Predictive Role Of High-Density Lipoprotein And Body Mass Index In Differentiated Thyroid Carcinoma

Objective: High-density lipoprotein (HDL) and body mass index (BMI) have been implicated in carcinogenesis. However, the significance of HDL and BMI in differentiated thyroid carcinoma (DTC) has not been elucidated. The aim of this study was to assess the roles of HDL and BMI in carcinogenesis and in the prognosis of DTC. Methods: HDL concentrations and BMI values were measured in 155 male patients with DTC and in 65 male patients with benign thyroid nodules. Multivariate logistic regression and Cox regression analyses were performed to evaluate the correlation between variables. Receiver operating characteristic (ROC) curves were constructed to assess the performance of HDL and BMI in the diagnosis of DTC and the prediction of four-year recurrence. Results: HDL (OR, 0.581; 95% CI, 0.371-0.909; p = 0.018) and BMI (OR, 1.174; 95% CI, 1.051-1.130, p = 0.004) were both independent risk factors of DTC. HDL was negatively correlated with distant metastasis (OR, 0.006; 95% CI, 0.000-0.517; p = 0.025), while BMI was significantly correlated with capsule invasion (OR, 1.193; 95% CI, 1.057-1.347; p = 0.004) and multifocality (OR, 1.208; 95% CI, 1.079-1.353; p = 0.001). ROC analysis indicated that HDL could be a good marker for the diagnosis of DTC (AUC, 0.857; 95% CI, 0.805-0.910; p = 0.006) at a cutoff value of 1.37 mmol/L and the prediction of four-year recurrence (AUC, 0.730; 95% CI, 0.585-0.875; p = 0.006) at a cutoff value of 1.14 mmol/L. Multivariate Cox regression analysis showed that a low HDL level (<= 1.14 mmol/L) was able to predict four-year recurrence (HR, 0.199; 95% CI, 0.059-0.667; p = 0.009) and a worse outcome. Conclusion: A low HDL level incurs an increased risk of DTC and four-year recurrence, while a high BMI is associated with capsule invasion and multifocality. However, more advanced research is needed in the future to confirm these results.