Public Health Department, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, 32 West Section 2, 1st Ring Road, Chengdu, 610072, China.
NHC Key Laboratory of Food Safety Risk Assessment, Chinese Academy of Medical Science Research Unit (No. 2019RU014), China National Center for Food Safety Risk Assessment, No. 7 Panjiayuan Nanli, Beijing, 100021, China.
Sci Rep. 2024 Aug 27;14(1):19813. doi: 10.1038/s41598-024-70860-2.
Thyroid nodule (TN) has been becoming a great concern worldwide due to its high incidence. Although some studies have reported associations between trace elements exposure and the risk of TNs, the linkage was not inconclusive. The present study aimed to identify the association of selected serum trace elements (Ca, Mg, V, Fe, Co, Cu, Zn, Se, Mn and Mo) with TNs among general adults. A cross-sectional study was conducted in January 2021 in Chengdu, China. 1282 subjects completed the questionnaire and gave at least one human biological material after an overnight fast, venous blood, and urine, including 377 TN participants defined through ultrasound. Various trace elements in serum specimens were determined by inductively coupled plasma mass spectrometry. Thyroid functions were tested by chemiluminescent microparticle immunoassay (CMIA). The associations between trace elements levels and the risk of TNs were examined by restricted cubic splines (RCS) regression and bayesian kernel machine regression (BKMR) models. TNs were more common in females (P < 0.001) and in the elderly (P < 0.001) and that they were also frequently associated with fertility, marital status, annual household income, drinking, anxiety, vitamin supplement, tea consumption, hypertension and hyperlipidemia. After adjusting for confounders by a propensity score matching model, the association between trace elements concentrations and TNs risk was found to be statistically insignificant in the RCS (P for nonlinear > 0.05) and BKMR models. FT3 or T4 (total or free) increased significantly with increasing total trace elements mixture levels. In TI-RADS-4 TN subjects, TPO-Ab level increased significantly with increasing total trace elements mixture levels in the high-dose range. Ca, Zn, Mo at their 75th percentile showed positive individual effects on TPO-Ab, which was examined to be interactive. The detection of trace elements for TNs in general adults may be of no significance, but once individuals classified as TI-RADS-4 TNs are detected with abnormal TPO-Ab, Ca, Zn and Mo level are recommended to measure. The substantive association on it still needs to be continuously explored in the future.
甲状腺结节 (TN) 由于其高发病率已成为全球关注的焦点。尽管一些研究报告了微量元素暴露与 TN 风险之间的关联，但关联并不确定。本研究旨在确定一般成年人中选定血清微量元素（Ca、Mg、V、Fe、Co、Cu、Zn、Se、Mn 和 Mo）与 TN 之间的关联。2021 年 1 月在中国成都进行了一项横断面研究。1282 名受试者完成了问卷调查，并在禁食过夜后至少提供了一种人体生物材料，包括通过超声定义的 377 名 TN 参与者的静脉血和尿液。通过电感耦合等离子体质谱法测定血清标本中的各种微量元素。通过化学发光微粒子免疫测定法（CMIA）测试甲状腺功能。通过受限立方样条（RCS）回归和贝叶斯核机回归（BKMR）模型检查微量元素水平与 TN 风险之间的关联。TN 在女性中更为常见（P<0.001），在老年人中更为常见（P<0.001），并且与生育能力、婚姻状况、家庭年收入、饮酒、焦虑、维生素补充剂、茶消费、高血压和高血脂有关。通过倾向评分匹配模型调整混杂因素后，RCS（P 非线性>0.05）和 BKMR 模型均发现微量元素浓度与 TN 风险之间无统计学关联。FT3 或 T4（总或游离）随总微量元素混合物水平的增加而显著增加。在 TI-RADS-4 TN 患者中，TPO-Ab 水平随总微量元素混合物水平在高剂量范围内的增加而显著增加。Ca、Zn、Mo 的第 75 个百分位数对 TPO-Ab 有正向个体效应，经检验呈交互作用。一般成年人中 TN 检测微量元素可能没有意义，但一旦检测到 TI-RADS-4 TN 患者的 TPO-Ab 异常，建议测量 Ca、Zn 和 Mo 水平。未来仍需要继续探索其实质性关联。
