多溴联苯醚和多溴联苯暴露与女性甲状腺癌风险：单污染物和多污染物方法。
Exposure to Polybrominated Diphenyl Ethers and a Polybrominated Biphenyl and Risk of Thyroid Cancer in Women: Single and Multi-Pollutant Approaches.
机构信息
Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut.
Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut.
出版信息
Cancer Epidemiol Biomarkers Prev. 2019 Oct;28(10):1755-1764. doi: 10.1158/1055-9965.EPI-19-0526. Epub 2019 Aug 6.
BACKGROUND
Thyroid cancer incidence is the most rapidly increasing malignancy; rates are three times higher in women than men. Thyroid hormone-disrupting flame-retardant chemicals, including polybrominated diphenyl ethers (PBDE) and polybrominated biphenyls (PBB), may contribute to this trend.
METHODS
We investigated the relationship between PBDE/PBB exposure and papillary thyroid cancer (PTC) in 250 incident female papillary thyroid cancer cases and 250 female controls frequency-matched on age. Interviews and postdiagnostic serum samples were collected from 2010 to 2013. Serum samples were analyzed for 11 congeners. We calculated ORs and 95% confidence intervals (95% CI) using single-pollutant logistic regression models for continuous and categorical lipid-adjusted serum concentrations of PBDE/PBB, adjusted for age, alcohol consumption, and education. We applied three multi-pollutant approaches [standard multipollutant regression models, hierarchical Bayesian logistic regression modeling (HBLR), principal components analysis (PCA)] to investigate associations with PBDE/PBB mixtures.
RESULTS
In single-pollutant models, a decreased risk was observed at the highest (>90th percentile) versus lowest (<median) category of BDE-209 concentrations (OR, 0.47; 95% CI, 0.23-0.98); an elevated PTC risk was observed at the highest versus lowest category of BB-153 concentrations (OR, 1.81; 95% CI, 0.96-3.39). In standard multi-pollutant models, an interquartile range increase in BDE-100 concentrations was associated with increased PTC risk (OR, 1.18; 95% CI, 1.01-1.38). HBLR and PCA yielded no statistically significant results.
CONCLUSIONS
Our results using single- and multi-pollutant modeling do not generally support a positive association with PBDE/PBB and PTC risk.
IMPACT
Prospective studies with more advanced statistical approaches to analyze mixtures and populations with higher exposures could reveal new insights.
背景
甲状腺癌的发病率增长最快，女性发病率是男性的三倍。甲状腺激素破坏型阻燃剂化学物质，包括多溴联苯醚（PBDE）和多溴联苯（PBB），可能导致这一趋势。
方法
我们调查了 250 名女性甲状腺乳头状癌（PTC）病例和 250 名年龄匹配的女性对照者的 PBDE/PBB 暴露与 PTC 之间的关系。访谈和诊断后血清样本于 2010 年至 2013 年收集。对血清样本进行了 11 种同系物的分析。我们使用单污染物逻辑回归模型，对 PBDE/PBB 的连续和分类脂质调整血清浓度进行了计算，以评估 ORs 和 95%置信区间（95%CI），调整因素为年龄、饮酒和教育。我们应用了三种多污染物方法[标准多污染物回归模型、分层贝叶斯逻辑回归建模（HBLR）、主成分分析（PCA）]来研究与 PBDE/PBB 混合物的关联。
结果
在单污染物模型中，与最低（中位数）浓度类别相比，最高（第 90 个百分位）浓度类别中 BDE-209 浓度的风险降低（OR，0.47；95%CI，0.23-0.98）；与最低浓度类别相比，最高浓度类别中 BB-153 浓度的 PTC 风险升高（OR，1.81；95%CI，0.96-3.39）。在标准多污染物模型中，BDE-100 浓度增加一个四分位间距与 PTC 风险增加相关（OR，1.18；95%CI，1.01-1.38）。HBLR 和 PCA 未得出统计学意义的结果。
结论
我们使用单污染物和多污染物模型的结果通常不支持 PBDE/PBB 与 PTC 风险之间存在正相关关系。
影响
使用更先进的统计方法分析混合物和暴露水平较高的人群的前瞻性研究可能会提供新的见解。
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