Analysis Of The Relationship Between Body Mass Index And Estrogen And Differentiated Thyroid Carcinoma

Objective: To investigate the relationship between body mass index(BMI)and estrogen and differentiated thyroid carcinoma(DTC)and to provide the basis for clinical diagnosis and treatment of DTC.Methods: This study retrospectively analyzed the data of 1242 patients who were treated by the same surgical group of bethune in the First Affiliated Hospital of Jilin University from October 2014 to October 2016.There were 917 cases of DTC and 325 cases of benign thyroid tumor.We carried out a comparative study to compare the differences of clinical features and the pathological characteristics of DTC.Single factor analysis was used to find the influencing factors of DTC,At the same time,the single factor analysis was applied into the multivariate analysis,and the risk factors of differentiated thyroid cancer were found by multiple regression analysis.Analysis of the relationship between BMI and estrogen levels in DTC according to the World Health Organization definition standard of overweight and obesity:BMI<25kg/m2 as normal control group,25kg/m2≤ BMI < 30kg/m2 as overweight,BMI ≥ 30kg/m2 as obese group,comparison of the clinical features of DTC in different groups,and risk analysis of BMI increased 5kg/m2 differentiated thyroid.According to the basic level of estrogen in males and females,respectively.The correlation between male and female hormone level and clinical characteristics,pathological features and compare the relationship between estrogen levels and of differentiated thyroid carcinoma.Female patients were divided into two groups according to their previous history of endocrine diseases.Results:(1)There are 155 males cases and 762 female cases of all 917 cases,the ratio of male to female was 1:4.9.(2)Single factor analysis:(1)BMI ≥ 25Kg/m2 accounted for 42% in patients with DTC(398/917),with increase in body mass index,the risk of DTC increased by 1.35 times(OR=1.35,95%:1.04-1.75,P=0.026);(2)The risk of DTC was increased by 2.54 times with the increase of estradiol level(OR=2.54,95%:1.95-3.31,P<0.001).(3)Multivariate logistic regression analysis showed that age less than 45 years,TSH>2.11 m U/L,BMI≥25Kg/m2 are the independent risk factors of DTC;(4)Relationship between BMI and DTC:(1)The risk of DTC increased with the increase of body weight per 5Kg/m2,the difference was statistically significant(P=0.049);(2)the malignant degree of DTC and BMI does not have certain correlation;(5)The relationship between estrogen and DTC:1)for women patients:(1)the estrogen level more than 175 pmol/L,the ratio of patients with DTC accounted for 84.5%(432/511),estrogen levels less than 175 pmol/L,the ratio of patients with DTC accounted for 64.6%(330/511),the difference was statistically significant(P<0.05);(2)female patients with DTC,estrogen > 175 pmol/L,lymph node metastasis rate was 44.4%(192/432),female patients with estrogen more than 175pmol/L,the lymph node metastasis rate was 33.9%(112/330),the difference was statistically significant(P<0.05);(3)DTC patients with the history of endocrine disease(breast cancer,breast fibroma,breast nodules,uterine fibroids,ovarian cysts)accounted for 83%(117/141),DTC patients who did not have history of endocrine diseases accounted for 73.2%(645/881),the difference was statistically significant(P<0.05);2).For male patients:(1)male hormone levels more than 113 pmol/L,DTC accounted for 76.8%(86/112),estrogen less than 113pmol/L,DTC accounted for 63.9%(69/108),the difference was statistically significant(P < 0.05).Conclusions:(1)patients aged less than 45 years,TSH>2.11 m U/L and BMI≥25Kg/m2 are the independent risk factors of DTC,which should be paid attention;(2)the risk of differentiated thyroid carcinoma increases with the increase of BMI,patients who has exceeding BMI should be paid more attention;(3)BMI and malignant degree of DTC do not have a certain correlation;(4)higher level of estrogen has correlationship with higher risk of DTC,and is more likely to be associated with lymph node metastasis;(5)female patients with endocrine system disease history has increased risk of DTC,at the same time,it has been proved that the change of estrogen level has a certain influence on the development of DTC;(6)male patients with elevated estrogen levels are more likely to suffer from DTC.