Are systemic inflammatory markers linked to euthyroid nodular goiter?

Liljana Todorovska; Petar Avramovski; Maja Avramovska; Jovan Todorovski; Biljana Ilkovska; Kosta Sotiroski; Olivija Vaskova

Liljana Todorovska Department of Nuclear Medicine, Clinical Hospital Dr Trifun Panovski, Bitola, North Macedonia
Petar Avramovski Department of Internal Medicine, Clinical Hospital Dr Trifun Panovski, University St. Kliment Ohridski, Bitola, North Macedonia
Maja Avramovska Department of Obstetrics and Gynecology, Clinical Hospital Dr Trifun Panovski, University St. Kliment Ohridski, Bitola, North Macedonia
Jovan Todorovski Department of Social Medicine, Public Health Institution – Center of Public Health, Bitola, North Macedonia
Biljana Ilkovska Department of Medical Biochemistry, Clinical Hospital Dr Trifun Panovski, University St. Kliment Ohridski, High Medical School, Bitola, North Macedonia
Kosta Sotiroski Department of Statistics, University St. Kliment Ohridski – Bitola, Faculty of Economics – Prilep, Prilep, North Macedonia
Olivija Vaskova Institute of Pathophysiology and Nuclear Medicine, Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, North Macedonia

Keywords: goiter, nodular, inflammation, markers, C-reactive protein

Abstract

The role of systemic inflammatory markers (SIMs) in euthyroid nodular goiter (ENG) is unclear. This study evaluated their associations and predictive value for ENG in iodine-sufficient adults. Material and methods: In this prospective, case-control study, 212 euthyroid participants (20–60 years) underwent thyroid ultrasound. Laboratory evaluations included thyroid-stimulating hormone, free thyroxine, anti-thyroid peroxidase antibodies, C-reactive protein, and blood cell counts. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), systemic inflammation response index (SIRI), and the systemic immune-inflammation index (SII) were calculated, with logarithmic SIRI [log (SIRI)] and square root SII [sqrt (SII)] transformations. Logistic regression and receiver operating characteristic (ROC) curve analysis were applied. Results: Mean age was 43±9 years (83% female). ENG (n=103) and controls (n=100) did not differ in age, thyroid function, autoimmunity, or SIMs. Age correlated with ENG (ρ=0.148, P=0.032). Log (SIRI) (positive) and sqrt (SII) (inverse) were independent ENG predictors. ROC analysis confirmed log (SIRI) as the strongest, gender-independent predictor of ENG (an area under the curve=0.675, P<0.001; cut-off >0.760). SIRI was the strongest, gender-independent predictor of ENG, while SII was inversely associated.