# Association of gender and metabolic factors with thyroid nodules in T2DM: a retrospective study

## TL;DR

This study found that thyroid nodules are more common in women with type 2 diabetes, especially those who are obese or have high uric acid levels.

## Contribution

The study identifies sex-specific metabolic risk factors for thyroid nodules in type 2 diabetes patients.

## Key findings

- Thyroid nodules occurred in 36.95% of type 2 diabetes patients, with a significantly higher rate in females (52.75%) than males (27.85%).
- Obesity and hyperuricemia were independently associated with thyroid nodules in females but not in males.
- A nomogram for predicting thyroid nodules in female T2DM patients was developed with a C-index of 0.704.

## Abstract

Sex differences in the incidence of thyroid nodules (TNs) are broadly recognized, but further analysis is lacking. Thus, the aim of this study was to evaluate the association between TNs and anthropometric parameters in type 2 diabetic males and females.

This cross-sectional study included 747 patients with type 2 diabetes mellitus (T2DM). All patients underwent clinical examination, thyroid ultrasound, laboratory tests, anthropometrics and body composition. Multivariable logistic regression assessed factors associated with TNs, and a simple nomogram was finally developed.

In total, the incidence of TNs was 36.95% (276/747) and was significantly higher in females (52.75%) than in males (27.85%). Age was positively correlated with TNs risk in patients with T2DM (males: OR = 4.141, 95% CI [1.999–8.577], females: OR = 4.630, 95% CI [1.845–11.618]). Obesity (OR = 2.655, 95% CI [1.257–5.607]) and hyperuricemia (OR = 1.997, 95% CI [1.030–3.873]) were only associated with the risk of TNs independent of other risk factors in type 2 diabetic females, as well as other obesity factors such as weight, BMI, waist-hip ratio, percent body fat, visceral curve area, and upper arm circumference, but not in type 2 diabetic males. However, the diameter of the largest thyroid nodule was only related to age (R = 0.226, p < 0.01). Finally, the nomogram for evaluating TNs in female T2DM patients was established, and the C-index of the nomogram was 0.704 (95% CI [0.89–0.94]).

TNs occur with a significantly higher frequency in type 2 diabetic females than in males, especially those with hyperuricemia and obesity. Modifiable metabolic factors, such as obesity and hyperuricemia, are a major focus for improving TNs risk in women.