Research Paper Volume 13, Issue 18 pp 22232—22241

High prevalence of thyroid carcinoma in patients with insulin resistance: a meta-analysis of case-control studies

Junyu Zhao1,2, *, , Qianping Zhang3, *, , Yupeng Yang4, , Jinming Yao1,2, , Lin Liao1,2, , Jianjun Dong5, ,

  • 1 Department of Endocrinology and Metabology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan 250014, China
  • 2 Department of Endocrinology and Metabology, Shandong Provincial Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250014, China
  • 3 Division of Endocrinology, Dezhou Municipal Hospital, Dezhou 253000, China
  • 4 Division of Breast and Thyroid Surgery, Jinan Zhangqiu District Hospital of Traditional Chinese Medicine, Jinan 250200, China
  • 5 Division of Endocrinology, Department of Internal Medicine, Qilu Hospital of Shandong University, Jinan 250012, China
* Equal contribution

Received: December 23, 2020       Accepted: September 3, 2021       Published: September 22, 2021
How to Cite

Copyright: © 2021 Zhao et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


The association between insulin resistance and thyroid carcinoma is controversial. We conducted this meta-analysis of association between insulin resistance and thyroid carcinoma. There were 14 studies included in this meta-analysis. Random-effect model was used to merge the weighted mean difference value of fasting serum insulin level and the pooled effect shows that the level of fasting serum insulin is higher in patients with thyroid carcinoma than those of controls (1.88, 95% CI 0.87 to 2.90, P=0.0003). Random-effect model was used to estimate the pooled weighted mean difference and it shows that thyroid carcinoma patients have a higher level of homeostasis model assessment of insulin resistance (HOMA-IR) than patients without thyroid carcinoma (0.54, 95% CI 0.29 to 0.78, P<0.0001). Fixed-effect model with the odds ratio of insulin resistance shows that insulin resistance could increase the risk of thyroid carcinoma 216% compared with participants without insulin resistance (3.16, 95% CI 2.09 to 4.77, P<0.0001). In conclusion, insulin resistance might be a risk factor for thyroid carcinoma.


DTC: differentiated thyroid carcinoma; PTC: Papillary thyroid carcinoma; FTC: Thyroid cancer, follicular; ATC: Thyroid Carcinoma, Anaplastic; MTC: Thyroid cancer, medullary; NOS: Newcastle-Ottawa Scale; WMD: weighted mean difference; SMD: standardized mean difference; CI: confidence intervals; OR: odds ratio; IGF-1: insulin-like growth factor-1.