The Value of Monocyte-to-Apolipoprotein A1 Ratio in Differentiating the Nature of Thyroid Nodules in Patients with Type 2 Diabetes Mellitus
LI Xiufen
SUN Tairan
FENG Yunxia
NIU Lili
XIE Xiaoxie
AN Yang
Abstract：Objective To explore the value of the monocyte-to-apolipoprotein A1 ratio(MAR)in differentiating the nature of thyroid nodules in patients with type 2 diabetes mellitus(T2DM).Methods A total of 104 patients with T2DM and thyroid nodules admitted to the Second Affiliated Hospital of Hebei North University from May 2023 to April 2025 were enrolled.All patients underwent fine-needle aspiration biopsy and were divided into a benign group(83 cases)and a malignant group(21 cases)based on the pathology results.The levels of monocyte(MN),apolipoprotein A1(ApoA1),and MAR were compared between the two groups.ROC curve analysis was used to evaluate the diagnostic value of MN,ApoA1,and MAR in distinguishing thyroid nodule nature.Multivariate Logistic stepwise regression was applied to identify factors influencing the nature of thyroid nodules in T2DM patients.Results The malignant group had higher levels of MN and MAR,and a lower level of ApoA1 than the benign group(P<0.01).The area under the ROC curve of MN,ApoA1,and MAR for discriminating thyroid nodule nature were 0.755,0.876,and 0.903,respectively.The cut-off values were 4.39×109/L,1.25 g/L,and 3.59,respectively;the sensitivity values were 93.41%,93.41%,and 87.15%,respectively;and the specificity values were 57.45%,66.82%,and 85.09%,respectively.Compared with the benign group,the malignant group had a longer T2DM duration,higher rates of hypoechoic texture and rich peripheral blood flow,higher glycated hemoglobin levels,and lower high-density lipoprotein cholesterol levels(P<0.05).Multivariate Logistic stepwise regression analysis indicated that rich peripheral blood flow,low levels of high-density lipoprotein cholesterol,high glycated hemoglobin,and high MAR were independent risk factors for malignant thyroid nodules in T2DM patients(OR=1.853,95%CI:1.370-2.506,P<0.01;OR=0.482,95%CI:0.342-0.680,P<0.01;OR=2.300,95%CI:1.566-3.378,P<0.01;OR=2.635,95%CI:1.709-4.064,P<0.01).Conclusion A high MAR is associated with malignant thyroid nodules in T2DM patients and shows certain diagnostic value in discriminating the nature of thyroid nodules.
Keywords：type 2 diabetes mellitusnature of thyroid nodulesmonocyte-to-apolipoprotein A1 ratiodifferential diagnosis
Publication Date：2025-09-20
Online Publishing Date：2025-09-29(First online date of this platform, not the publication date of the document)
Pages：5( 57-61 )