Abstract
Introduction: Thyroid cancer is one of the most common endocrine system malignancies with 9 out of 100,000 estimated annual incidence and papillary carcinoma is the most common type of thyroid cancer. Papillary thyroid cancer (PTC) increases blood insulin levels by creating insulin resistance. Many studies have suggested the role of insulin resistance in the prognosis of PTC.
Objectives: The aim of the present study was to determine the prevalence of impaired glucose tolerance in patients with PTC and to compare the relationship between insulin resistance and disease severity, lymph node involvement and distant metastasis.
Patients and Methods: In this cross-sectional study, 68 patients with PTC diagnosis examined for metastasis by whole body scan and cervical lymph nodes by ultrasound were included in this study. A 75 g oral glucose tolerance test was also performed on subjects.
Results: In this study 68 patients (76.5% female and 23.5% male) were enrolled. The mean age of the patients was 44.2±13.8 years. The mean serum level of fasting blood glucose (FBG in patients was 103.14±21.8 mg/dL and the mean 2 hours past-prandial was 145.12±22.37 mg/dL. Statistically significant lymphatic involvement was observed in 25% of patients between insulin resistance and nodal involvement (P=0.03). A significantly higher metastasis was also observed in 16.2% of patients with glucose intolerance (P<0.05).
Conclusion: The results indicated that the rate of insulin resistance in PTC patients is significantly higher and glucose intolerance in these patients is associated with increased lymphatic involvement and increased risk of metastasis and poor prognosis.