title: The association between insulin resistance and vascularization of thyroid nodules.
abstract: BACKGROUND
  Insulin resistance (IR) is an important factor for the growth and progression of thyroid nodules, which might be associated with the distribution, construction, and density of nodular vascularization.
  
  
  OBJECTIVE
  The objective of the study was to explore the association between IR and the vascularization of thyroid nodules.
  
  
  METHODS
  A cross-sectional, population-based study was conducted in Nanjing, China, from June to November 2011.
  
  
  METHODS
  Among 10 050 participants aged 40-79 years, 2886 thyroid nodule cases were detected and 2532 cases met eligibility criteria for enrollment in the study.
  
  
  METHODS
  Power Doppler was performed to measure the flow patterns, resistive index (RI), and vascular index (VI) of thyroid nodular vascularization. Fasting insulin, fasting glucose, 2-hour oral glucose tolerance test, glycosylated hemoglobin (HbA1c), homeostasis model assessment of IR (HOMA-IR), and body mass index were also tested.
  
  
  RESULTS
  HOMA-IR (R = 0.35, P < .001) and HbA1c (R = 0.19, P < .001) were positively correlated with thyroid nodular flow patterns, and the positive correlations were more significant in participants with large nodules (volume ≥ 0.2 mL). Additionally, in participants with large nodules, HOMA-IR and HbA1c were positively correlated with RI (HOMA-IR: β = .42, SE = .03, R = 0.43, P < .001; HbA1c: β = .22, SE = .04, R = 0.23, P < .001) and VI (HOMA-IR: β = .49, SE = 0.05, R = 0.53, P < .001; HbA1c: β = .34, SE = 0.11, R = 0.37, P < .001).
  
  
  CONCLUSIONS
  IR and hyperglycemia were positively correlated with the flow patterns, RI, and VI of thyroid nodules, especially in large nodules. The findings suggest a pivotal role of IR in the distribution, construction, and density of thyroid nodular vascularization, which might contribute to the growth and the progression of thyroid nodules.
authors.affiliation: Departments of Endocrinology (K.W., Y.Y., J.C., D.Z., X.M., C.L.) and Ultrasonography (X.W., X.L.), Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, China; and Department of Endocrinology (Y.W.), The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou 213003, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Yu
authors.initials: Y
authors.lastname: Yang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.forename: Jie
authors.initials: J
authors.lastname: Chen
authors.forename: Danyu
authors.initials: D
authors.lastname: Zhang
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Mao
authors.forename: Xinping
authors.initials: X
authors.lastname: Wu
authors.forename: Xianqin
authors.initials: X
authors.lastname: Long
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D014463:Ultrasonography
chemical_list: D001786:Blood Glucose