Thyroid dysfunction is involved in several types of carcinoma. Hypothyroidism is one of the most common medical morbidities among patients with endometrial cancer; however, the related mechanism is unclear. Among the risk factors related to endometrial cancer, hypothyroidism interacts with metabolic syndrome, polycystic ovarian syndrome and infertility or directly acts on the endometrium itself, which may influence the development and progression of endometrial cancer. We summarize recent studies on the relationship between hypothyroidism and endometrial cancer and its risk factors to provide references for basic research as well as for clinical treatment and prognostic evaluation.
Ovarian volume and cyst formation ↑; PCOS ↑; CC resistance ↑[23-26].
Menstrual problems, breakthrough bleeding, anovulation, and infertility↑ [27, 28].
TH → SREBP-2 and LDL-receptors ↑ → cholesterol removal from the liver ; TH → lipoprotein lipase and hepatic lipase activity ↑ → serum TG and cholesterol↓ ; TSH → acting on TSH receptors in the hepatocyte membranes → HMGC ↑ → cholesterol synthesis in the liver ↑ ; TSH acts on preadipocyte differentiation and adipogenesis → lipolysis↑→ serum free fatty acid↑ .
T3 acts on arterial smooth muscle cells of blood vessels to cause vasodilation . Hypothyroidism → abnormal sodium metabolism, the sympathetic nervous system activity ↑; glomerular filtration rate↓[32, 33].
Variant FBN3 →TGFβ and Treg ↓ → development of autoimmunity; anovulation → E/P → autoantibodies ↑; SHBG↓ →free sex hormones↑ [34-36].
Clearance of androstendione and estrone ↓ → aromatization, leading to free estrogen ↑; TRH ↑ →PRL ↑; GnRH pulse change → LH peak delays and luteum function disorders and coagulation defects [27, 37].
Actions on adipocytes → stimulate leptin secretion .
Table 1 Relationship between hypothyroidism and risk factors for EC.
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