Association between Obesity and Tumor Size in Patients with Papillary Thyroid Cancer
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Purpose: Many observational studies have reported a correlation between obesity and increased risk of thyroid malignancy. However, the relationship of obesity with aggressive features in papillary thyroid cancer (PTC) is controversial. We aimed to investigate whether the clinicopathological features of PTC are associated with obesity. Methods: We reviewed the medical records of 210 PTC patients who were followed up over a period of 10 years and examined body mass index (BMI) and other biochemical and clinicopathological parameters. The relationships between BMI and these parameters were assessed by logistic regression models based on BMI quartile (Q). The mean follow-up duration was 135.6±14.8 (range, 120–151) months. Results: BMI had a strong positive correlation with age (r=0.208; P=0.002) and tumor size (r=0.177; P=0.01). We also found that patients with a higher BMI tended to be older (P=0.011) and have elevated triglyceride concentration (P=0.006), fasting plasma glucose (P<0.001), and thyroid-stimulating hormone (P=0.035). According to pair-wise comparisons of BMI, tumor size was remarkably higher in patients in Q4 (overweight and obese) than in patients in Q2 (normal weight) (P=0.01). In a multivariable-adjusted model, higher BMI was consistently significantly associated with larger tumor size (odds ratio, 1.433; 95% confidence interval, 1.097–2.053; P=0.041). However, there was no significant difference in long-term disease status, such as recurrence, persistent disease, and disease-free status, by BMI (P=0.781). Conclusion: Higher BMI (>26.4 kg/m2) was significantly correlated with larger tumor size, but not long-term disease status, in patients with PTC.
Abstract
Purpose: Many observational studies have reported a correlation between obesity and increased risk of thyroid malignancy. However, the relationship of obesity with aggressive features in papillary thyroid cancer (PTC) is controversial. We aimed to investigate whether the clinicopathological features of PTC are associated with obesity. Methods: We reviewed the medical records of 210 PTC patients who were followed up over a period of 10 years and examined body mass index (BMI) and other biochemical and clinicopathological parameters. The relationships between BMI and these parameters were assessed by logistic regression models based on BMI quartile (Q). The mean follow-up duration was 135.6±14.8 (range, 120–151) months. Results: BMI had a strong positive correlation with age (r=0.208; P=0.002) and tumor size (r=0.177; P=0.01). We also found that patients with a higher BMI tended to be older (P=0.011) and have elevated triglyceride concentration (P=0.006), fasting plasma glucose (P<0.001), and thyroid-stimulating hormone (P=0.035). According to pair-wise comparisons of BMI, tumor size was remarkably higher in patients in Q4 (overweight and obese) than in patients in Q2 (normal weight) (P=0.01). In a multivariable-adjusted model, higher BMI was consistently significantly associated with larger tumor size (odds ratio, 1.433; 95% confidence interval, 1.097–2.053; P=0.041). However, there was no significant difference in long-term disease status, such as recurrence, persistent disease, and disease-free status, by BMI (P=0.781). Conclusion: Higher BMI (>26.4 kg/m2) was significantly correlated with larger tumor size, but not long-term disease status, in patients with PTC.
참고문헌 (18)
- Stevens GA, "National, regional, and global trends in adult overweight and obesity prevalences", Popul Health Metr, 10, pp.22~ (2012)
- Haslam DW, "Obesity", Lancet, 366, pp.1197~1209 (2005)
- Son H, "The risk of thyroid cancer and obesity: a nationwide population-based study using the Korea National Health Insurance Corporation cohort database", Surg Oncol, 27, pp.166~171 (2018)
- Calle EE, "Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults", N Engl J Med, 348, pp.1625~1638 (2003)
- Wolin KY, "Obesity and cancer", Oncologist, 15, pp.556~565 (2010)
- Reeves GK, "Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study", BMJ, 335, pp.1134~ (2007)
- Renehan AG, "Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies", Lancet, 371, pp.569~578 (2008)
- Allott EH, "Obesity and cancer: mechanistic insights from transdisciplinary studies", Endocr Relat Cancer, 22, pp.R365~R386 (2015)
- Han JM, "Obesity is a risk factor for thyroid cancer in a large, ultrasonographically screened population", Eur J Endocrinol, 168, pp.879~886 (2013)
- Paes JE, "The relationship between body mass index and thyroid cancer pathology features and outcomes: a clinicopathological cohort study", J Clin Endocrinol Metab, 95, pp.4244~4250 (2010)
- Hursting SD, "Energy balance, host-related factors, and cancer progression", J Clin Oncol, 28, pp.4058~4065 (2010)
- Lee J, "Association between obesity and BRAFV600E mutation status in patients with papillary thyroid cancer", Ann Surg Oncol, 22(Suppl 3), pp.S683~S690 (2015)
- Kim HJ, "Associations between body mass index and clinico-pathological characteristics of papillary thyroid cancer", Clin Endocrinol (Oxf), 78, pp.134~140 (2013)
- Wu C, "Associations between body mass index and lymph node metastases of patients with papillary thyroid cancer: a retrospective study", Medicine (Baltimore), 96, pp.e6202~ (2017)
- Grani G, "Lack of association between obesity and aggressiveness of differentiated thyroid cancer", J Endocrinol Invest (2018)
- Kitahara CM, "Obesity and thyroid cancer risk among U.S. men and women: a pooled analysis of five prospective studies", Cancer Epidemiol Biomarkers Prev, 20, pp.464~472 (2011)
- Kitahara CM, "Childhood height and body mass index were associated with risk of adult thyroid cancer in a large cohort study", Cancer Res, 74, pp.235~242 (2014)
- Dieringer P, "Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study", J Cancer Res Clin Oncol, 141, pp.93~98 (2015)