Correlation Between Thyroid Nodules and Metabolic Syndrome: A Systematic Review and Meta-Analysis

Abstract

ObjectiveThyroid nodules (TNs) are a common thyroid disorder that can be caused by many factors. Several studies have investigated the relationship between TNs and metabolic syndrome (MetS), but the role of sex and age remains controversial. The purpose of this paper was to analyze published data from all relevant studies to reliably estimate the relationship between TNs and MetS.MethodsThirteen articles were included in this study; articles were identified by searching for publications until July 2021 in PubMed, EMBASE, the Cochrane Library and the Web of Science. The outcomes are presented as the summary odds ratio (OR) and 95% confidence interval (CI) and the pooled prevalence and 95% CI.ResultsThe TNs prevalence was significantly higher in MetS patients than in controls (OR 1.88, 95% CI 1.42-2.50, P < 0.0001) and was independent of sex (male: OR 1.53, 95% CI 1.20-1.94, P = 0.0006; female: OR 1.90, 95% CI 1.54-2.33, P < 0.00001; combined: OR 2.06, 95% CI 1.31-3.25, P = 0.002) and age (< 40 years old: OR 1.62, 95% CI 1.39-1.89, P < 0.0001; 40~50 years old: OR 2.14, 95% CI 1.49-3.08, P < 0.0001;50~60 years old: OR 1.50, 95% CI 1.08-2.07, P = 0. 01; 60 years old: OR 1.70, 95% CI 1.36-2.14, P < 0.00001); the pooled TNs prevalence in MetS patients was 45% (95% CI 36-54%). However, it has not yet been considered that MetS is related to TNs in people with iodine deficiency (OR 3.14, 95% CI 0.92-10.73, P = 0.07).ConclusionThe meta-analysis results showed a strong correlation between TNs and MetS. Both male and female patients with MetS had an increased TNs prevalence. In addition, the prevalence was independent of age. However, MetS is not considered to be associated with TNs in iodine-deficient populations.

The prevalence of thyroid nodules and its factors among Chinese adult women: A cross-sectional study

“…Metabolic Syndrome is indeed associated with the prevalence of TN(s). Component diseases such as central obesity, abnormal blood pressure, hyperglycemia, and hypertriglyceridemia are also associated with thyroid nodules, a finding supported by several meta-analyses ( 25 , 29 ). However, our results did not show a correlation between low HDL - C and thyroid nodules, which is inconsistent with other conclusions ( 58 ).…”

“…It is worth noting that most of these risk factors are components of Metabolic Syndrome (MetS), which includes abdominal obesity; atherogenic dyslipldemia; hypertension; hyperglycemia and so on. A meta-analysis showed that a strong correlation between TN(s) and MetS in the non-iodine-deficient population ( 25 ). A study found that the thyroid was the target organs for MetS ( 3 ), and a portion of MetS patients had thyroid nodules ( 26 ).…”

Glucose Metabolism Derangements and Thyroid Nodules: Does Sex Matter?

“…Previous studies explored the association between GMD and TNs [ 20 , 21 , 22 , 23 ], but only a few of them investigated a possible sex-based association between GMD and TNs [ 24 , 25 , 26 , 27 ]. In the study by Ding et al [ 24 ], T2DM and metabolic syndrome were independently associated with TNs in females but not in males, supporting the hypothesis that sex may be an important factor influencing TN development in the general population living in a rural Chinese region.…”

“…Insulin-resistance (IR) plays a pivotal role in causing hyperinsulinemia, which, in turn, could stimulate thyroid follicular cell proliferation [ 20 ]. Furthermore, metabolic syndrome seems to be associated with TNs [ 21 , 22 , 23 ].…”

Accuracy of fine‐needle aspiration cytopathology to differentiate malignant and benign thyroid nodules with ≥4 cm diameter: A retrospective study

“…Thyroid nodules (TN) are a relatively prevalent thyroid gland disorder. 1 Palpation detects only a small number of TNs (3%-7%), While this rate is much higher in ultrasonographic examination with highresolution devices (up to 76%), 2 making it the first choice for nodule detection and investigation for potential malignancy. 3 Malignancy risk of TN has been reported to be 3.1% and 4.7% in patients with multinodular goiter and solitary TNs, respectively.…”