Circulating adipokines and metabolic setting in differentiated thyroid cancer

Abstract

The associative link relating insulin resistance (IR) and adipokines to the occurrence and phenotype of differentiated thyroid cancer (DTC) is unknown. The aim of this study was to evaluate the relationship between IR and adipokines in DTC patients, as compared with carriers of benign thyroid diseases (BTD) and healthy controls. This observational study enrolled 77 subjects phenotyped as DTC (N = 30), BTD (N = 27) and healthy subjects (N = 20). Each subject underwent preoperative analysis of anthropometric parameters, thyroid function and autoimmunity, insulin resistance (HOMA-IR) and levels of unacylated (UAG) and acylated ghrelin (AG), obestatin, leptin and adiponectin. Multivariate regression models were used to test the predictive role of metabolic correlates on thyroid phenotypes and DTC extension. The three groups showed similar age, gender distribution, smoking habit, BMI and thyroid parameters. Obestatin was significantly higher in DTC group compared to BTD (P < 0.05) and control subjects (P < 0.0001). DTC and BTD groups showed higher levels of UAG (P < 0.01) and AG (P < 0.05). Leptin levels were comparable between groups, whereas adiponectin levels were lower in DTC compared to BTD group (P < 0.0001) and controls (P < 0.01). In parallel, HOMA-IR was higher in DTC than BTD (P < 0.05) and control group (P < 0.01). Stepwise multivariable regression analysis showed that obestatin and UAG were independent predictors of DTC (P = 0.01 for both). In an analysis restricted to the DTC group, obestatin levels were associated with the absence of lymph node metastases (P < 0.05). Our results highlight a potential association between metabolic setting, circulating adipokines and thyroid cancer phenotype.

Adiponectin and leptin exert antagonizing effects on proliferation and motility of papillary thyroid cancer cell lines

“…More recently, also in a prospective study, Dossus and colleagues suggested a negative association between the pre-diagnostic circulating level of Acrp30 in woman and TC risk, unlike the circulating level of leptin which appears to be not associated with TC risk [ 15 ]. Accordingly, Mele and colleagues showed that circulating Acrp30 levels were lower in patients with differentiated TC compared to subjects with benign thyroid diseases and healthy controls, while the circulating level of leptin was comparable between these groups [ 20 ]. Nevertheless, other studies reported that the serum leptin levels were higher in TC patients compared to control subjects and decreased following surgery [ 1 , 27 ].…”

Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma

“…Insulin, as a cell growth factor, activates phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) and mitogen-activated protein kinase (MAPK) signaling pathways, prompts angiogenesis and prompts tumor proliferation (39); non-hyperinsulinemia pathways include the estrogen or androgen imbalance caused by increased aromatase activity in adipose tissue of obese patients, the enhanced effects of adipokines and inflammatory factors, and increased thyroid-stimulating hormone (TSH) levels, etc. (40)(41)(42)(43). In addition, the effect of BMI on thyroid cancer is influenced by gender and age.…”

High prevalence of thyroid carcinoma in patients with insulin resistance: a meta-analysis of case-control studies

“…Figure 1 showed the details of systematic search process. Of these included 14 studies, three are published in Chinese [ 10 , 11 , 17 ] and the rest are all published in English [ 5 – 9 , 13 – 16 , 18 , 19 ]. Four studies were conducted in Turkey and three in China.…”