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Hu Y, Xue C, Ren S, Dong L, Gao J, Li X. Association between vitamin D status and thyroid cancer: a meta-analysis. Front Nutr 2024; 11:1423305. [PMID: 38962442 PMCID: PMC11221265 DOI: 10.3389/fnut.2024.1423305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/31/2024] [Indexed: 07/05/2024] Open
Abstract
Background Cumulative evidence has suggested that vitamin D deficiency is related with an increased susceptibility to various types of cancers. However, the association between vitamin D and thyroid cancer (TC) has remained to be unknown. Thus, there has been an urgent need for a meta-analysis to summarize existing evidence on vitamin D levels and the risk of TC. Objective This meta-analysis aimed to figure out the association between vitamin D level and the risk of TC. Methods A systematic search was performed for eligible articles on the association between vitamin D and TC based on PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov. Outcomes were the vitamin D level of cases with TC and the incidence of vitamin D deficiency in cases with TC comparing with the controls. The effect measures included standardized mean difference (SMD), ratio of means (RoM), and odds ratio (OR). A dose-response meta-analysis was performed to assess the correlation between vitamin D level and the risk of TC. Subgroup analyses and meta-regressions were conducted to explore the source of heterogeneity. And publication bias was evaluated through Begg's and Egger's tests. Results Results of the meta-analysis revealed lower levels of vitamin D in TC cases comparing with those in control [SMD = -0.25, 95% CI: (-0.38, -0.12); RoM = 0.87, 95% CI: (0.81, 0.94)] and the levels of 1,25 (OH)D in cases with TC were also lower than controls [SMD = -0.49, 95% CI: (-0.80, -0.19); RoM = 0.90, 95% CI: (0.85, 0.96)]. And vitamin D deficiency was associated with the increased risk of TC [OR = 1.49, 95% CI: (1.23, 1.80)]. Additionally, results from the dose-response meta-analysis showed that there is a 6% increase in the risk of TC for each 10 ng/ml decrease in 25 (OH)D levels [OR = 0.94; 95% CI: (0.89, 0.99)]. Conclusions Individuals with TC had lower levels of vitamin D compared to controls, and vitamin D deficiency was correlated with an increase risk of TC. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=504417, identifier: CRD42024504417.
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Affiliation(s)
- Yue Hu
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Qi-Huang Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Chongxiang Xue
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
- Department of Integrative Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Shumeng Ren
- Qi-Huang Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lishuo Dong
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jiaqi Gao
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Guang'anmen Hospital, School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiuyang Li
- Institute of Metabolic Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Shao Y, Hu X, Wang Y, Shao Y, Li L, Zeng Q, Lai H, Sheng L. Association of serum 25-hydroxyvitamin D levels with aggressiveness of papillary thyroid cancer. Endocr Connect 2024; 13:e230373. [PMID: 37991208 PMCID: PMC10762552 DOI: 10.1530/ec-23-0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 11/22/2023] [Indexed: 11/23/2023]
Abstract
Objective Serum 25-hydroxyvitamin D (25(OH)D) deficiency has been known to be associated with the risk and mortality of several cancers. However, the role of 25(OH)D in papillary thyroid cancer (PTC) remains controversial. This study aimed to investigate the association between 25(OH)D and clinicopathologic features of PTC. Methods Patients who underwent thyroidectomy were retrospectively reviewed. Serum 25(OH)D levels were measured within a week prior to surgery. The patients were categorized into four quartiles according to season-specific 25(OH)D levels. The association between 25(OH)D levels and clinicopathologic features of PTC was analyzed. Results A total of 2932 patients were enrolled in the study. The 25(OH)D levels were significantly higher in patients with lymph node metastasis (LNM; P < 0.001), lateral LNM (P < 0.001), and multifocal tumors (P < 0.001). Compared to the first quartile (Q1) of 25(OH)D level, the third quartile (Q3) and the fourth quartile (Q4) showed an unadjusted OR of 1.36 (95% CI: 1.09-1.69; P = 0.006) and 1.76 (95% CI: 1.42-2.19; P < 0.001) for LNM (P for trend < 0.001), respectively. An increased risk of multifocal tumors was strongly associated with high 25(OH)D concentration (P for trend <0.001). Similar results were obtained after adjusting for confounding factors. Conclusion High 25(OH)D levels are associated with aggressive features of PTC, such as lymph node metastasis and multifocality.
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Affiliation(s)
- Yuting Shao
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Xiaole Hu
- Department of Operating Room, Qilu Hospital of Shandong University, Shandong, China
| | - Yuxi Wang
- Department of Breast and Thyroid Surgery, People’s Hospital of Mengyin County, Linyi, Shandong, China
| | - Yi Shao
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Luchuan Li
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Qingdong Zeng
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hong Lai
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Lei Sheng
- Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Aydogdu YF, Emreol U, Emre G, Buyukkasap C, Akin M. Determination of Diagnostic Features of Serum Thyroid Hormones and Thyroglobulin Ratios in Normothyroid Differentiated Thyroid Carcinoma Cases. SISLI ETFAL HASTANESI TIP BULTENI 2023; 57:257-262. [PMID: 37899801 PMCID: PMC10600635 DOI: 10.14744/semb.2023.77012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/02/2023] [Accepted: 06/02/2023] [Indexed: 10/31/2023]
Abstract
Objectives Ultrasonography and fine-needle aspiration biopsy (FNAB) are the gold standard methods in the prediction of benign and malignant thyroid nodules. However, despite being easily applicable, FNAB is an invasive procedure. Less invasive biomarkers should be utilized in the diagnosis of thyroid malignancies. In this study, we aimed to determine the parameters that can be used in the diagnosis of differentiated thyroid cancer (DTC) based on the serum thyroid and thyroglobulin (TG) levels which are routinely checked in patients followed up for thyroid nodules. Methods In the study, we evaluated patients who underwent thyroid surgery for nodular diseases between January 2015 and June 2022. Of the 1444 patients evaluated, 919 patients who met the inclusion criteria (normothyroid benign nodular disease or normothyroid DTC) were included in the study. Patients were divided into two groups as benign group (BG) and DTC group (DTCG). We compared patients' pre-operative serum thyroid and TG values and the diagnostic properties of their ratios. Results Of the 919 patients included, 517 (56.3%) were in BG and 402 (43.7%) were in DTCG. In DTCG, 318 patients were female and 84 patients were male. The mean age in the DTCG was 47.8 years. Comparison of DTCG and BG revealed a significant difference between T3/T4 ratio (p=0.002), T3/TSH ratio (p≤0.001), T4/TSH ratio (p≤0.001), TG/TSH ratio (p≤0.001), and TSH/TG ratio (p≤0.001). However, evaluation of the specified values by ROC analysis showed that the T3/T4 ratio did not make a significant difference between the two groups (p=0.1), whereas the other values displayed a significant difference (p≤0.001 for T3/TSH, p=0.001 for T4/TSH, p≤0.001 for TG/TSH, and p<0.001 for TSH/TG). Conclusion T3/TSH (cutoff =2.183), T4/TSH (cutoff=0.6), and TG/TSH (cutoff=29.67) values were found to be significant tumor markers for the prediction of malignancy in thyroid nodules, and low values were found to be associated with malignancy. TSH/TG (cutoff=0.031) value was also significant in predicting malignancy while high values were found to be associated with malignancy. Thyroid hormone and TG ratios may alter the preferred treatment method for thyroid nodules.
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Affiliation(s)
| | - Umut Emreol
- Department of General Surgery, Usak Training and Research Hospital, Usak, Türkiye
| | - Gulcek Emre
- Department of General Surgery, Polatli Duatepe State Hospital, Ankara, Türkiye
| | - Cagri Buyukkasap
- Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Türkiye
| | - Murat Akin
- Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Türkiye
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ARSLAN İE, HEPŞEN S, AKHANLI P, UCAN B, ÖZTÜRK ÜNSAL İ, ÇALAPKULU M, ÇAKAL E. The effect of serum 25-hydroxy vitamin D levels on malignancy in exophytic thyroid nodules. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1128198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: The increase in the incidence of thyroid cancer brings about research of new risk factors. In this study, we aimed to investigate the effect of vitamin D status on malignancy in exophytic nodules.
Material and Method: Two hundred and sixteen patients with exophytic thyroid nodules were included in the study. All patients’ thyroid nodule ultrasonographic features, fine needle aspiration biopsy cytology results, rate of surgery and surgery histopathological results were recorded. Vitamin D levels were analyzed and patients were divided into two groups as vitamin D sufficient groups (vitamin D≥20 ng/ml) and vitamin D deficient group (vitamin D<20 ng/ml).
Results: Malignancy rate was significantly higher in the vitamin D deficient group (%19 vs %8.7; p=0.03). There were no significant difference between two groups in terms of demographic characteristics and ultrasonographic features including diameter, hypoechoic nature, having irregular border and microcalcifications.
Conclusion: In exophytic nodules, vitamin D deficiency increases malignancy risk. Determining vitamin D levels may be useful in patients with exophytic nodules.
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Affiliation(s)
- İsmail Emre ARSLAN
- Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, Endokrinoloji ve Metabolizma Bölümü
| | - Sema HEPŞEN
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
| | - Pınar AKHANLI
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
| | - Bekir UCAN
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
| | - İlknur ÖZTÜRK ÜNSAL
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
| | - Murat ÇALAPKULU
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
| | - Erman ÇAKAL
- dışkapı yıldırım beyazıt training and research hospital, department of endocrinology and metabolism
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Palanca A, Ampudia-Blasco FJ, Real JT. The Controversial Role of Vitamin D in Thyroid Cancer Prevention. Nutrients 2022; 14:nu14132593. [PMID: 35807774 PMCID: PMC9268358 DOI: 10.3390/nu14132593] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/19/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
Thyroid cancer is the most common endocrine malignancy and exhibits rising incidence. Annual incidence varies by sex, age, and geographical location. It has been reported that impairment of vitamin D signalling promotes thyroid cancer progression. Recent studies have shown that vitamin D, a fat-soluble vitamin that acts as both a nutrient and a hormone, may have utility in the prevention of autoimmune thyroid-related diseases. However, the precise role of vitamin D in the pathobiology of thyroid cancer is controversial. Previous studies have suggested that elevated serum vitamin D levels have a protective role in thyroid cancer. However, there is also evidence demonstrating no inverse relationship between vitamin D levels and the occurrence of thyroid cancer. Furthermore, recent data provide evidence that circulating vitamin D concentration is inversely correlated with disease aggressiveness and poor prognosis, while evidence of an association with tumour initiation remains weak. Nevertheless, a variety of data support an anti-tumorigenic role of vitamin D and its potential utility as a secondary chemopreventive agent. In this review, we highlighted recent findings regarding the association of vitamin D status with the risk of thyroid cancer, prognosis, potential mechanisms, and possible utility as a chemopreventive agent.
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Affiliation(s)
- Ana Palanca
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Correspondence: (A.P.); (F.J.A.-B.); Tel.: +34-96-197-35-00 (A.P. & F.J.A.-B.)
| | - Francisco Javier Ampudia-Blasco
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), 46010 Valencia, Spain
- Correspondence: (A.P.); (F.J.A.-B.); Tel.: +34-96-197-35-00 (A.P. & F.J.A.-B.)
| | - José T. Real
- Endocrinology and Nutrition Department, Valencia University Clinic Hospital, 46010 Valencia, Spain;
- INCLIVA Biomedical Research Institute, 46010 Valencia, Spain
- CIBERDEM, CIBER Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain
- Department of Medicine, Medicine Faculty, University of Valencia (UV), 46010 Valencia, Spain
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