Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA; Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
Environ Res. 2013 Oct;126:91-7. doi: 10.1016/j.envres.2013.07.003. Epub 2013 Jul 25.
Phthalates are ubiquitous environmental chemicals with endocrine disruptive properties. The impact of these chemicals on endocrine-related disease in reproductive-age women is not well understood.
To investigate the relationship between urinary phthalate metabolite concentrations and the risk of a hormonally-driven disease, endometriosis, in reproductive-age women.
We used data from a population-based case-control study of endometriosis, conducted among female enrollees of a large healthcare system in the U.S. Pacific Northwest. We measured urinary phthalate metabolite concentrations on incident, surgically-confirmed cases (n=92) diagnosed between 1996 and 2001 and population-based controls (n=195). Odds ratios (OR), and 95% confidence intervals (CI) were estimated using unconditional logistic regression, adjusting for urinary creatinine concentrations, age, and reference year.
The majority of women in our study had detectable concentrations of phthalate metabolites. We observed a strong inverse association between urinary mono-(2-ethyl-5-hexyl) phthalate (MEHP) concentration and endometriosis risk, particularly when comparing the fourth and first MEHP quartiles (aOR 0.3, 95% CI: 0.1-0.7). Our data suggested an inverse association between endometriosis and urinary concentrations of other di-2-ethylhexyl phthalate (DEHP) metabolites (mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP)) and ∑DEHP, however, the confidence intervals include the null. Our data also suggested increased endometriosis risk with greater urinary concentrations of mono-benzyl phthalate (MBzP) and mono-ethyl phthalate (MEP), although the associations were not statistically significant.
Exposure to select phthalates is ubiquitous among female enrollees of a large healthcare system in the U.S. Pacific Northwest. The findings from our study suggest that phthalates may alter the risk of a hormonally-mediated disease among reproductive-age women.
邻苯二甲酸酯是普遍存在的环境化学物质，具有内分泌干扰特性。这些化学物质对生殖年龄段妇女内分泌相关疾病的影响尚不清楚。
研究尿邻苯二甲酸酯代谢物浓度与内分泌相关疾病子宫内膜异位症风险之间的关系，该疾病发生在生殖年龄段的妇女中。
我们使用了一项基于人群的子宫内膜异位症病例对照研究的数据，该研究在美国太平洋西北地区的一家大型医疗保健系统的女性参与者中进行。我们测量了 1996 年至 2001 年间确诊为子宫内膜异位症的新发病例（n=92）和基于人群的对照（n=195）的尿邻苯二甲酸酯代谢物浓度。使用非条件逻辑回归估计比值比（OR）和 95%置信区间（CI），并调整了尿肌酐浓度、年龄和参考年份。
我们研究中的大多数女性都有可检测到的邻苯二甲酸酯代谢物浓度。我们观察到尿单-(2-乙基-5-己基)邻苯二甲酸酯（MEHP）浓度与子宫内膜异位症风险之间存在强烈的负相关关系，特别是在比较第四和第一 MEHP 四分位时（aOR 0.3，95%CI：0.1-0.7）。我们的数据表明，尿二-2-乙基己基邻苯二甲酸酯（DEHP）代谢物（单-(2-乙基-5-羟基己基)邻苯二甲酸酯（MEHHP）、单-(2-乙基-5-氧代己基)邻苯二甲酸酯（MEOHP））和∑DEHP 浓度与子宫内膜异位症之间存在负相关关系，但置信区间包含零值。我们的数据还表明，随着尿中单苄基邻苯二甲酸酯（MBzP）和单乙基邻苯二甲酸酯（MEP）浓度的增加，子宫内膜异位症的风险增加，尽管这些关联没有统计学意义。
在美国太平洋西北地区的一家大型医疗保健系统的女性参与者中，普遍存在邻苯二甲酸酯的暴露。我们的研究结果表明，邻苯二甲酸酯可能会改变生殖年龄段妇女中激素介导疾病的风险。
