环境因素和污染物对从胎儿到成年期甲状腺功能和疾病的影响:当前证据和未来方向。
The impact of environmental factors and contaminants on thyroid function and disease from fetal to adult life: current evidence and future directions.
机构信息
Department of Medicine and Surgery, University of Parma and Unit of Pediatrics, University Hospital of Parma, Parma, Italy.
Unit of Paediatrics, University Hospital of Parma, P. Barilla Children's Hospital, Parma, Italy.
出版信息
Front Endocrinol (Lausanne). 2024 Jun 19;15:1429884. doi: 10.3389/fendo.2024.1429884. eCollection 2024.
The thyroid gland regulates most of the physiological processes. Environmental factors, including climate change, pollution, nutritional changes, and exposure to chemicals, have been recognized to impact thyroid function and health. Thyroid disorders and cancer have increased in the last decade, the latter increasing by 1.1% annually, suggesting that environmental contaminants must play a role. This narrative review explores current knowledge on the relationships among environmental factors and thyroid gland anatomy and function, reporting recent data, mechanisms, and gaps through which environmental factors act. Global warming changes thyroid function, and living in both iodine-poor areas and volcanic regions can represent a threat to thyroid function and can favor cancers because of low iodine intake and exposure to heavy metals and radon. Areas with high nitrate and nitrite concentrations in water and soil also negatively affect thyroid function. Air pollution, particularly particulate matter in outdoor air, can worsen thyroid function and can be carcinogenic. Environmental exposure to endocrine-disrupting chemicals can alter thyroid function in many ways, as some chemicals can mimic and/or disrupt thyroid hormone synthesis, release, and action on target tissues, such as bisphenols, phthalates, perchlorate, and per- and poly-fluoroalkyl substances. When discussing diet and nutrition, there is recent evidence of microbiome-associated changes, and an elevated consumption of animal fat would be associated with an increased production of thyroid autoantibodies. There is some evidence of negative effects of microplastics. Finally, infectious diseases can significantly affect thyroid function; recently, lessons have been learned from the SARS-CoV-2 pandemic. Understanding how environmental factors and contaminants influence thyroid function is crucial for developing preventive strategies and policies to guarantee appropriate development and healthy metabolism in the new generations and for preventing thyroid disease and cancer in adults and the elderly. However, there are many gaps in understanding that warrant further research.
甲状腺调节着大多数生理过程。环境因素,包括气候变化、污染、营养变化和接触化学物质,已被认为会影响甲状腺功能和健康。过去十年中,甲状腺疾病和癌症的发病率有所增加,后者每年增加 1.1%,这表明环境污染物肯定在其中发挥了作用。本综述探讨了环境因素与甲状腺解剖和功能之间关系的现有知识,报告了最新数据、机制以及环境因素作用的差距。全球变暖改变了甲状腺功能,生活在缺碘地区和火山地区都会对甲状腺功能构成威胁,因为碘摄入不足以及接触重金属和氡会增加癌症的风险。水和土壤中硝酸盐和亚硝酸盐浓度高的地区也会对甲状腺功能产生负面影响。空气污染,特别是室外空气中的颗粒物,会使甲状腺功能恶化,并具有致癌性。环境中接触内分泌干扰化学物质会以多种方式改变甲状腺功能,因为一些化学物质可以模拟和/或干扰甲状腺激素的合成、释放和对靶组织的作用,如双酚、邻苯二甲酸酯、高氯酸盐和全氟及多氟烷基物质。在讨论饮食和营养时,最近有证据表明肠道微生物组发生了变化,动物脂肪摄入量的增加与甲状腺自身抗体的产生增加有关。微塑料也有一些负面影响的证据。最后,传染病会显著影响甲状腺功能;最近,从 SARS-CoV-2 大流行中吸取了教训。了解环境因素和污染物如何影响甲状腺功能对于制定预防策略和政策以保障新一代的适当发育和健康代谢以及预防成人和老年人的甲状腺疾病和癌症至关重要。但是,在理解方面仍存在许多差距,需要进一步研究。