v">

Figure 1. Histogram of age groups Vs. BMI in 226 patients.

Figure 2. Histogram showing the percentage of smokers in different age groups.

Figure 3. Histogram showing the percentage of “Shisha” smokers at different age groups.

Figure 4. Multiple parameters histogram showing smokers numbers vs. smoking period.

Table 1. Total study sample age groups and gender.

Table 2. Patients age groups and ultrasound findings.

Data in n and N% columns are numbers and percentages of smokers and non-smokers. P-value column refers to results of Chi-square (χ2) test for the relation between smoking and thyroid function.

Table 3. Effect of smoking on thyroid function.

Data in n and N% columns are numbers and percentages of smokers and non-smokers. P-value column refers to results of Chi-square test for the relation between smoking and thyroid gland enlargement.

Table 4. Effect of smoking on thyroid gland enlargement.

Data in n and N% columns are numbers and percentages of smokers and non-smokers. P-value column refers to results of Chi-square test for the relation between smoking and thyroid gland enlargement.

Table 5. Effect of the smoking period on thyroid gland enlargement.

Data in n and N% columns are numbers and percentages of smokers and non-smokers. P-value column refers to results of Chi-square test for the relation between smoking and thyroid gland enlargement.

Table 6. Effect of cigarette smoking frequency on thyroid gland enlargement.

Data in n and N% columns are numbers and percentages of smokers and non-smokers. P-value column refers to results of Chi-square test for the relation between smoking and thyroid gland enlargement.

Table 7. Effect of Shisha smoking frequency on thyroid gland enlargement.

4. Discussion

The thyroid gland controls almost all of the metabolic processes in the body. The most common thyroid disorder involves abnormal production of thyroid hormones. Hyperthyroidism means too much of thyroid hormone, on the other hand, insufficient hormone production leads to hypothyroidism.

The results of this study revealed that the percentage of randomly selected cases was higher in the male than the female cases i.e. 128 (57%) and male 98 (43%) respectively. Most of the cases i.e. 119 cases were in the age group between 20 to 30 years old. Less frequency of cases was in the age group above 60 years old which was 12 cases. The other age groups come close in the number of cases were between 20 to 30 cases. The vast majority of cases scanned were males i.e. 88 cases in the age group of 20 to 30 years old, and the least number of cases were patients above 60 years old which was only 2 cases as demonstrated in Table 1.

Age groups versus BMI in 226 patients revealed that the highest registered BMI (33.1 kg/m2) for the age group above 60 years old. The age group from 50 to 60 years old was close to the age group of patient who are above 60 years old and it was 32.5 kg/m2. These patients in these groups suffer from obesity (Note that: the obesity in BMI is between 30 to 40 kg/m2). The patient who are in the age groups less than 20, 30 to 40 and 40 to 50 years old see their numbers are very close together and were 26.0, 29.4 and 29.6 kg/m2. The age group of patient who are between 20 to 30 years old has a normal weight as shown in Figure 1.

The highest percentage of smokers in different age groups found to be in the age group from 20 to 30 years (40.02%). The second category was the patients who are below 20 years of age (30.82%). The third and fourth categories were in the age group between 30 to 40 and 40 to 50 years old (30.43% and 13.33% respectively). There were no smokers above 50 years old in the study whole sample. The study sample was randomly chosen, but it was concentrating on 20 to 30 years old because many university students accepted the invitation and performed the scan Figure 2.

The characteristic of the figure showing an increased number of “Shisha” smokers in the category of patient less than 20 years old whereas 20 to 30 years old comes 31.09% compared to 40.02% of cigarette smokers. The third and fourth categories were the patient were 30 - 40 and 50 - 60 years old which represent 21.74% and 10% of the smoking cases respectively. There were no “Shisha” smokers in age groups from 40 to 50 and above 60 years old Figure 3.

According to the different parameters demonstrating the period of smoking it was found that many smokers recently started smoking from 1 to 5 years which is 35 cases, and we report 27 cases of Shisha from the whole sample. It was also found that 21 smokers who have been smoking from 5 to 10 years and another 15 cases reported to smoke Shisha for more than 5 to 10 years and more than ten years of smoking were 12 cases of cigarette smokers and 3 cases of shisha smokers. However, this indicates more than 50% of our samples are smoking 1 to 5 years. Accordingly, the effect of long period smoking has the least cases percentage in our study which creates a limitation which needs further investigation with expansion and focus on this category Figure 4.

Ultrasonography of thyroid was performed for 166 participants (73%) and revealed that normal cases 96 (58%) abnormal “solid” 46 (28%) and abnormal “cyst” 24 (14%) as demonstrated in Table 2.

A larger proportion of cigarette smokers had a normal thyroid function (66.7%) compared to non-smokers (70.8%); however, the difference between these frequencies was not statistically significant, and the number of subjects in the cigarette smoking group was too small to draw a firm conclusion as listed in Table 3. The number of shisha smokers was too small to perform statistical tests.

A lower proportion of cigarette and shisha smokers (15.4% and 5.6% respectively) had an enlarged thyroid gland compared to no cigarettes or shisha smokers (47.9% and 47.3% respectively). The difference between these frequencies was statistically significant (χ2 = 9.446 and 11.424, p = 0.002 and p = 0.001 for cigarette and shisha smoking respectively; Table 4). The effect of the period and frequency of smoking on thyroid gland enlargement could not be addressed due to small numbers of smokers in study subjects (Tables 5-7). The study findings agrees with the findings conducted by Asvold BO et al. [16] and Aydin et al. [17] .

5. Conclusion & Recommendation

This work revealed that there are no direct significant values correlating smoking habit to thyroid volume or function. However, it is always recommended not smoke due to other well-known threats. Authors recommend further studies to be conducted due to limitations of smokers sample size.

Cite this paper
Jastaniah, S. , Abed Alhazmi, A. , Alabdullah, H. , Fawzi Selamee, F. , Khalid Barahim, W. , Wazzan, M. , Yousef, M. and M. Alkhateeb, S. (2017) Investigating the Association of Smoking with Thyroid Volume and Function. Health, 9, 1843-1851. doi: 10.4236/health.2017.913133.
References
[1]   Ferrara, A.M., Liao, X.H., Gil-Ibanez, P., Marcinkowski, T., Bernal, J., Weiss, R.E., Dumitrescu, A.M. and Refetoff, S. (2013) Changes in Thyroid Status during Perinatal Development of MCT8-Deficient Male Mice. Endocrinology, 154, 2533-2541.
https://doi.org/10.1210/en.2012-2031

[2]   Pohlenz, J., Maqueem, A., Cua, K., Weiss, R.E., Van Sande, J. and Refetoff, S. (1999) Improved Radioimmunoassay for Measurement of Mouse Thyrotropin in Serum: Strain Differences in Thyrotropin Concentration and Thyrotroph Sensitivity to Thyroid Hormone. Thyroid, 9, 1265-1271. https://doi.org/10.1089/thy.1999.9.1265

[3]   Prummel, M.F. and Wiersinga, W.M. (1993) Smoking and Risk of Graves’ Disease. JAMA, 269, 479-482.
https://doi.org/10.1001/jama.1993.03500040045034

[4]   Thornton, J., Kelly, S.P., Harrison, R.A. and Edwards, R. (2007) Cigarette Smoking and Thyroid Eye Disease: A Systematic Review. Eye, 21, 1135-1145.
https://doi.org/10.1038/sj.eye.6702603

[5]   Völzke, H., Schwahn, C., Kohlmann, T., Kramer, A., Robinson, D.M., John, U., et al. (2005) Risk Factors for Goiter in a Previously Iodine-Deficient Region. Experimental and Clinical Endocrinology & Diabetes, 113, 507-515.
https://doi.org/10.1055/s-2005-865741

[6]   Warmuz-Stangierska, I., Czarnywojtek, A., Florek, E. and Sowinski, J. (2004) Smoking among Thyroid Patients. Przeglad Lekarski, 61, 1077-1079.

[7]   Czarnywojtek, A., Kurdybacha, P., Florek, E., Warmuz-Stangierska, I., Zdanowska, J., Zgorzlewicz, M., et al. (2010) Smoking and Thyroid Diseases—What Is New? Przeglad Lekarski, 67, 1056-1060.

[8]   Ericsson, U.-B. and Lindgãrde, F. (1991) Prevalence of Goitre, Thyrotoxicosis and Autoimmune Thyroiditis. Journal of Internal Medicine, 229, 67-71.
https://doi.org/10.1111/j.1365-2796.1991.tb00308.x

[9]   Fisher, C.L., Mannino, D.M., Herman, W.H. and Frumkin, H. (1997) Cigarette Smoking and Thyroid Hormone Levels in Males. International Journal of Epidemiology, 26, 972-977.
https://doi.org/10.1093/ije/26.5.972

[10]   Jorde, R. and Sundsfjord, J. (2006) Serum TSH Levels in Smokers and Non-Smokers: The 5th Tromso Study. Experimental and Clinical Endocrinology & Diabetes, 114, 343-347.
https://doi.org/10.1055/s-2006-924264

[11]   Knudsen, N., Bulow, I., Laurberg, P., Perrild, H., Ovesen, L. and Jorgensen, T. (2002) High Occurrence of Thyroid Multinodularity and Low Occurrence of Subclinical Hypothyroidism among Tobacco Smokers in a Large Population Study. Journal of Endocrinology, 175, 571-576.
https://doi.org/10.1677/joe.0.1750571

[12]   Holm, I.A., Manson, J.E., Michels, K.B., Alexander, E.K., Willett, W.C. and Utiger, R.D. (2005) Smoking and Other Lifestyle Factors and the Risk of Graves’ Hyperthyroidism. Archives of Internal Medicine, 165, 1606-1611.
https://doi.org/10.1001/archinte.165.14.1606

[13]   Prummel, M.F. and Wiersinga, W.M. (1993) Smoking and Risk of Graves’ Disease. JAMA, 269, 479-482.
https://doi.org/10.1001/jama.1993.03500040045034

[14]   Vestergaard, P. (2002) Smoking and Thyroid Disorders: A Meta-Analysis. European Journal of Endocrinology, 146, 153-161. https://doi.org/10.1530/eje.0.1460153

[15]   Vestergaard, P., Rejnmark, L., Weeke, J., et al. (2002) Smoking as a Risk Factor for Graves’ Disease, Toxic Nodular Goiter, and Autoimmune Hypothyroidism. Thyroid, 12, 69-75.
https://doi.org/10.1089/105072502753451995

[16]   Asvold, B.O., Bjøro, T., Nilsen, T.I. and Vatten, L.J. (2007) Tobacco Smoking and Thyroid Function. Archives of Internal Medicine, 167, 1428-1432.
https://doi.org/10.1001/archinte.167.13.1428

[17]   Aydin, L.Y., Aydin, Y., Besir, F.H., Demirin, H., Yildirim, H., Önder, E., Dumlu, T. and Celbek, G. (2011) Effect of Smoking Intensity on Thyroid Volume, Thyroid Nodularity and Thyroid Function: The Melen Study. Minerva Endocrinologica, 36, 273-280.

 
 
Top