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Abiri B, Ahmadi AR, Valizadeh A, Abbaspour F, Valizadeh M, Hedayati M. Obesity and thyroid cancer: unraveling the connection through a systematic review and meta-analysis of cohort studies. J Diabetes Metab Disord 2024; 23:461-474. [PMID: 38932807 PMCID: PMC11196530 DOI: 10.1007/s40200-024-01425-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 03/21/2024] [Indexed: 06/28/2024]
Abstract
Background The relationship between adiposity indicators and thyroid cancer (TC) risk has garnered increasing attention due to the rising prevalence of obesity and its potential impact on cancer incidence. We conducted a comprehensive meta-analysis to investigate this association across various effect measures. Method Until July 2022, a comprehensive search of databases was conducted to identify cohort studies that assessed the association between adiposity and the development of TC. Meta-analysis was performed using random effects models. Subgroup analyses were conducted to explore heterogeneity. Publication bias was assessed using Begg's tests. Results A systematic literature search identified 27 eligible studies reporting odds ratios (OR), relative risks (RR), or hazard ratios (HR) as effect measures. Pooling the studies irrespective of the effect measure, a significant positive association between adiposity indicators and TC risk was observed, yielding an effect estimate of 1.16 (95% CI 1.12-1.21). The combined effect estimate for OR/RR studies was 1.10 (95%CI 1.04-1.17), while HR studies yielded an effect estimate of 1.20 (95%CI 1.13-1.26). Subgroup analyses revealed associations across different age groups, obesity indices, and regions, with some variations based on effect measure. Meta-regression identified follow-up duration as a confounding factor only in HR studies. Conclusion The synthesis of 27 studies with diverse designs and populations underscores a robust positive association between adiposity and TC risk, providing compelling evidence for the potential role of increased adiposity in TC development. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-024-01425-3.
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Affiliation(s)
- Behnaz Abiri
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Ali Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Faeze Abbaspour
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Majid Valizadeh
- Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Hedayati
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Li H, Yang M, Yang J, Seery S, Ma C, Liu Y, Zhang X, Li A, Guo H. Per- and polyfluoroalkyl substances and the associated thyroid cancer risk: A case-control study in China. CHEMOSPHERE 2023; 337:139411. [PMID: 37419160 DOI: 10.1016/j.chemosphere.2023.139411] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 06/13/2023] [Accepted: 07/02/2023] [Indexed: 07/09/2023]
Abstract
The role of perfluoroalkyl and polyfluoroalkyl substances (PFAS) as thyroid carcinogens is unclear. Therefore, we intended to identify associations between each PFAS congener and their mixture with thyroid cancer risk. This case-control study of thyroid cancer was conducted in Shijiazhuang, Hebei Province, China. Three hundred participants were recruited from January to May 2022 and were matched according to sex and age. Twelve PFAS were assessed using ultra-high-performance liquid chromatography-tandem mass spectrometry. Associations between PFAS congeners and thyroid cancer risk were considered under conditional logistic regression analysis and a restricted cubic spline model. Mixture effects were also assessed with quantile g-computation and a Bayesian kernel machine regression model. Compared to the first tertile, third tertile PFOA, PFNA, PFHxS, PFDA, and PFUnDA concentrations were associated with lower thyroid cancer risk (ORPFOA: 0.32, 95% confidence interval (CI): 0.15-0.69; ORPFNA: 0.18, 95% CI: 0.07-0.46; ORPFHxS: 0.37, 95% CI: 0.15-0.92; ORPFDA: 0.07, 95% CI: 0.02-0.23; ORPFUnDA: 0.12, 95% CI: 0.05-0.30) after adjusting for confounding factors. PFNA, PFDA, and PFUnDA had a negative dose-response relationship with thyroid cancer risk. Mixture analysis also showed that thyroid cancer risk is negatively associated with the overall mixture and carboxylates. In the overall mixture, PFOS and PFDA contributed most to positive and negative changes in thyroid cancer risk, respectively. However, PFOS, PFNA, PFDA, and PFUnDA were of equally high importance. This study is the first to confirm the effects of the PFAS mixture on thyroid cancer, and further large-scale prospective studies are still warranted to test these inverse associations.
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Affiliation(s)
- Haoran Li
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China; Department of Pharmacy, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, PR China
| | - Ming Yang
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, PR China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, PR China
| | - Jing Yang
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Samuel Seery
- Faculty of Health and Medicine, Division of Health Research, Lancaster University, Lancaster, LA1 4YW, UK; School of Humanities and Social Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - Chaoying Ma
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Yi Liu
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Hebei Province, Shijiazhuang, 050017, PR China
| | - Xiaoguang Zhang
- Core Facilities and Centers of Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, PR China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, PR China.
| | - Huicai Guo
- Department of Toxicology, School of Public Health, Hebei Medical University, Shijiazhuang, 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Hebei Province, Shijiazhuang, 050017, PR China.
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Abdel-Rahman O, Ghosh S, Morrish D. Impact of baseline body mass index on the outcomes of patients with neuroendocrine neoplasms. J Endocrinol Invest 2022; 45:1683-1688. [PMID: 35606667 DOI: 10.1007/s40618-022-01805-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 04/13/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the impact of baseline body mass index (BMI) on the outcomes of patients with neuroendocrine neoplasms (NENs) in a population-based setting. METHODS Linked provincial administrative databases (within the province of Alberta, Canada), 2004-2019, were accessed, and patients with NENs and complete information about BMI near the time of diagnosis were reviewed. The impact of BMI on overall survival was evaluated through the use of Kaplan-Meier survival estimates and multivariable Cox regression modeling. RESULTS A total of 1010 patients with NENs and BMI information were included. Using Kaplan-Meier survival estimates, survival outcomes were best with individuals with obesity and were worst with underweight individuals (P < 0.0001). The following factors were associated with worse overall survival, older age (HR: 1.02; 95% CI: 1.01-1.03), male sex (HR: 1.60; 95% CI: 1.32-1.93), higher Charlson comorbidity index (HR: 1.22; 95% CI: 1.13-1.31), non-small intestinal primary (HR for gastric primary versus small intestinal primary: 2.36; 95% CI: 1.44-3.85), stage 4 disease (HR: 2.67; 95% CI: 2.16-3.31), neuroendocrine carcinoma histology (HR: 1.76; 95% CI: 1.43-2.17), and underweight BMI (HR versus normal BMI: 1.74; 95% CI: 1.11-2.73). When the model was repeated using BMI as a continuous variable (rather than as a categorical variable), increasing BMI was associated with better overall survival (HR with increasing BMI: 0.97; 95% CI: 0.95-0.98). CONCLUSIONS Lower BMI is associated with worse overall survival among patients with NENs. This finding was demonstrable regardless of the tumor's stage or histology.
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Affiliation(s)
- O Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada.
| | - S Ghosh
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada
- Alberta Health Services- Cancer Care, Cross Cancer Institute, Edmonton, AB, Canada
| | - D Morrish
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada
- Division of Endocrinology, Department of Internal Medicine, University of Alberta, Edmonton, AB, Canada
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Lu P, Ma Y, Kai J, Wang J, Yin Z, Xu H, Li X, Liang X, Wei S, Liang X. A Low Advanced Lung Cancer Inflammation Index Predicts a Poor Prognosis in Patients With Metastatic Non–Small Cell Lung Cancer. Front Mol Biosci 2022; 8:784667. [PMID: 35096967 PMCID: PMC8795874 DOI: 10.3389/fmolb.2021.784667] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/10/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction: Inflammation plays a crucial role in cancers, and the advanced lung cancer inflammation index (ALI) is considered to be a potential factor reflecting systemic inflammation. Objectives: This work aimed to explore the prognostic value of the ALI in metastatic non–small cell lung cancer (NSCLC) and classify patients according to risk and prognosis. Methods: We screened 318 patients who were diagnosed with stage IV NSCLC in Hubei Cancer Hospital from July 2012 to December 2013. The formula for ALI is body mass index (BMI, kg/m2) × serum albumin (Alb, g/dl)/neutrophil–lymphocyte ratio (NLR). Categorical variables were analyzed by the chi-square test or Fisher’s exact test. The overall survival (OS) rates were analyzed by the Kaplan–Meier method and plotted with the R language. A multivariate Cox proportional hazard model was used to analyze the relationship between ALI and OS. Results: According to the optimal cut-off value determined by X-tile software, patients were divided into two groups (the ALI <32.6 and ALI ≥32.6 groups), and the median OS times were 19.23 and 39.97 months, respectively (p < 0.01). A multivariable Cox regression model confirmed that ALI and chemotherapy were independent prognostic factors for OS in patients with NSCLC. OS in the high ALI group was better than that in the low ALI group (HR: 1.39; 95% CI: 1.03–1.89; p = 0.03). Conclusions: Patients with a low ALI tend to have lower OS among those with metastatic NSCLC, and the ALI can serve as an effective prognostic factor for NSCLC patients.
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Affiliation(s)
- Ping Lu
- Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Yifei Ma
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China
| | - Jindan Kai
- Department of Thoracic Surgery, Hubei Cancer Hospital, Wuhan, China
| | - Jun Wang
- Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Zhucheng Yin
- Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Hongli Xu
- Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Xinying Li
- Department of Epidemiology and Biostatistics, The Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, China
| | - Xin Liang
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China
| | - Shaozhong Wei
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Wuhan, China
- *Correspondence: Xinjun Liang, ; Shaozhong Wei,
| | - Xinjun Liang
- Department of Medical Oncology, Hubei Cancer Hospital, Wuhan, China
- *Correspondence: Xinjun Liang, ; Shaozhong Wei,
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Fang T, Lin L, Ou Q, Lin L, Zhang H, Chen K, Quan H, He Y. An Investigation on the Risk Factors of Thyroid Diseases in Community Population in Hainan. Int J Endocrinol 2022; 2022:4514538. [PMID: 35855806 PMCID: PMC9288325 DOI: 10.1155/2022/4514538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In recent years, the incidence of thyroid diseases has increased significantly, which has seriously affected people's work and life. The purpose of this study was to explore the epidemiological characteristics of thyroid diseases and autoantibodies. METHOD According to the principle of overall sampling, resident residents ≥18 years and who will not move within 5 years are randomly selected. A total of 2136 eligible individuals were divided into case and control groups according to whether they have thyroid disease. Finally, the impact of potential risk factors on thyroid diseases was evaluated. RESULTS The overall prevalence of thyroid disease was 58.3%, and there was a significant difference in the prevalence of thyroid disease between women and men (p = 0.004). Except for the age group ≥70 years, with the increase in age, the prevalence gradually increased (p < 0.05). Participants with positive thyroid autoantibodies (TPOAb or TgAb) had a higher prevalence than participants with negative autoantibodies. The positive rate of autoantibodies in women was higher than that in men (p < 0.05). UIC (p = 0.004) and free thyroid hormone (FT4) (p = 0.001) levels of men were higher than those of women, and the TSH level of women was higher than that of men (p = 0.002). The regression analysis showed that women, older age, and family history of thyroid disease were independent risk factors for thyroid disease. CONCLUSION The prevalence of thyroid diseases in Hainan was high. Women are more susceptible to thyroid disease than men, and the prevalence increased with age.
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Affiliation(s)
- Tuanyu Fang
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Qianying Ou
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Lu Lin
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Huachuan Zhang
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yangli He
- Department of Health Care Centre, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
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Abdel-Rahman O. Disparities in modifiable cancer risk factors among Canadian provinces, territories, and health regions. Curr Med Res Opin 2021; 37:1973-1989. [PMID: 34414833 DOI: 10.1080/03007995.2021.1971184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Data about small area estimates of cancer risk factors are difficult to obtain in Canada. The current study aims to provide an assessment of the prevalence of different behavioral risk factors of cancer at the level of Canadian provinces/territories and sub provincial health regions/units. METHODS Canadian Community Health Survey (CCHS) datasets for 2017/2018 were reviewed and adult participants (≥ 18 years old) were included. Baseline demographic data and health behaviors (including ever-smoking, current smoking, alcohol drinking in the past 12 months, below-recommended physical activity, and obesity) were reviewed. Prevalence of each of these behaviors within different provinces/territories as well as within each health region was reviewed. Multivariable logistic regression analysis was then done to examine the association between place of residence and cancer risk factors. RESULTS A total of 104,636 adult participants were included in the current analysis. For ever-smoking, the highest prevalence was noted in Nunavut (79.7%); for current smoking, the highest prevalence was noted in Nunavut (67.2%); for alcohol drinking in the past 12 months, the highest prevalence was noted in Quebec (89.3%); for below-recommended physical activity, the highest prevalence was noted in Nunavut (51.3%); for obesity, the highest prevalence was noted in Northwest territories (31.5%). Compared to individuals living within a territory, individuals living within a province were less likely to ever smoke (OR: 0.62; 95% CI: 0.54-0.71), currently smoke (OR: 0.51; 95% CI: 0.45-0.59), be obese (OR: 0.82; 95% CI: 0.71-0.95), but more likely to drink alcohol in the past 12 months (OR: 1.41; 95% CI: 1.20-1.65). There is no difference between both categories with regards to physical activity (OR: 1.02; 95% CI: 0.89-1.15). CONCLUSIONS There is a general province/territory disparity in the prevalence of different modifiable cancer risk factors as well as disparity between individual provinces/health regions in Canada.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta and Cross Cancer Institute, Edmonton, Canada
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Abstract
PURPOSE OF REVIEW In this review, we evaluate recent findings related to the association between obesity and thyroid cancer. RECENT FINDINGS During the last several decades, the prevalence of obesity and thyroid cancer have been increasing in parallel on a global scale. Current evidence suggests that the growing incidence of differentiated thyroid cancer (DTC) is pathogenically linked to the spread of obesity, but the biological mechanisms that may explain this connection have been only partially described. Furthermore, unlike other tumors, data on the impacts of obesity on the aggressiveness of DTC and response to treatment of DTC remain conflicting. SUMMARY Emergent knowledge regarding the links between obesity and thyroid cancer suggests a relevant role for obesity as a risk factor for DTC, with no apparent impact on its aggressiveness.
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Affiliation(s)
- Antonio Matrone
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Baidoun F, Saad AM, Abdel-Rahman O. New paradigms in the treatment of low-risk thyroid cancer. Expert Rev Endocrinol Metab 2020; 15:251-260. [PMID: 32511023 DOI: 10.1080/17446651.2020.1773802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/21/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Thyroid cancer is the most common endocrine malignancy. Multiple different staging systems have been introduced and used for differentiated thyroid carcinoma (DTC). AREAS COVERED In this literature review we provide an overview of the standard options for management of patients with low risk differentiated thyroid cancer. EXPERT OPINION Surgery is considered the first and most important step in managing DTC with goal to remove all the malignant foci in order to achieve cure and increase the survival with least chance of recurrence. Many studies have been conducted to determine the best surgical approaches and how aggressive surgeries should be in order to achieve the best outcomes regarding efficacy as well as safety. Radioactive iodine (RAI) therapy has also been a part of the treatment regimen and is used for different purposes with three main goals: post-surgical ablation, adjuvant therapy and persisted/recurrent disease treatment. Radiation therapy, on the other hand, is still not recommended to be used routinely in DTC because of the conflicting data of its benefit.
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Affiliation(s)
- Firas Baidoun
- Internal medicine department, Cleveland Clinic Foundation , Cleveland, OH, USA
| | - Anas M Saad
- Internal medicine department, Cleveland Clinic Foundation , Cleveland, OH, USA
| | - Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute , Edmonton, Alberta, Canada
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