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Otani H, Notsu M, Yamauchi M, Nawata K, Kanasaki K. Association Between Papillary Thyroid Carcinoma and Vertebral Fracture. Horm Metab Res 2023; 55:592-598. [PMID: 37068493 DOI: 10.1055/a-2059-8830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Suppression of TSH levels associated with levothyroxine treatment is a known risk factor for fracture. However, it is unclear whether patients with papillary thyroid carcinoma (PTC) have a higher risk of vertebral fracture (VF) before TSH suppression. The aim of the study was to examine whether the risk of VF is higher in PTC than in healthy subjects. A hospital-based, matched case-control study was conducted comparing PTC and healthy individuals. We enrolled 43 postoperative patients with PTC scheduled for radioiodine therapy and 43 age- and sex-matched healthy controls. Serum and urinary biological parameters, bone mineral density (BMD), and presence of VFs were evaluated in both groups. We compared these indices using χ2 and Mann-Whitney U-test and analyzed the association between PTC and VF by logistic regression analysis. The PTC group had higher BMI, HbA1c and phosphorus, and lower intact PTH than the control group. Lumbar and femoral neck BMD did not differ between the two groups. Prevalence of VFs was significantly higher in the PTC group (44.1%) than in the control group (16.3%). Multivariate logistic regression analyses adjusted for age, sex, and BMI identified PTC as being associated with the presence of VFs (odds ratio, 5.63; 95% confidence interval: 1.82 to 17.5). This relationship remained significant after additional adjustment for HbA1c and BMD. There is an association between PTC and a risk of VF independent of sex, BMI, glucose metabolism, and BMD, suggesting the importance of fracture risk assessment before TSH suppression.
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Affiliation(s)
- Hazuki Otani
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Masakazu Notsu
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
| | - Mika Yamauchi
- Research Institute for Metabolic Bone Diseases, Eikokai Ono Hospital, Ono, Japan
| | - Kiyoko Nawata
- Health and Nutrition, The University of Shimane, Izumo, Japan
| | - Keizo Kanasaki
- Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan
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Babić Leko M, Jureško I, Rozić I, Pleić N, Gunjača I, Zemunik T. Vitamin D and the Thyroid: A Critical Review of the Current Evidence. Int J Mol Sci 2023; 24:ijms24043586. [PMID: 36835005 PMCID: PMC9964959 DOI: 10.3390/ijms24043586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/15/2023] Open
Abstract
Vitamin D is necessary for the normal functioning of many organs, including the thyroid gland. It is, therefore, not surprising that vitamin D deficiency is considered a risk factor for the development of many thyroid disorders, including autoimmune thyroid diseases and thyroid cancer. However, the interaction between vitamin D and thyroid function is still not fully understood. This review discusses studies involving human subjects that (1) compared vitamin D status (primarily determined by serum calcidiol (25-hydroxyvitamin D [25(OH)D]) levels) with thyroid function assessed by thyroid stimulating hormone (TSH), thyroid hormones, and anti-thyroid antibody levels; and (2) evaluated the effect of vitamin D supplementation on thyroid function. Due to the many inconsistencies in the results between the studies, it is still difficult to draw a definite conclusion on how vitamin D status affects thyroid function. Studies in healthy participants observed either a negative correlation or no association between TSH and 25(OH)D levels, while the results for thyroid hormones showed high variability. Many studies have observed a negative association between anti-thyroid antibodies and 25(OH)D levels, but equally many studies have failed to observe such an association. Regarding the studies that examined the effect of vitamin D supplementation on thyroid function, almost all observed a decrease in anti-thyroid antibody levels after vitamin D supplementation. Factors that could contribute to the high variability between the studies are the use of different assays for the measurement of serum 25(OH)D levels and the confounding effects of sex, age, body-mass index, dietary habits, smoking, and the time of year when the samples were collected. In conclusion, additional studies with larger numbers of participants are needed to fully understand the effect of vitamin D on thyroid function.
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Low Vitamin D Status is Not Associated with the Aggressive Pathological Features of Papillary Thyroid Cancer. SISLI ETFAL HASTANESI TIP BULTENI 2022; 56:132-136. [PMID: 35515959 PMCID: PMC9040301 DOI: 10.14744/semb.2022.36048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022]
Abstract
Objectives: In the present study, we investigated the effects of Vitamin D (vit D) deficiency on aggressiveness of papillary thyroid cancer (PTC). Methods: Patients with PTC confirmed with pathological examination, whom were operated by a single surgeon between 2012 and 2017, were included in the study. The data of the patients were analyzed retrospectively. Cancers other than PTC, patients with hyperthyroidism and/or using antithyroid drugs were excluded from the study. The patients were classified as four quartiles according to serum Vit D levels; category 1 (<7.1 ng/mL), category 2 (7.2–11.8 ng/mL), category 3 (11.9–23.4 ng/mL) and category 4 (>23.5 ng/mL). Results: A total of 133 patients (103 female, 30 male) with mean age of 46.4±13.6 (17–82) years were included in the study. There was no significant difference between the categories in terms of preoperative Vit D values according to the evaluated tumor aggressiveness characteristics. It was determined that the presence of tumor with a size above 1 cm and T3/4 tumor were not affected by Vit D level. There was no significant difference between Vit D categories regarding the characteristics of aggressiveness such as multicentricity, lymphovascular invasion, central, and lateral metastases. Conclusion: According to our results, serum Vit D levels are not associated with the aggressive tumor characteristics of PTC.
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Thyroid nodules and its association with vitamin D in centenarians. Exp Gerontol 2022; 161:111730. [DOI: 10.1016/j.exger.2022.111730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/30/2022] [Accepted: 02/02/2022] [Indexed: 11/22/2022]
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Ashok T, Palyam V, Azam AT, Odeyinka O, Alhashimi R, Thoota S, Sange I. Relationship Between Vitamin D and Thyroid: An Enigma. Cureus 2022; 14:e21069. [PMID: 35165540 PMCID: PMC8826546 DOI: 10.7759/cureus.21069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
Hypothyroidism is a frequently encountered endocrine disorder in clinical practice. Besides its traditional role in bone health, vitamin D has been shown to have favorable effects in a variety of different systems due to its pleiotropic qualities and ubiquitous receptor expression. Over the years, researchers have been fascinated by the intricate molecular interplay between vitamin D and thyroid. In this regard, attempts have emerged to demonstrate the role of vitamin D in thyroid disorders. This article has reviewed the existing literature on the role of vitamin D in hypothyroidism. We explored studies discussing the physiological interactions between vitamin D and thyroid, as well as the clinical consequences, supplemental and prognostic relevancy of vitamin D in auto-immune thyroid disease (AITD) and hypothyroidism.
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Kim MJ, Kim D, Koo JS, Lee JH, Nam KH. Vitamin D Receptor Expression and its Clinical Significance in Papillary Thyroid Cancer. Technol Cancer Res Treat 2022; 21:15330338221089933. [PMID: 35379049 PMCID: PMC8988685 DOI: 10.1177/15330338221089933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Objective: This study aimed to evaluate the association between vitamin D receptor (an essential component in the vitamin D signaling pathway) and serum vitamin D as well as its clinical significance in papillary thyroid cancer. Methods: This prospective cohort study comprised patients with thyroid tumors who visited our hospital, from 2017 to 2018. The level of vitamin D receptor expression from thyroid tissue was measured in patients with thyroid tumor and evaluated for correlation with serum vitamin D levels and clinicopathologic characteristics of papillary thyroid cancer. Data from 501 patients with papillary thyroid cancer from The Cancer Genome Atlas database were analyzed. Results: Increased vitamin D receptor protein and mRNA expression were observed in papillary thyroid cancer compared to those in normal and benign tissues. Lower vitamin D receptor protein expression was associated with high TNM stage papillary thyroid cancer and low p21 protein expression. Lower relative vitamin D receptor mRNA expression in papillary thyroid cancer was associated with low serum 25-hydroxyvitamin D level. The Cancer Genome Atlas database showed a positive correlation among mRNA expression of vitamin D receptor, CYP24A1, and p21. Conclusions: An association between decreased vitamin D receptor protein expression and advanced stage papillary thyroid cancer, and a correlation between low vitamin D receptor mRNA expression with low serum 25-hydroxyvitamin D level was observed. Low vitamin D receptor expression in papillary thyroid cancer was shown to positively correlate with low serum vitamin D level and disease aggressiveness.
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Affiliation(s)
- Min Jhi Kim
- Department of Surgery, CHA Ilsan Medical Center, 65470CHA University School of Medicine, Goyang-si, Gyeonggi-do, South Korea.,Department of Surgery, Graduate School, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Daham Kim
- Department of Internal Medicine, Institute of Endocrine Research, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Ja Seung Koo
- Department of Pathology, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Ju Hee Lee
- Department of Dermatology, 37991Yonsei University College of Medicine, Seoul, South Korea
| | - Kee-Hyun Nam
- Department of Surgery, 37991Yonsei University College of Medicine, Seoul, South Korea
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Abuduwaili M, Xing Z, Xia B, Fei Y, Zhu J, Su A. Correlation between Pre-Operative 25-Hydroxyvitamin D Levels and Poor Prognostic Factors for Papillary Thyroid Cancer. J INVEST SURG 2021; 35:1076-1082. [PMID: 34865593 DOI: 10.1080/08941939.2021.2010842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
PURPOSE To evaluate the relationship between pre-operative 25-hydroxyvitamin D (25 (OH) D) levels and poor prognostic factors for papillary thyroid cancer (PTC). METHODS A total of 1161 patients diagnosed with PTC were analyzed retrospectively. The patients were categorized .based on their pre-operative 25 (OH) D levels into three groups: the severe vitamin D deficiency (VDD) group (25 (OH) D < 10 ng/mL), moderate VDD group (20 ng/mL > 25 (OH) D ≥ 10 ng/mL), and control group (25(OH)D ≥ 20 ng/mL) Differences in the demographic and clinicopathological characteristics among the three groups were analyzed. Linear and logistic regression analyses were also performed to determine the effect of 25 (OH) D levels on the established poor prognostic factors for PTC. RESULTS We observed a negative correlation between 25 (OH) D levels and tumor size (r = -0.067, P = 0.049). Severe VDD and moderate VDD were independently associated with lymph node metastasis and distant metastasis diagnosed during surgery (P = 0.00, odds ratio (OR) = 4.11; P = 0.00, OR = 3.33, respectively). After adjusting parameters such as sex, age, body mass index, and thyroid-stimulating hormone (TSH) levels, severe VDD and moderate VDD were found to be closely associated with advanced cancer stage (stage III or IV) (P = 0.018, OR = 3.02; P = 0.041, OR = 3.60, respectively). Additionally, a significant correlation (P = 0.007) was observed between the pre-operative 25 (OH) D and TSH levels. CONCLUSION 25 (OH) D levels were significantly associated with certain poor prognostic factors for PTC, including larger tumor diameter and the occurrence of lymph node metastasis. More prospective studies are needed to evaluate whether the assessment and supplementation of vitamin D contributes to the pre-operative management of patients with PTC.
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Affiliation(s)
- Munire Abuduwaili
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Zhichao Xing
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Baoying Xia
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Fei
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Jingqiang Zhu
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
| | - Anping Su
- Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China
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The Role of Vitamin D as a Prognostic Marker in Papillary Thyroid Cancer. Cancers (Basel) 2021; 13:cancers13143516. [PMID: 34298730 PMCID: PMC8304998 DOI: 10.3390/cancers13143516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/28/2021] [Accepted: 07/02/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Thyroid cancer is the most common endocrine malignancy in the United States and papillary thyroid cancer is by far the most common subtype. Vitamin D has been postulated as a key modulator in several cancer-related pathways, although its contributions to thyroid cancer remain controversial. In this paper, we review the metabolic pathways of vitamin D and explore potential links to cancer-related mechanisms. In addition, we also explore the medical literature related to vitamin D as a prognostic marker for staging in papillary thyroid cancer. Abstract The role of vitamin D in modulating several cancer-related pathways has received an increasing amount of attention in the past several years. Previous literature has found an abundance of evidence of vitamin D exerting an anti-proliferative, anti-inflammatory, and pro-differentiation effect in various types of cancers including breast, colon, prostate, and pancreatic cancer. Although the link between vitamin D and thyroid cancer remains controversial, both biochemical evidence and clinical studies have attempted to establish a link between papillary thyroid carcinoma (PTC) and vitamin D status. Furthermore, the use of vitamin D as a prognostic marker has received increased attention, both in regards to clinical outcomes and cancer staging. In this review, we briefly discuss the metabolism and proposed mechanism of action of vitamin D in the context of PTC, and explore links between modulators in the vitamin D pathway and progression of PTC. We provide evidence from both clinical studies as well as molecular studies of metabolic targets, including vitamin D receptor and activating enzymes exerting an effect on PTC tissue, which indicate that vitamin D may play a significant prognostic role in PTC.
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Analyses of the Association between Thyroid Cancer and Osteoporosis/Fracture Histories: A Cross-Sectional Study Using KoGES HEXA Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094732. [PMID: 33946728 PMCID: PMC8124932 DOI: 10.3390/ijerph18094732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/11/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The purpose of this study was to determine the association among thyroid cancer, osteoporosis and fracture history. (2) Methods: The data collected from 2004 through 2016 for the Korean Genome and Epidemiology Study were retrieved. For a total of 1349 participants with thyroid cancer and 163,629 control participants, the odds ratios (ORs) with 95% confidence intervals (CIs) of osteoporosis and fracture history were evaluated using a logistic regression model. (3) Results: The adjusted ORs of osteoporosis comparing thyroid cancer with the control group were 1.41 (95% CI = 1.18–1.70, p < 0.001) for all participants and 1.43 (95% CI = 1.19–1.71, p < 0.001) for women. The adjusted ORs of fracture history comparing these two groups were not significantly associated within the entire group of participants, men only or women only. (4) Conclusions: The adjusted OR of osteoporosis was significantly higher than 1, comparing thyroid cancer with the control group, especially in women. The adjusted OR of fractures was not significantly higher than 1, comparing the thyroid cancer group with the control group.
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Abdellateif MS, Shaarawy S, Elesawy YF, Mansour M, Tharwat E, Ibrahim NH, Eissa MS. The Role of Vitamin D, Platelet-Derived Growth Factor and Insulin-Like Growth Factor 1 in the Progression of Thyroid Diseases. Asian Pac J Cancer Prev 2020; 21:2083-2089. [PMID: 32711436 PMCID: PMC7573424 DOI: 10.31557/apjcp.2020.21.7.2083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Indexed: 12/24/2022] Open
Abstract
Background: Thyroid cancer (TC) is a common malignant tumor, however the role of total vitamin D: 25(OH)D, Platelet Derived Growth Factor (PDGF) and Insulin Like Growth Factor 1 (IGF-1) in the development of TC is still unclear. Aim: To assess the roles of 25(OH)D, PDGF and IGF-1 in the progression of thyroid diseases. METHODS: The serum levels of 25(OH)D, PDGF and IGF-1 were assessed in 70 patients with papillary thyroid cancer (PTC), 60 patients with benign thyroid nodules (BN) compared to 60 normal controls (NC) using ELISA technique. Results: There was a significant decrease in the serum level of 25(OH)D in TC patients compared to NC (P<0.001) and BN patients (P=0.006). There was a significant increase in the serum levels of PDGF and IGF-1 in TC patients (P<0.001), and BN patients (P<0.001) compared to NC, while there were no significant differences between TC and BN (P=0.087, and 0.258; respectively). PDGF correlated significantly with IGF-1 (r=0.412, P<0.001), TSH (r=0.146, P=0.045), and inversely correlated with 25(OH)D (r= -0.156, P=0.013) and FT4 (r=-0.178, P=0.014). There was a significant inverse correlation between the serum levels of IGF-1 and FT4 (r=-0.172, P=0.017). Sensitivity and specificity for assessment of TC patients were (65.7% and 58.3%, P= 0.001) for 25(OH)D, (65.7% and 58.3%, P=0.021) for IGF-1, and (68.6% and 61.7%, P=0.006) for PDGF. Multivariate analysis demonstrated that serum 25(OH)D (OR=0.578, 95%CI= 0.426-0.783), IGF-1 (OR=1.019, 95%CI= 1.010-1.029) and PDGF (OR=1.007, 95%CI= 1.004-1.009) were considered independent risk factors for thyroid cancer (P<0.001, for all). Conclusion: 25(OH) D, IGF-1 and PDGF are significantly different in TC and BN cases compared to control. They have an important role in the progression of TC. However, these data should be validated on a larger sample size.
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Affiliation(s)
- Mona S Abdellateif
- Medical Biochemistry and Molecular Biology, Department of Cancer Biology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Sabry Shaarawy
- Medical Biochemistry and Molecular Biology, Department of Cancer Biology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Yasmine F Elesawy
- Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mona Mansour
- Department of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Effat Tharwat
- Medical Biochemistry and Molecular Biology, Department of Cancer Biology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Noha H Ibrahim
- Department of Clinical and Chemical Pathology, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Marwa S Eissa
- Department of Internal Medicine and Endocrinology, Faculty of Medicine, Cairo University, Cairo, Egypt
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Hu MJ, Niu QS, Wu HB, Lu XL, Wang L, Tong XR, Huang F. Association of thyroid cancer risk with plasma 25-hydroxyvitamin D and vitamin D binding protein: a case-control study in China. J Endocrinol Invest 2020; 43:799-808. [PMID: 31863361 DOI: 10.1007/s40618-019-01167-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/16/2019] [Indexed: 01/08/2023]
Abstract
PURPOSE To investigate the association of thyroid cancer (TC) with 25-hydroxyvitamin D [25(OH)D] and vitamin D binding protein (DBP) and examine whether there was an interaction between 25(OH)D and DBP in relation to TC risk. METHODS A matched case-control study based on multiple hospitals included 506 pairs of cases with newly diagnosed TC and controls. All subjects were divided into the quartiles according to the distribution of 25(OH)D and DBP in controls. Odds ratio (OR) and 95% confidence intervals (CIs) for the association of TC with 25(OH)D and DBP were estimated by conditional logistic regression. RESULTS Comparing the highest to lowest quartiles, a decreased TC risk was respectively associated with plasma 25(OH)D (OR 0.63, 95% CI 0.40-1.00, P-trend = 0.046) and DBP (OR 0.49, 95% CI 0.32-0.77, P-trend = 0.001). However, the association between DBP and TC might be modified by 25(OH)D (P-interaction = 0.014) and physical activity (P-interaction = 0.017). Compared to participants with 25(OH)D and DBP concentrations respectively below medians, those with both concentrations above medians had a lower risk of TC (OR 0.56, 95% CI 0.39-0.82). In stratified analysis based on clinical characteristics of tumor, significantly negative association between 25(OH)D, and DBP and TC were observed among the cases with early stage of tumor progression. CONCLUSIONS This study suggested that 25(OH)D and DBP had protective effects against TC. But the negative association between TC and DBP might be modified by 25(OH)D and physical activity.
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Affiliation(s)
- M-J Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Q-S Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - H-B Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - X-L Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - L Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - X-R Tong
- Second Department of Clinical Medicine, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Central Laboratory of Preventive Medicine, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
- Laboratory for Environmental Toxicology, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, China.
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Notsu M, Yamauchi M, Morita M, Nawata K, Sugimoto T. Papillary thyroid carcinoma is a risk factor for severe osteoporosis. J Bone Miner Metab 2020; 38:264-270. [PMID: 31664535 DOI: 10.1007/s00774-019-01053-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 10/06/2019] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Thyroid-stimulating hormone (TSH)-suppressive therapy is recommended after surgical treatment in high-risk papillary thyroid carcinoma (PTC) patients. TSH-suppressive therapy is a known risk factor for osteoporosis and fractures. However, whether patients with PTC themselves are at a higher risk of osteoporosis than healthy individuals remains unclear. This study aimed to clarify whether PTC is a risk factor for osteoporosis. MATERIALS AND METHODS Serum and urinary biochemical parameters, bone mineral density (BMD), and presence of vertebral fractures (VFs) and non-VFs were evaluated in 35 PTC patients and 35 age- and sex-matched healthy individuals. We compared the parameters between PTC and control subjects and performed multiple logistic regression analyses after adjustments for variables. RESULTS Patients with PTC had higher body mass index (BMI) and hemoglobin (Hb)A1c, as well as lower eGFR and intact PTH than controls (p < 0.05, each). There were no significant differences in the prevalence of osteoporosis and VFs and non-VFs between patients with PTC and controls. However, the prevalence of severe osteoporosis diagnosed according to WHO criteria was significantly higher in PTC subjects (34.3%) than in controls (11.4%, p < 0.05). Multivariate logistic regression analyses adjusted for age, BMI, eGFR and HbA1c identified PTC as being associated with the presence of severe osteoporosis (odds ratio, 4.20; 95% confidence interval, 1.05-16.8; p < 0.05). CONCLUSIONS We identified PTC as a risk factor for severe osteoporosis, independent of BMI, renal function and glucose profile.
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Affiliation(s)
- Masakazu Notsu
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan.
| | - Mika Yamauchi
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Miwa Morita
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
| | - Kiyoko Nawata
- Health and Nutrition, The University of Shimane, Matsue, Shimane, Japan
| | - Toshitsugu Sugimoto
- Department of Internal Medicine 1, Faculty of Medicine, Shimane University, 89-1 Enya-cho, Izumo, Shimane, 693-8501, Japan
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Barrea L, Gallo M, Ruggeri RM, Giacinto PD, Sesti F, Prinzi N, Adinolfi V, Barucca V, Renzelli V, Muscogiuri G, Colao A, Baldelli R. Nutritional status and follicular-derived thyroid cancer: An update. Crit Rev Food Sci Nutr 2020; 61:25-59. [PMID: 31997660 DOI: 10.1080/10408398.2020.1714542] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The incidence of differentiated thyroid cancer has been increasing in the last decades all over the world. Such a steady growth cannot be entirely attributable to more intensive thyroid nodule screening and more sensitive diagnostic procedures. Several environmental factors have changed with sufficient rapidity in the same time frame and may represent credible candidates for this increase. They include modified iodine intake, lifestyle-associated risk factors, exposure to various toxic compounds, pollutants and xenobiotics, nutritional deficiencies, eating habits and comorbidities. Foremost, nutritional patterns have gained high interest as possible promoters and modifiable risk factors for thyroid cancer in recent years. The aim of this narrative review is to focus on the relationship between thyroid cancer and nutritional factors, dietary habits and obesity. Low iodine intake has been associated to increased risk of thyroid cancer, favoring the development of more aggressive histotypes. Moreover, correction of iodine deficiency can shift thyroid cancer subtypes toward less aggressive forms, without affecting the overall risk for cancer. Actually, evidence regarding the association between selenium and vitamin D deficiency and thyroid cancer is very limited, despite their well-known anti-cancer potentials, and the clinical usefulness of their supplementation is still uncertain in this setting. Albeit the relationship between single foods and thyroid cancer is difficult to examine, fish and iodine-rich foods, vegetables, and fruits might exert protective effects on thyroid cancer risk. Conversely, no clear association has been found for other foods to date. Lastly, a clear association between obesity and the risk of thyroid cancer, with more aggressive behavior, seems to emerge from most studies, likely involving variations in thyroid function and chronic inflammation mediated by cytokines, insulin, leptin and adiponectins. Although no definite association between dietary factors and thyroid cancer has been firmly established so far, some nutritional patterns, together with excessive weight, seem to play a relevant role in thyroid cancer carcinogenesis as well as in its severity and aggressiveness. These effects may play an additive role to the well-established one exerted by environmental carcinogens, such as pollutants and radiation exposure.
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Affiliation(s)
- Luigi Barrea
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - Rosaria Maddalena Ruggeri
- Unit of Endocrinology, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Paola Di Giacinto
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
| | - Franz Sesti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Natalie Prinzi
- Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale Tumori Milano, ENETS Center of Excellence, Milan, Italy
| | - Valerio Adinolfi
- Endocrinology and Diabetology Unit, ASL Verbano Cusio Ossola, Domodossola, Italy
| | - Viola Barucca
- Digestive and Liver Disease Unit, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Valerio Renzelli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanna Muscogiuri
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Annamaria Colao
- Unit of Endocrinology, Dipartimento di Medicina Clinica e Chirurgia, Federico II University Medical School of Naples, Naples, Italy
| | - Roberto Baldelli
- Endocrinology Unit, Department of Oncology and Medical Specialities, A.O. San Camillo-Forlanini, Rome, Italy
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14
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Dutta D, Sharma M, Aggarwal S, Mohindra R, Bhattacharya S, Kalra S. Vitamin D, Thyroid Autoimmunity and Cancer: An Interplay of Different Factors. Indian J Endocrinol Metab 2019; 23:507-513. [PMID: 31803589 PMCID: PMC6873262 DOI: 10.4103/ijem.ijem_526_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND AND AIMS In spite of large volume of data linking Vitamin D with cardiovascular morbidity, autoimmunity, cancer, and virtually every organ system, Vitamin D and thyroid is a lesser-known aspect of Vitamin D in clinical practice. This article intends to highlight the current literature on the impact of Vitamin D status and supplementation on thyroid autoimmunity and cancer. METHODS References for this review were identified through searches of PubMed for articles published to from 1950 to August 2019 using the terms "thyroid" [MeSH Terms] AND "Vitamin D" [MeSH Terms] OR "thyroid" [All Fields] AND "Vitamin D" [All Fields]. RESULTS Significant inverse correlation was documented between anti-thyroid peroxidase antibody (TPOAb) and serum 25-hydroxy-Vitamin D (25OHD). TPOAb positivity is more prevalent in Vitamin D deficient individuals. A large volume of medical literature is available from observational studies linking Vitamin D with thyroid autoimmunity. Data from interventional studies documenting beneficial effects of Vitamin D on thyroid autoimmunity is also available, but lesser than that from observational studies. Short-term high dose oral Vitamin D supplementation reduces TPOAb titers. Certain Vitamin D receptor (VDR) gene polymorphism have been linked to increased occurrence of autoimmune thyroid disorders (AITD). Vitamin D deficiency, decreased circulating calcitriol has been linked to increased thyroid cancer. Certain VDR gene polymorphisms have been linked with increased as well as decreased occurrence of thyroid cancer. Data is scant on use of Vitamin D and its analogues for treating thyroid cancer. CONCLUSION In spite of large volume of medical literature from observational studies linking Vitamin D with thyroid autoimmunity and cancer, meaningful concrete clinical data on impact of Vitamin D supplementation on hard clinical end points in these disorders is lacking, and should be the primary area of research in the next decade.
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Affiliation(s)
- Deep Dutta
- Department of Endocrinology, CEDAR Super-Specialty Clinics, Dwarka, Gujarat, India
| | - Meha Sharma
- Department of Rheumatology, CEDAR Super-Specialty Clinics, Dwarka, Gujarat, India
| | - Sameer Aggarwal
- Department of Endocrinology, Apex Super-Specialty Hospital, Rohtak, Haryana, India
| | | | | | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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15
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Sulibhavi A, Rohlfing ML, Jalisi SM, McAneny DB, Doherty GM, Holick MF, Noordzij JP. Vitamin D deficiency and its relationship to cancer stage in patients who underwent thyroidectomy for papillary thyroid carcinoma. Am J Otolaryngol 2019; 40:536-541. [PMID: 31036419 DOI: 10.1016/j.amjoto.2019.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 02/08/2023]
Abstract
PURPOSE As imaging technology improves and more thyroid nodules and malignancies are identified, it is important to recognize factors associated with malignancy and poor prognosis. Vitamin D has proven useful as a prognostic tool for other cancers and may be similarly useful in thyroid cancer. This study explores the relationship of Vitamin D to papillary thyroid carcinoma stage while accounting for socioeconomic covariates. MATERIALS AND METHODS The medical records of all patients who underwent thyroidectomy at one institution between 2000 and 2015 were reviewed. Subjects with non-papillary thyroid cancer pathology, prior malignancy, and without Vitamin D levels were excluded. The remaining 334 patient records were examined for cancer stage, Vitamin D levels, Vitamin D deficiency listed in history, and demographic and comorbid factors. RESULTS Vitamin D laboratory values showed no significant relationship to cancer stage (p = 0.871), but patients with Vitamin D deficiency documented in the medical record were more likely to have advanced disease (28.6% versus 14.7%; p = 0.028). The patients with documented Vitamin D deficiency also had lower 25-hydroxyvitamin D nadirs (21.5 ng/mL versus 26.5 ng/mL, p = 0.008) and were more likely to be on Vitamin D supplementation (92.6% versus 41.8%, p < 0.001). CONCLUSIONS The results suggest that Vitamin D deficiency may have value as a negative prognostic indicator in papillary thyroid cancer and that pre-operative laboratory evaluation may be less useful. This is important because Vitamin D deficiency is modifiable. While different racial subgroups had different rates of Vitamin D deficiency, neither race nor socioeconomic status showed correlation with cancer stage.
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16
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Warakomski J, Romuk E, Jarząb B, Krajewska J, Siemińska L. Concentrations of Selected Adipokines, Interleukin-6, and Vitamin D in Patients with Papillary Thyroid Carcinoma in Respect to Thyroid Cancer Stages. Int J Endocrinol 2018; 2018:4921803. [PMID: 30627158 PMCID: PMC6304902 DOI: 10.1155/2018/4921803] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/08/2018] [Accepted: 11/06/2018] [Indexed: 12/11/2022] Open
Abstract
The relationships between thyroid cancer and obesity are not fully understood. Adipokines, proinflammatory cytokines, and vitamin D may mediate these associations. In this study, we estimated serum concentrations of leptin, adiponectin, chemerin, interleukin-6 (IL-6), and vitamin D in patients with papillary thyroid cancer (PTC). We searched for associations between the adipokines, IL-6, vitamin D, anthropometric parameters, and TNM AJCC/UICC 2017 classification in 177 patients diagnosed with PTC (151 women and 26 men). Normal weight patients were predominantly classified as clinical stage I. The prevalence of stages higher than I was significantly higher in PTC patients with BMI ≥ 25 or with metabolic syndrome. Using logistic regression waist circumference ≥ 88 cm in women and ≥102 cm in men, upper tertiles of IL-6 and leptin were associated with a higher clinical stage. There were no differences in the prevalence of microcarcinomas in analyzed groups (BMI ≥ 25 versus BMI < 25 and with metabolic syndrome presence versus without metabolic syndrome). No significant relationships between serum concentrations of leptin, adiponectin, chemerin, IL-6, vitamin D, and tumor size in PTC were found. Although insulin resistance represented by the HOMA index was associated with anthropometric variables and with serum leptin, adiponectin, chemerin, and IL-6 concentrations, in our study, no statistically significant relations with PTC staging were identified.
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Affiliation(s)
- Jakub Warakomski
- Department of Pathophysiology and Endocrinology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Ewa Romuk
- Department of Biochemistry, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
| | - Barbara Jarząb
- Nuclear Medicine and Endocrine Oncology Department, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jolanta Krajewska
- Nuclear Medicine and Endocrine Oncology Department, Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Lucyna Siemińska
- Department of Pathophysiology and Endocrinology, School of Medicine with the Division of Dentistry, Medical University of Silesia, Zabrze, Poland
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17
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Kim D. The Role of Vitamin D in Thyroid Diseases. Int J Mol Sci 2017; 18:ijms18091949. [PMID: 28895880 PMCID: PMC5618598 DOI: 10.3390/ijms18091949] [Citation(s) in RCA: 118] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 09/06/2017] [Accepted: 09/07/2017] [Indexed: 01/12/2023] Open
Abstract
The main role of vitamin D is regulating bone metabolism and calcium and phosphorus homeostasis. Over the past few decades, the importance of vitamin D in non-skeletal actions has been studied, including the role of vitamin D in autoimmune diseases, metabolic syndromes, cardiovascular disease, cancers, and all-cause mortality. Recent evidence has demonstrated an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease, and impaired vitamin D signaling has been reported in thyroid cancers. This review will focus on recent data on the possible role of vitamin D in thyroid diseases, including autoimmune thyroid diseases and thyroid cancers.
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Affiliation(s)
- Dohee Kim
- Division of Endocrinology, Department of Internal Medicine, Dankook University College of Medicine, Dandae-ro, Dongnam-gu, Cheonan-si, Chungnam 330-714, Korea.
- Department of Kinesiologic Medical Science, Graduate, Dankook University, Cheonan 330-714, Korea.
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18
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Abstract
Vitamin D exerts its canonical roles on the musculoskeletal system and in the calcium/phosphorus homeostasis. In the last years, increasing evidences suggested several extra-skeletal actions of this hormone, indicating that vitamin D may produce effects in almost all the body tissues. These are mediated by the presence of vitamin D receptor (VDR) and thanks to the presence of the 1-α-hydroxylase, the protein that converts the 25-hydroxyvitamin (calcidiol) to the active form 1,25-dihydroxyvitamin (calcitriol). Several studies evaluated the possible role of vitamin D in the pathogenesis of thyroid diseases, and this review will focus on the available data of the literature evaluating the association between vitamin D and thyroid function, vitamin D and autoimmune thyroid diseases, including Hashimoto's thyroiditis, Graves' disease and post-partum thyroiditis, and vitamin D and thyroid cancer.
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Affiliation(s)
- Immacolata Cristina Nettore
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy
| | - Luigi Albano
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II", Napoli, Italy
| | - Paola Ungaro
- Istituto di Endocrinologia ed Oncologia Sperimentale del CNR (IEOS-CNR) "G. Salvatore", Napoli, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli "Federico II", Via S. Pansini, 5, 80131, Napoli, Italy.
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19
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Vaughan-Shaw PG, O'Sullivan F, Farrington SM, Theodoratou E, Campbell H, Dunlop MG, Zgaga L. The impact of vitamin D pathway genetic variation and circulating 25-hydroxyvitamin D on cancer outcome: systematic review and meta-analysis. Br J Cancer 2017; 116:1092-1110. [PMID: 28301870 PMCID: PMC5396104 DOI: 10.1038/bjc.2017.44] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/20/2017] [Accepted: 01/26/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Vitamin D has been linked with improved cancer outcome. This systematic review and meta-analysis investigates the relationship between cancer outcomes and both vitamin D-related genetic variation and circulating 25-hydroxyvitamin D (25OHD) concentration. METHODS A systematic review and meta-analysis of papers until November 2016 on PubMed, EMBASE and Web of Science pertaining to association between circulating vitamin D level, functionally relevant vitamin D receptor genetic variants and variants within vitamin D pathway genes and cancer survival or disease progression was performed. RESULTS A total of 44 165 cases from 64 studies were included in meta-analyses. Higher 25OHD was associated with better overall survival (hazard ratio (HR=0.74, 95% CI: 0.66-0.82) and progression-free survival (HR=0.84, 95% CI: 0.77-0.91). The rs1544410 (BsmI) variant was associated with overall survival (HR=1.40, 95% CI: 1.05-1.75) and rs7975232 (ApaI) with progression-free survival (HR=1.29, 95% CI: 1.02-1.56). The rs2228570 (FokI) variant was associated with overall survival in lung cancer patients (HR=1.29, 95% CI: 1.0-1.57), with a suggestive association across all cancers (HR=1.26, 95% CI: 0.96-1.56). CONCLUSIONS Higher 25OHD concentration is associated with better cancer outcome, and the observed association of functional variants in vitamin D pathway genes with outcome supports a causal link. This analysis provides powerful background rationale to instigate clinical trials to investigate the potential beneficial effect of vitamin D in the context of stratification by genotype.
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Affiliation(s)
- P G Vaughan-Shaw
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - F O'Sullivan
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - S M Farrington
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - E Theodoratou
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - H Campbell
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH164UX, UK
| | - M G Dunlop
- MRC Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh EH42XU, UK
| | - L Zgaga
- Department of Public Health and Primary Care, Trinity College Dublin, Dublin 24, Republic of Ireland
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20
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Leung HW, Muo CH, Liu CF, Chan AL. Vitamin D3 Intake Dose and Common Cancer: A Population-Based Case Control Study in a Chinese Population. J Cancer 2016; 7:2028-2034. [PMID: 27877218 PMCID: PMC5118666 DOI: 10.7150/jca.16505] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 09/18/2016] [Indexed: 12/15/2022] Open
Abstract
Objectives: Epidemiological studies suggest that vitamin D status is associated inversely with risk of common cancers in western populations. This study aimed to investigate whether vitamin D is associated with risk of common cancers in Chinese population. Methods: A population-based retrospective case-control study was conducted analyzing data retrieved from the Catastrophic Illness Patient Databases (CIPD) and longitudinal health insurance database (LHID) from January 1, 2010 to December 31, 2011and January 1, 2000 to December 31, 2011, respectively. Cases were identified as subjects diagnosed with site-specific cancers (International Classification of Diseases, Ninth Revision,) and frequency matched to select controls. Use of vitamin D3 was compared between two groups. Odds ratios (ORs) were employed to quantify the risk associated with exposure to vitamin D3 by logistic regression. Results: There were 1.21% (1961/161806) patients in cases and 0.67 % (1092/161806) patients in controls identified were vitamin D3 users. Overall risk of cancers associated with vitamin D3 users was 1.67 (95% CI:1.55 -1.81). Among these, the risk of kidney cancer and bladder cancer associated with intakes of vitamin D3 were significant (OR 2.59; 95% CI 1.81-3.70; OR 4.97; 95% CI 4.40-5.60) in an adjusted model. In further stratification analysis, we found a statistically significant risk of bladder cancer associated with high intake of vitamin D3. Except this, no statistically significant risk of other site-specific cancers associated with high intake of vitamin D3. Conclusion: Except bladder cancer in stratification analysis, we observed no statistically significant association between high intake of vitamin D3 and other site-specific cancers.
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Affiliation(s)
- Henry Wc Leung
- Department of Radiation Therapy, An-Nan Hospital, China Medical University, Tainan, Taiwan;; Department of Nursing, Min-Hwei College of Health Care management, Tainan City 736, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Feng Liu
- Department of Information Management, Chia Nan University of Pharmacy & Science, Tainan City 71710, Taiwan
| | - Agnes Lf Chan
- Department of Nursing, Min-Hwei College of Health Care management, Tainan City 736, Taiwan;; Department of Pharmacy, An-Nan Hospital, China Medical University, Tainan, Taiwan
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21
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Danilovic DLS, Ferraz-de-Souza B, Fabri AW, Santana NO, Kulcsar MA, Cernea CR, Marui S, Hoff AO. 25-Hydroxyvitamin D and TSH as Risk Factors or Prognostic Markers in Thyroid Carcinoma. PLoS One 2016; 11:e0164550. [PMID: 27737011 PMCID: PMC5063319 DOI: 10.1371/journal.pone.0164550] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/08/2016] [Indexed: 11/19/2022] Open
Abstract
Objective The increasing incidence of thyroid nodules demands identification of risk factors for malignant disease. Several studies suggested the association of higher TSH levels with cancer, but influence of 25-hydroxyvitamin D (25OHD) is controversial. This study aimed to identify the relationship of thyroid cancer with higher TSH levels and hypovitaminosis D and to evaluate their influence on prognostic characteristics of papillary thyroid carcinomas (PTC). Methods We retrospectively evaluated 433 patients submitted to thyroidectomy for thyroid nodules. Patients were categorized according to quartiles of TSH and 25OHD levels. Clinicopathological features were analyzed. Results Subjects with thyroid carcinomas were more frequently male and younger compared to those with benign disease. Their median TSH levels were higher and adjusted odds-ratio (OR) for cancer in the highest-quartile of TSH (> 2.4 mUI/mL) was 2.36 (1.36–4.09). Although vitamin D deficiency/insufficiency was prevalent in our cohort (84%), no significant differences in 25OHD levels or quartile distribution were observed between benign and malignant cases. Among 187 patients with PTC, analyses of prognostic features revealed increased risk of lymph nodes metastases for subjects with highest-quartile TSH levels (OR = 3.7, p = 0.029). Decreased 25OHD levels were not overtly associated with poor prognosis in PTC. Conclusions In this cross-sectional cohort, higher TSH levels increased the risk of cancer in thyroid nodules and influenced its prognosis, particularly favoring lymph nodes metastases. On the other hand, no association was found between 25OHD levels and thyroid carcinoma risk or prognosis, suggesting that serum 25OHD determination may not contribute to risk assessment workup of thyroid nodules.
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Affiliation(s)
- Debora Lucia Seguro Danilovic
- Endocrinology, Instituto do Câncer do Estado de São Paulo, Sao Paulo, Brazil
- Laboratório de Endocrinologia Celular e Molecular (LIM25), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
- * E-mail:
| | - Bruno Ferraz-de-Souza
- Laboratório de Investigação Médica 18 (LIM-18), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Amanda Wictky Fabri
- Laboratório de Endocrinologia Celular e Molecular (LIM25), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Nathalie Oliveira Santana
- Laboratório de Endocrinologia Celular e Molecular (LIM25), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Marco Aurelio Kulcsar
- Head and Neck Surgery, Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil
| | | | - Suemi Marui
- Laboratório de Endocrinologia Celular e Molecular (LIM25), Faculdade de Medicina da Universidade de São Paulo, Sao Paulo, Brazil
| | - Ana Oliveira Hoff
- Endocrinology, Instituto do Câncer do Estado de São Paulo, Sao Paulo, Brazil
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