酒精、吸烟和咖啡因与生育能力的关系，并受 NAT2 的影响。
alcohol, smoking, and caffeine in relation to fecundability, with effect modification by NAT2.
机构信息
University of North Carolina at Chapel Hill, USA.
出版信息
Ann Epidemiol. 2011 Nov;21(11):864-72. doi: 10.1016/j.annepidem.2011.04.011.
PURPOSE
Common polymorphisms in the N-acetyltransferase-2 (NAT2) metabolic enzyme determine slow or rapid acetylator phenotypes. We investigated the effects of alcohol, smoking, and caffeine on fecundability, and determined whether the effects were modified by NAT2.
METHODS
Three NAT2 polymorphisms were genotyped in 319 women office workers participating in a prospective pregnancy study (1990-1994). Women were ages 20-41 and at risk for pregnancy. Discrete-time survival analysis was used to determine the effects of alcohol, smoking, and caffeine on fecundability and evaluate effect modification by NAT2.
RESULTS
We followed 319 women (161 slow acetylators, 158 rapid) for an average of 8 menstrual cycles, resulting in 124 pregnancies. There was no effect of caffeine on fecundability. Drinking ≥1 alcoholic drink per day and current smoking were significantly associated with reduced fecundability, but only among slow acetylators (adjusted fecundability odds ratio [FOR] for smoking = 0.34; 95% confidence interval, 0.22-0.90; adjusted FOR for ≥1 drink per day = 0.20; 0.05-0.92). There was no effect among rapid acetylators.
CONCLUSIONS
NAT2 status significantly modified the effects of alcohol and smoking on fecundability, emphasizing the importance of incorporating genetic and metabolic information in studies of reproductive health. Replication of this study is warranted.
目的
N-乙酰基转移酶-2（NAT2）代谢酶中的常见多态性决定了缓慢或快速乙酰化表型。我们研究了酒精、吸烟和咖啡因对生育能力的影响，并确定 NAT2 是否改变了这些影响。
方法
在一项前瞻性妊娠研究（1990-1994 年）中，对 319 名参与的职业女性办公室工作人员的三种 NAT2 多态性进行了基因分型。女性年龄在 20-41 岁之间，有怀孕的风险。离散时间生存分析用于确定酒精、吸烟和咖啡因对生育能力的影响，并评估 NAT2 的修饰作用。
结果
我们对 319 名女性（161 名缓慢乙酰化酶，158 名快速乙酰化酶）进行了平均 8 个月经周期的随访，共发生了 124 次妊娠。咖啡因对生育能力没有影响。每天饮用≥1 份含酒精饮料和当前吸烟与生育能力降低显著相关，但仅在缓慢乙酰化酶中（吸烟的调整生育能力比值比 [FOR] = 0.34；95%置信区间，0.22-0.90；每天≥1 份含酒精饮料的调整 FOR = 0.20；0.05-0.92）。在快速乙酰化酶中没有这种影响。
结论
NAT2 状态显著改变了酒精和吸烟对生育能力的影响，强调了在生殖健康研究中纳入遗传和代谢信息的重要性。有必要对此项研究进行复制。
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