Moon Sang Yi, Son Minkook, Cho Jung-Hwan, Kim Hye In, Han Ji Min, Bae Ji Cheol, Suh Sunghwan
Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea.
Department of Physiology, Dong-A University College of Medicine, Busan, Republic of Korea.
Thyroid. 2025 Jan;35(1):79-86. doi: 10.1089/thy.2024.0522. Epub 2024 Dec 18.
Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a hepatic manifestation of metabolic syndrome. This study investigated the association between newly developed nomenclature MASLD and the risk of thyroid cancer in the Korean population. After excluding individuals with a history of liver disease or malignancy, we analyzed a cohort of 214,502 Korean adults aged 40 years and above who participated in the National Health Screening Program from 2009 to 2010. Participants were categorized into four groups: no steatotic liver disease (SLD) without a cardiometabolic risk factor (CMRF), no SLD with at least one CMRF, MASLD, and metabolic and alcohol-related/associated liver disease (MetALD). SLD was diagnosed using a fatty liver index threshold of ≥30. The primary outcome was the diagnosis of new thyroid cancer during the follow-up period. We examined the relationship between CMRF/SLD and thyroid cancer incidence using the multivariable-adjusted Cox proportional hazards model. A total of 2761 participants (1.3%) were newly diagnosed with thyroid cancer over an average follow-up of 9.61 years. Compared with participants without CMRF and SLD, those with CMRF (hazard ratio [HR] 1.33, confidence interval [CI] 1.16-1.52), those with MASLD (HR 1.36, CI 1.17-1.58), and the MetALD group (HR 1.40, CI 1.04-1.88) exhibited a significantly higher risk of thyroid cancer. In addition, MetALD is significantly associated with thyroid cancer incidence solely in men. In addition to CMRF, MASLD and MetALD were associated with a higher incidence of thyroid cancer in the Korean population. This study is the first to demonstrate the association between thyroid cancer and the CMRF-MASLD-MetALD continuum.
代谢功能障碍相关脂肪性肝病（MASLD）是代谢综合征的一种肝脏表现形式。本研究调查了新提出的术语MASLD与韩国人群甲状腺癌风险之间的关联。在排除有肝脏疾病或恶性肿瘤病史的个体后，我们分析了一组214,502名年龄在40岁及以上的韩国成年人队列，他们参加了2009年至2010年的国家健康筛查项目。参与者被分为四组：无脂肪性肝病（SLD）且无心血管代谢危险因素（CMRF）、无SLD但有至少一项CMRF、MASLD以及代谢和酒精相关肝病（MetALD）。使用脂肪肝指数阈值≥30来诊断SLD。主要结局是随访期间新诊断的甲状腺癌。我们使用多变量调整的Cox比例风险模型检查了CMRF/SLD与甲状腺癌发病率之间的关系。在平均9.61年的随访中，共有2761名参与者（1.3%）被新诊断为甲状腺癌。与无CMRF和SLD的参与者相比，有CMRF的参与者（风险比[HR] 1.33，置信区间[CI] 1.16 - 1.52）、有MASLD的参与者（HR 1.36，CI 1.17 - 1.58）以及MetALD组（HR 1.40，CI 1.04 - 1.88）的甲状腺癌风险显著更高。此外，MetALD仅在男性中与甲状腺癌发病率显著相关。除CMRF外，MASLD和MetALD与韩国人群中较高的甲状腺癌发病率相关。本研究首次证明了甲状腺癌与CMRF - MASLD - MetALD连续体之间的关联。
