Thyroid function test profile in patients who have thyroid nodule and its correlation with ultrasound TIRAD scoring system and cytological results.

Thyroid nodules are common, as they are found in up to 8% of adults. These nodules are becoming increasingly prevalent, possibly because of the increased use of ultrasound imaging. These nodules are mostly benign but remain a source of concern for both physicians and patients due to the possibility of malignant transformation. The aim of this study was to assess the ability and usefulness of thyroid function tests in predicting ultrasound and FNA outcomes of thyroid nodules and therefore confirm or rule out the malignant potential of these nodules. In this case‒control, prospective study, one hundred patients who presented to the outpatient clinic from March 2022 to June 2024 for evaluation of thyroid nodules were included. Follow-up protocols included medical history review, physical examination, thyroid function tests, ultrasound imaging examination and fine needle aspiration if indicated. Data were analyzed using SPSS 25, and a p value less than 0.05 indicated statistical significance. 40% of patients who had thyroid nodules had normal thyroid function tests, 28% had subclinical hyperthyroidism, 22% had subclinical hypothyroidism, 8% had overt hypothyroidism according to laboratory findings, and 2% had overt hyperthyroidism according to laboratory findings. A higher-than-normal BMI was significantly associated with TIRADS 2 nodules (95% C. I 0.40-0.97, p value < 0.0001), and a low BMI was significantly associated with TIRADS 4 nodules (95% C. I 0.08-0.53, p value 0.04). High levels of TSH were significantly associated with TIRADS 2 nodules (95% C. I 0.52_1.11, p value < 0.0001), and low levels of TSH, despite normal T3 and T4 levels, were correlated with TIRADS 4 nodules (95% C. I -1.10_0.9, p value < 0.0001). Low levels of TSH, despite normal T3 and T4 levels, and cytological findings were associated with Bethesda 2 nodules, which are benign follicular neoplasms (95% c. I 1.08-1.44, p value < 0.0001. Most patients who had thyroid nodules had normal thyroid function tests; however, low TSH levels were significantly associated with ultrasound evidence of TIRAD 4 nodules and Bethesda 2 nodules according to FNA, and high TSH levels were significantly associated with ultrasound evidence of TIRADS 2 nodules.