Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD 20852, USA.
Chemosphere. 2011 Dec;85(11):1742-8. doi: 10.1016/j.chemosphere.2011.09.027. Epub 2011 Oct 20.
An evolving body of evidence suggests an adverse relation between persistent organochlorine pollutants (POPs) and menstruation, though prospective longitudinal measurement of menses is limited and served as the impetus for study. We prospectively assessed the relation between a mixture of persistent organochlorine compounds and menstrual cycle length and duration of bleeding in a cohort of women attempting to become pregnant. Eighty-three (83%) women contributing 447 cycles for analysis provided a blood specimen for the quantification of 76 polychlorinated biphenyls and seven organochlorine pesticides, and completed daily diaries on menstruation until a human chorionic gonadotropin confirmed pregnancy or 12 menstrual cycles without conception. Gas chromatography with electron capture detection was used to quantify concentrations (ng g(-1)serum); enzymatic methods were used to quantify serum lipids (mg dL(-1)). A linear regression model with a mixture distribution was used to identify chemicals grouped by purported biologic activity that significantly affected menstrual cycle length and duration of bleeding adjusting for age at menarche and enrollment, body mass index, and cigarette smoking. A significant 3-d increase in cycle length was observed for women in the highest tertile of estrogenic PCB congeners relative to the lowest tertile (β=3.20; 95% CI 0.36, 6.04). A significant reduction in bleeding (<1 d) was observed among women in the highest versus lowest tertile of aromatic fungicide exposure (γ=-0.15; 95% CI -0.29, -0.00). Select POPs were associated with changes in menstruation underscoring the importance of assessing chemical mixtures for female fecundity.
不断增加的证据表明,持久性有机污染物 (POPs) 与月经之间存在不良关系,尽管前瞻性纵向测量月经的情况有限,但这是该研究的动力。我们前瞻性地评估了在试图怀孕的女性队列中,持久性有机氯化合物混合物与月经周期长度和出血持续时间之间的关系。83 名(83%)女性共提供了 447 个周期进行分析,她们提供了一份血液样本,用于定量测定 76 种多氯联苯和 7 种有机氯农药,并在人绒毛膜促性腺激素确认怀孕或 12 个没有怀孕的月经周期之前,每天填写月经日记。使用带电子捕获检测的气相色谱法来定量浓度(ng g(-1)血清);使用酶法来定量血清脂质(mg dL(-1))。使用混合分布的线性回归模型来确定按假定的生物活性分组的化学物质,这些化学物质显著影响月经周期长度和出血持续时间,同时调整初潮年龄和入组时、体重指数和吸烟状况。与最低三分位组相比,最高三分位组的雌激素类 PCB 同系物的女性周期长度增加了 3 天(β=3.20;95%CI 0.36,6.04)。与最低三分位组相比,最高三分位组的芳香族杀真菌剂暴露的女性出血量减少(<1 天)(γ=-0.15;95%CI -0.29,-0.00)。一些 POPs 与月经变化有关,这突显了评估女性生育能力的化学混合物的重要性。