A Case-control Study On The Relationship Between Pbdes And The Risk Of Nodular Goiter

ObjectivePoly brominated diphenyl ethers(PBDEs)are persistent organic pollutants that are ubiquitous in the global environment.It has great harm to human health for the endocrine disrupting effect,thyroid toxicity,neurodevelopmental toxicity and other biological toxicity.This study aims to determine plasma levels of PBDEs in patients with nodular goiter and controls and explore the relationship between plasma levels of PBDEs and the incidence of nodular goiter.MethodsFrom June 2017 to June 2019,newly diagnosed patients with nodular goiter admitted to Anhui Provincial Tumor Hospital and the First Affiliated Hospital of Anhui Medical University were collected as cases.1:2 matched healthy residents in the community were collected as control group,according to gender and age(±3 years).After obtaining the informed consent of the participants,a face-to-face question-and-answer questionnaire was conducted.General demographic characteristics,living habits,disease history,family history of thyroid disease,medical radiation exposure history,and female reproductive information were collected and fasting blood and morning urine samples were collected in the next day.Eight poly brominated diphenyl ethers homologues in plasma were determined by gas chromatography-mass spectrometry(GC-MS).The blood lipid was determined by Kubel automatic biochemical analyzer.The FT3,FT4,TSH were determined by Roche electrochemical luminescence immune analyzer.Iodine and creatinine in urine were determined by digital display ultraviolet spectrophotometer.In the statistical analysis,the influence of PBDES on the incidence of nodular goiter was investigated by multivariate conditional Logistic regression model.The nodular goiter was classified according to the diameter,number and type of nodules,and the conditional Logistic regression model was used for analysis.Subgroup analysis was conducted according to age,education level and exercise frequency.Unconditional Logistic regression model was used to explore the association between PBDES in different subgroups and the risk of nodular goiter.ResultsA 1:2 match of gender and age(±3 years)was performed in the case and control.A total of 182 cases of nodular goiter and 364 community residents were collected.The mean ±standard deviation of age in the nodular goiter group was(52.03±12.18 years)and that in the control group was(52.57±12.00 years).After correction of fat mass,the BDE-028,BDE-100,BDE-154,BDE-209 and(50)PBDE plasma concentration in the case group was higher than the control group.Based on multivariate analysis,it was found that the moderate and high exposure levels of BDE-028,BDE-099,BDE-100 and BDE-154 poly brominated diphenyl ether homologue could increase the risk of nodular goiter.Moderate exposure levels of BDE-047 were statistically associated with nodular goiter.High exposure levels of BDE-153、BDE-209、(50)PBDE can increase the incidence of nodular goiter.The pathological characteristics of nodular goiter showed that(50)PBDE had a promoting effect on the incidence of nodular goiter which diameter ≤2cm,and BDE-028,BDE-099 and BDE-100 could increase the risk of nodular goiter which diameter >2cm.According to nodules is cystic or solid,eight kinds of poly rominated diphenyl ether congeners was associated with cystic nodular goiter,BDE-028,BDE-100,BDE-154 had significant statistical correlation with solid association nodular goiter,BDE-153,the BDE-209 and(50)PBDE and solid nodular goiter associated with statistical significance.According to the number of the nodules is divided into single nodules and multiple nodules,BDE-100 has statistically associated with multiple nodular goiter,high exposure levels of BDE-154,BDE-209,(50)PBDE increases the risk of multiple nodular goiter.Hierarchical analysis results show that the BDE-028,BDE-100,BDE-153,BDE-154,(50)PBDE rises nodular goiter morbidity level in group that exercise less than three times a week.In the group which age < 50 years old,(50)PBDE may increased risk for nodular goiter.Education level below junior high school may sensitive to the BDE-100、BDE-153、(50)PBDE caused nodular goiter.ConclusionsThis study showed that the detection rates of eight PBDEs were all higher than 80%,and the population was generally exposed to PBDEs.BDE-028、BDE-099、BDE-100、BDE-154 cloud increase the risk of incidence of nodular goiter.The association between PBDES and nodular goiter is different in different pathological features.Health authorities should develop targeted measures to reduce the internal and external exposure of PBDEs.