Association Between Exposure to Ambient Air Pollution and Thyroid Function in Korean Adults

Associations between short-term exposure to air pollution and thyroid function in a representative sample of the Korean population

BACKGROUND

Disruption of thyroid function can profoundly affect various organ systems. However, studies on the association between air pollution and thyroid function are relatively scarce and most studies have focused on the long-term effects of air pollution among pregnant women.

OBJECTIVES

This study aimed to explore the associations between short-term exposure to air pollution and thyroid function in the general population.

METHODS

Data from the Korea National Health and Nutrition Examination Survey (2013-2015) were analyzed (n = 5,626). Air pollution concentrations in residential addresses were estimated using Community Multiscale Air Quality models. The moving averages of air pollution over 7 days were set as exposure variables through exploratory analyses. Linear regression and quantile g-computation models were constructed to assess the effects of individual air pollutants and air pollution mixture, respectively.

RESULTS

A 10-ppb increase in NO2 (18.8-μg/m3 increase) and CO (11.5-μg/m3 increase) was associated with 2.43% [95% confidence interval (CI): 0.42, 4.48] and 0.19% (95% CI: 0.01, 0.36) higher thyroid-stimulating hormone (TSH) levels, respectively. A 10-μg/m3 increase in PM2.5 and a 10-ppb increase in O3 (19.6-μg/m3 increment) were associated with 0.87% (95% CI: 1.47, -0.27) and 0.59% (95% CI: 1.18, -0.001) lower free thyroxine (fT4) levels, respectively. A simultaneous quartile increase in PM2.5, NO2, O3, and CO levels was associated with lower fT4 but not TSH levels.

CONCLUSIONS

As the subtle changes in thyroid function can affect various organ systems, the present results may have substantial public health implications despite the relatively modest effect sizes. Because this was a cross-sectional study, it is necessary to conduct further experimental or repeated-measures studies to consolidate the current results.

Air pollution exposure, accelerated biological aging, and increased thyroid dysfunction risk: Evidence from a nationwide prospective study

BACKGROUND

Long-term air pollution exposure is a major health concern, yet its associations with thyroid dysfunction (hyperthyroidism and hypothyroidism) and biological aging remain unclear. We aimed to determine the association of long-term air pollution exposure with thyroid dysfunction and to investigate the potential roles of biological aging.

METHODS

A prospective cohort study was conducted on 432,340 participants with available data on air pollutants including particulate matter (PM2.5, PM10, and PM2.5-10), nitrogen dioxide (NO2), and nitric oxide (NO) from the UK Biobank. An air pollution score was calculated using principal component analysis to reflect joint exposure to these pollutants. Biological aging was assessed using the Klemera-Doubal method biological age and the phenotypic age algorithms. The associations of individual and joint air pollutants with thyroid dysfunction were estimated using the Cox proportional hazards regression model. The roles of biological aging were explored using interaction and mediation analyses.

RESULTS

During a median follow-up of 12.41 years, 1,721 (0.40 %) and 9,296 (2.15 %) participants developed hyperthyroidism and hypothyroidism, respectively. All air pollutants were observed to be significantly associated with an increased risk of incident hypothyroidism, while PM2.5, PM10, and NO2 were observed to be significantly associated with an increased risk of incident hyperthyroidism. The hazard ratios (HRs) for hyperthyroidism and hypothyroidism were 1.15 (95 % confidence interval: 1.00-1.32) and 1.15 (1.08-1.22) for individuals in the highest quartile compared with those in the lowest quartile of air pollution score, respectively. Additionally, we noticed that individuals with higher pollutant levels and biologically older generally had a higher risk of incident thyroid dysfunction. Moreover, accelerated biological aging partially mediated 1.9 %-9.4 % of air pollution-associated thyroid dysfunction.

CONCLUSIONS

Despite the possible underestimation of incident thyroid dysfunction, long-term air pollution exposure may increase the risk of incident thyroid dysfunction, particularly in biologically older participants, with biological aging potentially involved in the mechanisms.

Association between short-term air pollution exposure and perturbation in thyrotropin levels in 1.38 million Chinese women: A national longitudinal analysis, 2014-2019

Prevalence of subclinical hypothyroidism substantially increased during the last decade in China, which has been commonly/clinically diagnosed as elevation in thyrotropin (thyroid-stimulating hormone [TSH]). Tobacco smoke containing toxic substances has been linked to thyroid dysfunction; however, data on perturbation of TSH following air pollution exposure in human has not been assessed at nationwide population level. We investigated the longitudinal impact of daily ambient air pollution estimated at residential level on serum TSH in 1.38 million women from China's 29 mainland provinces between 2014 and 2019. We observed that particulate matter with aerodynamic diameter ≤ 10 and ≤ 2.5 µm (PM10, PM2.5) and nitrogen dioxide (NO2) at cumulative lag 0-7 days of exposure were associated with percent elevations in TSH (0.88% [95% CI: 0.71, 1.05] per [interquartile range, IQR: 54.8 μg/m3] of PM10; 0.89% [95% CI, 0.71, 1.07] per IQR [40.3 μg/m3] of PM2.5; 2.01% [95% CI: 1.81, 2.22] per IQR [27.4 μg/m3] of NO2). Greater associations were observed in participants living in areas with ≥adequate iodine intake and those with low BMI levels and high inflammation status. Our results suggest that increased concentrations of recent ambient air pollutants at exposure ranges commonly encountered in Asia were associated with increases in TSH, supporting disturbing role of short-term air pollution exposure on the regulation of thyroid hormone homeostasis.

Graves' disease and systemic lupus erythematosus: a Mendelian randomization study

Introduction

Previous observational studies have established a correlation between Graves' disease(GD) and systemic lupus erythematosus(SLE). However, whether a causal relationship exists between these two diseases remains unknown.We utilized Mendelian randomization to infer the causal association between GD and SLE.

Methods

This study employed GWAS summary statistics of GD and SLE in individuals of Asian descent. The random effect inverse variance weighted (IVW) method was utilized to aggregate the causal effect estimates of all SNPs. Cochran's Q values were computed to evaluate the heterogeneity among instrumental variables. Sensitivity analyses such as MR-Egger method, median weighting method, leave-one-out method, and MR-PRESSO method were used to test whether there was horizontal pleiotropy of instrumental variables.

Results

Our study found genetically predicted GD may increase risk of SLE (OR=1.17, 95% CI 0.99-1.40, p=0.069). Additionally, genetically predicted SLE elevated the risk of developing GD by 15% (OR=1.15, 95% CI 1.05-1.27, p= 0.004). After correcting for possible horizontal pleiotropy by excluding outlier SNPs, the results suggested that GD increased the risk of SLE (OR=1.27, 95% CI 1.09-1.48, p =0.018), while SLE also increased the risk of developing GD (OR=1.13, 95% CI 1.05-1.22, p =0.003).

Conclusion

The findings of the study indicate that there may be a correlation between GD and SLE, with each potentially increasing the risk of the other. These results have important implications for the screening and treatment of patients with co-morbidities in clinical settings, as well as for further research into the molecular mechanisms underlying the relationship between GD and SLE.

Association between ambient air pollution and thyroid hormones levels: A systematic review and meta-analysis

BACKGROUND

Growing studies have focused on the effects of ambient air pollution on thyroid hormones (THs), but the results were controversial. Therefore, a systematic review and meta-analysis was conducted by pooling current evidence on this association.

METHODS

Four databases were searched for studies examining the associations of particulate matter [diameter ≤10 μm (PM10) or ≤2.5 μm (PM2.5)] and gaseous [sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO)] pollutants with THs levels. Random effects models were used to pool the changes in THs levels with increasing air pollutant concentrations. Subgroup analyses were constructed by region, design, sample size, pollutant concentrations, evaluated methods, and potential risk exposure windows.

RESULTS

A total of 14 studies covering 357,226 participants were included in this meta-analysis. The pooled results showed significant associations of exposure to PM2.5, PM10, NO2, SO2, and CO with decreases in free thyroxine (FT4) with percent changes (PC) ranging from -0.593 % to -3.925 %. PM2.5, NO2, and CO were negatively associated with levels of FT4/FT3 (PC: from -0.604 % to -2.975 %). In addition, results showed significant associations of PM2.5 with hypothyroxinemia and high thyroid-stimulating hormone (TSH). Subgroup analyses indicated that PM2.5 and NO2 were significantly associated with FT4 in studies of Chinese, and similar significant findings were found in studies of PM2.5 and FT4/FT3 in areas with higher concentrations of air pollutants and larger samples. PM2.5 exposure in the first trimester was found to be associated with lower FT4 levels in pregnant women.

CONCLUSION

Our findings suggest that exposure to air pollution is associated with changes in THs levels. Enhanced management of highly polluted areas, identification of harmful components and sources of PM, and protection from harmful exposures in early pregnancy may be of great public health importance for the population's thyroid function.

Dynamic changes in ambient PM2.5 and body mass index among old adults: a nationwide cohort study

Outdoor air pollution has been considered as a severe environmental health issue that almost affecting everyone in the world, and intensive actions were launched. However, little is known about the association between dynamic changes in ambient fine particulate matter (PM2.5) exposure and body mass index (BMI) among old adults. To investigate the dynamic changes in ambient PM2.5 and body mass index among the elderly, we included a total of 7204 participants from 28 provinces of China during 2011-2015 in the China Health and Retirement Longitudinal Study (CHARLS). Ambient fine particle matter (PM2.5) was estimated using a well-validated space-time extremely randomized trees model. Change in PM2.5 and BMI (ΔPM2.5 and ΔBMI) were calculated as the value at a follow-up visit minus value at baseline. Linear mixed-effects models were applied to quantify the associations, controlling for sociodemographic factors. We found that per 1 μg/m3 increase in PM2.5 exposure was associated with a 0.031-0.044 kg/m2 increase in BMI among the elderly. We observed an approximate linear concentration-response relationship of PM2.5 and BMI in each visit. Each 1 μg/m3 increase in ΔPM2.5 exposure was associated with an increase in ΔBMI (β = 0.040, 95% CI 0.030, 0.049), while per 1 μg/m3 decrease in the ΔPM2.5 exposure level was associated with a decrease in ΔBMI (β = -0.016, 95% CI -0.027, -0.004). Our findings suggest that dynamic changes in ambient PM2.5 was positively associated with changes in BMI among old Chinese population.

Effects of the abdominal fat distribution on the relationship between exposure to air pollutants and thyroid hormones among Korean adult males

BACKGROUND

Several significant associations between air pollution and thyroid function have been reported, but few studies have identified whether these associations differ by obesity, particularly its regional distribution. We assessed the relationship between ambient air pollution and thyroid hormone, and whether this relationship is modified by abdominal adiposity, as indicated by the waist circumference, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and visceral-to-subcutaneous fat ratio (VSR) in Korean men.

METHODS

We included 2440 male adults in the final analysis and used each person's annual average exposure to four air pollutants: particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide, sulfur dioxide (SO2), and carbon monoxide (CO). Abdominal fat deposition was quantified by computed tomography. Serum thyrotropin (TSH) and free thyroxine (FT4) concentrations were measured for thyroid hormone. To evaluate the relationship between air pollution and thyroid hormone according to adiposity, we performed multiple linear regression analysis on the two subgroups stratified by abdominal fat level.

RESULTS

Abdominal adiposity was significantly related to FT4 concentration. The exposures to air pollutants were associated with increased TSH and decreased FT4 concentrations. In stratified analysis using abdominal fat traits, ambient air pollution except for SO2 was significantly related to increased TSH and decreased FT4 concentrations in the high adiposity group (all p < 0.05), but not in the normal adiposity group. Among the air pollutants, PM10 showed an association with an increase of TSH concentration in all group with high adiposity, including high VAT, high SAT, and high VSR groups (all p < 0.05). In case of FT4, CO showed a similar pattern. Among the abdominal fat-related traits, the VSR in the high adiposity group had the largest effect on the relationship between exposure to air pollutants and thyroid hormone.

CONCLUSIONS

This study suggests the first clue that the relationship between air pollution exposure and thyroid hormone differs according to abdominal fat distribution among Korean adult males.

Type 2 diabetes and thyroid cancer: Synergized risk with rising air pollution

Diabetes is a complex condition, and the causes are still not fully understood. However, a growing body of evidence suggests that exposure to air pollution could be linked to an increased risk of diabetes. Specifically, exposure to certain pollutants, such as particulate Matter and Ozone, has been associated with higher rates of diabetes. At the same time, air pollution has also been linked to an increased risk of thyroid cancer. While there is less evidence linking air pollution to thyroid cancer than to diabetes, it is clear that air pollution could have severe implications for thyroid health. Air pollution could increase the risk of diabetes and thyroid cancer through several mechanisms. For example, air pollution could increase inflammation in the body, which is linked to an increased risk of diabetes and thyroid cancer. Air pollution could also increase oxidative stress, which is linked to an increased risk of diabetes and thyroid cancer. Additionally, air pollution could increase the risk of diabetes and thyroid cancer by affecting the endocrine system. This review explores the link between diabetes and air pollution on thyroid cancer. We will discuss the evidence for an association between air pollution exposure and diabetes and thyroid cancer, as well as the potential implications of air pollution for thyroid health. Given the connections between diabetes, air pollution, and thyroid cancer, it is essential to take preventive measures to reduce the risk of developing the condition.

Fine particulate matter induces adipose tissue expansion and weight gain: Pathophysiology

Dysregulations in energy balance represent a major driver of obesity. Recent evidence suggests that environmental factors also play a pivotal role in inducing weight gain. Chronic exposure to fine particulate matter (PM_2.5 ) is associated with white adipose tissue (WAT) expansion in animals and higher rates of obesity in humans. This review discusses metabolic adaptions in central and peripheral tissues that promote energy storage and WAT accumulation in PM_2.5 -exposed animals and humans. Chronic PM_2.5 exposure produces inflammation and leptin resistance in the hypothalamus, decreasing energy expenditure and increasing food intake. PM_2.5 promotes the conversion of brown adipocytes toward the white phenotype, resulting in decreased energy expenditure. The development of inflammation in WAT can stimulate adipogenesis and hampers catecholamine-induced lipolysis. PM_2.5 exposure affects the thyroid, reducing the release of thyroxine and tetraiodothyronine. In addition, PM_2.5 exposure compromises skeletal muscle fitness by inhibiting Nitric oxide (NO)-dependent microvessel dilation and impairing mitochondrial oxidative capacity, with negative effects on energy expenditure. This evidence suggests that pathological alterations in the hypothalamus, brown adipose tissue, WAT, thyroid, and skeletal muscle can alter energy homeostasis, increasing lipid storage and weight gain in PM_2.5 -exposed animals and humans. Further studies will enrich this pathophysiological model.

Effect of the Marine Exercise Retreat Program on Thyroid-Related Hormones in Middle-Aged Euthyroid Women

This study aimed to investigate the effects of a marine exercise retreat program on thyroid-related hormone levels. A total of 62 middle-aged euthyroid women participated in a 6-day marine exercise retreat program. Using thyroid-stimulating hormone (TSH) and free thyroxine (fT4) hormone levels, the participants were divided into high and low-hormone-level groups. Despite decreased TSH and fT4 levels after the program, the factors influencing changes in each group were different. TSH levels were influenced by changes in the normalized low frequency (nLF) of heart rate variability and carbon monoxide (CO) from all the participants, and changes in body fat percentage, nLF, and nitrogen dioxide (NO2) exposure level in the high TSH group. fT4 levels were influenced by changes in body mass index (BMI), NO2 exposure, and particulate matter diameter of 10 µm or less (PM10) exposure in all participants. Changes in BMI and CO exposure influenced the low fT4 group. Lastly, changes in the exercise stress test affected the high fT4 group. Thus, the marine exercise retreat program affected euthyroid thyroid-related hormone levels, and influencing factors differ depending on the initial value of the hormone.

Association between ambient carbon monoxide levels and hospitalization costs of patients with myocardial infarction: Potential effect modification by ABO blood group

Previous researches have reported the association between air pollution and various diseases. However, few researches have investigated whether air pollutants are associated with the economic loss resulting from patients' hospitalization, especially the economic loss of hospitalization due to acute cardiovascular events. The purpose of our research was to explore the association between the levels of carbon monoxide (CO), taken as an index of pollution, and the hospitalization costs of myocardial infarction (MI), and the potential effect modification by the ABO blood group. A total of 3237 MI inpatients were included in this study. A multiple linear regression model was used to evaluate the association between ambient CO levels and hospitalization costs of MI patients. Moreover, we performed stratified analyses by age, gender, body mass index (BMI), season, hypertension, and ABO blood types. There was a positive association between the levels of CO in the air and the costs of hospitalization caused by MI. Furthermore, such association was stronger in males, BMI ≥25, <65 years, with hypertension, and non-O blood group. Interestingly, we found the association was particularly significant in patients with blood group B. Overall, our study first found that ambient CO levels could have an impact on the hospitalization costs for MI patients, and those with blood group B can be more sensitive.

Causal relationship between particulate matter 2.5 and hypothyroidism: A two-sample Mendelian randomization study

Background

Epidemiological surveys have found that particulate matter 2.5 (PM2.5) plays an important role in hypothyroidism. However, due to the methodological limitations of traditional observational studies, it is difficult to make causal inferences. In the present study, we assessed the causal association between PM2.5 concentrations and risk of hypothyroidism using two-sample Mendelian randomization (TSMR).

Methods

We performed TSMR by using aggregated data from genome-wide association studies (GWAS) on the IEU Open GWAS database. We identified seven single nucleotide polymorphisms (SNPs) associated with PM2.5 concentrations as instrumental variables (IVs). We used inverse-variance weighting (IVW) as the main analytical method, and we selected MR-Egger, weighted median, simple model, and weighted model methods for quality control.

Results

MR analysis showed that PM2.5 has a positive effect on the risk of hypothyroidism: An increase of 1 standard deviation (SD) in PM2.5 concentrations increases the risk of hypothyroidism by ~10.0% (odds ratio 1.10, 95% confidence interval 1.06-1.13, P = 2.93E-08, by IVW analysis); there was no heterogeneity or pleiotropy in the results.

Conclusion

In conclusion, increased PM2.5 concentrations are associated with an increased risk of hypothyroidism. This study provides evidence of a causal relationship between PM2.5 and the risk of hypothyroidism, so air pollution control may have important implications for the prevention of hypothyroidism.

Microarray analysis of mRNA expression profiles in liver of ob/ob mice with real-time atmospheric PM2.5 exposure

Epidemiological studies have demonstrated the association between exposure to fine particulate matter (PM_2.5) and the onset of non-alcoholic fatty liver disease (NAFLD). However, the potential biological mechanism is largely unknown. Our study was aimed to explore the impact of PM_2.5 on the transcriptome level in the liver of ob/ob mice by atmosphere PM_2.5 whole-body dynamic exposure system, and meanwhile preliminarily investigated the effects of metformin intervention in this process. More than three thousand differentially expressed genes (DEGs) was screened out by microarray analysis (p < 0.05, |FC|> 1.5). KEGG pathway enrichment analysis showed that these DEGs were mainly enriched in cancers, infectious diseases, and signal transduction, and the most significant pathways were thyroid hormone signaling pathway, chronic myeloid leukemia and metabolic pathways. Then, 12 hub genes were gained through weighted gene correlation network analysis (WGCNA) and verified by qRT-PCR. The expression of 5 genes in darkslateblue module (cd53, fcer1g, cd68, ctss, laptm5) increased after PM_2.5 exposure and decreased after metformin intervention. They were related to insulin resistance, glucose and lipid metabolism and other liver metabolism, and also neurodegenerative diseases. This study provided valuable clues and possible protective measures to the liver damage in ob/ob mice caused by PM_2.5 exposure, and further research is needed to explore the related mechanism in detail.

Alterations in the gut microbiota and its metabolic profile of PM2.5 exposure-induced thyroid dysfunction rats

Fine particulate matter (PM_2.5) has drawn more and more interest due to its adverse effects on health. Thyroid has been demonstrated to be the key organ impacted by PM_2.5. However, the mechanisms for PM_2.5 exposure-induced thyrotoxicity remain unclear. To explore the mechanisms, a rat thyroid injury model was established by exposing rats to PM_2.5 via passive pulmonary inhalation. Thyroid hormones and thyroid function proteins were detected. The thyroid function affected by PM_2.5 exposure was investigated via metabolomics analysis using liquid chromatography-mass spectrometry and 16S rRNA gene sequencing. Results showed that PM_2.5 exposure induced remarkable alterations in gut microbiome evenness, richness, and composition. Metabolomics profiling revealed that the urine metabolites levels were changed by PM_2.5 exposure. The altered gut microbiota and urine metabolites showed significant correlations with thyroid function indicators (total T3, total T4 and thyrotropin hormone, etc.). These metabolites were involved in metabolic pathways including thyroid hormone synthesis, metabolisms of tryptophan, d-Glutamine and D-glutamate, histidine, glutathione, etc. The altered gut microbiota showed significant correlations with urine metabolites (glutathione, citric acid, D-Glutamic acid, kynurenic acid and 5-Aminopentanoic acid, etc.). For example, the taurocholic acid levels positively correlated with the relative abundance of several genera including Elusimicrobium (r = 0.9741, p = 0.000000), Muribaculum (r = 0.9886, p = 0.000000), Candidatus_Obscuribacter (r = 0.8423, p = 0.000585), Eubacterium (r = 0.9237, p = 0.000017), and Parabacteroides (r = 0.8813, p = 0.000150), while it negatively correlated with the relative abundance of Prevotella (r = -0.8070, p = 0.001509). PM_2.5 exposure-induced thyrotoxicity led to remarkable alterations both in gut microbiome composition and some metabolites involved in metabolic pathways. The altered intestinal flora and metabolites can in turn influence thyroid function in rats. These findings may provide novel insights regarding perturbations of the gut-thyroid axis as a new mechanism for PM_2.5 exposure-induced thyrotoxicity.

Ambient air pollution and thyroid function in Spanish adults. A nationwide population-based study (Di@bet.es study)

BACKGROUND

Recent reports have suggested that air pollution may impact thyroid function, although the evidence is still scarce and inconclusive. In this study we evaluated the association of exposure to air pollutants to thyroid function parameters in a nationwide sample representative of the adult population of Spain.

METHODS

The Di@bet.es study is a national, cross-sectional, population-based survey which was conducted in 2008-2010 using a random cluster sampling of the Spanish population. The present analyses included 3859 individuals, without a previous thyroid disease diagnosis, and with negative thyroid peroxidase antibodies (TPO Abs) and thyroid-stimulating hormone (TSH) levels of 0.1-20 mIU/L. Participants were assigned air pollution concentrations for particulate matter <2.5μm (PM_2.5) and Nitrogen Dioxide (NO₂), corresponding to the health examination year, obtained by means of modeling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). TSH, free thyroxine (FT4), free triiodothyronine (FT3) and TPO Abs concentrations were analyzed using an electrochemiluminescence immunoassay (Modular Analytics E170 Roche).

RESULTS

In multivariate linear regression models, there was a highly significant negative correlation between PM_2.5 concentrations and both FT4 (p<0.001), and FT3 levels (p<0.001). In multivariate logistic regression, there was a significant association between PM_2.5 concentrations and the odds of presenting high TSH [OR 1.24 (1.01-1.52) p=0.043], lower FT4 [OR 1.25 (1.02-1.54) p=0.032] and low FT3 levels [1.48 (1.19-1.84) p=<0.001] per each IQR increase in PM_2.5 (4.86 μg/m³). There was no association between NO₂ concentrations and thyroid hormone levels. No significant heterogeneity was seen in the results between groups of men, pre-menopausal and post-menopausal women.

CONCLUSIONS

Exposures to PM_2.5 in the general population were associated with mild alterations in thyroid function.

National cohort and meteorological data based nested case-control study on the association between air pollution exposure and thyroid cancer

The objective of this study was to evaluate the influence of exposure to meteorological conditions, including air pollution, on thyroid cancer. A nested case–control study was conducted utilizing 4632 patients with thyroid cancer and 18,528 control subjects who were matched at a 1:4 ratio by age group, sex, income, and region of residence. Korean National Health Insurance Service-Health Screening Cohort data from 2002 to 2015 were used. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for thyroid cancer correlated with meteorological and air pollution exposure over a moving average of 3 years before the index dates. For all participants, the adjusted ORs associated with relative humidity (1.01, 95% CI 1.00–1.03, P value = 0.023), ambient atmospheric pressure (1.02, 95% CI 1.01–1.03, P value < 0.001), and sunshine duration (1.17, 95% CI 1.04–1.31, P value = 0.007) indicated correlations with the occurrence of thyroid cancer; however, these results were inconsistent in the subgroup analyses. Overall, exposure to nitrogen dioxide (NO₂) (1.33, 95% CI 1.24–1.43, P value < 0.001) and particulate matter (PM₁₀) (0.64, 95% CI 0.60–0.69, P value < 0.001) were related to thyroid cancer. These relationships persisted in the subgroup analyses. In conclusion, thyroid cancer occurrence was positively associated with NO₂ exposure and negatively associated with PM₁₀ exposure.

Higher Risk of Hyperthyroidism in People with Asthma: Evidence from a Nationwide, Population-Based Cohort Study

BACKGROUND

Studies have indicated that hyperthyroidism exacerbates asthma; however, the influence of asthma in the development of hyperthyroidism has not been adequately studied.

OBJECTIVE

The aim of this population-based, retrospective cohort study was to investigate the association between asthma and the development of hyperthyroidism.

METHODS

In this retrospective cohort study, datasets from the Longitudinal Health Insurance Database 2000 in Taiwan during 1997 to 2013 were retrieved. Patients newly diagnosed with asthma (International Classification of Diseases, Ninth Revision: 493) during 2000 to 2013 were identified as the exposure cohort. The 1:1 propensity-score-matched nonasthma individuals were selected as the comparison cohort. The hazard ratio (HR) of development of hyperthyroidism in patients with asthma and its association with age and follow-up time were examined.

RESULTS

A total of 45,182 individuals were included in the study, including 22,591 and 22,591 patients with (asthma group) and without (control group) asthma, respectively. Incidence rates (per 100,000 person-months) of hyperthyroidism in the study groups were 12.88 in the control group and 16.95 in the asthma group. The adjusted HR for developing hyperthyroidism was 1.31 (95% confidence interval, 1.12-1.53) in patients with asthma compared with controls. The risk of developing hyperthyroidism was higher in patients with asthma aged>30 years old and with a follow-up of <3 years than in other subgroups.

CONCLUSION

Patients with asthma had a higher risk of developing hyperthyroidism, especially those over 30 years of age and in the first 3 years after diagnosis of asthma. Clinicians caring for patients with asthma should be aware of this increased risk.

Outdoor air pollution and hormone-assessed pubertal development in children: Results from the GINIplus and LISA birth cohorts

BACKGROUND

Air pollution is hypothesized to affect pubertal development. However, the few studies on this topic yielded overall mixed results. These studies did not consider important pollutants like ozone, and none of them involved pubertal development assessed by estradiol and testosterone measurements. We aimed to analyze associations between long-term exposure to four pollutants and pubertal development based on sex hormone concentrations among 10-year-old children.

METHODS

These cross-sectional analyses were based on the 10-year follow-up medical examinations of 1945 children from the Munich and Wesel centers of the GINIplus and LISA German birth cohorts. Female and male pubertal development was assessed by dichotomizing the concentration of hormones in serum at 18.4 pmol/L and 0.087 nmol/L using the lower limits of quantification for estradiol and testosterone, respectively. Land-use regression models derived annual average concentrations of particulate matter with an aerodynamic diameter < 2.5 and 10 µm (PM_2.5 and PM₁₀), as well as spatial models assessed yearly average concentrations of nitrogen dioxide (NO₂) and ozone, were calculated at the 10-year residential addresses. To evaluate associations, we utilized logistic regressions adjusted for potential covariates. The analyses were stratified by area and sex.

RESULTS

Around 73% of the 943 females and 25% of the 1002 males had a high level of hormones and had already started puberty at the age of 10. Overall, we found no statistically significant associations between exposure to particles (PM_2.5 or PM₁₀) and pubertal development. Results on NO₂ and ozone were not significant as well; for instance, per 10 µg/m³ increase in ozone concentration, odds ratios and 95% confidence intervals were 0.900 (0.605, 1.339) and 0.830 (0.573, 1.203) for females and males, respectively. Stratified by area, the aforementioned results did not reveal any associations either.

CONCLUSIONS

Our study did not observe the associations between ambient air pollutants and pubertal development determined by estradiol and testosterone levels in children. However, due to the current limited number of studies on this topic, our results should be cautiously interpreted. Future longitudinal studies are needed to assess the association.