Association between Iodine Intake, Thyroid Function, and Papillary Thyroid Cancer: A Case-Control Study
김경식, 조선욱, 박영주, 이규은, 이동욱, Park Sue-K.,
소속 상세정보
김경식 ( Kim Kyung-Sik )
Seoul National University College of Medicine Department of Preventive Medicine
조선욱 ( Cho Sun-Wook )
Seoul National University College of Medicine Department of Internal Medicine
박영주 ( Park Young-Joo )
Seoul National University College of Medicine Department of Internal Medicine
이규은 ( Lee Kyu-Eun )
Seoul National University College of Medicine Seoul National University Hospital Department of Surgery
이동욱 ( Lee Dong-Wook )
Dongguk University School of Medicine Department of Family Medicine
( Park Sue-K. )
Seoul National University College of Medicine Department of Preventive Medicine
Abstract
Background: This study aimed to assess the effects of iodine intake, thyroid function, and their combined effect on the risk of papillary thyroid cancer (PTC) and papillary thyroid microcarcinoma (PTMC).
Methods: A case-control study was conducted including 500 community-based controls who had undergone a health check-up, and 446 overall PTC cases (209 PTC and 237 PTMC) from the Thyroid Cancer Longitudinal Study. Urinary iodine concentration (UIC), was used as an indicator of iodine intake, and serum for thyroid function. The risk of PTC and PTMC was estimated using unconditional logistic regression.
Results: Excessive iodine intake (UIC ≥220 μg/gCr) was associated with both PTC (odds ratio [OR], 18.13 95% confidence interval [CI], 8.87 to 37.04) and PTMC (OR, 8.02; 95% CI, 4.64 to 13.87), compared to adequate iodine intake (UIC, 85 to 219 μg/gCr). Free thyroxine (T4) levels ≥1.25 ng/dL were associated with PTC (OR, 1.97; 95% CI, 1.36 to 2.87) and PTMC (OR, 2.98; 95% CI, 2.01 to 4.41), compared to free T4 levels of 0.7 to 1.24 ng/dL. Individuals with excessive iodine intake and high free T4 levels had a greatly increased OR of PTC (OR, 43.48; 95% CI, 12.63 to 149.62), and PTMC (OR, 26.96; 95% CI, 10.26 to 70.89), compared to individuals with adequate iodine intake and low free T4 levels.
Conclusion: Excessive iodine intake using creatinine-adjusted UIC and high free T4 levels may have a synergistic effect on PTC and PTMC. Considering both iodine intake and thyroid function is important to assess PTC and PTMC risk.
키워드
Thyroid cancer, papillary; Papillary thyroid microcarcinoma; Iodine; Thyroid function tests
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