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Abstract
BackgroundThe 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.MethodsA 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.ResultsUrinary 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).ConclusionsPerchlorate can increase the risk of PTC in a non-linear dose–response relationship and disturb the thyroid hormone homeostasis and thyroid autoantibody levels.
Highlights
The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide
Perchlorate can increase the risk of papillary thyroid carcinoma
The present study demonstrated a positive association between perchlorate and the risk of papillary thyroid carcinoma (PTC) and perchlorate can disturb the homeostasis of thyroid function, but did not find an association between perchlorate and nodular goiter (NG) and papillary thyroid microcarcinoma (PTMC)
Summary
The incidence rates of thyroid tumors and nodular goiter show an upward trend worldwide. Thyroid tumors are divided into benign thyroid adenoma and malignant thyroid cancer (TC), and thyroid nodules (TNs) are a common benign proliferative disease of the thyroid gland with the detection rate in the general population as high as 65% [1]. The incidence rate of TC in Shenzhen, a typical fast modern and urbanized city of China, increased at an average rate of 11.33% per year from 2001 to 2015; the world population standard incidence rate increased from 3.55/100,000 to 17.97/100,000, ranking TC from the tenth to the second most common malignant tumor [6]. Studies have shown that thyroid disease management costs in the United States are expected to triple by up to $3.5 billion/year by 2030, TC brings a great health and economic burden to human society [7]. There is an urgent need to explore the risk factors and potential environmental chemicals related to thyroid tumors so that thyroid disease can be controlled and prevented around the world
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