1. Department of Internal Medicine, Bilecik State Hospital, Merkez, Bilecik, Turkey
2. Department of Endocrinology and Metabolism Bilecik State Hospital, Merkez, Bilecik, Turkey
Citation : Cengizhan MS, Celik M. Insulin Resistance and Thyroid Cancer. Clin Res Diab Endocrinol 2018;1(1):1-2.
It is known that the cancer development process is multifactorial nowadays. The relationship between insulin and cancer has recently been gaining in importance. The number of studies between insulin resistance and thyroid cancer is very small, although the association between obesity, type 2 diabetes, and insulin resistance, particularly breast, colon, and pancreatic cancer development, is long. There are studies advocating increased growth factors with insulin resistance as well as triode cancer after thyroid angiogenesis. Insulin and insulin-like growth factors may be the primary causes of pathophysiology in many cancers, especially thyroid cancer, with mitogenic activity.
Obesity, which doubles in the last three decades, is the most common metabolic problem associated with insulin resistance . Cancer-related deaths that are 14% in men and 20% in women are linked to obesity. Insulin resistance has been shown in studies in which the proliferation of thyroid cells is stimulated to cause growth in the thyroid gland and thyroid nodules. When the relationship between insulin resistance and thyroid cancer is examined, there are four basic studies in the literature [Table 1]. Three of these studies showed a positive relationship between insulin resistance and thyroid cancer, but no relationship was found in one study.
Two adipokines that play a role in the cancer pathophysiology potentially associated with the best-known insulin resistance are leptin and adiponectin . Leptin functions mainly as an appetite regulator through specific membrane receptors. Leptin abnormal expression is associated with thyroid cancer and various malignant diseases [7,8]. Adiponectin is an adipocyte that is negatively associated with insulin resistance . There are a number of studies showing a strong association between serum thyroid-stimulated hormone (TSH) levels and thyroid cancer development in thyroid cancer formation. The mitogenic effect of TSH on human thyroids is thought to be enhanced by insulin and insulin-like growth factors [9,10].
In animal studies, it has been argued that chronic hyperinsulinemia plays an important role in the development of cancer in male mice overexpressing insulin-like growth factor 1 receptors [11,12]. In a recent study, he suggested that insulin resistance may increase the growth of thyroid nodules by increasing angiogenesis . In this case, it is possible to predict the proliferation of cells by stimulating vascular endothelial growth factor expression of the basic pathophysiologically responsible insulin .
There is a need for further studies in the world whether increased thyroid cancer is associated with increased obesity and insulin resistance.
Calle EE, Kaaks R. Overweight, obesity and cancer: Epidemiological evidence and proposed mechanisms. Nat Rev Cancer 2004;4:579-91.
Rezzonico JN, Rezzonico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord 2009;7:375-80.
Balkan F, Onal ED, Usluogullari A, Tuzun D, Ozdemir D, Inancli SS, et al. Is there any association between insulin resistance and thyroid cancer?: A case control study. Endocrine 2014;45:55-60.
Sahin M, Ucan B, Ginis Z, Topaloglu O, Gungunes A, Bozkurt NC, et al. Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients. Med Oncol 2013;30:589.
Bae MJ, Kim SS, Kim WJ, Yi YS, Jeon YK, Kim BH, et al. High prevalence of papillary thyroid cancer in Korean women with insulin resistance. Head Neck 2016;38:66-71.
Paz-Filho G, Lim EL, Wong ML, Licinio J. Associations between adipokines and obesity-related cancer. Front Biosci 2011;16:1634-50.
Cheng SP, Yin PH, Chang YC, Lee CH, Huang SY, Chi CW. Differential roles of leptin in regulating cell migration in thyroid cancer cells. Oncol Rep 2010;23:1721-7.
Uddin S, Hussain AR, Siraj AK, Khan OS, Bavi PP, Al-Kuraya KS. Role of leptin and its receptors in the pathogenesis of thyroid cancer. Int J ClinExpPathol 2011;4:637-43.
Kimura T, Van Keymeulen A, Golstein J, Fusco A, Dumont JE, Roger PP. Regulation of thyroid cell proliferation by TSH and other factors: A critical evaluation of in vitro models. Endocr Rev 2001;22:631-56.
Boelaert K, Horacek J, Holder RL, Watkinson JC, Sheppard MC, Franklyn JA. Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab 2006;91:4295-301.
Rostoker R, Abelson S, Bitton-Worms K, Genkin I, Ben-Shmuel S, Dakwar M, et al. Highly specific role of the insulin receptor in breast cancer progression. Endocr Relat Cancer 2015;22:145-57.
Gallagher EJ, Alikhani N, Tobin-Hess A, Blank J, Buffin NJ, Zelenko Z, et al. Insulin receptor phosphorylation by endogenous insulin or the insulin analog AspB10 promotes mammary tumor growth independent of the IGF-I receptor. Diabetes 2013;62:3553-60.
Wang K, Yang Y, Wu Y, Chen J, Zhang D, Mao X, et al. The association between insulin resistance and vascularization of thyroid nodules. J Clin Endocrinol Metab 2015;100:184-92.
Miele C, Rochford JJ, Filippa N, Giorgetti-Peraldi S, Van Obberghen E. Insulin and insulin-like growth factor-I induce vascular endothelial growth factor mRNA expression via different signaling pathways. J BiolChem 2000;275:21695-702.