Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia.
Department of Surgery, King Fahad Armed Forces Hospital, Jeddah 21159, Saudi Arabia.
Medicina (Kaunas). 2023 Sep 14;59(9):1658. doi: 10.3390/medicina59091658.
The effect of obesity on the development/progression of thyroid nodules with uncertain cytology is unknown. Therefore, our objective was to assess the role of body mass index (BMI) in predicting malignancy in patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) nodules. We retrospectively analyzed 113 patients with available BMI data and final histopathology of benign or differentiated thyroid cancer. Patients were classified into four groups based on BMI: <18.5 (underweight), 18.5-24.9 (normal weight), 25-29.9 (overweight), and ≥30 (obesity) kg/m. The association between risk of malignancy and BMI was examined for all data and subgroups based on nodule size, sex, and age. Overall, 44.2% were obese, 36.3% were ≥45 years, and 75.4% were women. Final pathological results showed malignant nodules in 52 patients (46%) and benign nodules in 61 patients (54%) (mean age: 41 ± 11.6 vs. 39.9 ± 11.7 years; = 0.62). Men had more malignant nodules than benign nodules (32.7% vs. 16.4%, < 0.05). Overall, no significant correlation was identified between the risk of thyroid cancer and BMI, and the risk of malignancy was not significantly different between obese men and women ( = 0.4). However, in individuals with BMI < 30 kg/m (non-obese group), malignant nodules were more frequent in men than in women (71% vs. 41%, = 0.04). No significant difference was observed in mean nodule size between the benign and malignant groups. Furthermore, BMI was not related to increased risk of malignancy in multiple logistic regression models using all data, even after controlling for confounding variables (odds ratio, 0.99, 95% confidence interval: 0.93-1.06, = 0.87) or when stratifying by sex. Our study showed no correlation between obesity and thyroid cancer in patients with AUS/FLUS. Moreover, men had more malignant nodules than benign nodules. Further well-designed prospective studies are required to confirm our findings.
肥胖对具有不确定细胞学特征的甲状腺结节的发展/进展的影响尚不清楚。因此,我们的目的是评估体重指数(BMI)在预测具有不明确意义的异形性/滤泡性病变不明确意义(AUS/FLUS)结节患者恶性肿瘤中的作用。我们回顾性分析了 113 例具有可用 BMI 数据和良性或分化型甲状腺癌最终组织病理学的患者。根据 BMI 将患者分为四组:<18.5(体重不足)、18.5-24.9(正常体重)、25-29.9(超重)和≥30(肥胖)kg/m。检查了所有数据以及基于结节大小、性别和年龄的亚组中 BMI 与恶性肿瘤风险之间的关系。总体而言,44.2%的患者肥胖,36.3%的患者年龄≥45 岁,75.4%的患者为女性。最终病理结果显示 52 例患者(46%)为恶性结节,61 例患者(54%)为良性结节(平均年龄:41 ± 11.6 岁 vs. 39.9 ± 11.7 岁;= 0.62)。男性的恶性结节多于良性结节(32.7%比 16.4%,<0.05)。总体而言,BMI 与甲状腺癌风险之间未发现显著相关性,肥胖男性和女性的恶性肿瘤风险无显著差异(= 0.4)。然而,在 BMI<30 kg/m(非肥胖组)的个体中,男性的恶性结节比女性更常见(71%比 41%,= 0.04)。良性和恶性组之间的平均结节大小无显著差异。此外,即使在控制混杂因素后(优势比,0.99,95%置信区间:0.93-1.06,= 0.87),或在按性别分层后,使用所有数据的多变量逻辑回归模型中,BMI 与恶性肿瘤风险增加无关。我们的研究表明,在 AUS/FLUS 患者中,肥胖与甲状腺癌之间没有相关性。此外,男性的恶性结节比良性结节多。需要进一步进行设计良好的前瞻性研究来证实我们的发现。