Lipid metabolism disturbances in papillary thyroid cancer patients and the relationship with iodine nutrition status

Abstract

Objective: Cancer patients are frequently accompanied by problems in lipid metabolism. Uncertainty exists as to whether changes in serum lipids occur in patients with papillary thyroid cancer (PTC) and their relationship with iodine nutrition remains obscure. The aim of this study was to explore lipid metabolism disturbances in PTC patients and their relationship with iodine nutrition status. Methods: A total of 909 patients who were initially diagnosed with PTC and 183 patients who were initially diagnosed with benign thyroid nodules were enrolled in this study. The serum iodine concentration (SIC), the urine iodine concentration (UIC) and nine serum lipids indicators were measured. The generalized linear model (GLM) together with other statistical methods were used to determine whether there were differences in serum lipids between patients with PTC and those with benign thyroid nodules. Results: After adjusting for baseline information, triglycerides (TG) levels in the control group (4.29±1.21) were significantly higher than in the cancer group (1.59±1.25). The rate of abnormal thyroid function was significantly lower in the patients with PTC than in the patients with benign nodules. In the PTC patients, different clinicopathological features had an impact on thyroid function, as reflected by a significant increase in FT3 in PTC with lymph node metastases, a significant increase in TSH, TGAb, and TPOAb, and a significant decrease in FT4 in PTC with AITD. Correlation analysis revealed weak to moderate correlations between iodine nutritional status, thyroid function, and serum lipids. In benign thyroid nodule patients, LDL-C and ApoB values in patients with benign thyroid nodules were significantly higher in the high SIC group than in the adequate and deficient groups. In PTC patients. ApoE levels in the low UIC group were significantly higher than in the middle and high UIC groups. Mediating effects were used to analyze the effect of iodine nutrition on the serum lipids, it showed that the total and direct effects of iodine nutritional status on serum lipids were significant, and the mediating effect of thyroid function was not significant. Conclusion: TG levels in the control group were significantly higher than in the PTC group. Iodine nutritional status influences lipids, and an excess or deficient iodine nutrition increases the risk of dyslipidemia in patients with thyroid nodule. Iodine nutritional status had a direct effect on serum lipids.