Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055, China.
School of Public Health, Southern Medical University, No.1023 Shatai Road, Baiyun District, Guangzhou, 510515, China.
Environ Health. 2022 Jan 4;21(1):4. doi: 10.1186/s12940-021-00818-8.
The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide. There are limited reports on the risk of perchlorate and iodine on thyroid tumors, but evidence from population studies is scarce, and their impact on thyroid function is still uncertain. Therefore, the objective of this study was to investigate the association of perchlorate and iodine with the risk of nodular goiter (NG), papillary thyroid microcarcinoma (PTMC), and papillary thyroid carcinoma (PTC) and to assess the correlation between perchlorate and iodine with thyroid function indicators.
A case-control population consisting of 184 pairs of thyroid tumors and nodular goiter matched by gender and age (±2 years) was recruited in this study. Serum and urine samples were collected from each participant. Thyroid function indicators in serum were tested by automatic chemical immunofluorescence, and perchlorate and iodine levels in urine were determined by ultra-high performance liquid chromatography tandem-mass spectrometry and inductively coupled plasma-mass spectrometry, respectively. Conditional logistic regressions and multiple linear regressions were used to analyze the associations.
Urinary perchlorate concentration was significantly higher in total cases, NG and PTC than in the corresponding controls (P < 0.05). Perchlorate was positively associated with PTC (OR = 1.058, 95% CI: 1.009, 1.110) in a non-linear dose-response relationship, but there was no association between perchlorate and NG or PTMC. Iodine was not associated with the risk of thyroid tumors and NG and did not correlate with the thyroid function indicators. Furthermore, perchlorate showed a positive correlation with thyroid stimulating hormone (TSH) at iodine adequate levels (P < 0.05), and a negative correlation with free triiodothyronine (FT3) and a positive correlation with thyroglobulin antibody (TgAb) at iodine more than adequate or excess levels (P < 0.05).
Perchlorate can increase the risk of PTC in a non-linear dose-response relationship and disturb the thyroid hormone homeostasis and thyroid autoantibody levels.
甲状腺肿瘤和结节性甲状腺肿的发病率在全球呈上升趋势。有关高氯酸盐和碘对甲状腺肿瘤的风险的报道有限，但人群研究的证据很少，其对甲状腺功能的影响仍不确定。因此，本研究旨在探讨高氯酸盐和碘与结节性甲状腺肿（NG）、甲状腺微小乳头状癌（PTMC）和甲状腺乳头状癌（PTC）风险的关系，并评估高氯酸盐和碘与甲状腺功能指标的相关性。
本研究纳入了 184 对性别和年龄（±2 岁）相匹配的甲状腺肿瘤和结节性甲状腺肿病例对照人群。采集每位参与者的血清和尿液样本。血清中的甲状腺功能指标采用自动化学免疫荧光法检测，尿液中的高氯酸盐和碘含量分别采用超高效液相色谱串联质谱法和电感耦合等离子体质谱法测定。采用条件 logistic 回归和多元线性回归分析关联。
总病例、NG 和 PTC 组的尿高氯酸盐浓度明显高于相应对照组（P<0.05）。高氯酸盐与 PTC 呈非线性剂量反应关系，呈正相关（OR=1.058，95%CI：1.009，1.110），但与 NG 或 PTMC 无关。碘与甲状腺肿瘤和 NG 的风险无关，也与甲状腺功能指标无关。此外，在碘充足水平时，高氯酸盐与促甲状腺激素（TSH）呈正相关（P<0.05），在碘高于充足或过量水平时，与游离三碘甲状腺原氨酸（FT3）呈负相关，与甲状腺球蛋白抗体（TgAb）呈正相关（P<0.05）。
高氯酸盐在非线性剂量反应关系中可增加 PTC 的风险，并扰乱甲状腺激素的动态平衡和甲状腺自身抗体水平。
