{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:42:09Z","timestamp":1791916929605,"version":"4.3.4"},"reference-count":47,"publisher":"Institute of Physiology of the Czech Academy of Sciences","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Physiol Res"],"abstract":"<jats:p>Objective\u02d0 patients with type 2 diabetes (T2DM) and obesity are generally known to have increased risk of various types of cancer, though studies addressing associations between T2DM\/obesity and thyroid cancer are inconclusive. The aim of our study was to evaluate the risk of thyroid cancer focusing on diabetic patients under conditions of euthyroid status. A retrospective study in 184 patients was performed. Three cohorts were established according to tumor histology: malignant (M), benign (B) and low-risk carcinoma (MB). Fisher\u2019s exact test and Kruskal-Wallis one-way ANOVA of ranks were used for statistical analysis. The M (39.1 %), B (57.6 %) and MB (3.3 %) cohorts had comparable age (p=0.4), BMI (p=0.452), glycaemia (p=0.834), Hb1AC (p=0.157) and HOMA-IR (p=0.235). T2DM patients had larger thyroid gland volumes (28.8 vs 17.6 mL;p=0.001) compared to the cohort with normal glucose tolerance. Compared to women, men had more frequently present distal metastases (p=0.017), minimally invasive disease (p=0.027), more advanced staging (p=0.01) and positive pathogenic mutations in the TERT gene (p=0.009);these results were also significant for the diabetic male cohort (p=0.026). Type 2 diabetes and obesity are not risk factors for thyroid cancer, but a subgroup of males seems to have thyroid cancers of poorer prognosis. In general, diabetic patients with insulin resistance and hyperinsulinemia are also prone to have a goiter.<\/jats:p>","DOI":"10.33549\/physiolres.935433","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T16:32:21Z","timestamp":1738168341000},"page":"1025-1035","source":"Crossref","is-referenced-by-count":4,"title":["Type 2 Diabetes, Obesity and Their Relation to the Risks of Thyroid Cancer"],"prefix":"10.33549","author":[{"given":"T","family":"Grimmichov\u00e1","sequence":"first","affiliation":[{"name":"Institute of Endocrinology, Prague, Czech Republic tgrimmichova@endo.cz"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V","family":"Kuklikov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B","family":"Bulanov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Pa\u010desov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"V\u00e1clav\u00edkov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Moravcov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Z","family":"Nov\u00e1k","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Mastnikova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Va\u0148kov\u00e1","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"19169","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Megwalu UC, Moon PK. Thyroid Cancer Incidence and Mortality Trends in the United States: 2000-2018. Thyroid 2022;32:560-570. https:\/\/doi.org\/10.1089\/thy.2021.0662","DOI":"10.1089\/thy.2021.0662"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Ito Y, Nikiforov YE, Schlumberger M, Vigneri R. Increasing incidence of thyroid cancer:controversies explored. Nat Rev Endocrinol 2013;9:178-184. https:\/\/doi.org\/10.1038\/nrendo.2012.257","DOI":"10.1038\/nrendo.2012.257"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Roti E, Degli Uberti EC, Bondanelli, Braverman LE. Thyroid papillary microcarcinoma: a descriptive and meta-analysis study. Eur J Endocrinol 2008;159:659-73. https:\/\/doi.org\/10.1530\/EJE-07-0896","DOI":"10.1530\/eje-07-0896"},{"key":"ref3","unstructured":"Zhang W, Bai X, Ge H, Cui H, Wei Z, Han G. Meta-analysis in the association between obesity and risk of thyroid cancer. Int J Clin Exp Med 2014;15:5268-74."},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Standl E, Khunti K, Hansen TB, Schnell O. The global epidemics of diabetes in the 21st century: Current situation and perspectives. Eur J Prev Cardiol 2019;26:7-14. https:\/\/doi.org\/10.1177\/2047487319881021","DOI":"10.1177\/2047487319881021"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Chatterjee S, Khunti K, Davies MJ. Type 2 diabetes. Lancet 2017;3: 2239-2251. https:\/\/doi.org\/10.1016\/S0140-6736(17)30058-2","DOI":"10.1016\/s0140-6736(17)30058-2"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Bellary S, Kyrou I, Brown JE, Bailey CJ. Type 2 diabetes mellitus in older adults: clinical considerations and management. Nat Rev Endocrinol 2021;17:534-548. https:\/\/doi.org\/10.1038\/s41574-021-00512-2","DOI":"10.1038\/s41574-021-00512-2"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"La Vecchia C, Negri E, Franceschi S, D'Avanzo B, Boyle P. A case-control study of diabetes mellitus and cancer risk. Br J Cancer 1994;70:950-3. https:\/\/doi.org\/10.1038\/bjc.1994.427","DOI":"10.1038\/bjc.1994.427"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Paes JE, Hua K, Nagy R, Kloos RT, Jarjoura D, Ringel MD. The relationship between body mass index and thyroid cancer pathology features and outcomes: a clinicopathological cohort study. J Clin Endocrinol Metab 2010;95:4244-5p. https:\/\/doi.org\/10.1210\/jc.2010-0440","DOI":"10.1210\/jc.2010-0440"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Biondi B, Kahaly GJ, Robertson RP. Thyroid Dysfunction and Diabetes Mellitus: Two Closely Associated Disorders. Endocr Rev 2019;1:789-824. https:\/\/doi.org\/10.1210\/er.2018-00163","DOI":"10.1210\/er.2018-00163"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Biondi B, Cappola AR, Cooper DS. Subclinical Hypothyroidism: A Review. JAMA 2019;322:153-160. https:\/\/doi.org\/10.1001\/jama.2019.9052","DOI":"10.1001\/jama.2019.9052"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Waring AC, Arnold AM, Newman AB, B\u00f9zkov\u00e1 P, Hirsch C, Cappola AR. Longitudinal changes in thyroid function in the oldest old and survival: the cardiovascular health study all-stars study. J Clin Endocrinol Metab 2012;97:3944-50. https:\/\/doi.org\/10.1210\/jc.2012-2481","DOI":"10.1210\/jc.2012-2481"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, Collins BS, Cusi K et al. American Diabetes Association. Addendum. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2023. Diabetes Care 2023;46:S49-S67. https:\/\/doi.org\/10.2337\/dc23-S004","DOI":"10.2337\/dc23-ad09"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Pearce SH, Brabant G, Duntas LH, Monzani F, Peeters RP, Razvi S, Wemeau JL. 2013 ETA Guideline: Management of Subclinical Hypothyroidism. Eur Thyroid J 2013;2:215-28. https:\/\/doi.org\/10.1159\/000356507","DOI":"10.1159\/000356507"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Ladenson PW, Singer PA, Ain KB, Bagchi N, Bigos ST, Levy EG, S A Smith SA et al. American Thyroid Association guidelines for detection of thyroid dysfunction. Arch Intern 2000;160:1573-1575. https:\/\/doi.org\/10.1001\/archinte.160.11.1573","DOI":"10.1001\/archinte.160.11.1573"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"American Diabetes Association. Standards of medical care in diabetes-2018: Diabetes Care 2018;31:S12-S54. https:\/\/doi.org\/10.2337\/dc08-S012","DOI":"10.2337\/dc08-s012"},{"key":"ref16","doi-asserted-by":"publisher","unstructured":"Dieringer P, Klass EM, Caine B, Smith-Gagen J. Associations between body mass and papillary thyroid cancer stage and tumor size: a population-based study. J Cancer Res Clin 2015;141:93-8. https:\/\/doi.org\/10.1007\/s00432-014-1792-2","DOI":"10.1007\/s00432-014-1792-2"},{"key":"ref17","doi-asserted-by":"publisher","unstructured":"Roh E, Noh E, Hwang SY, Kim JA, Song E, Choi KM, Baik SH et al. Increased Risk of Type 2 Diabetes in Patients With Thyroid Cancer After Thyroidectomy: A Nationwide Cohort Study. J Clin Endocrinol Met 2022;17:e1047-e1056. https:\/\/doi.org\/10.1210\/clinem\/dgab776","DOI":"10.1210\/clinem\/dgab776"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M Peters AL et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2015;58:429-42. https:\/\/doi.org\/10.1007\/s00125-014-3460-0","DOI":"10.1007\/s00125-014-3460-0"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care 2004;27:1487-95. https:\/\/doi.org\/10.2337\/diacare.27.6.1487","DOI":"10.2337\/diacare.27.6.1487"},{"key":"ref20","doi-asserted-by":"publisher","unstructured":"Grimmichova T, Pacesova P, Hill M, Pekova B, Vankova M, Moravcova J Vrbikova J et al. Thyroid Cancer Detection in a Routine Clinical Setting: Performance of ACR TI-RADS, FNAC, and Molecular Testing in Prospective Cohort Study. Biomedicines 2022;10:954. https:\/\/doi.org\/10.3390\/biomedicines10050954","DOI":"10.3390\/biomedicines10050954"},{"key":"ref21","doi-asserted-by":"publisher","unstructured":"Miranda-Filho A, Lortet-Tieulent J, Bray F, Cao B, Franceschi S, Vaccarella S. Thyroid cancer incidence trends by histology in 25 countries: a population-based study. Lancet Diabetes Endocrinol 2021;9:225-234. https:\/\/doi.org\/10.1016\/S2213-8587(21)00027-9","DOI":"10.1016\/s2213-8587(21)00027-9"},{"key":"ref22","doi-asserted-by":"publisher","unstructured":"Robenshtok E, Neeman B, Reches L, Ritter A, Bachar G, Kaminer K, Shimon I et al. Adverse Histological Features of Differentiated Thyroid Cancer Are Commonly Found in Autopsy Studies: Implications for Treatment Guidelines. Thyroid 2022;32:37-45. https:\/\/doi.org\/10.1089\/thy.2021.0268","DOI":"10.1089\/thy.2021.0268"},{"key":"ref23","doi-asserted-by":"publisher","unstructured":"Pearson-Stuttard J, Papadimitriou N, Markozannes G, Cividini S, Kakourou A, Gill D, Rizos EC et al. Type 2 Diabetes and Cancer: An Umbrella Review of Observational and Mendelian Randomization Studies. Cancer Epidemiol 2021;30:1218-1228. https:\/\/doi.org\/10.1158\/1055-9965.EPI-20-1245","DOI":"10.1158\/1055-9965.epi-20-1245"},{"key":"ref24","doi-asserted-by":"publisher","unstructured":"Inoue M, Iwasaki M, Otani T, Sasazuki S, Noda M, Tsugane S. Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan. Arch Intern 2006;25:1871-7. https:\/\/doi.org\/10.1001\/archinte.166.17.1871","DOI":"10.1001\/archinte.166.17.1871"},{"key":"ref25","doi-asserted-by":"publisher","unstructured":"Grega T, Vojtechova G, Gregova M, Zavoral M, Suchanek S. Pathophysiological Characteristics Linking Type 2 Diabetes Mellitus and Colorectal Neoplasia. Physiol Res;2021 31:509-522. https:\/\/doi.org\/10.33549\/physiolres.934631","DOI":"10.33549\/physiolres.934631"},{"key":"ref26","doi-asserted-by":"publisher","unstructured":"Saarela K, Tuomilehto J, Sund R, Keskimaki I, Hartikainen R, Pukkala E. Cancer incidence among Finnish people with type 2 diabetes during 1989-2014. Eur J Epidemiol 2019;34:259-265. https:\/\/doi.org\/10.1007\/s10654-018-0438-0","DOI":"10.1007\/s10654-018-0438-0"},{"key":"ref27","doi-asserted-by":"publisher","unstructured":"Goto A, Yamaji T, Sawada N, Momozawa Y, Kamatani Y, Kubo M, Shimazu T et al. Diabetes and cancer risk: A Mendelian randomization study. Int J Cancer 2020;146:712-719. https:\/\/doi.org\/10.1002\/ijc.32310","DOI":"10.1002\/ijc.32310"},{"key":"ref28","doi-asserted-by":"publisher","unstructured":"Aschebrook-Kilfoy B, Sabra MM, Brenner A, Moore SC, Ron E, Schatzkin A, Hollenbeck A et al. Diabetes and thyroid cancer risk in the National Institutes of Health-AARP Diet and Health Study. Thyroid 2011;21:957-63. https:\/\/doi.org\/10.1089\/thy.2010.0396","DOI":"10.1089\/thy.2010.0396"},{"key":"ref29","doi-asserted-by":"publisher","unstructured":"Fu M, Yang L, Wang H, Chen Y, Chen X, Hu Q, Sun H. Research progress into adipose tissue macrophages and insulin resistance. Physiol Res 2023;72:287-299. https:\/\/doi.org\/10.33549\/physiolres.935046","DOI":"10.33549\/physiolres.935046"},{"key":"ref30","doi-asserted-by":"publisher","unstructured":"Rapp K, Schroeder J, Klenk J, Ulmer H, Concin H, Diem G, Oberaigner W et al. Fasting blood glucose and cancer risk in a cohort of more than 140,000 adults in Austria. Diabetologia 2006;49:945-52. https:\/\/doi.org\/10.1007\/s00125-006-0207-6","DOI":"10.1007\/s00125-006-0207-6"},{"key":"ref31","doi-asserted-by":"publisher","unstructured":"Yeo Y, Ma SH, Hwang Y, Horn-Ross PL, Hsing A, Lee KE. Diabetes mellitus and risk of thyroid cancer: a meta-analysis. PLoS One 2014;13:e98135. https:\/\/doi.org\/10.1371\/journal.pone.0098135","DOI":"10.1371\/journal.pone.0098135"},{"key":"ref32","doi-asserted-by":"publisher","unstructured":"Kitahara CM, Platz EA, Beane Freeman LE, Black A, Hsing AW, Linet MS Park Y et al. Physical activity, diabetes, and thyroid cancer risk: a pooled analysis of five prospective studies. Cancer Causes Control 2012;23: 463-471. https:\/\/doi.org\/10.1007\/s10552-012-9896-y, https:\/\/doi.org\/10.1007\/s10552-012-0039-2","DOI":"10.1007\/s10552-012-9896-y"},{"key":"ref33","doi-asserted-by":"publisher","unstructured":"Luo J, Phillips L, Liu S, Wactawski-Wende J, Margolis KL. Diabetes Treatment, and Risk of Thyroid Cancer. J Clin Endocrinol Met 2016;101: 1243-8. https:\/\/doi.org\/10.1210\/jc.2016-2011, https:\/\/doi.org\/10.1210\/jc.2015-3901","DOI":"10.1210\/jc.2015-3901"},{"key":"ref34","doi-asserted-by":"publisher","unstructured":"Dong WW, Zhang DL, Wang ZH, Lv CZ, Zhang P, Zhang H. Different types of diabetes mellitus and risk of thyroid cancer: A meta-analysis of cohort studies. Frontiers in Endocrinology 2022;23:971213. https:\/\/doi.org\/10.3389\/fendo.2022.971213","DOI":"10.3389\/fendo.2022.971213"},{"key":"ref35","doi-asserted-by":"publisher","unstructured":"Grimmichova T, Haluzik M, Vondra K, Matucha P, Hill M. Relations of prediabetes and type 2 diabetes to the thyroid cancer. Endocrine Connections 2020;1:607-16. https:\/\/doi.org\/10.1530\/EC-20-0180","DOI":"10.1530\/ec-20-0180"},{"key":"ref36","doi-asserted-by":"publisher","unstructured":"Fang M, Wang D, Coresh J, Selvin E. Undiagnosed Diabetes in U.S. Adults: Prevalence and Trends. Diabetes Care 2022;1:1994-2002. https:\/\/doi.org\/10.2337\/dc22-0242","DOI":"10.2337\/figshare.20098115"},{"key":"ref37","doi-asserted-by":"publisher","unstructured":"Fang Y, Zhang X, Xu H, Smith-Warner SA, Xu D, Fang H, Xu WH. Cancer risk in Chinese diabetes patients: a retrospective cohort study based on management data. Endocr Connect 2018;7:1415-1423. https:\/\/doi.org\/10.1530\/EC-18-0381","DOI":"10.1530\/ec-18-0381"},{"key":"ref38","doi-asserted-by":"publisher","unstructured":"Rezz\u00f3nico JN, Rezz\u00f3nico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr 2009;7:375-380. https:\/\/doi.org\/10.1089\/met.2008.0062","DOI":"10.1089\/met.2008.0062"},{"key":"ref39","doi-asserted-by":"publisher","unstructured":"Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of Type 2 Diabetes - Global Burden of Disease and Forecasted Trends. J Epidemiol 2020;10:107-111. https:\/\/doi.org\/10.2991\/jegh.k.191028.001","DOI":"10.2991\/jegh.k.191028.001"},{"key":"ref40","doi-asserted-by":"crossref","unstructured":"Wolin KY, Carson K, Colditz GA. Obesity and cancer. Oncologist 2010;15: 556-565. https:\/\/doi.org\/10.1634\/theoncologist.2009-0285","DOI":"10.1634\/theoncologist.2009-0285"},{"key":"ref41","doi-asserted-by":"publisher","unstructured":"Kim SH, Park HS, Kim KH, Yoo H, Chae BJ, Bae JS, Jung SS. Correlation between obesity and clinicopathological factors in patients with papillary thyroid cancer. Surg Today 2015;45:723-729. https:\/\/doi.org\/10.1007\/s00595-014-0984-3","DOI":"10.1007\/s00595-014-0984-3"},{"key":"ref42","doi-asserted-by":"publisher","unstructured":"Ma J, Huang M, Wang L, Ye W, Tong Y, Wang H. Obesity and risk of thyroid cancer: evidence from a meta-analysis of 21 observational studies. Med Sci Monit 2015;21:283-291. https:\/\/doi.org\/10.12659\/MSM.892035","DOI":"10.12659\/msm.892035"},{"key":"ref43","doi-asserted-by":"publisher","unstructured":"Oberman B, Khaku A, Camacho F & Goldenberg D. Relationship between obesity, diabetes and the risk of thyroid cancer. Am J Otolaryng 2015;36: 535-541. https:\/\/doi.org\/10.1016\/j.amjoto.2015.02.015","DOI":"10.1016\/j.amjoto.2015.02.015"},{"key":"ref44","doi-asserted-by":"publisher","unstructured":"Farfel A, Kark JD, Derazne E, Tzur D, Barchana M, Lazar L, Afek A et al. Predictors for thyroid carcinoma in Israel: a national cohort of 1,624,310 adolescents followed for up to 40 years. Thyroid 2014;24:987-993. https:\/\/doi.org\/10.1089\/thy.2013.0173","DOI":"10.1089\/thy.2013.0173"},{"key":"ref45","doi-asserted-by":"publisher","unstructured":"O'Neill RJ, Abd Elwahab S, Kerin MJ, Lowery AJ. Association of BMI with Clinicopathological Features of Papillary Thyroid Cancer: A Systematic Review and Meta-Analysis. World J Surg 2021;45:2805-2815. https:\/\/doi.org\/10.1007\/s00268-021-06193-2","DOI":"10.1007\/s00268-021-06193-2"},{"key":"ref46","doi-asserted-by":"publisher","unstructured":"Kaplan RM, Chambers DA, Glasgow RE. Big data and large sample size: a cautionary note on the potential for bias. Clin Transl Sci 2014;7:342-346. https:\/\/doi.org\/10.1111\/cts.12178","DOI":"10.1111\/cts.12178"}],"container-title":["Physiological Research"],"original-title":[],"language":"en","deposited":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T16:32:37Z","timestamp":1738168357000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.biomed.cas.cz\/physiolres\/pdf\/2024\/73_1025.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,31]]},"references-count":47,"URL":"https:\/\/doi.org\/10.33549\/physiolres.935433","relation":{},"ISSN":["1802-9973","0862-8408"],"issn-type":[{"value":"1802-9973","type":"electronic"},{"value":"0862-8408","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12,31]]}}}