Relationship between insulin resistance and thyroid cancer in Chinese euthyroid subjects without conditions affecting insulin resistance

Abstract

Backgrounds In recent years, many studies have shown that insulin resistance is related to the occurrence of thyroid cancer, but there are few reports on whether the two are related under the premise that thyroid function is normal and the metabolic components related to insulin resistance are excluded. This study aims to analyze the insulin resistance of patients with differentiated thyroid cancer after excluding the population with abnormal metabolic components, and to study the risk factors of thyroid cancer in this population. Methods 61 subjects diagnosed with differentiated thyroid carcinoma (DTC) formed the DTC group and 262 subjects with benign nodules formed the control group. Body mass index (BMI, kg/m2), waist circumference (WC), lipid profiles, and free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TGAb), alanine transaminase (ALT), aspartate aminotransferase (AST), fasting plasma glucose (FPG), fasting serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured. Results Mean subjects age (P = 0.021), BMI (P = 0.049), WC (P = 0.01), serum insulin concentration (P = 0.006), and HOMA-IR level (P = 0.005) were significantly greater in the DTC group than in the control group. Multivariate binary logistic regression analysis identified advanced age (OR = 1.027 [1.003–1.051], P = 0.029) and an increased HOMA-IR level (OR = 1.572 [1.277–1.935], P < 0.001) as significant risk factors for thyroid cancer. Conclusions IR may increase the risk of thyroid cancer development even in the absence of conditions affecting insulin resistance.

The Prevalence and Associated Predictors for Diabetes Mellitus in Adult Patients With Thyroid Nodules

“…This may be explained by the influence of Dio2, the enzyme responsible for the conversion of T4 to T3 [ 40 ], which is associated with an increased risk of increased insulin resistance and T2DM [ 39 ]. The results of the present study are in accordance with the outcomes of many studies that have shown no significant associations between DM and other associated predictors (gender, FT4, TSH, thyroid status, hematological indices, vitamin D levels and the ACR TI-RADS scoring system) [ 38 , 58 - 60 ].…”

“…In contrast, some clinical studies reported no significant influence of insulin resistance on the pathogenesis of TNs; hence, some other pathological mechanisms may be more prominent during TN formation and carcinogenesis [ 17 , 44 ]. Our study and many current clinical studies revealed that advanced age is a significant predictor for DM in patients with TNs conducted in China [ 8 - 10 , 38 ], Turkey [ 31 ] and Korea [ 32 ]. This may be explained by the fact that thyroid dysfunction is common in the elderly, which may take on different clinical conditions: clinical and subclinical hypo- and hyperthyroidism, thyroid nodular diseases and thyroid cancer [ 45 ].…”

“…Insulin resistance is associated with the insulin-like growth factor 1 signalling pathway that is involved in the proliferation of thyroid cells, an effect enhanced by TSH [ 37 ]. Similarly, many studies demonstrated the effect of insulin resistance on thyroid tissue proliferation and increases in nodule formation and goiter size [ 6 , 9 , 30 , 38 ]. Likewise, the polymorphism in a single nucleotide (type 2 deiodinase (Dio2) results in a threonine change to alanine (Thr92Ala) at codon 92, the enzyme responsible for the conversion of T4 to T3, indicating close relationship to increased insulin resistance, T2DM and increased BMI [ 39 , 40 ].…”

“…On the other hand, our study demonstrated significant higher levels of HDL among patients with DM and thyroid nodular disease, as reported in one study [ 53 ]. While HDL emerged as a significant protective factor in these patients [ 54 , 55 ], other studies documented a nonsignificant association [ 10 , 38 ]. The current study and recently published studies revealed that both cholesterol and triglyceride levels were not significantly associated with DM and TNs [ 10 , 38 ].…”

“…While HDL emerged as a significant protective factor in these patients [ 54 , 55 ], other studies documented a nonsignificant association [ 10 , 38 ]. The current study and recently published studies revealed that both cholesterol and triglyceride levels were not significantly associated with DM and TNs [ 10 , 38 ]. Interestingly, statin therapy was associated with a decrease in the dominant TN volume among patients with DM, which might be attributed to the antiproliferative effects of statin therapy on the TNs [ 51 , 52 ].…”