{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:16:05Z","timestamp":1790374565081,"version":"4.1.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fine particulate matter (PM2.5) is a significant source of endocrine disrupting chemicals. However, epidemiological evidence linking PM2.5 exposure to thyroid function, particularly thyroid-stimulating hormone (TSH), remains inconsistent. We hypothesized that this inconsistency stems from unmeasured effect modification by thyroid autoimmunity status, specifically the presence of thyroid peroxidase antibodies (TPOAb).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether TPOAb status modifies the association between PM2.5 exposure and thyroid function in women planning pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cohort study was conducted in Liaoning, China as a part of the China Medical University Birth Cohort. Serum TSH, FT4, and FT3 were measured, along with TPOAb and TgAb status. PM2.5 exposure was estimated for 1 to 12 month periods prior to blood draw. Linear regression with interaction terms was used to assess effect modification by TPOAb status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1,357 women were included between January 2019 and December 2023.\u00a0A significant interaction was observed between half-year average PM2.5 exposure and TPOAb status on TSH levels (P for interaction = 0.003). Critically, the direction of association was opposite: each 10 \u03bcg\/m\u00b3 increase in PM2.5 was associated with a decrease in TSH among TPOAb-negative women (\u03b2 = -0.074, 95% CI: -0.122, -0.026), but with an increase in TSH among TPOAb-positive women (\u03b2 = 0.156, 95% CI: 0.014, 0.299). This effect modification was specific to TSH (no associations with FT4 or FT3), most pronounced for the 6-month exposure window.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TPOAb status critically modifies the direction of association between PM2.5 exposure and TSH levels in preconception women. TPOAb-positive women may represent an environmentally susceptible subgroup, highlighting the importance of considering individual autoimmune status in environmental endocrine disruption research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1818739","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T04:29:25Z","timestamp":1780374565000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Opposing effects of PM2.5 on TSH levels: effect modification by thyroid peroxidase antibody status in a preconception cohort"],"prefix":"10.3389","volume":"17","author":[{"given":"Heze","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University","place":["Shenyang, Liaoning, China"]},{"name":"Key Laboratory of Maternal-Fetal Medicine of Liaoning Province","place":["Shenyang, Liaoning, 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