Brucker-Davis F, Thayer K, Colborn T
Service d'Endocrinologie, Diabétologie et Médecine de la Reproduction, Hôpital de l'Archet 1, Nice, France.
Environ Health Perspect. 2001 Mar;109 Suppl 1(Suppl 1):21-6. doi: 10.1289/ehp.01109s121.
We review the significant and adverse health effects that can occur with relatively small endogenous hormonal changes in pubertal and adult humans. We discuss the effects of hormonal changes that occur within normal physiologic ranges--such as the rising levels of estrogen in peripuberty, which cause growth spurts at low levels and then the fusion of epiphyses at higher levels--and the hormonal variations during the menstrual cycle and their relation to genital phenotypic changes and intercurrent disease evolution. We turn next to adaptive changes in gonadal and other functions during aging, exercise, stress, starvation, and chronic diseases, which can serve as models for the effects of exogenous, hormonally active compounds. Then we review the states of borderline hormonal imbalances such as subclinical (having few or very mild symptoms, if any) hypothyroidism or hyperthyroidism, glucose intolerance, and other endocrine conditions. Finally, we review the deleterious systemic effects of gonadal imbalance. Information stemming from clinical observations leads to the concept of "no threshold" within the endocrine system and thus illustrates the importance of considering low-dose testing for chemicals that interfere with hormonal activity. We also urge attention to more sensitive, less visible end points such as osteoporosis, increased risk for cardiovascular disease, or cognitive changes.
我们回顾了青春期和成年人体内相对较小的内源性激素变化可能产生的显著和不良健康影响。我们讨论了在正常生理范围内发生的激素变化的影响，例如青春期前雌激素水平的上升，低水平时会导致生长突增，而在较高水平时会导致骨骺融合；以及月经周期中的激素变化及其与生殖器表型变化和并发疾病演变的关系。接下来，我们探讨衰老、运动、压力、饥饿和慢性疾病期间性腺及其他功能的适应性变化，这些变化可作为外源性激素活性化合物影响的模型。然后，我们回顾边缘性激素失衡状态，如亚临床（几乎没有或只有非常轻微症状，如果有的话）甲状腺功能减退或亢进、葡萄糖不耐受和其他内分泌状况。最后，我们回顾性腺失衡的有害全身影响。来自临床观察的信息引出了内分泌系统内“无阈值”的概念，从而说明了考虑对干扰激素活性的化学物质进行低剂量测试的重要性。我们还敦促关注更敏感、不太明显的终点，如骨质疏松症、心血管疾病风险增加或认知变化。
