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Liu J, Feng Z, Gao R, Liu P, Meng F, Fan L, Liu L, Du Y. Establishment and validation of a multivariate logistic model for risk factors of thyroid nodules using lasso regression screening. Front Endocrinol (Lausanne) 2024; 15:1346284. [PMID: 38628585 PMCID: PMC11018967 DOI: 10.3389/fendo.2024.1346284] [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: 11/29/2023] [Accepted: 03/21/2024] [Indexed: 04/19/2024] Open
Abstract
Objective This study aims to analyze the association between the occurrence of thyroid nodules and various factors and to establish a risk factor model for thyroid nodules. Methods The study population was divided into two groups: a group with thyroid nodules and a group without thyroid nodules. Regression with the least absolute shrinkage and selection operator (Lasso) was applied to the complete dataset for variable selection. Binary logistic regression was used to analyze the relationship between various influencing factors and the prevalence of thyroid nodules. Results Based on the screening results of Lasso regression and the subsequent establishment of the Binary Logistic Regression Model on the training dataset, it was found that advanced age (OR=1.046, 95% CI: 1.033-1.060), females (OR = 1.709, 95% CI: 1.342-2.181), overweight individuals (OR = 1.546, 95% CI: 1.165-2.058), individuals with impaired fasting glucose (OR = 1.590, 95% CI: 1.193-2.122), and those with dyslipidemia (OR = 1.588, 95% CI: 1.197-2.112) were potential risk factors for thyroid nodule disease (p<0.05). The area under the curve (AUC) of the receiver operating characteristic (ROC) curve for the Binary Logistic Regression Model is 0.68 (95% CI: 0.64-0.72). Conclusions advanced age, females, overweight individuals, those with impaired fasting glucose, and individuals with dyslipidemia are potential risk factors for thyroid nodule disease.
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Affiliation(s)
- Jianning Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhuoying Feng
- Department of Physical Diagnostics, Beidahuang Industry Group General Hospital, Harbin, Heilongjiang, China
| | - Ru Gao
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Peng Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Fangang Meng
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lijun Fan
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Lixiang Liu
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yang Du
- Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, Heilongjiang, China
- Key Lab of Etiology and Epidemiology, Education Bureau of Heilongjiang Province & Ministry of Health (23618504), Heilongjiang Provincial Key Lab of Trace Elements and Human Health, Harbin Medical University, Harbin, Heilongjiang, China
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Yan Y, Dong J, Li S, Yang G, Huang K, Tian W, Su J, Zhang Z. Risk factors associated with the prevalence of thyroid nodules in adults in Northeast China: a cross-sectional population-based study. BMJ Open 2023; 13:e069390. [PMID: 37907298 PMCID: PMC10619099 DOI: 10.1136/bmjopen-2022-069390] [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: 10/20/2022] [Accepted: 10/18/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVES This study examined the association between anthropometric measurements, lifestyle factors and the prevalence of thyroid nodules among adults in Northeast China. DESIGN We employed a cross-sectional approach involving a questionnaire survey, which focused on participants' living habits, and a physical examination that included anthropometry and ultrasound imaging. SETTING The data were procured during multiple trips by medical teams from the first hospital of China Medical University to towns in Northeast China. PARTICIPANTS Of the 1092 participants, 489 did not have thyroid nodules (mean age: 54.02±11.49 years; 297 females (60.7%)), 99 had single thyroid nodules (mean age: 58.19±10.77 years; 59 females (59.6%)) and 504 had multiple thyroid nodules (mean age: 60.05±10.68 years; 394 females (78.2%)). Inclusion criteria mandated participants be over 20 years old without other medical conditions. We excluded individuals who had undergone surgical resection for thyroid nodules. RESULTS The prevalence of thyroid nodules was significantly associated with being female (OR 2.569, 95% CI 1.937 to 3.405, p<0.001) and increased age (OR 1.054, 95% CI 1.041 to 1.066, p<0.001). This association was more pronounced in those with multiple thyroid nodules. For males under 60, non-smoking was inversely correlated with the prevalence of multiple thyroid nodules (OR 0.321, 95%CI 0.149 to 0.69, p<0.05). For females under 60, diastolic blood pressure (DBP) was significantly linked with the prevalence of thyroid nodules (OR 0.978, 95% CI 2.614 to 2.705, p<0.05). CONCLUSIONS Besides gender and age, the prevalence of thyroid nodules in Northeast China correlates with smoking habits and DBP.
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Affiliation(s)
- Yudie Yan
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Junhe Dong
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Shufeng Li
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Guochun Yang
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Kunbo Huang
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wen Tian
- Department of Geriatric, the First Hospital of China Medical University, Shenyang City, Liaoning Province, People's Republic of China
| | - Jingtong Su
- Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Zhen Zhang
- Department of Ultrasound, The First Hospital of China Medical University, Shenyang, Liaoning, China
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Ren T, Jiang M, Wu J, Zhang F, Zhang C. Clinical value of grayscale ultrasound combined with real-time shear wave elastography nomogram in risk prediction of thyroid cancer. BMC Med Imaging 2023; 23:123. [PMID: 37700270 PMCID: PMC10496161 DOI: 10.1186/s12880-023-01099-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/06/2023] [Indexed: 09/14/2023] Open
Abstract
OBJECTIVES This study constructed a nomogram based on grayscale ultrasound features and real-time shear wave elastography (SWE) parameters to predict thyroid cancer. METHODS Clinical data of 217 thyroid nodules of 201 patients who underwent grayscale ultrasound, real-time SWE, and thyroid function laboratory examination in Ma'anshan People's Hospital from January 2019 to December 2020 were retrospectively analyzed. The subjects were divided into a benign nodule group (106 nodules) and a malignant nodule group (111 nodules). The differences in grayscale ultrasound features, quantitative parameters of real-time SWE, and laboratory results of thyroid function between benign and malignant thyroid nodules were analyzed. We used a chi-square test for categorical variables and a t-test for continuous variables. Then, the independent risk factors for thyroid cancer were analyzed using multivariate logistic regression. Based on the independent risk factors, a nomogram for predicting thyroid cancer risk was constructed using the RMS package of the R software. RESULTS Multivariate logistic regression showed that the grayscale ultrasound features of thyroid nodules were the shape, margin, echogenicity, and echogenic foci of the nodules,the maximum Young's modulus (SWE-max) of thyroid nodules, and the ratio of thyroid nodule and peripheral gland (SWE-ratio) measured by real-time SWE were independent risk factors for thyroid cancer (all p < 0.05), and the other variables had no statistical difference (p > 0.05). Based on the shape (OR = 5.160, 95% CI: 2.252-11.825), the margin (OR = 9.647, 95% CI: 2.048-45.443), the echogenicity (OR = 6.512, 95% CI: 1.729-24.524), the echogenic foci (OR = 2.049, 95% CI: 1.118-3.756), and the maximum Young's modulus (SWE-max) (OR = 1.296, 95% CI: 1.140-1.473), the SWE-ratio (OR = 2.001, 95% CI: 1.403-2.854) of the thyroid nodule to peripheral gland was used to establish the related nomogram prediction model. The bootstrap self-sampling method was used to verify the model. The consistency index (C-index) was 0.979, ROC curve was used to analyze the nomogram scores of all patients, and the AUC of nomogram prediction of thyroid cancer was 0.976, indicating that the nomogram model had high accuracy in the risk prediction of thyroid cancer. CONCLUSIONS The nomogram model of grayscale ultrasound features combined with SWE parameters can accurately predict thyroid cancer.
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Affiliation(s)
- Tiantian Ren
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Mingfei Jiang
- School of Public Health, Southeast University, Hunan Road, Nanjing, Jiangsu 210000 China
| | - Jiawei Wu
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Fan Zhang
- Department of Medical Ultrasound, Maanshan People’s Hospital, Hubei Road, Anhui Maanshan, 243032 China
| | - Chaoxue Zhang
- Department of Ultrasound, The First Affiliated Hospital of Anhui Medical University, Meishan Road, AnHui Hefei, 230000 China
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Al-Angari SS, AlAngari HS, Al-Dhahri SF. Prognostic value of preoperative thyroid autoantibodies for post-thyroidectomy patient pathology: A retrospective cohort study. Clin Otolaryngol 2023; 48:766-772. [PMID: 37391932 DOI: 10.1111/coa.14083] [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: 04/24/2022] [Revised: 04/10/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the clinical value of preoperative thyroid autoantibodies with reference to the post-thyroidectomy patient pathology. DESIGN A retrospective cohort study. SETTING Two tertiary care academic hospitals. MATERIALS AND METHODS A total of (n = 473) subjects who underwent thyroidectomy from 2009 to 2019 were included. Preoperative serum thyroid autoantibodies (anti-thyroglobulin [anti-Tg] and anti-thyroperoxidase [anti-TPO]) were measured, and the potential predictors of postoperative pathological diagnosis (age, gender, and thyroid autoantibodies) were assessed using multivariable regression models. RESULTS Patients with positive thyroid autoantibodies were more likely to have malignant disease than benign disease; adjusted odds ratio (AOR) = 1.6 (1.3-2.7, p = 0.002) for anti-Tg, and AOR = 1.6 (1.1-2.5, p = 0.027) for anti-TPO. A subset analysis of the same predictors performed on patients with cancer (malignant vs. microcarcinoma) showed that patients with ages ≥40 were more likely to develop microcarcinoma as opposed to malignant disease; AOR = 1.8 (1.1-3.1, p = 0.03) for anti-TPO, and AOR = 1.7 (1.0-2.9, p = 0.04) for anti-Tg. CONCLUSION Preoperative thyroid autoantibodies could be used clinically to predict the risk of malignancy in thyroid nodules, thus helping guide treatment decisions in patients with thyroid nodules and speeding up the decision to undergo surgical intervention.
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Affiliation(s)
- Samiah S Al-Angari
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hussam S AlAngari
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Saleh F Al-Dhahri
- Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Otolaryngology-Head & Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
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Liang Y, Li X, Wang F, Yan Z, Sang Y, Yuan Y, Qin Y, Zhang X, Ju M. Detection of Thyroid Nodule Prevalence and Associated Risk Factors in Southwest China: A Study of 45,023 Individuals Undergoing Physical Examinations. Diabetes Metab Syndr Obes 2023; 16:1697-1707. [PMID: 37312898 PMCID: PMC10259576 DOI: 10.2147/dmso.s412567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
Background Thyroid nodules (TNs) are among the most common thyroid lesions, and rates of these nodules have risen over the past three decades. As the majority of TN patients remain asymptomatic when these nodules are in the early stages of development, malignant nodules may continue to develop into thyroid cancer when not detected. As such, early screening and diagnosis-based strategies represent the most promising means of preventing or treating TNs and associated cancers. The present study was thus developed to explore TN prevalence among individuals in Luzhou, China. Methods Here, thyroid ultrasonography and metabolic-related indicators from 45,023 adults undergoing routine physical examinations in the Health Management Center of a large Grade A hospital in Luzhou over the last three years were retrospectively reviewed in an effort to identify factors associated with TN risk and the detection of these nodules through univariate and multivariate logistic regression analyses. Results In total, 13,437 TNs were detected in these 45,023 healthy adults for an overall 29.8% detection rate. This TN detection rate rose with age, and multivariate logistic regression analyses revealed that independent risk factors associated with TNs included greater age (≥31 years old), female (OR = 2.283, 95% CI: 2.177-2.393), central obesity (OR = 1.115, 95% CI: 1.051-1.183), impaired fasting glucose (OR = 1.203, 95% CI: 1.063-1.360), overweight status (OR = 1.085, 95% CI: 1.026-1.147), and obesity (OR = 1.156, 95% CI: 1.054-1.268), while low BMI was a protective factor associated with lower rates of TN incidence (OR = 0.789, 95% CI: 0.706-0.882). When results were stratified by gender, impaired fasting glucose was not an independent predictor of TN risk among males, while high LDL levels were an independent predictor of TNs among females, and other risk factors were not significantly changed. Conclusion TN detection rates were high among adults in Southwestern China. Female, elderly individuals, individuals exhibiting central obesity, and those with high levels of fasting plasma glucose are more likely to develop TN.
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Affiliation(s)
- Yi Liang
- Health Management Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Xiaohong Li
- Health Management Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Fang Wang
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Zongting Yan
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Yuhuan Sang
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Yuan Yuan
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Yun Qin
- Health Management Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Xuefei Zhang
- Health Management Center, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
| | - Mei Ju
- Nursing College, Southwest Medical University, Luzhou, Sichuan, 646000, People’s Republic of China
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Demetriou E, Fokou M, Frangos S, Papageorgis P, Economides PA, Economides A. Thyroid Nodules and Obesity. Life (Basel) 2023; 13:1292. [PMID: 37374075 DOI: 10.3390/life13061292] [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: 05/11/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
A widely discussed topic in the pathophysiology of thyroid nodules is the role of obesity, a state that leads to increased systemic inflammatory markers. Leptin plays a vital role in forming thyroid nodules and cancer through several mechanisms. Together with chronic inflammation, there is an augmentation in the secretion of tumor necrosis factor (TNF) and the cytokine interleukin 6 (IL-6), which contributed to cancer development, progression and metastasis. In addition, leptin exerts a modulatory action in the growth, proliferation and invasion of thyroid carcinoma cell lines via activating various signal pathways, such as Janus kinase/signal transducer and activator of transcription, mitogen-activated protein kinase (MAPK) and/or phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt). Through several proposed mechanisms, aberrant endogenous estrogen levels have been suggested to play a vital role in the development of both benign and malignant nodules. Metabolic syndrome triggers the development of thyroid nodules by stimulating thyroid proliferation and angiogenesis due to hyperinsulinemia, hyperglycemia and dyslipidemia. Insulin resistance influences the distribution and structure of the thyroid blood vessels. Insulin growth factor 1 (IGF-1) and insulin affect the regulation of the expression of thyroid genes and the proliferation and differentiation of thyroid cells. TSH can promote the differentiation of pre-adipocytes to mature adipocytes but also, in the presence of insulin, TSH possesses mitogenic properties. This review aims to summarize the underlying mechanisms explaining the role of obesity in the pathophysiology of thyroid nodules and discuss potential clinical implications.
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Affiliation(s)
- Elpida Demetriou
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | - Maria Fokou
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | - Savvas Frangos
- Nuclear Medicine Department and Thyroid Cancer Clinic, Bank of Cyprus Oncology Center, 2404 Nicosia, Cyprus
| | | | - Panayiotis A Economides
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
- Economides Thyroid and Endocrinology Center, Engomi, 2404 Nicosia, Cyprus
| | - Aliki Economides
- Economides Thyroid and Endocrinology Center, Engomi, 2404 Nicosia, Cyprus
- Department of Health Sciences, European University Cyprus, 2404 Nicosia, Cyprus
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Dong W, Wu Y, Cai T, Wang X. Comparison of diagnostic performance and FNA management of the ACR-TIRADS and Chinese-TIRADS based on surgical histological evidence. Quant Imaging Med Surg 2023; 13:1711-1722. [PMID: 36915304 PMCID: PMC10006137 DOI: 10.21037/qims-22-685] [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: 06/27/2022] [Accepted: 01/12/2023] [Indexed: 02/25/2023]
Abstract
Background The sonography-based risk stratification of thyroid nodules is based on the different sonographic features of benign and malignant thyroid nodules. The American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS) and the Chinese-TIRADS define different risks for malignancy categories and the size criteria for fine-needle aspiration (FNA). Few studies have compared their diagnostic performance and FNA management approaches. Thus, we sought to compare the diagnostic performance and FNA management approaches of the ACR-TIRADS and Chinese-TIRADS based on surgical histological evidence. Methods This retrospective study included patients with complete thyroid ultrasound images and histologic evidence who were consecutively selected from The Affiliated Hospital of Nanjing University of Chinese Medicine. A total of 333 nodules from 252 patients with definitive surgical histological findings were examined. Ultrasonography categories and FNA management proposals were assigned according to the ACR-TIRADS and Chinese-TIRADS. The thyroid nodules were divided into 2 groups based on a cut-off size of 1 cm. The diagnostic performance and recommended and unnecessary FNA rates for each group were compared for both systems. Results Overall, 280 malignant thyroid nodules (84.1%) and 53 benign nodules (15.9%) were analyzed. Across all groups, the ACR-TIRADS had higher sensitivity, specificity, positive and negative predictive values, and accuracy, and a higher area under the curve (AUC) than the Chinese-TIRADS. However, there was a significant difference in the negative predictive value between the ACR-TIRADS and Chinese-TIRADS of <1 and ≥1 cm, and the overall AUCs differed significantly (39.5% vs. 35.1%, P=0.007 for <1 cm; 70.0% vs. 62.8%, P=0.014 for ≥1 cm; 0.843 vs. 0.806, P=0.037 for all). The rate for recommending the FNA of the nodules in the ACR-TIRADS was lower than that in the Chinese-TIRADS (25.2% vs. 56.5%, P<0.0001), but there was no significant difference between the ACR-TIRADS and Chinese-TIRADS in terms of the unnecessary FNA rate (14.3% vs. 13.8%, P=0.931). The kappa statistics for the consistency of the ACR-TIRADS and Chinese-TIRADS FNA recommendations for nodules sized ≥1.0 to <1.5, ≥1.5 to <2.5, and ≥2.5 cm were 0.084, 0.635, and 0.909, respectively. Conclusions The ACR-TIRADS had slightly better diagnostic performance and a lower recommended FNA rate than the Chinese-TIRADS for thyroid nodules. For thyroid nodules ≥1.5 cm in size, the FNA recommendations of the 2 guidelines had good consistency.
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Affiliation(s)
- Weilu Dong
- Department of Ultrasound Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine), Nanjing, China
| | - Yiyun Wu
- Department of Ultrasound Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine), Nanjing, China
| | - Ting Cai
- Department of Ultrasound Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine), Nanjing, China
| | - Xiangqian Wang
- Department of Ultrasound Medicine, The Affiliated Hospital of Nanjing University of Chinese Medicine (Jiangsu Province Hospital of Chinese Medicine), Nanjing, China
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Mu C, Ming X, Tian Y, Liu Y, Yao M, Ni Y, Liu Y, Li Z. Mapping global epidemiology of thyroid nodules among general population: A systematic review and meta-analysis. Front Oncol 2022; 12:1029926. [PMID: 36439513 PMCID: PMC9685339 DOI: 10.3389/fonc.2022.1029926] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/18/2022] [Indexed: 08/29/2023] Open
Abstract
INTRODUCTION An emerging public health issue is brought on by the worldwide increase of thyroid nodules (TNs). The goal of the current study is to determine the global prevalence of TNs among the general population. METHODS We screened articles published from January 2000 to May 2022. TN prevalence was calculated with the DerSimonian-Laird random effects model with arcsine transformation. RESULTS A total of 20,358 entries were found in our research, and 102 of them met our inclusion criteria. A total of 9,276,178 individuals have been diagnosed as TNs; the overall prevalence was 24.83% (95% CI 21.44-28.55), regardless of the diagnostic techniques. TNs have become more prevalent during 2012-2022 (29.29%) compared with 2000-2011 (21.53%, p = 0.02). In addition, we discovered that women (36.51%) were more likely to have TNs than men (23.47%, p < 0.01). Interestingly, we found that obesity was correlated with the prevalence of TNs. Additionally, age-specific-stratified TN prevalence was found in our results. DISCUSSION This meta-analysis shows that, regardless of country development and economic status, TNs are spreading more widely over the world. Our findings showed a strong correlation between rising TN prevalence and older age, female sex, and elevated weight. To stop the TN epidemic from spreading over the world, increased awareness, the understanding of the disease, and quick action are required.
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Affiliation(s)
- Chunyang Mu
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Ming
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ye Tian
- Department of Ultrasound, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yang Liu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Menglin Yao
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center for Geriatrics, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yinyun Ni
- Department of Respiratory and Critical Care Medicine, National Clinical Research Center for Geriatrics, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Yong Liu
- Department of Gastroenterological Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhihui Li
- Department of Thyroid and Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Huang D, Niu Y, Zhang W, Li X, Lin N, Yang Z, Qin L, Su Q, Ran H, Zhang H. OPG
is associated with thyroid nodule development in type 2 diabetes. J Clin Lab Anal 2022; 36:e24615. [PMID: 35870175 PMCID: PMC9459264 DOI: 10.1002/jcla.24615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/27/2022] [Accepted: 07/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Thyroid nodule prevalence is increasing lately, especially in diabetes, but the mechanism of which is not clear. In this study, we investigated if osteoprotegerin (OPG) is involved in the pathogenesis of thyroid nodules in diabetes. Methods A total of 7568 individuals with detailed information and ultrasound examination results were studied for the prevalence of thyroid nodules. Among them, 1883 were with type 2 diabetes and 5685 were non‐diabetic. Then, 1120 individuals were randomly selected for the measurement of OPG. Diabetic rats were made by feeding a high‐fat‐high‐fructose diet for 28 weeks. Rats fed with a normal diet were as controls. Fresh thyroid tissues were obtained and fixed, dehydrated, and embedded in paraffin for hematoxylin‐eosin staining and observing pathological changes. qPCR and western blot were used to detect OPG expression in rat thyroid tissues. Results We found that HbA1c is an independent risk factor for thyroid nodules (Exp [β] = 1.158, p < 0.001). The prevalence of thyroid nodules in type 2 diabetes was higher than that in non‐diabetes (53.9% vs. 46.7%, p < 0.001). Serum OPG levels were significantly elevated in the diabetes group than in the non‐diabetes group (3160.17 pg/ml vs. 2819.39 pg/ml, p < 0.01). The expression of OPG increased significantly in the thyroid tissues of diabetic rats. Conclusion Osteoprotegerin may be associated with thyroid nodule development in diabetes.
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Affiliation(s)
- Dazhi Huang
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Pudong New Area Gaoqiao community health center Shanghai China
| | - Yixin Niu
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Weiwei Zhang
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Ning Lin
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Zhen Yang
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
- Department of Endocrinology, Xinhua Hospital Chongming Branch Shanghai Jiaotong University School of Medicine Shanghai China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Hui Ran
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
| | - Hongmei Zhang
- Department of Endocrinology, Xinhua Hospital Shanghai Jiaotong University School of Medicine Shanghai China
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10
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Yang N, Yang H, Guo JJ, Hu M, Li S. Cost-Effectiveness Analysis of Ultrasound Screening for Thyroid Cancer in Asymptomatic Adults. Front Public Health 2021; 9:729684. [PMID: 34631648 PMCID: PMC8494179 DOI: 10.3389/fpubh.2021.729684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/16/2021] [Indexed: 02/05/2023] Open
Abstract
Objectives: This study evaluated the long-term cost-effectiveness of ultrasound screening for thyroid cancer compared with non-screening in asymptomatic adults. Methods: Applying a Markov decision-tree model with effectiveness and cost data from literature, we compared the long-term cost-effectiveness of the two strategies: ultrasound screening and non-screening for thyroid cancer. A one-way sensitivity analysis and a probabilistic sensitivity analysis were performed to verify the stability of model results. Results: The cumulative cost of screening for thyroid cancer was $18,819.24, with 18.74 quality-adjusted life years (QALYs), whereas the cumulative cost of non-screening was $15,864.28, with 18.71 QALYs. The incremental cost-effectiveness ratio of $106,947.50/QALY greatly exceeded the threshold of $50,000. The result of the one-way sensitivity analysis showed that the utility values of benign nodules and utility of health after thyroid cancer surgery would affect the results. Conclusions: Ultrasound screening for thyroid cancer has no obvious advantage in terms of cost-effectiveness compared with non-screening. The optimized thyroid screening strategy for a specific population is essential.
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Affiliation(s)
- Nan Yang
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Han Yang
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Jeff Jianfei Guo
- James L. Winkle College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, United States
| | - Ming Hu
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism, West China Hospital, Sichuan University, Chengdu, China.,Chinese Evidence-Based Medicine Center, Cochrane China Center and MAGIC China Center, West China Hospital, Sichuan University, Chengdu, China
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11
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Tian C, Bu Y, Ji C, Shi M, Zhang L, Kong D, Dong X, Liu Y. Iodine Nutrition and the Prevalence Status of Thyroid Nodules in the Population: a Cross-sectional Survey in Heilongjiang Province, China. Biol Trace Elem Res 2021; 199:3181-3189. [PMID: 33123864 DOI: 10.1007/s12011-020-02442-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/15/2020] [Indexed: 10/23/2022]
Abstract
The aim of this study was to determine the iodine nutritional status and the epidemiological characteristics of thyroid nodules (TNs) in the adult population of Heilongjiang Province. From December 2017 to December 2018, a total of 3661 adults aged 20-70 years were selected through probability proportional to size (PPS) sampling for a cross-sectional survey. During the field epidemiological investigation, each participant received a questionnaire survey and thyroid ultrasonography examination. The iodine concentrations in casual urine specimens and household edible salt were measured. The household coverage of iodized salt was 86.56%. The median urinary iodine concentration (MUIC) in the adult population in Heilongjiang Province was 161.57 μg/L (25th-75th percentile: 100.35-245.15 μg/L). The prevalence of TNs was 36.88%, and the prevalence in females was significantly higher than that in males (41.25% vs 32.50%, χ2 = 11.841, P < 0.01). The prevalence of TNs increased with age (χ2trend = 49.80, P < 0.001). The prevalence of multiple TNs increased with age (χ2trend = 48.709, P < 0.001). There was no significant difference in the MUIC between healthy control group and those with TNs (Z = - 1.386, P = 0.166). The female, age (40-49 age group, 50-59 age group, 60-70 age group), BMI (obesity, overweight), history of hypertension, history of diabetes, and smoking history were all independent risk factors that affected the occurrence of TNs. The iodine nutritional status of the adult population in Heilongjiang Province was adequate. The prevalence of TNs was higher in middle-aged and elderly women, so these individuals should be the focus of the prevention and treatment of thyroid nodule disease.
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Affiliation(s)
- Chunyuan Tian
- Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Ye Bu
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China
| | - Chunlei Ji
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China
| | - Mengqi Shi
- Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China
| | - Liwei Zhang
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China
| | - Dejiao Kong
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China
| | - Xiaoqiu Dong
- The Fourth Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, China.
| | - Ying Liu
- Key Laboratory of Etiology and Epidemiology, National Health and Family Planning Commission, Center for Endemic Disease Control, Chinese Center for Disease Control and Prevention, Harbin Medical University, Harbin, 150081, Heilongjiang, China.
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12
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Xu L, Zeng F, Wang Y, Bai Y, Shan X, Kong L. Prevalence and associated metabolic factors for thyroid nodules: a cross-sectional study in Southwest of China with more than 120 thousand populations. BMC Endocr Disord 2021; 21:175. [PMID: 34452638 PMCID: PMC8400405 DOI: 10.1186/s12902-021-00842-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/16/2021] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE To explore the prevalence and its associated metabolic factors of thyroid nodules (TNs) among subjects who participated in the physical examinations in Chongqing, China. METHODS The participants from the Health Management Center of JinShan Hospital of Chongqing Medical University, between September 2015 and May 2020, were included in this study. All of the participants underwent thyroid ultrasonography, anthropometric measurements, and serum examinations. Differences in the TNs prevalence were compared with the chi-square test or Wilcoxon rang-sum test. Multivariable logistic regression analyses were used to estimate the metabolic factors associated with TNs and multiple thyroid nodules (MTNs). RESULTS Of the included 121,702 participants, 41,547 had TNs, and 20,899 had MTNs, with the prevalence of 34.1 and 17.0 %, respectively. Women had a significantly higher prevalence of TNs than men (40.6 % vs. 29.8 %; χ2 = 1517.33, P < 0.001), and TNs prevalence was gradually increased with age (P for trend < 0.001). Female gender, advanced age, and metabolic factors including central obesity, hypertension, diabetes and fatty liver were positively associated with TNs; BMI, hyperlipoidemia and hyperuricemia were not independent risk factors of TNs. While female gender, advanced age, central obesity, hypertension and diabetes were independent risk factors of MTNs. CONCLUSIONS The prevalence of thyroid nodules was relatively high. The associated factors identified in this study could help the clinicians to detect the high-risk patients and make targeted screening strategies for the preventing of the occurrence of TNs.
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Affiliation(s)
- Li Xu
- Health Management Centre, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Fanling Zeng
- Health Management Centre, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China
| | - Yutong Wang
- Department of Health Management Centre (Epidemiology and Biostatistics), First Affiliated Hospital, Army Medical University, 400038, Chongqing, China
| | - Ye Bai
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Chongqing Medical University, 400016, Chongqing, China
| | - Xuefeng Shan
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China.
| | - Lingxi Kong
- Department of Pharmacy, The First Affiliated Hospital of Chongqing Medical University, 400016, Chongqing, China.
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13
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Zhao W, Lu R, Yin L, Guo R. The value of superb microvascular imaging (SMI) scoring assignment method in differentiating benign and malignant thyroid nodules by conventional ultrasound. Clin Hemorheol Microcirc 2021; 78:355-363. [PMID: 34366330 DOI: 10.3233/ch-211235] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To explore the application value of SMI scoring assignment method combined with 2017 American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS) in differentiating benign and malignant thyroid nodules. METHODS According to the 2017 ACR TI-RADS classification, the enrolled nodules were divided into 3 points group, 4 points group, 5 points group, 6 points group and≥7 points group. The nodules were assigned scores according to the echocity of the nodules and the microvessels detected by SMI and their distribution patterns based on ACR TI-RADS. Accompany with the scores increased or decreased after assignment, the thyroid nodules were re-grouped. RESULTS The AUC after the scores assignment is better than before (Z = 3.881, P < 0.001). The specificity, positive predictive value and accuracy after score assigned are better than those of before (Z = 8.323, P < 0.001; Z = 8.619, P < 0.001; Z = 5.345, P < 0.001), there is no statistical difference in sensitivity before and after score assigned (Z = -0.513, P = 0.60), and the negative predictive value before assigned score is better than that of after (Z = -3.826, P < 0.001). CONCLUSION The diagnostic efficacy after scoring was better than that of before.
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Affiliation(s)
- Wei Zhao
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ruigang Lu
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Li Yin
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Ruijun Guo
- Department of Ultrasound, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Zhou J, Song Y, Zhan W, Wei X, Zhang S, Zhang R, Gu Y, Chen X, Shi L, Luo X, Yang L, Li Q, Bai B, Ye X, Zhai H, Zhang H, Jia X, Dong Y, Zhang J, Yang Z, Zhang H, Zheng Y, Xu W, Lai L, Yin L. Thyroid imaging reporting and data system (TIRADS) for ultrasound features of nodules: multicentric retrospective study in China. Endocrine 2021; 72:157-170. [PMID: 32852733 DOI: 10.1007/s12020-020-02442-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/28/2020] [Indexed: 01/25/2023]
Abstract
PURPOSE To establish a practical and simplified Chinese thyroid imaging reporting and data system (C-TIRADS) based on the Chinese patient database. METHODS A total of 2141 thyroid nodules that were neither cystic nor spongy were used in the current study. These specimens were derived from 2141 patients in 131 alliance hospitals of the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound. The ultrasound features, including location, orientation, margin, halo, composition, echogenicity, echotexture, echogenic foci and posterior features were assessed. Univariate and multivariate analyses were performed to investigate the association between ultrasound features and malignancy. The regression equation, the weighting, and the counting methods were used to determine the malignant risk of the thyroid nodules. The areas under the receiver operating characteristic curve (Az values) were calculated. RESULTS Of the 2141 thyroid nodules, 1572 were benign, 565 were malignant, and 4 were borderline. Vertical orientation, ill-defined, or irregular margin (including extrathyroidal extension), microcalcifications, solid, and markedly hypoechoic were positively associated with malignancy, while comet-tail artifacts were negatively associated with malignancy. The logistic regression equation yielded the highest Az value of 0.913, which was significantly higher than that obtained using the weighting method (0.893) and the counting method (0.890); however, no significant difference was found between the latter two. The C-TIRADS, based on the counting method, was designed following the principle of balancing the diagnostic performance and sensitivity of the risk stratification with the ease of use. CONCLUSIONS A relatively simple C-TIRADS was established using the counting value of positive and negative ultrasound features.
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Affiliation(s)
- JianQiao Zhou
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
| | - YanYan Song
- Department of Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China.
| | - WeiWei Zhan
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
| | - Xi Wei
- Department of Diagnostic and Therapeutic Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Sheng Zhang
- Department of Diagnostic and Therapeutic Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - RuiFang Zhang
- Department of Ultrasound, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, China
| | - Ying Gu
- Department of Ultrasound, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, China
| | - Xia Chen
- Department of Ultrasound, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, China
| | - Liying Shi
- Department of Ultrasound, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, China
| | - XiaoMao Luo
- Department of Ultrasound, The Third Affiliated Hospital Of Kunming Medical University, Yunnan Cancer Hospital, Kunming, 650031, China
| | - LiChun Yang
- Department of Ultrasound, The Third Affiliated Hospital Of Kunming Medical University, Yunnan Cancer Hospital, Kunming, 650031, China
| | - QiaoYing Li
- Department of Ultrasound Diagnostics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - BaoYan Bai
- Department of Ultrasound, Affiliated Hospital of Yan'an University, School of Medicine, Yan'an University, Shanxi, 716000, China
| | - XinHua Ye
- Department of Ultrasound, the first affiliated Hospital of Nanjing Medical University, NanJing, 210029, China
| | - Hong Zhai
- Department of Abdominal Ultrasound, The fourth Clinical Medical Collegen, Xinjiang Medical University, Urumqi, 830000, China
| | - Hua Zhang
- Department of ultrasound, Anyang tumor hospital, The Fourth Affiliated Hospital of Henan University of Science and Technology, Anyang, 455000, China
| | - XiaoHong Jia
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - YiJie Dong
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - JingWen Zhang
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - ZhiFang Yang
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - HuiTing Zhang
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - Yi Zheng
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - WenWen Xu
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - LiMei Lai
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - LiXue Yin
- Institute of Ultrasound in Medicine, The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China, Chengdu, 610071, China
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Durcan E, Sahin S, Dedeoglu SE, Ozkaya HM, Gonen MS. Can "VAI" Better Indicate Metabolic Syndrome Compared with Other Metabolic Syndrome-Related Parameters in Patients with Thyroid Nodules? A Study from Turkey. Metab Syndr Relat Disord 2021; 19:358-366. [PMID: 33794138 DOI: 10.1089/met.2020.0147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: To investigate the relationship between visceral adiposity index (VAI) and other metabolic syndrome (MetS)-related parameters, and thyroid nodules. Methods: This single-center, prospective, case-control study included 67 patients with thyroid nodules and 48 healthy volunteers with similar age, sex, and body mass index (BMI). Biochemical parameters were obtained from medical charts. Anthropometric measurements and total body composition analysis were performed to calculate VAI and other MetS parameters. The parenchymal structure was evaluated according to VESINC (Volume, Echogenicity, Sonographic texture, Infiltration of pseudonodular Nodules, Cysts) system on thyroid ultrasound and nodule characteristics were also detected. MetS was defined according to International Diabetes Federation criteria. Results: We examined a total of 67 patients with thyroid nodule and 48 healthy volunteers. Sixty-one (91%) were female in the patient group; and 43 (90%) were female in the control group. The mean age was 48.5 ± 11.6 years in the patient group; 47.2 ± 9.5 years in the control. The median VAI was significantly higher in the patient group than the control group [4.1 interquartile range (IQR: 2.6-5.9) vs. 3 (IQR: 2-4.3), P = 0.024]. There was a positive correlation between VAI and BMI, waist/hip ratio (WHpR), waist/height ratio (WHtR), and homeostasis of model assessment of insulin resistance (HOMA-IR). On the other hand, there was no significant correlation between VAI and thyroid function tests and autoantibodies and thyroid volume. Conclusions: In conclusion, we demonstrated that MetS was more common in patients with thyroid nodules. Although VAI and HOMA-IR levels were significantly different between the two groups, we found no significant difference in terms of waist circumference, WHpR, and WHtR. This might suggest that VAI compared with these parameters, better predicts the risk of MetS in patients with thyroid nodules.
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Affiliation(s)
- Emre Durcan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdar Sahin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Selin Ece Dedeoglu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hande Mefkure Ozkaya
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mustafa Sait Gonen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Cerrahpasa Medical School, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Răcătăianu N, Leach NV, Bolboacă SD, Soran ML, Opriş O, Dronca E, Valea A, Ghervan C. Interplay between metabolic and thyroid parameters in obese pubertal children. Does visceral adipose tissue make the first move? Acta Clin Belg 2021; 76:40-48. [PMID: 31448702 DOI: 10.1080/17843286.2019.1660021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objectives: The mechanisms of obesity-associated thyroid dysfunction in children are incompletely deciphered. We aimed to evaluate whether visceral adipose tissue (VAT), insulin resistance (IR), inflammation, oxidative stress (OS) are involved in thyroid morpho-functional changes in pubertal obese children. Methods: We recruited 43 obese pubertal children without history of thyroid pathology. Metabolic and thyroid parameters (visceral fat thickness [VFT], waist/hip ratio [WHR], waist/height ratio [WHtR], insulin, glucose, liver parameters, thyroid stimulation hormone [TSH], free thyroxine [FT4], free triiodothyronine [FT3], thyroid and abdominal ultrasonography) were evaluated. Serum monocyte chemoattractant protein-1 (MCP-1) and malondialdehyde (MDA) levels were quantified as markers of inflammation and OS. Results: VFT correlated positively both with WHR (p= 0.034) and the presence of thyroid nodules (p= 0.036). WHR associated with TSH (p= 0.005), FT3/FT4 (p= 0.033) and was independently associated with FT3/FT4 increase (p< 0.001). HOMA-IR increased with visceral obesity (waist circumference, p= 0.001; WHR, p= 0.018; WHtR: p< 0.001), hepatic impairment (alanine aminotransferase, p= 0.019) and hepatic steatosis (HS; p= 0.013) and correlated positively with FT3/FT4 (p= 0.036). TSH was significantly higher in subjects with HS versus those without HS (p= 0.007) and logistic regression analysis identified TSH as a risk factor for HS (p= 0.014). MDA correlated positively with MCP-1 (p= 0.021). Conclusion: VAT and IR may be responsible for changes in thyroid parameters associated with obesity: elevated TSH, FT3/FT4 levels and increased prevalence of thyroid nodules. WHR was predictive of increased FT3/FT4. In obese children, there is an interdependent relationship between HS and thyroid function.
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Affiliation(s)
- Nicoleta Răcătăianu
- Department of Endocrinology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Nicoleta V. Leach
- 5th Department of Internal Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sorana D. Bolboacă
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Maria Loredana Soran
- National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Ocsana Opriş
- National Institute for Research and Development of Isotopic and Molecular Technologies, Cluj-Napoca, Romania
| | - Eleonora Dronca
- Molecular Sciences Department, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ana Valea
- Department of Endocrinology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cristina Ghervan
- Department of Endocrinology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Zhang F, Li Y, Yu X, Wang X, Lin Z, Song B, Tian L, Feng C, Shan Z, Teng W. The Relationship and Gender Disparity Between Thyroid Nodules and Metabolic Syndrome Components Based on a Recent Nationwide Cross-Sectional Study and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:736972. [PMID: 34621243 PMCID: PMC8490942 DOI: 10.3389/fendo.2021.736972] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 08/30/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) has a potential connection with thyroid disease, but its relationship with thyroid nodules (TNs) is still controversial. This study aims to clarify the relationship between MetS and TNs, and this relationship in the subgroup of gender. METHODS The recent nationwide cross-sectional study called Thyroid Disorders, Iodine Status, and Diabetes Epidemiological survey provided the newest data on the relationship between MetS and TNs from China and included 56,729 subjects. We also researched related literature in PubMed, EMBASE, Cochrane Library, and MEDLINE until Oct 30, 2020, in order to perform a meta-analysis. The relevant articles were examined, and the eligible studies were included to assess the association between MetS and TNs. RESULTS The meta-analysis included 15 studies (involving 468,845 subjects). Of these, 14 studies were from the databases, and one study was this cross-sectional data. The meta-analysis showed that TNs were associated with a higher prevalence of MetS (OR=1.87, 95% CI: 1.44-2.45) and the components of MetS, including central obesity (OR=1.41, 95% CI: 1.15-1.72), hypertriglyceridemia (OR=1.13, 95% CI: 1.10-1.15), low high-density lipoprotein cholesterolemia (OR=1.11, 95% CI: 1.02-1.20), abnormal blood pressure (OR=1.68, 95% CI: 1.62-1.75), and hyperglycemia (OR=1.59, 95% CI: 1.46-1.74). Central obesity displayed gender differences, being a risk factor in males (OR=1.38, 95% CI: 1.02-1.86) but not in females (OR=1.47, 95% CI: 0.97-2.23). CONCLUSION TNs were indeed associated with a higher prevalence of MetS. In addition, its component diseases, such as central obesity, hypertriglyceridemia, abnormal blood pressure, and hyperglycemia, were also associated with TNs. Females with MetS or its components had a higher risk of suffering from TNs than males.
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Li Y, Jin C, Li J, Tong M, Wang M, Huang J, Ning Y, Ren G. Prevalence of Thyroid Nodules in China: A Health Examination Cohort-Based Study. Front Endocrinol (Lausanne) 2021; 12:676144. [PMID: 34122350 PMCID: PMC8188053 DOI: 10.3389/fendo.2021.676144] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Thyroid nodules are a common clinical problem and some are potentially cancerous; however, little is known about the prevalence of thyroid nodules in China. The objective of this study was to investigate the prevalence of thyroid nodules in a healthy Chinese population. METHODS We reviewed electronic medical records of 13,178,313 participants from 30 provinces and regions who received health examinations and underwent thyroid ultrasound at Meinian Onehealth Healthcare in 2017. Among them, 6,192,357 were excluded based on predefined criteria. All thyroid nodules were diagnosed by ultrasonography, and standardized protocols were adopted for data collection, quality control, and data management. RESULTS A total of 6,985,956 participants (mean age: 42.1 ± 13.1 years) were included in this study. The overall prevalence of thyroid nodules was 36.9% (95% CI, 35.7%-38.1%; age- and sex-standardized prevalence 38.0% [95% CI, 37.0%-39.1%]). The prevalence of thyroid nodules in females (44.7% [95% CI, 43.4%-45.9%], age-standardized prevalence: 45.2% [95% CI, 44.1%-46.4%]) was significantly higher than that in males (29.9% [95% CI, 28.8%-31.0%], age-standardized prevalence 31.2% [95% CI, 30.1%-32.2%]; P < 0.001). The prevalence of thyroid nodules decreased from <18 to 25 years, while increased with age over 25 years old. The top three provinces with the highest prevalence of thyroid nodules were Jilin (47.6%), Liaoning (44.8%), and Shandong (43.9%), whereas Guizhou (23.9%), Chongqing (26.2%), and Shaanxi (26.4%) had the lowest prevalence. Females had more than 10% higher rates of thyroid nodules than males in all included provinces and regions, except for Tianjin (8.0%). Based on the geographical regions of China, the northeast had the highest prevalence (46.8% [95% CI, 44.1%-49.2%]), whereas northwest had the lowest prevalence (28.9% [95% CI, 26.9%-31.6%]. Based on multivariable logistic regression analysis, factors including age, gender, body mass index, systolic blood pressure, diastolic blood pressure, uric acid, fasting blood glucose, triglycerides, high-density lipoproteins, and low-density lipoproteins were significantly associated with the presence of thyroid nodules. CONCLUSION This study provides the first nationwide analysis of the prevalence of thyroid nodules in China. Our results showed that the prevalence of thyroid nodules was high in health screening Chinese people with regional-specific patterns.
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Affiliation(s)
- Yunhai Li
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Jin
- Meinian Institute of Health, Beijing, China
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
| | - Jie Li
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingkun Tong
- Meinian Institute of Health, Beijing, China
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
| | - Mengxue Wang
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jiefeng Huang
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi Ning
- Meinian Institute of Health, Beijing, China
- Peking University Health Science Center, Meinian Public Health Research Institute, Beijing, China
- *Correspondence: Yi Ning, ; Guosheng Ren,
| | - Guosheng Ren
- Department of Endocrine and Breast Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Yi Ning, ; Guosheng Ren,
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Zhou J, Yin L, Wei X, Zhang S, Song Y, Luo B, Li J, Qian L, Cui L, Chen W, Wen C, Peng Y, Chen Q, Lu M, Chen M, Wu R, Zhou W, Xue E, Li Y, Yang L, Mi C, Zhang R, Wu G, Du G, Huang D, Zhan W. 2020 Chinese guidelines for ultrasound malignancy risk stratification of thyroid nodules: the C-TIRADS. Endocrine 2020; 70:256-279. [PMID: 32827126 DOI: 10.1007/s12020-020-02441-y] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 07/28/2020] [Indexed: 02/05/2023]
Abstract
Thyroid nodules are very common all over the world, and China is no exception. Ultrasound plays an important role in determining the risk stratification of thyroid nodules, which is critical for clinical management of thyroid nodules. For the past few years, many versions of TIRADS (Thyroid Imaging Reporting and Data System) have been put forward by several institutions with the aim to identify whether nodules require fine-needle biopsy or ultrasound follow-up. However, no version of TIRADS has been widely adopted worldwide till date. In China, as many as ten versions of TIRADS have been used in different hospitals nationwide, causing a lot of confusion. With the support of the Superficial Organ and Vascular Ultrasound Group of the Society of Ultrasound in Medicine of the Chinese Medical Association, the Chinese-TIRADS that is in line with China's national conditions and medical status was established based on literature review, expert consensus, and multicenter data provided by the Chinese Artificial Intelligence Alliance for Thyroid and Breast Ultrasound.
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Affiliation(s)
- JianQiao Zhou
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
| | - LiXue Yin
- Institute of Ultrasound in Medicine, The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China, Chengdu, 610071, China.
| | - Xi Wei
- Department of Diagnostic and Therapeutic Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - Sheng Zhang
- Department of Diagnostic and Therapeutic Ultrasound, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, 300060, China
| | - YanYan Song
- Department of Biostatistics, Institute of Medical Sciences, Shanghai Jiaotong University School of Medicine, Shanghai, 200025, China
| | - BaoMing Luo
- Department of Ultrasound, SunYat-sen Memorial Hospital, SunYat-sen University, Guangzhou, 510120, China
| | - JianChu Li
- Department of Ultrasound, Peking Union Medical College Hospital, Beijing, 100730, China
| | - LinXue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - LiGang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing, 100191, China
| | - Wen Chen
- Department of Ultrasound, Peking University Third Hospital, Beijing, 100191, China
| | - ChaoYang Wen
- Department of Ultrasound, Peking University International Hospital, Beijing, 102206, China
| | - YuLan Peng
- Department of Ultrasound, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Qin Chen
- Department of Ultrasound, The Affiliated Sichuan Provincial People's Hospital of Electronic Science and Technology University of China, Chengdu, 610071, China
| | - Man Lu
- Department of Ultrasound, Sichuan Cancer Hospital, Chengdu, 610041, China
| | - Min Chen
- Department of Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Rong Wu
- Department of Ultrasound, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, 201620, China
| | - Wei Zhou
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China
| | - EnSheng Xue
- Department of Ultrasound, Fujian Medical University Union Hospital, Fuzhou, 350001, China
| | - YingJia Li
- Department of Ultrasound, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - LiChun Yang
- Department of Ultrasound, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Kunming, 650031, China
| | - ChengRong Mi
- Department of Ultrasound, General Hospital of Ningxia Medical University, Yinchuan, 750021, China
| | - RuiFang Zhang
- Department of Ultrasound, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, 450052, China
| | - Gang Wu
- Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - GuoQing Du
- Department of Ultrasound, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150086, China
| | - DaoZhong Huang
- Department of Ultrasound, Tongji Hospital, Tongji Medical Colloge, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - WeiWei Zhan
- Department of Ultrasound, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200025, China.
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Yang H, Holowko N, Grassmann F, Eriksson M, Hall P, Czene K. Hyperthyroidism is associated with breast cancer risk and mammographic and genetic risk predictors. BMC Med 2020; 18:225. [PMID: 32838791 PMCID: PMC7446157 DOI: 10.1186/s12916-020-01690-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/30/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Despite the biological link between thyroid hormones and breast cancer cell proliferation shown in experimental studies, little is known about the association between hyperthyroidism and breast cancer, as well as its association with the most common mammographic and genetic risk predictors for breast cancer. METHODS This study estimates the incidence rate ratios (IRRs) of breast cancer among women diagnosed with hyperthyroidism, compared to those who are not, using two cohorts: a Swedish national cohort of the general female population (n = 3,793,492, 2002-2011) and the Karolinska Mammography Project for Risk Prediction of Breast Cancer (KARMA, n = 69,598, 2002-2017). We used logistic regression to estimate the odds ratios (ORs) of hyperthyroidism according to the mammographic and genetic risk predictors for breast cancer. RESULTS An increased risk of breast cancer was observed in patients in the national cohort with hyperthyroidism (IRR = 1.23, 95% CI = 1.12-1.36), particularly for toxic nodular goiter (IRR = 1.38, 95% CI = 1.16-1.63). Hyperthyroidism was associated with higher body mass index, early age at first birth, and lower breastfeeding duration. Higher mammographic density was observed in women with toxic nodular goiter, compared to women without hyperthyroidism. Additionally, among genotyped women without breast cancer in the KARMA cohort (N = 11,991), hyperthyroidism was associated with a high polygenic risk score (PRS) for breast cancer overall (OR = 1.98, 95% CI = 1.09-3.60) and for estrogen receptor-positive specific PRS (OR = 1.90, 95% CI = 1.04-3.43). CONCLUSION Hyperthyroidism is associated with an increased risk of breast cancer, particularly for patients with toxic nodular goiter. The association could be explained by higher mammographic density among these women, as well as pleiotropic genetic variants determining shared hormonal/endocrine factors leading to the pathology of both diseases.
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Affiliation(s)
- Haomin Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Xuefu North Road 1, University Town, Fuzhou, 350122 China
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Natalie Holowko
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Felix Grassmann
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Mikael Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
- Department of Oncology, South General Hospital, SE-11883 Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-17177 Stockholm, Sweden
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Li H, Wang Z, Liu JS, Zou BS, Chen HR, Xu Z, Li H, Tian S, Shi YL, Li S, Wu KN, Ran L, Kong LQ. Association Between Breast and Thyroid Lesions: A Cross-Sectional Study Based on Ultrasonography Screening in China. Thyroid 2020; 30:1150-1158. [PMID: 32148169 DOI: 10.1089/thy.2019.0184] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Introduction: Prior research has shown an association between breast and thyroid cancers, although their relationship is unclear. In China, asymptomatic women undergoing regular health checkups usually undergo breast and thyroid ultrasonography screening. The present cross-sectional ultrasound-based study estimated the prevalence of breast masses (BM) and thyroid nodules (TN) and their relationship among a population-based cohort of Chinese women. Methods: This study included 34,184 consecutive asymptomatic Chinese women who underwent both breast and thyroid ultrasound evaluation during one health care examination. Detected lesions were assigned into categories of different malignant risks according to the Breast and Thyroid Imaging Reporting and Data System (BI-/TI-RADS). Binomial logistic regression was used to determine the association between occurrence of BM and TN, and multinomial logistic regression was used to analyze the correlation of BM and TN in different BI-/TI-RADS categories. Associations between BM and TN, as well as anthropometric and biochemical markers, were also explored. Results: Of those enrolled, 6371 (18.6%) had BM, 12,153 (35.6%) had TN, and 2279 (6.7%) had both. After adjusting for age, body mass index (BMI), and height, females with TN had a higher risk of BM (odds ratio [OR] = 1.151, 95% confidence interval [CI 1.081-1.225], p < 0.0001) than those with normal thyroids, and females with BM had a higher risk of TN (OR = 1.165 [CI 1.096-1.238], p < 0.0001) than those without BM. Women with a TN >10 mm (OR = 1.249 [CI 1.104-1.413], p = 0.0004) and those with a TN ≤10 mm (OR = 1.134 [CI 1.062-1.211], p = 0.0002) were at higher risk of BM compared with those with normal thyroids. As RADS categories increased, so did the correlation between BM and TN. The increased risk of TN was associated with a higher BMI, height, systolic blood pressure, and a lower plasma albumin level. The increased risk of BM was associated with a lower BMI, plasma albumin levels, and higher height. Conclusions: A high prevalence of BM and TN was detected by ultrasonography screening in this cohort of Chinese women. These lesions occurred frequently and simultaneously, particularly in women with lesions in higher RADS categories.
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Affiliation(s)
- Hao Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ze Wang
- Department of Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Jia-Shuo Liu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bao-Shan Zou
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao-Ran Chen
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhou Xu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shen Tian
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yan-Ling Shi
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shu Li
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai-Nan Wu
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liang Ran
- Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-Quan Kong
- Department of Endocrine and Breast Surgery; The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Eissa MS, Abdellateif MS, Elesawy YF, Shaarawy S, Al-Jarhi UM. Obesity and Waist Circumference are Possible Risk Factors for Thyroid Cancer: Correlation with Different Ultrasonography Criteria. Cancer Manag Res 2020; 12:6077-6089. [PMID: 32801859 PMCID: PMC7382758 DOI: 10.2147/cmar.s256268] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/30/2020] [Indexed: 01/06/2023] Open
Abstract
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.
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Affiliation(s)
- Marwa S Eissa
- Internal Medicine and Endocrinology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona S Abdellateif
- Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Yasmine F Elesawy
- Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Sabry Shaarawy
- Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ula M Al-Jarhi
- Internal Medicine and Endocrinology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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23
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Lai X, Ouyang P, Zhu H, An S, Xia L, Yao Y, Zhang H, Li Z, Deng K. [Detection rate of thyroid nodules in routine health check-up and its influencing factors: a 10-year survey of 309 576 cases]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:268-273. [PMID: 32376525 DOI: 10.12122/j.issn.1673-4254.2020.02.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To analyze the detection rate of thyroid nodules and its influencing factors among individuals undergoing routine health check-up in Guangdong Province. METHODS We analyzed the results of thyroid ultrasonography of 309 576 individuals receiving routine health check-up in a general hospital in Guangdong Province over the past 10 years. The data were compared between the individuals with and without thyroid nodules using two independent samples t test, MannWhitney U test and Chi-square test. Binary logistic regression was used to analyze the relationship between different factors and thyroid nodules, and the odds ratio (OR) and 95% confidence interval (95% CI) were calculated. RESULTS Based on the structured and standardized data, the total detection rate of thyroid nodules was 9.68% among the individuals, 7.71% in male and 13.51% in female subjects, showing a significant gender difference (χ2=2677.08, P < 0.001). In the overall population, the detection rates of thyroid nodules gradually increased with age, but in each age group, the detection rate remained significantly higher in female subjects than in male subjects (P < 0.001). The subjects with thyroid nodules showed a significant higher percentage of male gender, an older age, a greater BMI, and significantly higher SBP, DBP, FBG, TC, LDL-C, HDL-C, TG as well as higher detection rates of fatty liver, hyperlipidemia, hyperglycemia, and metabolic syndrome than those without thyroid nodules (all P < 0.001). Binary logistic regression analysis showed that thyroid nodules were significantly associated with gender (OR=0.455, 95%CI: 0.443-0.468), age (45-59 years: OR=1.660, 95%CI: 1.613-1.710; ≥ 60 years: OR=3.329, 95%CI: 3.202- 3.462), BMI (underweight: OR=0.808, 95%CI: 0.755-0.864; overweight: OR=1.074, 95%CI: 1.038-1.112; obesity: OR=1.281, 95%CI: 1.221-1.343), hyperlipidemia (OR=1.053, 95%CI:1.022-1.085), high blood glucose (OR=1.177, 95%CI: 1.105-1.252), and metabolic syndrome (OR=1.111, 95%CI: 1.071-1.152). CONCLUSIONS The detection rate of thyroid nodule is much higher in female than in male individuals in Guangdong Province and is significantly associated with gender, age, BMI and metabolic related diseases. Male gender and underweight might be protective factors for thyroid nodules, while an advanced age, overweight/obesity, hyperlipidemia, high blood glucose and metabolic syndrome are associated with an increased risk of thyroid nodules. Thyroid ultrasound examination is recommended in routine health check-up for early detection and treatment of thyroid diseases.
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Affiliation(s)
- Xiaoying Lai
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Ping Ouyang
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Hong Zhu
- Hospital Office, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Shengli An
- School of Public Health, Southern Medical University, Guangzhou 510515, China
| | - Lijuan Xia
- Department of Health Management, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
| | - Yiting Yao
- School of Health Management, Southern Medical University, Guangzhou 510515, China
| | - Han Zhang
- School of Physics and Telecommunications Engineering, South China Normal University, Guangzhou 510631, China
| | - Zhi Li
- School of Physics and Telecommunications Engineering, South China Normal University, Guangzhou 510631, China
| | - Kan Deng
- Beijing Rxthinking Technology Co., Ltd., Beijing 100193, China
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Pan Q, Wang Y, Wang G. The Association Between Hyperhomocysteinemia and Thyroid Nodule Prevalence in an Adult Population. Metab Syndr Relat Disord 2020; 18:368-372. [PMID: 32598216 DOI: 10.1089/met.2020.0057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Thyroid nodule is the most common disorder of thyroid. Metabolic syndrome was regarded as an important factor for the prevalence of thyroid nodule. Homocysteine has been shown to be related to metabolic syndrome, inflammation, and several common cancers. In this study, we aimed to investigate the relationship between serum homocysteine and the prevalence of thyroid nodule. Materials and Methods: This was a cross-sectional study that included 2040 adults in a health checkup population in Beijing Chao-yang hospital. Thyroid ultrasound data, together with anthropometric characteristics, metabolic parameters, and serum homocysteine, were recorded respectively. Results: Hyperhomocysteinemia (defined as serum homocysteine ≥15 μmol/L) was detected in 452 participants (21.91%). Thyroid nodule prevalence was significantly higher in hyperhomocysteinemia participants than in normal homocysteine participants (52.57% vs. 45.16%, P = 0.006). Logistic regression analysis revealed that age [odds ratio (OR) 1.054; P < 0.001], female gender (OR 2.242; P < 0.001), body mass index (OR 1.050; P < 0.001), and serum homocysteine level (OR 1.022; P = 0.001) were the independent risk factors for thyroid nodule. Conclusions: Subjects with hyperhomocysteinemia have significantly higher thyroid nodule prevalence. Homocysteine is an independent risk factor for thyroid nodule. It implies that individuals with hyperhomocysteinemia have higher susceptibility to thyroid nodule.
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Affiliation(s)
- Qingrong Pan
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Physical Examination Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Guang Wang
- Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Lai X, Zhang B, Wang Y, Jiang Y, Li J, Gao L, Wang Y. Adiposity and the risk of thyroid nodules with a high-suspicion sonographic pattern: a large cross-sectional epidemiological study. J Thorac Dis 2020; 11:5014-5022. [PMID: 32030217 DOI: 10.21037/jtd.2019.11.79] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background To our knowledge, no previous studies have evaluated the association between obesity and the risk of thyroid nodules with a high-suspicion sonographic pattern defined by the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancers. In this large cross-sectional epidemiological study, we investigated whether a positive association existed between anthropometric measurements and the risk of thyroid nodules. Methods In total, 10,504 individuals from two towns in northern China were enrolled between May to September 2016. The height and weight were measured and the body mass index (BMI), body fat percentage (BFP), and body surface area (BSA) were calculated. A logistic regression model was used to estimate age-, sex-, and study site-adjusted odds ratios (ORs) and confidence intervals (CIs) for each of the anthropometric measurements with respect to the risk of thyroid nodules. Results The final analyses included 9,096 participants, among whom 3,614 (39.7%) had thyroid nodules and 365 (4.0%) had thyroid nodules with a high-suspicion sonographic pattern. An increased risk of any thyroid nodules was associated with greater height, weight, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 1.33 (95% CI: 1.09-1.62) in women and 1.89 (95% CI: 1.35-2.65) in men. An increased risk of thyroid nodules with a high-suspicion sonographic pattern was associated with greater weight, BMI, BFP, and BSA in both men and women. Compared with the lowest quartile of BFP, the ORs for the highest quartile were 2.19 (95% CI: 1.32-3.64) in women and 3.10 (95% CI: 1.31-7.36) in men. Conclusions Our results demonstrated that BFP was the most pronounced anthropometric factor associated with an increased risk of any thyroid nodules and thyroid nodules with a high-suspicion sonographic pattern.
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Affiliation(s)
- Xingjian Lai
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Bo Zhang
- Department of Ultrasound, China-Japan Friendship Hospital, Beijing 100029, China
| | - Yong Wang
- Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Yuxin Jiang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Jianchu Li
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Luying Gao
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
| | - Ying Wang
- Department of Ultrasound, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing 100730, China
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de Siqueira RA, Rodrigues APDS, Miamae LM, Tomimori EK, Silveira EA. Thyroid Nodules in Severely Obese Patients: Frequency and Risk of Malignancy on Ultrasonography. Endocr Res 2020; 45:9-16. [PMID: 31256691 DOI: 10.1080/07435800.2019.1625056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: We aimed to compare the thyroid ultrasonographic findings of severely obese versus nonobese individuals, and the frequency, characteristics, and risk of malignancy in detected nodules.Design: Case-control study including 67 adults with severe obesity (body mass index [BMI] ≥ 35 kg/m2) and 67 nonobese controls (BMI < 30 kg/m2). The participants underwent ultrasound evaluation of the thyroid and cervical subcutaneous tissue. The risk of malignancy in detected nodules was determined using the American Thyroid Association (ATA) 2015 and the Thyroid Imaging Reporting and Data System (TI-RADS) classifications. Fine-needle aspiration biopsy (FNAB) was performed in nodules for which the procedure was recommended according to the ATA-2015 or TI-RADS criteria, and the cytological evaluation followed the Bethesda classification.Results: The mean BMI values in the case and control groups were 47.0 ± 6.1 kg/m2 and 22.8 ± 2.7 kg/m2, respectively. There were no differences between groups regarding sex, age, total T3, and antiperoxidase (antiTPO) antibody positivity. When compared with controls, severely obese individuals showed a greater frequency of parenchymal hypoechogenicity (p = 0.042), cervical subcutaneous tissue thickness (p < 0.001), overall frequency of thyroid nodules (p = 0.038), and frequency of multiple nodules (p = 0.013). No significant differences were observed in terms of risk of nodular malignancy according to both the ATA-2015 and TI-RADS classifications in severely obese compared with nonobese individuals.Conclusions: Severely obese individuals (versus nonobese controls) presented increased parenchymal hypoechogenicity and frequency of thyroid nodules on ultrasonographic evaluation. However, no significant differences were observed in terms of risk of nodular malignancy between both groups according to the ATA-2015 and TI-RADS criteria. Thus, ultrasonographic thyroid screening of severely obese individuals is not justified.
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Affiliation(s)
- Raquel Andrade de Siqueira
- Health Science postgraduate program, Medical School, Universidade Federal de Goiás, Goiânia, Brazil
- Endocrinology Unit, Thyroid Department, Goiânia General Hospital, Goiânia, Brazil
| | | | - Lucas Massao Miamae
- Department of Radiology at Clinical Hospital, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Erika Aparecida Silveira
- Health Science postgraduate program, Medical School, Universidade Federal de Goiás, Goiânia, Brazil
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He Q, Sun H, Li F, Liang N. Obesity and risk of differentiated thyroid cancer: A large-scale case-control study. Clin Endocrinol (Oxf) 2019; 91:869-878. [PMID: 31479527 DOI: 10.1111/cen.14091] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/11/2019] [Accepted: 08/12/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Recently, the incidence of thyroid cancer as well as obesity has dramatically increased worldwide. Whether obesity contributes to the development of differentiated thyroid cancer (DTC) remains controversial. We evaluated the relationship between anthropometric measurements and DTC risk. DESIGN/PATIENTS/MEASUREMENTS A large frequency-matched case-control study based on hospital data was performed. A total of 10 668 DTC patients and 11 858 controls were enrolled. Body mass index (BMI), body surface area (BSA) and body fat percentage (BF%) were calculated. An unconditional logistic regression model was applied. RESULTS The univariate analysis showed a significant increase in DTC risk with increased height, weight, BMI, BSA and BF%. The multivariate analysis also showed a positive relationship. Based on the Chinese BMI (CN-BMI) classification, for women of all ages, the ORs for DTC risk in overweight and obesity were 1.151 (1.037-1277) and 1.292 (1.092-1.528), respectively. For men under 50, the ORs were 1.221 (1.014-1.469) and 1.520 (1.202-1.923), respectively, but the ORs for men over 50 were not significant. Additionally, BSA showed a significant association with DTC risk for both sexes under 50 (P = .02 and P < .001). BF% remained significant only for women under 50 (P = .003). However, for both sexes over 50, neither BSA nor BF% was significantly associated with DTC risk. Based on The World Health Organization BMI (WHO-BMI) classification, for all women and men over 50, the results were consistent with CN-BMI. For men under 50, BF%, but not BMI, showed a significant association with DTC risk. CONCLUSION BMI, BSA and BF% were positively correlated with the risk of DTC, which was potentially affected by age and sex.
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Affiliation(s)
- Qiao He
- Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, China
| | - Hui Sun
- Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, China
| | - Fang Li
- Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, China
| | - Nan Liang
- Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun, China
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Yang HX, Zhong Y, Lv WH, Zhang F, Yu H. Association of adiposity with thyroid nodules: a cross-sectional study of a healthy population in Beijing, China. BMC Endocr Disord 2019; 19:102. [PMID: 31619235 PMCID: PMC6794777 DOI: 10.1186/s12902-019-0430-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 09/16/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND The relationship between thyroid nodules (TNs) and adiposity is controversial. This paper describes a cross-sectional investigation performed to determine the existence of any such relationship. To assess adiposity, body mass index (BMI) and visceral fat area (VFA) were utilized. METHODS Between January 1, 2017 and March 3, 2019. Three thousand five hundred thirty four healthy people were examined using thyroid ultrasonography, visceral fat and anthropometric measurements, laboratory tests and questionnaire interview. Binary logistic regression analyses were used. RESULTS Of the 3534 healthy subjects, 58.69% (2074/3534) of the subjects had TNs. A total of 55.91% (1976/3534) had BMI ≥ 25 kg/m2 and 39.67% (1402/3534) had VFA ≥ 100 cm2. After adjustment to address confounders, BMI-based overweight and obesity levels only correlated with higher risk TNs when used as a continuous variable (OR = 1.031, 95% CI: 1.008-1.055, P = 0.008), while VFA was both a continuous variable (OR = 1.003, 95% CI: 1.000-1.005, P = 0.034) and a categorical variable (OR = 1.198, 95% CI: 1.014-1.417, P = 0.034) associated with significantly elevated risk of TNs. Analyzing the subgroups, BMI ≥ 25 kg/m2 (OR = 1.500, 95% CI: 1.110-2.026, P = 0.008) was significantly correlated with TN risk in individuals with TG ≥ 1.7 mmol/L. VFA ≥ 100 cm2 correlated with the TN risk irrespective of age (< 50 years: OR = 1.374, 95% CI: 1.109-1.703, P = 0.004; ≥ 50 years: OR = 1.367, 95% CI: 1.063-1.759, P = 0.015) and in the following subgroups: women (OR = 4.575, 95% CI: 2.558-8.181, P = 0.000), FBG ≥ 6.1 mmol/L (OR = 1.522, 95% CI: 1.048-2.209, P = 0.027), and TG ≥ 1.7 mmol/L (OR = 1.414, 95% CI: 1.088-1.838, P = 0.010). CONCLUSIONS Adiposity correlates with TNs. To assess TN risk in Chinese individuals, VFA is better than BMI.
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Affiliation(s)
- Hui-xia Yang
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Yu Zhong
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Wei-hua Lv
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Feng Zhang
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
| | - Hong Yu
- Beijing Rehabilitation Hospital, Capital Medical University, Xixiazhuang, Badachu, Shijingshan District, Beijing, 100144 China
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Guo W, Tan L, Chen W, Fan L, Chen Y, Du C, Zhu M, Wei H, Wang W, Gao M, Cui T, Shen J, Zhang W. Relationship between metabolic syndrome and thyroid nodules and thyroid volume in an adult population. Endocrine 2019; 65:357-364. [PMID: 30919285 DOI: 10.1007/s12020-019-01901-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/12/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE The effects of metabolic syndrome (MetS) on thyroid nodules (TN) and thyroid volume (TV), especially the related gender and age disparities, are controversial. In this study, we aimed to assess the relationships between MetS and TN and TV in an adult population. METHODS This cross-sectional study was performed in an adult population in Tianjin. A total of 2606 subjects were enrolled. TV and TN were measured by thyroid ultrasonography. Blood samples were collected to measure biochemical and metabolic parameters. RESULTS The prevalence of TN was significantly higher in the MetS (+) group than in the MetS (-) group (P < 0.0001). MetS was independently associated with increased TN risk (OR: 1.24, 95% CI: 1.01-1.51). When stratified by gender, MetS was associated with higher prevalence of TN in males (OR: 1.38, 95% CI: 1.05-1.81) compared with females (OR: 1.02, 95% CI: 0.75-1.39). However, the interaction effect of gender and MetS on TN was not statistically significant (P for interaction = 0.94). MetS was associated with the greater risks of TN in both the <60-year-old group (OR: 1.32, 95% CI: 1.05-1.68) and the ≥60-year-old group (OR: 1.84, 95% CI: 1.24-2.73), while the OR value was significantly higher in the elderly group (P for interaction = 0.03). Additionally, TV was significantly higher in subjects with TN (β = 1.94, P < 0.0001) and MetS (β = 0.94, P = 0.0037). CONCLUSIONS This study suggested positive relationships between MetS and an increased risk of TN and enlarged TV. Elderly people (≥60 years old) with MetS were associated with a higher risk of TN than younger people (<60 years old). The effect of MetS on TN was not significantly affected by gender.
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Affiliation(s)
- Wenxing Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Long Tan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wen Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Lili Fan
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yanting Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Cong Du
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Mei Zhu
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Hongyan Wei
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Min Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tingkai Cui
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Shen
- Department of Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wanqi Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Tianjin Medical University, Tianjin, China.
- Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.
- Tianjin Center for International Collaborative Research in Environment, Nutrition and Public Health, Tianjin, China.
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Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration. Eur Arch Otorhinolaryngol 2019; 276:2559-2564. [PMID: 31250085 DOI: 10.1007/s00405-019-05523-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/15/2019] [Indexed: 12/25/2022]
Abstract
PURPOSE As the lack of consensus in the initial levothyroxine (LT4) dose titration following total thyroidectomy exists, the aim of this study was to identify and quantify predictive factors for LT4 dose replacement. METHODS A retrospective analysis of a prospectively gathered data of 234 patients who underwent total-thyroidectomy at two institutions between November 9, 2009 and January 1, 2016 was conducted. Outcome variable was the clinically observed optimal LT4 dose. Linear and polynomial regression methods were used for prediction. Continuous variables were tested for mean differences using Student's t-test and association using Pearson's correlation. RESULTS We identified Body Surface Area (BSA) as the most significant predictor. We propose a model that titrates LT4 dose based on BSA (1.4 µg /kg/day for BSA > 1.79 m2 vs. 1.7 µg /kg/day for BSA ≤ 1.79 m2; P = 0.00). Men required higher doses than women and no differences were noted based on DM status or pathological diagnosis. CONCLUSIONS Our analysis shows BSA as an independent predictor of LT4 dose post total thyroidectomy. Despite the possibility of generating different equations for predicting LT4 post total-thyroidectomy, finding a practical and clinically relevant prediction model is yet of limited efficiency.
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Li L, Ying Y, Zhang C, Wang W, Li Y, Feng Y, Liang J, Song H, Wang Y. Bisphenol A exposure and risk of thyroid nodules in Chinese women: A case-control study. ENVIRONMENT INTERNATIONAL 2019; 126:321-328. [PMID: 30825751 DOI: 10.1016/j.envint.2019.02.026] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/27/2019] [Accepted: 02/10/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Thyroid nodules (TNs) are highly prevalent worldwide and have a pattern of female predominance. Bisphenol A (BPA) is an endocrine disruptor that can lead to adverse effects in human health. However, epidemiologic studies revealing the association between BPA exposure and TNs are limited and the results are inconsistent. We aimed to examine the association between urinary BPA and TNs in women who are more susceptible to TNs. METHODS We conducted a case-control study with 1416 women aged 18 years or older (705 cases, 711 controls). All participants underwent thyroid ultrasonography. Urinary total BPA (free and conjugated) concentration was quantified using the HPLC-MS/MS. We analyzed the association between urinary BPA concentration and the risk of TNs using crude and multivariable logistic regression models. Participants were further stratified into thyroid autoantibody positive group (at least one positive) and thyroid autoantibody negative group (both negative) according to the thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) levels, and restricted cubic spline regression was also applied to determine the possible nonlinear relationship between urinary BPA and TNs. RESULTS Compared with women in the first quartile, the odds of TNs was 72% (adjusted OR = 1.72, 95% CI: 1.25 to 2.35) higher for those in the second quartile, 54% (adjusted OR = 1.54, 95% CI: 1.12 to 2.12) higher for those in the third quartile, and 108% (adjusted OR = 2.08, 95% CI: 1.50 to 2.90) higher for those in the fourth quartile after adjusting for age, BMI, education, HDL-C, LDL-C, triglyceride, total cholesterol, urinary iodine, TGAb and TPOAb. When the study population was stratified into thyroid autoantibody positive group and thyroid autoantibody negative group, we found that only in the positive group, the association was significant in model 1 (crude OR = 2.80; 95% CI = 1.90 to 4.12), model 2 (adjusted OR = 2.84; 95% CI = 1.91 to 4.22), model 3 (adjusted OR = 4.01; 95% CI = 2.57 to 6.27) and model 4 (adjusted OR = 3.71; 95% CI = 2.36 to 5.83). Multivariable-adjusted restricted cubic spline analysis demonstrated a similar result that in the thyroid autoantibody positive group, the association between urinary BPA and TNs risk was near linear (P-overall <0.001; P-non-linear = 0.054). CONCLUSION In Chinese women, higher urinary BPA concentration was associated with increased risk of TNs only in those with positive thyroid autoantibodies. Moreover, this association was near linear, indicating that any rise in BPA exposure was associated with elevated TNs risk.
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Affiliation(s)
- Lu Li
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Yingxia Ying
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Changrun Zhang
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China
| | - Wei Wang
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Yan Li
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Yan Feng
- School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China
| | - Jun Liang
- Department of Endocrinology, the Central Hospital of Xuzhou, Affiliated Hospital of Southeast University, Xuzhou 221009, Jiangsu Province, China
| | - Huaidong Song
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China.
| | - Yan Wang
- The Core Laboratory in Medical Center of Clinical Research, Department of Endocrinology, Shanghai Ninth People's Hospital, State Key Laboratory of Medical Genomics, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200011, China; School of Public Health, Shanghai Jiao Tong University (SJTU) School of Medicine, Shanghai 200025, China.
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Liu J, Wang C, Tang X, Fu S, Jing G, Ma L, Sun W, Li Y, Wu D, Niu Y, Niu Q, Guo H, Song P. Correlation analysis of metabolic syndrome and its components with thyroid nodules. Diabetes Metab Syndr Obes 2019; 12:1617-1623. [PMID: 31564932 PMCID: PMC6724178 DOI: 10.2147/dmso.s219019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/12/2019] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE This study aimed to analyze the relationship between the metabolic syndrome (MetS) and its components with the occurrence of thyroid nodules. METHODS A total of 2719 volunteers from some areas of Gansu Province, China, who participated in the national survey of thyroid diseases and iodine nutrition status (Tide) and diabetes prevalence, were selected. Their height, weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure were recorded. The fasting plasma glucose (FPG), 2-h plasma postprandial glucose (2hPG), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glycosylated hemoglobin (HbA1C) levels were measured. The prevalence of MetS and thyroid nodules was evaluated, and the correlation between each component of MetS and thyroid nodules was studied. RESULTS The prevalence of MetS and thyroid nodules was 15.4% and 17.2%, respectively. WC, SBP, body mass index, FPG, 2hPG, TG, TC, and thyroid-stimulating hormone levels were significantly higher in the thyroid nodule group. The prevalence of thyroid nodules was significantly higher in the MetS group. A positive correlation was found between the degree of metabolic disorder and the occurrence of thyroid nodules. WC was found to be a risk factor for the occurrence of thyroid nodules. For WC≥90 cm, an increase in the independent variables led to a significant rise in the incidence of thyroid nodules. CONCLUSION The prevalence of thyroid nodules was higher in the MetS group. The WC of the MetS components might be an independent risk factor for the occurrence of thyroid nodules.
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Affiliation(s)
- Jingfang Liu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
- Correspondence: Jingfang Liu; Xulei Tang Department of Endocrinology, The First Hospital of Lanzhou University, 1 Donggang West Road, Lanzhou, Gansu730000, People’s Republic of ChinaTel +86 0 931 835 6470Email
| | - Chenge Wang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Xulei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Songbo Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Gaojing Jing
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Lihua Ma
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Weiming Sun
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Yujuan Li
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Dan Wu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Ying Niu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Qianglong Niu
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Huiping Guo
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
| | - Pei Song
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu730000, People’s Republic of China
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Yao Y, Chen X, Wu S, Guo L, Zhang H, Zhu Q, Tang J, Luan F, Zhao Y, Lv F, He Y. Thyroid nodules in centenarians: prevalence and relationship to lifestyle characteristics and dietary habits. Clin Interv Aging 2018; 13:515-522. [PMID: 29662307 PMCID: PMC5892957 DOI: 10.2147/cia.s162425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Thyroid nodules (TNs) are common thyroid lesions in older population. Few studies have focused on the prevalence of TNs and their relationship to lifestyle characteristics and dietary habits in centenarians. The current study aimed at determining the prevalence of TNs in Chinese centenarians by using high-resolution ultrasound (US) equipment and at investigating its relationship to lifestyle characteristics and dietary habits. Participants and methods The current study was part of the China Hainan Centenarian Cohort Study that was conducted in Hainan, an iodine-sufficient region in People’s Republic of China. A total of 874 permanent residents aged ≥100 years (mean age =102.8±2.8 years) without any missing data were included in the analysis. Results Among the participants, 649 of them were detected at least one TN under the US examinations. The overall prevalence rate of TNs was 74.3%. The prevalence of TNs was higher in participants who were women, had hypertension, had diabetes, and were underweight compared with their counterparts. Multivariate logistic regression analyses showed that being female, hypertensive, and diabetic; betel quid consumption; and red meat consumption were independent risk factors, while being underweight and nut consumption were independent protective factors for TNs. Conclusion Our findings indicate that the presence of TNs was highly prevalent in Chinese centenarians, particularly in women. In addition to gender, having hypertension, having diabetes, and being underweight, the presence of TNs was independently associated with betel quid, red meat, and nut consumption. Further prospective studies are warranted to verify these associations in populations from different age strata, races, cultures, and iodine supplementation.
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Affiliation(s)
- Yao Yao
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xianghui Chen
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Shengzheng Wu
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Liang Guo
- Department of Ultrasonography, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Hao Zhang
- Department of Health Policy and Management, Texas A&M University, College Station, TX, USA
| | - Qiao Zhu
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Jie Tang
- Department of Ultrasonography, Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Fuxin Luan
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Yali Zhao
- Central Laboratory, Hainan Branch of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Faqin Lv
- Department of Ultrasonography, Hainan Branch of PLA General Hospital, Sanya, People's Republic of China
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatric Disease, Chinese PLA General Hospital, Beijing, People's Republic of China
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Song B, Zuo Z, Tan J, Guo J, Teng W, Lu Y, Liu C. Association of thyroid nodules with adiposity: a community-based cross-sectional study in China. BMC Endocr Disord 2018; 18:3. [PMID: 29374470 PMCID: PMC5787304 DOI: 10.1186/s12902-018-0232-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 01/19/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The association between thyroid nodules and adiposity remains controversial. We performed a cross-sectional, community-based study to examine whether thyroid nodules are associated with overweight and obesity, as defined with body mass index (BMI) and waist circumference. METHODS The study included 1482 subjects (≥20 years of age; residing in Nanjing, China) receiving questionnaire interview, anthropometric measurements, laboratory tests and thyroid ultrasonography in 2009-2010. Overweight and obesity were defined as BMI ≥24 and ≥28 kg/m2, respectively. Central obesity was defined as waist circumference at ≥90 cm in men and ≥80 cm in women. A sensitivity analysis was conducted using the American Diabetes Association (ADA) criteria for overweight and obesity (BMI ≥ 23 and ≥25 kg/m2). RESULTS Thyroid nodules were identified in 12.6% of the subjects. A greater proportion of the subjects with thyroid nodules had a BMI at ≥24 kg/m2 (51.9% vs. 40.5% in those without thyroid nodules, P = 0.003) and central obesity (43.3% vs. 24.2%, P < 0.001). After adjustment for other confounders, central obesity was still associated with significantly elevated risk of thyroid nodules (OR 1.62, 95%CI 1.14-2.28), whereas obesity/overweight based on BMI was not in both the main analysis and sensitivity analysis with the alternative criteria. In the subgroup analysis, BMI ≥24 kg/m2 (OR 1.61, 95%CI 1.01-2.54), as well as BMI ≥25 kg/m2 (OR 1.95, 95%CI 1.14-3.34), was significantly associated with higher risk of thyroid nodules among women. Using the ADA criteria, overweight and obesity were associated with thyroid nodules (OR 5.59, 95%CI 1.39-22.51 and 5.15, 95%CI 1.30-20.37) in thyroid-stimulating hormone (TSH) > 4.2 mIU/L subgroup. Central obesity correlated with higher risk of thyroid nodules regardless of age (< 50 years: OR 1.87, 95%CI 1.05-3.32: ≥50 years: OR 1.54, 95%CI 1.00-2.37) and in the following subgroups: men (OR 1.91, 95%CI 1.14-3.20), TSH > 4.2 mIU/L (OR 3.05, 95%CI 1.01-9.22), and urine iodine ≥200 µg/L (OR 1.79, 95%CI 1.14-2.81). CONCLUSION Waist circumference is superior to BMI for assessing risk of thyroid nodules in Chinese subjects.
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Affiliation(s)
- Bin Song
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
- Department of Endocrinology, Clinical Medical College, Yangzhou University, 98 Nantong West Road, Yangzhou, 225001 China
| | - Zhihua Zuo
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
| | - Juan Tan
- Department of Gerontology, Huai’an First People’s Hospital, Nanjing Medical University, 6 Beijing West Road, Huai’an, 223300 China
| | - Jianjin Guo
- Department of Endocrinology, Second Hospital of Shanxi Medical University, 382 Wuyi Road, Taiyuan, 030001 China
| | - Weiping Teng
- Department of Endocrinology and Metabolism, The First Hospital of China Medical University, 155 Nanjing Road, Shenyang, 110001 China
| | - Yibing Lu
- Department of Endocrinology, The Second Affiliated Hospital of Nanjing Medical University, 125 Jiangjiayuan Road, Nanjing, 211166 China
| | - Chao Liu
- Endocrine and Diabetes Center, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, 8 Huadian East Road, Nanjing, 210028 China
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Chen Y, Zhu C, Chen Y, Wang N, Li Q, Han B, Zhao L, Chen C, Zhai H, Lu Y. The Association of Thyroid Nodules with Metabolic Status: A Cross-Sectional SPECT-China Study. Int J Endocrinol 2018; 2018:6853617. [PMID: 29721016 PMCID: PMC5867611 DOI: 10.1155/2018/6853617] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/08/2018] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to investigate the association of thyroid nodules (TNs) and their ultrasound (US) characteristics related to malignancy with metabolic status. METHODS The data were obtained from a cross-sectional study (SPECT-China, 2014-2015). The study included 9898 participants older than 18 years. Participants underwent several checkups, which included the measurement of anthropometric parameters, blood pressure, TSH levels, glucose, and lipid profiles. TN and nonalcoholic fatty liver disease (NAFLD) were diagnosed by US. TN US characteristics, including microcalcification and a taller-than-wide shape, were recorded. RESULTS Participants with TN [TN(+)] had a higher prevalence of metabolic syndrome (Met-S), obesity, central obesity, hyperlipidaemia, diabetes, hypertension, and NAFLD, especially women (all P ≤ 0.001). After full adjustment, logistic regression analysis indicated that metabolic syndrome, obesity, central obesity, and hyperlipidaemia were all independent risk factors for the increased prevalence of TN in both genders (P < 0.05). In terms of TN US imaging characteristics associated with malignancy, being female with obesity, central obesity, and NAFLD had 1.91-fold, 2.09-fold, and 1.75-fold increased risks of developing a taller-than-wide nodule (P = 0.014, 0.004, and 0.027, resp.). CONCLUSIONS The status of metabolic disorders might be associated with higher risks of TN in both genders. In women, obesity, central obesity, and NAFLD might contribute to the development of a taller-than-wide nodule. The potential role of metabolic status in the pathogenesis of the thyroid nodule and thyroid cancer remains to be elucidated.
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Affiliation(s)
- Yi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunfang Zhu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Li
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Han
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhao
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Chen
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Wang N, Fang H, Fu C, Huang P, Su M, Jiang F, Zhao Q, Chen Y, Jiang Q. Associations of adiposity measurements with thyroid nodules in Chinese children living in iodine-sufficient areas: an observational study. BMJ Open 2017; 7:e016706. [PMID: 29084792 PMCID: PMC5665290 DOI: 10.1136/bmjopen-2017-016706] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Obesity has been found to be associated with an elevated risk of thyroid nodule(s), mainly in adults; however, evidence for this association in children was limited. The objective of this study was to investigate the association of adiposity and thyroid nodule(s) in children living in iodine-sufficiency areas. SETTING AND PARTICIPANTS We conducted a cross-sectional study of 1403 Chinese children living in the East Coast of China in 2014. OUTCOME MEASURES Anthropometric measures including height, weight and waist and hip circumferences were taken, and body mass index (BMI), body surface area (BSA) and waist-hip ratio (WHR) were then calculated. Thyroid ultrasonography was performed to assess thyroid volume and nodules. RESULTS Based on BMI, 255 (18.17%) children were overweight and 174 (12.40%) were obese. Thyroid nodule(s) was detected in 18.46% of all participants and showed little age and sex variations. As compared with normal-weight children, obese children experienced significantly higher risks for solitary (OR 2.07 (95% CI 1.16 to 3.71)) and multiple (OR 1.67 (95% CI 1.03 to 2.70)) thyroid nodules. Similar associations with thyroid nodule(s) were observed with adiposity measured by waist circumference and BSA, but not WHR. There were no notable differences in the associations between children consuming iodised and non-iodised salt. CONCLUSIONS These findings provide further evidence that childhood obesity is associated with the risk for thyroid nodule(s).
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Affiliation(s)
- Na Wang
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Hong Fang
- Department of Chronic Disease Control and Prevention, Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Chaowei Fu
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Peixin Huang
- Department of Chronic Disease Control and Prevention, Haimen City Center for Disease Control and Prevention, Haimen, China
| | - Meifang Su
- Department of Chronic Disease Control and Prevention, Yuhuan County Center of Disease Control and Prevention, Taizhou, China
| | - Feng Jiang
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yue Chen
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Qingwu Jiang
- Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
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Chen Y, Chen Y, Wang N, Chen C, Nie X, Li Q, Han B, Xia F, Zhai H, Jiang B, Shen Z, Lu Y. Are thyroid nodules associated with sex-related hormones? A cross-sectional SPECT-China study. BMJ Open 2017; 7:e015812. [PMID: 28775186 PMCID: PMC5629675 DOI: 10.1136/bmjopen-2016-015812] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Little is known about the association between thyroid nodules (TNs) and endogenous sex hormones. We aimed to investigate the relationship between TNs and sex-related hormones among men in China. SETTING The data were obtained from a cross-sectional study Survey on Prevalence in East China for Metabolic Diseases and Risk Factors (SPECT-China study, 2014-2015) based on the population. PARTICIPANTS In total, 4024 men over 18 years of age who were not using hormone replacement therapy and who underwent complete assays of the serum total testosterone (T), oestradiol (E2), follicle-stimulating hormone (FSH), luteinising hormone (LH) and sex hormone-binding globulin (SHBG) levels as well as thyroid ultrasonography (US) enrolled in this study. RESULTS Of the 4024 participants (54.15±13.08 years old), 1667 participants (41.4%) had TNs. Men with TN(s) (TN(+) group) had significantly lower levels of total T and SHBG and higher E2/T levels compared with the men without TN(s) (TN(-) group) (p<0.05). The TN prevalence decreased with the quartiles of the SHBG level (p<0.05). Binary logistic analysis showed that lower quartiles of SHBG had a greater risk of TN(s) (all p for trend <0.05). This association persisted in the fully adjusted model (p for trend=0.017), in which, for the lowest compared with the highest quartile of SHBG, the OR of TN(s) was 1.42 (95% CI 1.07 to 1.89). No statistically significant association was found between sex-related hormones and US characteristics associated with malignancy (nodule >10 mm, microcalcification and a 'taller' than 'wider' shape). CONCLUSIONS TNs are highly prevalent in men in China. A lower SHBG level was significantly associated with TN among men. The potential role of SHBG in the pathogenesis of the TN remains to be elucidated.
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Affiliation(s)
- Yi Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Yingchao Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Chi Chen
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Xiaomin Nie
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qin Li
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Bing Han
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Fangzhen Xia
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Hualing Zhai
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Boren Jiang
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Zhoujun Shen
- Department of Urology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingli Lu
- Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Panagiotou G, Komninou D, Anagnostis P, Linardos G, Karoglou E, Somali M, Duntas L, Kita M, Tziomalos K, Pazaitou-Panayiotou K. Association between lifestyle and anthropometric parameters and thyroid nodule features. Endocrine 2017; 56:560-567. [PMID: 28390011 DOI: 10.1007/s12020-017-1285-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/20/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Thyroid nodularity has been associated with obesity, but data regarding associations of body composition parameters with specific ultrasound features of thyroid nodules are lacking. The aim of the present study was to assess associations between thyroid nodule ultrasound characteristics, lifestyle, and anthropometric parameters. SUBJECTS AND METHODS This was a cross-sectional study in the general apparently healthy population of Northern Greece. Thyroid ultrasound data together with medical history, demographic, and anthropometric characteristics were individually recorded. Body composition was evaluated using bioelectrical impedance. RESULTS Three hundred and six subjects [215 females (70.3%), aged 20-83 years] were included. Ultrasound revealed one or more thyroid nodules in 168 subjects (54.9%). Subjects with thyroid nodules were more frequently females (p = 0.033), older (p < 0.001) and had higher fat mass (p = 0.011), total body fat percentage (p < 0.001) and waist circumference (p = 0.045) than subjects without nodules. In logistic regression analyses, age and female gender were the only independent predictors of presence of thyroid nodules, as well as specific sonographic features. Additionally, total body fat percentage was positively correlated with nodule size (rho = 0.210, p = 0.006) and was the only independent predictor of hypoechoic thyroid nodule(s) and peripheral vascularity, while lack of exercise was predictive of internal vascularity. CONCLUSIONS Body fat accumulation and lack of exercise, used as surrogate markers of sedentary lifestyle, influence thyroid nodule size and could predict some ultrasonographic characteristics, like hypoechoicity and internal vascularity. Therefore, routine thyroid examination of obese patients and promotion of active lifestyle may be warranted to prevent thyroid nodule formation and possibly progression to malignancy.
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Affiliation(s)
- Grigorios Panagiotou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Despina Komninou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | | | - George Linardos
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Eleni Karoglou
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Maria Somali
- Department of Endocrinology, Hippokration General Hospital, Thessaloniki, Greece
| | - Leonidas Duntas
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
| | - Marina Kita
- Department of Endocrinology, Hippokration General Hospital, Thessaloniki, Greece
| | - Konstantinos Tziomalos
- Department of Endocrinology-Endocrine Oncology, Theagenio Cancer Hospital, Thessaloniki, Greece
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Gender Disparity in the Relationship between Prevalence of Thyroid Nodules and Metabolic Syndrome Components: The SHDC-CDPC Community-Based Study. Mediators Inflamm 2017; 2017:8481049. [PMID: 28607535 PMCID: PMC5457761 DOI: 10.1155/2017/8481049] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 02/20/2017] [Indexed: 12/31/2022] Open
Abstract
The study is aimed to investigate the pathogenesis underlying the increased prevalence of thyroid nodule (TN) in different levels of metabolic syndrome (MetS) components and analyze the relationships between TN and MetS components. A total of 6,798 subjects, including 2201 patients with TN, were enrolled in this study. Anthropometric, biochemical, thyroid ultrasonographic, and other metabolic parameters were all measured. There was obviously sexual difference in the prevalence of TN (males 26.0%, females 38.5%, resp.). The prevalence of TN in hyperuricemia (45.7% versus 37.4%, P = 0.001), NAFLD (41.2% versus 36.4%, P < 0.05), and MetS (41.4% versus 35.4%, P < 0.001) groups was significantly increased only in females. Insulin resistance [OR = 1.31 (1.15, 1.49)], MetS [OR = 1.18 (1.03, 1.35)], and diabetes [OR = 1.25 (1.06, 1.48)] were all independent risk factors for TN in total subjects, whereas, after stratified analysis of gender, MetS [OR = 1.29, (1.09, 1.53)] and diabetes [OR = 1.47, (1.17, 1.84)] are still strongly and independently associated with the higher risks of TN in female subjects, but not in males. Our results suggest that the components of MetS might associate with the higher risks of TN in women than in men, but further cohort study of this gender disparity in the association between TN and MetS is required.
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Li C, Zhan W, Yi F, Zheng B, Zhou Y, Zhao R, Jia Y. Fine needle aspiration cytology guided by ultrasound in the diagnosis of subcentimetre thyroid nodules. SPRINGERPLUS 2016; 5:876. [PMID: 27386325 PMCID: PMC4920789 DOI: 10.1186/s40064-016-2555-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/09/2016] [Indexed: 12/31/2022]
Abstract
Background This study aimed to investigate the value of fine needle aspiration biopsy (FNAB) under ultrasound guidance in diagnosis of thyroid nodules. In a retrospective analysis of FNAB in 1050 cases of patients with 1100 nodules, patients were divided according to the maximum diameter of their nodules into two groups: >1.0 and ≤1.0 cm. The ultrasound-guided FNAB cytology results were compared between two groups. Results Ultrasound findings showed that among 1100 thyroid nodules, 547 were highly suspicious, 358 were moderately, 175 were low, and 19 were very low. Cytology results showed papillary carcinomas in 453, possible papillary cancer in 126 cases, follicular tumors in 26, suspicious follicular tumors in 6, atypical cells in 7, nodular goiter in 289, colloid in 13, chronic lymphocytic thyroiditis in 175, and undiagnosed specimen in 5. Ultrasound diagnosis of thyroid nodules had an overall sensitivity of 86.0 %, and a specificity of 81.9 %. In nodules larger than 1.0 cm, the sensitivity was 92.8 %, and the specificity 92.3 %. In nodules ≤1.0 cm, the sensitivity was 82.4 %, and the specificity was 81.7 %. Conclusions Patients with highly suspicious thyroid nodules on ultrasonography, regardless of nodule sizes, should receive ultrasound-guided FNAB to confirm their natures and direct clinical managements.
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Affiliation(s)
- Cheng Li
- Department of Ultrasound, North Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Weiwei Zhan
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Fang Yi
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bin Zheng
- Department of Ultrasound, North Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yaqin Zhou
- Department of Ultrasound, North Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ran Zhao
- Department of Ultrasound, North Branch of Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yi Jia
- Department of Ultrasound, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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