Endocrine Abstracts

JOINT19

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD) represents a hepatic manifestation of metabolic syndrome. This study investigated the association between MASLD and the risk of thyroid cancer in a Korean population.

Methods: After excluding individuals with a history of liver disease or malignancy, we analyzed a cohort of 214,502 Korean adults aged 40 and above who participated in the National Health Screening Program from 2009 to 2010. Participants were categorized into four groups; no SLD without a cardiometabolic risk factor (CMRF), no SLD with at least one CMRF, MASLD, and metabolic and alcohol related/associated liver disease (MetALD). SLD was diagnosed using a fatty liver index threshold of ≥30. The primary outcome was the diagnosis of new thyroid cancer during the follow-up period. We examined the relationship between CMRF/SLD and thyroid cancer incidence using the Cox proportional-hazards model with adjustments for multiple variables.

Results: A total of 2,761 participants (1.3%) were newly diagnosed with thyroid cancer over an average follow-up of 9.61 years. Compared with participants without CMRF and SLD, those with CMRF (hazard ratio [HR] 1.33, 95% CI 1.16-1.52), those with MASLD (HR 1.36, 95% CI 1.17-1.58), and the MetALD group (HR 1.40, 95% CI 1.04-1.88) exhibited a significantly higher risk of thyroid cancer. In addition, MetALD significantly associated with thyroid cancer incidence solely in men.

Conclusion: In addition to CMRF, MASLD and MetALD was associated with an increased risk of thyroid cancer in the Korean population. This study is the first to demonstrate the association between thyroid cancer and the CMRF-MASLD-MetALD continuum.