甲状腺结节和差异化甲状腺癌中的胰岛素耐药性和代谢功能障碍
Stefano Iuliano1, Maria Mirabelli, Stefania Giuliano
1Department of Health Sciences, University of Catanzaro Magna Graecia, Catanzaro, Italy.
Current opinion in oncology
|November 12, 2025
概括
代谢功能障碍,包括肥胖和胰岛素抵抗,越来越多地与甲状腺结节生长和差异化甲状腺癌有关. 解决代谢健康对于精确的甲状腺疾病管理至关重要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 代谢健康 代谢健康
背景情况:
- 全球肥胖率上升,代谢综合征 (MetS),胰岛素抵抗 (IR) 和2型糖尿病 (T2DM) 影响甲状腺疾病的流行病学.
- 甲状腺结节性疾病和差异化甲状腺癌 (DTC) 特别受到代谢功能障碍的影响.
- 新出现的证据将代谢功能障碍与甲状腺结节生长和瘤发生联系起来.
研究的目的:
- 审查新出现的证据,将新陈代谢功能障碍与甲状腺结节生长和瘤发生联系起来.
- 要总结支持这种联系的分子机制和临床发现.
- 讨论对预防和治疗策略的影响.
主要方法:
- 对流行病学,分子和转化证据的审查.
- 在甲状腺细胞中分析信号通路 (PI3K/AKT/mTOR,MAPK/ERK).
- 检查将代谢参数 (HOMA-IR,MetS) 与甲状腺结节性联系起来的临床数据.
- 评估环境和荷尔蒙因素.
主要成果:
- 慢性高胰岛素血症在IR中激活了甲状腺细胞中的线粒发生的途径,因INSR-A和IGF1R过度表达而放大.
- 脂肪组织功能障碍,炎症和氧化应激有助于甲状腺风险.
- MetS是甲状腺结节的独立预测因子;甲状腺结节患者的HOMA-IR值较高.
- 甲胺通过AMPK激活和mTOR抑制显示出治疗前景.
- 对于GLP-1受体激动剂的甲状腺安全问题在很大程度上是理论上的.
结论:
- 汇聚的证据凸显了代谢功能障碍和甲状腺疾病之间的复杂相互作用.
- 整合代谢健康对于精确管理甲状腺结节和DTC至关重要.
- 需要进一步的研究,包括随机试验,以完善治疗策略.
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