Associations of demographic, anthropometric, and laboratory factors with Korean Thyroid Imaging Reporting and Data System (K-TIRADS) ultrasonographic risk stratification in patients with thyroid nodules

Siti Nafisah (Residency Program in Radiology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia)
Indrita Iqbalawati (Division of Head and Neck Neuroradiology, Department of Radiology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia Division of Head and Neck Neuroradiology, Department of Radiology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indone)
Hendra Zufry (Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia Thyroid Center, Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Med)
Iskandar Zakaria (Division of Interventional Radiology, Department of Radiology, Faculty of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia Division of Interventional Radiology, Department of Radiology, Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia)
Rini Safitri (Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia)

Narra J
Vol. 6 No. 2 (2026): August 2026

Thyroid nodules are commonly detected by ultrasonography and require standardized imaging-based risk stratification. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) classifies thyroid nodules according to ultrasonographic features associated with suspected malignancy; however, factors associated with higher K-TIRADS classification remain incompletely understood. The aim of this study was to evaluate the associations of demographic, anthropometric, and laboratory factors with K-TIRADS ultrasonographic risk stratification in patients with thyroid nodules. A cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia. Adult patients with clinically suspected thyroid nodules were included using total sampling. Thyroid ultrasonography was performed using a standardized protocol, and nodules were classified according to the 2021 K-TIRADS. Demographic, anthropometric, and laboratory factors included age, sex, body mass index (BMI), and serum thyroid-stimulating hormone (TSH) level. Generalized estimating equations (GEE) were used to assess associations while accounting for clustering of multiple nodules within the same patient. A total of 109 patients with 171 thyroid nodules were included. Most patients were female (81.7%), with a median age of 46 years (IQR 34–59). Most nodules were classified as K-TIRADS 3 (48.0%) or K-TIRADS 4 (35.7%). Univariate analyses suggested that age was significantly associated with higher K-TIRADS classification (β=0.010; 95%CI: 0.003–0.018; p=0.008), whereas sex, BMI, and serum TSH level were not significant. In multivariable analysis, increasing age (β=0.010; 95%CI: 0.002–0.018; p=0.012) and higher serum TSH level (β=0.007; 95%CI: 0.002–0.011; p=0.002) were independently associated with higher K-TIRADS classification. No significant associations were observed for sex or BMI. The findings highlight that increasing age and higher serum TSH level were independently associated with higher K-TIRADS ultrasonographic risk stratification in patients with thyroid nodules. Selected demographic and laboratory factors may complement the ultrasonography-based classification system.