TY - JOUR
T1 - The role of metabolic setting in predicting the risk of early tumour relapse of differentiated thyroid cancer (DTC)
AU - Mele, Chiara
AU - Caputo, Marina
AU - Samà, Maria Teresa
AU - Bullara, Valentina
AU - Mauri, Maria Grazia
AU - Prodam, Flavia
AU - Aimaretti, Gianluca
AU - Pagano, Loredana
AU - Marzullo, Paolo
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85086166565&partnerID=8YFLogxK
U2 - 10.1038/s41430-020-0671-y
DO - 10.1038/s41430-020-0671-y
M3 - Article
SN - 0954-3007
VL - 74
SP - 1038
EP - 1046
JO - European Journal of Clinical Nutrition
JF - European Journal of Clinical Nutrition
IS - 7
ER -