胰岛素抵抗:在甲状腺癌流行病学变化中起作用吗?
Insulin Resistance: Any Role in the Changing Epidemiology of Thyroid Cancer?
作者信息
Malaguarnera Roberta, Vella Veronica, Nicolosi Maria Luisa, Belfiore Antonino
机构信息
Endocrinology, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
School of Human and Social Sciences, "Kore" University of Enna, Enna, Italy.
出版信息
Front Endocrinol (Lausanne). 2017 Nov 14;8:314. doi: 10.3389/fendo.2017.00314. eCollection 2017.
In the past few decades, the incidence of thyroid cancer (TC), namely of its papillary hystotype (PTC), has shown a steady increase worldwide, which has been attributed at least in part to the increasing diagnosis of early stage tumors. However, some evidence suggests that environmental and lifestyle factors can also play a role. Among the potential risk factors involved in the changing epidemiology of TC, particular attention has been drawn to insulin-resistance and related metabolic disorders, such as obesity, type 2 diabetes, and metabolic syndrome, which have been also rapidly increasing worldwide due to widespread dietary and lifestyle changes. In accordance with this possibility, various epidemiological studies have indeed gathered substantial evidence that insulin resistance-related metabolic disorders might be associated with an increased TC risk either through hyperinsulinemia or by affecting other TC risk factors including iodine deficiency, elevated thyroid stimulating hormone, estrogen-dependent signaling, chronic autoimmune thyroiditis, and others. This review summarizes the current literature evaluating the relationship between metabolic disorders characterized by insulin resistance and the risk for TC as well as the possible underlying mechanisms. The potential implications of such association in TC prevention and therapy are discussed.
在过去几十年中,甲状腺癌(TC),尤其是其乳头状组织学类型(PTC)的发病率在全球范围内呈稳步上升趋势,这至少部分归因于早期肿瘤诊断率的提高。然而,一些证据表明环境和生活方式因素也可能起作用。在参与TC流行病学变化的潜在风险因素中,胰岛素抵抗及相关代谢紊乱,如肥胖、2型糖尿病和代谢综合征,由于广泛的饮食和生活方式改变在全球范围内也迅速增加,已引起特别关注。根据这种可能性,各种流行病学研究确实收集了大量证据,表明胰岛素抵抗相关的代谢紊乱可能通过高胰岛素血症或通过影响其他TC风险因素(包括碘缺乏、促甲状腺激素升高、雌激素依赖性信号传导、慢性自身免疫性甲状腺炎等)而与TC风险增加相关。本综述总结了当前评估以胰岛素抵抗为特征的代谢紊乱与TC风险之间关系以及可能潜在机制的文献。讨论了这种关联在TC预防和治疗中的潜在意义。
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