Effects of concomitant obesity and diabetes on the aggressiveness and outcomes of differentiated thyroid cancer patients

Elbasan, Onur; Yavuz, Dilek Gogas

doi:10.20945/2359-3997000000361

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…Recently, Elbasan et al (42) investigated the association of T2DM on the histological aggressiveness in DTC patients, and did not found the additive effect of T2DM on DTC aggressiveness. Guo et al (43) conducted a study in China and found that hyperinsulinemia might be the risk factor of PTC, but not disease severity.…”

Section: Discussionmentioning

confidence: 99%

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Abnormal Glucose Metabolism Parameters and the Aggressiveness of Differentiated Thyroid Carcinoma: A Hospital-Based Cross-Section Study in China

Zhao¹,

Tian²,

Jia³

et al. 2022

Front. Endocrinol.

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PurposeThe correlation of abnormal glucose metabolism and thyroid carcinoma, especially the aggressiveness of thyroid cancer, still remains controversial. We conducted this study to investigate the relationship between abnormal glucose metabolism parameters and differentiated thyroid carcinoma (DTC) in the Chinese population.Materials and MethodsThe study was designed as a hospital-based case–control study and was approved by the Ethics Committee of our hospital and registered in the Clinical Trial Protocol Registration and Results System (Registration code: NCT 03006289). From January 1, 2018 to June 30, 2021, a total of 377 DTC patients were enrolled in the study. Demographic and general characteristics, details of thyroid surgery and histopathological results, hematological test indicators were collected. Glucose metabolism parameters were calculated. Variables were analyzed by t-test, ANOVA, chi-squared analysis and Fisher’s exact test. Pearson bi-variate correlation and Spearman’s correlation analysis were used for bi-variate analysis.ResultsMore than 40% of patients with DTC were multifocality, more than half were extra-glandular invasion, and nearly 85% complied by lymph node metastasis. The prevalence of diabetes mellitus (DM) was about 10.08% in DTC patients. It was found that the proportion of postprandial 2 h blood glucose ≥11.1mmol/L and HbA1c ≥6.5% was significantly higher than the known proportion of DM (17.8%, 16.7% vs. 10.08%). Additionally, 87.3% of the DTC patients in this study had varying degrees of insulin resistance. Further analysis found that higher T staging was associated with higher levels of area under curve of C-peptide (P = 0.029), insulin sensitivity index (P = 0.012) and C-peptide sensitivity index (P = 0.016). A delayed peak of insulin secretion was found to be positive related with capsule invasion (r = 0.206, P = 0.004). In patients without a DM history, homeostasis model assessment of insulin resistance (P = 0.017), insulin sensitivity index (P = 0.019) and C-peptide sensitivity index (P = 0.020) were statistic associated with T staging. Also, the glucose metabolism parameter at 3-hour after a meal was related to a larger number of metastatic lymph nodes.ConclusionAbnormal glucose metabolism, namely, DM, hyperinsulinemia and insulin resistance, were significantly associated with the carcinogensis and aggressiveness of DTC.

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Section: Discussionmentioning

confidence: 99%

“…Recently, Elbasan et al. ( 42 ) investigated the association of T2DM on the histological aggressiveness in DTC patients, and did not found the additive effect of T2DM on DTC aggressiveness. Guo et al.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Glucose Metabolism Parameters and the Aggressiveness of Differentiated Thyroid Carcinoma: A Hospital-Based Cross-Section Study in China

Zhao¹,

Tian²,

Jia³

et al. 2022

Front. Endocrinol.

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Clinicopathological features and prognosis of papillary thyroid cancer patients with type 2 diabetes mellitus

Shi¹,

Zhang²,

Liu³

et al. 2022

Gland Surg

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Background: The clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC) combined with type 2 diabetes mellitus (T2DM) and patients with PTC alone were explored and compared in order to provide a more reasonable treatment plan for the clinical diagnosis and treatment of these patients.Methods: A total of 1,771 patients from January 2017 to December 2019 who underwent PTC surgery for the first time in the west branch of the Fourth Hospital of Hebei Medical University were analyzed retrospectively. Among them, 111 patients had PTC with T2DM (D-T group) and 1,660 patients had PTC alone (PTC group). The differences in general data and clinical characteristics between the D-T group and the PTC group were analyzed.Results: There were statistically significant differences in age, gender, and body mass index (BMI) between the D-T group and PTC group (P<0.05). Multifocality and extra-glandular invasion in the D-T group were significantly higher than the PTC group (P<0.05). In women, the D-T group was older, had a higher BMI, and was more likely to have extra-glandular invasion (P<0.05) than the PTC group. The prognosis of the D-T group was worse than that of the PTC group as determined by 3 well-developed prognostic staging systems, 8th AJCC TNM staging, MAGIS SCORE, AMES staging, and the results were statistically significant (P=0.001, P<0.001, P=0.021).Conclusions: Our study showed that the overall prognosis of PTC patients with T2DM was worse than that of patients with PTC alone. At the same time, especially in patients younger than 55 years of age, multifocal carcinoma and extra-glandular invasion are likely to occur. In addition, female patients with T2DM are more likely to have extra-glandular invasion than male patients. Therefore, for such patients, preoperative evaluation should be fully conducted.

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Effects of concomitant obesity and diabetes on the aggressiveness and outcomes of differentiated thyroid cancer patients

Cited by 2 publications

References 28 publications

Abnormal Glucose Metabolism Parameters and the Aggressiveness of Differentiated Thyroid Carcinoma: A Hospital-Based Cross-Section Study in China

Abnormal Glucose Metabolism Parameters and the Aggressiveness of Differentiated Thyroid Carcinoma: A Hospital-Based Cross-Section Study in China

Clinicopathological features and prognosis of papillary thyroid cancer patients with type 2 diabetes mellitus

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