title: PBDE flame retardants, thyroid disease, and menopausal status in U.S. women.
abstract: Women have elevated rates of thyroid disease compared to men. Environmental toxicants have been implicated as contributors to this dimorphism, including polybrominated diphenyl ethers (PBDEs), flame retardant chemicals that disrupt thyroid hormone action. PBDEs have also been implicated in the disruption of estrogenic activity, and estrogen levels regulate thyroid hormones. Post-menopausal women may therefore be particularly vulnerable to PBDE induced thyroid effects, given low estrogen reserves. The objective of this study was to test for an association between serum PBDE concentrations and thyroid disease in women from the United States (U.S.), stratified by menopause status.
  
  
  
  Serum PBDE concentrations (BDEs 47, 99, 100 and 153) from the National Health and Examination Survey (NHANES) and reports on thyroid problems were available in the NHANES 2003-2004 cycle. Odds ratios (ORs) were calculated using multivariate logistic regression models accounting for population-weighted survey techniques and controlling for age, body mass index (BMI), education, smoking, alcohol consumption and thyroid medication. Menopause status was obtained by self-reported absence of menstruation in the previous 12 months and declared menopause.
  
  
  
  Women in the highest quartile of serum concentrations for BDEs 47, 99, and 100 had increased odds of currently having thyroid disease (ORs: 1.5, 1.8, 1.5, respectively) compared to the reference group (1st and 2nd quartiles combined); stronger associations were observed when the analysis was restricted to postmenopausal women (ORs: 2.2, 3.6, 2.0, respectively).
  
  
  
  Exposure to BDEs 47, 99, and 100 is associated with thyroid disease in a national sample of U.S. women, with greater effects observed post-menopause, suggesting that the disruption of thyroid signaling by PBDEs may be enhanced by the altered estrogen levels during menopause.
authors.affiliation: Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02215, USA. jgallen@hsph.harvard.edu.
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Allen
authors.affiliation: Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02215, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Gale
authors.affiliation: University of Massachusetts Amherst, Amherst, MA, USA.
authors.forename: R Thomas
authors.initials: RT
authors.lastname: Zoeller
authors.affiliation: Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02215, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Spengler
authors.affiliation: National Cancer Institute/NIEHS, Research Triangle Park, NC, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Birnbaum
authors.affiliation: Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA, 02215, USA.
authors.forename: Eileen
authors.initials: E
authors.lastname: McNeely
mesh_terms: D004785:Environmental Pollutants / Q000097:blood*; D005260:Female; D005411:Flame Retardants / Q000032:analysis*; D055768:Halogenated Diphenyl Ethers / Q000097:blood*; D006801:Humans; D008297:Male; D008593:Menopause / Q000097:blood*; D009749:Nutrition Surveys; D016017:Odds Ratio; D015995:Prevalence; D013959:Thyroid Diseases / Q000097:blood* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D004785:Environmental Pollutants; D005411:Flame Retardants; D055768:Halogenated Diphenyl Ethers
keywords: Endocrine disruptors; Menopause; PBDE; Polybrominated diphenyl ethers; Thyroid