TY - JOUR T1 - The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases. TT - Benign nodüler ve malign tiroid hastalıklarında metabolik sendrom ve bileşenlerinin değerlendirilmesi. AU - Can, Sevinc AU - Anıl, Cuneyd AU - Nar, Asli AU - Gursoy, Alptekin PY - 2019 DA - September Y2 - 2019 DO - 10.31362/patd.558418 JF - Pamukkale Medical Journal JO - Pam Tıp Derg PB - Pamukkale University WT - DergiPark SN - 1308-0865 SP - 423 EP - 431 VL - 12 IS - 3 LA - en AB - Purpose: Metabolic syndrome (MetS) isa condition harboring a group of metabolic abnormalitieswhereinsulin resistance (IR) plays a major role. The aim of our study is to evaluateMetS and its components in patients with benign and malignant nodular thyroiddisease (NTD).Materials and methods: Atotal of 800 patients (430 euthyroid benign nodular and 370 euthyroid malignantNTD) were analyzed for MetS and its components. Serum insulin levels and IR estimatedby homeostasis model assessment (HOMA-IR), as well as other MetS parameterswere evaluated. Results: Metabolic syndrome wasdetected in 59.8% of 800 patients. There was no significant difference betweenbenign and malignant NTD groups related to the prevalence of the MetS (61.4% inbenign 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 thebenign group compared to the overall average. In the malignant group, it wasdetermined that low HDL-C level was the most common and high blood pressure wasthe least common component. There was no significant difference between benignand malignant NTD groups in terms of insulin levels and HOMA-IR. Conclusions: The results suggestthat patients with NTD have significantly increased MetS prevalence compared topatients without NTD. However, there was no significant difference betweenbenign and malignant NTD in this respect. KW - Metabolik sendrom KW - insülin direnci KW - tiroid KW - nodül KW - benign KW - malign N2 - Amaç:Metabolik Sendrom (MetS) insülin direncinin belirgin rol oynadığı ve metabolikanormalliklerin kümelendiği bir tablodur. Bu çalışmanın amacı benign ve malignnodüler tiroid hastalığı olanlarda metabolik sendrom ve bileşenlerinideğerlendirmektir. Gereçve yöntem: Dörtyüzotuz ötiroid benign nodüler ve 370 ötiroid malignnodüler tiroid hastalığı olan toplam 800 hasta metabolik sendrom ve bileşenleriyönünden incelendi. MetS parametrelerinin yanı sıra insülin düzeyleri vehomeostasis model assessment- IR (HOMA-IR) ile hesaplanan İD seviyelerideğerlendirildi.Bulgular:Çalışmaya alınan 800 hastanın %59,8’inde metabolik sendrom saptandı. Benign vemalign nodüler tiroid hastalığı olan gruplar arasında metabolik sendrom sıklığıaçısından anlamlı fark saptanmadı (benign nodüler grupta % 61,4, malign nodülergrupta % 57,8, p>0,05). Metabolik sendrom bileşenleri incelendiğinde en çokyüksek 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 vemalign nodüler tiroid hastaları ayrı ayrı incelendiklerinde ise benign grubunMetS bileşen dağılımı genel ortalama ile benzer sıklıkta olup, malign grubunMetS bileşen dağılımında en sık düşük HDL kolesterol düzeyi (%71,9), en az isekan basıncı yüksekliği (%26,2) olduğu bulundu. Benign ve malign nodüler tiroidhastaları arasında insülin düzeyleri ve insülin direnci açısından anlamlı farksaptanmadı.Sonuç:Sonuçlar nodüler tiroid patolojisi olan hastaların, nodüler tiroid hastalığı olmayanlaragöre anlamlı olarak artmış metabolik sendrom prevalansına sahip olduklarınıgöstermektedir. Ancak benign ve malign noduler gruplar arasında MetS bileşendağılımı açısından fark saptanmamıştır. CR - 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 CR - Referans 2: Vella V, Sciacca L, Pandini G, et al. The IGF system in thyroid cancer: new concepts. Mol Pathol. 2001;54:121–124 CR - 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 CR - 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 CR - 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 CR - 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 CR - Referans 7:Gursoy A. Rising thyroid cancer incidence in the world might be related to insulin resistance. Medical Hypotheses.2010;74:35-36 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - Referans 18: Edge SB, Byrd DR, Compton CC, et al. AJCC cancer staging manual (7th ed). New York, NY: Springer; 2010 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 CR - 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 UR - https://doi.org/10.31362/patd.558418 L1 - https://dergipark.org.tr/en/download/article-file/814350 ER -