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Guo H, Cheng L, Duolikun D, Yao Q. Aerobic Exercise Training Under Normobaric Hypoxic Conditions to Improve Glucose and Lipid Metabolism in Overweight and Obese Individuals: A Systematic Review and Meta-Analysis. High Alt Med Biol 2023; 24:312-320. [PMID: 38127802 DOI: 10.1089/ham.2022.0099] [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] [Indexed: 12/23/2023] Open
Abstract
Guo, Hai, Linjie Cheng, Dilihumaier Duolikun, and Qiaoling Yao. Aerobic exercise training under normobaric hypoxic conditions to improve glucose and lipid metabolism in overweight and obese individuals: a systematic review and meta-analysis. High Alt Med Biol. 24:312-320, 2023. Background: Obesity is a critical public health issue around the world, reaching epidemic proportions in some countries. However, only a few studies have examined the effects of hypoxic training on metabolic parameters in an obese population. This systematic review and meta-analysis aimed to determine the effects of aerobic exercise training under normobaric hypoxic conditions versus normoxic training in improving glucose and lipid metabolism in obese individuals. Methods: A systematic search of PubMed, EMBASE, Web of Science, and Wan Fang databases (up to August 2021) was performed to identify randomized controlled trials (RCTs) of overweight or obese human subjects eligible for inclusion. Main study endpoints were changes in body mass index (BMI), waist/hip (W/H) ratio, leptin, blood glucose and insulin levels, as well as blood lipids between hypoxic and normoxic conditioning. Results: Fourteen RCTs with a total of 413 subjects qualified for inclusion. Pooled analyses revealed that BMI (d = 0.38), W/H ratio (d = 0), blood glucose (d = 0.01), and triglyceride (d = -2.27) were not significantly different between aerobic exercise training under hypoxic and normoxic conditions. However, significant differences were found in heart rate at rest (d = -4.50) between aerobic exercise training under hypoxic versus normoxic conditions. Conclusions: In conclusion, no significant benefits were noted in aerobic exercise training under hypoxic conditions over normoxic conditions in overweight or obese individuals. However, the maximum training heart rate mm was significantly higher under hypoxic conditions than under normoxic conditions. Future studies with larger samples controlling for exercise-related parameters, and addressing the potential modifying effects of level of hypoxia, sex, or age on the role of hypoxic exercise training are warranted. PROSPERO registration number: CRD42020221680.
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Affiliation(s)
- Hai Guo
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
- Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
- Xinjiang Perioperative Organ Protection Laboratory, Urumqi, China
| | - Linjie Cheng
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Dilihumaier Duolikun
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
| | - Qiaoling Yao
- Department of Physiology, School of Basic Medical Sciences, Xinjiang Medical University, Urumqi, China
- Xinjiang Key Laboratory of Molecular Biology for Endemic Diseases, Urumqi, China
- State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, 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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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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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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Ahmadi S, Pappa T, Kang AS, Coleman AK, Landa I, Marqusee E, Kim M, Angell TE, Alexander EK. Point of Care Measurement of Body Mass Index and Thyroid Nodule Malignancy Risk Assessment. Front Endocrinol (Lausanne) 2022; 13:824226. [PMID: 35222281 PMCID: PMC8873520 DOI: 10.3389/fendo.2022.824226] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Large scale epidemiology studies have suggested obesity may increase the risk of thyroid cancer, though no prospective analyses using real-world measurement of BMI at a time proximate to initial thyroid nodule evaluation have been performed. METHODS We performed a prospective, cohort analysis over 3 years of consecutive patients presenting for thyroid nodule evaluation. We measured BMI proximate to the time of initial evaluation and correlated this with the final diagnosis of benign or malignant disease. We further correlated patient BMI with aggressivity of thyroid cancer, if detected. RESULTS Among 1,259 consecutive patients with clinically relevant nodules, 199(15%) were malignant. BMI averaged 28.6 kg/m2 (SD: 6.35, range:16.46-59.26). There was no correlation between the measurement of BMI and risk of thyroid cancer (p=0.58) as mean BMI was 28.9 kg/m2 and 28.6 kg/m2 in cancerous and benign cohorts, respectively. Similarly, BMI did not predict aggressive thyroid cancer (p=0.15). While overall nodule size was associated with increased BMI (p<0.01), these data require further validation as obesity may hinder nodule detection until large. CONCLUSION In contrast to findings published from large scale association studies drawn from national databases, these prospective data of consecutive patients presenting for nodule evaluation detect no association of obesity (as measured by BMI) with thyroid cancer. Real time measurement of BMI at the time of thyroid nodule evaluation does not contribute to cancer risk assessment.
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Affiliation(s)
- Sara Ahmadi
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
- *Correspondence: Sara Ahmadi,
| | - Theodora Pappa
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Alex S. Kang
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Alexandra K. Coleman
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Iñigo Landa
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Ellen Marqusee
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Matthew Kim
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
| | - Trevor E. Angell
- Department of Medicine, Division of Endocrinology and Diabetes, Keck School Medicine of USC, Los Angeles, CA, United States
| | - Erik K. Alexander
- Thyroid Section, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, United States
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