Metabolic Changes Enhance the Cardiovascular Risk with Differentiated Thyroid Carcinoma - A Case Control Study from Manipal Teaching Hospital of Nepal

Mittal, Ankush; Poudel, Bibek; Pandeya, Dipendra Raj; Gupta, Satrudhan Pd; Sathian, Brijesh; Yadav, Shambhu Kumar

doi:10.7314/apjcp.2012.13.5.2335

Cited by 9 publications

(4 citation statements)

References 11 publications

(10 reference statements)

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“…Serum glucose was significantly lower and insulin level was higher in DTC patients compared with controls, although treatment details were not fully described 58. However, there was no significant difference in glycated hemoglobin (HbA1c) levels.…”

Section: Discussionmentioning

confidence: 96%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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BackgroundDifferentiated thyroid cancer (DTC) occurs in relatively young patients and is associated with a good prognosis and long survival. The management of this disease involves thyroidectomy, radioiodine therapy, and long-term thyroid-stimulating hormone suppression therapy (THST). The long-term effects of the treatment and the interaction between subclinical hyperthyroidism and long-term hypoparathyroidism are poorly understood. This review sought to examine the available evidence.MethodsA PubMed search was carried out using the search terms “Thyroid Neoplasms” AND (“Thyroxine” OR “Hypocalcemia” OR “Thyrotropin”). Original English language articles published in the last 30 years studying the morbidity from thyroid-stimulating hormone (TSH) suppression and hypoparathyroidism following a surgery for DTC were retrieved and reviewed by 2 authors.ResultsOf the 3,000 results, 66 papers including 4,517 patients were selected for the present study. Studies reported on a range of skeletal (included in 34 studies, 1,647 patients), cardiovascular (17 studies, 957 patients), psychological (10 studies, 663 patients), and other outcomes (10 studies, 1,348 patients). Nine of 26 studies on patients who underwent THST showed a reduction in bone density, and 13 of 23 studies showed an increase in bone turnover markers. Skeletal effects were more marked in postmenopausal women. There was no evidence of increased fracture risk, and only little data were available on hypoparathyroidism. Four of five studies showed an increased left ventricular mass index on echocardiography, and one study showed a higher prevalence of atrial fibrillation (AF). There was little difference in basic physiological parameters and limited literature regarding symptoms or significant events. Six studies showed associations between long-term TSH suppression and impaired quality of life. Impaired glucose metabolism and prothrombotic states were also found in DTC patients.ConclusionThere is limited literature regarding long-term DTC treatment-related morbidity, particularly regarding the effects of long-term hypocalcemia. Most studies have focused on surrogate markers and not on clinical outcomes. A large prospective study on defined clinical outcomes would help characterize the morbidity of treatment and stimulate research on tailoring treatment strategies.

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Section: Discussionmentioning

confidence: 96%

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Parker¹,

Edafe²,

Balasubramanian³

2017

POR

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“…Glucose is the critical source of carbon that helps in the maintenance of cancer cell anabolism, TCA anaplerosis, aerobic glycolysis, hexokinase II activation, and modified signal transduction 70,71. Glucose was the most frequent metabolite elevated in most cancers26,72,73 and has been used as the oncometabolite of TCs in both targeted42,44 and untargeted studies 50,54,56. Analysis of the serum metabolic alterations among PTC, benign thyroid tumor, and healthy controls suggested that glucose metabolism cannot be the only important metabolite because metabolism of lipids, amino acids, and nucleic acids is important as well 50.…”

Section: Discussionmentioning

confidence: 99%

<p>Oncometabolites as biomarkers in thyroid cancer: a systematic review</p>

Khatami

Moloud

Sarvari

et al. 2019

CMAR

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Introduction Thyroid cancer (TC) is an important common endocrine malignancy, and its incidence has increased in the past decades. The current TC diagnosis and classification tools are fine-needle aspiration (FNA) and histological examination following thyroidectomy. The metabolite profile alterations of thyroid cells (oncometabolites) can be considered for current TC diagnosis and management protocols. Methods This systematic review focuses on metabolite alterations within the plasma, FNA specimens, and tissue of malignant TC contrary to benign, goiter, or healthy TC samples. A systematic search of MEDLINE (PubMed), Scopus, Embase, and Web of Science databases was conducted, and the final 31 studies investigating metabolite biomarkers of TC were included. Results A total of 15 targeted studies and 16 untargeted studies revealed several potential metabolite signatures of TC such as glucose, fructose, galactose, mannose, 2-keto- d -gluconic acid and rhamnose, malonic acid and inosine, cholesterol and arachidonic acid, glycosylation (immunoglobulin G [IgG] Fc-glycosylation), outer mitochondrial membrane 20 (TOMM20), monocarboxylate transporter 4 (MCT4), choline, choline derivatives, myo-/scyllo-inositol, lactate, fatty acids, several amino acids, cell membrane phospholipids, estrogen metabolites such as 16 alpha-OH E1/2-OH E1 and catechol estrogens (2-OH E1), and purine and pyrimidine metabolites, which were suggested as the TC oncometabolite. Conclusion Citrate was suggested as the first most significant biomarker and lactate as the second one. Further research is needed to confirm these biomarkers as the TC diagnostic oncometabolite.

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“…Insulin resistance, a typical feature of patients with T2DM, is considered to be a risk factor for a variety of cancers, such as hepatocellular, breast cancer ( 34 , 35 ). Although several studies have found the relationship between insulin resistance and thyroid nodules or thyroid cancer ( 11 , 36 ), the role of insulin resistance in carcinogenesis of thyroid is still debatable, some studies have found a correlation ( 11 – 13 , 37 , 38 ), in contrast, others did not find positive results ( 15 , 39 – 41 ). In our study, ISI was associated with the aggressiveness of thyroid cancer, but HOMA-IR was not.…”

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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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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Metabolic Changes Enhance the Cardiovascular Risk with Differentiated Thyroid Carcinoma - A Case Control Study from Manipal Teaching Hospital of Nepal

Cited by 9 publications

References 11 publications

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

Long-term treatment-related morbidity in differentiated thyroid cancer: a systematic review of the literature

<p>Oncometabolites as biomarkers in thyroid cancer: a systematic review</p>

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

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