Search for a command to run...
Aim. To assess the relationship between the development of follicular thyroid adenoma and visceral obesity, insulin resistance and the body's supply of selenium, zinc, and copper (in hair). Design. Observational, comparative, open, single-center, cross-sectional study. Materials and methods. Over a 2-year period, the study included all women who underwent surgery at the Kuzbass Clinical Oncology Dispensary named after M.S. Rappoport and had a histologically confirmed diagnosis of follicular thyroid adenoma (n = 107). The control group (n = 46) was formed from the list of patients undergoing a medical examination. Every third woman without thyroid diseases, carbohydrate metabolism disorders and diabetes mellitus, severe diseases of organs and systems, including mental and infectious diseases, as well as cancer of various localizations in the anamnesis and at the time of the study, was randomly selected. Participants in both groups were comparable in age (20–60 years). All women were assessed for anthropometric parameters: height, body weight, body mass index (BMI), waist circumference (WC), the ratio of WC to hip circumference (HC); as well as levels of thyroid-stimulating hormone, free thyroxine, glucose, insulin, and insulin-like growth factor 1 (IGF-1) in venous plasma, and levels of selenium, zinc, and copper in hair, an ultrasound examination of the thyroid gland was performed. The Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index was used to assess tissue sensitivity to insulin. Results. Most patients with follicular thyroid adenoma were overweight (30.8%) and obese (38.4%) with predominant visceral fat deposition. Elevated HOMA-IR index in follicular thyroid adenoma was observed in every third woman with normal weight (30.3%), in 51.5% with overweight, and in 75.6% with obesity. Elevated IGF-1 levels were found in 51.4% of patients with follicular thyroid adenoma, while in the control group they did not exceed reference values. The median IGF-1 level in women with follicular thyroid adenoma was significantly higher than in participants without thyroid pathology: 251.2 (216.5; 311.4) versus 187 (166.4; 218.6) ng/ml, p = 0.000. In most cases of follicular thyroid adenoma, a deficiency of essential microelements was recorded: zinc (65.4%), selenium (70.1%), and copper (64.5%). Inverse correlations were found between selenium, zinc, and copper levels and the HOMA-IR index, as well as direct associations between zinc and copper concentrations and IGF-1 levels in women with follicular thyroid adenoma. Using logistic regression, we identified prognostically significant predictors of follicular thyroid adenoma development: low zinc and copper levels, high IGF-1 levels, the WC/HC ratio, and the HOMA-IR index. Conclusion. The association between thyroid function and visceral obesity, IR, and micronutrient imbalance, as determined by logistic regression, helped identify prognostically significant adverse factors for thyroid function. The resulting predictive model will allow for assessing the risk of thyroid function based on hair zinc and copper concentrations, the WC/HR ratio, the HOMA-IR index, and blood IGF-1 levels. Keywords: follicular adenoma, insulin resistance, selenium, zinc, copper.