Inverse Relationship of BMI to TSH and Risk of Papillary Thyroid Cancer in Surgical Patients

Handelsman, Rachel S.; Alvarez, Alexandra L.; Picado, Omar; Farrá, Josefina C.; Lew, John I.

doi:10.1016/j.jss.2019.06.017

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…In addition, these data were confirmed by Reinehr et al, 37 who reported a significant causal relationship between TSH and obesity, which might be through several mechanisms mainly leptin secretion. On the other hand, these data are contradictory to that observed by Handelsman et al 32 that increased BMI is significantly associated with decreased serum TSH level in patients who underwent thyroid lobectomy or total thyroidectomy. This discrepancy in data could be explained by that BMI is not a real indicator of central obesity, as the later had been proved to be associated with other health problems like insulin resistance and metabolic syndrome.…”

Section: Discussioncontrasting

confidence: 88%

“…Our data are consistent with that reported by Song et al, 31 who performed a communitybased population study in China and concluded that Waist circumference is superior to BMI for assessing the risk of developing TC. On the contrary, Handelsman et al 32 reported inverse relationship between increased BMI and decreased rate of Papillary thyroid cancer, they suggested that there were other factors that may be involved in thyroid carcinogenesis other than BMI. The conflicting data in the literature around the association between BMI and the risk of TC are mainly due to that BMI is a quite nonspecific measure of adiposity including muscle mass, bone mass, peripheral and abdominal adipose tissue.…”

Section: Discussionmentioning

confidence: 95%

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

Eissa¹,

Abdellateif

Elesawy³

et al. 2020

CMAR

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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.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 95%

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

Eissa¹,

Abdellateif

Elesawy³

et al. 2020

CMAR

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“…Such discrepancy might be attributed to other factors, such as thyroid disease, pathological obesity, smoking or gender [7,[15][16][17][18]. On contrary, a recent study has found that there is a negative relationship between BMI and TSH in patients with thyroid cancer [19]. However, this is only the accidental discovery of the researchers, while no detailed analysis has been performed.…”

Section: Discussionmentioning

confidence: 96%

“…between BMI and TSH levels, while others suggest that there is no significant relationship between the two [10][11][12]. In this sense, there is still controversy about the relationship between BMI and TSH level.…”

mentioning

confidence: 99%

Body mass index (BMI) is associated with serum thyroid-stimulating hormone (TSH) level in infertile women: a cross-sectional study

et al. 2020

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Studies suggest that there is a relationship between body mass index (BMI) and thyroid-stimulating hormone (TSH) levels. But conflicting evidence exists regarding the relationship between the two variables. Moreover, thyroid function is closely related to female fertility and has certain effects on infertility. Therefore, the present study will explore the relationship between BMI and TSH levels in patients with infertility in our center. We retrospectively analyzed relevant indicators of 2,789 in Tubal Factor Infertility patients undergoing assisted reproduction technology from January 2016 to December 2018 in our center in order to analyze the relationship between BMI and serum TSH level. The medical histories of patients were reviewed. The relationship between BMI and TSH was assessed using smooth curve fitting and multivariate regression model. The smoothing curve fitting between BMI and TSH exhibited a non-linear relationship, and the resulting curve exhibited a two-stage change and a breakpoint. By multivariate piecewise linear regression, we found that the TSH level was increased with the increase of BMI when the BMI was greater than 25.3 kg/m 2 (β 0.06, 95% CI 0.02, 0.01; p = 0.0028). In contrast, the TSH level was decreased with the increase of BMI when the BMI was less than 25.3 kg/m 2 (β-0.02, 95% CI-0.05, 0.00; p = 0.0573). Collectively, our study described a non-linear relationship between BMI and TSH level in infertile patients after adjustment of potential confounders. However, such causal relationship between BMI and TSH in infertile women still needs to be further clarified in future investigations.

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“…However, many environmental and biological factors can contribute to this phenomenon: exposure to ionizing radiation, diet low in iodine, estrogen treatment, Hashimoto's thyroiditis and heredity [4]. Obesity has also been proposed to be an additional risk factor, but its association with thyroid cancer remains controversial [5][6][7][8][9][10][11]. Thyroid cancer is three to four times more common in women than in men [12].…”

Section: Introductionmentioning

confidence: 99%

Effect of Age, Gender, and Body Mass Index on Thyroid Bethesda Classification: A Retrospective Study

et al. 2022

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Background: Thyroid cancer incidence is increasing nowadays. Bethesda system classifies fine needle aspiration (FNA) cytology into six categories linked to cancer risk. Several papers have studied relationships between thyroid pathology results and age, gender, and body mass index (BMI), but very few have taken into consideration the Bethesda score. The aim of this study was to assess the relationship between the Bethesda system and age, gender, and BMI.Methods: All the patients who underwent an ultrasound-guided FNA of a thyroid nodule between November 2017 and September 2020 were included in this study (668 subjects, 80.7% women, mean age 50.1 ± 13.3 years). Bethesda classification results, age, gender, and BMI were collected from the archives of the institution's Pathology Department. Results:The observed proportions of the incremental Bethesda classes (1 through 6) were respectively 13.3%, 57.0%, 15.7%, 6.1%, 4.9%, and 2.8%. Bethesda score was negatively correlated with age (Spearman's rho = -0.106 (95% confidence interval (CI): -0.180; -0.026), P value = 0.006). The ratio men/women increased with increasing Bethesda score (linear trend P value = 0.043). Bethesda score was not correlated with BMI (Spearman's rho = 0.049 (95% CI: -0.033; 0.120), P value = 0.21), even after adjustment for gender and age.Conclusions: Bethesda scores decreases with age and are not associated with gender; however, men/women ratio increases with increasing scores. BMI does not correlate with higher Bethesda scores. More studies should be performed to identify factors that might influence Bethesda score.

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Inverse Relationship of BMI to TSH and Risk of Papillary Thyroid Cancer in Surgical Patients

Cited by 6 publications

References 28 publications

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

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

Body mass index (BMI) is associated with serum thyroid-stimulating hormone (TSH) level in infertile women: a cross-sectional study

Effect of Age, Gender, and Body Mass Index on Thyroid Bethesda Classification: A Retrospective Study

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