Skip to main content

Advertisement

SpringerLink
Log in

Influence of body mass index on the clinicopathological features of 13,995 papillary thyroid tumors

  • Original Article
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

Abstract

Purpose

This retrospective study aimed to assess the association between obesity, gender, and specific clinicopathological features in patients with papillary thyroid cancer (PTC) and whether diagnostic ultrasonography (US) is adversely affected by obesity in these patients.

Materials and methods

This study retrospectively analyzed 13,995 adult patients with PTC from a single medical center in China. Data stratification was performed to assess the association of obesity with US features and aggressive clinicopathological features in different models according to the World Health Organization Body Mass Index (WHO-BMI) and Chinese BMI classification (CN‐BMI). The odds ratio (OR) of malignant US features and aggressive clinicopathological features was calculated from binary logistic regression models.

Results

The BMI, obesity ratio, malignant US features, and aggressive pathological characteristics of males were significantly higher than those of females. After adjusting for confounding factors, the association of obesity with malignant US features and aggressive pathological characteristics was found to be sex-dependent. Next, obesity (WHO-BMI) was found to have an “interfering effect” on the US assessment of PTC (OR = 0.754, 95% CI 0.609–0.932, P = 0.009) in women. Among both sexes, obesity (WHO-BMI) increased the risk of tumor size (ORmale = 1.539 and ORfemale = 1.521) and multifocality (ORmale = 1.659 and ORfemale = 1.449). However, obesity did not increase the risk of capsular invasion or tumor staging in males. The above results are consistent with the CN-BMI. In addition, age was found to have an “interfering effect” on the US evaluation of malignant nodules in both sexes.

Conclusion

The results of our study confirm that higher BMI is significantly associated with aggressive clinicopathological features of PTC. Gender differences were present with obesity ratios and aggressive clinicopathological features being significantly higher in men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. NCD Risk Factor Collaboration (2016) Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 192 million participants. Lancet 387(10026):1377–1396

    Article  Google Scholar 

  2. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F et al (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66(2):115–132

    Article  PubMed  Google Scholar 

  3. Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K (2016) Body fatness and cancer-viewpoint of the IARC Working Group. N Engl J Med 375(8):794–798

    Article  PubMed  PubMed Central  Google Scholar 

  4. Shan Z, Chen L, Lian X, Liu C, Shi B, Shi L et al (2016) Iodine status and prevalence of thyroid disorders after introduction of mandatory universal salt iodization for 16 years in china: a cross-sectional study in 10 cities. Thyroid 26(8):1125–1130

    Article  CAS  PubMed  Google Scholar 

  5. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA et al (2017) ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol 14(5):587–595

    Article  PubMed  Google Scholar 

  6. Perrier ND, Brierley JD, Tuttle RM. Differentiated and anaplastic thyroid carcinoma: major changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin 2018;68(1):55–63.

    Article  PubMed  Google Scholar 

  7. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organization technical report series. 2000;894:i-xii, 1–253.

  8. Chinese expert consensus compilation committee of overweight/obesity medical nutrition therapy. Consensus statement of the Chinese medical and nutritional experts on management for overweight/obesity in China. Chin J Diabetes Mellitus. 2016;8(9):525‐540.

  9. Li CL, Zhou L, Dionigi G, Li F, Zhao YS, Sun H (2020) The association between tumor tissue calcification, obesity, and thyroid cancer invasiveness in a cohort study. Endocrine Practice. https://doi.org/10.4158/EP-2020-0057.

  10. Tresallet C, Seman M, Tissier F, Buffet C, Lupinacci RM, Vuarnesson H et al (2014) The incidence of papillary thyroid carcinoma and outcomes in operative patients according to their body mass indices. Surgery 156(5):1145–1152

    Article  PubMed  Google Scholar 

  11. Kim HJ, Kim NK, Choi JH, Sohn SY, Kim SW, Jin SM et al (2013) Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer. Clin Endocrinol 78(1):134–140

    Article  Google Scholar 

  12. Dieringer P, Klass EM, Caine B, Smith-Gagen J (2015) Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study. J Cancer Res Clin Oncol 141(1):93–98

    Article  PubMed  Google Scholar 

  13. Gasior-Perczak D, Palyga I, Szymonek M, Kowalik A, Walczyk A, Kopczynski J et al (2018) The impact of BMI on clinical progress, response to treatment, and disease course in patients with differentiated thyroid cancer. PLoS ONE 13(10):e0204668

    Article  PubMed  PubMed Central  Google Scholar 

  14. Grani G, Lamartina L, Montesano T, Ronga G, Maggisano V, Falcone R et al (2019) Lack of association between obesity and aggressiveness of differentiated thyroid cancer. J Endocrinol Invest 42(1):85–90

    Article  CAS  PubMed  Google Scholar 

  15. Paes JE, Hua K, Nagy R, Kloos RT, Jarjoura D, Ringel MD (2010) The relationship between body mass index and thyroid cancer pathology features and outcomes: a clinicopathological cohort study. J Clin Endocrinol Metab 95(9):4244–4250

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Kim SK, Woo JW, Park I, Lee JH, Choe JH, Kim JH et al (2016) Influence of body mass index and body surface area on the behavior of papillary thyroid carcinoma. Thyroid 26(5):657–666

    Article  PubMed  Google Scholar 

  17. Yu ST, Chen W, Cai Q, Liang F, Xu D, Han P et al (2017) Pretreatment BMI is associated with aggressive clinicopathological features of papillary thyroid carcinoma: a multicenter study. Int J Endocrinol 2017:5841942

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lee J, Lee CR, Ku CR, Kang SW, Jeong JJ, Shin DY et al (2015) Association between obesity and brafv600e mutation status in patients with papillary thyroid cancer. Ann Surg Oncol 22(Suppl 3):S683–S690

    Article  PubMed  Google Scholar 

  19. Choi JS, Kim EK, Moon HJ, Kwak JY (2015) Higher body mass index may be a predictor of extrathyroidal extension in patients with papillary thyroid microcarcinoma. Endocrine 48(1):264–271

    Article  CAS  PubMed  Google Scholar 

  20. Wu C, Wang L, Chen W, Zou S, Yang A (2017) Associations between body mass index and lymph node metastases of patients with papillary thyroid cancer: a retrospective study. Medicine 96(9):e6202

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kim SH, Park HS, Kim KH, Yoo H, Chae BJ, Bae JS et al (2015) Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer. Surg Today 45(6):723–729

    Article  CAS  PubMed  Google Scholar 

  22. Feng JW, Yang XH, Wu BQ, Sun DL, Jiang Y, Qu Z (2019) Influence of Body mass index on the clinicopathologic features of papillary thyroid carcinoma. Ann Otol Rhinol Laryngol 128(7):625–632

    Article  PubMed  Google Scholar 

  23. Rotondi M, Castagna MG, Cappelli C, Ciuoli C, Coperchini F, Chiofalo F, Maino F, Palmitesta P, Chiovato L, Pacini F (2016) Obesity does not modify the risk of differentiated thyroid cancer in a cytological series of thyroid nodules. Eur Thyroid J 5(2):125–131

    Article  PubMed  PubMed Central  Google Scholar 

  24. Zhao ZG, Guo XG, Ba CX, Wang W, Yang YY, Wang J, Cao HY (2012) Overweight, obesity and thyroid cancer risk: a meta-analysis of cohort studies. J Int Med Res 40(6):2041–2050

    Article  CAS  PubMed  Google Scholar 

  25. Huang H, Rusiecki J, Zhao N, Chen Y, Ma S, Yu H et al (2017) Thyroid-stimulating hormone, thyroid hormones, and risk of papillary thyroid cancer: a nested case-control study. Cancer Epidemiol Biomark Prev 26(8):1209–1218

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Engineering Laboratory of Thyroid Disease Prevention and Control, Changchun, Jilin, China

    C. L. Li, Y. S. Zhao, N. Liang & H. Sun

  2. Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital G. Martino, University of Messina, Via C. Valeria 1, 98125, Messina, Italy

    G. Dionigi

Authors
  1. C. L. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Dionigi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. S. Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Liang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H. Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: HS, GD. Administrative support: Hui Sun. Collection and assembly of data: CL. Data analysis and interpretation: CL. Manuscript writing: CL, GD. Final approval of manuscript: All authors.

Corresponding author

Correspondence to H. Sun.

Ethics declarations

Conflict of interest

The author claims that there is no conflict of interest.

Ethical approval

The study was approved by the Health Care Ethics Committee of the China-Japan Union Hospital of Jilin University (No.2019040806).

Informed consent

Written informed consent for participation was obtained from each study participant.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 114 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, C.L., Dionigi, G., Zhao, Y.S. et al. Influence of body mass index on the clinicopathological features of 13,995 papillary thyroid tumors. J Endocrinol Invest 43, 1283–1299 (2020). https://doi.org/10.1007/s40618-020-01216-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40618-020-01216-6

Keywords

Search

Navigation