Insulin resistance surrogate indices and papillary thyroid carcinoma in patients with thyroid nodules undergoing surgery
6 affiliations
- 1Department of Endocrinology, The First Medical Center, Chinese PLA General Hospital
- 2Department of Endocrinology and Rheumatology, The Sixth Medical Center, Chinese PLA General Hospital
- 3Medical Clinic of the 32137 Mobile Communications Battalion, Chinese People’s Liberation Army
- 4Department of Endocrinology, Hainan Hospital of Chinese PLA General Hospital
- 5School of Medicine, Nankai University
- 6Department of Endocrinology, Aerospace Center Hospital
Abstract
Background: Metabolic abnormalities may be associated with thyroid cancer-related metabolic profiles, whereas body mass index (BMI)-based assessment may not fully capture metabolic heterogeneity. This study investigated the associations between insulin resistance surrogate indices reflecting glucose and lipid metabolic alterations and papillary thyroid carcinoma (PTC) among patients with thyroid nodules undergoing surgery.
Methods: This retrospective case-control study included 4,047 patients with thyroid nodules (3,415 PTC and 632 benign thyroid nodules). Three insulin resistance surrogate indices, including the triglyceride-glucose (TyG) index, metabolic score for insulin resistance (METS-IR), and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), were calculated from routinely available clinical parameters. Multivariable logistic regression and restricted cubic spline analyses were performed, with additional BMI-stratified analyses and interaction testing.
Results: Patients with PTC had higher levels of TyG, METS-IR, and TG/HDL-C than those with benign nodules. After adjustment for age, sex, BMI, diabetes mellitus, lipid-lowering therapy, smoking status, and alcohol consumption, TyG (OR 1.42, 95% CI 1.20–1.68, P < 0.001) and METS-IR (OR 1.05, 95% CI 1.02–1.08, P < 0.001) remained associated with higher odds of PTC, whereas TG/HDL-C was not statistically significant (OR 1.07, 95% CI 0.99–1.16, P = 0.081). Restricted cubic spline analyses showed significant overall associations of TyG and METS-IR with PTC, with evidence of nonlinear relationships. BMI-stratified analyses showed associations between TyG and METS-IR and PTC in participants with BMI ≤28 kg/m ² , whereas similar associations were not statistically significant in participants with BMI >28 kg/m ² . However, interaction tests did not provide statistical evidence that BMI modified these associations.
Conclusions: Higher levels of TyG and METS-IR were associated with higher odds of PTC after multivariable adjustment. These findings suggest that TyG and METS-IR may provide additional information for characterizing metabolic profiles among patients undergoing surgery for thyroid nodules.
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BibTeX
@article{jia2026insulin,
title = {{Insulin resistance surrogate indices and papillary thyroid carcinoma in patients with thyroid nodules undergoing surgery}},
author = {Xiaomeng Jia and Xiaodong Hu and Lina Jiang and Zhe Xue and Huaijin Xu and Hongzhou Liu and Zhaohui Lyu},
journal = {Frontiers in Endocrinology},
year = {2026},
month = nov,
doi = {10.3389/fendo.2026.1960841},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1960841/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Insulin resistance surrogate indices and papillary thyroid carcinoma in patients with thyroid nodules undergoing surgery
AU - Xiaomeng Jia
AU - Xiaodong Hu
AU - Lina Jiang
AU - Zhe Xue
AU - Huaijin Xu
AU - Hongzhou Liu
AU - Zhaohui Lyu
PY - 2026
DA - 2026/11/04
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1960841
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1960841/full
AB - Background: Metabolic abnormalities may be associated with thyroid cancer-related metabolic profiles, whereas body mass index (BMI)-based assessment may not fully capture metabolic heterogeneity. This study investigated the associations between insulin resistance surrogate indices reflecting glucose and lipid metabolic alterations and papillary thyroid carcinoma (PTC) among patients with thyroid nodules undergoing surgery. Methods: This retrospective case-control study included 4,047 patients with thyroid nodules (3,415 PTC and 632 benign thyroid nodules). Three insulin resistance surrogate indices, including the triglyceride-glucose (TyG) index, metabolic score for insulin resistance (METS-IR), and triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C), were calculated from routinely available clinical parameters. Multivariable logistic regression and restricted cubic spline analyses were performed, with additional BMI-stratified analyses and interaction testing. Results: Patients with PTC had higher levels of TyG, METS-IR, and TG/HDL-C than those with benign nodules. After adjustment for age, sex, BMI, diabetes mellitus, lipid-lowering therapy, smoking status, and alcohol consumption, TyG (OR 1.42, 95% CI 1.20–1.68, P < 0.001) and METS-IR (OR 1.05, 95% CI 1.02–1.08, P < 0.001) remained associated with higher odds of PTC, whereas TG/HDL-C was not statistically significant (OR 1.07, 95% CI 0.99–1.16, P = 0.081). Restricted cubic spline analyses showed significant overall associations of TyG and METS-IR with PTC, with evidence of nonlinear relationships. BMI-stratified analyses showed associations between TyG and METS-IR and PTC in participants with BMI ≤28 kg/m ² , whereas similar associations were not statistically significant in participants with BMI >28 kg/m ² . However, interaction tests did not provide statistical evidence that BMI modified these associations. Conclusions: Higher levels of TyG and METS-IR were associated with higher odds of PTC after multivariable adjustment. These findings suggest that TyG and METS-IR may provide additional information for characterizing metabolic profiles among patients undergoing surgery for thyroid nodules.
SN - 1664-2392
ER -