FPSA, a potential risk factor for thyroid nodules by gender: A cohort study in China
Wentao Yang, Shanshan Chu, Wenqian Wu, Tingting Shi, Xu Wang, Penghong XuBackground
The global prevalence of thyroid nodules is rising, prompting heightened clinical concern given their potential for malignant transformation. Although tumor markers are routinely assessed to aid in malignancy evaluation, their potential to predict thyroid nodule development and their value for early risk stratification remain insufficiently established.
Methods
In this prospective cohort study, 462 adults underwent three standardized physical examinations after enrollment. Comprehensive baseline data, including demographics, anthropometrics, vital signs, laboratory parameters, and ultrasound-confirmed thyroid nodule status have been collected. variance inflation factor and Least Absolute Shrinkage and Selection Operator were used in variable selection while logistic regression was used in statistical analysis.
Results
A total of 302 participants were included in the final analytical cohort. In this cohort, female sex, age, BMI, and DBP were significantly associated with the occurrence of thyroid nodules. When further analyzed using a discrete-time hazard model, age, SBP, and FPSA were significantly associated with nodule occurrence at the second and third examination. In males, logistic regression identified age, BMI, and FPSA as significant risk factors, and the discrete-time hazard model confirmed age, FPSA as independent predictors. In females, however, logistic regression showed that age was a risk factor while DBP was a protective factor, findings that were replicated in the discrete-time hazard model.
Conclusion
Female sex, age, BMI, DBP, and FPSA show distinct associations with thyroid nodule development: FPSA is a male-specific risk marker, while DBP is protective in females. These findings point to sex-specific biological pathways and warrant mechanistic study and validation in diverse populations.