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Xing Z, Liu S, Ding P, Yu X, Song J, Sun H, Cui Y, Liu H. A Meta-Analysis of the Prevalence of Children Goiter in High Water Iodine Areas of China. Biol Trace Elem Res 2024:10.1007/s12011-023-04035-x. [PMID: 38172419 DOI: 10.1007/s12011-023-04035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Although there are now a large number of studies confirming that high iodine levels can cause goiter, there is controversy and a lack of quantitative data. A systematic search of PubMed, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and China Biomedical Database for literature on high iodine and goiter in children was performed with a time limit from January 2013 to October 2023. After screening the literature based on the inclusion criteria, extracting the literature data, and evaluating the risk of bias of the included studies, a single-arm meta-analysis was performed using R 4.0.4 software. Twenty-three studies with a total of 50,980 subjects were included. Meta-analysis showed that the prevalence of goiter among children in water-borne iodine-excess areas was 6.0% [95% CI (4.3%, 7.6%)], and subgroup analyses showed that the prevalence of goiter in children with water iodine 100.1-150 µg/L, 150.1-300 µg/L, and > 300 µg/L was 7.5% [95% CI (0.0%, 15.8%)], 5.5% [95% CI (3.1%, 8.0%)], and 10.2% [95% CI (6.7%, 13.6%)], respectively, and the difference was statistically significant (P < 0.01); The prevalence of goiter among children in the northern China (5.8% [95% CI (4.1%, 7.5%)]) was higher than that in the southern China (3.5% [95% CI (1.0%, 6.0%)]) (P < 0.01); the prevalence of goiter in children with urinary iodine levels 100-199 µg/L, 200-299 µg/L, and ≥ 300 µg/L was 2.4% [95% CI (1.9%, 2.9%)], 3.3% [95% CI (1.9%, 4.8%)], and 7.3% [95% CI (4.4%, 9.9%)], respectively, the difference was statistically significant (P < 0.01); the prevalence of goiter in children aged 8, 9, 10, 11, and 12 years old was 5.1% [95% CI (3.9%, 6.4%)], 8.0% [95% CI (4.0%, 11.9%)], 6.2% [95% CI (3.9%, 8.5%)], 5.5% [95% CI (0.0%, 13.2%)], and 5.4% [95% CI (0.0%, 15.1%)], and when age ≥ 9 years, the relationship between goiter prevalence and age showed a trend toward decreasing with age, but the relationship between different age was no statistical difference in the prevalence of goiter between ages. urinary iodine. The prevalence of goiter in children was higher in areas with high water iodine; the prevalence of goiter in children in the north was significantly higher than that in the south; the prevalence of goiter in children tends to increase with increased urinary iodine levels.
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Affiliation(s)
- Zhilei Xing
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Siyu Liu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Peisen Ding
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Xiaomeng Yu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Jiahui Song
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Huajun Sun
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China
| | - Yushan Cui
- Tianjin Centers for Disease Control and Prevention, 6 Huayue Road, Hedong District, Tianjin, 300011, China.
| | - Hongliang Liu
- School of Public Health, Tianjin Medical University, 22 Qixiangtai Road, Heping District, Tianjin, 300070, People's Republic of China.
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Xu B, Gu SY, Zhou NM, Jiang JJ. Association between thyroid stimulating hormone levels and papillary thyroid cancer risk: A meta-analysis. Open Life Sci 2023; 18:20220671. [PMID: 37588997 PMCID: PMC10426723 DOI: 10.1515/biol-2022-0671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/15/2023] [Accepted: 07/06/2023] [Indexed: 08/18/2023] Open
Abstract
High thyroid stimulating hormone (TSH) levels may stimulate papillary thyroid cancer (PTC) cell proliferation; however, the relationship between TSH levels and PTC risk remains controversial. We aim to ascertain the association through a meta-analysis. Literature searches were conducted in PubMed, Embase, and Web of Science databases. After literature screening, the methodological quality was assessed using the Newcastle-Ottawa Scale and Agency for Healthcare Research and Quality methods. Cochran's Q and I 2 tests were used to evaluate heterogeneity in the meta-analysis. Egger's test was applied to assess publication bias. A total of 12 eligible studies were included in this meta-analysis; all were of moderate and high methodological quality. The pooled results suggested that increased TSH levels were significantly associated with PTC risk; however, the included studies were significantly heterogeneous. Stratification analysis indicated that the heterogeneity might be from the area or type of control. Although significant publication bias existed among the studies, the trim-and-fill method and sensitivity analysis revealed that the combined results were stable and robust. TSH levels are significantly associated with the PTC risk; however, more high-quality studies in large sample sizes are recommended to verify the extrapolation of these findings.
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Affiliation(s)
- Bin Xu
- Department of Ultrasound, Shanghai Fifth People’s Hospital, Fudan University, 128 Ruili Road, Minhang District, Shanghai, 200240, China
| | - Shu-Yan Gu
- Department of Ultrasound, Shanghai Fifth People’s Hospital, Fudan University, 128 Ruili Road, Minhang District, Shanghai, 200240, China
| | - Ning-Ming Zhou
- Department of Ultrasound, Shanghai Fifth People’s Hospital, Fudan University, 128 Ruili Road, Minhang District, Shanghai, 200240, China
| | - Jun-Jie Jiang
- Department of Ultrasound, Shanghai Fifth People’s Hospital, Fudan University, 128 Ruili Road, Minhang District, Shanghai, 200240, China
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Wang Z, Lin Y, Jiang Y, Fu R, Wang Y, Zhang Q. The associations between thyroid-related hormones and the risk of thyroid cancer: An overall and dose-response meta-analysis. Front Endocrinol (Lausanne) 2022; 13:992566. [PMID: 36568112 PMCID: PMC9768331 DOI: 10.3389/fendo.2022.992566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Objective Thyroid cancer (TC) is one of the most common malignant tumours of the endocrine system. Thyroid-stimulating hormone (TSH) is known as being a risk factor for TC, but other thyroid-related hormones are inconsistently associated with TC. The purpose of this study was to comprehensively evaluate the relationships between thyroid-related hormones and the risk of TC. Methods This study utilized searches of PubMed, Embase, Web of Science and Cochrane library up to the date of March 31st, 2022. Additionally, we performed a systematic review of related original studies combining overall and dose-response meta-analyses. Results A total of 30, 5 and 7 articles were included in the meta-analyses of TSH, Free triiodothyronine (FT3), free thyroxine (FT4) and TC risk with 58437, 6813 and 7118 participants respectively. An increased risk of TC was associated with high TSH exposure (OR=1.28, 95% CI: 1.19-1.37, P < 0.001) in the overall meta-analysis. For every 1 mU/L increase in TSH, the risk of TC increased by 16%. However, in those studies that used healthy subjects as controls, the association was not statistically significant(P=0.62). Additionally, high serum FT3 demonstrated a reduced risk of TC, with a combined OR of 0.86 in the fixed-effect model (95% CI: 0.81-0.90, P < 0.001). In addition, a statistically significant increase in TC risk was found when FT4 concentrations reached a certain threshold (approximately 2.2 ng/dL) in the dose-response meta-analysis. Conclusions Significant associations between thyroid-related hormones and the risk of TC were found in this study. Further research is needed to understand the underlying mechanisms.
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Affiliation(s)
- Zheng Wang
- Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Yuxin Lin
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yixian Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Rong Fu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yabing Wang
- Department of Thyroid and Breast Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Qian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
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Zhang X, Zhang F, Li Q, Feng C, Teng W. Iodine nutrition and papillary thyroid cancer. Front Nutr 2022; 9:1022650. [PMID: 36337631 PMCID: PMC9631789 DOI: 10.3389/fnut.2022.1022650] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/30/2022] [Indexed: 09/19/2023] Open
Abstract
Thyroid cancer (TC) is the most frequent endocrine malignancy. The incidence of TC, especially papillary thyroid carcinoma (PTC), has continued to rise all over the world during the past few years, for reasons that are not entirely clear. Though the phenomenon of overdiagnosis is occurring, it is not the sole driver of the substantial increase in incidence. Lifestyle, environmental factors, or complications are considered to be potential risk factors. Among these factors, iodine is a micronutrient that is vital to thyroid function. The effect of iodine intake on PTC has been controversial for many years and the epidemiological or experimental studies provided diametrically opposite conclusions. Combining all these studies, we found that iodine nutrition may affect the overall prevalence, distribution of the histological types, and clinicopathological aggressiveness of TC, especially PTC. However, the available evidence is poor due to the impact of various internal and external related factors. Therefore, this article sums up available results from both epidemiological and experimental studies, future studies are also warranted to expound on the relationship between overall PTC prevalence and iodine intake.
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Hu MJ, Wang S, Zhang Q, He JL, Zhao HH, Hu WL, Huang F. Associations between environmental exposure to polybrominated diphenyl ethers and nodular goiter risk: A case-control study. ENVIRONMENTAL RESEARCH 2022; 212:113345. [PMID: 35469855 DOI: 10.1016/j.envres.2022.113345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/18/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are widespread and persistent environmental contaminants, but their association with nodular goiter (NG) remains unknown. The present case-control study of 179 NG cases and 358 matched normal controls aimed to investigate the association between PBDEs and risk of NG. The plasma concentrations of 8 PBDEs congeners (BDE-28, -47, -99, -100, -153, -154, -183, and -209) were determined by gas chromatograph-mass spectrometer. Conditional logistic regression model was used to evaluate the odds ratio (OR) and 95% confidence interval (CI) for the association between each PBDEs congener and NG. Bayesian kernel machine regression (BKMR) was used to evaluate the association between overall levels of 8 PBDEs mixture and NG. The results of logistic model suggested that increased risk of NG was associated with elevated concentrations of all PBDEs congeners, except for BDE-209. In BKMR model, the risk of NG increased with the increase in overall exposure level of 8 PBDEs mixture. Compared to when all PBDEs mixture were at their median value, the risk of exposure-response function for NG increased by 0.34 units when all PBDEs were at their 75th percentile. In women, the results showed similar trends after additional adjustment for age at menarche and menopausal status. These findings provide novel epidemiological evidence for the prevention of NG. However, larger prospective studies are required to address the associations between PBDEs exposure and NG risk.
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Affiliation(s)
- Ming-Jun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Sheng Wang
- The Center for Scientific Research of Anhui Medical University, Hefei, Anhui, 230032, China
| | - Qian Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, Fujian, 350122, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Huan-Huan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Wen-Lei Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China; Key Laboratory for Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, Anhui, 230032, China.
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Kermoison G, Draganescu C. Role of Dietary and Environmental Factors on Thyroid Cancer in Romania: A Brief Review. Diagnostics (Basel) 2022; 12:diagnostics12081959. [PMID: 36010309 PMCID: PMC9406885 DOI: 10.3390/diagnostics12081959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/26/2022] [Accepted: 08/05/2022] [Indexed: 11/25/2022] Open
Abstract
Thyroid cancer is the most common endocrine tumor, accounting for about 1% of all human malignancies. There are environmental factors that can potentiate the onset of thyroid cancer, in particular pollutants, lifestyle or radiation exposure. Another major cause responsible for the appearance of thyroid cancer is the habitat in endemic areas where there is a deficit of iodine in the soil, drinking water and food. We operated using the PubMed database in order to find the articles of interest. After a wary review of the literature, we designated the relevant articles necessary for our study including various factors such as alimentation, effects of the Chernobyl fallout radiation and the iodine and vitamin D deficiency in Romania. The aim of this article is to make a correlation between the different environmental and dietary factors in Romania, and the increased incidence of thyroid cancer.
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Affiliation(s)
- Gilles Kermoison
- Doctoral School of Iuliu Hațieganu, University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Nuclear Medicine Department, “Prof. Dr. Ion Chiricuta” Institute of Oncology, 400015 Cluj-Napoca, Romania
- Nuclear Medicine Department, University Institut of Martinique, 97200 Fort-de-France, France
- Correspondence: ; Tel.: +40-756-328-839
| | - Ciprian Draganescu
- Nuclear Medicine Department, University Institut of Martinique, 97200 Fort-de-France, France
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Cocco P. Time for Re-Evaluating the Human Carcinogenicity of Ethylenedithiocarbamate Fungicides? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052632. [PMID: 35270318 PMCID: PMC8909994 DOI: 10.3390/ijerph19052632] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 12/16/2022]
Abstract
Background. In January 2021, the European Union ended the license of Mancozeb, the bestselling ethylenedithiocarbamate (EBDC) fungicide, because of some properties typical of human carcinogens. This decision contrasts the IARC classification of EBDC fungicides (Group 3, not classifiable as to human carcinogenicity). A systematic review of the scientific literature was conducted to explore the current evidence. Methods. Human and experimental studies of cancer and exposure to EBDC fungicides (Mancozeb, Maneb, Zineb, and others) and ethylene thiourea (ETU), their major metabolite, published in English as of December 2021, were retrieved using PubMed, the list of references of the relevant reports, and grey literature. Results. The epidemiological evidence of EBDC carcinogenicity is inadequate, with two studies each suggesting an association with melanoma and brain cancer and inconsistent findings for thyroid cancer. Experimental animal studies point at thyroid cancer in rats and liver cancer in mice, while multiple organs were affected following the long-term oral administration of Mancozeb. The mechanism of thyroid carcinogenesis in rats has also been shown to occur in humans. Genotoxic effects have been reported. Conclusions. The results of this systematic review suggest inadequate evidence for the carcinogenicity of EBDC fungicides from human studies and sufficient evidence from animal studies, with positive results on three out of ten key characteristics of carcinogens applying to humans as well. An IARC re-evaluation of the human carcinogenicity of EBDC fungicides is warranted.
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Affiliation(s)
- Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, University of Manchester, Manchester M13 9PL, UK
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Wang H, Jiang Y, Song J, Liang H, Liu Y, Huang J, Yin P, Wu D, Zhang H, Liu X, Zhou D, Wei W, Lei L, Peng J, Zhang J. The risk of perchlorate and iodine on the incidence of thyroid tumors and nodular goiter: a case-control study in southeastern China. Environ Health 2022; 21:4. [PMID: 34980104 PMCID: PMC8725411 DOI: 10.1186/s12940-021-00818-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The 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. METHODS A 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. RESULTS Urinary 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). CONCLUSIONS Perchlorate can increase the risk of PTC in a non-linear dose-response relationship and disturb the thyroid hormone homeostasis and thyroid autoantibody levels.
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Affiliation(s)
- Huirong Wang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
- School of Public Health, Southern Medical University, No.1023 Shatai Road, Baiyun District, Guangzhou, 510515 China
| | - Yousheng Jiang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Jiayi Song
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Huiwen Liang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Yuan Liu
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Jiewu Huang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Pengliang Yin
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Dongting Wu
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
- Shenzhen Eye Hospital, Shenzhen Key Ophthalmic Laboratory, the Second Affiliated Hospital of Jinan University, No.18 Zetian Road, Futian District, Shenzhen, 518040 China
| | - Hang Zhang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
| | - Xinjie Liu
- Shenzhen People’s Hospital, No.1017 Dongmen North Road, Luohu District, Shenzhen, 518020 China
| | - Dongxian Zhou
- Shenzhen People’s Hospital, No.1017 Dongmen North Road, Luohu District, Shenzhen, 518020 China
| | - Wei Wei
- Peking University Shenzhen Hospital, No.1120 Lianhua Road, Futian District, Shenzhen, 518036 China
| | - Lin Lei
- Shenzhen Center for Chronic Disease Control, No.2021 Buxin Road, Luohu District, Shenzhen, 518020 China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, No.2021 Buxin Road, Luohu District, Shenzhen, 518020 China
| | - Jianqing Zhang
- Shenzhen Center for Disease Control and Prevention, No.8 Longyuan Road, Nanshan District, Shenzhen, 518055 China
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Zhang X, Zhang F, Li Q, Aihaiti R, Feng C, Chen D, Zhao X, Teng W. The relationship between urinary iodine concentration and papillary thyroid cancer: A systematic review and meta-analysis. Front Endocrinol (Lausanne) 2022; 13:1049423. [PMID: 36387866 PMCID: PMC9659619 DOI: 10.3389/fendo.2022.1049423] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The effect of iodine on papillary thyroid cancer (PTC) has been controversial for many years. Since urinary iodine is an effective indicator of iodine intake, some recent epidemiological studies have described the relationship between urinary iodine concentration (UIC) and PTC. METHODS We searched PubMed, Embase, Cochrane Library, and Web of Science for case-control studies about UIC and PTC published before September 2022. Results are presented as the overall odds ratio (OR) and 95% confidence intervals (CI). RESULTS According to the analysis of the included studies, excessive iodine intake (UIC≥300ug/L) was positively associated with the occurrence of PTC patients compared with healthy controls (OR4.05, 95%CI 1.64-10.02, P=0.002). Meanwhile, adequate iodine exposure (100≤UIC<200ug/L) may play a protective role in the occurrence of PTC compared with healthy individuals (OR 0.36, 95%CI 0.14-0.91, P=0.03) while the difference in the prevalence of insufficient iodine intake (UIC<100ug/L) and iodine above requirements (200≤UIC<300ug/L) among the two groups were not significant (deficiency: OR 0.38, 95%CI 0.13-1.16, P=0.09; above requirements: OR 0.92, 95%CI 0.40-2.10, P=0.84). After comparing the UIC levels of PTC patients with those of other thyroid diseases, we found that there was also no significant difference in the incidence of different levels of UIC in the two groups (excessive: OR 1.25, 95%CI 0.87-1.80, P=0.22; above requirements: OR 0.93, 95%CI 0.77-1.14, P=0.49; adequate: OR 0.96, 95%CI 0.78-1.17, P=0.67; deficiency: OR 1.02, 95%CI 0.86-1.22, P=0.80). The result of this meta-analysis also did not support the relationship between UIC and the BRAF mutation and lymph node metastasis (LNM) of PTC patients. Besides, we also found that studies on the relationship between urinary iodine and PTC may be influenced by the way UIC was measured. CONCLUSION The 10 case-control included studies involved a total of 6,544 participants. The results of this meta-analysis showed excessive iodine intake, that is, UIC≥300ug/L was associated with the occurrence of PTC but not with BRAF mutation and LNM while adequate iodine intake (100≤UIC<200ug/L) may be one of the protective factors for PTC.
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Abstract
Trace elements, such as iodine and selenium (Se), are vital to human health and play an essential role in metabolism. They are also important to thyroid metabolism and function, and correlate with thyroid autoimmunity and tumors. Other minerals such as iron (Ir), lithium (Li), copper (Co), zinc (Zn), manganese (Mn), magnesium (Mg), cadmium (Cd), and molybdenum (Mo), may related to thyroid function and disease. Normal thyroid function depends on a variety of trace elements for thyroid hormone synthesis and metabolism. These trace elements interact with each other and are in a dynamic balance. However, this balance may be disturbed by the excess or deficiency of one or more elements, leading to abnormal thyroid function and the promotion of autoimmune thyroid diseases and thyroid tumors.The relationship between trace elements and thyroid disorders is still unclear, and further research is needed to clarify this issue and improve our understanding of how trace elements mediate thyroid function and metabolism. This paper systematically reviewed recently published literature on the relationship between various trace elements and thyroid function to provide a preliminary theoretical basis for future research.
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Affiliation(s)
- Qing Zhou
- Department of Thyroid Surgery, General Surgery Center, The Hospital of Jilin University, Changchun, China
| | - Shuai Xue
- Department of Thyroid Surgery, General Surgery Center, The Hospital of Jilin University, Changchun, China
- *Correspondence: Shuai Xue, ; Guang Chen,
| | - Li Zhang
- Department of Nephrology, The Hospital of Jilin University, Changchun, China
| | - Guang Chen
- Department of Thyroid Surgery, General Surgery Center, The Hospital of Jilin University, Changchun, China
- *Correspondence: Shuai Xue, ; Guang Chen,
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Zeng Z, Li K, Wang X, Ouyang S, Zhang Z, Liu Z, Sun J, Ye X, Kang W, Yu J. Low urinary iodine is a protective factor of central lymph node metastasis in papillary thyroid cancer: a cross-sectional study. World J Surg Oncol 2021; 19:208. [PMID: 34253203 PMCID: PMC8276512 DOI: 10.1186/s12957-021-02302-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 12/26/2022] Open
Abstract
Background An abrupt increase of thyroid cancer has been witnessed paralleling the supplemented iodine intake in formerly iodine-deficient countries. And increased iodine intake has been linked to the rising incidence rate of papillary thyroid cancer (PTC). However, the correlation between iodine and clinicopathological features of PTC has not been well-characterized. This study aimed to investigate the associations between iodine intake and the clinicopathological features of PTC patients. Methods Three hundred and fifty-nine PTC patients who received surgical treatment in Peking Union Medical College Hospital from May 2015 to November 2020 were retrospectively reviewed. The associations between urinary iodine (UI), urinary iodine/creatinine ratio (UI/U-Cr), and the clinicopathological features of PTC were analyzed. Univariate and multivariate analysis were performed to investigate the relationship between UI level and central lymph node metastasis (CLNM). Results There were no significant differences in UI in different groups according to the variables studied, except that patients with CLNM had higher UI level than CLNM(−) patients. No associations were found between UI/U-Cr and clinicopathological features except variant subtypes (classic/follicular). After dividing patients into high-iodine group and low-iodine group, more patients were found to have CLNM in the high-iodine group (p = 0.02). In addition, younger age, larger tumor size, and classic variant were positively correlated with CLNM (p < 0.05). Univariate analysis showed that insufficient iodine intake (≤ 99 μg/L) was associated with decreased CLNM risk in PTC. And after defining insufficient iodine intake as ≤ 109 μg/L and above requirements as ≥ 190 μg/L, multivariate analysis showed that lower iodine was associated with CLNM in total population of PTC (OR 0.53, 95% CI 0.31–0.91) and in PTC < 1 cm (papillary thyroid microcarcinoma, PTMC) (OR 0.43, 95% CI 0.21–0.87). Conclusions Low iodine was a protective factor for CLNM in papillary thyroid cancer, particularly in those < 1 cm. These results indicated that iodine may not only be an initiator of tumorigenesis, but also a promoter of the development of PTC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-021-02302-6.
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Affiliation(s)
- Ziyang Zeng
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Kang Li
- Department of Vascular Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianze Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Siwen Ouyang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zimu Zhang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zhen Liu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Juan Sun
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xin Ye
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Weiming Kang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
| | - Jianchun Yu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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12
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Choi JY, Lee JH, Song Y. Evaluation of Iodine Status among Korean Patients with Papillary Thyroid Cancer Using Dietary and Urinary Iodine. Endocrinol Metab (Seoul) 2021; 36:607-618. [PMID: 34154044 PMCID: PMC8258329 DOI: 10.3803/enm.2021.1005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. METHODS Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. RESULTS The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. CONCLUSION Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.
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Affiliation(s)
- Ji Yeon Choi
- Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon,
Korea
| | - Joon-Hyop Lee
- Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon,
Korea
| | - YoonJu Song
- Department of Food Science & Nutrition, The Catholic University of Korea, Bucheon,
Korea
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13
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Hu MJ, He JL, Tong XR, Yang WJ, Zhao HH, Li GA, Huang F. Associations between essential microelements exposure and the aggressive clinicopathologic characteristics of papillary thyroid cancer. Biometals 2021; 34:909-921. [PMID: 33961183 DOI: 10.1007/s10534-021-00317-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 04/29/2021] [Indexed: 02/06/2023]
Abstract
Aim of this study was to evaluate the association between multiple essential microelements exposure and the aggressive clinicopathologic characteristics of papillary thyroid carcinoma (PTC). The concentrations of 10 essential microelements in urine [cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), strontium (Sr), zinc (Zn), and iodine (I)] were measured in 608 patients newly diagnosed with PTC, including 154 males and 454 females. Chi square test and Wilcoxon rank sum test were used to compare general characteristics among males and females. Multivariate logistic regression was used to evaluate the associations between essential microelements and PTC clinicopathologic characteristics in single- and multi-microelement models. In this study, we only observed that the frequency of lymph node metastasis in males was higher than in females, and males had higher levels of zinc than females, but males had lower levels of iodine than females. It was found that high levels of Fe were associated with decreased risk of PTC tumor size > 1 cm, capsular invasion, and advanced T stage (T3/4a/4b). High levels of Co and Mo were associated with decreased risk of capsular invasion and lymph node metastasis, respectively. However, high levels of Mn and Sr were associated with increased risk of capsular invasion and multifocality respectively, and both were associated with increased risk of advanced T stage (T3/4a/4b). These findings indicated that certain essential microelements might have potential effects on PTC progression and aggressiveness. Further studies are required to confirm these findings.
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Affiliation(s)
- Ming-Jun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Jia-Liu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Xin-Ran Tong
- Second Department of Clinical Medicine, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Wan-Jun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Huan-Huan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Guo-Ao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China. .,Laboratory for Environmental Toxicology, Anhui Medical University, Hefei, 230032, Anhui, China.
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14
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Liu Y, Lai F, Long J, Peng S, Wang H, Zhou Q, Li B, Su L, Gan L, Shi Y, Lv W, Li Y, Cheng K, Xiao H. Screening and the epidemic of thyroid cancer in China: An analysis of national representative inpatient and commercial insurance databases. Int J Cancer 2020; 148:1106-1114. [PMID: 32930403 PMCID: PMC7821127 DOI: 10.1002/ijc.33298] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 12/29/2022]
Abstract
Reasons behind the rapid increase of thyroid cancer (TC) in China are uncertain. We assessed the burden of TC and the role of access to screening and salt iodization. We analyzed two national databases in China: Hospital Quality Monitoring System (HQMS) and China Reinsurance Company (CRC) database. HQMS covered 1037 (44.3%) Class 3 hospitals and 76 263 617 Class 3 hospital inpatients in 2013 to 2017 and CRC covered 93 123 018 clients in 2000 to 2016. The proportion of TC inpatients among inpatients in HQMS and TC incidence in critical illness insurance buyers were used to evaluate the association with screening and iodine status. Between 2013 and 2017, the proportion of TC patients in HQMS with urban employee medical insurance and good access to screening increased sharply while there was little change among those with the other two forms of medical insurance. Across provinces, the proportion of TC inpatients in HQMS was positively correlated with per capita disposable income but not with median urinary iodine. Similar findings were observed in the CRC database. In 2017, approximately 1000 individuals were overdiagnosed with TC daily. We conservatively forecast that 5.1 million healthy individuals would become TC patients unnecessarily between 2019 and 2030. Our findings suggested the epidemic of TC in China was substantially underestimated. It was associated with screening but not with salt iodization. What's new? In recent decades, the incidence of thyroid cancer has increased rapidly worldwide. In China, the role of thyroid cancer screening as part of regular health checks and potential overdiagnosis remain unclear. Moreover, there are concerns among the general public that mandatory salt iodization may have contributed to the epidemic of thyroid cancer. Here, the authors found that the increase in thyroid cancer in China is associated with increased access to health care and screening, but not with salt iodization. Moreover, the results suggest that approximately 1000 individuals are overdiagnosed with thyroid cancer daily, calling for urgent measures to prevent overdiagnosis.
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Affiliation(s)
- Yihao Liu
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Fenghua Lai
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jianyan Long
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sui Peng
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haibo Wang
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qian Zhou
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lei Su
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lanxia Gan
- China Standard Medical Information Research Center, Shenzhen, China
| | - Ying Shi
- China Standard Medical Information Research Center, Shenzhen, China
| | - Weiming Lv
- Department of Breast and Thyroid Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanbing Li
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Karkeung Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Haipeng Xiao
- Department of Endocrinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Huang F, Cong W, Xiao J, Zhou Y, Gong M, Sun J, Shan L, Xiao Q, Wang L, Liu J, Yu Z, Jia H. Association between excessive chronic iodine exposure and the occurrence of papillary thyroid carcinoma. Oncol Lett 2020; 20:189. [PMID: 32952658 PMCID: PMC7479532 DOI: 10.3892/ol.2020.12051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/04/2020] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to elucidate the association between excessive chronic iodine exposure and the risk of developing papillary thyroid carcinoma (PTC). The demographic information and pathological characteristics of patients with thyroid nodules were retrieved from medical records at The Second Hospital of Shandong University. A fasting urine specimen was collected, and creatinine and urinary iodine concentration (UIC) were determined. The water iodine data from the domicile districts of these patients were collated from published reports. The results revealed that almost half of the patients with PTC (44.3%) also exhibited a high UIC (≥300 µg/l). Multivariate analysis revealed that the adjusted odds ratio for high UIC was 3.987 (95% CI: 1.355–11.736) and the adjusted area under the receiver operating characteristic curve was 0.776 (95% CI: 0.687–0.864), which was associated with PTC risk in patients with thyroid nodules. Integrated ecological assessment of chronic iodine exposures demonstrated that >80% (81.4%) of the patients with PTC who also exhibited a high UIC were from historically non-iodine-deficient regions, and 66.7% of patients with PTC who resided in historically iodine-excessive regions were characterized by high UICs. Importantly, a high UIC was significantly associated with capsular invasion and extrathyroid metastasis (P<0.05). Moreover, self-matching results indicated that, in patients with PTC, there were no significant differences in UIC grading between the pre- and postoperative specimens. In conclusion, excessive chronic iodine exposure is significantly associated with the risk of PTC, which contributes to increased capsular invasion and extrathyroid metastases. However, further research is required to validate these findings and to elucidate the potential molecular mechanisms involved.
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Affiliation(s)
- Fengyan Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Wei Cong
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Juan Xiao
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Yong Zhou
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Maosong Gong
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Jingfu Sun
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Liqun Shan
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Qiang Xiao
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Lihua Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Jianing Liu
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Zhigang Yu
- Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
| | - Hongying Jia
- Department of Epidemiology and Health Statistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China.,Department of Thyroid Surgery, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong 250033, P.R. China
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16
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Bisphenols as Environmental Triggers of Thyroid Dysfunction: Clues and Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082654. [PMID: 32294918 PMCID: PMC7216215 DOI: 10.3390/ijerph17082654] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/25/2022]
Abstract
Bisphenols (BPs), and especially bisphenol A (BPA), are known endocrine disruptors (EDCs), capable of interfering with estrogen and androgen activities, as well as being suspected of other health outcomes. Given the crucial role of thyroid hormones and the increasing incidence of thyroid carcinoma in the last few decades, this review analyzes the effects of BPS on the thyroid, considering original research in vitro, in vivo, and in humans published from January 2000 to October 2019. Both in vitro and in vivo studies reported the ability of BPs to disrupt thyroid function through multiple mechanisms. The antagonism with thyroid receptors (TRs), which affects TR-mediated transcriptional activity, the direct action of BPs on gene expression at the thyroid and the pituitary level, the competitive binding with thyroid transport proteins, and the induction of toxicity in several cell lines are likely the main mechanisms leading to thyroid dysfunction. In humans, results are more contradictory, though some evidence suggests the potential of BPs in increasing the risk of thyroid nodules. A standardized methodology in toxicological studies and prospective epidemiological studies with individual exposure assessments are warranted to evaluate the pathophysiology resulting in the damage and to establish the temporal relationship between markers of exposure and long-term effects.
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17
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Yan AR, Zhang X, Shen H, Zhou X, Li R, Yuan Z. Urinary iodine is increased in papillary thyroid carcinoma but is not altered by regional population iodine intake status: a meta-analysis and implications. Endocr J 2019; 66:497-514. [PMID: 30890682 DOI: 10.1507/endocrj.ej18-0532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Excessive iodine intake has been associated with increased risk of thyroid cancer (TC) in many studies, but the results have not been consistent. Since it was common knowledge that urinary iodine (UI) is considered a sensitive marker of current iodine intake, we conducted a meta-analysis to clarify the association between high UI and TC. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and the Cochrane Collaboration. Between-group meta-analyses were performed to compare UI between TC patients and the healthy/euthyroid subjects in local residents and benign thyroid nodules (BTN) patients. Then, between-group meta-analyses to compare the incidence rate of iodine excess were also conducted. The 22 case-control studies included in the meta-analyses represented 15,476 participants. It is the first time to clarify that UI was increased in PTC patients, but was not altered by regional population iodine intake status. Compared with BTN patients, PTC patients exhibited both higher UIC and higher odds ratio of iodine excess only in adequate iodine intake status subgroup; UIC, not the odds ratio of iodine excess, was higher in patients with PTC than those with BTN in above requirements iodine intake subgroup. A novel insight is offered that high UI in PTC patients was less influenced by regional population iodine intake status. It is indicted that high iodine intake is not a risk factor for PTC and high urinary iodine is just a specific characteristic of the disease.
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Affiliation(s)
- Ann-Rong Yan
- Faculty of Health, University of Canberra, Canberra 2617, Australia
| | - Xiaojuan Zhang
- Zhenghua South Street Community Healthcare Center, Datong 037000, China
| | - Hong Shen
- Neuro-psychiatric Institute, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xia Zhou
- Neuro-psychiatric Institute, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Rui Li
- School of Pharmacy, Nanjing Medical University, Nanjing 210029, China
| | - Zhexing Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
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18
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Excessive iodine intake is associated with formation of thyroid nodules in pregnant Chinese women. Nutr Res 2019; 66:61-67. [DOI: 10.1016/j.nutres.2019.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 01/04/2019] [Accepted: 02/27/2019] [Indexed: 02/08/2023]
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19
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Zhu G, Deng Y, Pan L, Ouyang W, Feng H, Wu J, Chen P, Wang J, Chen Y, Luo J. Clinical significance of the BRAFV600E mutation in PTC and its effect on radioiodine therapy. Endocr Connect 2019; 8:754-763. [PMID: 31071680 PMCID: PMC6547306 DOI: 10.1530/ec-19-0045] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/09/2019] [Indexed: 12/18/2022]
Abstract
The goal of this study was to explore the relationship of the BRAFV600E mutation with clinicopathologic factors and evaluate the effect of radioactive iodine (RAI) therapy in a large group of intermediate- and high-risk papillary thyroid cancer (PTC) patients with the BRAFV600E mutation and without distant metastases. We collected data for PTC patients who underwent total or near-total thyroidectomy and RAI treatment in our hospital from January 2014-December 2017. There were 1220 PTC patients who met the criteria, and the BRAFV600E mutation was observed in 979 of them (80.2%). Multivariate analysis identified that the BRAFV600E mutation remained independently associated with age at diagnosis, and bilaterality (OR = 1.023, 95% CI = 1.012-1.039, P < 0.001; OR = 1.685, 95% CI = 1.213-2.341, P = 0.002, respectively). In addition, the patients with bilateral PTCs had a higher prevalence of extrathyroid invasion, capsular invasion and fusion of metastatic lymph nodes than the unilateral PTC patients. The response to RAI therapy was evaluated in both the entire series and the patients with a high recurrence risk; no significant difference was discerned between the BRAFV600E mutation and the wild-type groups (P = 0.237 and P = 0.498, respectively). To summarize, our results confirmed that PTC patients with the BRAFV600E mutation exhibit more aggressive characteristics. In addition, the patients with bilateral PTC have a higher incidence of extrathyroid invasion. Moreover, BRAFV600E mutation PTC patients did not show a poorer clinical response after postsurgical RAI therapy, suggesting that RAI therapy may improve the general clinical outcome of these patients.
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Affiliation(s)
- Guoquan Zhu
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yuying Deng
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Liqin Pan
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Wei Ouyang
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
- Correspondence should be addressed to W Ouyang:
| | - Huijuan Feng
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Juqing Wu
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Pan Chen
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Jing Wang
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Yanying Chen
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
| | - Jiaxin Luo
- Department of Nuclear Medicine, Zhujiang Hospital of Southern Medical University, Guangzhou, China
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20
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Yang X, Sun J, Han J, Sun L, Wang H, Zhang D, Fang Q, Liu J, Qiao H. Iodine promotes thyroid cancer development via SPANXA1 through the PI3K/AKT signalling pathway. Oncol Lett 2019; 18:637-644. [PMID: 31289536 PMCID: PMC6546993 DOI: 10.3892/ol.2019.10391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 05/03/2019] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to examine the impact of iodine on the development of thyroid cancer cells and to detect the underlying mechanisms. It was observed that proliferation was promoted and apoptosis was inhibited in cells treated with iodine at a specific concentration. This treatment group was then selected for further analysis, to investigate how iodine affects the development of thyroid cancer cells. It was reported that sperm protein associated with the nucleus, X-linked, family member A1 (SPANXA1) expression in iodine-treated cells was significantly upregulated. Furthermore, downregulation of SPANXA1 inhibited cell proliferation, migration and invasion, and promoted cell apoptosis. These results suggested that SPANXA1 played an important role in iodine-treated thyroid cancer cells. Novel associations between SPANXA1 and thyroid cancer were described in the current study. In addition, SPANXA1 gene silencing resulted in the downregulation of PI3K and phosphorylated (p)AKT expression in iodine-treated thyroid cancer cells, whereas iodine treatment alone resulted in upregulated PI3K and p-AKT expression. Inhibiting PI3K further suppressed cell proliferation and contributed to apoptosis, even in the presence of SPANXA1 at high levels. As a consequence, PI3K/AKT may be one of the key signalling pathways by which iodine promotes thyroid cancer development in association with SPANXA1. In addition, our results further suggested that patients with thyroid cancer may need to avoid high-iodine intake.
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Affiliation(s)
- Xiaoyao Yang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China.,Department of Science and Education, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150036, P.R. China
| | - Jingxue Sun
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Jun Han
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Lulu Sun
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Hongzhi Wang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Dexin Zhang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Qingxiao Fang
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
| | - Jiapeng Liu
- Department of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang 150080, P.R. China
| | - Hong Qiao
- Department of Endocrinology and Metabolism, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150086, P.R. China
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21
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Zhao H, Li H, Huang T. High iodine intake and central lymph node metastasis risk of papillary thyroid cancer. J Trace Elem Med Biol 2019; 53:16-21. [PMID: 30910201 DOI: 10.1016/j.jtemb.2019.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 01/17/2019] [Accepted: 01/25/2019] [Indexed: 10/27/2022]
Abstract
The relationship between iodine intake and clinicopathologic characteristics of papillary thyroid cancer (PTC) is unclear. We aim to investigate the relationship between iodine intake and central lymph node metastasis (CLNM) of PTC. A total of 4040 consecutive patients with PTC receiving thyroidectomy and central lymph node dissection were enrolled from 2013 to 2018. Pathological features of tumors and urinary iodine concentration (UIC) were recorded. Multivariate analysis was performed to investigate the association between iodine intake and CLNM of PTC. More than adequate (UIC: 200.0-299.9 μg/L) and excessive iodine intake (UIC ≥ 300.0 μg/L) were present in 1741 cases (43.09%). Iodine deficiency (UIC ≤ 99.9 μg/L) was inversely associated with female PTC risk only with OR (95% CI): 0.48 (0.29-0.80) relative to adequate iodine intake (UIC: 100.0-199.9 μg/L). However, more than adequate and excessive iodine intake was not associated with PTC risk among the general population and patients with thyroid nodules. In addition, high iodine intake was not associated CLNM risk of PTC. After defining CLNM as metastatic lymph nodes ≥ 2, excessive iodine intake was marginally associated with CLNM among female PTC patients with OR (95% CI): 1.25 (0.99-1.57) by multivariate analysis. Additionally, excessive iodine intake was marginally associated with larger tumor size and capsular invasion. Furthermore, we found that female PTC patients were more closely linked with iodine intake than male ones. In conclusion, high iodine intake appears not to be an initiator, but may be a weak promoter for female PTC progression, which needs further validation.
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Affiliation(s)
- Hengqiang Zhao
- Department of Breast and Thyroid Surgery, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Hehe Li
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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22
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Zhang L, Fang C, Liu L, Liu X, Fan S, Li J, Zhao Y, Ni S, Liu S, Wu Y. A case-control study of urinary levels of iodine, perchlorate and thiocyanate and risk of papillary thyroid cancer. ENVIRONMENT INTERNATIONAL 2018; 120:388-393. [PMID: 30125856 DOI: 10.1016/j.envint.2018.08.024] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The incidence of thyroid cancer has recently increased worldwide. With the exception of radiation exposure, the effects of potential risk factors on thyroid cancer incidence remain controversial. OBJECTIVES The association between exposure to iodine, perchlorate, and thiocyanate and papillary thyroid cancer (PTC) incidence was evaluated and risk factors were predicted. METHODS A pair-matching case-control study was performed including 116 age- and sex-matched PTC cases and 116 non-PTC controls. Iodine, perchlorate, and thiocyanate concentrations in urine specimens were determined by inductively coupled plasma mass spectrometry and ultra-performance liquid chromatography-tandem mass spectrometry. The association between iodine, perchlorate, and thiocyanate urinary concentrations and PTC was evaluated using univariable conditional regression logistic analysis followed by multivariable conditional logistic regression analyses with backward stepwise selection to predict risk factors for PTC. RESULTS After adjusting for confounders and creatinine standardization, urinary concentrations of iodine [odds ratio (OR) = 11.01, 95% confidence interval (CI): 1.97-30.52] and perchlorate (OR = 2.27, 95% CI: 1.03-5.03) were associated with the risk of PTC, whereas urinary thiocyanate concentration showed a negative association (OR = 0.24, 95% CI: 0.09-0.65). CONCLUSIONS Increased exposure to iodine and perchlorate may affect PTC development, whereas high thiocyanate exposure may have a beneficial effect.
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Affiliation(s)
- Lei Zhang
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Congrong Fang
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Liping Liu
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Xin Liu
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Sai Fan
- Beijing Center for Disease Control and Prevention, Beijing, China
| | - Jingguang Li
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Yunfeng Zhao
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China
| | - Song Ni
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.
| | - Shaoyan Liu
- Department of Head and Neck Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Yongning Wu
- The Key Laboratory of Food Safety Risk Assessment, Ministry of Health (CFSA) and China National Center for Food Safety Risk Assessment, Beijing, China.
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23
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Hu MJ, Zhang Q, Liang L, Wang SY, Zheng XC, Zhou MM, Yang YW, Zhong Q, Huang F. Association between vitamin D deficiency and risk of thyroid cancer: a case-control study and a meta-analysis. J Endocrinol Invest 2018; 41:1199-1210. [PMID: 29464660 DOI: 10.1007/s40618-018-0853-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 02/13/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Although vitamin D is reportedly associated with various cancers, the association between vitamin D and thyroid cancer is indefinite. We aimed to investigate whether this association applies to thyroid cancer (TC). METHODS A total of 276 Chinese Han people were recruited in a current matched case-control study. Multivariable conditional logistic regression was computed to estimate the association between plasma 25(OH)D and papillary thyroid cancer (PTC). In addition, we searched relevant studies in PubMed and Web of Science databases before December 2017 to conduct a meta-analysis. RESULTS In our case-control study, plasma 25(OH)D concentration was inversely associated with PTC risk (highest tertile vs lowest tertile: adjusted OR = 0.25; 95% CI 0.10, 0.61; Ptrend = 0.003). This association was independent of body mass index and physical activity (all adjusted Pinteraction > 0.05). A total of 11 studies were included in the meta-analysis, among which ten studies have been published and one was our case-control study. Compared with 25(OH)D non-deficient group, the pooled OR of TC was 1.42 (95% CI 1.17, 1.73) in the deficient group. Similarly, blood 25(OH)D levels in patients with TC were tend to be lower than those in the controls (SMD = - 0.20, 95% CI - 0.36, - 0.03). CONCLUSIONS A high level of circulating 25(OH)D was associated with a decreased TC risk. This association has important significance in public health and should, therefore, be further studied.
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Affiliation(s)
- M-J Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - L Liang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - S-Y Wang
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - X-C Zheng
- Department of Head and Neck, Breast Surgery, Anhui Provincial Cancer Hospital, No. 107 East Lake Road, Hefei, 230032, Anhui, People's Republic of China
| | - M-M Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Y-W Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - Q Zhong
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China
| | - F Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Shushan District, Hefei, 230032, Anhui, People's Republic of China.
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24
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Lee JH, Song RY, Yi JW, Yu HW, Kwon H, Kim SJ, Chai YJ, Choi JY, Moon JH, Lee KE, Park YJ, Park SK. Case-Control Study of Papillary Thyroid Carcinoma on Urinary and Dietary Iodine Status in South Korea. World J Surg 2018; 42:1424-1431. [PMID: 29067516 DOI: 10.1007/s00268-017-4287-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The association between iodine levels and the risk of papillary thyroid cancer (PTC) has been suggested, but not definitively established. This study is to compare the iodine status of a group of patients with PTC (with and without BRAF V600E) with that of a healthy population cohort. METHODS A cohort of patients scheduled for thyroidectomy was enrolled, along with a community-based health-screening cohort with no known history of thyroid disease. Median urinary iodine (UI) levels, creatinine-adjusted median UI levels, and food frequency questionnaire (FFQ) scores (mean ± SD) were compared. In a subgroup analysis, these values were compared between BRAF V600E-positive and BRAF V600E-negative patients in the PTC group. RESULTS The PTC group consisted of 210 patients, and the control group consisted of 90 healthy individuals. Among the 191 PTC patients whose BRAF V600E mutational status was reported, 169 (88.5%) were revealed positive for the mutation. The median UI levels were significantly higher in the PTC group (786.0 μg/l) than the control group (112.0 μg/l; p < 0.001), as was the case with creatinine-adjusted median UI levels (884.6 μg/g creatinine versus 182.0 μg/g creatinine; p < 0.001) and FFQ scores (66.2 ± 17.5, range 13-114 versus 54.6 ± 21.5, range 16-134; p < 0.001). No significant differences were seen in the subgroup analysis between BRAF V600E-positive and BRAF V600E-negative patients. CONCLUSIONS Our results indicate that iodine status differs significantly between patients with PTC and healthy controls, suggesting that iodine may be involved in the occurrence of PTC, although the association between iodine levels and BRAF mutational status did not reach statistical significance.
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Affiliation(s)
- Joon-Hyop Lee
- Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea.,Thyroid and Endocrine Surgery Section, Department of Surgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Ra-Yeong Song
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Jin Wook Yi
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hyeong Won Yu
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Hyungju Kwon
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Jun Chai
- Department of Surgery, Seoul National University Hospital Boramae Medical Center, Seoul, Republic of Korea
| | - June Young Choi
- Department of Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Kyu Eun Lee
- Department of Surgery, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. .,Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Young Joo Park
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Internal Medicine, Seoul National University Hospital and College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
| | - Sue K Park
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea
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25
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Nettore IC, Colao A, Macchia PE. Nutritional and Environmental Factors in Thyroid Carcinogenesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081735. [PMID: 30104523 PMCID: PMC6121258 DOI: 10.3390/ijerph15081735] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/05/2018] [Accepted: 08/05/2018] [Indexed: 02/06/2023]
Abstract
Several epidemiological studies suggest an increased incidence of thyroid carcinoma (TC) in recent years, especially for the papillary histotype (PTC), suggesting that specific carcinogens might promote molecular abnormalities that are typical of PTC. The increased incidence is probably attributed to more intensive and sensitive diagnostic procedures, even if recent data suggest that various toxic elements could explain the phenomenon. Ionizing radiation exposure represents the most accepted risk factor for differentiated thyroid cancer that includes both the follicular and papillary histotypes. In this review, we examined the other environmental carcinogens that play a role in TC, such as eating habits, living in volcanic areas, and xenobiotic elements. Among eating habits, iodine intake represents one of the more discussed elements, because its deficiency is associated with follicular thyroid carcinomas (FTCs), while its progressive increment seems to be responsible for PTC. The gas, ash, and lava emissions of volcanoes are composed of various toxic compounds that pollute ground water, vegetables, and animals, contaminating humans via the food chain. Finally, the risk of developing PTC has also been associated with exposure of the population to xenobiotics in the environment or in the home. Their carcinogenic effects are probably caused by their accumulation, but additional studies are necessary to better understand the mechanisms of action.
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Affiliation(s)
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
| | - Paolo Emidio Macchia
- Dipartimento di Medicina Clinica e Chirurgia, Università di Napoli Federico II, 80138 Napoli NA, Italy.
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26
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Zhao H, Li H, Huang T. High Urinary Iodine, Thyroid Autoantibodies, and Thyroid-Stimulating Hormone for Papillary Thyroid Cancer Risk. Biol Trace Elem Res 2018; 184:317-324. [PMID: 29164514 DOI: 10.1007/s12011-017-1209-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/17/2017] [Indexed: 10/18/2022]
Abstract
Thyroid nodules have become a common clinical problem, and the clinical importance of thyroid nodules lies in the determination of thyroid cancer. This study aims to evaluate the risk factors for papillary thyroid cancer (PTC) with regard to urinary iodine concentration (UIC), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) in comparison to thyroid nodular goiter (NG). Among the 2041 patients, 43.8% of which showed more than adequate (UIC 200-299 μg/L) and excessive iodine (UIC ≥ 300.0 μg/L) status. Compared with adequate iodine intake, iodine deficiency (UIC < 100 μg/L) was inversely associated with multifocality (OR 0.59, P = 0.040), while more than adequate iodine intake was independently associated with an increased risk of larger tumor size (OR 1.33, P = 0.002) in female PTC patients but not in males. No significant difference in UIC was observed between patients with PTC and NG, suggesting that high iodine intake may be related with the growth of PTC, but not with its oncogenesis. Besides, positive for TPOAb and TGAb were individually associated with papillary thyroid microcarcinoma (PTMC) risk (OR 2.05 and 1.71, respectively, both P < 0.05) in female patients with tumor foci < 1 cm but not in males. Furthermore, younger age (< 46 years), TGAb positivity and small thyroid nodules in both sexes, higher TSH, TPOAb positivity, and multifocality in females could all predict PTC risk (all P < 0.05). These results might have clinical significance for managing patients with thyroid nodules and those with thyroidectomy.
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Affiliation(s)
- Hengqiang Zhao
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Hehe Li
- Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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27
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Factors Affecting Thyroid Cancer in Patients with Thyroid Nodules Using Logistic Regression in Interval Censored Data. INTERNATIONAL JOURNAL OF CANCER MANAGEMENT 2018. [DOI: 10.5812/ijcm.9111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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28
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Higher urinary bisphenol A concentration and excessive iodine intake are associated with nodular goiter and papillary thyroid carcinoma. Biosci Rep 2017; 37:BSR20170678. [PMID: 28684549 PMCID: PMC5529210 DOI: 10.1042/bsr20170678] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/04/2017] [Accepted: 07/06/2017] [Indexed: 12/31/2022] Open
Abstract
In the present study, we investigated whether bisphenol A (BPA) levels and excessive iodine intake were associated with papillary thyroid carcinoma (PTC) and nodular goiter (NG). We determined total BPA concentrations (TBC) in paired serum and urine samples, and urinary iodine concentrations (UIC) in urine samples collected from PTC patients, NG patients, and healthy individuals, then compared BPA concentrations and UIC within and between each patient group. The results showed that there were no gender-specific differences in serum TBC and UIC in each group, and no differences across all patient groups. Urinary BPA concentrations (UBC) were higher in the NG and PTC groups compared with the control group. UBC showed gender-specific differences in the NG and PTC group. Furthermore, UIC were higher in the NG and PTC groups compared with the control group. Higher UBC and excessive iodine intake were risk factors for NG and PTC according to multivariate logistic regression analysis. There was a significant correlation between UBC and UIC in each group. These data suggested that higher UBC and excessive iodine intake are associated with NG and PTC. The metabolic and functional pathways between BPA and iodine are potentially linked to the pathogenesis and progression of NG and PTC.
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29
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Zhang J, Zhang X, Li Y, Zhou Z, Wu C, Liu Z, Hao L, Fan S, Jiang F, Xie Y, Jiang L. Low dose of Bisphenol A enhance the susceptibility of thyroid carcinoma stimulated by DHPN and iodine excess in F344 rats. Oncotarget 2017; 8:69874-69887. [PMID: 29050248 PMCID: PMC5642523 DOI: 10.18632/oncotarget.19434] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Accepted: 06/02/2017] [Indexed: 01/20/2023] Open
Abstract
Thyroid carcinoma (TC) is the most common endocrine neoplasm. The risk of TC as a second primary malignancy (SPM) of breast cancer is significantly increased. Bisphenol A (BPA) is a widely contacted xenoestrogen and increases susceptibility to breast cancer through binding to estrogen receptor alpha (ERα). However, the effect of BPA on thyroid carcinogenesis has not been fully demonstrated. This present study aimed to characterize the effects of BPA on the development of TC using a Fischer 344 (F344) rat model. In this study, we established a TC model using female F344 rats pretreated with N-Bis (2-hydroxypropyl) nitrosamine (DHPN) at a single dose of 2800 mg/kg (the DA group) or without DHPN (the DN group), followed by stimulation with BPA at the level of 250 μg/kg (BPA250) or 1000 μg/kg (BPA1000) and a basic diet containing potassium iodine (KI, 1000 μg/L) for 64 weeks. We demonstrated that the incidence of TC in the BPA250 + KI of DA groups reached the highest at 50%, the incidence of thyroid hyperplasia lesions (including both tumors and focal hyperplasia lesions) in the BPA1000 + KI of DA groups reached 100% (P < 0.05). ERα protein and immunochemistry expression was upregulated in the BPA-exposed groups and the immunochemistry scores were positively correlated with PCNA. Thus, the present results indicate that BPA could enhance the susceptibility to TC stimulated by DHPN and iodine excess. ERα is probably involved in the proliferation effect of BPA. BPA or KI alone could not increase TC incidence.
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Affiliation(s)
- Jing Zhang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Hemodialysis, Heze Municipical Hospital, Heze 274000, China
| | - Xiaochen Zhang
- Department of Nursing, Heze Medical College, Heze 274000, China
| | - Yanan Li
- Department of Endocrinology, Laiwu City People's Hospital, Laiwu 271100, China
| | - Zhenzhen Zhou
- Department of Radiotherapy, Jinhua Municipal Central Hospital, Jinhua 321000, China0
| | - Chuanlong Wu
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Zhiyan Liu
- Department of Pathology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Lanxiang Hao
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China.,Department of Endocrinology, Yancheng First People's Hospital, Yancheng 224001, China
| | - Shanshan Fan
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Fang Jiang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Yan Xie
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - Ling Jiang
- Department of Endocrinology, Qilu Hospital of Shandong University, Jinan 250012, China
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30
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Lee JH, Hwang Y, Song RY, Yi JW, Yu HW, Kim SJ, Chai YJ, Choi JY, Lee KE, Park SK. Relationship between iodine levels and papillary thyroid carcinoma: A systematic review and meta-analysis. Head Neck 2017; 39:1711-1718. [DOI: 10.1002/hed.24797] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/17/2017] [Accepted: 02/23/2017] [Indexed: 01/31/2023] Open
Affiliation(s)
- Joon-Hyop Lee
- Department of Surgery; Seoul National University Bundang Hospital; 300 Gumi-dong Bundang-gu Seongnam-si Gyeonggi-do Korea
- Thyroid and Endocrine Surgery Section, Department of Surgery; Gachon University Gil Medical Center; Incheon Republic of Korea
| | - Yunji Hwang
- Department of Preventive Medicine; Seoul National University College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Ra-Yeong Song
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Jin Wook Yi
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Hyeong Won Yu
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
| | - Su-jin Kim
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Young Jun Chai
- Department of Surgery; Seoul National University Hospital Boramae Medical Center; Seoul Korea
| | - June Young Choi
- Department of Surgery; Seoul National University Bundang Hospital; 300 Gumi-dong Bundang-gu Seongnam-si Gyeonggi-do Korea
| | - Kyu Eun Lee
- Department of Surgery; Seoul National University Hospital and College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
| | - Sue K. Park
- Department of Preventive Medicine; Seoul National University College of Medicine; 101 Daehak-ro Jongno-gu Seoul Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul Korea
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31
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Katagiri R, Yuan X, Kobayashi S, Sasaki S. Effect of excess iodine intake on thyroid diseases in different populations: A systematic review and meta-analyses including observational studies. PLoS One 2017; 12:e0173722. [PMID: 28282437 PMCID: PMC5345857 DOI: 10.1371/journal.pone.0173722] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 02/24/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although several reports concerning the association of iodine excess and thyroid disease have appeared, no systematic review of the association between iodine excess intake and thyroid diseases, especially hyperthyroidism and hypothyroidism, has yet been reported. METHOD We conducted a systematic search of Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials databases, Ichushi-Web and CiNii database for intervention trials and observational studies. Search terms were constructed from related words for excess AND iodine intake or excretion AND thyroid hormones or diseases AND study designs. After considering the qualitative heterogeneity among studies, a meta-analysis was conducted and odds ratios and 95% confidence intervals (CI) were estimated in random-effects models. A protocol was registered with PROSPERO (No. CRD42015028081). RESULTS 50 articles were included, including three intervention trials, six case-control studies, six follow-up studies and 35 cross-sectional studies. Three cross-sectional studies in adults included in meta-analysis. Odds ratio of overt and subclinical hypothyroidism between excess and adequate populations were 2.78 (CI:1.47 to 5.27) and 2.03 (CI:1.58 to 2.62) in adults, respectively. Source of excess iodine status was mainly iodized salt or water in included studies. CONCLUSION Although universal salt iodization has improved goiter rates, chronic exposure to excess iodine from water or poorly monitored salt are risk factors for hypothyroidism in free-living populations. Monitoring of both iodine concentration in salt as well as the iodine concentration in local drinking water are essential to preventing thyroid diseases. Hypothyroidism should be also carefully monitored in areas with excess iodine. Because of the low quality and limited number of included studies, further evidence and review are required.
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Affiliation(s)
- Ryoko Katagiri
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Xiaoyi Yuan
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satomi Kobayashi
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology, Graduate School of Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Social and Preventive Epidemiology, School of Public Health, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Iodine intake as a risk factor for BRAF mutations in papillary thyroid cancer patients from an iodine-replete area. Eur J Nutr 2017; 57:809-815. [PMID: 28258306 DOI: 10.1007/s00394-016-1370-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 12/21/2016] [Indexed: 01/17/2023]
Abstract
PURPOSE Both deficient and excessive iodine intake leads to thyroid disease, which shows U-shaped curves. Our previous study showed that a relatively low [urinary iodine concentration (UIC) <300 μg/L] and extremely excessive (UIC ≥ 2500 μg/L) iodine intake were associated with thyroid cancer in Korea, an iodine-replete area. Papillary thyroid cancer (PTC) accounts for more than 97 % of thyroid cancer and 80% or more PTC cases harbor the BRAF mutation in Korea. We aimed to investigate the relationship between iodine intake and the prevalence of the BRAF mutation in PTC in Korea. METHODS UIC was measured by inductively coupled plasma mass spectrometry. The BRAF mutation was detected using both allele-specific polymerase chain reaction and mutant enrichment with 3'-modified oligonucleotide sequencing. Risk factors for the occurrence of BRAF mutations in PTC were evaluated using multivariate logistic regression models. RESULTS The median UIC in all patients with PTC was 287 μg/L (range from 7 to 7, 426 μg/L). Nearly half of the patients (102/215, 47%) belonged to the excessive iodine intake category (UIC ≥ 300 μg/L) according to the WHO iodine recommendations. The frequency of BRAF mutations was lowest in the 300-499 μg/L UIC group; it was significantly different compared to the relatively low (UIC < 300 μg/L) and more than excessive (UIC ≥ 500 μg/L) iodine intake groups. UIC was an independent predictor for BRAF mutations in PTC. The multivariate-adjusted odds ratios (95% confidence intervals) in the relatively low and more than excessive iodine intake groups for the BRAF mutation were 4.761 (1.764-12.850) and 6.240 (2.080-18.726), respectively, compared to the 300-499 μg/L UIC group. CONCLUSION Relatively low iodine intake and more than excessive iodine intake seem to be significant risk factors for the occurrence of BRAF mutations in the thyroid and, therefore, may be risk factors for the development of PTC in an iodine-replete area.
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Li R, Liu HP, Hong CL, Dai ZX, Liu JW, Zhou J, Hu CQ, Weng HX. Iodide and iodate effects on the growth and fruit quality of strawberry. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2017; 97:230-235. [PMID: 26992053 DOI: 10.1002/jsfa.7719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 03/05/2016] [Accepted: 03/13/2016] [Indexed: 05/08/2023]
Abstract
BACKGROUND Iodine deficiency is an environmental health problem affecting one-third of the global population. An iodine biofortification hydroponic experiment was conducted to explore the iodide and iodate uptake characteristics of strawberry plants, to measure the dosage effects of iodine on plant growth and to evaluate the influence of I- or IO3- application on fruit quality. RESULTS After biofortification, the iodine contents of the fresh strawberry fruits were 600-4000 µg kg-1 , covering the WHO dietary iodine allowance of 150 µg · day-1 for adults. The iodine uptake of the strawberry plants increased with increasing I- or IO3- concentration of the culture solution. At the same iodine concentration, the iodate uptakes of various plant organs under I- treatments were apparently more than those under IO3- treatments. Low-level exogenous iodine (I- ≤ 0.25 mg L-1 or IO3- ≤ 0.50 mg L-1 ) not only promoted plant growth and increased biomass per plant, but also improved fruit quality by enhancing the vitamin C and soluble sugar contents of the strawberry fruits. Nevertheless, excessive exogenous iodine inhibited plant growth and reduced biomass per plant. IO3- uptake apparently increased the total acidity and nitrate content of the fruits, reducing the quality of the strawberry fruits. Conversely, I- uptake obviously decreased the total acidity and nitrate content of the strawberry fruits, improving the fruit quality. CONCLUSION The strawberry can be used as a target crop for iodine biofortification. Furthermore, applying an appropriate dose of KI can improve the fruit quality of the strawberry plants. © 2016 Society of Chemical Industry.
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Affiliation(s)
- Rui Li
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Geological Research Center for Agricultural Application, China Geological Survey, Hangzhou 311201, Zhejiang, China
| | - Hui-Ping Liu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Chun-Lai Hong
- Zhejiang Academy of Agricultural Sciences, Hangzhou 310021, Zhejiang, China
| | - Zi-Xi Dai
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Jia-Wei Liu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Jun Zhou
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Chun-Qing Hu
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
| | - Huan-Xin Weng
- School of Earth Science, Zhejiang University, Hangzhou 310027, Zhejiang, China
- Institute of Environment and Biogeochemistry, Zhejiang University, Hangzhou 310027, Zhejiang, China
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Zeng R, Shou T, Yang KX, Shen T, Zhang JP, Zuo RX, Zheng YQ, Yan XM. Papillary thyroid carcinoma risk factors in the Yunnan plateau of southwestern China. Ther Clin Risk Manag 2016; 12:1065-74. [PMID: 27418831 PMCID: PMC4935083 DOI: 10.2147/tcrm.s105023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective This study investigated clinical and pathological characteristics and risk factors in papillary thyroid carcinoma (PTC) patients’ native to Yunnan plateau in southwestern China. Methods Clinical data from 1,198 patients diagnosed with PTC (n=578) and control subjects (n=620) with benign thyroid disease (ie, thyroid nodule disease, benign thyroid diseases [BTD]) in Yunnan province were analyzed retrospectively. Results The mean patient age was lower for PTC than for BTD. Positive ratios of thyroid peroxidase antibody, thyroglobulin antibody (TGAb), and thyrotrophin receptor antibody (TRAb) were higher in PTC than in BTD patients. The ratio of PTC coexisting with Hashimoto’s thyroiditis (HT) or with lymphocytic thyroiditis was higher than that of BTD. The number of patients whose age at menarche was ≤13 years, who had given birth to less than or equal to two children, or who were in premenopause were higher in the PTC than in the BTD group. Multivariate conditional logistic regression analyses revealed that age >45 years, nodal size >1 cm, and elevated TG levels were protective factors against PTC. Abnormally elevated TGAb and TRAb levels were independent risk factors for PTC in females. Conclusion HT was not an independent risk factor for but was associated with PTC. TRAb is a risk factor for PTC in individuals living in the Yunnan plateau, but not for those in the plains region.
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Affiliation(s)
- Rong Zeng
- Faculty of Environmental Science and Engineering, Kunming University of Science and Technology, Kunming, People's Republic of China; Faculty of Life Science and Technology, Kunming University of Science and Technology, Kunming, People's Republic of China; Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Tao Shou
- Medical Oncology, The First People's Hospital of Yunnan Province, Kunming, People's Republic of China
| | - Kun-Xian Yang
- Surgical Oncology, The First People's Hospital of Yunnan Province Kunming, People's Republic of China
| | - Tao Shen
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Jin-Ping Zhang
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Rong-Xia Zuo
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Yong-Qing Zheng
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
| | - Xin-Ming Yan
- Institute of Clinical and Basic Medicine Research, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, People's Republic of China
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Kim HJ, Kim NK, Park HK, Byun DW, Suh K, Yoo MH, Min YK, Kim SW, Chung JH. Strong association of relatively low and extremely excessive iodine intakes with thyroid cancer in an iodine-replete area. Eur J Nutr 2016; 56:965-971. [DOI: 10.1007/s00394-015-1144-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 12/16/2015] [Indexed: 10/22/2022]
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