ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1629050
Environmental Exposures, Sleep, Physical Activity, and Risk of Thyroid Nodules in Older Adults: A Cross-Sectional Study
Provisionally accepted
- 1Northern Theater Command General Hospital, Shenyang, China
- 2Department of Endocrinology, General Hospital of Northern Theater Command, Liaoning, China, Shenyang, China
- 3Department of Clinical Epidemiology and Center of Evidence-Based Medicine, The First Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang 110001, China, Shenyang, China
- 4Department of Dermatology, General Hospital of Northern Theater Command, Liaoning, China, Shenyang, China
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As the global population ages, promoting healthy aging has become a critical public health priority. Emerging evidence suggests that environmental stressors-particularly residential noise-may influence endocrine health by disrupting behaviors essential to physiological homeostasis, such as sleep and physical activity.In this cross-sectional study of 2,483 community-dwelling adults aged ≥60 years, we examined the associations between behavioral and environmental risk factors and the presence of thyroid nodules, assessed via standardized ultrasonography. Residential noise exposure was estimated using geospatial monitoring data. Sleep duration and quality, as well as physical activity levels, were collected through validated questionnaires. Poor sleep was defined as self-reported sleep duration of ≤6 hours and/or symptoms of disturbed sleep. Multivariable logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).Poor sleep (adjusted OR = 3.24; 95% CI: 2.70-3.90), low physical activity (adjusted OR = 2.51; 95% CI: 2.08-3.02), and high residential noise exposure (adjusted OR = 4.46; 95% CI: 3.70-5.39) were each significantly associated with the presence of thyroid nodules. Increasing age was also independently associated with higher risk.Mediation analyses indicated that sleep quality and physical activity jointly accounted for approximately 15-20% of the effect of noise exposure on thyroid nodule risk.Behavioral and environmental stressors, particularly poor sleep, physical inactivity, and noise exposure, may contribute to thyroid nodule formation in older adults. These findings highlight the importance of addressing modifiable behavioral pathways when evaluating environmental impacts on endocrine health.
Keywords: Environmental exposures1, air pollution2, Noise, Sleep behavior3, physical activity4, Thyroid nodules5, older adults6
Received: 15 May 2025; Accepted: 31 Jul 2025.
Copyright: © 2025 Zhang, Zhao, Jin and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenping Wang, Department of Endocrinology, General Hospital of Northern Theater Command, Liaoning, China, Shenyang, China
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