Long‑term metabolic risks after thyroidectomy and thyroid hormone therapy in thyroid cancer survivors: a nationwide cohort study

Cancer research · Thyroid cancer

Thyroidectomy was associated with higher odds of multiple metabolic abnormalities compared with matched general population without TC and to TC patients without thyroidectomy, with most associations evident from 5 years onward and some from 8 years.

As long‑term survival rates improve among thyroid cancer patients, the metabolic consequences of thyroidectomy and thyroid hormone therapy have gained increasing importance. We conducted a retrospective, population‑based cohort study using nationwide data from the Korea National Health Insurance Service. The risk of incident metabolic abnormalities (obesity, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and metabolic dysfunction‑associated steatotic liver disease) within 5, 8, and 10 years was estimated by multivariable logistic regression models. Thyroidectomy was associated with higher odds of multiple metabolic abnormalities compared with matched general population controls and with patients who had not undergone surgery. Thyroid hormone therapy was also significantly associated with metabolic abnormalities among patients who had undergone thyroidectomy. In sex‑stratified analyses, overall patterns were similar, but metabolic dysfunction‑associated steatotic liver disease was not significantly associated with thyroidectomy or therapy in males. These findings support ongoing metabolic monitoring in thyroid cancer survivors and warrant further studies to determine whether individualized hormone management can reduce long‑term metabolic risk.

The study shows that both thyroid surgery and long‑term thyroid hormone replacement increase the risk of several metabolic disorders in thyroid cancer survivors, underscoring the need for routine metabolic screening and potentially tailored hormone management in this growing survivor population.

Evidence level: Állatkísérletes. Állatmodellben vizsgálták.

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