Obesity, obesity-related metabolic conditions, and risk of thyroid cancer in women: results from a prospective cohort study (Sister Study)

Pasqual, Elisa; O’Brien, Katie M.; Rinaldi, Sabina; Sandler, Dale P.; Kitahara, Cari M.

doi:10.1016/j.lana.2023.100537

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…First, there was a lack of information on potential confounders, including ionizing radiation exposure, thyroid disease history, and family history of thyroid cancer. Additionally, a high percentage of participants were missing BMI data; therefore, we may not have sufficiently adjusted for obesity, an established PTC risk factor [ 37 , 46 , 56 , 87 ]. However, prior work has suggested lower prevalence of obesity and larger lean body mass among military personal compared to the general U.S. population [ 73 ], so residual confounding of BMI would likely be minimized.…”

Section: Discussionmentioning

confidence: 99%

Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study

Rusiecki,

McAdam,

Denic-Roberts

et al. 2024

Environ Health

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Background The effects of organochlorine pesticide (OCP) exposure on the development of human papillary thyroid cancer (PTC) are not well understood. A nested case-control study was conducted with data from the U.S. Department of Defense Serum Repository (DoDSR) cohort between 2000 and 2013 to assess associations of individual OCPs serum concentrations with PTC risk. Methods This study included 742 histologically confirmed PTC cases (341 females, 401 males) and 742 individually-matched controls with pre-diagnostic serum samples selected from the DoDSR. Associations between categories of lipid-corrected serum concentrations of seven OCPs and PTC risk were evaluated for classical PTC and follicular PTC using conditional logistic regression, adjusted for body mass index category and military branch to compute odds ratios (OR) and 95% confidence intervals (CIs). Effect modification by sex, birth cohort, and race was examined. Results There was no evidence of associations between most of the OCPs and PTC, overall or stratified by histological subtype. Overall, there was no evidence of an association between hexachlorobenzene (HCB) and PTC, but stratified by histological subtype HCB was associated with significantly increased risk of classical PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 1.61, 95% CI, 1.09, 2.38; p for trend = 0.05) and significantly decreased risk of follicular variant PTC (third tertile above the limit of detection (LOD) vs. <LOD, OR = 0.38, 95% CI, 0.16, 0.91; p for trend = 0.04). Further stratified by sex, risk of classical PTC was higher for females (third tertile above LOD vs. <LOD, OR = 2.23, 95% CI: 1.23, 4.06; p-trend = 0.02) than for males (OR = 1.22, 95%CI: 0.72–2.08; p-trend = 0.56), though the test for interaction by sex was not statistically significant (p-interaction = 0.30). Similarly, β-hexachlorocyclohexane (β-HCCH) was associated with a higher risk for classical PTC for women with concentrations ≥LOD versus <LOD (OR = 1.76, 95% CI: 1.07, 2.89), while the effects were null for men. There were no consistent trends when stratified by race or birth year. Conclusions The U.S. Environmental Protection Agency has classified HCB and other OCPs we studied here as probable human carcinogens. Our findings of increased risks for classical PTC associated with increased concentrations of HCB and β-HCCH, which were stronger among females, should be replicated in future studies of other populations.

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Section: Discussionmentioning

confidence: 99%

Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study

Rusiecki,

McAdam,

Denic-Roberts

et al. 2024

Environ Health

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Section: Diagnosis Of Shypo In Obese Patientsmentioning

confidence: 99%

“…It is still up for discussion whether obesity affects the aggressiveness of thyroid cancer [51,52]. In The Sister Study, a cohort of sisters of women diagnosed with breast cancer, excess adiposity and several obesity related metabolic conditions were associated with increased thyroid cancer incidence [53] Regardless of thyroid function, the guidelines advise avoiding using routine thyroid gland ultrasonography in obese patients [50]. Despite the high risk of thyroid nodules in obese patients, systematic ultrasound examination of the thyroid is considered unnecessary and expensive [50].…”

Section: Diagnosis Of Shypo In Obese Patientsmentioning

confidence: 99%

Subclinical Hypothyroidism in Patients with Obesity and Metabolic Syndrome: A Narrative Review

Biondi

2023

Nutrients

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The literature on the connection between obesity, metabolic syndrome, and subclinical hypothyroidism is critically analyzed in this narrative review. These conditions are frequently observed among adult populations and various studies and meta-analyses have assessed their association. The prevalence of subclinical hypothyroidism in obese individuals is higher than in non-obese subjects and this trend is more pronounced in unhealthy obesity phenotypes. However, the diagnosis and treatment of subclinical hypothyroidism can be difficult in obese patients. Exaggerated body fat is linked to thyroid hypoechogenicity as evident through ultrasonography and euthyroid obese people have greater TSH, FT3, and FT3/FT4 ratios than non-obese individuals in a euthyroid condition. Moreover, a reduced expression of the TSH receptor and altered function of deiodinases has been found in the adipose tissue of obese patients. Current data do not support the necessity of a pharmacological correction of the isolated hyperthyrotropinemia in euthyroid obese patients because treatment with thyroid hormone does not significantly improve weight loss and the increase in serum TSH can be reversible after hypocaloric diet or bariatric surgery. On the other hand, obesity is linked to elevated leptin levels. Inflammation can raise the risk of Hashimoto thyroiditis, which increases the likelihood that obese patients will experience overt or subclinical hypothyroidism. Both metabolic syndrome and subclinical hypothyroidism are associated with atherosclerosis, liver and kidney disease. Hence, the association of these two illnesses may potentiate the adverse effects noted in each of them. Subclinical hypothyroidism should be identified in patients with obesity and treated with appropriate doses of L-thyroxine according to the lean body mass and body weight. Randomized controlled trials are necessary to verify whether treatment of thyroid deficiency could counteract the expected risks.

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“…The international focus on obesity has led to a steep increase in the number of studies dealing with possible interactions between obesity and other diseases or physiology and pathophysiology of the various organs and tissues of the body. [2] The relationship between obesity and the thyroid gland is complex and bidirectional. Thyroid dysfunction (hypothyroidism or hyperthyroidism) results in changes in body weight because of the participation of thyroid hormones in the control of thermogenesis and appetite.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Function Tests, Reverse T3 and Body Mass Index in Euthyroid Elderly.

Ismail,

Abdul-Rahman,

elmaleh

2024

The Egyptian Journal of Geriatrics and Gerontology

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Background: With aging, marked changes in thyroid hormone production, metabolism, and action occur. Endocrine abnormalities are common in obesity, including altered thyroid function. Objective: To assess the relation between thyroid hormones, reverse T3 and body mass index. Patients and methods: A cross sectional study including 102 elderly patients (>60 years) was conducted in Ain-Shams University hospitals. Weight, height, body mass index (BMI), thyroid hormones and reverse T3 were measured for all patients. Patients with thyroid dysfunctions were excluded from the study. Results: BMI was not significantly related to reverse T3 or any of the measured thyroid hormone. Plot curves demonstrate a positive correlation between BMI and RT3, indicating that a rise in RT3 corresponds to an increase in body weight. Additionally, they reveal that RT3 decreases with underweight and increases with overweight, but these relationships are not statistically significant. Conclusion: Thyroid function tests and body mass index are not significantly correlated.

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Obesity, obesity-related metabolic conditions, and risk of thyroid cancer in women: results from a prospective cohort study (Sister Study)

Cited by 7 publications

References 30 publications

Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study

Organochlorine pesticides and risk of papillary thyroid cancer in U.S. military personnel: a nested case-control study

Subclinical Hypothyroidism in Patients with Obesity and Metabolic Syndrome: A Narrative Review

Thyroid Function Tests, Reverse T3 and Body Mass Index in Euthyroid Elderly.

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