Purpose:Chronotype can be used to describe individual's circadian preference in behavioral and circadian rhythm, representing the preferences for earlier or later sleep times. This study aimed to investigate the association of chronotype with hypertension and metabolic parameters in middle-aged and older adults. Patients and Methods:A total of 945 participants were recruited from December 2023 to December 2024 at First Affiliated Hospital of University of Science and Technology of China. Chronotype was determined using the full Morningness-Eveningness Questionnaire, with higher scores indicating preference for morning chronotype. Chronotype was dichotomized at the median score in current cohort, classifying 447 participants as morning chronotypes and 498 as evening chronotypes. Anthropometric measurements and biochemical analyses were also conducted. Multivariable logistic, linear regression, and restricted cubic spline (RCS) analyses were employed to evaluate association between chronotype, metabolic parameters, and hypertension. Results:After adjustment for covariates, evening chronotype was significantly associated with hypertension risk (OR = 1.60, 95% CI: 1.17-2.17), compared with morning chronotype. The RCS analysis suggested a significant nonlinearity association between chronotype score and hypertension (P for nonlinear = 0.047). Furthermore, higher chronotype score was significantly associated with decreased levels of total cholesterol [TC, β (95% CI): -0.12 (-0.19, -0.04)], low-density lipoprotein-cholesterol [LDL-C, β (95% CI): -0.21 (-0.33, -0.08)] and serum uric acid [SUA, β (95% CI): -0.09 (-0.18, -0.01)], but with increased levels of aspartate aminotransferase [AST, β (95% CI): 0.16 (0.05, 0.27)]. In discrimination model, chronotype was associated with hypertension independently of TC, SUA, alanine transaminase, and alkaline phosphatase, with model's AUC of 0.779 (95% CI: 0.749-0.808). Conclusion:In middle-aged and older adults, preference for morning chronotype was associated with decreased levels of TC, LDL-C, and SUA, but with increased levels of AST. Moreover, evening chronotype was significantly independently associated with increased risk of hypertension.

Exposure to metal(loid)s and glucose metabolism may influence the progression of gastric precancerous lesions (GPLs) or gastric cancer (GC), but their combined effects remain unclear. Our study aimed to elucidate the combined impact of metal (including metalloid and trace element) exposure and disturbances in glucose metabolism on the progression of GPLs and GC. From a prospective observational cohort of 1829 individuals, their metal(loid) levels and blood metabolism were analysed via inductively coupled plasma‒mass spectrometry and targeted metabolomics gas chromatography‒mass spectrometry, respectively. From healthy normal controls (NC) or GPLs to GC, we observed that the aluminum and arsenic levels decreased, whereas the vanadium, titanium and rubidium levels increased, but the iron, copper, zinc and barium levels initially decreased but then increased; these changes were not obvious from the NC to GPL group. With respect to glucose homeostasis, most metabolites decreased, except for phosphoenolpyruvate (PEP), which increased. Multiple logistic regression analysis revealed that titanium and phosphoenolpyruvate might be risk factors for GPLs, that barium is a protective factor for GC, and that D-glucaric acid might be a protective factor for GPLs and GC. Selenium, vanadium, titanium, succinate, maleate, isocitrate, PEP, and the tricarboxylic acid cycle (TCA) had good predictive potential for GPL and GC. Additionally, metal(loid)s such as arsenic, titanium, barium, aluminum, and vanadium were significantly correlated with multiple glucose metabolites involved in the TCA cycle in the GPL and GC groups. Our findings imply that metal(loid) exposure disrupts glucose metabolism, jointly influencing GPL and GC progression.

Background The risk factors associated with niche on the cesarean scar have been reported, however, the degree of these factors associated with large niche and the accumulation effects of these risk factors on the development of large niche are unclear. Methods Large niche was evaluated by transvaginal sonography during mid-follicular phase. Logistic regression model was used to assess 32 risk factors by univariate analysis. Then, a scoring model based on the screened risk factors was generated. The performance of this model was evaluated by area under curve (AUC). Finally, the scoring model was applied in 123 women to assess the external validation. Result(s) In the training cohort study, 163 women were diagnosed with large niche. The final scoring model involves eight risk factors with the rating scores including age at delivery (30–34 years: 1 point; ≥ 35 years: 4.5 points), retroflexed uterus (8.5 points), meconium-stained amniotic fluid (4.5 points), twice CSs (4.0 points), postpartum endometritis (4.5 points), premature rupture of membranes (2.5 points), intrahepatic cholestasis of pregnancy (mild to moderate: 3 points; severe: 6.5 points), and cervical dilatation (1-3 cm: 2.0 points; 4-10 cm: 4.5 points). The accumulation effect with a cut-off value of 8.0 in the scoring was associated with the large niche after CS. Conclusion(s) This is the first scoring model to objectively quantify the risk of a large niche after CS. Optimal risk factors control by avoiding high score factors and multiple factors accumulation may eliminate the risk of large niche development.

Hypertension is still a common chronic disease worldwide and seriously affects human health. Aim of this study was to investigate the association between tricarboxylic acid (TCA) cycle-related metabolites and hypertension in older adults. A total of 1127 community-dwelling older adults were included in this cross-sectional analysis, of whom 609 were assigned to the hypertension group and 518 to the no-hypertension group. Plasma concentrations of 8 TCA cycle-related metabolites (citrate, cis-aconitate, isocitrate, 2-oxoglutarate, succinate, maleate, fumarate, and malate) were determined by gas chromatography-triple quadrupole mass spectrometry. Multivariate logistic regression was used to assess the association between these metabolites and hypertension risk. After adjustment for covariates, we found that the increased plasma concentrations of 2-oxoglutarate and malate were significantly associated with hypertension. These two associations remained unchanged after using the false discovery rate (FDR)-adjustment method (both FDR-adjusted P-trend <0.05). In stratified analysis, these two associations were not modified by overweight, physical activity, and current drinking (all P-interaction >0.05). In the multivariate diagnostic model, the inclusion of these two metabolites modestly and significantly improved the diagnosis of hypertension (AUC = 0.64, 95% CI: 0.60-0.67). These results indicated that plasma 2-oxoglutarate and malate might be the candidate metabolic markers of hypertension among older adults. However, further longitudinal and experimental studies are necessary to confirm this finding.

Objective The purpose of this study was to explore the effect of night-shift work on the risk of hypertension for improving workers' health. Methods A total of 10,038 Chinese participants were constituted in the cross-sectional study. Logistic regression and restricted cubic spline were used to estimate the effect of night shift on hypertension. Results There were higher odds of having hypertension in any night-shift workers (odds ratio [OR], 1.16 [95% confidence interval, 1.03–1.30]) when compared with day workers. Having 5 to 10 night shifts per month were significantly more likely to be hypertensive (OR, 1.19 [95% confidence interval, 1.03–1.38]). The OR for hypertension increased as the number of night shifts increased as the result of the restricted cubic spline. Conclusions Our results support the hypothesis that night shift is associated with an elevated risk of hypertension.

OBJECTIVE:The purpose of this study was to explore the effect of night-shift work on the risk of hypertension for improving workers' health.METHODS:A total of 10,038 Chinese participants were constituted in the cross-sectional study. Logistic regression and restricted cubic spline were used to estimate the effect of night shift on hypertension.RESULTS:There were higher odds of having hypertension in any night-shift workers (odds ratio [OR], 1.16 [95% confidence interval, 1.03-1.30]) when compared with day workers. Having 5 to 10 night shifts per month were significantly more likely to be hypertensive (OR, 1.19 [95% confidence interval, 1.03-1.38]). The OR for hypertension increased as the number of night shifts increased as the result of the restricted cubic spline.CONCLUSIONS:Our results support the hypothesis that night shift is associated with an elevated risk of hypertension.

Obesity has caused a huge burden of disease. Few studies have explored individuals' environmental exposure level and the impact of multiple environmental exposures on obesity. The aim of this study was to explore individual air pollution exposure evaluation, and the association between and multiple environmental factors and obesity among adult residents in rural areas of China. In this study, 8400 residents of 14 districts and counties in eastern of China were selected by multistage stratified cluster sampling, and a total of 8377 residents were included in the final analysis. We adopted BMI (Body Mass Index) > 28 kg/m2 as the definition of obesity. First, an individual air pollution evaluation model was established based on the monitoring data of air pollution stations closest to residential address, different demographic characteristics of residents and daily living habits using generalized linear model and random forest model. Then, we used Bayesian Kernel Machine Regression (BKMR) and Quantile gComputation (QgC) models to explore multiple environmental exposures on obesity. The results showed that six air pollutants were significantly positively associated with obesity, and green space had a significant protective effect on obesity. The BKMR model showed that the effects of different air pollutants on obesity were significantly enhanced by each other, while green space significantly reduced the positive effect of air pollution on obesity. The QgC model showed a significant positive association with obesity when all environmental factors were exposed as a whole, especially in males, higher household incomes and young people. It suggested that relevant authorities should improve regional air quality and green space to reduce the burden of disease caused by obesity.

Recently, the high prevalence of hypertension (HTN) has caused serious disease burden. Previous studies mostly focused on the separate association between outdoor or indoor air pollution and HTN, and did not explore their possible interaction with HTN. To explore this issue, this study investigated the relationship between indoor and outdoor air pollution and HTN and their possible interactions among adult residents in 14 rural areas in eastern China. The generalized linear model (GLM) and interplot model were used to evaluate the separate effects and potential interaction of outdoor or indoor air pollutants on HTN. In separate analyses, we found a significant positive association between outdoor and indoor air pollution and HTN, and a significant negative association between range hood use and HTN. In the interaction analysis, outdoor air pollution could significantly enhance the positive effects of indoor air pollution on HTN. In addition, PM2.5 and O3 could significantly reduce the protective effect of range hoods use on HTN. Finally, we found that females were more susceptible to both indoor and outdoor air pollution.

Recently, the burden of cardiovascular disease (CVD) has attracted global attention. Meanwhile, CVD has become the leading cause of death in China. Some epidemiological studies have indicated that ambient air pollution may contribute to increased mortality from CVD diseases. Many studies have found a strong association between air pollutants and the risk of CVD deaths in some big cities, but few have focused on the effects of six pollutants in rural areas. Our study aimed to investigate the effects of six air pollutants (CO, NO2, O3, PM2.5, PM10, and SO2) on CVD deaths of rural areas in Anhui Province and to further clarify which populations were susceptible to air pollution. First, the generalized additive models were combined with the distributed lag nonlinear models to evaluate the individual effects of air pollution on CVD deaths in each area. Then, random-effects models were used to aggregate the associations between air pollutants and CVD mortality risk in nine regions. Overall, all six pollutants had a statistically significant effect on the risk of CVD deaths on the lag 07 days. The associations between PM2.5, PM10, and SO2 and daily CVD deaths were strongest, with maximum cumulative RR (lag 07) of 1.91 (1.64–2.18), 2.27 (1.50–3.05), and 2.13 (1.44–2.82). In general, we found that six air pollutants were the important risk factors for CVD and specific CVD deaths in Anhui Province. The elderly were susceptible to PM2.5, PM10, and SO2.

Hypertension (HTN) was a major preventable cause of cardiovascular disease (CVD), contributing to a huge disease burden. Ambient temperature, air pollution and green space were important influencing factors of HTN, and few studies have assessed the effects and interactions of ambient temperature, air pollution and green space on HTN in rural areas. In this study, we selected 8400 individuals randomly in rural areas of Anhui Province by a multi-stage stratified cluster sampling. A total of 8383 individuals were included in the final analysis. We collected particulate pollutants and meteorological data from the local air quality monitoring stations and National Center for Meteorological Science from January 1 to December 31, 2020, respectively. The normalized differential vegetation index (NDVI) of Anhui Province in 2020 was produced and processed by remote sensing inversion on the basis of medium resolution satellite images. The average annual mean exposure concentrations of air pollution, meteorological factors, and NDVI were calculated for each individual based on the geocoded residential address. HTN was defined according the Chinese Guidelines for Prevention and Treatment of HTN. The effects and interactions of ambient temperature, air pollution and green space on HTN were evaluated by generalized linear model and interaction model, respectively. In this study, the prevalence of HTN was 24.14%. The adjusted odd ratio of HTN for each 1 μg/m3 increasing in PM2.5 and PM10, 1 °C of ambient temperature, and 0.1 of NDVI were:1.276 (1.013, 1.043), 1.012 (1.006, 1.018), 0.862 (0.862, 0.981) and 0.669 (0.611, 0.733), respectively. The results showed that air pollutants were positively correlated with HTN, while ambient temperature and green space were negatively correlated with HTN. Meanwhile, the negative associations of green space on HTN could decrease with the increasing concentrations of air pollution, but increase with the rising of ambient temperature.

Polybrominated diphenyl ethers (PBDEs) are widespread and persistent environmental contaminants, but their association with nodular goiter (NG) remains unknown. The present case-control study of 179 NG cases and 358 matched normal controls aimed to investigate the association between PBDEs and risk of NG. The plasma concentrations of 8 PBDEs congeners (BDE-28,-47,-99,-100,-153,-154,-183, and-209) were determined by gas chromatograph-mass spectrometer. Conditional logistic regression model was used to evaluate the odds ratio (OR) and 95% confidence interval (CI) for the association between each PBDEs congener and NG. Bayesian kernel machine regression (BKMR) was used to evaluate the association between overall levels of 8 PBDEs mixture and NG. The results of logistic model suggested that increased risk of NG was associated with elevated concentrations of all PBDEs congeners, except for BDE-209. In BKMR model, the risk of NG increased with the increase in overall exposure level of 8 PBDEs mixture. Compared to when all PBDEs mixture were at their median value, the risk of exposure-response function for NG increased by 0.34 units when all PBDEs were at their 75th percentile. In women, the results showed similar trends after additional adjustment for age at menarche and menopausal status. These findings provide novel epidemiological evidence for the prevention of NG. However, larger prospective studies are required to address the associations between PBDEs exposure and NG risk.

Recently, elevated blood pressure (BP) and hypertension (HTN) have caused a huge burden of health loss. Previous studies used ambient air pollutants as a proxy for individual exposure, limiting the assessment of its multiple exposure to health effects. For the first time, this study constructed individual PM2.5 component (SO42-, NO3-, NH4+, OM, and BC) exposure model DAG (Directed Acyclic Graph), DAG-oriented generalized linear model and random forest model, and explored the effects of single and multiple exposures to PM2.5 components on BP at different stages by the generalized linear model (GLM) and Quantile g-Computation (QgC) model based on a large cohort study in China. We defined BP in four stages according to the 2017 ACC/AHA guidelines. After excluding the lack of key information, the cohort analyses ultimately included 9031 participants. Our results showed that the individual PM2.5 component exposure model had good efficacy. Single or multiple exposure to PM2.5 components had significant positive effects on normal BP to elevated BP and elevated BP to stage 1 HTN. In addition, males, the elderly and urban residents were more sensitive to PM2.5 components. This study provided implications for environmental exposure assessment and control of particulate pollution in the future.

The incidence of thyroid cancer (TC) has increased rapidly in last decades. Multiple trace elements in the external environment have important effects with thyroid function. However, the evidence for these on TC risk were rarely reported. A total of 585 newly diagnosed TC patients and 585 healthy controls were included in this study, and 14 urinary elements were measured to explain the fixed-exposure effect on TC risk. Conditional logistic regressions were used to reflect the multi-element associations, and Bayesian kernel machine regression (BKMR) was applied to show the tendency of mixed effects. Furthermore, the interaction effects were examined by Generalized linear model (GLM). The levels of lithium (Li), cobalt (Co), strontium (Sr), zinc (Zn) and copper (Cu) had negative effects with TC risk, nevertheless lead (Pb), arsenic (As) and chromide (Cr) showed positive effects. The BKMR and GLM models reflected the effect fluctuations of different elements, and there was a slight interaction effects between Li and Cr, Co, Zn and Pb. Further study is required to confirm these results in the future.

ObjectiveTo examine the relationship between urinary copper (Cu), zinc (Zn) and arsenic (As) and the incidence of nodular goiter and to provide evidences for nodular goiter prevention and treatment. MethodsThe cases of the study were 373 pathologically diagnosed nodular goiter patients hospitalized in the Department of Head and Neck Surgery of Anhui Cancer Hospital from September 2016 through March 2019; while, the controls were 1 : 1 individually gender- and age (± 2 years)-matched healthy people selected from a cohort study conducted in Anhui province. Face-to-face questionnaire interviews and laboratory tests were carried out among the participants. ResultsSignificantly lower morning urinary Cu (median [µg/g]; 25th quartile, 75th quartile) was detected in the cases compared to that in the controls (6.13; 2.36, 11.00 vs. 10.36; 6.27, 16.95; Z = – 6.625; P < 0.001); while, no significant differences between the cases and the controls were detected in morning urinary Zn (312.16; 98.65, 500.19 vs. 340.40; 99.41, 580.54) and As (30.44; 4.36, 88.30 vs. 23.75; 3.67, 81.82) (both P > 0.05). After adjusting for confounding factors such as gender, age, marital status, smoking, passive smoking, alcohol consumption, daily sleep time, body mass index, fasting blood glucose, serum total cholesterol, serum triglyceride, serum high density lipoprotein cholesterol, urinary Zn and urinary As, the results of multivariate logistic regression analysis showed that higher urinary Cu was associated with a decreased risk of nodular goiter (the third quartile [Q3] – the highest quartile [Q4] vs. the lowest quartile [Q1]: odds ratio [OR] = 0.73, 95% confidence interval [95% CI]: 0.54 – 0.98; [Q4] vs. Q1: OR = 0.56, 95% CI: 0.39 – 0.81; and Q4 vs. Q1: OR = 0.42, 95% CI: 0.19 – 0.97 only for male participants); the analyses did not revealed significant correlations between urinary Zn and As and nodular goiter incidence (all P > 0.05). ConclusionUrinary Cu concentration may reversely associated with nodular goiter incidence in Chinese people.

目的 了解马鞍山市肺癌筛查队列肺结节检出者的结节转归状况,并分析其影响因素.方法 对2020年基线筛查出的398名肺结节检出者于2021年进行随访调查,收集基线及随访期间的基本资料和结节信息,采用单因素分析结合多因素logistic回归分析探讨肺癌筛查人群肺结节转归的影响因素.结果 在这398人中,共有95人(23.9％)结节进展,64人(16.1％)结节改善,239人(60.0％)结节稳定.多因素logistic回归分析结果显示,进展组与稳定组相比,有肺部相关疾病史(OR=2.920,95％CI:1.169～7.291,P=0.022)及有职业暴露(OR=1.656,95％CI:1.002～2.735,P=0.049)者,更容易出现结节进展.改善组与稳定组相比,高中及以上学历(OR=2.361,95％CI:1.036～5.383,P=0.041)者更容易出现结节改善,没有油烟暴露(OR=0.504,95％CI:0.281～0.904,P=0.021)者更容易出现结节改善.结论 文化程度、肺部相关疾病史、职业暴露、油烟暴露等因素是影响肺结节转归的重要因素.

Aim of this study was to evaluate the association between multiple essential microelements exposure and the aggressive clinicopathologic characteristics of papillary thyroid carcinoma (PTC). The concentrations of 10 essential microelements in urine [cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), molybdenum (Mo), selenium (Se), strontium (Sr), zinc (Zn), and iodine (I)] were measured in 608 patients newly diagnosed with PTC, including 154 males and 454 females. Chi square test and Wilcoxon rank sum test were used to compare general characteristics among males and females. Multivariate logistic regression was used to evaluate the associations between essential microelements and PTC clinicopathologic characteristics in single- and multi-microelement models. In this study, we only observed that the frequency of lymph node metastasis in males was higher than in females, and males had higher levels of zinc than females, but males had lower levels of iodine than females. It was found that high levels of Fe were associated with decreased risk of PTC tumor size > 1 cm, capsular invasion, and advanced T stage (T3/4a/4b). High levels of Co and Mo were associated with decreased risk of capsular invasion and lymph node metastasis, respectively. However, high levels of Mn and Sr were associated with increased risk of capsular invasion and multifocality respectively, and both were associated with increased risk of advanced T stage (T3/4a/4b). These findings indicated that certain essential microelements might have potential effects on PTC progression and aggressiveness. Further studies are required to confirm these findings.

Although several studies indicate that exposure to polybrominated diphenyl ethers (PBDEs) and metals may influence thyroid function, the evidence is limited and inconsistent in general population. The current study was conducted to determine the levels of plasma PBDEs and urinary metals and evaluate the associations of co-exposure to both with thyroid hormones (THs) among rural adult residents along the Yangtze River, China. A total of 329 subjects were included in current analyses, and 8 PBDEs congeners and 14 urinary metals were measured to reflect the levels of environmental exposure. Multiple linear regression models were used to evaluate the association between PBDEs, metals and THs levels. Bayesian Kernel Machine Regression (BKMR) was used to examine PBDEs and metals mixtures in relation to THs. The geometric mean (GM) and 95% confidence interval (CI) of total measured PBDEs was 65.10 (59.96, 70.68) ng/g lipid weights (lw). BDE-209 was the most abundant congener, with a GM (95% CI) of 47.91 (42.95, 53.26) ng/g lw, accounting for 73.6% of the total PBDEs. Free thyroxine (FT4) was significantly negatively associated with BDE-28, 47, 99, 100, 154, and 183, and urinary strontium [β (95% CI): −0.04 (−0.07, −0.02)], but positively associated with selenium [β (95% CI): 0.04 (0.02, 0.06)]. Free triiodothyronine (FT3) was negatively associated with BDE-28 [β (95% CI): −0.03 (−0.05, −0.01)] and urinary arsenic [β (95% CI): −0.01 (−0.02, −0.001)]. The current study did not observe a statistically significant association of thyroid-stimulating hormone (TSH) with PBDEs and urinary metals. BKMR analyses showed similar trends when these chemicals were taken into consideration simultaneously. We found no significant interaction in the association between individual chemical at the 25th versus 75th percentiles and THs estimates, comparing the results when other chemicals were set at their 10th, 50th, and 90th percentile levels. Further study is required to confirm these findings and determine potential mechanisms.

Background: Thyroid cancer (TC) is threefold more common in women than men. Reproductive and menstrual factors may be related to the onset of papillary thyroid cancer (PTC). This study aims to determine the association of reproductive and menstrual factors with PTC in Chinese females. Methods: A total of 335 histologically confirmed cases of PTC were recruited in this case-control study. The controls were matched for age with a deviation of +/- 2 years, which conducted from September 2016 to February 2019. Logistic regression models were applied to identify the association of reproductive and menstrual factors with PTC. Results: After adjustment by some variables, early menarche age (OR < 13 years vs. > 13years = 2.40, 95 % CI 1.12-5.13) and shorter lifetime breastfeeding (OR <6 months vs. >= 6 months = 1.99, 95 % CI 1.11-3.55) significantly increased the risk of PTC, whereas younger age at first pregnancy had a protective effect against PTC (OR < 24years vs. > 24 years = 0.66, 95 % CI 0.44-0.98). There was a positive correlation between premenopausal and PTC in the lower age group (OR premenopausal vs. Menopause by natural =2.34, 95 %CI 1.03-5.28). Conclusions: Early menarche age, abortion, shorter breastfeeding duration and premenopausal may be related to the occurrence of PTC. Early age at first pregnancy and larger number of full-time pregnancies were possible to decrease the risk of PTC.

Background: It is unclear whether weight change after middle adulthood influences the risk of thyroid cancer. The aim of this study was to investigate associations between the risk of papillary thyroid cancer (PTC) and body mass index (BMI) and weight change after middle adulthood (age 35). Methods: A matched case-control study based on three hospitals included 516 pairs of cases newly diagnosed with PTC and controls. Current height and weight after defecation in the morning were measured by trained nurses. During measurement, all subjects were requested to wear lightweight clothing and no shoes. Weight at age 35 was self-reported. BMI and weight change were modeled as continuous and categorical variables. Conditional and unconditional logistic regression models were used to estimate the odds ratio (OR) and 95% confidence interval (95%CI) for the association between BMI and weight change after middle adulthood and PTC. Results: After adjustment for covariates, measured BMI at the time of current diagnosis was positively associated with PTC (OR 1.16, 95%CI 1.10-1.21). According to WHO BMI guidelines for Asia-Pacific populations, the OR (95%CI) for PTC risk in obesity was 2.99 (1.92-4.67) compared to normal weight (p-trend <0.001). Moreover, PTC was positively associated with BMI at age 35; the OR (95%CI) for PTC risk per unit increase in BMI was 1.06 (1.02-1.11). Compared to stable weight (changed <0.5 kg/year), weight gain >= 1.0 kg/year after middle adulthood was positively associated with PTC (OR 2.57, 95%CI 1.39-4.76, p-trend <0.001). Compared to maintaining non-overweight status, the PTC risk was significantly increased in those individuals who gained weight and became overweight after middle adulthood (OR 3.82, 95%CI 2.50-5.85). Conclusion: This study showed that high BMI and obesity were positively associated with increased risk of PTC, and weight gain after middle adulthood also could elevate the PTC risk.