Evaluation of Risk Factors for Malignancy in Patients With Thyroid Nodules

Amir M. Zaid, Eslam Eid, Sherihan I. Gouda, Mohamed M. Aboelnaga, Ramy A. Abdelsalam, Ahmed Mamdouh Gaber Elbeltagy, Doaa M. Khedr, Mosab Shetiwy, Islam A. Elzahaby, Mohamed T. Hafez


Background: Despite thyroid nodules mostly have benign nature, there are always malignancy risks. Therefore, understanding the mechanisms influencing this potential malignant transformation is highly important in thyroid cancer prevention strategies. We aimed in this case-control study to investigate the relationship of anthropometric parameters, and insulin resistance with thyroid nodules and the malignancy risk in nodular thyroid patients.

Methods: This single-center case-control study included 81 patients with thyroid nodules who were divided into two groups according to post-thyroidectomy pathology: the malignant group included 36 differentiated thyroid carcinoma patients and the benign group included 45 patients. We compared the anthropometric and radiological parameters, homeostasis model assessment of insulin resistance (HOMA-IR), and insulin levels between both groups.

Results: We observed significant differences as regard HOMA-IR, insulin levels and waist circumference between both groups. Benign thyroid nodules volume correlated with weight, waist, body mass index (BMI), fat percentage, age, HOMA-IR, and insulin levels. Malignant thyroid nodules volume did not correlate with any parameters apart from weight. We found that the final significant risk factor was HOMA-IR in stepwise logistic regression analysis.

Conclusions: Malignant thyroid nodules are associated with higher insulin resistance, visceral obesity, and hyperinsulinemia. Furthermore, higher HOMA-IR is a significant risk factor for differentiated thyroid carcinoma.

J Endocrinol Metab. 2022;12(2):66-72
doi: https://doi.org/10.14740/jem770


Thyroid nodules; HOMA-IR; Insulin; Waist; Visceral obesity

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