Aim of this study was to evaluate the association between body mass index (BMI) and aggressive features of differentiated thyroid cancer (DTC) in a prospective cohort.
Patients with DTC were prospectively enrolled at a tertiary referral center and grouped according to their BMI. Aggressive clinic-pathological features were analyzed following the American Thyroid Association Initial Risk Stratification System score.
The cohort was composed of 432 patients: 5 (1.2%) were underweight, 187 (43.3%) normal weight, 154 (35.6%) overweight, 68 (15.7%) grade 1 obese, 11 (2.5%) grade 2 obese and 7 (1.6%) grade 3 obese. No single feature of advanced thyroid cancer was more frequent in obese patients than in others. No significant correlation was found between BMI, primary tumor size (Spearman’s ρ − 0.02; p = 0.71) and ATA Initial Risk Stratification System score (ρ 0.03; p = 0.49), after adjustment for age. According to the multivariate logistic regression analysis, male gender and pre-surgical diagnosis of cancer were significant predictors of cancer with high or intermediate–high recurrence risk according to the ATA system (OR 2.06 and 2.51, respectively), while older age at diagnosis was a protective factor (OR 0.98), and BMI was not a predictor. BMI was a predictor of microscopic extrathyroidal extension only (OR 1.06).
Obesity was not associated with aggressive features in this prospective, European cohort of patients with DTC.
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The study was supported by the Italian Ministry of Universities and Research (MIUR/PRIN 2015 cod. 2015B7M39T_005), the Fondazione Umberto Di Mario ONLUS and Banca d’Italia.
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Thyroid cancer patient data were collected at our site, after obtaining the informed consent of the patients and approval of the local ethics committee.
The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.
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Grani, G., Lamartina, L., Montesano, T. et al. Lack of association between obesity and aggressiveness of differentiated thyroid cancer. J Endocrinol Invest 42, 85–90 (2019). https://doi.org/10.1007/s40618-018-0889-x
- Body mass index
- Thyroid cancer
- Cancer size
- Aggressive cancer
- Advanced stage