Fisch Harry, Lambert Sarah M, Hensle Terry W, Hyun Grace
New York Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.
J Urol. 2009 May;181(5):2291-4. doi: 10.1016/j.juro.2009.01.059. Epub 2009 Mar 19.
The testicular dysgenesis syndrome describes urogenital abnormalities associated with exposure to environmental endocrine disruptors such as phthalates, specifically decreased semen quality, and increased rates of testis cancer and hypospadias. Recently there has been concern that these abnormalities described in animal studies may also be present in humans. To determine if hypospadias rates are increasing, we retrospectively reviewed the total prevalence of hypospadias in New York State from 1992 to 2005, categorized by maternal age younger than 35 years and 35 years or older.
Hypospadias rates were obtained from the New York State Congenital Malformations Registry from 1992 to 2005. An analysis was also performed on the rates of children with hypospadias who had mothers younger than 35 years and mothers 35 years or older. This investigation was approved by the Columbia University internal review board.
There was no statistical change in hypospadias rates in New York State from 1992 to 2005 (r = 0.127, p = 0.6). Overall the mean +/- SE prevalence rate was 34.9 +/- 0.36 per 10,000 live births. However, mean +/- SE hypospadias rates in children of mothers 35 years old or older (38.7 +/- 0.7) were significantly greater than those in children of mothers younger than 35 years (34.1 +/- 0.386, t test p <0.01).
Hypospadias rates have not changed in New York State from 1992 to 2005. Additionally advanced maternal age continues to be a risk factor for hypospadias. Combined with previous studies that demonstrate sperm counts are not declining, these data suggest that the testicular dysgenesis syndrome described in animal models may not be evident in humans.
睾丸发育不全综合征描述了与接触环境内分泌干扰物(如邻苯二甲酸盐)相关的泌尿生殖系统异常,具体表现为精液质量下降、睾丸癌发病率增加以及尿道下裂发病率增加。最近,人们担心动物研究中描述的这些异常情况在人类中也可能存在。为了确定尿道下裂的发病率是否在上升,我们回顾性分析了1992年至2005年纽约州尿道下裂的总体患病率,并按母亲年龄小于35岁和35岁及以上进行分类。
1992年至2005年纽约州先天性畸形登记处提供了尿道下裂发病率数据。我们还对母亲年龄小于35岁和35岁及以上的尿道下裂患儿发病率进行了分析。本研究经哥伦比亚大学内部审查委员会批准。
1992年至2005年纽约州尿道下裂发病率无统计学变化(r = 0.127,p = 0.6)。总体而言,每10,000例活产婴儿中尿道下裂的平均患病率为34.9±0.36。然而,母亲年龄在35岁及以上的儿童尿道下裂平均患病率(38.7±0.7)显著高于母亲年龄小于35岁的儿童(34.1±0.386,t检验p<0.01)。
1992年至2005年纽约州尿道下裂发病率没有变化。此外,母亲年龄较大仍然是尿道下裂的一个危险因素。结合之前显示精子数量没有下降的研究,这些数据表明动物模型中描述的睾丸发育不全综合征在人类中可能并不明显。