Yıl 2019, Cilt 12 , Sayı 3, Sayfalar 423 - 431 2019-09-30

The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.
Benign nodüler ve malign tiroid hastalıklarında metabolik sendrom ve bileşenlerinin değerlendirilmesi.

Sevinc Can [1] , Cuneyd ANIL [2] , Asli NAR [3] , Alptekin Gursoy [4]


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.

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.

Metabolik sendrom, insülin direnci, tiroid, nodül, benign, malign
  • 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
Birincil Dil en
Konular Endokrinoloji ve Metabolizma
Yayımlanma Tarihi Eylül 2019
Bölüm Araştırma Makalesi
Yazarlar

Orcid: 0000-0001-5921-8029
Yazar: Sevinc Can (Sorumlu Yazar)
Kurum: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-3802-9733
Yazar: Cuneyd ANIL
Kurum: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0003-0998-8388
Yazar: Asli NAR
Kurum: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Orcid: 0000-0002-0494-9200
Yazar: Alptekin Gursoy
Kurum: BAŞKENT ÜNİVERSİTESİ, TIP FAKÜLTESİ
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 30 Eylül 2019

Bibtex @araştırma makalesi { patd558418, journal = {Pamukkale Tıp Dergisi}, issn = {}, eissn = {1308-0865}, address = {Pamukkale Üniversitesi Tıp Fakültesi Eğitim Blokları Kınıklı kampüsü 20070 Kınıklı, Denizli}, publisher = {Pamukkale Üniversitesi}, year = {2019}, volume = {12}, pages = {423 - 431}, doi = {10.31362/patd.558418}, title = {The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.}, key = {cite}, author = {Can, Sevinc and ANIL, Cuneyd and NAR, Asli and Gursoy, Alptekin} }
APA Can, S , ANIL, C , NAR, A , Gursoy, A . (2019). The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.. Pamukkale Tıp Dergisi , 12 (3) , 423-431 . DOI: 10.31362/patd.558418
MLA Can, S , ANIL, C , NAR, A , Gursoy, A . "The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.". Pamukkale Tıp Dergisi 12 (2019 ): 423-431 <https://dergipark.org.tr/tr/pub/patd/issue/48923/558418>
Chicago Can, S , ANIL, C , NAR, A , Gursoy, A . "The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.". Pamukkale Tıp Dergisi 12 (2019 ): 423-431
RIS TY - JOUR T1 - The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases. AU - Sevinc Can , Cuneyd ANIL , Asli NAR , Alptekin Gursoy Y1 - 2019 PY - 2019 N1 - doi: 10.31362/patd.558418 DO - 10.31362/patd.558418 T2 - Pamukkale Tıp Dergisi JF - Journal JO - JOR SP - 423 EP - 431 VL - 12 IS - 3 SN - -1308-0865 M3 - doi: 10.31362/patd.558418 UR - https://doi.org/10.31362/patd.558418 Y2 - 2019 ER -
EndNote %0 Pamukkale Tıp Dergisi The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases. %A Sevinc Can , Cuneyd ANIL , Asli NAR , Alptekin Gursoy %T The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases. %D 2019 %J Pamukkale Tıp Dergisi %P -1308-0865 %V 12 %N 3 %R doi: 10.31362/patd.558418 %U 10.31362/patd.558418
ISNAD Can, Sevinc , ANIL, Cuneyd , NAR, Asli , Gursoy, Alptekin . "The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.". Pamukkale Tıp Dergisi 12 / 3 (Eylül 2019): 423-431 . https://doi.org/10.31362/patd.558418
AMA Can S , ANIL C , NAR A , Gursoy A . The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.. Pamukkale Tıp Dergisi. 2019; 12(3): 423-431.
Vancouver Can S , ANIL C , NAR A , Gursoy A . The prevalence of metabolic syndrome and its components in benign and malignant nodular thyroid diseases.. Pamukkale Tıp Dergisi. 2019; 12(3): 431-423.