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Khosravipour M, Gharagozlou F, Kakavandi MG, Nadri F, Barzegar A, Emami K, Athar HV. Association of prolonged occupational co-exposures to electromagnetic fields, noise, and rotating shift work with thyroid hormone levels. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115837. [PMID: 38104436 DOI: 10.1016/j.ecoenv.2023.115837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023]
Abstract
The purpose of this study was to determine the association of prolonged occupational co-exposure to extremely low-frequency electromagnetic fields (ELF-EMFs), noise, and rotating shift work with the levels of thyroid hormones (triiodothyronine (T3), thyroxine (T4), and thyroid-stimulating hormone (TSH). From 2016 to 2017, we enrolled all male workers without a history of thyroid disorders and followed them until 2020. To measure ELF-EMFs and noise exposures, we calculated the 8-hour equivalent sound pressure levels (Leq) and the 8-hour average of ELF-EMFs, respectively. Shift work schedules involved 8-hr fixed day and 8-hr clockwise 3-rotating night schedules. The participant's thyroid hormone levels were obtained from blood test results in their medical records. The percentage change in the levels of T3, T4, and TSH was estimated by using different mixed-effects linear regression models. The TSH levels were significantly elevated per a 10-dB increment of noise. The levels of T4 hormone were significantly changed per a unit increase in the levels of ELF-EMFs. Compared to the fixed-day workers, we observed workers exposed to shift work had a significantly lower T4 level. For T4 and TSH hormones, we found significant interactions among noise, ELF-EMFs, and shift work variables. In summary, this study warranted that prolonged exposure to ELF-EMFs, noise, and rotating shift work might be associated with thyroid dysfunction.
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Affiliation(s)
- Masoud Khosravipour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences. Tehran, Iran.
| | - Faramarz Gharagozlou
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Ghanbari Kakavandi
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farshad Nadri
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Akbar Barzegar
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran; Research center for environmental determinant of health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khosro Emami
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Valadi Athar
- Department of Occupational Health Engineering, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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Studen KB, Gaberscek S, Zaletel K, Blinc A, Sabovic M, Schernthaner GH, Anagnostis P, Antignani PL, Jensterle M, Mikhailidis DP, Poredos P. Thyroid Disorders and Peripheral Arterial Disease. Curr Vasc Pharmacol 2024; 22:36-40. [PMID: 37957913 DOI: 10.2174/0115701611271284231105063148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023]
Abstract
Hypothyroidism and hyperthyroidism, both overt and subclinical, are associated with increased risk of cardiovascular morbidity and mortality. The association between thyroid-stimulating hormone levels and cardiovascular risk has been demonstrated in large epidemiological studies and meta-analyses and is now considered a U-shaped curve. Several pathophysiological mechanisms linking thyroid and cardiovascular disease are known; however, specific clinical complications of peripheral arterial disease as endpoints of clinical trials have not been adequately investigated. The potential mechanisms linking hypothyroidism and peripheral arterial disease are endothelial dysfunction, blood pressure changes, dyslipidemia, and low-grade systemic inflammation. The potential mechanisms linking hyperthyroidism and peripheral arterial disease are hyperdynamic circulation, elevated systolic blood pressure, hypercoagulability, and possibly increased arterial inflammation.
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Affiliation(s)
- Katica Bajuk Studen
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Simona Gaberscek
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Katja Zaletel
- Department of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Ales Blinc
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Miso Sabovic
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | - Panagiotis Anagnostis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynaecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Mojca Jensterle
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Dimitri P Mikhailidis
- Department of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London Medical School, University College London (UCL) and Department of Clinical Biochemistry, Royal Free Hospital Campus (UCL), London, UK
| | - Pavel Poredos
- Department of Internal Medicine, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Ettleson MD. Cardiovascular outcomes in subclinical thyroid disease: an update. Curr Opin Endocrinol Diabetes Obes 2023; 30:218-224. [PMID: 37288727 PMCID: PMC10527066 DOI: 10.1097/med.0000000000000818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE OF REVIEW Subclinical thyroid disease is defined by a thyroid stimulating hormone (TSH) level outside of the normal range with normal circulating thyroid hormone levels. Excess adverse cardiovascular outcomes have been observed in certain patient populations with subclinical hypothyroidism (SCH) and hyperthyroidism (SCHr). The role of thyroid hormone and antithyroid treatments for subclinical thyroid disease remains debated. RECENT FINDINGS Cardiovascular disease appears to be a major mediator of all-cause mortality in patients with SCH, in particular those aged at least 60 years of age. In contrast, pooled clinical trial results did not find that levothyroxine reduced the incidence of cardiovascular events or mortality in this patient population. The association between SCHr and atrial fibrillation is well established; however, a 5-year follow-up of older patients with mild (TSH 0.1-0.4 mIU/l) SCHr found no increased incidence of atrial fibrillation. Separately, SCHr was associated with derangements in endothelial progenitor cell function that may underlie vascular disease independent from effects on cardiac function. SUMMARY The impact of treatment of subclinical thyroid disease on cardiovascular outcomes remains uncertain. Additional prospective and trial data are needed to evaluate treatment effects on cardiovascular outcomes in younger populations.
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Affiliation(s)
- Matthew D. Ettleson
- University of Chicago, Section of Endocrinology, Diabetes, and Metabolism, Chicago, IL
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Muzurović E, Borozan S, Vujošević S, Gurnell M. Thyroid Status and Vascular Risk: An Update. Curr Vasc Pharmacol 2022; 20:460-462. [PMID: 36200192 DOI: 10.2174/1570161120666221004144414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 01/25/2023]
Affiliation(s)
- Emir Muzurović
- Department of Internal Medicine, Endocrinology Section, Clinical Centre of Montenegro, Ljubljanska bb, Podgorica, Montenegro.,Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro
| | - Sanja Borozan
- Department of Internal Medicine, Endocrinology Section, Clinical Centre of Montenegro, Ljubljanska bb, Podgorica, Montenegro
| | - Snežana Vujošević
- Department of Internal Medicine, Endocrinology Section, Clinical Centre of Montenegro, Ljubljanska bb, Podgorica, Montenegro.,Faculty of Medicine, University of Montenegro, Kruševac bb, Podgorica, Montenegro
| | - Mark Gurnell
- Wellcome-MRC Institute of Metabolic Science, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge CB2 0QO, United Kingdom
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Arterial Stiffness in Thyroid and Parathyroid Disease: A Review of Clinical Studies. J Clin Med 2022; 11:jcm11113146. [PMID: 35683533 PMCID: PMC9180991 DOI: 10.3390/jcm11113146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/23/2022] [Accepted: 05/30/2022] [Indexed: 01/27/2023] Open
Abstract
Growing evidence shows that arterial stiffness measurement provides important prognostic information and improves clinical stratification of cardiovascular risk. Thyroid and parathyroid diseases are endocrine diseases with a relevant cardiovascular burden. The objective of this review was to consider the relationship between arterial stiffness and thyroid and parathyroid diseases in human clinical studies. We performed a systematic literature review of articles published in PubMed/MEDLINE from inception to December 2021, restricted to English languages and to human adults. We selected relevant articles about the relationship between arterial stiffness and thyroid and parathyroid diseases. For each selected article, data on arterial stiffness were extracted and factors that may have an impact on arterial stiffness were identified. We considered 24 papers concerning hypothyroidism, 9 hyperthyroidism and 16 primary hyperparathyroidism and hypoparathyroidism. Most studies evidenced an increase in arterial stiffness biomarkers in hypothyroidism, hyperthyroidism and primary hyperparathyroidism, even in subclinical and mild forms, although heterogeneity of measurement methods and of study designs prevented a definitive conclusion, suggesting that the assessment of arterial stiffness may be considered in the clinical evaluation of cardiovascular risk in these diseases.
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