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Erschienen in: Medical Oncology 2/2013

01.06.2013 | Original Paper

Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients

verfasst von: Mustafa Şahin, Bekir Uçan, Zeynep Giniş, Oya Topaloğlu, Aşkın Güngüneş, Nujen Çolak Bozkurt, Müyesser Sayki Arslan, İlknur Öztürk Ünsal, Esra Tutal Akkaymak, Taner Demirci, Melia Karaköse, Mustafa Çalışkan, Erman Çakal, Mustafa Özbek, Tuncay Delibaşı

Erschienen in: Medical Oncology | Ausgabe 2/2013

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Abstract

Both insulin resistance (IR) and vitamin D deficiency (VDD) are found to be associated with many cancer types. In this study, we evaluated the presence of IR and VDD in thyroid cancer patients based on controls. Total 344 papillary thyroid cancer and 116 controls were part of the study. Glucose, insulin, homeostasis model analysis-insulin resistance (HOMA-IR) (control group 2.12 ± 0.9 and patient group 3.6 ± 1.1; p < 0.0001), LDL were significantly high; HOMA-S and vitamin D3 levels (control group 19.11 ± 8 and patient group 17 ± 16; p = 0.004) were significantly low in the patient group. Vitamin D deficiency (64/108 in controls vs 166/235; p = 0.026) and insulin resistance (24/108; 115/235; p < 0.0001) were more frequent in papillary thyroid cancer patients. After regression analysis, tumor diameter showed significant association with log-HOMA-IR (B = 0.315; p = 0.017) and log-vitamin D3 (B = 0.207; p = 0.04). Vitamin D deficiency and insulin resistance frequencies show no difference between micro- and macropapillary thyroid cancers. Receiver operating characteristic curve shows the best cutoff point for tumor diameter showing that the presence of lymph node metastasis was 0.65 cm with 81.2 % sensitivity and 52 % specificity. Best cutoff point for the capsular invasion tumor diameter was 0.75 cm with 83.3 % sensitivity and 60.4 % specificity. No difference between follicular and classical type papillary thyroid carcinomas has been yet discovered. As a result, thyroid cancer patients are more insulin resistant and vitamin D3 deficient. Vitamin D3 levels and HOMA-IR index may affect tumor diameter. Tumor size that is lower than 1 cm (0.65–0.75 cm) may be related with capsular invasion and lymph node involvement.
Literatur
1.
Zurück zum Zitat Cooper DS, Doherty GM, Haugen BR, et al. Revised american thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.PubMedCrossRef Cooper DS, Doherty GM, Haugen BR, et al. Revised american thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.PubMedCrossRef
2.
Zurück zum Zitat Sahin M, Mciver B. Thyroid carcinoma. In: Hospital Physician, Endocrinology board review manual, vol. 3, part 3, 2001. p. 1–11. Sahin M, Mciver B. Thyroid carcinoma. In: Hospital Physician, Endocrinology board review manual, vol. 3, part 3, 2001. p. 1–11.
3.
Zurück zum Zitat Lang BH, Lo CY, Chan WF, Lam AK, Wan KY. Classical and follicular variant of papillary thyroid carcinoma: a comparative study on clinicopathologic features and long-term outcome. World J Surg. 2006;30(5):752–8.PubMedCrossRef Lang BH, Lo CY, Chan WF, Lam AK, Wan KY. Classical and follicular variant of papillary thyroid carcinoma: a comparative study on clinicopathologic features and long-term outcome. World J Surg. 2006;30(5):752–8.PubMedCrossRef
4.
Zurück zum Zitat Belfiore A, La Rosa GL, La Porta GA, et al. Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med. 1992;93:363–9.PubMedCrossRef Belfiore A, La Rosa GL, La Porta GA, et al. Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med. 1992;93:363–9.PubMedCrossRef
5.
Zurück zum Zitat Wolden-Kirk H, Gysemans C, Verstuyf A, Mathieu C. Extraskeletal effects of vitamin D. Endocrinol Metab Clin North Am. 2012;41(3):571–94.PubMedCrossRef Wolden-Kirk H, Gysemans C, Verstuyf A, Mathieu C. Extraskeletal effects of vitamin D. Endocrinol Metab Clin North Am. 2012;41(3):571–94.PubMedCrossRef
6.
Zurück zum Zitat lyer RL, Sirinvasin P, Joglekar M, Sikes RA, van Golen KL, Nohe A. Differential effects of vitamin D treatment on inflammatory and non-inflammatory breast cancer cell lines. Clin Exp Metastasis. 2012;29(8):971–9.CrossRef lyer RL, Sirinvasin P, Joglekar M, Sikes RA, van Golen KL, Nohe A. Differential effects of vitamin D treatment on inflammatory and non-inflammatory breast cancer cell lines. Clin Exp Metastasis. 2012;29(8):971–9.CrossRef
7.
Zurück zum Zitat Pálmer HG, Sánchez-Carbayo M, Ordóñez-Morán P, Larriba MJ, Cordón-Cardó C, Muñoz A. Genetic signatures of differentiation induced by 1alpha,25-dihydroxyvitamin D3 in human colon cancer cells. Cancer Res. 2003;63(22):7799–806.PubMed Pálmer HG, Sánchez-Carbayo M, Ordóñez-Morán P, Larriba MJ, Cordón-Cardó C, Muñoz A. Genetic signatures of differentiation induced by 1alpha,25-dihydroxyvitamin D3 in human colon cancer cells. Cancer Res. 2003;63(22):7799–806.PubMed
8.
Zurück zum Zitat Nemazannikova N, Antonas K, Dass CR. Vitamin D: metabolism, molecular mechanisms, and mutations to malignancies. Mol Carcinog. 2013. doi: 10.1002/mc.21999. Nemazannikova N, Antonas K, Dass CR. Vitamin D: metabolism, molecular mechanisms, and mutations to malignancies. Mol Carcinog. 2013. doi: 10.​1002/​mc.​21999.
9.
Zurück zum Zitat Laney N, Meza J, Lyden E, Erickson J, Treude K, Goldner W. The prevalence of vitamin D deficiency is similar between thyroid nodule and thyroid cancer patients. Int J Endocrinol. 2010;2010:805716.PubMed Laney N, Meza J, Lyden E, Erickson J, Treude K, Goldner W. The prevalence of vitamin D deficiency is similar between thyroid nodule and thyroid cancer patients. Int J Endocrinol. 2010;2010:805716.PubMed
10.
Zurück zum Zitat Stepien T, Krupinski R, Sopinski J, Kuzdak K, Komorowski J, Lawnicka H, Stepien H. Decreased 1–25 dihydroxyvitamin D3 concentration in peripheral blood serum of patients with thyroid cancer. Arch Med Res. 2010;41(3):190–4.PubMedCrossRef Stepien T, Krupinski R, Sopinski J, Kuzdak K, Komorowski J, Lawnicka H, Stepien H. Decreased 1–25 dihydroxyvitamin D3 concentration in peripheral blood serum of patients with thyroid cancer. Arch Med Res. 2010;41(3):190–4.PubMedCrossRef
11.
Zurück zum Zitat Pardanani A, Drake MT, Finke C, Lasho TL, Rozell SA, Jimma T, Tefferi A. Vitamin D insufficiency in myeloproliferative neoplasms and myelodysplastic syndromes: clinical correlates and prognostic studies. Am J Hematol. 2011;86(12):1013–6.PubMedCrossRef Pardanani A, Drake MT, Finke C, Lasho TL, Rozell SA, Jimma T, Tefferi A. Vitamin D insufficiency in myeloproliferative neoplasms and myelodysplastic syndromes: clinical correlates and prognostic studies. Am J Hematol. 2011;86(12):1013–6.PubMedCrossRef
12.
Zurück zum Zitat Sahin M, Taslipinar A, Kebapcilar L, Yilmaz H, Akgul OE, Beyhan Z, Ozgurtas T, Yaman H, Bolu E, Taslipinar MY, Delibasi T, Kutlu M. Low vitamin D3 levels in euthyroid hashimoto thyroiditis. Int Med J. 2012;19(4):317–320. Sahin M, Taslipinar A, Kebapcilar L, Yilmaz H, Akgul OE, Beyhan Z, Ozgurtas T, Yaman H, Bolu E, Taslipinar MY, Delibasi T, Kutlu M. Low vitamin D3 levels in euthyroid hashimoto thyroiditis. Int Med J. 2012;19(4):317–320.
13.
Zurück zum Zitat Bozkurt NC, Karbek B, Ucan B, Sahin M, Cakal E, Ozbek M, Delibasi T. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract. 2013;21:1–14.CrossRef Bozkurt NC, Karbek B, Ucan B, Sahin M, Cakal E, Ozbek M, Delibasi T. The association between severity of vitamin D deficiency and Hashimoto’s thyroiditis. Endocr Pract. 2013;21:1–14.CrossRef
14.
Zurück zum Zitat Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. High vitamin D status in younger individuals is associated with low circulating thyrotropin Thyroid. 2013;23(1):25–30. doi:10.1089/thy.2012.0001. Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B. High vitamin D status in younger individuals is associated with low circulating thyrotropin Thyroid. 2013;23(1):25–30. doi:10.​1089/​thy.​2012.​0001.
15.
Zurück zum Zitat Inoue M, Tsugane S. Insulin resistance and cancer: epidemiological evidence. Endocr Relat Cancer. 2012;19(5):F1–8.PubMedCrossRef Inoue M, Tsugane S. Insulin resistance and cancer: epidemiological evidence. Endocr Relat Cancer. 2012;19(5):F1–8.PubMedCrossRef
16.
Zurück zum Zitat Boyle P, Koechlin A, Pizot C, Boniol M, Robertson C, Mullie P, Bolli G, Rosenstock J, Autier P. Blood glucose concentrations and breast cancer risk in women without diabetes: a meta-analysis. Eur J Nutr. 2012. doi:10.1007/s00394-012-0460-z. Boyle P, Koechlin A, Pizot C, Boniol M, Robertson C, Mullie P, Bolli G, Rosenstock J, Autier P. Blood glucose concentrations and breast cancer risk in women without diabetes: a meta-analysis. Eur J Nutr. 2012. doi:10.​1007/​s00394-012-0460-z.
17.
Zurück zum Zitat Yasar HY, Ertuğrul O, Ertuğrul B, Ertuğrul D, Sahin M. Insulin resistance in nodular thyroid disease. Endocr Res. 2011;36(4):167–74.PubMedCrossRef Yasar HY, Ertuğrul O, Ertuğrul B, Ertuğrul D, Sahin M. Insulin resistance in nodular thyroid disease. Endocr Res. 2011;36(4):167–74.PubMedCrossRef
18.
Zurück zum Zitat Rezzónico JN, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord. 2009;7(4):375–80.PubMedCrossRef Rezzónico JN, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord. 2009;7(4):375–80.PubMedCrossRef
19.
Zurück zum Zitat Lippi G, Montagnana M, Targher G, Salvagno GL, Guidi GC. Prevalence of folic acid and vitamin B12 deficiencies in patients with thyroid disorders. Am J Med Sci. 2008;336(1):50–2.PubMedCrossRef Lippi G, Montagnana M, Targher G, Salvagno GL, Guidi GC. Prevalence of folic acid and vitamin B12 deficiencies in patients with thyroid disorders. Am J Med Sci. 2008;336(1):50–2.PubMedCrossRef
20.
Zurück zum Zitat Torréns JI, Burch HB. Serum thyroglobulin measurement. Utility in clinical practice. Endocrinol Metab Clin North Am. 2001;30(2):429–67.PubMedCrossRef Torréns JI, Burch HB. Serum thyroglobulin measurement. Utility in clinical practice. Endocrinol Metab Clin North Am. 2001;30(2):429–67.PubMedCrossRef
21.
Zurück zum Zitat Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998;21(12):2191–2.PubMedCrossRef Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998;21(12):2191–2.PubMedCrossRef
22.
Zurück zum Zitat Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, Baklaci N, Sengul A, Guvener N. High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care. 2003;26(11):3031–4.PubMedCrossRef Gokcel A, Ozsahin AK, Sezgin N, Karakose H, Ertorer ME, Akbaba M, Baklaci N, Sengul A, Guvener N. High prevalence of diabetes in Adana, a southern province of Turkey. Diabetes Care. 2003;26(11):3031–4.PubMedCrossRef
23.
Zurück zum Zitat Peehl DM, Krishnan AV, Feldman D. Pathways mediating the growth-inhibitory actions of vitamin D in prostate cancer. Pathways mediating the growth-inhibitory actions of vitamin D in prostate cancer. J Nutr. 2003;133(7 suppl):2461S–9S.PubMed Peehl DM, Krishnan AV, Feldman D. Pathways mediating the growth-inhibitory actions of vitamin D in prostate cancer. Pathways mediating the growth-inhibitory actions of vitamin D in prostate cancer. J Nutr. 2003;133(7 suppl):2461S–9S.PubMed
24.
Zurück zum Zitat Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, Pischon T, Jansen EH, Slimani N, Byrnes G, Rinaldi S, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Morois S, Kaaks R, Linseisen J, Boeing H, Bergmann MM, Trichopoulou A, Misirli G, Trichopoulos D, Berrino F, Vineis P, Panico S, Palli D, Tumino R, Ros MM, van Gils CH, Peeters PH, Brustad M, Lund E, Tormo MJ, Ardanaz E, Rodríguez L, Sánchez MJ, Dorronsoro M, Gonzalez CA, Hallmans G, Palmqvist R, Roddam A, Key TJ, Khaw KT, Autier P, Hainaut P, Riboli E. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ. 2010;21(340):b5500.CrossRef Jenab M, Bueno-de-Mesquita HB, Ferrari P, van Duijnhoven FJ, Norat T, Pischon T, Jansen EH, Slimani N, Byrnes G, Rinaldi S, Tjønneland A, Olsen A, Overvad K, Boutron-Ruault MC, Clavel-Chapelon F, Morois S, Kaaks R, Linseisen J, Boeing H, Bergmann MM, Trichopoulou A, Misirli G, Trichopoulos D, Berrino F, Vineis P, Panico S, Palli D, Tumino R, Ros MM, van Gils CH, Peeters PH, Brustad M, Lund E, Tormo MJ, Ardanaz E, Rodríguez L, Sánchez MJ, Dorronsoro M, Gonzalez CA, Hallmans G, Palmqvist R, Roddam A, Key TJ, Khaw KT, Autier P, Hainaut P, Riboli E. Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study. BMJ. 2010;21(340):b5500.CrossRef
25.
Zurück zum Zitat Boi F, Minerba L, Lai ML, Marziani B, Figus B, Spanu F, Borghero A, Mariotti S Both thyroid autoimmunity and increased TSH are independent risk factors for malignancy in patients with thyroid nodules. J Endocrinol Invest. 2012 Aug 29. [Epub ahead of print]. Boi F, Minerba L, Lai ML, Marziani B, Figus B, Spanu F, Borghero A, Mariotti S Both thyroid autoimmunity and increased TSH are independent risk factors for malignancy in patients with thyroid nodules. J Endocrinol Invest. 2012 Aug 29. [Epub ahead of print].
26.
Zurück zum Zitat Biondi B, Cooper DS. Benefits of thyrotropin suppression versus the risks of adverse effects in differentiated thyroid cancer. Thyroid. 2010;20(2):135–46.PubMedCrossRef Biondi B, Cooper DS. Benefits of thyrotropin suppression versus the risks of adverse effects in differentiated thyroid cancer. Thyroid. 2010;20(2):135–46.PubMedCrossRef
Metadaten
Titel
Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients
verfasst von
Mustafa Şahin
Bekir Uçan
Zeynep Giniş
Oya Topaloğlu
Aşkın Güngüneş
Nujen Çolak Bozkurt
Müyesser Sayki Arslan
İlknur Öztürk Ünsal
Esra Tutal Akkaymak
Taner Demirci
Melia Karaköse
Mustafa Çalışkan
Erman Çakal
Mustafa Özbek
Tuncay Delibaşı
Publikationsdatum
01.06.2013
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 2/2013
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-013-0589-5

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