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. 2021 Sep 16:12:730279.
doi: 10.3389/fendo.2021.730279. eCollection 2021.

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

Chenyu Zhang  1 , Xiaotong Gao  1 , Yutong Han  1 , Weiping Teng  1 , Zhongyan Shan  1
Affiliations

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

Chenyu Zhang et al. Front Endocrinol (Lausanne). .

Abstract

Objective: Thyroid 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.

Methods: Thirteen 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.

Results: The 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).

Conclusion: The 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.

Keywords: iodine-deficient; meta-analysis; metabolic syndrome; thyroid; thyroid nodules.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart showing the detailed inclusion or exclusion procedure. Thirteen independent articles were included in the meta-analysis.
Figure 2
Figure 2
Forest plot of the prevalence of TNs in MetS patients and non-MetS patients (controls).
Figure 3
Figure 3
Prevalence of TNs in MetS patients.
Figure 4
Figure 4
Pooled effect size forest plots of TNs prevalence in MetS patients versus non-MetS patients according to sex (male, female and combined groups).
Figure 5
Figure 5
Pooled effect size forest plots of TNs prevalence in MetS patients versus non-MetS patients according to iodine nutrition status (iodine-deficient and iodine-adequate).
Figure 6
Figure 6
Pooled effect size forest plots of TNs prevalence in MetS patients versus non-MetS patients according to mean age (< 40 years old, 40 ~ 50 years old, 50 ~ 60 years old and ≥60 years old groups).
Figure 7
Figure 7
Funnel plot to assess publication bias in studies on the association between TNs and the risk of MetS. Each point represents a separate study for the indicated association. Log OR, natural logarithm of OR. The vertical line represents the effect size.
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