Araştırma Makalesi
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Benign nodüler ve malign tiroid hastalıklarında metabolik sendrom ve bileşenlerinin değerlendirilmesi.

Yıl 2019, Cilt: 12 Sayı: 3, 423 - 431, 30.09.2019
https://doi.org/10.31362/patd.558418

Öz

Amaç:
Metabolik Sendrom (MetS) insülin direncinin belirgin rol oynadığı ve metabolik
anormalliklerin kümelendiği bir tablodur. Bu çalışmanın amacı benign ve malign
nodüler tiroid hastalığı olanlarda metabolik sendrom ve bileşenlerini
değerlendirmektir.

Gereç
ve yöntem:
Dörtyüzotuz ötiroid benign nodüler ve 370 ötiroid malign
nodüler tiroid hastalığı olan toplam 800 hasta metabolik sendrom ve bileşenleri
yönünden incelendi. MetS parametrelerinin yanı sıra insülin düzeyleri ve
homeostasis model assessment- IR (HOMA-IR) ile hesaplanan İD seviyeleri
değerlendirildi.

Bulgular:
Çalışmaya alınan 800 hastanın %59,8’inde metabolik sendrom saptandı. Benign ve
malign nodüler tiroid hastalığı olan gruplar arasında metabolik sendrom sıklığı
açısından anlamlı fark saptanmadı (benign nodüler grupta % 61,4, malign nodüler
grupta % 57,8, p>0,05). Metabolik sendrom bileşenleri incelendiğinde en çok
yüksek bel çevresi değeri (%65), ikinci sıklıkta düşük HDL kolesterol düzeyi
(%64,8) ve en az da yüksek kan şekeri değeri (%30,8) olduğu saptandı. Benign ve
malign nodüler tiroid hastaları ayrı ayrı incelendiklerinde ise benign grubun
MetS bileşen dağılımı genel ortalama ile benzer sıklıkta olup, malign grubun
MetS bileşen dağılımında en sık düşük HDL kolesterol düzeyi (%71,9), en az ise
kan basıncı yüksekliği (%26,2) olduğu bulundu. Benign ve malign nodüler tiroid
hastaları arasında insülin düzeyleri ve insülin direnci açısından anlamlı fark
saptanmadı.

Sonuç:
Sonuçlar nodüler tiroid patolojisi olan hastaların, nodüler tiroid hastalığı olmayanlara
göre anlamlı olarak artmış metabolik sendrom prevalansına sahip olduklarını
göstermektedir. Ancak benign ve malign noduler gruplar arasında MetS bileşen
dağılımı açısından fark saptanmamıştır.

Kaynakça

  • Referans 1: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285:2486-2497
  • Referans 2: Vella V, Sciacca L, Pandini G, et al. The IGF system in thyroid cancer: new concepts. Mol Pathol. 2001;54:121–124
  • Referans 3: Arcidiacono B, Iiritano S, Nocera A,et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012;2012:7891
  • Referans 4: Rezzonico J, Rezzonico M, Pusiol E, et al. Introducing the thyroid gland as another victim of the insulin resistance syndrome. Thyroid 2008;18(4):461–464
  • Referans 5:Ayturk S, Gursoy A, Kut A, et al. Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area. Eur J Endocrinol 2009 Oct; 161(4):599-605
  • Referans 6: Rezzonico JN, Rezzónico M, Pusiol E, et al. Increased Prevalence of Insulin Resistance in Patients with Differentiated Thyroid Carcinoma. Metab Syndr Relat Disord. 2009;7:375-380
  • Referans 7:Gursoy A. Rising thyroid cancer incidence in the world might be related to insulin resistance. Medical Hypotheses.2010;74:35-36
  • Referans 8:Pitoia F, Abelleira E, Bueno F, Urciuoli C, Schmidt A, Niepomniszcze H. Insulin resistance is another factor that increases the risk of recurrence in patients with thyroid cancer. Endocrine 2015Apr;48(3):894-901
  • Referans 9:Balkan F, Onal ED, Usluogullari A, et al. "Is there any association between insulin resistance and thyroid cancer? : A case control study". Endocrine 2014 Feb; 45(1):55-60
  • Referans 10: Park HT, Cho GJ, Ahn KH, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas 2009;62:301–305
  • Referans 11:Roos A, Bakker SJ, Links TP, et al. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab 2007;92:491–496
  • Referans 12: Feng S, Zhang Z, Xu S, et al. The Prevalence of Thyroid Nodules and Their Association with Metabolic Syndrome Risk Factors in a Moderate Iodine Intake Area. Metab Syndr Relat Disord 2017 Mar;15(2):93-97
  • Referans 13: Almquist M, Johansen D, Björge T, et al. Metabolic factors and risk of thyroid cancer in the Metabolic syndrome and Cancer project (Me-Can). Cancer Causes Control 2011 May; 22(5):743-51
  • Referans 14: Blanc E, Ponce C, Brodschi D, et al. Association between worse metabolic control and increased thyroid volume and nodular disease in elderly adults with metabolic syndrome. Metab Syndr Relat Disord 2015 Jun;3(5):221-6
  • Referans 15: American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009 Nov; 19(11):1167-214
  • Referans 16: Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419
  • Referans 17: Kozan O, Oguz A, Abaci A, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007 Apr; 61(4):548-53
  • Referans 18: Edge SB, Byrd DR, Compton CC, et al. AJCC cancer staging manual (7th ed). New York, NY: Springer; 2010
  • Referans 19: Ozsahin AK, Gokcel A, Sezgin N, et al. Prevalence of the metabolic syndrome in a Turkish adult population. Diabet Nutr Metab. 2004;17:230–234
  • Referans 20: Santisteban P, Acebrón A, Polycarpou-Schwarz M, et al. Insulin and insulin-like growth factor I regulate a thyroid-specific nuclear protein that binds to the thyroglobulin promoter. Mol Endocrinol 1992; 6(8):1310–7
  • Referans 21: Tode B, Serio M, Rotella CM, et al. Insulin-like growth factor-I: autocrine secretion by human thyroid follicular cells in primary culture. J Clin Endocrinol Metab 1989; 69:639–647
  • Referans 22: Namba H, Nakashima M, Hayashi T, et al. Clinical implication of hot spot BRAF mutation, V599E, in papillary thyroid cancers. J Clin Endocrinol Metab 2003; 88:4393–4397
  • Referans 23: Kimura ET, Nikiforova MN, Zhu Z, et al. High prevalence of BRAF mutations in thyroid cancer: genetic evidence for constitutive activation of the RET/PTC-RAS-BRAF signaling pathway in papillary thyroid carcinoma. Cancer Res 2003;63:1454–1457
  • Referans 24: Maccario M, Tassone F, Grottoli S, et al. Neuroendocrine and metabolic determinants of the adaptation of GH/IGF-I axis to obesity. Ann Endocrinol (Paris) 2002;63(2 pt 1):140–144
  • Referans 25: Yu H, Rohan T. Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 2000; 92:1472–1489
  • Referans 26: Rendina D1, De Filippo G, Mossetti G, et al. Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. J Endocrinol Invest. 2012Apr; 35(4):407-12
  • Referans 27: Giusti M, Mortara L,Degrandi R, Cecoli F, et al. Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study. Thyroid Research 2008;1:2
  • Referans 28: Sanisoglu SY, Oktenli C, Hasimi A, et al. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006; 6:92
  • Referans 29: Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287:356–359
  • Referans 30: Ramachandran A, Snehalatha C, Satyavani K, et al. Metabolic syndrome in urban Asian Indian adults – a population study using modified ATP III criteria. Diabet Res Clin Pract 2003;60:199–204
  • Referans 31: Gupta R, Deedwania PC, Gupta A, et al. Prevalence of metabolic syndrome in an Indian urban population. Int J Cardiol 2004;97:257–261
  • Referans 32: Kim ES, Han SM, Kim YI, et al. Prevalence and clinical characteristics of metabolic syndrome in a rural population of South Korea. Diabet Med 2004; 21:1141–1143
  • Referans 33: Chuang SY, Chen CH, Chou P. Prevalence of metabolic syndrome in a large health check-up population in Taiwan. J Chin Med Assoc 2004;67:611–620
  • Referans 34: Duc Son LNT, Kunii D, Hung NT, et al. The metabolic syndrome: prevalence and risk factors in the urban population of Ho Chi Minh City. Diabet Res Clin Pract 2005; 67:243–250
  • Referans 35 :Enkhmaaa B, Shiwakua K, Anuurada E, et al. Prevalence of the metabolic syndrome using the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and the modified ATP III definitions for Japanese and Mongolians. Clin Chim Acta 2005;352:105–113
  • 36. Soysal A, Demiral Y, Soysal D,et al. The prevalence of metabolic syndrome among young adults in İzmir, Turkey. Anadolu Kardiyoloji Dergisi 2005;5:196-201

The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.

Yıl 2019, Cilt: 12 Sayı: 3, 423 - 431, 30.09.2019
https://doi.org/10.31362/patd.558418

Öz

Purpose: Metabolic syndrome (MetS) is
a condition harboring a group of metabolic abnormalitieswhere
insulin resistance (IR) plays a major role. The aim of our study is to evaluate
MetS and its components in patients with benign and malignant nodular thyroid
disease (NTD).

Materials and methods: A
total of 800 patients (430 euthyroid benign nodular and 370 euthyroid malignant
NTD) were analyzed for MetS and its components. Serum insulin levels and IR estimated
by homeostasis model assessment (HOMA-IR), as well as other MetS parameters
were evaluated.

Results: Metabolic syndrome was
detected in 59.8% of 800 patients. There was no significant difference between
benign and malignant NTD groups related to the prevalence of the MetS (61.4% in
benign nodular group, 57.8% in malignant nodular group, p>0.05). The most common MetS component was abdominal obesity
(65%), followed by low HDL-C level (64.8%), and high blood glucose level
(30.8%). When patients with benign and malignant NTD were evaluated separately,
the occurrence of the MetS components were found in similar frequency in the
benign group compared to the overall average. In the malignant group, it was
determined that low HDL-C level was the most common and high blood pressure was
the least common component. There was no significant difference between benign
and malignant NTD groups in terms of insulin levels and HOMA-IR.

Conclusions: The results suggest
that patients with NTD have significantly increased MetS prevalence compared to
patients without NTD. However, there was no significant difference between
benign and malignant NTD in this respect.

Kaynakça

  • Referans 1: Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001; 285:2486-2497
  • Referans 2: Vella V, Sciacca L, Pandini G, et al. The IGF system in thyroid cancer: new concepts. Mol Pathol. 2001;54:121–124
  • Referans 3: Arcidiacono B, Iiritano S, Nocera A,et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res 2012;2012:7891
  • Referans 4: Rezzonico J, Rezzonico M, Pusiol E, et al. Introducing the thyroid gland as another victim of the insulin resistance syndrome. Thyroid 2008;18(4):461–464
  • Referans 5:Ayturk S, Gursoy A, Kut A, et al. Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area. Eur J Endocrinol 2009 Oct; 161(4):599-605
  • Referans 6: Rezzonico JN, Rezzónico M, Pusiol E, et al. Increased Prevalence of Insulin Resistance in Patients with Differentiated Thyroid Carcinoma. Metab Syndr Relat Disord. 2009;7:375-380
  • Referans 7:Gursoy A. Rising thyroid cancer incidence in the world might be related to insulin resistance. Medical Hypotheses.2010;74:35-36
  • Referans 8:Pitoia F, Abelleira E, Bueno F, Urciuoli C, Schmidt A, Niepomniszcze H. Insulin resistance is another factor that increases the risk of recurrence in patients with thyroid cancer. Endocrine 2015Apr;48(3):894-901
  • Referans 9:Balkan F, Onal ED, Usluogullari A, et al. "Is there any association between insulin resistance and thyroid cancer? : A case control study". Endocrine 2014 Feb; 45(1):55-60
  • Referans 10: Park HT, Cho GJ, Ahn KH, et al. Thyroid stimulating hormone is associated with metabolic syndrome in euthyroid postmenopausal women. Maturitas 2009;62:301–305
  • Referans 11:Roos A, Bakker SJ, Links TP, et al. Thyroid function is associated with components of the metabolic syndrome in euthyroid subjects. J Clin Endocrinol Metab 2007;92:491–496
  • Referans 12: Feng S, Zhang Z, Xu S, et al. The Prevalence of Thyroid Nodules and Their Association with Metabolic Syndrome Risk Factors in a Moderate Iodine Intake Area. Metab Syndr Relat Disord 2017 Mar;15(2):93-97
  • Referans 13: Almquist M, Johansen D, Björge T, et al. Metabolic factors and risk of thyroid cancer in the Metabolic syndrome and Cancer project (Me-Can). Cancer Causes Control 2011 May; 22(5):743-51
  • Referans 14: Blanc E, Ponce C, Brodschi D, et al. Association between worse metabolic control and increased thyroid volume and nodular disease in elderly adults with metabolic syndrome. Metab Syndr Relat Disord 2015 Jun;3(5):221-6
  • Referans 15: American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL, McIver B, Pacini F, Schlumberger M, Sherman SI, Steward DL, Tuttle RM. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009 Nov; 19(11):1167-214
  • Referans 16: Matthews DR, Hosker JP, Rudenski AS, et al. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28:412-419
  • Referans 17: Kozan O, Oguz A, Abaci A, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007 Apr; 61(4):548-53
  • Referans 18: Edge SB, Byrd DR, Compton CC, et al. AJCC cancer staging manual (7th ed). New York, NY: Springer; 2010
  • Referans 19: Ozsahin AK, Gokcel A, Sezgin N, et al. Prevalence of the metabolic syndrome in a Turkish adult population. Diabet Nutr Metab. 2004;17:230–234
  • Referans 20: Santisteban P, Acebrón A, Polycarpou-Schwarz M, et al. Insulin and insulin-like growth factor I regulate a thyroid-specific nuclear protein that binds to the thyroglobulin promoter. Mol Endocrinol 1992; 6(8):1310–7
  • Referans 21: Tode B, Serio M, Rotella CM, et al. Insulin-like growth factor-I: autocrine secretion by human thyroid follicular cells in primary culture. J Clin Endocrinol Metab 1989; 69:639–647
  • Referans 22: Namba H, Nakashima M, Hayashi T, et al. Clinical implication of hot spot BRAF mutation, V599E, in papillary thyroid cancers. J Clin Endocrinol Metab 2003; 88:4393–4397
  • Referans 23: Kimura ET, Nikiforova MN, Zhu Z, et al. High prevalence of BRAF mutations in thyroid cancer: genetic evidence for constitutive activation of the RET/PTC-RAS-BRAF signaling pathway in papillary thyroid carcinoma. Cancer Res 2003;63:1454–1457
  • Referans 24: Maccario M, Tassone F, Grottoli S, et al. Neuroendocrine and metabolic determinants of the adaptation of GH/IGF-I axis to obesity. Ann Endocrinol (Paris) 2002;63(2 pt 1):140–144
  • Referans 25: Yu H, Rohan T. Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer Inst 2000; 92:1472–1489
  • Referans 26: Rendina D1, De Filippo G, Mossetti G, et al. Relationship between metabolic syndrome and multinodular non-toxic goiter in an inpatient population from a geographic area with moderate iodine deficiency. J Endocrinol Invest. 2012Apr; 35(4):407-12
  • Referans 27: Giusti M, Mortara L,Degrandi R, Cecoli F, et al. Metabolic and cardiovascular risk in patients with a history of differentiated thyroid carcinoma: A case-controlled cohort study. Thyroid Research 2008;1:2
  • Referans 28: Sanisoglu SY, Oktenli C, Hasimi A, et al. Prevalence of metabolic syndrome-related disorders in a large adult population in Turkey. BMC Public Health 2006; 6:92
  • Referans 29: Ford ES, Giles WH, Dietz WH. Prevalence of the metabolic syndrome among US adults: Findings from the third National Health and Nutrition Examination Survey. JAMA 2002; 287:356–359
  • Referans 30: Ramachandran A, Snehalatha C, Satyavani K, et al. Metabolic syndrome in urban Asian Indian adults – a population study using modified ATP III criteria. Diabet Res Clin Pract 2003;60:199–204
  • Referans 31: Gupta R, Deedwania PC, Gupta A, et al. Prevalence of metabolic syndrome in an Indian urban population. Int J Cardiol 2004;97:257–261
  • Referans 32: Kim ES, Han SM, Kim YI, et al. Prevalence and clinical characteristics of metabolic syndrome in a rural population of South Korea. Diabet Med 2004; 21:1141–1143
  • Referans 33: Chuang SY, Chen CH, Chou P. Prevalence of metabolic syndrome in a large health check-up population in Taiwan. J Chin Med Assoc 2004;67:611–620
  • Referans 34: Duc Son LNT, Kunii D, Hung NT, et al. The metabolic syndrome: prevalence and risk factors in the urban population of Ho Chi Minh City. Diabet Res Clin Pract 2005; 67:243–250
  • Referans 35 :Enkhmaaa B, Shiwakua K, Anuurada E, et al. Prevalence of the metabolic syndrome using the Third Report of the National Cholesterol Educational Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) and the modified ATP III definitions for Japanese and Mongolians. Clin Chim Acta 2005;352:105–113
  • 36. Soysal A, Demiral Y, Soysal D,et al. The prevalence of metabolic syndrome among young adults in İzmir, Turkey. Anadolu Kardiyoloji Dergisi 2005;5:196-201
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Endokrinoloji
Bölüm Araştırma Makalesi
Yazarlar

Sevinc Can 0000-0001-5921-8029

Cuneyd Anıl 0000-0003-3802-9733

Asli Nar 0000-0003-0998-8388

Alptekin Gursoy Bu kişi benim 0000-0002-0494-9200

Yayımlanma Tarihi 30 Eylül 2019
Gönderilme Tarihi 26 Nisan 2019
Kabul Tarihi 30 Temmuz 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 12 Sayı: 3

Kaynak Göster

AMA Can S, Anıl C, Nar A, Gursoy A. The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases. Pam Tıp Derg. Eylül 2019;12(3):423-431. doi:10.31362/patd.558418
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