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[饮用水中高氟暴露对女性内分泌激素的影响]

[The influence of high fluoride exposure in drinking water on endocrine hormone in female].

作者信息

Hou Jia-xiang, Yang Yue-jin, Gong Biao, Li Shi-hong, Ding Zhong, Wen Shi-bao, Li Shi-qun, Cheng Xue-min, Cui Liu-xin, Ba Yue

机构信息

Department of Environmental Health, College of Public Health in Zhengzhou University, Zhengzhou, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Feb;47(2):142-6.

Abstract

OBJECTIVE

To explore the influence of water fluoride exposure on reproductive hormones in female.

METHODS

Cross-sectional study was conducted in seven villages of a county in Henan province by using simple random sampling including high fluoride area, defluoridation project area and control area on April, 2011 based on the preliminary study results of fluoride concentration in drinking water. Women who were born and growth or lived in the village at least 5 years and aged 18-48 years old were recruited using cluster sampling. They were divided into high fluoride group (HFG, 116 subjects), defluoridation project group (DFPG, 132 subjects) and control group (CG, 227 subjects) in accordance with the above areas. All subjects accepted questionnaire and physical checkup. Fasting blood and morning urine samples were collected. The concentration of fluoride in urine was determined by fluoride ion selective electrode method. The serum level of GnRH was detected using enzyme linked immunosorbent assay (ELISA). The serum level of luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), estradiol (E2) were determined by chemiluminesence immunoassay (CLIA).

RESULTS

The average age was (39.44 ± 7.34), (38.84 ± 8.03), (37.45 ± 7.70) years old in female from DFPG, HFG and CG respectively, there were no significant differences among the three groups (F = 3.02, P = 0.05). The urine fluoride levels were (1.34 ± 1.07), (2.59 ± 1.57), (0.92 ± 0.46) mg/ml in female from DFPG, HFG and CG respectively, there was a significant difference among three groups (F = 105.38, P < 0.01). No significant differences were observed of serum GnRH, LH, T, FSH and E2 among three groups in follicular phase (P > 0.05). The serum levels of E2 in Ovulatory period were 67.73, 58.09, 84.96 pg/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in CG (H = 4.00, P < 0.05). The serum levels of T in Ovulatory period were 0.55, 0.45, 0.55 ng/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 6.47, P < 0.05), but no significant difference was observed between HFG and CG (H = 2.41, P > 0.05). The serum levels of GnRH in Luteal phase were 24.09, 20.16, 23.50 ng/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 14.14, P < 0.05) and CG (H = 12.53, P < 0.05). The serum level of E2 in luteal phase were 81.47, 64.60, 74.55 pg/ml in female from DFPG, HFG and CG respectively. It was lower in HFG than that in DFPG (H = 5.69, P < 0.05). As for LH, FSH and T, no significant differences were observed among the three groups (P > 0.05 respectively). The abnormal rates of E2 level were 22.73 (30/102), 37.93 (44/72), 20.26 (46/181) in female from DFPG, HFG and CG respectively. The E2 abnormal rate in female from HFG was higher that from DFPG (χ(2) = 6.82, P < 0.05) and CG (χ(2) = 12.38, P < 0.05).

CONCLUSION

Fluoride exposure may influence reproductive hormones in female, especially in ovulatory and luteal phase of menstrual cycle.

摘要

目的

探讨氟暴露对女性生殖激素的影响。

方法

基于前期饮用水氟浓度研究结果,于2011年4月在河南省某县7个村庄采用单纯随机抽样法进行横断面研究,包括高氟区、改水降氟工程区和对照区。采用整群抽样法选取在本村出生、成长或居住至少5年且年龄在18 - 48岁的女性。根据上述区域将她们分为高氟组(HFG,116例)、改水降氟工程组(DFPG,132例)和对照组(CG,227例)。所有受试者均接受问卷调查和体格检查。采集空腹血和晨尿样本。采用氟离子选择电极法测定尿氟浓度。采用酶联免疫吸附测定(ELISA)法检测血清促性腺激素释放激素(GnRH)水平。采用化学发光免疫测定(CLIA)法测定血清黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、雌二醇(E2)水平。

结果

DFPG组、HFG组和CG组女性的平均年龄分别为(39.44 ± 7.34)岁、(38.84 ± 8.03)岁、(37.45 ± 7.70)岁,三组间差异无统计学意义(F = 3.02,P = 0.05)。DFPG组、HFG组和CG组女性的尿氟水平分别为(1.34 ± 1.07)mg/ml、(2.59 ± 1.57)mg/ml、(0.92 ± 0.46)mg/ml,三组间差异有统计学意义(F = 105.38,P < 0.01)。卵泡期三组间血清GnRH、LH、T、FSH和E2水平差异无统计学意义(P > 0.05)。排卵期DFPG组、HFG组和CG组女性的血清E²水平分别为67.73 pg/ml、58.09 pg/ml、84.96 pg/ml。HFG组低于CG组(H = 4.00,P < 0.05)。排卵期DFPG组、HFG组和CG组女性的血清T水平分别为0.55 ng/ml、0.45 ng/ml、0.55 ng/ml。HFG组低于DFPG组(H = 6.47,P < 0.05),但HFG组与CG组间差异无统计学意义(H = 2.41,P > 0.05)。黄体期DFPG组、HFG组和CG组女性的血清GnRH水平分别为24.09 ng/ml、20.16 ng/ml、23.50 ng/ml。HFG组低于DFPG组(H = 14.14,P < 0.05)和CG组(H = 12.53,P < 0.05)。黄体期DFPG组、HFG组和CG组女性的血清E²水平分别为81.47 pg/ml、64.60 pg/ml、74.55 pg/ml。HFG组低于DFPG组(H = 5.69,P < 0.05)。至于LH、FSH和T,三组间差异无统计学意义(P均> 0.05)。DFPG组、HFG组和CG组女性的E²水平异常率分别为22.73%(30/102)、37.93%(44/72)、20.26%(46/181)。HFG组女性的E²异常率高于DFPG组(χ² = 6.82,P < 0.05)和CG组(χ² = 12.38,P < 0.05)。

结论

氟暴露可能影响女性生殖激素,尤其是在月经周期的排卵期和黄体期。

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