Obesity and Waist Circumference are Possible Risk Factors for Thyroid Cancer: Correlation with Different Ultrasonography Criteria
Received 31 March 2020
Accepted for publication 30 June 2020
Published 21 July 2020 Volume 2020:12 Pages 6077—6089
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Eileen O'Reilly
Marwa S Eissa,1 Mona S Abdellateif,2 Yasmine F Elesawy,3 Sabry Shaarawy,2 Ula M Al-Jarhi1
1Internal Medicine and Endocrinology Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 2Medical Biochemistry and Molecular Biology, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt; 3Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
Correspondence: Mona S Abdellateif Email email@example.com
Background: Obesity has an important role in the pathogenesis of cancer; however, there are no clear mechanisms explaining the association between obesity and risk of thyroid cancer (TC).
Methods: It is a cross-sectional study including 184 patients with benign thyroid nodules (BN) and 19 patients with TC. Body mass index (BMI), waist circumference (WC), hip circumference (HC), waist/hip (W/H) ratio were assessed and correlated to relevant clinico-pathological features of the patients, different ultra-sonographic (U/S) criteria and risk of malignancy.
Results: There was a significant increase in BMI, WC and W/H ratio in TC patients compared to BN group (P=0.001, 0.011 and 0.003). Increased BMI, WC and HC were associated significantly with solid nodules (P< 0.05). WC increased in hypoechoic (103.1± 15.4cm) and heterogeneous (103.8± 16.7cm) nodules, compared to isoechoic (97.3± 15.5cm) and hyperechoic (96.1± 10cm) nodules (P=0.046). It also increased with lymph nodes enlargement (P=0.04). There was a significant association between WC and TIRADS classification (P=0.032), as it increased with TR4b (118.5 ± 12.9 cm) and TR5 (117.3 ± 13.9 cm) compared to TR2 (114.1 ± 15.7 cm, P=0.025 and 0.008, respectively). WC is an independent predictor for TC [OR: 1.092, CI: 1.020– 1.170, P=0.012]. It achieved sensitivity, specificity and AUC (71.4%, 68.7% and 0.750; respectively), at a cutoff value of 108.5 cm (P=0.003), and when combined with BMI at a cutoff value of 32.59 (77.8% and 68.4%, respectively, AUC: 0.780, P< 0.001).
Conclusion: Central adiposity is strongly associated with the risk of TC. WC is more superior to BMI when correlated with TIRADS classification and also is an independent predictor for TC.
Keywords: thyroid nodules, BMI, WC, obesity, ultrasonography
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]