Objective: To evaluate whether long-term exposure to heavy environmental pollution with polychlorinated biphenyls (PCBs) could result in impairment of thyroid status as evaluated by an epidemiological field survey. Methods: Thyroid volume (ThV) was measured by ultrasound in 238 employees of a factory (EMP) which previously produced PCBs and 454 adolescents from the surrounding area polluted by PCBs. Controls (C) were 572 adults and 965 adolescents from much less polluted areas. In the 238 EMP and various numbers (shown in parentheses) of adult C the levels of thyroid-stimulating hormone (TSH) (n ¼ 498), thyroxine (n ¼ 498), thyroglobulin (n ¼ 278) and thyroid antibodies (anti-peroxidase (TPO Ab), n ¼ 517; anti-thyroglobulin (Tg Ab), n ¼ 455; anti-TSH receptor (TSHR Ab), n ¼ 238) were estimated in serum, while only TSH and TPO Ab were measured in 269 and 171 adolescents from polluted and control areas respectively. In several subjects in whom thyroid disease was suspected, total tri-iodothyronine or free thyroxine and tri-iodothyronine were measured. In a total of 362 adults and adolescents the urinary iodine was estimated. Results: Using the Mann-Whitney test, ThV in EMP (mean Ϯ S.E. ¼ 18.85 Ϯ 0.69 ml, median ¼ 17.3 ml, upper quartile ¼ 22.9 ml, n ¼ 238) was significantly higher (P < 0.001) than that in C (13.47 Ϯ 0.48 ml, 11.5 ml, 15.3 ml, n ¼ 486 respectively). Similarly, ThV in adolescents from the polluted area (9.37 Ϯ 0.17 ml, 8.9 ml, 11.0 ml, n ¼ 454 respectively) was significantly higher (P < 0.001) than that in C (8.07 Ϯ 0.10 ml, 7.6 ml, 9.6 ml, n ¼ 965 respectively).In adults, a significantly increased prevalence of TPO Ab (P<0.05) was found (using the chi-square test) in EMP women of all ages (54/190) vs C women (70/282), in EMP women aged 31-50 years (40/117 vs 70/282 respectively) and those aged 41-50 years (28/77 vs 54/215 respectively). Compared with C, there was also a higher prevalence of Tg Ab in EMP women aged 31-60 years (36/169 vs 50/342 respectively) and of TSHR Ab (P < 0.001) in the group of EMP men and women (25/238) vs sex-and age-matched C (6/238).No difference between EMP and C was found in the level of thyroxine (mean Ϯ S.D. ¼ 116.1 Ϯ 31.2 nmol/l, n ¼ 238 vs 112.2 Ϯ 37.0 nmol/l, n ¼ 460 respectively), TSH in the range 0.1-4.5 mU/l (1.56 Ϯ 0.86 mU/l, n ¼ 219 vs 1.51 Ϯ 0.84 mU/l, n ¼ 460 respectively), prevalence of TSH >4.5 (14/238 vs 28/498 respectively) and <0.1 mU/l (5/238 vs 10/498 respectively). The prevalence of individuals without any defined clinical or laboratory signs of thyroid disorders among EMP who had worked in the factory for 21-35 years (43/128, 33.6%) was significantly lower than that in twice as many matched C (118/256, 46.1%, P < 0.025) or in EMP who had worked for only 11-20 years (36/73, 49.3%, P < 0.05).In adolescents, no difference was found in the prevalence of TPO Ab or TSH >4.5 mU/l between the polluted (17/269, 6.3% and 2/243, 0.8% respectively) and C areas (15/171, 8.5% and 4/140, 2.8% respectively). The median values of urinary iodine were in the op...

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Background:  Timing and criteria of testing for gastric dysmotility in pancreatic diabetes is not well established. Aim:  To investigate the pattern of EGG and autonomic neuropathy (AN) in patients with pancreas diabetes mellitus to clarify the relationship between autonomic neuropathy, alcohol consumption, glucose homeostasis, diabetes duration, and EGG. Patients and methods:  Thirty patients with pancreas diabetes mellitus were enrolled into the study. Mean duration of diabetes mellitus was 11 (0–25) years, mean blood glucose levels: 8.13 ± 2.7 mmoll−1, HbA1c 8.3 ± 2.96%; 25/30 patients were treated with insulin, the others were on rigorous diet, all of them received high dose pancreatin substitution therapy. Ten matched controls without diabetes and pancreatic insufficiency were also examined. AN was evaluated by the cardiovascular reflex tests according to the Ewing's criteria (Diab. Care 8 (5): 491–497, 1985.), EGG was monitored for 30–30 min in both fasting and in postprandial states, using a Digitrapper EGG (Synectic Med., Stockholm). EGG rhythm disturbances (bradygastria: 0–2 cpm, tachygastria: 4–10 cpm) and meal evoked EGG signal amplitude (power) changes were determined. Results:  9/30 pts had mild to moderate parasympathetic AN, 1/30 pts had sympathetic AN, 5/30 pts had both parasympathetic and sympathetic AN; 17/30 pts demonstrated myoelectric abnormalities: 5/30 pts had predominant bradygastria, 3/30 tachygastria, and in other 9/30 pts only an absence of increase in the postprandial signal amplitude was found. Overall, 7/30 pts with abnormal EGG did not demonstrated AN. Abnormal EGG showed no correlation with actual blood sugar values or HbA1c, but it was associated with diabetes duration more than 10 years. Conclusion:  Our results suggest that beside neuropathy other factors such as alcohol toxicity, sympathetic and parasympathetic imbalance or long‐term inappropriate glucose metabolism may be involved in the gastric myoelectric abnormalities provoked by pancreas diabetes.

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