REVIEW

Thyroid Diseases, Metformin and the AMP Kinase Pathway
Tiroid Hastalıkları, Metformin ve AMP Kinaz Yolağı
Received Date : 06 Jul 2021
Accepted Date : 29 Sep 2021
Available Online : 21 Oct 2021
Doi: 10.25179/tjem.2021-85359 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:387-391
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
An increase in the adenosine monophosphate (AMP)/adenosine triphosphate ratio activates AMP-activated protein kinase (AMPK), leading to inhibition of the mammalian target of rapamycin signaling pathway that is associated with autophagy, mitochondriogenesis, glucose uptake, mRNA stabilization, and cell cycle regulation. Metformin activates AMPK and inhibits mitochondrial oxidative phosphorylation. Currently, there is an increasing interest in investigating the effects of metformin on thyroid diseases. Recent data show an association between metformin treatment and lower incidence of thyroid cancer, better survival of patients with thyroid cancer, and lower thyroid volume and nodule size. Insulin-like growth factor receptor and AKT pathways are the AMPK-independent mechanisms through which metformin acts on thyroid diseases. Although metformin has a promising role in adjuvant therapy for thyroid cancers, welldesigned prospective trials are required before reaching a final decision.
ÖZET
Artan adenozin monofosfat (AMP)/adenozin trifosfat oranı, AMP ile aktive olan protein kinazı (AMPK) aktive ederek; otofaji, mitokondriogenez, glukoz alımının artması, mRNA ve hücre döngüsünün stabilizasyonuyla sonuçlanan memeli hedefi rapamisin sinyal yolağının inhibisyonuna neden olur. Metformin, AMPK’yi aktive; mitokondriyal oksidatif fosforilasyonunu ise inhibe eder. Metforminin, tiroid hastalıkları üzerindeki etkisinin araştırılmasına artan bir ilgi vardır. Son veriler, metformine maruz kalma ile daha düşük tiroid kanseri insidansı, daha iyi tiroid kanseri sağkalımı, daha düşük tiroid hacmi ve nodül boyutu arasında bir ilişki olduğunu göstermektedir. Metformin, AMP kinaz yolağı dışında insülin benzeri büyüme faktörü ve AKT yolaklarını da kullanarak tiroid hastalıkları üzerinde etkili olur. Metforminin, tiroid kanserleri için adjuvan tedavide umut verici bir rolü vardır, ancak nihai bir karara varmadan önce iyi tasarlanmış prospektif çalışmalara ihtiyaç vardır.
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