25-Hydroxyvitamin D and TSH as Risk Factors or Prognostic Markers in Thyroid Carcinoma

Abstract

ObjectiveThe increasing incidence of thyroid nodules demands identification of risk factors for malignant disease. Several studies suggested the association of higher TSH levels with cancer, but influence of 25-hydroxyvitamin D (25OHD) is controversial. This study aimed to identify the relationship of thyroid cancer with higher TSH levels and hypovitaminosis D and to evaluate their influence on prognostic characteristics of papillary thyroid carcinomas (PTC).MethodsWe retrospectively evaluated 433 patients submitted to thyroidectomy for thyroid nodules. Patients were categorized according to quartiles of TSH and 25OHD levels. Clinicopathological features were analyzed.ResultsSubjects with thyroid carcinomas were more frequently male and younger compared to those with benign disease. Their median TSH levels were higher and adjusted odds-ratio (OR) for cancer in the highest-quartile of TSH (> 2.4 mUI/mL) was 2.36 (1.36–4.09). Although vitamin D deficiency/insufficiency was prevalent in our cohort (84%), no significant differences in 25OHD levels or quartile distribution were observed between benign and malignant cases. Among 187 patients with PTC, analyses of prognostic features revealed increased risk of lymph nodes metastases for subjects with highest-quartile TSH levels (OR = 3.7, p = 0.029). Decreased 25OHD levels were not overtly associated with poor prognosis in PTC.ConclusionsIn this cross-sectional cohort, higher TSH levels increased the risk of cancer in thyroid nodules and influenced its prognosis, particularly favoring lymph nodes metastases. On the other hand, no association was found between 25OHD levels and thyroid carcinoma risk or prognosis, suggesting that serum 25OHD determination may not contribute to risk assessment workup of thyroid nodules.

The Role of Vitamin D, Platelet-Derived Growth Factor and Insulin-Like Growth Factor 1 in the Progression of Thyroid Diseases

“…Penna-Martinez et al, (2012), reported an association between the incidence of differentiated thyroid cancer (DTC) and low levels of 25(OH)D and 1,25(OH)2D in certain CYP24A1 haplotypes. On contrary, other studies reported no significant association between serum level of 25(OH) D and thyroid cancer risk (Jonklaas et al, 2013;Ahn et al, 2016;Danilovic et al, 2016;Kim, 2016;Choi et al, 2017). Another marker assessed in the current study is the serum levels of PDGF-AB in the patients' groups, it revealed a significant increase in the level of PDGF-AB in the TC and BN patients compared to the control group.…”

The Role of Vitamin D in Thyroid Diseases

“…Danilovic et al, evaluated 433 patients that underwent thyroidectomy for thyroid nodules and observed no significant differences in preoperative 25(OH)D levels or quartile distribution between benign and malignant cases. Decreased 25(OH)D levels were not overtly associated with a poorer prognosis among 187 patients with PTC [ 71 ]. The author also investigated 410 patients that underwent ultrasonography-guided fine-needle aspiration for thyroid nodules and found that serum 25(OH)D levels and the prevalence of vitamin D insufficiency (25(OH)D level < 75 nmol/L) did not significantly differ between benign and malignant thyroid nodules.…”

<p>The Blood Biomarkers of Thyroid Cancer</p>

“…23 Although most studies support a decrease in serum selenium levels in patients with thyroid cancer, and supplementation with selenium may reduce the risk of certain diseases, the decline is not specific, except for thyroid cancer, including infections, many diseases, including Parkinson's, can cause selenium levels to decline. 24 The significance of vitamin D in the diagnosis and prognosis of thyroid cancer is also conflicted, although in 2016 and 2017, Choi 25 and Danilovic 26 denied serum 25 (OH) D 3 's role in determining the risk of thyroid cancer in their studies respectively. But in 2018, Zhang et al found that the content of 1,25 (OH) 2 D 3 in the serum of patients with PTC is significantly lower than that of healthy people, so maybe 1,25 (OH) 2 D 3 can become a potential diagnostic marker for PTC.…”

“…The significance of vitamin D in the diagnosis and prognosis of thyroid cancer is also conflicted, although in 2016 and 2017, Choi 25 and Danilovic 26 denied serum 25 (OH) D 3 ’s role in determining the risk of thyroid cancer in their studies respectively. But in 2018, Zhang et al found that the content of 1,25 (OH) 2 D 3 in the serum of patients with PTC is significantly lower than that of healthy people, so maybe 1,25 (OH) 2 D 3 can become a potential diagnostic marker for PTC.…”