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Peer-reviewedCC BY 4.0Frontiers in Endocrinology

Associations of fasting blood glucose and the triglyceride–glucose index with aggressive pathological features of papillary thyroid carcinoma

  • Xiang Xu1,2
  • Kun Gong3
  • Chengqian Li2
  • Yonglu Hu2
  • Cong Liu2,4
  • Pei Guo5
  • Wenjuan Zhao2
  • Yangang Wang2
  • Bingzi Dong2
5 affiliations
  1. 1Department of Cardiology, The Affiliated Hospital of Qingdao University
  2. 2Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University
  3. 3Department of Echocardiography, The Affiliated Hospital of Qingdao University
  4. 4Department of Surgical Intensive Care Unit, Yantai Yantaishan Hospital
  5. 5Medical Records Management Center, The Affiliated Hospital of Qingdao University
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Abstract

Background: The prevalence of papillary thyroid carcinoma (PTC) along with abnormal glucose-lipid metabolism and obesity is rising. Metabolic abnormalities may be associated with adverse pathological features of PTC.

Objective: To evaluate the associations between metabolic indicators and the pathological features of PTC, and to assess the relationships of fasting blood glucose (FBG) and the triglyceride–glucose (TyG) index with PTC aggressiveness.

Methods: Clinical data from patients with histologically confirmed PTC were analyzed. Logistic regression was used to examine the associations between metabolic indicators and adverse pathological features. Receiver operating characteristic (ROC) curves, DeLong’s test, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the incremental value of FBG and TyG. Internal validation was performed using bootstrap resampling.

Results: PTC patients with diabetes were associated with tumor diameter >1 cm, extracapsular extension, lymph node metastasis, intermediate-to-high recurrence risk, and advanced TNM stage. Elevated FBG (≥6.1 mmol/L), BMI (≥25 kg/m²), TG and UA were associated with multiple unfavorable pathological characteristics. The highest TyG quartile was associated with extracapsular extension (OR = 2.103, P<0.05). The areas under the ROC curve (AUCs) for the baseline, FBG, and TyG models were 0.710, 0.738, and 0.722for extracapsular extension and 0.712, 0.727, and 0.714 for lymph node metastasis, respectively. TyG showed no clear incremental value for lymph node metastasis. Bootstrap-corrected values ranged from 0.698 to 0.722, with calibration slopes of 0.881–0.902.

Conclusion: Elevated FBG, TG, UA, BMI, and TyG were associated with adverse pathological features of PTC. FBG was associated with extracapsular extension and lymph node metastasis, whereas TyG was associated with extracapsular extension but showed no clear incremental value for risk reclassification of lymph node metastasis.

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Cite

BibTeXRIS
BibTeX
@article{xu2026associations,
  title = {{Associations of fasting blood glucose and the triglyceride–glucose index with aggressive pathological features of papillary thyroid carcinoma}},
  author = {Xiang Xu and Kun Gong and Chengqian Li and Yonglu Hu and Cong Liu and Pei Guo and Wenjuan Zhao and Yangang Wang and Bingzi Dong},
  journal = {Frontiers in Endocrinology},
  year = {2026},
  month = oct,
  doi = {10.3389/fendo.2026.1931124},
  url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1931124/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Associations of fasting blood glucose and the triglyceride–glucose index with aggressive pathological features of papillary thyroid carcinoma
AU  - Xiang Xu
AU  - Kun Gong
AU  - Chengqian Li
AU  - Yonglu Hu
AU  - Cong Liu
AU  - Pei Guo
AU  - Wenjuan Zhao
AU  - Yangang Wang
AU  - Bingzi Dong
PY  - 2026
DA  - 2026/10/21
JO  - Frontiers in Endocrinology
DO  - 10.3389/fendo.2026.1931124
UR  - https://www.frontiersin.org/articles/10.3389/fendo.2026.1931124/full
AB  - Background: The prevalence of papillary thyroid carcinoma (PTC) along with abnormal glucose-lipid metabolism and obesity is rising. Metabolic abnormalities may be associated with adverse pathological features of PTC.  Objective: To evaluate the associations between metabolic indicators and the pathological features of PTC, and to assess the relationships of fasting blood glucose (FBG) and the triglyceride–glucose (TyG) index with PTC aggressiveness.  Methods: Clinical data from patients with histologically confirmed PTC were analyzed. Logistic regression was used to examine the associations between metabolic indicators and adverse pathological features. Receiver operating characteristic (ROC) curves, DeLong’s test, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the incremental value of FBG and TyG. Internal validation was performed using bootstrap resampling.  Results: PTC patients with diabetes were associated with tumor diameter >1 cm, extracapsular extension, lymph node metastasis, intermediate-to-high recurrence risk, and advanced TNM stage. Elevated FBG (≥6.1 mmol/L), BMI (≥25 kg/m²), TG and UA were associated with multiple unfavorable pathological characteristics. The highest TyG quartile was associated with extracapsular extension (OR = 2.103, P<0.05). The areas under the ROC curve (AUCs) for the baseline, FBG, and TyG models were 0.710, 0.738, and 0.722for extracapsular extension and 0.712, 0.727, and 0.714 for lymph node metastasis, respectively. TyG showed no clear incremental value for lymph node metastasis. Bootstrap-corrected values ranged from 0.698 to 0.722, with calibration slopes of 0.881–0.902.  Conclusion: Elevated FBG, TG, UA, BMI, and TyG were associated with adverse pathological features of PTC. FBG was associated with extracapsular extension and lymph node metastasis, whereas TyG was associated with extracapsular extension but showed no clear incremental value for risk reclassification of lymph node metastasis.
SN  - 1664-2392
ER  -