title: Metformin and thyroid disease.
abstract: An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studiesin vitroandin vivohave demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF1 and mTOR pathways. Besides, metformin treatment was associated with a decrease in the levels of serum thyroid-stimulating hormone (TSH) in diabetic patients possibly by enhancing the effects of thyroid hormones in the pituitary and activating the adenosine monophosphate-activated protein kinase (AMPK). Based on this evidence, metformin appears to be a promising therapeutic tool in patients with thyroid disease. More clinical studies are necessary to evaluate the clinical significance of metformin for the treatment of thyroid diseases.
authors.affiliation: Chinese Medicine Hospital in Linyi CityLinyi, China.
authors.forename: Xianghui
authors.initials: X
authors.lastname: Meng
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western MedicineNanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Shuhang
authors.initials: S
authors.lastname: Xu
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western MedicineNanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China.
authors.forename: Guofang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Division of EndocrinologyDepartment of Medicine, St. Hedwig Hospital, Berlin, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Derwahl
authors.affiliation: Affiliated Hospital of Integrated Traditional Chinese and Western MedicineNanjing University of Chinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, China liuchao@nfmcn.com.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
mesh_terms: D006801:Humans; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use; D008687:Metformin / Q000494:pharmacology* / Q000627:therapeutic use; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism; D013959:Thyroid Diseases / Q000188:drug therapy* / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism*; D013972:Thyrotropin / Q000097:blood*
chemical_list: D007004:Hypoglycemic Agents; D013963:Thyroid Hormones; D013972:Thyrotropin; D008687:Metformin
keywords: metformin; thyroid cancer; thyroid disease; thyroid nodule; thyrotropin