Journal of the Endocrine Society | 2021
Metabolic Factors Can Influence the Risk of Differentiated Thyroid Cancer
Abstract
\n Introduction: Worldwide, the increasing incidence of thyroid cancer, along with a parallel increase in obesity and metabolic disorders, suggests that modifications of lifestyle and environmental factors might explain the rise in thyroid cancer incidence (1). Objective: To investigate the association between metabolic syndrome and their elements and their possible association with the risk of thyroid cancer. Materials and Methods: We enrolled 200 patients, who underwent total thyroidectomy for multinodular goiter (Bethesda II-V categories on the basis of fine needle aspiration biopsy cytological examination). We included subjects with differentiated thyroid carcinoma, the ones with poorly differentiated, anaplastic, medullary thyroid carcinomas and secondary tumors were excluded from the analysis. Patients were divided into two groups, according to the post-surgical histological diagnosis: 60 patients diagnosed with papillary or follicular thyroid cancer and 60 diagnosed with benign thyroid disease. The patients had a mean age of 56.9 years old and the majority were females (90%). Relative risk of incident thyroid cancer was assessed by preoperative levels of body mass index (BMI), blood pressure, blood levels of glucose, cholesterol, triglycerides, and the presence of metabolic syndrome (according to the NCEP ATP III definition). The two groups had similar age, gender distribution, smoking habit. Mean BMI was slightly higher in the group with patients with differentiated thyroid cancer and the majority were obese (27.41 ± 5.38 kg/m2versus 26.42 ± 5.18 kg/m2). The patients from the differentiated thyroid cancer group showed a higher percentage of diabetes mellitus and impaired fasting glucose compared to the second group (20% versus 13%), with mean fasting blood sugar levels of 97 ± 2.69 mg/dl in the first group versus 73 ± 3.06 mg/dl in the second group. 30% of the patients from the differentiated thyroid cancer group presented criteria for metabolic syndrome. There was a positive correlation between the presence of hypertension and the diagnosis of differentiated thyroid cancer (p<0.05). Conclusion: Our study showed a potential association between metabolic risk factors and the diagnosis of differentiated thyroid cancer. Besides the improvement of diagnosis, thyroid cancer increasing incidence is probably due to environmental factors and lifestyle modifications. As a future perspective of this study and based on the hypothesis of glucose dependency of many tumor types, another therapeutic strategy can involve diet (low-carbohydrate, high-fat) in order to target metabolism in tumors and alter the Walburg phenothype. Reference: (1). Mele, C., Samà, M. et al. (2019). Circulating adipokines and metabolic setting in differentiated thyroid cancer, Endocrine Connections, 8(7), 997-1006.