{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:10:34Z","timestamp":1788844234525,"version":"build-2803163510"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As long-term survival rates improve among thyroid cancer patients, the metabolic consequences of thyroidectomy and thyroid hormone therapy have gained increasing importance. While these treatments are crucial for cancer management, their long-term effects on metabolic health remain inadequately understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, population-based cohort study utilizing nationwide data from the Korea National Health Insurance Service. We estimated the risk of incident metabolic abnormalities (i) among patients with TC who underwent thyroidectomy compared with matched individuals from the general population without TC, (ii) among TC patients according to thyroidectomy status, and (iii) among TC patients who underwent thyroidectomy, according to thyroid hormone therapy status. The incidence of obesity, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and metabolic dysfunction-associated steatotic liver disease (MASLD) within 5, 8, and 10 years was estimated using multivariable logistic regression models, adjusting for age, sex, household income, alcohol consumption, smoking status, and physical activity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thyroidectomy was associated with higher odds of multiple metabolic abnormalities compared with the matched general population without TC and to TC patients without thyroidectomy, with most associations evident from 5 years onward and some from 8 years. Among TC patients who underwent thyroidectomy, thyroid hormone therapy was significantly associated with metabolic abnormalities. In sex-stratified analyses, overall patterns were largely similar; however, MASLD was not significantly associated with thyroidectomy or thyroid hormone therapy in males.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Thyroidectomy and thyroid hormone therapy are associated with incidence of metabolic abnormalities within 5, 8, or 10 years among thyroid cancer survivors. 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1845515","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:26:17Z","timestamp":1788841577000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term metabolic risks after thyroidectomy and thyroid hormone therapy in thyroid cancer survivors: a nationwide cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Jiwoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine","place":["Hwaseong, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, College of Medicine, Chung-Ang University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeonjae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, College of Medicine, Chung-Ang University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeonjung","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, CHA Bundang Medical Center, CHA University","place":["Gyeonggi-do, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun Mi","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine","place":["Hwaseong, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bomi","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, College of Medicine, Chung-Ang University","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.26348","article-title":"Thyroid cancer: a review","volume":"331","author":"Boucai","year":"2024","journal-title":"Jama"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i5745","article-title":"Association between screening and the thyroid cancer \"epidemic\" in South Korea: evidence from a nationwide study","volume":"355","author":"Park","year":"2016","journal-title":"Bmj"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-1322","article-title":"Survival and death causes in differentiated thyroid carcinoma","volume":"91","author":"Eustatia-Rutten","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0449","article-title":"All-cause and cause-specific mortality among low-risk differentiated thyroid cancer survivors in the United States","volume":"34","author":"Tran","year":"2024","journal-title":"Thyroid"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.3803\/enm.2023.1896","article-title":"Adequate dose of levothyroxine for thyroid-stimulating hormone suppression after total thyroidectomy in patients with differentiated thyroid cancer","volume":"39","author":"Ryu","year":"2024","journal-title":"Endocrinol Metab (Seoul)"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2025.1582734","article-title":"Levothyroxine therapy in thyroidectomized patients: ongoing challenges and controversies","volume":"16","author":"Rossi","year":"2025","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00030.2013","article-title":"Thyroid hormone regulation of metabolism","volume":"94","author":"Mullur","year":"2014","journal-title":"Physiol Rev"},{"key":"B8","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1210\/er.2013-1006","article-title":"Thyroid hormone, thyromimetics, and metabolic efficiency","volume":"35","author":"Yehuda-Shnaidman","year":"2014","journal-title":"Endocr Rev"},{"key":"B9","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1159\/000351249","article-title":"Thyroid hormones and the metabolic syndrome","volume":"2","author":"Iwen","year":"2013","journal-title":"Eur Thyroid J"},{"key":"B10","doi-asserted-by":"publisher","first-page":"dgaa672","DOI":"10.1210\/clinem\/dgaa672","article-title":"Treatment of thyroid dysfunction and serum lipids: a systematic review and meta-analysis","volume":"105","author":"Kotwal","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0257","article-title":"Association between primary hypothyroidism and nonalcoholic fatty liver disease: a systematic review and meta-analysis","volume":"28","author":"Mantovani","year":"2018","journal-title":"Thyroid"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1159\/000342994","article-title":"Thyroid function and obesity","volume":"1","author":"Laurberg","year":"2012","journal-title":"Eur Thyroid J"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2016-2816","article-title":"Thyroid signaling, insulin resistance, and 2 diabetes mellitus: a Mendelian randomization study","volume":"102","author":"Bos","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2011.91","article-title":"Blood pressure levels in patients with subclinical thyroid dysfunction: a meta-analysis of cross-sectional data","volume":"34","author":"Cai","year":"2011","journal-title":"Hypertens Res"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2532","article-title":"Update in lipid alterations in subclinical hypothyroidism","volume":"97","author":"Pearce","year":"2012","journal-title":"J Clin Endocrinol Metab"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00303","article-title":"Abnormal glucose metabolism and insulin resistance are induced via the IRE1\u03b1\/XBP-1 pathway in subclinical hypothyroidism","volume":"10","author":"Xu","year":"2019","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2015.04.002","article-title":"Thyroid disease and the heart","volume":"116","author":"Klein","year":"2007","journal-title":"Circulation"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00560","article-title":"Thyroid hormones play role in sarcopenia and myopathies","volume":"9","author":"Bloise","year":"2018","journal-title":"Front Physiol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.7754","article-title":"Association of thyrotropin suppression with survival outcomes in patients with intermediate- and high-risk differentiated thyroid cancer","volume":"2","author":"Klubo-Gwiezdzinska","year":"2019","journal-title":"JAMA Netw Open"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1210\/er.2017-00067","article-title":"Controversies in the management of low-risk differentiated thyroid cancer","volume":"38","author":"Haymart","year":"2017","journal-title":"Endocr Rev"},{"key":"B21","doi-asserted-by":"publisher","first-page":"7465","DOI":"10.3390\/jcm13237465","article-title":"Metabolic consequences of thyroidectomy and patient-centered management","volume":"13","author":"Wang","year":"2024","journal-title":"J Clin Med"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1223527","article-title":"Significant dysregulation of lipid metabolism in patients with papillary thyroid carcinoma after thyroidectomy","volume":"14","author":"Zhou","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3803\/enm.2015.30.3.343","article-title":"Weight changes in patients with differentiated thyroid carcinoma during postoperative long-term follow-up under thyroid stimulating hormone suppression","volume":"30","author":"Sohn","year":"2015","journal-title":"Endocrinol Metab (Seoul)"},{"key":"B24","doi-asserted-by":"publisher","first-page":"799","DOI":"10.1093\/ije\/dyw253","article-title":"Data resource profile: the national health information database of the National Health Insurance Service in South Korea","volume":"46","author":"Cheol Seong","year":"2017","journal-title":"Int J Epidemiol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"146","DOI":"10.4082\/kjfm.20.0062","article-title":"Conducting and reporting a clinical research using Korean healthcare claims database","volume":"41","author":"Kim","year":"2020","journal-title":"Korean J Family Med"},{"key":"B26","doi-asserted-by":"publisher","first-page":"39","DOI":"10.30773\/pi.2020.0174","article-title":"Risk of suicide attempt after thyroidectomy: a nationwide population study in South Korea","volume":"18","author":"Kim","year":"2021","journal-title":"Psychiatry Invest"},{"key":"B27","doi-asserted-by":"publisher","first-page":"16280","DOI":"10.1038\/s41598-023-43461-8","article-title":"Impact of thyroid hormone replacement on the risk of second cancer after thyroidectomy: a Korean National Cohort Study","volume":"13","author":"Ho","year":"2023","journal-title":"Sci Rep"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13520","article-title":"Obesity in South and Southeast Asia\u2014a new consensus on care and management","volume":"24","author":"Tham","year":"2023","journal-title":"Obes Rev"},{"key":"B29","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1186\/s12933-019-0838-9","article-title":"Weight change and mortality and cardiovascular outcomes in patients with new-onset diabetes mellitus: a nationwide cohort study","volume":"18","author":"Kim","year":"2019","journal-title":"Cardiovasc Diabetol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"56","DOI":"10.3904\/kjim.2022.249","article-title":"Long-term cardiovascular events in hypertensive patients: full report of the Korean Hypertension Cohort","volume":"38","author":"Lee","year":"2022","journal-title":"Korean J Internal Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2023.0135","article-title":"Dyslipidemia fact sheet in South Korea, 2022","volume":"47","author":"Jin","year":"2023","journal-title":"Diabetes Metab J"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.12997\/jla.2021.10.1.88","article-title":"Hypertriglyceridemia is an independent risk factor for cardiovascular diseases in Korean adults aged 30\u201349 years: a nationwide population-based study","volume":"10","author":"Koo","year":"2021","journal-title":"J Lipid Atheroscl"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1111\/jdi.12313","article-title":"Clinical characteristics of metabolic syndrome in Korea, and its comparison with other Asian countries","volume":"6","author":"Hong","year":"2015","journal-title":"J Diabetes Invest"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/cm9.0000000000000503","article-title":"Validation of fatty liver index and hepatic steatosis index for screening of non-alcoholic fatty liver disease in adults with obstructive sleep apnea hypopnea syndrome","volume":"132","author":"Chen","year":"2019","journal-title":"Chin Med J"},{"key":"B35","doi-asserted-by":"publisher","first-page":"117","DOI":"10.5009\/gnl19301","article-title":"Hepatic steatosis index in the detection of fatty liver in patients with chronic hepatitis B receiving antiviral therapy","volume":"15","author":"Chang","year":"2020","journal-title":"Gut Liver"},{"key":"B36","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1210\/endrev\/bnab031","article-title":"Optimal thyroid hormone replacement","volume":"43","author":"Jonklaas","year":"2022","journal-title":"Endocr Rev"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnaf013","article-title":"The chronobiology of hormone administration: \"Doctor, what time should I take my medication","volume":"46","author":"Colonnello","year":"2025","journal-title":"Endocr Rev"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.02.045","article-title":"Thyroid hormones and cardiovascular function and diseases","volume":"71","author":"Razvi","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2014.07.001","article-title":"Thyroid hormone regulation of hepatic lipid and carbohydrate metabolism","volume":"25","author":"Sinha","year":"2014","journal-title":"Trends Endocrinol Metab"},{"key":"B40","doi-asserted-by":"publisher","first-page":"12797","DOI":"10.3390\/ijms222312797","article-title":"Hypothyroidism-associated dyslipidemia: potential molecular mechanisms leading to NAFLD","volume":"22","author":"Mavromati","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21719","article-title":"American Cancer Society nutrition and physical activity guideline for cancer survivors","volume":"72","author":"Rock","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"B42","doi-asserted-by":"publisher","first-page":"6692","DOI":"10.1038\/s41598-025-91221-7","article-title":"Exploring the nexus between hypothyroidism and metabolic dysfunction-associated steatotic liver disease: a UK biobank cohort study","volume":"15","author":"Wang","year":"2025","journal-title":"Sci Rep"},{"key":"B43","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s12902-020-00586-5","article-title":"Sex differences in subclinical hypothyroidism and associations with metabolic risk factors: a health examination-based study in mainland China","volume":"20","author":"Jiang","year":"2020","journal-title":"BMC Endocr Disord"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2022.08.001","article-title":"NAFLD and thyroid function: pathophysiological and therapeutic considerations","volume":"33","author":"Hatziagelaki","year":"2022","journal-title":"Trends Endocrinol Metab"},{"key":"B45","doi-asserted-by":"publisher","first-page":"790","DOI":"10.1210\/endrev\/bnaf018","article-title":"The impact of estrogen deficiency on liver metabolism: implications for hormone replacement therapy","volume":"46","author":"Dong","year":"2025","journal-title":"Endocr Rev"},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-70178-3_12","article-title":"Role of estrogens in the regulation of liver lipid metabolism","volume":"1043","author":"Palmisano","year":"2017","journal-title":"Adv Exp Med Biol"},{"key":"B47","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s12929-018-0488-3","article-title":"A new approach to study the sex differences in adipose tissue","volume":"25","author":"Fitzgerald","year":"2018","journal-title":"J BioMed Sci"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2009.09.020","article-title":"Contribution of visceral adiposity and insulin resistance to metabolic risk factors in Japanese men","volume":"59","author":"Oka","year":"2010","journal-title":"Metabolism"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000028409","article-title":"Association between thyroid hormone and components of metabolic syndrome in euthyroid Korean adults: a population-based study","volume":"100","author":"Shin","year":"2021","journal-title":"Med (Baltimore)"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1845515\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:26:18Z","timestamp":1788841578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1845515\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":49,"alternative-id":["10.3389\/fendo.2026.1845515"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1845515","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"article-number":"1845515"}}