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Meta-Analysis
. 2014 Feb 14;9(2):e88787.
doi: 10.1371/journal.pone.0088787. eCollection 2014.

Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--meta-analysis and systematic review

Kosma Wolinski  1 , Agata Czarnywojtek  1 , Marek Ruchala  1
Affiliations
Meta-Analysis

Risk of thyroid nodular disease and thyroid cancer in patients with acromegaly--meta-analysis and systematic review

Kosma Wolinski et al. PLoS One. .

Abstract

Introduction: Acromegaly is a quite rare chronic disease caused by the increased secretion of growth hormone (GH) and subsequently insulin - like growth factor 1. Although cardiovascular diseases remains the most common cause of mortality among acromegalic patients, increased prevalence of malignant and benign neoplasms remains a matter of debate. The aim of this study is to evaluate the risk of thyroid nodular disease (TND) and thyroid cancer in patients with acromegaly.

Materials and methods: PubMed, Cochrane Library, Scopus, Cinahl, Academic Search Complete, Web of Knowledge, PubMed Central, PubMed Central Canada and Clinical Key databases were searched to identify studies containing. Random-effects model was used to calculate pooled odds ratios and risk ratios of TND in acromegaly. Studies which not included control groups were systematically reviewed.

Results: TND was more frequent in acromegaly than in control groups (OR = 6.9, RR = 2.1). The pooled prevalence of TND was 59.2%. Also thyroid cancer (TC) proved to be more common in acromegalic patients (OR = 7.5, RR = 7.2), prevalence was 4.3%. The pooled rate of malignancy (calculated per patient) was equal to 8.7%.

Conclusions: This study confirms that both TND and TC occur significantly more often in acromegalic patients than in general population. These results indicate that periodic thyroid ultrasound examination and careful evaluation of eventual lesions should be an important part of follow-up of patients with acromegaly.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flowchart presenting the steps of literature search and selection.
Figure 2
Figure 2. Forest plot showing individual and pooled ORs with 95% CI and p - values for studies comparing the prevalence of thyroid nodular disease in acromegalic patients and control groups.
Figure 3
Figure 3. Forest plot showing individual and pooled ORs with 95% CI and p - values for studies comparing the prevalence of thyroid cancer in acromegalic patients and control groups.
Figure 4
Figure 4. Cumulative forest plot for studies comparing the prevalence of thyroid cancer in acromegalic patients and control groups.
See this image and copyright information in PMC

References

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