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Gong Y, Jiang Q, Zhai M, Tang T, Liu S. Thyroid cancer trends in China and its comparative analysis with G20 countries: Projections for 2020-2040. J Glob Health 2024; 14:04131. [PMID: 38873786 DOI: 10.7189/jogh.14.04131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
Background Thyroid cancer, a leading type of endocrine cancer, accounts for 3-4% of all cancer diagnoses. This study aims to analyse and compare thyroid cancer patterns in China and the Group twenty (G20) countries, and predict these trend for the upcoming two decades. Methods This observational longitudinal study utilised data from the Global Burden of Disease (GBD) study 2019. We used metrics including incidence, mortality, mortality-incidence ratio (MIR), age-standardised rate (ASR) and average annual percent change (AAPC) to examine thyroid cancer trends. Joinpoint regression analysis was used to identify periods manifesting notable changes. The association between sociodemographic index (SDI) and AAPC were investigated. The autoregressive integrated moving average (ARIMA) model was used to predict thyroid cancer trends from 2020 to 2040. Results From 1990 to 2019, thyroid cancer incidence cases in China increased by 289.6%, with a higher AAPC of age-standardised incidence rate (ASIR) in men. Contrastingly, the G20 demonstrated a smaller increase, particularly among women over 50. Despite the overall age-standardised mortality rate (ASMR) was higher in the G20, the increase in mortality was less pronounced than in China. Age-standardised incidence rate increased across all age groups and genders, with a notable rise among men aged 15-49. ASMR decreased in specific age groups and genders, especially among women. Conversely, the ASMR significantly increased in group aged over 70. The MIR exhibited a declining trend, but this decrease was less noticeable in men and the group aged over 70. Joinpoint analysis pinpointed significant shifts in overall ASIR and ASMR, with the most pronounced increase in ASIR during 2003-2011 in China and 2003-2010 in the G20. Predictions suggested a continual ASIR uptrend, especially in the 50-69 age group, coupled with a predicted ASMR downturn among the elderly by 2040. Moreover, the proportion of thyroid cancer deaths attributable to high body mass index (BMI) escalated, with significant increase in Saudi Arabia and a rise to 7.4% in China in 2019. Conclusions Thyroid cancer cases in incidence and mortality are escalating in both China and the G20. The increasing trend may be attributed to factors beyond overdiagnosis, including environmental and genetic factors. These findings emphasise the necessity for augmenting prevention, control, and treatment strategies. They also highlight the significance of international collaboration in addressing the global challenge posed by thyroid cancer.
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Affiliation(s)
- Yi Gong
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qin Jiang
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Mimi Zhai
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Tenglong Tang
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Sushun Liu
- Department of General Surgery, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
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Coperchini F, Greco A, Croce L, Teliti M, Calì B, Chytiris S, Magri F, Rotondi M. Do PFCAs drive the establishment of thyroid cancer microenvironment? Effects of C6O4, PFOA and PFHxA exposure in two models of human thyroid cells in primary culture. ENVIRONMENT INTERNATIONAL 2024; 187:108717. [PMID: 38728818 DOI: 10.1016/j.envint.2024.108717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/12/2024] [Accepted: 05/02/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Exposure to environmental pollutants is suspected to be one of the potential causes accounting for the increase in thyroid cancer (TC) incidence worldwide. Among the ubiquitous pollutants, per-polyfluoroalkyl substances (PFASs), were demonstrated to exert thyroid disrupting effects. Perfluoroalkyl carboxylates (PFCAs) represent a subgroup of PFAS and include perfluoro carboxylic acids (PFOA and PFHxA) and perfluoropolyether carboxylic acid (C6O4). The potential relationship between exposure to PFCAs and TC was not yet fully elucidated. This in vitro study investigated whether certain PFCAs (C6O4, PFOA, and PFHxA) can influence the composition of TC microenvironment. METHODS Two models of normal thyroid cells in primary cultures: Adherent (A-NHT) and Spheroids (S-NHT) were employed. A-NHT and S-NHT were exposed to C6O4, PFOA or PFHxA (0; 0.01; 0.1, 1; 10; 100; 1000 ng/mL) to assess viability (WST-1 and AV/PI assay), evaluate spherification index (SI) and volume specifically in S-NHT. CXCL8 and CCL2 (mRNA and protein), and EMT-related genes were assessed in both models after exposure to PFCAs. RESULTS PFHxA reduced the viability of both A-NHT and S-NHT. None of the PFCAs interfered with the volume or spherification process in S-NHT. CXCL8 and CCL2 mRNA and protein levels were differently up-regulated by each PFCAs, being PFOA and PFHxA the stronger inducers. Moreover, among the tested PFCAs, PFHxA induced a more consistent increase in the mRNA levels of EMT-related genes. CONCLUSIONS This is the first evaluation of the effects of exposure to PFCAs on factors potentially involved in establishing the TC microenvironment. PFHxA modulated the TC microenvironment at three levels: cell viability, pro-tumorigenic chemokines, and EMT-genes. The results provide further evidence of the pro-tumorigenic effect of PFOA. On the other hand, a marginal effect was observed for C6O4 on pro-tumorigenic chemokines.
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Affiliation(s)
- Francesca Coperchini
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy
| | - Alessia Greco
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy
| | - Laura Croce
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, Italy
| | - Marsida Teliti
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, Italy
| | - Benedetto Calì
- Istituti Clinici Scientifici Maugeri IRCCS, Department of General and Minimally Invasive Surgery, Pavia, (PV) 27100, Italy
| | - Spyridon Chytiris
- Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, Italy
| | - Flavia Magri
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, Italy
| | - Mario Rotondi
- Department of Internal Medicine and Therapeutics, University of Pavia, 27100, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Unit of Internal Medicine and Endocrinology, Laboratory for Endocrine Disruptors, 27100 Pavia, Italy.
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Feier CVI, Vonica RC, Faur AM, Streinu DR, Muntean C. Assessment of Thyroid Carcinogenic Risk and Safety Profile of GLP1-RA Semaglutide (Ozempic) Therapy for Diabetes Mellitus and Obesity: A Systematic Literature Review. Int J Mol Sci 2024; 25:4346. [PMID: 38673931 PMCID: PMC11050669 DOI: 10.3390/ijms25084346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
The broadening application of glucagon-like peptide (GLP)-1 receptor agonists, specifically semaglutide (Ozempic) for the management of diabetes and obesity brings a critical need to evaluate its safety profile, considering estimates of up to 20 million prescriptions per year in the US until 2035. This systematic review aims to assess the incidence of thyroid cancer and detail the spectrum of adverse events associated with semaglutide, focusing on its implications for patient care. Through a systematic search of PubMed, Scopus, and Embase databases up to December 2023, ten randomized controlled trials (RCTs) involving 14,550 participants, with 7830 receiving semaglutide, were analyzed, with an additional number of 18 studies that were separately discussed because they reported data from the same RCTs. The review focused on thyroid cancer incidence, gastrointestinal symptoms, and other significant adverse events attributed to semaglutide. The incidence of thyroid cancer in semaglutide-treated patients was less than 1%, suggesting no significant risk. Adverse events were predominantly gastrointestinal, including nausea (2.05% to 19.95%) and diarrhea (1.4% to 13%). Nasopharyngitis and vomiting were also notable, with mean prevalences of 8.23% and 5.97%, respectively. Other adverse events included increased lipase levels (mean of 6.5%), headaches (mean prevalence of 7.92%), decreased appetite (reported consistently at 7%), influenza symptoms (mean prevalence of 5.23%), dyspepsia (mean prevalence of 5.18%), and constipation (mean prevalence of 6.91%). Serious adverse events varied from 7% to 25.2%, highlighting the need for vigilant patient monitoring. These findings underscore the gastrointestinal nature of semaglutide's adverse events, which, while prevalent, did not significantly deter from its clinical benefits in the treatment landscape. This systematic review provides a comprehensive assessment of semaglutide's safety profile, with a focus on gastrointestinal adverse events and a low incidence of thyroid cancer. Despite the prevalence of gastrointestinal symptoms, semaglutide remains an efficacious option for managing diabetes and obesity. The detailed characterization of adverse events underscores the importance of monitoring and managing these effects in clinical practice, excluding the hypothesis of carcinogenesis.
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Affiliation(s)
- Catalin Vladut Ionut Feier
- First Discipline of Surgery, Department X-Surgery, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania;
- First Surgery Clinic, “Pius Brinzeu” Clinical Emergency Hospital, 300723 Timisoara, Romania
| | - Razvan Constantin Vonica
- Preclinical Department, Discipline of Physiology, Faculty of General Medicine, “Lucian Blaga” University of Sibiu, 550169 Sibiu, Romania
| | - Alaviana Monique Faur
- Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania;
| | - Diana Raluca Streinu
- Department of Doctoral Studies, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania;
| | - Calin Muntean
- Medical Informatics and Biostatistics, Department III-Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 2 E. Murgu Sq., 300041 Timisoara, Romania;
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Christensen JD, Basheer HT, Lado Abeal JJ. Thyroid Cancer Prevalence, Risk Exposure, and Clinical Features Among Transgender Female Veterans. J Endocr Soc 2024; 8:bvae060. [PMID: 38633896 PMCID: PMC11023629 DOI: 10.1210/jendso/bvae060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose Transgender women experience higher-than-average rates of multiple medical conditions. Thyroid cancer occurs more frequently in those assigned female at birth than in those assigned male at birth. We sought to characterize thyroid cancer among transgender female veterans. Methods We reviewed charts of veterans who were (1) seen in Veterans Affairs clinics across the United States from July 2017 to December 2022, (2) had an International Classification of Diseases, revision 10, diagnosis code for thyroid cancer, and (3) had an International Classification of Diseases, revision 10, diagnosis code for gender dysphoria or were assigned male at birth and ever had a prescription for estrogens. Charts of cisgender veterans were also reviewed for comparison. Results Compared with calculated estimates of 0.641% (95% CI, 0.572-0.724) among cisgender females and 0.187% (95% CI, 0.156-0.219) among cisgender males, the measured prevalence among transgender female veterans was 0.341% (34/9988). Average age at thyroid cancer diagnosis in this population was 53.8 (± SEM 2.61) years. A total of 32.3% (11/34) of these patients had extrathyroidal disease at diagnosis. Discussion To our knowledge, this study represents the first report of thyroid cancer prevalence among transgender women in the United States. Risk exposure among all transgender veterans including further assessment of the possible contributions of obesity, smoking, and gender-affirming hormone therapy are important future analyses.
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Affiliation(s)
- John David Christensen
- Department of Internal Medicine, Division of Endocrinology, Diabetes & Metabolism, UC Davis Health, Sacramento, CA 95817, USA
- VA Northern California Healthcare System, Section of Endocrinology, Mather, CA 95321, USA
| | - Hiba T Basheer
- Department of Internal Medicine, Division of Endocrinology, Diabetes & Metabolism, UC Davis Health, Sacramento, CA 95817, USA
- VA Northern California Healthcare System, Section of Endocrinology, Mather, CA 95321, USA
| | - Jose Joaquin Lado Abeal
- Department of Internal Medicine, Division of Endocrinology, Diabetes & Metabolism, UC Davis Health, Sacramento, CA 95817, USA
- VA Northern California Healthcare System, Section of Endocrinology, Mather, CA 95321, USA
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Zhang M, Liang J, Han J, Zhang W, Wan P, Yang L, Zang X, Ren W, Zhang L, Dai H, Wu Y, Jin T. SOWAHB polymorphisms affect thyroid cancer risk in the Chinese Han population. Expert Rev Mol Diagn 2024; 24:333-339. [PMID: 38263767 DOI: 10.1080/14737159.2024.2305183] [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: 05/29/2023] [Accepted: 12/19/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES This study aimed to detect the correlation between SOWAHB polymorphisms and Thyroid cancer (TC) risk in the Chinese Han population. METHODS We genotyped SOWAHB variants in 510 TC patients and 509 controls using Agena MassARRAY. We assessed the association between SOWAHB polymorphisms and TC susceptibility, with the significant results evaluated through FPRP analysis. We predicted TC risk by the SNP-SNP interaction, analyzed by MDR. RESULTS Carriers with rs2703129 CC had a lower probability of TC (codominant, recessive: p = 0.002), while subjects with rs1874564 AG had an increased risk of developing TC (codominant, recessive: p = 0.000, log-additive: p = 0.028). In subjects aged > 45 years, rs2703129 may reduce TC predisposition (codominant: p = 0.011, recessive: p = 0.007), but there was an increased association between rs1874564 and TC risk (codominant: p = 0.030, dominant: p = 0.047). Also, rs2703129 was associated with a lower risk of TC among males (codominant: p = 0.018, recessive: p = 0.013). Conversely, rs1874564 was associated with an increased risk of TC in females (codominant: p = 0.001, dominant: p = 0.003). CONCLUSION SOWAHB SNPs were related to the occurrence of TC, and rs2703129 may be a protective site for TC.
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Affiliation(s)
- Man Zhang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Jing Liang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Junhui Han
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Wenjing Zhang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Panpan Wan
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Leteng Yang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Xufeng Zang
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
| | - Wanli Ren
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ling Zhang
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hao Dai
- Department of Otolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yue Wu
- Operation Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Tianbo Jin
- Key Laboratory of Resource Biology and Biotechnology in Western China, Ministry of Education, School of Life Sciences, Northwest University institution, Xi'an, Shaanxi, China
- College of Life Science, Northwest University, Xi'an, Shaanxi, China
- Shaanxi Provincial Key Laboratory of Biotechnology, Northwest University, Xi'an, Shaanxi, China
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Prete A, Matrone A, Plebani R. State of the Art in 3D Culture Models Applied to Thyroid Cancer. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:520. [PMID: 38674166 PMCID: PMC11051914 DOI: 10.3390/medicina60040520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 03/08/2024] [Accepted: 03/15/2024] [Indexed: 04/28/2024]
Abstract
Thyroid cancer (TC) is the prevalent endocrine tumor with a rising incidence, particularly in higher-income countries, leading to an increased interest in its management and treatment. While overall, survival rates for TC are usually favorable, advanced cases, especially with metastasis and specific histotypes, pose challenges with poorer outcomes, advocating the need of systemic treatments. Targeted therapies have shown efficacy in both preclinical models and clinical trials but face issues of resistance, since they usually induce partial and transient response. These resistance phenomena are currently only partially addressed by traditional preclinical models. This review explores the limitations of traditional preclinical models and emphasizes the potential of three-dimensional (3D) models, such as transwell assays, spheroids, organoids, and organ-on-chip technology in providing a more comprehensive understanding of TC pathogenesis and treatment responses. We reviewed their use in the TC field, highlighting how they can produce new interesting insights. Finally, the advent of organ-on-chip technology is currently revolutionizing preclinical research, offering dynamic, multi-cellular systems that replicate the complexity of human organs and cancer-host interactions.
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Affiliation(s)
- Alessandro Prete
- Department of Clinical and Experimental Medicine, Endocrine Unit 2, University of Pisa, 56122 Pisa, Italy;
| | - Antonio Matrone
- Department of Clinical and Experimental Medicine, Endocrine Unit 2, University of Pisa, 56122 Pisa, Italy;
| | - Roberto Plebani
- Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University, 66100 Chieti-Pescara, Italy;
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Abu Arar Y, Shilo M, Bilenko N, Friger M, Marsha H, Fisher D, Fraenkel M, Yoel U. Are Higher Body Mass Index and Worse Metabolic Parameters Associated with More Aggressive Differentiated Thyroid Cancer? A Retrospective Cohort Study. Healthcare (Basel) 2024; 12:581. [PMID: 38470692 PMCID: PMC10930676 DOI: 10.3390/healthcare12050581] [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: 02/01/2024] [Revised: 02/17/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024] Open
Abstract
Obesity is a risk factor for differentiated thyroid cancer (DTC), but the association with DTC aggressiveness is controversial. To evaluate the association between preoperative body mass index (BMI)/other metabolic parameters and DTC aggressiveness in our surgical cohort, we retrospectively evaluated patients following thyroid surgery who were diagnosed with DTC between December 2013 and January 2021. Baseline characteristics, histopathological features, treatment modalities, and follow-up data were studied. We conducted logistic regression to analyze the association between BMI/other metabolic parameters and adverse DTC features. The final study cohort included 211 patients (79.6% women; mean age± standard deviation 48.7 ± 15.9 years): 66 (31.3%) with normal weight, 81 (38.4%) with overweight, and 64 (30.3%) with obesity. The median follow-up was 51 months (range 7-93). Complete versus partial thyroidectomy was more common among patients living with overweight or obesity than in normal weight patients (79.7% versus 61.7%, p = 0.017, respectively). Logistic regression demonstrated that higher BMI was associated with mildly increased risk for lymph nodes metastases (odds ratio [OR] 1.077, 95% CI: 1.013-1.145), and higher triglycerides/high-density lipoprotein-cholesterol (TG/HDL-C) ratio was associated with aggressive histological variants of DTC (OR 1.269, 95% CI 1.001-1.61). To conclude, specific adverse clinical and histopathological DTC features were indeed associated with higher BMI and higher TG/HDL-C ratio.
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Affiliation(s)
- Yasmin Abu Arar
- Internal Medicine Ward D, Soroka University Medical Center, Beer-Sheva 84101, Israel;
| | - Michael Shilo
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Natalya Bilenko
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Michael Friger
- Department of Epidemiology, Biostatistics and Community Health, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel; (M.S.); (N.B.); (M.F.)
| | - Hagit Marsha
- Faculty of Health Sciences, Goldman Medical School, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel;
| | - David Fisher
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
| | - Merav Fraenkel
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel
| | - Uri Yoel
- Endocrinology Unit, Soroka University Medical Center, Beer-Sheva 84101, Israel (M.F.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84015, Israel
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8
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Szablewski L. Insulin Resistance: The Increased Risk of Cancers. Curr Oncol 2024; 31:998-1027. [PMID: 38392069 PMCID: PMC10888119 DOI: 10.3390/curroncol31020075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/15/2024] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
Insulin resistance, also known as impaired insulin sensitivity, is the result of a decreased reaction of insulin signaling to blood glucose levels. This state is observed when muscle cells, adipose tissue, and liver cells, improperly respond to a particular concentration of insulin. Insulin resistance and related increased plasma insulin levels (hyperinsulinemia) may cause metabolic impairments, which are pathological states observed in obesity and type 2 diabetes mellitus. Observations of cancer patients confirm that hyperinsulinemia is a major factor influencing obesity, type 2 diabetes, and cancer. Obesity and diabetes have been reported as risks of the initiation, progression, and metastasis of several cancers. However, both of the aforementioned pathologies may independently and additionally increase the cancer risk. The state of metabolic disorders observed in cancer patients is associated with poor outcomes of cancer treatment. For example, patients suffering from metabolic disorders have higher cancer recurrence rates and their overall survival is reduced. In these associations between insulin resistance and cancer risk, an overview of the various pathogenic mechanisms that play a role in the development of cancer is discussed.
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Affiliation(s)
- Leszek Szablewski
- Chair and Department of General Biology and Parasitology, Medical University of Warsaw, Chałubińskiego 5 Str., 02-004 Warsaw, Poland
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9
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Loberg MA, Tigue ML, Gallant JN, Wang H, Canberk S, Weiss VL. Evolving approaches in paediatric thyroid cytopathology: A review. Cytopathology 2024; 35:60-69. [PMID: 37759375 PMCID: PMC11027193 DOI: 10.1111/cyt.13311] [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: 07/11/2023] [Revised: 08/22/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023]
Abstract
The guidelines for the workup of thyroid nodules have been established in adult populations and secondarily applied to paediatric populations. In particular, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is commonly applied to both adult and paediatric thyroid nodules. However, as paediatric nodules have distinct molecular drivers and behavioural trajectories, there is renewed interest in diagnostic and management strategies that are paediatric specific. Here, we review key differences between paediatric and adult thyroid cancer and recent literature evaluating the use of TBSRTC in paediatric populations.
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Affiliation(s)
- Matthew A Loberg
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Megan L Tigue
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jean-Nicolas Gallant
- Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Huiying Wang
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Sule Canberk
- i3S/ Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
| | - Vivian L Weiss
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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10
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Biondi B. Subclinical Hypothyroidism in Patients with Obesity and Metabolic Syndrome: A Narrative Review. Nutrients 2023; 16:87. [PMID: 38201918 PMCID: PMC10780356 DOI: 10.3390/nu16010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
The literature on the connection between obesity, metabolic syndrome, and subclinical hypothyroidism is critically analyzed in this narrative review. These conditions are frequently observed among adult populations and various studies and meta-analyses have assessed their association. The prevalence of subclinical hypothyroidism in obese individuals is higher than in non-obese subjects and this trend is more pronounced in unhealthy obesity phenotypes. However, the diagnosis and treatment of subclinical hypothyroidism can be difficult in obese patients. Exaggerated body fat is linked to thyroid hypoechogenicity as evident through ultrasonography and euthyroid obese people have greater TSH, FT3, and FT3/FT4 ratios than non-obese individuals in a euthyroid condition. Moreover, a reduced expression of the TSH receptor and altered function of deiodinases has been found in the adipose tissue of obese patients. Current data do not support the necessity of a pharmacological correction of the isolated hyperthyrotropinemia in euthyroid obese patients because treatment with thyroid hormone does not significantly improve weight loss and the increase in serum TSH can be reversible after hypocaloric diet or bariatric surgery. On the other hand, obesity is linked to elevated leptin levels. Inflammation can raise the risk of Hashimoto thyroiditis, which increases the likelihood that obese patients will experience overt or subclinical hypothyroidism. Both metabolic syndrome and subclinical hypothyroidism are associated with atherosclerosis, liver and kidney disease. Hence, the association of these two illnesses may potentiate the adverse effects noted in each of them. Subclinical hypothyroidism should be identified in patients with obesity and treated with appropriate doses of L-thyroxine according to the lean body mass and body weight. Randomized controlled trials are necessary to verify whether treatment of thyroid deficiency could counteract the expected risks.
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Affiliation(s)
- Bernadette Biondi
- Division of Internal Medicine and Cardiovascular Endocrinology, Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy
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11
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Rodrigues MT, Michelli APP, Caso GF, de Oliveira PR, Rodrigues-Junior DM, Morale MG, Machado Júnior J, Bortoluci KR, Tamura RE, da Silva TRC, Raminelli C, Chau E, Godin B, Calil-Silveira J, Rubio IGS. Lysicamine Reduces Protein Kinase B (AKT) Activation and Promotes Necrosis in Anaplastic Thyroid Cancer. Pharmaceuticals (Basel) 2023; 16:1687. [PMID: 38139812 PMCID: PMC10748177 DOI: 10.3390/ph16121687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/22/2023] [Accepted: 11/24/2023] [Indexed: 12/24/2023] Open
Abstract
Anaplastic thyroid cancer (ATC) is an aggressive form of thyroid cancer (TC), accounting for 50% of total TC-related deaths. Although therapeutic approaches against TC have improved in recent years, the survival rate remains low, and severe adverse effects are commonly reported. However, unexplored alternatives based on natural compounds, such as lysicamine, an alkaloid found in plants with established cytotoxicity against breast and liver cancers, offer promise. Therefore, this study aimed to explore the antineoplastic effects of lysicamine in papillary TC (BCPAP) and ATC (HTH83 and KTC-2) cells. Lysicamine treatment reduced cell viability, motility, colony formation, and AKT activation while increasing the percentage of necrotic cells. The absence of caspase activity confirmed apoptosis-independent cell death. Necrostatin-1 (NEC-1)-mediated necrosome inhibition reduced lysicamine-induced necrosis in KTC-2, suggesting necroptosis induction via a reactive oxygen species (ROS)-independent mechanism. Additionally, in silico analysis predicted lysicamine target proteins, particularly those related to MAPK and TGF-β signaling. Our study demonstrated lysicamine's potential as an antineoplastic compound in ATC cells with a proposed mechanism related to inhibiting AKT activation and inducing cell death.
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Affiliation(s)
- Mariana Teixeira Rodrigues
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Structural and Functional Biology Post-Graduate Program, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Ana Paula Picaro Michelli
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Gustavo Felisola Caso
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Paloma Ramos de Oliveira
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Dorival Mendes Rodrigues-Junior
- Department of Medical Biochemistry and Microbiology, Science for Life Laboratory, Biomedical Center, Uppsala University, 752 36 Uppsala, Sweden;
| | - Mirian Galliote Morale
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
| | - Joel Machado Júnior
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
| | - Karina Ramalho Bortoluci
- Pharmacology Department, Escola Paulista de Medicina, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil;
| | - Rodrigo Esaki Tamura
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
- Biology–Chemistry Post-Graduate Program, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil
| | - Tamiris Reissa Cipriano da Silva
- Department of Chemistry, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil; (T.R.C.d.S.); (C.R.)
| | - Cristiano Raminelli
- Department of Chemistry, Institute of Environmental, Chemical and Pharmaceutical Science, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil; (T.R.C.d.S.); (C.R.)
| | - Eric Chau
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; (E.C.); (B.G.)
| | - Biana Godin
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX 77030, USA; (E.C.); (B.G.)
- Department of Obstetrics and Gynecology, Weill Cornell Medicine College, New York, NY 10065, USA
| | - Jamile Calil-Silveira
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Health Board III, Universidade Nove de Julho, São Paulo 01525-000, Brazil
| | - Ileana G. Sanchez Rubio
- Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.T.R.); (A.P.P.M.); (G.F.C.); (P.R.d.O.); (J.C.-S.)
- Structural and Functional Biology Post-Graduate Program, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil
- Cancer Molecular Biology Laboratory, Universidade Federal de São Paulo—UNIFESP, São Paulo 04021-001, Brazil; (M.G.M.); (R.E.T.)
- Biological Science Department, Universidade Federal de São Paulo—UNIFESP, Diadema 09920-000, Brazil;
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Jammah AA, AlSadhan IM, Alyusuf EY, Alajmi M, Alhamoudi A, Al-Sofiani ME. The American Thyroid Association risk stratification and long-term outcomes of differentiated thyroid cancer: a 20-year follow-up of patients in Saudi Arabia. Front Endocrinol (Lausanne) 2023; 14:1256232. [PMID: 38047113 PMCID: PMC10690932 DOI: 10.3389/fendo.2023.1256232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023] Open
Abstract
Background Studies have reported differing factors associated with poor outcomes in patients with differentiated thyroid cancer (DTC). We aimed to describe our 20 years of experience in the management of thyroid cancer (TC) and identify predictors of treatment outcomes. Methods We conducted a retrospective review of medical records of patients with TC seen in the Thyroid Center at King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia, between the years 2000 and 2020. Demographic and clinical data including pathological characteristics were collected. The American Thyroid Association (ATA) risk stratification was determined for all patients at the postoperative period as well as the response to therapy at the final follow-up visit. Results A total of 674 patients (mean age: 47.21 years) with TC, 571 (84.7%) of which were women, were included. There were 404 (60.0%) patients with ATA low risk, 127 (18.8%) with intermediate risk, and 143 (21.2%) with high-risk histology. Overall, 461 patients (68.4%) had an excellent response to treatment, 65 (9.6%) had an indeterminate response, 83 (12.3%) had a biochemical incomplete response, and 65 (9.6%) had a structural incomplete response. Patients who had an excellent response were mostly ATA low risk (n = 318 of 431, 68.1%), whereas 40 of 65 patients (61.5%) of those with ATA high-risk histology had a structural incomplete response to treatment. There were significantly more women who had an excellent response compared with men. Obesity, lymphovascular invasion, and size of the tumor were significant predictors of worse outcomes to therapy. Conclusion Tumor size, lymphovascular invasion, and obesity are strong predictors of a worse response to therapy among patients with TC. Patients with obesity should be carefully followed up regardless of their risk stratification in light of the recent compelling evidence associating obesity with thyroid cancer and its higher risk of a worse disease outcome. ATA risk stratification is well correlated with patient long-term outcomes.
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Affiliation(s)
- Anwar Ali Jammah
- Endocrinology and Diabetes Division, Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Mohammed AlSadhan
- Endocrinology and Diabetes Division, Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | | | - Mubarak Alajmi
- Internal Medicine Division, Department of Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alhamoudi
- Endocrinology and Diabetes Division, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed E. Al-Sofiani
- Division of Endocrinology, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Division of Endocrinology, Diabetes & Metabolism, The Johns Hopkins University, Baltimore, MD, United States
- Endocrinology and Diabetes Division, Strategic Center for Diabetes Research, Riyadh, Saudi Arabia
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13
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Wang X, Yu Y, Ji Y, Ma Z, Tan J, Jia Q, Li N, Zheng W. Clinical characteristics and therapeutic response of differentiated thyroid carcinoma with obesity and diabetes. BMC Cancer 2023; 23:1077. [PMID: 37940857 PMCID: PMC10631042 DOI: 10.1186/s12885-023-11591-x] [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: 08/02/2023] [Accepted: 10/30/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND The effects of obesity and diabetes on the clinical outcomes of differentiated thyroid cancer (DTC) remain unclear. OBJECTIVES To explore the association between obesity and diabetes with pathological features and therapeutic response of DTC. METHODS Patients were categorized based on body mass index (BMI) and glycemic status. Compare the correlation between BMI and glycemic status with pathological features and therapeutic response of DTC. To analyze the independent risk factors for the aggressiveness of DTC. RESULTS The proportion of patients with bilateral tumors was higher in the overweight, obese and diabetes group (P = 0.001, 0.045). The overweight group demonstrated a higher TNM stage (P = 0.004), while the T and TNM stages were higher in the diabetes group (P = 0.032, 0.000). The probability of distant metastasis increases by 37.4% for each unit of BMI increase (odds ratio (OR) = 1.374, CI 95% 1.061-1.778, P < 0.05). The BMI of Biochemical Incomplete Response (BIR) is significantly higher than that of Excellent Response (ER) (P = 0.015), the fasting plasma glucose (FPG) of Structural Incomplete (SIR) was significantly higher than that of ER and BIR (P = 0.030, 0.014). CONCLUSION Obesity and diabetes have effect on DTC aggressiveness. BMI and FPG have correlation with the therapeutic response of DTC patients.
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Affiliation(s)
- Xuan Wang
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yang Yu
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Yanhui Ji
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ziyu Ma
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jian Tan
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiang Jia
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Ning Li
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zheng
- Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin, China.
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Goswami S, Zhang Q, Celik CE, Reich EM, Yilmaz ÖH. Dietary fat and lipid metabolism in the tumor microenvironment. Biochim Biophys Acta Rev Cancer 2023; 1878:188984. [PMID: 37722512 PMCID: PMC10937091 DOI: 10.1016/j.bbcan.2023.188984] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/26/2023] [Accepted: 08/28/2023] [Indexed: 09/20/2023]
Abstract
Metabolic reprogramming has been considered a core hallmark of cancer, in which excessive accumulation of lipids promote cancer initiation, progression and metastasis. Lipid metabolism often includes the digestion and absorption of dietary fat, and the ways in which cancer cells utilize lipids are often influenced by the complex interactions within the tumor microenvironment. Among multiple cancer risk factors, obesity has a positive association with multiple cancer types, while diets like calorie restriction and fasting improve health and delay cancer. Impact of these diets on tumorigenesis or cancer prevention are generally studied on cancer cells, despite heterogeneity of the tumor microenvironment. Cancer cells regularly interact with these heterogeneous microenvironmental components, including immune and stromal cells, to promote cancer progression and metastasis, and there is an intricate metabolic crosstalk between these compartments. Here, we focus on discussing fat metabolism and response to dietary fat in the tumor microenvironment, focusing on both immune and stromal components and shedding light on therapeutic strategies surrounding lipid metabolic and signaling pathways.
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Affiliation(s)
- Swagata Goswami
- Department of Biology, The David H. Koch Institute for Integrative Cancer Research at MIT, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Qiming Zhang
- Department of Biology, The David H. Koch Institute for Integrative Cancer Research at MIT, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Cigdem Elif Celik
- Department of Biology, The David H. Koch Institute for Integrative Cancer Research at MIT, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Hacettepe Univ, Canc Inst, Department Basic Oncol, Ankara TR-06100, Turkiye
| | - Ethan M Reich
- Department of Biology, The David H. Koch Institute for Integrative Cancer Research at MIT, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Ömer H Yilmaz
- Department of Biology, The David H. Koch Institute for Integrative Cancer Research at MIT, Massachusetts Institute of Technology, Cambridge, MA 02139, USA; Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA; Department of Pathology, Massachusetts General Hospital and Beth Israel Deaconness Medical Center and Harvard Medical School, Boston, MA 02114, USA.
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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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Rind F, Zhao S, Haring C, Kang SY, Agrawal A, Ozer E, Old MO, Carrau RL, Seim NB. Body Mass Index (BMI) Related Morbidity with Thyroid Surgery. Laryngoscope 2023; 133:2823-2830. [PMID: 37265205 DOI: 10.1002/lary.30789] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/19/2023] [Accepted: 05/10/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The increase in incidence of thyroid cancer correlates with strict increases in body mass index (BMI) and obesity in the United States. Thyroid hormone dysregulation has been shown to precipitate circulatory volume, peripheral resistance, cardiac rhythm, and even cardiac muscle health. Theoretically, thyroid surgery could precipitate injury to the cardiopulmonary system. METHODS The American College of Surgery National Quality Improvement Program database was queried for thyroidectomy cases in the 2007-2020 Participant User files. Continuous and categorical associations between BMI and cardiopulmonary complications were investigated as reported in the database. RESULTS The query resulted 186,095 cases of thyroidectomy procedures in which the mean age was 51.3 years and sample was 79.3% female. No correlation was evident in univariate and multivariate analyses between BMI and the incidence of postoperative stroke or myocardial infarction. The incidence of complications was extremely low. However, risk of deep venous thrombosis correlated with BMI in the categorical, univariate, and multivariate (OR 1.036, CI 1.014-1.057, p < 0.01) regression analysis. Additionally, increased BMI was associated with increased risk of pulmonary embolism (PE) (OR 1.050 (1.030, 1.069), p < 0.01), re-intubation (OR 1.012 (1.002, 1.023), p = 0.02), and prolonged intubation (OR 1.031 (1.017, 1.045), p < 0.01). CONCLUSION Despite the rarity of cardiopulmonary complications during thyroid surgery, patients with very high BMI carry a significant risk of deep venous thrombosis, PE, and prolonged intubation. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2823-2830, 2023.
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Affiliation(s)
- Fahad Rind
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
| | - Songzhu Zhao
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Catherine Haring
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Stephen Y Kang
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Amit Agrawal
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Enver Ozer
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Matthew O Old
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Ricardo L Carrau
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Nolan B Seim
- Comprehensive Cancer Center, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, Ohio, USA
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
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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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18
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Alqahtani SM, Altalhi BA, Alalawi YS, AlFattani AA, Al-Sobhi SS. Weighty Matters: The Obesity-Thyroid Nodule Connection Unveiling the Impact of Obesity on Thyroid Cancer Risk. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1658. [PMID: 37763777 PMCID: PMC10534825 DOI: 10.3390/medicina59091658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/06/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: The effect of obesity on the development/progression of thyroid nodules with uncertain cytology is unknown. Therefore, our objective was to assess the role of body mass index (BMI) in predicting malignancy in patients with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) nodules. Materials and Methods: We retrospectively analyzed 113 patients with available BMI data and final histopathology of benign or differentiated thyroid cancer. Patients were classified into four groups based on BMI: <18.5 (underweight), 18.5-24.9 (normal weight), 25-29.9 (overweight), and ≥30 (obesity) kg/m2. The association between risk of malignancy and BMI was examined for all data and subgroups based on nodule size, sex, and age. Results: Overall, 44.2% were obese, 36.3% were ≥45 years, and 75.4% were women. Final pathological results showed malignant nodules in 52 patients (46%) and benign nodules in 61 patients (54%) (mean age: 41 ± 11.6 vs. 39.9 ± 11.7 years; p = 0.62). Men had more malignant nodules than benign nodules (32.7% vs. 16.4%, p < 0.05). Overall, no significant correlation was identified between the risk of thyroid cancer and BMI, and the risk of malignancy was not significantly different between obese men and women (p = 0.4). However, in individuals with BMI < 30 kg/m2 (non-obese group), malignant nodules were more frequent in men than in women (71% vs. 41%, p = 0.04). No significant difference was observed in mean nodule size between the benign and malignant groups. Furthermore, BMI was not related to increased risk of malignancy in multiple logistic regression models using all data, even after controlling for confounding variables (odds ratio, 0.99, 95% confidence interval: 0.93-1.06, p = 0.87) or when stratifying by sex. Conclusions: Our study showed no correlation between obesity and thyroid cancer in patients with AUS/FLUS. Moreover, men had more malignant nodules than benign nodules. Further well-designed prospective studies are required to confirm our findings.
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Affiliation(s)
- Saad M. Alqahtani
- Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah 11952, Saudi Arabia
| | - Bassam A. Altalhi
- Department of Surgery, King Fahad Armed Forces Hospital, Jeddah 21159, Saudi Arabia;
| | - Yousef S. Alalawi
- Department of Surgery, King Salman Armed Forces Hospital Northwestern Region, Tabuk 71411, Saudi Arabia;
| | - Areej A. AlFattani
- Department of Biostatistics, Epidemiology, and Scientific Computing, King Faisal Specialist Hospital and Research Centre, Riyadh 11211, Saudi Arabia;
| | - Saif S. Al-Sobhi
- Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia;
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Yuan K, Hu D, Mo X, Zeng R, Wu B, Zhang Z, Hu R, Wang C. Uncovering the pathogenesis of obesity complicated with papillary thyroid carcinoma via bioinformatics and experimental validation. Aging (Albany NY) 2023; 15:8729-8743. [PMID: 37671970 PMCID: PMC10522395 DOI: 10.18632/aging.204993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/10/2023] [Indexed: 09/07/2023]
Abstract
This study aimed to investigate the common molecular mechanism between obesity and papillary thyroid cancer (PTC), the most common pathological type of thyroid cancer. In this study, we obtained gene expression datasets for obesity (GSE151839) and PTC (GSE33630) from the Gene Expression Omnibus (GEO). We used the Perl program and R software to identify differentially expressed genes (DEGs) and common genes, perform GO function and KEGG pathway enrichment analysis, construct a protein-protein interaction (PPI) network, identify hub genes, and perform transcription factors (TFs) analysis. After undergoing validation in external datasets and in vitro experiments, common targets for both diseases were ultimately identified. A total of 23 genes that were differentially expressed (DEGs) between obesity and papillary thyroid carcinoma (PTC) were identified in our study. Among these DEGs, 17 genes were up-regulated while 6 genes were down-regulated. Then the top ten key genes were identified from the PPI network using cytoHubba and MCODE plug-in. Further evidence from external datasets revealed that MMP9, MNDA, TNC, and CHIT1 were identified as hub genes for both diseases. The study utilized Transcriptional Regulatory Relationships Unraveled by Sentence-based Text mining (TRRUST) to perform an enrichment analysis of TFs. This analysis identified ELF4 and STAT3 as common TFs for both diseases. Additionally, in vitro experiments were conducted to further analyze the clinical significance and biological functions of these TFs. The identification and investigation of hub genes and their corresponding TFs that regulate abnormalities in obesity and PTC can enhance our comprehension of the underlying connection between these two diseases, thus leading to the development of novel diagnostic approaches.
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Affiliation(s)
- Kaisheng Yuan
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou 510630, Guangdong, China
| | - Di Hu
- Department of Neurology and Stroke Centre, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510630, Guangdong, China
| | - Xiaocong Mo
- Department of Oncology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510630, Guangdong, China
| | - Ruiqi Zeng
- Department of Urology Surgery, The Second People’s Hospital of Yibin City, Yibin 644002, Sichuan, China
| | - Bing Wu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou 510630, Guangdong, China
| | - Zunhao Zhang
- Department of Pathology, The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510630, Guangdong, China
| | - Ruixiang Hu
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou 510630, Guangdong, China
| | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou 510630, Guangdong, China
- Guangdong-Hong Kong-Macao Joint University Laboratory of Metabolic and Molecular Medicine, The University of Hong Kong and Jinan University, Guangzhou 510630, Guangdong, China
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20
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Xu L, Yang Z, Li T, Yu L, Zhu Z, Wu Y, Tang M, Jin M, Chen K, Wang J. Estimation of cancer mortality attributable to excess body weight during 2006–2015 in China. Cancer Epidemiol 2023; 84:102358. [PMID: 37011535 DOI: 10.1016/j.canep.2023.102358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023]
Abstract
BACKGROUND Cancer is one of the most common causes of death. Excess body weight (EBW), a risk factor for cancer, is highly prevalent in China. We aimed to estimate the number and proportion of cancer deaths attributed to EBW and their changes during 2006-2015 in China. METHODS Population attributable fractions in 2006, 2010, and 2015 were calculated with 1) prevalence of overweight/obesity, exacted from the China Health and Nutrition Survey conducted in 8-9 provinces of China in 1997, 2000, and 2004; 2) relative risks for EBW and site-specific cancers, obtained from previous studies; 3) data on cancer deaths in 2006, 2010, and 2015, originated from the Chinese Cancer Registry Annual Report. RESULTS In 2015, EBW contributed to 45,918 (3.1% of all) cancer deaths in China, with 24,978 (2.6%) in men and 20,940 (3.8%) in women. By region, the fraction of cancer deaths attributable to EBW ranged from 1.6% (West) to 4.1% (Northeast). Cancers of liver, stomach, and colorectum were the main EBW-attributable cancers. The fractions of cancer deaths attributable to EBW were 2.4% (95%CI: 0.8-4.2%) in 2006, 2.9% (95%CI: 1.0-5.2%) in 2010, and 3.1% (95%CI: 1.0-5.4%) in 2015, respectively, and increased for all gender, region, and cancer site during 2006-2015. CONCLUSIONS The proportion of cancer deaths attributed to EBW was higher in women and Northeastern China, with an upward trend in the recent decade. A combination of comprehensive and individualized measures is necessary to reduce the prevalence of EBW and related cancer burden in China.
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Affiliation(s)
- Lisha Xu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China
| | - Zongming Yang
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China
| | - Tiezheng Li
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China
| | - Luhua Yu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China
| | - Zhanghang Zhu
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yonghao Wu
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China
| | - Mengling Tang
- Department of Public Health, Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Mingjuan Jin
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Kun Chen
- Department of Public Health, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Jianbing Wang
- Department of Public Health, and Department of Endocrinology of the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Children's Health, Hangzhou 310058, China.
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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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22
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Mañas-Martinez AB, Gimeno-Orna JA. Comment on Bezin et al. GLP-1 Receptor Agonists and the Risk of Thyroid Cancer. Diabetes Care 2023;46:384-390. Diabetes Care 2023; 46:e119. [PMID: 37185691 DOI: 10.2337/dc23-0076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- Ana B Mañas-Martinez
- Endocrinology and Nutrition Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
| | - Jose A Gimeno-Orna
- Endocrinology and Nutrition Department, Hospital Clinico Universitario Lozano Blesa, Zaragoza, Spain
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23
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Trevellin E, Bettini S, Pilatone A, Vettor R, Milan G. Obesity, the Adipose Organ and Cancer in Humans: Association or Causation? Biomedicines 2023; 11:biomedicines11051319. [PMID: 37238992 DOI: 10.3390/biomedicines11051319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Epidemiological observations, experimental studies and clinical data show that obesity is associated with a higher risk of developing different types of cancer; however, proof of a cause-effect relationship that meets the causality criteria is still lacking. Several data suggest that the adipose organ could be the protagonist in this crosstalk. In particular, the adipose tissue (AT) alterations occurring in obesity parallel some tumour behaviours, such as their theoretically unlimited expandability, infiltration capacity, angiogenesis regulation, local and systemic inflammation and changes to the immunometabolism and secretome. Moreover, AT and cancer share similar morpho-functional units which regulate tissue expansion: the adiponiche and tumour-niche, respectively. Through direct and indirect interactions involving different cellular types and molecular mechanisms, the obesity-altered adiponiche contributes to cancer development, progression, metastasis and chemoresistance. Moreover, modifications to the gut microbiome and circadian rhythm disruption also play important roles. Clinical studies clearly demonstrate that weight loss is associated with a decreased risk of developing obesity-related cancers, matching the reverse-causality criteria and providing a causality correlation between the two variables. Here, we provide an overview of the methodological, epidemiological and pathophysiological aspects, with a special focus on clinical implications for cancer risk and prognosis and potential therapeutic interventions.
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Affiliation(s)
- Elisabetta Trevellin
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Silvia Bettini
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Anna Pilatone
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Roberto Vettor
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
| | - Gabriella Milan
- Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, 35128 Padova, Italy
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24
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Sørensen SM, Urbute A, Frederiksen K, Kjaer SK. Prepregnancy Body Mass Index and Risk of Differentiated Thyroid Cancer: A Prospective Cohort Study of More than 440,000 Danish Women. Thyroid 2023; 33:365-372. [PMID: 36173097 DOI: 10.1089/thy.2022.0259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: High body mass index (BMI) has previously been associated with increased risk of differentiated thyroid cancer (DTC); however, only few studies have investigated the association with BMI in a large cohort assessed at a young age and with sufficient data on confounding factors. We assessed the association between excess body weight and the risk of DTC and papillary thyroid cancer (PTC) in a large cohort of young Danish women with substantial confounder control. Methods: We included all parous Danish women registered with a prepregnancy BMI ≥18.5 kg/m2 during 2004-2016 in the Danish Medical Birth Registry in the study population. Cox proportional hazards regression models were used to estimate the hazard ratios (HRs) with confidence intervals (CIs) of DTC according to BMI. In subanalyses, we investigated PTC as a separate group. Analyses were adjusted for calendar time, education, smoking status, benign thyroid disease (BTD), type II diabetes, parity, and oral contraceptive use. In addition, we examined the association with increasing BMI stratified for previous BTD. Results: A total of 443,403 women were included in the study population, and the median age at baseline was 30.0 years. Altogether, 463 women were diagnosed with DTC during follow-up. Excess body weight was associated with a higher rate of DTC (overweight, BMI 25-29.9 kg/m2: HR = 1.54; CI 1.25-1.90. Obese, BMI ≥30 kg/m2: HR = 1.32; CI 1.00-1.75) compared with normal weight. Results were similar in PTC. In addition, we found an increased rate of DTC with increasing BMI, when investigating BMI as a continuous variable per 5 kg/m2 increase (HR = 1.17; CI 1.07-1.27). The results were similar in women without previous BTD. Conclusions: Our study confirms that excess body weight is associated with an increased incidence of DTC and PTC in women.
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Affiliation(s)
- Sarah M Sørensen
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Aivara Urbute
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kirsten Frederiksen
- Unit of Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Susanne K Kjaer
- Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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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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26
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Guan B, Chen Y, Wu Z, Chong TH, Ming WK, Wang C, Huang S, Lee WJ, Yang J. Combined Laparoscopic Bariatric Surgery and Thyroidectomy: A Proof-of-Concept Study. Bariatr Surg Pract Patient Care 2023. [DOI: 10.1089/bari.2022.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023] Open
Affiliation(s)
- Bingsheng Guan
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yanya Chen
- Department of Basic Nursing, School of Nursing, Jinan University, Guangzhou, China
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, China
| | - Zhenpeng Wu
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Tsz Hong Chong
- Department of Thyroid Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wai-kit Ming
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, China
| | - Cunchuan Wang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shifang Huang
- Department of Intensive Care Unit, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wei-Jei Lee
- Department of Surgery, Min-Sheng General Hospital, Taoyuan, Taiwan, China
| | - Jingge Yang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, China
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27
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Dong Z, Liu W, Su F, Cheng R. Association of Body Mass Index With Clinicopathological Features of Papillary Thyroid Carcinoma: A Retrospective Study. Endocr Pract 2023; 29:83-88. [PMID: 36481471 DOI: 10.1016/j.eprac.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE We examined the effect of body mass index (BMI) on clinicopathological features of papillary thyroid carcinoma (PTC). METHODS The clinical data of 4476 patients with PTC who underwent surgical treatment were retrospectively analyzed. According to the different BMI of patients, it can be divided into underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 24.0 kg/m2), overweight (24 ≤ BMI < 28 kg/m2), and obese (BMI ≥ 28 kg/m2). Spearman correlation analysis was performed to assess the relationship between the BMI and the size of PTC tumor. Multivariate binary logistic regression analysis was performed to estimate the association of overweight and obesity with clinicopathological features of PTC. RESULTS There was a positive correlation between the BMI and PTC tumor size (r = 0.087, P < .001). As compared with normal weight patients with PTC, overweight and obese patients with PTC had a greater risk of bilaterality (odds ratio [OR] = 1.295, OR = 1.669), multifocality (OR = 1.273, OR = 1.617), extrathyroidal extension (OR = 1.560, OR = 2.477), T (3 + 4) stage (OR = 1.482, OR = 2.392), and recurrence risk (intermediate-high risk) (OR = 1.215, OR = 1.718) (P < .05 for all). As compared with normal weight patients with papillary thyroid microcarcinoma (PTMC), overweight and obese patients with PTMC had a greater risk of bilaterality (OR = 1.341, OR = 1.737), multifocality (OR = 1.244, OR = 1.640), extrathyroidal extension (OR = 1.992, OR = 2.080), T (3 + 4) stage (OR = 1898, OR = 2.039), and recurrence risk (intermediate-high risk) (OR = 1.458, OR = 1.536) (P < .05 for all). CONCLUSION Overweight and obesity were significantly associated with aggressive clinicopathological features of PTC and PTMC. The impact of overweight and obesity should be considered when choosing treatment decisions for PTC and PTMC.
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Affiliation(s)
- Zhizhong Dong
- Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wen Liu
- Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Feng Su
- Department of Nephrology, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Ruochuan Cheng
- Department of Thyroid Surgery, Clinical Research Center for Thyroid Diseases of Yunnan Province, The First Affiliated Hospital of Kunming Medical University, Kunming, China.
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28
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Vlooswijk C, Husson O, Oerlemans S, Ezendam N, Schoormans D, de Rooij B, Mols F. Self-reported causes of cancer among 6881 survivors with 6 tumour types: results from the PROFILES registry. J Cancer Surviv 2023; 17:110-119. [PMID: 33644846 PMCID: PMC9971112 DOI: 10.1007/s11764-021-00989-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/07/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Our aim was to describe and compare self-reported causal attributions (interpretations of what caused an illness) among cancer survivors and to assess which sociodemographic and clinical characteristics are associated with them. METHODS Data from five population-based PROFILES registry samples (i.e. lymphoma (n = 993), multiple myeloma (n = 156), colorectal (n = 3989), thyroid (n = 306), endometrial (n = 741), prostate cancer (n = 696)) were used. Causal attributions were assessed with a single question. RESULTS The five most often reported causal attributions combined were unknown (21%), lifestyle (19%), biological (16%), other (14%), and stress (12%). Lymphoma (49%), multiple myeloma (64%), thyroid (55%), and prostate (64%) cancer patients mentioned fixed causes far more often than modifiable or modifiable/fixed. Colorectal (33%, 34%, and 33%) and endometrial (38%, 32%, and 30%) cancer survivors mentioned causes that were fixed, modifiable, or both almost equally often. Colorectal, endometrial, and prostate cancer survivors reported internal causes most often, whereas multiple myeloma survivors more often reported external causes, while lymphoma and thyroid cancer survivors had almost similar rates of internal and external causes. Females, those older, those treated with hormonal therapy, and those diagnosed with prostate cancer were less likely to identify modifiable causes while those diagnosed with stage 2, singles, with ≥2 comorbid conditions, and those with endometrial cancer were more likely to identify modifiable causes. CONCLUSION In conclusion, this study showed that patients report both internal and external causes of their illness and both fixed and modifiable causes. This differsbetween the various cancer types. IMPLICATIONS FOR CANCER SURVIVORS Although the exact cause of cancer in individual patients is often unknown, having a well-informed perception of the modifiable causes of one's cancer is valuable since it can possibly help survivors with making behavioural adjustments in cases where this is necessary or possible.
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Affiliation(s)
- Carla Vlooswijk
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Olga Husson
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Simone Oerlemans
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Nicole Ezendam
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Dounya Schoormans
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Belle de Rooij
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - Floortje Mols
- Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands.
- CoRPS - Center of Research on Psychological and Somatic Disorders, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands.
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Ullmann TM, Papaleontiou M, Sosa JA. Current Controversies in Low-Risk Differentiated Thyroid Cancer: Reducing Overtreatment in an Era of Overdiagnosis. J Clin Endocrinol Metab 2023; 108:271-280. [PMID: 36327392 PMCID: PMC10091361 DOI: 10.1210/clinem/dgac646] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 11/06/2022]
Abstract
CONTEXT Low-risk differentiated thyroid cancer (DTC) is overdiagnosed, but true incidence has increased as well. Owing to its excellent prognosis with low morbidity and mortality, balancing treatment risks with risks of disease progression can be challenging, leading to several areas of controversy. EVIDENCE ACQUISITION This mini-review is an overview of controversies and difficult decisions around the management of all stages of low-risk DTC, from diagnosis through treatment and follow-up. In particular, overdiagnosis, active surveillance vs surgery, extent of surgery, radioactive iodine (RAI) treatment, thyrotropin suppression, and postoperative surveillance are discussed. EVIDENCE SYNTHESIS Recommendations regarding the diagnosis of DTC, the extent of treatment for low-risk DTC patients, and the intensity of posttreatment follow-up have all changed substantially in the past decade. While overdiagnosis remains a problem, there has been a true increase in incidence as well. Treatment options range from active surveillance of small tumors to total thyroidectomy followed by RAI in select cases. Recommendations for long-term surveillance frequency and duration are similarly broad. CONCLUSION Clinicians and patients must approach each case in a personalized and nuanced fashion to select the appropriate extent of treatment on an individual basis. In areas of evidential equipoise, data regarding patient-centered outcomes may help guide decision-making.
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Affiliation(s)
- Timothy M Ullmann
- Division of General Surgery, Department of Surgery, Albany Medical College, 50 New Scotland Ave., MC-193, Albany, NY 12208, USA
| | - Maria Papaleontiou
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, 2800 Plymouth Road, Bldg. 16, Rm 453S, Ann Arbor, MI 48109, USA
| | - Julie Ann Sosa
- Section of Endocrine Surgery, Department of Surgery, University of California, San Francisco, 513 Parnassus Ave. Ste. S320, Box 0104, San Francisco, CA 94143, USA
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Obesity and Cancer: A Current Overview of Epidemiology, Pathogenesis, Outcomes, and Management. Cancers (Basel) 2023; 15:cancers15020485. [PMID: 36672434 PMCID: PMC9857053 DOI: 10.3390/cancers15020485] [Citation(s) in RCA: 86] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 01/11/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Obesity or excess body fat is a major global health challenge that has not only been associated with diabetes mellitus and cardiovascular disease but is also a major risk factor for the development of and mortality related to a subgroup of cancer. This review focuses on epidemiology, the relationship between obesity and the risk associated with the development and recurrence of cancer and the management of obesity. METHODS A literature search using PubMed and Google Scholar was performed and the keywords 'obesity' and cancer' were used. The search was limited to research papers published in English prior to September 2022 and focused on studies that investigated epidemiology, the pathogenesis of cancer, cancer incidence and the risk of recurrence, and the management of obesity. RESULTS About 4-8% of all cancers are attributed to obesity. Obesity is a risk factor for several major cancers, including post-menopausal breast, colorectal, endometrial, kidney, esophageal, pancreatic, liver, and gallbladder cancer. Excess body fat results in an approximately 17% increased risk of cancer-specific mortality. The relationship between obesity and the risk associated with the development of cancer and its recurrence is not fully understood and involves altered fatty acid metabolism, extracellular matrix remodeling, the secretion of adipokines and anabolic and sex hormones, immune dysregulation, and chronic inflammation. Obesity may also increase treatment-related adverse effects and influence treatment decisions regarding specific types of cancer therapy. Structured exercise in combination with dietary support and behavior therapy are effective interventions. Treatment with glucagon-like peptide-1 analogues and bariatric surgery result in more rapid weight loss and can be considered in selected cancer survivors. CONCLUSIONS Obesity increases cancer risk and mortality. Weight-reducing strategies in obesity-associated cancers are important interventions as a key component of cancer care. Future studies are warranted to further elucidate the complex relationship between obesity and cancer with the identification of targets for effective interventions.
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Pidchenko N. Thyroid gland cancer and insulin resistance: a modern view of the problem. УКРАЇНСЬКИЙ РАДІОЛОГІЧНИЙ ТА ОНКОЛОГІЧНИЙ ЖУРНАЛ 2022. [DOI: 10.46879/ukroj.3.2022.79-92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background. The impact of insulin resistance on the probability of increase in thyroid cancer risk has been drawing a lot of attention of researchers lately. This problem is far from being completely solved. Studying this interrelationship may influence the effectiveness of the treatment of the mentioned widespread pathology.
Purpose – to review present literature sources on research of interrelationship between insulin resistance and thyroid cancer, and also possible mechanisms of this relationship.
Materials and methods. Literature search was performed manually by the keywords (thyroid cancer, insulin resistance, IGF-1, IGF-2, abdominal obesity, increase in body mass index, metformin), and also literature sources from evidential data bases PubMed, Web of Science were reviewed. Metaanalyses, systematic reviews and cohort studies were also taken into account. 148 literature sources were studied in total. The sources, which had been published within the last 10 years, were preferably selected.
Results. Insulin resistance is viewed as an important independent factor of development of numerous malignancies. The carcinogenic activity of insulin resistance is caused by the resistance itself, as well as by the metabolic disorders related to it. It has been established that excessive weight and obesity are to a great extent attributed to more aggressive clinical pathological signs of thyroid cancer. Recent research showed a larger volume of thyroid and higher risk of knot forming in patients with insulin resistance. Thus, thyroid cancer is one of the main factors of thyroid transformation. Therapeutic methods of eliminating metabolic syndrome and associated hormonal diseases for prevention and therapy of oncologic diseases are drawing ever-greater scientific interest. The anti-tumor features of metformin and its capability of retarding carcinogenesis are shown in the studies.
Conclusions. The given literature analysis has proved that the problem of treating malignant thyroid tumors and their metastasis is caused not only by morphological, cellular and molecular-biological features of the tumor itself, but also by insufficient knowledge about the interrelationship between insulin resistance, abdominal obesity, increase in body mass index, high-calorie diet and reduction of consumption of polyunsaturated fats, harmful impact of environment with molecular changes, specific for thyroid cancer. It is confirmed by a significant increase in thyroid cancer rate, especially papillary histotype, alongside with an increase in obesity rate. The studying of possibilities of decreasing incidence and mortality rates of oncologic pathology when using medications, which stabilize insulin and contribute to a decrease in degree of hyperinsulinemia, one of which is metformin, generates profound interest
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Matrone A, Basolo A, Santini F, Elisei R. Understanding the effect of obesity on papillary thyroid cancer: is there a need for tailored diagnostic and therapeutic management? Expert Rev Endocrinol Metab 2022; 17:475-484. [PMID: 36203362 DOI: 10.1080/17446651.2022.2131529] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/29/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION Several studies have focused on the relationship between obesity and differentiated thyroid carcinoma (DTC), particularly papillary histotype (PTC). However, the association of obesity with both incidence and aggressiveness of PTC is still incompletely understood. AREAS COVERED We reviewed the mechanisms underlying the cross talk between obesity and thyroid carcinomas and described the most recent evidence evaluating the effect of obesity on the development of PTC, as well as the impact of excessive body weight on the clinicopathologic features and outcome of this type of cancer. EXPERT OPINION Available evidence suggests that excessive body weight is linked with a higher risk of getting PTC, while its impact on the aggressiveness of the disease, if present, is still not clear. Therefore, while attention should be paid to discover thyroid cancer in patients with obesity earlier, once diagnosed it should be managed following a conventional workup as in normal weight patients, based on the clinical presentation of the disease and including active surveillance if appropriate, as recommended by referral guidelines.
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Affiliation(s)
- Antonio Matrone
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Alessio Basolo
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Ferruccio Santini
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
| | - Rossella Elisei
- Department of Clinical and Experimental Medicine, Unit of Endocrinology, University Hospital of Pisa - via Paradisa 2, Pisa, Italy
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Xu H, Hu X, Li J, Nie Z, Kang S, Liu H, Wang Y, Jia X, Lyu Z. The Inverse Association of Serum Magnesium with Papillary Thyroid Cancer in Thyroid Nodules: a Cross-Sectional Survey Based on Thyroidectomy Population. Biol Trace Elem Res 2022; 201:3279-3289. [PMID: 36227448 DOI: 10.1007/s12011-022-03448-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/04/2022] [Indexed: 11/02/2022]
Abstract
Magnesium is considered to play a role in preventing cancer. However, the association between serum magnesium and papillary thyroid cancer (PTC) remains unknown. We retrospectively reviewed records of all patients who underwent thyroidectomy with thyroid nodules confirmed pathologically as benign nodule or PTC at our institution from January 2016 to December 2020. Data including demographic characteristics, laboratory tests, and pathological features were analyzed in 5709 adult patients eventually. The subjects with benign nodules had a higher mean serum magnesium level than those with PTC (P < 0.001), and the proportions of PTCs decreased across quartiles of serum magnesium within the normal range. After adjustment for confounders, patients with the lowest quartile of serum magnesium had a higher prevalence of PTC than those with the highest quartile (OR = 1.421, 95%CI: 1.125-1.795, P for trend = 0.005), and the risk of PTC was 0.863 (95%CI: 0.795-0.936) for a per-SD change in serum magnesium. The contribution of serum magnesium remained in subgroup analysis (P for interaction for all analyses > 0.05). Based on the ROC curve, the cut-off value of serum magnesium used to differentiate benign nodules from PTCs was 935 μmol/L. Combining serum magnesium with other clinical indicators can improve the efficacy of predicting PTC. Our results showed that lower serum magnesium within the normal range was associated with a greater risk of PTC among patients with thyroid nodules considering thyroidectomy. Serum magnesium may be an independent protective factor against PTC and provide additional information on the odds of malignancy in uncertain thyroid nodules in combination with other clinical factors.
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Affiliation(s)
- Huaijin Xu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Xiaodong Hu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Jiefei Li
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Zhimei Nie
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Shaoyang Kang
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Hongzhou Liu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Yuhan Wang
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China
| | - Xiaomeng Jia
- Center for Endocrine Metabolism and Immune Disease, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China
| | - Zhaohui Lyu
- Department of Endocrinology, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, 100853, Beijing, China.
- School of Medicine, Nankai University, Tianjin, 300071, China.
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Blonde L, Umpierrez GE, Reddy SS, McGill JB, Berga SL, Bush M, Chandrasekaran S, DeFronzo RA, Einhorn D, Galindo RJ, Gardner TW, Garg R, Garvey WT, Hirsch IB, Hurley DL, Izuora K, Kosiborod M, Olson D, Patel SB, Pop-Busui R, Sadhu AR, Samson SL, Stec C, Tamborlane WV, Tuttle KR, Twining C, Vella A, Vellanki P, Weber SL. American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. Endocr Pract 2022; 28:923-1049. [PMID: 35963508 PMCID: PMC10200071 DOI: 10.1016/j.eprac.2022.08.002] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective of this clinical practice guideline is to provide updated and new evidence-based recommendations for the comprehensive care of persons with diabetes mellitus to clinicians, diabetes-care teams, other health care professionals and stakeholders, and individuals with diabetes and their caregivers. METHODS The American Association of Clinical Endocrinology selected a task force of medical experts and staff who updated and assessed clinical questions and recommendations from the prior 2015 version of this guideline and conducted literature searches for relevant scientific papers published from January 1, 2015, through May 15, 2022. Selected studies from results of literature searches composed the evidence base to update 2015 recommendations as well as to develop new recommendations based on review of clinical evidence, current practice, expertise, and consensus, according to established American Association of Clinical Endocrinology protocol for guideline development. RESULTS This guideline includes 170 updated and new evidence-based clinical practice recommendations for the comprehensive care of persons with diabetes. Recommendations are divided into four sections: (1) screening, diagnosis, glycemic targets, and glycemic monitoring; (2) comorbidities and complications, including obesity and management with lifestyle, nutrition, and bariatric surgery, hypertension, dyslipidemia, retinopathy, neuropathy, diabetic kidney disease, and cardiovascular disease; (3) management of prediabetes, type 2 diabetes with antihyperglycemic pharmacotherapy and glycemic targets, type 1 diabetes with insulin therapy, hypoglycemia, hospitalized persons, and women with diabetes in pregnancy; (4) education and new topics regarding diabetes and infertility, nutritional supplements, secondary diabetes, social determinants of health, and virtual care, as well as updated recommendations on cancer risk, nonpharmacologic components of pediatric care plans, depression, education and team approach, occupational risk, role of sleep medicine, and vaccinations in persons with diabetes. CONCLUSIONS This updated clinical practice guideline provides evidence-based recommendations to assist with person-centered, team-based clinical decision-making to improve the care of persons with diabetes mellitus.
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Affiliation(s)
| | | | - S Sethu Reddy
- Central Michigan University, Mount Pleasant, Michigan
| | | | | | | | | | | | - Daniel Einhorn
- Scripps Whittier Diabetes Institute, La Jolla, California
| | | | | | - Rajesh Garg
- Lundquist Institute/Harbor-UCLA Medical Center, Torrance, California
| | | | | | | | | | | | - Darin Olson
- Colorado Mountain Medical, LLC, Avon, Colorado
| | | | | | - Archana R Sadhu
- Houston Methodist; Weill Cornell Medicine; Texas A&M College of Medicine; Houston, Texas
| | | | - Carla Stec
- American Association of Clinical Endocrinology, Jacksonville, Florida
| | | | - Katherine R Tuttle
- University of Washington and Providence Health Care, Seattle and Spokane, Washington
| | | | | | | | - Sandra L Weber
- University of South Carolina School of Medicine-Greenville, Prisma Health System, Greenville, South Carolina
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Wu J, Zhao X, Sun J, Cheng C, Yin C, Bai R. The epidemic of thyroid cancer in China: Current trends and future prediction. Front Oncol 2022; 12:932729. [PMID: 36119514 PMCID: PMC9478365 DOI: 10.3389/fonc.2022.932729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/01/2022] [Indexed: 12/24/2022] Open
Abstract
Background Thyroid cancer (TC) is one of the most common cancers in China. The aim of this study was to identify the potential age, period, and cohort effect under the long-term trends in TC incidence and mortality, making projections up to 2030. Methods Incidence and mortality data on TC were obtained from the Global Burden of Disease Study 2019. The population predictions were obtained from the United Nations World Population Prospects 2019. An age–period–cohort model was used for the analysis. Results From 1990 to 2019, the net drift (the overall annual percentage change of TC over time adjusted for age groups) of the TC incidence was 5.01% (95% confidence interval [CI]: 4.72%, 5.29%) for men and 1.48% (95% CI: 1.14%, 1.82%) for women. The net drift of TC mortality was 1.64% (95% CI: 1.38%, 1.91%) for men and –2.51% (95% CI: –2.77%, –2.26%) for women. Regarding the incidence of TC, both the period and the cohort relative risks (RRs) in men and women showed an overall increasing trend. As to the mortality rate of TC, both the period and cohort RRs in women showed a monotonic declining trend. The period RRs for men decreased after 2015, but the cohort RRs revealed a fluctuating upward pattern. From 2019 to 2030, the TC incidence was projected to rise by 32.4% in men and 13.1% in women, the mortality declining by 13.0% in men and 17.3% in women. The elderly was projected to have an increasing proportion of TC occurrence and deaths. Conclusions Over the past 30 years, the incidence rate of TC in China has continually increased, and this trend was projected to continue. Although male mortality has increased in the past, it is expected to decline in the future. The proportion of older people among TC occurrence and death was projected to gradually increase, and the difficulties elderly with TC lrequire more attention.
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Affiliation(s)
- Jiayuan Wu
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Xiaoyan Zhao
- Medical Innovation Research Department, People’s Liberation Army (PLA) General Hospital, Beijing, China
| | - Jianzhong Sun
- Health Science Center, Xi’an Jiaotong University, Xi’an, China
| | - Chong Cheng
- Hospital of Nanjing University of Science and Technology, Nanjing, China
| | - Chunyu Yin
- Clinical Research Service Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Department of Outpatient, First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Ruhai Bai, ; Chunyu Yin,
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
- *Correspondence: Ruhai Bai, ; Chunyu Yin,
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Baidoun F, Abdel-Rahman O. The role of surgery in small differentiated thyroid cancer. Endocrine 2022; 77:469-479. [PMID: 35657579 DOI: 10.1007/s12020-022-03097-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/25/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The incidence of small, differentiated thyroid cancer (DTC) cases has been increasing in the United States and the world mainly due to incidental detection because of widespread use of diagnostic modalities. While the option of active surveillance instead of surgical resection is getting more popular, there is still an open discussion about the best approach in these cases. MATERIALS AND METHODS The National Cancer Database was queried for patients diagnosed with non-metastatic small T1/N0 DTC between 2004 and 2016, who have known surgical status and Charlson comorbidity index of two or less. We evaluated the overall survival (OS) based on the surgery status using Kaplan-Meier estimates and multivariable cox regression analyses. RESULTS A total of 98,501 patients with non-metastatic small DTC were included, within which 96,612 (98.1%) were treated with surgery, and 1889 (1.9%) were not treated with surgery or other ablative modalities. We found that patients who were treated with surgery had better OS compared to patients who were not treated with surgery (mean OS 171 months vs 134.1 months, P < 0.001, median OS was not reached). This difference was still statistically significant even after we used propensity score matching for age, gender, race, Charlson-Deyo score, tumor size, and histology. On multivariate analysis, surgery was associated with better OS (HR 0.218; 95% CI: 0.196-0.244; P < 0.001). Same trend was found in subgroup analysis when we split the cohort according to tumor size (<1 and ≥1 cm), histology (follicular, papillary and Hurthle cell carcinoma), and age (<55 years vs ≥55 years). CONCLUSION Patients with non-metastatic small DTC who were treated with surgery had significant improvement in OS compared to patients who were not treated with surgery. Notwithstanding the limitations of the current analysis, these results call for caution prior to recommending routine surveillance for all patients with small DTC.
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Affiliation(s)
- Firas Baidoun
- Department of Hospital Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA.
| | - Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, Canada
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Graceffa G, Salamone G, Contino S, Saputo F, Corigliano A, Melfa G, Proclamà MP, Richiusa P, Mazzola S, Tutino R, Orlando G, Scerrino G. Risk Factors for Anaplastic Thyroid Carcinoma: A Case Series From a Tertiary Referral Center for Thyroid Surgery and Literature Analysis. Front Oncol 2022; 12:948033. [PMID: 35875085 PMCID: PMC9303013 DOI: 10.3389/fonc.2022.948033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is a very rare and extremely aggressive disease with a very poor prognosis. Several risk factors have been hypothesized, but there is no clear-cut literature data on it. We reviewed the literature concerning risk factors for ATC and analyzed the institutional database from 2005 to 2022. In total, 15 papers were suitable for review, while the retrospective data collection search, conducted on our institutional database, provided 13 results. In our experience, in agreement with literature data, ATC seems to be a neoplasm peculiar to old age (in our database, mean age is 72 years), with a higher prevalence in subjects with a low level of education and a long history of multinodular goiter (MNG). The role of cigarette smoking and blood group, hypothesized on some literature data, was more uncertain, although the small sample size evaluated probably had a great influence on these results. The higher incidence of the disease in individuals with a history of MNG could suggest more aggressive choices in the treatment of a benign disease, in contrast to current practice. However, this may be a highly questionable point considering that ATC accounts for no more than 2% of all thyroid neoplasms in surgical departments, even those dedicated to endocrine neck surgery. Further studies are therefore necessary for a step forward in this direction.
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Affiliation(s)
- Giuseppa Graceffa
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Giuseppe Salamone
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Silvia Contino
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Federica Saputo
- Department of Surgical, Oncological and Oral Sciences, University of Palermo, Palermo, Italy
| | - Alessandro Corigliano
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Giuseppina Melfa
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Maria Pia Proclamà
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
| | - Pierina Richiusa
- Section of Endocrinology-Department of Health Promotion Sciences Maternal and Infantile Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Palermo, Italy
| | - Sergio Mazzola
- Unit of Clinical Epidemiology and Tumor Registry, Department of Laboratory Diagnostics, Policlinico “P. Giaccone” University of Palermo, Palermo, Italy
| | - Roberta Tutino
- Department of General and Specialized Surgery, City of Health and Science Hospital of Turin, Turin, Italy
| | - Giuseppina Orlando
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
- *Correspondence: Giuseppina Orlando,
| | - Gregorio Scerrino
- Department of Surgical Oncological and Oral Sciences, Unit of General and Emergency Surgery, University of Palermo, Palermo, Italy
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Huang L, Feng X, Yang W, Li X, Zhang K, Feng S, Wang F, Yang X. Appraising the Effect of Potential Risk Factors on Thyroid Cancer: A Mendelian Randomization Study. J Clin Endocrinol Metab 2022; 107:e2783-e2791. [PMID: 35366326 DOI: 10.1210/clinem/dgac196] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Various risk factors have been associated with the risk of thyroid cancer in observational studies. However, the causality of the risk factors is not clear given the susceptibility of confounding and reverse causation. OBJECTIVE A 2-sample Mendelian randomization approach was used to estimate the effect of potential risk factors on thyroid cancer risk. METHODS Genetic instruments to proxy 55 risk factors were identified by genome-wide association studies (GWAS). Associations of these genetic variants with thyroid cancer risk were estimated in GWAS of the FinnGen Study (989 cases and 217 803 controls). A Bonferroni-corrected threshold of P = 9.09 × 10-4 was considered significant, and P < 0.05 was considered to be suggestive of an association. RESULTS Telomere length was significantly associated with increased thyroid cancer risk after correction for multiple testing (OR 4.68; 95% CI, 2.35-9.31; P = 1.12 × 10-5). Suggestive associations with increased risk were noted for waist-to-hip ratio (OR 1.85; 95% CI, 1.02-3.35; P = 0.042) and diastolic blood pressure (OR 1.60; 95% CI, 1.08-2.38; P = 0.019). Suggestive associations were noted between hemoglobin A1c (HbA1c) (OR 0.20; 95% CI, 0.05-0.82; P = 0.025) and decreased risk of thyroid cancer. Risk of thyroid cancer was not associated with sex hormones and reproduction, developmental and growth, lipids, diet and lifestyle, or inflammatory factors (All P > 0.05). CONCLUSION Our study identified several potential targets for primary prevention of thyroid cancer, including central obesity, diastolic blood pressure, HbA1c, and telomere length, which should inform public health policy.
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Affiliation(s)
- Lulu Huang
- Department of Radiotherapy, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiuming Feng
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Wenjun Yang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Guangxi Collaborative Innovation Center for Biomedicine (Guangxi-ASEAN Collaborative Innovation Center for Major Disease Prevention and Treatment), Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiangzhi Li
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Kang Zhang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Shuzhen Feng
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Basic Medicine, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
| | - Fei Wang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xiaobo Yang
- Guangxi Key Laboratory on Precise Prevention and Treatment for Thyroid Tumor, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
- Department of Occupational Health and Environmental Health, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
- Department of Public Health, School of Medicine, Guangxi University of Science and Technology, Liuzhou 545005, Guangxi, China
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Pizzato M, Li M, Vignat J, Laversanne M, Singh D, La Vecchia C, Vaccarella S. The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020. Lancet Diabetes Endocrinol 2022; 10:264-272. [PMID: 35271818 DOI: 10.1016/s2213-8587(22)00035-3] [Citation(s) in RCA: 161] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Thyroid cancer incidence rates have increased in many countries and settings; however, mortality rates have remained stable at lower rates. This epidemiological pattern has been largely attributed to an overdiagnosis effect. Timely evidence for the global epidemiological status is necessary to identify the magnitude of this problem and the areas mostly affected by it. We therefore aimed to provide an up-to-date assessment on the global distribution of thyroid cancer incidence and mortality rates in 2020. METHODS We extracted age-standardised incidence and mortality rates per 100 000 person-years of thyroid cancer as defined by the International Classification of Diseases for Oncology 10th Revision (code C73), for 185 countries or territories by sex and 18 age groups (ie, 0-4, 5-9, …, 80-84, and ≥85 years) from the GLOBOCAN database. Both incidence and mortality estimates were presented by country and aggregated across the 20 UN-defined world regions and according to the UN's four-tier Human Development Index (ie, low, medium, high, and very high) in 2020. FINDINGS Globally, in 2020, the age-standardised incidence rates of thyroid cancer were 10·1 per 100 000 women and 3·1 per 100 000 men, and age-standardised mortality rates were 0·5 per 100 000 women and 0·3 per 100 000 men. In both sexes, incidence rates were five times higher in high and very high Human Development Index countries than in low and medium Human Development Index countries, whereas mortality rates were relatively similar across different settings. Incidence rates in women differed by more than 15 times across world regions, with the highest incidence rates being in the Federated States of Micronesia and French Polynesia (18·5 per 100 000 women), North America (18·4 per 100 000), and east Asia (17·8 per 100 000, with South Korea reaching 45 per 100 000). Mortality rates were less than one per 100 000 in most countries and in both sexes. South Korea had the highest incidence-to-mortality rate ratio in both sexes, followed by Cyprus and Canada. INTERPRETATION The current thyroid cancer epidemiological landscape is strongly suggestive of a large effect of overdiagnosis in many countries and settings worldwide, confirming the relevance of thyroid cancer overdiagnosis as a global public health problem. FUNDING None.
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Affiliation(s)
- Margherita Pizzato
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy; International Agency for Research on Cancer, Lyon, France.
| | - Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jerome Vignat
- International Agency for Research on Cancer, Lyon, France
| | - Mathieu Laversanne
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Cao Y, Lin J, Zhai K, Jiang W, Zou H, Ren H, Wang P, Gao X, Zhang M, Yu S, Zhao Y, Xuan Z, Zhang D, Liu Y, Lou X. Long-term investigation of environmental radioactivity levels and public health around the Qinshan Nuclear Power Plant, China. Sci Rep 2022; 12:4945. [PMID: 35322138 PMCID: PMC8943193 DOI: 10.1038/s41598-022-09091-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
To evaluate the impact of the Qinshan Nuclear Power Plant (Qinshan NPP) in normal operation on the surrounding environment and population, the radioactivity levels of drinking water and the ambient environment, as well as the residents’ cancer incidence, were continuously monitored for a period of 9 years (2012–2020). All of the gross α and β radioactivity concentrations in drinking water were less than the WHO recommended values (0.5 Bq/L for gross α and 1 Bq/L for gross β). The results of ambient environment accumulated dose monitored by thermoluminescent dosimeters (TLDs) indicated that the ambient environment radioactive level around the Qinshan NPP is consistently at natural background radiation levels. The age-dependent annual effective doses due to the ingestion of tap water or exposure to the outdoor ambient environment are lower than the reference dose of 0.1 mSv/year. The corresponding excess risks are at relatively low levels. Thus, the consumption of drinking water and outdoor activities are not expected to give rise to any detectable adverse effects on the health of the public around the Qinshan NPP. For all cancers combined, the age-standardized incidence rate by the Chinese 2000 standard population of the inhabitants living around Qinshan NPP is consistent with that of Zhejiang Province as a whole. Based on current radiation risk estimates, radiation exposure is not a plausible explanation for any excess cancers observed in the vicinity of the Qinshan NPP.
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Affiliation(s)
- Yiyao Cao
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Junping Lin
- Institute of Radiation Medicine, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, 300192, China
| | - Kangle Zhai
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Wei Jiang
- Center for Disease Control and Prevention of Haiyan, Jiaxing, 314300, Zhejiang, China
| | - Hua Zou
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Hong Ren
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Peng Wang
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Xiangjing Gao
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Meibian Zhang
- National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Shunfei Yu
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Yaoxian Zhao
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Zhiqiang Xuan
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Dongxia Zhang
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China
| | - Yulian Liu
- Institute of Radiation Medicine, Chinese Academy of Medical Science and Peking Union Medical College, Tianjin, 300192, China.
| | - Xiaoming Lou
- Department of Occupational Health and Radiation Protection, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang, China.
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41
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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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Franchini F, Palatucci G, Colao A, Ungaro P, Macchia PE, Nettore IC. Obesity and Thyroid Cancer Risk: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031116. [PMID: 35162142 PMCID: PMC8834607 DOI: 10.3390/ijerph19031116] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 02/07/2023]
Abstract
Thyroid cancer (TC) is the most common endocrine malignancy worldwide and its incidence has increased dramatically in recent years. In parallel, the prevalence of overweight and obesity has also increased, suggesting a possible link between these two diseases. Indeed, low-grade chronic inflammation, altered cytokine levels, insulin resistance, oxidative stress, and hormonal changes that occur in obese patients are all factors that contribute to the occurrence and growth of TC. In this review, the most recent evidence supporting the potential role of the mechanisms linking obesity to TC will be discussed.
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Affiliation(s)
- Fabiana Franchini
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Giuseppe Palatucci
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Paola Ungaro
- National Research Council–Institute for Experimental Endocrinology & Oncology ‘Gaetano Salvatore’, 80145 Napoli, Italy;
| | - Paolo Emidio Macchia
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
| | - Immacolata Cristina Nettore
- Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Napoli, Italy; (F.F.); (G.P.); (A.C.); (P.E.M.)
- Correspondence: ; Tel.: +39-081-7463848; Fax: +39-081-7462108
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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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Wang H, Jiang Y, Song J, Liang H, Liu Y, Huang J, Yin P, Wu D, Zhang H, Liu X, Zhou D, Wei W, Lei L, Peng J, Zhang J. The risk of perchlorate and iodine on the incidence of thyroid tumors and nodular goiter: a case-control study in southeastern China. Environ Health 2022; 21:4. [PMID: 34980104 PMCID: PMC8725411 DOI: 10.1186/s12940-021-00818-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide. There are limited reports on the risk of perchlorate and iodine on thyroid tumors, but evidence from population studies is scarce, and their impact on thyroid function is still uncertain. Therefore, the objective of this study was to investigate the association of perchlorate and iodine with the risk of nodular goiter (NG), papillary thyroid microcarcinoma (PTMC), and papillary thyroid carcinoma (PTC) and to assess the correlation between perchlorate and iodine with thyroid function indicators. METHODS A case-control population consisting of 184 pairs of thyroid tumors and nodular goiter matched by gender and age (±2 years) was recruited in this study. Serum and urine samples were collected from each participant. Thyroid function indicators in serum were tested by automatic chemical immunofluorescence, and perchlorate and iodine levels in urine were determined by ultra-high performance liquid chromatography tandem-mass spectrometry and inductively coupled plasma-mass spectrometry, respectively. Conditional logistic regressions and multiple linear regressions were used to analyze the associations. RESULTS Urinary perchlorate concentration was significantly higher in total cases, NG and PTC than in the corresponding controls (P < 0.05). Perchlorate was positively associated with PTC (OR = 1.058, 95% CI: 1.009, 1.110) in a non-linear dose-response relationship, but there was no association between perchlorate and NG or PTMC. Iodine was not associated with the risk of thyroid tumors and NG and did not correlate with the thyroid function indicators. Furthermore, perchlorate showed a positive correlation with thyroid stimulating hormone (TSH) at iodine adequate levels (P < 0.05), and a negative correlation with free triiodothyronine (FT3) and a positive correlation with thyroglobulin antibody (TgAb) at iodine more than adequate or excess levels (P < 0.05). CONCLUSIONS Perchlorate can increase the risk of PTC in a non-linear dose-response relationship and disturb the thyroid hormone homeostasis and thyroid autoantibody levels.
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Affiliation(s)
- Huirong Wang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
- School of Public Health, Southern Medical University, No.1023 Shatai Road, Baiyun District, Guangzhou, 510515 China
| | - Yousheng Jiang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Jiayi Song
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Huiwen Liang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Yuan Liu
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Jiewu Huang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Pengliang Yin
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Dongting Wu
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
- Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, the Second Affiliated Hospital of Jinan University, No.18 Zetian Road, Futian District, Shenzhen, 518040 China
| | - Hang Zhang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Xinjie Liu
- Shenzhen People’s Hospital, No.1017 Dongmen North Road, Luohu District, Shenzhen, 518020 China
| | - Dongxian Zhou
- Shenzhen People’s Hospital, No.1017 Dongmen North Road, Luohu District, Shenzhen, 518020 China
| | - Wei Wei
- Peking University Shenzhen Hospital, No.1120 Lianhua Road, Futian District, Shenzhen, 518036 China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, No.2021 Buxin Road, Luohu District, Shenzhen, 518020 China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, No.2021 Buxin Road, Luohu District, Shenzhen, 518020 China
| | - Jianqing Zhang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
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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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Ambient particulate matter air pollution is associated with increased risk of papillary thyroid cancer. Surgery 2022; 171:212-219. [PMID: 34210530 PMCID: PMC8688174 DOI: 10.1016/j.surg.2021.05.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The association between exposure to air pollution and papillary thyroid carcinoma is unknown. We sought to estimate the relationship between long-term exposure to the fine (diameter ≤ 2.5 μm) particulate matter component of air pollution and the risk of papillary thyroid cancer. METHODS Adult (age ≥18) patients with newly diagnosed papillary thyroid carcinoma between January 1, 2013 and December 31, 2016 across a single health system were identified using electronic medical records. Data from 1,990 patients with papillary thyroid carcinoma were compared with 3,980 age- and sex-matched control subjects without any evidence of thyroid disease. Cumulative fine (diameter <2.5 μm) particulate matter exposure was estimated by incorporating patients' residential zip codes into a deep learning neural networks model, which uses both meteorological and satellite-based measurements. Conditional logistic regression was performed to assess for association between papillary thyroid carcinoma and increasing fine (diameter ≤2.5 μm) particulate matter concentrations over 1, 2, and 3 years of cumulative exposure preceding papillary thyroid carcinoma diagnosis. RESULTS Increased odds of developing papillary thyroid carcinoma was associated with a 5 μg/m3 increase of fine (diameter ≤2.5 μm) particulate matter concentrations over 2 years (adjusted odds ratio = 1.18, 95% confidence interval: 1.00-1.40) and 3 years (adjusted odds ratio = 1.23, 95% confidence interval: 1.05-1.44) of exposure. This risk differed by smoking status (pinteraction = 0.04). Among current smokers (n = 623), the risk of developing papillary thyroid carcinoma was highest (adjusted odds ratio = 1.35, 95% confidence interval: 1.12-1.63). CONCLUSION Increasing concentration of fine (diameter ≤2.5 μm) particulate matter in air pollution is significantly associated with the incidence of papillary thyroid carcinoma with 2 and 3 years of exposure. Our novel findings provide additional insight into the potential associations between risk factors and papillary thyroid carcinoma and warrant further investigation, specifically in areas with high levels of air pollution both nationally and internationally.
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Le Moli R, Vella V, Tumino D, Piticchio T, Naselli A, Belfiore A, Frasca F. Inflammasome activation as a link between obesity and thyroid disorders: Implications for an integrated clinical management. Front Endocrinol (Lausanne) 2022; 13:959276. [PMID: 36060941 PMCID: PMC9437482 DOI: 10.3389/fendo.2022.959276] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
Obesity is strongly associated with chronic low-grade inflammation. Obese patients have an increased risk to develop thyroid autoimmunity and to became hypothyroid, suggesting a pathogenetic link between obesity, inflammation and autoimmunity. Moreover, type 2 diabetes and dyslipidemia, also characterized by low-grade inflammation, were recently associated with more aggressive forms of Graves' ophthalmopathy. The association between obesity and autoimmune thyroid disorders may also go in the opposite direction, as treating autoimmune hyper and hypothyroidism can lead to weight gain. In addition, restoration of euthyroidism by L-T4 replacement therapy is more challenging in obese athyreotic patients, as it is difficult to maintain thyrotropin stimulation hormone (TSH) values within the normal range. Intriguingly, pro-inflammatory cytokines decrease in obese patients after bariatric surgery along with TSH levels. Moreover, the risk of thyroid cancer is increased in patients with thyroid autoimmune disorders, and is also related to the degree of obesity and inflammation. Molecular studies have shown a relationship between the low-grade inflammation of obesity and the activity of intracellular multiprotein complexes typical of immune cells (inflammasomes). We will now highlight some clinical implications of inflammasome activation in the relationship between obesity and thyroid disease.
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Nguyen DN, Kim J, Kim MK. Association of Metabolic Health and Central Obesity With the Risk of Thyroid Cancer: Data from the Korean Genome and Epidemiology Study. Cancer Epidemiol Biomarkers Prev 2021; 31:543-553. [PMID: 34933959 DOI: 10.1158/1055-9965.epi-21-0255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/23/2021] [Accepted: 12/08/2021] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND It is unknown whether the risk of thyroid cancer differs among metabolically healthy/unhealthy, normal-weight, or obese women. We aimed to assess the association of metabolic health and obesity with thyroid cancer risk. METHODS The Korean Genome and Epidemiology Study is a population-based prospective cohort study. Data were obtained from 173,343 participants (age {greater than or equal to}40 years) enrolled from 2004 to 2013. Obese participants were those with body mass index (BMI) {greater than or equal to}25 kg/m2. Participants with abnormalities in three of these indices were considered metabolically unhealthy: triglycerides, blood pressure, high-density lipoprotein cholesterol (HDL-cholesterol), waist circumference (WC), and fasting glucose levels. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for thyroid cancer risk associated with metabolic health and obesity. RESULTS Compared to non-obese women without metabolic abnormalities, metabolically unhealthy women, either normal-weight or obese, had an increased risk of thyroid cancer (HR [95% CI]=1.57[1.02-2.40] and 1.71[1.21-2.41], respectively). Significant association was not observed in men. Thyroid cancer risk was higher among non-obese women with high WC ({greater than or equal to}85 cm; HR [95% CI]=1.62[1.03-2.56]) than in non-obese women with low WC, and in obese women with low HDL-cholesterol (<50 mg/dL; HR[95% CI]=1.75[1.26-2.42]) compared to non-obese women with high HDL-cholesterol. CONCLUSIONS Metabolically unhealthy women or women with central adiposity may be at an increased thyroid cancer risk despite normal BMI. IMPACT This study suggests that women with central obesity and metabolically abnormality despite normal BMI may constitute a target group for thyroid cancer prevention and control programs.
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Affiliation(s)
- Dung Ngoc Nguyen
- Division of Cancer Epidemiology and Prevention, National Cancer Center
| | - Jinhee Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center
| | - Mi Kyung Kim
- Division of Cancer Epidemiology and Prevention, National Cancer Center
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Deligiorgi MV, Siasos G, Vakkas L, Trafalis DT. Charting the Unknown Association of COVID-19 with Thyroid Cancer, Focusing on Differentiated Thyroid Cancer: A Call for Caution. Cancers (Basel) 2021; 13:5785. [PMID: 34830939 PMCID: PMC8616091 DOI: 10.3390/cancers13225785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Conceived of as the "silver lining" of the dark cloud of the coronavirus disease 2019 (COVID-19) pandemic, lessons taught by this catastrophe should be leveraged by medical authorities and policy makers to optimize health care globally. A major lesson is that resilient health systems should absorb sudden shocks incited by overwhelming health emergencies without compromising the continuum of care of chronic diseases, especially of cancer. METHODS The present review dissects the association between COVID-19 and thyroid cancer (TC), especially with differentiated TC (DTC), focusing on available data, knowledge gaps, current challenges, and future perspectives. RESULTS Obesity has been incriminated in terms of both COVID-19 severity and a rising incidence of TC, especially of DTC. The current conceptualization of the pathophysiological landscape of COVID-19-(D)TC association implicates an interplay between obesity, inflammation, immunity, and oxidative stress. Whether COVID-19 could aggravate the health burden posed by (D)TC or vice versa has yet to be clarified. Improved understanding and harnessing of the pathophysiological landscape of the COVID-19-(D)TC association will empower a mechanism-guided, safe, evidence-based, and risk-stratified management of (D)TC in the COVID-19 era and beyond. CONCLUSION A multidisciplinary patient-centered decision-making will ensure high-quality (D)TC care for patients, with or without COVID-19.
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Affiliation(s)
- Maria V. Deligiorgi
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
| | - Gerasimos Siasos
- First Department of Cardiology, Hippokration General Hospital of Athens, Faculty of Mediine, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Lampros Vakkas
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
| | - Dimitrios T. Trafalis
- Clinical Pharmacology Unit–Department of Pharmacology, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., 11527 Athens, Greece; (L.V.); (D.T.T.)
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Yin Y, Xu X, Shen L, Zhao W, Diao H, Li C. Influencing Factors and Cumulative Risk Analysis of Cervical Lymph Node Metastasis of Papillary Thyroid Microcarcinoma. Front Oncol 2021; 11:644645. [PMID: 34660255 PMCID: PMC8514816 DOI: 10.3389/fonc.2021.644645] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 09/13/2021] [Indexed: 12/20/2022] Open
Abstract
Objective To explore the influencing factors and cumulative risk of lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC) patients. Methods 607 patients confirmed PTMC pathologically after thyroidectomy were enrolled in this retrospective study. The rate of LNM was calculated. Different clinicopathological characteristics were compared in PTMC patients with and without LNM and in different subgroups of LNM, respectively. Correlation between clinicopathological characteristics and LNM was analyzed and the cumulative risk of LNM according to different clinicopathological characteristics was calculated. Results (1) There were 228 cases (37.56%) of PTMC combined with LNM. Compared with the non-lymph node metastasis group, the proportion of age <55 years, male, multiple foci, bilateral foci, diameter>0.5cm, extracapsular invasion, HT and intermediate-to-high risk stratification for recurrence of the LNM group was significantly increased (all p<0.05);(2) Multivariate logistic regression analysis showed that age <55years, male, multiple foci, diameter>0.5cm,HT were independently positively correlated with LNM (all p <0.05); (3) Subgroup analysis showed that women aged <55 years combined with HT and aged≥55 years combined with BMI≥25 kg/m2 were independently positively associated with LNM; (4) With the increase of the tumor diameter, the cumulative risk of LNM in group of age <55 years, males, and multiple foci increased gradually, and was higher than those of age≥55 years, females and single foci, respectively. (5) Among the 228 cases of LNM, the proportion of lymph nodes (LN) >5 and the positive rate of LN were both higher in male group than that in the female group. The proportion of multiple foci and HT in LLNM group was higher than that in CLNM group (all P<0.05). Conclusion Age <55 years, males, multiple foci, diameter >0.5cm and HT were independent risk factors of LNM; HT was an independent risk factor for LNM in female <55 years old, and BMI≥25 kg/m2 was an independent risk factor for LNM in female ≥55 years old; The increase of tumor diameter in age <55 years, males, multiple foci, and bilateral foci increased the cumulative risk of LNM, respectively; The number of LNM and the positive rate of LNM were both higher in male, and patients with multiple foci or HT were more likely to develop into LLNM.
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Affiliation(s)
- Yirong Yin
- Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiang Xu
- International Medical Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liyan Shen
- Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Wenjuan Zhao
- Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hongcui Diao
- Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Chengqian Li
- Department of Endocrine and Metabolic Diseases, The Affiliated Hospital of Qingdao University, Qingdao, China
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