J Endocr Surg.  2018 Sep;18(3):173-182. 10.16956/jes.2018.18.3.173.

Association between Obesity and Tumor Size in Patients with Papillary Thyroid Cancer

• Kim MK
• Yim SH
• Lee J
• Jo YS

• KMID: 2420774
• DOI: http://doi.org/10.16956/jes.2018.18.3.173

Abstract

PURPOSE
Many observational studies have reported a correlation between obesity and increased risk of thyroid malignancy. However, the relationship of obesity with aggressive features in papillary thyroid cancer (PTC) is controversial. We aimed to investigate whether the clinicopathological features of PTC are associated with obesity.
METHODS
We reviewed the medical records of 210 PTC patients who were followed up over a period of 10 years and examined body mass index (BMI) and other biochemical and clinicopathological parameters. The relationships between BMI and these parameters were assessed by logistic regression models based on BMI quartile (Q). The mean follow-up duration was 135.6±14.8 (range, 120-151) months.
RESULTS
BMI had a strong positive correlation with age (r=0.208; P=0.002) and tumor size (r=0.177; P=0.01). We also found that patients with a higher BMI tended to be older (P=0.011) and have elevated triglyceride concentration (P=0.006), fasting plasma glucose (P < 0.001), and thyroid-stimulating hormone (P=0.035). According to pair-wise comparisons of BMI, tumor size was remarkably higher in patients in Q4 (overweight and obese) than in patients in Q2 (normal weight) (P=0.01). In a multivariable-adjusted model, higher BMI was consistently significantly associated with larger tumor size (odds ratio, 1.433; 95% confidence interval, 1.097-2.053; P=0.041). However, there was no significant difference in long-term disease status, such as recurrence, persistent disease, and disease-free status, by BMI (P=0.781).
CONCLUSION
Higher BMI (>26.4 kg/m2) was significantly correlated with larger tumor size, but not long-term disease status, in patients with PTC.

Keyword

Obesity; Body mass index; Thyroid cancer; Prognosis

MeSH Terms

Blood Glucose
Body Mass Index
Fasting
Follow-Up Studies
Humans
Logistic Models
Medical Records
Obesity*
Prognosis
Recurrence
Thyroid Gland*
Thyroid Neoplasms*
Thyrotropin
Triglycerides
Thyrotropin

Figure

• 

  Fig. 1 Cut-off points of BMI divided by the range of probability distribution into contiguous intervals with equal quartiles, as follows: Q1 (<22 kg/m2), Q2 (22–23.8 kg/m2), Q3 (23.8–26.4 kg/m2), and Q4 (>26.4 kg/m2). BMI = body mass index; Q = quartile.

• 

  Fig. 2 Correlation between BMI with a 5-kg/m2 increase and clinicopathologic factors in patients with papillary thyroid carcinoma. (A) Correlation between BMI and age. (B) Correlation between BMI and tumor size (r=Pearson's correlation coefficient). BMI = body mass index.

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