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.
Highlights
Thyroid nodule (TN), one of the most common clinical thyroid diseases, has been becoming increasingly prevalent all over the world in the last decades and its associated risk factors have received much attention [1]
The metabolic risk factors such as obesity, insulin resistance, and abnormal glucose metabolism are involved in the pathogenesis of TN in patients and these have been targeted for therapeutic intervention [14, 15], up to now, the metabolic mechanisms facilitating TN in individuals still have not been fully investigated, and there has been scarce literature investigating the different levels of metabolic syndrome (MetS) risk factors in subjects with or without TN
Regardless of gender, analysis of the clinical risk factors revealed that subjects with TN were significantly older and had higher levels of SBP, fasting plasma glucose (FPG), PPG, Hemoglobin A1c Fasting plasma insulin (FINS) (HbA1c), FINS, HOMA-Insulin resistance (IR), HOMA-beta, Free thyroxine thyroid-stimulating hormone (TSH) (FT4), and thyroid peroxidase antibody (TPOAB) than subjects without TN
Summary
Thyroid nodule (TN), one of the most common clinical thyroid diseases, has been becoming increasingly prevalent all over the world in the last decades and its associated risk factors have received much attention [1]. Previous studies have showed that impaired glucose metabolism is an independent risk factor for increased thyroid volume and nodule prevalence [5,6,7]. It has been suggested that metabolic syndrome (MetS) was associated with the functional and morphological alterations of the thyroid gland and may be involved in the pathogenesis of TN [12, 13]. The metabolic risk factors such as obesity, insulin resistance, and abnormal glucose metabolism are involved in the pathogenesis of TN in patients and these have been targeted for therapeutic intervention [14, 15], up to now, the metabolic mechanisms facilitating TN in individuals still have not been fully investigated, and there has been scarce literature investigating the different levels of MetS risk factors in subjects with or without TN. TN are most frequently observed in females and in the elderly [17, 18]; there is very little epidemiological data related to the gender disparity in the relationship between TN and the components of MetS in aged populations
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