人类接触内分泌干扰化学物质与隐睾症和尿道下裂的产前风险因素：一项巢式病例对照研究。
Human exposure to endocrine-disrupting chemicals and prenatal risk factors for cryptorchidism and hypospadias: a nested case-control study.
作者信息
Fernandez Mariana F, Olmos Begoña, Granada Alicia, López-Espinosa Maria José, Molina-Molina José-Manuel, Fernandez Juan Manuel, Cruz Milagros, Olea-Serrano Fátima, Olea Nicolás
机构信息
Laboratory of Medical Investigations, San Cecilio University Hospital, Granada, Spain.
出版信息
Environ Health Perspect. 2007 Dec;115 Suppl 1(Suppl 1):8-14. doi: 10.1289/ehp.9351.
BACKGROUND
Exposure to xenoestrogens during pregnancy may disturb the development and function of male sexual organs.
OBJECTIVE
In this study we aimed to determine whether the combined effect of environmental estrogens measured as total effective xenoestrogen burden (TEXB) is a risk factor for male urogenital malformations.
METHODS
In a case-control study, nested in a mother-child cohort (n = 702) established at Granada University Hospital, we compared 50 newborns with diagnosis of cryptorchidism and/or hypospadias with 114 boys without malformations matched by gestational age, date of birth, and parity. Controls did not differ from the total cohort in confounding variables. TEXB and levels of 16 organochlorine pesticides were measured in placenta tissues. Characteristics of parents, pregnancy, and birth were gathered by questionnaire. We used conditional and unconditional regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs).
RESULTS
TEXB from organohalogenated compounds was detectable in 72% and 54% of case and control placentas, respectively. Compared with controls, cases had an OR for detectable versus non-detectable TEXB of 2.82 (95% CI, 1.10-7.24). More pesticides were detected in cases than in controls (9.34 +/- 3.19 vs. 6.97 +/- 3.93). ORs for cases with detectable levels of pesticides, after adjusting for potential confounders in the conditional regression analysis, were o,p'-DDT (OR = 2.25; 95% CI, 1.03-4.89), p,p'-DDT (OR = 2.63; 95% CI, 1.21-5.72), lindane (OR = 3.38; 95% CI, 1.36-8.38), mirex (OR = 2.85; 95% CI, 1.22-6.66), and endosulfan alpha (OR = 2.19; 95% CI, 0.99-4.82). Engagement of mothers in agriculture (OR = 3.47; 95% CI, 1.33-9.03), fathers' occupational exposure to xenoestrogens (OR = 2.98; 95% CI, 1.11-8.01), and history of previous stillbirths (OR = 4.20; 95% CI, 1.11-16.66) were also associated with risk of malformations.
CONCLUSIONS
We found an increased risk for male urogenital malformations related to the combined effect of environmental estrogens in placenta.
背景
孕期接触外源性雌激素可能会干扰男性性器官的发育和功能。
目的
在本研究中，我们旨在确定以总有效外源性雌激素负荷（TEXB）衡量的环境雌激素联合作用是否为男性泌尿生殖系统畸形的危险因素。
方法
在一项病例对照研究中，该研究嵌套于格拉纳达大学医院建立的母婴队列（n = 702）中，我们将50例诊断为隐睾症和/或尿道下裂的新生儿与114例无畸形的男孩进行比较，这些男孩在胎龄、出生日期和产次方面相匹配。对照组在混杂变量方面与整个队列无差异。在胎盘组织中测量TEXB和16种有机氯农药的水平。通过问卷调查收集父母、妊娠和分娩的特征。我们使用条件和无条件回归模型来估计比值比（OR）和95%置信区间（CI）。
结果
分别在72%的病例胎盘和54%的对照胎盘中检测到来自有机卤化物的TEXB。与对照组相比，病例组中可检测到与未检测到TEXB的OR为2.82（95%CI，1.10 - 7.24）。病例组中检测到的农药比对照组更多（9.34±3.19对6.97±3.93）。在条件回归分析中对潜在混杂因素进行调整后，病例组中可检测到农药水平的OR分别为：o,p'-滴滴涕（OR = 2.25；95%CI，1.03 - 4.89）、p,p'-滴滴涕（OR = 2.63；95%CI，1.21 - 5.72）、林丹（OR = 3.38；95%CI，1.36 - 8.38）、灭蚁灵（OR = 2.85；95%CI，1.22 - 6.66）和α-硫丹（OR = 2.19；95%CI，0.99 - 4.82）。母亲从事农业工作（OR = 3.47；95%CI，1.33 - 9.03）、父亲职业性接触外源性雌激素（OR = 2.98；95%CI，1.11 - 8.01）以及既往死产史（OR = 4.20；95%CI，1.11 - 16.66）也与畸形风险相关。
结论
我们发现胎盘环境雌激素联合作用与男性泌尿生殖系统畸形风险增加有关。
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