Correlation Between Serum Insulin Levels And Papillary Thyroid Cancer

Objective: To compare the clinical and metabolic characteristic differences between papillary thyroid cancer and benign thyroid nodules.We investigate if serum insulin levels or insulin resistance is correlated with the occurrence of papillary thyroid cancer.Methods: To collect data and serum samples of 258 inpatients who underwent thyroidectomy at thyroid surgery department of the Second Affiliated Hospital of Dalian Medical University between March 2016 and August 2016.According to postoperative pathology results,all subjects were divided into papillary thyroid cancer group and benign thyroid nodules group.There were 153 patients in papillary thyroid cancer group and 105 patients in benign thyroid nodules group respectively.The gender,age,height,body weight,history of hypertension,fasting plasma glucose,fasting insulin,TSH,FT3,FT4,TPOAb,TGAb,triglyceride,total cholesterol,LDL-C,HDL-C,BMI and HOMA-IR were measured and compared between two groups.Multiple logistic regression analysis was used to explore the risk factor of papillary thyroid cancer.Results: 1.Among the 258 cases,there were 105 patients with benign nodules(40.7%)and 153 cases with papillary thyroid cancer(59.3%).Benign nodules group included 80females(76.2%)and 25 males(23.8%)and papillary thyroid cancer group included 116females(75.8%)and 37 males(24.2%).The average age of benign nodules group were(48.42 ± 11.85)years old and the average age of papillary thyroid cancer group were(45.67±11.61)years old.The gender and age of two groups were no significant difference(P>0.05).2.Benign nodules group with history of hypertension were 13 cases,accounting for12.7% and papillary thyroid cancer group with history of hypertension were 26 cases,accounting for 17.0%.There was no significant difference in history of hypertension of two groups(P>0.05).3.The average level of fasting insulin was(7.82±5.88)u U/ml in benign group and(10.00 ± 8.14)u U/ml in papillary thyroid cancer group.The fasting insulin levels in papillary thyroid cancer group were higher significantly than those in benign nodules(P < 0.05).The average values of HOMA-IR was(1.94 ± 1.81)in benign group and(2.46±2.09)in papillary thyroid cancer group.The HOMA-IR values in papillary thyroid cancer group were higher significantly than those in benign nodules(P<0.05).4.The average level of serum uric acid was(287.42±76.89)umol/L in benign group and(307.78 ± 83.94)umol/L in papillary thyroid cancer group.The serum uric acid levels in papillary thyroid cancer group were higher significantly than those in benign nodules(P<0.05).5.The median and quartile for thyroperoxidase antibody were 28.00(21.92,42.55)U/ml in benign group and 31.30(27.00,87.09)U/ml in papillary thyroid cancer group(P<0.05).6.There were no significant difference in BMI,fasting plasma glucose,TSH,FT3,FT4,TGAb,total cholesterol,triglyceride,LDL and HDL between two groups(P >0.05).7.Logistic regression analysis revealed that papillary thyroid cancer was positively correlated with fasting insulin and TPOAb(P<0.05).Conclusion:1.The levels of fasting insulin,HOMA-IR,TPOAb and serum uric acid in papillary thyroid cancer group are higher than those in benign group.There are significant differences between two groups.2.There is no significant difference in age,gender,history of hypertension,BMI,fasting plasma glucose,TSH,FT3,FT4,TGAb,LDL,HDL,total cholesterol and triglyceride between two groups.3.Hyperinsulinemia and higher TPOAb levels are the risk factors of papillary thyroid cancer.Thyroid nodules patients with type 2 diabetes,metabolic syndrome or Hashimoto's thyroiditis should be closely followed up.