Evidence map›Paper›PMID 40524145›Full record

ArticleEnvironmental health : a global access science source2025

Environmental exposure to mixtures of per- and polyfluoroalkyl substances in Northeast China: exploring links to nodular goiter and papillary thyroid carcinoma.

Ziqing Sun, Boying Liu, Rui Ding, Xin Wang, Yanyan Chen, Yi Wang

Abstract read
In one paragraph

Article in Environmental health : a global access science source, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ziqing SunKey Laboratory of Environmental Stress and Chronic Disease Control & Prevention, Ministry of Education (China Medical University), Shenyang, Liaoning, PR China.
Boying LiuDepartment of Clinical Epidemiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China.
Rui DingKey Laboratory of Environmental Stress and Chronic Disease Control & Prevention, Ministry of Education (China Medical University), Shenyang, Liaoning, PR China.
Xin WangTianjin Centers for Disease Control and Prevention, Tianjin, PR China.
Yanyan ChenThe First Affiliated Hospital of China Medical University, Shenyang, Liaoning, PR China. chenyanyan_cmu@163.com.
Yi WangKey Laboratory of Environmental Stress and Chronic Disease Control & Prevention, Ministry of Education (China Medical University), Shenyang, Liaoning, PR China. wangyi@cmu.edu.cn.

Funding

Key Discipline Program of the Tianjin Health Commission Science and Technology Program TJWJ2023XK029
6 · The paper itself

Abstract

backgroundEnvironmental exposure to per- and polyfluoroalkyl substances (PFAS) has been related to some adverse health effects. An increasing number of people are suffering from nodular goiter (NG) and papillary thyroid carcinoma (PTC), the specific types of thyroid tumors with the highest prevalence. In vivo and in vitro studies have indicated that exposure to PFAS can disrupt thyroid homeostasis and exhibit apparent endocrine-disrupting toxicity, including the decreased thyroid hormone levels and abnormal expression of thyroid-related genes. However, epidemiological evidence supporting the cause-effect relationship between PFAS exposure and the risk of NG and PTC is still lacking.

methodsWe enrolled 290 participants to explore the relationship between PFAS exposure and NG/PTC risk. 21 urinary PFAS were detected by ultra-high performance liquid chromatography-triple quadrupole mass spectrometry (UPLC-MS/MS). Logistic regression, restricted cubic spline (RCS), Bayesian Kernel Machine Regression (BKMR) and quantile g-computation (qgcomp) models were adopted to examine effects of single and mixed PFAS exposure on NG/PTC risk.

resultsOur data showed that perfluoroheptane sulfonate (PFHpS) (P = 0.033) and perfluorohexane sulfonate (PFHxS) (P = 0.003) levels in NG cases and perfluoroheptanoic acid (PFHpA) (P = 0.008) levels in PTC cases were significantly higher than those in the controls. After adjustment for confounders, PFHxS was significantly related to higher NG/PTC risk (all P for trend < 0.05). A remarkable non-linear association was found between PFHpA exposure and PTC risk (P-overall < 0.001, P-non-linear = 0.001). The BKMR model indicated that PFAS mixtures significantly increased NG risk, with PFHxS contributing the most (groupPIP: 0.886, condPIP: 0.658). In stratified analyses, PFAS mixtures were positively associated with NG/PTC risk in females and normal-weight subjects.

conclusionOur results suggest that environmental exposure to PFAS mixtures may be associated with increased NG/PTC risk, and each PFAS may contribute to NG/PTC risk in very different ways. To the best of our knowledge, this is the first epidemiological study to examine effects of PFAS exposure on NG/PTC risk.

Indexed as

Carcinoma, PapillaryEnvironmental ExposureEnvironmental PollutantsFluorocarbonsGoiter, NodularThyroid Cancer, PapillaryThyroid NeoplasmsAdultAgedChinaFemaleHumansMaleMiddle AgedYoung AdultEnvironmental PollutantsFluorocarbonsMixture analysesNodular goiterPapillary thyroid carcinomaPer- and polyfluoroalkyl substances

Identifiers

PMID40524145
PMCPMC12168296

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.