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      Correlation Between Glycemic Control and Serum Thyroglobulin Levels in a Patient With RAI-Refractory Thyroid Cancer

      case-report

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          Abstract

          Diabetes is a risk factor for thyroid cancer development. Serum thyroglobulin (Tg) levels are useful as sensitive and specific tumor markers for monitoring radioiodine (RAI)-refractory thyroid cancer; however, the impact of glycemic control on serum Tg levels is poorly understood. Here, we present a case of a female patient with lung metastases of RAI-refractory thyroid cancer in whom glycemic control may have influenced the serum Tg levels. Despite receiving thyroid-stimulating hormone suppression therapy, her serum Tg levels remained elevated. Subsequently, she developed type 2 diabetes and was administered antidiabetic medications for 6 years. Throughout the course of diabetes management, her serum Tg levels fluctuated according to the level of glycemic control, showing a strong correlation with her hemoglobin A1c levels ( r = 0.92, P < .01). Similar to the serum levels of other tumor markers, such as the carcinoembryonic antigen and carbohydrate antigen 19-9, the serum levels of Tg can be influenced by glycemic control. Therefore, serum Tg levels in patients with RAI-refractory thyroid cancer and diabetes should be monitored with attention to glycemic control.

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          2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer.

          Bryan Haugen, Erik Alexander, Keith Bible … (2016)
          Thyroid nodules are a common clinical problem, and differentiated thyroid cancer is becoming increasingly prevalent. Since the American Thyroid Association's (ATA's) guidelines for the management of these disorders were revised in 2009, significant scientific advances have occurred in the field. The aim of these guidelines is to inform clinicians, patients, researchers, and health policy makers on published evidence relating to the diagnosis and management of thyroid nodules and differentiated thyroid cancer.
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            Anthropometric Factors and Thyroid Cancer Risk by Histological Subtype: Pooled Analysis of 22 Prospective Studies.

            Cari M. Kitahara, Marjorie L. McCullough, Silvia Franceschi … (2016)
            Greater height and body mass index (BMI) have been associated with an increased risk of thyroid cancer, particularly papillary carcinoma, the most common and least aggressive subtype. Few studies have evaluated these associations in relation to other, more aggressive histologic types or thyroid cancer-specific mortality.
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              Hyperglycemia-Induced Aberrant Cell Proliferation; A Metabolic Challenge Mediated by Protein O-GlcNAc Modification

              Tamas Nagy, Viktória Fisi, Dorottya Frank … (2019)
              Chronic hyperglycemia has been associated with an increased prevalence of pathological conditions including cardiovascular disease, cancer, or various disorders of the immune system. In some cases, these associations may be traced back to a common underlying cause, but more often, hyperglycemia and the disturbance in metabolic balance directly facilitate pathological changes in the regular cellular functions. One such cellular function crucial for every living organism is cell cycle regulation/mitotic activity. Although metabolic challenges have long been recognized to influence cell proliferation, the direct impact of diabetes on cell cycle regulatory elements is a relatively uncharted territory. Among other “nutrient sensing” mechanisms, protein O-linked β-N-acetylglucosamine (O-GlcNAc) modification emerged in recent years as a major contributor to the deleterious effects of hyperglycemia. An increasing amount of evidence suggest that O-GlcNAc may significantly influence the cell cycle and cellular proliferation. In our present review, we summarize the current data available on the direct impact of metabolic changes caused by hyperglycemia in pathological conditions associated with cell cycle disorders. We also review published experimental evidence supporting the hypothesis that O-GlcNAc modification may be one of the missing links between metabolic regulation and cellular proliferation.
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                Author and article information

                Contributors
                Yuji Hataya:
                ORCID: https://orcid.org/0000-0002-4710-6393
                Takumi Nomura
                Yuko Fujishima
                Kanta Fujimoto
                Toshio Iwakura
                Naoki Matsuoka
                Journal
                Journal ID (nlm-ta): JCEM Case Rep
                Journal ID (iso-abbrev): JCEM Case Rep
                Journal ID (publisher-id): jcemcr
                Title: JCEM Case Reports
                Publisher: Oxford University Press (US )
                ISSN (Electronic): 2755-1520
                Publication date Collection: May 2024
                Publication date (Electronic): 03 May 2024
                Publication date PMC-release: 03 May 2024
                Volume: 2
                Issue: 5
                Electronic Location Identifier: luae085
                Affiliations
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1 , Kobe, Hyogo 650-0047, Japan
                Author notes
                Correspondence: Yuji Hataya, MD, PhD, Department of Diabetes and Endocrinology, Kobe City Medical Center General Hospital, 2-1-1, Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan. Email: yhataya@ 123456kcho.jp .
                Author information
                https://orcid.org/0000-0002-4710-6393
                Article
                Publisher ID: luae085
                DOI: 10.1210/jcemcr/luae085
                PMC ID: 11066931
                PubMed ID: 38707655
                SO-VID: fb22fae9-0b07-4681-b8ae-360794689e58
                Copyright © © The Author(s) 2024. Published by Oxford University Press on behalf of the Endocrine Society.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence ( https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

                History
                Date received : 01 February 2024
                Date: 17 April 2024
                Date: 03 May 2024
                Page count
                Pages: 5
                Categories
                Subject: Case Report
                Subject: AcademicSubjects/MED00010
                Subject: AcademicSubjects/MED00160
                Subject: AcademicSubjects/MED00250
                Subject: AcademicSubjects/MED00300
                Subject: AcademicSubjects/MED00905

                Keywords: radioiodine-refractory thyroid cancer,thyroglobulin,type 2 diabetes,glycemic control,metformin
                Data availability:
                Keywords: radioiodine-refractory thyroid cancer, thyroglobulin, type 2 diabetes, glycemic control, metformin

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