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Yan W, Luo X, Gao QJ, Chen BF, Ye H. Analysis of Body Mass Index and Clinicopathological Factors in Patients with Papillary Thyroid Carcinoma. Diabetes Metab Syndr Obes 2024; 17:2013-2019. [PMID: 38765470 PMCID: PMC11100954 DOI: 10.2147/dmso.s453468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/29/2024] [Indexed: 05/22/2024] Open
Abstract
Objective To analyze the correlation between body mass index (BMI) and clinicopathological factors of papillary thyroid cancer (PTC). Methods The clinical data of patients with PCT who were hospitalized in the Department of Thyroid Surgery of the Affiliated Hospital of Guizhou Medical University from March 2023 to September 2023 were retrospectively collected, including age, gender, height, weight, BMI, v-raf murine sarcoma viral oncogene homolog B (BRAF) gene mutation, tumor size, multifocus, Hashimoto's thyroiditis, lymph node metastasis and other clinicopathological factors. According to the World Health Organization (WHO) definition for Asian population, BMI≥25kg/m2 was obese group, 23≤BMI≤24.9kg/m2 was overweight group, 18.5≤BMI≤22.9kg/m2 was normal weight group, and BMI≤18.5kg/m2 was low weight group. The clinicopathological factors of overweight and obese patients with PTC were analyzed. Results A total of 164 PTC patients were included, with an average BMI of (24.44±3.57) kg/m2. Age of overweight and obese PTC patients (Z=1.978, p=0.083); Gender of overweight and obese PTC patients (χ2 value: 11.570, p=0.004); Tumor size in overweight and obese PTC patients (Z=0.894, p=0.411); BRAF gene mutation in overweight and obese PTC patients (χ2 value: 1.452, p =0.623); Multifocal lesions were found in overweight and obese patients (χ2 value: 1.653, p =0.201). Hashimoto's thyroiditis was found in overweight and obese PTC patients (χ2 value: 1.147, p=0.298). Overweight and obese patients with PTC had lymph node metastasis (χ2 value: 1.690, p =0.251). Conclusion Overweight and obesity in PTC patients are correlated with male, but not with age, tumor size, BRAF mutation, multifocality, Hashimoto's thyroiditis and lymph node metastasis.
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Affiliation(s)
- Wei Yan
- Department of Thyroid Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, People’s Republic of China
| | - Xue Luo
- Department of Thyroid Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, People’s Republic of China
| | - Qing-Jun Gao
- Department of Thyroid Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, People’s Republic of China
| | - Bing-Feng Chen
- Guizhou Medical University, Guiyang, 550001, People’s Republic of China
| | - Hui Ye
- Department of Thyroid Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, 550001, People’s Republic of China
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Alqahtani SM, Rayzah M, Shaik RA, Alzahrani MK, Alalawi Y, Alnefaie S, Ahmad MS. Gauging the Awareness of Physicians in Saudi Arabia Regarding Risk Factors for Thyroid Cancer. Cureus 2024; 16:e53747. [PMID: 38465048 PMCID: PMC10921024 DOI: 10.7759/cureus.53747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
Background The prevalence of obesity and thyroid cancer (TC) is increasing worldwide, and obesity is a risk factor for TC. Objectives This study aimed to elucidate physicians' awareness of obesity as a risk factor for TC. Materials and methods A cross-sectional, self-report online questionnaire was distributed to physicians in all regions of Saudi Arabia. The questionnaire comprised sociodemographic data and questions concerning the risk factors for TC, including obesity. Results A total of 310 physicians participated in this study. Of the respondents, 35.8% (n = 111) were aged 30-40 years, 40.6% (n = 126) were board certified, and 52.3% (n = 162) had >10 years of experience. Only 36.8% (n = 114) of respondents were familiar with the relationship between obesity and TC risk (P < 0.001). In terms of knowledge of obesity as a risk factor for TC, a significant difference was observed for the following sociodemographic characteristics: sex, educational attainment, and years of experience. A significant difference was also observed with awareness of other risk factors for TC. Conclusions In light of the limited awareness of the correlation between obesity and TC, the most effective approach to address these misconceptions would be to implement diverse and ongoing medical education initiatives.
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Affiliation(s)
- Saad M Alqahtani
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | - Musaed Rayzah
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | - Riyaz A Shaik
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | - Mansour K Alzahrani
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah, SAU
| | - Yousef Alalawi
- Department of Surgery, King Salman Armed Forces Hospital, Tabuk, SAU
| | - Sahar Alnefaie
- Department of Surgery, College of Medicine, Taif University, Taif, SAU
| | - Mohammad S Ahmad
- Department of Family and Community Medicine, College of Medicine, Majmaah University, Al-Majmaah, SAU
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Crudele L, Novielli F, De Matteis C, Petruzzelli S, Suppressa P, Berardi E, Antonica G, Piazzolla G, Sabbà C, Graziano G, Moschetta A. Thyroid nodule malignancy is associated with increased non-invasive hepatic fibrosis scores in metabolic subjects. Front Oncol 2023; 13:1233083. [PMID: 37965446 PMCID: PMC10641401 DOI: 10.3389/fonc.2023.1233083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction Thyroid cancer incidence is increasing, and adiposity-related conditions are gaining space in its pathogenesis. In this study, we aimed to detect any anthropometric, biohumoral, and clinical features that might be associated with thyroid nodule malignancy, potentially representing novel non-invasive markers of thyroid cancer. Materials and methods The study was conducted in a group of 142 consecutive outpatients (47 men and 95 women) who underwent fine-needle aspiration biopsy/cytology (FNAB/C) due to suspicion of malignancy from January 2018 to September 2022. We compared lipid and glycemic blood profiles as well as non-invasive liver fibrosis indexes such as aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet ratio index (APRI), and fibrosis index based on four factors (FIB-4) between patients with benign and malignant newly diagnosed nodules. Then, we performed receiver operating characteristic (ROC) analysis to assess their best cutoff values for discrimination of malignant nodules and chi-squared test to evaluate the association of specific dysmetabolic conditions with malignancy. To understand whether and to what degree dysmetabolic conditions increased the risk of thyroid nodule malignancy, we also calculated the odds ratio (OR) of the main biomarkers. Results After FNAB/C, 121 (85%) patients were diagnosed with benign thyroid nodules, while 21 (15%) individuals were diagnosed with thyroid cancer. Comparing patients with benign and malignant nodules, we found that individuals with thyroid cancer exhibited increased body mass index (BMI) (p = 0.048) and fasting plasma glucose (p = 0.046). Intriguingly, considering non-invasive scores for liver fibrosis, subjects with thyroid cancer presented increased AAR (p < 0.001) and APRI (p = 0.007), and these scores were associated with malignancy (p < 0.005) with OR = 7.1 and OR = 5, respectively. Moreover, we showed that only in the cancer group, low levels of vitamin D correlated with stigmata of impaired metabolism. Discussion In our study, AAR and APRI scores were associated with thyroid nodule malignancy and could be used to predict it and to speed up the diagnostic process. From a pathogenic point of view, we speculated that metabolic-associated fatty liver disease (MAFLD) along with hyperglycemia and vitamin D deficiency may represent putative drivers of thyroid carcinogenesis.
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Affiliation(s)
- Lucilla Crudele
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Fabio Novielli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Carlo De Matteis
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Stefano Petruzzelli
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Patrizia Suppressa
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Elsa Berardi
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Gianfranco Antonica
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Giuseppina Piazzolla
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Carlo Sabbà
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
| | - Giusi Graziano
- Center for Outcomes Research and Clinical Epidemiology (CORESEARCH), Pescara, Italy
| | - Antonio Moschetta
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, Bari, Italy
- IINBB National Institute for Biostructure and Biosystems, Roma, Italy
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Abstract
PURPOSE OF REVIEW This review explores recent evidence assessing the relationship between obesity and thyroid cancer. RECENT FINDINGS Consistent evidence from observational studies suggests that obesity increases the risk of thyroid cancer. The relationship persists when alternative measures of adiposity are used, but the strength of association may vary according to the timing and duration of obesity and how obesity or other metabolic parameters are defined as exposures. Recent studies have reported an association between obesity and thyroid cancers that are larger or have adverse clinicopathologic features, including those with BRAF mutations, thus providing evidence that the association is relevant for clinically significant thyroid cancers. The underlying mechanism for the association remains uncertain but may be driven by disruption in adipokines and growth-signaling pathways. SUMMARY Obesity is associated with an increased risk of thyroid cancer, although further research is required to understand the biological mechanisms underpinning this relationship. Reducing the prevalence of obesity is predicted to lessen the future burden of thyroid cancer. However, the presence of obesity does not impact current recommendations for screening or management of thyroid cancer.
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Affiliation(s)
- Lauren C Burrage
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital
- School of Medicine
| | - Donald S A McLeod
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital
- School of Medicine
- Population Health Department, QIMR Berghofer Medical Research Institute, Queensland
| | - Susan J Jordan
- Population Health Department, QIMR Berghofer Medical Research Institute, Queensland
- School of Public Health, The University of Queensland, Australia
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Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Reynales-Shigematsu LM, Barnoya J, Cavalcante TM, Canelo-Aybar C, Santero M, Feliu A, Espina C, Rivera JA. Latin American and the Caribbean Code Against Cancer 1st edition: Weight, physical activity, diet, breastfeeding, and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102436. [PMID: 37852731 DOI: 10.1016/j.canep.2023.102436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/06/2023] [Accepted: 07/13/2023] [Indexed: 10/20/2023]
Abstract
In Latin America and the Caribbean a considerable proportion of the population have excess body weight, do not meet the recommendations of physical activity and healthy diet, and have suboptimal rates of breastfeeding. Excess body weight is associated with at least 15 cancer sites, physical activity protects against three cancers, with some evidence suggesting a protective effect for eight more cancer sites, and sedentary behavior probably increases the risk of five cancer sites. Fiber and wholegrains protect against colorectal cancer, high intake of fruits and vegetables could reduce the risk of aerodigestive cancers; processed and red meat increase the risk of colorectal cancer; and very hot beverages are associated with esophageal cancer. Moreover, sugar-sweetened beverages and ultra-processed foods are a convincing cause for excess body weight, increasing cancer risk through this pathway, with some emerging evidence suggesting also direct pathways. Breastfeeding protects against breast cancer, and could protect against ovarian cancer. Taking this evidence into account, the Latin America and the Caribbean Code Against Cancer recommends the general public to maintain a healthy body weight, be physically active and limit sedentary behavior, eat a healthy diet (eat plenty of vegetables, fruits, wholegrains and legumes; avoid sugar-sweetened beverages and processed meat; and limit ultra-processed foods, red meat and very hot beverages), and breastfeed. Moreover, the Latin America and the Caribbean Code Against Cancer also includes a set of public policy recommendations for cancer prevention to inform policy makers and civil society about the need of policies to shape healthy environments and create opportunities to facilitate the adoption of the recommendations directed to the public.
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Affiliation(s)
- Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, United States
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Champaign-Urbana, Illinois, United States
| | - Luz M Reynales-Shigematsu
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico
| | - Joaquín Barnoya
- Research Department, Integra Cancer Institute, Guatemala City, Guatemala; Department of Environmental and Occupational Health, Colorado School of Public Health, CU Anschutz, United States
| | - Tania M Cavalcante
- Instituto Nacional de Câncer José de Alencar Gomes da Silva, Secretaria Executiva da Comissão Nacional para a Implementação da Convenção-Quadro para o Controle do Tabaco, Rio de Janeiro, RJ, Brasil
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Marilina Santero
- Department of Clinical Epidemiology and Public Health, Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07 France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, 62100 Cuernavaca, Mexico.
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Amini S, Golshani M, Moslehi M, Hajiahmadi S, Askari G, Iraj B, Bagherniya M. The effect of selenium supplementation on sonographic findings of salivary glands in papillary thyroid cancer (PTC) patients treated with radioactive iodine: study protocol for a double-blind, randomized, placebo-controlled clinical trial. Trials 2023; 24:501. [PMID: 37550760 PMCID: PMC10405508 DOI: 10.1186/s13063-023-07470-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 06/21/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Thyroid cancer is a very damaging disease. The most common treatment for this disease includes thyroidectomy and then using radioactive iodine (RAI). RAI has many side effects, including a decrease in salivary secretions, followed by dry mouth and oral and dental injuries, as well as increased inflammation and oxidative stress. Selenium can be effective in these patients by improving inflammation and oxidative stress and by modulating salivary secretions. So far, only one clinical trial has investigated the effect of selenium on thyroid cancer patients treated with radioiodine therapy (RIT) conducted on 16 patients; considering the importance of this issue, to show the potential efficacy of selenium in these patients, more high-quality trials with a larger sample size are warranted. METHODS This is a parallel double-blind randomized controlled clinical trial that includes 60 patients aged 20 to 65 years with papillary thyroid cancer (PTC) treated with RAI and will be conducted in Seyyed al-Shohada Center, an academic center for referral of patients to receive iodine, Isfahan, Iran. Thirty patients will receive 200 µg of selenium for 10 days (3 days before to 6 days after RAI treatment) and another 30 patients will receive a placebo for the same period. Sonographic findings of major salivary glands, salivary secretions, and sense of taste will be evaluated before and 6 months after 10-day supplementation. DISCUSSION Due to its anti-inflammatory and antioxidant effects, as well as improving salivary secretions, selenium may improve the symptoms of thyroid cancer treated with radioactive iodine. In past studies, selenium consumption has not reduced the therapeutic effects of radiation therapy, and at a dose of 300 to 500 μg/day, it has not had any significant side effects in many types of cancer under radiation therapy. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20201129049534N6 . Registered on 16 September 2021.
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Affiliation(s)
- Sepide Amini
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Golshani
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Moslehi
- Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Hajiahmadi
- Department of Radiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
- Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Bijan Iraj
- Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
- Anesthesia and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
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Sauter ER. Obesity, metabolic and bariatric surgery, and cancer prevention: what do we need to learn and how do we get there? Surg Obes Relat Dis 2023; 19:781-787. [PMID: 36918327 PMCID: PMC10293064 DOI: 10.1016/j.soard.2023.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 01/29/2023] [Indexed: 02/10/2023]
Abstract
Obesity and associated metabolic dysfunction are on the rise in the United States and around the world. Metabolic dysfunction often leads to chronic disease, including cancer. Recent evidence suggests that weight loss among individuals with obesity may decrease cancer risk. Metabolic and bariatric surgery (MBS) leads to greater maximum and sustained weight loss than nonsurgical dietary strategies and demonstrates the most convincing evidence that weight loss lowers cancer risk. Caloric restriction diets combined with GLP-1 receptor agonists demonstrate weight loss intermediate between MBS and other nonsurgical diet strategies so long as individuals consistently take the medication. Weight regain after initial loss is a major problem with all weight loss strategies. To better prevent cancer in individuals with obesity, we need to individualize weight loss strategies, determining what strategy works for a given individual and how to implement it. We need to learn (1) what an individual's impediments to initial and sustained weight loss are; (2) what the optimal weight loss strategy, be it diet modification, diet modification + medication, or MBS followed by diet modification, is; (3) how exercise(s) should be incorporated into weight loss strategies; (4) where medications fit into the treatment strategy of individuals with obesity; and (5) what the mechanisms driving the influence of MBS on cancer risk are. We also need to (6) explore expanding the eligibility of MBS to individuals with a body mass index <35 kg/m2. Answers to these questions require a better understanding of how MBS impacts cancer risk, including in which groups (women versus men, which racial and ethnic groups, which cancers, which MBS procedure) MBS works best to reduce risk. The National Cancer Institute, through new funding opportunities, hopes to advance our understanding of how obesity drives cancer risk and how individuals with obesity can prevent cancer development and, among those with cancer, prevent disease recurrence.
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Affiliation(s)
- Edward R Sauter
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland.
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8
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Demetriou E, Fokou M, Frangos S, Papageorgis P, Economides PA, Economides A. Thyroid Nodules and Obesity. Life (Basel) 2023; 13:1292. [PMID: 37374075 DOI: 10.3390/life13061292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
A widely discussed topic in the pathophysiology of thyroid nodules is the role of obesity, a state that leads to increased systemic inflammatory markers. Leptin plays a vital role in forming thyroid nodules and cancer through several mechanisms. Together with chronic inflammation, there is an augmentation in the secretion of tumor necrosis factor (TNF) and the cytokine interleukin 6 (IL-6), which contributed to cancer development, progression and metastasis. In addition, leptin exerts a modulatory action in the growth, proliferation and invasion of thyroid carcinoma cell lines via activating various signal pathways, such as Janus kinase/signal transducer and activator of transcription, mitogen-activated protein kinase (MAPK) and/or phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt). Through several proposed mechanisms, aberrant endogenous estrogen levels have been suggested to play a vital role in the development of both benign and malignant nodules. Metabolic syndrome triggers the development of thyroid nodules by stimulating thyroid proliferation and angiogenesis due to hyperinsulinemia, hyperglycemia and dyslipidemia. Insulin resistance influences the distribution and structure of the thyroid blood vessels. Insulin growth factor 1 (IGF-1) and insulin affect the regulation of the expression of thyroid genes and the proliferation and differentiation of thyroid cells. TSH can promote the differentiation of pre-adipocytes to mature adipocytes but also, in the presence of insulin, TSH possesses mitogenic properties. This review aims to summarize the underlying mechanisms explaining the role of obesity in the pathophysiology of thyroid nodules and discuss potential clinical implications.
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Affiliation(s)
- Elpida Demetriou
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | - Maria Fokou
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
| | - Savvas Frangos
- Nuclear Medicine Department and Thyroid Cancer Clinic, Bank of Cyprus Oncology Center, 2404 Nicosia, Cyprus
| | | | - Panayiotis A Economides
- Department of Medicine, School of Medicine, European University Cyprus, 2404 Nicosia, Cyprus
- Economides Thyroid and Endocrinology Center, Engomi, 2404 Nicosia, Cyprus
| | - Aliki Economides
- Economides Thyroid and Endocrinology Center, Engomi, 2404 Nicosia, Cyprus
- Department of Health Sciences, European University Cyprus, 2404 Nicosia, Cyprus
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Balajam NZ, Mousavian AH, Sheidaei A, Gohari K, Tavangar SM, Ghanbari-Motlagh A, Ostovar A, Shafiee G, Heshmat R. The 15-year national trends of endocrine cancers incidence among Iranian men and women; 2005-2020. Sci Rep 2023; 13:7632. [PMID: 37164997 PMCID: PMC10172312 DOI: 10.1038/s41598-023-34155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/25/2023] [Indexed: 05/12/2023] Open
Abstract
Cancer is one of the important health problems in Iran, which is considered as the third cause of death. Endocrine cancers are rare but mostly curable. Thyroid cancer, the most common endocrine tumors, includes about one percent of malignant cancer. In this study, we examined the 15-year national trend of endocrine cancer incidence in Iranian men and women. The data in each province were evaluated based on age, gender, and cancer type according to International Classification of Disease Codes version 10 (ICD-10) from 2005 to 2020 in Iran. All data were obtained from the reports of the Statistics Center of Iran (SCI), 6 phases of the step-by-step approach to monitoring the risk factors of chronic diseases over 18 years old (STEPs), and 3 periods of the CASPIAN study (survey of non-communicable diseases in childhood and adolescence). Statistical analyzes and graph generation were done using R statistical software. Poisson regression with mixed effects was used for data modeling and incidence rate estimation. The incidence of thyroid gland malignancy is higher in women than in men. On the other hand, the incidence of adrenal gland cancer is slightly higher in men than in women. The same pattern is observed for other endocrine neoplasms and related structures. The incidence rate of these types of cancers has generally increased from 2005 to 2020 in Iran. This increase is more in women than in men. In addition, in the middle of the country, there is a strong region in terms of the occurrence of these types of cancers. The incidence rate in these provinces is relatively higher for both sexes and all studied periods. We conducted a study to observe the changing trends for various types of endocrine cancers over 15 years in men and women. Considering the increasing trend of thyroid cancers in Iran, therefore, creating essential policies for the management of these types of cancers for prevention, rapid diagnosis, and, timely treatment is particularly important.
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Affiliation(s)
- Narges Zargar Balajam
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir-Hossein Mousavian
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medicine Sciences, Tarbiat Modares University, Tehran, Iran
| | - Seyed Mohammad Tavangar
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Ghanbari-Motlagh
- Department of Radiotherapy, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Li LR, Song JL, Liu HQ, Chen C. Metabolic syndrome and thyroid Cancer: risk, prognosis, and mechanism. Discov Oncol 2023; 14:23. [PMID: 36811728 PMCID: PMC9947216 DOI: 10.1007/s12672-022-00599-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/01/2022] [Indexed: 02/24/2023] Open
Abstract
The increasing incidence of thyroid cancer (TC) cannot be fully explained by overdiagnosis. Metabolic syndrome (Met S) is highly prevalent due to the modern lifestyle, which can lead to the development of tumors. This review expounds on the relationship between Met S and TC risk, prognosis and its possible biological mechanism. Met S and its components were associated with an increased risk and aggressiveness of TC, and there were gender differences in most studies. Abnormal metabolism places the body in a state of chronic inflammation for a long time, and thyroid-stimulating hormones may initiate tumorigenesis. Insulin resistance has a central role assisted by adipokines, angiotensin II, and estrogen. Together, these factors contribute to the progression of TC. Therefore, direct predictors of metabolic disorders (e.g., central obesity, insulin resistance and apolipoprotein levels) are expected to become new markers for diagnosis and prognosis. cAMP, insulin-like growth factor axis, angiotensin II, and AMPK-related signaling pathways could provide new targets for TC treatment.
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Affiliation(s)
- Ling-Rui Li
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Jun-Long Song
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Han-Qing Liu
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China
| | - Chuang Chen
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, No. 238 Jieang Road, Wuchang District, Wuhan, 430060, Hubei, PR China.
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Nguyen LTD, Gunathilake M, Lee J, Kim J. Association between dietary habits and incident thyroid cancer: A prospective cohort study. Front Nutr 2023; 10:1104925. [PMID: 36875835 PMCID: PMC9975340 DOI: 10.3389/fnut.2023.1104925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/20/2023] [Indexed: 02/17/2023] Open
Abstract
Background In addition to the thyroid cancer (TC) risk from lifestyle and environmental factors such as radiation exposure, some studies have indicated that diet may affect TC development; however, previous findings are inconsistent. The objective of our study was to investigate the association between dietary habits and TC risk in a Korean population. Materials and methods A total of 13,973 participants were selected after excluding ineligible subjects from the Cancer Screenee Cohort at National Cancer Center in Korea from October 2007 to December 2021. Participants were followed until May 2022 to identify incident TC cases. Information on dietary habits and general characteristics was collected using a self-report questionnaire administered at enrollment without keeping track of changes in eating habits during the follow-up period. A Cox proportional hazards model was used to determine the hazard ratio (HR) and 95% confidence interval (CI) of TC risk for each dietary factor. Results A total of 138 incident TC cases were identified during the median follow-up period of 7.6 years. Of the 12 dietary habits evaluated, only two habits showed significant associations with TC. A significantly decreased TC risk was found among participants who consumed milk and/or dairy products 5 or more days a week [adjusted HR (aHR), 0.58; 95% CI, 0.39-0.85]. Notably, a stronger protective effect of dairy consumption was observed in participants aged ≥ 50 years (aHR, 0.44; 95% CI, 0.26-0.75), in women (aHR, 0.53; 95% CI, 0.35-0.81), and in non-smokers (aHR, 0.60; 95% CI, 0.39-0.92). There was a reduced risk of TC in participants with meal durations longer than 10 min (aHR, 0.58; 95% CI, 0.41-0.83). However, this association was limited to individuals aged ≥ 50 years (aHR, 0.49; 95% CI, 0.31-0.79), women (aHR, 0.61; 95% CI, 0.41-0.90), and non-smokers (aHR, 0.62; 95% CI, 0.41-0.92). Conclusion Our findings suggest that consuming milk and/or dairy products 5 or more days a week and having a meal duration longer than 10 min could be protective factors against TC, especially in individuals aged ≥ 50 years, women and non-smokers. Further prospective studies are needed to investigate the association of dietary intake with specific types of TC.
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Affiliation(s)
- Linh Thi Dieu Nguyen
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Madhawa Gunathilake
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeonghee Lee
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang-si, Republic of Korea
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12
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Papillary Thyroid Carcinoma: Current Position in Epidemiology, Genomics, and Classification. METHODS IN MOLECULAR BIOLOGY (CLIFTON, N.J.) 2022; 2534:1-15. [PMID: 35670964 DOI: 10.1007/978-1-0716-2505-7_1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Papillary thyroid carcinoma is the most common type of thyroid malignancy both in adults and pediatric population. Since the 1980s, there are changes in criteria in labelling thyroid lesions as "papillary thyroid carcinomas." Radiation exposure is a well-established risk factor for papillary thyroid carcinoma. Other environmental risk factors include dietary iodine, obesity, hormones, and environmental pollutants. Papillary thyroid carcinomas could occur in familial settings, and 5% of these familial cases have well-studied driver germline mutations. In sporadic papillary thyroid carcinoma, BRAF mutation is common and is associated with clinicopathologic and prognostic markers. The mutation could aid in the clinical diagnosis of papillary thyroid carcinoma. Globally, thyroid cancer is among the top ten commonest cancer in females. In both adult and pediatric populations, there are variations of prevalence of thyroid cancer and rising incidence rates of thyroid cancer worldwide. The increase of thyroid cancer incidence was almost entirely due to the increase of papillary thyroid carcinoma. The reasons behind the increase are complex, multifactorial, and incompletely understood. The most obvious reasons are increased use of diagnostic entities, change in classification of thyroid neoplasms, as well as factors such as obesity, environmental risk factors, and radiation. The prognosis of the patients with papillary thyroid carcinoma is generally good after treatment. Nevertheless, cancer recurrence and comorbidity of second primary cancer may occur, and it is important to have awareness of the clinical, pathological, and molecular parameters of papillary thyroid carcinoma.
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13
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Shin A, Cho S, Jang D, Abe SK, Saito E, Rahman MS, Islam MR, Sawada N, Shu XO, Koh WP, Sadakane A, Tsuji I, Sugawara Y, Ito H, Nagata C, Park SK, Yuan JM, Kim J, Tsugane S, Cai H, Wen W, Ozasa K, Matsuyama S, Kanemura S, Oze I, Wada K, Wang R, Yoo KY, Potter JD, Ahsan H, Boffetta P, Chia KS, Matsuo K, Qiao YL, Rothman N, Zheng W, Inoue M, Kang D. Body Mass Index and Thyroid Cancer Risk: A Pooled Analysis of Half a Million Men and Women in the Asia Cohort Consortium. Thyroid 2022; 32:306-314. [PMID: 34915752 PMCID: PMC8971972 DOI: 10.1089/thy.2021.0445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Although previous meta-analyses have suggested a dose-response relationship between body mass index (BMI) and thyroid cancer risk, limited evidence has been presented about Asian populations. To assess this association among Asian populations, where underweight is more prevalent than in other regions, a pooled analysis from the Asia Cohort Consortium was conducted. Methods: Baseline height and weight were measured in five cohorts and self-reported in eight cohorts. Thyroid cancer incidence was ascertained by linkage to local cancer registries. Cohorts were treated as a stratum in the Cox proportional hazard model to estimate the pooled hazard ratios (HRs) and corresponding confidence intervals (CIs) from the estimates for each cohort. All analyses were stratified by sex. Results: A total of 538,857 men and women from 13 cohorts from mainland China, Korea, Japan, and Singapore were included in the analysis. During a mean of 15.1 years of follow-up, 1132 thyroid cancer cases were ascertained. Using a BMI of 18.5-22.9 kg/m2 as a reference, an elevated risk of thyroid cancer was observed for groups with a BMI between 25 and 29.9 kg/m2 (HR: 1.31, [CI: 0.95-1.80]) and a BMI of 30 kg/m2 and greater (HR: 1.84, [CI: 0.89-3.81]) in men. Thyroid cancer risk was elevated in women with a BMI of 23-24.9 kg/m2 (HR: 1.26, [CI: 1.07-1.48]). The HRs for 5-U increment of BMI showed a linear association among men (HR: 1.25, [CI 1.10-1.55]) but not among women (HR: 1.07, [CI: 0.97-1.18]). Although the overall thyroid cancer risk was lower among underweight men and women, the papillary cancer risk may be elevated among underweight men (HR: 2.24, [CI: 0.75-6.66]). Conclusion: While higher BMI is associated with an elevated risk of thyroid cancer in both men and women, the association of underweight BMI may differ by sex and histological subtype.
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Affiliation(s)
- Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Address correspondence to: Aesun Shin, MD, PhD, Department of Preventive Medicine, College of Medicine, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea
| | - Sooyoung Cho
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Doeun Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Sarah Krull Abe
- Division of Prevention, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Eiko Saito
- Division of Cancer Statistics Integration Center for Cancer Control & Information Services National Cancer Center, Chuo-ku, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Md Shafiur Rahman
- Division of Prevention, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Md Rashedul Islam
- Division of Prevention, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Norie Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Xiao-Ou Shu
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Woon-Puay Koh
- Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Atsuko Sadakane
- Radiation Effects Research Foundation, Hiroshima, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Ichiro Tsuji
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Yumi Sugawara
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Hidemi Ito
- Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Chisato Nagata
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Jeongseon Kim
- Graduate School of Science and Policy, National Cancer Center, Goyang, Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Chuo-ku, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Hui Cai
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Wanqing Wen
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Kotaro Ozasa
- Radiation Effects Research Foundation, Hiroshima, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Sanae Matsuyama
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Seiki Kanemura
- Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Isao Oze
- Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Keiko Wada
- Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Renwei Wang
- UPMC Hillman Cancer Center and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Keun-Young Yoo
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Veterans Health Service Medical Center, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - John D. Potter
- Research Centre for Hauora and Health, Massey University, Wellington, New Zealand.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Habibul Ahsan
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Kee Seng Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Keitaro Matsuo
- Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - You-Lin Qiao
- Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology & Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Wei Zheng
- Division of Epidemiology, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Manami Inoue
- Division of Prevention, Center for Public Health Sciences, National Cancer Center Institute for Cancer Control, Tokyo, Japan.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
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14
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Ma XN, Ma CX, Hou LJ, Fu SB. The association of obesity with thyroid carcinoma risk. Cancer Med 2022; 11:1136-1144. [PMID: 35032114 PMCID: PMC8855891 DOI: 10.1002/cam4.4498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 11/10/2021] [Accepted: 11/18/2021] [Indexed: 12/24/2022] Open
Abstract
Background The prevalence of obesity and an increased incidence of thyroid carcinoma (TC) threaten public health in parallel on a global scale. Sufficient evidence supports excess body fatness in thyroid carcinogenesis, and the role and anthropometric markers of obesity have been causally associated with the rising risk of TC. Methods A literature search was conducted in PubMed. Studies focused on the effect of obesity in TC. Results This review mainly discusses the global incidence and prevalence of obesity‐related TC. We also review the role of obesity in TC and potential clinical strategies for obesity‐related TC. Conclusions Excess body fatness in early life and TC survival initiate adverse effects later in life. The incidence of thyroid cancer has been increasing in the last decades all over the world. Such a steady growth cannot be entirely attributable to more sensitive diagnostic procedures. Obesity has increased with sufficient rapidity in the same time frame and may as possible promoters and modifiable risk factors for thyroid cancer in recent years. The aim of this review was to focus on the relationship between obesity and the risk of thyroid cancer. Obesity seems to play a relevant role in thyroid cancer carcinogenesis as well as in its severity and aggressiveness. The possible underlying mechanism is involved chronic inflammation mediated by cytokines, leptin, and adiponectins.
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Affiliation(s)
- Xiao-Ni Ma
- Department of Laboratory Medicine, The First Hospital of Lanzhou University, Lanzhou, Gansu, China.,The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China
| | - Cheng-Xu Ma
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.,Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Li-Jie Hou
- Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
| | - Song-Bo Fu
- The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu, China.,Department of Endocrinology, The First Hospital of Lanzhou University, Lanzhou, Gansu, China
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15
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Alyousif H, Adam I, Alamin NA, Sid Ahmed MA, Al Saeed A, Hassoni AH, Musa IR. The prevalence and associated predictors for Bethesda III-VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia. Ther Adv Endocrinol Metab 2022; 13:20420188221122486. [PMID: 36111207 PMCID: PMC9469765 DOI: 10.1177/20420188221122486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thyroid cancer is increasing globally and is currently the most prevalent endocrine malignancy. Recent data show an increase in the incidence of thyroid cancer in the Kingdom of Saudi Arabia (KSA). Thyroid ultrasound and fine-needle aspiration cytology (FNAC) are the cornerstones in managing thyroid nodules. We conducted this study to evaluate the prevalence and the associated predictors for thyroid nodule Bethesda III-VI in eastern KSA. METHODS A retrospective study was conducted between January 2015 and 31 August 2021. The participants were recruited patients who received a thyroid ultrasound and ultrasound-guided thyroid FNAC, using the thyroid imaging reporting and data system (TI-RADS) and the Bethesda Classification, respectively. RESULT Three hundred and ten patients who underwent thyroid FNAC were enrolled in the study. The median (interquartile, IQR) age was 47.0 (20.0) years, and 266 (85.8%) of them were females. The median (IQR) body mass index was 30.2 (7.6) kg/m2. Out of these participants, 64.8% were euthyroid, 27.4% had hypothyroidism and 7.7% had hyperthyroidism. The ACR TI-RADS-3, 4 and 5 were 51.3%, 46.1% and 2.6%, respectively. The Bethesda outcome of thyroid FNAC I-VI was 5.2%, 63.9%, 15.5%, 5.8%, 3.5% and 6.1%, respectively. The risk for malignancy (Bethesda III-VI) was documented in 31.0% and atypia of undetermined significance was most prevalent (15.5%). A higher ACR TI-RADS score was associated with a higher risk of malignancy: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%). In a multivariate analysis, only the ACR TI-RADS score was significantly associated with the outcome of thyroid FNAC: ACR TI-RADS-4 [OR = 2.59 (95% CI = 1.54-4.36)] and ACR TI-RADS-5 [OR = 29.03 (95% CI = 3.44-245.07)]. CONCLUSION There was a high prevalence of Bethesda III-VI and atypia of undetermined significance was most prevalent. A thyroid ultrasound report for TI-RADS was significantly associated with the outcome of thyroid FNAC and is a reliable tool in the absence of molecular testing for thyroid cancer.
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Affiliation(s)
- Hussain Alyousif
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | | | - Mona A. Sid Ahmed
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
| | - Ayat Al Saeed
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
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16
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Wu WX, Feng JW, Ye J, Qi GF, Hong LZ, Hu J, Liu SY, Jiang Y, Qu Z. Influence of Obesity Parameters on Different Regional Patterns of Lymph Node Metastasis in Papillary Thyroid Cancer. Int J Endocrinol 2022; 2022:3797955. [PMID: 36389127 PMCID: PMC9663220 DOI: 10.1155/2022/3797955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Obesity increases risk of thyroid cancer. However, the association between obesity and the progression of papillary thyroid cancer (PTC) remains controversial. This retrospective study aimed to explore the relationship between obesity and regional patterns of lymph node metastasis (LNM) in PTC. METHODS We retrospectively reviewed data from 1015 patients with PTC. We calculated obese parameters, such as body mass index (BMI), body fat percentage (BFP), and body surface area (BSA). Logistic regression models were used to assess associations between obese parameters and the rate of lymph node metastasis (LNM), number of LNM, pattern of LNM, and lymph node ratio (LNR). RESULTS Higher BMI was not associated with different regional patterns of LNM in PTC. In men with PTC, high BFP was an independent predictor of total LNM, central lymph node metastasis (CLNM), total lateral lymph node metastasis (LLNM), multiple lateral lymph node metastasis, and simultaneous metastasis in lateral compartment. In addition, male patients with high BFP had higher central LNR and higher number of CLNM. For women, high BSA was an independent predictor of LLNM and level IV metastasis. Female patients with high BSA had higher number of CLNM. CONCLUSION BFP and BSA, possibly influenced by gender, were positively associated with the number and risk of LNM in different regions of PTC patients. However, BMI was not the predictor for aggressiveness of PTC in terms of LNM. Clinical decision-making for regional LNM in PTC patients should consider the factor of obesity.
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Affiliation(s)
- Wan-Xiao Wu
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Jia-Wei Feng
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Jing Ye
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Gao-Feng Qi
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Li-Zhao Hong
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Jun Hu
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Sheng-Yong Liu
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Yong Jiang
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
| | - Zhen Qu
- The Third Affiliated Hospital of Soochow University, Changzhou First People's Hospital, Changzhou, Jiangsu, China
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17
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Ahmadi S, Pappa T, Kang AS, Coleman AK, Landa I, Marqusee E, Kim M, Angell TE, Alexander EK. Point of Care Measurement of Body Mass Index and Thyroid Nodule Malignancy Risk Assessment. Front Endocrinol (Lausanne) 2022; 13:824226. [PMID: 35222281 PMCID: PMC8873520 DOI: 10.3389/fendo.2022.824226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Large scale epidemiology studies have suggested obesity may increase the risk of thyroid cancer, though no prospective analyses using real-world measurement of BMI at a time proximate to initial thyroid nodule evaluation have been performed. METHODS We performed a prospective, cohort analysis over 3 years of consecutive patients presenting for thyroid nodule evaluation. We measured BMI proximate to the time of initial evaluation and correlated this with the final diagnosis of benign or malignant disease. We further correlated patient BMI with aggressivity of thyroid cancer, if detected. RESULTS Among 1,259 consecutive patients with clinically relevant nodules, 199(15%) were malignant. BMI averaged 28.6 kg/m2 (SD: 6.35, range:16.46-59.26). There was no correlation between the measurement of BMI and risk of thyroid cancer (p=0.58) as mean BMI was 28.9 kg/m2 and 28.6 kg/m2 in cancerous and benign cohorts, respectively. Similarly, BMI did not predict aggressive thyroid cancer (p=0.15). While overall nodule size was associated with increased BMI (p<0.01), these data require further validation as obesity may hinder nodule detection until large. CONCLUSION In contrast to findings published from large scale association studies drawn from national databases, these prospective data of consecutive patients presenting for nodule evaluation detect no association of obesity (as measured by BMI) with thyroid cancer. Real time measurement of BMI at the time of thyroid nodule evaluation does not contribute to cancer risk assessment.
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Affiliation(s)
- Sara Ahmadi
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- *Correspondence: Sara Ahmadi,
| | - Theodora Pappa
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Alex S. Kang
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Alexandra K. Coleman
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Iñigo Landa
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Ellen Marqusee
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Matthew Kim
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Trevor E. Angell
- Department of Medicine, Division of Endocrinology and Diabetes, Keck School Medicine of USC, Los Angeles, CA, United States
| | - Erik K. Alexander
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
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Abukanna AMA, Alanazi ZMS, Alanazi AMH, Alenazi AHS, Alanazi AOA, Alenezi KA, Alsalmi GM. Obesity as a Risk Factor for Different Cancers: Systematic Review. CLINICAL CANCER INVESTIGATION JOURNAL 2022. [DOI: 10.51847/k1awbiln5t] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Gimenez-Perez G, Recasens A, Chicharro S, Simo O, Murillo J, Castells I. Presence of risk factors for thyroid cancer does not improve the performance of ultrasound screening for thyroid nodules in patients with obesity. Int J Clin Pract 2021; 75:e14211. [PMID: 33826764 DOI: 10.1111/ijcp.14211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE It has been suggested, on a theoretical basis, that ultrasound screening of thyroid nodules in obese patients with additional risk factors (family history, chronic autoimmune thyroiditis or high thyrotropin) might be cost-effective for the early detection and treatment of thyroid cancer. The present study evaluates if this approach can be validated in a real clinical setting. METHODS Patients with obesity who attended hospital-based clinics were evaluated for risk factors of thyroid cancer and ultrasound screened for thyroid nodularity. Detected nodules were evaluated according to current guidelines. RESULTS A total of 429 patients were evaluated (70.2% women, mean age 49.1 ± 11.0, mean body mass index 42.6 ± 5.8 kg/m2 ). Risk factors were present in 129 (30.1%) patients. Thyroid nodules with indication for fine-needle aspiration biopsy were detected in 69 (16.1%). We did not find differences in the risk of harbouring thyroid nodules according to the presence of risk factors (no risk factors 16.6%, risk factors 14.1%, P = .64). No single risk factor conferred an increased risk for thyroid nodules During the screening procedure, four cases of thyroid cancer were detected, none of them with the evaluated risk factors. CONCLUSION The presence of known risk factors for thyroid cancer does not improve the performance of a US screening strategy aimed at the detection of thyroid nodules in obese patients. According to current guidelines, screening for thyroid nodules in obese patients is not recommended regardless of the presence of thyroid cancer risk factors.
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Affiliation(s)
| | - Assumpta Recasens
- Endocrinology Section, Hospital General de Granollers, Granollers, Spain
- Medicine Department, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallés, Spain
| | - Sandra Chicharro
- Endocrinology Section, Hospital de Mollet, Mollet del Vallés, Spain
| | - Olga Simo
- Endocrinology Section, Hospital General de Granollers, Granollers, Spain
| | - Jesus Murillo
- Endocrinology Section, Hospital de Mollet, Mollet del Vallés, Spain
| | - Ignasi Castells
- Endocrinology Section, Hospital General de Granollers, Granollers, Spain
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Economides A, Giannakou K, Mamais I, Economides PA, Papageorgis P. Association Between Aggressive Clinicopathologic Features of Papillary Thyroid Carcinoma and Body Mass Index: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2021; 12:692879. [PMID: 34276564 PMCID: PMC8279812 DOI: 10.3389/fendo.2021.692879] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The association between adiposity and papillary thyroid carcinoma (PTC) has been reported in several studies, but its association with aggressive clinicopathologic features is not well-recognized. Our aim is to systematically review the literature to identify whether adiposity, expressed through Body Mass Index (BMI), is related to aggressive clinicopathologic features such as tumor-node-metastasis (TNM) stage, extrathyroidal extension (ETE), lymph node (LN) metastasis and multifocality in patients with PTC. METHODS A systematic search for articles was performed using the PubMed, EBSCO, and Cochrane Library for all articles published in English until December 2020. Specific keywords such as "papillary thyroid carcinoma", "Body Mass Index", "clinicopathologic features" were used in the search strategy. Two independent reviewers screened all retrieved articles based on predefined inclusion and exclusion criteria. Meta-analysis was performed in the studies that reported crude and adjusted odds ratios (OR). The methodological quality was assessed using the Newcastle-Ottawa Scale. RESULTS A total of 11 retrospective cohort studies involving 26,196 participants included. Our findings showed that elevated BMI was significantly associated with ETE in both overweight (OR 1.26, 95% CI: 1.09-1.44) and obesity group (OR 1.45, 95% CI:1.26-1.64). Elevated BMI was also significantly associated with multifocality in overweight patients (OR 1.17, 95% CI:1.10-1.24) and obese patients (OR 1.45, 95% CI:1.29-1.62). Also, obesity was significantly associated with increased tumor size (OR 1.77, 95% CI:1.52-2.03) and with LN metastasis (OR 1.28, 95% CI: 1.12-1.44), whereas being overweight was significantly associated with advanced TNM stage (OR 1.55, 95% CI:1.27-1.83). CONCLUSION Our results provide strong evidence for the association between higher BMI and ETE, multifocality, and tumor size. Further studies with a larger number of participants are required to elucidate further the association of increased BMI with advanced TNM stage and LN metastasis.
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Affiliation(s)
- Aliki Economides
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- Thyroid & Endocrinology Center, Nicosia, Cyprus
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Ioannis Mamais
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
| | - Panayiotis A. Economides
- Thyroid & Endocrinology Center, Nicosia, Cyprus
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | - Panagiotis Papageorgis
- Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia, Cyprus
- *Correspondence: Panagiotis Papageorgis,
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