J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Original Article

Volume 15, Number 3, March 2023, pages 166-173

The Prevalence and Associated Predictors for Diabetes Mellitus in Adult Patients With Thyroid Nodules

**Table 1.** ACR TI-RADS Category Definitions
ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System.
ACR TI-RADS 1	Benign
ACR TI-RADS 2	Not suspicion
ACR TI-RADS 3	Mildly suspicion
ACR TI-RADS 4	Moderately suspicion
ACR TI-RADS 5	Highly suspicion

Table 1. ACR TI-RADS Category Definitions

ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System.

ACR TI-RADS 1

Benign

ACR TI-RADS 2

Not suspicion

ACR TI-RADS 3

Mildly suspicion

ACR TI-RADS 4

Moderately suspicion

ACR TI-RADS 5

Highly suspicion

**Table 2.** General Characteristics of Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021
Variables	Median	Interquartile range
ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System.
Age, years	46.00	20.0
Body mass index, kg/m²	30.26	7.71
Vitamin D, nmol/L	14.50	12.00
Thyroid-stimulating hormone, mmol/L	1.71	2.43
Free triiodothyronine, nmol/L	2.69	0.40
Free thyroxine, ng/dL	1.12	0.45
Total cholesterol, mmol/L	5.8	3.89
Low-density lipoprotein, mmol/L	3.76	0.80
High-density lipoprotein, mmol/L	2.99	1.71
Triglyceride, mmol/L	1.78	1.11
	Number	Proportion
Gender
Female	332	84.9
Male	59	15.1
Diabetes mellitus
No	297	76
Yes	94	24.0
Hypertension
No	303	77.5
Yes	88	22.5
Asthma
No	360	92.1
Yes	31	7.9
Thyroid status
Euthyroid	250	64.0
Hypothyroidism	112	28.6
Hyperthyroidism	29	7.4
Ultrasound based on ACR TI-RADS
ACR TI-RADS 1	10	2.6
ACR TI-RADS 2	72	18.4
ACR TI-RADS 3	159	40.7
ACR TI-RADS 4	142	36.3
ACR TI-RADS 5	8	2

Table 2. General Characteristics of Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021

Variables

Median

Interquartile range

ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System.

Age, years

46.00

20.0

Body mass index, kg/m²

30.26

7.71

Vitamin D, nmol/L

14.50

12.00

Thyroid-stimulating hormone, mmol/L

1.71

2.43

Free triiodothyronine, nmol/L

2.69

0.40

Free thyroxine, ng/dL

1.12

0.45

Total cholesterol, mmol/L

5.8

3.89

Low-density lipoprotein, mmol/L

3.76

0.80

High-density lipoprotein, mmol/L

2.99

1.71

Triglyceride, mmol/L

1.78

1.11

Number

Proportion

Gender

Female

332

84.9

Male

15.1

Diabetes mellitus

297

Yes

24.0

Hypertension

303

77.5

Yes

22.5

Asthma

360

92.1

Yes

7.9

Thyroid status

Euthyroid

250

64.0

Hypothyroidism

112

28.6

Hyperthyroidism

7.4

Ultrasound based on ACR TI-RADS

ACR TI-RADS 1

2.6

ACR TI-RADS 2

18.4

ACR TI-RADS 3

159

40.7

ACR TI-RADS 4

142

36.3

ACR TI-RADS 5

**Table 3.** Univariate Analysis of the Factors Associated With Diabetes Mellitus in Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021
Variables	DM (n = 94), median (IQR)	No DM (n = 297), median (IQR)	OR (95.0% CI)	P
ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System; CI: confidence interval; DM: diabetes mellitus; IQR: interquartile range; OR: odds ratio.
Age, years	56.00 (15.0)	43.00 (20.0)	1.069 (1.048 - 1.092)	< 0.000
Body mass index, kg/m²	32.87 (9.47)	29.58 (7.00)	1.004 (0.995 - 1.013)	0.399
Vitamin D	15.73 (11.82)	14.00 (10.6)	1.020 (1.000 - 1.041)	0.047
Thyroid-stimulating hormone, mmol/L	2.0750 (2.32)	1.63 (2.42)	1.004 (0.997 - 1.011)	0.278
Free triiodothyronine, nmol/L	2.691 (0.40)	2.691 (0.41)	0.649 (0.459 - 0.919)	0.015
Free thyroxine, ng/dL	1.19 (0.45)	1.10 (0.46)	0.902 (0.743 - 1.095)	0.298
Hemoglobin, g/dL	12.70 (1.86)	12.50 (1.80)	0.99 (0.942 - 1.041)	0.695
White blood cell, 10⁹/L	7.40 (2.65)	6.9 (2.79)	1.090 (0.979 - 1.214)	0.114
Platelet, 10³/dL	275.58 (99.5)	276.2 (85.70)	0.999 (0.996 - 1.001)	0.289
Total cholesterol, mmol/L	4.85 (1.94)	6.27 (3.69)	1.001 (0.995 - 1.008)	0.702
Low-density lipoprotein, mmol/L	3.145 (1.66)	3.76 (0.44)	0.427 (0.314 - 0.58)	< 0.000
High-density lipoprotein, mmol/L	1.39 (1.89)	3.00 (1.51)	0.462 (0.352 - 0.607)	< 0.000
Triglyceride, mmol/L	1.44 (0.84)	2.26 (1.07)	0.665 (0.463 - 0.954)	0.027
Gender
Male	19 (20.2)	40 (13.5)	Reference	0.114
Female	75 (79.8)	257 (86.5)	1.628 (0.89 - 2.977)
Thyroid status
Euthyroid	57 (60.6)	193 (65.0)	Reference
Hypothyroidism	32 (34.0)	80 (26.9)	1.418 (0.517 - 3.89)	0.497
Hyperthyroidism	5 (5.3)	24 (8.1)	1.92 (0.674 - 5.47)	0.222
Hypertension
No	47 (50.0)	256 (86.2)	Reference	0.000
Yes	47 (50.0)	41 (13.8)	0.16 (0.095 - 0.27)
Bronchial asthma
No	83 (88.3)	277 (93.3)	Reference	0.125
Yes	11 (11.7)	20 (6.7)	0.160 (0.095 - 0.27)
Ultrasound
ACR TI-RADS 1	3 (3.2)	7 (2.4)	Reference
ACR TI-RADS 2	19 (20.2)	53 (17.8)	3.000 (0.248 - 36.325	0.388
ACR TI-RADS 3	33 (35.1)	126 (42.4)	2.509 (0.289 - 21.756)	0.404
ACR TI-RADS 4	38 (40.4)	104 (35.0)	1.83 (0.218 -15.428)	0.577
ACR TI-RADS 5	1 (1.1)	7 (2.4)	2.556 (0.305 - 21.479)	0.387

Table 3. Univariate Analysis of the Factors Associated With Diabetes Mellitus in Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021

Variables

DM (n = 94), median (IQR)

No DM (n = 297), median (IQR)

OR (95.0% CI)

ACR TI-RADS: American College of Radiology Thyroid Imaging Reporting and Data System; CI: confidence interval; DM: diabetes mellitus; IQR: interquartile range; OR: odds ratio.

Age, years

56.00 (15.0)

43.00 (20.0)

1.069 (1.048 - 1.092)

< 0.000

Body mass index, kg/m²

32.87 (9.47)

29.58 (7.00)

1.004 (0.995 - 1.013)

0.399

Vitamin D

15.73 (11.82)

14.00 (10.6)

1.020 (1.000 - 1.041)

0.047

Thyroid-stimulating hormone, mmol/L

2.0750 (2.32)

1.63 (2.42)

1.004 (0.997 - 1.011)

0.278

Free triiodothyronine, nmol/L

2.691 (0.40)

2.691 (0.41)

0.649 (0.459 - 0.919)

0.015

Free thyroxine, ng/dL

1.19 (0.45)

1.10 (0.46)

0.902 (0.743 - 1.095)

0.298

Hemoglobin, g/dL

12.70 (1.86)

12.50 (1.80)

0.99 (0.942 - 1.041)

0.695

White blood cell, 10⁹/L

7.40 (2.65)

6.9 (2.79)

1.090 (0.979 - 1.214)

0.114

Platelet, 10³/dL

275.58 (99.5)

276.2 (85.70)

0.999 (0.996 - 1.001)

0.289

Total cholesterol, mmol/L

4.85 (1.94)

6.27 (3.69)

1.001 (0.995 - 1.008)

0.702

Low-density lipoprotein, mmol/L

3.145 (1.66)

3.76 (0.44)

0.427 (0.314 - 0.58)

< 0.000

High-density lipoprotein, mmol/L

1.39 (1.89)

3.00 (1.51)

0.462 (0.352 - 0.607)

< 0.000

Triglyceride, mmol/L

1.44 (0.84)

2.26 (1.07)

0.665 (0.463 - 0.954)

0.027

Gender

Male

19 (20.2)

40 (13.5)

Reference

0.114

Female

75 (79.8)

257 (86.5)

1.628 (0.89 - 2.977)

Thyroid status

Euthyroid

57 (60.6)

193 (65.0)

Reference

Hypothyroidism

32 (34.0)

80 (26.9)

1.418 (0.517 - 3.89)

0.497

Hyperthyroidism

5 (5.3)

24 (8.1)

1.92 (0.674 - 5.47)

0.222

Hypertension

47 (50.0)

256 (86.2)

Reference

0.000

Yes

47 (50.0)

41 (13.8)

0.16 (0.095 - 0.27)

Bronchial asthma

83 (88.3)

277 (93.3)

Reference

0.125

Yes

11 (11.7)

20 (6.7)

0.160 (0.095 - 0.27)

Ultrasound

ACR TI-RADS 1

3 (3.2)

7 (2.4)

Reference

ACR TI-RADS 2

19 (20.2)

53 (17.8)

3.000 (0.248 - 36.325

0.388

ACR TI-RADS 3

33 (35.1)

126 (42.4)

2.509 (0.289 - 21.756)

0.404

ACR TI-RADS 4

38 (40.4)

104 (35.0)

1.83 (0.218 -15.428)

0.577

ACR TI-RADS 5

1 (1.1)

7 (2.4)

2.556 (0.305 - 21.479)

0.387

**Table 4.** Multivariate Analysis of the Factors Associated With Diabetes Mellitus in Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021
Variables	OR (95.0% CI)	P
CI: confidence interval; OR: odds ratio.
Age, years	1.037 (1.012 - 1.062)	0.004
Free triiodothyronine, nmol/L	0.635 (0.412 - 0.980)	0.040
Vitamin D, nmol/L	1.007 (0.995 - 1.020)	0.248
Low-density lipoprotein, mmol/L	0.643 (0.456 - 0.907)	0.012
High-density lipoprotein, mmol/L	0.654 (0.465 - 0.919)	0.015
Triglyceride, mmol/L	0.920 (0.710 - 1.192)	0.526
White blood cell, 10⁹/L	1.128 (0.991 - 1.284)	0.068
Hypertension
No	Reference
Yes	0.374 (0.203 - 0.689)	0.002
Bronchial asthma
No	Reference
Yes	0.741 (0.281 - 1.949)	0.543
Gender
Male	Reference
Female	0.645 (0.284 - 1.465)	0.295

Table 4. Multivariate Analysis of the Factors Associated With Diabetes Mellitus in Adult Patients With Thyroid Nodules in Eastern Region 2015 - 2021

Variables

OR (95.0% CI)

CI: confidence interval; OR: odds ratio.

Age, years

1.037 (1.012 - 1.062)

0.004

Free triiodothyronine, nmol/L

0.635 (0.412 - 0.980)

0.040

Vitamin D, nmol/L

1.007 (0.995 - 1.020)

0.248

Low-density lipoprotein, mmol/L

0.643 (0.456 - 0.907)

0.012

High-density lipoprotein, mmol/L

0.654 (0.465 - 0.919)

0.015

Triglyceride, mmol/L

0.920 (0.710 - 1.192)

0.526

White blood cell, 10⁹/L

1.128 (0.991 - 1.284)

0.068

Hypertension

Reference

Yes

0.374 (0.203 - 0.689)

0.002

Bronchial asthma

Reference

Yes

0.741 (0.281 - 1.949)

0.543

Gender

Male

Reference

Female

0.645 (0.284 - 1.465)

0.295