Type 2 Diabetes, Obesity and Their Relation to the Risks of Thyroid Cancer.

IF 1.9 4区医学 Q3 PHYSIOLOGY

Physiological research Pub Date : 2024-12-31

T Grimmichová, V Kukliková, B Bulanová, P Pačesová, E Václavíková, J Moravcová, Z Novák, K Mastnikova, M Vaňková

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引用次数: 0

Abstract

Objective: patients with type 2 diabetes (T2DM) and obesity are generally known to have increased risk of various types of cancer, though studies addressing associations between T2DM/obesity and thyroid cancer are inconclusive. The aim of our study was to evaluate the risk of thyroid cancer focusing on diabetic patients under conditions of euthyroid status. A retrospective study in 184 patients was performed. Three cohorts were established according to tumor histology: malignant (M), benign (B) and low-risk carcinoma (MB). Fisher's exact test and Kruskal-Wallis one-way ANOVA of ranks were used for statistical analysis. The M (39.1 %), B (57.6 %) and MB (3.3 %) cohorts had comparable age (p=0.4), BMI (p=0.452), glycaemia (p=0.834), Hb1AC (p=0.157) and HOMA-IR (p=0.235). T2DM patients had larger thyroid gland volumes (28.8 vs 17.6 mL;p=0.001) compared to the cohort with normal glucose tolerance. Compared to women, men had more frequently present distal metastases (p=0.017), minimally invasive disease (p=0.027), more advanced staging (p=0.01) and positive pathogenic mutations in the TERT gene (p=0.009);these results were also significant for the diabetic male cohort (p=0.026). Type 2 diabetes and obesity are not risk factors for thyroid cancer, but a subgroup of males seems to have thyroid cancers of poorer prognosis. In general, diabetic patients with insulin resistance and hyperinsulinemia are also prone to have a goiter.

Key words: Thyroid cancer, Type 2 diabetes, Obesity, Thyroid nodule, Insulin resistance.

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2型糖尿病、肥胖及其与甲状腺癌风险的关系

目的：众所周知，2型糖尿病（T2DM）和肥胖患者患各种癌症的风险增加，尽管关于T2DM/肥胖与甲状腺癌之间关系的研究尚无定论。本研究的目的是评估甲状腺功能正常的糖尿病患者患甲状腺癌的风险。对184例患者进行回顾性研究。根据肿瘤组织学分为恶性(M)、良性(B)、低危癌（MB） 3组。统计分析采用Fisher精确检验和Kruskal-Wallis单因素方差分析。M（39.1%）、B（57.6%）和MB（3.3%）组的年龄（p=0.4）、BMI （p=0.452）、血糖（p=0.834）、Hb1AC （p=0.157）和HOMA-IR （p=0.235）具有可比性。与糖耐量正常的队列相比，T2DM患者甲状腺体积更大（28.8 mL vs 17.6 mL;p=0.001）。与女性相比，男性更常出现远端转移（p=0.017）、微创性疾病（p=0.027）、更晚期（p=0.01）和TERT基因阳性致病突变（p=0.009）；这些结果在糖尿病男性队列中也很显著（p=0.026）。2型糖尿病和肥胖不是甲状腺癌的危险因素，但男性的一个亚群似乎有预后较差的甲状腺癌。一般来说，伴有胰岛素抵抗和高胰岛素血症的糖尿病患者也容易发生甲状腺肿。关键词：甲状腺癌，2型糖尿病，肥胖，甲状腺结节，胰岛素抵抗

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来源期刊

Physiological research 医学-生理学

CiteScore

4.00

自引率

4.80%

发文量

108

审稿时长

3 months

期刊介绍： Physiological Research is a peer reviewed Open Access journal that publishes articles on normal and pathological physiology, biochemistry, biophysics, and pharmacology. Authors can submit original, previously unpublished research articles, review articles, rapid or short communications. Instructions for Authors - Respect the instructions carefully when submitting your manuscript. Submitted manuscripts or revised manuscripts that do not follow these Instructions will not be included into the peer-review process. The articles are available in full versions as pdf files beginning with volume 40, 1991. The journal publishes the online Ahead of Print /Pre-Press version of the articles that are searchable in Medline and can be cited.