title: Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients.
abstract: Both insulin resistance (IR) and vitamin D deficiency (VDD) are found to be associated with many cancer types. In this study, we evaluated the presence of IR and VDD in thyroid cancer patients based on controls. Total 344 papillary thyroid cancer and 116 controls were part of the study. Glucose, insulin, homeostasis model analysis-insulin resistance (HOMA-IR) (control group 2.12 ± 0.9 and patient group 3.6 ± 1.1; p < 0.0001), LDL were significantly high; HOMA-S and vitamin D3 levels (control group 19.11 ± 8 and patient group 17 ± 16; p = 0.004) were significantly low in the patient group. Vitamin D deficiency (64/108 in controls vs 166/235; p = 0.026) and insulin resistance (24/108; 115/235; p < 0.0001) were more frequent in papillary thyroid cancer patients. After regression analysis, tumor diameter showed significant association with log-HOMA-IR (B = 0.315; p = 0.017) and log-vitamin D3 (B = 0.207; p = 0.04). Vitamin D deficiency and insulin resistance frequencies show no difference between micro- and macropapillary thyroid cancers. Receiver operating characteristic curve shows the best cutoff point for tumor diameter showing that the presence of lymph node metastasis was 0.65 cm with 81.2 % sensitivity and 52 % specificity. Best cutoff point for the capsular invasion tumor diameter was 0.75 cm with 83.3 % sensitivity and 60.4 % specificity. No difference between follicular and classical type papillary thyroid carcinomas has been yet discovered. As a result, thyroid cancer patients are more insulin resistant and vitamin D3 deficient. Vitamin D3 levels and HOMA-IR index may affect tumor diameter. Tumor size that is lower than 1 cm (0.65-0.75 cm) may be related with capsular invasion and lymph node involvement.
authors: Endocrinology and Metabolism Department, Ankara University School of Medicine, İbni Sina Hastanesi Ek Bina M-blok Kat:1, 06100, Sıhhıye, Ankara, Turkey. drsahinmustafa@yahoo.com
authors: Mustafa
authors: M
authors: Sahin
authors: Bekir
authors: B
authors: Uçan
authors: Zeynep
authors: Z
authors: Giniş
authors: Oya
authors: O
authors: Topaloğlu
authors: Aşkın
authors: A
authors: Güngüneş
authors: Nujen Çolak
authors: NÇ
authors: Bozkurt
authors: Müyesser Sayki
authors: MS
authors: Arslan
authors: İlknur Öztürk
authors: İÖ
authors: Ünsal
authors: Esra Tutal
authors: ET
authors: Akkaymak
authors: Taner
authors: T
authors: Demirci
authors: Melia
authors: M
authors: Karaköse
authors: Mustafa
authors: M
authors: Çalışkan
authors: Erman
authors: E
authors: Çakal
authors: Mustafa
authors: M
authors: Özbek
authors: Tuncay
authors: T
authors: Delibaşı
mesh_terms: D000328:Adult; D002277:Carcinoma / Q000097:blood*; D002291:Carcinoma, Papillary; D016022:Case-Control Studies; D002762:Cholecalciferol / Q000097:blood* / Q000172:deficiency; D005260:Female; D005492:Folic Acid / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D013954:Thyroglobulin / Q000097:blood; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000097:blood*; D014805:Vitamin B 12 / Q000097:blood
chemical_list: D002762:Cholecalciferol; D013954:Thyroglobulin; D005492:Folic Acid; D014805:Vitamin B 12
references: Metab Syndr Relat Disord. 2009 Aug;7(4):375-80
references: 19320560
references: Eur J Nutr. 2013 Aug;52(5):1533-40
references: 23124254
references: Int J Endocrinol. 2010;2010:805716
references: 20016683
references: Thyroid. 2013 Jan;23(1):25-30
references: 22931506
references: Am J Med Sci. 2008 Jul;336(1):50-2
references: 18626236
references: Cancer Res. 2003 Nov 15;63(22):7799-806
references: 14633706
references: J Nutr. 2003 Jul;133(7 Suppl):2461S-2469S
references: 12840225
references: Endocrinol Metab Clin North Am. 2001 Jun;30(2):429-67
references: 11444170
references: Arch Med Res. 2010 Apr;41(3):190-4
references: 20682176
references: Endocr Relat Cancer. 2012 Sep 05;19(5):F1-8
references: 22851686
references: J Endocrinol Invest. 2013 May;36(5):313-20
references: 22931861
references: Diabetes Care. 1998 Dec;21(12):2191-2
references: 9839117
references: Mol Carcinog. 2014 Jun;53(6):421-31
references: 23359295
references: Thyroid. 2010 Feb;20(2):135-46
references: 20151821
references: Endocrinol Metab Clin North Am. 2012 Sep;41(3):571-94
references: 22877430
references: Am J Med. 1992 Oct;93(4):363-9
references: 1415299
references: World J Surg. 2006 May;30(5):752-8
references: 16680590
references: Thyroid. 2009 Nov;19(11):1167-214
references: 19860577
references: Clin Exp Metastasis. 2012 Dec;29(8):971-9
references: 22610818
references: Am J Hematol. 2011 Dec;86(12):1013-6
references: 22086864
references: BMJ. 2010 Jan 21;340:b5500
references: 20093284
references: Diabetes Care. 2003 Nov;26(11):3031-4
references: 14578235
references: Endocr Res. 2011;36(4):167-74
references: 21973236
references: Endocr Pract. 2013 May-Jun;19(3):479-84
references: 23337162