POSITIVE ASSOCIATION BETWEEN IMPAIRED FASTING GLUCOSE, GLUCOSE INTOLERANCE, AND TYPE 2 DIABETES WITH ADVANCED TUMOR STAGE OF DIFFERENTIATED THYROID CANCER AT DIAGNOSIS

positive AsSociation between impaIred Fasting gLucose, GLUCOSE INTOLerance, and type 2 diabetes with advanced tumor stage OF differentiaTED thyroid caNcER at diagnosis.

Janka-Zires M, Cuevas-Ramos D, Gómez-Pérez FJ. Department of Endocrinology and Metabolism. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

INTRODUCTION: Studies suggest an association between hyperglycemia, metabolic syndrome, glucose intolerance and BMI with a higher incidence of thyroid cancer. We evaluate here the association between glucose metabolic alterations with tumor stage of differentiated thyroid cancer (DTC) at diagnosis. 

 

OBJECTIVE: To investigate the relation between impaired fasting glucose, glucose intolerance, and type 2 diabetes with TNM stage of DTC at diagnosis.

 

METHODS: Retrospective analysis of patients with DTC between 2009 and 2011. Before the diagnosis of DTC, men and women, with overweight or obesity, were grouped according to their glucose impairment [(normal glucose (NG), impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and type 2 diabetes (T2D)]. Logistic regression was used to assess the relationship between each glucose alteration with tumor stage (low=stage 1 and 2; high = stage 3 and 4). The analysis was adjusted for age, BMI, triglycerides and gender.

 

RESULTS: A total of 93 patients fulfilled study selection criteria (NG=31; IFG=30; IGT=20; and T2D=12). The mean age was 45±10 years with a BMI of 29±3.6 kg/m². The proportion of cases in stage 1 were significantly higher for NG (n=21, 67%); compared to IFG (n=17; 56%); IGT (n=9; 45%); and T2D (n=5; 41%, p<0.05). Accordingly, higher proportion of patients had worse glucose metabolic diagnosis in stage 4 (NG=19.4%; IFG=30%; IGT=35%; T2D=41.7%, p<0.05). A logistic regression analysis showed an independent and positive association between worse TNM stage with worse glucose metabolic alteration [IFG (OR=2.83; CI95% 0.72-11; p=0.13); IGT (4.78; 1.1-20.5; p=0.03); T2D (7.5 (1.4-40.6); p=0.01).  

 

CONCLUSIONS: We found a positive association between worse TNM stages of DTC at diagnosis, and worse glucose metabolic alteration.