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Hou T, Li Y, Yan Q, Zhou Y, Cheng M, Gu K, Wu C, Pang Y, Yu P, Kain K, Bloomgarden Z, Ning G, Li Q, Tian J, Shi Y. The interaction effect between BMI, diabetes and age at diabetes onset on the risk of thyroid cancer: A population-based cohort study in Shanghai, China. Diabetes Obes Metab 2024; 26:3988-3997. [PMID: 38978180 DOI: 10.1111/dom.15746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 07/10/2024]
Abstract
AIM To determine the association of the presence of diabetes and, among persons with diabetes, the age at type 2 diabetes mellitus (T2DM) onset, BMI and the interactive effect with the subsequent thyroid cancer risk. MATERIALS AND METHODS We conducted a population register-based longitudinal cohort study in Shanghai, including 428 568 persons with new-onset T2DM matched with the general population. The risk of thyroid cancer among subgroups was calculated based on standardized incidence ratio (SIR), hazard ratio (HR) and Cox proportional hazards models. RESULTS In total, 1142 thyroid cancer cases were identified during 8 years of follow-up, with an incidence rate of 59.01/100 000 person-years and a higher risk (SIR = 1.21) compared with the general population. The earlier age at T2DM onset and higher BMI were associated with an increasing risk of thyroid cancer independently (onset age <50, SIR: 1.46; BMI ≥30.0 kg/m2, SIR: 1.93), with the highest risk in patients with both BMI ≥30.0 kg/m2 and onset age <50 years (SIR = 3.91, HR = 3.04). Among patients with T2DM onset age <60 years, SIR increased with higher BMI, while there were no trends when onset age ≥60 years. Among patients with BMI ≥25.0 kg/m2, SIR increased with an earlier onset age, whereas no trends were shown in the BMI <24.9 kg/m2 groups. Obese (BMI ≥30.0 kg/m2) patients had a significantly higher HR of thyroid cancer only when T2DM onset age <60 years. CONCLUSIONS Both earlier age of T2DM onset (<50 years) and higher BMI (≥30 kg/m2) contributed to the higher risk of thyroid cancer. Patients with young-onset T2DM and obesity are considered more vulnerable to thyroid cancer development.
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Affiliation(s)
- Tianzhichao Hou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumour, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Yanyun Li
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Qinghua Yan
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Yulin Zhou
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumour, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minna Cheng
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Kai Gu
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Chunxiao Wu
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Yi Pang
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Pengcheng Yu
- Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Khalil Kain
- Princess Margaret Cancer Centre-University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Zachary Bloomgarden
- Department of Medicine, Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumour, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinyu Li
- Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jingyan Tian
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai National Clinical Research Centre for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumour, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Shi
- Division of Chronic Non-Communicable Disease and Injury, Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
- National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Zhou X, Ruan W, Li J, Wang T, Liu H, Zhang G. No causal associations of genetically predicted birth weight and life course BMI with thyroid function and diseases. Obesity (Silver Spring) 2024; 32:1585-1593. [PMID: 38956411 DOI: 10.1002/oby.24095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 04/26/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVE Observational studies have suggested associations of birth weight, childhood BMI, and adulthood BMI with thyroid function or diseases. However, the causal relationships remain unclear due to residual confounding inherent in conventional epidemiological studies. METHODS We performed a two-sample Mendelian randomization (MR) study to investigate causal relationships of genetically predicted birth weight, childhood BMI, and adulthood BMI with a range of clinically relevant thyroid outcomes. Additionally, we conducted a reverse MR analysis on adulthood BMI. Data on exposures and outcomes were obtained from large-scale genome-wide association study meta-analyses predominantly composed of individuals of European ancestry. RESULTS The MR analysis revealed no evidence of causal associations of birth weight or BMI at different life stages with thyrotropin (TSH) levels, hypothyroidism, hyperthyroidism, autoimmune thyroid disorders, or thyroid cancer. Contrarily, thyroid cancer demonstrated a significant causal relationship with increased adulthood BMI (β = 0.010, 95% CI: 0.006-0.015; p = 5.21 × 10-6). CONCLUSIONS Our comprehensive MR did not find causal links of birth weight, childhood BMI, or adulthood BMI with thyroid diseases but provided evidence that thyroid cancer may play a role in weight gain. Our research findings offer valuable insights into the intricate relationship between body weight and thyroid health throughout an individual's life.
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Affiliation(s)
- Xiaoqin Zhou
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Research Center of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
- Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Weiqiang Ruan
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Jing Li
- Research Center of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Ting Wang
- Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Huizhen Liu
- Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, People's Republic of China
| | - Guiying Zhang
- Research Center of Clinical Epidemiology and Evidence-Based Medicine, West China Hospital, Sichuan University, Chengdu, People's Republic of China
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Li F, Su L, Shao R, Luo J, Chen Y, Huang Y, Wei M, Zhang J, Gao Y, Ma K, Liu X, Xi W, Gao S. Selenium Status Associates with Thyroid Hormone and Thyroid Dysfunction in Older Chinese Adults. Biol Trace Elem Res 2024:10.1007/s12011-024-04286-2. [PMID: 38907121 DOI: 10.1007/s12011-024-04286-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024]
Abstract
Selenium (Se) is physiologically essential for thyroid function. However, epidemiological studies on the association between Se status and thyroid function are limited and the results are inconsistent. Therefore, we explored this association in an elderly Chinese population sample. Participants in the cross-sectional study were people aged 65 years or older who provided fingernail and whole blood samples. Hyperthyroidism and hypothyroidism were defined by serum thyroid hormones concentrations, including thyroid stimulating hormone (TSH), total triiodothyronine (TT3), total thyroxine (TT4), free thyroxine (FT3), and free thyrotropin (FT4). Significant positive association was observed between whole blood and fingernail Se concentrations (r = 0.672, P < 0.001). Compared with the lowest Se quartile (Q1), the other fingernail Se quartile groups had lower TSH, higher FT3 and FT4 levels, and Q2 had higher TT3 levels after adjusting for covariates; the other whole blood Se quartile groups had lower TSH levels, Q2 had higher FT3, FT4 and TT3 levels, Q3 had higher FT3 levels, and Q4 had higher FT4 levels after adjusting for covariates. Compared with Q1, the adjusted odds ratios (OR) and 95% confidence intervals (95%CIs) of hypothyroidism for Q4 of whole blood Se was 0.141 (0.029,0.675), and the adjusted OR (95%CIs) of hyperthyroidism for Q2 and Q3 of fingernail Se were 4.121 (1.233,13.733) and 3.614 (1.095,11.926). Higher Se levels were significantly associated with lower TSH levels and higher levels of TT3, FT3 and FT4. Meanwhile, higher Se levels were associated with lower risk of hypothyroidism and higher risk of hyperthyroidism.
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Affiliation(s)
- Feng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Liqin Su
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China.
| | - Ranqi Shao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Jiao Luo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Yi Chen
- Qionglai Center for Disease Control and Prevention, Chengdu, 611530, China
| | - Yifeng Huang
- Gaomi Center for Disease Control and Prevention, Weifang, 261500, China
| | - Minghai Wei
- Jiange Center for Disease Control and Prevention, Guangyuan, 628317, China
| | - Jiliang Zhang
- Zichuan Center for Disease Control and Prevention, Zibo, 255100, China
| | - Yumei Gao
- Zichuan Center for Disease Control and Prevention, Zibo, 255100, China
| | - Kui Ma
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Xiyao Liu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Key Laboratory of Trace Element Nutrition, National Health Commission of the People's Republic of China, Beijing, 100050, China
| | - Weihao Xi
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Sujuan Gao
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, 46202-2872, USA
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Guglielmi V, Dalle Grave R, Leonetti F, Solini A. Female obesity: clinical and psychological assessment toward the best treatment. Front Endocrinol (Lausanne) 2024; 15:1349794. [PMID: 38765954 PMCID: PMC11099266 DOI: 10.3389/fendo.2024.1349794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Obesity is a heterogeneous condition which results from complex interactions among sex/gender, sociocultural, environmental, and biological factors. Obesity is more prevalent in women in most developed countries, and several clinical and psychological obesity complications show sex-specific patterns. Females differ regarding fat distribution, with males tending to store more visceral fat, which is highly correlated to increased cardiovascular risk. Although women are more likely to be diagnosed with obesity and appear more motivated to lose weight, as confirmed by their greater representation in clinical trials, males show better outcomes in terms of body weight and intra-abdominal fat loss and improvements in the metabolic risk profile. However, only a few relatively recent studies have investigated gender differences in obesity, and sex/gender is rarely considered in the assessment and management of the disease. This review summarizes the evidence of gender differences in obesity prevalence, contributing factors, clinical complications, and psychological challenges. In addition, we explored gender differences in response to obesity treatments in the specific context of new anti-obesity drugs.
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Affiliation(s)
- Valeria Guglielmi
- Unit of Internal Medicine and Obesity Center, Department of Systems Medicine, Policlinico Tor Vergata, University of Rome Tor Vergata, Rome, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, VR, Italy
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Anna Solini
- Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy
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Di Filippo G, Canu GL, Lazzari G, Serbusca D, Morelli E, Brazzarola P, Rossi L, Gjeloshi B, Caradonna M, Kotsovolis G, Pliakos I, Poulios E, Papavramidis T, Cappellacci F, Nocini PF, Calò PG, Materazzi G, Medas F. Exploring the Link between BMI and Aggressive Histopathological Subtypes in Differentiated Thyroid Carcinoma-Insights from a Multicentre Retrospective Study. Cancers (Basel) 2024; 16:1429. [PMID: 38611106 PMCID: PMC11011018 DOI: 10.3390/cancers16071429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 03/28/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
Obesity's role in thyroid cancer development is still debated, as well as its association with aggressive histopathological subtypes (AHSs). To clarify the link between Body Mass Index (BMI) and AHS of differentiated thyroid carcinoma (DTC), we evaluated patients who underwent thyroidectomy for DTC from 2020 to 2022 at four European referral centres for endocrine surgery. Based on BMI, patients were classified as normal-underweight, overweight, or obese. AHSs were defined according to 2022 WHO guidelines. Among 3868 patients included, 34.5% were overweight and 19.6% obese. Histological diagnoses were: 93.6% papillary (PTC), 4.8% follicular (FTC), and 1.6% Hürthle cell (HCC) thyroid carcinoma. Obese and overweight patients with PTC had a higher rate of AHSs (p = 0.03), bilateral, multifocal tumours (p = 0.014, 0.049), and larger nodal metastases (p = 0.017). In a multivariate analysis, BMI was an independent predictor of AHS of PTC, irrespective of gender (p = 0.028). In younger patients (<55 years old) with PTC > 1 cm, BMI predicted a higher ATA risk class (p = 0.036). Overweight and obese patients with FTC had larger tumours (p = 0.036). No difference was found in terms of AHS of FTC and HCC based on BMI category. Overweight and obese patients with PTC appear to be at an increased risk for AHS and aggressive clinico-pathological characteristics.
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Affiliation(s)
- Giacomo Di Filippo
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
| | - Gian Luigi Canu
- Department of Surgical Sciences, University of Cagliari, SS554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
| | - Giovanni Lazzari
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
| | - Dorin Serbusca
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
| | - Eleonora Morelli
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
| | - Paolo Brazzarola
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
| | - Leonardo Rossi
- Endocrine Surgery Unit, University Hospital of Pisa, Via Paradisa 2, 56100 Pisa, Italy
| | - Benard Gjeloshi
- Endocrine Surgery Unit, University Hospital of Pisa, Via Paradisa 2, 56100 Pisa, Italy
| | - Mariangela Caradonna
- Endocrine Surgery Unit, University Hospital of Pisa, Via Paradisa 2, 56100 Pisa, Italy
| | - George Kotsovolis
- First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 85 Karakasi Str., 54453 Thessaloniki, Greece
| | - Ioannis Pliakos
- First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 85 Karakasi Str., 54453 Thessaloniki, Greece
| | - Efthymios Poulios
- First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 85 Karakasi Str., 54453 Thessaloniki, Greece
| | - Theodosios Papavramidis
- First Propedeutic Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, 85 Karakasi Str., 54453 Thessaloniki, Greece
| | - Federico Cappellacci
- Department of Surgical Sciences, University of Cagliari, SS554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
| | - Pier Francesco Nocini
- Endocrine Surgery Unit, Department of Surgery and Oncology, Verona University Hospital, 37134 Verona, Italy
- Department of Oral and Maxillofacial Surgery, University of Verona, 37134 Verona, Italy
| | - Pietro Giorgio Calò
- Department of Surgical Sciences, University of Cagliari, SS554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
| | - Gabriele Materazzi
- Endocrine Surgery Unit, University Hospital of Pisa, Via Paradisa 2, 56100 Pisa, Italy
| | - Fabio Medas
- Department of Surgical Sciences, University of Cagliari, SS554 Bivio Sestu, Monserrato, 09042 Cagliari, Italy
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Abu Arar Y, Shilo M, Bilenko N, Friger M, Marsha H, Fisher D, Fraenkel M, Yoel U. Are Higher Body Mass Index and Worse Metabolic Parameters Associated with More Aggressive Differentiated Thyroid Cancer? A Retrospective Cohort Study. Healthcare (Basel) 2024; 12:581. [PMID: 38470692 PMCID: PMC10930676 DOI: 10.3390/healthcare12050581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/17/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
Obesity is a risk factor for differentiated thyroid cancer (DTC), but the association with DTC aggressiveness is controversial. To evaluate the association between preoperative body mass index (BMI)/other metabolic parameters and DTC aggressiveness in our surgical cohort, we retrospectively evaluated patients following thyroid surgery who were diagnosed with DTC between December 2013 and January 2021. Baseline characteristics, histopathological features, treatment modalities, and follow-up data were studied. We conducted logistic regression to analyze the association between BMI/other metabolic parameters and adverse DTC features. The final study cohort included 211 patients (79.6% women; mean age± standard deviation 48.7 ± 15.9 years): 66 (31.3%) with normal weight, 81 (38.4%) with overweight, and 64 (30.3%) with obesity. The median follow-up was 51 months (range 7-93). Complete versus partial thyroidectomy was more common among patients living with overweight or obesity than in normal weight patients (79.7% versus 61.7%, p = 0.017, respectively). Logistic regression demonstrated that higher BMI was associated with mildly increased risk for lymph nodes metastases (odds ratio [OR] 1.077, 95% CI: 1.013-1.145), and higher triglycerides/high-density lipoprotein-cholesterol (TG/HDL-C) ratio was associated with aggressive histological variants of DTC (OR 1.269, 95% CI 1.001-1.61). To conclude, specific adverse clinical and histopathological DTC features were indeed associated with higher BMI and higher TG/HDL-C ratio.
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Affiliation(s)
- Yasmin Abu Arar
- Internal Medicine Ward D, Soroka University Medical Center, Beer-Sheva 84101, Israel;
| | - Michael Shilo
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Natalya Bilenko
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Michael Friger
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Hagit Marsha
- Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel;
| | - David Fisher
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
| | - Merav Fraenkel
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel
| | - Uri Yoel
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel
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7
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Greca AL, Grau L, Arbet J, Liao LM, Sosa JA, Haugen BR, Kitahara CM. Anthropometric, dietary, and lifestyle factors and risk of advanced thyroid cancer: The NIH-AARP diet and health cohort study. Clin Endocrinol (Oxf) 2023; 99:586-597. [PMID: 37694684 DOI: 10.1111/cen.14970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/17/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Most patients diagnosed with thyroid cancer have low-risk disease, but some have a higher risk for persistent or recurrent disease and even death from thyroid cancer. Few studies have evaluated potential anthropometric, lifestyle, or dietary risk factors for advanced or aggressive types of thyroid cancer. METHODS Using data from a large US cohort study, we examined associations for high-risk thyroid cancer (HRTC) and, separately, low-risk thyroid cancer (LRTC) in relation to anthropometric factors, diet, smoking, and alcohol consumption. The National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study included 304,122 participants (124,656 women and 179,466 men) without a history of cancer who completed a mailed questionnaire in 1996-1997 and were followed for cancer incidence through 2011 via linkages with state cancer registries. Hazard ratios (HRs) for anthropometric, dietary, and lifestyle factors in relation to HRTC or LRTC, defined using guidance from the American Thyroid Association initial risk of recurrence classification, were calculated using multivariable-adjusted Cox proportional hazards regression models. RESULTS During follow-up (median = 10.1 years), 426 participants were diagnosed with HRTC (n = 95) or LRTC (n = 331). In models combining men and women, baseline waist circumference (per 5 cm, HR = 1.13, 95% confidence interval [CI] 1.01-1.27) and weight gain from age 18 years to baseline age (per 5 kg, HR = 1.14, 95% CI 1.02-1.28) were positively associated with risk of HRTC but not LRTC. In contrast, vegetable intake (per cup equivalents/day, HR = 1.15, 95% CI 1.01-1.30), cigarette smoking (current vs. never, HR = 0.39, 95% CI 0.23-0.68), and alcohol consumption (per drink/day, HR = 0.83, 95% CI 0.70-0.97) were associated with risk of LRTC but not HRTC. The association of LRTC risk with vegetable intake was limited to men, and that of current smoking was more pronounced in women. CONCLUSIONS Our findings suggest that greater waist circumference and adulthood weight gain are associated with thyroid cancers at higher risk for recurrence. These results may have implications for the primary prevention of advanced thyroid cancer.
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Affiliation(s)
- Amanda La Greca
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Laura Grau
- Department of Biostatistics & Informatics, University of Colorado, Aurora, Colorado, USA
| | - Jaron Arbet
- Department of Biostatistics & Informatics, University of Colorado, Aurora, Colorado, USA
| | - Linda M Liao
- Division of Cancer Epidemiology & Genetics, Metabolic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Julie A Sosa
- Department of Surgery, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Bryan R Haugen
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado, Aurora, Colorado, USA
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
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8
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Jin S, Luo L, Xu X, Xia K. Thyroid cancer burden and risk factors in China from 1990-2019: a systematic analysis using the global burden of disease study. Front Oncol 2023; 13:1231636. [PMID: 38023126 PMCID: PMC10663347 DOI: 10.3389/fonc.2023.1231636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Thyroid cancer (TC) is the most common endocrine system malignancy with a rapidly increasing incidence in China. Epidemiological data on TC at the national level are lacking. This study aimed to quantify the TC disease burden in China between 1990 and 2019 and evaluate the current status and trends of the disease burden attributed to a high body mass index (HBMI). Methods The 2019 Global Burden of Disease Study dataset was used to explore the TC disease burden. Age-standardized rates of incidence (ASIR), prevalence (ASPR), deaths (ASDR), and disability-adjusted life years (DALYs) were considered and the estimated annual percentage change (EAPC) was calculated as a measure of the average change in age-standardized rates. The trend in TC-related mortality and DALYs attributed to an HBMI, accounting for different age groups and sexes, was examined. Results Between 1990 and 2019, the ASDR and DALYs for TC decreased by 0.02/100000 and 1.17/100000, respectively. The ASPR and ASIR increased by 9.88/100000 and 1.04/100000, respectively. The EAPC for ASDR, age-standardized rates of DALYs, ASPR, and ASIR were 0.06 (95% CI: -0.09, 0.21), -0.20 (95% CI: -0.31, -0.10), 3.52 (95% CI: 3.35, 3.68), and 2.73 (95% CI: 2.58, 2.88), respectively. TC-related deaths, DALYs, and their prevalence and incidence in China increased by 118%, 350%, 81%, and 290%, respectively. The disease burden of TC was higher among male than female patients in different age groups, with varying distributions. The disease burden attributed to HBMI gradually increased over the past 30 years according to age-standardized DALYs, particularly in male patients. Conclusion The TC burden has increased in China over the past 30 years, and population aging poses a challenge to TC prevention and control. HBMI has become an important factor in the TC disease burden and further research should focus on reducing the disease burden among Chinese male patients with TC.
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Affiliation(s)
- Shuai Jin
- School of Biology and Engineering (School of Health and Medicine Modern Industry), Guizhou Medical University, Guiyang, China
| | - Li Luo
- Department of Clinical Laboratory, The Second People’s Hospital of Guiyang, Guiyang, China
| | - Xiaodong Xu
- Hospital Infection Management Department, Bijie First People’s Hospital, Bijie, China
| | - Kaide Xia
- Molecular Diagnostic Laboratory, Guiyang Maternal and Child Health Care Hospital, Guiyang, China
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9
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Abstract
PURPOSE OF REVIEW This review explores recent evidence assessing the relationship between obesity and thyroid cancer. RECENT FINDINGS Consistent evidence from observational studies suggests that obesity increases the risk of thyroid cancer. The relationship persists when alternative measures of adiposity are used, but the strength of association may vary according to the timing and duration of obesity and how obesity or other metabolic parameters are defined as exposures. Recent studies have reported an association between obesity and thyroid cancers that are larger or have adverse clinicopathologic features, including those with BRAF mutations, thus providing evidence that the association is relevant for clinically significant thyroid cancers. The underlying mechanism for the association remains uncertain but may be driven by disruption in adipokines and growth-signaling pathways. SUMMARY Obesity is associated with an increased risk of thyroid cancer, although further research is required to understand the biological mechanisms underpinning this relationship. Reducing the prevalence of obesity is predicted to lessen the future burden of thyroid cancer. However, the presence of obesity does not impact current recommendations for screening or management of thyroid cancer.
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Affiliation(s)
- Lauren C Burrage
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital
- School of Medicine
| | - Donald S A McLeod
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital
- School of Medicine
- Population Health Department, QIMR Berghofer Medical Research Institute, Queensland
| | - Susan J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Queensland
- School of Public Health, The University of Queensland, Australia
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10
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Palomba S, Colombo C, Busnelli A, Caserta D, Vitale G. Polycystic ovary syndrome and thyroid disorder: a comprehensive narrative review of the literature. Front Endocrinol (Lausanne) 2023; 14:1251866. [PMID: 37635968 PMCID: PMC10453810 DOI: 10.3389/fendo.2023.1251866] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Background Published data on the relationship between polycystic ovary syndrome (PCOS) and thyroid dysfunction are sparse and confusing. Objective To comprehensively review data available in the literature regarding the relationship between PCOS and the thyroid function, and its abnormalities. Methods Nine main areas of interest were identified and analyzed according to the available evidence: 1) Evaluation of thyroid function for PCOS diagnosis; 2) Epidemiology data on thyroid function/disorders in patients with PCOS, and vice versa; 3) Experimental data supporting the relationship between thyroid function/disorders and PCOS; 4) Effects of thyroid function/disorders on PCOS features, and vice versa; 5) Effect of thyroid alterations on the cardiometabolic risk in women with PCOS; 6) Effect of thyroid abnormalities on reproductive outcomes in women with PCOS; 7) Relationship between thyroid function/abnormalities in patients with PCOS who are undergoing fertility treatment; 8) Effect of treatments for thyroid diseases on PCOS; and 9) Effect of treatments for PCOS on thyroid function. An extensive literature search for specific keywords was performed for articles published from 1970 to March 2023 using PubMed and Web of Science. Data were reported in a narrative fashion. Results PCOS is a diagnosis of exclusion for which diagnosis is possible only after excluding disorders that mimic the PCOS phenotype, including thyroid dysfunctions. However, the tests and the cutoff values used for this are not specified. Many experimental and clinical data suggest a relationship between perturbations of the thyroid function and PCOS. Direct and unequivocal evidence on the effects of thyroid function/disorders on PCOS features are lacking. High thyroid-stimulating hormone levels and subclinical hypothyroidism may be associated with significant worsening of several intermediate endpoints of cardiometabolic risk in women with PCOS. Thyroid abnormalities may worsen reproductive outcomes, especially in patients undergoing fertility treatment. To date, there are no data demonstrating the efficacy of thyroid medications on fertility and cardiometabolic risk in women with PCOS. Lifestyle modification changes, metformin, and vitamin D seem to improve thyroid function in the general population. Conclusion PCOS and thyroid disorders are closely related, and their coexistence may identify patients with a higher reproductive and metabolic risk. Regular screening for thyroid function and thyroid-specific autoantibodies in women with PCOS, particularly before and during pregnancy, is highly recommended.
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Affiliation(s)
- Stefano Palomba
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Carla Colombo
- Division of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Andrea Busnelli
- Department of Gynecology, Division of Gynecology and Reproductive Medicine, Fertility Center, Humanitas Clinical and Research Center-IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Donatella Caserta
- Division of Gynecology, Sant’Andrea Hospital, University “Sapienza” of Rome, Rome, Italy
| | - Giovanni Vitale
- Department of Medical Biotechnology and Translational Medicine (BIOMETRA), University of Milan, Milan, Italy
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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11
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Pasqual E, O’Brien K, Rinaldi S, Sandler DP, Kitahara CM. Obesity, obesity-related metabolic conditions, and risk of thyroid cancer in women: results from a prospective cohort study (Sister Study). LANCET REGIONAL HEALTH. AMERICAS 2023; 23:100537. [PMID: 37346380 PMCID: PMC10279535 DOI: 10.1016/j.lana.2023.100537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
Background Thyroid cancer incidence has increased worldwide. Obesity trends may play a role, but the underlying biological pathways are not well-characterized. Therefore, we examined associations of excess adiposity and obesity-related metabolic conditions with thyroid cancer incidence. Methods From the Sister Study, a cohort of sisters of women with breast cancer, we included 47,739 women who were cancer-free at baseline (2003-2009). Height, weight, waist and hip circumference, and blood pressure were measured at baseline and medical history was self-reported. Cox proportional hazards regression models were adjusted for age (time scale), race/ethnicity, smoking, baseline history of benign thyroid disease, and frequency of routine healthcare visits. Findings During follow-up (median = 12.5; max = 15.9 years), 259 women reported incident thyroid cancer. Body mass index (BMI) (hazard ratio [HR]per-5 kg/m2 = 1.25, 95% CI = 1.14-1.37), waist circumference (HRper-5 cm increase = 1.11, 95% CI = 1.06-1.15), and waist-to-hip ratio (HR ≥0.85-versus-<0.85 = 1.49, 95% CI = 1.14-1.94) were positively associated with thyroid cancer incidence, as were metabolic syndrome (HR = 1.67, 95% CI = 1.24-2.25), dyslipidemia (HR = 1.46, 95% CI = 1.13-1.90), borderline diabetes (HR = 2.06, 95% CI = 1.15-3.69), hypertension (HR = 1.49, 95% CI = 1.12-1.96), and polycystic ovary syndrome (PCOS, HR = 2.10, 95% CI = 1.20-3.67). These associations were attenuated with additional BMI adjustment, although dyslipidemia (HR = 1.35, 95% CI = 1.04-1.75) and PCOS (HR = 1.86, 95% CI = 1.06-3.28) remained associated with thyroid cancer incidence. Hypothyroidism was not associated with thyroid cancer. Interpretation In this cohort of sisters of women diagnosed with breast cancer, excess adiposity and several obesity-related metabolic conditions were associated with thyroid cancer incidence. These findings provide insights into potential biological mechanisms linking obesity and thyroid cancer. Funding This research was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute and National Institute of Environmental Health Sciences (Z01-ES044005).
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Affiliation(s)
- Elisa Pasqual
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20892, USA
- International Agency for Research on Cancer, 25 Avenue Tony Garnier, CS 90627, 69366 Lyon CEDEX 07, France
| | - Katie O’Brien
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Sabina Rinaldi
- International Agency for Research on Cancer, 25 Avenue Tony Garnier, CS 90627, 69366 Lyon CEDEX 07, France
| | - Dale P. Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, 20892, USA
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12
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Nguyen LTD, Gunathilake M, Lee J, Kim J. Association between dietary habits and incident thyroid cancer: A prospective cohort study. Front Nutr 2023; 10:1104925. [PMID: 36875835 PMCID: PMC9975340 DOI: 10.3389/fnut.2023.1104925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
Background In addition to the thyroid cancer (TC) risk from lifestyle and environmental factors such as radiation exposure, some studies have indicated that diet may affect TC development; however, previous findings are inconsistent. The objective of our study was to investigate the association between dietary habits and TC risk in a Korean population. Materials and methods A total of 13,973 participants were selected after excluding ineligible subjects from the Cancer Screenee Cohort at National Cancer Center in Korea from October 2007 to December 2021. Participants were followed until May 2022 to identify incident TC cases. Information on dietary habits and general characteristics was collected using a self-report questionnaire administered at enrollment without keeping track of changes in eating habits during the follow-up period. A Cox proportional hazards model was used to determine the hazard ratio (HR) and 95% confidence interval (CI) of TC risk for each dietary factor. Results A total of 138 incident TC cases were identified during the median follow-up period of 7.6 years. Of the 12 dietary habits evaluated, only two habits showed significant associations with TC. A significantly decreased TC risk was found among participants who consumed milk and/or dairy products 5 or more days a week [adjusted HR (aHR), 0.58; 95% CI, 0.39-0.85]. Notably, a stronger protective effect of dairy consumption was observed in participants aged ≥ 50 years (aHR, 0.44; 95% CI, 0.26-0.75), in women (aHR, 0.53; 95% CI, 0.35-0.81), and in non-smokers (aHR, 0.60; 95% CI, 0.39-0.92). There was a reduced risk of TC in participants with meal durations longer than 10 min (aHR, 0.58; 95% CI, 0.41-0.83). However, this association was limited to individuals aged ≥ 50 years (aHR, 0.49; 95% CI, 0.31-0.79), women (aHR, 0.61; 95% CI, 0.41-0.90), and non-smokers (aHR, 0.62; 95% CI, 0.41-0.92). Conclusion Our findings suggest that consuming milk and/or dairy products 5 or more days a week and having a meal duration longer than 10 min could be protective factors against TC, especially in individuals aged ≥ 50 years, women and non-smokers. Further prospective studies are needed to investigate the association of dietary intake with specific types of TC.
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Affiliation(s)
- Linh Thi Dieu Nguyen
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
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13
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Larsson SC, Spyrou N, Mantzoros CS. Body fatness associations with cancer: evidence from recent epidemiological studies and future directions. Metabolism 2022; 137:155326. [PMID: 36191637 DOI: 10.1016/j.metabol.2022.155326] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/27/2022] [Accepted: 09/27/2022] [Indexed: 12/12/2022]
Abstract
This narrative review highlights current evidence linking greater body fatness to risk of various cancers, with focus on evidence from recent large cohort studies and pooled analyses of cohort studies as well as Mendelian randomization studies (which utilized genetic variants associated with body mass index to debrief the causal effect of higher body fatness on cancer risk). This review also provides insights into the biological mechanisms underpinning the associations. Data from both observational and Mendelian randomization studies support the associations of higher body mass index with increased risk of many cancers with the strongest evidence for digestive system cancers, including esophageal, stomach, colorectal, liver, gallbladder, and pancreatic cancer, as well as kidney, endometrial, and ovarian (weak association) cancer. Evidence from observational studies suggests that greater body fatness has contrasting effects on breast cancer risk depending on menopausal status and on prostate cancer risk depending on disease stage. Experimental and Mendelian randomization studies indicate that adiponectin, insulin, and sex hormone pathways play an important role in mediating the link between body fatness and cancer risk. The possible role of specific factors and pathways, such as other adipocytokines and hormones and the gut microbiome in mediating the associations between greater body fatness and cancer risk is yet uncertain and needs investigation in future studies. With rising prevalence of overweight and obesity worldwide, the proportion of cancer caused by excess body fatness is expected to increase. There is thus an urgent need to identify efficient ways at the individual and societal level to improve diet and physical activity patterns to reduce the burden of obesity and accompanying comorbidities, including cancer.
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Affiliation(s)
- Susanna C Larsson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Unit of Medical Epidemiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Nikolaos Spyrou
- The Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA; Section of Endocrinology, VA Boston Healthcare System, Harvard Medical School, Boston, MA, USA
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14
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Matrone A, Basolo A, Santini F, Elisei R. Understanding the effect of obesity on papillary thyroid cancer: is there a need for tailored diagnostic and therapeutic management? Expert Rev Endocrinol Metab 2022; 17:475-484. [PMID: 36203362 DOI: 10.1080/17446651.2022.2131529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/29/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Several studies have focused on the relationship between obesity and differentiated thyroid carcinoma (DTC), particularly papillary histotype (PTC). However, the association of obesity with both incidence and aggressiveness of PTC is still incompletely understood. AREAS COVERED We reviewed the mechanisms underlying the cross talk between obesity and thyroid carcinomas and described the most recent evidence evaluating the effect of obesity on the development of PTC, as well as the impact of excessive body weight on the clinicopathologic features and outcome of this type of cancer. EXPERT OPINION Available evidence suggests that excessive body weight is linked with a higher risk of getting PTC, while its impact on the aggressiveness of the disease, if present, is still not clear. Therefore, while attention should be paid to discover thyroid cancer in patients with obesity earlier, once diagnosed it should be managed following a conventional workup as in normal weight patients, based on the clinical presentation of the disease and including active surveillance if appropriate, as recommended by referral guidelines.
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Affiliation(s)
- Antonio Matrone
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Alessio Basolo
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Ferruccio Santini
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
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15
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Jang Y, Kim T, Kim BHS, Park B. Association between Obesity Indexes and Thyroid Cancer Risk in Korean Women: Nested Case-Control Study. Cancers (Basel) 2022; 14:cancers14194712. [PMID: 36230635 PMCID: PMC9563606 DOI: 10.3390/cancers14194712] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: This study aimed to identify the association between various obesity indexes, including waist circumference (WC), waist−hip ratio (WHR), waist−height ratio (WHTR), and BMI, and their combinations with body mass index (BMI) and thyroid cancer risk. Methods: Of the 65,639 participants who completed a follow-up survey of the Health Examinee Study (HEXA), a prospective cohort of the Korean Genome and Epidemiology Study, 412 female incident thyroid cancer cases, and 1648 birth year- and enrollment year-matched female controls were included. Multiple conditional logistic regression was used to estimate the association between obesity indexes and thyroid cancer risk. Results: The risk of developing thyroid cancer was increased by 1.37-fold (95% confidence interval (CI) = 1.03−1.81) higher in the obese BMI group (≥25.0 Kg/m2) compared to that in the normal BMI group (<23.0 Kg/m2). Obesity in terms of WC (≥85.0 cm) and WHTR (≥0.5) was associated with an increased risk of thyroid cancer (OR 1.55, 95% CI = 1.16−2.07; OR 1.37, 95% CI = 1.07−1.75, respectively). However, increased WHR levels did not show any significant association. Women with both obese levels of BMI (≥25.0 Kg/m2) and other obesity indexes (WC ≥ 85.0 cm, WHR ≥ 0.85, or WHTR ≥ 0.5) showed an increased risk of thyroid cancer with OR of 1.63 (95% CI = 1.14−2.31), 1.49 (95% CI = 1.05−2.12), and 1.42 (95% CI = 1.04−1.94), compared to those with normal levels of BMI and each obesity index. Conclusion: These results provide evidence of the contribution of both total and central adiposity across the lifespan of thyroid cancer incidence. Risk factor modifications must be considered to explain the current thyroid cancer epidemic.
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Affiliation(s)
- Yoonyoung Jang
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Program in Regional Information, Department of Agricultural Economics and Rural Development, Seoul National University, Seoul 08826, Korea
| | - Taehwa Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea
| | - Brian H. S. Kim
- Program in Regional Information, Department of Agricultural Economics and Rural Development, Seoul National University, Seoul 08826, Korea
- Program in Agricultural and Forest Meteorology, Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Korea
- Correspondence: (B.H.S.K.); (B.P.); Tel.: +82-2-880-4717 (B.H.S.K.); +82-2-2220-0682 (B.P.); Fax: +82-2-873-5080 (B.H.S.K.); +82-31-2220-0699 (B.P.)
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul 04763, Korea
- Correspondence: (B.H.S.K.); (B.P.); Tel.: +82-2-880-4717 (B.H.S.K.); +82-2-2220-0682 (B.P.); Fax: +82-2-873-5080 (B.H.S.K.); +82-31-2220-0699 (B.P.)
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