[母乳中的环境污染物与隐睾症]

[Environmental pollutants in maternal milk and cryptorchidism].

作者信息

Brucker-Davis F, Ducot B, Wagner-Mahler K, Tommasi C, Ferrari P, Pacini P, Boda-Buccino M, Bongain A, Azuar P, Fénichel P

机构信息

Service d'endocrinologie-diabétologie-médecine de la reproduction, pôle Gore, hôpital l'Archet 1, CHU de Nice, 151, route de Saint-Antoine-de-Ginestière, 06200 Nice, France.

出版信息

Gynecol Obstet Fertil. 2008 Sep;36(9):840-7. doi: 10.1016/j.gyobfe.2008.06.024. Epub 2008 Aug 15.

Abstract

OBJECTIVE

Numerous maternal lipophilic compounds are eliminated into milk during lactation, their concentrations reflecting fetal in utero exposure. Some of them are endocrine disruptors. Their role in the occurrence of genital malformation, dysfunction or cancer has been suggested. We wanted to study the exposure of our population and its potential association with cryptorchidism, as few clinical studies are available.

PATIENTS AND METHODS

Over three years, we screened for cryptorchidism all boys born alive at or above 34 weeks of gestational age, in two maternity wards (CHU Nice, CHG Grasse). Cryptorchid boys were matched with two controls. Nursing mothers provided a colostrum sample that was screened for 15 compounds known for their antiandrogenic and/or anti estrogenic properties, including dichloro-diphenyl-trichloro-ethylene (DDE), polychlorinated biphenyls (PCBs), dibutylphthalate (DBP) (& metabolite monobutylphthalate-mBP) and hexachlorobenzene (HCB).

RESULTS

Out of 6246 boys, 102 were cryptorchid (1.6%). All available colostrums (56 for cryptorchid and 69 for controls) were contaminated. Median concentrations of DDE, PCBs, HCB and phthalates were higher though not significantly in cryptorchid versus controls. Cryptorchid boys were more likely to be classified in the most contaminated groups for DDE and SigmaPCBs, with a trend for mBP. Odds ratio (OR) for cryptorchidism was increased for the highest score of SigmaPCB, with a trend only for DDE versus the lowest score of those components. Our results are similar to those of a Scandinavian study with comparable design.

DISCUSSION AND CONCLUSIONS

Our results show the universal contamination of milk with endocrine disruptors in our area, and support the association between congenital cryptorchidism and fetal exposure to PCBs and possibly DDE, alone or in association with other chemicals.

摘要

目的

许多亲脂性母体化合物在哺乳期会排入乳汁,其浓度反映胎儿在子宫内的暴露情况。其中一些是内分泌干扰物。有人提出它们在生殖器畸形、功能障碍或癌症的发生中起作用。由于可用的临床研究较少,我们想研究我们人群的暴露情况及其与隐睾症的潜在关联。

患者与方法

在三年时间里,我们在两个产科病房(尼斯大学中心医院、格拉斯综合医院)对所有孕龄34周及以上出生的存活男婴进行了隐睾症筛查。隐睾男婴与两名对照进行匹配。哺乳期母亲提供初乳样本,对15种具有抗雄激素和/或抗雌激素特性的化合物进行筛查,包括二氯二苯三氯乙烷(DDE)、多氯联苯(PCBs)、邻苯二甲酸二丁酯(DBP)(及其代谢物单丁基邻苯二甲酸酯 - mBP)和六氯苯(HCB)。

结果

在6246名男婴中,102名患有隐睾症(1.6%)。所有可用的初乳(56份来自隐睾症患儿,69份来自对照组)均受到污染。隐睾症患儿的DDE、PCBs、HCB和邻苯二甲酸盐的中位数浓度虽高于对照组,但无显著差异。隐睾症患儿更有可能被归类为DDE和总PCBs污染最严重的组,mBP也有此趋势。总PCBs得分最高时,隐睾症的比值比(OR)增加,DDE仅与这些成分得分最低时相比有此趋势。我们的结果与一项设计类似的斯堪的纳维亚研究结果相似。

讨论与结论

我们的结果表明我们地区乳汁普遍受到内分泌干扰物污染,并支持先天性隐睾症与胎儿暴露于PCBs以及可能与DDE单独或与其他化学物质联合暴露之间的关联。

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