Pituitary neuroendocrine tumors and differentiated thyroid cancer: do metabolic and inflammatory risk factors play roles?

Purpose It is postulated that patients with different types of pituitary neuroendocrine tumors (PitNETs) may present a higher incidence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk...

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Published in:	Journal of endocrinological investigation Vol. 44; no. 4; pp. 735 - 744
Main Authors:	Cortês Nascimento, G., de Araujo Cortês Nascimento, A. G. P., de Maria Ribeiro Veiga Parente, C., Rodrigues, V. P., de Sousa Azulay, R. S., de Carvalho Rocha, V. C., da Silva Pereira Damianse, S., Magalhães, M., dos Santos Faria, M., Gomes, M. B.
Format:	Journal Article
Language:	English
Published:	Cham Springer International Publishing 01-04-2021 Springer Nature B.V
Subjects:	Acromegaly Acromegaly - complications Acromegaly - epidemiology Acromegaly - metabolism Adenocarcinoma - epidemiology Adenocarcinoma - etiology Adenocarcinoma - metabolism Adult Aged Aged, 80 and over Blood glucose Blood Glucose - metabolism Body weight Brazil - epidemiology C-reactive protein Cardiometabolic Risk Factors Case-Control Studies Cross-Sectional Studies Endocrinology Female Humans Incidence Inflammation Inflammation - complications Inflammation - epidemiology Inflammation - metabolism Insulin Insulin - metabolism Insulin resistance Insulin Resistance - physiology Internal Medicine Leptin Male Medicine Medicine & Public Health Metabolic Diseases Metabolism Middle Aged Neuroendocrine tumors Neuroendocrine Tumors - complications Neuroendocrine Tumors - epidemiology Neuroendocrine Tumors - metabolism Original Article Overweight Pituitary Pituitary Neoplasms - complications Pituitary Neoplasms - epidemiology Pituitary Neoplasms - metabolism Risk Factors Thyroid cancer Thyroid carcinoma Thyroid Neoplasms - epidemiology Thyroid Neoplasms - etiology Thyroid Neoplasms - metabolism Ultrasound Young Adult Brazil Acromegaly Low-grade inflammation Insulin resistance Thyroid cancer Pituitary tumors Leptin
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Summary:	Purpose It is postulated that patients with different types of pituitary neuroendocrine tumors (PitNETs) may present a higher incidence of cancer. Factors underlying individuals becoming overweight, such as insulin resistance, hyperleptinemia, and low-grade inflammation, may play a role in the risk of differentiated thyroid carcinoma (DTC) in such patients. This study aimed to investigate the frequency of and obesity-related risk factors associated with DTC in patients with PitNETs. Methods This cross-sectional study involved 149 patients with nonacromegalic PitNETs (AG group), 71 patients with acromegaly (ACRO group), and 156 controls (CG group). All participants underwent insulin and blood glucose measurements with the determination of the homeostatic model assessment-insulin resistance (HOMA-IR) index, leptin, and high-sensitivity C-reactive protein (hsCRP), and they also underwent thyroid ultrasound. Clinically significant nodules were biopsied for subsequent cytopathological evaluation, and participants were operated on when indicated. Results Patients in the AG group had high levels of insulin resistance and significantly higher levels of leptin and hsCRP compared with those of patients in the ACRO group. There were no cases of DTC in the AG group; two findings, one incidental, of DTC occurred in the CG group, and three cases of DTC were present in the ACRO group. Acromegaly was associated with DTC after adjusted analysis. Conclusions Our findings in patients with nonacromegalic PitNETs do not indicate a high risk for DTC despite the presence of metabolic and inflammatory risk factors for neoplastic events. In contrast, acromegaly promotes a greater risk of DTC.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1720-8386 0391-4097 1720-8386
DOI:	10.1007/s40618-020-01357-8