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Sex-Specific Associations of Five Serum Essential Metal Elements with Thyroid Nodules in Euthyroid Adults: a Cross‑sectional Study

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Abstract

The association between the serum essential metal elements (magnesium, iron, copper, zinc, and calcium) and thyroid nodules is still inconsistent. The current study aims to investigate the relationship of metal elements with thyroid nodules and their malignant tendency. A total of 6480 Chinese euthyroid adults were included in our study. We collect basic information through questionnaires and medical checkups. We diagnose thyroid nodules by ultrasound and detect serum trace metal concentrations by using an automatic biochemical analyzer. Binary and multinomial logistic regressions were used to investigate the associations. As a result, we found that serum copper concentrations were positively associated with thyroid nodules in the second, third, and fourth quartiles, compared to the first quartile (P = 0.024, P = 0.016, P = 0.032) in women and P for trend is 0.038. There is a significant sex-specific association between copper concentrations and thyroid nodules (P for interaction = 0.009). The results of the multinomial logistic regression analyses indicate high serum calcium and magnesium concentrations emerged as consistent risk factors for thyroid nodules in both genders, whereas low zinc was a sex-specific factor. We also observed significant sex interactions in the relationships of magnesium (P for interaction = 0.043) with thyroid nodules with malignant tendency among participants with thyroid nodules. In conclusion, our study suggests that gender is an important factor when studying the association between serum metals and thyroid nodules. The imbalance of selected metal elements (calcium, copper, zinc, and magnesium) may relate to thyroid nodules and their malignant tendency, and future prospective studies are needed to further confirm the associations.

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Data Availability

The data supporting the study findings are available from the corresponding authors upon reasonable request.

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Acknowledgements

The authors thank all team members and participants in the cross-sectional study.

Funding

This work was supported by the National Natural Science Foundation of China (82200960, 82170800) and the Guangdong Basic and Applied Basic Research Foundation (2021A1515110682).

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Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shunde Hospital, Southern Medical University (The First People’s Hospital of Shunde, Foshan), No.1 of Jiazi Road, Lunjiao, Shunde District, Foshan City, 528308, Guangdong Province, China

    Qintao Ma, Ying Li, Genfeng Yu, Siyang Liu, Yuqi Jiang, Hualin Duan, Dongmei Wang, Yajun He, Xingying Chen, Nanfang Yao, Xu Lin, Heng Wan & Jie Shen

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  1. Qintao Ma
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Contributions

Study concept and design: QM, JS, and HW. Literature searches: SL, YJ, HD, YH, XC, NY, XL, and DW. Statistical analysis: QM, YL, and GY. Drafting of the manuscript: QM, YL, and GY. Data collection: all authors. Critical revision: JS and HW. Study supervision: JS and HW. All authors contributed to the manuscript for important intellectual content and approved the submission.

Corresponding authors

Correspondence to Heng Wan or Jie Shen.

Ethics declarations

Ethics Approval and Consent to Participate

The purpose and procedures of the survey were explained to the participants, and they provided informed consent before enrollment. The ethics committee of Shunde hospital of Southern Medical University approved the research protocol (20211103).

Competing Interests

The authors declare no competing interests.

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Qintao Ma, Ying Li, and Genfeng Yu contributed equally to this work.

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Ma, Q., Li, Y., Yu, G. et al. Sex-Specific Associations of Five Serum Essential Metal Elements with Thyroid Nodules in Euthyroid Adults: a Cross‑sectional Study. Biol Trace Elem Res (2023). https://doi.org/10.1007/s12011-023-04024-0

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