Inverse Relationship of BMI to TSH and Risk of Papillary Thyroid Cancer in Surgical Patients

Application of color doppler ultrasound and US shear wave elastography with connective tissue growth factor in the risk assessment of papillary thyroid carcinoma

BACKGROUND

This study aims to investigate the role of shear wave elastography (SWE) and connective tissue growth factor (CTGF) in the assessment of papillary thyroid carcinoma (PTC) prognosis.

METHODS

CTGF expression was detected with immunohistochemistry. Clinical and pathological data were collected. Parameters of conventional ultrasound combined with SWE were also collected. The relationship among CTGF expression, ultrasound indicators, the elastic modulus and the clinicopathological parameters were analyzed.

RESULTS

Univariate analysis showed that patients with high risk of PTC were characterized with male, Uygur ethnicity, increased expression of CTGF, convex lesions, calcified, incomplete capsule, intranodular blood flow, rear echo attenuation, cervical lymph node metastasis, lesions larger than 1 cm, psammoma bodies, advanced clinical stage, increased TSH and high value in the shear modulus (P < 0.05). Multivariate analysis demonstrated that the risk factors of high expression of CTGF according to contribution size order were irregular shape, aspect ratio ≥ 1, and increased TSH. The logistic regression model equation was Logit (P) = 1.153 + 1.055 × 1 + 0.926 × 2 + 1.190 × 3 and the Area Under Curve value of the logistic regression was calculated to be 0.850, with a 95% confidence interval of 0.817 to 0.883.

CONCLUSION

SWE and CTGF are of great value in the risk assessment of PTC. The degree of fibrosis of PTC is closely related to the prognosis. The hardness of PTC lesions and the expression level of CTGF are correlated with the main indexes of conventional ultrasound differentiating benign or malignant nodules. Irregular shape, aspect ratio ≥ 1, and increased TSH are independent factors of CTGF.

Correlation analysis of serum thyroglobulin, thyroid-stimulating hormone levels, and thyroid-cancer risk in thyroid nodule surgery

BACKGROUND

Thyroglobulin (Tg) is one of the markers of thyroid cancer, and its concentration may be elevated in patients with malignant thyroid tumors. Thyroid-stimulating hormone (TSH) is secreted by the pituitary gland, which has a significant impact on thyroid gland function. Excessively high or low TSH levels may be associated with an increased risk of thyroid cancer. Thus, in-depth studies on the association of serum Tg and TSH levels with thyroid cancer risk in patients with thyroid nodules are warranted. This can help determine whether Tg and TSH levels can predict the degree of malignancy of thyroid nodules, which can in turn guide doctors in making accurate diagnoses and treatment decisions. Furthermore, such studies can provide more accurate diagnostic methods for thyroid nodules and help patients become aware of the presence of thyroid cancer as early as possible, thereby improving the success rate of treatment and prognosis.

AIM

To investigate the association of serum Tg and TSH levels with the risk of thyroid cancer in patients undergoing thyroid nodule surgery.

METHODS

The clinical data and laboratory examination results of 130 patients who underwent thyroid nodule surgery were retrospectively analyzed. Furthermore, their preoperative serum Tg and TSH levels were recorded. Histopathological examination conducted during follow-up revealed the presence of thyroid cancer. Correlation analysis were used to analyze the association of Tg and TSH levels with the risk of thyroid cancer.

RESULTS

Of the 130 patients, 60 were diagnosed with thyroid cancer. Statistical analysis revealed a significant positive correlation between serum Tg levels and the risk of thyroid cancer (P < 0.05). This suggests that high serum Tg levels are associated with an increased risk of thyroid cancer. However, no significant correlation was observed between serum TSH levels and the risk of thyroid cancer (P > 0.05).

CONCLUSION

In patients who underwent thyroid nodule surgery, serum Tg levels exhibited a significant correlation with the risk of thyroid cancer but serum TSH levels did not. These findings suggest that serum Tg can serve as an important biomarker for assessing the risk of thyroid cancer in these patients.

Body mass index (BMI) is associated with serum thyroid-stimulating hormone (TSH) level in infertile women: a cross-sectional study

Studies suggest that there is a relationship between body mass index (BMI) and thyroid-stimulating hormone (TSH) levels. But conflicting evidence exists regarding the relationship between the two variables. Moreover, thyroid function is closely related to female fertility and has certain effects on infertility. Therefore, the present study will explore the relationship between BMI and TSH levels in patients with infertility in our center. We retrospectively analyzed relevant indicators of 2,789 in Tubal Factor Infertility patients undergoing assisted reproduction technology from January 2016 to December 2018 in our center in order to analyze the relationship between BMI and serum TSH level. The medical histories of patients were reviewed. The relationship between BMI and TSH was assessed using smooth curve fitting and multivariate regression model. The smoothing curve fitting between BMI and TSH exhibited a non-linear relationship, and the resulting curve exhibited a two-stage change and a breakpoint. By multivariate piecewise linear regression, we found that the TSH level was increased with the increase of BMI when the BMI was greater than 25.3 kg/m² (β 0.06, 95% CI 0.02, 0.01; p = 0.0028). In contrast, the TSH level was decreased with the increase of BMI when the BMI was less than 25.3 kg/m² (β -0.02, 95% CI -0.05, 0.00; p = 0.0573). Collectively, our study described a non-linear relationship between BMI and TSH level in infertile patients after adjustment of potential confounders. However, such causal relationship between BMI and TSH in infertile women still needs to be further clarified in future investigations.

Obesity and Waist Circumference are Possible Risk Factors for Thyroid Cancer: Correlation with Different Ultrasonography Criteria

Background

Obesity has an important role in the pathogenesis of cancer; however, there are no clear mechanisms explaining the association between obesity and risk of thyroid cancer (TC).

Methods

It is a cross-sectional study including 184 patients with benign thyroid nodules (BN) and 19 patients with TC. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist/hip (W/H) ratio were assessed and correlated to relevant clinico-pathological features of the patients, different ultra-sonographic (U/S) criteria and risk of malignancy.

Results

There was a significant increase in BMI, WC and W/H ratio in TC patients compared to BN group (P=0.001, 0.011 and 0.003). Increased BMI, WC and HC were associated significantly with solid nodules (P<0.05). WC increased in hypoechoic (103.1±15.4cm) and heterogeneous (103.8±16.7cm) nodules, compared to isoechoic (97.3±15.5cm) and hyperechoic (96.1±10cm) nodules (P=0.046). It also increased with lymph nodes enlargement (P=0.04). There was a significant association between WC and TIRADS classification (P=0.032), as it increased with TR4b (118.5 ± 12.9 cm) and TR5 (117.3 ± 13.9 cm) compared to TR2 (114.1 ± 15.7 cm, P=0.025 and 0.008, respectively). WC is an independent predictor for TC [OR: 1.092, CI: 1.020-1.170, P=0.012]. It achieved sensitivity, specificity and AUC (71.4%, 68.7% and 0.750; respectively), at a cutoff value of 108.5 cm (P=0.003), and when combined with BMI at a cutoff value of 32.59 (77.8% and 68.4%, respectively, AUC: 0.780, P<0.001).

Conclusion

Central adiposity is strongly associated with the risk of TC. WC is more superior to BMI when correlated with TIRADS classification and also is an independent predictor for TC.