The online version of this article (https://doi.org/10.1186/s12902-018-0232-8) contains supplementary material, which is available to authorized users.
The association between thyroid nodules and adiposity remains controversial. We performed a cross-sectional, community-based study to examine whether thyroid nodules are associated with overweight and obesity, as defined with body mass index (BMI) and waist circumference.
The study included 1482 subjects (≥20 years of age; residing in Nanjing, China) receiving questionnaire interview, anthropometric measurements, laboratory tests and thyroid ultrasonography in 2009–2010. Overweight and obesity were defined as BMI ≥24 and ≥28 kg/m2, respectively. Central obesity was defined as waist circumference at ≥90 cm in men and ≥80 cm in women. A sensitivity analysis was conducted using the American Diabetes Association (ADA) criteria for overweight and obesity (BMI ≥ 23 and ≥25 kg/m2).
Thyroid nodules were identified in 12.6% of the subjects. A greater proportion of the subjects with thyroid nodules had a BMI at ≥24 kg/m2 (51.9% vs. 40.5% in those without thyroid nodules, P = 0.003) and central obesity (43.3% vs. 24.2%, P < 0.001). After adjustment for other confounders, central obesity was still associated with significantly elevated risk of thyroid nodules (OR 1.62, 95%CI 1.14–2.28), whereas obesity/overweight based on BMI was not in both the main analysis and sensitivity analysis with the alternative criteria. In the subgroup analysis, BMI ≥24 kg/m2 (OR 1.61, 95%CI 1.01–2.54), as well as BMI ≥25 kg/m2 (OR 1.95, 95%CI 1.14–3.34), was significantly associated with higher risk of thyroid nodules among women. Using the ADA criteria, overweight and obesity were associated with thyroid nodules (OR 5.59, 95%CI 1.39–22.51 and 5.15, 95%CI 1.30–20.37) in thyroid-stimulating hormone (TSH) > 4.2 mIU/L subgroup. Central obesity correlated with higher risk of thyroid nodules regardless of age (< 50 years: OR 1.87, 95%CI 1.05–3.32: ≥50 years: OR 1.54, 95%CI 1.00–2.37) and in the following subgroups: men (OR 1.91, 95%CI 1.14–3.20), TSH > 4.2 mIU/L (OR 3.05, 95%CI 1.01–9.22), and urine iodine ≥200 µg/L (OR 1.79, 95%CI 1.14–2.81).
Waist circumference is superior to BMI for assessing risk of thyroid nodules in Chinese subjects.
Additional file 1: Table S1. Analysis of associations of thyroid nodules with different BMI cut-offs. (DOCX 19 kb)12902_2018_232_MOESM1_ESM.docx
Additional file 2: Table S2. Associations of thyroid nodules with different BMI cut-offs in subgroups of subjects stratified by gender, age, TSH or UIC. (DOCX 16 kb)12902_2018_232_MOESM2_ESM.docx
Sharen G, Zhang B, Zhao R, Sun J, Gai X, Lou H. Retrospective Epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects. Chin Med J. 2014;127(9):1661–5. PubMed
Yin J, Wang C, Shao Q, Qu D, Song Z, Shan P, Zhang T, Xu J, Liang Q, Zhang S, et al. Relationship between the prevalence of thyroid nodules and metabolic syndrome in the iodine-adequate area of Hangzhou, China: a cross-sectional and cohort study. Int J Endocrinol. 2014;2014:675796. CrossRefPubMedPubMedCentral
Chen H, Zhang H, Tang W, Xi Q, Liu X, Duan Y, Liu C. Thyroid function and morphology in overweight and obese children and adolescents in a Chinese population. J Pediatr Endocrinol Metab. 2013;26(5–6):489–96. PubMed
Chen W. Consensus statement of the Chinese medical and nutritional experts on management for overweight/obesity in China (2016). Chin J Diabetes Mellitus. 2016;8(9):525–40.
Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr. 2004;79(3):379–84. PubMed
Mamtani M, Kulkarni H, Dyer TD, Almasy L, Mahaney MC, Duggirala R, Comuzzie AG, Samollow PB, Blangero J, Curran JE. Increased waist circumference is independently associated with hypothyroidism in Mexican Americans: replicative evidence from two large, population-based studies. BMC Endocr Disord. 2014;14:46. CrossRefPubMedPubMedCentral
- Association of thyroid nodules with adiposity: a community-based cross-sectional study in China
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