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Peer-reviewedCC BYAnnals of medicine

Association between triglyceride glucose-waist height ratio index and incident thyroid nodules: a prospective cohort study.

  • Ling Deng1
  • Yi Liu2
  • Yaojia Zhou3
  • Xiaoxia Zheng1
  • Min Ren4
  • Min Zhang4
  • Yang Liu4
4 affiliations
  1. 1Department of Health Management & Institute of Health Management, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
  2. 2Physical Examination Center, Yunyang County People's Hospital, Chongqing, China.
  3. 3Animal Experimental Center of West China Hospital, Sichuan University, Chengdu, China.
  4. 4Department of Geriatric Endocrinology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
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Abstract

Background

Insulin resistance is associated with thyroid nodule formation. The triglyceride-glucose (TyG) index is a widely recognized surrogate for insulin resistance, and its clinical value increases when integrated with adiposity indices. We tested whether an elevated triglyceride glucose-waist height ratio (TyG-WHtR) is independently associated with incident thyroid nodules.Methods

This prospective cohort study recruited 65,347 participants between January and December 2021, with follow-up surveys conducted between January and December 2025. We examined associations of baseline and cumulative TyG-WHtR quartiles with thyroid nodule occurrence using multivariable binary logistic regression. Restricted cubic spline (RCS) models tested nonlinear trends in the association between thyroid nodules and TyG-WHtR. Receiver operating characteristic (ROC) curves were generated to compare the area under the curve (AUC) across four metabolic metrics: baseline TyG, WHtR, TyG-WHtR, as well as cumulative TyG-WHtR, with thyroid nodule status as the outcome. We also conducted subgroup and sensitivity analyses, which collectively confirmed the robustness of our observed associations.Results

During a mean follow-up of 4.08 ± 0.27 years, 4,029 participants (15.8%) were diagnosed with thyroid nodules by 2025. In fully adjusted models, the highest versus lowest quartile of baseline TyG-WHtR showed an OR of 1.57 (95% CI: 1.22-2.02), and cumulative TyG-WHtR yielded an OR of 1.57 (95% CI: 1.25-1.96). Each 1-SD increment in baseline and cumulative TyG-WHtR corresponded to ORs of 1.15 (1.05-1.26) and 1.17 (1.07-1.27), respectively. RCS analyses confirmed linear dose-response relationships for both (P for nonlinearity > 0.05). ROC curve analysis demonstrated that cumulative TyG-WHtR had the highest AUC (0.539) for thyroid nodules.Conclusions

TyG-WHtR is independently associated with thyroid nodule risk, with cumulative TyG-WHtR showing a stronger association than baseline TyG-WHtR. Maintaining favorable TyG and waist circumference levels over time may reduce thyroid nodule risk in this Chinese population.

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Cite

BibTeXRIS
BibTeX
@article{deng2026association,
  title = {{Association between triglyceride glucose-waist height ratio index and incident thyroid nodules: a prospective cohort study.}},
  author = {Ling Deng and Yi Liu and Yaojia Zhou and Xiaoxia Zheng and Min Ren and Min Zhang and Yang Liu},
  journal = {Annals of medicine},
  year = {2026},
  month = oct,
  doi = {10.1080/07853890.2026.2748230},
  url = {https://europepmc.org/article/MED/42897960},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Association between triglyceride glucose-waist height ratio index and incident thyroid nodules: a prospective cohort study.
AU  - Ling Deng
AU  - Yi Liu
AU  - Yaojia Zhou
AU  - Xiaoxia Zheng
AU  - Min Ren
AU  - Min Zhang
AU  - Yang Liu
PY  - 2026
DA  - 2026/10/20
JO  - Annals of medicine
DO  - 10.1080/07853890.2026.2748230
UR  - https://europepmc.org/article/MED/42897960
AB  - Background  Insulin resistance is associated with thyroid nodule formation. The triglyceride-glucose (TyG) index is a widely recognized surrogate for insulin resistance, and its clinical value increases when integrated with adiposity indices. We tested whether an elevated triglyceride glucose-waist height ratio (TyG-WHtR) is independently associated with incident thyroid nodules.Methods  This prospective cohort study recruited 65,347 participants between January and December 2021, with follow-up surveys conducted between January and December 2025. We examined associations of baseline and cumulative TyG-WHtR quartiles with thyroid nodule occurrence using multivariable binary logistic regression. Restricted cubic spline (RCS) models tested nonlinear trends in the association between thyroid nodules and TyG-WHtR. Receiver operating characteristic (ROC) curves were generated to compare the area under the curve (AUC) across four metabolic metrics: baseline TyG, WHtR, TyG-WHtR, as well as cumulative TyG-WHtR, with thyroid nodule status as the outcome. We also conducted subgroup and sensitivity analyses, which collectively confirmed the robustness of our observed associations.Results  During a mean follow-up of 4.08 ± 0.27 years, 4,029 participants (15.8%) were diagnosed with thyroid nodules by 2025. In fully adjusted models, the highest versus lowest quartile of baseline TyG-WHtR showed an OR of 1.57 (95% CI: 1.22-2.02), and cumulative TyG-WHtR yielded an OR of 1.57 (95% CI: 1.25-1.96). Each 1-SD increment in baseline and cumulative TyG-WHtR corresponded to ORs of 1.15 (1.05-1.26) and 1.17 (1.07-1.27), respectively. RCS analyses confirmed linear dose-response relationships for both (P for nonlinearity > 0.05). ROC curve analysis demonstrated that cumulative TyG-WHtR had the highest AUC (0.539) for thyroid nodules.Conclusions  TyG-WHtR is independently associated with thyroid nodule risk, with cumulative TyG-WHtR showing a stronger association than baseline TyG-WHtR. Maintaining favorable TyG and waist circumference levels over time may reduce thyroid nodule risk in this Chinese population.
SN  - 0785-3890
SN  - 1365-2060
ER  -