Relation between iodine nutrition and thyroid diseases in Qinghai, China

Establishment and validation of a multivariate logistic model for risk factors of thyroid nodules using lasso regression screening

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.

The relationship between subclinical hypothyroidism and invasive papillary thyroid cancer

Background

Subclinical hypothyroidism is the most common thyroid dysfunction. Approximately 10% of patients with thyroid cancer have subclinical hypothyroidism. There is a paucity of real-world studies examining the relationship between subclinical hypothyroidism and known correlates of invasiveness of papillary thyroid carcinoma (PTC).

Materials and methods

A retrospective cohort study of 13,717 patients with PTC was conducted. Odds ratios were calculated to assess the relationship between subclinical hypothyroidism and extrathyroidal extension (ETE) after adjusting for BMI and genders. The Cancer Genome Atlas (TCGA) data were utilized for the analysis of TSHR-associated pathways, while qRT-PCR was employed to validate the expression levels of pivotal genes in the relevant signaling pathways.

Results

In total, 13,717 PTC patients (10,769 women and 2,948 men; mean [SD] age, 42.90 [9.43] years) were included in the retrospective study. Subclinical hypothyroidism was an independent risk factor for ETE (OR adjusted, 1.168 [95% CI, 1.028-1.327]; P=0.017). In normal-weight patients, subclinical hypothyroidism was an independent risk factor for ETE (OR adjusted, 1.287 [95% CI, 1.089-1.520]; P=0.003). However, this risk was not observed in under-weight, overweight, and obese patients. Compared to females, subclinical hypothyroidism was a higher risk factor for ETE in male patients with normal body weight (OR male=2.363 vs. OR female=1.228). Subclinical hypothyroidism was found to be a significant risk factor for ETE in the subgroup of patients younger than 38 years old (OR1 adjusted, 1.382 [95% CI, 1.032-1.852], P=0.030). The findings from Gene Set Enrichment Analysis (GSEA) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis revealed the involvement of the autophagy signaling pathway in TSHR/ETE/EMT regulation. Moreover, the gene expression levels demonstrated a concentration-dependent relationship between TSH intervention levels and the expression of key genes in the autophagy pathway of thyroid cancer cells.

Conclusion

Subclinical hypothyroidism was an independent risk factor for ETE in patients with PTC. This association was particularly significant in normal-weight and younger patients. The risk of ETE associated with subclinical hypothyroidism was higher in males compared to females. Our study indicates a potential involvement of the autophagy pathway in regulating the ETE phenotype in thyroid cancer, specifically in the context of subclinical hypothyroidism.

Serum iodine concentration and its associations with thyroid function and dietary iodine in pregnant women in the southeast coast of China: a cross-sectional study

Background

Iodine deficiency is a major public health problem in pregnant women. Serum iodine (SI) may represent a useful biomarker for iodine nutrition evaluation. We aimed to assess the relationship between serum iodine concentration (SIC) and urinary iodine concentration (UIC), dietary iodine, thyroid function, and thyroid diseases in pregnant women in the southeast coast of China, and to provide a normal reference range of SIC for pregnant women.

Methods

A multistage random sampling method was used to select the study population. We collected urine and blood samples from pregnant women and determined UIC and SIC as well as thyroid function using Arsenic-Cerium Catalytic Spectrophotometry, inductively coupled plasma mass spectrometry, and Beckman Coulter Access2 chemiluminescent immunoanalyzer and kit, respectively, and administered a questionnaire on dietary iodine intake in pregnant women.

Results

There was a significant negative correlation between SI and thyroid-stimulating hormone (TSH) (r = -0.141) and a significant positive correlation between SI and free triiodothyronine (FT3) (r = 0.106), free thyroxine (FT4) (r = 0.236), triiodothyronine (TT3) (r = 0.229), total thyroxine (TT4) (r = 0.433), and dietary iodine intake (r = 0.068). There was a significant difference in SI levels of pregnancy between the second (78.13 μg/L) and third trimester (75.37 μg/L) (p = 0.018). SI levels between inadequate intake (74.58 μg/L) and appropriate intake (77.92 μg/L) groups were statistically different (p = 0.036). Low SIC was a risk factor for the development of hypothyroxinemia (adjusted OR = 3.14, 95% confidence interval: 1.75-5.66). The reference range for SIC in normal pregnant women is 45.03-112.44 μg/L.

Conclusion

SI may be a composite indicator of iodine nutritional status and thyroid function.