Rezzónico Jorge N, Rezzónico Mariana, Pusiol Eduardo, Pitoia Fabian, Niepomniszcze Hugo
Centro Privado de Endocrinología, Mendoza, Argentina.
Metab Syndr Relat Disord. 2009 Aug;7(4):375-80. doi: 10.1089/met.2008.0062.
Patients with insulin resistance (IR) have a higher prevalence of thyroid nodules. In the present study, we present original data showing that patients with differentiated thyroid carcinoma (DTC) also have a higher frequency of IR.
Twenty women with DTC (group 1, G1) and 20 euthyroid individuals (control group, CG) were investigated for IR. G1 and CG subjects were matched in pairs by age, gender, and body mass index (BMI). The diagnosis of IR was made when the homeostasis model assesment of insulin resistance (HOMA-IR) index was higher than 2.5. According to the BMI, 20 women (10 with DTC and 10 of the CG) had a BMI < 25, whereas the other 20 had higher BMI values (overweight and obese patients).
IR was present in the 50% of G1, but only in the 10% of the CG (P < 0.001). In the groups with lower BMI (<25), we found IR in 30% of G1 and no cases in the CG, whereas in those with BMI > 25 the IR was present in 70% of G1 and 20% of CG. There were no differences between the two subgroups regarding the time in which the IR tests were performed. IR was present in 56.3% of patient with papillary anol 25% of follicular thyroid carcinomas, respectively.
We conclude that such a high prevalence of IR would be an important risk factor for developing DTC, as it is well known with some other nonthyroid carcinomas.
胰岛素抵抗（IR）患者甲状腺结节的患病率较高。在本研究中，我们提供的原始数据表明，分化型甲状腺癌（DTC）患者中IR的发生率也较高。
对20例DTC女性患者（第1组，G1）和20例甲状腺功能正常的个体（对照组，CG）进行IR调查。G1组和CG组受试者按年龄、性别和体重指数（BMI）进行配对。当胰岛素抵抗稳态模型评估（HOMA-IR）指数高于2.5时，诊断为IR。根据BMI，20名女性（10名DTC患者和10名CG组患者）BMI<25，而另外20名女性BMI值较高（超重和肥胖患者）。
G1组中50%存在IR，而CG组中仅10%存在IR（P<0.001）。在BMI较低（<25）的组中，我们发现G1组中有30%存在IR，而CG组中无病例；而在BMI>25的组中，G1组中有70%存在IR，CG组中有20%存在IR。两个亚组在进行IR检测的时间方面没有差异。乳头状癌患者中IR的发生率为56.3%，滤泡状甲状腺癌患者中IR的发生率为25%。
我们得出结论，IR的如此高患病率将是发生DTC的一个重要危险因素，这与其他一些非甲状腺癌一样是众所周知的。
