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High Body Mass Index and Thyroid Stimulating Hormone Levels Do Not Affect Thyroid Nodule Selection for Fine-Needle Aspiration Biopsy after Ultrasound Evaluation
Int J Thyroidol 2019;12(1):44-53
Published online May 30, 2019;
© 2019 Korean Thyroid Association.

Hyun Gi Kim1,2,*, Hye Sun Lee3, Eun Kyung Kim2, Chung-Mo Nam4, Hee Jung Moon2, Hae Kyoung Jung5 and Jin Young Kwak2

Department of Radiology, Ajou University Medical Center, Ajou University School of Medicine1, Suwon, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine2, Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine3, Department of Preventive Medicine, Yonsei University College of Medicine4, Seoul, Department of Radiology, CHA Bundang Medical Center, CHA University School of Medicine5, Seongnam, Korea
Correspondence to: Jin Young Kwak, MD, PhD, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: 82-2-2228-7413, Fax: 82-2-393-3035, E-mail:
*Current affiliation: Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic
University of Korea, Seoul, Korea
Received October 15, 2018; Revised March 12, 2019; Accepted April 29, 2019.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background and Objectives: This study was to evaluate whether high body mass index (BMI) or thyroid stimulating hormone (TSH) level would affect selecting thyroid nodule for fine-needle aspiration biopsy (FNA) after ultrasound (US) evaluation. Materials and Methods: A total of 3155 thyroid nodules (2159 benign and 996 malignant nodules) were included. Four grades of BMI and three levels of TSH were applied for grouping. US features of the thyroid nodules were divided into ‘probably benign’ and ‘suspicious for malignancy’ categories. Patients were grouped according to gender and univariate and multivariate logistic regression analysis were used to find the association between variables and malignancy. Results: TSH levels were significantly higher in the malignant group (p<0.001). The grades of BMI did not show difference between the malignant and benign groups (females, p=0.074 and males, p=0.157). Younger age and ‘suspicious for malignancy’ US category were independent risk factors for malignancy in both genders. In females, a high TSH level (odds ratio=1.010, p<0.001) had significant association with malignancy. Except for younger age (odds ratio=0.998, p<0.001), no variable in nodules with ‘probably benign’ US category was significantly associated with malignancy. Conclusion: High TSH levels were more frequent in thyroid malignancy group, but neither high BMI nor high TSH level give additional information for FNA selection after US.
Keywords : Thyroid cancer, Ultrasound, Obesity, Thyroid stimulating hormone, Fine-needle aspiration biopsy

November 2019, 12 (2)