Impact of Excess Weight on Thyroid Nodule Formation in Pediatric Populations
Overview
This large-scale prospective cohort study of approximately 300,000 children and adolescents in Fukushima found that overweight status is associated with an increased risk of developing thyroid nodules. The association was observed across sexes and age groups, with a stronger effect noted in adolescent females.
Background
Thyroid nodules are common in adults but less prevalent in children and adolescents, though pediatric nodules carry a higher malignancy risk. Known risk factors include radiation exposure, iodine intake, and obesity. Previous small-scale studies suggested obesity may increase thyroid nodule risk in youth, but causal relationships were unclear. Following the Fukushima nuclear accident, a large thyroid screening program was initiated to monitor radiation effects and related health outcomes, including the impact of obesity on thyroid nodules.
Data Highlights
Parameter
Value
Initial participants (1st exam)
299,939
Participants without nodules after 2 exams
184,519
New thyroid nodules detected
660
Adjusted odds ratio for nodules in overweight vs normal weight
1.27 (95% CI: 1.04-1.57)
Adjusted OR in males
1.21
Adjusted OR in females
1.32
Adjusted OR by age groups (0-9, 10-14, 15-19 years)
Range 1.17 to 1.75
Average follow-up duration
4.2 years
Key Findings
Overweight children and adolescents had a 27% higher odds of developing new thyroid nodules compared to their normal-weight peers.
The association between overweight status and thyroid nodules was observed in both males (OR 1.21) and females (OR 1.32), with a stronger effect in females.
Age-stratified analysis showed increased odds of thyroid nodules across all pediatric age groups, with odds ratios ranging from 1.17 to 1.75.
The risk association was independent of proximity to the Fukushima nuclear power plant, suggesting obesity as an independent risk factor.
The study utilized a large, population-based prospective cohort with repeated thyroid ultrasonography examinations over an average of 4.2 years.
Clinical Implications
Clinicians should consider overweight status as a modifiable risk factor for thyroid nodule development in pediatric populations. Early identification and management of obesity may help reduce the incidence of thyroid nodules and potentially thyroid malignancies in children and adolescents. Regular thyroid screening may be warranted in overweight youth, especially adolescent females.
Conclusion
This extensive prospective study demonstrates that overweight status is significantly associated with the development of thyroid nodules in children and adolescents, highlighting the importance of obesity prevention in reducing thyroid disease risk in this population.
References
Fukushima Health Management Survey 2024 -- Impact of Excess Weight on Thyroid Nodule Formation
