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Life sciences · Journal article
Frontiers in Endocrinology · October 21, 2026
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Background The prevalence of papillary thyroid carcinoma (PTC) along with abnormal glucose-lipid metabolism and obesity is rising. Metabolic abnormalities may be associated with adverse pathological features of PTC. Objective To evaluate the associations between metabolic indicators and the pathological features of PTC, and to assess the relationships of fasting blood glucose (FBG) and the triglyceride–glucose (TyG) index with PTC aggressiveness. Methods Clinical data from patients with histologically confirmed PTC were analyzed. Logistic regression was used to examine the associations between metabolic indicators and adverse pathological features. Receiver operating characteristic (ROC) curves, DeLong’s test, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to evaluate the incremental value of FBG and TyG. Internal validation was performed using bootstrap resampling. Results PTC patients with diabetes were associated with tumor diameter >1 cm, extracapsular extension, lymph node metastasis, intermediate-to-high recurrence risk, and advanced TNM stage. Elevated FBG (≥6.1 mmol/L), BMI (≥25 kg/m²), TG and UA were associated with multiple unfavorable pathological characteristics. The highest TyG quartile was associated with extracapsular extension (OR = 2.103, P<0.05). The areas under the ROC curve (AUCs) for the baseline, FBG, and TyG models were 0.710, 0.738, and 0.722for extracapsular extension and 0.712, 0.727, and 0.714 for lymph node metastasis, respectively. TyG showed no clear incremental value for lymph node metastasis. Bootstrap-corrected values ranged from 0.698 to 0.722, with calibration slopes of 0.881–0.902. Conclusion Elevated FBG, TG, UA, BMI, and TyG were associated with adverse pathological features of PTC. FBG was associated with extracapsular extension and lymph node metastasis, whereas TyG was associated with extracapsular extension but showed no clear incremental value for risk reclassification of lymph node metastasis.