Siqueira Raquel Andrade de, Noll Matias, Rodrigues Ana Paula dos Santos, Silveira Erika Aparecida
Department of Thyroid, Hospital Geral de Goiânia (HGG), Brazil. Email:
Instituto Federal Goiano, Brazil.
Asian Pac J Cancer Prev. 2019 Mar 26;20(3):693-697. doi: 10.31557/APJCP.2019.20.3.693.
Background: The association of obesity with the occurrence of thyroid nodules and thyroid cancer has been demonstrated. However, there is limited knowledge on the risk factors of thyroid nodules in in severely obese patients. The aim was to evaluate the occurrence of thyroid nodules in severely obese and nonobese patients and determine the factors associated considering sociodemographic, lifestyle, and biochemical variables. Methods: This is a case-control study of 134 adults which 67 nonobese, control group, and 67 severely obese (BMI ≥ 35 kg/m2), case group. All participants underwent thyroid ultrasound. Results: The occurrence of thyroid nodules in a control group was 13.4% (n = 9), while in a case group was 29.9%, n = 20), difference statistically significant (p = 0.017). Factors associated with the occurrence of thyroid nodules in severely obese patients were lower mean age (p = 0.022); higher economic class (p = 0.010); nonconsumption of alcohol (p = 0.017); higher fasting glycemia (p = 0.009), fasting insulin (p = 0.001), homeostatic model assessment of insulin resistance [HOMA-IR] (p = 0.045), and triglyceride (p = 0.009) mean values; and lower vitamin D3 (p = 0.045) and high-density lipoprotein cholesterol (p = 0.041) mean values. Conclusions: Occurrence of thyroid nodules in severely obese patients was higher than nonobese. Lower age at diagnosis, higher economic level, nonconsumption of alcohol, hyperinsulinemia, higher HOMA-IR scores, and lower vitamin D3 levels were factors associated with the occurrence of thyroid nodules in severely obese patients.
肥胖与甲状腺结节及甲状腺癌的发生之间的关联已得到证实。然而，对于重度肥胖患者甲状腺结节的危险因素了解有限。本研究旨在评估重度肥胖和非肥胖患者甲状腺结节的发生情况，并确定与社会人口统计学、生活方式及生化变量相关的因素。方法：这是一项针对134名成年人的病例对照研究，其中67名非肥胖者作为对照组，67名重度肥胖者（BMI≥35kg/m²）作为病例组。所有参与者均接受了甲状腺超声检查。结果：对照组甲状腺结节的发生率为13.4%（n = 9），而病例组为29.9%（n = 20），差异具有统计学意义（p = 0.017）。与重度肥胖患者甲状腺结节发生相关的因素包括较低的平均年龄（p = 0.022）；较高的经济阶层（p = 0.010）；不饮酒（p = 0.017）；较高的空腹血糖（p = 0.009）、空腹胰岛素（p = 0.001）、胰岛素抵抗稳态模型评估[HOMA-IR]（p = 0.045）及甘油三酯（p = 0.009）均值；以及较低的维生素D3（p = 0.045）和高密度脂蛋白胆固醇（p = 0.041）均值。结论：重度肥胖患者甲状腺结节的发生率高于非肥胖患者。诊断时年龄较小、经济水平较高、不饮酒、高胰岛素血症、较高的HOMA-IR评分及较低的维生素D3水平是与重度肥胖患者甲状腺结节发生相关的因素。
