participants, male is 44,4% and female is 55,6%

3.1.2. Age:

Table 2. Distribution of participants into age group

In our study, the age group of 31 – 40 years is highest (42,1%), the age group of 61 – 70 years is lowest (6%)

3.1.3. TSH level of patients in our study

Table 3. TSH level of patients in our study


In 1301 paticipants in our study, there is 9 patients with high TSH level (0,7%), 568 patients with normal TSH level (43,7%) and 719 patients don’t have this test. 

3.1.4. FT4 level of patients in our study

Table 4. FT4 level of patients in our study

In 1301 participants, there is 582 patients that have FT4 level test, in which: patients with normal FT4 level is 44,2% and patients with high FT4 level is 0,3%.

3.2. The rate of thyroid nodules

3.2.1. The rate of thyroid nodules in physical examination

Figure 1. The rate of thyroid nodules in physical examination

There are 74 patients that were diagnosed thyroid nodules in physical examination (5,7%)

3.2.2. The rate of thyroid nodules in thyroid sonography

Figure 5. The rate of thyroid nodules in thyroid sonography

In 1301 paticipants, there is 294 patients with thyroid nodules in thyroid sonography (22,6%).

IV. DISCUSSION

4.1. Characteristic of patients in our study

In our study, there is 577 males (44,4%) and 724 females (55,6%). The age group of 31 – 60 years is highest (84,5), the age group of 61 – 70 years is lowest (6%). The average age in our study is 41,28 ± 10,6. It is easy to understand because the age group of 31 – 60 years is in labour age, so people in this age group often go to hospital and they have enough economic condition to exam their health more than the other age group. In our study, there are 719 patients that don’t have FT4 and TSH level test (55,3%). In 582 patients that have FT4 and TSH level test, the rate of patients with normal FT4 and TSH level test is highest (97,6% of paticipants with normal TSH level test and 99,1% of participants with normal FT4 level test). There is 9 patients that have high TSH level test (77,8% of whom are female, and 22,2% of whom are male). There are 8 patients in subclinical hypothyroidism (1,4%) (75% of whom are female and 25% of whom are male). There is only one patient in overt hypothyroidism (0,2%). According to Colorado Thyroid Disease Prevalence, the rate of subclinical hypothyroidism is 8,5% and overt hypothyroidism is 0,4% [6].

4.2. The rate of thyroid nodules

4.2.1. The rate of thyroid nodules in physical examination

In 1301 paticipants in our study, there are 74 patients that have thyroid nodules diagnosed in physical examination (5,7%). This result is the same as the result in other study such as Đo Thanh Binh’s study (2004) (the rate of thyroid nodules in physical examination is 6,2%[7]. According to WHO (1995), the rate of thyroid nodules is 5%, Vander JB’s study (1968) show that the rate of thyroid nodule is 4,6%, Tunbridge WM’s study (1977) show that the rate of thyroid nodule is 3,2%. In USA, the rate of thyroid nodules is 5 – 7% of the population.

Our result is not different from the results in other studies. However, the rate of thyroid nodules that are diagnosed in physical examination in different study is not the same because of physician’s experience, life style of patients…

4.2.2. The rate of thyroid nodules in thyroid sonography

In 1301 participants, there are 294 patients that have thyroid nodules diagnosed in thyroid sonography (22,6%). This result is the same as the result in Do Thanh Binh’s study (the rate of thyroid nodules in sonography is 11,6%), Papillon’s study (the rate of thyroid nodules in sonography is 33%), Guith S’s study (the rate of thyroid nodule in sonography is 68%)

V. CONCLUSION

The rate of thyroid nodule in physical examination is 5,7%

The rate of thyroid nodule in sonography is 22,6%

REFERENCES

  1. Stephen J. McPhee ,Maxine A. Papadakis (2008). Endocrine Disorders.Current Medical Diagnosis and treatment,thirty- third edition ed., Printed in USA. 912-976.
  2. Welker M.J,Orlov D (2003). Thyroid nodules.Am Fam physican. 67(3): p. 559-66.
  3. Douglas S (2002). Non- palpable Thyroid Nodules- Managing an Epidemic.The Journal of Clinical Endocrinology and Metabolisme. 87(5): p. 1983- 1940.
  4. JL. Sadoul (1995). Genesis of thyroid nodules, Physioligical and pathological machanisms, clinical implications. Ann- Endocrinol- Paris. 56 (1).
  5. 5. Shlomo Melmed, Kenneth S. Polonsky (2011). Nontoxic goiter; diffuse and nodular.WILLIAMS Textbook ofEndocrinology. 12th EDITION ed.
  6. Jeffrey R, Garber, cs (2012). Clinical Practice Guidelines for Hypothyroidism in Adults:Cosponsored by the American Association of ClinicalEndocrinologists and the American Thyroid Association. Thyroid. Volume 22: p. 1208.
  7. Hossein Gharib,cs, Enrico Papini và (2010). Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. AACE/AME/ETA Guidelines. 16;10
  8. 8. Marqusee E (November 2000). Usefulness of Ultrasonography in the management of Nodular thyroid disease. Ann Intern Med. 133(9): p. 696- 700.
  9. David S. Cooper, Gerard M. Doherty, cs (2006). Management guidelines for patient with thyroid nodules and differented thyroid cancer. Vol 16, number 2: p. 7.
  10. 10. Lewis E. Braverman (2003). Diseases of the Thyroid, Evaluation and managerment of the euthyroid nodular and difuse goiter. second edition ed.: Humana press Totowa, New Jersey.

11.       Mazzaferri EL ( 1993). Management of a solitary thyroid nodule.N England J Med. 328: p. 553- 559.

Print Friendly, PDF & Email

About Hội Nội tiết & Đái tháo đường Miền Trung

Check Also

Rối loạn Lipid máu do thuốc

RỐI LOẠN LIPID MÁU DO THUỐC Nguyễn Hải Thủy DOI: 10.47122/vjde.2021.47.8 TÓM TẮT Rối loạn …