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The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 12:00 PM

The Level of Urinary Cotinine in Patients with Hyperthyroidism – Preliminary Study.-

Wojciech Piekoszewski, PhD1, Agata Czarnywojtek, MD2, Izabela Warmuz-Stangierska, MSc2, Barbara Rabska-Pietrzak, MD2, Marek Ruchala, MD2, Ewa Florek2, Krzysztof Michalek, MD2, and Jerzy Sowiñski, MD2. (1) Institute of Forensic Research, Westerplatte 9, Krakow, 31-033, Poland, (2) Department of Endocrinology, University of Medical Sciences, Przybyszewskiego 49, Poznan, 60-355, Poland

Objective: Aim of our study was to measure the concentration of cotinine in urine in patients with hyperthyroidism.

Methods: The examined group included 28 female and 2 male (mean age: 31+/-12.23 yrs.) hyperthyroid patients: 1. Graves-Basedow disease (GB) – 11 (36,7%) women and 1 (3,3%) man, 2. Graves' Ophtalmopathy (GO) – 10 (33,3%) women and 1 (3,3%) men, 3. toxic nodular goiter (TNG) – 7 (23,4%) women. The diagnosis of hyperthyroidism was determined by serum fT4, TSH and anti-TSH receptor antibodies (TRAb). The estimation of thyroid gland morphology – ultrasonography – Aloka SSd500 with linear head 7.5mHz. Ophthalmopathy was classified according to the system recommended by the American Thyroid Association (ATA) committee. Smoking status was established by Fagerströme questionnaire and urine cotinine measurement.

Results: Laboratory and clinical parameters were corresponded with hyperthyroidism. Five of the GB patients (5 males) showed ophthalmopathy defined as ATA class III and were classified as GO and six patients (five female and one male) were soft tissue involvement (ATA class II). Twelve patients showed no ophthalmopathy (ATA class 0) among Graves-Basedow patients. There was a statistically significant difference in the level of cotinine among smokers suffering from GO and GB (p < 0.05, the Mann-Whitney test). Similar results were obtained within GO and TNG (p<0.05, t-test with Welsch correction). There was no statistically significant difference between GB and TNG. Fagerströme questionnaire's scores were comparable with urine cotinine level. Our results showed significant prevalence of urine cotinine in the group of smoking patients with GO.