Endocrine Abstracts

JOINT2714

Introduction: Multinodular goiter (MNG) is a common thyroid disorder, often associated with an increased risk of differentiated thyroid cancer (DTC). Vitamin D insufficiency and multinodular goiter are prevalent worldwide, including in the Romanian population. Recent research has highlighted the potential role of vitamin D in various malignancies, but its influence on thyroid cancer development remains inconclusive. Given the high prevalence of both vitamin D deficiency and thyroid disorders, investigating their possible relationship is crucial. This study aims to assess the association between plasma 25-hydroxyvitamin D (25OHD) levels and the risk of DTC in patients with MNG, providing insight into potential endocrine and oncologic implications.

Material and Methods: We performed a retrospective study which included 351 patients evaluated for thyroid nodular goiter with fine needle aspiration (FNA) in a tertiary Endocrinology Department between 2022-2024. Mean age of the study group was 53.56±13.6 years (range 17-83 years), (16.8% males). The following data were collected from medical files: age, body mass index, serum 25OHD, freeT4, TSH, ATPO, anti-TG, ultrasound features of the thyroid nodules, Bethesda class at FNA.

Results: No significant differences were found in terms of age, body mass index and thyroid nodule dimensions between Bethesda subgroups. Patients with Bethesda class 3 or higher (n = 72) had significantly lower levels of 25-hydroxyvitamin D (22.6±10.58 ng/ml) in comparison with patients with Bethesda class 2 (n = 279, 25.5±11.6 ng/ml, P = 0.043). Moreover, serum 25-hydroxyvitamin D level was associated with ultrasound characteristics of the thyroid nodule. Thus, the presence of irregular margins was associated with significantly lower levels of serum 25 hydroxyvitamin D (22.42±11.53 ng/ml) in comparison with patients with nodules with regular margins (25.56±11.39 ng/ml, P = 0.041), and marginal vascularization was more frequently found in patients with 25-hydroxyvitamin D below 30 ng/ml (51%) in comparison with those with 25-hydroxyvitamin D above 30 ng/ml (39.6%, P = 0.05). Moreover, we found a tendency that patients with 25-hydroxyvitamin D below 20 ng/ml to present more frequently with incomplete hallo (19.1%) in comparison with patients with 25-hydroxyvitamin D above 20 ng/ml (12.3%, P = 0.068).

Conclusion: Our study suggests that lower levels of serum 25-hydroxyvitamin D might be associated with increased risk of thyroid malignancy.