Abstract
To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved. The elderly people enrolled in our study were divided into three groups according to the thyroid histopathology: malignant nodule group, benign nodule group, and normal group, and the clinical data and sleep quality were collected. Among the patients of surgery, 56 fresh thyroid tissues were collected for real-time PCR, immunohistochemistry and western blotting analysis of CLOCK, BMAL1, CRYs and PERs. Poor sleep quality, sleep latency and daytime dysfunction were the independent risk factors of malignant nodule after adjusted by other impacts. The expression levels of CLOCK, BMAL1 and PER2 in thyroid malignant group were significantly higher than benign and normal groups, while CRY2 was decreased, p < 0.05. In addition, CLOCK and BMAL1 protein levels were positively correlated with PSQI of corresponding patients and CRY2 was negatively correlated. Circadian rhythm genes mainly altered in malignant nodules, and sleep disorders may be involved in the occurrence of elderly thyroid malignancy through the high expressions of CLOCK and BMAL1, and low expression of CRY2.
Highlights
To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved
The essential question we addressed in our study was whether sleep quality and circadian rhythm genes expression were altered upon thyroid nodule patients, especially malignant nodules; whether poor sleep quality was the risk factor associated with thyroid malignancies; and whether there was a correlation between sleep disorders and circadian rhythm genes, which may be involved in the development of thyroid malignancy
The damage of circadian clock is associated with increased risk of cancer, metabolic syndrome, cardiovascular dysfunction, cognitive impairment, and immune system d isorders[22]
Summary
To study the alterations of sleep quality and circadian rhythm genes expressions upon elderly thyroid nodule patients, the risk factors associated with thyroid malignancies, and the potential relationship involved. Circadian rhythm genes mainly altered in malignant nodules, and sleep disorders may be involved in the occurrence of elderly thyroid malignancy through the high expressions of CLOCK and BMAL1, and low expression of CRY2. Perturbation of circadian rhythms both in humans (shift workers) and animals has been associated with malignant transformations[8] This is a new field, the complexity of the regulation of peripheral clock is just beginning to be explored and recognized, which deserves our attention. The rate of thyroid cancer was significantly increased when TSH secretion disorders, lower levels of TSH were associated with a lower risk of papillary thyroid cancer in patients with thyroid nodular d isease[12], indicating that the biological rhythm might be related to the occurrence of thyroid cancer
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