Login Register Cart 0
Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

The Relationship between Insulin Resistance and Thyroid Volume in Georgia

Author(s): Nino Lomtadze*, Elene Giorgadze, Shota Janjgava, Tinatin Kacharava and Iamze Taboridze

Volume 23, Issue 10, 2023

Published on: 17 May, 2023

Page: [1318 - 1325] Pages: 8

DOI: 10.2174/1871530323666230220093432

Price: $65

Abstract

Patients with insulin resistance (IR) have a higher thyroid volume therefore the aim of our study is to examine the correlation between IR and thyroid volume in the residents of Georgia.

Methods: 413 patients with a mean age of 37.3 ± and 11.4 years were included in this study. Out of those, 120 were males, and 293 were females who were studied retrospectively. They had hyperinsulinemia and were referred to the clinic from 2017 to 2019.

The factors studied were age, sex, body mass index (BMI), clinical signs, thyroid ultrasound, alanine aminotransferase (ALT), aspartate aminotransferase (AST), lipids, fasting insulin, fasting glucose, thyroid stimulating hormone (TSH), Free thyroxine (FT4), and Zinc (Zn).

Results: IR was detected in 252 individuals. The frequency of men with insulin resistance was significantly higher than in the control group - 72.50%, and 56.31%, respectively (F = 9.55, p= 0.0021). Mean thyroid volume in the patients with IR was significantly higher compared to the controls 20.52 + 6.39 cm3 and 15.25 + 6.55 cm3, respectively (p < 0.001). Hyperinsulinemia had a significant positive correlation with Goiter r = 0.445, p < 0.0001. The associated factors for hyperinsulinemia are: Goiter (1) – OR = 5.12 (95% CI:3.02-8.69); Cholesterol – OR = OR = 3.31 (95% CI: 1.54-7.14); Triglycerides – OR = 3.23 (95% CI:1.02-10.28); Obesity (1)- OR = 3.94 (95% CI: 2.23-6.98); Thyroid structural changes (1) – OR = 2.01 (95% CI: 1.12-3.60); ALT/AST-OR = 4.53 (95% CI: 2.33-8.80); Zn decreased Odds Ratio hyperinsulinemia – OR = 0.95 (95% CI: 0.94-0.97).

Conclusion: Hyperinsulinemia is the most common cause of diffuse goiter and the heterogeneous structure of the thyroid. The volume of the thyroid gland shows a significant positive association with the characteristics of metabolic syndrome and increased thyroid volume predictors of metabolic syndrome.

Keywords: Insulin, resistance, hyperinsulinemia, obesity, thyroid, volume, goiter.

« Previous Next »
Graphical Abstract

[1]
Freeman, A.M.; Pennings, N. Insulin Resistance. 2022 Jul 4. In: StatPearls [Internet]; Treasure Island (FL): StatPearls Publishing, 2022. Jan-.
[PMID: 29939616]
[2]
van der Aa, M.P.; Fazeli Farsani, S.; Knibbe, C.A.; de Boer, A.; van der Vorst, M.M. Population-based studies on the epidemiology of insulin resistance in children. J. Diabetes Res., 2015, 2015, 362375.
[3]
Bonora, E.; Kiechl, S.; Willeit, J.; Oberhollenzer, F.; Egger, G.; Targher, G.; Alberiche, M.; Bonadonna, R.C.; Muggeo, M. Prevalence of insulin resistance in metabolic disorders: The Bruneck Study. Diabetes, 1998, 47(10), 1643-1649.
[http://dx.doi.org/10.2337/diabetes.47.10.1643]
[4]
Vanderpump, M.P. The epidemiology of thyroid disease. Br. Med. Bull., 2011, 99, 39-51.
[5]
Lind, P.; Langsteger, W.; Molnar, M.; Gallowitsch, H.J.; Mikosch, P.; Gomez, I. Epidemiology of thyroid diseases in iodine sufficiency. Thyroid, 1998, 8(12), 1179-1183.
[http://dx.doi.org/10.1089/thy.1998.8.1179] [PMID: 9920375]
[6]
Zheng, R.; Rios-Diaz, A.J.; Thibault, D.P.; Crispo, J.A.G.; Willis, A.W.; Willis, A.I. A contemporary analysis of goiters undergoing surgery in the United States. Am. J. Surg., 2020, 220(2), 341-348.
[http://dx.doi.org/10.1016/j.amjsurg.2020.01.005] [PMID: 31948703]
[7]
Pemayun, T.G. Current diagnosis and management of thyroid nodules. Acta Med. Indones., 2016, 48(3), 247-257.
[PMID: 27840362]
[8]
Armerinayanti, NW. Goitre as predisposing factor of thyroid carcinomas. Warmad. Med. J., 2016, 1(2), 42-50.
[9]
Yasar, H.Y. Ertuğrul, O.; Ertuğrul, B.; Ertuğrul, D.; Sahin, M. Insulin resistance in nodular thyroid disease. Endocr. Res., 2011, 36(4), 167-174.
[http://dx.doi.org/10.3109/07435800.2011.593011]
[10]
Gursoy, A. Rising thyroid cancer incidence in the world might be related to insulin resistance. Med. Hypotheses, 2010, 74(1), 35-36.
[http://dx.doi.org/10.1016/j.mehy.2009.08.021] [PMID: 19720470]
[11]
Kapadia, K.B.; Bhatt, P.A.; Shah, J.S. Association between altered thyroid state and insulin resistance. J. Pharmacol. Pharmacother., 2012, 3(2), 156-160.
[PMID: 22629091]
[12]
Heidari, Z.; Mashhadi, M.A.; Nosratzehi, S. Insulin resistance in patients with benign thyroid nodules. Arch. Iran Med., 2015, 18(9), 572-576.
[13]
Unlu, M.T.; Kostek, M.; Aygun, N.; Isgor, A.; Uludag, M. Non-toxic multinodular goiter: From etiopathogenesis to treatment. SiSli Etfal Hastanesi Tip Bulteni Med. Bull. Sisli Hosp., 2022, 56(1), 21-40.
[http://dx.doi.org/10.14744/SEMB.2022.56514] [PMID: 35515961]
[14]
Layegh, P.; Asadi, A.; Jangjoo, A.; Layegh, P.; Nematy, M.; Salehi, M.; Shamsian, A.; Ranjbar, G. Comparison of thyroid volume, TSH, free T4 and the prevalence of thyroid nodules in obese and non-obese subjects and correlation of these parameters with insulin resistance status. Caspian J. Intern. Med., 2020, 11(3), 278-282.
[PMID: 32874434]
[15]
Kushchayeva, Y.S.; Kushchayev, S.V.; Startzell, M.; Cochran, E.; Auh, S.; Dai, Y.; Lightbourne, M.; Skarulis, M.; Brown, R.J. Thyroid abnormalities in patients with extreme insulin resistance syndromes. J. Clin. Endocrin. Metabolism., 2019, 104(6), 2216-2228.
[http://dx.doi.org/10.1210/jc.2018-02289]
[16]
Tsatsoulis, A. The role of insulin resistance/hyperinsulinism on the rising trend of thyroid and adrenal nodular disease in the current environment. J Clin Med, 2018, 7(3), 37.
[17]
Anil, C.; Akkurt, A.; Ayturk, S.; Kut, A.; Gursoy, A. Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area. Metabolism, 2013, 62(7), 970-975.
[http://dx.doi.org/10.1016/j.metabol.2013.01.009] [PMID: 23395200]
[18]
Yildirim Simsir, I.; Cetinkalp, S.; Kabalak, T. Review of factors contributing to nodular goiter and thyroid carcinoma. Med. Princ. Pract., 2020, 29(1), 1-5.
[http://dx.doi.org/10.1159/000503575] [PMID: 31542786]
[19]
Saltiel, A.R. Insulin signaling in health and disease. J. Clin. Invest., 2021, 131(1), e142241.
[20]
Mendez, D.A.; Ortiz, R.M. Thyroid hormones and the potential for regulating glucose metabolism in cardiomyocytes during insulin resistance and T2DM. Physiol. Rep., 2021, 9(16), e14858.
[http://dx.doi.org/10.14814/phy2.14858] [PMID: 34405550]
[21]
Tang, Y.; Yan, T.; Wang, G.; Chen, Y.; Zhu, Y.; Jiang, Z.; Yang, M.; Li, C.; Li, Z.; Yu, P.; Wang, S.; Zhu, N.; Ren, Q.; Ni, C. Correlation between insulin resistance and thyroid nodule in type 2 diabetes mellitus. Intern J of endocrn, 2017, 2017, 1617458.
[http://dx.doi.org/10.1155/2017/1617458]
[22]
Buscemi, S.; Massenti, F.M.; Vasto, S.; Galvano, F.; Buscemi, C.; Corleo, D.; Barile, A.M.; Rosafio, G.; Rini, N.; Giordano, C. Association of obesity and diabetes with thyroid nodules. Endocrine, 2018, 60(2), 339-347.
[http://dx.doi.org/10.1007/s12020-017-1394-2] [PMID: 28836113]
[23]
Biondi, B. Thyroid and obesity: An intriguing relationship. J. Clin. Endocrinol. Metab., 2010, 95(8), 3614-3617.
[24]
Sari, R.; Balci, M. K.; Altunbas, H.; Karayalcin, U. The effect of body weight and weight loss on thyroid volume and function in obese women. Clin endocrin, 2003, 59(2), 258-262.
[http://dx.doi.org/10.1046/j.1365-2265.2003.01836.x]
[25]
Sousa, P.A.M.; Vaisman, M.; Carneiro, J.R.I.; Guimarães, L.; Freitas, H.; Pinheiro, M.F.C.; Liechocki, S.; Monteiro, C.M.M.; Teixeira, P.F.S. Prevalence of goiter and thyroid nodular disease in patients with class III obesity. Arq. Bras. Endocrinol. Metabol, 2013, 57(2), 120-125.
[http://dx.doi.org/10.1590/S0004-27302013000200004] [PMID: 23525289]
[26]
Osborn, O.; Olefsky, J.M. The cellular and signaling networks linking the immune system and metabolism in disease. Nat. Med., 2012, 18(3), 363-374.
[http://dx.doi.org/10.1038/nm.2627] [PMID: 22395709]
[27]
Bjornstad, P.; Eckel, R.H. Pathogenesis of lipid disorders in insulin resistance: A brief review. Curr. Diab. Rep., 2018, 18(12), 127.
[http://dx.doi.org/10.1007/s11892-018-1101-6] [PMID: 30328521]
[28]
Gómez-Sámano, M.Á.; Cuevas-Ramos, D.; Mehta, R.; Brau-Figueroa, H.; Meza-Arana, C.E.; Gulias-Herrero, A. Association of alanine aminotransferase levels (ALT) with the hepatic insulin resistance index (HIRI): A cross-sectional study. BMC Endocr. Disord., 2012, 12(1), 16.
[http://dx.doi.org/10.1186/1472-6823-12-16] [PMID: 22947097]
[29]
Zhao, L.; Cheng, J.; Chen, Y.; Li, Q.; Han, B.; Chen, Y.; Xia, F.; Chen, C.; Lin, D.; Yu, X.; Wang, N.; Lu, Y. Serum alanine aminotransferase/aspartate aminotransferase ratio is one of the best markers of insulin resistance in the Chinese population. Nutr. Metab., 2017, 14, 64.
[30]
Prager, R.; Wallace, P.; Olefsky, J.M. Hyperinsulinemia does not compensate for peripheral insulin resistance in obesity. Diabetes, 1987, 36(3), 327-334.
[http://dx.doi.org/10.2337/diab.36.3.327] [PMID: 3542654]
[31]
Skalny, A.V.; Aschner, M.; Tinkov, A.A. Zinc. Adv. Food Nutr. Res., 2021, 96, 251-310.
[32]
Banach, W.; Nitschke, K.; Krajewska, N. Mongiałło, W.; Matuszak, O.; Muszyński, J.; Skrypnik, D. The association between excess body mass and disturbances in somatic mineral levels. Int. J. Mol. Sci., 2020, 21(19), 7306.
[http://dx.doi.org/10.3390/ijms21197306] [PMID: 33022938]
[33]
Olechnowicz, J.; Tinkov, A.; Skalny, A.; Suliburska, J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J. Physiol. Sci., 2018, 68(1), 19-31.
[http://dx.doi.org/10.1007/s12576-017-0571-7] [PMID: 28965330]
[34]
Ortega, R.M.; Rodríguez-Rodríguez, E.; Aparicio, A.; Jiménez, A.I.; López-Sobaler, A.M.; González-Rodríguez, L.G.; Andrés, P. Poor zinc status is associated with increased risk of insulin resistance in Spanish children. Br. J. Nutr., 2012, 107(3), 398-404.
[http://dx.doi.org/10.1017/S0007114511003114] [PMID: 22277170]
[35]
Ozata, M.; Salk, M.; Aydin, A.; Sayin, S.; Oktenli, C.; Beyhan, Z.; Isimer, A.; Ozdemir, I.C. Iodine and zinc, but not selenium and copper, deficiency exists in a male Turkish population with endemic goiter. Biol. Trace Elem. Res., 1999, 69(3), 211-216.
[http://dx.doi.org/10.1007/BF02783873]
[36]
Keshteli, A.H.; Hashemipour, M.; Siavash, M.; Kelishadi, R.; Amini, M. High prevalence of goiter in schoolchildren in Isfahan; zinc deficiency does not play a role. Endokrynol. Pol., 2010, 61(3), 287-290.
[37]
Teixeira, P.F.D.S.; Dos Santos, P.B.; Pazos-Moura, C.C. The role of thyroid hormone in metabolism and metabolic syndrome. Ther. Adv. Endocrinol. Metab., 2020, 11, 2042018820917869.
[http://dx.doi.org/10.1177/2042018820917869]
[38]
Kushchayeva, Y.S.; Startzell, M.; Cochran, E.; Auh, S.; Sekizkardes, H.; Soldin, S.J.; Kushchayev, S.V.; Dieckmann, W.; Skarulis, M.; Abdul Sater, Z.; Brychta, R.J.; Cypess, A.M.; Lin, T.C.; Lightbourne, M.; Millo, C.; Brown, R.J. Thyroid hormone effects on glucose disposal in patients with insulin receptor mutations. J. Clin. Endocrinol. Metab., 2020, 105(3), e158-e171.
[http://dx.doi.org/10.1210/clinem/dgz079] [PMID: 31588494]
[39]
Ostrowska, L.; Gier, D. Zyśk, B. The influence of reducing diets on changes in thyroid parameters in women suffering from obesity and hashimoto’s disease. Nutrients, 2021, 13(3), 862.
[http://dx.doi.org/10.3390/nu13030862] [PMID: 33808030]
[40]
Du, F.M.; Kuang, H.Y.; Duan, B.H.; Liu, D.N.; Yu, X.Y. Effects of thyroid hormone and depression on common components of central obesity. J Intern Med Res, 2019, 47(7), 3040-3049.
[41]
Hojman, L.; Karsulovic, C. Cardiovascular disease-associated skin conditions. Vasc. Health Risk Manag., 2022, 18, 43-53.
[http://dx.doi.org/10.2147/VHRM.S343319] [PMID: 35210782]
[42]
Adibi, N.; Robati, R. Skin and metabolic syndrome: A review of the possible associations. J. Res. Med. Sci., 2021, 26(1), 16.
[http://dx.doi.org/10.4103/jrms.JRMS_585_20] [PMID: 34084195]
[43]
Hu, Y.; Zhu, Y.; Lian, N.; Chen, M.; Bartke, A.; Yuan, R. Metabolic syndrome and skin diseases. Front. Endocrinol., 2019, 10, 788.
[http://dx.doi.org/10.3389/fendo.2019.00788] [PMID: 31824416]
[44]
Napolitano, M.; Megna, M.; Monfrecola, G. Insulin resistance and skin diseases. Sci. World J., 2015, 2015(4), 479354.
[PMID: 25977937]
[45]
Pes, G.M.; Fanciulli, G.; Delitala, A.P.; Piana, A.F.; Dore, M.P. Spatial association between gastric cancer mortality and goiter in Sardinia. Asian Pac. J. Cancer Prev., 2021, 22(1), 105-110.
[http://dx.doi.org/10.31557/APJCP.2021.22.1.105]
[46]
Testini, M.; Gurrado, A.; Avenia, N.; Bellantone, R.; Biondi, A.; Brazzarola, P.; Calzolari, F.; Cavallaro, G.; De Toma, G.; Guida, P.; Lissidini, G.; Loizzi, M.; Lombardi, C.P.; Piccinni, G.; Portincasa, P.; Rosato, L.; Sartori, N.; Zugni, C.; Basile, F. Does mediastinal extension of the goiter increase morbidity of total thyroidectomy? A multicenter study of 19,662 patients. Ann. Surg. Oncol., 2011, 18(8), 2251-2259.
[http://dx.doi.org/10.1245/s10434-011-1596-4] [PMID: 21336513]
[47]
Can, A.S.; Rehman, A. Goiter. 2022 Aug 22. In: StatPearls; Treasure Island (FL): StatPearls Publishing.
[PMID: 32965832]

Rights & Permissions Print Cite
Article Metrics
28
3
Wayfinder Image
World Diabetes Day
© 2024 Bentham Science Publishers | Privacy Policy