Correlation Analysis of Metal Exposure and Hashimoto's Thyroiditis based on NHANES Database

LI Mengran; ZHANG Deyang; ZHOU Yibin; WANG Zhaoyi; NI Lei

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Journal of Hunan Normal University(Medical Science) ›› 2024, Vol. 21 ›› Issue (4) : 73-80.

Clinical Medicine

Correlation Analysis of Metal Exposure and Hashimoto's Thyroiditis based on NHANES Database

LI Mengran¹, ZHANG Deyang², ZHOU Yibin³, WANG Zhaoyi¹, NI Lei¹

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Abstract

Objective This study aimed to expore the potential relationship between heavy metals in urine and Hashimoto's thyroiditis （HT）,providing a basis for the prevention and control of heavy metal exposure in the general population and in those with HT. Methods Data included 5 011 cases with both urinary heavy metals （cadmium,cobalt,barium,lead,uranium）concentration indexes and thyroid peroxidase antibody （TPOAb）or thyroglobulin antibody （TgAb）from the 2007-2012 National Health and Nutrition Examination Survey （NHANES）（2007-2012）. Logistic regression models were used to explore the relationship between heavy metals in urine and HT,and restricted cubic spline models were used to examine possible nonlinear associations and to use restricted cubic spline models to visualize the dose-response relationship between different concentrations of cadmium,cobalt,and barium and HT. Furthermore,subgroup analyses were performed for gender. Results The urinary cadmium concentration in HT patinets （0.27 μg/L）was significantly higher than that in the normal population （0.24 μg/L）,while the concentrations of the other heavy metals showed no statistical difference in HT distribution. Multifactorial logistic regression showed that the risk of HT increased by 23.7 % for each quartile increase in urinary cadmium （OR=1.237,95 % CI 1.083-1.414）,and by 9.7% for each quartile increase in urinary cobalt （OR=1.097,95 % CI 1.021-1.177）. Compared to the group with the lowest urinary barium concentration （Q1）,the group with the highest urinary barium concentration （Q4）had a 48 % reduction of the risk of HT （OR=0.520,95 % CI 0.295-0.916）. However,the results of restricted cubic spline regression showed no dose-response relationship between the three and the prevalence of HT. Conclusion Exposure to heavy metals （cadmium,cobalt,barium）is associated with HT. Cadmium and cobalt may serve as potential risk factors for HT,while barium may have a protective effect against the disease. Cadmium and cobalt may be more pronounced in women. This provides the evidence for the development of intervention and health promotion guidelines,raising awareness of heavy metal exposure.

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Hashimoto's thyroiditis / metal exposure / national health and nutrition examination survey / correlation analysis

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LI Mengran, ZHANG Deyang, ZHOU Yibin, WANG Zhaoyi, NI Lei. Correlation Analysis of Metal Exposure and Hashimoto's Thyroiditis based on NHANES Database[J]. Journal of Hunan Normal University(Medical Science). 2024, 21(4): 73-80

References

[1] RALLI M, ANGELETTI D, FIORE M, et al.Hashimoto's thyroiditis: An update on pathogenic mechanisms, diagnostic protocols, therapeutic strategies, and potential malignant transformation[J]. Autoimmunity Rev, 2020, 19(10): 102649.
[2] CHAKER L, BIANCO A C, JONKLAAS J, et al.Hypothyroidism[J]. Lancet, 2017, 390(10101), 1550-1562.
[3] WANG S, WANG K, CHEN X, et al.The relationship between autoimmune thyroid disease, thyroid nodules and sleep traits: a Mendelian randomization study[J]. Front Endocrinol, 2024, 14, 1325538.
[4] RAGUSA F, FALLAHI P, ELIA G, et al.Hashimotos' thyroiditis: Epidemiology, pathogenesis, clinic and therapy[J]. Best Pract Res Clin Endocrinol Metab, 2019, 33(6): 101367.
[5] CARDONA C A, CANDY C W S, SANDRO V. Predictors of autoimmune thyroid disease[J]. Proc (Bayl Univ Med Cent), 2022, 35(5): 608-614.
[6] LI Y Z, TENG D, BA J M, et al.Efficacy and safety of long-term universal salt iodization on thyroid disorders: Epidemiological evidence from 31 provinces of mainland China[J]. Thyroid, 2020, 30(4): 568-579.
[7] ALMERUD P, ZAMARATSKAIA G, LINDROOS A, et al.Cadmium, total mercury, and lead in blood and associations with diet, sociodemographic factors, and smoking in Swedish adolescents[J]. Environ Res, 2021, 197: 110991.
[8] XU J, ZHAO M, PEI L, et al.Effects of heavy metal mixture exposure on hematological and biomedical parameters mediated by oxidative stress[J]. Sci Total Environ, 2020, 705: 134865.
[9] LI A, MEI Y, ZHAO M, et al.Do urinary metals associate with the homeostasis of inflammatory mediators? results from the perspective of inflammatory signaling in middle-aged and older adults[J]. Environ Int, 2022, 163: 107237.
[10] LI A, LI Y, MEI Y, et al.Associations of metals and metals mixture with lipid profiles: a repeated-measures study of older adults in Beijing[J]. Chemosphere, 2023, 319: 137833.
[11] REN J, CUI J, CHEN Q, et al.Low-level lead exposure is associated with aberrant sperm quality and reproductive hormone levels in Chinese male individuals: results from the MARHCS study low-level lead exposure is associated with aberrant sperm quality[J]. Chemosphere, 2020, 244: 125402.
[12] PAITHANKAR J, SAINI S, DWIVEDI S, et al.Heavy metal associated health hazards: an interplay of oxidative stress and signal transduction[J]. Chemosphere, 2021, 262: 128350.
[13] GUO J, LV N, TANG J, et al.Associations of blood metal exposure with thyroid hormones in Chinese pregnant women: a cross-sectional study Environ[J]. Environ Int, 2018, 121(Pt 2): pp.1185-1192.
[14] WANG X, SUN X, ZHANG Y, et al.Identifying a critical window of maternal metal exposure for maternal and neonatal thyroid function in China: A cohort study[J]. Environ Int, 2020, 139: 105696.
[15] BABIĆ L M, GUNJAČA I, PLEIĆ N, et al. Environmental Factors Affecting Thyroid-Stimulating Hormone and Thyroid Hormone Levels[J]. Int J Mol Sci, 2021, 22(12): 6521.
[16] NATIONAL CENTER for HEALTH STATISTICS. National health and nutrition examination survey homepage[EB/OL].[2023-12-11]. https://www.cdc.gov/nchs/nhanes/index.html.
[17] WU J, HUANG H, YU X.How does Hashimoto's thyroiditis affect bone metabolism[J]. Rev Endocr Metab Disord, 2023, 24(2): 191-205.
[18] ZHENG G, CAI Y, GUO Y, et al.The association between dietary Selenium intake and Hashimoto's thyroiditis among US adults: National Health and Nutrition Examination Survey (NHANES), 2007-2012[J]. J Endocrinol Invest, 2023, 46(7): 1385-1395.
[19] WRIGHT J J, POWERS A C, JOHNSON D B.Endocrine toxicities of immune checkpoint inhibitors[J]. Nature Rev Endocrinol, 2021, 17(7): 389-399.
[20] FELDT-RASMUSSEN U.Hashimoto's thyroiditis as a risk factor for thyroid cancer[J]. Curr Opin Endocrinol Diabetes Obes, 2020, 27(5): 364-371.
[21] VARGAS-URICOECHEA H.Molecular Mechanisms in Autoimmune Thyroid Disease. Cells, 2023, 12(6): 918.
[22] WEETMAN A P.An update on the pathogenesis of Hashimoto's thyroiditis[J]. J Endocrinol Invest, 2021, 44(5): 883-890.
[23] LIONTIRIS M I, MAZOKOPAKIS E E.A concise review of Hashimoto thyroiditis (HT) and the importance of iodine, selenium, vitamin D and gluten on the autoimmunity and dietary management of HT patients. Points that need more investigation[J]. Hell J Nucl Med, 2017, 20(1): 51-56.
[24] KORTENKAMP A, FAUST M.Regulate to reduce chemical mixture risk[J]. Sci, 2018, 361(6405): 957-959.
[25] VELLINGIRI B, SURIYANARAYANAN A, SELVARAJ P, et al.Role of heavy metals (copper (Cu), arsenic (As), cadmium (Cd), iron (Fe) and lithium (Li)) induced neurotoxicity[J]. Chemosphere, 2022, 301: 134625.
[26] STEPHEN C B.Metal toxicity and neuroinflammation[J]. Curr Opin Toxicol, 2021, 26: 8-13.
[27] LI A, ZHOU Q, MEI Y, et al.Thyroid disrupting effects of multiple metals exposure: Comprehensive investigation from the thyroid parenchyma to hormonal function in a prospective cohort study[J]. J Hazard Mater, 2023, 459: 132115.
[28] KIM K, ARGOS M, PERSKY V W, et al.Associations of exposure to metal and metal mixtures with thyroid hormones: Results from the NHANES 2007-2012[J]. Environ Res, 2022, 212(Pt C): 113413.
[29] ORLANDO P, SILVESTRI S, CIRILLI I, et al.Involvement of different hemoprotein thiol groups of Oncorhynchus mykiss in cadmium toxicity[J]. J Elem Med Bio, 2021, 66: 126746.
[30] KIRAN, RUCHI B, RENU S.Effect of heavy metals: an overview[J]. Mater Today, 2022, 51(1): 880-885.
[31] Buha A, Matovic V, ANTONIJEVIC B, et al.Overview of cadmium thyroid disrupting effects and mechanisms[J]. Int J Mol Sci, 2018, 19(5): 1501.
[32] CHEN Y, ZHOU, C, BIAN Y, et al.Cadmium exposure promotes thyroid pyroptosis and endocrine dysfunction by inhibiting Nrf2/Keap1 signaling[J]. Ecotoxicol Environ Saf, 2023, 249: 114376.
[33] CHEN A, KIM S S, CHUNG E, et al.Thyroid hormones in relation to lead, mercury, and cadmium exposure in the National Health and Nutrition Examination Survey, 2007-2008[J]. Environ Health Perspect, 2013, 121(2): 181-186.
[34] MARGETAKI K, VAFEIADI M, KAMPOURI M, et al.Associations of exposure to cadmium, antimony, lead and their mixture with gestational thyroid homeostasis[J]. Environ Pollut, 2021, 289: 117905.
[35] BYRNE C, DIVEKAR SD, STORCHAN GB, et al.Cadmium—a metallohormone?[J]. Toxicol Appl Pharmacol, 2009, 238(3): 266-271.
[36] PRZYBYLIK-MAZUREK E, HUBALEWSKA-DYDEJCZYK A, FEDOROWICZ A, et al.Factors connected with the female sex seem to play an important role in differentiated thyroid cancer[J]. Gynecol Endocrinol, 2011, 27(11): 961-965.
[37] ZHANG S, TANG H, ZHOU M.Sex-specific associations between nine metal mixtures in urine and urine flow rate in US adults: NHANES 2009-2018[J]. Front Public Health, 2023, 11: 1241971.
[38] YORITA CHRISTENSEN K L. Metals in blood and urine, and thyroid function among adults in the United States 2007-2008[J]. Int J Hyg Environ Health, 2013, 216(6): 624-632.
[39] CALDERÓN-OSPINA C A, NAVA-MESA M O. B Vitamins in the nervous system: Current knowledge of the biochemical modes of action and synergies of thiamine, pyridoxine, and cobalamin[J]. CNS Neurosci Ther, 2020, 26(1): 5-13.
[40] GENCHI G, LAURIA G, CATALANO A, et al.Prevalence of cobalt in the environment and its role in biological processes[J]. Biology (Basel), 2023, 12(10): 1335.
[41] IARC working group on the evaluation of carcinogenic risks to humans. Cobalt in hard metals and cobalt sulfate, gallium arsenide, indium phosphide and vanadium pentoxide[J]. IARC Monogr Eval Carcinog Risks Hum, 2006, 86: 1-294.
[42] ALEXANDER L F, PATEL N J, CASERTA M P, et al.Thyroid ultrasound: diffuse and nodular disease[J]. Radiol Clin North Am, 2020, 58(6): 1041-1057.
[43] GENCHI G, LAURIA G, CATALANO A, et al.Prevalence of Cobalt in the Environment and Its Role in Biological Processes[J]. Biology (Basel), 2023, 12(10): 1335.
[44] GOYAL T, MIRA P, SINGH P, et al.Effect of occupational co-exposure to lead and cadmium on selected immunomodulatory cytokines[J]. Toxicol Ind Health, 2022, 38(1): 1-10.