Oberman Benjamin, Khaku Aliasgher, Camacho Fabian, Goldenberg David
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Department of Public Health Sciences, Division of Health Services and Behavioral Research, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.
Am J Otolaryngol. 2015 Jul-Aug;36(4):535-41. doi: 10.1016/j.amjoto.2015.02.015. Epub 2015 Mar 3.
Analyze the relationship between obesity and type-2 diabetes mellitus (DM) and the development of differentiated thyroid cancer (DTC).
A randomized case-controlled retrospective chart review of outpatient clinic patients at an academic medical center between January 2005 and December 2012. DTC patients were compared to two control groups: primary hyperparathyroidism (PHPTH) patients with euthyroid state and Internal Medicine (IM) patients. Exposure variables included historical body-mass-index (BMI), most recent BMI within 6 months and DM. Multivariate logistic regressions adjusting for gender, age, and year of BMI assessed the adjusted Odds Ratio (OR) of DTC with both BMI and DM.
Comparison of means showed a statistically significant higher BMI in DTC (BMI=37.83) than PHPTH, IM, and pooled controls, BMI=30.36 p=<0.0001, BMI=28.96 p=<0.0001, BMI=29.53 p=<0.0001, respectively. When compared to PHPTH, DM was more frequent in DTC (29% vs. 16%) and prevalence trended towards significance (p=0.0829, 95% CI =0.902-5.407). BMI adjusted OR was significant when compared to PHPTH, IM and pooled controls: 1.125 (p=0.0001), 1.154 (p=<0.0001), and 1.113 (p=<0.0001), respectively. DM adjusted OR was significant when compared to PHPTH and pooled controls at 3.178 (95% 1.202,8.404, p=0.0198) and 2.237 (95% 1.033,4.844, p=0.0410), respectively.
Our results show that obesity and, to a lesser degree, DM are significantly associated with DTC. BMI in particular was a strong predictive variable for DTC (C=0.82 bivariate, C=0.84 multivariate).
分析肥胖与2型糖尿病（DM）以及分化型甲状腺癌（DTC）发生发展之间的关系。
对2005年1月至2012年12月间某学术医学中心门诊患者进行随机病例对照回顾性图表审查。将DTC患者与两个对照组进行比较：甲状腺功能正常的原发性甲状旁腺功能亢进症（PHPTH）患者和内科（IM）患者。暴露变量包括既往体重指数（BMI）、6个月内的最近BMI以及DM。多因素逻辑回归在调整性别、年龄和BMI年份后，评估BMI和DM与DTC的调整比值比（OR）。
均值比较显示，DTC患者的BMI（BMI = 37.83）在统计学上显著高于PHPTH患者、IM患者以及合并对照组，分别为BMI = 30.36，p < 0.0001；BMI = 28.96，p < 0.0001；BMI = 29.53，p < 0.0001。与PHPTH患者相比，DTC患者中DM更为常见（29%对16%），患病率有显著趋势（p = 0.0829，95%CI = 0.902 - 5.407）。与PHPTH患者、IM患者以及合并对照组相比，BMI调整后的OR均具有显著性：分别为1.125（p = 0.0001）、1.154（p < 0.0001）和1.113（p < 0.0001）。与PHPTH患者和合并对照组相比，DM调整后的OR具有显著性，分别为3.178（95% 1.202,8.404，p = 0.0198）和2.237（95% 1.033,4.844，p = 0.0410）。
我们的结果表明，肥胖以及在较小程度上的DM与DTC显著相关。特别是BMI是DTC的一个强有力的预测变量（二元C = 0.82，多因素C = 0.84）。
