Increased Prevalence of Insulin Resistance in Patients With Differentiated Thyroid Carcinoma

Rezzónico, Jorge; Rezzónico, Mariana; Pusiol, Eduardo; Pitoia, Fabián; Nièpomniszcze, Hugo

doi:10.1089/met.2008.0062

Cited by 121 publications

(113 citation statements)

References 45 publications

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“…More importantly, rising world-wide incidence of thyroid cancer is also believed to be related to IR (Rezzonico et al 2009), explained insulin/IGF1-mediated growth stimulation. The insulin growth factors (IGFs) are potent mitogenic and anti-apoptotic factors and play a major role in a variety of human malignancies, including thyroid tumors (Kimura et al 2001).…”

Section: The Pathogenesis Of Thyroid Nodulementioning

confidence: 99%

Metformin and thyroid disease

Meng

Chen

et al. 2017

Journal of Endocrinology

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An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studies in vitro and in vivo have demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF1 and mTOR pathways. Besides, metformin treatment was associated with a decrease in the levels of serum thyroid-stimulating hormone (TSH) in diabetic patients possibly by enhancing the effects of thyroid hormones in the pituitary and activating the adenosine monophosphate-activated protein kinase (AMPK). Based on this evidence, metformin appears to be a promising therapeutic tool in patients with thyroid disease. More clinical studies are necessary to evaluate the clinical significance of metformin for the treatment of thyroid diseases.

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Section: The Pathogenesis Of Thyroid Nodulementioning

confidence: 99%

Metformin and thyroid disease

Meng

Chen

et al. 2017

Journal of Endocrinology

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“…In addition, about 30% of the subjects in G1 and G3 presented with larger nodules (O1 cm), whereas only 5 and 7% of the subjects in G2 and G4 presented with such nodules (Rezzonico et al 2008). In order to verify if IR would specifically be increased in DTC patients, apart from other thyroid nodules, the same group further investigated 20 DTC women and 20 euthyroid subjects, observing that 50% of DTC patients but only 10% of the control group presented with IR; they suggested that IR could be an important risk factor for DTCs (Rezzonico et al 2009). Not only the Argentinean group has reported the association of IR with thyroid nodules, but other studies in Turkish and Italian populations have also shown that …”

Section: Ir and The Role Of Igf1mentioning

confidence: 99%

Obesity and thyroid cancer

Marcello,

Cunha,

Batista

et al. 2014

Endocrine Related Cancer

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Many studies have provided observational data on the association of obesity and thyroid cancers, but only few of them propose mechanisms that would permit a better understanding of the causal molecular mechanisms of this association. Considering that there is an increasing incidence of both obesity and thyroid cancers, we need to summarize and link recent studies in order to characterize and understand the contribution of obesity-related factors that might affect thyroid cancer development and progression. Adipose tissue is involved in many vital processes, including insulin sensitivity, angiogenesis, regulation of energy balance, activation of the complement system, and responses such as inflammation. Although these processes have their own molecular pathways, they involve the same molecules through which obesity and adipose tissue might exert their roles in carcinogenesis, not only affecting MAPK and PI3K or even insulin pathways, but also recruiting local inflammatory responses that could result in disease formation and progression. This review describes five important issues that might explain the link between excessive weight and thyroid cancer: thyroid hormones, insulin resistance, adipokines, inflammation, and sexual hormones.

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“…Although this recent rise in thyroid cancer is likely related to improved imaging modalities, altered histopathologic criteria for diagnosis of thyroid cancer, and nuclear exposure, it should be questioned whether there are other modifiable risk factors contributing to this increased risk (41,43). In a very recent analysis, a significant association of IR with differentiated thyroid cancer was reported by Rezzonico et al They concluded that a high prevalence of IR would be an important risk factor for developing differentiated thyroid cancer, as it is well known with some other nonthyroid carcinomas (44). Three malignant thyroid nodules by FNAB were found in 3 out of 29 (7.1%) thyroid nodules.…”

Section: Thyroid Nodulementioning

confidence: 99%

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

Ayturk

Gürsoy

Kut

et al. 2009

European Journal of Endocrinology

181

146

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Objective: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities with insulin resistance (IR) as a major component. It has been recently questioned whether MetS and its related components are associated with functional and morphological alterations of the thyroid gland. The aim of our study is to examine thyroid volume and nodule prevalence in a case-control study of patients with MetS in a mild-to-moderate iodine-deficient area. Design: Two hundred and seventy-eight patients with MetS were randomly matched for age, gender, and smoking habits with 261 subjects without MetS. Serum TSH, free tri-iodothyronine and thyroxine, and the level of IR, which was estimated by the homeostasis model assessment for IR, as well as other MetS parameters were evaluated. Thyroid ultrasonography was performed in all subjects. All subjects with thyroid nodules O1 cm were offered to undergo thyroid fine needle aspiration biopsy. Results: TSH was significantly positively correlated with the presence of MetS diagnosis. There was no association between free thyroid hormone levels and MetS and its related components. Mean thyroid volume was significantly higher in patients with MetS than in controls (17.5G5.5 vs 12.2G4.2 ml, P!0.0001). Also the percentage of patients with thyroid nodules was significantly higher in patients with MetS (50.4 vs 14.6%, P!0.0001). Subjects were also divided into two groups according to the presence of IR. The group of subjects with IR had increased thyroid volume and nodule formation. The odds ratio for the development of thyroid nodule in the presence of IR was 3.2. TSH as well as all MetS components were found to be independent predictors for thyroid volume increase. IR but not TSH was found to be correlated with thyroid nodule formation. Thyroid cancer was diagnosed in 3 out of 38 patients with MetS who agreed to have a biopsy (7.9%). None of the subjects in the control group was diagnosed to have thyroid cancer. Conclusions:The results suggest that patients with MetS have significantly increased thyroid volume and nodule prevalence. Multivariate regression analysis model demonstrated that the presence of IR contributed substantially to this increased risk. Our data provide the first evidence that IR is an independent risk factor for nodule formation in an iodine-deficient environment.

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Increased Prevalence of Insulin Resistance in Patients With Differentiated Thyroid Carcinoma

Abstract: We conclude that such a high prevalence of IR would be an important risk factor for developing DTC, as it is well known with some other nonthyroid carcinomas.

Cited by 121 publications

References 45 publications

Metformin and thyroid disease

Metformin and thyroid disease

Obesity and thyroid cancer

Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine-deficient area

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