Prevalence Of Thyroid Nodules Research Articles

Epidemiology of Thyroid Cancer.

Epidemiology of Thyroid Cancer.

Thyroid nodule ultrasound accuracy in predicting thyroid malignancy based on TIRADS system.

A frequent prevalence of thyroid nodules in patients prioritizes the need for an accurate method that characterizes them as benign or malignant. Fine-needle aspiration biopsy (FNAB) and thyroid ultrasonography (USG) are currently used for this purpose. However, since FNAB is complicated, time-consuming and expensive, thyroid USG, a fast and highly sensitive method, is preferably used. Although USG is reported as a suitable method for characterization of thyroid nodules, there are some contrasting studies available which report its limited use in the differentiation of benign and malignant thyroid nodules. This meta-analysis aims to assess the accuracy of ultrasound in predicting thyroid cancer in terms of sensitivity, specificity and diagnostic odds ratios (ORs) for positive and negative results. Systematic and extensive literature search on the use of ultrasound (US) to predict thyroid cancer was conducted in the databases of Scopus, CINAHL (via EBSCO), MEDLINE (via PubMed), and Web of Science, covering the period from 2010 till 2021. The morphological features of thyroid nodules observed during the USG were analyzed based on Thyroid Imaging Reporting And Data System (TIRADS) guidelines. The accuracy of thyroid US was determined using parameters such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic ORs. Moreover, the respective forest plot and hierarchical summary receiver operating characteristics (HSROC) curve were plotted. A total of 2765 reference studies were examined, and among them, 15 relevant references were selected. The selected studies were heterogeneous and included retrospective and prospective studies. The risk of publication bias is low as the p-value for both Egger's and Begg's tests is >0.05. The overall sensitivity of 92.53% (95% confidence interval (95% CI): [84.55%; 96.33%]), specificity of 33.88% (95% CI: [23.16%; 45.53%]) and diagnostic OR of 12.36 (95% CI: [3.90%; 54.11%]) are achieved. These results were statistically significant with a p-value < 0.001 and are predictive of US accuracy in detecting cancer. The present meta-analysis, on the basis of statistically significant results, demonstrated the high accuracy of thyroid ultrasound in detection of malignant nature of nodules in patients suspected with a worrisome thyroid nodule.

Thyroid nodules and its association with vitamin D in centenarians

Thyroid Nodules (TNs) and hypovitaminosis D are common conditions in old people. Our objective was to determine the prevalence of benign and malignant thyroid nodules in centenarians and to examine their associations with serum vitamin D levels. A population-based survey of 875 centenarians in Hainan, China was conducted. The thyroid glands and neck areas were scanned by board-certified sonographers using standard procedures. The prevalence of thyroid nodules (TN) was 74.2%, with 58.9% in group of possibly benign thyroid nodules (TIRADS 2, 3) and 15.5% in group of possibly malignant thyroid nodules (TIRADS 4A, 4B, 4C, 5). An analysis of logistic regression revealed that serum vitamin D levels were independently associated with increased thyroid nodule prevalence. We observed an inverse dose-effect relationship between TNs and serum vitamin D status with full adjustments (P for trend=0.025%). For the severely vitamin D deficient group, the deficient group, and the insufficient group, respectively, odds ratios and 95% confidence intervals (OR: CI) for possibly malignant TNs were 3.46 (1.26-9.51), 2.15 (1.08-4.28), and 1.41 (0.72-2.75), compared to the optimal vitamin D status group. The multivariable OR with a 5ng/mL decrease in serum vitamin D levels was 1.16 (95% CI: 1.01-1.33), for possibly malignant TNs in centenarians. Nearly three-quarters of centenarians were found to have thyroid nodules. Most of these nodules were benign and did not possess any suspicious ultrasound findings. Vitamin D deficiency was associated with thyroid nodules as suggestive characteristics of malignancy in this population.

The Association of Thyroid Nodules With Blood Trace Elements Identified in a Cross-Section Study.

BackgroundThe association between occurrence of thyroid nodules (TNs) and trace elements detectable in blood are still inconclusive. The present study sought to determine the relationship between selected trace elements and TNs in the iodine-adequate area of Guangdong, China.MethodsA total of 1,048 participants from four communities were enrolled. A number of medical checkups were conducted to collect relevant data on anthropometric parameters, blood pressure, glucose blood levels and lipid profiles, as well as data on thyroid function, presence of thyroid autoantibodies, and trace elements. Presence of TN was diagnosed by ultrasonography.ResultsOf the 1048 participants (49.5 ± 14.4 years old), 543 participants (51.8%) had TNs. Serum copper, magnesium and zinc levels are associated with the presence of TNs among healthy subjects. Subjects with higher levels of zinc, magnesium and copper had 1.23-fold, 1.04-fold, and 1.007-fold increased risks of the prevalence of TNs (P = 0.013, 0.017, and < 0.001, resp). Compared with the first quartile of copper content in serum, participants in the fourth quartile had the highest prevalence of TNs with an odds ratio of 8.90 (95% confidence interval (CI) 5.41, 14.94) among all participants. Women in the third quartile of magnesium level had a 1.86-fold (95%CI 1.05, 3.31) risk of the prevalence of TNs. Subjects in the highest quartile of zinc level had a 1.82-fold (95%CI 1.06, 3.16) risk of the prevalence of TNs in females.ConclusionTNs were found highly prevalent in females in the investigated population from an iodine-adequate area of Guangdong, China. The imbalance of selected trace elements (copper, magnesium and zinc) in the body is related to the presence of TNs among healthy subjects. The observed correlation of copper on TNs warrants further studies.

Prevalence of thyroid nodules and its association with water iodine among Chinese men and women

BackgroundBecause of the large change in iodine nutrition and other lifestyle in China, there is concern that thyroid nodules (TNs) may become epidemic. However, few data are currently available on the national prevalence of TNs. In addition, whether excess iodine in drinking water is associated with an increased risk of TNs, following universal salt iodization, has been less studied. We aim to estimate a national prevalence of TNs and its association with drinking water iodine. MethodsWe conducted a national survey of 9,381,032 adults, aged 18 years or older, from 30 provinces and municipalities in China, who underwent a thyroid ultrasound test from January 2018 to December 2018. Crude and standardized prevalence of TNs were estimated. We further evaluated the ecological association between province- or city-specific iodine levels in drinking water and the prevalence of TNs using linear regression. ResultsThe age-standardized prevalence of TNs in men, women, and both sexes were 29.8%, 44.7%, and 37.1%, respectively. The prevalence increased with age from 22.7% (18–30 years) to 71.5% (≥70 years), and body mass index from 26.1% (<18.5 kg/m2) to 40.8% (≥28 kg/m2). Participants living in the eastern, northern, and northeastern regions had a higher prevalence of TNs (ranged from 38.7% to 43.7%) than those in other regions (ranged from 30.1% to 35.5%). The coastal residents (40.1%) had a higher prevalence of TNs than those in inlanders (35.4%). Higher levels of iodine in drinking water were linearly associated with increased prevalence of TNs, with Pearson correlation coefficients of 0.47 (P < 0.01) in men, 0.40 (P = 0.03) in women, and 0.46 (P = 0.01) in overall participants. ConclusionThis was a nationwide prevalence study of TNs in China, showing that TNs were common health problems, and increased concentration of iodine in drinking water was associated with a higher prevalence of TNs.

Thyroid Nodules in Children With Familial Adenomatous Polyposis.

Ultrasound screening for thyroid cancer is recommended in familial adenomatous polyposis (FAP). This study investigated the prevalence of thyroid neoplasia in children with FAP. Cross-sectional study of children with FAP at an academic hospital. Clinical and ultrasound data were analyzed for the prevalence of thyroid nodules and cancer. Of 37 children with FAP, 8 (22%) had thyroid nodules and 2 (5%) had thyroid cancer. Nodules (30%) and cancer (9%) were more common among female subjects and rare among male subjects. Thyroid ultrasound screening in adolescence may benefit female subjects with FAP but has limited utility in male subjects.

Gender-Specific Associations Between Metabolic Disorders and Thyroid Nodules: A Cross-Sectional Population-Based Study from China.

Background: Metabolic disorders (MDs) and the metabolic syndrome (MetS) may be associated with thyroid diseases. The aim of this study was to investigate the relationship between MDs and various types of thyroid nodules (TNs), according to gender. Methods: We analyzed cross-sectional data from the Thyroid Disorders, Iodine Status, and Diabetes Epidemiological (TIDE) survey in China. A total of 56,729 subjects ≥18 years of age were included. Thyroid gland morphology was assessed by thyroid standardized ultrasonography. A multivariate logistic regression model was used to explore the odds ratio (OR) and confidence intervals [CIs] for any associations between MDs and TNs. Subgroup analyses were conducted according to gender and TN type (solitary, S-TN; multiple, M-TNs). Results: The prevalence of TNs was increased in several MDs, and was higher in women than men regardless of whether they suffered from MDs (22.0%, CI [21.6-22.5%] vs. 15.7%, CI [15.3-16.7%], p < 0.001). TNs were associated with the presence of MDs (OR = 1.189, CI [1.107-1.278], p < 0.001), hypercholesterolemia (OR = 1.235, CI [1.177-1.296], p < 0.001), high low-density lipoprotein cholesterol (LDL-C; OR = 1.249, CI [1.186-1.316], p < 0.001), and hyperuricemia (OR = 1.206, CI [1.126-1.293], p < 0.001). MDs and MetS were, respectively, significantly associated with TNs, S-TNs, and M-TNs in men, while MDs were significantly associated with the three TN profiles in women. With respect to dyslipidemia, hypercholesterolemia and high LDL-C had the strongest association with TNs, whereas hypertriglyceridemia had no effect. Conclusions: TNs (especially M-TNs) may be associated with MDs and their various components, and there appear to be some gender-specific associations.

Prevalence and characterization of asymptomatic thyroid nodules in Assin North District, Ghana.

Ultrasound is now the initial imaging modality of choice for detection and characterization of lesions of the thyroid gland. Ultrasound imaging studies of the thyroid gland report varied prevalence of asymptomatic thyroid nodules (ATN), ranging from 20 to 67%. This study estimated the prevalence, characterized and determined factors associated with ATN in selected communities in the Assin North Municipality, Central Region, Ghana. The study was a cross-sectional design, involving 320 participants from six (6) communities in the Assin North District of the Central Region of Ghana. Socio-demographic data and data from ultrasound examination of the thyroid gland were analyzed using descriptive and inferential statistical techniques. The prevalence of ATN was 11.3% among 320 participants with the mean age of 56.53(±16.5) years. ATNs were common in the left lobe (69%) and predominantly solitary (64%). ATNs increased with age and body mass index (BMI). Those aged 60 years and above had significantly higher odds (OR = 24.40, 95% CI = 2.59-229.86) of having ATNs, likewise overweigh (OR = 5.32, 95% CI = 1.12-25.20) and obese (OR = 12.51, 95% CI = 1.47-106.58) individuals. The prevalence of ATN in our study population was relatively low, and more predictable among those 60 years or older, those in unhealthy BMI categories. There is the need for the reinforcement and intensification of educational campaigns on the consumption of iodized dietary salt as well as the consumption of foods rich in iodine content, particularly among older individuals.

Thyroid nodules and thyroid cancer in women with positive thyroid screening in pregnancy: a double-centric, retrospective, cohort study.

ObjectiveThyroid nodules are a common finding in the general population. The primary aim of the study was to determine the prevalence of thyroid nodules and cancer found by ultrasound (US) in women who underwent screening for thyroid dysfunction during pregnancy.DesignA double-centric, retrospective, cohort study.Patients and methodsWe searched through medical records, including thyroid ultrasonography, of pregnant women who were positively screened for thyroid disorders (using thyroid-stimulating hormone and thyroid antibodies) from an unselected population (‘universal screening group’, n = 690) and of women who underwent the testing based on the presence of clinical risk factors defined by American Thyroid Association (’case-finding group’, n = 249).ResultsPrevalence of benign and malignant thyroid nodules was lower in the ‘universal screening group’ than in the ‘case-finding group’ (9.9% vs 17.7%, P= 0.002, and 0.9% vs 7.2%, P< 0.001, respectively). Consistently, the thyroid cancer rate was lower among the nodules in the ‘universal screening group’ than in the ‘case-finding group’ (8.1% vs 29.0%, P= 0.003). Ultrasound EU-TIRADS (European Thyroid Imaging and Reporting Data System) category ≥4 had a 95.8% sensitivity for thyroid cancer. In palpable nodules, the prevalence of cancer was significantly higher than in the non-palpable ones (44.0% vs 2.2%, P < 0.001). In a multivariate regression analysis, thyroid nodules were associated with a history of infertility and parity.ConclusionsCompared to the data from cancer registries, universal screening allowed detecting thyroid cancer in pregnancy three to five times more frequently, but the cancer rate among nodules (8.1%) did not differ from the common population. US had very good sensitivity for thyroid cancer in pregnancy.

Adjusted association between type 2 immunity and low risk thyroid nodules: a retrospective cohort study

BackgroundImmune responses, especially type 2 immunity, might be related to the prevalence of thyroid nodules, while the key regulators and potential pathways are remaining largely unknown. In addition, the immune status of individuals could be affected by mixed metabolic background. Herein our aim was to investigate the adjusted association between ultrasound-diagnosed low risk thyroid nodules and immune responses, excluding the interference of metabolic effects on immunity.MethodsWe retrospectively enrolled 1764 subjects who underwent a thorough thyroid ultrasound examination. To eliminate the interference of confounders, we used propensity score matching (PSM) to match age, gender, cigarette smoking and alcohol drinking, parameters that are related with metabolic syndrome (MetS). Then the potential effectors of immune responses involved in the laboratorial assays were evaluated. Binary logistic regression analysis was used to assess the independent predictors of thyroid nodules in a multivariate manner.ResultsThe 1172 subjects were remained after PSM, and differences of demographic background between subjects with and without thyroid nodules were eliminated. Metabolic parameters comprising blood pressure, fasting blood glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein and serum uric acid were shown no significant difference between post-PSM subjects with and without thyroid nodules. Among the biochemistry and hematological parameters, white blood cell count and the positive rate of eosinophil percentage were increased in subjects with thyroid nodules than in those without thyroid nodules. In contrast, the positive rate of basophil percentage was lower in subjects with thyroid nodules than in those without thyroid nodules. In addition, the thyroid function test results showed that subjects with thyroid nodules had higher positive rates of antithyroglobulin antibody (TgAb) and antithyroid peroxidase antibody (TPOAb) than subjects without thyroid nodules. The logistic regression analysis indicated that the positive value of TgAb as well as high level of white blood cell count and BMI could serve as independent risk factors of thyroid nodules.ConclusionsThe type 2 immune responses mediated by increased level of eosinophils, along with positive value of TgAb and TPOAb were associated with the presence of thyroid nodules. In addition, the potential role of basophils in protecting against thyroid nodules and the pathogenesis of immune-metabolic status remains to be elucidated.

The prevalence of thyroid nodules and risk factors of thyroid nodules with metabolic disorder in Beijing

Background: In recent years, the prevalence of thyroid nodules (TNs) has been increasing, but the relationship between metabolic abnormalities and the incidence of TNs is not well defined, and there is scant data evaluating this relationship stratified by gender. This study aims to analyze the prevalence of TNs and possible risk factors for TNs across gender lines and various metabolic states in Beijing, China. Patients and Methods: A total of 6001 subjects who underwent thyroid ultrasounds as part of a routine medical checkup at Luhe Hospital between 2017 and 2018 were enrolled in this study. Multivariate adjustment logic was used to analyze possible demographic and clinical risk factors of TN stratified by gender. Results: The prevalence of TNs was 44.1%, of which 45.9% were female and 40% were male. In general, the prevalence of TNs increased in parallel with advancing age. These findings were even starker among females, with TN prevalences of 37.5%, 46.5%, 52.9%, and 54.1%, among participants in &lt;55-, 55–65-, 65–75-, and &gt;75-year-old age groups, respectively. The prevalence of TNs was significantly higher among patients with obesity (46.8% vs. 43%, P = 0.008), central obesity (45% vs. 40.4%, P = 0.005), hypertension (47.1% vs. 42.4%, P &lt; 0.001), metabolic syndrome (MetS) (46.1% vs. 41%, P &lt; 0.001), and low TSH levels (46.5% vs. 37.1%, P &lt; 0.001). MetS and obesity were independent risk factors for the prevalence of TNs (odds ratio [OR] = 1.167, [1.002–1.277] and (OR = 0.038, [1.01–1.396]), respectively). TSH had a protective effect on the prevalence of TNs (OR = 0.664, [0.585–0.75]). Conclusions: The present study supports the existing research that contends a strong correlation between older age, MetS, and other clinical risk factors and the prevalence of TNs. This relationship only persisted among women when stratified by gender. These results set the precedent for further research on how gender influences the incidence of TNs, particularly in the setting of other clinical and demographic risk factors.

Spectrum of thyroid nodules in a tertiary care center in the Kingdom of Bahrain

Background: This study investigates and analyses the thyroid nodules in Bahrain, and correlates the diagnosis of cytopathology with a subsequent excision histopathology. Materials &amp; Methods: We conducted a retrospective study for all thyroid cases diagnosed at the Salmaniya Medical Complex during a 7-year period (January 2013 to December 2019). Results: A total of 1218 thyroid nodules were diagnosed during the study period. Among them, 1,037 (85%) of the patients were females and 181 were males (15%), with an average age of 48.2 years. Surgical excision was performed on 263 out of 1,037 (25%) of the cases. Conclusions: The study revealed that the prevalence of thyroid nodules is higher among females. The most common nodules are benign multinodular goiters. A statistically significant correlation was observed between fine needle aspiration cytology (FNA) and surgical excision of the thyroid nodule. Keywords: Thyroid, FNA, thyroid nodules, cytology, excision

Clinical, Laboratory, and Ultrasound Related Diagnoses of Thyroid Disorders: Using a Family Medicine Center Data to Assess Thyroiditis and Thyroid Nodules in the Eastern Province of Saudi Arabia.

Introduction/Objectives:The prevalence of thyroid disorders is high in Saudi Arabia. Among the disorders, goiter and thyroiditis are the most common and have unique ultrasound (US) features, underscoring the need for US screening for thyroid pathologies. This study aimed to determine the prevalence of thyroiditis and thyroid nodules in patients attending the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University.Methods:This registry-based cross-sectional study analyzed laboratory and US data from 240 patients who attended the Family and Community Medicine Center of Imam Abdulrahman Bin Faisal University from January 2020 to December 2021. Abnormalities of the thyroid gland were categorized according to laboratory and US data. Associations between different types of thyroid pathology and clinical and laboratory findings were assessed using appropriate statistical methods.Results:The majority of participants were Saudi women. The prevalence of thyroiditis in the study population was 43%. Approximately 25% of these patients had more than 1 nodule, and fine-needle aspiration biopsy showed that most nodules were benign. Most nodules were found in clinically euthyroid patients. Thyroiditis might be associated with abnormal thyroid function.Conclusions:Thyroiditis and thyroid nodules were common in our cohort. Vitamin D deficiency, other autoimmune diseases, and a family history of thyroid disorders were associated with thyroiditis and thyroid nodules. US is useful for identifying the type of thyroid disease.

Epidemiological Survey of Thyroid Nodules in 2098 Patients for Routine Physical Examination in Fujian, China.

Objective The aim of this study is to establish the prevalence, ultrasound manifestations, and signs of thyroid nodules (thyroid nodules, TNS) in the healthy population, in order to provide a basis for the early diagnosis, treatment, and health education for clinical prevention of thyroid diseases. Methods The data of 2098 physical examination clients who underwent thyroid color Doppler ultrasound examination at our hospital's physical examination center from January 1, 2017, to December 31, 2018, were randomly selected, and the prevalence, size, nature, number, and Thyroid Imaging Reporting and Data System (TI-RADS) classification of the thyroid nodules were statistically analyzed. Results Of the 2098 results analyzed, 992 cases (47.28%) had thyroid nodules; 327 (15.59%) males and 665 (31.70%) females. The prevalence among females was significantly higher than that among males (p < 0.01), and the prevalence increased with age (p < 0.05). The composition ratios of multiple nodules and single nodules in each age group were compared, and the difference was statistically significant (p < 0.05). Detected thyroid nodules were mainly solid, and they were significantly different compared to the cystic and mixed nodules (p < 0.01). The actual classification in our study is consistent with the theory of TI-RADS1∼5 classification. Conclusion In conclusion, to sum up, thyroid color Doppler ultrasonography is very important for screening thyroid nodules in healthy people during routine physical examination, especially in high-pressure and high-intensity working environment, post-menopausal women, and men with family members with a history of thyroid cancer. Therefore, high-risk groups are encouraged to have regular thyroid ultrasonography, while health care workers are encouraged to publicize the risk factors of thyroid nodules and the importance of routine thyroid ultrasound examination.

Correlation between ultrasound TI-RADS classification system and Bethesda cytology result in assessment of thyroid nodule among a sample of Iraqi patient in wasit province

Background: Thyroid nodule is a common presentation. The estimated prevalence of thyroid nodules is 5-10% by clinical examination and up to 70% on ultrasonographic (USG) evaluation. Most are benign without any symptoms or cosmetic concerns. Only around 7-15% are found to be malignant. Objective: This study was conducted to assess the association between Thyroid Imaging, Reporting, Data System (TI-RADS) and the corresponding category of Bethesda System for Reporting Thyroid Cytology (TBSRTC) in evaluation of thyroid nodules and assessing risk of malignancy. Methods: This retrospective study evaluated a total of 172 patients with thyroid nodules presenting to out-patient laboratory in AL-Kut in a period of three years, by categorizing them into different categories using Thyroid Imaging Reporting and Data System (TIRADS) by USG and The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) by fine needle aspiration (FNA). The correlation between TIRADS and TBSRTC was evaluated using SPSS Statistics. Result: By FNA, 93% were benign nodules (category II-III), whereas 7.4% were malignant (category IV-V). By ultrasound 85% were benign (TI-RADS 1-3). The risk of malignancy for TI-RADS1, 2, 3, 4, 5 was 0, 0, 2.9, 38, and 80% respectively. No statistically significant difference between males and females. Overall agreement between the cases by USG and FNA using the TIRADS and TBSRTC respectively was significant (p&lt;0.0001), and the area under the ROC curve was 0.913. Conclusion: Our study observed a substantial agreement between the diagnosis made by TIRADS on ultrasound and TBSRTC on FNA, so using TI-RADS as the initial step in stratification of all thyroid nodules and as the only step in TI-RADS 1 and TIRADS2 nodules, so that only suspicious lesions undergo FNA, can reduce the need for invasive more expensive procedures without risking cancer missing.

Metastatic renal cell carcinoma to the thyroid gland

The thyroid nodules are frequent in general population. The nodules are more prevalent in women and the prevalence of thyroid nodules increased with age and detection are increased in people who underwent thyroid ultrasound, even for diagnostic imaging unrelated to the thyroid. (1) Most thyroid nodules are benign and around 5 % of all nodules are cancer. Approximately 90 % of thyroid cancer are differentiated thyroid cancer. Metastasis to thyroid are rarely observed in the clinical practice. The incidence of metastasis to thyroid gland is 0.36 % in all thyroid malignancies.

Six Air Pollutants Associated With Increased Risk of Thyroid Nodules: A Study of 4.9 Million Chinese Adults.

BackgroundThyroid nodules has become a significant public health issue worldwide with a rapidly increasing prevalence. However, its association with outdoor air pollution remains poorly understood. We aim to investigate the relationship between six outdoor air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and the risk of thyroid nodules.MethodsWe utilized a database including 4,920,536 participants who attended the annual physical examinations in the Meinian HealthCare Screening Center in 157 Chinese cities in 2017. City-specific concentrations of six pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) from 2015 to 2017 were estimated based on the China’s National Urban Air Quality Real Time Publishing Platform. Thyroid nodule was measured with ultrasound. Multivariable Logistic regression was used to examine the associations between air pollutants and thyroid nodules with adjustment for age, sex, education, smoking, body mass index, fasting blood glucose, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, urine iodine, gross domestic product, and thyroid stimulating hormone. We conducted stratified analyses to investigate potential effect modification by sex, age, and urine iodine groups.ResultsApproximately 38% of the participants (1,869,742) were diagnosed with thyroid nodules. Each of the six air pollutants was significantly and linearly associated with the risk for thyroid nodules. The adjusted odds ratios [95% CI] for every increase of 10 μg/m3 for PM2.5, PM10, NO2, SO2, and O3 were 1.062 [1.061, 1.064], 1.04 [1.03, 1.04], 1.10 [1.09, 1.10], 1.11 [1.11, 1.12], and 1.151 [1.149, 1.154], respectively; The odds ratio for each increase of 1 mg/m3 for CO was 1.50 [1.49 to 1.52]. Furthermore, these associations were significantly higher in the participants who were men, younger, or having lower urine iodine level (p <0.001).ConclusionThe six air pollutants may contribute to the high prevalence of thyroid nodules in China.

ANALYSING ASSOCIATION BETWEEN ANTHROPOMETRIC INDICATORS OF INSULIN RESISTANCE AND INSULIN-LIKE GROWTH FACTOR-1 IN PATIENTS WITH NODULAR GOITER

Publications suggesting that thyroid nodule might be associated with insulin resistance (IR) and metabolic syndrome are quite interesting. In a very recent report, increased thyroid volume and nodule prevalence were also reported in patients with IR in an iodine-sufficient area []. The purpose of the work is to analyze the association between anthropometric indicators IR and IGF-1 in patients with nodular goiter. &#x0D; Materials and methods. During the study the authors examined 73 patients with euthyroid single-node (n = 34) and multinodular goiter (n = 39) aged 17 to 74 years (mean - (51.0 ± 10.6) years), determining WC, WC / HC, BMI, WHtR, ABSI, BFD, BRI, CI, AVI, BAI, IGF-1, TSH, fT4, fT3. Thyroid volume, its structure, number, size and location of foci was assessed by an ultrasonic complex Aloka SSD-1100 (Japan), using a linear sensor 7.5 MHz.&#x0D; Results and their discussion. In the total number of patients with nodular goiter IGF-1 is nonlinearly negatively associated with BMI (r = -0.30; P = 0.016), WC (r = -0.26; P = 0.036), WHtR (r = -0.30) ; P = 0.020), AVI (r = -0.27; P = 0.03), ABSI (r = -0.31; P = 0.015), nonlinear positive with BFD (r = 0.27; P = 0.033) ), BRI (r = 0.29; P = 0.02) and linearly positive with BAI (r = 0.36; P = 0.004); thyroid volume is linearly positively associated with age (r = 0.35; P = 0.009), nonlinearly positively with WC / HC (r = 0.43; P = 0.001), BFD (r = 0.26; P = 0.06 ) and CI (r = 0.31; P = 0.02).&#x0D; In patients with nodular goiter with BMI≥35 kg / m2 thyroid volume is linearly positively associated with BMI (r = 0.71; P = 0.049). In patients with nodular goiter with IRF-1 above the sex-age norm, thyroid volume is nonlinearly positively associated with WC / HC (r = 0.71; P = 0.01), BAI (r = 0.66; P = 0.03 ) and nonlinearly negative with BFD (r = -0.52; P = 0.01). It has been found that BAI explains 82.37% of the variance of IGF-1 in the general group and more than 90% of the variance of its level in groups of patients with nodular goiter with high IGF-1 with / without obesity. In patients with nodular goiter with high IGF-1 and obesity, the predictor of increased thyroid volume is BRI, which explains 81.14% of the variance of its volume.&#x0D; Conclusions: Patients with nodular goiter with IGF-1 level in blood above the sex-age norm have significantly higher values ​​of anthropometric indicators IR (WHtR, ABSI, BFD and BAI) compared with patients with a normal level of this indicator; in patients with nodular goiter with II degree obesity and above, thyroid volume is significantly associated with BMI; BAI (R2 = 82.37%) is a predictor of increased levels of IGF-1 in blood of patients with nodular goiter, regardless of the obesity; BRI (R2 = 81.14%) is a predictor of increased thyroid volume in patients with nodular goiter with IGF -1 high level and obesity.&#x0D; Key words: nodular goiter, anthropometric indicators, insulin resistance

Effect of the transition from more than adequate iodine to adequate iodine on national changes in the prevalence of thyroid disorders: repeat national cross-sectional surveys in China.

ObjectiveLongitudinal studies have investigated the effects of changing iodine status on thyroid disorders, but the effect of a transition from more than adequate iodine to adequate iodine on national changes in prevalence adjusted for changing risk factors remains unclear.Design Two repeat nationwide surveys were conducted from 2009–2010 to 2015–2017 to assess changes in thyroid disorder prevalence and iodine status in China.Methods A multistage stratified random sampling method was used to obtain a nationally representative sample of urban adults aged 18 and older in mainland China in 2009 (n = 14 925) and 2015 (n = 12 553). Changes in thyroid disorder prevalence, urinary iodine concentration (UIC), and thyroid-stimulating hormone (TSH) levels were assessed. Logistic regression models were used to examine changes in prevalence over time.ResultsThe median UIC decreased significantly from 219.7 to 175.9 μg/L (P < 0.0001). The weighted prevalence of overt hyperthyroidism, subclinical hyperthyroidism, Graves’ disease, and goitre decreased between 2009 and 2015 in the overall population (P < 0.05 for all). Despite no significant changes in subclinical hyperthyroidism or hypothyroidism or anti-thyroid peroxidase or anti-thyroglobulin antibody positivity prevalence, a significant increase in thyroid nodule prevalence (P < 0.0001) was found in the overall population. The 2.5th TSH percentile increased by 0.15 mIU/L (95% CI: 0.01 to 0.30 mIU/L, P = 0.04) from 2009 to 2015.Conclusions With the iodine status transition from more than adequate to adequate, thyroid disorder (except for thyroid nodules) prevalence remained stable or even decreased after adjusting for confounding factors among adults in mainland China between 2009 and 2015. Additional studies are needed to explore the reasons for the increased thyroid nodule prevalence.

Iodine nutritional status, the prevalence of thyroid goiter and nodules in rural and urban residents: a cross-sectional study from Guangzhou, China.

ObjectivesA variety of factors differed between rural and urban areas may further influence iodine status and thyroid structure. Hence, this study compared iodine nutrition, the prevalence of thyroid goiter, and nodules between rural and urban residents in Guangzhou, a southern coastal city of China.MethodsA total of 1211 rural residents and 1305 urban residents were enrolled in this cross-sectional study. A questionnaire regarding personal characteristics was administered. Urinary iodine concentration (UIC) was examined. Ultrasonography of the thyroid was performed to evaluate thyroid goiter and nodules. Multiple logistic analysis was used to identify the potential associated factors.ResultsThe median UIC was significantly lower in rural residents than in urban residents (120.80 μg/L vs 136.00 μg/L, P < 0.001). Although the coverage rate of iodized salt was much higher in rural residents than in urban residents (99.59% vs 97.29%, P < 0.001), the percentages of seafood intake (8.60% vs 29.29%, P < 0.001), iodine-containing drug consumption (0.33% vs 1.24%, P = 0.011), and iodine contrast medium injection (0.58% vs 1.87%, P = 0.004) were lower in rural residents than in urban residents. Both the prevalence of thyroid goiters and nodules was significantly higher in rural residents than in urban residents (goiter: 8.06% vs 1.20%, P < 0.001; nodules: 61.89% vs 55.04%, P = 0.023). Living in rural areas was associated with thyroid goiter (OR 5.114, 95% CI 2.893–9.040, P < 0.001).ConclusionsThere were differences in iodine nutrition and the prevalence of thyroid goiter and nodules in rural and urban residents in Guangzhou. Differentiated and specialized monitoring is recommended in our area.