title: Higher body mass index and larger waist circumference may be predictors of thyroid carcinoma in patients with Hürthle-cell lesion/neoplasm fine-needle aspiration diagnosis.
abstract: OBJECTIVE
  High body mass index (BMI) has been found to be associated with raised thyroid cancer risk, particularly in women. We examined the associations for BMI and waist circumference (WC) with thyroid cancer risk among women with Hürthle-cell lesion/neoplasm (HLN) on fine-needle aspiration biopsy (FNAB) with the hypothesis that BMI and WC could guide the management of these challenging indeterminate lesions.
  
  
  METHODS
  This cross-sectional study included 224 women with HLN who underwent thyroidectomy. In all patients, TSH and thyroid auto-antibodies were evaluated, and thyroid nodule features were recorded. Patients were grouped according to BMI (<30 or ≥30 kg/m(2)) and WC (<88 or ≥88 cm). Relationships of thyroid cancer with BMI and WC were assessed using logistic regression analysis.
  
  
  RESULTS
  Mean weight, BMI (31·26 ± 5·1 vs 26·47 ± 5·9, P < 0·001), WC (98·23 ± 7·6 vs 86·18 ± 11, P = 0·001), and proportion of patients with high BMI (≥30 kg/m(2)) (65·9 vs 33·8%, P < 0·001) or large WC (≥88 cm) (84·1 vs 47·9%, P < 0·001) were significantly higher in malignant group compared to benign group. In regression analysis, BMI and WC significantly associated with existence of malignancy. Malignancy risk was 3·819-fold higher (95% CI: 2·068-7·054) in BMI≥30 kg/m(2) group compared to BMI<30 kg/m(2), which was independent of TSH and age. Large WC was also associated with increased risk (OR = 5·593, 95% CI: 2·736-11·434). Baseline tumour characteristics were similar according to BMI and WC groups.
  
  
  CONCLUSIONS
  A great BMI and large WC were associated with higher thyroid cancer risk in patients with FNAB diagnosis of HLN. Further studies are needed to use BMI or WC in the management of patients with HLN.
authors.affiliation: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Diabetes, Endocrine and Obesity Branch, Bethesda, MD, USA.
authors.forename: Ayse
authors.initials: A
authors.lastname: Arduc
authors.affiliation: Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Bercem Aycicek
authors.initials: BA
authors.lastname: Dogan
authors.affiliation: Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Mazhar Muslum
authors.initials: MM
authors.lastname: Tuna
authors.affiliation: Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Tutuncu
authors.affiliation: Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Serhat
authors.initials: S
authors.lastname: Isik
authors.affiliation: Department of Endocrinology and Metabolism, Ministry of Health, Ankara Numune Research and Training Hospital, Ankara, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Berker
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Hitit University, Corum, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Guler
mesh_terms: D018249:Adenoma, Oxyphilic / Q000097:blood / Q000473:pathology* / Q000601:surgery; D000328:Adult; D001323:Autoantibodies / Q000097:blood; D044963:Biopsy, Fine-Needle; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007453:Iodide Peroxidase / Q000276:immunology; D016015:Logistic Models; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D013954:Thyroglobulin / Q000276:immunology; D013961:Thyroid Gland / Q000473:pathology* / Q000601:surgery; D013964:Thyroid Neoplasms / Q000097:blood / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood; D055105:Waist Circumference
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D014284:Triiodothyronine; D013972:Thyrotropin; D013954:Thyroglobulin; D007453:Iodide Peroxidase; D013974:Thyroxine