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      Multiple adverse thyroid and metabolic health signs in the population from the area heavily polluted by organochlorine cocktail (PCB, DDE, HCB, dioxin)

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          Abstract

          Background

          Several our previous studies showed associations of increasing blood level of persistent organochlorinated pollutants (POPs) with individual thyroid and metabolic adverse health signs in subjects from heavily polluted area (POLL) compared to these from the area of background pollution (BCGR). In this study we present increasing number of subjects with multiple adverse signs positively associated with blood level of polychlorinated biphenyls (PCBs) which is used as a marker of other POPs cocktail.

          Methods

          In a total of 2046 adults (834 males and 1212 females; age range 21–75) from POLL and BCGR the serum level of major POPs such as of 15 most abundant PCBs congeners, dichlorodiphenyl-dichloroethylene ( p,p'-DDE) and hexachlorobenzene (HCB) was estimated by high resolution gas chromatography. In addition, the data on thyroid volume by ultrasound and body mass index were obtained and serum level of thyroperoxidase and thyrotropin receptor antibodies as well as that of free thyroxine, total triiodothyronine, thyrotropin, thyroglobulin, fasting glucose and insulin, cholesterol and triglycerides was measured. Thus, a total of 13 adverse signs were defined and the interrelations between PCBs level and increasing number of subjects with increasing number of adverse signs were evaluated.

          Results

          Because of high correlation between major POPs (PCB, DDE and HCB), for this purpose the level of PCBs was considered as a marker also for the presence of DDE and HCB. Thus, if all data obtained from 2046 subjects were stratified according to quintiles of PCBs level, highly significant increase was found (p < 0.02 to 0.0000 by chi-sqauare) for the frequency of 8 among 13 signs, while the increase of one additional sign was slightly above significance limit and that in 4 other was not significant. Also the number of subjects with multiple adverse signs was significantly higher in POLL than in BCGR. For instance, in BCGR area (1038 subjects; median PCB level of 744 ng/g and 5%–95% range of 423 – 1329 ng/g serum lipids) there were 84 (8.1%) cases with 6 or 7 adverse health signs, while in POLL area (1008 subjects; median PCB level of 1892 ng/g; 5%–95% range of 685 – 9016 ng/g) the prevalence of respective cases was twice as high (195 cases = 19.3%; p < 0.001 by chi-square). For the subjects with the same PCB levels, but with 8 or 9 adverse signs the respective values were 22/1038 (2.1%) vs. 54/1008 (5.3%; p < 0.001).

          Conclusion

          Significantly higher accumulation of adverse signs in subjects with high POPs level was found in POLL thus supporting the conclusion that POPs appear to increase the prevalence of several subclinical and overt thyroid and metabolic disorders.

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          Most cited references22

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          Diagnosis and classification of diabetes mellitus.

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            The estimation of total serum lipids by a completely enzymatic 'summation' method.

            Expressing serum organic toxicant concentrations per weight of total lipid rather than by volume of serum is often advantageous, but it requires a reliable and convenient method for determining the total serum lipids. We compared a completely enzymatic 'summation' method for estimating serum total lipids with a traditional gravimetric analysis. Serum total cholesterol (TC), nonesterified cholesterol (FC), triglycerides (TG), and phospholipids (PL) were assayed by automated, enzymatic methods and total lipids (TL) were calculated from the expression TL = 1.677 * (TC-FC) + FC + TG + PL. Examining three reference serum pools by both summation and gravimetric methods yielded results that agreed within 1-3%. The evaluation of thirty serum samples resulted in similar mean total lipid values (697 mg/dl gravimetric; 675 mg/dl summation) with excellent correlation between the two methods (r2 = 0.978). We conclude that the enzymatic summation procedure is a useful method for routinely estimating serum total lipid content.
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              Thyroid volume and urinary iodine in European schoolchildren: standardization of values for assessment of iodine deficiency.

              Up to 1992, most European countries used to be moderately to severely iodine deficient. The present study aimed at evaluating possible changes in the status of iodine nutrition in 12 European countries during the past few years. Thyroid volume was measured by ultrasonography in 7599 schoolchildren aged 7-15 years in one to fifteen sites in The Netherlands. Belgium, Luxemburg, France, Germany, Austria, Italy, Poland, the Czech and Slovak Republics, Hungary and Romania. The concentrations of urinary iodine were measured in 5709 of them. A mobile unit (ThyroMobil van) equipped with a sonographic device and facilities for the collection of urine samples visited all sites in the 12 countries. All ultrasounds and all urinary iodine assays were performed by the same investigators. The status of iodine nutrition in schoolchildren has markedly improved in many European countries and is presently normal in The Netherlands, France and Slovakia. It remains unchanged in other countries such as Belgium. There is an inverse relationship between urinary iodine and thyroid volume in schoolchildren in Europe. Goiter occurs as soon as the urinary iodine is below a critical threshold of 10 micrograms/dl. Its prevalence is up to 10 to 40% in some remote European areas. This work produced updated recommendations for the normal volume of the thyroid measured by ultrasonography as a function of age, sex and body surface area in iodine-replete schoolchildren in Europe. This study proposes a method for a standardized evaluation of iodine nutrition on a continental basis, which could be used in other continents.
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                Author and article information

                Journal
                Thyroid Res
                Thyroid Research
                BioMed Central
                1756-6614
                2009
                31 March 2009
                : 2
                : 3
                Affiliations
                [1 ]Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
                [2 ]Department of Toxic Organic Pollutants, Slovak Medical University, Bratislava, Slovakia
                [3 ]1st Clinic of Internal Medicine, P.J. Šafárik University, Košice, Slovakia
                [4 ]Department of Statistics, Faculty of Economic Informatics, Economics University, Bratislava, Slovakia
                Article
                1756-6614-2-3
                10.1186/1756-6614-2-3
                2679721
                19335881
                e917bc7b-7432-4c7e-a5ec-3294017bff9d
                Copyright © 2009 Langer et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 February 2009
                : 31 March 2009
                Categories
                Research

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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