中国甲状腺功能正常的无影响胰岛素抵抗的情况下的人群中，胰岛素抵抗与甲状腺癌之间的关系。
Relationship between insulin resistance and thyroid cancer in Chinese euthyroid subjects without conditions affecting insulin resistance.
机构信息
Department of Endocrinology and Metabolism, The Second Hospital of Dalian Medical University, Dalian, 116027, P.R. China.
出版信息
BMC Endocr Disord. 2022 Mar 7;22(1):58. doi: 10.1186/s12902-022-00943-6.
BACKGROUNDS
In recent years, many studies have shown that insulin resistance is related to the occurrence of thyroid cancer, but there are few reports on whether the two are related under the premise that thyroid function is normal and the metabolic components related to insulin resistance are excluded. This study aims to analyze the insulin resistance of patients with differentiated thyroid cancer after excluding the population with abnormal metabolic components, and to study the risk factors of thyroid cancer in this population.
METHODS
61 subjects diagnosed with differentiated thyroid carcinoma (DTC) formed the DTC group and 262 subjects with benign nodules formed the control group. Body mass index (BMI, kg/m2), waist circumference (WC), lipid profiles, and free T3 (FT3), free T4 (FT4), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid globulin antibody (TGAb), alanine transaminase (ALT), aspartate aminotransferase (AST), fasting plasma glucose (FPG), fasting serum insulin and homeostatic model assessment of insulin resistance (HOMA-IR) levels were measured.
RESULTS
Mean subjects age (P = 0.021), BMI (P = 0.049), WC (P = 0.01), serum insulin concentration (P = 0.006), and HOMA-IR level (P = 0.005) were significantly greater in the DTC group than in the control group. Multivariate binary logistic regression analysis identified advanced age (OR = 1.027 [1.003-1.051], P = 0.029) and an increased HOMA-IR level (OR = 1.572 [1.277-1.935], P < 0.001) as significant risk factors for thyroid cancer.
CONCLUSIONS
IR may increase the risk of thyroid cancer development even in the absence of conditions affecting insulin resistance.
背景
近年来，许多研究表明胰岛素抵抗与甲状腺癌的发生有关，但在甲状腺功能正常且排除与胰岛素抵抗相关的代谢成分的情况下，关于两者之间的关系的报道较少。本研究旨在分析排除代谢成分异常人群后分化型甲状腺癌患者的胰岛素抵抗，并研究该人群中甲状腺癌的危险因素。
方法
61 例诊断为分化型甲状腺癌（DTC）的患者组成 DTC 组，262 例良性结节患者组成对照组。测量体重指数（BMI，kg/m2）、腰围（WC）、血脂谱、游离三碘甲状腺原氨酸（FT3）、游离甲状腺素（FT4）、促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TGAb）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）、空腹血糖（FPG）、空腹血清胰岛素和稳态模型评估的胰岛素抵抗（HOMA-IR）水平。
结果
DTC 组的平均年龄（P=0.021）、BMI（P=0.049）、WC（P=0.01）、血清胰岛素浓度（P=0.006）和 HOMA-IR 水平（P=0.005）均显著高于对照组。多变量二元逻辑回归分析确定年龄较大（OR=1.027[1.003-1.051]，P=0.029）和 HOMA-IR 水平升高（OR=1.572[1.277-1.935]，P<0.001）是甲状腺癌的显著危险因素。
结论
即使在不影响胰岛素抵抗的情况下，IR 也可能增加甲状腺癌发展的风险。
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