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中国成年人环境暴露于高氯酸盐、硝酸盐和硫氰酸盐与甲状腺功能:一项基于社区的横断面研究。

Environmental exposure to perchlorate, nitrate and thiocyanate, and thyroid function in Chinese adults: A community-based cross-sectional study.

机构信息

Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Non-communicable Disease Prevention and Control, Shenzhen Nanshan Center for Chronic Disease Control, Shenzhen, China.

出版信息

Environ Int. 2023 Jan;171:107713. doi: 10.1016/j.envint.2022.107713. Epub 2022 Dec 21.

Abstract

BACKGROUND

Evidence on environmental exposure to perchlorate, nitrate, and thiocyanate, three thyroidal sodium iodine symporter (NIS) inhibitors, and thyroid function in the Chinese population remains limited.

OBJECTIVE

To investigate the associations of environmental exposure to perchlorate, nitrate, and thiocyanate with markers of thyroid function in Chinese adults.

METHODS

A total of 2441 non-pregnant adults (mean age 50.4 years and 39.1% male) with a median urinary iodine of 180.1 μg/L from four communities in Shenzhen were included in this cross-sectional study. Urinary perchlorate, nitrate, thiocyanate, and thyroid profiles, including serum free thyroxine (FT4), total thyroxine (TT4), free triiodothyronine (FT3), total triiodothyronine (TT3), and thyroid stimulating hormone (TSH), were measured. Generalized linear model was applied to investigate the single-analyte associations. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were used to examine the association between the co-occurrence of three anions and thyroid profile.

RESULTS

The median levels of urinary perchlorate, nitrate, and thiocyanate were 5.8 μg/g, 76.4 mg/g, and 274.1 μg/g, respectively. After adjusting for confounders, higher urinary perchlorate was associated with lower serum FT4, TT4, and TT3, and higher serum FT3 and TSH (all P < 0.05). Comparing extreme tertiles, subjects in the highest nitrate tertile had marginally elevated TT3 (β: 0.02, 95% CI: 0.00-0.04). Each 1-unit increase in log-transformed urinary thiocyanate was associated with a 0.04 (95% CI: 0.02-0.06) pmol/L decrease in serum FT3. The WQS indices were inversely associated with serum FT4, TT4, and FT3 (all P < 0.05). In the BKMR model, the mixture of three anions was inversely associated with serum FT4, TT4, and FT3.

CONCLUSIONS

Our study provides evidence that individual and combined environmental exposure to perchlorate, nitrate, and thiocyanate are associated with significant changes in thyroid function markers in the Chinese population with adequate iodine intake.

摘要

背景

有关中国人暴露于高氯酸盐、硝酸盐和硫氰酸盐(三种甲状腺钠碘同向转运体(NIS)抑制剂)与甲状腺功能之间的关系的证据仍然有限。

目的

研究中国成年人环境暴露于高氯酸盐、硝酸盐和硫氰酸盐与甲状腺功能标志物之间的关联。

方法

本横断面研究共纳入了来自深圳四个社区的 2441 名非妊娠成年人(平均年龄 50.4 岁,39.1%为男性),其尿碘中位数为 180.1μg/L。检测了尿液中的高氯酸盐、硝酸盐、硫氰酸盐和甲状腺参数,包括血清游离甲状腺素(FT4)、总甲状腺素(TT4)、游离三碘甲状腺原氨酸(FT3)、总三碘甲状腺原氨酸(TT3)和促甲状腺激素(TSH)。应用广义线性模型研究单一分析物的相关性。加权总量和(WQS)回归和贝叶斯核机器回归(BKMR)模型用于检验三种阴离子共同存在与甲状腺参数之间的关系。

结果

尿液中高氯酸盐、硝酸盐和硫氰酸盐的中位数分别为 5.8μg/g、76.4mg/g 和 274.1μg/g。调整混杂因素后,高尿液高氯酸盐与血清 FT4、TT4 和 TT3 降低以及血清 FT3 和 TSH 升高有关(均 P<0.05)。与极端三分位相比,处于最高硝酸盐三分位的受试者 TT3 略有升高(β:0.02,95%CI:0.00-0.04)。尿液中硫氰酸盐的自然对数值每增加 1 个单位,血清 FT3 就会降低 0.04(95%CI:0.02-0.06)pmol/L。WQS 指数与血清 FT4、TT4 和 FT3 呈负相关(均 P<0.05)。在 BKMR 模型中,三种阴离子的混合物与血清 FT4、TT4 和 FT3 呈负相关。

结论

本研究表明,在中国碘摄入充足的人群中,个体和联合的环境暴露于高氯酸盐、硝酸盐和硫氰酸盐与甲状腺功能标志物的显著变化有关。

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