双酚A与复发性自然流产的相关性研究

[A correlative study on Bisphenol A and recurrent spontaneous abortion].

作者信息

Liu Yin-Mei, Shen Yue-Ping, Liang Hong, Wang Yan, Luo Xiao-Ming, Shen Zong-Ji, Chen Xin, Yuan Wei

机构信息

Department of Epidemiology and Health Statistics, Radiation Medicine and Public Health School of Soochow University, Suzhou 215123, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2011 Apr;45(4):344-9.

PMID:21624331

Abstract

OBJECTIVE

This study was to investigate the association of Bisphenol A and unexplained recurrent spontaneous abortion.

METHODS

A hospital-based 1:1 matched case-control study was conducted. Sixty patients with unexplained recurrent abortion were included. Each case was matched with one normal control by age (± 2 years), living district and the same gestational age. The levels of Bisphenol A in urine for 60 cases and 60 controls were detected using high performance liquid chromatography after fluorescent derivatization. The levels of urinary Bisphenol A in case was compared with that in control in education levels, occupation, smoking history. Data was analyzed by means of Wilcoxon-test, Student-Newman-Keuls after rank transform, univariate and multivariate conditional Logistic regression analysis. The software used was SAS 9.1.3.

RESULTS

The values of urinary Bisphenol A in cases and controls were (0.10 ± 0.21) µg/ml, (0.03 ± 0.08) µg/ml, respectively. The level of urinary Bisphenol A in cases was significantly higher than that in controls (Z = 3.988, P < 0.0001). The urinary Bisphenol A levels in cases were significant higher than those in controls from senior middle school (the levels were 0.10, 0.06 µg/ml respectively, Z = 1.996, P = 0.0459), college (the levels were 0.14, 0.03 µg/ml respectively, Z = 2.586, P = 0.0097), workers or farmers (the levels were 0.08, 0.03 µg/ml respectively, Z = 2.265, P = 0.0235), businessmen (the levels were 0.10, 0.03 µg/ml respectively, Z = 2.544, P = 0.0109), and no passive smokers (the levels were 0.09, 0.03 µg/ml respectively, Z = 3.767, P = 0.0002). After adjustment by age, body mass index, marital status during pregnancy and other factors, compared to Bisphenol A below 0.06 µg/ml, the adjusted OR was 4.03 (1.67 - 9.74) for Bisphenol A levels between 0.06 µg/ml and 0.20 µg/ml, and was 5.46 (1.95 - 15.27) for Bisphenol A over 0.20 µg/ml. The risk of unexplained recurrent spontaneous abortion increased progressively with the growth of urinary Bisphenol A levels (χ(2) = 13.042, trend test P = 0.0003). There were significant differences on Bisphenol A among controls, two abortions, and three or more abortions (the levels were 0.03 µg/ml, 0.09 µg/ml, 0.21 µg/ml respectively, F = 9.04, P = 0.0002).

CONCLUSION

Exposure to Bisphenol A may be associated with unexplained recurrent spontaneous abortion.

摘要

目的

本研究旨在探讨双酚A与不明原因复发性自然流产之间的关联。

方法

进行一项基于医院的1:1匹配病例对照研究。纳入60例不明原因复发性流产患者。每个病例按年龄（±2岁）、居住地区和相同孕周与一名正常对照进行匹配。采用荧光衍生化后高效液相色谱法检测60例病例和60例对照尿液中双酚A的水平。比较病例组和对照组在教育程度、职业、吸烟史方面的尿双酚A水平。数据采用Wilcoxon检验、秩转换后的Student-Newman-Keuls检验、单因素和多因素条件Logistic回归分析。使用的软件为SAS 9.1.3。

结果

病例组和对照组尿双酚A值分别为(0.10±0.21)μg/ml、(0.03±0.08)μg/ml。病例组尿双酚A水平显著高于对照组(Z = 3.988, P < 0.0001)。病例组尿双酚A水平显著高于对照组中高中文化程度者（水平分别为0.10、0.06μg/ml，Z = 1.996, P = 0.0459）、大专文化程度者（水平分别为0.14、0.03μg/ml，Z = 2.586, P = 0.0097）、工人或农民（水平分别为0.08、0.03μg/ml，Z = 2.265, P = 0.0235）、商人（水平分别为0.10、0.03μg/ml，Z = 2.544, P = 0.0109）以及无被动吸烟史者（水平分别为0.09、0.03μg/ml，Z = 3.767, P = 0.0002）。在调整年龄、体重指数、孕期婚姻状况等因素后，与双酚A低于0.06μg/ml相比，双酚A水平在0.06μg/ml至0.20μg/ml之间时调整后的OR为4.03(1.67 - 9.74)，双酚A高于0.20μg/ml时调整后的OR为5.46(1.95 - 15.27)。不明原因复发性自然流产的风险随尿双酚A水平的升高而逐渐增加(χ(2)=13.042，趋势检验P = 0.0003)。对照组、有两次流产史者和有三次或更多次流产史者之间的双酚A水平存在显著差异（水平分别为0.03μg/ml、0.09μg/ml、0.21μg/ml，F = 9.04, P = 0.0002）。