Does fluoride exposure affect thyroid function? A systematic review and dose-response meta-analysis

作者：Inga Iamandii, Lisa De Pasquale, Maria Edvige Giannone, Federica Veneri, Luigi Generali, Ugo Consolo, Linda S. Birnbaum, Jacqueline Castenmiller, Thorhallur I. Halldorsson, Tommaso Filippini, Marco Vinceti · 发表于：Environmental Research · 年份：2023 · DOI：10.1016/j.envres.2023.117759 · 被引用次数：35 · 研究领域：Fluoride Effects and Removal、Arsenic contamination and mitigation、Groundwater and Isotope Geochemistry

INTRODUCTION: Fluoride exposure may have various adverse health effects, including affecting thyroid function and disease risk, but the pattern of such relation is still uncertain. METHODS: We systematically searched human studies assessing the relation between fluoride exposure and thyroid function and disease. We compared the highest versus the lowest fluoride category across these studies, and we performed a one-stage dose-response meta-analysis for aggregated data to explore the shape of the association. RESULTS: Most retrieved studies (27 of which with a cross-sectional design) were conducted in Asia and in children, assessing fluoride exposure through its concentrations in drinking water, urine, serum, or dietary intake. Twenty-four studies reported data on thyroid function by measuring thyroid-related hormones in blood (mainly thyroid-stimulating-hormone - TSH), 9 reported data on thyroid disease, and 4 on thyroid volume. By comparing the highest versus the lowest fluoride categories, overall mean TSH difference was 1.05 μIU/mL. Dose-response curve showed no change in TSH concentrations in the lowest water fluoride exposure range, while the hormone levels started to linearly increase around 2.5 mg/L, also dependending on the risk of bias of the included studies. The association between biomarkers of fluoride exposure and TSH was also positive, with little evidence of a threshold. Evidence for an association between fluoride exposure and blood concentrations of thyroid ...