The role of metabolic setting in predicting the risk of early tumour relapse of differentiated thyroid cancer (DTC).

Autor: Mele C; Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy. chiara.mele1989@gmail.com.; Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, Verbania, Italy. chiara.mele1989@gmail.com., Caputo M; Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Samà MT; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Bullara V; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Mauri MG; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Prodam F; Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Aimaretti G; Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.; Division of Endocrinology, University Hospital 'Maggiore della Carità', Novara, Italy., Pagano L; Division of Endocrinology, Diabetology and Metabolism, Department of Medical Sciences, University of Turin, Turin, Italy., Marzullo P; Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy.; Division of General Medicine, S. Giuseppe Hospital, I.R.C.C.S. Istituto Auxologico Italiano, Verbania, Italy.
Jazyk: angličtina
Zdroj: European journal of clinical nutrition [Eur J Clin Nutr] 2020 Jul; Vol. 74 (7), pp. 1038-1046. Date of Electronic Publication: 2020 Jun 09.
DOI: 10.1038/s41430-020-0671-y
Abstrakt: Background: The role of insulin resistance and adipocytokines in determining the phenotype and recurrence of differentiated thyroid cancer (DTC) is still unknown. In a previous study, we observed an association between metabolic setting, circulating adipocytokines and thyroid cancer phenotype. The aim of this study was to evaluate the clinical follow-up of patients with DTC and the predictive role of metabolic setting on the risk of tumour relapse.
Methods: Between September 2016 and January 2017, 57 patients were admitted to our institution to undergo total thyroidectomy because of suspected DTC. Thirty patients with post-surgical histological diagnosis of DTC were included in the study. Each subject underwent pre-surgical analysis of anthropometric parameters, thyroid function and autoimmunity, glucose metabolism, insulin resistance (HOMA-IR) and levels of unacylated and acylated ghrelin, obestatin, leptin and adiponectin. Tumour recurrence at 1 and 3 years from diagnosis was assessed.
Results: Most patients were females (21F, 9M) with a median age at diagnosis of 50.0 (41.0-58.8). At baseline, overweight was found in 7 patients and obesity in 6 cases. Insulin resistance was detected in 14 patients. Overall, 17 patients (56.7%) underwent radioiodine treatment after surgery. During the follow-up, we observed a persistent biochemical disease in one patient whereas tumour relapse was found in six patients at 1 year from diagnosis (lymph node metastases) and in one patient at 3 years from diagnosis (lung metastases). Independently from age, sex, stage of disease and the presence of lymph node metastasis at diagnosis, higher BMI, leptin and insulin levels as well as HOMA-IR were associated with a higher risk of tumour relapse (p < 0.05 for all).
Conclusions: Our results highlight a possible role for BMI, leptin and insulin resistance as predictors of early DTC relapse.
Databáze: MEDLINE
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