Per- and polyfluoroalkyl substances and the associated thyroid cancer risk: A case-control study in China

Li, Haoran; Yang, Ming; Yang, Jing; Seery, Samuel; Ma, Chao; Liu, Yi; Huang, Zhaohui; Li, Ang; Guo, Huicai

doi:10.1016/j.chemosphere.2023.139411

Cited by 15 publications

(3 citation statements)

References 62 publications

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“…Several studies have underscored the integral role of inflammation in the pathogenesis of a broad spectrum of diseases, including cardiovascular diseases [9,10], diabetes [11], and cancer [12].…”

Section: Introductionmentioning

confidence: 99%

Association between Combined Metals and PFAS Exposure with Dietary Patterns: A Preliminary Study

Odediran,

Obeng-Gyasi

2024

Environments

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Background: The global burden of chronic diseases has been increasing, with evidence suggesting that diet and exposure to environmental pollutants, such as per- and polyfluoroalkyl substances (PFAS) and heavy metals, may contribute to their development. The Dietary Inflammatory Index (DII) assesses the inflammatory potential of an individual’s diet. However, the complex interplay between PFAS, heavy metals, and DII remains largely unexplored. Objective: The goal of this cross-sectional study was to investigate the associations between diet operationalized as the DII with individual and combined lead, cadmium, mercury, perfluorooctanoic acid (PFOA), and perfluorooctanesulfonic acid (PFOS) exposures using data from the National Health and Nutrition Examination Survey (NHANES) 2017–2018. Methods: Descriptive statistics, a correlational analysis, and linear regression were initially used to assess the relationship between the variables of interest. We subsequently employed Bayesian kernel Machine regression (BKMR) to analyze the data to assess the non-linear, non-additive, exposure–response relationships and interactions between PFAS and metals with the DII. Results: The multi-variable linear regression revealed significant associations between the DII and cadmium and mercury. Our BKMR analysis revealed a complex relationship between PFAS, metal exposures, and the DII. In our univariate exposure–response function plot, cadmium and mercury exhibited a positive and negative linear relationship, respectively, which indicated a positive and negative relationship across the spectrum of exposures with the DII. In addition, the bivariate exposure–response function between two exposures in a mixture revealed that cadmium had a robust positive relationship with the DII for different quantiles of lead, mercury, PFOA, and PFOS, indicating that increasing levels of cadmium are associated with the DII. Mercury’s bivariate plot demonstrated a negative relationship across all quantiles for all pollutants. Furthermore, the posterior inclusion probability (PIP) results highlighted the consistent importance of cadmium and mercury with the inflammatory potential of an individual’s diet, operationalized as the DII in our study, with both showing a PIP of 1.000. This was followed by PFOS with a PIP of 0.8524, PFOA at 0.5924, and lead, which had the lowest impact among the five environmental pollutants, with a PIP of 0.5596. Conclusion: Our study suggests that exposures to environmental metals and PFAS, particularly mercury and cadmium, are associated with DII. These findings also provide evidence of the intricate relationships between PFAS, heavy metals, and the DII. The findings underscore the importance of considering the cumulative effects of multi-pollutant exposures. Future research should focus on elucidating the mechanistic pathways and dose–response relationships underlying these associations in a study that examines causality, which will enable a deeper understanding of the dietary risks associated with environmental pollutants.

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Section: Introductionmentioning

confidence: 99%

Association between Combined Metals and PFAS Exposure with Dietary Patterns: A Preliminary Study

Odediran,

Obeng-Gyasi

2024

Environments

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“…Recently, van Gerwen et al were the first to find a significantly positive association between linear PFOS and thyroid cancer when comparing the plasma of 88 thyroid cancer patients with 88 non-cancer controls (odds ratio (OR): 1.56; 95% confidence interval (CI): 1.17–2.15) [ 17 ]. However, a case–control study in China demonstrated that higher levels of the PFASs PFNA, PFDA, and PFUnDA as well as PFAS mixtures were associated with a lower risk of thyroid cancer, but since the study participants were recruited from the same hospital, the results may not be generalizable to the general population [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Per- and Polyfluoroalkyl Substances (PFAS) in Community Water Systems (CWS) and the Risk of Thyroid Cancer: An Ecological Study

Alsen,

Leung,

van Gerwen

2023

Toxics

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Thyroid cancer incidence has been steadily increasing over the past decade in the United States (US). A discussion exists regarding the potential contribution of exposure to endocrine-disrupting chemicals, encompassing certain per- and poly-fluoroalkyl substances (PFASs). This ecological study evaluated the potential correlation between PFAS levels in drinking water and thyroid cancer incidence in the US. Data on age-adjusted thyroid cancer incidence rate (per 100,000 persons) by county were obtained from the Centers for Disease Control and Prevention (CDC) for US counties with available data in 2015–2019. Data on PFAS concentrations in the drinking water of selected community water systems (CWSs) were obtained from the CDC National Environmental Public Health Tracking Network in 2013–2015. The correlation between PFASs in CWSs and thyroid cancer incidence was calculated using Spearman correlation. A statistically significant correlation was found between perfluorooctanoic acid (PFOA) (r = 0.031; p = 0.043), perfluorononanoic acid (PFNA) (r = 0.058; p ≤ 0.001), and thyroid cancer incidence. The results suggest a potential link between certain PFAS exposures and thyroid cancer risk. However, due to the nature of an ecological study, no conclusions can be drawn at the individual level or causality. More research is needed, particularly on an individual level to allow for more detailed exposure assessment.

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“…In contrast, the participants in the control group were selected at the same hospital from healthy individuals without a history of thyroid disease. Similar study designs and enrollment criteria were used in other case-control studies. − Second, our investigation evaluated the relationship between thyroid cancer and exposure to brominated flame retardants and organophosphates; it did not aim to determine the disease’s prevalence, which is often the primary goal of cross-sectional studies. Third, our research retrospectively examined the relationship between exposure to novel flame retardants and the incidence of thyroid cancer.…”

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confidence: 99%

Rebuttal to Correspondence on “Exposure to Novel Brominated Flame Retardants and Organophosphate Esters and Associations with Thyroid Cancer Risk: A Case–Control Study in Eastern China”

Liu,

Li,

et al. 2024

Environ. Sci. Technol.

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Per- and polyfluoroalkyl substances and the associated thyroid cancer risk: A case-control study in China

Cited by 15 publications

References 62 publications

Association between Combined Metals and PFAS Exposure with Dietary Patterns: A Preliminary Study

Association between Combined Metals and PFAS Exposure with Dietary Patterns: A Preliminary Study

Per- and Polyfluoroalkyl Substances (PFAS) in Community Water Systems (CWS) and the Risk of Thyroid Cancer: An Ecological Study

Rebuttal to Correspondence on “Exposure to Novel Brominated Flame Retardants and Organophosphate Esters and Associations with Thyroid Cancer Risk: A Case–Control Study in Eastern China”

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