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Potential impact of obesity on the aggressiveness of low- to intermediate-risk papillary thyroid carcinoma: results from a MASTER cohort study

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Abstract

Purpose

Obesity is associated with an increased risk of papillary thyroid carcinoma (PTC). Evidence of the impact of obesity on PTC aggressiveness is scarce. We aimed to evaluate the association between the body mass index (BMI) and the presence of aggressive features of low- to intermediate-risk PTC in a prospective cohort.

Methods

We prospectively enrolled 1,032 patients with low- to intermediate-risk PTC who underwent lobectomy at 22 hospitals in Korea and divided into three groups according to BMI, as follows: normal/underweight ( < 23 kg/m2), overweight (23–24.9 kg/m2), and obese ( ≥ 25 kg/m2). Clinicopathological features of PTC at diagnosis were evaluated.

Results

Obese patients had a higher rate of macro-PTC ( > 1 cm) and greater incidence of extra-thyroidal extension (ETE), vascular invasion, and intermediate-risk tumors than those not classified as obese. Increased BMI was positively associated with the incidence of macro-PTC, ETE, vascular invasion, and intermediate-risk category. After adjusting for age, sex, pathological features, metabolic syndrome, thyroid function test, and smoking habits, obesity was a risk factor for ETE (odds ratio [OR] = 1.7, 95% confidence interval [CI]: 1.2–2.5, p = 0.005) and intermediate-risk PTC (OR = 1.7, 95% CI: 1.1–2.5, p = 0.011) in women. The association between obesity and ETE was significant regardless of whether or not women had metabolic syndrome. There was no significant association between obesity and aggressive PTC features in men.

Conclusion

BMI at the time of thyroid cancer diagnosis may affect the aggressiveness of low- to intermediate-risk PTC, especially in women.

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Funding

This study was supported by a grant from the Patient-Centered Clinical Research Coordinating Center funded by the Ministry of Health & Welfare, Republic of Korea (grant numbers: HI19C0481, HC19C0103).

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Author notes

  1. These authors contributed equally: Mijin Kim, Yae Eun Kang

Authors and Affiliations

  1. Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea

    Mijin Kim & Bo Hyun Kim

  2. Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Mijin Kim & Bo Hyun Kim

  3. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea

    Yae Eun Kang

  4. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea

    Young Joo Park

  5. Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine, Daejeon, Republic of Korea

    Bon Seok Koo

  6. Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea

    Eu Jeong Ku

  7. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

    June Young Choi

  8. Center for Thyroid Cancer, National Cancer Center, Goyang, Republic of Korea

    Eun Kyung Lee

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  1. Mijin Kim
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Correspondence to Eun Kyung Lee or Bo Hyun Kim.

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The study protocol was reviewed and approved by the Institutional Review Board of each participating institution (trial registration number: KCT0004989).

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Kim, M., Kang, Y.E., Park, Y.J. et al. Potential impact of obesity on the aggressiveness of low- to intermediate-risk papillary thyroid carcinoma: results from a MASTER cohort study. Endocrine 82, 134–142 (2023). https://doi.org/10.1007/s12020-023-03416-5

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  • DOI: https://doi.org/10.1007/s12020-023-03416-5

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