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城市空气污染与自身免疫性甲状腺疾病发病的关系。

Urban Air Pollution Associated with the Incidence of Autoimmune Thyroid Diseases.

机构信息

Clinic for Radiology and Nuclear Medicine, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina.

Faculty of Pharmacy, University of Tuzla, Tuzla, Bosnia and Herzegovina.

出版信息

Med Arch. 2022 Apr;76(2):115-121. doi: 10.5455/medarh.2022.76.115-121.

DOI:10.5455/medarh.2022.76.115-121
PMID:35774048
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9233456/
Abstract

BACKGROUND

Endocrine disrupting air pollutants such as sulphur dioxide (SO), carbon monoxide (CO), nitrogen dioxide (NO), fine particle matter (PM), and ozone (O) can affect thyroid gland function on the level of synthesis, metabolism, and the action of its hormones.

OBJECTIVE

The aim of this study was to establish whether increased air pollution could contribute to an increased incidence of autoimmune thyroid diseases (AITD).

METHODS

A retrospective analysis was conducted of the medical records of 82000 patients at the University Clinical Centre in Tuzla, Bosnia and Herzegovina. The target group of this study comprised a total of 174 patients from the Lukavac area. Daily data on concentrations of air pollutants were collected from the air quality monitoring station located in Lukavac. The study covered the period from 2015 to 2020.

RESULTS

The results of the monitoring confirmed the presence of air pollutants in concentrations above the permitted limits throughout the entire observed period. Concentrations of PM, SO, NO, CO, and O were in the range of 1.90-431.40 μg/m, 3.60-620.50 μg/m, 3.40-66.20 μg/m, 48.00-7002.00 μg/m, and 0.70-89.40 μg/m, with means of 64.08 μg/m, 77.48 μg/m, 22.57 μg/m, 1657.15 μg/m, and 31.49 μg/m, respectively. During the six-year period, 174 cases of AITD were registered, of which 150 (86.21%) were women and 24 (13.79%) men. Hashimoto's thyroiditis was found in 33 patients (18.97%), whilst 141 patients (81.03%) were diagnosed with atrophic thyroiditis. The highest total incidence of autoimmune thyroiditis was recorded in 2017, when it reached 99.49, 95% CI.

CONCLUSION

The effects of chronic exposure to a mixture of air pollutants on the function of the thyroid gland are still not sufficiently well-known, but the numerical tendency towards a higher incidence of AITD in this study, albeit without statistical significance (p>0.05), still underlines the need for additional research.

摘要

背景

内分泌干扰空气污染物,如二氧化硫(SO)、一氧化碳(CO)、二氧化氮(NO)、细颗粒物(PM)和臭氧(O),会影响甲状腺的合成、代谢和激素作用水平,从而影响甲状腺功能。

目的

本研究旨在确定空气污染增加是否会导致自身免疫性甲状腺疾病(AITD)发病率增加。

方法

对波斯尼亚和黑塞哥维那图兹拉大学临床中心的 82000 名患者的病历进行回顾性分析。该研究的目标人群是来自卢卡瓦茨地区的总共 174 名患者。从位于卢卡瓦茨的空气质量监测站收集了每日空气污染物浓度数据。该研究涵盖了 2015 年至 2020 年期间。

结果

监测结果证实,整个观察期间,空气中的污染物浓度均超过允许限值。PM、SO、NO、CO 和 O 的浓度范围分别为 1.90-431.40μg/m、3.60-620.50μg/m、3.40-66.20μg/m、48.00-7002.00μg/m 和 0.70-89.40μg/m,平均值分别为 64.08μg/m、77.48μg/m、22.57μg/m、1657.15μg/m 和 31.49μg/m。在六年期间,共登记了 174 例 AITD 病例,其中 150 例(86.21%)为女性,24 例(13.79%)为男性。33 例(18.97%)患者被诊断为桥本甲状腺炎,而 141 例(81.03%)患者被诊断为萎缩性甲状腺炎。2017 年自身免疫性甲状腺炎的总发病率最高,达到 99.49%,95%CI。

结论

慢性暴露于空气污染物混合物对甲状腺功能的影响仍知之甚少,但本研究中 AITD 发病率呈上升趋势,尽管没有统计学意义(p>0.05),但仍强调需要进一步研究。

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