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Obesity and Waist Circumference are Possible Risk Factors for Thyroid Cancer: Correlation with Different Ultrasonography Criteria

Authors Eissa MS, Abdellateif MS, Elesawy YF, Shaarawy S, Al-Jarhi UM

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

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

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