Sex-dependent impact of obesity on aggressiveness of papillary thyroid cancer

Xiu Huang; Yali Han; Jie Yang; Le Bu; Xiaoyun Cheng; Xiaojuan Zha; Haibing Chen; Yueye Huang; Shen Qu

doi:10.1007/s42000-023-00517-8

Sex-dependent impact of obesity on aggressiveness of papillary thyroid cancer

Hormones (Athens). 2023 Dec 19. doi: 10.1007/s42000-023-00517-8. Online ahead of print.

Authors

Xiu Huang^#^{1

2}, Yali Han^#^{1

2}, Jie Yang^#³, Le Bu¹, Xiaoyun Cheng¹, Xiaojuan Zha^{1

2}, Haibing Chen¹, Yueye Huang^{4

5}, Shen Qu^{6

7}

Affiliations

¹ Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
² Shanghai Center of Thyroid Diseases, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China.
³ Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, 200433, People's Republic of China.
⁴ Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China. huangyueye19890603@163.com.
⁵ Shanghai Center of Thyroid Diseases, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China. huangyueye19890603@163.com.
⁶ Department of Endocrinology and Metabolism, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China. qushencn@hotmail.com.
⁷ Shanghai Center of Thyroid Diseases, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, 200072, People's Republic of China. qushencn@hotmail.com.

^# Contributed equally.

PMID: 38112916
DOI: 10.1007/s42000-023-00517-8

Abstract

Purpose: To investigate the impact of body mass index (BMI) on the aggressiveness of papillary thyroid cancer (PTC).

Methods: A total of 1720 PTC patients with total thyroidectomy or lobectomy, from January 2017 to April 2020, were retrospectively evaluated. Based on BMI, they were divided into two groups, as follows: control (CON, < 24 kg/m²) and overweight and obesity (OB, ≥ 24 kg/m²), each sex being analyzed separately.

Results: In the whole cohort, the OB group had significantly higher rates of extrathyroidal extension (21.5 vs. 16.8%, p = 0.013), multifocality (43.2 vs. 37.7%, p = 0.018), and BRAF-V600E mutation (82.9 vs. 79.3%, p = 0.015) than the CON group. In males, the OB group had increased rates of tumor size over 1cm (54.4 vs. 42.7%, p = 0.008), extrathyroidal extension (24.9 vs. 12.4%, p = 0.001), and multifocality (42.7 vs. 33.5%, p = 0.038). The OB group had significantly higher adjusted odds ratios (ORs) of 1.63 (1.14-2.33, p = 0.008), 2.12 (1.26-3.57, p = 0.005), and 1.56 (1.07-2.29, p = 0.022) for tumor size over 1cm, extrathyroidal extension, and multifocality compared with CON. Additionally, overweight and obesity were analyzed alone and the rates of extrathyroidal extension (30/100, 30.0%, p = 0.001) and tumor size over 1cm (65/100, 65.0%, p = 0.001) were significantly higher in the obesity group than in the overweight and CON groups. The obesity group had robust higher adjusted ORs of 2.51(1.50-4.20, p < 0.001), 2.93 (1.50-5.73, p = 0.002) and 1.89 (1.11-3.22, p = 0.020) for tumor size over 1cm, extrathyroidal extension, and multifocality compared with CON.

Conclusions: Overweight and obesity were predominant independent risk factors for PTC aggressiveness in males. These data indicated that the therapeutic treatment should be based on risk stratification by BMI in males.

Keywords: Obesity; Papillary thyroid cancer; Risk factors; Sex.

Abstract

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